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ActualMeds - Health Datapalooza Genius Bar
- 1. 888-838-9053 info@actualmeds.com www.actualmeds.com @actualmeds MEDICATION MANAGEMENT AND RECONCILIATION for High Risk Patients (C) 2014 ActualMeds Corp Come see us mainstage at 8:55am Monday, or 4pm Monday in the Exhibition Hall Apps Demo Booth
- 2. Getting to the crux of poor medication outcomes in high risk patients ... HIGH RISK PATIENTS 13 different physicians 50 different Rx’s 76% of all hospital admissions Preventable Hospitalizations, Re-admissions, Long Term Care and Unnecessary Rx > $290 Billion Healthcare Costs WHY?... A patient’s medication information is mostly incomplete, inaccurate and unavailable WHEN and WHERE it is needed by healthcare teams to improve these outcomes
- 3. ActualMeds: Best Possible Medication Information at the Right Time and Right Place PAYER (claims) PROVIDER (EHR) PATIENT (?) Rx Filled Self Medication Behavior Rx Ordered PAYER: risk resolution and management PROVIDER: Tailored intervention at Point of Care PATIENT: engagement and adherence Reduced Preventable Hospitalizations Re-admissions Lower Costs ActualMeds Aggregation & Validation of Data including Patient Self- Medication Identification of Risk Medication Action Plans for Care Team & Patient BetterHealthCare Deliivery
- 4. ActualMeds: Better Medication Management All Around the Care Continuum Payer Patient Provider Home Care Admission Acute Care Discharge Ambulatory Care Payers • Cost-effective MTM • Population risk management • STARS medication metrics Providers • Medication management and reconciliation at transitions of care, complex care • HEDIS measures; MU II & III Patients • Personal medication record and virtual pillbox available through Payer and Provider portals
- 5. Accelerated Workflow: Validation of Real Regimen Based on Best Available Data Healthcare team has validated information ready for reconciliation (C) 2014 ActualMeds Corp
- 6. Structured Patient Interview Adds Context to “Known” Sources Structured interview captures patient self-medication behavior (C) 2014 ActualMeds Corp
- 7. Evidence-based automated risk assessment guides tailored intervention Risk rules incorporate CMS STAR rating metrics for medication and adherence, other quality measures
- 8. Action Plans support care coordination workflows Medication Action Plans can be shared among payer, health care team, and patient, within the ActualMeds system or as an external message (C) 2014 ActualMeds Corp
- 9. Medication Reconciliation On-DemandTM (C) 2014 ActualMeds Corp Completed reconciliation available as a CCD or C-CDA export or transaction, bringing high quality structured data back to the EHR or HIE
- 10. Better Medication Reconciliation & Management 1. Get the data: automate what you can – All possible third party sources • Accommodate a variety of standards – Patient self reporting (as appropriate) – Structured interview with the patient 2. Make the data meaningful for the long haul – Mapped to coded values – Harmonized for comparison – “Scrub as you go” adds structure, interoperability, value – Save and share in standards-based formats 3. Merge into a variety of care workflows: evolution OR revolution 4. Flexible analytics – requirements will change (C) 2014 ActualMeds Corp
- 11. Data Sources – “Off the shelf “ • Demographics / patient load – “834” CMS approved, HIPAA-compliant Benefit Enrollment and Maintenance Transaction.csv batch • Claims/Fills: ActualMeds - Certified Surescripts integration partner for Acute Medication History since August 2012 • EHRs: per-patient upload of EHR exports of CCR/CCD/CDA/C-CDA standards-based data files – In development – State Health Information Network of New York (SHIN-NY) – app on the SHIN-NY data backbone. – Allscripts – Development Partner – Custom or workflow integrations available • e.g. PBM feed, EHR, HIE, care coordination platforms, other
- 12. Medication Reconciliation Is Critical for Successful Care Transitions VALUE PROPOSITION PROVIDERS PAYERS Improve Outcomes & Reduce Cost of Care* Reduces < 30 Day Hospital Readmissions Reduces preventable hospitalizations & re- admissions Earn Govt. Incentives HEDIS Quality Metrics; ONC Meaningful Use 2 & 3 Incentives Medicare Quality rating & bonus payments : STARS and HEDIS metrics Cost-effective Workflows Saves time Reduces labor costs Bridge to complex care teams *Improving Medicaton Adherence & Reducing Re-admissions; NEHI Brief; Literature Review; October 2012
- 13. Medication Reconciliation “On Demand” ™ at the Point of Care Home Care Admission Acute Care Discharge Ambulatory Care Targeting High Risk Patients
