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Interoperability Problems Undercut Conclusions of CHIME Most Wired Survey

Posted on November 11, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Most of you have probably already seen the topline results from CHIME’s  “Healthcare’s Most Wired: National Trends 2018” study, which was released last month.

Some of the more interesting numbers coming out of the survey, at least for me, included the following:

  • Just 60% of responding physicians could access a hospital network’s virtual patient visit technology from outside its network, which kinda defeats the purpose of decentralizing care delivery.
  • The number of clinical alerts sent from a surveillance system integrated with an EHR topped out at 58% (alerts to critical care units), with 35% of respondents reporting that they had no surveillance system in place. This seems like quite a lost opportunity.
  • Virtually all (94%) participating organizations said that their organization’s EHR could consume discrete data, and 64% said they could incorporate CCDs and CCRs from physician-office EHRs as discrete data.

What really stands out for me, though, is that if CHIME’s overall analysis is correct, many aspects of our data analytics and patient engagement progress still hang in the balance.

Perhaps by design, the hospital industry comes out looking like it’s doing well in most of the technology strategy areas that it has questions about in the survey, but leaves out some important areas of weakness.

Specifically, in the introduction to its survey report, the group lists “integration and interoperability” as one of two groups of foundational technologies that must be in place before population health management/value-based care,  patient engagement and telehealth programs can proceed.

If that’s true, and it probably is, it throws up a red flag, which is probably why the report glossed over the fact that overall interoperability between hospitals is still very much in question. (If nothing else, it’s high time the hospitals adjust their interoperability expectations.) While it did cite numbers regarding what can be done with CCDs, it didn’t address the much bigger problems the industry faces in sharing data more fluidly.

Look, I don’t mean to be too literal here. Even if CHIME didn’t say so specifically, hospitals and health systems can make some progress on population health, patient engagement, and telehealth strategies even if they’re forced to stick to using their own internal data. Failing to establish fluid health data sharing between facility A and facility B may lead to less-than-ideal results, but it doesn’t stop either of them from marching towards goals like PHM or value-based care individually.

On the other hand, there certainly is an extent to which a lack of interoperability drags down the quality of our results. Perhaps the data sets we have are good enough even if they’re incomplete, but I think we’ve already got a pretty good sense that no amount of CCD exchange will get the results we ultimately hope to see. In other words, I’m suggesting that we take the CHIME survey’s data points in context.

Five Guiding Principles for Leveraging the Healthcare Contact Center

Posted on November 2, 2018 I Written By

The following is a guest blog post by Mike Wisz, Director, Analytics – Healthcare, Advisory Services, and Melissa Baker, Business Analyst, Healthcare, Advisory Services, at Burwood Group.

Consumer experience is more critical than ever for healthcare organizations. Today, the financial performance of health systems increasingly depends on converting consumers into patients and retaining patients within network—patients who now have expanding options for urgent, primary, and elective care. A contact center is a critical component of an inviting “digital front door” for consumers—which is why forward-looking healthcare organizations are envisioning how to transform call centers into patient engagement centers.

As part of an enterprise approach to patient access and experience, each organization will chart its own path in building out contact center capabilities. Healthcare CEOs increasingly recognize that consumers want to interact with their healthcare services as they do with companies in other industries, such as retail or hospitality.

The following are five guiding principles for developing a consumer-grade contact center experience.

First do no harm.

A poorly performing call center can result in frustrated patients or guests whose experience prompts them to look elsewhere for services. So first, deal with current problems, even if they are not easily discoverable. Using all available data sources, assess call handle times, customer effort required, and call routing accuracy against established targets or external benchmarks. If service levels are not acceptable, these problems must be resolved.

Make it easy for patients to connect.

Health systems should make it very easy for customers to access services using their preferred channel of communication. This access should be aligned from the customer’s perspective across touchpoints such as consumer-facing websites, patient portals and self-scheduling applications, and mobile applications offered to patients.

Remember: Productive agents create happy customers.

Consolidating contact center operations should result in more efficiency. Improving efficiency while offering additional services across more medical groups requires automation. Domain-specific knowledge support including scripts and protocols, empowers agents to rapidly resolve service requests. Skills-based routing gives managers the ability to staff flexibly while ensuring target service level performance. Desktop integrations with scheduling, billing, and clinical systems inform agents of highlighted information to reduce contact handle times and increase first-contact resolution rates.

