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Interoperability, HIEs and the
Future...
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As care collaboration becomes the
corn...
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Table of Contents
Collaborating for S...
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Collaborating for Success

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Standing Still Not an
Option for Home...
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are on the front lines with patients,
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value to care partners. If your home h...
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care model being explored or activated...
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Univita Health is partnering with majo...
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is trying to establish an ACO for peop...
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Hospital readmissions continue to make...
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Sharp sees four requirements for home
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Putting HIEs to Work for You

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Four Healthcare
Truths in 2020
By Ran...
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that not only communicate smoothly wit...
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By connecting with other providers and...
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immaturity of electronic health inform...
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More Data,
More Movement,
Fewer Error...
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and report performance, share health
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Turning on the Tap:
PHRs Improve Pati...
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conditions, frequent users of healthca...
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doors to provide other services for wh...
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System security
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Protection against ...
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Interoperability: HIEs and the Future of Homecare

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Gain insight into how you can best position your homecare or hospice agency for success in an environment of change by reading this e-book.

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Interoperability: HIEs and the Future of Homecare

  1. 1. ................................................................................... Interoperability, HIEs and the Future of Homecare McKesson [Course title] 0
  2. 2. ................................................................................... As care collaboration becomes the cornerstone of quality healthcare, the clinical success of your agency is just as important as its financial success. The Affordable Care Act is marching forward, and standing still to wait for change to subside is not an option if you want your agency to survive and thrive. The question, then, is how best to position your agency for the changes that need to happen. Over the last several months, McKesson Homecare Talk has featured a number of blogs that focus on two major areas: Collaborating for Success and Putting HIEs to Work for You. We’ve compiled this e-book to provide insight into how you can demonstrate value to your partners and interpret healthcare data intelligence. We believe that home health will be central to the success of whatever may be the next trend, care model or healthcare innovation. Home health brings value to the community, but you must be at the table to be considered. You can be taking extraordinary care of your patients, but if the wider world doesn’t know about your agency, your opportunities for growth will be limited. If your home health agency is not partnering with other care providers, tracking key metrics and carefully observing outcomes, you have some catching up to do. And let’s not forget the vital role home health agencies can play in the ACO model. Accountable care is at the forefront of the healthcare debate because it aligns incentives in a patient-focused way. However, care transitions and hospital-athome programs also are gaining in popularity. Home health and hospice agencies are a critical, but often overlooked, component of the care continuum. How will you raise the profile of your agency and position it for greater success? As Randy Hyun, general manager of the Extended Care Solutions Group at McKesson, states in his contribution to this e-book, interoperability will define the future of healthcare because “all health care is local.” Not only will health information exchanges (HIEs) help improve clinician workflow and satisfaction, but involving patients in their own care also will help improve outcomes and strengthen ties with the homecare community. The importance of data and analytics will continue to grow. Using evidence-based practices and tracking key performance measures are critical to an agency’s success within any collaboration effort. To succeed in the next few years, we’ll all need a strong focus on both technology and process. Realtime information across the care continuum is the ultimate goal, and if we work together, we will get there. 1
