Health Tech REPORT - Technology Solutions That Drive ...€¦ · 2 Health Tech Report SUMMER 2013...

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Transforming Care at a Distancewith Telepresence TechnologyPAGE 18

Navigating the Ins and Outsof Patient Data Management PAGE 16

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THE EXPERTSTALKINGARE

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REPORTHealth TechSUMMER 2013An Inside Look at I.T. Trends for the Healthcare Market

2 Health Tech Report SUMMER 2013

ONLINE RESOURCES

STAY IN THE KNOWKeep on top of industry trends, expert views and breaking news.

@CDW_Healthcare

CDW.com/view

PATIENT DATA MANAGEMENT With the explosion in the amount of patient data, having the right technology components in place is imperative. Find out how to efficiently manage patient data.

CDW.com/datamigration

KEEPING AN EYE ON VISUAL SOLUTIONSThe use of visual technology ranges widely across a health system. Learn about the latest visual solutions to help boost workflow and improve patient engagement.

CDW.com/patientstaffcomm

TO LEARN MORE ABOUT CDW HEALTHCARE, VISIT:

CDW.com/communIT

PUTTING PATIENTS FIRST — FROM HOSPITAL TO HOMEEngage. Educate. Empower. We hear these buzzwords again and again. Improving the patient experience is fast becoming a top priority for healthcare executives as HCAHPS ratings, meaningful use Stage 2 and accountable care shine a brighter spotlight on patient satisfaction. Some progressive healthcare organizations are even appointing a chief customer officer (CCO) or a chief experience officer (CXO) to focus exclusively on addressing patient needs. But, as is the case with many of our clients, the responsibility of boosting patient satisfaction falls partly on the shoulders of the I.T. department.

That’s because information technology is playing an even more critical role in shaping the patient experience inside and outside hospital walls. Innovations in point-of-care technology are bringing “infotainment” to the bedside, while visual solutions are enhancing patient, staff and family communication across the enterprise. Behind the scenes, healthcare organizations are investing in I.T. infrastructure upgrades to better store, secure and analyze the growing volumes of patient data as they prepare for population health management. Partnering with patients is extending beyond an onsite visit, as more providers turn to telehealth, online portals and mobile technology to promote remote care right in the home in an effort to lower healthcare costs and improve care.

Delivering a positive experience is a key driver to happier, healthier patients. That’s why this new issue of Health Tech Report offers tips, trends and insights from industry leaders who are leveraging technology to focus on the patient. CDW Healthcare is here to support you with expertise and I.T. solutions that help you strengthen patient partnerships across the continuum of care.

BOB ROSSIVice President, CDW Healthcare

LETTER FROM BOB

SUMMER 2013 Health Tech Report 3

DATA MERGE AHEAD

5 Ways to Use DisplaysGet the picture on how the latest visual technology enhances healthcare across the enterprise.

Navigating the Ins and Outs of Patient Data ManagementLearn how data migration and security can impact a patient data management strategy.

Transforming Care at a Distance with Cisco HealthPresence 2.5How the new Cisco HealthPresence 2.5 platform leverages telepresence to close geographic barriers to patients in need of immediate treatment and evaluation.

SOLUTION SNAPSHOT 10 MEANINGFUL INSIGHTS

12 PEER PERSPECTIVE

20 KEY LEARNINGS

22 INDUSTRY SPOTLIGHT

TECH TIPS

PARTNER CORNER

CONTENTSHIT WATCH

Dial in to the latest I.T. trends impacting the healthcare landscape as we move into the second half of 2013.

04

14

16

18

The Rise of Healthcare Consumerism and Patient-Facing Technology

How are consumer expectations shaping healthcare today? Three healthcare industry experts share their views.

Seeing Results with Digital Visual Communication Solutions

The CIO of Baptist Health discusses how technology improves communication between patients and staff.

Steps to Success: Putting an ACO in Motion

Hear how the Vice President and CIO of Sharp HealthCare has addressed care coordination and population health management to better serve ACO populations.

I.T. Increasingly at Home in Healthcare

As the U.S. population continues to age, see how changes in today’s healthcare technology have made home healthcare a growing trend.

TALK OF THE TOWN10 HIT TRENDS CREATING BIG BUZZ


TalkOF

the TOWN

Talk TOWNOF

the

10 HIT TRENDS

EHR BYOD DATA GROWTH

PATIENT DATA

ONLINE ACCESS

BUSINESS CONTINUITY

I.T. EXPERTS

MEANINGFUL USE

HIE ACOs

1 2 3 4 5 6 7 8 9 10

The healthcare industry continues to adjust to a new reality. EHRs have increasingly become a fact of life, pressure is mounting to prepare for meaningful use Stage 2, the financial stakes for successful patient engagement have been raised and ACOs are playing a more prominent role in the move toward value-based care delivery. Investing in the right I.T. solutions can streamline the transition and pay big dividends in expanded capability and improved performance on measures across the board. Here are some of the technology trends you’re going to be hearing a lot about in the coming months.

HIT WATCH


EHR SATISFACTION AND USABILITY MOVE FRONT AND CENTER

The good news is that physician satisfaction with EHRs increases after the systems have been in place for five years, according to the results of an AmericanEHR Partners survey. The less-good news is that user satisfaction has declined 12% over the past two years and nearly 40% would not recommend their EHRs to colleagues. Primary care physicians are the most satisfied — possibly because the majority of systems were designed for primary care users — and surgeons are the least satisfied. A KLAS study found that with more on the line in terms of meaningful use, accountable care and other pressures, EHR users are increasingly demanding that vendors pay more attention to user concerns and take more responsibility for improving usability.

