“Voice of the Patient” Front & Center at the 10th Annual SAS Health Care and Life Sciences Executive Conference

The SAS Health Care and Life Sciences Executive Conference kicks off in Cary, North Carolina on May 15th with executive attendees from across the health care continuum. Health care providers, payers and life sciences companies will all be represented at the SAS event.

New for this year, SAS will highlight the “voice of the patient” throughout the conference. The health care industry has a “new patient” – the empowered consumer who will have discretionary health care dollars upon which to choose how they are allocated, access to a wealth of health information, and a social media platform upon which to share their delights and dissatisfaction. In the post-reform world, there will be both winners and losers across the health care ecosystem. Winners will be adept at listening to patients through multiple channels; identifying attitudes, needs and usage of patient populations; choreographing every patient engagement, and delivering a positive patient experience. These winners will apply health analytics on both traditional and non-traditional data sets.

At the event, “voice of the customer” will be heard from keynote speaker, 'e-Patient Dave' deBronkart, who is a leading spokesman for patient engagement. Additionally, we will be hearing from Disney about how they have created magical moments for their theme park and resort “guests,” and how the experiences is enriched by deep consumer insights gleaned from data and analytics.

Why is NOW the time for “listening” to the patient?

  • The Affordable Care Act (ACA) includes financial components for both improved patient outcomes and patient satisfaction.
  • The ACA provides for an estimated 30 million additional insured patient consumers who will have the latitude to select their payer and/or provider.
  • These empowered patients will bring their expectations from interacting with other service providers – including “customer centricity,” real-time interactions and service status, and future wants and needs. Think Amazon, FedEx, Netflix, Nordstrom’s and Hilton.

The players within this new health care ecosystem have considerable service expectations upon them. The first step is getting closer to their customers by understanding them through insights from their existing data and on-going interactions these customers.

We look forward to exploring the many opportunities to listen, engage and support the empowered patient at the conference.

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Health and Life Science Leaders Gather to Discuss the Impact of Big Data Analytics

Want to get a glimpse of the future of healthcare?  Would you like to be able to hear what leading organizations are doing to prepare for the huge opportunities (and challenges) associated with healthcare "big data" - without ever having to leave your office?  If so, why not click here to logon and join us for our annual SAS Health Care and Life Sciences Executive Conference, which is being held at SAS's global headquarters in North Carolina on 15th May 2013.

Nearly two hundred senior leaders and strategists, representing some of the largest and most powerful healthcare companies in the world - from big pharma and medical devices, to nationally and internationally recognized commercial health plans and healthcare delivery systems - will be gathering at the SAS campus for this, our 10th annual meeting of senior healthcare executives.

Hear how these leading organizations are leveraging big data analytics to gain a deeper understanding of their market opportunities, improve efficiency, build stronger differentiation and most importantly to improve both care quality and outcomes, while controlling costs.

You'll also hear from Dr. Peter Diamondes, founder of the X-Prize Foundation, about how your organization can adopt hi-tech innovation strategies that have proven highly successful in other industries...as well as from "ePatient Dave" deBronkart, a cancer survivor and passionate evangelist for how personal health data rights and empowered person centric healthcare.  The Expert Leadership Panel will explore how leading organizations are thinking about using data and analytics to drive deeper insights to support personalized medicine and will field questions from the audience as well as from virtual attendees.

SAS CEO, Dr. Jim Goodnight will join us provide an update on the ways in which high performance visual analytics are being applied to help shine a light on the "dark data" that exists today, yet currently remains unanalyzed at any significant scale.  Attendees at the SAS Campus will then break out into industry workgroups to share best practices and the ways in which they breaking new ground in the use of healthcare analytics.

This is one of the few events nationally that pulls together leaders from across different healthcare sectors, not only to explore how analytics are being leverage to improve insights for individual organizations, but perhaps more importantly to glimpse into a future where healthcare data truly follows the individual and can be made available to help us better understand disease risk, onset and progression as well as how to most effectively engage with patients to improve individual and population health and healthcare delivery.

The future of healthcare is closer than you may think.  Why don't you join us and become part of the journey.

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Top 5 reasons I am looking forward to the 10th Annual SAS Health & Life Sciences Executive Conference

This week marks the 10th Annual SAS Health and Life Sciences conference in Cary with a lineup of spectacular speakers and panel participants! As part of the Life Sciences content development team, I have a behind the scenes view and thought you may be interested in learning a bit more about the event.  Let's start with the top  5 reasons I am looking forward to Wednesday:

1)      Listening to health care and business leaders discuss their innovation successes and how their methods can translate across the health care continuum. These speakers and conference participants are rarely in the same venue, yet each are looking at the health care continuum in new ways.

