Bill Siwicki

A whistleblower blog claimed many other executives within the NYC Health + Hospitals EHR project were deeply concerned. But the health system countered that the electronic health record software would be ready by implementation.

While mobile apps are new enough on the care delivery scene that many providers have only begun dabbling, consumers are sending a strong message that forward-thinking hospital executives can translate into an opportunity for improving population health management programs. Northwestern University's Feinberg School of Medicine is conducting clinical trials that use mobile health apps to do much more than just communicate with patients — the software teaches mental health patients cognitive behavioral therapy, or CBT, techniques designed to improve population health and reduce mental healthcare costs. This story is part of a reporting package on the rise of population in health in healthcare IT management. Stories include our analysis of health system strategies, an overview of the work done by Essentia Health and a look at how mobile apps are supporting initiatives. Designed by Northwestern's Center for Behavioral Intervention Technologies, the ThinkFeelDo website (a responsive design site built to render effectively on any device) and the IntelliCare suite of mobile apps (available in the Google Play store for Android devices, with Apple iOS apps in the works) break up the various CBT techniques into separate modules to make learning the techniques and applying them in situations an easier task. The modules include text, animation and video. Caregiver coaches, on the other end of the mobile site and apps, review patient progress and can intervene during lessons to help patients with any challenges or issues and to provide encouragement. "Costs can be saved by giving depressed patients these kinds of tools, decreasing overall health care utilization for an individual," said Kenneth R. Weingardt, scientific director at the Center for Behavioral Intervention Technologies. Weingardt also is a licensed psychologist. "We are now saving more money because the cost of the app is much lower than the cost of face-to-face. For some folks who are fairly well-functioning and can go it alone, these types of technology may provide them with what they need so they do not have a long depressive episode that impacts their health and costs a health plan money." ThinkFeelDo and IntelliCare are still in clinical trials at Northwestern, though CBITs is in discussions with Kaiser about deploying IntelliCare through its patient portal. "Mobile interventions have much farther reach than individual providers can have," Weingardt said. "They can reach many more people beyond those we can see in our clinic. And a health system that adopts these kinds of tools can improve their bandwidth and their ability to address these problems beyond the capacity of their workforce.” [Like Healthcare IT News on Facebook] In the Northwestern’s clinical trials, Weingardt added, that means giving participants tools to get symptoms under control and making it less likely they will come back with complaints. Providers such as Northwestern and other simply cannot ignore the trend toward mobile tools any longer, said population health management vendor Enli Health Intelligence chief medical officer Joseph Siemienczuk, MD. "We have to follow the communication preferences of the community and and it is clear that their communication preferences have moved to mobile technology,” Siemienczuk said. "As we pursue effectiveness, moving patient engagement activities to mobile technology is an imperative." Twitter: @SiwickiHealthIT

As 67 percent of healthcare organizations have population health management programs in place, experts say information technology is key in making them work.