More than half of physician respondents are satisfied with their EHR features and functionality, and about 40% are satisfied or very satisfied with their EHR’s ability to improve patient care.

AmericanEHR Partners

BYOD BRINGS BENEFITS — AND RISK

As the grassroots popularity of BYOD continues to soar, healthcare organizations can no longer afford to ignore it or take a “wait and see” attitude. The likelihood that determined users will simply find unapproved workarounds can drive up the already high risk of data breach, outweighing the many benefits BYOD brings to both clinicians and organizations. These benefits include convenience, improved productivity, enhanced satisfaction, better patient care and cost savings.

To safeguard sensitive patient data in a BYOD environment, organizations must employ a multi-layered security strategy that includes encryption, mobile device management (MDM) software solutions, developing and enforcing stringent BYOD password and network access policies, and preventing users from storing data on mobile devices. However, many providers have their work cut out for them — barely a third of respondents to a Cisco study reported their organizations were prepared to properly protect data.

Citing reasons ranging from lack of specific features and interoperability to poor vendor support, up to 17% of EHR users are considering switching systems by the end of 2013.

Black Book Rankings17%

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BYOD SECURITY

Nearly 89% of U.S. healthcare workers use their personal smartphones for work purposes.

But only 41% have their phones password-protected,

and 53% access unsecured or unknown Wi-Fi networks — a well-known cyber-security vulnerability.

“BYOD Insights 2013: A Cisco Partner Network Study,” Cisco Systems

LEARN MORE about mobility management by downloading our new white paper, “Smart moves for managing healthcare mobility.”

53%

41%

89%


ONC’s “THREE A’s” OF PATIENT ENGAGEMENT

1. Provide individuals with ACCESS to healthcare data

2. Help patients take ACTION on that data toward improved health

3. Shape the ATTITUDES of patients and providers to understand the value of data access

MAKE SURE PATIENTS CAN VDT ASAP

The rise of healthcare consumerism, coupled with meaningful use criteria, has spurred demand for more innovative patient education and engagement tools. In Stage 2, providing patients with the ability to “View, Download and Transmit” (VDT) their health data electronically from their provider’s EHR becomes a core item. The Consumer eHealth team from the Office of the National Coordinator for Health IT (ONC) has

taken its Blue Button initiative — designed to provide patients with easy, secure electronic access to their health data — several steps further with the introduction of Blue Button Plus. This blueprint for secure, structured data sharing between consumers and clinicians meets and builds on the VDT requirements. A growing number of “data holders” are starting to incorporate the Blue Button in their patient portal offerings, supporting provider outreach efforts to ensure patients actually access the data offered.

THE ONLINE PATH TO HEALTH AND HAPPINESS

While studies show most U.S. doctors believe patients should have some access to their EHRs, they generally remain reluctant to give patients the ability to fully access and update their own records. Understandably, many express concern about data accuracy, increased work for office staff and potential confusion or distress for patients. However, a growing body of research shows that not only are these fears groundless, but online access actually delivers positive benefits. For example, a pilot study at an Oregon Veterans Administration medical center found patients who were given access to visit notes, lab results, discharge summaries and other key components of their EHRs gained knowledge about their health and did a better job taking care of — and advocating for — themselves. And a Harvard Medical School study showed most patients who participated in doctor’s-visit note sharing found it helpful and wanted to continue viewing the information.

PACS storage requirements in

U.S. hospitals have grown at a rate of

more than 20% per year for the past

five years.

Frost & Sullivan

More than 85 million Americans have access to Blue Button data from at least one source today. The number is expected to increase to more than 115 million by year-end.

U.S. Department of Veterans Affairs4

5

of American doctors want patients to actively participate in their own care by self-updating their EHRs, and nearly half believe giving patients access to EHRs is crucial to providing more effective care. However, barely one-fifth currently allowed even the most basic access.

Accenture

82%MAMMOTH DATA GROWTH CREATES MONUMENTAL CHALLENGES

Fueled by the widespread adoption of EMR, rapidly expanding numbers of HIT applications and increasing use of highly sophisticated imaging technology, the massively growing volume of digital patient data threatens to bury data centers at many healthcare organizations. Limited budgets and overtaxed I.T. staffs exacerbate this predicament. The key to optimizing data center performance lies in implementing resourceful strategies. State-of-the-art storage management solutions such as automatic tiering, virtualization, data deduplication and cloud storage maximize capacity and ease the management burden. Other solutions including server virtualization, converged infrastructure, sustainable power and cooling, backup and disaster recovery, and defense-in-depth security safeguard data, ensure high data availability, enhance business continuity capability, improve regulatory compliance and rein in costs.

3HIT WATCH


SHARPER FOCUS ON BUSINESS CONTINUITY

It’s probably no surprise that in the wake of Superstorm Sandy, disaster recovery/business continuity shot up from #11 to #5 in the annual Healthcare Technology Online survey that ranks I.T. trends. The power outages, flooding and other chaos wreaked by Sandy affected HIT systems — and patient care — in several East Coast states and beyond. Lessons learned include the need to invest in fully redundant data centers in geographically dispersed locations and the need for reliable health information exchange, both of which help minimize interruptions to critical EHR data access even if patients have to be evacuated to other facilities. At least healthcare systems have come a long way from Hurricane Katrina, which destroyed hundreds of thousands of paper patient records. While losing temporary access to EHRs is not ideal, digital data can be restored.