  3. 3. ................................................................................... Table of Contents Collaborating for Success .................................................................... 3 Standing Still Not an Option for Home Health Agencies........................................ 4 Three Reasons Why Home Health Will Define Healthcare’s Future .......................5 Three Ways to Get Noticed In Your Market……………………………………………………..6 Home Health Needs to Roll With the Changes ........................................................ 7 ACO Models Focusing on Certain Conditions ......................................................... 8 Local Research Can Pay Dividends – Literally ....................................................... 9 Agencies Must Show Value to ACOs ...................................................................... 10 Putting HIEs to Work for You ............................................................. 12 Four Healthcare Truths in 2020 ............................................................................ 13 Is It Time to Join a Health Information Exchange? .............................................. 14 Interoperability Defines the Future of Healthcare ................................................. 15 More Data, More Movement, Fewer Errors .......................................................... 17 HIEs Can Improve Clinician Workflow, Satisfaction ............................................ 18 Turning on Tap: PHRs Improve Patient Communication and Engagement ......... 19 Leverage Data to Show Your Value to Referral Sources ....................................... 20 Sharing More Data? Ask More Questions. ........................................................... 21 2
  4. 4. ................................................................................... Collaborating for Success 3
  5. 5. ................................................................................... Standing Still Not an Option for Home Health Agencies By Karen Utterback Vice President, Product Marketing and Strategy, McKesson advantage of new opportunities. Your plans “have to be in tune with local culture, customs and delivery patterns,” Langsdale says. Key strategies include: Use technology better  Align provider interest  Connect quality to value  According to Troy Langsdale, partner in the healthcare practice at CliftonLarsonAllen, the first step is to conduct a strategic analysis of your agency and your market, then develop an action plan to improve organizational performance and take Prepare to assume risk  But you may not realize that standing still to wait for the change to subside is not an option if you want your agency to survive and thrive in the future. The question, then, is how best to position your agency for the changes that need to occur. Decide whether to lead, follow or resist  Today’s care and reimbursement environment is one of constant change. I’m not telling you anything that you don’t already recognize during each work day.  Build new relationships An agency owner interested in growing, for example, could become involved with community health initiatives. Then, if a new care model such as an ACO is formed, the owner would naturally be part of the conversation. Likewise, you probably already are doing disease management in your agency, but are you calling it that? A simple name change and the capturing of data will help show your value to partners and potential partners. Langsdale also stresses the importance of operational efficiency, eliminating waste wherever possible, maximizing value-added offerings and minimizing anything that doesn’t bring value to the organization. “You need to build processes around the norm, not the exception,” Langsdale says. And you should actively solicit ideas from among your staff, he notes. Your employees 4
  6. 6. ................................................................................... are on the front lines with patients, providers, payers and community members. He suggests setting up a specific email address for ideas and monitoring it frequently. Despite the myriad changes in the industry, Langsdale says, “On the post-acute side, I’m bullish. The industry is well-positioned in healthcare reform.” The industry may be well-positioned, but is your agency? That’s a question that only you can answer. And answer it you should. Three Reasons Home Health Will Define Healthcare’s Future By Karen Utterback Vice President, Product Marketing and Strategy, McKesson If I had a crystal ball and could accurately envision what the future of healthcare will look like, I could retire a rich woman. Unfortunately, I don’t. But I do know that home health will be central to the success of whatever may be the next trend, care model or healthcare innovation. Here are three reasons why home health is uniquely positioned:  We understand our patients in a holistic way that most other care providers don’t.  We know about and have access to community resources.  We have feet on the street with a mobile workforce that can reach these patients, day in and day out, wherever they are. That may be one reason home health spending increased 8.4% from January 2012 to January 2013, according to Altarum Institute, a nonprofit health systems research and consulting organization. Admittedly, the amount spent on home care is relatively small compared to what’s spent on the big three (hospitals, physicians and prescriptions take 60 cents of each healthcare dollar). But the month-to-month percentage increase for home health was considerably higher than those other categories. That’s not to say we don’t face our own challenges. The biggest obstacle I see for our industry is a lack of data to show our 5
  7. 7. ................................................................................... value to care partners. If your home health agency is not partnering with other care providers, tracking key metrics and carefully observing outcomes, then you have some catching up to do. A reliable clinical management system is the best way to collect and interpret valuable home healthcare data intelligence. This is not the time to stand by and hope the changes impacting the healthcare industry will go away. They won’t. It is the time to try new things, expand on what works and change what doesn’t. You will be judged not only on your outcomes, but on your ability to show the value that your home health agency provides. Three Ways to Get Noticed in Your Market By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Make no doubt about it – we are in a relationship business. However, many people confuse relationships or partnerships with