2)      Participating in a life science discussion focused on moving the patient to the center of health care, from research through commercialization.

3)      Engaging in cross-industry dialogues about the convergence of health care across historical boundaries to focus on the patient.

4)      Networking  to hear how the barriers to “doing business the way we always have” are dissipating — moving from “I can’t because …,” to “I can try based on a strategic approach,” which can be contagious in a healthy way.

5)      Advancing health care innovation through new relationships and shared visions.

Let me elaborate:

I will hear Dr. Peter Diamandis describe his inspiration and success as an entrepreneur changing the way people drive revolution in various industries, including health care. Dr. Diamandis is CEO, X Prize Foundation and co-author of Abundance: The Future Is Better Than You Think. I noticed the tag line on Dr. Diamandis’ X Prize Foundation website is “Making the Impossible Possible”.  Isn’t that what the entire US health care continuum is striving for? We are all looking for new ways to turn the impossible into the possible. Each of us is seeking how to:

  • Bend the cost curve while improving health care delivery.
  • Eliminate waste and abuse.
  • Treat the patient as an individual with unique issues and health concerns.
  • Reform a complicated health care system with misaligned incentives.

The list goes on. Some pessimists will say a transformation is impossible, so I look forward to hearing Dr. Diamandis’ thoughts on actually making reform possible.

Several sessions will address  the patient focus evolving across health care — partially mandated by the ACA and enabled through innovation and technology.  This concept has more applicability than I have time to include here, and there are entire conferences devoted to each dimension of this shift. It spans R&D clinical trial development and recruitment, electronic medical records, pay for performance vs. volume, disease management offerings, personalized medicines, member engagement for payers, health care provider education and support, formulary placement, and much more. But this week, I’ll focus on the patient-centered messages from three unique perspectives:

1)      First, the empowered patient:

Empowered patient spokesperson "e-Patient Dave" deBronkart, International Health Policy Adviser and author of Let Patients Help! I read in his blog recently (and I am sure he will touch on the theme): “An engaged patient plays an active role in his or her care.” Or, as e-patients.net founder “Doc Tom” Ferguson said, “e-Patients are Empowered, Engaged, Equipped and Enabled.”

In my opinion, there is a currently a very broad spectrum of patients’ levels of empowerment, engagement, equipment and enablement for a plethora of reasons. At some point people must take ownership of their own health and that of their loved ones. For those unable to manage on their own, the health care industry demands various safety nets. Without this involvement, our health care economy will continue to incur waste and abuse while missing opportunities to prevent disease progression.

2)      Next, the population engagement and retention experts:

I will attend the presentation of an expert making significant strides to fulfill the corporate vision to “delight the guest and create magical moments.”  I will be learning from Disney executive, Ed Gaffin, Director CRM and Marketing Analytics, how Disney corporation engages and retains the population across demographics. After all, who builds customer engagement and retention better than Disney?

Of course, I recognize there are differences between the personalization and outreach latitude Disney has vs. the highly regulated and litigious environment of health care and HIPPA. Yet there are similarities and opportunities for learning from one large organization to another tasked with integrating massive disparate data sources across divisions and incorporating innovation to change the way they drive business. There are many insights organizations can glean from Disney’s commitment, willingness to work across silos, and their ability to innovate, streamline, and enhance the Disney experience both internally and externally.

3)      Finally, organizations striving to be patient-centered:

A life science panel discussion will include executives describing their organization’s vision to be patient-centered by revolutionizing R&D processes, organizational structures, and customer relationships — be it payer, provider or patient. Outsiders may be surprised to hear life science wasn’t always patient-focused when they discovered and commercialized new products to improve a patient’s quality of life. What we really mean is meeting the patient’s needs in new ways – just as they are supported in their everyday lives through retail, banking, travel, education etc. To shift to THIS new way translates to:

  1. Engaging health care professionals in new ways.
  2. Looking for new data sources, new skill sets and capabilities to gain wisdom about disease and patient cohorts.
  3. Changing payer relationships.
  4. Initiating cross-industry discussions.
  5. Challenging the status quo.
  6. Reducing business cost through advanced analytics.

Whew! My head will be spinning by conference end – yet what a great opportunity to look at the market in different ways and from new perspectives. Please stay tuned to the conversation as I recap the event in the following weeks.

