Posts in Category: cardiology

Are You Ready for the New Cardiac Bundled-Payment Program? 

Heart hospital across the country are preparing for the new mandatory bundled-payment program for cardiac care. Set to begin this July, the program makes hospitals in certain markets accountable for the quality and cost of care for bypass and heart attack patients until 90 days after discharge.

CMS predicts that the program-which also covers knee and hip replacements-will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent, according to Modern Healthcare.

The bundled-payment model allows hospitals to keep the savings they achieve if they spend less than a target price for an episode of care. However, hospitals that exceed the target price must repay Medicare. Target prices will be determined retrospectively.

LUMEDX offers a path to meeting or beating those targets. Our Cardiovascular Performance Program helps facilities gather the consolidated CV data they need to see and manage quality and cost of care in real time. The program helps CV service lines analyze their data, identify higher-risk patients and act to ensure they are performing at or better than national targets so they can keep any savings they have realized-and avoid repaying Medicare. 

Inpatient costs are likely to account for most of the cost of the 90-day bundled-payment period, and LUMEDX is uniquely positioned to help providers reduce those expenses. Our Cardiovascular Performance Program can help CV service lines contain costs while improving outcomes by reducing:

  • Door-to-balloon time
  • Door-to-Troponin-testing time
  • PCI and CABG complications
  • PCI and CABG cost-per-case variation

These are just a few of the many ways LUMEDX solutions can help heart hospitals demonstrate best-quality, best-value care delivery-and uncover the solutions to radical improvement. 

How will the bundled-payment program impact your CV service line? Share your thoughts in our comment section, below. 

3 New Clients Join LUMEDX Family 

Hospitals in Alabama, Massachusetts and Texas begin CVIS implementation

LUMEDX is happy to welcome to our family three new clients: Marshall Medical Centers; Holyoke Medical Center; and Baylor Scott & White Health, the largest not-for-profit healthcare organization in Texas.

The first Baylor Scott & White location to implement the LUMEDX solution is Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas. LUMEDX is providing the hospital with comprehensive cardiovascular data management that:

  • Connects isolated data sources,
  • Integrates with the enterprise electronic health record (EHR), and
  • Eliminates redundant data collection.

Holyoke Medical Center has gone live with our PACS with Echo Workflow software. After all phases of the CVIS deployment are completed, the secure, cloud-delivered software-as-a-service (SaaS) solution will provide the medical center-located in Holyoke, Massachusetts-with comprehensive management of its Echo, Nuclear, ECG, Holter and Stress workflows, and will offer remote access for physicians, allowing them to access data and complete reports from any location.

The deployment for Marshall Medical Centers is taking place at two hospitals: Marshall Medical North in Guntersville, Alabama; and Marshall Medical South in Boaz, Alabama. Both hospitals have implemented Echo Workflow and ECG-Holter software, which will help them improve performance and quality of care while containing costs and minimizing inefficiency.

We look forward to long and productive relationships with our new partners!

 

AUC and the CVIS 

Leveraging Appropriate Use Criteria for Better Outcomes—and Collateral Benefits

Appropriate Use Criteria (AUC) is intended to help physicians achieve the best outcomes using the most appropriate treatment plan for any situation. Ensuring that physicians comply with established AUC guidelines is crucial to the overall success of a facility. Demonstrated AUC excellence can impact: 

  • Patient outcomes and satisfaction
  • Hospital reputation
  • Reimbursement in the value-based care era

While the goal of all physicians is to provide best-quality, appropriate care for their patients, in the real world this can be challenging to accomplish—and to document—because of the lack of point-of-care access to complete, longitudinal patient information. Providing physicians with access to relevant patient data, and ensuring they have a clear understanding of AUC guidelines, can lead to improved outcomes—and cost savings as well. 


Rachanee Curry, LUMEDX Service Line & Analytics Consultant, explains how LUMEDX solutions help physicians access the patient data they need to comply with Appropriate Use Criteria.

