are Val alue-bas ased Car A Complimentary Webinar From - - PowerPoint PPT Presentation

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

“Clinical Inte

tegrati tion as as a a Key to to Val alue-bas ased Car are”

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 Ingredie ient of Value lueBased Care”

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

• HIPAA 5010
• ICD-10
• Meaningful Use of EHR
• Quality Reporting
• Cost reduction (14-20%)
• Shared Services
• Labor
• Supply Chain
• Clinical Resource Management
• Clinical Effectiveness Research
• ACOs, Population Health
• Physician Alignment
• New Medical Home
• Bundled Payments
• Health Exchanges
• Growth strategies
• M&A
• Clinical Integration
• HIE/REC
• HITECH
• Personal Health Records
• Image Sharing/VNA
• Analytics

Performance Improvement Regulation & Compliance Health Information Technology Health Reform Market Growth & Transformation

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 patientamong

authorized providers engaged in the coordinated delivery of healthcare services. Resulting in effective care transitions to reduce readmissions Connected, secure sharing of specific patient information Authorized Providers engaged in coordinated delivery of services

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Triple Aim

• Extends our zone of influence to more closely match our zone of concern – i.e., we are better able to ensure closed

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

cohort of patient for which we are accountable Better Outcomes

• Improving the patient experience by confirming shared information vs. collecting it new at each visit across the

continuum (Chronic Disease Management)

• Increased patient safety through sharing of CCD content around allergies, active medications and problem lists

Improved Patient Experience

• Through a better set of relevant information, target the most appropriate care for the individual patient at the right

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

among authorized providers Lower Cost

In the context of the Triple Aim, Clinical Integration provides the following benefits to our PHO members and the patients for which we care:

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Enabling Clinical Integration with HIT

Connectivity Intelligence Workflow Solutions Consumer Engagement Health Financial Services Clinical Services

HIE Quality/PQRS Interactive Web Presence Patient Portal Provider Portal Disease Registries Telemedicine Independent Practice Extended Enterprise Scheduling Problem List Reconciliation Meaningful Use Reporting Population Management Health Risk Assessments Beneficiary Management Referral Management CRM Contact Center

Now Next Later

Community Collaboration Master Patient Index Enterprise Data Warehouse Nurse Advice Line Expanded HIE Services E-Visits Case Management Timing

Illustration

Payer/Employer Portal

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Success Metrics

• # of lives under

management

• Portfolio of profitable

contracts

• Clinical Integration
• Geographic coverage
• Mix of PCP/Specialists
• Quality LTC, HH
• Performance standards
• Attribution of members
• Retention
• Satisfaction
• Engagement
• Retention of Referrals
• Readmissions
• Days without SSE
• Incentive Payments
• Patient Outcomes
• Quality Measures
• Distribution of Shared

Savings

Key Business Functions

• Benefit Design
• Risk Management
• Managed Care

Contracting

• Contract Administration
• Recruiting
• Practice Transformation
• EMR implementation
• Data rendering
• Beneficiary Management
• Onboarding
• Customer Service
• Scheduling
• Nurse Line
• Care Transitions
• Chronic Disease

Management

• Care Advocacy
• Population Health
• Medication Reconciliation
• Quality Improvement
• Monitor provider

performance

IT Enablers

• Managed Care

Contracting

• Payer/Employer Portal
• Provider Portal
• Quality Reporting
• Analytics
• EMR
• HIE/Direct
• Clinical Messaging
• Patient/Member Portal
• CRM
• Call Center
• Enterprise Scheduling
• Registries
• Referral Management
• Case Management
• Care Plans
• Tele-presence
• Image Sharing
• Analytics
• Contract Management

Value Chain of Value Based Care

Payer Contracts Provider Network Members, Patients Coordinate Care Manage Results

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Program Sca cale Considerations

B A P a t i e n t s P r o v i d e r s

“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

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

specific cohort, e.g., Specialists, PAC

• D = Compliment of all other patients seen by that

group of providers

• E = Universe of additional providers and patients in

the market place Important to consider scale of the program required to accomplish the desired goals.

