From Information Exchange to Population Health Management

Transcription

1 GE Healthcare From Information Exchange to Population Health Management Central Florida RHIO Joel Vengco VP & GM ehealth Solutions March 26, / GE /

2 Discussion Goals Review the foundational goal of Central Florida s HIE Going beyond the HIE: expansion, sustainability, differentiation Achieving population management and the role of HIE Caradigm: GE & Microsoft s new joint venture 2 /

3 Healthcare is undergoing a seismic change Paradigm shift in managing care and cost Disruption Healthcare cost is a global crisis Healthcare quality is inconsistent across care delivery and does not correlate with cost Value Migration Revenue model (FFS) threatened Reimbursement model (Payers) threatened ACOs risk management & cost containment Information & Analytics a must Patient engagement Population vs. Episodic Care Market response Market consolidation Vendor consolidation Maturing product markets Next Gen Solutions EMR vs Community solutions Monolithic vs Modular Proprietary vs Open 3 /

4 KeyHIE: An industry leader in HIE Example #2: Disparate Systems Integration + large hospitals Enabling high quality, convenient, and efficient care through collaborative health information exchange The Keystone Health Information Exchange connects healthcare professionals in a 31-county region of Pennsylvania Strategic Value of HIE: KeyHIE Connected Community: Hospitals & Integrated EMR Systems Evangelica l MosesTaylor CMC Providing patient data to ED Integrating labs Connecting multidisciplinary providers Automating medical home model Engaging patients with portal Shamokin 7 Hospitals Connected 2.9M patients in MPI 420,000+ patients consented Chose GE because: Standards-based Highly scalable Proven interoperability 4 /

5 Boston Medical Center & Boston HealthNet Example #1: Disparate Systems Integration + application development Boston Medical Center collaborates with 15 neighborhood health centers through Clinical Information Exchange A private, not for profit, 626 licensed bed, academic medical center emphasizing community based care Focus on sharing medications, problems, allergies, and lab results HIE access directly from physician s EMR Centricity Epic LMR NextGen Eclipsys Picis 5 /

7 ehealth Information Exchange the basics Primary Care Physician EMR Master Patient Index Other HIE Labs Orders and Results Document Registry Document Repository Patient Personal Health Records Independent Health Facility Imaging Long-term Care Physical Therapy Document Repository Payers Medicaid/ Medicare Private Pharmacy eprescribing Medication History Government Quality and Efficiency Public Health Specialty Practice EMR ereferral Academic Medical Center Research Clinical Trials Community Hospital PACS HIS Departmental 7 /

8 Beyond Information Exchange It starts with an HIE as the foundation for information liquidity, then a knowledge platform that converts that information into insight and intelligence, eventually enabling the delivery of performance applications that address care delivery across the community. 8 /

9 Population Health Management System (PHMS) Managing Care for a Community 9 /

10 Achieving Population Management Five Core Pillars Proactive Interoperability Collaboration Analytics Accountability Population Management One Patient, One Record Communication & Transparency Population Stratification Cost & Utilization Management Care Management Unified Application Experience Care Transitions Predictive Modeling Resource Management & Productivity Health Maintenance & Wellness Integrated Workflow Patient Engagement Gaps in Care Guideline & Standards Driven Evolving Care Plan Longitudinal 10 /

11 Interoperability At All Levels Information, Application, Workflows Proactive Interoperability Collaboration Analytics Accountability Population Management One Patient, One Record Communication & Transparency Population Stratification Cost & Utilization Management Care Management Unified Application Experience Care Transitions Predictive Modeling Resource Management & Productivity Health Maintenance & Wellness Integrated Workflow Patient Engagement Gaps in Care Guideline & Standards Driven Evolving Care Plan Longitudinal 11 /

12 Information Interoperability: Exchange Across All Stakeholders Managing a population requires data of all types and an HIE that leverages transactions of all kinds. These must include standard feeds like HL7 and IHE-based protocols. It must also leverage other protocols like HIPAA transactions (e.g. X12) and conversion of data like MDS3 for LTC or SIU for scheduling. 12 /

