Disclosures. Real World Data Sources

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Disclosures. Real World Data Sources"

Transcription

1 Disclosures Real World Data Sources Christopher M. Blanchette, PhD, MBA Director, HEOR, Otsuka America Pharmaceutical Inc. Research Associate Professor, Public Health Sciences, University of North Carolina, Charlotte Editor in Chief, Drugs in Context I am an employee of Otsuka America Pharmaceutical Inc. I am a faculty member of the University of North Carolina, Charlotte I am the editor in chief of Drugs in Context The statements presented here are my own and do not represent that of Otsuka America Pharmaceutical Inc., UNC Charlotte or Drugs in Context.

2 Data are disparate globally IMS Capabilities Real World Data Types Feeding Models Electronic Medical Records Administrative claims / billing Hospital / event Surveys Longitudinal cohorts Payer EMR Hospital Rx Oncology Lab

3 Electronic Medical Records An electronic chart used to document the care and treatment of a patient within a patient care setting Clinical detail including laboratory values and clinical measures Longitudinal follow up for natural history data Electronic Medical Record Examples Database name Centricity IMS Health Cegedim Strategic Data Patient Databases MedMining Company GE Healthcare IMS Health Cegedim MedMining Source Doctors using GE Healthcare medical record system Multiple sources (outpatient) Pulse Complete EHR product Number of lives 15 million 20 million Unknown 1 million Geisinger Health plan Northeast PA Historical data 1996 to present 2006 to present Unknown 1998 to present Update frequency Daily Daily Daily Daily Number of doctors 15,000? 20,000 workstations Unknown Typically lacking complete view of healthcare use Missing data, no incentives to complete records Limited populations, typically not inclusive of modeled population US National dispersion US National dispersion Linkable to subset of patient s claims 35 specialties Deep penetration in Europe for European EMR analyses Link to Geisinger claims for more details Closed system

4 Administrative claims / billing An electronic record of claims submitted for the purpose of payment for services Provides a longitudinal view into a patient s use of healthcare services Economic theory provides assurances of services inclusion Typically includes reimbursed, patient paid amounts Typically lacking clinical depth Patients are not representative of the population but rather only those with health insurance Database name Claims Data Sources Clinformatics Data Mart Clinformatics Data Mart Multiplan MarketScan Company Optum Insight Optum Insight Thomson HealthCore Source UnitedHealth Group UnitedHealth Group plus 46 regional plans Large employers and mid market HMOs Number of lives 13 million 22 million 47 m total; 29 m per year HealthCore Integrated Research Database Wellpoint health plan Blue Cross Blue Shield and Anthem plans 34 million Historical data 36+ months 36+ months 1992 to present 2000 to present Update frequency Semi annual/ quarterly Semi annual/ quarterly Semi annual/ quarterly Quarterly Data Lag 90 days 180 days 90 days 90 days Enrollment Full Partial, some inferred Full Full Lab results Ability to link to other data sources Chart abstractions Diversity of payers Considerable use so researchers have experience Often least costly Lab results Chart abstractions

5 Hospital Hospital based chargemaster / administrative data Provides a detailed view into a patient s use of services in the hospital Economic theory provides assurances of services inclusion Database name Hospital Data Sources MarketScan Hospital (US) Belgian Inpatient HES/HPA (UK) Premier Perspective Database (US) Company Thomson IMS Health IMS Health Premier Source Hospital charge master data (from HCI and Solucient acquisitions) Hospital inpatient stay information Hospital Episode Statistics integrated with hospital drug usage and GP EMR data Number of lives Unknown Unknown Unknown Unknown Hospital billing records and details from hospital/ outpatient clinic systems Historical data 2006 to present 1999 to present Update frequency Unknown monthly Typically lacking clinical depth Patients are not representative of the population but rather only in the hospital Unit of analysis is the event, not the patient Limited follow up outside of the hospital Number of sites (facilities) % bed coverage nationally Not readily linkable to other data Includes inpatient and hospital based outpatient Age & gender, Admit & discharge dates, Diagnosis Procedures, Clinical History, Risk, Post-discharge care, Readmissions, Date and time of transaction, Product, form and strength dispensed to patient 600 (47m inpatient records; 248m outpatient records) Linked to Optum data through probablistic match

6 National Surveys Population based surveys collecting patient reported information Provides a detailed view into a patient s experience with health and disease May be longitudinal Typical population based May not be clinically valid results Typically lacking link to clinical detail or healthcare services data Response bias National Surveys Database name NHANES (US) National Health & Wellness Survey Company CDC Kantar Health Source US Population Global (US, EU-5, Russia, Japan, China, Brazil) Number of lives Variable US: 75,000 EU 5: 20 Russia: 10,000 Japan: 25,000 China: 20,000 Brazil: 12,000 Historical data 1999 to present US: 1998 EU 5: 2000 Russia: 2011 Japan: 2008 China: 2009 Brazil: 12,000 Update frequency Annually? Number of sites (facilities) NA NA Nationally representative, some clinical data depending on the focus for that year. History of healthcare and diagnosis. Health behaviors. Patient attitudes, behaviors, demographics, characteristics Population epidemiology, trends and treatment behaviors