I.T. TALENT: A HOT COMMODITY

For the second straight year, healthcare I.T. executives in the annual HIMSS Leadership Survey reported that inadequate staffing resources posed the most significant barrier to implementing I.T. in their organizations. Driven by an increase in the number of systems they need to manage, more than half the respondents expected to increase the number of I.T. staff in the next year, with the greatest need for professionals in clinical application support, network/architecture support and clinical informatics — if they can find them. A report by PwC’s Health Research Institute found nearly 80% of healthcare CEOs plan to invest in I.T. this year but many are held back by the lack of qualified professionals, particularly a shortage of people with the ability to combine technical savvy and business strategy.

“It’s not enough to just back up files every night. You also have to consider how long it’s going to take to put data back in case of an event.”

Chuck Christian, CIO, Good Samaritan Hospital, Vincennes, Indiana 66% of healthcare

organizations and professionals surveyed

said finding I.T. workers with the appropriate skills is a challenge.

TEKsystems and HIMSS

6

7

LEARN MORE about Good Samaritan’s strategies for business continuity and disaster recovery by downloading this PDF.


RAISING THE BAR FOR MEANINGFUL USE

Health I.T. boss Farzad Mostashari, MD, knows better than anyone that meaningful use is a means to an end, not an end in itself. But with his eye on the ultimate prize — transforming healthcare — he recognizes that encouraging universal EHR adoption and driving meaningful use momentum provide a critical foundation for getting from here to there. In 2012, the Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare &

Medicaid Services (CMS) set a goal of having 100,000 healthcare providers earn incentives by year-end. Turns out more than twice that number did. So this spring, ONC launched the State Meaningful Use Acceleration Challenge 2.0 to encourage states to continue collaborating with stakeholders in order to strategically leverage MU criteria and improve the quality of care. Goals for 2013 include 50% of physician offices using EHRs and 80% of eligible hospitals receiving MU incentive payments.

8TWO-THIRDS OF ORGANIZATIONS HAVE QUALIFIED FOR MEANINGFUL USE STAGE 1

THREE-QUARTERS OF ORGANIZATIONS EXPECT TO QUALIFY FOR STAGE 2 IN 2014

28% SAY IMPLEMENTING THE SYSTEMS NEEDED TO ACHIEVE MEANINGFUL USE IS THEIR KEY I.T. PRIORITY

25% REPORT THEY WILL INVEST A MINIMUM OF $1 MILLION TO ACHIEVE STAGE 2

66%

75%

28%

25%24th Annual HIMSS Leadership Survey, sponsored by InforFarzad Mostashari, MD

HIT WATCH


Nearly half the CIOs surveyed believe the responsibility for ensuring interoperability should be shared between vendors and healthcare systems.

“Healthcare Information Technology: Trends and Transformations,”

Greenway

Three types of Centers for Medicare & Medicaid Services ACO models:

Medicare Shared Savings Program. Rewards ACOs that lower costs and meet quality benchmarks

Pioneer ACOs. Designed for organizations experienced in coordinating care across care settings

Advanced Payment ACOs. Physician-based and rural providers can repay cash advances through achieving shared savings

SUBSCRIBE to Industry View to get the latest HIT trends every week CDW.com/HITlist

HELPING HIE REACH NEW HEIGHTS

Along with the meaningful use Stage 2 criteria come heightened hopes for improved interoperability and robust healthcare information exchange (HIE), both so essential to value-based care. Stage 2 requires certified EHRs to be able to send and receive key structured and coded data, and Stage 3 appears likely to set the bar even higher. At the same time, ONC aims to accelerate the creation and growth of HIEs nationwide with substantial financial grants to HIE framework and standards-building organizations such as DirectTrust and the EHR/HIE Interoperability Workgroup, as well as through the State HIE Grantee Recognition program. The recently launched CommonWell Health Alliance, a multi-vendor collaboration, also seeks to boost interoperability efforts.

ACOs GATHER STEAM

Of late, the number of accountable care organizations in the public and private sectors has grown significantly to well over 300 in 49 states. Sponsored primarily by hospital systems, physician groups, insurers and community-based organizations, ACOs seek to better manage the health of their patient populations to achieve and share cost savings. The key to success, experts say, is taking advantage of information technology to achieve systemic change in the way healthcare is delivered. “ACOs need to be able to manage chronic disease, which drives 75% of payer costs,” says John P. Hoyt, FACHE, FHIMSS, Executive Vice President, Organizational Services, HIMSS Analytics. He identifies vendor-neutral archives, clinical integration, interoperability, the ability to store and share non-DICOM images, data analytics, telemedicine and easy-to-use patient tools as critical I.T. components for ACOs.9

10

“Ambulatory EMRs

and acute EMRs must

be interoperable

to generate savings

for ACOs.”

John P. Hoyt, FACHE, FHIMSS, Executive Vice President, Organizational Services, HIMSS Analytics

Follow us on Twitter @CDW_Healthcare


THE RISE OF HEALTHCARE CONSUMERISM AND PATIENT-FACING TECHNOLOGY

ROUNDTABLE DISCUSSION:

MEANINGFUL INSIGHTS


CONNEon T

#HIMSS13

Q: When it comes to choosing healthcare providers, what do patients look for by today’s standards?