Leveraging Appropriate Use for Cost Savings & More

With the shift to value-based care, service line leaders must seek out every cost-control opportunity. The good news is that there are collateral benefits to AUC compliance: In addition to improved clinical outcomes, collecting and serving up data so physicians can provide appropriate care helps heart and vascular centers improve their financial performance by:

  • Providing the right information, at the right time, to support appropriate clinical decision-making and best-quality care. When you deliver best-quality care, you are avoiding redundant or excessive treatment that can drive up costs; 
  • Delivering clinical workflows wherein quality data can be captured at or as close to the point of care as possible, optimizing efficiency and minimizing redundant manual work. This saves labor costs because clinicians spend more time on direct patient care rather than administrative tasks; 
  • Providing integrated clinical and operational data in near-real time so service line leaders can monitor their programs' performance and take action to improve.

In addition, when you demonstrate that your facility is consistently AUC-compliant, you are better positioned to work with payers on providing best-value care for that patient population. 

LUMEDX HealthView CVIS: Serving Up the Right Data at the Right Time 

HealthView CVIS helps heart hospitals navigate AUC and value-based care standards. The system collects point-of-care data and delivers actionable insights, facilitating better clinical decision-making and helping to improve business operations through increased efficiency and cost savings. 
HealthView CVIS can play a critical role in any hospital's move toward better patient care, greater efficiency, and improved fiscal performance. 


Heart Attack Patients Get Faster Care When Medical Teams Use Smartphone Social Network System 

18-month study tracked 114 STEMI patients

New research shows that patients in need of a hospital transfer were treated 27 minutes faster when their medical teams used a smartphone app-based social network system (SNS) to set up the transfer, compared to medical teams who didn’t use the smartphone technology.

The research, published in the Journal of the American College of Cardiology, monitored the time that patients with ST-elevated myocardial infarction (STEMI) suffered from ischemia (reduction in blood supply) while they waited to have a procedure opening their blocked arteries. On nights and weekends, the treatment time reduction was even greater than during the regular work week.

One of the study’s senior researchers, Jin Joo Park, M.D., pointed out that there is a higher risk of death for patients who get to a hospital during off hours—a worldwide trend.

“Transferred STEMI patients rarely achieve timely reperfusion due to delays in the transfer process, especially when transferred during off-hours,” Park told Dicardiology.com. “The use of a smartphone SNS (Social Network System) can help to achieve timely reperfusion for transferred STEMI patients with rapid, seamless communication among healthcare providers.”

Over a period of 18 months, the study enrolled 114 STEMI patients who were transferred to Seoul National University Bundang Hospital. The transfers for 50 of the patients were completed using the SNS app, while the remaining patient transfers used a non-smartphone-based STEMI hotline. The transit times for both groups of patients were similar.

Click here to read the research letter.

 

Enhancing the EHR 

Why Department-Level Systems Remain Critical to Quality 

The need for Electronic Health Records (EHRs) has become widely accepted, and methods to accelerate hospital adoption are proving to be successful, albeit resource-and cost-intensive. While EHRs are highly useful tools for collecting certain kinds of information and making that information available widely across services, cardiovascular care is complex; the data generated by this care is equally complex; and therefore cardiovascular service lines require systems that can match this complexity.


 

Chris Winquist, LUMEDX President and COO, explains how the CVIS augments the EHR to provide CV services with the deep data needed for clinical and business excellence.

Publicly Reported Measures & the Need for Deep Data

Even with the rapid pace of innovations in treatments and technologies, cardiovascular disease is the leading cause of death in the United States.(1) Unsurprisingly, today a large percentage of publicly reported quality measures are CV measures. Further, new value-based payment models are making up-to-date tracking and managing of performance ever more critical. Demonstrating quality of care delivered has never been more central to cardiac and vascular departments. 

