Health System & Health Plan Innovation, Change & Growth During Uncertain Times – Part 1

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Last week’s Health Information Technology Social Media (#HITsm) tweetchat was co-hosted by the Healthcare Executive Group, GuideWell and GuideWell Connect from the 2017 AHIP Institute & Exhibition in Austin, TX.

The theme of the chat was “Health System & Health Plan Innovation, Change & Growth During Uncertain Times” and following six topics were discussed:

T1: What specific ‘areas of opportunity’ must health plans/systems address to improve health outcomes, lower costs & improve equity?
T2: What must health systems & health plans focus on over next 8 to 18 months regardless of health reform outcome?
T3: Who’s most likely to disrupt healthcare: insiders or outsiders? And what barriers do each face – right now or in near future?
T4: What technologies will do the most to move healthcare supply-side toward improving outcomes, lowering costs & enhancing equity?
T5: Incentives drive innovation. How can they be aligned to meaningfully support innovation that improves outcomes & lowers costs?
Bonus: What are examples of innovative healthcare programs, processes, people and organizations – U.S.-based or elsewhere?

Thanks to Hosts & Participants!

Special thanks to John Lynn (@TechGuy) of Healthcare Scene, our co-hosts @_GWConnect and @_GuideWell and all the 70+ who participated in the chat.  A complete transcript of the chat can be found here.

Insight, Ideas and Opinions on Topic #1

This post shares insight, ideas and opinions shared by #HITsm chat participants on Topic #1. We’ll share more on the other topics in future blog posts.

Precision Medicine – aka. Personalized Medicine

  1. Precision medicine (aka ‘personalized medicine) was a hot topic at this week’s #AHIPInstitute in Austin.
  2. Patients with complex needs require a custom approach. Personalized medicine promises to improve outcomes at lower cost.
  3. Be excited when we get to the point where #AI effective for health plans. We’re still collectively digging for gold in claims data.
  4. Implementing positive changes in the healthcare industry that give clinicians the opportunity to view #PatientCare in a new light
  5. We definitely need this for #UX — the difference b/t changing your bank profile and your payer profile is enormous

Patients, Consumers & Health Plan Members

  1. It wasn’t that long ago that HC plan leaders were saying “HC plan members aren’t consumers,” LOL
  2. Addressing the healthcare needs of the #aging population of the country will need to take a seat in the front row
  3. Taking advantage of the data we are given to visualize the patient condition and identify at-risk patients earlier
  4. Getting members engaged and empowered in understanding, maintaining, and improving their own health journey
  5. Consumerism has been making inroads into healthcare, patients are acting like consumers about their healthcare options
  6. Until patients “get it” health outcomes can only improve so much

Importance of Basic Health Education, Literacy & Preventive Care

  1. Improving basic health education & literacy through active & coordinated outreach to members & patients is a big opportunity
  2. Improving education & literacy can be as simple as adopting universal languages so plan members aren’t constantly confused
  3. More focus to prevention & wellness. Reach patients before they get ill or have a major medical event.
  4. We need to focus more on prevention – spending too much on too few people – and often late in life.

Customer Relationship Management

  1. Customer service is an area of opportunity, healthcare needs to accept the change and adapt accordingly
  2. Before the healthcare industry dives into AI – they should incorporate basic CRM functions into #EHR systems. Huge communication disconnect!
  3. Addressing the need for clinical decision support and getting the right information available at the right time

Data is Critical to Healthcare

  1. Challenge w/ personalized medicine starts w/ lack of ability to accurately identify correct patient some crazy % of time…
  2. And, of course, standardizing data (#interoperability) to encourage cooperation between all #healthcare entities
  3. Systems that can use unstructured data to inform decisions. AI and machine learning?
  4. Real-time data sharing, especially clinical data, with providers and especially patients
  5. Absolutely! RTI approach needs to be incorporated from data driven perspective
  6. Systems need 2 embrace outcome-driven & SDOH/BDOH-driven ops to lower costs & affect outcomes. Walk the walk; we’ve heard the talk