Mike: Today’s consumers are faced with the daunting challenge of sorting through more choices than ever in an increasingly competitive landscape. We see a trend in patients really looking for increased levels of comfort and satisfaction from a healthcare provider.

Jon: With HCAHPS scores as a key driver, hospitals are looking for ways to build customer loyalty just like other industries such as retail, sports and airlines. Consumers don’t just want to be tested, diagnosed or treated in a healthcare facility; they want the comforts of home while they’re receiving safe, high-quality care.

Carole: Interestingly, the patient experience is one of the top three priorities of hospital leaders over the next three years, according to the Beryl Institute. Providers are trying to meet the demands of changing industry regulations and to attract patients by ensuring their experience is top-notch.

Q: It sounds like consumer expectations are shifting. Can you elaborate?

Mike: In general, consumers are much more tech-savvy. At the same time, meaningful use Stage 2 specifies that patients have access to their electronic medical records, prescriptions, lab results and more. They’ll expect this, and the ability to connect online at any time, from their physicians.

Jon: In addition to HCAHPS, hospitals need to achieve high ratings and recognition from other sources like the Joint Commission, Healthgrades and U.S. News & World Report. All these sources combined are shaping consumer perceptions and, ultimately, what they expect from a provider.

Carole: To add to that, word of mouth is equally powerful in spreading a positive — or negative — patient experience as more consumers connect with each other via social media.

Q: So, technology is playing a greater role in serving today’s patients?

Mike: Carole made a good point. With the explosion of social media and increased communication promoting health and wellness, technology is a must in reaching consumers. We’re seeing the rise of a “connected generation,” as more patients embrace smartphones and other devices to communicate with providers. Increasingly, consumers will also want integration of their information across all their device platforms. And providers will need to make sure they use secure and compliant technology.

Jon: We’re observing an uptick in patient utilization of technology, both inside and outside hospital walls. A satisfactory patient experience stretches well beyond the healthcare facility — from door to door — and technology is helping facilitate that continued connection between patient and provider.

Carole: Speaking to the patient experience inside the hospital, innovation in technology at the point of care is definitely trending in ways that positively impact clinical workflow and patient satisfaction during visits.

Q: How is accountable care influencing the evolution of patient-facing technology?

Mike: Under accountable care, there’s a clear emergence of more “behavior modification” mobile apps focused on sending patients constant reminders or alerts for their condition, to better manage individual and population health. One example is how texting is used in smoking cessation programs.

Jon: As the pendulum swings to preventive health, technology will play an even greater role in keeping patients healthy. E-alerts, provider communication via email, chat and text, and telemedicine technology for home care all contribute to curbing costly hospital readmissions and reimbursement denials.

Carole: Within the ACO model, patients must be carefully tracked and “followed” over time — and often that begins with their inpatient hospital stay. Patient-facing technology such as smart bedside terminals not only gives clinicians the ability to securely access and update patient data at the touch of a screen, it offers patients education and entertainment like TV, Internet, phone, movies and meal menus to help improve their experience.

Q: In the end, what should providers be doing to embrace this new wave of technology innovation?

Mike: Providers should be on the lookout for technologies that are both demanded by consumers and supported, and even encouraged, by payers and those responsible for accountable care. All the efforts by providers and ACOs will be linked to how the consumer ultimately judges these entities for quality and satisfaction. Technologies that enable better patient care and empowerment are key.

Jon: Stay in tune with your patients. Survey them frequently. Keep a pulse on changing community demographics. This will help dictate how — and which types — of technologies are used by consumers today, and where the demand is going tomorrow, so providers can stay in front of the curve.

Carole: Invest in patient-facing technology that offers a dual benefit of providing a more personalized service to patients and simultaneously increasing staff productivity and workflow. The ROI will be easier to measure, as one smart terminal can potentially replace the per-room cost of a telephone and TV, and replace the need for a workstation on wheels.

“ WORD OF MOUTH IS EQUALLY POWERFUL IN SPREADING A POSITIVE — OR NEGATIVE — PATIENT EXPERIENCE AS MORE CONSUMERS CONNECT WITH EACH OTHER VIA SOCIAL MEDIA.”

Carole Ireland , Director of Sales, Point of Care, Barco Healthcare

We had the opportunity to sit down with Mike Mytych, Principal, Health Information Consulting; Jon Karl, Director of Sales, CDW Healthcare; and Carole Ireland, Director of Sales, Point of Care, Barco Healthcare, to hear their thoughts on this timely topic.


Good communication has always been a cornerstone of quality patient care, patient safety and a positive patient experience. But communication takes on heightened importance in today’s era of value-based care, meaningful use, and reimbursement tied to patient satisfaction and HCAHPS scores.

Our healthcare system recognized early on that technology offers innovative ways to improve communication between staff members and between staff and patients. And we firmly believe that the more visual the solution, the more effective it is. For example, in our OR waiting rooms, we’ve installed large-format electronic screens that display exactly where every surgical patient is at any given time. Our goal is to keep patients’ family members better informed while their loved ones are in surgery, so they have a higher comfort level during this stressful time. Since HIPAA requirements prevent us from using patient names, we assign a code to each patient that family members can follow instead. The response has been extremely positive.

