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The Connected Healthcare Ecosystemfirstillinoishfma.org/wp-content/uploads/1_MCHC_The... ·...
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The Connected Healthcare Ecosystem 11/4/13
Transcript of The Connected Healthcare Ecosystemfirstillinoishfma.org/wp-content/uploads/1_MCHC_The... ·...
The Connected Healthcare Ecosystem
11/4/13
Learning Objectives
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Learning Objectives After this session, the learner should be able to: • Explain what the Connected HealthCare Ecosystem is. • Explain how the Connected HealthCare Ecosystem can
function. • Identify key Benefits from having a Connected
HealthCare Ecosystem in their region. • Explain Who Can Facilitate a Connected Healthcare
Ecosystem. • Identify who should participate in a Connected
HealthCare Ecosystem
What is a Connected Healthcare Ecosystem?
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A Group of HealthCare Delivery Organizations who are: • Connected by a common, standards-based
communications network to share data regardless of Entity/Organizational Boundaries
• Utilizing common Policies & Procedures to ensure Secure & Compliant Data Exchange across Entity/Organizational Boundaries
• Utilizing a shared IT Infrastructure to reduce cost of Data Exchange and HealthCare delivery regardless of Entity/Organizational Boundaries
Connected HealthCare Ecosystem
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Connected HealthCare Ecosystem
Health Information Exchange Platform
Long Term Care
PHYSICIAN
HOSPITALS
LAB
GROUP PRACTICE
Imaging Center
OTHER HIE’s
Rx
Consumer
How Does a Connected Healthcare Ecosystem Work?
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• Imagine a world where….
The Future
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• For purposes of description we are going to follow a Patient persona through our Connected HealthCare Ecosystem. – Patient is a 72 year old male with no immediate family
in-state. – Patient is a member of an ACO – Patient has been identified as an “At Risk” patient and
is the recipient of that ACO’s enhanced Managed Care Plan, under an assigned Case manager.
Future Care Delivery
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• ACO Case Manager reviews a list of high risk patients managed under Care Plans and discovers: – A cardiac patient who missed a scheduled
appointment with their PCP, and is approaching a date for a regularly scheduled diagnostic screening.
Future Care Delivery, Cont.
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• The Case Manager intervenes with Patient: – Contacts Patient about scheduling an appointment
with their PCP – Uses secure messaging provided by Regional HIE to
contact the Primary Care Physician – Succeeds in getting an appointment scheduled
Future Care Delivery, Cont.
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• PCP office requests summary of care record from regional HIE in advance of Visit
• Summary of Care record Enables: – Review of past medical history – Review of allergies, problem lists, and any recent
screenings or acute care events – PCP is better prepared for Visit
Future Care Delivery, Cont.
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• PCP sees patient and does blood draw that is sent to an outside lab service.
• PCP refers patient to a larger facility for an EKG – PCP sends Transition of Care to Provider receiving
EKG referral – PCP episode of care closes and records are sent to
regional HIE to be added to Patient’s linear record
Future Care Delivery, Cont.
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• Outside lab delivers performs required blood work, and: – Results sent to PCP – Results also sent to regional HIE to be added to
patient’s linear record
Future Care Delivery, Cont.
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• Facility to perform EKG requests Summary of Care from regional HIE;
• Summary of Care record Enables: – Review of past medical history – Review of allergies, problem lists, and any other
recent screenings or acute care events
Future Care Delivery, Cont.
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• Summary of Care record Enables: – Provider reviews a result report from a past EKG at
another facility. – Provider is able to request DICOM files of prior exam
via HIE Image Exchange for Cardiologist to review as Patient’s Prior Exam.
Future Care Delivery, Cont.
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• Larger facility performs EKG and: – Find significant blockage in coronary artery – Diagnostic report sent to Regional HIE linear record – Cardiologist sends report directly to PCP via HIE
Secure Message – PCP request DICOM files of EKG via HIE Image
Exchange
Future Care Delivery, Cont.
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• PCP and Cardiologist agree bypass surgery is urgent: – Patient is referred to Cardiac Surgery Provider – Cardiologist sends referral and Transition of Care
record to Cardiac Surgery Provider
Future Care Delivery, Cont.
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• Prior to Admission at Cardiac Surgery Provider: – Facility retrieves summary of care from Regional HIE
in order to: Review allergies, past medical history, EKG report, and retrieves EKG images via HIE Image Exchange
– Cardiac facility identifies patient allergy in Summary of Care, allowing proper medication plan
Future Care Delivery, Cont.
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• Patient admitted to surgical hospital – Admission notification sent to PCP and ACO case
manager – Correct medication is administered based upon
allergy information in Transition of Care – Surgery is successful, bypass in place
Future Care Delivery, Cont.
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• Patient transition begins: – Due to lack of caregiver in home,
Case Manager recommends Patient be discharged to Rehabilitation Facility
– Cardiac Surgery records sent to HIE
– Cardiac Surgery Provider sends Transition of Care to Rehabilitation Facility via HIE secure message
Future Care Delivery, Cont.
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• Prior to Admission at Rehabilitation Provider: – Facility retrieves summary of care from Regional HIE
in order to: Review allergies, past medical history, records of Cardiac Surgery.
• Patient admitted to Rehabilitation Provider – Admission notification sent to PCP and ACO case
manager – After two weeks, Patient is discharged to home – Rehabilitation Facility records sent to Regional HIE – Discharge notification sent to PCP and ACO case
manager
Future Care Delivery, Cont.
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• ACO Case Manager reviews Patient History and recommends Home Health visits for 12 weeks due to lack of caregiver in Patient’s home.
