Analytics

Electronic health records are typically touted as providing two primary and vital services: readily accessible patient records and protection against contraindicated medications. But Intermountain Healthcare is benefiting from a growing and transformative versatility in the application of its EHRs.

It’s a futuristic idea to be sure: Harnessing the intelligence of IBM Watson, the Jeopardy-winning supercomputer, to support cardiac-care recovery, reduce hospital readmissions, and save healthcare costs. But that’s what the Colorado-based healthcare nonprofit Centura Health and consumer enterprise platform vendor Welltok are doing right now with CaféWell Concierge, currently in pilot with consumers who are transitioning back to everyday life after experiencing a heart condition. See all of our HIMSS16 previews “Cognitive computing mimics the way humans think by combining artificial intelligence and machine-learning algorithms,” said Jeff Margolis, CEO of Welltok. “IBM Watson understands natural language in context; it can determine the intent of a phrase or question and provide a pertinent, useful response.” Margolis, along with Pam Nicholson, senior vice president of strategy for Centura Health, will present “Applying Cognitive Computing to Population Health” at HIMSS16. Nicholson said that the technology the companies are piloting learns from interactions to provide personalized recommendations over time. For example, if a consumer has opportunities to join a team activity challenge and schedule a one-on-one coaching session, and consistently chooses the team activity, the app would recognize that this person favors social activities and recommend a support group at the local community center. [Also: IBM Watson picked to help tackle heart disease] Among the other ways that patients interact with CaféWell: Finding options for cardiac rehabilitation exercises and activities; researching new heart-healthy recipes and dishes at local restaurants, and identifying educational resources and videos on living with heart conditions. In these ways, cognitive computing is broadening the scope of healthcare delivery “so that it can happen outside what we normally think of as the healthcare setting,'” Nicholson said. “The contrast with traditional health care, where we only get to interact with the consumer when they step inside our four walls and temporarily become a patient, is profound.” As the real-world pilot users continue to train the application’s “brain,” as Margolis put it, these innovators see ample opportunities for cognitive computing to have an impact in the four areas of health: healthy behaviors, genetics, medical interventions, and environment. [Like Healthcare IT News on Facebook] “In five years, we believe that predictive analytics will further evolve and enable providers and consumers to make better health decisions while allowing for care to be highly personalized,” Nicholson said. “This will require us to continue to build solutions that incorporate timely and new data sources, offer reliable, consistent predictive models, deliver convenient and immediate personalized health and lifestyle recommendations, and learn intuitively and rapidly.” The session "Applying Cognitive Computing to Population Health,” is slated to take place March 3, 2016 from 1 to 2 p.m. in Rock of Ages Theater at the Sands Expo Convention Center. Twitter: @HenryPowderly 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.

The consultant, which proposes moving away from evaluating physicians independently to a methodology in which physicians are evaluated in clusters, will share insights at HIMSS16.

(SPONSORED) What if you could know in advance which patients would benefit from certain therapies? Or could intervene in a medical crisis before it's too late? While doctors have traditionally had to rely on instinct to make these calls, predictive analytics could be a game changer for hospitals, healthcare providers and patients.

Analytics functionality has improved measurably in recent years, according to Chilmark Research, but  workflow integration remains a key hurdle.

Digitizing clinical quality measures, also known as eCQM, isn’t just about meeting government requirements. It’s also about healthcare organizations smartly using electronic data to drive decisions, said Keith Woeltje, MD, director of healthcare informatics at the Center for Clinical Excellence at BJC HealthCare. “It’s not just about the government, but what we choose to do ourselves,” he added. Woeltje is responsible for informatics, analytics and reporting at BJC HealthCare, in addition to leading its clinical quality measurement group. He will deliver a presentation on eCQM at HIMSS16. See all of our HIMSS16 previews Woeltje said his team found electronic measures easy to use on patient adverse events and other subsequent events. However, while BJC HealthCare met the Centers for Medicare and Medicaid Services meaningful use requirements, there were “enormous discrepancies” with the health system’s EHR data. Woeltje will present on eCQM and BJC HealthCare’s successful implementation at HIMSS16 in Las Vegas. In his session, “Reconciling Abstracted to Electronic Quality Measures,” Woeltje will discuss BJC HealthCare’s integrated transition to electronic quality measures and his findings and recommendations, using abstracted measures. [Also: CMS makes annual update to 2016 eCQMs] It was the aforementioned discrepancies that led BJC HealthCare to partner with Encore, a healthcare IT consultancy, to analyze these gaps and manage workflows and EHR data. “We wanted to tease those out,” Woeltje said. “We met the requirements, but given that this will be the way we report clinical quality in the future, we needed to it reflect our actual quality of care,” Woeltje said. Going through the audit and discrepancy process was enormously helpful for successfully implementing eCQM. But there’s no tool that can fix these gaps, Woeltje said. While BJC HealthCare could have continued to use certified EHRs and forced the workflows to capture data to reduce gaps and improve the quality of care, the health system turned to the physicians to discover what was needed to “use electronic data to focus on internal issues for electronic surveillances,” Woeltje said. “No health system is thinking about adding more projects,” Woeltje said. “Hospitals want to focus on solutions to reduce errors and become as efficient as possible.” [Like Healthcare IT News on Facebook] Woeltje and his team at BJC HealthCare planned the integrated approach when they noticed more quality programs were moving into eMeasures. The results from BJC HealthCare’s transition can prove helpful for those organizations considering similar changes. The session “Reconciling Abstracted to Electronic Quality Measures” is scheduled for Tuesday, March 1, 2016, at the Sands Expo Convention Center in Palazzo D. HIMSS16 runs from Feb. 29-Mar. 4. Twitter: @JessiefDavis 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.