7 Longitudinal Cohorts Observational cohort followed over time to observe disease progression Provides a detailed view into a patient s progression of disease over many years Data are typically very rich including treatment, clinical data, patient reported symptoms and burden Longitudinal Cohorts Database name Lovelace Smokers Cohort Framingham Heart Study Company Lovelace Respiratory Research Institute NHLBI / Boston University Source Albuquerque, New Mexico Framingham, Massachusetts Number of lives 2000 (enrolling) Variable Historical data Approx 10 years 1948 Update frequency Annually Continuously Number of sites (facilities) 1 1 city Longitudinal follow up on the effects of smoking and to identify biomarkers for progression Long term follow up on a cohort of individuals and their children to assess heart disease. Expensive Typically not linked to utilization data outside of the disease Limited sample size and geographical representation

Accelerating the Adoption of Electronic Medical Records

Accelerating the Adoption of Electronic Medical Records Accelerating the Adoption of Electronic Medical Records For Discussion Purposes September 2006 1 EMR Benefits are Significant... EMR Benefits Consumers: Improved care quality and health Medical record

More information

Natalia Olchanski, MS, Paige Lin, PhD, Aaron Winn, MPP. Center for Evaluation of Value and Risk in Health, Tufts Medical Center.

Natalia Olchanski, MS, Paige Lin, PhD, Aaron Winn, MPP. Center for Evaluation of Value and Risk in Health, Tufts Medical Center. ISPOR 2013, New Orleans, LA Using EMR data for conducting retrospective studies: Opportunities and Pitfalls Natalia Olchanski, MS, Paige Lin, PhD, Aaron Winn, MPP Center for Evaluation of Value and Risk

More information

Marcus Wilson, PharmD. First Plenary Session

Marcus Wilson, PharmD. First Plenary Session Moderator First Plenary Session THE USE OF "BIG DATA" - WHERE ARE WE AND WHAT DOES THE FUTURE HOLD? Marcus Wilson, PharmD HealthCore Wilmington, DE, USA Speakers First Plenary Session THE USE OF "BIG DATA"

More information

Using Big Data To Study Childhood Vision Disorders

Using Big Data To Study Childhood Vision Disorders Using Big Data To Study Childhood Vision Disorders David C. Musch, PhD, MPH University of Michigan Dept. of Ophthalmology and Visual Sciences 3 rd Annual Focus on Eye Health Summit Washington, DC June

More information

SUBMIT/RECEIVE STATEWIDE ADMISSION, DISCHARGE, TRANSFER (ADT) NOTIFICATIONS

SUBMIT/RECEIVE STATEWIDE ADMISSION, DISCHARGE, TRANSFER (ADT) NOTIFICATIONS Use Case Summary NAME OF UC: SUBMIT/RECEIVE STATEWIDE ADMISSION, DISCHARGE, TRANSFER (ADT) NOTIFICATIONS Sponsor(s): MiHIN / BCBSM Date: 5/28/15 The purpose of this Use Case Summary is to allow Sponsors,

More information

My Big Data experience getting my feet wet in the puddle and still treading water 2 years later 28 th June 2013. Rob Walls Healthcare Data Analytics

My Big Data experience getting my feet wet in the puddle and still treading water 2 years later 28 th June 2013. Rob Walls Healthcare Data Analytics My Big Data experience getting my feet wet in the puddle and still treading water 2 years later 28 th June 2013 Rob Walls Healthcare Data Analytics Abstract "Big Data" - Electronic Health Records (EHR)

More information

Research funding was provided by TAP Pharmaceutical Products, Inc.

Research funding was provided by TAP Pharmaceutical Products, Inc. DOES THE DOSING FREQUENCY OF PROTON PUMP INHIBITORS (PPIs) AFFECT SUBSEQUENT RESOURCE UTILIZATION AND COSTS AMONG PATIENTS DIAGNOSED WITH GASTROESOPHAGEAL REFLUX DISEASE (GERD)? Boulanger L 1, Mody R 2,

More information

An Optum Company. The Journey: From Healthcare To Health

An Optum Company. The Journey: From Healthcare To Health The Journey: From Healthcare To Health June 2014 Cross-Continuum Clinical & Claims Analytics Platform Aggregate data across the continuum Clean, normalize and validate data Transform data into insight

More information

Changing Clinical Behaviors to Lower Costs and Reduce Catheter-Associated Urinary Tract Infections (CAUTI)

Changing Clinical Behaviors to Lower Costs and Reduce Catheter-Associated Urinary Tract Infections (CAUTI) Changing Clinical Behaviors to Lower Costs and Reduce Catheter-Associated Urinary Tract Infections (CAUTI) ARKANSAS METHODIST MEDICAL CENTER: How a foley catheter management system combined with education

More information

How to extract transform and load observational data?

