Posts in Category: healthcare reform

Spotlight on Analytics, Part 5 

Q & A with Gus Gilbertson, Product Manager for LUMEDX

Predictive Analytics

Q: How much of the healthcare industry has adopted predictive analytics?

A: By definition, negotiations between providers and payers are a game of who can better predict patient outcomes. Win-win scenarios can certainly be devised, but a lack of predictive ability puts an organization at risk for poor contract structuring.

Clinical outcomes are increasingly a game of predicting outcomes and identifying the levers that affect those outcomes so providers are able to improve on future outcomes. Operational predictions are also important, as misunderstanding patient care needs can lead to expensive outlier care patterns or care variations that break capacity management efforts and budgets.

Q: How do you see predictive analytics having an impact on healthcare organizations, and specifically on heart hospitals?

A: Outcome prediction and risk profiling will increasingly guide care pathway selection and tailor care patterns to targeted patient profiles. Predicting and applying the care pathway that leads to the best health outcome at the lowest cost is the foundation of healthcare in the value-based purchasing era.

The dynamics of heart health are increasingly being researched and documented, leading to continued technical evolution and improved outcomes. Being able to predict which technology will lead to the best patient outcomes per dollar spent--whether it be a TVR, and VAD, or an aspirin—is a crucial skill for providers.

Q: What is the role of predictive analytics in affecting areas like heart failure readmissions?

A: Estimates continue to suggest that as much as 20 percent or more of care is wasted. Access to predictive models for identifying patients at risk for readmissions--and providing better targeted treatment up front--are the keys to reducing readmission. Those who best understand their care pathways and patient risk profiles will be the ones who can provide the best value in heart failure care. They will be the ones who can best explain the risk factors inherent in their readmission outcomes to stakeholders from patients to community groups and regulators.

Stay tuned for Part 6 of this series!

 

Spotlight on Analytics, Part 4 

Q & A with Gus Gilbertson, Product Manager for LUMEDX

Exploring CV Service Line Analytics

Q: Where should heart hospitals begin if they want to start using data analytics?

A: Digitization is the key. Start by identifying areas where paper continues to hide data rather than illuminate care process dynamics. For all digital information, build standards for producing and consuming data so that the data collected has meaning, and those who need the information have access and know what to do with the information available.

Q: What unique challenges do heart hospitals face that can be addressed by healthcare analytics?

A: Understanding biometrics, imaging data, labs, medications, process, and outcomes measures make for a richly complex set of data to leverage to drive value in cardiovascular care.

Q: How can data analytics improve clinical care in a cardiology department?

A: With good data governance, a cardiology department can efficiently care for a variety of patients. With well-controlled processes to ensure proper procedures and medication therapies applied, patient health risks and quality of life are managed effectively.

Q: Who are the end users of an analytics product at a heart hospital? Who else should see that data and analysis?

A: The care teams are the key consumers of analytics products at a heart hospital. Clinical and administrative leaders need to know:

  • Whether health care processes are working
  • How well they are doing at achieving positive health outcomes for patients
  • What the risk profiles of their patient profiles look like compared to those of competitors and across payers

Quality, regulatory, operations, and financial stakeholders also need to understand the dynamics of the clinical, operational, and financial performance of the heart program –and where there are opportunities for improvement or celebration of achievement.

Stay tuned for Part 5 of Spotlight on Analytics, where we'll discuss Predictive Analytics. Parts 3, 2, and 1 are below.

 

Posted by Tuesday, July 12, 2016 11:08:00 AM Categories: analytics healthcare analytics healthcare reform healthcare today industry news Lumedx performance

Spotlight on Analytics, Part 3 

Q&A with Gus Gilbertson, LUMEDX Products Manager

Financial Impacts on Healthcare

Q: What are some of the key financial challenges facing healthcare providers today?

A: One of the big challenges is the rapid technology change from health tracking, diagnosis, and risk modelling. That, combined with growing care quality and population management solutions, will change the way we look at health.

Q: What are the financial benefits of using data analytics for healthcare providers?

A: The key financial benefits for providers are the ability to manage patient risk and tailor care plans more efficiently to improve patient health. Healthier patients will likely get better jobs and be able to afford more healthcare. (Who isn’t willing to spend on their family’s health?)