We also use the same large-format screens in our OR and emergency department (ED) so the physicians and nurses can track — and, more efficiently and accurately, manage — their patients. The electronic boards have been particularly popular in the ED, given how fast-paced and fast-changing things are there. Our ED physicians love being able to easily see where patients are, sort of like following a Wall Street ticker.

SEEING RESULTS WITH DIGITAL VISUAL COMMUNICATION SOLUTIONSBy Wanda Sims, Chief Information Officer, Baptist Health

PEER PERSPECTIVE


CLEAR VIEW OF PATIENT FLOW

The results have been so encouraging that we’ve expanded this visual tracking concept from the departmental level to the entire organization. As in most hospitals, moving hundreds of patients seamlessly throughout the facility poses huge challenges for us. One of the biggest is when patients come through the ED and need to be admitted. While it can be difficult to predict when and where a bed will become available, it’s also no surprise that patients forced to wait in the ED for hours before moving into a room can become very unhappy.

So, in the first phase of our efforts to visually track patient flow on a comprehensive scale, we established a command center staffed with members of the patient access team, nurses and case managers. Using several large-format screens, this team tracks the entire patient population, floor by floor. Icons on the screen indicate the status of patient rooms. For example, a broom shows a room is waiting to be cleaned. When that icon changes, staff monitoring the boards know they can transfer a patient to that room.

We’re now in the process of implementing the second phase, which is a unidirectional interface that will channel orders directly from our EMR into a logistics application. That will enable us to more efficiently manage patient flow between all departments. For instance, if a patient needs an x-ray, we can figure out exactly when radiology will be ready and bring him then, eliminating a long wait sitting in a wheelchair for his turn.

The third phase will be a physician logistics solution, which we expect will have a positive impact on both patient and physician satisfaction as well as on staff productivity. Basically, this solution enables physicians to schedule their room visits during hospital rounds and send a message to patients with that information. Family members and patients will no longer have to guess when the physician they want to see might arrive, and the physicians can use their time most efficiently.

VISIBLY IMPROVED PATIENT SATISFACTION

We’re relying on digital visual solutions to streamline other patient interactions, too. We’ve introduced self-service kiosks for patient admissions. When patients arrive at the hospital, all they have to do is swipe their driver’s license or other identification and they can breeze through the check-in process. The response has been even more positive than we anticipated.

In addition, as part of our effort to meet meaningful use requirements and improve patient communication, we’re moving forward with our patient portal development. We want our patients to have the convenience of handling a variety of tasks online, from looking up personal health information to checking lab results to paying bills.

For more insights on digital visual solutions from Wanda Sims, visit CDW.com/visualsol.

Take advantage of analytics.

We have to capture the right data, understand the data our audience needs,

and deliver the information in a way that’s accessible,

personalized and meaningful.

Involve your stakeholders in the technology selection process.

The technology has to solve the problems the people using it

every day need it to address.

Make sure your network infrastructure is solid.

We’ve invested time and money in upgrading our network

so it can reliably handle the increased demand.

1

2

3

Looking for POSITIVE OUTCOMES?

If your healthcare organization is seeking to improve communications and patient satisfaction

through digital visual technology, here are three recommendations based on our experience:


Waiting family and friends are reassured as they’re constantly

updated about the status of loved ones undergoing medical

procedures or tests.

The Story of Screens. Visual solutions provide instant, interactive data-sharing capacity to enhance the patient experience throughout the hospital. From the time visitors enter the hospital and need directions to find their way, to waiting rooms where patient updates are readily available, to patient rooms where entertainment meets information, visual solutions make their mark.

SEE STATUS

WAYS TO USE

DISPLAYS

2

Interactive way-finding displays show family and friends visiting the hospital how to get

where they need to go.

LOCATE ROOMS

1

5 SOLUTION SNAPSHOT


REVIEW RESULTS

Medical displays enable patients and physicians to

view images and data conveniently at the bedside.

4

GET CONNECTEDPatients can relax in their rooms

with mounted displays that access TV, email, lunch menus

and educational materials.

5

Hospital staff use digital information boards to find out when procedures are

scheduled and where.

KEEP UP WITH SCHEDULES3

LEARN MORE View our complimentary white paper,

“Visual Solutions: Seeing is Achieving.”


NAVIGATING THE INs AND OUTs

OF PATIENT DATA MANAGEMENT

Q&A WITH PHIL ASIALACDW FIELD SOLUTION ARCHITECT

Phil Asiala addresses healthcare providers’ I.T. needs every day, and has come to understand the importance of securing, sharing and storing ever-increasing volumes of electronic patient information. Here, he discusses patient data management technology and its growing implications for healthcare organizations.

TECH TIPS

DATA MERGE AHEAD


Q: How have EMR adoption and the onset of meaningful use impacted patient data management?A: It used to be healthcare organizations would have a separate application for each area, such as the ED and OR. These applications wouldn’t really talk to each other. With EMR adoption, we’re now seeing implementation of technologies that cover multiple areas and where data is co-located in the same database. Patient data management is integral to achieving this centralization of information and integration of applications.

And with meaningful use, providers are exchanging a lot more data with outside entities, be it laboratories, other hospitals or ambulatory practices. Because of this, patient data gateways and patient portals (which facilitate quick, secure information sharing with patients and third parties) are becoming more popular.