How to extract transform and load observational data? How to extract transform and load observational data? Martijn Schuemie Janssen Research & Development Department of Pharmacology & Pharmacy, The University of Hong Kong Outline Observational data & research

More information

December 2014. Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency

December 2014. Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency December 2014 Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency I. Background Federal Employees Health Benefits (FEHB) Program Report on Health

More information

Electronic Health Record (EHR) Data Analysis Capabilities

Electronic Health Record (EHR) Data Analysis Capabilities Electronic Health Record (EHR) Data Analysis Capabilities January 2014 Boston Strategic Partners, Inc. 4 Wellington St. Suite 3 Boston, MA 02118 www.bostonsp.com Boston Strategic Partners is uniquely positioned

More information

Distributed Networking

Distributed Networking Distributed Networking Millions of people. Strong collaborations. Privacy first. Jeffrey Brown, Lesley Curtis, Richard Platt Harvard Pilgrim Health Care Institute and Harvard Medical School Duke Medical

More information

Real World Data: How It s Used at a Medical Device Company

Real World Data: How It s Used at a Medical Device Company MD MEDICAL SAFETY Real World Data: How It s Used at a Medical Device Company Myoung Kim, Ph.D., MBA. Andrew Yoo, M.D., M.S. Epidemiology and Health Informatics Medical Devices Johnson & Johnson May 29,

More information

Big Data and Real World Evidence

Big Data and Real World Evidence Big Data and Real World Evidence Healthcare s most powerful currency: RWE as a patient-centric approach to Big-data Dr. Benjamin Hughes 8/26/2014 Today s take-aways RWE a focused approach to unlock Big

More information

Disclosure. VeinExperts.org Principal

Disclosure. VeinExperts.org Principal Disclosure VeinExperts.org Principal Documentation and EMR Usage Peggy Bush, APN, CNS, MSN Palm City, Florida Business of Medicine is Changing Government influences to improve public health Insurance Companies

More information

Impact Intelligence. Flexibility. Security. Ease of use. White Paper

Impact Intelligence. Flexibility. Security. Ease of use. White Paper Impact Intelligence Health care organizations continue to seek ways to improve the value they deliver to their customers and pinpoint opportunities to enhance performance. Accurately identifying trends

More information

AGENDA. Data Collection Methodologies. Sampling and Projection. Quality Control. Selected Countries

AGENDA. Data Collection Methodologies. Sampling and Projection. Quality Control. Selected Countries Use of IMS Data in Pharmaceutical Policy Analysis Andreas Gieshoff Vice President Statistics & Advanced Analytics, EMEA Utrecht, January 2010 IMS Health 2008 AGENDA Data Collection Methodologies Sampling

More information

The Potential Impact of State Mandatory Assignment Legislation on Consumers

The Potential Impact of State Mandatory Assignment Legislation on Consumers The Potential Impact of State Mandatory Assignment Legislation on Consumers September 4, 2003 Prepared by: Jon M. Wander, F.S.A., M.A.A.A. Daniel E. Freier, F.S.A., M.A.A.A. At the Request of the Blue

More information

HL7 & Meaningful Use. Charles Jaffe, MD, PhD CEO Health Level Seven International. HIMSS 11 Orlando February 23, 2011

HL7 & Meaningful Use. Charles Jaffe, MD, PhD CEO Health Level Seven International. HIMSS 11 Orlando February 23, 2011 HL7 & Meaningful Use Charles Jaffe, MD, PhD CEO Health Level Seven International HIMSS 11 Orlando February 23, 2011 Overview Overview of Meaningful Use HIT Standards and Meaningful Use Overview HL7 Standards

More information

All Payer Claims Databases: Options for Consideration Feasibility Study Final Report Presentation to the Alaska Health Care Commission March 7, 2013

All Payer Claims Databases: Options for Consideration Feasibility Study Final Report Presentation to the Alaska Health Care Commission March 7, 2013 All Payer Claims Databases: Options for Consideration Feasibility Study Final Report Presentation to the Alaska Health Care Commission March 7, 2013 Overview of the Presentation Project summary Health

More information

SMD# 13-001 ACA #23. Re: Health Home Core Quality Measures. January 15, 2013. Dear State Medicaid Director:

SMD# 13-001 ACA #23. Re: Health Home Core Quality Measures. January 15, 2013. Dear State Medicaid Director: DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SMD# 13-001 ACA #23 Re: Health Home Core Quality

More information

Achieving Value from Diverse Healthcare Data

Achieving Value from Diverse Healthcare Data Achieving Value from Diverse Healthcare Data Paul Bleicher, MD, PhD Chief Medical Officer Humedica Boston MA The Information Environment in Healthcare Pharma, Biotech, Devices Hospitals Physicians Pharmacies

More information

CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works

CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works CARE MANAGEMENT SERIES Part 6 Developing a Staffing Model That Works We will get to staffing but let s start by reviewing core functions. Care Management As we have discussed previously, Care Management

More information

APPENDIX 1. Medicaid Emergency Psychiatric Demonstration Application Proposal Guidelines

APPENDIX 1. Medicaid Emergency Psychiatric Demonstration Application Proposal Guidelines APPENDIX 1 Medicaid Emergency Psychiatric Demonstration Application Proposal Guidelines INTRODUCTION Section 2707 of the Affordable Care Act authorizes a 3-year Medicaid Emergency Psychiatric Demonstration

