INNOVATIONREPORT

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Introduction ................................................................................................................. 3Recognition of Best In Show Winners .......................................................................... 4Recognition of Winners ................................................................................................ 5Recognition of Finalists ................................................................................................ 7Recognition of Judges ................................................................................................. 8Industry Articles: Eric Topol: Before We Embrace New Tools, We Must Prove They Work ...................... 12The Growing Role of Mobile Technology in Radiology ................................................. 14How Lancaster General Health Reduced Annual Pharmacy Costs by $1.5 million ............................................................................................................. 16Partners Solving Problems **Sponsored Content** ..................................................... 17Case Study: Children’s Healthcare of Atlanta and Coffee Regional Medical Center ............................................................................................................ 18Health Information Exchange: Start With the Right Structure to Find Success ............................................................................................................... 20Texas Children’s Hospital’s Blueprint for a Data-Driven Culture of Excellence **Sponsored Content** .............................................................................. 21Work Smarter, Not Harder **Sponsored Content** ...................................................... 23Intermountain executive: Focus on Patient-Centeredness, Not Revenue Enhancement ............................................................................................................... 24Enabling improved health outcomes for the millennial era: Virtusa’s solution for medication adherence **Sponsored Content** ......................................... 25

Directory Listings ......................................................................................................... 28

INNOVATION IS TRANSFORMING HEALTHCARE DELIVERYConventional wisdom is that the healthcare industry is slow to embrace change. But is that characterization out-of-date? There isn’t a hospital, health system or physician practice today that hasn’t been touched—or even transformed—by technology, from remote monitoring and telehealth to electronic health records and health information exchanges, from patient portals to mobile health apps.

This Fierce Innovation Report, a supplement to the Fierce Innovation Awards program, recognizes some of the game-changing healthcare technologies that are catapulting the industry into exciting new realms. You’ll find an exclusive interview with mHealth visionary Eric Topol, a professor of genomics at The Scripps Research Institute in San Diego, who talks about helping physicians embrace change by incorporating mHealth and other digital tools into their workflows. We also explore the growing array of mobile and remote technologies that are putting radiology images in doctors’ hands at the point of care, engaging residents in their training and enabling tele-consults with specialists in areas where access is a challenge.

Although technology plays a huge role in healthcare innovation, hospitals and health systems also are making strides in other areas. For example, Lancaster (Pa.) General Health system used standardization principles to cut pharmacy costs by $1.5 million. And at Utah’s Intermountain Healthcare, executives focused on patient engagement to reduce costs and improve care quality.

And of course, this report also highlights the winners and finalists of our first annual Fierce Innovation Awards for the healthcare industry. Twenty-nine finalists were recognized within 10 distinct categories, including clinical information management, data analytics and population health management. Our judges included CIOs and other technology leaders from the most prestigious healthcare organizations in the country, including the Mayo Clinic, Boston Children’s Hospital and Memorial Sloan-Kettering Cancer Center.

We were truly blown away by the volume and the quality of the applicants – more than 100 entries were submitted. Once again, the visionaries of our industry have shown that innovation is alive and well in the healthcare industry.

Wendy Johnson Publisher, FierceHealthcare, FierceHealthIT & FierceMobileHealthcare

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BEST COST-SAVER

QPID, Inc

BEST PROBLEM-SOLVER

Health Catalyst

MOST ENGAGING

NexJ Systems, Inc

BEST NEW PRODUCT/SERVICE

CoverMyMeds

BEST IN SHOW WINNERS

CLINICAL INFORMATION MANAGEMENT

QPID, Inc

HEALTH INFORMATION EXCHANGE

CoverMyMeds

DATA ANALYTICS

Health Catalyst

CLOUD COMPUTING

SA Ignite

INTEROPERABILITY

AstraZeneca MEA

EHRs

Humetrix

®

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WINNERS (CONTINUED)

mHEALTH AND TELEMEDICINE

Vital Connect

PRIVACY/SECURITY

nCrypted Cloud

POPULATION HEALTH MANAGEMENT

NexJ Systems, Inc

REVENUE CYCLE MANAGEMENT

Patientco

FINALISTS

CLINICAL INFORMATION MANAGEMENT

Global Device Management LLC RightCare Solutions, Inc

CLOUD COMPUTING

Acrometis LLC Decision Simulation LLC

DATA ANALYTICS

Medalogix ResMed

EHRs

Modernizing Medicine SwiftKey

HEALTH INFORMATION EXCHANGE

AstraZeneca MEA Texas Tech University Health Sciences Center

INTEROPERABILITY

Perminova

mHEALTH AND TELEMEDICINE

Perminova Virtusa Corporation

POPULATION HEALTH MANAGEMENT

Phytel Skylight Healthcare Systems

PRIVACY SECURITY

AirWatch M2SYS Technology

REVENUE CYCLE MANAGEMENT

PointCare Prodigo Revenue Cycle Services

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INDRANIL GANGULY Vice President and Chief Information OfficerCentraState Medical CenterIndranil is the vice president and CIO of Freehold, N.J.-based CentraState Medical Center, a 282-bed hospital. He received a Master of Business Administration from New York Institute Technology and a Bachelor of Arts from Queens College, City University of New York. He is a member of several industry professional associations, including CHIME, where he is a member of the policy steering committee vice-chair of the CIO StateNet initiative.

JESSICA GROSSET Vice Chair for IT operations and infrastructure Mayo Clinic, Rochester, Minn.In September, FierceHealthIT named Jessica one of the most Influential Women in Health IT. Under Grosset’s watch, Mayo has saved $40 million by automating basic EMR functions and implementing a CPOE system. Mayo earned HIMSS Stage 7 EMRAM status in 2011.

DR. JOHN HALAMKA Chief Information Officer Beth Israel Deaconess Medical Center, BostonJohn is also a Professor of Medicine at Harvard Medical School, Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), co-Chair of the national HIT Standards Committee, co-Chair of the Massachusetts HIT Advisory Committee and a practicing Emergency Physician. As Chief Information Officer of Beth Israel Deaconess Medical Center, he is responsible for all clinical, financial, administrative and academic information technology serving 3,000 doctors, 14,000 employees and two million patients. As Chairman of NEHEN he oversees clinical and administrative data exchange in Eastern Massachusetts. As co-Chair of the HIT Standards Committee he facilitates the process of electronic standards harmonization among stakeholders nationwide. As co-Chair of the Massachusetts HIT Advisory Committee, he engages the stakeholders of the Commonwealth to guide the development of a statewide health information exchange. John also serves on the FierceHealthIT Editorial Advisory Board.

JUDGESJUDGES

SUSAN HEICHERT Chief Information Officer and Senior Vice PresidentAllina Health, MinneapolisSusan was part of the team that implemented the Electronic Health record. She received her Bachelors Degree in Nursing from the University of Maryland and a Masters from the University of Minnesota. Susan has been working in Healthcare Informatics for over 25 years in various capacities.

THERESA MEADOWS Senior Vice President and Chief Information OfficerCook Children’s Health Care SystemTheresa is the CIO of Cook Children’s Health Care System, an integrated system in Fort Worth, Texas, that includes two hospitals, an ambulatory surgery center, specialty clinics and a health plan. She has a master’s degree in healthcare informatics from the University of Alabama at Birmingham and a bachelor’s degree in nursing from the University of Alabama at Birmingham. She is a HIMSS fellow and a member of CHIME.

ROGER NEAL Chief Information Officer and Vice President of Information Technology Duncan Regional HospitalRoger is the vice president of IT and CIO for the 145-bed Duncan (Okla.) Regional Hospital. He has lead projects including the installation of a hospital-wide PACS, electronic nursing documentation systems, integrated physician office systems and patient safety systems. He received a Master of Science degree in telecommunications management from Oklahoma State University.

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DANIEL NIGRIN SVP of Information Services & CIO, Division of Endocrinology & Informatics ProgramBoston Children’s HospitalDaniel also serves as assistant professor of pediatrics at Harvard Medical School; is a senior staff member of the Children’s Hospital Informatics Program (CHIP) and is a practicing member of Boston Children’s Division of Pediatric Endocrinology. Earlier this year, he was recognized by Healthcare IT News as one of the health IT industry’s most influential game-changers. In 2010, HIMSS Analytics awarded Boston Children’s Hospital a Stage 7 designation on its EMR Adoption Score. And in 2005, Computerworld named him a ”Premier 100 IT Leader.” As CIO of one of the world’s preeminent institutions for pediatric clinical care and research, he is responsible for all clinical, research, teaching and administrative IT systems serving 10,000 staff at Boston Children’s. As a practicing physician, medical informatics researcher and information technology executive, he is in a unique position to put into practice cutting edge technologies and ideas developed by CHIP and other biomedical informatics centers of excellence.

TODD RICHARDSON Chief Information Officer Aspirus, Inc.Todd is the CIO at Aspirus, Inc., a non-profit, community-directed health system based in Wausau, Wis., that includes four hospitals and four ambulatory surgery centers. Prior to joining Aspirus, Todd was the CIO at Deaconess Health System, a six-hospital system in Evansville, Ind. He also has served as the vice president of information systems for both Christus St. Vincent’s Hospital in Santa Fe, N.M., and Wheaton Franciscan Healthcare in Waterloo, Iowa.

