reimagining care delivery: why better data improved care ... · •inconsistent data definition...
TRANSCRIPT
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Reimagining Care Delivery: Why Better
Data Improved Care Coordination and
Patient Engagement
November 21, 2016
2:00 – 3:00 pm ET
**Audio for this webinar streams through the web. Please make
sure the sound on your computer is turned on and you have
speakers. If you need technical assistance, please contact
ReadyTalk Customer Care: 800.843.9166.
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Housekeeping Issues
All participants are muted• To ask a question or make a comment, please submit via the chat feature and
we will address as many as possible after the presentations.
Audio and Visual is through www.readytalk.com• If you are experiencing technical difficulties accessing audio through the web,
there will be a dial-in phone number displayed for you to call. In addition, if you
have any challenges joining the conference or need technical assistance, please
contact ReadyTalk Customer Care: 800.843.9166.
Today’s slides will be available for download on the eHI
Resource page at
https://www.ehidc.org/resources/eventsummaries
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About eHealth Initiative
Since 2001, eHealth Initiative has been advocating the value of technology and innovation in healthcare through research and education.
eHI convenes its multi-stakeholder members, from across the healthcare ecosystem, to discuss how to transform healthcare through information and technology.
eHI members released The 2020 Roadmap. The primary objective is enable coordinated efforts by the public and private sector to transform healthcare by the year 2020.
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Multi-Stakeholder Leaders in Every Sector of Healthcare
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The 2020 RoadmapKey Focus Areas in 2016
Interoperability
Privacy & Security
Business & Clinical Motivators
Health IT Policy
Data & Analytics
Innovation
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Upcoming Events
November 30:
– The State of Federal Funding for HIEs today
December 13:
– MACRA: A Payor Provider Perspective
March 21 – 23, 2017:
– eHI Annual Conference
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This webinar was made possible through the generosity and support of
Availity!
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Reimagining Care Delivery: Why Better Data
Improved Care Coordination and Patient
Engagement
Speakers
• Katherine Downing, MA, RHIA, CHPS, PMP
Sr. Director, Information Governance
AHIMA
• Russ Thomas, CEO
Availity
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© 2015
Katherine Downing, MA, RHIA, CHPS, PMP Sr. Director AHIMA IG and IGAdvisors™
2016
Re-imagining Care Delivery: Why Better Data Drives Improved Care Coordination and Provider Engagement
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• According to IBM – 2.5 quintillion bytes of data are generated every day and 90% of the data in the world has been created in the last two years
• According to Cisco - Connected healthcare applications such as health monitors, medicine dispensers, first-responder connectivity, and telemedicine … the fastest-growing industry segment in the big data picture.
Healthcare Information Surge
Source: Cisco The Zettabyte Era: Trends and Analysis, July 2016 White Paper
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• Volume is growing on a exponential
path in healthcare.
• The age of big data is here–
massive growth in data volumes
and velocity.
• Only about 25%of data being
stored has real business value.
Information is a High Value Asset
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HealthIT.Gov Benefits of the EHR but…
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Issues Examples
Data design and capture issues
•Inconsistent data definition across/between systems•Inability to tag and capture high value data elements•Inconsistencies between data in structured and unstructured notes.
Information integrity and quality issues
•Lack of trust in data (impedes ability to utilize for analytics)•Patient identification and patient data from devices, other records•Lack of data quality management efforts / tools•Process breaks / redundancies (shadow records) •Errors found at the ‘end of the line’ in patient portals
Inability to use data for analytics / advanced reporting
•Insufficient knowledge and skill of analysts•Errors found in data are not traced back to source•Siloed ownership at business or clinical level•Little or no ability to report across systems
Lack of interoperability •Cost of interoperability•Systems ability to trade data and information •Trust in inbound information from other organizations
Issues with Information for Care Delivery
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EHR practices contribute to data quality and integrity issues. Risky documentation practices create the potential for patient safety, quality of care, and compliance concerns. Examples include:– Template Challenges
– Patient Identification Errors
– Amendment Integrity
– Copy Paste
– Addendum / Late Entries
Risks to EHR Documentation Integrity
Source: AHIMA Integrity of the Healthcare Record Documentation
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• Risks of Copy Functionality– Inaccurate, redundant, or outdated information in
the patient record
– Inability to identify original author
– Propagation of false information
– Inability to follow the care of the patient (inaccurate coding)
– Unnecessarily lengthy and redundant progress notes
– Legal / Liability issues (per the AMA)
– Negative patient outcomes (per OIG)
EHR Copy Function and Information Integrity
Source: AHIMA: A Practical Guide: Information Management and Governance of Copy Functions in EHR
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• Financial– Increased operating costs
– Decreased revenues
– Missed opportunities
– Reduction or delays in payments / pay for performance $
• Satisfaction– Patient satisfaction / decreased organizational trust
when portal, billing or other information is incorrect
– Low confidence in forecasting by leadership
– Inconsistent reporting and re-work / validation
– Delayed decision making
The Cost of Poor Information Quality in Healthcare
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• Productivity– Duplication in the EHR creating increased workloads,
decreased throughput, increased processing time, or decreased end-product quality.