Focus on outcomes. Measure and monitor.

Identify the business outcomes that are most important to determining success. These will likely focus on customer experience, agent productivity, and overall operational effectiveness. Many KPIs and metrics can be measured, but pick a few that will highlight performance against your most important outcomes. Ensure reports are available that provide visibility into key metrics and that reporting is timely enough to be actionable.

Align to enterprise vision and objectives.

It is not always clear in healthcare organizations who owns the “consumer experience.” Leaders from groups representing marketing, population health, clinical quality, and revenue cycle management should align and work together to ensure the contact center serves as a vital component of the organization’s comprehensive approach to patient experience.

In this new environment driven by consumerism, competition for patients will only continue to escalate. Successful health systems will learn to better leverage their contact centers as a way to attract and retain patients and optimize physician utilization, and to tackle a complex set of new challenges.

About Burwood Group
Burwood Group, Inc. is an IT consulting and integration firm. We help forward-thinking leaders design, use, and manage technology to transform their business and improve outcomes. Our services in consulting, technology, and operations are rooted in business alignment and technical expertise in cloud, automation, security, and collaboration. Burwood Group was founded in Chicago, IL and is celebrating over 20 years in business. Today, Burwood includes 250 employees and seven U.S. offices including a 24×7 Operations Center in San Diego, CA. Whether you are developing strategy, deploying technology, or creating an operational model, Burwood is a dedicated partner. To learn more, visit www.burwood.com.

Do We Need Another Interoperability Group?

Posted on September 20, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the last few years, industry groups dedicated to interoperability have been popping up like mushrooms after a hard rain. All seem to be dedicated to solving the same set of intractable data sharing problems.

The latest interoperability initiative on my radar, known as the Da Vinci Project, is focused on supporting value-based care.

The Da Vinci Project, which brings together more than 20 healthcare companies, is using HL7 FHIR to foster VBC (Value Based Care). Members include technology vendors, providers, and payers, including Allscripts, Anthem Blue Cross and Blue Shield, Cerner, Epic, Rush University Medical Center, Surescripts, UnitedHealthcare, Humana and Optum. The initiative is hosted by HL7 International.

Da Vinci project members plan to develop a common set of standards for data exchange that can be used nationally. The idea is to help partner organizations avoid spending money on one-off data sharing development projects.

The members are already at work on two test cases, one addressing 30-day medication reconciliation and the other coverage requirements discovery. Next, members will begin work on test cases for document templates and coverage rules, along with eHealth record exchange in support of HEDIS/STARS and clinician exchange.

Of course, these goals sound good in theory. Making it simpler for health plans, vendors and providers to create data sharing standards in common is probably smart.

The question is, is this effort really different from others fronted by Epic, Cerner and the like? Or perhaps more importantly, does its approach suffer from limitations that seem to have crippled other attempts at fostering interoperability?

As my colleague John Lynn notes, it’s probably not wise to be too ambitious when it comes to solving interoperability problems. “One of the major failures of most interoperability efforts is that they’re too ambitious,” he wrote earlier this year. “They try to do everything and since that’s not achievable, they end up doing nothing.”

John’s belief – which I share — is that it makes more sense to address “slices of interoperability” rather than attempt to share everything with everyone.

It’s possible that the Da Vinci Project may actually be taking such a practical approach. Enabling partners to create point-to-point data sharing solutions easily sounds very worthwhile, and could conceivably save money and improve care quality. That’s what we’re all after, right?

Still, the fact that they’re packaging this as a VBC initiative gives me pause. Hey, I know that fee-for-service reimbursement is on its way out and that it will take new technology to support new payment models, but is this really what happening here? I have to wonder.

Bottom line, if the giants involved are still slapping buzzwords on the project, I’m not sure they know what they’re doing yet. I guess we’ll just have to wait and see where they go with it.

Pricing Transparency and Provider Quality: Insights from Utah HIMSS

Posted on September 10, 2018 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Working to improve Health IT has been a major focus of Utah HIMSS this year. I am honored to serve as part of the Utah HIMSS Board. Utah HIMSS hosts educational events and luncheons for members. On August 29, 2018  the meeting focused on Pricing Transparency and Provider Quality. Health Informatics is positioned to help reduce waste in healthcare and providing better care for patients.