ED RICKS Vice President of Information Services & Chief Information Officer Beaufort (S.C.) Memorial HospitalEd has spent more than twenty five years working in health IT. Last year, he was identified as an “EHR Game Changer” by the healthcare industry media for his CPOE implementation and for his deployment of a virtualized desktop environment that allows staff to easily access patient information at multiple workstations. In 2013 Beaufort Memorial was named one of the nation’s “Most Wired” hospitals for the eleventh consecutive year. In 2011, Ed was named a “Premier 100 IT Leader” by Computerworld. He was formerly a VP & CIO at Samaritan Medical Center in Watertown, N.Y.

JUDGES JUDGES

SUE SCHADE Chief Information OfficerUniversity of Michigan Hospitals and Health Centers, Ann ArborThis year, the University of Michigan Hospitals and Health Centers year was again identified by U.S. News & World Report as offering the best hospital care in the state. Sue, who was appointed CIO in August 2012, was formerly the CIO of Brigham and Women’s Hospital in Boston, where she received several recognitions, including the 2008 CIO 100 Award. Under Sue’s leadership, Brigham and Women’s achieved HIMSS Stage 6 status. Schade has been recognized by Computerworld magazine as a “Premier 100 IT Leader” and has been named a HIMSS chapter “CIO of the Year.” She also serves on the FierceHealthIT Editorial Advisory Board.

PAT SKARULIS Vice President of Information Systems and Chief Information OfficerMemorial Sloan-Kettering Cancer CenterPat oversees all computing and communications for the clinical, educational and research enterprise. Prior to joining Sloan Kettering, she served in a similar capacity as Vice President and CIO at Rush University Medical Center in Chicago where she was also an Assistant Professor in the Department of Health Systems Management. Prior positions include: Vice President for Information Systems and Vice Chancellor at Duke University where she was also Professor of the Practice of Computer Science; Director, Administrative Systems at Princeton University; Assistant Director, Academic Computing at Rutgers University, and Associate Member of Technical Staff at Bell Laboratories. She received her M.A. and B.A. in Mathematics from St. John’s University in New York, and attended the Institute for Educational Management, an executive program for higher education at Harvard.

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FierceHealthIT: What do you think it’s going to take to ensure that doctors who use newer digital tools are the norm in everyday healthcare, rather than the exception to the rule?Topol: All these years since 1816, we’ve had a stethophone; now we have a true stethoscope--a high-resolution, mini-ultrasound device. I carry it in my pocket, and I haven’t listened to a heart in over three years. A couple of med schools are giving these stethoscope ultrasound devices out to their medical students on their first day, which is a sign of the times.

Getting the next generation of physicians loaded with these tools is key, but we can’t wait that long. It would take decades before we had enough physicians who were up to speed. We’ve got to convert the unwilling currently practicing physicians in this country now. That’s why I wrote my book. I’m appealing to the public to help drive this.

I don’t want to wait 20 years before we have enough physicians to repopulate with the state-of-the- art tools.

FHIT: How soon do you think genome testing for patients will become routine?Topol: We’re a little ways from routine. I think you can make a really strong case for using whole

genome sequencing for initial cancer diagnoses. You can also make a case for using genome sequencing in people with a serious illness who don’t have a diagnosis yet--people who go from one medical center to another on “diagnostic odysseys.”

There have only been tens of thousands of people in the world who have had whole genome sequencing. We need millions with various conditions before we know what whole human genome sequences need. We only know of our common variations right now, but most of the important stuff is a low-frequency, rare variance. We know relatively little about that.

It’s still expensive and it’s not as accurate as it could be. In the next few years, we should see bigger strides bringing the price well below $1,000, maybe even down to $100 per genome.

FHIT: Where will we see early practical uses of genomics in medicine?Topol: We don’t need amniocentesis anymore, or chorionic villus sampling. You get far better information just by doing a maternal blood test. One tube of blood. Why would you put a woman at risk anymore? There’s already a big jump forward.

And with that same tube of blood,

POPULATION HEALTH MANAGEMENT

ERIC TOPOL: BEFORE WE EMBRACE NEW TOOLS, WE MUST PROVE THEY WORKBY DAN BOWMAN

you could get a whole genome sequence of a fetus at 8 weeks, long before the 12-week threshold where you might consider termination of pregnancy. That has tremendous implications. Not only getting rid of amniocentesis, but what would be the boundaries for terminating pregnancy; what constitutes a serious malady that you wouldn’t want to bring a child into the world. Talk about bioethical considerations!

FHIT: Have you encountered skepticism of your ideas?Topol: Yes, there’s one pushback that I get—and I should emphasize that I agree with it: Before we embrace these tools, we’ve got to prove that they work. Not that they measure the blood pressure or glucose levels, but that they change outcomes and that they lower costs. That’s a validation step, and what we’re doing a lot of at our Scripps Translation Science Institute.

We need groups all over the world to take that validation challenge on. We can’t just accept in a willy-nilly way, just because something is new and wireless that it’s some kind of magic. We’ve got a long history of making serious mistakes and increasing costs with technologies that were never validated.

I think that ultimately, this revolution of medicine will not take hold unless each one of the technologies going forward is fully validated. We can’t afford to have another false illusion of “this is better” without proof. l

“We’ve got a long history of making serious mistakes and increasing costs with technologies that were never validated.”

The shift to digitize care is unquestionably the biggest shakeup in the history of medicine. Still, the industry has a ways to go before it will be able to shake its “slow moving” reputation, according to cardiologist Eric Topol, a professor of genomics at The Scripps Research Institute in San Diego and author of The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.

“We need to take initiative and ask our physicians why they’re using old tools or sending us for outdated tests,” Topol told FierceHealthIT earlier this year. “We need to tell our doctors that we don’t want to be in the dark, getting some cookbook recipe for care of one kind of disease or another.”`

The status quo won’t cut it in healthcare anymore. That’s the shared message delivered earlier this

year by former President Bill Clinton and cardiologist Eric Topol, the West Endowed Chair of Innovative Medicine at The Scripps Research Institute in La Jolla, Calif.

“Eventually, almost every major system gets long in the tooth,” said Clinton, delivering the keynote address at the Healthcare Information and Management Systems Society’s annual conference in March. “We have all these horse-and-buggy systems and people hanging onto a lack of transparency … but there’s nothing we can’t fix. The whole promise of IT is that we can manage data in ways that we never could before … so that we don’t have unexamined lives of unexamined healthcare systems.”

Clinton also talked about the promise of genomics in healthcare, harkening back to efforts undertaken during his time in the White House. “I spent $3 billion of your taxpayer dollars to do that thing,” he said. It won’t be long, he said, before people can undergo routine physical examinations “just by walking into a canister.”

Speaking separately at the conference, Topol kicked off his keynote by talking about how far technology has come in a short period of time--except when it comes to healthcare delivery.

“How quickly we forget, there wasn’t even a YouTube video

until 2005,” he said. “The digital revolution is irreversibly transferring our world … except in medicine, so far.”

Topol added that the nation is in the midst of the third industrial revolution, saying that we’re just getting started with the “great inflection” of medicine right now.

“Now we have the ability to digitize human beings … homo digitus … that’s what’s so exciting,” he said.

He warned, though, that medicine can’t continue to be practiced at a population level, using the example of the annual physical as what’s wrong with healthcare today.

“We do everything the same and don’t recognize that each person is an individual,” Topol said. “We can get incredibly precise for the future of medicine. Wearable sensors are a way to get started with this … something as simple as a watchband.” l

CLINTON, TOPOL PREACH THE IMPORTANCE OF EVOLUTION IN HEALTHCAREBY DAN BOWMAN

“We have all these horse-and-buggy systems and people hanging onto a lack of transparency … but there’s nothing we can’t fix. The whole promise of IT is that we can manage data in ways that we never could before … so that we don’t have unexamined lives of unexamined healthcare systems.”

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Mobile devices like tablets and smartphones have had a huge impact on radiology, according to Elliot Fishman, M.D., a professor of radiology, oncology, and surgery at Baltimore-based Johns Hopkins Medicine, and a big proponent of iPads in the clinical setting.

These tools have proven to be multi-functional, as radiologists are able to perform tasks ranging from mundane (like sending and receiving email) to critical (interpretation of imaging test results). And the devices seem to be performing all of these tasks quite well, he says.

“I’ve looked at hundreds of Cardiac CTs and other images and I’ve never had a situation where I looked at one on an iPad, then came back the next day and looked at it on a monitor and said, ‘Oh, my god, look at what I missed,’” Fishman says.

In a study published last summer in Emergency Radiology, Fishman and other Johns Hopkins researchers said

the same; they found no difference between the use of an iPad and a PACS workstation with regard to diagnostic accuracy for detecting pulmonary embolism.

According to the study, readers--regardless of the display

platform--interpreted 98 percent of the studies they read correctly.

The device “has the potential to expand radiologists’ availability for consultation and expedite emergency patient management,” Fishman and his colleagues concluded.

Another study, published in January in the Journal of the American College of Radiology, found no detectable effect when using an iPad 2 compared with a regular LCD monitor to diagnose tuberculosis.

“Mobile radiologic diagnosis holds the promise of expanding radiologists’ availability for consultation and reducing dependence to specific fixed locations for review of medical images,” wrote researchers from the University of Maryland School of Medicine in Baltimore.

A LEARNING TOOLEducation is a common--and critical--component of the iPad when it comes to radiology, according to Fishman. “The convenience of having it all in one place works quite nicely,” he says.

He pointed out, for example, that the American Journal of Roentgenology, gives subscribers the choice of print only, print and online, and online-only subscriptions. “I think what’s happening is that people are using their mobile devices to keep the articles they want so they can read them when and where they want,” Fishman says. “It’s just a much more convenient way of doing things.”