• Risk and Compliance– Patient safety
– Patient identification (should be 99.99% accurate)
– Potential for fraud
– Data leakage (physicians texting nurses / notes not in chart)
The Cost of Poor Information Quality in Healthcare
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1
2 3
4ORGANIZATION-WIDE
ALL TYPES—INFO
ALL TYPES—ORGANIZATION
ALL MEDIA
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Robert F. SmallwoodInformation Governance Concepts, Strategies, and Best Practices
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Healthcare strategy How Information Governance Supports:
Reduce Operating Costs
•Reduced data storage costs•Technology decisions based on IG (interdisciplinary) assessment of demonstrated need and cost benefit•Improved data quality improves decision making
Quality and Safety Benchmarks
•Enterprise standards for capturing consistent quality and safety metrics•Desired standards throughout the organization•Trusted data for analytics and business intelligence
Population Health Initiatives
•Reduces obstacles from data silos•Trusted data to evaluate and reengineer processes•Timely and complete information speeds up process
Reimbursement Models
•Reduces obstacles from data silos•Timely, trusted, complete information•Standards based claims•Value based purchasing and MACRA (Medicare Access and CHIP reauthorization act)
Excerpt based on Figure 3.5 (p34) Implementing Information Governance Kloss 2015. Purchase in the AHIMA store: https://www.ahimastore.org/SearchResults.aspx?SearchString=kloss
Quality Information is Vital for Healthcare
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Healthcare strategy How Information Governance Supports:
Data Breach Avoidance
•Sensitive information is better protected from corruption, loss, theft, hacking and inappropriate use•Uniform policies for all types of information not just PHI•Mitigation of fines and investigations
Support Mergers,Acquisitions and New Affiliations
•Avoid new risk, redundancy, costs of inefficiency•Quicker transition of information from one organization to another•Standardized use and definition of data and information
Improve Care Management
•Longitudinal information to manage avoidable admissions, readmissions and ED visits •Trusted data•Patients have more confidence (aren’t finding issues via portal)•Better data for supporting chronic disease, research, etc
Excerpt based on Figure 3.5 (p34) Implementing Information Governance Kloss 2015. Purchase in the AHIMA store: https://www.ahimastore.org/SearchResults.aspx?SearchString=kloss
Quality Information is Vital for Healthcare
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• Engaging patients to decrease costs and improve outcomes increase the health of your populations
• Map information creation, usage, storage (we can’t keep everything forever!)
• Use industry standard frameworks (AHIMA’s Information Governance Adoption Model (IGAM)) and best practices (e.g., healthcare and beyond, IG Blogs, IG Toolkit)
Focus on the Central Impact
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• Core disciplines in a Data Governance program include: – use of data stewards,– data life cycle management, – data quality management, – master and reference data management, – metadata management, – data architecture management, – data development, and – business intelligence management.
Data Governance – A Key IG Competency
Source: Enterprise Information Management and Data Governance, Merida Johns. https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=17054
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AHIMA’s Data Quality Management Model
"Data Quality Management Model (2015 Update)" Journal of AHIMA 86, no.10.
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Better Data is a Team Effort
IG Competency Competency Leaders
Information Governance Structure –defining responsibilities and accountabilities for data / info efforts
IG Project Leader, IG Executive Sponsor, Health Information Management (HIM)
Strategic Alignment – aligning data efforts with organization strategies
IG Executive Sponsor, CIO, HIM Director, Quality, Risk, Compliance, CMIO
Privacy and Security Chief Information Privacy & Security Officer(s)
Legal & Regulatory Requirements Compliance & Regulatory Leaders, Attorney
Data Governance IT and Data/Business Intelligence Leaders, CIO, HIM
IT Governance IT, Clinical, CMIO, and HIM Leaders
Analytics IT, HIM and Data/Business Intelligence Leaders
IG and DG Performance Data/Business Intelligence Leaders, Internal Audit
Enterprise Information Management IT & HIM Leaders, Quality, Risk, Compliance
Awareness & Adherence – for all staff Chief Learning Officer, VP/Dir of Human Resources
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IG Executive Training Video
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IG Executive Video
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IGIQ.com – IG Tools and Resources
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© 2015
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© 2015
• AHIMA Information Governance Adoption Model for Healthcare©• AHIMA www.IGHealthRate.com• AHIMA www.IGAdvisors.com• Information Governance Concepts, Strategies, and Best Practices, 2014.
Robert F. Smallwood – available in AHIMA store
• Implementing Health Information Governance, 2015. Linda Kloss, MA, RHIA, FAHIMA – available in AHIMA store
• Enterprise information management and data governance, 2015. Merida Johns – available in AHIMA store
• Images from www.images.google.com
• Cisco The Zettabyte Era: Trends and Analysis, July 2016 White Paper
Resources and Recommended Reading
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IG Structure
Strategic Alignment
Privacy & Security
Legal and Regulatory
Data Governance
IT Governance
Analytics
IG Performance
Enterprise Info Mgnt
Awareness & Adherence
AHIMA’s Information Governance Adoption Model Competencies
(IGAM)™
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IGAM Competencies Overview
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IGAM Competencies Overview
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IGAM Competencies Overview
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IGAM Competencies Overview
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Healthcare and the provider engagement problem
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Claims
Util. Man.
Network Man.
Elig. & Ben.
$HEDIS,STARS
Primary care
Specialist
Hospital
Fax
25X!
? DATA
MLR
Provider Engagement Platform
• $650B Consumers• 50% CMS VBC
• Transformation• Engagement• Real time data & Analytics• 75% Commercial VBC• Costs
HealthPlanNotRead
y
60%
& Satisfaction
$300BAdminWaste
Right Place, Right Time, In Workflow
© 2016 Availity, LLC. All rights reserved. Confidential and
proprietary—do not distribute.41
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Questions and Answers!
Please use the chat feature to ask questions
Today’s slides will be available for download on our
homepage at www.ehidc.org
If you have any questions, please contact Claudia
Ellison, [email protected]
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This webinar was made possible through the generosity and support of
Availity!