Remember, value equals cost / quality, so lower cost increases value and higher quality increases value. The U.S. healthcare industry is spending a lot of time looking at value in recent years. Patients, too, are slowly shifting to an awareness that they need to measure the cost of care against the quality of care.

Better targeting of care pathways and therapies will reduce variations in care and make the whole industry more efficient. By reducing costs and improving quality, providers and payers who embrace the new technologies will attract patients and payers looking for value.

Q: How does healthcare analytics tie into the trend toward evidence-based care?

A: Evidence from labs, meds, genomics and related biometrics will lead to more personalized medical care.

Q: How can hospital management use healthcare analytics to make financial improvements?

A: The keys to financial improvements in healthcare come from making efficient use of resources--from supplies to provider time, and from reducing variations in care due to identifiable variations in health status. The keys to success are understanding labor dynamics, making sure that the major care pathways are well defined and efficient, and managing outlier cases effectively.

Stay tuned for Part 4 of Spotlight on Analytics, where we'll discuss CV service line analytics. 

 

Posted by Monday, June 27, 2016 2:17:00 PM Categories: analytics healthcare reform healthcare today HIT hospitals

The Best of Health IT News: Week of 4/18/16 

We've found the stories you won't want to miss!


ACA, population health will be game changers in next three years, say hospital execs

C-suite leaders predict that their most important areas of focus in the next three years will be high-value post-acute care networks and innovative approaches to care delivery, according to Premier Inc.'s spring Economic Outlook. The impact that the Affordable Care Act and population health management will have on care delivery is the reason these areas of focus will be so important, executives say. "About 95 percent said expanding high-value post-acute care networks is crucial to population health efforts," FierceHealthcare reports. "In addition, 94 percent said such networks are one of their greatest challenges."

ACC notifies 1,400 institutions of potential data breach

More than 1,000 institutions have been notified by the American College of Cardiology (ACC) that patient data from the National Cardiovascular Data Registry (NCDR) might have been breached. "After discovering the issue in December, the ACC found that four software development vendors who were testing software had access to NCDR patient data," reports Cardiovascular Business. "The data was copied between 2009 and 2010, and was included in one of more than 250 tables that software developers used in a test environment."

EHR fraud recommendations remain unimplemented, HHS Inspector General says

Warnings from the its Office of Inspector General have yet to prompt the Department of Health and Human Services to adequately address the issue of hospitals failing to employ safeguards and prevent electronic health record fraud and abuse via recommended tools already in place, according to the Inspector General. "The Inspector General's Office says that nearly all hospitals with EHRs had RTI-recommended audit functions in place, but that those functions were not being used to their full extent," FierceHealthcare reports.

The Most Innovative Trends and Technologies from ACC.16

DAIC Editor Dave Fornell takes a tour of some of the trends and interesting new technologies from the vendor booths on the expo floor at the 2016 meeting of the American College of Cardiology (ACC). 

 

 

The Best of Cardio and Health IT News: Week of 3/28/16 

A sampling of this week's healthcare stories that you won't want to miss.

Female cardiologists remain underrepresented, report more work-life challenges than men

Two decades have brought little change for women in cardiology, according to a new study. Women account for only 20 percent of cardiologists who see adult patients, and are more likely than their male counterparts to face professional discrimination. 

Study eases concerns about antidepressants and cardiovascular risk

Patients who take antidepressants are not increasing their risk of arrhythmia, MI, stroke or transient ischemic attack, according to new study. Prior research had suggested a link between depression and negative cardiovascular outcomes.

ACC honors 18 people for their contributions to cardiology

Eighteen people have been selected for a Distinguished Award from the American College of Cardiology (ACC). The recipients will receive their awards on April 4 during the ACC’s annual scientific session in Chicago. 

Integrated approach slashes ER use for heart failure

One health system is using coordinated teams to cut emergency room visits and improve medication management for heart failure patients. A new blog post details how Geisinger Health System built on its record of care integration and coordination to address emergency and inpatient care for heart failure patients.

Can healthcare learn safety lessons from aviation model?