Further educational benefits of iPads were illustrated in a recent study out of Beth Israel Deaconess Medical Center in Boston, published in the Journal of the American College of Radiology.

For the study, residents were provided with iPad 2 tablets and subscriptions to e-Anatomy and

MEDICAL IMAGING

THE GROWING ROLE OF MOBILE TECHNOLOGY IN RADIOLOGYBY MIKE BASSETT

The device “has the potential to expand

radiologists’ avail-ability for consulta-tion and expedite emergency patient management.” ELLIOT FISHMAN, M.D., A PROFESSOR OF RADIOLOGY, ONCOLOGY, AND SURGERY AT BALTIMORE-BASED JOHNS HOPKINS MEDICINE

STATdx. When asked to assess their use of the technology, 86 percent of the residents reported that they used the iPad on a daily basis, with most preferring to use it to read journal articles, and about half reporting that they used the tablet to read textbooks.

“[They] also are a good source of creating information,” Fishman says of mobile tools. Case in point: there are hundreds of radiology education applications available for the iPad, several of which he has developed.

“And we are developing more of them--a couple every month,” Fishman says. They range from hand and foot anatomy applications to one on CT contrast protocols.

SMARTPHONES ALSO USEFULBart Demaerschalk, M.D., and colleagues from the Mayo Clinic in Phoenix have shown that a mobile smartphone application can be used to evaluate medical images during a telestroke evaluation.

In telestroke care, the use of a telemedicine platform in a rural area, or an urban hospital lacking

emergency neurological care, allows a stroke patient to be seen in real time by a neurology specialist. Physicians often are still tied to a laptop or desktop computer, which means there could be delays in getting access to brain imaging studies. Smartphones eliminate that delay, says Demaerschalk, alluding to his study published last fall in the journal Stroke.

“Someone who is away from the hospital or home and carrying his smartphone will have much faster access to a patient than someone with a laptop who has to set it up and find a connection,” Demaerschalk says. “It’s all about time and reducing neurological disability.”

In their study, Demaerschalk and his colleagues evaluated 53 patients who presented at Yuma Regional Medical Center with acute stroke and underwent a CT brain scan. The scans were interpreted by radiologists in Yuma, as well as telestroke doctors with smartphones.

While the researchers determined that the smartphones didn’t perform perfectly—particularly when it came

to evaluating subtle neurological features—there was a high level of agreement when it came to the critical aspects of CT scan interpretation, such as making treatment recommendations.

Fishman called such functionality “convenient and accurate” when it comes to reading studies, but says it has its drawbacks.

“It’s good because you’re always available and if a person wants your opinion, you can give it remotely right away,” Fishman says. “That’s also the downside—you’re always available, and that can be a challenge for some people.”

While such portable devices may encroach on off-hours, ultimately, radiologists should recognize that they also offer an opportunity to create a better connection with referring physicians.

“We have this concern about radiology becoming a commodity,” Fishman says. “But, something like the iPad allows you to be totally available and really demonstrate that radiology is not a commodity.” l

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While hospitals across the United States are being asked to do more with less in this era of post-healthcare reform, at Lancaster General Health (LGH), a 623-licensed bed, not-for-profit health system in Central Pennsylvania, we worked with our regional purchasing coalition to identify and implement tactics such as standardization and utilization.

Hospital standardization programs typically involve physician preference items for orthopedic/spine and the catheterization lab. However, this approach also can be used in other departments as hospitals look for ways to cut costs.

In particular, pharmacies represent a significant cost-saving opportunity since pharmaceuticals represent a substantial percent of hospitals’ operating budgets.

We successfully reduced our pharmacy costs by $1.5 million in 2012. One of the keys to our success has been our engaged, interdisciplinary formulary and pharmacy and therapeutics committees, which include physicians and other clinicians and pharmacists, particularly those with knowledge in clinical pharmacotherapeutics. The committees work together to identify new ways to standardize and improve patient care while lowering costs.

Every month we review our top 50 drug spends to identify trends in cost and usage. We also analyze our year-over-year drug spend and compare our prices with those of other hospitals of similar size. We’ve found 10 percent of medications represent 90 percent of our costs, especially when it comes to biologics and medications administered in our infusion center.

With this information, we worked

with clinicians on the following standardization and utilization efforts:

Cardiology: We were paying $280,000 a year to administer esmolol, an injectable drug to treat hospitalized patients with hypertension. For uncomplicated, non-emergent patients, diltiazem is an equally effective drug to reduce high blood pressure. Result: Through an education campaign of the cost impact of available alternative therapies with our cardiologists, emergency medicine providers and hospitalist physicians, we have decreased usage by 50 percent, saving approximately $130,000 a year after considering the cost of diltiazem while preserving good clinical outcomes.

Chemotherapy: Oncology medications are our number one drug spend, representing 40 percent of our budget. To reduce waste and maximize cost avoidance, we round pemetrexed dosages to the nearest 100mg and bendamustine to the nearest 25mg, which helped improve the bottom line without impacting care.

Blood Product Derivatives: In the case of blood derivatives, cost savings stemmed from a patient safety initiative to prevent dangerous potential side effects of epoetin alfa, as thrombosis and other serious events can occur with too high hemoglobin levels. Result: We began pharmacist-monitoring of patients’ hemoglobin and more frequently adjusting the dose of epoetin alfa per protocol to ensure the most cost-effective approach that resulted in the safest care possible while saving $80,000 per year. We also reduced waste by switching from 20,000 units to 5,000 units of thrombin in the operating room and to adjusted weight-based dosing for IVIG (an immunoglobulin agent).

Antibiotic Stewardship: We also took a number of steps to better manage antibiotics prescribing. For example, we prescribe aztreonam (an expensive antibiotic) to patients with penicillin allergies. However, upon examination of records we found 38 percent of those who received the drug did not have a penicillin allergy. Result: Changing this practice saved our hospital $25,000 a year. l

REVENUE CYCLE

HOW LANCASTER GENERAL HEALTH REDUCED ANNUAL PHARMACY COSTS BY $1.5 MILLION BY JILL REBUCK, PharmD, Director of Pharmacy Services at Lancaster (Pa.) General Health

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Today, the Internal Medicine and Orthopedics departments, along with over a dozen other specialties within the Washington University School of Medicine, have patient-centric document management operating at peak performance. They took what many organizations post-EHR implementation are struggling with and brought the problem to its knees.

LET’S JUMP BACK IN TIME FOR JUST A MOMENT…Electronic Health Record software, the exciting, new frontier of a patient visit, is introduced to the healthcare community. The promise of a better tomorrow.

“All the data at our fingertips, faster and more efficient visits, and all done without us doing anything. Let’s do it!”

Healthcare leaders everywhere charge forward, headed to the paperless promise land. Implementations and Meaningful Use reporting begin. Cash incentives flow. Everything’s great. Then, regulations begin to change and belt buckles tighten and critical questions surface.

Questions like:• Why are my operating costs

going up, not down?

• Why don’t my providers have access to the information they need, when they need it?

• How do we get our workflow optimized so we can stay paperless?

There are no simple answers. Any time you adjust workflow you face potential challenges with the speed and quality of care. And the paper never stops coming. It’s the gigantic pile of faxes and paper that’s supposed to magically end up in the patient record, but doesn’t! Industry-wide, the paper cloud hangs over us…

THEN COMES BETTERCHARTRemember earlier, when I spoke about our friends at Washington University School of Medicine solving a problem? Let’s discuss…

A few months into their EHR roll out, Washington University School of Medicine came to us feeling challenged with the thousands of daily documents that needed to be filed into their EHR.

WUSM was in need of a solution that automates the indexing of all documents that pile into the EHR every day. They wanted faster access to critical information, while reducing operational costs. With critical insight offered by WUSM and the strong partnership between the two organizations, DISC Corporation developed BetterChart.

Today, BetterChart is revolutionizing the way organizations cure this problem. We created BetterChart to automate the manual indexing process overworked staff has to squeeze into their schedule every day. Automation means less errors, which ultimately leads to a higher quality of care. BetterChart solves problems!

NOW, LET’S FLASH FORWARD TO TODAY.

Beyond Washington University School of Medicine, BetterChart is solving these very issues in other organizations. These organizations are fearlessly facing rising operational costs and less than perfect chart access head on and implementing a solution that just 2 years ago was only a dream.

BetterChart.

PARTNERS SOLVING PROBLEMSBY KC FRANK, EVP, DISC Corporation

SPONSORED CONTENT

“There is no doubt that implementing BetterChart has allowed us to improve patient care while reducing costs and errors. Music to our ears!”WASHINGTON UNIVERSITY SCHOOL OF MEDICINE – ST. LOUIS, MO

primary “corporation” logo

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INNOVATION REPORT

achieves multiple goals. “We rarely ask families to bring a child to Atlanta; our goal is to support the healthcare professionals in the community. If we were seeing a patient in Coffee County, for example, who needed multiple tests, the labs there would do the work and get the revenue,” says D.D. Fritch-Levens, R.N., director of the contact center for CHOA. In other instances, CHOA has proactively identified patients who travel significant distances and asked them whether they would prefer a telemedicine consult at a more convenient presenting site.

“We can’t put bricks and mortar everywhere in the state. With telemedicine we don’t need to. We can partner with communities and local physicians to increase pediatric medical knowledge,” she says. In keeping with that objective, CHOA recently completed a three-part series on pediatric cardiology offered to physicians and mid-level practitioners through telemedicine links and plans sessions on pediatric nursing and pulmonology.