(SPONSORED) Health may be priceless, but healthcare is not. With medical costs on the rise, insurance companies and government payers are increasingly asking pharmaceutical companies and device manufacturers to prove--and quantify--the value of their therapies.

As the Zika virus spreads from South America to the United States, epidemiologist and public health expert Christine Hockett says disease surveillance technology is key to protecting against it. Keeping open lines of electronic communication between hospitals and their state and local health agencies is critical as those departments "collect and analyze disease counts and monitor how disease spreads throughout a community or geographic location," said Hockett, who works for Xerox-owned Consilience. [Also: Experts warn of Zika epidemic as hospitals, health departments prepare] Zika, spread to people through mosquito bites, is currently most prevalent in South America. In response, the U.S. Centers for Disease Control and Prevention issued a travel alert for U.S. citizens traveling to regions where virus transmission is ongoing. But Hockett says she expects the virus to increasingly move into the United States. She points to a recent article in The Lancet, which argued that, "with an estimated 440,000 – 1.3 million cases currently in Brazil alone, Zika virus could be following in the footsteps of dengue and chikungunya, which are also transmitted by the Aedes aegypti mosquito. "Given that an outbreak anywhere is potentially a threat everywhere," the authors argued, "now is the time to step up all efforts to prevent, detect, and respond to Zika virus." "I don't think 'scared' is the right word," said Hockett. "But we need to be aware of what's happening. And definitely, I think there are certain areas of the U.S. that are more vulnerable than others." Robust electronic surveillance – data collection and reporting – is essential to keeping that spread as limited as possible. Syndromic surveillance has been a key part of meaningful use since the very beginning, of course, with the government requiring providers to prove their ability to use "timely pre-diagnostic data and statistical tools to detect and characterize unusual activity for further public health investigation." The Maven Outbreak Management Software offers Web-based case management tools that can help local and state health systems do disease surveillance, enabling them to analyze the health data from specific diseases. Rather than a siloed database, the Maven tool is accessible across jurisdictions to local and state public health departments, and can integrate electronic reporting. Outbreaks can be assessed and triaged as confirmed cases emerge or patients at risk present themselves, with updates shared electronically or via its secure Web portal, according to the company. It can also be updated as new disease threats emerge. That happened in 2014 during the Ebola crisis, and it did again earlier this month as Zika started to spread. "With the configurability of Maven, you're able to adapt to these new emerging diseases," she said. "The CDC on Jan. 15 said, 'You need to be able to do this in your disease surveillance systems.' A couple weeks later, all of our deployments have this Zika-enabled data module." Here’s how it would work from hospital's perspective. "Say I recently just traveled to Brazil," she said. "And I come back to the U.S. I go and see my primary care provider and say, 'Please test me for the Zika virus, just to make sure I don't have it.'" (Zika symptoms are very mild, and could be easy to miss.) "So I get tested, that then gets entered into the EHR system. That lab report, once the lab processes that, not only does the doctor report it to the state health department, but the lab does too. That reporting is done through the connections into Maven, which is hosted within the local and state health departments – a case is created, the epidemiologist can see that I am a potential case of Zika. They would call me and do the necessary follow up and data collection needed, specific to the virus. Once that case is confirmed, the system is able to report it to CDC." If technology is critical in the fight against Zika, however, people and process are even more so. [Also: Questions raised about EHR workflow in Ebola case] As seen in the 2014 Ebola outbreak – when a patient at Dallas-based Texas Health Resources first appeared with Ebola symptoms, but the fact that he had recently traveled from Africa, while logged in his EHR, was still missed by subsequent members of his care team – the balance between IT and clinical workflow can be a challenge. "It's definitely a collaborative effort," said Hockett. She pointed to the One Health concept, which holds that the health of humans is inextricably connected to the health of animals and the environment. [Like Healthcare IT News on Facebook] That holistic approach means there's a deep need for collaboration, she said. "Use of effective surveillance systems is essential: knowing the symptoms of the diseases that are going on, talking with your provider community and epidemiologists and local and state health departments. The communications between hospitals and local and state health departments are critical." Twitter: @MikeMiliardHITN

ACO quality measures were enhanced by pay-for-performance programs, according to the JAMA network, but providers also need advanced technologies, interventions, and close contact with patients. 

New rules are anticipated to allow organizations -- those approved as qualified entities -- to confidentially share or sell analyses of the data.