Your SlideShare is downloading. ×
MIT Enterprise Forum  Innovation Series Event: Healthcare Innovation After ObamaCare, April 30, 2014
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.


Saving this for later?

Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime - even offline.

Text the download link to your phone

Standard text messaging rates apply

MIT Enterprise Forum Innovation Series Event: Healthcare Innovation After ObamaCare, April 30, 2014


Published on

Christina Severin, President & CEO, Beth Israel Deaconess Care Organization presentation on healthcare technology for the MIT Enterprise Forum Innovation Series Event: Healthcare Innovation After …

Christina Severin, President & CEO, Beth Israel Deaconess Care Organization presentation on healthcare technology for the MIT Enterprise Forum Innovation Series Event: Healthcare Innovation After ObamaCare

  • Be the first to comment

  • Be the first to like this

No Downloads
Total Views
On Slideshare
From Embeds
Number of Embeds
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

No notes for slide


  • 1. MIT Innovation Series Christina Severin, President and CEO April 30, 2014
  • 2. About BIDCO • BIDCO is a value-based, physician and hospital network and an Accountable Care Organization (ACO).  Located in Westwood, Mass.  Employs more than 80 staff members  Contracts with 2,100 physicians, including nearly 450 primary care physicians and 1,700 specialists and 6 hospitals  Contracted by Centers for Medicare and Medicaid Services (CMS) as a Pioneer ACO • $1B in risk revenue management • Our highest level goal is to promote the best quality and value of care to patients, providers, health insurers, and employers. 2
  • 3. BIDCO structure 3 BIDCO Confidential Physician LLC Hospital LLC
  • 4. High-level goals • Grow the business  Creates virtual cycle of opportunity  Ensures needed scale • Effective risk contracting  Moves away from fee-for-service (“click-fee”) model  Manages total cost of care for populations • Beating budgets to earn surplus (or not)  Offers financial opportunity for improved quality (P4P) • Provide governance structure needed to support legal and business requirements of an ACO 4
  • 5. Essential business functions • Ensure business processes that support cost management and quality improvement goals  Financial management of risk contracts  Care management  Disease management  Quality improvement  Clinical integration • EHR hosting and support • Data interchanges  Provider support services  Risk contracting with CMS and other managed care companies 5
  • 6. Highest level challenges • Manage total cost of care (“TME”) budgets  Effectively manage risk contracts to return value to Members (>$1B)  Right care in the right place at the right time • Improve quality  Effectively earn quality dollars to return value to Members  76 unique ambulatory goals over four major contracts; only two goals appear in all contracts 6
  • 7. Technology limitations • Inherent complexities of data-sharing in an environment of minimal interoperability  Patient information in silos (e.g., stand-alone EHRs)  Limitations in moving information along a system of care • Clinical integration  Fragmented access to data (access to some EHR data)  Cumbersome user experience for physicians and care management teams (multiple vendors, products, and modules)  Limited ability (claims data) to access “full view” of care experience • Therefore, there are several ways in which new technology could help solves for these limitations 7
  • 8. Innovation need #1 • One-stop, comprehensive physician performance reporting  Performance metrics, improvement suggestions  High-risk, high-cost members  Patient rosters, including location, diagnosis, ED visits  Gaps in care assessment  Prescription status  Coding improvements  Predictive tool to identify needed intervention, suggests intervention based on circumstance algorithm 8
  • 9. 9 Quality report Efficiency report EHR Financial performance Patient list Check email High-risk patient registry Current state: Performance reporting Login to Application #1
  • 10. Future state: Performance reporting Comprehensive physician performance reporting tool Single login 10 BIDCO Data repositories Claims Lab/ Rad Care mgmt. EHR Clinical data
  • 11. Innovation need #2 • ACO care record that travels with patient to site of care  Move fully integrated health information across care continuum  A fully connected clinical ACO community that leap frogs inter-operability by generating a clouded-based HIX for fully integrated data capture of all experience regardless of the site of care 11
  • 12. Current state: BIDCO data exchanges BIDCO Community EHR Integrated EHR, PMS & Billing 100+ databases Electronic Health Exchange Longitudinal Community Health Record Quality Data Center Clinical Quality Data repository of BIDCO member EHR Clincal data Payors Lab/ radiation Claims Data Warehouse Data Warehouse: Consolidation of claims, labs & clinical data for reporting CMS ACO reporting tool High-risk patient identification and stratification tool WebOMR BIDMC EHR Other Community Systems Centricity NextGen Other Risk- flagging database Hospital HIS 12
  • 13. PCP Office Surgical Center Pharmacy Skilled Nursing Facility Physical Therapy MRI Center Orthopedics Future state: BIDCO data exchange 13 Community Medical Record Inpatient
  • 14. Summary • The majority of new innovations being offered to ACO’s, are developed based on a concept that an ACO has simple data architecture  Data mining (how can you mine data if you can’t access the data?)  Predictive modeling (how can you predict if you can’t access all the data?)  Population management (how can you tell a doctor a patient needs a Ha1C if you don’t have access to all lab data?) • Payer claims data remains the most straight forward way to perform all analytics  However, this leaves EMR data – the primary source of clinical data – out of the picture • The reality is that our architecture is incredibly complex and diverse • Therefore, the most important solutions need to focus technology that can solve our complexity issues 14
  • 15. Questions 15