Power of the Patient Interface

patient-powerHealthcare providers have long known that engaging patients leads to improved health outcomes; in a value-based payment world, engaged patients also provide a stronger framework for increased revenues. For this to happen, however, practices need the right patient engagement platform—one that not only empowers patients to become partners in their own healthcare, but that also documents that engagement.

A reliable, cutting-edge patient portal, for example, can enlist patients to provide extensive personal health data outside of the actual healthcare encounter, freeing up caregivers to spend more time with patients. Further, as population health becomes of increasing concern, practices whose patient engagement platform offers the ability to aggregate and analyze these individual health histories will have a head start. Patient engagement is where relevant data on population health begins.

It is equally important that the patient portal supports compliance with MIPS (Merit-based Incentive Payment Systems), enabling practices to comply with government requirements under Meaningful Use and MACRA (Medicare Access and CHIP [Children’s Health Insurance Program] Reauthorization Act) regulations—this will increase Medicare payments and minimize takebacks.

Finally, the patient portal needs to integrate seamlessly with the organization’s electronic health record, health information exchange, and accountable care organization, if any. The right solution will be flexible enough to adapt to the healthcare facility’s IT system, not the other way around.

ACOs and Triple Aim’s interest in patient engagement

Patient engagement was not initially a concern of accountable care organizations (ACOs), which were born of healthcare reform as a way to redefine the shared responsibility of doctors and hospital staff for coordinating care, improving quality, and lowering costs. That changed when the Affordable Care Act officially codified them into law, and recognized that ACOs could not succeed without patient engagement.

Patient engagement has also been deemed essential for the success of the Triple Aim, a framework developed by the Institute for Healthcare Improvement for optimizing health system performance by:

  • improving the patient experience (including quality and satisfaction);
  • improving population health; and
  • reducing the per capita cost of healthcare.

According to the IHI, “quality” is defined from the perspective of an individual member of a given population which leads logically to a focus on patient-centric care and patient engagement.

The ideal patient portal should be easy-to-use, responsive, and allow your patients to communicate with your practice on their terms. Practices need to communicate and connect with their patients to improve healthcare.

Do you have the right platform to engage your patients?

Achieving Value-Based Care – Making the Right Partnership for Success

Christine Schiff

Christine Schiff

Government Affairs Specialist at SRS Health
Christine has been with SRS for over 5 years, working in Government Affairs and serving as the HIPAA Privacy Officer. She is devoted to providing excellent customer service, and she translates this passion into the work she does to support government program compliance. She has an expert understanding of MU and PQRS and serves as a valuable client resource.

Prior to joining SRS, Christine worked at NYU for 11 years where she also obtained her Bachelor of Science in Healthcare Management.
Christine Schiff

There are many factors that contribute to achieving “value-based care,” some of which your practice may already be targeting—patient engagement, interoperability, outcomes, and efficiency, just to name a few! The reality is that the shift to value-based care has been underway for some time, but the change-over is accelerating with the implementation of MACRA. Whether through Alternative Payment Models or the Merit-Based Incentive Payment System (MIPS), the emphasis is now on improving quality and reducing cost.

For most doctors, of course, delivering quality care has always been a priority, so the question really is how to document that while maintaining practice efficiency, containing costs, and continuing to provide excellent patient care. Let’s look at some of the components of Value-Based Care:value-based-care-infographic

 

Whether you focus on all or some of these components, there will likely be a shift in how you use your EHR. To be effective in your pursuit of value-based care, you need your HIT vendor to be a true partner. Here are some questions to consider as you determine your goals and your technology needs:

  • What am I doing to drive value-based care, and how are my partners supporting me?
  • Where do I need more assistance?

And more specifically:

  • Do I have the capability to effectively engage and maintain communication with my patients—both pre- and post-visit—to better manage their care?
  • Can I track outcomes and set standards of care/protocols?
  • Can my current technology improve my practice efficiency?

Don’t settle for only what is imposed by regulatory requirements—decide what is truly valuable for the care of your patients and then implement it. The right technology partners will help you to develop a strategy for achieving your patient-care goals. Remember: How to efficiently deliver the highest quality patient care is an ongoing conversation—make sure your technology partners are holding up their end of it.

Let’s continue the conversation – tell us what you are doing to drive value-based care.