GETTING STARTEDLister advises healthcare organizations considering adding or expanding telemedicine services to find someone within their practice or hospital who will champion it. Presenting sites should “canvas local doctors and find out what they need, what services they have trouble getting patients into.” Expect the service to evolve, she adds. “Initially, we had more requests for dermatology consults than anything else.” Now, pediatric subspecialties comprise three of the top four most requested services.

Fritch-Levens echoes the importance of finding internal champions. “The will to do this must come from the clinic side. The organization may plan to offer one service, but if that specialty or department is not interested in doing

it, and doesn’t have someone with passion to spearhead it, it simply won’t succeed,” she says. “There are too many competing priorities.”

MAKING IT WORKTo make it easy for physicians to work telemedicine consults into their daily schedule, Fritch-Levens advocates putting telemedicine facilities inside clinics or bringing wireless capability to the bedside.

Making remote consults part of the regular workflow also helps. Initially physicians would set aside available time and wait in the telemedicine suite for presenting sites to initiate visits, but for most practices, that led to underutilization. “On a typical clinic day, a physician sees 15-18 patients; on a busy telemedicine day, he might see four,” says Michael McConnell, medical director, CHOA telemedicine. “We’re trying to work telemedicine into the daily workflow of the clinic now. A doctor might have patients scheduled at 9:00, 9:30 and 10:00 for in-person visits and at 10:30 talk to someone via a telemedicine link and be back in the clinic for an 11:00 appointment.”

Fritch-Levens notes that some sites queue all their patients who need a particular type of consultation on

one day, and the specialist books the entire day in the telemedicine suite. This structure works especially well to continue care for patients when a specialist closes a practice in a rural location.

MEASURING SUCCESSIncreasing efficiency improves the economics of the program, but ultimately, CRMC and CHOA each consider the work part of their missions. For both hospitals, reimbursement, while steadily improving, does not fully cover the costs of the service.

“The program gives Children’s a voice in communities that we didn’t have before. It allows us to intervene in children’s health in a positive, impactful way,” says Fritch-Levens. “Recently, we did a consult with a teenage girl who had severe shortness of breath. She’d been treated for asthma and wasn’t improving. A pulmonologist remotely diagnosed her with pulmonary hypertension and she was in the ICU that night. She has a long road ahead, but now she’s getting the right treatment.”

“Improving care, saving lives,” says Lister. “That’s really the whole point of the system.” l

For years, physicians in rural Douglas, Ga., struggled to find nearby specialists to whom they could refer pediatric patients. The closest pediatric cardiologist was located in Macon, more than two hours away. To see other specialists, children had to travel 200 miles to Atlanta. Poverty further compounded lack of access.

“We frequently have people cancel clinic appointments because the car is out of gas and they can’t afford to buy enough to get the 10 miles to see us,” says Debra Lister, M.D., medical director of the telemedicine program at Coffee Regional Medical Center (CRMC), the only hospital in Douglas and surrounding Coffee County.

CONNECTING SPECIALISTS AND PATIENTS To improve access to specialists, in 2007 CRMC joined the Georgia Partnership for TeleHealth (GPT), a statewide network initially funded by an $11.5 million grant from

WellPoint, Inc. and $100 million in rural capital bonds. Early on, the hospital’s telemedicine program enabled neurologists at the Medical College of Georgia in Augusta, and cardiologists in Atlanta, to examine patients with strokes or heart attacks in the emergency department through a teleconferencing link; pulmonologists

could evaluate patients using the telemedicine suite in the hospital’s walk-in clinic. Consistent access to pediatric specialists, however, remained elusive.

In 2009, Children’s Healthcare of Atlanta (CHOA) launched a pilot program to offer subspecialty services outside the Atlanta metropolitan area through GPT. Over the next three years, the three-hospital, 529-bed organization expanded its telemedicine program to include 25 physicians in 14 pediatric subspecialties, including autism, cardiology, child protection, endocrinology, fetal echocardiography, nephrology, neurosurgery, orthopedics and pulmonology. CHOA provides consultations to 43 sites, including hospitals, public health departments, schools and department of family and children’s services offices.

“Now specialists can see children who otherwise would never have been able to come to their offices,” says Lister. Local physicians like the program, too, not only because their patients receive appropriate care but also because they can better manage the care patients receive.

KEEPING CARE IN THE COMMUNITY“Our families are very grateful not to have to travel far and our local doctors like that they have more control of their patients’ care. When we referred patients out of town for consultations, often the physician would refer the child to other specialists close to them—even if we had that specialty in Douglas,” Lister says. “We are very conscientious about sending reports from consults to primary care physicians. We act as a go-between to keep everything going smoothly during and after a telemedicine visit.”

For CHOA, keeping care local

TELEHEALTH

CASE STUDY: CHILDREN’S HEALTHCARE OF ATLANTA AND COFFEE REGIONAL MEDICAL CENTER BY ANNETTE M. BOYLE & BRENDA L. MOONEY

“Now specialists can see children

who otherwise would never have been able to come to their offices.”DEBRA LISTER, M.D., MEDICAL DIRECTOR OF THE TELEMEDICINE PROGRAM AT COFFEE REGIONAL MEDICAL CENTER

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FierceHealthIT: Describe the structure and philosophy of each of your organizations.Joy Duling: We’re a federated, nonprofit health exchange. We got our start under a regional healthcare improvement collaborative and spun off into an independent nonprofit about a year and a half ago. We cover 209 counties, 15 hospital members and nine non-hospital members. Eleven of those hospitals are currently contributing data.

Our model is completely subscription based—no federal or state money supporting us. We’re not transactional. We have a sliding scale based on

the size of the organization. It’s bed count for hospital and for independent providers it’s per-provider.

We’ve been very inclusive from the beginning. A lot of HIEs start out with the largest organizations in their area. We’ve really emphasized the smaller organizations in the community. So alongside the hospitals we’ve had federally-qualified health centers, health departments, behavioral health providers and very small independent practices—and that’s been important to us.Laura McCrary: One of the things that Kansas did was establish ourselves as an opt-out state. That’s an important

early consideration, whether you’re going to be an opt-in or opt-out.

Patients are notified that their providers participate in the healthcare information exchange. They’re notified through signs that are required to be posted in the practices. They’re also notified through brochures in the admit waiting areas. And all of our providers are required to change their notice of privacy practices 30 days prior to them going live and sharing data into the exchange.

FHIT: What are the benefits of an opt-out HIE?McCrary: In part it’s marketing. We’ve had a lot of positive publicity about things saving people’s lives in Kansas using the health information exchange. People sometimes re-think because it could save their lives.Duling: We’ve done quite a bit of consumer work in Illinois. Our senior citizens are some of our strongest advocates, because they’re the ones who have to carry around binders full of medical information. So maybe they don’t understand how the widgets fit together, but they get the concept--and they want their patient experience to be better.

HEALTH INFORMATION EXCHANGE

START WITH THE RIGHT STRUCTURE TO FIND SUCCESSBY GIENNA SHAW

As health information exchanges across the nation gain momentum, challenges remain. The first is choosing a model that fits within state guidelines and the culture of the community. The trial-and-error approach to HIEs led to some early failures. But jumping over that first hurdle and choosing the right structure also is the first step to long-term success.

In this exclusive interview, FierceHealthIT talked to Joy Duling, executive director of Central Illinois Health Information Exchange and Laura McCrary, executive director of the Kansas Health Information Network and about their organizations’ strategies, goals and challenges--including how to get patients and providers to participate in data exchange.JOY DULING LAURA MCCRARY

Continued on Page 22

It’s a natural question. Do healthcare awards and accolades reflect truly meaningful improvements or are they glorified popularity contests? For Texas Children’s Hospital (TCH), winning one of the industry’s highest honors was the culmination of seven years’ effort towards a goal that most hospitals can only dream of – the development of a truly data-driven approach to medicine.

It’s no wonder Texas Children’s CEO Mark Wallace and Senior Vice President of Information Systems Myrah Davis were recognized with the 2013 Transformational Leadership Award by the College of Healthcare Information Management Executives (CHIME) and the American Hospital Association (AHA). They and their teams have been striving since 2006 to deploy the systems and processes needed to drive improvements in clinical care and administrative services for the Houston-based hospital, the nation’s largest pediatric facility. Along the way, they’ve increased productivity and lowered costs, realizing $4.5 million in direct benefits from just four of the many analytics-powered projects they have underway.

The secret to Texas Children’s success may be that they never accepted anything less than the best, because they knew that’s what their patients deserved. For motivation, they needed to

look no further than their own emergency department and stories like that of five-year-old patient Jenny Jones. During one six-month period several years ago, Jenny received six different asthma action plans from six different physicians, exacerbating her uncontrolled asthma. Alarmed by such stories, Texas Children’s leadership deployed an enterprise-wide electronic health record (EHR) in 2008, digitizing care across the hospital. Then, after discovering that the EHR’s trove of valuable data was hard to extract and combine with other data sources, leadership took a bold, three-pronged approach to data management and quality improvement.

First, they deployed a healthcare-specific Late-Binding™ enterprise data warehouse (EDW) from Health Catalyst. Second, they added permanent, integrated workgroup teams to identify areas for care improvement and built evidence-based practices into the delivery workflow. Third, they used advanced analytics applications to prioritize, track and interpret iterative improvement – a critical component to establishing baseline results and ensuring sustainable improvements.

The resulting improvements have been multiple, and they keep coming. For example, in 2011, asthma accounted for 3,000 ED visits and 800 admissions at Texas Children’s. Leadership knew there was

waste in the process and opportunity for improvement. After applying the three-system approach, Texas Children’s Hospital was able to decrease the average length of stay by 11 hours. And that was just the beginning.