Bob White works with Select Health, one of the major insurance providers in the state, which is a subsidiary of Intermountain Healthcare. He was able to talk about payment models and value based care work within the Select Health group. Providing more visibility into the cost for patients and physicians has been a major focus on Select Health and payer provider entities have a unique market position. They want the cost of care delivery to be lower since they are paying the cost. Point of service adjudication requires that a lot of workflows need to be coordinated before the patient leaves the office.

Bob asked: How often do we feel like we don’t have complete information to know what is going on and what your options are?

One of the most notable things that he spoke about was the lack of adoption. They have great visibility but not everyone knows where to find that information. Some of the employees at Selecthealth have high deductible plans and in effect, become self-pay members. Becoming more educated consumers is a huge part of what Select Health has done with their pricing transparency.

Katie Harwood from the University Of Utah discussed their pricing transparency tool. The University of Utah is one of the first systems in the country to create an online interactive tool to help predict cost to patients. Patients can look up what a procedure might cost and enter information about their copay and caps. Most importantly, the cost estimator included the cost of facility and cost of provider, so patients don’t get stuck with unexpected out of network bills.

The most common search? Vaginal delivery without complications. I was thrilled to hear them speak because I’m pregnant and my provider is with the University of Utah Health. I got a cost estimate on my second visit to the OB and I was pleasantly surprised that they gave that information.  I was able to pay for what (might be) the cost of my maternity care. Being able to plan ahead is very valuable. The University of Utah has invested in creating bundled payment models to improve care coordination and as a patient, having that information has improved my healthcare experience.

While in development, the University of Utah wanted to add appointment scheduling for patients. Harwood mentioned this created a larger data matching challenge, as it was difficult to match exact providers with procedures. Insurance companies are trying to make it easier for patients to schedule and understand what their costs will be, and physician directories create unique challenges. What if you were a surgeon who performed a total knee replacement but you didn’t have the information connected with the correct insurance company for you to appear in the online scheduling tool?

Interestingly, many people go to the cost estimator tool enter “I don’t know” for some of their search criteria such as deductible and copay. Bridging the consumer gap to give even better information and creating the most accurate scheduling possible starts with efforts to create great health IT tools and adjusting them according to user behavior.

Holly Rimmasch from Health Catalyst was able to ask great questions and mentioned a program that Health Catalyst is doing to promote women in health IT. She served as a moderator and has an extensive background with pricing. They have promoted women in Health IT in the Utah area, including providing student scholarships for their Healthcare Analytics Summit in September.  A key question that Holly has focused on is “Are we making a difference in both quality and costs?”  “Does it translate into cost savings for those that are paying?” Part of her work involves bringing data sources together (clinical, financial, claims, etc.) to create transparency to services and care being provided and at what cost.  Over the last 6 years, Holly has been involved in developing a more accurate activity-based costing system. Accurate costing leads to more accurate pricing and more accurate pricing leads to improved price transparency. I am looking forward to learning more about what Health Catalyst does for improving Healthcare IT in Utah.

Norm Thurston is a Utah State Representative and I was surprised how much I enjoyed his presentation and I will tell you why. Norm Thurston has a background in statistics and I felt confident that the Utah legislature was getting good information about improving healthcare. Representative Thurston spoke about the availability of state data to see things like prescribing trends and billing trends among physicians. He asked Bob White about upcoding- and how the government of Utah looks at billing data to make that information more transparent for payers and providers. The checks and balances of legislators asking about trends based on data aren’t something I see every day in healthcare. Data backed inquiry can improve prescribing. Utah has had a decrease in opioid deaths in the last year, and the healthcare system and state efforts have actively used data to improve the numbers. Utah has historically been a state with a problem and has actively worked to improve rates of opioid deaths. One of the audience comments that I enjoyed was a question from Todd Allen, MD about how they evaluate the statistical significance of prescribing and billing differences. How do we know if using this drug or billing code 75% of the time has better outcomes that in the hospital where it is used less than 65% of the time? Having visibility and data is part of the equation for improving healthcare outcomes, and another part is interpreting the data and deciding best practices.

