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OutcomeAdvantage*	
  	
  
Pa#ent	
  Engagement	
  &	
  Management



Submitted by: Donald Santoski, CEO
*Trade name of Health eTechnologies, LLC.
Solution Overview
Engaging and Managing Patients More Efficiently and Effectively




 SelfCareKits™                    Connections improve        Timely information          Automation allows
 change behavior                  patient experience         enables more timely         personalized, need-
                                                             intervention                based contacts.
 Proprietary content is based     Our IVR/Web interface
 on medical anthropology          allows Patients to be      Real-time patient status    Whether responding
 and consumer insight:            aware and involved, not    in the Allscripts EHR.      or being proactive,
 Proven to engage the             passive “data sources.”    User interface displays     you have choices:
 patient more than any other      System captures vital      priorities by parameters    Prepared email, text
 approach.                        signs and records what     users set. Patients in      referral, voice mail,
 •  Consumer-tested               patients want to tell:     trouble are in red at the   live call or personalized
    medical devices               Behavior, emotion,         top! Click down to the      message. Contact one
 •  Proprietary tools invented    readiness, and symptoms.   details to know what’s      person or broadcast to
    for the specific challenges                              going on.                   them all.
    of self care
 Available now for the
  critical measures: AMI, HF
  pneumonia, and 20 other
  conditions
Solution Overview
Ø  In	
  addi(on	
  to	
  ge-ng	
  the	
  pa(ent	
  started	
  with	
  SelfCareKits,	
  we	
  
    create	
  condi(on-­‐specific	
  IVR	
  scripts	
  for	
  con(nuing	
  pa(ent	
  
    involvement.	
  	
  Triage	
  rules	
  and	
  campaigns	
  are	
  configured	
  by	
  the	
  
    customer	
  with	
  support	
  from	
  OutcomeAdvantage	
  (OA).	
  
Ø  Pa(ent	
  calls	
  and/or	
  web	
  surveys	
  are	
  sent	
  to	
  pa(ents	
  at	
  home	
  
    and	
  responses	
  are	
  visible	
  to	
  the	
  case	
  managers	
  in	
  real-­‐(me	
  
Ø  Case	
  managers	
  follow	
  up	
  with	
  those	
  pa(ents	
  who	
  are	
  in	
  the	
  
    red	
  zone	
  or	
  whose	
  answers	
  triggered	
  alerts	
  by	
  OA’s	
  system	
  
Ø  Case	
  managers	
  and	
                              Tracking systems, endorsed by the Juran
                                                            Quality Institute, allow both patient and
    administrators	
  can	
  create	
                    provider to see cause and effect at a glance:
                                                      Discovery learning for long-term behavior change!

    reports	
  to	
  show	
  progress	
  across	
  
    disease	
  states.
Solution Overview
Addressing crucial problems:	
  
Ø  Pa(ents	
  are	
  not	
  always	
  proficient	
  in	
  maintaining	
  their	
  care	
  
    regimens	
  once	
  they	
  return	
  home	
  
     •  OA	
  promotes	
  pa,ent	
  engagement	
  in	
  their	
  own	
  care	
  to	
  aid	
  chronic	
  disease	
  and	
  
        post-­‐discharge	
  management	
  
Ø  Given	
  extreme	
  workloads,	
  case	
  managers	
  have	
  difficulty	
  
    maintaining	
  communica(on	
  and	
  tracking	
  of	
  their	
  pa(ents’	
  
    progress	
  once	
  they	
  leave	
  the	
  care	
  environment	
  
     •  OA	
  improves	
  staff	
  efficiency	
  as	
  post-­‐discharge	
  monitoring,	
  triaging	
  responses,	
  
        and	
  sending	
  alerts	
  frees	
  case	
  managers	
  to	
  focus	
  on	
  their	
  most	
  pressing	
  cases.	
  
Ø  Providers	
  are	
  struggling	
  with	
  how	
  to	
  minimize	
  readmissions	
  to	
  
    avoid	
  penal(es	
  and	
  expensive	
  hospital	
  care	
  	
  
     •  OA	
  reduces	
  preventable	
  readmissions	
  by	
  contac(ng	
  pa(ents	
  post-­‐discharge	
  
        provides	
  a	
  cost-­‐efficient	
  and	
  effec(ve	
  way	
  to	
  avoid	
  CMS	
  penal(es.	
  