To reduce medical errors, providers should look to the skies, one physician writes. Following a 1977 airline disaster, the industry developed a "culture of safety" that could be worth emulating, writes David Nash, M.D., founding dean of Jefferson College of Population Health, Thomas Jefferson University.

The Best of Cardio and Health IT News: Week of 3/7/16 

Readmissions, Obamacare, and more

CMS targets hospital readmissions after CABG 

A proposed rule from the Centers for Medicare & Medicaid Services (CMS) would penalize hospitals that perform an index coronary artery bypass graft (CABG) and then have an unexpected 30-day readmission, even if the patient was discharged from a different hospital. "The proposed CABG 30-day readmission measure includes Medicare beneficiaries who are 65 years old or older who at the time of the index admission had been enrolled in a Medicare fee-for-service program for at least 12 months," Cardiovascular Business reports. "CMS intends to add CABG to its readmissions reduction program in 2017."

Most support keeping, building on Obamacare

The Affordable Care Act (Obamacare) continues to have public support, with 36 percent of those surveyed saying it should be expanded, according to the latest Kaiser Health Tracking Poll. That's the position advocated by presidential candidate and former Secretary of State Hillary Clinton. Nearly a quarter of respondents would like to see a single government plan, as advocated by Vermont Sen. Bernie Sanders, while 16 percent would repeal the ACA and not replace it. Repealing the act and replacing it with a Republican alternative was favored by 13% of respondents.

Analysis: U.S. health spending wouldn't be substantially decreased by price transparency

"Menu-izing the costs of care doesn’t turn the average American into a skilled healthcare shopper, but don’t blame the consumer," says Health Exec. "While some 43 percent of U.S. healthcare spending does indeed go into 'shoppable,' non-emergent care—everything from flu shots and blood tests to colonoscopies and electively timed surgeries—only around 7 percent of out-of-pocket spending goes to such services. The result, according to a new analysis from the Health Care Cost Institute, is that the healthcare system as a whole wrings little cost benefit out of the push for price transparency."

Cardiovascular risk increases with heavy alcohol consumption

Drinking alcohol is associated with higher cardiovascular risk immediately after consumption, according to systematic review and meta-analysis. "After 24 hours, there was a lower risk for moderate drinkers," Cardiovascular Business reports. "But the risk increased in heavy drinkers for the following day and week."

Major markets could see mega-regional healthcare systems

Consolidation is a trend expected to continue in the healthcare industry, according to Fierce Healthcare. The trend, with increased leverage and revenues, has led to the creation of super-regional system in several large markets. "In Chicago, consolidation reached a crescendo in 2014 when fully integrated health system Northwestern Memorial HealthCare and Winfield, Illinois' Cadence Health finalized a merger, with Northwestern expanding to include four hospitals under the deal," reported Becker's Hospital Review. Since then, Northwestern has expanded its reach, finalizing a deal with KishHealth in Dekalb, Illinois. The system now boasts six hospitals and more than 4,000 workers.

This Week in Cardio and Health IT News 

EHR developments, top hospitals list, and more

Here are some of this week's top stories in cardiology and health IT.

Big names in healthcare pledge to facilitate interoperability, EHR accessibility

The Obama administration has announced an agreement to increase interoperability by top U.S. health information technology developers and many of their larger customers. Signing on to the pledge--which requires signees to ease patient access to electronic health records--were Allscripts, Athenahealth, and Cerner Corp., among others. About 90 percent of U.S. hospitals use at least one of the vendors who signed on. 

Top 100 Hospital List released by Truven

Truven Health Analytics has released its list of the 100 top hospitals in the United States. In researching the hospitals, Truven discovered a trend toward reduced expense per patient among the majority of top-performing hospitals. This year's trend appeared for the first time in the awards' 23-year history. 

More patients survive when hospitals adhere to cardiac arrest protocol

Hospitals that closely followed recommended care protocols after in-hospital cardiac arrest (IHCA) had the highest survival rates. That's the conclusion of a new study published in JAMA Cardiology, which found that more than 24,000 lives could be saved annually if all hospitals operated at the level of the highest-scoring provider. 