- 14. 888-838-9053 info@actualmeds.com www.actualmeds.com @actualmeds MEDICATION MANAGEMENT AND RECONCILIATION for High Risk Patients (C) 2014 ActualMeds Corp Come see us mainstage at 8:55am Monday, or 4pm Monday in the Exhibition Hall Apps Demo Booth
Editor's Notes
- ActualMeds- a cloud-based enterprise solution for medication management and reconciliation for high risk patients- meaning older adults and individuals with chronic conditions
- They see multiple providers, fill dozens of prescriptions, and their complex medication regimens are directly related to the high costs of PREVENTABLE hospitalizations and re-admissions There are a many solutions aimed at helping patients stick to their medication regimens- but this is the tip of the iceberg for these complex patients. They would do little to prevent Grandma from arriving in the ER in hypoglycemic shock because no one realized she was taking 3 different insulin Prescriptions together. Nor would they help the senior healthcare executive who had to have his daughter, a physician, help him sort out his regular meds from those he received at discharge from the hospital after his heart surgery. Most of our frail and elderly patient population would not have that luxury and depend on encounters with their healthcare providers to guide their medication therapy. The root of the problem is that healthcare teams do not have the PATIENT’S MEDICATION INFORMATION when THEY have the best opportunity for patient engagement and can have the greatest impact on an outcome-
- Those were true stories and we hear a new one every day. They happen because Payers use their own retrospective claims data reflecting the patient’s prescription refill history. Providers rely only on partial lists of medications in their EHR to make treatment choices. And no one is aligning this with how and what the patient is really taking. ActualMeds aggregates,validates and aligns medication information from Payer, Provider and Patient to produce the most current and accurate medication history serving it up available at the right time and place. Risks are identified and made actionable by the care team. None of us would be at a HIMSS meeting if we did not believe that integration of this kind of information will be critical to transforming healthcare to improvie outcomes and reduce costs.
- ActualMeds controls a huge amount of squeaky clean, structured medication data and there are multiple uses for it around the care continuum- that’s a challenge for a small start-up – so we are focused FIRST on who is paying for this information now. Medicare requires Medicare Advantage plans to do medication management (MTM) for their highest risk members as well as to achieve performance levels tied to incentives measured through STARs ratings. Plans segment member populations by risk to manage these processes. ActualMeds data can help them do all of these more cost-effectively. Those lead us to the next product opportunities with Providers to automate medication reconciliation and support team based care; and to make tools and information available in formats appropriate for informal caregivers and the patients themselves.
- Please see us in the start-up showcase where we can demo : “the best damn med rec display” in the land Our structured interview tool that can be used by all levels of the care team and in a variety of settings to capture patient self-medciation info as structured data The heart of our IP- our evidence-based risk rules And how risk is made actionable by the care team
- Please see us in the start-up showcase where we can demo : “the best damn med rec display” in the land Our structured interview tool that can be used by all levels of the care team and in a variety of settings to capture patient self-medciation info as structured data The heart of our IP- our evidence-based risk rules And how risk is made actionable by the care team
- But now we know what we are dealing with – so we can begin to tackle those risks head on – and possibly prevent a major problem.
- Please see us in the start-up showcase where we can demo : “the best damn med rec display” in the land Our structured interview tool that can be used by all levels of the care team and in a variety of settings to capture patient self-medciation info as structured data The heart of our IP- our evidence-based risk rules And how risk is made actionable by the care team
- Surescripts Integrations typically available within 2 weeks after authorizations completed HER: user driven upload SHINY ActualMeds will be one of the earliest commercial vendors to certify on this API : Allscripts Deep integration including single-sign-on
- ActualMeds- a cloud-based enterprise solution for medication management and reconciliation for high risk patients- meaning older adults and individuals with chronic conditions