How can a hospital best report, monitor internally and improve quality performance in key measures like Mortality, Complications, and Appropriate Use? With discrete, queryable data. This data must be:

  • Acquired at the point of care so workflow is efficient and data is of high quality 
  • Made accessible to providers across the care continuum so they can make fully informed treatment decisions
  • Reported to the registries
Getting Actionable Information

It's not enough to report to the registries once a quarter and then hope for the best. A high-performing facility must monitor and drill-down into its own data to investigate any problems and take action-as quickly as possible. For this, service lines need systems that can capture information as queryable data elements. And these systems need to integrate with all the devices and clinical systems at work in the service line (ECGs, Stress, Holters, cardiac ultrasounds, hemodynamic systems--to name just a few). 

A dedicated departmental system-one that integrates with clinical-modality systems and the EHR, and offers automated registry data collection and submission to the full suite of cardiac and vascular registries-is the only way for complex environments like cardiac and vascular services to get the data they need to measure and improve performance (clinical, operational) in a substantive way.   

LUMEDX HealthView CVIS Enhances the EHR and Supports Operational Efficiency

With more than 30,000 discrete, queryable data points, HealthView CVIS offers the depth cardiac and vascular departments need for optimal clinical and business excellence. We've developed a powerful data engine that brings insight to every aspect of CV suite operations by drilling into details and reporting on both trending and outlier situations. 

The HealthView CVIS also accepts and transmits relevant data from and to the EHR, so that the enterprise and the service line can operate at the highest levels of efficiency, facilitating best-quality care, improved performance and cost savings.

(1) Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28-e292.

CVIS for management and analysis of cardiovascular data insights 

The CVIS: What It Is Today and Where It’s Headed

It's no secret that healthcare in the United States is moving away from the fee-for-service model toward a value-based system that reimburses for positive health outcomes. The value of improved clinical outcomes is obvious—for patients, for providers, and for payers. As the healthcare industry shifts to value-based care, measuring and monitoring outcomes becomes increasingly important. Hospitals and payers must seek new and deeper ways to track performance.

In the cardiovascular specialties, the American College of Cardiology’s National Cardiovascular Data Registry (NCDR®) and the Society of Thoracic Surgeons’ (STS) national databases have set the standards for care for decades. The data sets required by the registries, and systems that have developed around managing that data, were the foundation of the original cardiovascular information management systems.

Over time, Cardiovascular Information Systems (CVIS) grew to capture significantly more data, resulting in more automated workflows and much more complete pictures of patient care. Today’s CVIS includes hemodynamic monitoring, ECG management, Echo management, structured reporting, and Picture Archiving and Communications (PACS) systems data. The CVIS of today can—and should—provide a 360°-view of the quality of a cardiovascular service line’s clinical care.

Chris Winquist, LUMEDX President and COO, discusses the CVIS.

Registry Data – Only the Basics

Through participation in the cardiovascular registries, CV service lines can understand their level of care compared with national counterparts. The national registries produce quarterly reports on comparative clinical outcomes, and offer insights for various stakeholders, from payers to individual physicians.

However, data insights only have value when they can affect change, and to do that, they must be timely. Because ACC and STS registry outcomes reports are made available only on a quarterly basis, change can be slow. Change in the kinds of processes and practices that affect outcomes can take up to a year or more after data is collected, submitted, and then reported. By the time a facility receives its outcomes report, the data originally submitted—and thus the registry report itself—is stale.

It's also important to note that registry data is only a basic set of the total data that could be analyzed and used to affect change. With today's ability to collect a much larger set of discrete data points in an efficient manner, deeper insights are possible, and decisions about clinical and operational strategy can be made at the local level.

Today's CVIS Leverages Data to Improve Your CV Business

Historically, the healthcare industry has generated large amounts of data, driven by compliance and regulatory requirements, and the need to deliver and demonstrate evidence-based patient care. But much of that data varies in format and location, and the ability to derive meaningful insights from it has been slow.

The opportunity for data to provide valuable insights in cardiovascular care is now available. We call it LUMEDX data intelligence, and leveraging this intelligence transforms the CVIS into something that goes beyond an information repository, data warehouse, or workflow efficiency tool.

The HealthView CVIS not only collects and warehouses data, but also provides drill-down ability to gain deep insights into every aspect of cardiac care and treatment: from risk factors to specific treatment success rates, discharge medications, readmission rates, and many more.

