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Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013
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Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013

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Kurt Salmon - Get Plugged in: Defining Your Connectivity Strategy - April 2013

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  • 1. Get Plugged in: Defining Your Connectivity Strategy CHIME College Live 17 April 2013
  • 2. Topics Introductions Drivers Strategies Imperatives Discussion Page    2    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 3. Introductions
  • 4. Introductions Elaine Remmlinger Gerard Nussbaum Senior Partner Director, Technology Services Elaine.Remmlinger@kurtsalmon.com Gerard.Nussbaum@kurtsalmon.com 212-508-8374 212-508-8371 Page    4    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 5. About Kurt Salmon: Information Technology STRATEGY and PLANNING »  »  »  »  »  »  Strategic and Tactical Planning Physician-Hospital Alignment Connecting Communities Population Health and Care Coordination Technology Planning for New Facilities Business Intelligence and Analytics VENDER SELECTION and SUPPORT »  Vendor Selection and Contract Negotiation »  Pre-implementation Planning »  Implementation Oversight REGULATORY COMPLIANCE »  Meaningful Use Achievement »  ICD-10 Preparation »  Security and Privacy Compliance »  IT Transformation INFRASTRUCTURE and OPERATIONS »  Infrastructure Planning »  Right Sourcing »  Interim Leadership Page    5    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 6. About Kurt Salmon Extensive, relevant EXPERIENCE »  Academic, children’s, community, & national health systems Change LEADERS »  Highly pragmatic and focused PROVEN team »  Careers spent supporting leading health systems and complex environments Track record of SUCCESS »  Rich history dating to 1947 »  Over 75% of ongoing work with repeat clients Page    6    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved   Strategy Finance Facility/Capital Asset Planning Operations and Performance Information Technology
  • 7. Objectives »  Understand the drivers for connectivity »  Discuss potential connectivity strategies to achieve connectivity »  Consider challenges and marketplace realities »  Identify common themes and imperatives for moving forward Page    7    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 8. Drivers
  • 9. Drivers Connectivity is a prime area of interest for providers of all types – from sole practitioners through large health systems and encompassing all stops along the care continuum PRIMARY CARE PERSONAL HEALTH & WELLNESS MGMT Patient Portal HOSPITAL Ambulatory EMR Inpatient EMR INSURER CLAIMS DATA HIE PAPER PATIENT RECORD HOME HEALTH CARE Page    9    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved   HIE DRUG INFO PHARMACY Specialty EMR LAB TESTS LAB SPECIALIST
  • 10. Drivers Numerous forces are impelling providers to develop and execute a connectivity strategy »  Regulatory Drivers –  Meaningful Use Stage 2 –  Accountable Care –  Medicare Shared Savings Program/ –  Value-Based Purchasing Readmission reduction program –  EHR Donation »  Payment model shifts »  Population health management »  Community health improvement »  Affiliated community physician strategy »  Unifying the enterprise across the care continuum »  Consumer care involvement Page    10    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 11. Regulatory Drivers Ability to exchange clinical information as structured data and provide health information to all participants is embedded in a number of recent and forthcoming regulations »  Directly required by Meaningful Use for physicians (EPs) and hospitals –  Provide patients the ability to view online, download, and transmit their health information –  Electronically transmit summary of care record for transitions in care •  Including with another provider with a different EHR –  Secure electronic messaging to communicate with patients –  Registry reporting (cancer registry, specialty registry) (EP only) –  Structured electronic lab results to ambulatory providers (hospital only) –  Public health reporting •  Syndromic surveillance, •  Immunization reporting •  Electronic lab reporting (hospital only) –  eRx (electronic prescribing) – also required by eRx incentive program (MIPPA) Page    11    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 12. Regulatory Drivers Proposed extension of the EHR Donation Stark exception/Anti-Kickback Statute safe harbor acts as a catalyst for community connectivity »  Currently expires 31 December 2013 »  CMS/OIG proposing extension through end of 2016 »  Interoperability is a foundation requirement of EHRs subject to donation »  Will likely spark additional demand from community physicians for practice office EMRs »  Drives demand for connectivity »  Connectivity will generally be greater for community physicians with hospital/health system donated EHRs to drive affiliation strategy »  Donated EHR may also be a lever for adherence to –  Clinical best practices –  Quality reporting –  Performance benchmarks Page    12    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 13. Regulatory Drivers Sharing health information is critical to the ability to manage patient health and achieve success under a number of payment-related regulations »  Relevant regulations include –  Accountable Care –  Medicare Shared Savings Program/ –  Value-Based Purchasing Readmission Reduction Program »  Parallel non-regulatory programs (e.g., with private payors) require similar capabilities Page    13    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 14. Regulatory Drivers (continued) »  Key capabilities –  Provide information to cost-effectively manage care –  Promote provider communication –  Define dashboards and scorecards –  Build performance transparency –  Leverage algorithmic tools to identify need for intervention to arrest health decline –  More closely monitor/track patients –  Elevate patient to partner in their own health Page    14    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 15. Patient Engagement In addition to the regulatory incentives/requirements, better outcomes are generally available when the patient is actively involved in their own care Patient Benefits »  Engage patients in their care »  Build relationships between patients and providers »  Increased access to clinical information –  Personal health records –  Health library »  24/7 access to Practice Benefits »  Increased practice efficiency –  Decreased phone call volume, –  Ability to shift tasks to less busy times »  Improved provider-patient communication »  Improved financials (increased collections) »  Meaningful Use Stage 2 –  Scheduling –  Online access –  Bill pay –  Secure communications –  Messaging –  Prescription refill requests »  Increased patient satisfaction Page    15    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved   »  Satisfied patients