friendships. They are not the same. There should be some formality in a relationship, with expectations on both sides. In the homecare space, that means your home health agency should have performance measures at hand to share with partners or potential partners. At the same time, you should know what to expect from your partners, including how to get out of a relationship if it’s not working for your agency. In order to increase the number of relationships you have with potential partners, you need to get their attention. In my view, there are three ways to get noticed in your market:  “Shoot some bullets”  Get engaged in your community, state and regions  Build brand recognition What I mean by “shoot some bullets” is for you actively to explore new partnerships and new care offerings. Is your local hospital concerned about care transitions? What about medication reconciliation or the ongoing treatment of chronic conditions to prevent hospital admissions and readmissions? Every state now has an ACO, and there’s likely some type of alternative 6
  8. 8. ................................................................................... care model being explored or activated in your community. You have a crucial part to play. Home Health Needs to Roll with the Changes The second point is fairly straightforward. Various local, regional, state and interstate community entities are trying to tackle community healthcare challenges. Are you aware of the groups active in your area, and, more important, are you involved in them? Home health brings value to the community, but you must be at the table to be considered. By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Finally, you must understand the importance of brand recognition. Your agency should have a mission, a vision and organizational goals that every member of your agency understands and can articulate. And you must have effective branding. Do you have a company logo? Do you use it consistently? Do you have a presence on the web? Increase brand awareness by doing such things as sponsoring the local health fair or other community events. I know that you didn’t get into the home health business to become a marketer. Unfortunately, you can be taking extraordinary care of your patients, but if the wider world doesn’t know about your agency, your opportunities for growth will be limited. Were you aware that HHS has approved 259 Accountable Care Organizations (ACOs) that represent 8% of the Medicare population? Nearly half are physician-led and serve fewer than 10,000 Medicare patients, according to The Advisory Board Co. With the announcement of the latest list, at least one ACO now exists in every state. This fact serves as another reminder that the status quo will no longer suffice if you want your agency to not simply survive – but to thrive – over the next few years. Accountable care is coming to the forefront because it aligns incentives in a patientfocused way, but care transitions and hospital-at-home programs also are gaining in popularity. 7
  9. 9. ................................................................................... Univita Health is partnering with major insurers and hospital systems to set up care transition programs that include both clinical and non-clinical services. What are the hospitals, physician groups, insurers and community-service groups in your area doing to help folks stay at home? As a whole, healthcare is moving away from a fee-for-service environment toward capitation, which was last seen during the managed care environment of the 1980s. That generally was considered a failed experiment, but the industry has grown since then in its knowledge of population health. This growth has been fueled largely by powerful analytic programs that can distill huge amounts of data into manageable, actionable chunks. And that’s your challenge: Breaking down what your agency does to help patients recover from hospital stays, regain mobility and thrive at home in a way that demonstrates your value to partners and potential partners. Anyone can become constrained by the business models they’ve trained in and the regulations they’ve learned. They can lose the ability to think outside the box, to put aside preconceived notions and to think about what’s possible. But if you and your agency can’t learn to think outside the box, someone else will. Home health software can assist your agency in moving forward with change by facilitating improved care quality and documentation. ACO Models Focusing on Certain Conditions By Karen Utterback Vice President, Product Marketing and Strategy, McKesson A small number of accountable care organizations (ACOs) are beginning to focus on certain diseases or chronic conditions. Is your home health agency gearing up to compete? Florida Blue, the insurer formerly known as Blue Cross and Blue Shield of Florida, has established ACOs for cancer patients in the Miami and Tampa areas during 2012, according to a report in American Medical News. The article also mentioned that dialysis provider DaVita has launched the Accountable Kidney Care Collaborative and 8
  10. 10. ................................................................................... is trying to establish an ACO for people with kidney disease. The focus of ACOs on specific conditions may be the low-hanging fruit of the accountable care world. End-stage renal disease cost federal and commercial payers nearly $43 billion in 2010, and more than $124 billion was spent on cancer treatments the same year. Cost savings are shared among providers in the ACO model, so finding effective treatments and interventions for a specific disease can help nearly every patient in the group. But if the entire ACO were composed of those with a certain disease, positive treatments could have far-reaching effects, both to the quality of life for patients and significant savings that providers could share. I know that running your agency can sometimes feel like a juggling act, with dayto-day tasks competing with medium- and