Solution Overview
Ø The	
  applica(on	
  developed	
  addresses	
  the	
  following	
  
   category:	
  
   q Applications that improve management of high cost chronic disease
   q Innovative approaches to addressing value-based care imperatives
   þBoth
Usability and Design
Ø  With	
  the	
  OutcomeAdvantage	
  approach,	
  a	
  newly	
  discharged	
  
    pa(ent	
  with	
  a	
  specific	
  condi(on	
  will	
  receive	
  a	
  SelfCareKit	
  and	
  be	
  
    informed	
  that	
  they	
  will	
  receive	
  either	
  automated	
  calls	
  or	
  web	
  
    surveys.	
  	
  	
  
    •  For	
  example,	
  a	
  heart	
  failure	
  pa(ent	
  would	
  normally	
  be	
  instructed	
  to	
  
       closely	
  monitor	
  their	
  weight	
  each	
  morning	
  and	
  to	
  avoid	
  salty	
  food,	
  
       explaining	
  the	
  dangers	
  associated	
  with	
  excess	
  water	
  reten(on.	
  	
  
    •  The	
  discharge	
  nurse	
  will	
  tell	
  the	
  pa(ent	
  that	
  calls	
  (or	
  web	
  surveys)	
  will	
  be	
  
       sent	
  to	
  the	
  pa(ent	
  asking	
  them	
  to	
  respond	
  to	
  ques(ons,	
  including	
  ‘what	
  
       is	
  your	
  morning	
  weight?’,	
  	
  ‘did	
  you	
  take	
  your	
  medica(on?’,	
  ‘have	
  you	
  
       no(ced	
  any	
  swelling	
  in	
  your	
  hands	
  or	
  feet?’,	
  ‘how	
  are	
  you	
  feeling	
  today?’,	
  
       ‘would	
  you	
  like	
  to	
  talk	
  with	
  your	
  case	
  manager?’,	
  etc.	
  
Ø  Pa(ent	
  responses	
  will	
  be	
  viewable,	
  with	
  alerts	
  available	
  in	
  real-­‐
    (me.	
  	
  
Development Stage
Submission Date: 2/3/2013
 q Idea
 q Prototype
 þCode development in progress with Allscripts
 q Code complete
 q Code complete, tested and approved by Allscripts


Ø  OA has developed a robust solution that is currently in the
    marketplace. We have started integration with Allscripts’
    EHR and intend to leverage the EHR’s capabilities to
    deliver new solutions.
Integration Description
Ø  Integration points with Allscripts’ solutions
1.    Web surveys with notifications            3. Results charting
2.    Appointment planning                      4. Broadcasting of TTS/ self-
                                                   recorded prompts
Ø  APIs/Web Services calls used
1.  GetChangedPatients
2.  GetPatient
3.  SavePatient

Ø  Several others may be implemented including:
             GetPatientDiagnosis    GetPatientCDA   SaveProblemsData
             GetPatientFull         GetVitals       SaveResult
             GetPatientPharmacies   SaveAllergy     SaveRX
             GetPatientProblems     SaveDiagnosis   SaveSimpleRX
             GetProcedures          SaveERNote      SaveVitals
             GetProviders           SaveHistory     SaveVitalsData
             GetSchedule            SaveProblem
Go to Market Plans
Ø  OA will target hospitals, ACOs, home health care
    organizations and health plans. We will bring our solution
    to market in a number of ways:
      •  Manufacturers’ reps           •  Partnership arrangements
      •  Resellers                     •  Trade show activity

Ø  Pricing will depend on the market segment. Current pricing
    is listed below:
   Discharge situations:               ACO and chronic situations:
   •  $1000 installation fee            •  $1000 installation fee
   •  $500 application training fee     •  $500 application training fee
   •  $40 PMPM*                         •  $200 PMPY*
      *Does not include SelfCareKits
Video Demonstration

Ø http://vimeo.com/58789582

Ø  The demo illustrates OA’s patient engagement and
    management, including information capture and real-time
    triage
Why This Solution Should be Selected
Ø  OA	
  engages	
  pa(ents,	
  producing	
  greater	
  understanding	
  and	
  more	
  
    involvement	
  in	
  their	
  own	
  care	
  	
  
       •      Pa(ents	
  oZen	
  do	
  not	
  know	
  what	
  to	
  do	
  on	
  a	
  daily	
  basis	
  
       •      Given	
  their	
  workloads,	
  case	
  managers	
  are	
  not	
  able	
  to	
  communicate	
  	
  
              con(nuously	
  with	
  their	
  pa(ents	
  
       •      Lowers	
  overall	
  cost	
  of	
  case	
  management	
  and	
  augments	
  case	
  manager	
  
              interac(on	
  with	
  pa(ents.	
  