Q: What are the main components of a robust patient data management solution?A: A well-rounded patient data management solution typically is comprised of technologies that help manage, store, secure and allow authorized access to digital information. These often include:

Content/document management software

Storage management and virtualization solutions

Data loss prevention (DLP) technology

Patient portals

Aside from these components, hospitals often need assistance with labor-intense processes like migrating their data from one storage platform to another. Technology partners like CDW Healthcare can support their needs.

Q: As you mentioned, data migration is an important facet of patient data management as a whole. What should a healthcare facility consider to ensure the best possible migration strategy?A: Ensuring that a complete virtualization solution is in place is the first step before data migration can occur. A good place to start is with an in-depth server assessment where key performance characteristics are collected, including which servers are CPUs, how much memory they have, and other factors across the entire enterprise. That’s how facilities will get the best virtualized design to fit their specific needs, covering details such as how much cooling and electricity will be needed. Virtualization also greatly reduces complexity when it comes to disaster recovery and protecting sensitive data.

Also, organizations should consider the implications of having a converged I.T. infrastructure, and work toward that goal. A converged infrastructure provides key benefits in terms of data handling and network functionality, including lower costs, simplified management, improved quality of service, and increased flexibility when responding to changes in workload.

Q: It sounds like data security is also a really important facet of patient data management, given more stringent regulatory policies such as the HIPAA Omnibus Rule.A: It sure is. One big trend I’ve been seeing in the past 18 months is that organizations are now encrypting data on the storage units themselves. This usually equates to having security software or self-encrypting drives run in the SAN units. This is a significant benefit, given that I.T. staff is often stretched thin, and it’s becoming impossible to look at encrypting each individual app, of which most healthcare organizations now have hundreds or even thousands.

Q: What advice would you share with those looking to update or upgrade their patient data management technology?A: Assume nothing! First and foremost, engage a technology partner early on in the process, because it’s easy to underestimate what goes into data migration or neglect to ask the right questions from the start. Also, be sure to consider all aspects of patient data management when designing a solution. For instance, don’t overlook DLP, which helps automate the security of data in the data center. And keep in mind tying in patient portals, which are important right now because meaningful use Stage 2 requires that five percent of your patient population has to use a patient portal.

For more information on patient data management, view our video and listen to our audio podcast series featuring Phil Asiala.


As new health systems continue to be formed, their expansion finds care extending to far-reaching rural communities and areas where care historically has been more difficult to deliver. And as always, the need for immediate patient evaluation remains critical. Healthcare organizations need to close distance barriers to achieve streamlined connection for improved care delivery. Built on its TelePresence technology, Cisco recently launched Cisco HealthPresence 2.5 to help address these needs and help today’s healthcare organizations more efficiently achieve their communication and patient care goals.

We spoke with Cisco’s David Plummer about how Cisco HealthPresence 2.5 enables healthcare providers to close the communication gap between patient, physician and specialist.

TRANSFORMING CARE AT A DISTANCE with Cisco HealthPresence 2.5

PARTNER CORNER


Q: Can you speak to the healthcare trends that will impact the need for greater communication and collaboration in coming years?

A: With the passage of the national healthcare bill, we’ll likely see a significant rise in the volume of patients seeking treatment, because it’s becoming more accessible. In addition, we’re seeing escalating costs to deliver this care, coupled with reductions in reimbursement in many cases. At the same time, new models of care like ACOs and patient-centered medical homes are being adopted. These trends are converging to shape a new era of healthcare where providers will need to eliminate time, cost and distance barriers to deliver quality care. Cisco HealthPresence 2.5 can help healthcare organizations more efficiently and cost-effectively meet this need, regardless of patient or physician location.

Q: How can Cisco’s TelePresence solutions, like Cisco HealthPresence 2.5, help alleviate the stress that current healthcare trends and challenges place on an organization’s ability to provide timely care?

A: Cisco HealthPresence 2.5 has evolved to become an enterprise-wide, software-based telehealth platform that enhances care at a distance among patients, clinicians and specialists. It expands the boundaries of healthcare delivery to improve the accessibility and coordination of patient care. And specifically, by using the network as a platform, Cisco HealthPresence 2.5 can integrate high-definition video, advanced audio, medical devices, workflow and collaboration tools to deliver high-quality patient care.

Q: Can you give us some real-world examples of scenarios where Cisco HealthPresence 2.5 could be utilized?

A: Certainly. There are several instances of how and where Cisco HealthPresence could be used to provide care delivery, such as:

1. Reaching underserved populations. Provide care to areas that are underserved, such as rural areas, and those that pose challenges such as prisons, ships and military outposts.

2. Extending the reach of specialists. Make specialty-based care available to a larger population through the use of compatible medical devices and video consultations.

3. Providing triage care. Examine patients remotely to evaluate the severity of illness or injury and determine the best care facility, thus reducing the number of patients in emergency rooms with minor injuries or illnesses.

4. Coordinating post-operative care. Potentially save readmission costs of post-operative patients by providing follow-up care remotely.

5. Educating patients and caregivers. Provide education and counseling services to patients and their caregivers.

6. Serving corporate clinics. Assist employers to improve their employees’ health and wellness as well as manage healthcare expenses. Telehealth services can achieve these objectives by bringing specialty care to campus clinics and extending services to smaller campuses.