long-range planning, personnel issues, technology challenges and many other concerns. Talking about ACOs may seem like piling on, but accountable care organizations are gaining stature, traction – and dollars. You need to determine how your agency fits into an accountable care world. Local Research Can Pay Dividends – Literally By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Home health agencies can play a vital role in the ACO model, particularly in terms of disease management. Some agencies have developed programs that address specific morbidities such as diabetes, congestive heart failure or COPD. Last year, we held a webinar series that addressed ACO strategies. The three webinars are:  ACO Overview  Addressing the Triple Aim  Measures of Success I try to write about and comment on happenings of national importance in the home health and hospice industries. But for every national initiative I mention, there are a huge number of local initiatives that also are important. 9
  11. 11. ................................................................................... Hospital readmissions continue to make news on a nearly daily basis. The latest news is that Medicare reduced penalties for 1,246 hospitals and increased them for 226 others, according to Kaiser Health News. What are your local hospitals or health systems doing to decrease readmissions? And, more important, what role can home health play in helping them achieve fewer readmissions? Collaborative groups of hospitals and providers have formed all over the country to tackle common problems such as readmissions or explore common opportunities like care coordination and payment reform. Home health and hospice agencies are a critical, but often overlooked, component of the care continuum. You need to know where you fit in and how you start. How closely do you keep tabs on initiatives being explored by the local hospital or large provider groups? Make a note in your calendar to check local news websites on a consistent basis. Do you belong to your regional or state home care association? Bookmark the website of your closest association and check it frequently. If you are not active in the group, you are missing a fantastic opportunity to not only increase your knowledge about the industry, but also to raise the profile of your agency and position it for greater success. That’s what we do at McKesson – provide you with the agency and clinical management tools you need to be successful. But home health software technology can take you only so far – the rest of the journey is up to you. And it starts with paying close attention to the local and national issues likely to affect your agency. Agencies Must Show Value to ACOs By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Participating in ACOs can be a key growth strategy, but home health agencies must know what to expect and how to show their value, says Mark Sharp, CPA, partner at BKD, LLP. Sharp was among the featured speakers at the recent McKesson Home Health and Hospice Executive Summit. 10
  12. 12. ................................................................................... Sharp sees four requirements for home health agencies to participate effectively in ACOs:  Promote evidence-based medicine  Promote beneficiary engagement  Internal reporting on quality and cost metrics  Coordination of care Since hospitals and large physician groups are driving a majority of ACOs, Sharp says agencies must cater to their needs, which include managing transitions from acute to post-acute care and helping patients monitor their chronic conditions to prevent hospital stays in the first place. endeavor, although the marketing department can play a supporting role, Sharp notes. And an agency must be willing to cover the geographic footprint of an ACO – even though it may require either an expansion of services or a partnership with another agency. “You should take a team approach to build the internal processes you need to participate in ACOs,” Sharp says. “Then, you have to get out into your markets, tell your story and develop the relationships that you need to succeed.” Using evidence-based practices and tracking key performance measures are critical to an agency’s success within an ACO. “You have to be able to show outcomes and cost savings to the healthcare system,” Sharp says. “It’s not just cost savings within your agency; it’s cost savings across the continuum of care.” A robust home health software solution for agency management is a must to provide the level of detail that ACOs require. Quality metrics should be shown by patient and by disease state. Data on cost reduction is critical, as is the ability to handle different payment methodologies. Building the strong relationships necessary to become involved in ACOs is a C-suite 11
  13. 13. ................................................................................... Putting HIEs to Work for You 12
  14. 14. ................................................................................... Four Healthcare Truths in 2020 By Randy Hyun General Manager, Extended Care Solutions Group, McKesson There’s so much going on in healthcare at the moment that it seems ridiculous to focus on anything beyond the near future. In fact, times of rapid change require us to take a step back and look at the long-term possibilities. If we want to succeed, that is. At McKesson, we spend a lot of time talking about what 2020 will look like. A few years back when we started talking about it, it seemed very far away. Today, that’s no longer the case. At the National Users Conference in the spring, I outlined some of the things McKesson believes we can count on being true in 2020. 