	
  

Ø  OA’s	
  program	
  enables	
  more	
  efficient	
  use	
  of	
  resources	
  and	
  
    extends	
  the	
  reach	
  of	
  the	
  Allscripts	
  EHR	
  
       •      Reduces	
  unnecessary	
  ED	
  visits	
  and	
  bounce	
  backs.	
  
       •      Increases	
  ancillary	
  revenues	
  through	
  use	
  of	
  alterna(ve	
  care	
  facili(es.
       •      Allows	
  staff	
  to	
  focus	
  on	
  those	
  who	
  are	
  most	
  in	
  need.	
  

Ø  OA’s	
  solu(on	
  has	
  resulted	
  in	
  35%	
  to	
  85%	
  reduc(on	
  in	
  HF	
  
    readmission	
  rates	
  
       	
  
OutcomeAdvantage*	
  	
  
 Pa#ent	
  Engagement	
  &	
  Management



Submitted by: Donald Santoski, CEO
*Trade name of Health eTechnologies, LLC.

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OutcomeAdvantage- Allscripts Open App Challenge

  • 1. OutcomeAdvantage*     Pa#ent  Engagement  &  Management Submitted by: Donald Santoski, CEO *Trade name of Health eTechnologies, LLC.
  • 2. Solution Overview Engaging and Managing Patients More Efficiently and Effectively SelfCareKits™ Connections improve Timely information Automation allows change behavior patient experience enables more timely personalized, need- intervention based contacts. Proprietary content is based Our IVR/Web interface on medical anthropology allows Patients to be Real-time patient status Whether responding and consumer insight: aware and involved, not in the Allscripts EHR. or being proactive, Proven to engage the passive “data sources.” User interface displays you have choices: patient more than any other System captures vital priorities by parameters Prepared email, text approach. signs and records what users set. Patients in referral, voice mail, •  Consumer-tested patients want to tell: trouble are in red at the live call or personalized medical devices Behavior, emotion, top! Click down to the message. Contact one •  Proprietary tools invented readiness, and symptoms. details to know what’s person or broadcast to for the specific challenges going on. them all. of self care Available now for the critical measures: AMI, HF pneumonia, and 20 other conditions
  • 3. Solution Overview Ø  In  addi(on  to  ge-ng  the  pa(ent  started  with  SelfCareKits,  we   create  condi(on-­‐specific  IVR  scripts  for  con(nuing  pa(ent   involvement.    Triage  rules  and  campaigns  are  configured  by  the   customer  with  support  from  OutcomeAdvantage  (OA).   Ø  Pa(ent  calls  and/or  web  surveys  are  sent  to  pa(ents  at  home   and  responses  are  visible  to  the  case  managers  in  real-­‐(me   Ø  Case  managers  follow  up  with  those  pa(ents  who  are  in  the   red  zone  or  whose  answers  triggered  alerts  by  OA’s  system   Ø  Case  managers  and   Tracking systems, endorsed by the Juran Quality Institute, allow both patient and administrators  can  create   provider to see cause and effect at a glance: Discovery learning for long-term behavior change! reports  to  show  progress  across   disease  states.
  • 4. Solution Overview Addressing crucial problems:   Ø  Pa(ents  are  not  always  proficient  in  maintaining  their  care   regimens  once  they  return  home   •  OA  promotes  pa,ent  engagement  in  their  own  care  to  aid  chronic  disease  and   post-­‐discharge  management   Ø  Given  extreme  workloads,  case  managers  have  difficulty   maintaining  communica(on  and  tracking  of  their  pa(ents’   progress  once  they  leave  the  care  environment   •  OA  improves  staff  efficiency  as  post-­‐discharge  monitoring,  triaging  responses,   and  sending  alerts  frees  case  managers  to  focus  on  their  most  pressing  cases.   Ø  Providers  are  struggling  with  how  to  minimize  readmissions  to   avoid  penal(es  and  expensive  hospital  care     •  OA  reduces  preventable  readmissions  by  contac(ng  pa(ents  post-­‐discharge   provides  a  cost-­‐efficient  and  effec(ve  way  to  avoid  CMS  penal(es.  