• A+B; C+D; consistent flow within a practice
• A+C; consistent patient experience (per cohort across

sites)

C D E E E E E

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

Integration, Bundles, ACO

• Case/Care management
• Referral management, including ED
• Align care delivery partners
• eVisits, encounter reporting
• eCommerce, DME, home care
• Engage consumers, patients, physicians,

employers

• ePrescribing, Medication Reconciliation
• Personal Health Record (CCR)
• 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

(Intranet)

• Manage quality and provider

effectiveness

• Customer Relationship Management,

Scheduling

• Enterprise shared service for

(HR/Payroll, General Accounting, Supply Chain, IT, Facilities, Biomedical, PMO)

• Revenue allocations to partners in care

delivery

• Community integration, HIE
• Payer relationship management (HIPAA

5010)

• Business Intelligence

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Provider Network

Primary Care Physicians Specialists Participating Hospitals Home Health LTC Rehab Other Hospitals

• Core – PCP who drive attribution
• Secondary – members of the PHO who share

in distribution of shared savings, but don’t drive attribution

• Tertiary – participants in the extended

provider network who benefit from referral volume in exchange for cost, quality and access but are not members of the PHO.

• Universe – all other authorized providers

who might contribute randomly to care of

• ne of our patients.

Lab Community

Drivers of the Provider Network include requirements of the payer to have adequate access across a geography. Cadence considering means by which to bolster its market presence without full asset mergers.

PCP Specialists Universe Rx

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Care Coordination – the secret sauce

L Cost/encounter H H L Nurse Line (A+B+C+D) Chronic Disease Management (A+C only) Care Transitions (A+C only) Care Advocate (A only) Customer Intimacy “Intimacy at Scale”

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Population Health – enabled by Clinica cal Integration Collect Analyze Engage

Data Rendering Sickest patients Care Advocates EMR connection costs Tiering (1,2,3) Nurse Line Temporal alignment Target disease conditions Chronic Disease Management Data quality, attribution Impact of interventions Care Transitions DURSA Provider performance EMR Patient consent Payer contract performance Patient Portal

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Closing

• Clinical Integration is an enabler of Value and Volume Based Care.
• Balance your investment with the size and complexity of your payer

contracts (KISS).

• The vendor market is frothy with “must have” solutions,

caveat emptor.

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 Ingredie ient of Value lue-based Care”

Thomas Pickard, Director, Healthcare Industry Marketing Perceptive Software

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Unprecedented demand for information

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

The road to clinical integration

 Document management  External documentation  Back office  Intelligent capture  Mobile capture  Clinical documents and images  Video capture  DICOM CDs/DVDs  EMR connectivity  Image exchange  Migration  Storage consolidation  Enterprise viewing  Interoperability  Image sharing

Enterprise Content Management (ECM) Perceptive Vendor Neutral Archive (VNA) Enterprise Image Connectivity (EIC)

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Healthcare Content Management

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

About Perceptive Software

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Perceptive Bona Fides

• Top 3 “Best in KLAS” vendor for VNA and ECM in 2014
• Market share leader in vendor neutral archive solutions (IHS)
• Positioned as a “leader” in Gartner’s most recent Magic Quadrants

for both enterprise content management and enterprise search

• Our enterprise image connectivity solutions have been adopted by
• ver 50% of the U.S. hospital market
• One hundred percent of U.S.-based HIMSS Level 7 healthcare systems

use Perceptive Software products and solutions

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Customers across the continuum

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Q&A

Click on the Q&A 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.”

Slide Deck: http://goo.gl/X3clUu Webex Support 1-866-229-3239 Event #661 632 439

Thank You!

• Thanks to our featured speaker: Dan Kinsella & Dr. Tom Moran!
• Thanks to our sponsor: Tom Pickard & Perceptive Software
• http://perceptivesoftware.com/healthcare
• You will receive an email when our archive recording is ready.

(Separate registration is required)

• CHIME CHCIO Credits – Attending our Webinars = 1 CEU
• Questions/Comments – Anthony Guerra aguerra@healthsystemCIO.com

Go to www.healthsystemCIO.com/webinars to view our upcoming schedule and see the last 12 months of archived events.