More information

TRUVEN HEALTH UNIFY. Population Health Management Enterprise Solution

TRUVEN HEALTH UNIFY. Population Health Management Enterprise Solution TRUVEN HEALTH UNIFY Population Health Enterprise Solution A Comprehensive Suite of Solutions for Improving Care and Managing Population Health With Truven Health Unify, you can achieve: Clinical data integration

More information

Understanding Diseases and Treatments with Canadian Real-world Evidence

Understanding Diseases and Treatments with Canadian Real-world Evidence Understanding Diseases and Treatments with Canadian Real-world Evidence Real-World Evidence for Successful Market Access WHITEPAPER REAL-WORLD EVIDENCE Generating real-world evidence requires the right

More information

3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients

3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential

More information

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques

Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques Comprehensive EHR Infrastructure Across the Health Care System The goal of the Administration and the Department of Health and Human Services to achieve an infrastructure for interoperable electronic health

More information

Using Health Information Technology to Improve Quality of Care: Clinical Decision Support

Using Health Information Technology to Improve Quality of Care: Clinical Decision Support Using Health Information Technology to Improve Quality of Care: Clinical Decision Support Vince Fonseca, MD, MPH Director of Medical Informatics Intellica Corporation Objectives Describe the 5 health priorities

More information

Examining the Impact of Consumer-Driven Health Care Plans: An in-depth look at CDH plans after five years

Examining the Impact of Consumer-Driven Health Care Plans: An in-depth look at CDH plans after five years Examining the Impact of Consumer-Driven Health Care Plans: An in-depth look at CDH plans after five years Table of contents The patients................................................ 4 The positive test

More information

Custom Report Data Elements: IT Database Fields. Source: American Hospital Association IT Survey

Custom Report Data Elements: IT Database Fields. Source: American Hospital Association IT Survey Custom Report Data Elements: IT Database Fields Source: American Hospital Association IT Survey TABLE OF CONTENTS COMPUTERIZED SYSTEM IMPLEMENTATION... 4 Bar Coding... 4 Computerized Provider Order Entry...

More information

High Rehospitalization Rates: Evaluation and Impact

High Rehospitalization Rates: Evaluation and Impact High Rehospitalization Rates: Evaluation and Impact May 29, 2009 Denise Remus, PhD, RN Chief Quality Officer, BayCare Health System BayCare Health System BayCare is the largest full-service, community-based

More information

Mastering the Data Game: Accelerating

Mastering the Data Game: Accelerating Mastering the Data Game: Accelerating Integration and Optimization Healthcare systems are breaking new barriers in analytics as they seek to meet aggressive quality and financial goals. Mastering the Data

More information

Leveraging Social Networks to Conduct Observational Research: A Paradigm Shift in Methodology. Presented by: Elisa Cascade, MediGuard/Quintiles

Leveraging Social Networks to Conduct Observational Research: A Paradigm Shift in Methodology. Presented by: Elisa Cascade, MediGuard/Quintiles Leveraging Social Networks to Conduct Observational Research: A Paradigm Shift in Methodology Presented by: Elisa Cascade, MediGuard/Quintiles About Elisa Cascade, VP MediGuard/Quintiles Assisted in site

More information

Glossary of Frequently Used Billing and Coding Terms

Glossary of Frequently Used Billing and Coding Terms Glossary of Frequently Used Billing and Coding Terms Accountable Care Organization (ACO) Accounts Receivable Reports All Inclusive Fees Allowances and Adjustments Capitation Payments Care Coordination

More information

Meaningful Use Rules Proposed for Electronic Health Record Incentives Under HITECH Act By: Cherilyn G. Murer, JD, CRA

Meaningful Use Rules Proposed for Electronic Health Record Incentives Under HITECH Act By: Cherilyn G. Murer, JD, CRA Meaningful Use Rules Proposed for Electronic Health Record Incentives Under HITECH Act By: Cherilyn G. Murer, JD, CRA Introduction On December 30, 2009, The Centers for Medicare & Medicaid Services (CMS)

More information

Meaningful Use and Immunization Information Systems

Meaningful Use and Immunization Information Systems Meaningful Use and Immunization Information Systems Gary Urquhart, MPH Chief, Immunization Information Systems Support Branch Immunization Services Division National Center for Immunization and Respiratory

More information

Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics. David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014

Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics. David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014 Big Data Analytics in Healthcare In pursuit of the Triple Aim with Analytics David Wiggin, Director, Industry Marketing, Teradata 20 November, 2014 Agenda The Triple Aim Population Health in Russia The

More information

Basic, including 100% Part B coinsurance. Foreign Travel Emergency

Basic, including 100% Part B coinsurance. Foreign Travel Emergency BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, C, L and N

More information

Electronic Health Records Research in a Health Sector with Multiple Provider Types

Electronic Health Records Research in a Health Sector with Multiple Provider Types Electronic Health Records Research in a Health Sector with Multiple Provider Types Samantha Crossfield Susan Clamp Presented by Samantha Crossfield AMBCS, MSc info@researchone.org Outline Section Setting

More information

A Guide for the Utilization of HIRA National Patient Samples. Logyoung Kim, Jee-Ae Kim, Sanghyun Kim. Health Insurance Review and Assessment Service