National Health IT Week and the Ways We Help Patients

i_heart_hitNational Health IT Week is a proud time for all of us at SRS Health. Though we all took different paths to get here, the same overarching urge drove us: to help people. Despite our divergent skillsets and backgrounds, we share a lot in common with the specialists our IT solutions support. We are two halves of the same brain, and the betterment of clinical care is always at the forefront of our minds.

“We can harness data and technology to remove obstacles from the daily work of the people who keep us healthy,” believes Abraham Sanders, Principle Software Engineer at SRS Health. “There is amazing potential to consider. How can medical data be used to improve clinical outcomes for patients? How can the same data be used to help simplify the documentation of a patient visit, freeing clinicians up to focus on what matters most—the patient?”

These questions aren’t just food for thought, they drive every improvement and decision that goes into our HIT solutions. Where others see constraints and barriers, we see opportunities to lend a hand. Not the steady hand of a surgeon, or the gentle hands of nurse, but assistance that alleviates the pressure of paperwork and postage, remembers dates down to the millisecond, and notices the nuances that become patterns. As Hector Martinez, Sr. Implementation Specialist at SRS Health, puts it, “I enjoy the gratification that comes with enabling healthcare professionals to focus on practicing medicine and engaging with their patients. Seeing the clinical and nonclinical staff establish a level of confidence and comfort in their everyday roles is what I strive for.”

“When we suffer from a sickness or injury, we depend on healthcare professionals to get us back into shape,” says Ganesan Solaiappan, Software Development Manager at SRS Health. “Those professionals, in turn, depend on healthcare information technology to be able to do their work. In that way, I think I am helping to improve the quality of life by building and maintaining the systems that clinicians need.” Solaiappan adds, “Healthcare providers look to their IT systems to provide the information they need to make effective clinical decisions, to increase their awareness of innovations in the medical field, and to document and identify patterns. When doctors are able to provide complete and fully informed patient care, it may help to save a life. I’m thankful to be a part of that.”

“I am most proud of the way SRS comes together, cross functionally, to support our clients, even at the most inopportune times,” believes Michael Arbunzo, Technical Support Manager at SRS Health. “Emergency requests never take a holiday, and neither will physicians or the IT staff backing them up.”

To all our colleagues celebrating Health IT Week, especially the SRS Health Family, thank you for your unyielding dedication, hospitality, and warmth.

Is Healthcare Hi-Tech Enough?

Barbara Mullarky

Barbara Mullarky

Director, Product Management at SRS Health
Barbara has had a successful career in the healthcare industry, working for both vendors and healthcare provider organizations. She has held roles in sales, marketing, product management and professional services, working with EMR and department-focused solutions for the laboratory and imaging.

Prior to becoming the Director of Product Management at SRS, Barbara was with GE Healthcare (now GE Digital), where she held the positions of Senior Product Marketing Manager for Centricity imaging products, Product Marketing Manager and Customer Collaboration Leader for what is now Caradigm, and Upstream Marketing Manager for Centricity Laboratory. Barbara also worked at the University of Arizona Medical Center, where she managed a team that was responsible for implementing and maintaining 27 departmental IT solutions, the ambulatory EMR and the patient safety initiatives; Wyndgate Technologies (now Haemonetics); Sunquest Information Systems and Community Medical Center.

Originally from New Jersey, Barbara now lives in Tucson, AZ. She is a graduate of the West Virginia University College of Medicine and is a registered Medical Technologist. When not at work, she loves traveling, taking photographs, watching football and spending time with her two Brittanys.
Barbara Mullarky

Latest posts by Barbara Mullarky (see all)

315x236-Devices-med-iconsThe answer to that question depends on what part of the healthcare continuum you look at. When it comes to the actual treatment of disease, few fields can compare with medicine in terms of developing and incorporating new technology. Think of cyber knives, genetically guided cancer therapies, complex new drugs for autoimmune diseases, and the way that surgery has become increasingly less invasive through its reliance on computer imaging and magnification for micro-, laparoscopic, and robot assisted surgery.

On the other hand, when it comes to the use of information technology, healthcare hasn’t been nearly as forward looking as, say, banking, or travel, or even the food industry. How often have you visited a highly respected doctor, located in state-of-the-art facilities, and had to spend half an hour filling out pages of badly xeroxed forms, asking redundant and often irrelevant questions about your personal health history? How often has a member of your doctor’s staff had to spend the time to call you to remind you of an appointment? How often have you wasted time trying to reach your doctor by phone to ask a simple question about your treatment?