Clinical results aren’t the only improvements Texas Children’s has made. The hospital replaced the “report factory” workflow of their IT department using the EDW to give providers and managers direct access to visualizations and reports without IT assistance. In fact, on average, each EDW report costs 67 percent less to build than an EHR report. Additionally, labor productivity and operational efficiency both greatly increased thanks to analytics and the EDW. Texas Children’s expects to realize a savings of nearly $500,000 over four years from automated data integration.

Texas Children’s quality improvement and operational efficiency programs stand as an example for hospitals everywhere who seek to combine technology with new governance structures to build a truly data-driven culture of value. It’s why we at Health Catalyst come to work every day curious and excited to see what more we can do to improve the quality of America’s healthcare system.

TEXAS CHILDREN’S HOSPITAL’S BLUEPRINT FOR A DATA-DRIVEN CULTURE OF EXCELLENCEBY ANNE MARIE BICKMORE, RN

SPONSORED CONTENT

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FHIT: How are you encouraging provider participation and buy-in?Duling: On an individual level, physicians come into it with varying degrees of comfort. But then they have a-ha moments, when all of a sudden it becomes useful to them and we’ve won them over. In the Decatur community, we had one physician who looked up a patient’s record and found out they had just left the emergency room across town 15 minutes earlier—the information is that real-time in the HIE. And that changed how he interacted with that patient. He was sold.

FHIT: What other challenges are top-of-mind right now?Duling: Our biggest challenge is in the area of sensitive health information--behavioral healthcare information, for example. Illinois regulations are fairly restrictive and the state is working some legislation through to try to make it more explicit that behavioral health information can, in fact, be shared by an HIE. But in the meantime, the providers are being extra cautious about it.

FHIT: So what’s up next for KHIN?McCrary: We’re putting in a state-wide patient portal. It’s a personal health record that will connect to the health information exchange. Patients will be able to have their own information from the health information exchange and over time (we haven’t quite figured this out yet) we plan to allow patients to see who’s accessed their information in their personal health record.

Our vendor, ICA, has the ability to audit who has looked at an individual’s record. That’s a requirement. So it’s not that hard to allow a patient to access that same information. That reassures patients a lot, that their providers have access to their information but that they also have that

access to their own data.

FHIT: What’s the benefit of an HIE-sponsored patient portal?McCrary: There are two different kinds of patient portals. A personal health record allows you to enter information into the portal, such as over-the-counter medications, diet and exercise. We’re implementing a personal health record. There are tethered and untethered portals. Tethered are tied to a product, to an individual practice or hospital. But information exchanges can use an untethered portal that allows the information to come from and share among all of the providers in the exchange. The problem for the patient is that if you don’t have a regional or state-wide personal health record you may have to look at all three or four different portals to get all of your information.

FHIT: How does this help providers meet Meaningful Use requirements?Duling: One of the Meaningful Use requirements is that five percent of your patients have to look at that portal or you don’t get the Meaningful Use incentive payments.

Our providers who had tethered patient portals were having these competitions with each other to make sure theirs is cooler and sexier to get that 5 percent of patients. If patients

are only going to go to one, they want them to go to theirs. When I heard that I said “time out. We’re not pitting our providers against each other. We are about working together as a statewide exchange.”

ONC has said that if a patient looks at a patient portal that covers many different providers, every single provider who sees that patient gets to count it toward the 5 percent. That will help all of our providers hit that five percent, which I’m not sure they would without a statewide PHR.

It’s the right thing to do for the people of Kansas, too. It’s hard to find a PHR company that knows how to work with HIEs. We want someone who understands HIE--problems with master patient indexing and matching. You can get multiple returns on a name and send those to the provider to choose the correct one. You can’t do that with a patient.McCrary: We’ve also had some fun things around public health. We’ve been able to send data to our state immunization registry. We’ve also been able to send data to the CDC for biosense, for syndromic surveillance. So we’ve helped all of our providers meet those two Stage 2 Meaningful Use requirements, too. We’re working on the cancer registry and electronic lab reporting—that’s way harder than I ever thought it was going to be. l

Continued from Page 20

Within the dynamic healthcare-industry, Prodigo Revenue Cycle Services (ProdigoRCS) saw an opportunity in the marketplace to develop a pioneering web-based tool to assist with everyday revenue cycle functions.

The ease and efficiency with which an organization’s daily revenue cycle operates is a dominant aspect of the overall patient experience. ProdigoRCS offers results that are responsive to the market. It utilizes advanced screen-scraping technology and direct-to-payer connections to generate rich data-sets. This functionality is progressive and establishes streamlining and automation of transactions and workflow. Because of these improvements, an organization has the opportunity to realize a significant reduction in denials related to patient eligibility and overall days in A/R. In addition, capabilities to assist with Medical Assistance approvals, Financial Assistance scoring mechanisms, and automated insurance claim statuses are built into the product, making it a key component for the future of healthcare.

Using our established clients, it has been confirmed that ProdigoRCS improves accuracy and reduces overall business-unit costs while increasing revenue. With over 100 established payer connections and the ability to build more,

ProdigoRCS can enhance your department’s efficiency and create synergy across its various sectors.

ProdigoRCS offers a number of product suites that can be used to either provide transactions or work flow solutions. From the point of patient scheduling and registration to Medical Assistance eligibility and application to the denial and follow-up of claims on the back-end, ProdigoRCS offers advanced technological solutions to assist with the day-to-day operations of the Revenue Cycle process.

ProdigoRCS Product Suite:

• eEligibility

• eDenial Prevention

• eMA Eligibility

• eFinancial Assistance

• eClaim Status Inquiry

• eCoding Quality Assurance

From Transactions to Workflow: eEligibility and eClaim Status

• ProdigoRCS’ products offer Web-bot enabled Eligibility and Claim Status transaction processing technology. Using the standard 270/271 and 276/277EDI transactions along with a unique Web-scraping capability, these products provide richer access to payer data at a lower cost to the consumer.

• Both eEligibility and eClaim Status workflow solutions operate using exception-based work lists that only present claims requiring manual intervention. In addition, both also operate with a “No-Touch” philosophy to employ automated responses and actions if the system can resolve the issue itself.

WORK SMARTER, NOT HARDERBY APRIL LANGFORD, President and Chief Executive Officer, ProdigoRCS and Jackie Burtnett, Vice President, Marketing and Client Relations, ProdigoRCS

SPONSORED CONTENT

Revenue Cycle Services

The ease and efficiency with which an organization’s daily revenue cycle operates is a dominant aspect of the overall patient experience. ProdigoRCS offers results that are responsive to the market.

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FierceHealthcare: How has the industry’s approach to patient engagement evolved over the years?Brent James: Patient-centeredness has a number of different meanings: One is “nothing about me without me”—which means that patients ought to be in control of their own lives, especially in a healthcare setting; that we do nothing to them without their explicit permission and understanding.

Another definition comes from the idea that care is organized around the patient and his or her needs. Rather than building a care delivery system around the building or specific piece of technology or service or superstar physician, imagine that you organize the whole care delivery system around the patient.

Now most of healthcare delivery is disease treatment—when you do it that way you start to build around care delivery processes. That’s the work of Dr. W. Edwards Deming, called quality improvement theory.

At its core, quality improvement theory is the science of process management. We used to call it continuum of care. The idea is that you track a patient before the disease process, as it starts to take place in their body or life, all the way down to its treatment until some sort of conclusion, hopefully when it’s resolved and gone. That continuum of care idea is a natural extension of

process science.Here’s the funny thing that happens:

If you start to focus on care delivery processes and quality improvement, it forces you to that form of organizational patient-centered care.

Usually the more superficial view that is a bit easier to understand, is that view centered around the idea of nothing about me without me. But when you’re building systems of care, that second definition of continuum, boy it turns out to be important but it’s far more subtle.

FH: What are some barriers to fostering patient-centeredness, and how can hospitals overcome them?James: Most hospitals focused on revenue enhancement, which means you try to increase the numbers of services you supply. In a very real sense, the people who really consume those services are the physicians. So you have physicians who, with a

stroke of their pen, can make or break a hospital.

We tended to build our organizations and think about them in terms of a superstar physician, a new program, a new heart hospital, marketing more services for imaging or lab--those are all top-line revenue enhancers. For many hospitals, that’s the tradition. That’s how it’s done, so others did it too.

It was a pretty easy approach to take. It was what everyone else in the industry was doing, so the biggest barrier is tradition.

The fact is, that’s not what patients need moving ahead. We need care that’s designed around them, not around the big revenue generators.

FH: How did Intermountain move the focus away from revenue?James: The first thing you have to know about Intermountain is we are massively mission-driven. The short version of our mission is “best medical result at lowest necessary cost.” We’re a charitable not-for-profit and we actually behave that way, in most ways.So we realized that when we keep the cost of our services low, people can afford to come and take advantage of those services.

We proved William Edwards Deming’s idea that better quality

POPULATION HEALTH

INTERMOUNTAIN EXECUTIVE: FOCUS ON PATIENT-CENTEREDNESS, NOT REVENUE ENHANCEMENTBY ALICIA CARAMENICO

A prominent theme emerged earlier this year, when 11 top healthcare executives created their “CEO Checklist for High-Value Health Care” – the importance of patient engagement.

Brent James, chief quality officer and executive director of the Institute for Health Care Delivery Research at Utah’s Intermountain Healthcare was among the 11 execs who contributed to the list, which featured strategies for reducing costs and waste while improving outcomes.