In fact, over the last 25 years, we've captured more than 30,000 discrete data points that are available to help you track metrics against objectives, identify outliers and trends, and work to improve patient care, population health, and business outcomes—all in one place.

The kind of deep insights that the CVIS of the (near) future will deliver will have a positive impact on the hospital as both a business and a patient-care facility. HealthView brings 21st century data intelligence to bear and eliminates the problems associated with minimal, and stale, data. Heart hospitals can now have a robust and active dataset, where new data enters the system every day. This makes the path to improved care faster, and better care means shared cost savings and dramatically improved patient outcomes.   

Posted by Monday, June 06, 2016 11:58:00 AM Categories: analytics cardiology data Lumedx

The Best of Cardio and Health IT News: 4/14/16 

News stories you won't want to miss!

Higher patient ratings equal fewer readmissions, lower mortality

The scores patients assign their hospitals appear to correspond with the quality of the hospitals' patient outcomes, according to a study published in JAMA Internal Medicine. Researchers analyzed the scores patients assigned to the Centers for Medicare & Medicaid Services' star-rating system for more than 3,000 hospitals. Hospitals' star ratings were inversely proportional to their rates of death within a month of discharge. 

Hospitals reap $1.6M from specialists, including cardiologists

While the average primary care physician is generating less income for hospitals ($1.4 million in 2016 versus $1.56 million in 2013), that’s offset by specialist doctors, whose contribution to hospital revenues jumped 14% to $1.6 million, compared with $1.42 million three years ago. Among specialists, orthopedic physicians bring in the most business ($2.75 million each), followed by invasive cardiologists ($2.45 million) and neurosurgeons ($2.44 million.

5 ways make employees happy in a healthcare workplace

Healthcare organizations named to Fortune's 20 Best Workplaces in Health Care share a sense of camaraderie and pride in their work, and offer lessons to other hospitals and systems that strive to create a positive work environment that can attract and retain the best talent. The winning organizations overcame the natural hierarchy of a healthcare organization to create a friendly, emotionally supportive workplace where coworkers feel as though everyone is equal and they can count on coworkers to support them.

Heart, vascular department at Aurora St. Luke’s receives top accreditations

Building on its rich history as the premier heart hospital in Wisconsin and a global destination for heart care, Aurora St. Luke’s Medical Center has received two prestigious accolades from the Accreditation for Cardiovascular Excellence (ACE). Both acknowledgments from ACE reinforce Aurora St. Luke’s positioning as a global leader in cardiovascular excellence.

Momentum building for national unique patient IDs

As digitization of the healthcare system increases, issues around data exchange and medical records exchange make patient identification more challenging than ever. In the absence of a unique patient identifier system, doctors use a patient’s name and birth dates to identify them, and there can be hundreds or thousands of identical or similar names and dates in EMR systems. Get it wrong, and a diagnosis or treatment may be missed — sometimes with dire consequences.

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.

New dashboard facilitates near-real-time performance monitoring 

Check out LUMEDX's HealthView STS Adult Dashboard

By collecting outcomes data for submission to the STS Adult Cardiac Surgery Database, cardiac surgery providers are committing to improving the quality of care that their patients receive. High-achieving providers use the data they collect for this national registry to drive performance improvements on an ongoing basis. 

And what a lot of data there is to collect! From risk factors to discharge medications to readmission rates and more, providers are charged with keeping track of it all. They need tools that are up to the task.

LUMEDX's HealthView STS Adult Dashboard enables cardiac surgery suites to set performance objectives and track metrics against objectives, identify outliers and trends, and work to improve patient care and business outcomes—all in one place. The dashboard allows for efficient, automated monitoring of performance in near-real time, so providers can see, understand, and act on their data. 

Want to learn more? LUMEDX's Complete STS Adult Dashboard InfoPak includes information and ideas for efficient and highly effective management of cardiac surgery data. Click here to download a complimentary Complete STS Adult Dashboard InfoPak.

 

Posted by Wednesday, March 09, 2016 10:26:00 AM Categories: cardiology data health information technology industry news

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.

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