Health IT Consulting Demand To Explode This Year

Posted on August 24, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As payment models shift from fee-for-service to value-based care, hospitals are having to adopt new technologies and tweak existing ones. The thing is, it takes a mighty team of IT pros to make all this happen. In some cases, a provider has enough resources to handle this kind of big transition, but most need some help, especially when they’re handling major infrastructure improvements or even switching out technologies.

This seems to be at least part of what’s driving a dramatic increase in spending on health IT consulting, according to a new study from Black Book Research. The study drew on input from 1,586 professionals with knowledge of the US health IT industry.

Black Book concluded that health IT management consulting spending has grown from $20 billion in 2016 to $45 billion last year. Not only that, the firm expects to see this number climb to nearly $53 billion for 2018. That’s a massive increase, particularly given that providers were already spending heavily on consultants as they beat their enterprise EHRs into shape.

According to the analyst firm, 64% of last year’s spending paid for implementation of software, information systems, systems integration and optimization and support for mergers and acquisitions. This summary covers a lot of ground, but it’s hardly surprising given the drastic changes underway.

Going forward, respondents expect three key forces to drive healthcare consulting spend, including a lack of highly-skilled IT professionals (cited by 81% of respondents), adoption of cloud technology in healthcare (74%) and growing industry digitalization (71%). (I’d also expect to see investment in new organizational infrastructures — for, let’s say, ACOs)  — will continue to increase in importance as well.)

Providers responding to the study said that they expect to hire health IT consultants for EHR and RCM system optimization (61%) and to offer expertise in software training and implementation (46%) next year. Other areas providers hope to address include value-based care (39%), cloud infrastructure (36%), compliance issues (33%) and a grab bag of big data, decision support and analytics projects (31%).

The vast majority of respondents (84%) said they expect to enter into a wide range of consulting agreements to include work with single-shop consultants, single freelancers, group purchasing organizations, HIT vendors, networks of freelancers, boutique advisory firms and traditional major consultancies, Black Book reported. In other words, it’s all hands on deck!

What Happened to Care Pricing and Provider Quality Transparency?

Posted on August 21, 2018 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

I’m on the Utah HIMSS board and we’re hosting an event called “Full Disclosure- Price Transparency & Provider Ratings in Healthcare.”

At the event on August 29, 2018, we’ll be talking about pricing transparency and physician outcomes. The Pricing Transparency question has multiple goals and remains a complex problem in healthcare IT and other areas. Leaders in Utah Health IT will come together to discuss resources and experiences from Utah.

Pricing in healthcare remains the number one concern for many different stakeholders. Informatics departments are still concerned with denials and claims administration. Patients are unsure of price of care. Physicians’ practices are not clearly aligned with billing codes and claims can account for up to 30% of healthcare spending waste. In April of this year, Seema Verma announced that requirements for hospitals to post standard pricing would be the start of a broad initiative to increase transparency about healthcare prices.

Can price transparency & provider ratings help manage the costs of healthcare?

Price transparency might have the single biggest effect in informing the public about healthcare costs and could support a more efficient health care delivery system in the United States. Utah HIMSS members and others are invited to submit questions for panelists.  

Please register for the event and follow the Utah HIMSS pages Linkedin and Twitter.

Here’s a look at the panel members that will be involved:

Moderator: Holly Rimmasch- Health Catalyst

Holly Rimmasch is an Executive VP/Chief Clinical Officer of Health Catalyst.  She currently leads population health, patient safety and improvement services.  Ms. Rimmasch has over 30 years of experience in clinical and operational healthcare management. She has spent the last 20 years dedicated to improving clinical care and better understanding how to sustain and achieve better value.

Holly has extensive healthcare and operational experience.  Prior to joining Health Catalyst, she was an Assistant VP at Intermountain Healthcare responsible for Clinical Services.  While at Intermountain, she also served as the system Clinical Operations Director for Cardiovascular and Intensive Medicine.  Holly co-founded and was a Principal in HMS, Inc, a healthcare consulting firm focusing on population health.

Ms. Rimmasch holds a Master of Science in Adult Physiology from the University of Utah and a Bachelor of Science in Nursing from Brigham Young University.

