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Advancing Nationwide Person-Centered Health Data Exchange

Session # 102, February 21, 2017

Michael J. Maksymow, Jr., VP and CIO, Beebe Healthcare

Jitin Asnaani, Executive Director, CommonWell Health Alliance

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Speaker Introduction

Michael J. Maksymow Jr, CHCIO, FCHIME, FHIMSS, CPHIMS

VP and CIO

Beebe Healthcare

Jitin Asnaani

Executive Director

CommonWell Health Alliance

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Conflict of Interest

Michael J. Maksymow Jr, CHCIO, FCHIME, FHIMSS, CPHIMS

Has no real or apparent conflicts of interest to report.

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Conflict of Interest

Jitin Asnaani, MBA

Salary: CommonWell Health Alliance

Ownership Interest: Ixora Health Inc., Medullan Inc., Beacinsight Inc.

Advisory: National Health IT Standards Committee

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Agenda

• Barriers: Why Aren’t We There Yet?

• Opportunities: The Person Imperative

• Approach: The Big Picture

• Call to Action: Baby Steps

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Learning Objectives

• Discuss the barriers that hinder scalable, nationwide, vendor-neutral

interoperability today

• Recognize how to increase physician access to and use of external patient

records as part of their clinical treatment plans

• Identify the benefits for building person-centric information exchange services into

current health IT systems to reduce time to market and increase end user adoption

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Beebe Healthcare• Lewes, Delaware

Location

•Community, NFP

Type of organization

•210 licensed beds

Beds

•1 medical center

•4 walk-in care centers

•8 outpatient locations

•16 physician offices

•3 school based wellness programs

•hospitalist program

Facilities

•Over 350

Physicians

•Over 2,000

Employees

•1916

Founded

Mike Maksymow

Vice President & CIO

Beebe Healthcare

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Beebe Healthcare

• Disparate In-Patient & Ambulatory EMR’s

• Demographic changes

– Population increasing 8.2%

– Households increasing 9.2%

– 65+ age group increasing 20%

– 75+ age group increasing 31.4%

• Balance between established and transient population

• Enjoys a progressive state health information network

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Patient-Centered Exchange affects all the HIMSS STEPS™ for realizing value in Health IT

Are my physicians, staff, and patients happy?

T

E

P

S

S Satisfaction

Treatment/Clinical

Electronic Secure Data

Patient Engagement

and Population

ManagementSavings

Do I have what I need to treat safely and effectively?

Is the data electronic and available in the workflow?

Am I addressing my changing responsibilities?

Are we driving down (unreimbursed) delivery costs?

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Barriers:Why Aren’t We There Yet?

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Health IT is increasingly frenetic

MU Stage 1

MU Stage 2

Pioneer ACOs

MU Stage 3

MACRA

MIPS

PMI

HITSP ProfilesCCDA

Push

SMART Apps

FHIR

Query/Retrieve

Notify

2010

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Standardization != Execution

• We have been obsessed with standards –

and fundamental misunderstand their role.

• Standards do not execute in a vacuum.

In fact they don’t (usually) execute at all.

technical standard: (usually) a formal document that

establishes uniform engineering or technical criteria,

methods, processes and practices.

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Paradoxes within the health system

• Profitability

• Strategic Assets

• Patient Retention

• More risk

• Better care

• Openness

• Pop Health

• More data

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Fragment. Connect. Repeat.

Settings of care

EHRs and apps

Care team members

The static biosphere is an optical illusion

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Opportunities:The Person Imperative

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Value-Based Care: tipping the scales

– Less value in sickness, more value in health

– Alignment of effort with individual health

– Caregivers need to know the patient:

• Where they’ve been

• What issues they’ve had

• How “risky” they are.

• Across the continuum

Local Record

FFS

Person

Record

VBC

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Government is pointing the direction

1. Digitization

2. Interoperability

3. Anti-data blocking

4. Patient engagement

5. Patient empowerment

Local Record

FFS

Person

Record

VBC

Government

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The consumer will have the final say

• Costs are rising patients are noticing

– 2016 Kaiser Family Foundation survey found premiums

for family coverage have increased 20% since 20111

• “Quantified Self” continues to gain steam

• People are becoming more mobile2

• You only need 10% of a population to tip3

1 http://kff.org/report-section/ehbs-2016-summary-of-findings/

2 http://www.thefuturescentre.org/trend-card/increased-mobility

3 http://freakonomics.com/2011/07/28/minority-rules-why-10-percent-is-all-you-need/

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Approach:The Big Picture

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See the elephant!

• “Accountable” care implies that you know the

Person

– Where they have been for health and

care

– Clinical data

– Non-clinical data

– Know his/her STORY

• Fundamental difference between

“exchanging data” and being “person-centered”

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From data to insight to action

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X-Vendor initiatives are enablers

– Build into the workflow.

the health record

the portal

the app

the <insert future here>

– Increasingly widespread

– Future-proof

1 https://dashboard.healthit.gov/evaluations/data-briefs/non-federal-acute-care-hospital-ehr-adoption-2008-2015.php

May 2016 ONC Data Brief:

53% cited the biggest barrier

to interoperability as “shared

information not available to

clinicians in their EHRs”.1

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Caregivers can take it further!

• Build into the clinical conversation

• Further the patient story

• The relationship

• The trust

• The value

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Call to Action:Baby Steps

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Find out more

• Caregivers:

– Have you talked to your vendor?

– Have you inquired about the options?

• HIT Vendors:

– Have you examined the options?

– Go Participate. Maybe even Lead.

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Just get going!

• Try it out.

• Get better at it.

• Provide feedback.

• Take the first steps.

“It’s getting late early.” -Babe Ruth

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What we did to get started

Consistent repeatable experience for the clinician

regardless of the vendor or organization submitting the

CCD

Set a Goal

Get Buy-In

Begin Exploration Talk to vendors about options for data exchange;

test in limited environment

Tie the objective back to business and clinical value;

identify a sponsor

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Patient-Centered Exchange really shines because it enables Empowerment

Satisfaction from health IT really comes from empowerment:

• Physicians and caregivers who get what they need to take better care of patients

• Patients who trust their caregivers to be informed

• Consumers who trust that they can get their data

• Office staff that can efficiently find the information they need no matter where care occurred

The benefits percolate across the STEPS™

T

E

P

S

S Satisfaction

Treatment/Clinical

Electronic Secure Data

Patient Engagement

and Population

ManagementSavings

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Questions

Michael J. Maksymow, Jr

Beebe Healthcare

Email:

MMaksymow@BeebeHealthcare.org

LinkedIn: mmaksymow

Jitin Asnaani

CommonWell Health Alliance

Email:

jitin@commonwellalliance.org

LinkedIn: jasnaani

Twitter: @jitin