  • 16. Population Health Management Coordinate care delivery among different care settings for the given patients Perform risk stratification and monitor outcomes to improve care delivery Identify population to be managed and deliver care Receive and distribute payments to different entities To effectively manage population health rich information sets are required Page    16    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 17. Private HIEs »  Health systems are still actively building private connectivity solutions, including –  Portals –  Health information exchanges (HIEs) »  HIEs with broader membership (e.g., regional/community, state/federal) often –  Do not deliver breadth of data exchange needed to support health system goals –  Have significantly longer decision making and upgrade cycles –  Raise issues of sustainability, raising risks for health system strategic initiatives »  Despite some of the disadvantages, these multi-stakeholder HIEs remain key components of a connectivity strategy –  Provide wide catchment for broader populations •  Important in retrospective at risk population assignment such as in the MSSP –  Support more effective/efficient care for patients not primarily aligned with the health system –  Functionality will evolve –  Provide core dial tone services that ease connectivity with the broader world Page    17    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 18. Strategies
  • 19. Many Moving Parts »  Integrated vs. best of breed / interoperable solutions »  Proprietary vs. community HIEs »  Sponsored community physician EHRs »  Single vs. multiple patient portals »  Aggregator / viewer solutions »  ACO solutions »  Analytics »  Legalities and policies Page    19    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 20. No Universal Connectivity Strategy »  Key considerations in defining the appropriate connectivity strategy include –  Strategic enterprise priorities; for example: •  Building a physician network •  Creating patient-centered care •  Preparing for payment reform •  Maximizing Meaningful Use benefits –  Organizational structure/dynamics; for example: •  Multiple silos of care/diffuse •  Unified care delivery organization encompassing care continuum •  Merger / acquisition activity Page    20    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 21. No Universal Connectivity Strategy (continued) –  EHR solution environment across the care continuum •  Care locus specific EHRs •  Single EHR •  Multiple EHRs, even in similar care environments •  Diverse EHRs across the community –  Vendor marketplace status •  Integrated vs. interoperable •  Enterprise vs. best of breed solutions Page    21    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 22. Unifying the Enterprise Hospital Ambulatory Procedure Center Retail Pharmacy IP Rehab Physician Clinics SNF Lab Lab OP Rehab Home Wellness and Fitness Center Page    22    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved   Diagnostic/ Imaging Center Urgent Care Center Home Care
  • 23. Real World Examples To gain a flavor of the challenges and approaches, we will consider three real world examples »  Disparate Solutions »  Partial Integration »  Enterprise and Community Integration Page    23    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 24. Scenario 1: Disparate Solutions Other Providers Other EHR Other EHR Other EHR Community HIEs Patient Portal Other EHR Other EHR Hospital EHR Sponsored EHR Hospital EHR Community Physicians Clinical Enterprise ACO Payors Employed Physicians EHR 1.  Disparate Solutions »  EHRs »  Limited Data Sharing 2.  Shared Portal 3.  Separate ACO Solution 4.  Analytics Siloed Page    24    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 25. Scenario 2: Partial Integration Other Providers Community HIEs Employed Physicians EHR Other EHR Other EHR Other EHR Patient Portal Proprietary HIE Patient Portal Multi-Hospital EHR Sponsored EHR Community Physicians Clinical Enterprise ACO Payors Enterprise 1.  Single Integrated Hospital EHR 2.  Separate Physician EHRs 3.  Proprietary HIE 4.  Multiple Patient Portals 5.  Siloed Analytics Page    25    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 26. Scenario 3: Enterprise and Community Integration Other Providers Community HIEs Enterprise EHR Employed Physicians Other EHR Other EHR Patient Portal Multi-Hospitals Sponsored Community Physicians Other EHR Community Physicians Clinical Enterprise ACO Payors 1.  Enterprise EHR 2.  Shared Patient Portal 3.  Community HIE 4.  Enterprise Analytics Page    26    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 27. Imperatives
  • 28. Connectivity Supports Enhanced Care Delivery 1. ALERTS •  Identifying care gaps & alerting provider and/or patient INSURER PRIMARY CARE PERSONAL HEALTH & WELLNESS MGMT PATIENT VITALS/ FAMILY HISTORY CLAIMS DATA PAPER PATIENT RECORD •  Looks at registries, population-based data to stratify patient risk •  Looks at evidence-based clinical standards & defined quality standards to do quality reporting HOME HEALTH CARE HOSPITAL Ambulatory EMR HIE 2. BUSINESS INTELLIGENCE Page    28    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved   3. CARE COORDINATION Inpatient EMR HIE DRUG INFO •  Allows for care coordination workflows for communication between different providers Specialty EMR SPECIALIST LAB TESTS 4. PATIENT ENGAGEMENT PHARMACY LAB •  Allows for care coordination workflows for communication between different providers
  • 29. Imperatives Each situation differs; yet, there are some common imperatives that CIOs need to address. »  This is hard –  Lots of parts –  Even highly integrated environments need to connect with other players –  Currently expensive and duplicative –  There will be multiple rounds of connectivity solutions as this area matures – remaining flexible is key to managing the costs »  Not solely a technical issue –  Clear enterprise business objectives and priorities are essential –  Need to build collaboration with numerous diverse stakeholders internally and externally – who do not always share common goals –  Addressing the tangled legal thicket may slow progress •  Trust relationships •  Data Sharing agreements •  Privacy and Security (HIPAA, state and local laws, plus patient perception) »  Requires a companion analytics strategy Page    29    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  
  • 30. Page    30    |    Copyright  Kurt  Salmon  ©  2013–  All  Rights  Reserved  

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