A Guide for the Utilization of HIRA National Patient Samples. Logyoung Kim, Jee-Ae Kim, Sanghyun Kim. Health Insurance Review and Assessment Service A Guide for the Utilization of HIRA National Patient Samples Logyoung Kim, Jee-Ae Kim, Sanghyun Kim (Health Insurance Review and Assessment Service) Jee-Ae Kim (Corresponding author) Senior Research Fellow

More information

Electronic Medical Records

Electronic Medical Records Electronic Medical Records Milisa K Rizer, MD, MPH Clinical Director, Integrated Healthcare Information System Associate Professor, Clinical Family Medicine The Ohio State University Medical Center 2011

More information

Perspective on Payer-Based Electronic Personal Health Records

Perspective on Payer-Based Electronic Personal Health Records Healthcare technology solutions. Perspective on Payer-Based Electronic Personal Health Records Jeffrey H. Margolis Chairman and CEO, The TriZetto Group Copyright 2005 The TriZetto Group, Inc. Personal

More information

Reporting Period: For Stage 2, the reporting period must be the entire Federal Fiscal Year.

Reporting Period: For Stage 2, the reporting period must be the entire Federal Fiscal Year. Eligible Hospital and Critical Access Hospital (CAH) Attestation Worksheet for Stage 2 of the Medicare Electronic Health Record (EHR) Incentive Program The Eligible Hospital and CAH Attestation Worksheet

More information

HEALTHCARE CHANGES AFFECTING YOUR PRACTICE. Vinay Kumar MD, FACS, ABVM Endovascular options Dallas, Texas

HEALTHCARE CHANGES AFFECTING YOUR PRACTICE. Vinay Kumar MD, FACS, ABVM Endovascular options Dallas, Texas HEALTHCARE CHANGES AFFECTING YOUR PRACTICE Vinay Kumar MD, FACS, ABVM Endovascular options Dallas, Texas HEALTH CARE CHANGES 1 st Major overhaul of health care system since WWII introduction of 3 rd party

More information

Vermont s All Payer Claims Database: Status, Potential Uses, and Cautions. Maria Roemhildt, PhD

Vermont s All Payer Claims Database: Status, Potential Uses, and Cautions. Maria Roemhildt, PhD Vermont s All Payer Claims Database: Status, Potential Uses, and Cautions Maria Roemhildt, PhD September 24, 2015 Outline VHCURES - What is it? Development of VTs All Payer Claims Database Description

More information

Unit 1 Core Care Management Activities

Unit 1 Core Care Management Activities Unit 1 Core Care Management Activities Healthcare Management Services Healthcare Management Services (HMS) is responsible for all the medical management services provided to Highmark Blue Shield members,

More information

Basic, including 100% Part B coinsurance. Foreign Travel Emergency

Basic, including 100% Part B coinsurance. Foreign Travel Emergency BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, B, D and F

More information

Basic, including 100% Part B coinsurance. Foreign Travel Emergency

Basic, including 100% Part B coinsurance. Foreign Travel Emergency BLUE CROSS AND BLUE SHIELD OF SOUTH CAROLINA An Independent Licensee of the Blue Cross and Blue Shield Association OUTLINE OF MEDICARE SUPPLEMENT COVERAGE COVER PAGE 1 of 2: BENEFIT PLANS A, B, D and F

More information

Enabling Patients Decision Making Power: A Meaningful Use Outcome. Lindsey Mongold, MHA HIT Practice Advisor Oklahoma Foundation for Medical Quality

Enabling Patients Decision Making Power: A Meaningful Use Outcome. Lindsey Mongold, MHA HIT Practice Advisor Oklahoma Foundation for Medical Quality Enabling Patients Decision Making Power: A Meaningful Use Outcome Lindsey Mongold, MHA HIT Practice Advisor Oklahoma Foundation for Medical Quality Today 1. Meaningful Use (MU) 2. 2/3rds of MU relates

More information

Environmental Health Science. Brian S. Schwartz, MD, MS

Environmental Health Science. Brian S. Schwartz, MD, MS Environmental Health Science Data Streams Health Data Brian S. Schwartz, MD, MS January 10, 2013 When is a data stream not a data stream? When it is health data. EHR data = PHI of health system Data stream

More information

RESEARCH BRIEF SICKER AND COSTLIER: HEALTHCARE UTILIZATION OF U.S. HOSPITAL EMPLOYEES

RESEARCH BRIEF SICKER AND COSTLIER: HEALTHCARE UTILIZATION OF U.S. HOSPITAL EMPLOYEES RESEARCH BRIEF SICKER AND COSTLIER: HEALTHCARE UTILIZATION OF HOSPITAL EMPLOYEES AUGUST 2011 EXECUTIVE SUMMARY hospital workers are less healthy, consume more medical services, and accrue higher healthcare

More information

Optum One. The Intelligent Health Platform

Optum One. The Intelligent Health Platform Optum One The Intelligent Health Platform The Optum One intelligent health platform enables healthcare providers to manage patient populations. The platform combines the industry s most advanced integrated

More information

CMS & ehr - An Update

CMS & ehr - An Update Health Informatics in Hong Kong CMS & ehr - An Update Dr NT Cheung HA Convention 2010 CMS / epr is essential in the HA Each Day... 12,000 users 90,000 patients 8M CMS transactions 700,000 epr views In

More information

Accountable Care Organization Framework for Pharmaceuticals

Accountable Care Organization Framework for Pharmaceuticals Accountable Care Organization Framework for Pharmaceuticals Speakers Eleanor M. Perfetto, PhD, MS Senior Director, Reimbursement & Regulatory Affairs, Federal Government Relations Pfizer Inc. Robert W.