  • 5. Solution Overview Ø The  applica(on  developed  addresses  the  following   category:   q Applications that improve management of high cost chronic disease q Innovative approaches to addressing value-based care imperatives þBoth
  • 6. Usability and Design Ø  With  the  OutcomeAdvantage  approach,  a  newly  discharged   pa(ent  with  a  specific  condi(on  will  receive  a  SelfCareKit  and  be   informed  that  they  will  receive  either  automated  calls  or  web   surveys.       •  For  example,  a  heart  failure  pa(ent  would  normally  be  instructed  to   closely  monitor  their  weight  each  morning  and  to  avoid  salty  food,   explaining  the  dangers  associated  with  excess  water  reten(on.     •  The  discharge  nurse  will  tell  the  pa(ent  that  calls  (or  web  surveys)  will  be   sent  to  the  pa(ent  asking  them  to  respond  to  ques(ons,  including  ‘what   is  your  morning  weight?’,    ‘did  you  take  your  medica(on?’,  ‘have  you   no(ced  any  swelling  in  your  hands  or  feet?’,  ‘how  are  you  feeling  today?’,   ‘would  you  like  to  talk  with  your  case  manager?’,  etc.   Ø  Pa(ent  responses  will  be  viewable,  with  alerts  available  in  real-­‐ (me.    
  • 7. Development Stage Submission Date: 2/3/2013 q Idea q Prototype þCode development in progress with Allscripts q Code complete q Code complete, tested and approved by Allscripts Ø  OA has developed a robust solution that is currently in the marketplace. We have started integration with Allscripts’ EHR and intend to leverage the EHR’s capabilities to deliver new solutions.
  • 8. Integration Description Ø  Integration points with Allscripts’ solutions 1.  Web surveys with notifications 3. Results charting 2.  Appointment planning 4. Broadcasting of TTS/ self- recorded prompts Ø  APIs/Web Services calls used 1.  GetChangedPatients 2.  GetPatient 3.  SavePatient Ø  Several others may be implemented including: GetPatientDiagnosis GetPatientCDA SaveProblemsData GetPatientFull GetVitals SaveResult GetPatientPharmacies SaveAllergy SaveRX GetPatientProblems SaveDiagnosis SaveSimpleRX GetProcedures SaveERNote SaveVitals GetProviders SaveHistory SaveVitalsData GetSchedule SaveProblem
  • 9. Go to Market Plans Ø  OA will target hospitals, ACOs, home health care organizations and health plans. We will bring our solution to market in a number of ways: •  Manufacturers’ reps •  Partnership arrangements •  Resellers •  Trade show activity Ø  Pricing will depend on the market segment. Current pricing is listed below: Discharge situations: ACO and chronic situations: •  $1000 installation fee •  $1000 installation fee •  $500 application training fee •  $500 application training fee •  $40 PMPM* •  $200 PMPY* *Does not include SelfCareKits
  • 10. Video Demonstration Ø http://vimeo.com/58789582 Ø  The demo illustrates OA’s patient engagement and management, including information capture and real-time triage
  • 11. Why This Solution Should be Selected Ø  OA  engages  pa(ents,  producing  greater  understanding  and  more   involvement  in  their  own  care     •  Pa(ents  oZen  do  not  know  what  to  do  on  a  daily  basis   •  Given  their  workloads,  case  managers  are  not  able  to  communicate     con(nuously  with  their  pa(ents   •  Lowers  overall  cost  of  case  management  and  augments  case  manager   interac(on  with  pa(ents.     Ø  OA’s  program  enables  more  efficient  use  of  resources  and   extends  the  reach  of  the  Allscripts  EHR   •  Reduces  unnecessary  ED  visits  and  bounce  backs.   •  Increases  ancillary  revenues  through  use  of  alterna(ve  care  facili(es. •  Allows  staff  to  focus  on  those  who  are  most  in  need.   Ø  OA’s  solu(on  has  resulted  in  35%  to  85%  reduc(on  in  HF   readmission  rates    
  • 12. OutcomeAdvantage*     Pa#ent  Engagement  &  Management Submitted by: Donald Santoski, CEO *Trade name of Health eTechnologies, LLC.