Accountable Care

(Sponsored) Blockchain has huge potential to ensure different parties work together and collaborate to deliver high-quality care for patients by providing the optimum platforms for care providers, says Ali Rizwan, product manager for Solve.care.

(Sponsored) The AMA's award-winning tools help alleviate the problem of physician burnout, improving clinical workflows and removing patient-care barriers, says Laurie McGraw, SVP of Health Solutions at the AMA.

The enterprise software vendor will also be making the case for putting ERP in the cloud at the upcoming health IT conference.

The healthcare venture formed by Amazon, Berkshire Hathaway and JPMorgan Chase has hired insurance executive Dana Gelb Safran as head of measurement, a data-driven technology position, according to CNBC. Safran is the chief performance measurement and improvement officer and senior vice president of Enterprise Analytics, at Blue Cross Blue Shield of Massachusetts. She joins the Boston-based group headed by Dr. Atul Gawande. WHY IT MATTERS In her role at BCBS Massachusetts, Safran was responsible for leading efforts to use data, measurement, incentives, and reporting to improve the quality, outcomes, and affordability of care, according to biography information from the Medicare Payment Advisory Commission. Webinar: Women in Blockchain: Making a Difference in Healthcare through Distributed Ledger Technology Safran’s experience improving quality and outcomes while lowering the cost of care through IT is exactly how the industry views Amazon’s new venture and its potential to tackle healthcare’s greatest challenges. Data and analytics will loom large, as will offering the 1-plus million employees of the three companies a personalized approach to healthcare benefits. THE TREND Not much has been released about the new venture, which the big three formed earlier this year. It still has no official name. Gawande was named CEO in June. Safran’s background in health insurance, however, aligns with the innovations expected of Gawande, a Brigham and Women’s Hospital surgeon, author and New Yorker staff writer who, in the November 12 issue, sympathized with physicians struggling to balance EHR technology with work schedules and patient care. DANA SAFRAN: THERE'S MORE TO KNOW Safran was appointed to serve on MedPAC in 2017 in a term through April 2020. She is also an associate professor at Tufts University School of Medicine. She serves on a number of state and national advisory bodies related to healthcare quality and affordability, including the National Quality Forum Consensus Standards Approval Committee and the CMS Technical Expert Panel on the Quality Rating System. Twitter: @SusanJMorse Email the writer: susan.morse@himssmedia.com

The clinically integrated network, with 10 payer feeds, more than 40 practice billing systems and around 20 EHR feeds across two large health systems, has aggregated data from 1,380 physicians across 185 practice locations.

Carilion Clinic has been on a path toward value-based care for more than a decade, but staff realized they needed more support in gaining better insights into their patient population.

The accountable care organization connected 14 disparate EHR systems to get meaningful analytics, helping with population health and value-based reimbursement.

A case study about how tech helped Princeton reduce inpatient utilization by 5 percent and decrease expenditures in post-acute care by 12 percent since it began with the MSSP program.

The Einstein Medical Center wanted to decrease readmissions for liver failure patients by 50 percent. Caregivers had a longtime interest in the potential for remote patient monitoring and turned to telehealth technology to address this mandate. Thus far, since implementing the RPM processes, the hospital has gone more than two months without any readmissions. "The problems we encountered included issues that come up with all patients with a severe chronic illness," said Richard Kalman, MD, assistant professor of medicine SKMC in the department of digestive disease and transplantation in the division of hepatology at the Albert Einstein Healthcare Network in Philadelphia. Despite requiring all patients to attend follow-up appointments within two weeks, the readmission rate still was 40 percent. Patients often would come to the clinic and be readmitted directly because they were too sick, or would be called to come to the hospital for severe laboratory abnormalities, or would present to the emergency room feeling sick due to non-compliance. And some readmissions were unavoidable, of course. The hope with the initiation of the telehealth remote patient monitoring program was to find problems when they were still small and could be managed as an outpatient, thus avoiding a readmission. Einstein Medical Center uses remote patient monitoring technology from Vivify Health. Other vendors of remote patient monitoring technology include Biotronik, Boston Scientific, GE Healthcare, LifeData, Medtronic, Philips Healthcare and Spacelabs Healthcare. "The technology allows our patients to have a remote visit within 48 hours of discharge with one of their liver providers, and also allows the patient to relay information including symptom assessment and vital signs to the liver clinic as well as to our partnered visiting nurse program," Kalman explained. "The device is set up with the help of the visiting nurse, and the patient then uses the device to log symptoms and vitals." The program, which lasts for 30 days, is not currently integrated directly with the organization's EHR, but the online portal is user-friendly and allows for good communication, he said. Telemedicine technology allows the liver team to find small problems before they become major issues that might require hospital admission. The team is constantly adjusting blood pressure pills, diuretics and medications to control high ammonia levels that can lead to hepatic encephalopathy. "One example that comes to mind is of a rather cantankerous older gentleman who is on the list for liver transplant," Kalman recalled. "He would always claim that his blood pressure was elevated in the office because he disliked doctors so he never allowed me to prescribe a blood pressure pill. This technology allowed him to take his blood pressure at home, and I was able to demonstrate that his blood pressure was more than just white coat hypertension." His blood pressure is now under much better control, and although he has not yet reached the top of the transplant list, when he does, he will have a decreased risk of stroke and cardiac pathology because his blood pressure is under good control pre-operatively, Kalman added. The remote patient monitoring technology is not just having an impact on patients and readmissions, it is having an impact on value-based care. "The impact of this technology on value-based care is simple," Kalman said. "It allows the patient to provide more data to providers, thus allowing for more efficient and timely care that also allows for less frequent office visits and improved communication." Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com

New rule would advance interoperability, streamline measures accountable care organizations need to report and pay for more types of virtual visits.