Payer-provider collaborations called key to improved patient outcomes 

Payers and hospitals must overcome their differences to reduce readmissions, according to a special report by FierceHealthcare.com. "As providers increasingly move toward value-based care models, they must work with their counterparts in the payer sector to coordinate care and prevent readmissions," the report says. "But the transition is proving bumpy in some cases due in part to the historic mistrust between payers and providers."

Questioning whether readmission rates are a reliable care quality measure

Hospital readmission rates are not an outcome, but a measure of utilization, says one Harvard School of Public Health professor. He pointed to new federal research demonstrating that hospitals don't use observation status as a way to create the appearance of decreased readmissions, which had been a concern prior to the research. Readmission rates can decline for a number of reasons, including difficulty in being readmitted or better hospital-to-patient communication, he says.

The Best of Cardio and Health IT News: Week of 2/15/16 

Don't miss out on this week's top stories


CMS and health insurers announce alignment and simplification of quality measures

The Centers for Medicare & Medicaid Services (CMS) and America's Health Insurance Plans (the health plans' trade group)  announced that they have agreed on seven sets of clinical quality measuresThe standardized measures are designed to help payers and consumers shopping for high-quality care. "These measures support multi-payer alignment, for the first time, on core measures primarily for physician quality programs," according to the CMS. This work is informing the CMS’s implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Supreme Court: What will happen to healthcare cases after Justice Scalia's death?

A number of healthcare-related cases are in limbo following the death of conservative U.S. Supreme Court Justice Antonin Scalia, who died on Feb. 12. "The court is weighing a case about data sharing with potential implications for insurers and state healthcare reform efforts," Modern Healthcare reports. "Another case has the potential to reduce—or increase—the number of False Claims Act suits brought against healthcare providers and other companies." Also before the court is a case involving the contraception mandate in the Affordable Care Act. 

CMS anticipates giving out $7.7 billion in ACA reinsurance payouts

Healthcare insurance companies could receive as much as $7.7 billion as part of the Affordable Care Act's reinsurance program. Reflecting data from the 2015 benefit year, the payouts are to be issued this year. "The Affordable Care Act created the temporary, three-year reinsurance program to protect insurers during the early years of the new individual marketplaces," according to Modern Healthcare"Insurers pay into the reinsurance pool, and those funds are then paid out to health plans that had members with extremely high medical claims." 

Still stalled: Federal healthcare rule that ties Medicare, Medicaid payments to disaster-preparedness plans

A proposed federal rule that would require healthcare facilities and hospitals to create emergency-preparedness plans in order to receive Medicare and Medicaid funding is stalled in the Office of Management and Budget, undergoing a legally required review. It would affect more than 68,000 providers, according to a New York Times news analysis."Industry groups have been critical of the time and expense they said would be involved in steps such as test backup power generators more frequently and for longer periods, or to pay staff overtime during drills," according to FierceHealthcare.com.

Harvard researchers say PCI readmission metric could be model

A model for improving the quality and value of cardiology care may be found in a pilot program from the Centers for Medicare and Medicaid Services and the National Cardiovascular Data Registry (NCDR), according to Harvard researchers. The program evaluated and reported risk-adjusted 30-day readmission rates after PCI. "The researchers noted that preventing readmissions could improve the quality of care and reduce costs for cardiology patients," according to CardiovascularBusiness.com.

 

The Best of HealthIT News: Week of 2/8/16  

Population health, Obamacare, and cost containment

Did you have a chance to check out the latest news from the healthIT community? Let us help keep you up to date on the stories you won't want to miss.

Companies Form New Alliance to Target Healthcare Costs

Hoping to hold down the cost of healthcare benefits, 20 large companies—including American Express, Macy’s  and Verizon—have come together to use their collective data and market power. Members of the new alliance will share data about employee healthcare spending and outcomes, possibly using the data to change how they contract for care. "Some members say they could even form a purchasing cooperative to negotiate for lower prices, or try to change their relationships with insurance administrators and drug-benefit managers," Yahoo news reports.