1. Care will be right-sized 2. Patients will expect more transparency in their care 3. Patient data will flow across the entire health system 4. Data and analytics will be a forefront of healthcare Let’s take those predictions one at a time. First, when we talk about right-sized care, we mean a significant shift in where care takes place. Patients who would have been hospitalized will be cared for on an outpatient or homecare basis, conditions that used to be treated by physicians will be taken care of at a retail clinic staffed with nurses, and so on. What’s important to remember is that although it’s a major shift, it will happen fairly gradually and will have a positive impact on healthcare costs. Second, patients will continue to demand transparency in the form of personal health records and patient portals. Patients will have many more choices about where they can be treated, and providers that recognize the importance of transparency early on will be the winners here. Third is the flow of patient data. Right now, this feels like a bit of pipe dream, but we continue to work toward what we call a longitudinal patient record—everything from all providers in one place. Finally, the importance of data and analytics will continue to grow. We’ve come a long way from a decade ago when almost nothing was automated. By 2020, we’ll have successfully made the transition to systems 13
  15. 15. ................................................................................... that not only communicate smoothly with each other, but provide the exact information providers need about their patient populations at the moment they need it. As homecare providers, we know the value of making a strong connection with a patient. We also realize, to some extent, the importance of connecting our business to the various entities we work with. To succeed in the next few years, we’ll all need a strong focus on both technology and process. Real-time information is the ultimate goal, and if we work together, we will get there. In fact, those business connections are becoming more important every day, and here at McKesson, we’re seeing many of our customers joining health information exchanges (HIEs). In some cases, they are sharing clinical patient data with a state, regional or private HIE. In others, they’re setting up a private HIE for their health system. Is It Time to Join a Health Information Exchange? By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Specifically, healthcare providers can create a continuity of care document (CCD) that shows a patient’s problems, vital signs, medications, allergies and demographic information. The CCD can be shared with other providers via the HIE, and information like new conditions or medications can be added to the profile and shared. Some platforms designed to connect homecare providers to HIEs also offer a way to connect patients and families to their healthcare providers by making a patient’s health record accessible via the web (using well-tested security). Once the patient establishes an account, the homecare agency can send secure emails to individuals or broadcast messages to a predefined patient population. 14
  16. 16. ................................................................................... By connecting with other providers and patients over the web, homecare agencies can:  Improve relationships with community healthcare partners  Increase clinician satisfaction and productivity by providing easy-toaccess information  Connect patients and their families to healthcare providers in a secure manner  Engage patients in their care process through easier provider access  Create an agency-branded web interface that increases patient satisfaction Given how interconnected our world has become in the last few years, it makes sense for healthcare providers to step up their efforts in this area. And with strong benefits like enhanced collaboration and improved productivity, we expect to see many of our customers do just that. Interoperability Defines the Future of Healthcare By Randy Hyun General Manager, Extended Care Solutions Group, McKesson “All healthcare is local.” We’ve all heard that phrase used to describe the nature of healthcare. And it’s certainly true in the case of care delivered in the home, home health, hospice and personal care services. Even in the midst of health care reform and the Accountable Care Act, healthcare will remain local, but it will have to break out of its current silos. As new care models transform the healthcare industry, clinical interoperability is critical to the care process and delivery systems as we all strive to achieve the Triple Aim of better patient outcomes, better population health and reduced costs. Home health, hospices and personal care services have never felt the need to be more connected. The health care system is seeking to collaborate in real- or near-realtime and looking to their information systems to enable and support them, regardless of whether an agency is freestanding or part of a health system. This aspiration brings with it a number of challenges, not the least of which is the 15
  17. 17. ................................................................................... immaturity of electronic health information exchanges. Yet it is clear, with the increased emphasis on care coordination that’s required to participate in ACOs and other emerging care models, providers must have well adapted, reliable, flexible ways to share information among partners. The release of McKesson Homecare™ v13.0, which brings the use of a standard clinical terminology and evidence-based practices to the bedside, fully supports the goals of interoperability using McKesson Home Health Connect™ and McKesson Hospice Connect™ to enable the sharing of demographic and clinical information bidirectionally with the care teams, regardless of whether those care team members are a part of the same health system or not. McKesson Home Health Connect and McKesson Hospice Connect are truly gamechangers for homecare agencies. Clinical interoperability is becoming crucial, so agencies need to access, share and manage patient medical data in disparate systems. Not only do McKesson Home Health Connect and McKesson Hospice Connect allow agencies to share information with partners, they allow secure access with private, state and regional