Fortunately, the landscape is changing. The industry is starting to engage patients in new ways, using text messaging, video conferencing, and wearable devices to keep patients actively in the therapeutic loop rather than simply at the passive, receiving end. And it’s about time.

According to Pew research:

  • 88% of Americans use the Internet
  • 73% have broadband service at home
  • 95% of us carry a cell phone of some type
  • 62% of those have used their phone in the past year to look up information about a health condition.

Those numbers don’t surprise me. As I write this, I am sitting in O’Hare Airport and almost everyone in the departure lounge has a smart phone in his or her hand. Urban legend has it that people under 55 like to text while people over 60 prefer to make phone calls, but if O’Hare is any indication, the over-60 crowd is just as tech savvy as the younger generation. They’re checking the airline app—this happens to be a really bad travel day fraught with weather delays—so that they can text their families and friends with updates. In 2013, Exerpian Marketing found that adults over 55 send almost 500 text messages a month. I’m sure that number is much higher today.

So why not take advantage of this in your practice? Phones and texting allow you to engage with your patients in a whole new way. You can text them appointment reminders (my hair dresser has been doing it for years), let them know if your office is closed due to inclement weather, or notify them that it’s time to make an appointment to have their eyes checked.

Mobile devices can also be used as an electronic physician’s assistant, with apps to guide care and improve outcomes. Imagine if patients could log onto an app on their phones that reminded them of exercises they had to do that day, showed a video of how to do those exercises, recorded that the exercises had been done as well as the patient pain level and other progress indicators . . . and then automatically transmitted all of this information to the physician to become part of their charts. And that all this happened without the time and expense of the doctor’s staff having to make personal calls.

Even better, imagine that you, as the patient, could see your doctor without leaving your home or office. While video technology has been around for a long time, traditional physician practices have been slow to adopt teleservices. This is partly because state regulations and reimbursement policies have not encouraged it, outside of the few online physician services offering quick and relatively easy consults on a “pay now for service” basis. However, more and more states are passing legislation that allow doctors to establish provider-patient relationships through face-to-face interactive, two-way, real-time communication, or through store-and-forward technologies. In addition, some of the laws call out payment policies, and require that care provided via teleservices be billed the same as an in-office visit. I’d personally love it if my doctor adopted teleservices—it would save me the 30-minute drive to her office, the 10 minutes spent parking, the 20-minute delay because she is usually running late, and the 30-minute drive home. Instead, her office could text me when she’s ready and we could engage for 15 minutes via a telemedicine system. A lot better than the minimum 90+ minutes to do an in-person visit.

The final frontier is when healthcare manages to combine information technology with its existing drive for advanced treatment technology. One university research team is developing a tracking device that could be embedded in a pill; the device would activate when the patient took the medication, sending a message to a receiver app, which in turn would create a record for family members or physicians to review. This may initially sound a little too invasive, but think of the boon for families caring for an elder relative—they could verify that the correct meds were taken without having to hire an on-site care-giver or to make daily trips to ensure compliance.

What’s common to all these new technologies is that they recognize that the patient is at the center of the care team, and the information the patient provides must be incorporated into the therapeutic process in real time. The sooner we engage patients in their own care, the better outcomes we will all experience—and the technology that we are already using every day can help us get there. Is the healthcare you are providing hi-tech enough? What technology are you using now to advance your patient engagement?

We Must Enable Patients to Become Better Stewards of Their Own Care

Conventional wisdom says that people perform better if they have a vested interest in the outcome of a given situation. From experience, employers know this to be true: Employees who are given an ownership stake in their company historically perform better, and enjoy a higher degree of satisfaction from their respective jobs than do their non-stake-holding counterparts.

Recent research has shown that a similar premise holds true in healthcare as well. The Healthcare Information and Management Systems Society (HIMSS), which has expanded its focus on patient engagement each year states, “Patients want to be engaged in their healthcare decision-making process, and those who are engaged as decision-makers in their care tend to be healthier and have better outcomes.” The most commonly cited technologies hospitals plan to add involve patient-generated health data solutions (2016 HIMSS Connected Health Survey). Generally speaking, the greater the engagement of the patient, the better the results, and information technology (IT) can support improved engagement platforms, such as patient portals, secure messaging, social media and other technologies.Graph

Data underscores importance of patient engagement
According to a 2016 New England Journal of Medicine survey of 340 U.S. healthcare executives, clinician leaders and clinicians at organizations directly involved in healthcare delivery:

  • 42% of respondents indicated that less than a quarter of their patients were highly engaged.
  • More than 70% reported having less than half of their patients highly engaged.
  • And to underscore the importance of this result, 47% of those surveyed revealed that low patient engagement was the biggest challenge they faced in improving patient health outcomes.