Federal Insurance Marketplace Signs Up Millions of New Obamacare Users

The Obama administration reports that approximately 12.7 million new patients signed up for health insurance under the Affordable Care Act, or automatically renewed their policies during Obamacare's third annual open enrollment season. Sylvia Mathews Burwell, the secretary of the Department of Health and Human Services, told the New York Times that the signups show that “marketplace coverage is a product people want and need.” Most of the plan selections were for people in the 38 states—more than 9.6 million—who used the federal website, HealthCare.gov, the Times reported. The other 3.1 million people were enrolled in states that run their own marketplaces.

Healthcare Economics: Court Allows Some Hospitals to Save Money by Classifying Themselves as Both Rural and Urban

While an earlier Health and Human Services (HHS) rule had barred both urban and rural classifications at once, a new federal appeals court ruling removed the barrier for dual hospital classification. The recent court decision applies only to hospitals within the 2nd U.S. Circuit Court of Appeals, but some hope that—combined with an earlier similar decision in a different circuit—the 2nd Circuit Court's ruling will inspire HHS to change the regulation across the country. "The Center for Medicare & Medicaid Services allows hospitals to classify themselves as rural (which providers typically leverage for discounts on drug purchases) while also classifying themselves as urban, (an important factor to attract qualified clinicians)," according to Reuters. 

Population Health: Hospital-based Wellness Centers Are Changing the Healthcare Model

Wellness centers housed in hospitals are helping communities prioritize preventive care and management of chronic conditions. The centers are part of the population health management model that focuses on preventing illnesses rather than simply treating them when and if they occur. The idea is to get patients to seek treatment before their conditions worsen, thus easing the burden on emergency rooms and acute care centers—and saving money.

Cost Control: Surgical Safety Checklists Can Save Lives and Reduce Hospital Stays

Surgical safety checklists—if implemented correctly—can save time, lives, and money. After the checklists were implemented, one study found, the average length of a hospital stay dropped from 10.4 days to 9.6 days. In addition, the checklists led to a 27 percent drop in the risk of death following surgery. Proper and consistent implementation is critical, however, for the checklists to work.

The Best of Cardio and Healthcare News for the Week of 2/1/16 

Trending topics in HealthIT

Leave the researching to us! LUMEDX surveys the top healthcare and health IT stories of the week.

Healthcare economics: Basing healthcare decisions on Medicare data might not be best practice

A recent study found that the correlation between total spending per Medicare beneficiary and total spending per privately insured beneficiary was 0.14 in 2011, while the correlation for inpatient spending was 0.267. “What that suggests is that policy for Medicare doesn’t necessarily make better policy for the privately insured,” one researcher told Health Exec.

Reducing readmissions among minorities: 7 population health strategies

A new guide from Medicare gives hospitals methods for addressing ethnic and racial healthcare disparities in readmissions. The guide comes amid increasing concerns about racial and ethnic disparities in healthcare outcomes, and frustration about federal penalties that some say unfairly punish providers in high-risk communities. 

Sharing of medical-claim data would be allowed under proposed #CMS rule

"Some medical data miners may soon be allowed to share and sell Medicare and private-sector medical-claims data, as well as analyses of that data, under proposed regulations the CMS issued," Modern Healthcare reports. "Quality improvement organizations and other 'qualified entities' would be granted permission to perform data analytics work and share it with, or sell it, to others, under an 86-page proposed rule that carries out a provision of the Medicare Access and CHIP Reauthorization Act of 2015" (#MACRA). 

Federal gender pay equity rule: What will it mean for healthcare industry?

Nearly 80 percent of hospital employees are women. How might they be affected by President Obama's recent announcement that the Equal Employment Opportunity Commission will begin requiring companies that employ 100 or more people to report wage information that includes gender, race, and ethnicity?

The price of healthcare miscommunication: $1.7B and nearly 2,000 lives

New research shows that healthcare miscommunication has cost nearly 2,000 lives, and was a contributing  factor in 7,149 cases (30 percent) of 23,000 medical malpractice claims filed between 2009 and 2013. Communication failures were also to blame for 37 percent of all high-severity injury cases.

Physical fitness can decrease mortality risk following first heart attack

Being physically fit may not only help to reduce the risk of heart attacks, but may also decrease the risk of mortality following a first heart attack, according to a new study. The study used multivariable logistic regression models to assess how exercise affected the risk of mortality at 28, 90, and 365 days after a heart attack.

 

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