First-mover health systems are already using telehealth services to successfully manage patient populations and lower healthcare costs. Take Essentia Health, for instance. The 16-hospital and 68-clinic system uses an Epic EHR and telehealth technology from Medtronic to focus on improving the health of congestive heart failure patients and enhancing the care surrounding this chronic health problem. This story is part of a reporting package on the rise of population in health in healthcare IT management. Stories include our analysis of health system strategies, an overview of the work done by Essentia Health and a look at how mobile apps are supporting initiatives. Whereas 25 percent of congestive heart failure patients in the U.S. are readmitted to the hospital within 30 days, according the Agency for Healthcare Research and Quality, Essentia said that less than 2 percent of those participating in its telehealth program return in that same timeframe. Indeed, telemedicine technologies at Essentia and other tech-savvy hospitals can help fill in care gaps, monitor at-risk patients and extend services to patients who might not otherwise receive them. Essentia, for its part, started the telemedicine work in 1998 and then instituted a formal population health management program several years ago. Today, of the 2,500 patients in Essentia's congestive heart failure program, about 300 who meet certain clinical criteria have been given tele-scales. The electronic scales digitally report via landline or cellular phone service a patient’s weight every day as well as how that person responds to questions the scale literally asks aloud. Tele-scales cost between $70-$110 per month to lease. Physician assistants and registered nurses, in turn, can deliver telehealth care under the guidance of cardiologists. "Weighing every day helps you identify the real problems," said Denise Buxbaum, heart failure program manager at Essentia Health. "When these patients actually come into the hospital, most of the times they outspend their diagnosis-related group, anyway. Now we have contracts, we are an accountable care organization. BCBS of Minnesota did one study and with this technology we saved them $1.25 million." Buxbaum said the combination of regular monitoring and the patient education that comes with it lead to improved patient health and, as a result, lower costs. "Patients need to understand the consequences of their lifestyle choices, and by showing them – when they see it with their own eyes – they are more likely to make a better choice the next time when they learn from ongoing education," she said. "With telemedicine, we are catching things early before patients have to visit an emergency room." [Like Healthcare IT News on Facebook] Additionally, Essentia Health built an interface between the telemedicine system and its EHR so patient data that congestive heart failure nurses see can be readily available to all members of a care team. "Our EHR allows caregivers to review the patient medical record to see what other care coordinators or providers have done when caring for our patients," Buxbaum explained. "This allows for a more seamless, higher level of quality care when we all know what the rest of the health care team is doing." Twitter: @SiwickiHealthIT

A new report based on customer scores found that the two companies outperformed other EHR-dependent and EHR-independent vendors.

LAS VEGAS – Commvault, an enterprise data protection and information management technology provider, launched at HIMSS16 its Commvault Clinical Archive, a system designed to modernize the way healthcare organizations manage, migrate and share clinical data. As healthcare provider organizations look to control costs and improve care, Commvault Clinical Archive, the vendor said, can centralize information management and break down data silos, reducing storage costs and complexity, enabling better data-sharing, and eliminating costs of maintaining and supporting legacy systems. Following Commvault’s investment in PACS replacement data migration and storage services vendor Laitek, Commvault developed a system built on the Commvault Data Platform and Laitek’s Semperdata platform. The system migrates data and enables clinical data management for healthcare providers. Through this integration, Commvault Clinical Archive addresses data management on both the clinical and business sides of healthcare in a single platform. [Also: See photos from Day 3 of HIMSS16] As a result, for example, providers can decommission legacy PACS systems into a single data management platform while making legacy studies accessible to new PACS systems and available for bulk migration, Commvault said. Data is extracted from a legacy PACS in its original format, normalized and migrated into the clinical archive in a standard format for interoperability, and then stored for future use. Commvault Clinical Archive also can be used as a vendor-neutral archive for all clinical information. “Healthcare customers are facing many pressures to modernize data management strategies, reduce costs and increase efficiencies,” said N. Robert Hammer, chairman, president and CEO of Commvault. “Retiring legacy PACS and managing clinical data across multiple vendor silos is increasingly becoming frustrating for healthcare IT teams, and our new solution supported by Laitek’s technology will help healthcare organizations better manage, control and protect clinical data while also benefiting from our proven approach to overall data management.” Recent research by International Data Corp. dives into the issue of legacy PACS decommissioning and medical image archiving. “IDC research shows that replacing legacy picture archiving and communications systems is a priority among healthcare IT administrators as a result of high total cost of ownership and the solution’s proprietary and siloed nature with a single department, especially as new types of unstructured content other than medical images, like scanned documents, photos and videos, proliferate across the enterprise,” said Judy Hanover, research director at IDC Health Insights. “Healthcare providers are moving to standards-based application-independent clinical archiving solutions that have lower total cost of ownership and allow them to manage, secure and share medical images alongside other vital content, improving provider operations and the quality of care by making content available for clinical decision-making.” Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

