what does innovation look like in alaska? · • alaska’s population is aging. • demand for...
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What does Innovation Look like in Alaska?
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AN ALASKAN PHYSICIANS’ PERSPECTIVE ON
HEALTHTECH INNOVATIONSHADI BATTAH MD
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THE CASE
• Alaska’s population is aging. • Demand for services is on the rise.• Supply of healthcare personnel is short.• Inefficient processes.• Cost of care is high.
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THE GOAL
• The quadruple aim. The Institue of Healthcare Improvement.
• Keep Alaskans healthy and independent for as long as possible.
• Improve access to better quality care at a better cost. • Provide an excellent experience for the patient and the
clinician.
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PAIN POINTS
• Interoperability.• Access to care .• Transitions of care.• Throughput.• Mental health.• Healthcare personnel recruitment and retention.
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HEALTH-TECH CAN HELP
• Leverage human resources: • Telemedicine services• Remote patient monitoring• EHR functionality
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HEALTH-TECH CAN HELP
• Innovate:• Patient ownership of data• Blockchain • AI at the bedside • Device-embedded cloud, edge computing.
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HEALTHTECH INNOVATION AND THE STATE ECONOMY
• Revenues from innovative SaaS solutions to Alaskan issues with national implications/applicability can be a huge boon to the state economy.
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Innovation at Virginia Mason
Randi Anderson, M.S.Learning, Innovation, and Simulation Center
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© 2014 Virginia Mason Medical Center
About Virginia Mason
VISIONTo be the quality
leader and transform healthcare
MISSIONTo improve the health and wellbeing of the
patients we serve
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© 2014 Virginia Mason Medical Center
Why be Innovative?
Because our customers demand it.
Because our payers demand it.
Because we demand it of each other.
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© 2014 Virginia Mason Medical Center
Leveraging Technology
Patient Engagement platform
Telehealth
Connecting health-basedapps to our patient portal
Embedding clinical databases into our EMR
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© 2014 Virginia Mason Medical Center
Other forms of Innovation
Opioid management
Including patients in improvement efforts
Offering a warranty
Center of ExcellenceOrtho, Spine, Cardiac
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Alaska’s Health Information Exchange
What does Innovation Look like in Alaska?
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What is Health Information Exchange (HIE)?
• Per the ONC, “Electronic health information exchange (HIE) allows doctors, nurses, pharmacists, other health care providers and patients to appropriately access and securely share a patient’s vital medical information electronically—improving the speed, quality, safety and cost of patient care.”
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Who Is healtheConnect Alaska?
• Governed by a diverse Board with
representatives from:
• Hospitals and Nursing Homes
• Private Medical Providers
• Community Health Centers
• Behavioral Health
• Federal Health Care Providers
• Alaska Tribal Health Organizations
• Health Insurers
• Healthcare Consumers
• Employers
• State of Alaska
Established by State Statute as a not for profit organization under contract to the Department of Health and Social Services (DHSS) for Health Information Exchange in Alaska
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HIE InnovationEvent Notifications
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Hospital IP or ED Case Managers, Care Navigators,
Care Coordinators
5
• Confirm Meds• Confirm D/C Instructions• Schedule Follow-up
• A patient is discharged from the hospital with a diagnosis of particular interest• An alert is sent to the agency ONLY for certain conditions (i.e. drug overdose)• Case Management staff receive alert to schedule follow-up care
UseCase
• Reduce re-admissions by effective care coordination during transitions of care• Compliance with 5 day follow up requirement• All without swamping the Care Team with excessive, less valuable alerts
ValueProposition
HospitalDischarge
HL7 ADT
Powered by Ai
Alert
ENS Use Case - Alerts to ProviderLeverage event notification for specific panels
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HIE InnovationSocial Determinants of Health
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What are Social Determinants of Health?
• What are Social Determinants of Health?• A “place-based” organizing framework, reflecting five (5) key areas of
social determinants of health (SDOH), was developed by Healthy People 2020.
• Economic Stability• Education• Social and Community Context• Health and Health Care• Neighborhood and Built Environment
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Why Collect Social Determinants of Health?
• Deployment of social determinants of health interventions is shown to lower costs and improve health outcomes
• Studies show how social determinants:• Reduce Inpatient hospital admission rates• Improve Lack of health literacy• Demonstrate that High risk individuals experience issues with food and
transportation• Lead to a Reduction in care costs
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NEW PATIENTCompletes new patientforms including Medical
History andSDoH PRAPARE Tool
HIE Assists Providers with integrating PRAPARE tool into
their EHR
CLINIC STAFFRecords form data in
EHR database.
PROVIDERIf SDoH Indicators areflagged, recommendsfollow up with Care
Coordinator.Updates patient EHR
with services provided,treatment plan, and
referrals
HIE Automatically notifies Care
Coordinator based on SDoH Indicators
PATIENTFollows up with CareCoordinator at will.
CARE COORDINATORProvides referrals
basedon Community
ResourceList (Linked directly toSDoH PRAPARE Tool).Updates patient EHR
with notes and referrals.
HIE Maintains Community Resource Directory Centrally or links to 211 for up-to-date info
PATIENTFollows up with referrals
at will.
REFERREDCOMMUNITY
RESOURCEProvides services as
available and needed.
HIE notifies PROVIDER that patient has been
seen by REFERRED Provider
HIE automatically Sends electronic
referral notification to Community Resource
based on Zipcode
REFERREDPROVIDERSchedules
appointment.
REFERRED PROVIDERSubmits Non-
Emergency MedicalTransportation
Authorization asneeded.
REFERRED PROVIDERTreats patient. Updates
patient EHR withservices provided,
treatment plan, andreferrals.
REFERRED PROVIDER Utilizes HIE to see information from
previous PROVIDER Visit including SDoH
Data
SDoH data is available via the HIE based on consent
ProposedSDOH Workflow
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HIE InnovationBehavioral Health Data Exchange
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Importance of integrating BH
• According to a 2016 Healthcare Cost and Utilization Project report, stays with a secondary Mental and Substance Use Disorder diagnosis cost more and were longer than stays without an MSUD diagnosis. Stays for a principal MSUD accounted for 6.1 percent of all adult stays and 3.6 percent of total hospital costs ($15.3 billion), pointing to the relatively low resource intensity of MSUD care in community hospitals. On average, stays with a principal MSUD cost $7,100 with an average length of stay of 6.4 days.
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Challenges with Integration
• BH Providers on outdated technology (or paper!)• Providers uncomfortable with interpretation of federal rules on
privacy• Non-standard data set• Ability to collect patient consent at the point of care
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Behavioral Health
• healtheConnect Alaska will begin collecting data from behavioral health providers
• Data to be displayed on a special behavioral health tab in healtheHUB
• Data on this tab is subject to 42 CFR part 2 Consent• BH Data can only be seen if a patient has opted in OR• There is an emergency that requires “break the seal” access of the
record