Keep in mind that these are but a few examples of how Cisco HealthPresence 2.5 could help facilitate real-time communication and collaboration capabilities. Each healthcare organization that adopts Cisco HealthPresence 2.5 may find its own unique applications and uses for the technology within its workflow and care model.

DAVID PLUMMERGeneral Manager, Cisco HealthPresence

As General Manager for Cisco HealthPresence, David has global responsibilities for the overall strategic direction of and customer satisfaction with Cisco’s Care-at-a-Distance solutions.

It expands the boundaries of healthcare delivery to improve the accessibility and

coordination of patient care.

To learn more about telehealth technology, visit CDW.com/communIT.


PUTTING AN ACO IN

MOTIONSHARP HEALTHCARE HAS GROWN FROM A SINGLE HOSPITAL IN 1955 TO A LARGE, INTEGRATED

REGIONAL HEALTHCARE DELIVERY SYSTEM. HOW DID WE DO THIS? BY ALIGNING WITH OUR

PHYSICIAN PARTNERS, INTEGRATING I.T. SYSTEMS AND INFRASTRUCTURE, AND CENTRALIZING

SYSTEM SUPPORT SERVICES. WE HAVE OVER 25 YEARS OF EXPERIENCE MANAGING CARE UNDER

POPULATION-BASED PAYMENT STRUCTURES. IN FACT, OUR SHARP HEALTH PLAN INCLUDES

65,000 MEMBERS AND IS A KNOX KEENE LICENSED COMMERCIAL HEALTH PLAN.

by Bill Spooner, Senior Vice President and CIO, Sharp HealthCare

KEY LEARNINGS

STEPS TO SUCCESS


As Senior Vice President and CIO for Sharp HealthCare, Bill Spooner oversees this not-for-profit integrated regional healthcare delivery system based in San Diego, California. Sharp HealthCare has four acute care hospitals, three specialty hospitals, two affiliated medical groups and a health plan, plus a full spectrum of other facilities and services.

While accountable care organizations (ACOs) have really begun to emerge over the last few years, care coordination and population health management are not new concepts at Sharp. We’ve taken the correct steps to ensure we have alignment to better serve our ACO populations.

For us, these steps have included:

• Makingsurebeneficiariesareidentifiedandalignedprospectively, and making retrospective adjustments for any decedents or patients moving out of the network.

• RecognizingthatoncebeneficiariesarealignedtoanACO,they may opt out of data sharing with the ACO (although they may not opt out of being included in the ACO). However, patients who opt out of information sharing are still included in an ACO’s quality and cost results.

• Finally,recognizingthatpatientsretainunrestrictedchoiceof providers, where there are no authorizations required for services, so it is our challenge to motivate them to seek care from Sharp providers.

From improved ACO beneficiary alignment, we’ve been able to uncover key learnings, including where inpatient costs originate from, how much costs are “out of network,” the number of beneficiaries who have five or more ED visits without a corresponding admit, and how many had five or more hospital admits. These insights allow our health system to collaborate more closely and uncover opportunities for improving care. For instance, we are now using outbound calls to set up doctor appointments to enhance patient engagement.

Priority I.T. Investments for ACOsBut none of this could have been possible without us prioritizing the right I.T. requirements for setting up our ACO. Following are five key I.T. priorities to keep in mind when pursuing the creation or advancement of an ACO:

1. Master Person Index. Make sure you have a methodology in place for effective patient identification that offers both registration and connections to your legacy systems.

2. EHR. We created Pioneer flags in places such as our rounds report, profile dialogue and demographic screens to readily identify ACO patients when they come in for care.

3. Analytics/population health. As an ACO, having the right business intelligence (BI) tools is critical to evaluating all aspects of quality, access and cost of care, and identifying opportunities for improvement. This will be increasingly important as we progress through successive stages of care improvement.

4. Health Information Exchange (HIE). Participation in an HIE is key to ensuring that your ACO is able to view the complete patient record across all providers and therefore deliver top-quality care and minimize costs.

5. Patient portal. Putting a portal in place for patient convenience will further promote patient engagement and create “stickiness.” When leveraged, this could potentially grow into a CRM-type of capability.

Looking ahead, healthcare organizations that have the right I.T. components in place, open and collaborative communication, and strong data solutions will be on the right road to ACO success. For Sharp, that’s meant the ability to support effective care management from an operational perspective and with a core patient care focus.

Read more about Mr. Spooner’s insights on ACOs and download a copy of his HIMSS13 presentation by visiting CDW.com/HIMSS13ACO.

TODAY THERE ARE OVER

300 ACCOUNTABLE CARE

ORGANIZATIONS (ACOs) IN THIS

COUNTRY, TOUCHING BETWEEN

25 AND 30 MILLION PATIENTS. Source: PhysBizTech.com, April 2013


I.T. INCREASINGLY AT HOME IN HEALTHCAREHome, sweet home is looking sweeter than ever to the healthcare industry these days. Faced with an aging U.S. population, rising costs, declining reimbursement and increasing penalties for hospital readmissions, providers see tremendous promise in keeping older adults out of expensive hospitals and long-term care facilities and living independently in their own homes instead.

Thanks to the revolution in healthcare technology, particularly on the mobile front, the opportunities to help patients safely and cost-effectively manage their medical needs at home through treatment and proactive monitoring have been multiplying. In fact, Frost & Sullivan predicts North American spending on home health technology will more than double, from $126.8 million in 2010 to $294.9 million by 2015.