health information exchanges (HIEs). The webbased solutions store data in a secure environment and feature auditing protections that track users and allow patients to specify what records they choose to share. With McKesson Home Health Connect and McKesson Hospice Connect, clinicians can look at multiple continuity of care documents (CCDs) either separately or as a single, integrated document that’s aggregated from the available CCDs. Bringing this information together provides a powerful tool for clinicians as they are determining the best course of care for the patient and facing the challenges of having the most current list of problems, allergies and medications. McKesson Home Health Connect and McKesson Hospice Connect also help patients participate in their own care through the personal health record that’s part of the system. The patient portal is accessible via the web with security, privacy and auditing protections. Once patients have created a personal health record, your agency can send secure email messages to individuals or broadcast messages to a predefined patient population. Products such as McKesson Home Health Connect and McKesson Hospice Connect used in conjunction with home health software can help agencies stay on the cutting edge, adapt to new care environments and continue on their core mission – taking great care of their patients. 16
  18. 18. ................................................................................... More Data, More Movement, Fewer Errors By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Through HIEs, clinicians can place diagnostic orders that are electronically routed to the proper hospital department or homecare provider. Any test results and all visit documentation, including the order ID and the patient ID, are electronically returned to the clinician’s EMR. As manual procedures and handoffs are eliminated, the potential for error is greatly reduced. HIEs can help home health providers manage patient identity, patient consent and privacy rules and clinical terminology mapping across disparate systems. Having the best, most updated information on customers is a priority for virtually every business. In the homecare industry, that information can be critically important, even life-saving. These days, more patient information is being exchanged due to care transitions, care coordination efforts and new payer models like accountable care organizations (ACOs). Fortunately, technology providers are stepping up with health information exchanges (HIEs) that make sharing information easier, resulting in smoother data flow and lower risk of error. Indeed, HIE functions include medical record sharing, results delivery and exchange of continuity of care documents during care transitions. Experts believe that by ensuring a complete and comprehensive patient history is available at the point of care, HIEs can help:  Prevent hospital readmissions  Decrease dangerous medication errors  Improve providers’ diagnostic capabilities  Decrease duplicate testing by ensuring a complete and comprehensive patient history HIEs are even more important to providers moving into new models of care. ACOs, patient-centered medical homes and payfor-performance systems depend on HIEs to deliver patient-centered care, measure 17
  19. 19. ................................................................................... and report performance, share health information and improve the quality, coordination, safety and efficiency of care. HIEs Can Improve Clinician Workflow, Satisfaction By Karen Utterback Vice President, Product Marketing and Strategy, McKesson Often, improving clinician satisfaction can be as easy as making sure they have the tools they need to do their job. Of course, today’s home health providers consider data as important a diagnostic tool as a stethoscope, which can add a layer of complexity. Fortunately, health information exchanges (HIEs) are starting to prove their worth in this area. For example, HIEs allow clinicians better access to diagnostic images, usually with a single click from within a patient record. According to a recent article in Health Management Technology, clinicians are reporting that digital image exchange through an HIE is enabling them to significantly minimize duplicate tests, enhance quality of care and reduce patient exposure to radiation. Of course, it’s not just images that home health clinicians need at the point of care. Indeed, they need a combination of demographic and clinical data about the patient, including medical history, current issues, current medications, allergies and more. A private HIE allows patient information like this to flow more freely among hospitals, primary care physicians and home health providers. It also allows certain data to be exchanged with regional and state HIEs for research and other purposes. There’s another way that HIEs improve clinician satisfaction: improving workflow. Virtually every provider has a goal of spending more time with patients, which means reducing administrative tasks; HIEs provide the means for that. By allowing providers to abandon paper-based systems in favor of streamlined electronic forms, HIEs also reduce the potential for human error. Today, many in healthcare believe better data access will ultimately help clinicians make more precise diagnoses, better manage chronic diseases, reduce time spent on administration, and – most important – spend more time with patients. 18