The Importance of Home & Social Determinants of Health

  1. Health data taken from the home of the patient using this technology can be shown to doctors for perhaps better, tailored care
  2. Another area to take advantage of is using technology to bring healthcare to the home of patients.
  3. It is the space between heart beats where we live – IE not an “area” but care coordination between areas and with patients

Quality Measures & Measuring Outcomes

  1. How about better assessment & collection of what matters to members/patients? Instead of fancy analytics from quants?
  2. How do we measure feelings and happiness? Or are outcomes more quantifiable?
  3. System wide outcome driven treatment and outcome measures to tailor individual client centered care. Educate for prevention
  4. Analytics allows for effective clinical assessments by providing better patient outcomes
  5. We’re trying to do this now, in way, with HCAHPS/CAHPS, right? Don’t believe currently effective, but CAN be quantified.
  6. Do you see a worthwhile set of quality measures worth aligning to?
  7. Great idea: patient-centric measures. What outcomes do patients/members want to achieve, and what data do we need to drive them?
  8. We do this in OT for quality of life/ perceived ‘happiness’ with what is most valuable. All valid reliable and evidence based measure

Look for More on the Other Topics in Following Posts

Check back for more insight, ideas and opinions from the #HITsm chat. Thanks again to John Lynn and our co-hosts @_GWConnect and @_GuideWell and all those who participated in the chat.  A complete transcript of the chat can be found here. You can also follow @HCExecGroup to learn more about opportunities, challenges, and issues impacting healthcare plans, health systems and payers.

How Total Consumer Health is Impacted by Technology and the Human Touch

By | 2-Total Consumer Health, 5-Transparency, Member Posts, Top 10, Value-Based Care | No Comments

healthcare executive group hceg medica healthedge total consumer health MACRA MIPS APM social determinants of health“Total Consumer Health” means improving ones overall medical, social, financial, and environmental well-being and was identified by HCEG members as the second item on the 2017 HCEG Top 10 list of priorities, challenges and opportunities facing healthcare executives.

Leveraging Medical, Social and Other Data

As value-based care continues to impact the provision of key healthcare services, health plans and providers are seeing an urgent need for improved collaboration centering on the individual member. Total consumer health increasingly relies on innovative technology systems to incorporate data based on life issues and social determinants of health. Providers and care givers must assess, capture and integrate key information that goes beyond mere observation.

By leveraging a mix of actionable data insights and on-the-ground support, health plans are in position to integrate critical technology with a high touch and hyper local approach to care coordination. Total consumer health outcomes are improved when key social determinants are combined with important medical information.

Learn more on Wednesday, April 19th at 2:00pm EDT

 

Join Dr. Alan Spiro, MD, MBA, Chief Medical Officer at Medica, and Harry Merkin, Vice President of Marketing at HealthEdge to learn:value based care total consumer health social determinants of health

  • The appropriate balance between high and low tech options for care coordination
  • How to incorporate innovative tools and methods to address social determinants of health and other factors
  • Real-world examples of innovative collaborative arrangements that are making a positive impact on outcomes

Presenters

Dr. Alan Spiro, MD, MBA – Chief Medical Officer, Medica

As Chief Medical Officer, Dr. Spiro has overall responsibility for the work of Medica’s Health Management segment. This includes working with Medica’s provider partners to develop new models of collaboration aimed at improving quality, patient experience and value. It also includes working with Health Management staff and leaders from other Medica segments to build on the work currently underway to improve the quality and cost of health care.  Follow Medica on Twitter.

Harry Merkin – Vice President, Marketing, HealthEdge

Harry Merkin is a senior marketing executive and is responsible for the company’s demand generation programs, strategic partnerships, product marketing and thought leadership initiatives. He also frequently represents HealthEdge as a speaker at industry conferences and events. Harry has collaborated with many transformative entities across the healthcare landscape including both payers and providers. Follow HealthEdge on Twitter.