“ Clinical Inte tegrati tion as as a a Key to to are ” Val alue-bas ased Car A Complimentary Webinar From healthsystemCIO.com Sponsored by Perceptive Software Your Line Will Be Silent Until Our Event Begins at 12:00 ET Thank You! Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Housekeeping • Moderator – Anthony Guerra, editor-in-chief, healthsystemCIO.com • Ask A Question • We will be holding a Q&A session after the formal presentations. • You may submit your questions at any time by clicking on the QA panel located in the lower right corner of your screen, type in your questions in the text field and hit send. Please keep the send to default as “All Panelists.” • Download the Deck • Go to Download today's deck at: http://healthsystemcio.com/presentation/clinicalintegration-webinar.pdf • Shortened URL at bottom of all slides • View the Archive • You will receive an email when our archive recording is ready. • Separate registration is required. Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Agenda — Approximately 45 Minutes • 15 minutes: Dan Kinsella, EVP/CIO, Cadence Health System • 15 minutes: Tom Moran, MD, CMIO, Cadence Health System • 5 minutes: A Word From Our Sponsor: Thomas Pickard, Director, Healthcare Industry Marketing, Perceptive Software • 10 minutes: Q&A w/Dan Kinsella & Tom Moran Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
“ Examin inin ing Clini inical l Integration ion as a Key y lueBased Care ” Ingredie ient of Value Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Learning Object ctives • Define Clinical Integration in Context • Introduce the Value Chain of Value Based Care • Suggest Synergies Between Value and Volume Based Care • Share Lessons Learned Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Context fo for Healthcare Transformation 2015 2020 2020 • Cost reduction (14-20%) • HIPAA 5010 • Shared Services • ICD-10 Regulation & Performance • Labor • Meaningful Use of EHR Compliance Improvement • Supply Chain • Quality Reporting • Clinical Resource Management • Clinical Effectiveness Research • Clinical Integration • ACOs, Population Health • Physician Alignment • HIE/REC Health Reform • HITECH • New Medical Home Health • Bundled Payments Information • Personal Health Records Market Growth & Technology • Health Exchanges • Image Sharing/VNA Transformation • Analytics • Growth strategies • M&A Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Clinical Integration Defi fined • On our journey toward Value Based Care, Clinical Integration (CI) is one of a hand full of high impact capabilities that will add value to the business as we get more advanced. So, what is Clinical Integration? • At a very basic level, CI enables managed care group contracting among employed and affiliated providers without risk of anti-trust through the sharing of data to promote quality improvement . • At full maturity, Clinical Integration is the secure sharing of selected portions of the medical record for a specific patient among authorized providers engaged in the coordinated delivery of healthcare services. Authorized Providers engaged in Resulting in effective care transitions to Connected, secure sharing of specific coordinated delivery of services reduce readmissions patient information Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Triple Aim In the context of the Triple Aim, Clinical Integration provides the following benefits to our PHO members and the patients for which we care: • Extends our zone of influence to more closely match our zone of concern – i.e., we are better able to ensure closed Better loops in referrals and filling of meds based on the information flow that is Clinical Integration • Advanced capabilities such as registries enable focused program development around the greatest needs within the Outcomes cohort of patient for which we are accountable • Improving the patient experience by confirming shared information vs. collecting it new at each visit across the Improved Patient continuum (Chronic Disease Management) Experience • Increased patient safety through sharing of CCD content around allergies, active medications and problem lists • Through a better set of relevant information, target the most appropriate care for the individual patient at the right Lower time, thereby reducing higher cost, in appropriate episodes down the road (Care Transitions, Care Advocacy) • Avoid duplication of tests and procedures as recent and relevant information is shared in a secure environment Cost among authorized providers Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Illustration Enabling Clinical Integration with HIT Clinical Services Nurse Advice Line Connectivity HIE Disease Registries Interactive Web Presence Independent Practice Master Patient Index CRM Contact Center Expanded HIE Services Consumer Intelligence Quality/PQRS Patient Portal Engagement Telemedicine Enterprise Data Warehouse Meaningful Use Reporting Community Collaboration Population Management E-Visits Workflow Solutions Provider Portal Health Financial Services Referral Management Problem List Reconciliation Extended Enterprise Scheduling Health Risk Assessments Beneficiary Management Case Management Payer/Employer Portal Timing Now Later Next Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Value Chain of Value Based Care Payer Provider Members, Coordinate Manage Contracts Network Patients Care Results • • • Attribution of members • Retention of Referrals • Incentive Payments # of lives under Clinical Integration management • • Retention • Readmissions • Patient Outcomes Geographic coverage Success • Portfolio of profitable • • Satisfaction • Days without SSE • Quality Measures Mix of PCP/Specialists contracts • • Engagement • Distribution of Shared Quality LTC, HH Metrics Savings • Performance standards • • Recruiting • Beneficiary Management • Nurse Line • Quality Improvement Benefit Design • • Practice Transformation • Onboarding • Care Transitions • Monitor provider Risk Management Key • • EMR implementation • Customer Service • Chronic Disease performance Managed Care Contracting Management • Data rendering • Scheduling Business • • Care Advocacy Contract Administration Functions • Population Health • Medication Reconciliation • • Provider Portal • Patient/Member Portal • Registries • Analytics Managed Care Contracting • Quality Reporting • CRM • Referral Management • Contract Management IT • Payer/Employer Portal • Analytics • Call Center • Case Management • EMR • Enterprise Scheduling • Care Plans Enablers • HIE/Direct • Tele-presence • Clinical Messaging • Image Sharing Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Program Sca cale Considerations “ Duality Challenge ” reflects the need to provide consistent handling of patients in a setting... Don’t have a gold, silver, bronze line... • A = Cohort of program patients for our participating E E E providers (e.g., PCP) • B = Compliment of all other patients seen by this group of providers • C = Additional providers contributing to the care of a P a t i e n t s specific cohort, e.g., Specialists, PAC • D = Compliment of all other patients seen by that E group of providers B D • E = Universe of additional providers and patients in the market place Important to consider scale of the program required to accomplish the desired goals. E A C • A+B; C+D; consistent flow within a practice • A+C; consistent patient experience (per cohort across sites) P r o v i d e r s Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
Hedging your bet with IT… good for Value and Volume Before Care During Care After Care Provider Contracting: Clinical Case/Care management Referral management , including ED Integration, Bundles, ACO Align care delivery partners eVisits , encounter reporting eCommerce , DME, home care Engage consumers , patients, physicians, ePrescribing, Medication Reconciliation Personal Health Record (CCR) employers Manage service lines and branding Meaningful Use of EMR $$ Quality Reporting /PQRI Manage wellness ICD-10 precision in clinical documentation HIM Coding/ ICD-10 Patient Liability Estimator Collaboration tools , infrastructure Manage quality and provider (Intranet) effectiveness Customer Relationship Management, Enterprise shared service for Revenue allocations to partners in care Scheduling (HR/Payroll, General Accounting, Supply delivery Chain, IT, Facilities, Biomedical, PMO) Community integration, HIE Payer relationship management (HIPAA Business Intelligence 5010) Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439
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