FierceHealthcare recently spoke with James about how hospitals can use patient engagement to create high-quality, low-cost systems of care.

Continued on Page 26

“At its core, quality improvement theory is the science of process management. We used to call it continuum of care.”

Recent legislative changes in the United States are forcing healthcare companies to improve care outcomes while reducing overall healthcare spending. However this is not an easy task considering factors such as medication non-adherence that hinders positive care outcome and economic efficiency. Last year in the United States, close to $329 billion was spent on unnecessary medical bills that could have been avoided if patients had followed their physician’s prescriptions.

Non-adherence is not only detrimental to the patient’s health, but also results in negative financial impact for the entire healthcare ecosystem spanning patients, payers, providers, and pharmacies, resulting in increase in the overall cost of care across the population. Common factors that contribute to non-adherence in patients include forgetting to take medicines, poor social support, complex drug regimens, etc. Countering these varied and complex barriers to medication adherence while ensuring compliance with changing health standards and legislative mandates, requires comprehensive medication adherence solutions that leverage the potential of modern, millennial technologies to create a holistic ecosystem that can ensure the wellness goals of such programs.

Virtusa’s cloud-based medication adherence solution, built on a comprehensive care provisioning framework, is designed to support multi-dimensional interventions

spanning the patient, physician, health counsellor, family and other patients taking similar medication. The end-to-end framework has specific components to influence every step of a patient’s medication therapy, such as medication data acquisition, patient education, refill reminders, adherence monitoring and sending adherence reports to the physician.

The solution’s rich feature set leverages latest millennial and technology innovations enabling rapid implementation of a medication adherence intervention platform to¬¬ cater to large patient populations with improved effectiveness. The solution’s core engine, named Medication Manager, can be combined with one or more of the other six functional modules to customize and deploy medication adherence solutions based on the requirements of individual healthcare organizations:

1. Medication Mobile Advisor: IOS or Android based mobile application providing a clear view of prescribed medication schedule, reminders, pill images, etc.

2. Medication Source: Data integration block enabling real-time sourcing of patient medication details from EHR systems

3. Medication Counsellor: Web portal built on the core engine enabling medical practitioners to participate and drive holistic

patient medication adherence programs

4. Medication Social: Social media portal that gives patient’s family and friends access to patient’s medication adherence dashboard, and sends time-based alerts via social media for fills, refills, missed medications, etc.

5. Medication Content: Data integration block that enables seamless integration and delivers various drug related content

6. Medication Peer: Extension to the mobile application to support collaboration between patients taking similar or identical medication

Virtusa’s solution tackles non-adherence at any stage of a patient’s medication therapy journey. By leveraging the end-to-end care provisioning framework integrated with innovative technologies, the solution delivers high quality care outcomes including, improved productivity, higher levels of adherence and significant cost savings for the entire healthcare ecosystem supporting patient wellbeing.

For more information visit www.virtusa.com/dir/his or email us at HIS@virtusa.com

ENABLING IMPROVED HEALTH OUTCOMES FOR THE MILLENNIAL ERA: VIRTUSA’S SOLUTION FOR MEDICATION ADHERENCE

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INNOVATION REPORT

outcomes, in almost all circumstances, should reduce cost of operations. This happened back in the 1980s for Intermountain and we were the first group in the world to show that principle applied in clinical medicine.

Around 1987 or 1988, I came home from a meeting with Dr. Deming when he shared those principles. Up at LDS Hospital in Salt Lake City, we had a big trial running around improving clinical outcomes. John Burke, chief of infectious disease at LDS, had developed evidence that suggested there was an ideal time at which to give prophylactic antibiotics to prevent post-operative wound infection.

We used a two-hour time window before surgical incision and when we did this our wound infection rates fell from 1.8 percent to 0.4 percent.

At the time, we had thought quality meant spare no expense. We thought quality meant pull out all the stops; you can’t put a price on human life.

But what if we track costs as one more outcome, side by side with our clinical outcomes?

So we threw costs in and what we discovered is that as the infection rate fell from 1.8 percent to 0.4 percent, our cost of treating the infections went away. It saved the hospital a little bit more than $1 million a year in operating costs.

Now, it’s not always the case—about 15 percent of the time, delivering a higher quality outcome requires more resources and it increases costs. But a lot of the time you can reduce the cost of healthcare by improving your patients’ medical outcomes. At the time, this was completely antithetical to what everybody believed in healthcare.

Well, Intermountain got hooked on that. The way we get costs under control is not by rationing care but by actually doing better for our patients. That was an addictive drug for leadership at Intermountain.

And so we started to promote it heavily, ran a whole series of products on it and eventually started to organize our whole system around it.

At the core lies process management theory. If you start with process management, that forces you to that continuum of care, which drives you to patient-centered care.

FH: How has your organization used process management to lower costs?James: The jargon we use in quality improvement is “move upstream” in a process. The idea is you move up stream and prevent problems before they happen, and when you do you avoid the costs of dealing with the problem after the fact and it’s usually massive cost savings.

All of the savings came back to insurers as windfall savings, and they were potentially financially deadly to the care delivery crew. So we started to try to use it for contracting.

If I move to some form of a capitated system (shared savings models, bundled payment at a hospital level), in that payment setting all of the savings come back to care delivery group, as opposed to going to the insurers.

Then, you want to move even further upstream, it forces you to population level care and a whole new health system organized around patient needs as opposed to organized round revenue generation in the form of a superstar physician or a special program to try to promote more heart care.

I happen to fall into an organization at Intermountain where because its mission centers on patients, that strategy was acceptable. Intermountain was willing to invest in the future of our patients. Most places in healthcare would struggle with this kind of strategy.

In truth, we fight about it. And the reason is you’re asking the people in your system to do really hard things that appear to damage their success from a financial perspective. And then you’ve got to be willing to work your way through it.

FH: What advice would you give to other hospitals looking to empower patients at their organizations to improve care and lower costs?James: First, consider including patients directly on your strategic planning teams—the teams that build and manage the processes. Get that voice in there.

The second item goes hand in glove with that. As you move upstream, the first caregiver is the patient. And from them, you’ll get insights in how you can involve patients more fully in their own care, give them more personal control.

So the simple organizational thing to do is move to process management and put patients on your process teams—and then listen to them and follow their advice.

It’ll have reach and impact far beyond what that simple step seems to imply. It’s not so much an end in itself as a means to the secondary impacts it’ll have down the road.

A big part of it will still involve the experts; their voice will continue to be important. But make the patient part of the conversation to a degree that you haven’t in the past. Do it in a substantive way, not a superficial way. l

Continued from Page 24

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CLINICAL INFORMATION MANAGEMENTDISC Corporation specializes in helping healthcare organizations manage their clinical information. DISC healthcare solutions give clients precious time back into their day so they can focus on what’s important – patient care. Today, with healthcare technology changing at a rapid pace, DISC Corporation continues to lead the way, providing innovative document management solutions to the ambulatory healthcare market.DISC provides:• BetterChart – Automated document indexing and filing in your EHR• Scanning – Convert paper documents to your EHR• EHR Conversions – Convert data and documents from one EHR to anotherWith our ability to integrate our healthcare solutions with most leading Electronic Health Record solutions, our clients don’t worry about how documents and content flow into the patient chart. Whether the documents are coming from paper, fax, mail, or a legacy EHR or document management system, we file it away into the current EHR or document management system quickly, accurately, and cost-effectively. For more information, visit us at www.disccorporation.com.

Emdat is a leading supplier of web-based medical documentation solutions. Empowering over 20,000 clinicians, Emdat continues its single focus to create sophisticated technology designed to decrease cost and maximize productivity and accuracy of the document creation process while protecting the richness of the clinical narrative. Health care providers trust Emdat to provide mobile, flexible, user-friendly and cost effective solutions that streamline workflow within the EHR, automatically populating data, to help ensure successful adoption and meet meaningful use.

Global Device Management, LLC (GDM) provides an advanced Mobile Visual Information Collaboration platform (VACS®) for use across many medical applications, functions and specialties. VACS® helps solve the problems today’s clinicians face relating to increased work flow, decreases in available face-to-face patient time and increased demand for better outcomes. VACS® technology is an always-on, mobile, rich-media collaboration tool based on GDM’s experience in secure imaging for healthcare, the powerful capture capabilities of today’s mobile communication devices and healthcare professionals’ new awareness of fast, easy, picture and video sharing. VACS® is designed as an easy to use clinical information tool that increases clinical efficiency, enhances current PACS and EMR data and bridges the visual information gap in today’s growing clinical collaboration processes. For more information, visit: www.gdmworld.com or email: sales@gdmworld.com

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CLINICAL INFORMATION MANAGEMENT (CONTINUED)

CLOUD COMPUTING

QPID is a clinical insights software solution that automatically delivers relevant patient information from electronic health records and other data sources to the point of care. With QPID, clinicians are more productive, patients benefit from personalized decisions, and hospitals gain cost efficiencies. Applications built on the QPID platform eliminate time-consuming searches through patient health records. QPID solutions for cardiology, emergency, endoscopy, medicine, radiation and surgery anticipate and deliver answers to the questions commonly posed by expert clinicians. These applications support processes such as planning care for an admitted patient, rapid triage of a patient who has entered the emergency department, attesting to the appropriate use of ordered procedures, and pre-operative screening. QPID was developed at the Massachusetts General Hospital to address the problem of too much data that is too hard to find. QPID, Inc. launched in 2013 to bring the power of the QPID platform to hospitals and integrated delivery networks nationwide. Visit www.qpidhealth.com for more information.

