Download - MGMA of Greater St. Louis 2014
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Current & Emerging Technologies Supporting Patient Centered Care
Ben Quirk
Quirk Healthcare Solutions
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Person Instead of Patient
• Patient centered care can only go so far. We are now being held responsible for what patients do when they leave the clinic and become people again.
• The power of each individual is unleashed to be active in managing their health and partnering in their health care, enabled by information and technology.
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Personal Behavior
• According to BCBS foundation, 70% of
all healthcare costs are caused by
personal behavior.
• In addition, nearly three-quarters of all
costs can be traced to cardiovascular
disease, diabetes and obesity.
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The New Healthcare Paradigm
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ONC’s Core Values
• Individual self determination and the public good are both optimized.
• People can decide whether and how much to participate in managing their health and health care.
• People can access wellness and health care services enabled by technology that reflects their individual needs, values, and choices.
• Health care is a partnership between the patient, their caregivers, the care team, and supporting services.
• Information is shared as appropriate, between the individual and all their care partners to enable informed, participatory decisionmaking as desired by the individual.
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Why Do We Care?
• “We will replace once and for all our fee for service model with provider-led community wide care that can compete on quality, value over volume.” Hillary Clinton, HIMSS 2014
• “Transforming health care to slow the growth of spending requires a radical restructuring of how health services are paid for. The most powerful way to reduce costs (and make room to expand coverage) is to shift away from ‘volume-based’ reimbursement (the more you do, the more money you make) to ‘value-based’ reimbursement.” Newt Gingrich
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Physicians Are Already Paid Based On Health of Patients
• In the Value Based Payment Modifier, we are judged on outcomes not just reporting data.
• These outcomes will be published on the Physician Compare website and are already published by some Commercial Payers.
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LOOK INTO TECHNOLOGY
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Healthcare Technology
• Dan Holleran:
• Medtronic Minimed 530G Enlite
• Medtronic CareLink USB
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Healthcare Technology
• Wellpoint already provides seniors with chronic diseases in-home monitoring equipment that alert to issues:• Diabetes – Glucometers
• Hypertension – BP cuffs
• CHF - Scales
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Patient Portals
• MU2 requirement for interaction with portal and message to doctor.
• Responsibility is put on the provider for adoption.
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Data Aggregators
• HIEs consuming data and bringing them to payers and ACOs to identify trends.
• MU2 requirement for creating and sending a CDA for transitions of care.
• MU2 requirement to codify chart with SNOMED.
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Wellness Technology
• Fitbit, Nike Fuelband, etc
• Calorie Counters
• MyFitnessPal
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Nutritional Literacy
• Calorie counts on menus.
• Healthy options at chain restaurants.
• Smoking bans.
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REMAINING HURDLES
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Separation Between Healthcare and Wellness
• Healthcare• Healthcare technology
• Patient portals
• Data aggregators to pull together micro and macro patient trends
• Wellness• Wellness technology
• Nutritional literacy
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Data Aggregation
• Integrating HIE and wellness data into clinical visit.
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Pay for Value
• Reimbursement model to support care coordination and reduced visits.
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Closest Solution: Apple Health
• Despite current challenges, Apple Health is a strong push into bringing health and wellness data into clinic and engaging with patients when they become people.
• Uptake and efficacy remain to be seen.
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A CASE STUDY: “SAVANNAH INNOVATION CENTER”
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The Underpinnings
• NextGen EHR for clinic EHR
• Netpulse for wellness integration
• Mirth to compile claim, clinical, and wellness data into actionable care management
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2020: WHERE WE WILL BE
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Where ONC Wants Us to Be
• Self management and prevention – Persons are educated and make informed choices.
• Interactions – Healthcare data flows fluidly to persons and vice versa.
• Shared management – Providers are responsible for persons actions outside visit.
• Cross-cutting – Breaking down the barrier between health and wellness.
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The Rest of The Story
• Apple Health will make wellness fashionable.
• The reimbursement model to support the personal technology and fewer visits will come from payers and employers.
• Fee for service will be increasingly replaced by pay for value.
• Physicians who don’t make change will be see lower reimbursement or be removed from networks.
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QUESTIONS?