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Patient Engagement and Collaborative Care with Drex DeFord

Posted on August 7, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

#Paid content sponsored by Intel.

You don’t see guys like Drex DeFord every day in the health IT world. Rather than following the traditional IT career path, he began his career as a rock ‘n roll disc jockey. He then served as a US Air Force officer for 20 years — where his assignments included service as regional CIO for 12 hospitals across the southern US and CTO for Air Force Health — before focusing on private-sector HIT.

After leaving the Air Force, he served as CIO of Scripps Health, Seattle Children’s Hospital and Steward Health before forming drexio digital health (he describes himself as a “recovering CIO”). Drex is also a board member for a number of companies and was on the HIMSS National board and the Chairman of CHIME.

Given this extensive background in healthcare IT leadership, we wanted to get Drex’s insights into patient engagement and collaborative care. As organizations have shifted to value based reimbursement, this has become a very important topic to understand and implement in an organization. Have you created a culture of collaborative care in your organization? If not, this interview with Drex will shed some light on what you need to do to build that culture.

You can watch the full video interview embedded below or click from this list of topics to skip to the section of the video that interests you most:

What are you doing in your organization to engage patients? How are you using technology to facilitate collaborative care?

Does Clinical Integration Call For New Leaders?

Posted on October 10, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For quite some time now, U.S. healthcare reforms have been built around the idea that we need to achieve clinical integration between key care partners. Under these emerging models of integration, it isn’t good enough for physicians and hospitals to have a general sense of what care the other is delivering. Instead, the idea is for independent entities to function as much as possible as though they were part of the same organization.

Of course, for these partners in an integrated system to work together, they have to share a great deal of data on a patient, if not necessarily every scrap of their lifetime medical record. In other words, some degree of data integration isn’t “nice to have,” it’s a “must have.”  In fact, I wouldn’t be the first to suggest that without data integration, effective clinical integration is basically impossible.

However, while readers of this publication aren’t ignorant of this fact, my sense is that some participants in such schemes are hoping to jump in with both feet first, and figure out data sharing models later. This is mostly a hunch, but I’m pretty sure it’s happening, and moreover, I’m convinced that the mediocre performance of most ACOs is due to a leap-before-you-look approach to data sharing.

I don’t know if any models exist that emerging integrated clinical entities can use to lay out data pathways before they’re under the gun. But my sense is that we spend too little time figuring this out in advance.

Generally speaking, my guess is that these ACO partnerships and other integrated care projects are being driven by old-school healthcare execs. By this I mean folks who understand very well how to build for cross referrals between entities, forge partnerships that help all hospitals and doctors involved do better in insurance negotiations, know how to negotiate with health purchases such as large employers and the like.

Having followed such folks for some 25 years, I have nothing but respect for their strategic skills. However, I sort of doubt that they are the right people to guide larger healthcare organizations into the age of clinical and technical integration. While they might be very smart, their intuition tells them to hold back data as a proprietary asset, not share it with partners who might be competitors again in the future. And while it’s understandable why they think this way, it’s not constructive today.

Don’t get me wrong, I’m not suggesting that CXOs with decades of experience have suddenly become dinosaurs. There’s still plenty of work for them to do, and most of it is vitally important to the future of the health system. But if they want to be successful, they’ll have to turn their thinking around regarding data integration with partners. And if they can’t do that, it very well be time to bring in some fresh blood.

Epic Module Targets Patients For Care Coordination

Posted on May 15, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

At Gundersen Lutheran Health System, executives have put together a program to target the 1 to 2 percent of those most likely to be hospitalized, seen in the emergency department or face other complications. To manage the program, the La Crosse, Wis.-based system is leveraging a feature of their Epic EMR which sifts out the patients most in need of additional care coordination, reports Health Data Management.

Gundersen Lutheran is targeting complex patients with its program, but not just those with medically-complex conditions. They’re also hoping to find patients who, while they might have simpler conditions, live alone or have trouble following sometimes difficult medical care plans.  The system is using the EMR first to identify the patients, then to treat them, according to Health Data Management.

To find patients in need of extra care coordination services, Gundersen is using a “tiered scoring” module built in to the Epic platform which includes one component for medical complexity and another to measure psycho-social issues. When clinicians want to refer a patient to the care coordination program, physicians use the Epic scoring tool to see if  the patient qualifies. Clinicians can also notify the care coordination team using the Epic system, in three clicks or less, noted Beth Smith, R.N., executive director of patient and family-centered care at the health system.

The patients identified by the scoring model as in need of extra care coordination are farmed out to a group of 22 nurses and social workers, whose job it is to monitor the care of these complex patients who are more likely to face adverse events.