Through automating healthcare data collection and analytics, SA Ignite unlocks new, actionable insights from healthcare data that deliver transformative improvements in care quality and efficiency. The company’s flagship product, MU Assistant®, is the industry’s leading enterprise cloud platform for automating Meaningful Use (MU) reporting and attestation for eligible providers. MU Assistant delivers 200%+ return-on-investment within 12 months through accelerating MU compliance, freeing up MU staff to work on other key initiatives such as ICD-10, and reducing MU audit risk. Currently, MU Assistant serves 6,000+ Eligible Providers across 13 EHR brands, 50 organizations, and 21 States. Clients include Intermountain Healthcare, Mt. Sinai Medical Center of New York, and Northshore-Long Island Jewish Health System. The company was founded in 2009 and is based in Chicago, Illinois.http://www.saignite.com

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DATA ANALYTICSDiscovery Health Partners helps organizations reduce and contain healthcare spend through intelligent cost containment solutions. We specialize in technology, services, and solutions for Subrogation, Coordination of Benefits, Eligibility, Claims Review and Audit. Our clients include health plans, self-funded employer groups and government agencies that want to manage more efficiently with less risk and cost with advanced technology, information analytics and modernized workflow for superior identification and transparency. Working with Discovery Health Partners, our clients realize improved recoveries, reduced cost, and new levels of insight. Founded in 2008, Discovery Health Partners is a division of LaunchPoint, a provider of cloud-based analytic solutions and services for healthcare enterprises. Learn more at www.discoveryhealthpartners.com.

Based in Salt Lake City, Health Catalyst delivers a proven, Late-Binding™ Data Warehouse platform and analytic applications that actually work in today’s transforming healthcare environment. Health Catalyst’s data warehouse and analytics platforms aggregate and harness more than 3 trillion data points utilized in population health and ACO projects in support of over 22 million unique patients. The company maintains a current KLAS customer satisfaction score of 90/100, received the highest vendor rating in Chilmark’s 2013 Clinical Analytics Market Trends Report, and was selected as a 2013 Gartner Cool Vendor for Healthcare Providers. Health Catalyst platform clients operate 98 hospitals and 1,112 clinics accounting for over $79 billion in care annually. Clients include Allina Health, Indiana University Health, MultiCare Health System, North Memorial Health Care, Providence Health & Services, Stanford Hospital & Clinics, and Texas Children’s Hospital. To learn more, visit www.healthcatalyst.com.

Health Outcomes Worldwide (HOW) is the leading provider of healthcare software solutions that empower healthcare organizations to improve patient care and significantly reduce costs. With its advanced data analytics and clinical evidence, the company’s award-winning how2trak® software helps nurses and physicians gain valuable knowledge to improve patient care outcomes and maximize operational efficiency. HOW has the largest wound care database in Canada and specializes in wound care, diabetes, and surgical site surveillance. The company’s vision is to transform chronic disease management and is swiftly developing software modules for chronic obstructive pulmonary disorder (COPD), dementia, arthritis, and falls prevention. HOW also provides clinical consulting services for wound prevalence studies and wound environmental assessments. For more information, visit www.healthoutcomesww.com. For customer success stories, visit http://healthoutcomesww.com/proven-results.php

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DIRECTORY LISTINGS

DATA ANALYTICS (CONTINUED)

Medalogix is post acute specific technology that leverages an agency-specific predictive model to help care providers identify patients most at risk for readmissions and or determine which patients will benefit most from hospice care. What makes Medalogix different, and more effective, is its workflow component that helps clinicians incorporate Medalogix’s predicative findings into their day-to-day routines. This capability turns analytics into action. Medalogix has helped clients reduce readmissions by 36 percent and helped increase the identification of hospice candidates by more than 20 percent.

PluralSoft is an award-winning healthcare data analytics company that helps healthcare organizations unlock the power of their clinical, claims, operational and financial data by gaining timely and meaningful business insights, on rapid time-to-value basis. Our robust data analytics platform – CareQuotient™ - integrates, standardizes, analyzes and deliver over 1000 purpose-driven clinical, claims, operational and financial insights across the continuum of care. These insights enable healthcare organizations - Hospitals, Physicians, IDNs, Payers, Employers, Government, and Infomediaries (HIE, HCCN, QIO, etc.) – effect measurable improvements in patient safety, quality and cost of care while maximizing their profitability.Healthcare organizations use CareQuotient™ as an Enterprise Healthcare Analytics Platform to address Population Health Management, Clinical Quality Measurement, Disease Management, Compliance Reporting (Meaningful Use, NCQA HEDIS®, PQRS), ACO, PCMH, Care/Case Management, Revenue Cycle Management, Provider Performance Management, Cost and Utilization Management, and State All Payer-Provider Claims Database.Our solutions impact over 8 million lives in US.

THE PROSATIENT EXPECTATION IMPACT MODELA software data system that accurately simulates true experimental design to measure the impact of key hospital services on patient satisfaction. EIM is a decision support tool, allowing you to make the best decisions about where to invest your hospital’s limited time, resources, and creativity in developing the best way to achieve patient satisfaction.WHAT MAKES THE PROSATIENT EXPECTATION IMPACT MODEL DIFFERENT?The Prosatient System looks forward, not backwardThe Prosatient System isolates perceptions from realityThe Prosatient System links performance to satisfactionThe platform is an interactive web-accessed database housing the responses from a statistically representative sample of patients who have evaluated virtual hospital experiences. This system changes the focus of patient satisfaction from evaluation of past experiences to planning of future strategies and operations with a clear understanding of how those actions will be perceived by patients.www.prosatient.com • (877) 801-5753 • Contact: Michael Parker

Get a Sneak Peek Here

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EHRsCareCloud Charts, the company’s cloud-based EHR solution is designed in concert with dozens of physicians and group practices, this release features powerful new capabilities “rapid charting, intelligent task management, real-time patient flows“ to help doctors dramatically speed up clinical encounters while maintaining control over the administration of their offices. CareCloud Charts, certified as a Complete Meaningful Use EHR by Drummond Group, integrates with the company’s practice management and patient portal solutions to deliver the industry’s most modern clinical, financial and administrative platform for physicians. To learn more visit: www.carecloud.com/charts

The highest rated EHR for oncology is getting even betteriKnowMed Generation 2 provides a new level of best-in-class EHR functionality to help your oncology practice deliver the highest quality patient care. Learn more: mckessonspecialtyhealth.com/iKnowMed

App based EHR for Behavior Health, Public Health and Integrated Care. EHR matches your workflow and makes it easy to document patient encounters. EHR includes forms and reports required by mental health agencies. EHR supports all public health programs (e.g. BCCCP, STD, Family Planning) with the specific forms and reports mandated by federal, state and local regulatory agencies. Cloud based EHR, PM and Billing solution. Meaningful Use Certified. http://www.patagoniahealth.comhttp://twitter.com/patagoniahealth

DIRECTORY LISTINGS

www.SpiroPD.com 1.888.PMD.4YOU

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Capture, Collection and Dissemination

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INNOVATION REPORT

HEALTH INFORMATION EXCHANGE

INTEROPERABILITY

AstraZeneca is a global, innovation-driven biopharmaceutical business that focuses on the discovery, development and commercialization of prescription medicines, primarily for the treatment of cardiovascular, metabolic, respiratory, inflammation, autoimmune, oncology, infection and neuroscience diseases.AstraZeneca operates in over 100 countries around 50.000 employees and its innovative medicines are used by millions of patients worldwide. AstraZeneca invests over $4 billion into R&D each year to develop life-saving medicines.There are 2.200 employees in the Middle East and Africa (MEA) area who work with high respect and tolerance to dignity and diversity. AstraZeneca is committed to generate life saving initiatives in Africa to increase access to medicine and to meet unmet medical needs. In all initiatives, AstraZeneca works closely with stakeholders to better understand the challenges in the area and to co-create forces to drive continued progress in healthcare.

AstraZeneca is a global, innovation-driven biopharmaceutical business that focuses on the discovery, development and commercialization of prescription medicines, primarily for the treatment of cardiovascular, metabolic, respiratory, inflammation, autoimmune, oncology, infection and neuroscience diseases.AstraZeneca operates in over 100 countries around 50.000 employees and its innovative medicines are used by millions of patients worldwide. AstraZeneca invests over $4 billion into R&D each year to develop life-saving medicines.There are 2.200 employees in the Middle East and Africa (MEA) area who work with high respect and tolerance to dignity and diversity. AstraZeneca is committed to generate life saving initiatives in Africa to increase access to medicine and to meet unmet medical needs. In all initiatives, AstraZeneca works closely with stakeholders to better understand the challenges in the area and to co-create forces to drive continued progress in healthcare.

CoverMyMeds helps physicians, pharmacists, and their staff complete Prior Authorization (PA) and other insurance coverage determination forms for any drug, and almost all plans. We streamline the traditionally clunky PA process by automating forms, to submit electronically. We help stop the alarming and expensive trend of prescription abandonment, ultimately getting patients on their medications, faster. Sign up today at www.covermymeds.com

DIRECTORY LISTINGS

mHEALTH AND TELEMEDICINEAirPatrol Corporation is the developer of ZoneAware, a mobile device identification and locationing system that lets electronic healthcare and records systems provide secure access to information based on who the user is and where they are. With ZoneAware, Healthcare administrators and IT personnel can permit a clinician’s, nurse’s, care-giver’s and/or administrator’s access to patient information via mobile devices based on a location as small as a hospital room or as large as a medical campus. Once the user leaves the area, patient information is safely and securely returned to the records system and restricted from the device, effectively preventing the accidental or intentional release of personal health information. Please go here for a healthcare use case. AirPatrol customers include numerous government and military agencies and large enterprises around the globe.

