Caradigm

Four new developments in analytics solutions strengthen the tools available to support providers in effectively managing the health of their patients.

Providers are among those most impacted by the turbulence in today’s healthcare landscape – whether it be adding facilities, covering more patients, changing leadership, providing additional services or entering new value-based programs, such as MACRA, Bundled Payments or DSRIP. The “Quadruple Aim” was put forward to address the experience of providers in delivering care that is increasingly tied to cost and quality metrics. The so-called, second wave (post-EHR) of digital technology might be their greatest hope as providers manage this massive transformation to new value-based care and reimbursement models. With clinicians supporting new populations, managing multiple data sources and being tasked with additional processes, the burden of administrative tasks should be eased through the availability of resources that drive efficiency and enable a community-oriented, risk-based care approach. Paradoxically, it seems the introduction of new technology and processes can often be an added weight for clinicians to learn and adapt to. As we continue down the path of digital transformation, these tools should evolve to smoothly integrate into workflows and yield quick, measurable benefits for teams. So how do organizations scale activities and enable their teams to deliver care more efficiently and consistently throughout this period of rapid change? Weather the uncertain regulatory environment While lawmakers continue to battle it out, we should face one fact: value-based care is here to stay. Providers should push forward with a “no regrets” strategy. Prioritize efforts to drive more consistent, efficient and coordinated care, integrate your IT systems to support accurately forecasting patient risk, lowering cost structures, and building deeper relationships and loyalty with patients. Providers should not miss out on this incredible time of innovation in healthcare that I believe is going to accelerate even more as healthcare organizations build off their early successes and learnings. With uncertainty in legislative direction for healthcare (ACA, Value Based Payment Reforms, etc.), providers may feel uncertain about their IT buying decisions. Rather than feel uncertain, I suggest providers should continue moving forward, with a keen focus on flexible and extensible solutions to support any outcome of legislative direction. Quick time to value with an eye for the end game Healthcare organizations need strong capabilities to aggregate data from across the community to connect all clinicians responsible for a targeted population. Providers should demand short implementations to ensure rapid time to value. Beyond this, seeking a flexible and configurable solution “future proofs” the organization to accommodate new programs that may be launched. This “future proofing” will provide organizational agility to rapidly configure to meet continuously evolving payment reforms and legal requirements. Selecting a population health tool should include an evaluation of the vendor’s ability to meet organizations where they are and grow with them across programs, such as Medicare Shared Savings Program, Comprehensive Primary Care Plus, Bundled Payments, etc. Intelligent analytics and sophisticated tools Finding tailored software applications that enable clinicians to streamline workflows will drive positive results throughout your organization and help achieve scalability. Tools that facilitate targeted care management activities for prioritized patients will support care team efficiency. Interoperability is especially key in the case of mergers and acquisitions, considering the critical need to bring together data from potentially dozens of systems. Sophisticated risk stratification tools that consider clinical and claims data, financial information, social determinants, behavioral factors and that employ predictive analytics will further help organizations determine where to focus constrained resources to achieve the highest return and greatest impact on patient outcomes. These are all factors to consider when searching for the right IT solutions to support your organization’s growth and goals, while advancing the health of the population. Application integration into clinical workflows –  they can only use it if they can find it While many providers recognize the value of using data and analytics to improve the quality of care and lower costs, there are many that have not yet integrated these directly into clinical workflows to realize the greatest impact and efficiency. This integration is especially important for accountable care organizations (ACOs) and clinically integrated networks (CINs). Timely access to data is critical when you are responsible for the health of a population of patients who may be geographically dispersed and receiving care from several hospitals or specialists. IT solutions should be leveraged to surface gaps in care, risk scores and full medication histories so that a clinician can make educated care decisions while in the presence of the patient. Value-based care initiatives should be addressed as a series of interconnected activities rather than as distinct, siloed efforts. A successful strategy takes a team-based approach and engages staff across different facilities to focus not only on individual patients with individual diagnoses, but also the health and wellness of the community. IT solutions need to create a unified user experience to support the interconnectedness that plays an integral role in an organization’s evolving strategy. ACOs and CINs should integrate an enterprise solutions portfolio encompassing the capabilities critical to success in value-based care programs, including: data control, healthcare analytics, and care coordination and engagement. Providers should also partner with vendors that have deep industry experience to provide advisory services. The pace of change in our industry continues to accelerate, and no organization should feel they are navigating these waters alone. For more information staying ahead of the curve in healthcare, check out the ebook “Improving Transitions of Care in Population Health.”  About the Author Caradigm CEO Neal Singh

By Mike Willingham, Vice President of Quality Assurance and Regulatory Affairs, Caradigm The mandate for healthcare information security is clear. Our industry has to raise the bar. We are reminded of this by the constant stream of breaches affecting healthcare providers such as the recent incidents impacting 21st Century Oncology and Hollywood Presbyterian Medical Center. Industry reports like this one from the Ponemon Institute state that healthcare organizations face cyberattacks every month and are still struggling to find effective strategies to keep systems secure. One of the core vulnerabilities facing healthcare is identity and access risk as that most healthcare organizations have vulnerabilities, but don’t realize their security strategies are insufficient. With frequent industry consolidation and the emergence of population health, information security is becoming increasingly more challenging to manage. Data is now being shared from a multitude of applications with both employed and non-employed physicians. Managing this risk is further complicated because it has multiple layers. You have to consider elevated privileges, remote and mobile access, multi-factor authentication, and balance these concerns with providing efficient access. While single-sign on (SSO) tools are often looked upon as the first line of defense in controlling identity and access risk, providers need additional capabilities because the threat landscape has evolved. Providers need to assume that insiders and outsiders with malicious intent are attempting to gain unauthorized access. In order to reduce this risk, providers need greater visibility so that they can be more diligent. This entails a major shift in philosophy to a more proactive strategy that is constantly managing credentials and access rather than just reacting. The key to succeeding with this approach is to leverage automation. With the exploding number of applications and clinicians that must be managed, security teams must use tools that can automate manual security related processes. Here are a few examples of how automation can help manage risk: Provisioning and de-provisioning processes, which provides consistency in the process, saves IT many hours of work and prevents errors User, entitlements and behavior data can be brought together in a single view so you have all the information you need to take action A governance, risk and compliance (GRC) dashboard can be set up with analytics to monitor and proactively manage risk efficiently (e.g. an orphaned accounts report) Real-time alerting can identify a potential incident as it happens to minimize damage Remediation can be simplified so that access can be removed or suspended in just a couple of clicks Given the increased threats we face, healthcare needs to change its approach to security and privacy. Ultimately, the key is greater due diligence, day in and day out. If we use tools that help us accomplish this, then we give ourselves the best chance to win this battle.