And Berg Insights estimates the number of patients worldwide with home monitoring devices will quadruple to nearly 2.5 million by 2016.

Chronic diseases most commonly monitored at home include cardiac arrhythmia, sleep apnea, diabetes and chronic obstructive pulmonary disease. An estimated 11 million Americans with diabetes use home glucose monitors, many of which can now do everything from electronically transmitting data to continuously tracking glucose levels and alerting users to sudden changes. Cardiac monitoring represents one of the fastest-growing areas in home healthcare, with more than half a million blood pressure monitors expected to be wirelessly connected by year-end. And medication adherence systems that remind, dispense and monitor medication are also gaining popularity.

AGING BABY BOOMERS CREATE BIG DEMANDBy 2020, the number of Americans aged 65 and older is expected to increase to 50 million, or 17 percent of the population. Frequently referred to as the “silver tsunami,” this huge wave of Baby Boomers will likely strain healthcare resources, given that 84 percent of Medicare beneficiaries have at least one chronic condition and managing these conditions accounts for more than one-third of current healthcare spending.

A host of solutions, ranging from telemedicine and remote monitoring devices to home healthcare professionals equipped with tablets and smartphones, is already showing potential for reducing the costly emergency department visits, hospital admissions and readmissions related to chronic conditions. For example, a telehealth study conducted by Great Britain’s National Health Service found that home health monitoring of patients with chronic conditions reduced emergency hospital admissions by 20 percent, patient stays by one-quarter and readmissions by 14 percent. Impressed by the results, the government plans to expand the program to three million homes over the next five years.

A long-term U.S. Department of Veterans Affairs care coordination/home telehealth program for chronically ill veterans was able to reduce by 20 percent the number of days patients with diabetes spent in the hospital. In addition, a Stanford University study found that clinics using a home telehealth device to help care for Medicare patients with various chronic diseases cut spending as much as 13.3 percent, or $542 per person, per quarter. And in an effort to reduce emergency medical visits, Humana is testing an initiative giving patients home health computers to track blood pressure, weight, temperature and medication adherence. The daily self-monitoring is supported by weekly video check-ins with a nurse.

INDUSTRY SPOTLIGHT

Home, Sweet I.T. Home


mHEALTH EXPANDS POSSIBILITIESReal-time monitoring of patients at home received a boost last fall when the Federal Communications Commission (FCC) allocated part of the wireless spectrum to wearable sensors, also known as MBAN — medical body area network — devices. The FCC hopes to promote the widespread use of MBAN technologies, estimating they could save $1.2 billion annually by reducing the need for hospitalization.

Doctors certainly see the value in home monitoring, with more than 88 percent saying they would like their patients to track their weight, blood sugar levels and vital signs. By incorporating wireless wearable monitors into patients’ care plans, providers can help improve their chances of catching problems before they become serious. The devices also encourage patients to take ownership of their healthcare, heightening awareness of factors that affect their health including diet, physical activity and stress. In addition, an explosion of mobile apps that support prevention, self-diagnosis and self-care is further fueling greater patient engagement.

At the same time, home health agencies are increasingly taking advantage of mobile technology to improve patient care and caregiver efficiency. Notebooks or tablets with built-in mobile broadband enable caregivers to conveniently communicate with their patients or offices anywhere, anytime, even in rural areas. Nurses and other clinicians can also use the devices in patients’ homes to document information directly into EHRs and access the data needed to provide care.

TEAMING TECHNOLOGY WITH TRAINED PROFESSIONALSHome health technology offers a valuable tool to help reduce costs and improve outcomes, but it’s no substitute for experienced clinicians, who still have to read the print-outs, make home visits, diagnose problems, prescribe treatment and provide compassionate care. As David Pahlman, Chief Information Officer of technology pioneer Camellia Home Health & Hospice (see the sidebar at right) pointed out, “Our business is patient care, and we’ve got to keep that as our focus. We don’t want to bring in so much technology that it takes away from the patient-clinician experience.”

MOBILE TECHNOLOGY KEEPS FOCUS ON COMPASSIONATE CARECamellia Home Health & Hospice has grown right along with the demand for in-home health services. Based in Hattiesburg, Mississippi, the family-owned agency now has more than 1000 nurses and speech, occupational and physical therapists providing in-home healthcare services to primarily rural patients in four states.

Camellia’s Chief Information Officer David Pahlman believes the agency’s commitment to technology has helped ensure that compassionate, personalized care remains its top priority. “We’ve become a very efficient company, while maintaining the same small-town relationship with all our patients and clinicians,” he said.

The key to success was giving a tablet to each of Camellia’s highly mobile clinicians, enabling them to reliably access and enter or connect to information in their patients’ homes, the office or wherever they are. Recognizing that such a large-scale rollout would tax Camellia’s existing infrastructure, Pahlman first upgraded and expanded the agency’s server, storage and networking capability, including setting up new T1s, switches and access points. He then developed standardized rollout and training procedures to help clinicians hit the ground running. And last but not least, he implemented automated and centralized update, inventory, web filtering and backup systems.

Pahlman plans to integrate additional technology — such as using home monitoring devices for patients, improving online data access and creating a dedicated portal for patients’ family members — to further enhance the quality of home care Camellia delivers. “It’s very, very important to our administration that we stay cutting-edge in technology,” he said.

LEARN MORE View the Camellia Home Health & Hospice case study.

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