Price Transparency

A key question that Holly has focused on is “Are we making a difference in both quality and costs?”  “Does it translate into cost savings for those that are paying?” Part of her work involves bringing data sources together (clinical, financial, claims, etc.) to create transparency to services and care being provided and at what cost.  Over the last 6 years, Holly has been involved in developing a more accurate activity-based costing system. Accurate costing leads to more accurate pricing and more accurate pricing leads improved price transparency.

Panelist: Rep. Norm Thurston- Utah State Legislature

Personal & Professional

Dr. Thurston has a Masters and Ph.D. in economics from Princeton University, and an undergraduate degree in Spanish and Agribusiness Management from Brigham Young University.  His areas of specialty include insurance markets, health care provider markets, labor markets, and public finance/economics. 

Dr. Thurston has been a policy analyst and health economist for the Utah Department of Health since 2003. Currently, he is the Director of the Office of Health Care Statistics which is responsible for the collection, analysis, and dissemination of data related to health care cost and quality for the State of Utah.  In previous roles he has served as policy adviser and executive staff for health system reform efforts in the State of Utah. 

Before joining the state, Dr. Thurston worked for eight years as an assistant professor of economics at Brigham Young University.  He has published several articles on health care markets in nationally recognized economics journals.  He is a life-long resident of Utah, growing up in Morgan County.  He has native-level fluency in Spanish and was a Fulbright Scholar teaching economics in Argentina in 2001. He and his wife Maria have three children and two grandchildren.

Legislative

Rep. Thurston was elected to the Utah House of Representatives in 2014 from District 64 (Provo, Springville).  Currently, he is a member of the Government Operations Committee, the Economic Development and Workforce Services Committee, and the Social Services Appropriations Subcommittee.

Price Transparency:

“Norm Thurston is the director of the Office of Health Care Statistics (OHCS). The office collects, analyzes and disseminates data on health care utilization and costs for the State of Utah. Their two main data efforts include collecting information about patient encounters at hospitals and emergency rooms into the Healthcare Facilities Database and information about claims paid by health plans for all types of services into the All Payer Claims Database.

These data are used by a variety of entities, including healthcare facilities, plans, researchers, and public health programs.”

Panelist: Bob White- Intermountain Healthcare

Bob White, Vice President and Chief Operating Officer

Bob has over 27 years of experience in the Information Technology industry. He has been with SelectHealth for 20 years and currently leads member services, business systems support, program management, process improvement, business continuity, and information technology.

Previously, Bob was employed by the IBM Consulting Group. He attended Brigham Young University and holds a bachelor’s degree from DeVry University. He currently serves on the board of Trizetto Customer Group

Panelist: Katie Harwood- University of Utah Hospitals and Clinics

Patient and Financial Services Manager at the University of Utah Hospitals and Clinics

Katie Harwood is a Revenue Cycle Manager with University of Utah Health. She has been with the organization since 1995, most recently responsible for the admissions and financial counseling  teams. She is currently serving as the president of the American Association of Healthcare Administrative Management Utah Mountainwest chapter (AAHAM). She also participates with the National Association of Healthcare Access Management on the Certification Commission and is  a Certified Healthcare Access Manager. Outside of work she enjoys her two sons, dog, and Zumba.

Katie had the opportunity to participate in the development of the pricing transparency tool University of Utah Health. The goal was to create a tool that would have full care pricing available for consumers. She is excited to share what our experience in pricing transparency has been and how the consumer benefits from the use of it .

Health Leaders Go Beyond EHRs To Tackle Value-Based Care

Posted on March 30, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In the broadest sense, EHRs were built to manage patient populations — but largely one patient at a time. As a result, it’s little wonder that they aren’t offering much support for value-based care as is, as a recent report from Sage Growth Partners suggests.

Sage spoke with 100 healthcare executives to find out what they saw as their value-based care capabilities and obstacles. Participants included leaders from a wide range of entities, including an ACO, several large physician practices and a midsize integrated delivery network.

The overall sense Sage seems to have gotten from its research was that while value-based care contracts are beginning to pay off, health execs are finding it difficult support these contacts using the EHRs they have in place. While their EHRs can produce quality reports, most don’t offer data aggregation and analytics, risk stratification, care coordination or tools to foster patient and clinician engagement, the report notes.

To get the capabilities they need for value-based contracting, health organizations are layering population health management solutions on top of their EHRs. Though these additional PHM tools may not be fully mature, health executives told Sage that there already seeing a return on such investments.