• Home Health Provider – Requests Summary of Care record from Regional HIE
to review past history of Patient – Home Health visits assure patient recovery is
monitored
Future Care Delivery, Cont.
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• No Re-Admission, or ED Visit During Recovery • Patient Returns to Normal Activity
Future Care Delivery, Cont.
Who Benefits from a Connected Healthcare Ecosystem?
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• The Connected HealthCare Delivery Ecosystem saved the Patient’s Life through communication.
• The Patient also benefitted through: – Reduced severity of Acute Care event (ie. No Heart-
Attack, ED Visit, or related mental & physical trauma) – Delivery of coordinated care that did not rely on the
patient to be the method of communication between providers for most medical information
– Streamlined recovery to normal life through identification of care to fill gaps in Patient’s ability to care for self in absence of immediate family
The Patient
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• The Connected HealthCare Delivery Ecosystem benefitted in multiple ways: – Increased communication between caregivers – Intervention before a trauma/acute care event
occurred – Reduced the level of care required by avoiding an ED
admission – Reduced time to treatment at each care event due to
exchange of Transition of Care records – Reduced opportunity for error through access to
allergy information, allowing change of medication that prevented allergic reaction
HealthCare Ecosystem
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• The Connected HealthCare Delivery Ecosystem also benefits via: – Reduced opportunity for Acute Care Re-Admissions
through enhanced communication and identification of care gaps
– Reduced administrative cost through efficient communication of Healthcare Information as Patient transitioned from Provider to Provider, regardless of Entity/Organizational Boundaries
– Continued to add to Patient’s Linear Record in Community Records Repository for use in any future delivery of HealthCare
HealthCare Ecosystem, cont.
Who Can Facilitate?
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• A common, standards-based communications network to share data regardless of Entity/Organizational Boundaries
• Common Policies & Procedures to ensure Secure & Compliant Data Exchange across Entity/Organizational Boundaries
• A shared IT/Communications infrastructure to reduce cost of Data Exchange and HealthCare delivery regardless of Entity/Organizational Boundaries
What Elements Are Needed?
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• A Linear Patient record built with community data regardless of Entity/Organizational Boundaries
• Ability to aggregate cross community data for Population Health and Managed Care
• Ability to facilitate efficient communications between Case Managers, Primary Care Providers, Specialty Services, and Acute Care Providers.
What Elements Are Needed?
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• How can this be accomplished when the traditional Heathcare delivery system features: – A highly competitive marketplace – Desire to only share data with other
Entities/Organizations on an ‘as-needed’ basis – Legacy systems not originally designed for
interoperability – Continued usage of inefficient communications tools
such as fax, and mail for exchange of records between entities.
How To Achieve?
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• Stakeholder Goodwill is required
• Trust in the Value, Safety, and Governance of the HIE.
• Maintenance of these elements by regular communication, demonstrating value, and community involvement.
Social Capital & Community Trust
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A Neutral Third-Party Is Needed
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• Regional Exchanges, organized by the HealthCare delivery organizations in that region are the most effective, and efficient means to facilitate a Connected HealthCare Ecosystem.
Regional Exchanges Fill The Role
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• Regional Exchanges, organized by the HealthCare delivery organizations in that region directly address the needs of the community that developed the Regional Exchange.
Regional Exchanges, cont.
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• Regional Exchanges, organized by the HealthCare delivery organizations in that region allow for the development of an organization that functions as the Regional Subject Matter Expert for Coordinated Care Communications.
Regional Exchanges, cont.
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• Outside of an Organization’s own systems, Regional Exchanges, organized by the HealthCare delivery organizations in that region provide the most return on investment for HIE Dollars Spent on enhanced Coordinated Care Communications.
Regional Exchanges, cont.
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• Identify the Regional Exchange in your area and Participate in order to enhance its value and further help your Organization & Community deliver Better Patient Care and reduce overall HealthCare Delivery Costs.
Regional Exchanges, cont.
Who Should Participate in a Connected Healthcare Ecosystem?
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Participants • Physician Offices, Large Medical Practices,
Medical Homes (FQHC, Etc) • IDN, Specialty Hospitals (Cancer, Cardiac),
Hospitalists (Surgeons, ED Docs, Etc.), Hospital Physician Offices
• National or Local Labs, Diagnostic Imaging Centers, Other Specialty Clinics
• Rehabilitation, LTAC, Hospice, Home Health, Skilled Nursing
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Participants, cont. • Hospital Pharmacy, Retail Pharmacy (embedded
clinics also) • Any HealthCare Delivery Organization with
Managed Care requirements, such as: ACO, CCE, ACE, MCCN, FQHC
When to Participate?
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The Future is Now! • Managed Care delivery requires a connected
Healthcare Ecosystem to function • Meaningful Use Initiatives require Connectivity
today, and will only increase as it progresses to Stage 2, 3, and beyond
• Providers who participate early derive multiple benefits: – Better Care for their Patients – Reduced Cost via streamlined Care Coordination – Competitive advantage over slower adopters of fresh
approaches to Care Delivery
Adjourn
MCHC Contacts
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Contact the MetroChicago HIE Project Team MCHC Contacts:
– Dan Yunker, Sr. Vice President [email protected] or 312-906-6003 – Charles Cox, Director of HIE [email protected] or 312-906-6034 – Julio Silva, MD, MetroChicago HIE Medical Director [email protected] – Susan O’Keefe, Manager, Operations & Physician Services [email protected] or 312-906-6028 – Victor Boike, Technical Project Manager [email protected] or 312-906-6022 – Jodi Sassana, Program Manager HIE [email protected] or 312-906-6029