About CMT CorporationCMT Corp specializes in developing efficient and effective solutions using innovative cloud-based applications that provide secure telehealth/telemedicine collaboration capabilities via any Internet-ready device. The Physician Collaboration Platform (PCP) replaces inefficient and fragmented communications with a turnkey, on-demand, solution to organize and aggregate patient data from disparate sources. The system enables hospitals and physicians to create, brand, and manage secure collaborative communities of clinicians/providers. For more information, visit www.cmtcorp.com.

Health Care Service Corporation (HCSC) is the largest customer-owned health insurance company in the United States. HCSC offers a wide variety of health and life insurance products and related services, through its operating divisions and subsidiaries; including Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, and Dearborn National. The company employs nearly 20,000 people and serves nearly 14 million members. HCSC is committed to leading-edge Web and mobile solutions that support our members’ engagement in their own health care.

DIRECTORY LISTINGS

TM

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DIRECTORY LISTINGS

mHEALTH AND TELEMEDICINE (CONTINUED)

iTriage, LLC is a global healthcare technology company founded in 2008 by two emergency medicine physicians. The company’s market-leading platform and mobile-Web applications offer a proprietary Symptom-to-Provider™ pathway that empowers consumers to make better healthcare decisions and improves healthcare delivery for providers and payers. iTriage helps people answer the two most common medical questions: “What could be wrong?” and “Where can I go for treatment?” Users can quickly define the cause of their symptoms, locate the closest, most appropriate care for their condition, and securely store and manage their personal health information, resulting in more empowered patients, a more positive experience with the healthcare system, and lower healthcare costs. Millions of consumers have downloaded the free iTriage mobile app on their iPhone and Android devices, and thousands of healthcare providers use iTriage to reach and communicate critical facility and service information to patients.

Virtusa (NASDAQ: VRTU) is a global business consulting and IT outsourcing company that combines innovation, technology leadership and industry solutions to transform the customer experience. These services, which include IT consulting, application maintenance, development, systems integration and managed services, leverage a unique Platforming methodology that transforms clients’ businesses through IT rationalization. Virtusa helps customers accelerate business outcomes by consolidating, rationalizing and modernizing their core customer facing processes into one or more central systems. The Healthcare Information Services (HIS) segment at Virtusa specializes in delivering mobile health, healthcare analytics and information solutions for the healthcare market. We combine best practices and solution delivery experience working with clients in the payer, provider, consumer and life sciences segments to offer best in class solutions. For more information on our health information services email us at HIS@virtusa.com or visit http://www.virtusa.com/industries/mie/segments/information-services/healthcare-information-services/

VIRTUSA’S MEDICATION ADHERENCE SOLUTIONTransforming patient care in the millennial era

Healthcare Information Services (HIS) at Virtusa specializes in delivering mobile health, healthcare analytics and information solutions that help healthcare organizations transform the way they create and provision healthcare services and deliver cost-effective and targeted wellness programs to their patient population. Our millennial technology-based medication adherence solution impacts every step of a patient’s medication therapy.

For more information email us at HIS@virtusa.com or visit www.virtusa.com/dir/his

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Stay healthy. Stay happy.

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INNOVATION REPORT

POPULATION HEALTH MANAGEMENT

PRIVACY SECURITY

For more than a decade, San Diego-based Skylight® Healthcare Systems has been transforming the patient experience throughout the continuum of care. From pre-admission through post-discharge, Skylight CareNavigator, the company’s innovative interactive patient care system, uses common communication devices including televisions, computers, and mobile devices to address patient and family needs in health education, services and communication with physicians and care teams. Hospitals subsequently experience improved HCAHPS, reduced readmissions, greater clinical efficiencies and increased reimbursements. Together with Skylight’s account management and clinical consulting teams, hospitals, health systems and Accountable Care Organizations deploy CareNavigator to manage populations, increase patient satisfaction and achieve meaningful use. CareNavigator also integrates with existing hospital systems to streamline clinical workflow, improve operational efficiencies, and enhance revenue through additional service offerings including pharmacy and retail.

AirWatch is the world’s largest mobile security and enterprise mobility management provider with more than 8,500 customers and more than 1,500 global associates. The largest customer base, combined with the largest research and development team in the industry, allows AirWatch to provide the broadest functionality at the lowest cost. The AirWatch platform, featuring industry-leading mobile device management and application management, also incorporates the most secure content management solution, Secure Content Locker. These solutions can be used stand-alone for unique BYOD requirements or as a comprehensive, highly scalable enterprise-grade mobility platform.

DIRECTORY LISTINGS

® Imprivata® is a leading global provider of healthcare IT security solutions that enable seamless access to clinical applications, support more effective communication and collaboration amongst care teams and improve clinical workflow efficiency. Imprivata Cortext® is a HIPAA-compliant text messaging solution that improves clinical communication and collaboration, enables better focus on patient care and ensures the security of protected health information (PHI). For clinicians, Imprivata Cortext is an easy-to-use, real-time communication solution that enables text, photo and group messages to be sent securely across multiple organizations from a smartphone or computer. For IT, Imprivata Cortext is a software-as-a-service that is easy to set up and administer—adding and managing users can be done directly through Active Directory. Imprivata Cortext is the only secure texting solution from a leading healthcare IT partner that is verified as HIPAA compliant by an independent third party and is backed by a Business Associate Agreement.

DIRECTORY LISTINGS

PRIVACY SECURITY (CONTINUED)

Imprivata® is a leading global provider of healthcare IT security solutions that enable seamless access to clinical applications, support more effective communication and collaboration amongst care teams and improve clinical workflow efficiency. Imprivata OneSign® is the company’s leading single sign-on and authentication management solution that delivers fast, secure No Click Access® to electronic medical records and information to enable clinicians to better focus on patient care. Imprivata OneSign delivers a number of core capabilities in addition to single sign-on and authentication management, including self-service password management, secure walk-away, biometric identification and virtual desktop access. By streamlining access to clinical applications, Imprivata OneSign improves productivity, supports compliance, reduces IT costs and allows clinicians to focus on patient care. Recognized as an innovator and market leader by Gartner, KLAS and other leading independent industry organizations, Imprivata OneSign is used by more than 1,000 customers and more than 2.6 million healthcare users worldwide.

nCryptedCloud is a desktop, web, and mobile encryption application that seamlessly integrates with cloud storage services to give users the ability to set specific policies and security controls to their cloud data. nCrypted Cloud uses industry standard encryption technology (AES 256-bit encryption) to secure the data both at-rest and in-flight, ensuring that the data itself is protected no matter where it goes.By acting as a layer on top of cloud storage services, nCryptedCloud adopts the native cloud storage interface and provides additional security controls for existing cloud storage data. These controls allow for complete organization manageability, consistent policy controls, secure sharing and collaboration, corporate deployment, forensic auditing capabilities, complete access revocation, separation of corporate and personal documents in the same cloud, and compliance with business and regulatory requirements. www.ncryptedcloud.com

®

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INNOVATION REPORT

CONGRATULATIONS& THANK YOU TO ALL WHO APPLIED

TO ALL OF THE WINNERS AND FINALISTS

REVENUE CYCLE MANAGEMENT

Revenue Cycle Services

PointCarePA: Your Self-Pay SuiteScreening, Enrollment, Reporting—All in One SystemEvery Self-Pay Patient, Every Program, Every TimeScreening in Less than 90 Seconds: • ACA-Exchange Eligibility (Both Subsidized & Non-Subsidized)• Additional Private Plans (Individual, Group, COBRA, etc…)• Several Thousand Public Programs (Medicaid, CHIP, Cancer Assistance, etc…)• Premium & Prescription Assistance Options & Available Tax CreditsEnrollment Tracker: • Enables Quick Initiation of the Enrollment Process• Maintains Documents in a HIPAA-Compliant Environment• Provides the Needed Follow-Up Steps for Enrollment CompletionDashboard Reports: • Real-Time Reporting on Assists & Enrollments• Instant Identification of Patient Demographic Information• Ability to Track Staff Performance on Screenings & EnrollmentsEasy to Use—Requires Minimal Staff Training & No Additional WorkforceWeb-Based—Works on Any Device with Internet Access & Can Be Set-Up QuicklyLEARN MORE & SIGN-UP FOR A FREE DEMO TODAY! https://www.pointcare.com/demo-request/ Call 650-762-1928 with questions.

Prodigo Revenue Cycle Services (ProdigoRCS) is a wholly owned subsidiary of UPMC, a $10 billion dollar global health enterprise based in Pittsburgh, Pennsylvania. Leveraging the revenue cycle expertise of UPMC, ProdigoRCS brings to the market proven, provider-developed solutions designed to streamline processes, reduce costs, improve quality and enhance the patient experience. It utilizes advanced screen-scraping technology and direct-to-payer connections to generate rich data-sets and allow for automation of current processes to increase value driven staff intervention. ProdigoRCS helps its customers improve efficiency and achieve cost savings through a flexible suite of managed software products and services for revenue cycle operations. Its products include eEligibility, eDenial Prevention, eMedical Assistance, eFinancial Assistance, eClaim Status, and eCoding Quality Assurance. To learn more information about ProdigoRCS and its products and services, please visit our website at www.prodigorcs.com.

DIRECTORY LISTINGS