This is not necessarily because these organizations aren’t comfortable with their existing EHR. The Sage study found that 65% of respondents were somewhat or highly unlikely to replace their EHR in the next three years.

However, roughly half of the 70% of providers who had EHRs for at least three years also have third-party PHM tools in place as well. Also, 64% of providers said that EHRs haven’t delivered many important value-based contracting tools.

Meanwhile, 60% to 75% of respondents are seeking value-based care solutions outside their EHR platform. And they are liking the results. Forty-six percent of the roughly three-quarters of respondents who were seeing ROI with value-based care felt that their third-party population PHM solution was essential to their success.

Despite their concerns, healthcare organizations may not feel impelled to invest in value-based care tools immediately. Right now, just 5% of respondents said that value-based care accounted for over 50% of their revenues, while 62% said that such contracts represented just 0 to 10% of their revenues. Arguably, while the growth in value-based contracting is continuing apace, it may not be at a tipping point just yet.

Still, traditional EHR vendors may need to do a better job of supporting value-based contracting (not that they’re not trying). The situation may change, but in the near term, health executives are going elsewhere when they look at building their value-based contracting capabilities. It’s hard to predict how this will turn out, but if I were an enterprise EHR vendor, I’d take competition with population health management specialist vendors very seriously.

Pennsylvania Health Orgs Agree to Joint $1 Billion Network Dev Effort

Posted on December 27, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If the essence of deal-making is putting your money where your mouth is, a new agreement between Pennsylvania healthcare giants fit the description. They’ve certainly bitten off a mouthful.

Health organizations, Penn State Health and Highmark Health, have agreed to make a collective investment of more than $1 billion. That is a pretty big number to swallow, even for two large organizations, though it very well may take even more to develop the kind of network they have in mind.

The two are building out what they describe as a “community-based healthcare network,” which they’re designing to foster collaboration with community doctors and keep care local across its service areas.  Makes sense, though the initial press release doesn’t do much to explain how the two are going to make that happen.

The agreement between Penn State and Highmark includes efforts to support population health, the next step in accepting value-based payment. The investors’ plans include the development of population health management capabilities and the use of analytics to manage chronic conditions. Again, pretty much to be expected these days, though their goals are more likely to actually be met given the money being thrown at the problem.

That being said, one possible aspect of interest to this deal is its inclusion of a regionally-focused academic medical center. Penn State plans to focus its plans around teaching hospital Milton S. Hershey Medical Center, a 548-bed hospital affiliated with more than 1,100 clinicians. In my experience, too few agreements take enough advantage of hospital skills in their zeal to spread their arms around large areas, so involving the Medical Center might offer extra benefits to the agreement.

Highmark Health, for its part, is an ACO which encompasses healthcare business serving almost 50 million consumers cutting across all 50 states.  Clearly, an ACO with national reach has every reason in the world to make this kind of investment.

I don’t know what the demographics of the Penn State market are, but one can assume a few things about them, given the the big bucks the pair are throwing at the deal:

  • That there’s a lot of well-insured consumers in the region, which will help pay for a return on the huge investment the players are making
  • That community doctors are substantially independent, but the two allies are hoping to buy a bunch of practices and solidify their network
  • That prospective participants in the network are lacking the IT tools they need to make value-based schemes work, which is why, in part, the two players need to spend so heavily

I know that ACOs and healthcare systems are already striking deals like this one. If you’re part of a health system hoping to survive the next generation of reimbursement, big budgets are necessary, as are new strategies better adapted to value-based reimbursement.

Still, this is a pretty large deal by just about any measure. If it works out, we might end up with new benchmarks for building better-distributed healthcare networks.

Health Systems, Hospitals Getting Serious About Telemedicine

Posted on December 8, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In the spring of last year, I wrote up a story about hospitals and health systems and their growing interest in telemedicine. The story included data from a survey on hospitals and telemedicine, which found that health systems averaged 5.51 telemedicine service lines at the time, up almost 20% from 2015.

Given these stats, I was not surprised to see a new press release from Teladoc reporting that the company now supports more than 200 hospitals, a number which represents a 100% growth in such relationships during this year.

If you’re wondering why this has happened, you’ll get more or less the same answer from last year’s study and Teladoc’s news release. In short, it’s all about the outcomes, baby.