In addition, a 2017 U.S. Government Accountability Office (GAO) report recommends that the U.S. Department of Health and Human Services (HHS) “should assess the effectiveness of its efforts to enhance patient access to and use of electronic health information.”

This is not only true for hospitals, but also for specialty care practices, such as orthopaedists, ophthalmologists, dermatologists, gastroenterologists and other high-performance specialists. In these environments, it is imperative that practices understand the very specific needs of their patients, and how to best conduct outreach that will increase patient portal access and engagement.

How has your practice encouraged more patient engagement?

Patient-Reported Data Collection and Return on Investment

ROI-300x300-screenDetermining ROI Metrics

The determination of when an investment recoups its costs is in many instances a fairly straightforward matter. In other instances however, it isn’t quite that simple. As the transition to value-based healthcare advances, providers are keenly looking for ways to assess the impact of patient-reported outcomes data on their bottom line.

The identification of a specific ROI metric to the cost of deploying a patient-reported outcomes data platform deployment is dependent on a number of factors that are not always easily quantifiable. Much depends upon what kind of data is being collected, the purposes for which it is being collected and both the qualitative and quantitative nature of the data.

To ensure a credible and reliable calculation of the ROI of patient-reported outcomes data collection, providers should rely upon a rigorous systematic approach for evaluation. One such methodology can be found in the work of the ROI Institute, through their “evaluation framework,”1 which categorizes results in a prescribed, logical order. This recommended sequence represents a chain of impact that can attribute and account for benefits realized. This framework consists of 5 levels of information to consider:

  1. Reaction to the program, particularly the perceived value of the program.
  2. The extent of learning such as skills, competencies, knowledge, and insights in the program.
  3. The extent of application and use of knowledge, skill, and insights acquired during the process.
  4. The program’s effect on the data such as, sales, productivity, quality, time, and costs.
  5. The ROI, the net monetary benefits compared to the cost of the program.

Patient-reported outcomes data collection offers its users a myriad of ways to generate value. For researchers, the data analysis tools provide powerful opportunities to analyze deep data sets. Practice managers are enabled to follow physician members to uncover best practices. And of course physicians can optimize their CMS reimbursement adjustment amounts by monitoring their performance scores throughout a performance year. The point is each user has a unique basis from which to evaluate and determine the overall benefit Patient-reported outcomes data collection contributes to a provider’s practice. Any valid assessment of an ROI must be tailored to the specifics of each user. Any generalized metric is clumsy at best and more than likely misleading.

Value Return to Physicians

The value of any patient-reported data collection platform to a physician must be measured by an array of considerations requiring objective and deliberate analysis. Each aspect of a physician’s practice that is impacted, whether directly or indirectly, necessarily needs to be factored into the equation. Failure to pursue such diligence in the assessment process will more than likely produce an incomplete and misleading result.

Application of the ROI Institute’s evolution framework offers a substantive foundation on which to assemble a meaningful appraisal. The framework is flexible enough to enable application to each unique practice configuration, yet establishes cumulative benchmarks that result in a succinct and useful metric. The sequential nature of the framework reinforces an approach that captures seemingly disparate variables and leverages them collectively to reveal a deeper and more nuanced valuation of deploying a patient-reported outcomes measurement system.

Data mining technology, such as OBERD’s “Mountain,” can factor prominently in generating value out of the data being collected. With it, physicians have the power to slice and dice information in a myriad of ways for infinite uses. For example, providers may measure effectiveness of care, by specific procedure as well as in aggregate. These insights, which can be generated on-demand, can empower physicians with invaluable and actionable information. No longer is a physician constrained to wait for an annual, boilerplate report.

The capacity to robustly leverage data enables insightful benchmarking for both patient and practice analysis can fortify operational best practices. By incorporating efficiencies and successful procedures revealed through tools such as Mountain, new competitive and productive gains can be realized.

A byproduct of this ability to mine data is to provide physicians the opportunity to license newly uncovered knowledge to manufacturers for research and development by the medical and pharmaceutical industries.