The workload the care coordinators face is intense.  Typically, care managers are supervising some 1,700 patients each, who not only stay in touch with patients but also attend office visits and follow through with specialists.  Epic plays a role here too, however.  Care coordinators get a special tab in the Epic EMR which pulls key elements of the patient’s history into a single view,  making it easier to get a sense of the whole patient.  Epic also notifies them via a message in the system if a patient shows up in the ED.

According to Health Data Management, this program has helped stabilize hypertensive and diabetic patients, with just under half showing sustained improvements over a two-year period.

Healthcare Big Data vs Skinny Data

Posted on April 2, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I have heard a number of people talk about healthcare big data was all the buzz in the healthcare IT world. There’s little doubt that there’s a lot of conversation happening around big data and analytics in healthcare. While I think there’s tremendous value to be found in healthcare big data, I’ve been more intrigued by what Encore Health Resources calls skinny data.

You can read more about the Encore Health Resources CoreANALYTICS announcement, but the approach is what I find really interesting. Instead of trying to create a huge enterprise data warehouse that can be all healthcare data for everything, they instead decided to focus on created a smaller solution that just focused on one major problem: meaningful use.

Encore Health Resources was open about the reason why they chose to go with a skinny data model as opposed to a full enterprise data warehouse model, time and budget constraints. They basically were asked to produce a result with a limited budget and so there wasn’t time or money to do anything but achieve the desired results. One of the architects of the system said, “If you can give me the extra data for free, then give it to me. If it costs [time or money] more to get that data, then don’t do it. Although, if you don’t give me these other data elements, then I’m going to have issues.”

It seems like a pretty simple concept to me that makes me wonder why I haven’t seen more of it in healthcare. Encore has taken these concepts and started to expand beyond meaningful use and into other areas like at-risk populations, clinical analytics for care coordination, and financial analytics.

I asked them if CoreANALYTICS would eventually grow into what essentially becomes an enterprise data warehouse. They suggested that it wouldn’t likely ever get that large, but I can see a path to that type of result.

What I do love about skinny data is that it’s user the information a hospital has available and creating actual results. It’s one thing to have the data, but it’s what you do with that data that really matters.

HIT Bigshots Tackle Post-Hospital Care Coordination, Miss The Point

Posted on October 13, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she’s served as editor in chief of several healthcare B2B sites.

I’d be a pretty shallow gal, I would, if I didn’t take the problems patients face when transitioning from hospital to another setting seriously.  But I swear I’m not being flip when I say that holding another conference on how HIT can solve the problem is, uh, a bit lame.

The conference in question, which will bring together some bigshots in healthcare policy, politics and health IT, includes speaker spots by Farzad Mostashari, MD, National Coordinator for Health IT, Health Affairs Editor-in-Chief Susan Dentzer and Todd Park, CTO  of HHS. Wow. And that’s just some of the headliners.

The participants will cover some of the critical ways HIT can support seamless transitions from hospitals to a patient’s next location, including standards, interoperability, exchange and Meaningful Use, the event’s press release notes.

OK. Fine. I get it — to coordinate care, EMRs and other HIT systems have to be individually robust and share data fluidly. Providers have to get on board. And it’ll all work if everybody adopts the right technology and plays nicely with their pals.

It’s telling, though, that event leaders aren’t promising much talk on how patients and their families can leverage IT to help make this happen. It isn’t about empowering patients to access their health information, communicate with doctors as supportive team members or even about patient education. It’s all about making sure the machines and software do their job. A brilliantly orchestrated, thoughtfully developed, boundlessly powerful set of machines and software solutions, but technology nonetheless.

So count me as impatient. Until policy types and health IT gurus get their heads out of the enterprise IT, networking and software business, they’re going to talk around the real care coordination issue. And that’s not only a bore, it’s a dangerous waste of time. We’re fighting for people’s lives here.

Hospitals have and arguably have had for some time more than enough firepower to solve their end of the problem. But historically, they’ve done little to involve patients and families in managing their conditions once they’re gone. Discharge summaries are perfunctory at best, particularly given how much info hospitals have at their fingertips, and virtually no education takes place throughout a patient’s visit. Once they leave, it gets far worse. “Out of sight, out of mind” may be a bit too strong but I’m sure you see what I mean.

If they want to be part of the solution, hospitals will need to think about how they can support the patients directly through smart IT use, especially super-smart new mobile options and remote monitoring of chronic or emergent conditions in the home.  Otherwise, patients are likely to remain sick, puzzled and likely to fall between the cracks.