sponsored webinar: untangling interoperability challenges: key strategies for more efficient care...
TRANSCRIPT
“Our collective ability to provide the right data, to the right people at the right
time along the complete care continuum has no longer become a nice to have –
it is an imperative. “
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Today’s Presenters
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Brian HigdonPaula Hedlund
Chief Innovation OfficerUpper Peninsula Health Plan
Ms. Hedlund, Chief Innovation Officer at Upper Peninsula Health Plan, has also worked with Upper Peninsula Health Care Network, which is a collaboration between Upper Peninsula hospitals and providers to facilitate access to high quality healthcare at a reasonable cost. Hedlund has been with the organizations since their inception in 1998 and was responsible for implementing the IT infrastructure for health plan operations, claims processing, and in-house Third Party Administrator capabilities. She currently directs and oversees all IT operations for both UPHP and UPHCN.
Vice President Client ServicesICA –Interoperability Experts
Brian Higdon is Vice President of Client Services, for ICA, responsible for the implementation and support of the ICA solution across the country. His area of expertise is client services and implementation strategies, with a proven history of client satisfaction. Mr. Higdon has more than 22 years of experience in both military and civilian sectors, with strong leadership skills. He most recently ran Client and Member Services for Affinion Group, a $1.5B international marketing company where his teams developed and delivered client solutions for 4,500 institutions and more than 30 million customers.
What Do We Mean by Interoperability?
Connect Share Sending data from EMR to EMR; Device to EMR; EMR to Care Management Application, etc.
Connect Understand: Beyond basic Connectivity
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Transitions of Care from the Caregiver Point of View
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LTC
Home
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The Overriding Concept to Solve –Address Risks Associated with Transitions of Care
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What’s Standing in the Way of Better Managing Risks?
Payment Model Lack of
Coordination
Fragmented
Systems
Patient
Identity &
Security
Business Challenges
Technical Challenges
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Solving the Challenges –Getting the Stars to Align
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Solve Transitions of Care Challenges – provide real-time notifications to care team members on high-risk patients for Unplanned Patient Encounters.
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Upper Peninsula Health Plan –The breadth of providers has forced us to deal with how to most effectively communicate
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Upper Peninsula Health Plan –
Michigan’s Uniqueness
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Getting Started – UPHP Populations
MIHealth Link
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Advantage SNP
UPHP Challenges
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UPHP Challenges
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What We Needed
More timely
information
around patient
admits,
discharges and
ER visits
More efficient way to get that
information – the status quo
was not scalable as our
populations continue to grow
More effective way
to share that
information to
improve patient care
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Frequency
Connections across care
settings
Scope of Alerts Rules
How often
do we need
to send
alerts?
Who needs
to get which
alerts?
Which
high-risk
patients?
How do we
get the
alerts
delivered?
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Alerts
Introduce Technology – Real Time Alerting
Alert Technology
Platform
Distribution• Real time
alerts• Digest• Application
Feed• Secure FTP• Direct
Care Team
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Triggers
Risk
Rules Logic
The Aftermath – Lessons Learned
Real-time alerts are
overwhelming.
Send fewer, but more
high-value alerts.
Specify the risk attributes to
more closely define the
population.
Make sure care
coordinators know
what to do with alerts
– modify workflow.
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Where Are We Heading with Population Management
Average cost per ETG
(episode treatment
group) Diagnosis Based Alerts
Risk-based analysis of
future members
by product line
Calculation of High/Med/Lo
w AlertAlert
MDS ADT CCD
AlertsPlatform
Care Coordinator
Primary Care Provider
Ancillary Organizations
Service Frequency
Based Alerts
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Take Aways
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The Future of Rules-Based Alerts
Fee forService
Fully atRisk
Increasing intelligence, increases value…
Surveillance & Targeted Event Notification
Clinical Stratification and Workflow Automation
Tailored Content Delivery
Process Progression Detecting adverse events
Prevention-basedinterventions
Functional Progression Event Notification Predictive Alerting
Data Progression Administrative data Predictive algorithms and risk indexing
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What to Consider in an Alerting Solution
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Question and Answer Session
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Brian HigdonPaula HedlundChief Innovation OfficerUpper Peninsula Health Plan
Vice President Client ServicesICA –Interoperability Experts
Our Thanks for Attending
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Brian Higdon
Vice President Client [email protected]
Thanks to Paula for her time today in sharing their success story and to UPHP - a great client on the cutting edge of the power of interoperability.
Innovating the way care teams connect and healthcare is delivered