More information

Healthcare Informatics and Clinical Decision Support. Deborah DiSanzo CEO Healthcare Informatics, Philips Healthcare

Healthcare Informatics and Clinical Decision Support. Deborah DiSanzo CEO Healthcare Informatics, Philips Healthcare Healthcare Informatics and Clinical Decision Support Deborah DiSanzo CEO Healthcare Informatics, Philips Healthcare Leading the way Providing breakthroughs for more than a century * 1988 Technology was

More information

Major Depressive Disorder:

Major Depressive Disorder: Major Depressive Disorder: An Actuarial Commercial Claim Data Analysis July 2013 Prepared by: Milliman, Inc. NY Kate Fitch RN, MEd Kosuke Iwasaki FIAJ, MAAA, MBA This report was commissioned by Takeda

More information

The story is in the REAL data! Preparing and Utilizing Claims and Electronic Medical Records Data for Clinical Research

The story is in the REAL data! Preparing and Utilizing Claims and Electronic Medical Records Data for Clinical Research PhUSE 2015 Paper PP11 (Poster) The story is in the REAL data! Preparing and Utilizing Claims and Electronic Medical Records Data for Clinical Research Laurie Rose, SAS, Cary, NC, USA INTRODUCTION Real-world

More information

Numerator Details. - An acute or nonacute inpatient admission with a diagnosis of AOD (AOD Dependence

Numerator Details. - An acute or nonacute inpatient admission with a diagnosis of AOD (AOD Dependence Description Measure 0004: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (IET) (National Committee for Quality Assurance) The percentage of adolescent and adult patients with

More information

Home Healthcare Solutions. Brent Shafer, CEO Healthcare Home Healthcare Solutions

Home Healthcare Solutions. Brent Shafer, CEO Healthcare Home Healthcare Solutions 1 Home Healthcare Solutions Brent Shafer, CEO Healthcare Home Healthcare Solutions Home Healthcare Solutions focus Accelerating growth in: Sleep Respiratory Care Home Monitoring International expansion

More information

Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup

Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup Use and Integration of Freely Available U.S. Public Use Files to Answer Pharmacoeconomic Questions: Deciphering the Alphabet Soup Prepared by Ovation Research Group for the National Library of Medicine

More information

We decided to start with the New Basics!

We decided to start with the New Basics! What employees think of healthcare Confusing Uhh, What?... Frustrating I give up! We decided to start with the New Basics! Agenda City of Dallas Challenges (what caused our approach to benefits to change)

More information

International Health Plans

International Health Plans International Health Plans We are with you Plan Highlights Guaranteed Renewability Worldwide Coverage Including the U.S. Five deductibles to choose from Maternity Benefits, deductible waived Organ Transplants

More information

PULSE Systems, Inc. July 28, 2010

PULSE Systems, Inc. July 28, 2010 Acquisition PULSE Systems, Inc July 28, 2010 Group profile 2 Healthcare professionals 3 Cegedim Healthcare Software division 4 Cegedim become a global EHR player Pulse system inc Founded in 1997 Leading

More information

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF)

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Kick off Meeting November 11 13, 2015 MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Team Composition Justin Huynh, MD Internal Medicine, Physician Champion Mary Laubinger,

More information

Realizing ACO Success with ICW Solutions

Realizing ACO Success with ICW Solutions Realizing ACO Success with ICW Solutions A Pathway to Collaborative Care Coordination and Care Management Decrease Healthcare Costs Improve Population Health Enhance Care for the Individual connect. manage.

More information

New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare Plus and Medicaid

New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare Plus and Medicaid Update December 2009 No. 2009-96 Affected Programs: BadgerCare Plus, Medicaid To: All Providers, HMOs and Other Managed Care Programs New Substance Abuse Screening and Intervention Benefit Covered by BadgerCare

More information

Tom Deas, Jr. MD, MMM. Karen Van Wagner, Ph.D. Executive Director, North Texas Specialty Physicians

Tom Deas, Jr. MD, MMM. Karen Van Wagner, Ph.D. Executive Director, North Texas Specialty Physicians Essential Role of Health Information Exchange in Quality Improvement Tom Deas, Jr. MD, MMM Board Member, North Texas Specialty Physicians CMO, Sandlot, LLC Karen Van Wagner, Ph.D. Executive Director, North

More information

Electronic health records to study population health: opportunities and challenges

Electronic health records to study population health: opportunities and challenges Electronic health records to study population health: opportunities and challenges Caroline A. Thompson, PhD, MPH Assistant Professor of Epidemiology San Diego State University Caroline.Thompson@mail.sdsu.edu

More information

A Roadmap for Population Health: Best Practices for Achieving Operational Alignment