  20. 20. ................................................................................... Turning on the Tap: PHRs Improve Patient Communication and Engagement By Karen Utterback Vice President, Product Marketing and Strategy, McKesson provider and access medication information and test results using a secure web connection. Patients can also specify what data they are willing to share with other providers. Perhaps the best news is that PHRs have been shown to improve patient engagement in the care process. An article in the Journal of the American Medical Informatics Association (JAMIA) said many trials of PHRs have shown they improve patient and family access to knowledge for self-management of health and wellness issues. Here are some ways PHRs help improve patient satisfaction:  Communication, especially with customers, is the lifeblood of any business. Unfortunately, security concerns and government regulations can prevent communication from flowing smoothly in healthcare organizations. There’s good news, however. More homecare organizations are adopting health information exchange platforms (HIEs) to communicate with other providers and regional health information organizations, and those platforms enable creation of personal health records (PHRs). Through a PHR, patients and their families can communicate with their homecare Better communication with caregivers leads to improved relationships, which can lead to enhanced patient/provider shared decision-making  Access to providers helps reinforce trust and confidence  Better access helps patients feel more like partners in healthcare Although PHRs have not been adopted by the general public at the rate some expected (Google Health’s failure to catch on is a good example), PHRs are popular with the exact population served by homecare agencies. According to the JAMIA article, people with disabilities and chronic 19
  21. 21. ................................................................................... conditions, frequent users of healthcare services, and people caring for elderly parents tend to have the most interest in PHRs. Involving patients in their own care surely will improve outcomes and strengthen ties with the homecare community. Leverage Data to Show Your Value to Referral Sources “Home health and hospice agencies must be present in the ACO presentation, and you need to keep telling your story,” says Tecca. “You need to listen and tell how you demonstrate value and how you will make (other participants’) lives simple.” Basic research agency executives need to conduct before exploring partnerships includes:  Learning your agency’s strengths and how those strengths would benefit partners Knowing your competitors and how your agency is similar/dissimilar  A little data can go a long way, if it’s leveraged effectively, says Martha Tecca, founder and principal consultant at M&M Strategies. In order to participate in emerging care models, providers need to have outcomes data, which Tecca admits can be difficult to obtain in such a way to create apples-to-apples comparisons with competitors. Knowing what data and services potential partners are looking for  By Karen Utterback Vice President, Product Marketing and Strategy, McKesson  Bringing the right data to the table (ask beforehand what data partners consider crucial) To learn more about what data hospitals, physicians and other providers believe are important, Tecca recommends bookmarking the websites for the National Quality Forum, the Center for Medicare & Medicaid Innovation and the Dartmouth Atlas of Health Care. Tecca sees “a huge opportunity” for home health agencies to develop medication reconciliation programs. There may not be a bright line to reimbursement for this service at the outset, but it would be a way for an agency to differentiate itself and open 20
  22. 22. ................................................................................... doors to provide other services for which it would be reimbursed. At that point, medication reconciliation would be a valueadd offering while a clinician is in a patient’s home. Another good resource is the Home Health Care CAHPS survey, Tecca says. “A lot of folks submit HHCAHPS data but don’t care to delve further into it or engage it,” she notes. “But it can be a hugely valuable tool.” Sharing More Data? Ask More Questions. By Karen Utterback Vice President, Product Marketing and Strategy, McKesson As you share more data more often, security rises to the top of your list of concerns – as well as it should. Asking questions is the best way to familiarize yourself with security terminology and become comfortable with what constitutes a secure connection to an HIE. At a minimum, HIEs must be fully compliant with HIPAA and the statespecific privacy regulations in their region. They should also have readily available, detailed information on their security policies. For example, HIEs must consider the following: Physical security  Access to the production facility  Power quality and backup power  Smoke detection and redundant HVAC (heating and air) Network security   Sharing data is becoming a common occurrence for home health and hospice agencies, whether you’re exchanging specific patient data with another provider or more general data on your patient population with a state, regional or private health information exchange (HIE). Redundant firewalls Site autonomy  Restricted electronic access to the data center 21
  23. 23. ................................................................................... System security  Protection against electronic attacks  Hardening and monitoring of web servers, integration servers and file transfer servers. Access control  Controlled access requests  In a nutshell, any entity you exchange data with should be able to prove to you that it has well-tested physical/network security, that its facilities and processes are audited periodically, and that it has taken all potential patient privacy concerns into consideration. Strict security account policies o Encrypted remote access o Auditing Application security  Input validation  Strict authentication  Credentials management  Exception management Data security  Data separation (PHI never sent or received without being encrypted)  Data auditing  Data backup  Data destruction 22
  24. 24. ................................................................................... For more news and insight from the hospice and home health industry, visit McKesson Homecare Talk. www.mckesson.com/homecare 23

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