LAS VEGAS – Newly expanded health IT vendor CPSI has introduced nTrust, a program designed to help community hospitals and skilled nursing facilities improve financial operations while moving into an electronic health records system with no upfront costs, CPSI said. The vendor unveiled the program last week at the 2016 Annual HIMSS Conference and Exhibition. “There are many providers that are unhappy with their EHR, but they don’t have the financial capability to make a switch,” said Boyd Douglas, CPSI president and CEO. “With nTrust, we help providers in acute and post-acute settings improve business operations via our TruBridge management services, while at the same time funding the purchase of their EHR with no advance payment required.” Through nTrust, hospitals and senior care facilities outsource revenue cycle management operations to TruBridge business services, which recently has been strengthened by the addition of revenue cycle management tools from Rycan Technologies, CPSI said. As a result of this business relationship, proceeds are allocated to finance the purchase and ongoing support of either Evident’s EHR system for acute care providers or American HealthTech’s EHR for post-acute care facilities. [Also: See photos from Day 3 of HIMSS16] CPSI is the parent of Evident LLC, TruBridge LLC, Healthland Inc., American HealthTech Inc. and Rycan Technologies. “nTrust gives customers a pathway to a better-performing EHR without upfront costs, with a partner that is taking a stake in their success,” Douglas said. “We will help you achieve the improved cash flow and increased financial efficiency in your operations that will help pay for an EHR that fits your needs for the complex and shifting healthcare environment. We are making a financial investment in the ongoing success of our clients who choose to take advantage of this program.” Sharkey-Issaquena Community Hospital entered a relationship with CPSI that began with TruBridge services to improve the hospital’s business operations, explained John Hodnett, RN, director of clinical systems at the hospital. “To further enhance our ability to effectively serve our patients and our community, the Thrive EHR from Evident was implemented simultaneously,” he said. “This business venture was without a big upfront expense.” The partnership aspect of the nTrust approach is invaluable and made the goal of implementing a new electronic health records system financially obtainable, Hodnett added. Douglas added the nTrust program was specifically designed to be of value to rural and community hospitals and senior care facilities. “We understand how today’s complexities associated with revenue cycle management has put increasing pressure on community healthcare providers that are already financially stressed,” he said. “TruBridge brings proven operational expertise and industry leading tools to bear to greatly enhance the efficiency and effectiveness of managing the revenue cycle process.” Douglas said nTrust is the first of many product and service offerings emerging from the recent blending of the Evident, TruBridge, Healthland, American HealthTech and Rycan businesses. Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

LAS VEGAS – Population health management technology vendor ZeOmega has launched Jiva for Performance Management, a software-as-a-service system that enables healthcare organizations to quickly manage the clinical and financial performance of their pay-for-performance and readmission reduction programs across multiple payers, including Medicare, Medicaid and commercial contracts, the vendor said. ZeOmega made the announcement at the 2016 Annual HIMSS Conference and Exhibition. “While the industry has steadily moved toward value-based care, many healthcare organizations still struggle with the problem of provider performance measurement, which, in turn, impedes their ability to participate in meaningful risk-sharing models,” said Nandini Rangaswamy, chief strategy officer at ZeOmega. “Our conversations with hospital executives, industry analysts and consultants have indicated that the biggest challenges continue to be a lack of multi-payer support, the cost of interoperability and deployment time.” [Also: See photos from Day 3 of HIMSS16] Jiva for Performance Management was developed to address these challenges, Rangaswamy added. The new system integrates with nearly three dozen disparate health data systems, and healthcare organizations can use this single platform to measure and manage performance across multiple populations, multiple payers and different types of value-based care contracts, Rangaswamy said. ZeOmega said Jiva for Performance Management can be deployed in a matter of weeks and that the system is able to quickly integrate claims and electronic health records data. Dashboards monitor an organization’s progress toward achieving Star, Medicare Shared Savings Program, Healthcare Effectiveness Data and Information Set, and other pay-for-performance goals, the vendor added. The system also delivers patient registries, predictive analytics driven by psycho-social risk factors, and patient engagement capabilities that can enable organizations to better manage admission and readmission risk and develop patient outreach programs, ZeOmega said. Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