13 Unified Viewing & Workflow: Community Desktop 1.0 Unified Viewer of the Community Information and Applications Configurable Views and Dashboards Portal Technology (JSR 268) GE s use of standard IHE profiles like C32 and QED enable smart data aggregation Snap-in portlets that enable longitudinal views Next generation portal includes robust workflow capability 13 /

14 Collaboration & Engagement Community Collaboration, Patient Engagement Proactive Interoperability Collaboration Analytics Accountability Population Management One Patient, One Record Communication & Transparency Population Stratification Cost & Utilization Management Care Management Unified Application Experience Care Transitions Predictive Modeling Resource Management & Productivity Health Maintenance & Wellness Integrated Workflow Patient Engagement Gaps in Care Guideline & Standards Driven Evolving Care Plan Longitudinal 14 /

15 Collaboration Secure Messaging Use of DIRECT Provider to Provider Provider to Patient Care Alerting Subscribing to a patient s care activity (e.g., ED visit, admitted to a hosp) 15 /

16 GE ehealth s DIRECT Plus CONFIDENTIAL 16 /

17 ereferrals Care Transition Management Referral coordinator (RC) receives a task that a referral has been initiatied. She uses ereferral Portal to initiate and manage the referral.. Specialist coordinator (SC) receives referral request from RC and collaborates with RC to finalize appointment. Retrieves further information (e.g., Clinical Summary, Labs) from HIE as needed. Referring Repor t Specialty Patient visits PCP. PCP orders a Specialist Referral via his EMR. EMR sends Referral Order and Clinical Summary of Visit to HIE. ehealth HIE Completion of visit is flagged on ereferral Portal. Referring Clinic retrieves referral report from the HIE. Patient sees Specialist. Specialist access referral information from HIE via the EMR. Specialist uses native EMR as typical. Specialist completes visit. EMR submits Specialist note as a CCD into HIE. Refer Respond Report 17 /

18 ereferrals: Beyond Secure Messaging Referral Workspace 18 /

19 ereferrals: Beyond Secure Messaging Appointment Request & View into the HIE 19 /

20 Revenue Impact Satisfaction Impact Impact of ereferral System Outcomes at Boston Medical Center Improved Referral coordination tasks are complete, standardized, and trackable Improved Referring Physician and Specialist satisfaction Improved patient satisfaction Increased Scheduled Referrals information availability / collaboration timely appointments access to care Before ereferral = 30% After ereferral = 60-80% Improved appt scheduling turnaround Improved no show rates Before ereferral = 33 days After ereferral = 6-8 days Before ereferral = 25% After ereferral = 23% 20 /

21 ROI over 3 years Study performed by IBM $ 7,384,482 Benefits Increase Referral Follow-through Reduced cost of Operation Expedited Operations and Quicker Schedules $6,476,022 $908,460 Not Considered for ROI ROI % Improved Quality and Safety Improved Satisfaction Not Considered for ROI Not considered for ROI $869,520 Investment Grant Funding $543,535 In Kind Personnel $190, /

22 Patient Engagement Patient Online is a single channel of communications that extends the provider workflow to the patient s home to reduce costs, increase quality, and increase access to care. Strengthens the HCO s market/competitive position Improves efficiency of the patient management process Strengthens the patientprovider relationship Extends the HCO s reach for proactive care management Enables HCO s to meet all ARRA criteria for patient & family engagement 22 / Patient Online is not available in all countries. Contact your GE Healthcare sales representative for more information.