When I wrote the story last year, one of the things that stood out for me was that 96% of respondents had said they were planning to roll up telemedicine services because they felt it would improve patient outcomes. While that made sense to me at the time, it seemed more like an aspiration rather than a practical plan.

What made the survey data even more provocative is that “improving financial returns” turned out to be a very low priority for hospitals working on telemedicine programs. At the time, this focus on outcomes rather than direct financial returns surprised me.

Now, about 18 months later, I’m doing the facepalm thing and saying “of course, hospitals want affordable, flexible care delivery options — they’re a great tool for managing population health!” It’s a no-brainer, actually, but I guess my brain wasn’t working at the time.

Now, as far as I know, the assumption that telemedicine can help with PHM and value-based delivery generally has not been rigorously tested. Also, even if the assumption is correct, hospitals are likely to struggle with deploying telemedicine for a while until they develop the most efficient workflows for using it.

Also, while it’s all well and good to say that focusing on outcomes will create ROI as a secondary effect, for some hospitals it will be pretty rough to carry telemedicine infrastructure and staffing costs upfront for a while. After all, if they want to make an impact with telemedicine, they have to make a serious commitment; I’m guessing that most of us would agree that a scattershot approach would get most hospitals nowhere.

Ultimately, though, I think hospitals have it right. Telemedicine is likely to offer health systems and hospitals some amazing options for extending service lines, managing populations more effectively, and yes, improving outcomes.

Predictive Analytics Will Save Hospitals, Not IT Investment

Posted on October 27, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Most hospitals run on very slim operating margins. In fact, not-for-profit hospitals’ mean operating margins fell from 3.4% in fiscal year 2015 to 2.7% in fiscal year 2016, according to Moody’s Investors Service.

To turn this around, many seem to be pinning their hopes on better technology, spending between 25% and 35% of their capital budget on IT infrastructure investment. But that strategy might backfire, suggests an article appearing in the Harvard Business Review.

Author Sanjeev Agrawal, who serves as president of healthcare and chief marketing officer at healthcare predictive analytics company LeanTaaS, argues that throwing more money at IT won’t help hospitals become more profitable. “Healthcare providers can’t keep spending their way out of trouble by investing in more and more infrastructure,” he writes. “Instead, they must optimize the use of the assets currently in place.”

Instead, he suggests, hospitals need to go the way of retail, transportation and airlines, industries which also manage complex operations and work on narrow margins. Those industries have improved their performance by improving their data science capabilities.

“[Hospitals] need to create an operational ‘air traffic control’ for their hospitals — a centralized command-and-control capability that is predictive, learns continually, and uses optimization algorithms and artificial intelligence to deliver prescriptive recommendations throughout the system,” Agrawal says.

Agrawal predicts that hospitals will use predictive analytics to refine their key care-delivery processes, including resource utilization, staff schedules, and patient admits and discharges. If they get it right, they’ll meet many of their goals, including better patient throughput, lower costs and more efficient asset utilization.

For example, he notes, hospitals can optimize OR utilization, which brings in 65% of revenue at most hospitals. Rather than relying on current block-scheduling techniques, which have been proven to be inefficient, hospitals can use predictive analytics and mobile apps to give surgeons more control of OR scheduling.

Another area ripe for process improvements is the emergency department. As Agrawal notes, hospitals can avoid bottlenecks by using analytics to define the most efficient order for ED activities. Not only can this improve hospital finances, it can improve patient satisfaction, he says.

Of course, Agrawal works for a predictive analytics vendor, which makes him more than a little bit biased. But on the other hand, I doubt any of us would disagree that adopting predictive analytics strategies is the next frontier for hospitals.

After all, having spent many billions collectively to implement EMRs, hospitals have created enormous data stores, and few would argue that it’s high time to leverage them. For example, if they want to adopt population health management – and it’s a question of when, not if — they’ve got to use these tools to reduce outcome variations and improve quality of cost across populations. Also, while the deep-pocketed hospitals are doing it first, it seems likely that over time, virtually every hospital will use EMR data to streamline operations as well.

The question is, will vendors like LeanTaaS take a leading role in this transition, or will hospital IT leaders know what they want to do?  At this stage, it’s anyone’s guess.