LAS VEGAS – UnitedHealthcare and Qualcomm are collaborating on a new mobile health program dubbed UnitedHealthcare Motion that aims to boost wellness by linking financial incentives with the use of wearable devices. The goal is to help UnitedHealthcare plan participants enrolled in high-deductible health plans improve their health and save money by encouraging daily walking, while testing and building new connected health technologies for consumers. The new wellness program provides plan participants with wearable devices at no additional charge and enables them to earn up to $1,460 per year by meeting certain goals for the number of daily steps. UnitedHealthcare Motion was showcased for the first time at this year’s 2016 Annual HIMSS Conference and Exhibition. The collaboration between the two companies will seek to develop connected health systems to employees and consumers across the United States. The collaboration will focus on new UnitedHealthcare programs and services that incorporate the latest generation of wearables, medical devices and home diagnostic tests that use Qualcomm Life’s 2net Platform for medical-grade connectivity. [Also: See photos from Day 3 of HIMSS16] UnitedHealthcare Motion is now available to employers and their employees in Arkansas, Florida, Georgia, Louisiana, Maryland, Missouri, New Jersey, Ohio, Oregon, Pennsylvania, Virginia, Washington and Washington, D.C. Additional markets will be added later this year. The wellness program and related fitness trackers are being offered initially to companies with 101 to 300 employees with a fully insured health plan. Employees and their covered spouses receive custom-designed wearable devices that track the number of steps users take each day. Unlike other wearable devices that simply track the total number of steps, the UnitedHealthcare Motion devices tabulate the total number, frequency and intensity of the steps taken, providing a more accurate and comprehensive summary of the user’s daily activity, the companies said. The data then is sent to the UnitedHealthcare Motion app, which securely links to Qualcomm Life’s 2net Mobile connectivity platform. Employees can earn Health Reimbursement Account credits that can total up to $1,460 per year, while employers can obtain premium savings based on program participants’ combined results. “We’re excited to collaborate with UnitedHealthcare to power its connected care solutions, starting with the UnitedHealthcare Motion program,” said James Mault, MD, vice president and chief medical officer at Qualcomm Life. “UnitedHealthcare’s leadership in innovation and broad reach across the United States, combined with Qualcomm Life’s medical-grade connectivity solutions, enables personalized, connected care to health care consumers nationwide.” Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

LAS VEGAS – American HealthTech has partnered with Medtelligent to offer owners and managers of senior care facilities a new care and management system. The Assisted Living Solution is designed to help providers navigate the technology challenges of caring for seniors who move across the spectrum of care from assisted living to skilled nursing facilities and other provider organizations. The combination of American HealthTech’s skilled nursing electronic health records system and Medtelligent’s Assisted Living offering will be especially beneficial to the fast-growing sector of continuing care retirement communities, said the vendors, who announced the partnership at the 2016 Annual HIMSS Conference and Exhibition in Las Vegas. Post-acute organization owners and managers can use the combined technologies to provide accurate, detailed electronic care records for seniors as they move among assisted living, skilled nursing facilities, continuing care retirement communities, rehabilitation centers and other organizations, the vendors said. Further, the combined technologies can provide financial management and workflow tools for all post-acute senior care facilities, the vendors said. [Also: See photos from Day 3 of HIMSS16] American HealthTech has more than 3,300 skilled nursing facilities as clients while Medtelligent specializes in the assisted living industry and operates in 31 states, the vendors said. "The senior care landscape is challenging facility owners, with changing ownership models, shifting reimbursement models and the aging of America’s population," said American HealthTech president Teresa Chase. "The Medtelligent products add strength to our American HealthTech solutions and give our clients superior clinical and financial management tools across a wider landscape of care facilities." The two companies’ products blend well across care settings because of American HealthTech’s strength in skilled nursing and Medtelligent’s experience in the assisted living and memory care industries, said John Shafaee, Medtelligent’s CEO. "The big trends in our industry are upon us like a tsunami," said Chase, pointing out that in two years, 50 percent of Medicare payments will be based on quality and value of care. She added that by 2030, one of every five U.S. residents will be 65 or older and 2.3 percent of the population will be 85 or older. "Already, the 85-plus segment is the fastest growing population in the country. These trends are unstoppable, and this business partnership will help facility owners manage them." Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.