A Roadmap for Population Health: Best Practices for Achieving Operational Alignment RESEARCH BRIEF A Roadmap for Population Health: Best Practices for Achieving Operational Alignment Larry Yuhasz February 2014 Reform under the Patient Protection and Affordable Care Act (PPACA) demands

More information

TRUSTED PATIENT EDUCATION FOR BETTER OUTCOMES. MICROMEDEX Patient Connect. Patient Education & Engagement

TRUSTED PATIENT EDUCATION FOR BETTER OUTCOMES. MICROMEDEX Patient Connect. Patient Education & Engagement TRUSTED PATIENT EDUCATION FOR BETTER OUTCOMES MICROMEDEX Patient Connect Patient Education & Engagement Trusted Patient Education for Better Outcomes All your training, experience, tools, and technology

More information

HIMSS Electronic Health Record Definitional Model Version 1.0

HIMSS Electronic Health Record Definitional Model Version 1.0 HIMSS Electronic Health Record Definitional Model Version 1.0 Prepared by HIMSS Electronic Health Record Committee Thomas Handler, MD. Research Director, Gartner Rick Holtmeier, President, Berdy Systems

More information

Improved Revenue Cycle Management. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting

Improved Revenue Cycle Management. Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Improved Revenue Cycle Management Cathrina Caldwell, CPC, CPC-H Director, Sales Product Consulting Optum Businesses (Formerly Known as Ingenix) One of the largest health information, technology and consulting

More information

Health Care Utilization and Costs of Full-Pay and Subsidized Enrollees in the Florida KidCare Program: MediKids

Health Care Utilization and Costs of Full-Pay and Subsidized Enrollees in the Florida KidCare Program: MediKids Health Care Utilization and Costs of Full-Pay and Subsidized Enrollees in the Florida KidCare Program: MediKids Prepared for the Florida Healthy Kids Corporation Prepared by Jill Boylston Herndon, Ph.D.

More information

Use of routinely collected electronic healthcare data: Lessons Learned

Use of routinely collected electronic healthcare data: Lessons Learned Use of routinely collected electronic healthcare data: Lessons Learned Massoud Toussi, MD, PhD, MBA European lead, Pharmacoepidemiology and Safety Real World Evidence Solutions, IMS Health, France ENCePP

More information

Treatment Value. Non-Interventional and Clinical Studies. www.kantarhealth-clinical.com

Treatment Value. Non-Interventional and Clinical Studies. www.kantarhealth-clinical.com Non-Interventional and Clinical Studies www.kantarhealth-clinical.com 02 Introduction Building a common path for safety, outcomes and market access to take your product to global success. Historically,

More information

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009

Lowering Costs and Improving Outcomes. Patient Engagement Issues. Nancy Davenport-Ennis President & CEO. September 8 th, 2009 The Healthcare Imperative: Lowering Costs and Improving Outcomes Patient Engagement Issues Nancy Davenport-Ennis President & CEO National Patient Advocate Foundation September 8 th, 2009 Institute of Medicine

More information

Facing Healthcare Administration Challenges

Facing Healthcare Administration Challenges Facing Healthcare Administration Challenges Healthcare provider administration tasks, are facing different types of challenges. The delivery of health care services is the most visible part of any health

More information

Speaker Second Plenary Session ELECTRONIC HEALTH RECORDS FOR INFORMED HEALTH CARE IN ASIA- PACIFIC: LEARNING FROM EACH OTHER.

Speaker Second Plenary Session ELECTRONIC HEALTH RECORDS FOR INFORMED HEALTH CARE IN ASIA- PACIFIC: LEARNING FROM EACH OTHER. Speaker Second Plenary Session ELECTRONIC HEALTH RECORDS FOR INFORMED HEALTH CARE IN ASIA- PACIFIC: LEARNING FROM EACH OTHER Naoto Kume, PhD Kyoto University Kyoto Prefecture, Japan ISPOR 2014.09.08 11:15am-12:45pm

More information

Pharmaceutical business innovation through utilization of EMR

Pharmaceutical business innovation through utilization of EMR Pharmaceutical business innovation through utilization of EMR Abstract The pharmaceutical industry in Japan is in a transformation phase due to the government s tightening control over healthcare expenditure

More information

HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY

HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY HEALTH CARE ANALYTIC SERVICES CONTRACT TRUVEN HEALTH ANALYTICS AND BRANDEIS UNIVERSITY DECEMBER 2013 Healthcare Analytic Services Contract - Status Overview of the contract Current status Preliminary descriptive

More information

An Evaluation of Specialty Drug Pricing Under the Pharmacy and Medical Benefit

An Evaluation of Specialty Drug Pricing Under the Pharmacy and Medical Benefit An Evaluation of Specialty Drug Pricing Under the Pharmacy and Medical Benefit March 2014 PREPARED BY Brenda Motheral, MBA, PhD President Corey Belken, PharmD Vice President Artemetrx Specialty Drug Solutions

More information

Data Ownerships of Big Data Usages in Healthcare Industry

Data Ownerships of Big Data Usages in Healthcare Industry Data Ownerships of Big Data Usages in Healthcare Industry By Stephen Li, MBA Candidate, Class of 2017 May 2016 Big Data in Healthcare The goal of value based healthcare is providing high quality healthcare