Patient Engagement

Patient portals and other technologies that identify and fortify patient touch-points provide opportunities to encourage patient participation in their own care. Heightened patient engagement can lead to better healthcare outcomes at a lower cost by increasing the efficiency of the healthcare system/care offered. In addition, the deployment of patient defined outcomes instruments offers to maximize clinician-patient communication by facilitating an environment that involves patients in their care leading to a better understanding of their conditions and quality outcomes.

Tracking patient reported outcomes for research purposes provides an exceptional marketing tool to showcase your advancement in medical treatments/surgical practices. OBERD’s powerful analytic tool, Mountain, offers providers a platform to analyze and mine the data you collect, and to benchmark against other data sets, global or local.

MIPS Compliance

The determination of any unambiguous ROI regarding MIPS compliance relies upon several factors that presently are premature to firmly assess and are simply not available. No reliable computations can be made until CMS has aggregated Composite Performance Scores (CPS) of all physicians participating in MIPS performance year one, 2017. All scores achieved during this initial year will be used to determine a “CPS Threshold” against which providers will be compared in order to assign reimbursement adjustments that will affect payment year one amounts in 2019. Until that threshold is published, it is simply impossible to identify express ROI expectations.

That said, close monitoring of CMS communications are beginning to reveal benefits through the thoughtful and strategic usage of patient-reported data measurement for the collection, analysis and reporting of patient-reported outcomes data.

CMS has published guidelines to demonstrate how reimbursement will work through the Quality Payment Program (QPP) but has yet to provide specific monetary values. The program has allocated $833 million dollars yearly for the next 5 years that will be distributed based on eligible clinician merit with a focus on quality outcomes, which is reflected in one’s CPS.  The better one’s CPS, the higher the probability that positive reimbursement adjustment will follow. Beyond the funding set aside to incentivize performance merit, here is an additional $500 million dollars available annually for the next 5 years reserved for those with an overall composite score of 70 points or above.

OBERD continues to closely monitor CMS announcements and regulatory developments. As each iteration of QPP rules are revealed, OBERD will continue to refine its products to optimize results for its customers.

Reinforcing a Practice’s Marketing Message

The publication of CMS’s Physician Compare website, by publishing clinician measure scores, allows patient to embody the role of a consumer in shopping around for the best healthcare and for providers that demonstrate higher quality outcomes. CMS has further advanced the promotion of provider score transparency by empowering qualified clinical data registries (QCDR) to supplement Physician Compare website information with enriched content that will further empower patients to see additional information about providers and their practice. OBERD, as a CMS-approved QCDR, is developing multi-modality scorecards to showcase a provider’s best qualities, identify top performers, identify best practices and establish additional practice marketing opportunities.

Summary

As the transition from a fee-for-service to a value-based care system continues to evolve and accelerate, the ability to efficiently and economically collect, analyze and communicate patient-outcomes data will be foundational to a provider’s success. Evidence-based healthcare decisions will rely on leveraging a patient’s involvement in their own healthcare. By increasing the role of a patient to communicate on their own individual situation and progress, that patient is afforded a more active role, which promotes better patient experience and satisfaction. Better performance scores directly impact reimbursement computation.

Of the ROI Institute’s five point evaluation framework mentioned earlier, it needs to be underscored that the first three elements address subjects that do not lend themselves to quantifiable measurement. The perceived value derived from acquired knowledge, skills and insights precludes the value received in the application of those newly realized observations. Application of the new knowledge in turn can directly impact and drive a provider’s best practice.

The ROI evaluation framework begins to address quantifiable activities in step four only after the first three steps of the process are accomplished. These activities, such as sales, productivity and costs can only be accurately assessed in the context of framework steps 1-3. The ROI Institute’s framework requires that all four steps are necessary, a condition precedent, before any actual ROI, the net monetary benefit compared to cost, can be accurately assembled.

OBERD understands that providers desire to be free from the routine task of data collection. Providers can now harness exceptional new methods to gather information from their patients, learn from them and to apply those insights towards that patient’s care. A healthcare provider should be able to practice medicine, and not have to monitor every single regulatory change. OBERD is set up to do just that. Be assured that OBERD will continue to advance solutions that address the latest in compensation strategies that generate optimized benefit to its customers.

As seen in OBERD’s Insights Blog.

Learn how you can take your value-based care to new levels with our new outcomes solution in partnership with OBERD.