23 Performance Management & Analytics Population Stratification, Utilization Management Proactive Interoperability Collaboration Analytics Accountability Population Management One Patient, One Record Communication & Transparency Population Stratification Cost & Utilization Management Care Management Unified Application Experience Care Transitions Predictive Modeling Resource Management & Productivity Health Maintenance & Wellness Integrated Workflow Patient Engagement Gaps in Care Guideline & Standards Driven Evolving Care Plan Longitudinal 23 /

24 Performance Management Analytics CEO CFO CMO Finance Clinicians Compliance Analysts Network Mgmt Dashboards and Scorecards Workflow Intelligence Data Visualization Risk Segmentation Reporting and Analysis Third-Party Data Integration Business Rules Engine Benchmarking Interactive Drill Down Proactive Alerts Role-Based Security Document Management Clinical & Claims Aggregated Data Store Information Exchange Registration (ADT) Lab & Rx Decision Support Practice Management Claims and Remittances Electronic Medical Records Other Financial and Clinical Transaction Systems 24 /

25 Medical Management Analytics Medical Management Analytics is a clinical business intelligence solution that delivers more than $2.00 PMPM in savings and enables medical leadership to manage healthcare utilization and quality more effectively. Features and Benefits Identifies opportunities for improved population health management Supports accountable care Enables clinical integration Measures the effectiveness of UM and helps identify new UM policies Analyzes authorizations and pre-certs Alerts leadership to systemic gaps in care 25 /

26 Clinical Performance Manager Clinical Performance Manager reduces clinical resource costs, increases service line margins, improves quality outcomes, and supports accountable care, population health management, meaningful use, clinical integration, Physician Quality Reporting, pay-for-performance, valuebased purchasing, and other quality and cost containment initiatives. Features Service line trend analysis Individual physician scorecards Resource utilization/cost analysis Patient satisfaction scores Core measures analysis Physician cost and quality benchmarking Patient demographic analysis Cost/margin analysis 26 /

27 Managing & Caring for a Population Development Partnership with GEISINGER Proactive Interoperability Collaboration Analytics Accountability Population Management One Patient, One Record Communication & Transparency Population Stratification Cost & Utilization Management Care Management Unified Application Experience Care Transitions Predictive Modeling Resource Management & Productivity Health Maintenance & Wellness Integrated Workflow Patient Engagement Gaps in Care Guideline & Standards Driven Evolving Care Plan Longitudinal 27 /

28 GE and Geisinger Development partnership GE and Geisinger Health Plan (GHP) are codeveloping a Population Health Management solution for use at Geisinger and the global market. Geisinger is a pioneer in population health management and accountable care. Geisinger will deliver it s ProvenHealth Navigator as part of the solution. GE HCIT is a global leader in healthcare technology & ACO consulting solutions. With GE s existing HIE platform, EHR and HIT product lines, and it s global development capabilities, GE will deliver a net new solution to the market. 28 /

29 phms: care management User Home Page 29 /

30 phms: population views + patient list Viewing the panel in aggregate 30 /

31 phms: 360 o Patient View Community view of the patient 31 /

32 phms: 360 o Access leveraging legacy systems 32 /

33 phms: plan of care connecting problems goals - interventions 33 /

34 An attainable goal: Population Health Management on our CFRHIO Population Management: Stratify, Assess, Refer, and Manage. 360 Data: Timely and holistic data of a patient and population. Collaboration: Coordination and Communication across the community. Evidence-based: Guideline & policy driven workflow through a rules based system. Insight: Analytics & reporting of outcomes, quality indicators, staff productivity, and benefit utilization. Information Exchange: Share all pertinent information on patient, employer, provider. 34 /

35 Caradigm GE & Microsoft Joint Venture 35 /

36 Bringing together complementary capabilities Our goal is to enable care teams to improve quality, performance and the patient experience through a focus on population health management A joint venture that when launched will develop and market an open, interoperable technology platform and innovative clinical applications Capabilities in platform and ecosystem development Capabilities in clinical and administrative workflow solutions 36 /

37 Building the foundation To activate our vision, both GE Healthcare and Microsoft will contribute a substantial number of employees and significant intellectual property to the global venture Amalga an enterprise health intelligence platform Vergence single sign-on and context management Qualibria a clinical knowledge application environment ehealth a health information exchange platform expresso an enterprise single sign-on solution 37 /

38 CARADIGM AREAS OF INVESTMENT HEALTHCARE QUALITY IMPROVEMENT POPULATION HEALTH MANAGEMENT PATIENT RELATIONSHIP MANAGEMENT PLATFORM IDENTITY & ACCESS MANAGEMENT 38 /

39 Discussion 39 /