More information

Breathe With Ease. Asthma Disease Management Program

Breathe With Ease. Asthma Disease Management Program Breathe With Ease Asthma Disease Management Program MOLINA Breathe With Ease Pediatric and Adult Asthma Disease Management Program Background According to the National Asthma Education and Prevention Program

More information

Plan and manage clinical trials with clarity and confidence

Plan and manage clinical trials with clarity and confidence Plan and manage clinical trials with clarity and confidence Accurately identify opportunities and avoid obstacles throughout the clinical trial process with IMS Health Clinical Trial Optimization Solutions

More information

Access. Action. Insight. Healthcare Analytics and Marketing Communications Consultative, Analytical, and Promotional Solutions

Access. Action. Insight. Healthcare Analytics and Marketing Communications Consultative, Analytical, and Promotional Solutions Cardinal Health Specialty Solutions Healthcare Analytics and Marketing Communications Consultative, Analytical, and Promotional Solutions Access Action Insight In today s increasingly competitive healthcare

More information

Big Data in Healthcare: Current Possibilities and Emerging Opportunities

Big Data in Healthcare: Current Possibilities and Emerging Opportunities Big Data in Healthcare: Current Possibilities and Emerging Opportunities Andrew Bate Senior Director, Epidemiology Group Lead, Analytics 23 th March 2015 The Long Road In Developing a New Medicine Clinical

More information

Turkey: Your Partner in Healthcare

Turkey: Your Partner in Healthcare Turkey: Your Partner in Healthcare Beril Ongen Acıbadem Healthcare Group April 16, 2009 Chicago on behalf of Meri Bahar, Chairwoman of TAIK Health Committee Why receive care abroad? ACCESS BY PATIENTS:

More information

Empowering Value-Based Healthcare

Empowering Value-Based Healthcare Empowering Value-Based Healthcare Episode Connect, Remedy s proprietary suite of software applications, is a powerful platform for managing value based payment programs. Delivered via the web or mobile

More information

Strengthen Financial Performance: Start with Lab Outreach Gary Palgon, VP Healthcare Solutions Naveen Sarabu, Director Product Management

Strengthen Financial Performance: Start with Lab Outreach Gary Palgon, VP Healthcare Solutions Naveen Sarabu, Director Product Management Strengthen Financial Performance: Start with Lab Outreach Gary Palgon, VP Healthcare Solutions Naveen Sarabu, Director Product Management Liaison Technologies. All rights reserved. Liaison is a trademark

More information

Healthcare Beyond The Hospital and the ICT Infrastructure Needed to Support

Healthcare Beyond The Hospital and the ICT Infrastructure Needed to Support Healthcare Beyond The Hospital and the ICT Infrastructure Needed to Support Mark Blatt MD Worldwide Medical Director Intel Corporation Med-e-Tel April 2012 Agenda: Care Beyond The Hospital and the ICT

More information

The State of U.S. Hospitals Relative to Achieving Meaningful Use Measurements. By Michael W. Davis Executive Vice President HIMSS Analytics

The State of U.S. Hospitals Relative to Achieving Meaningful Use Measurements. By Michael W. Davis Executive Vice President HIMSS Analytics The State of U.S. Hospitals Relative to Achieving Meaningful Use Measurements By Michael W. Davis Executive Vice President HIMSS Analytics Table of Contents 1 2 3 9 15 18 Executive Summary Study Methodology

More information

Achieving Meaningful Use

Achieving Meaningful Use ARRA INCENTIVE FOR ELIGIBLE HOSPITALS On July 13, 2010, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued the

More information

Get access to health care around the world. Blue Shield and UC help expats, their families, and travelers access health care abroad

Get access to health care around the world. Blue Shield and UC help expats, their families, and travelers access health care abroad Get access to health care around the world Blue Shield and UC help expats, their families, and travelers access health care abroad Effective January 1, 2016 A plan for your personal state of health Get

More information

Team # 1 Open EMR Certification Gap Analysis

Team # 1 Open EMR Certification Gap Analysis Meaningful Use Stage 2 - Patient List Creation Patient List Objectives Patient List Measures OpenEMR Assesment Current Status Gap Action Plan Priority 1.Create a list of patients sort, access, and create

More information

StudentBlue University of Nebraska

StudentBlue University of Nebraska Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO What is the overall deductible? This is only a summary. If you want more details about

More information

Achieving meaningful use of healthcare information technology

Achieving meaningful use of healthcare information technology IBM Software Information Management Achieving meaningful use of healthcare information technology A patient registry is key to adoption of EHR 2 Achieving meaningful use of healthcare information technology

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: observation_room_services 2/1997 2/2016 2/2017 2/2016 Description of Procedure or Service Observation services

More information

Get access to health care around the world. Blue Shield and UC help expats, their families, and travelers access health care abroad

Get access to health care around the world. Blue Shield and UC help expats, their families, and travelers access health care abroad Get access to health care around the world Blue Shield and UC help expats, their families, and travelers access health care abroad Effective January 1, 2015 A plan for your personal state of health Get

More information