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Data Collaboration: Crowdsourcing for Health Care

Crowdsourcing is the ultimate in data collaboration. Crowdsourcing is an Internet-age phenomenon by which problems are distributed to “the crowd,” and those in the online community offer partial solutions. These partial solutions, when taken in aggregate, solve the overall problem.  This approach continues to gain in popularity. Great examples in health care already exist with regard to protein folding (supported by the University of Washington) and cancer cell identification (supported by Cancer Research UK). In both of these examples, the crowd – typically untrained in the relevant specialty (in these instances, either proteomics or cellular biology) – are contributing to scientific advances in health care.

While the crowdsourcing of cures appears to be a new concept, it’s really quite similar to the approach that’s been used for hundreds of years, with arguably the very first instance being the identification of a treatment for scurvy.  In that case, as in all modern day clinical trials, researchers identified new treatments based upon the valuable contributions of patients – through their health care data, their laboratory and tissue samples and their time.  These contributors – or crowds – are not the experts on their illness. But without them, it would be impossible to successfully identify new treatments.

In 2013, there is growing recognition that the contributions of patients are far too valuable to be confined within the walls of individual corporations. The FDA is pooling submitted data from multiple companies to better identify trends across classes of drugs. Companies like GSK have announced data transparency projects through which they are enabling qualified external researchers and analytics experts to access historically proprietary clinical trial data. Public availability will not only enable broader audiences to explore and identify new trends regarding treatments, it will help rebuild the trust and confidence that consumers have regarding commercial biopharmaceutical corporations.

Project Data Sphere is taking a different approach by actively recruiting data collaboration with various biopharmaceutical companies conducting oncology research. By aggregating the clinical trials data, the expectation is that the larger pool of crowdsourced data will enable new discoveries and better insights than the compartmentalized approach historically followed.  Once aggregated, as with GSK’s transparency project, access to the data and relevant analysis capabilities will available to qualified external researchers and analytics experts.

It’s a long way from scurvy to cancer – spanning oceans, science, time and technology – but the goals remain the same.  Patients want to be cured and will contribute, literally, their blood, sweat and tears to the effort.  Scientists, health care professionals and analytics experts are all working to help identify the cures and treatments.

Crowdsourced data. Crowdsourced analytics. Crowdsourced cures.

Attend the SAS Health Care & Life Sciences Virtual Conference to hear more about advances in healthcare through data collaboration and data transparency.

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HIMSS13 Day 4: Deja Vu All Over Again

As the last of the HIMSS13 sessions came to a close and the mass exodus to the New Orleans airport began in earnest Thursday, I found myself thinking of past similar gatherings and braced myself for the “return-to-business-as-usual let-down” from this week’s energized discussions. Passionate is often a word others have used when asked to describe me and I am always a bit humbled by that because ultimately I feel I am certainly no more so than those I admire or have served as mentors. After all, this industry impacts so many lives, wouldn’t passion come naturally? Perhaps for some our industry presents too many daunting challenges yet everyone brings a talent we must nurture. I, for one, find passion to be my personal “Red Bull” when the challenges become taxing.

 
Two Takeaways
This week drove two central themes home with me:

  1. Collaboration is critical to progress and there are an ever-increasing number of opportunities to get and stay engaged.
  2. The care provider sector is lagging behind in the journey the payer sector has already taken in terms of shifting from retroactive views to proactive predictive analytics to anticipate, recognize and adjust processes when high-risk variables become present (conditions, diseases, trends, patients, and even one’s own care protocols).

Addressing the later first, we must be vigilant to learn from organizations that have guided others through the analytical insight maturation curve and be willing to challenge even new reporting and statistical summation systems if there is more historical presentations over forecasts and optimization options.  My colleagues and I focus portions of everyday around the paths enterprises take to leverage and manage all relevant data available into gaining new insight that result in operational and fiscal advancements.

 
Collaboration Requires Diversity
Solving the “big hairy problems” cannot be done in a vacuum. The public-private partnerships, consortiums, and think-tanks addressing healthcare issues that bring together “strange bedfellows” in open dialogue stand the best chance to offer innovate solutions if the member’s business models can coexist with the partnerships objectives.
I mentioned the CommonWell Health Alliance in my March 6 post as a new partnership directed at sharing information for health improvements. I believe these relationships will grow over the next 12-18 months, but am convinced if questions like “how and what is done with shared data?” are not focused on analytic insight to change-the-game that an opportunity will be squandered.
I am convinced that other new efforts will face the same question but can serve, at a minimum, to force the question as more organizations participate in these efforts and look toward measurable changes in efficacy and efficiency. These include the HIMSS Innovation Center in Ohio and the HIMSS partnership with the International Institute for Analytics, IIA, in evaluating and scoring analytic maturity.

 
An Ecosystem That Accelerates the Use of Health Data
Given the US’s 39th overall ranking of the World Health Organization’s study of 191 health systems in member states yet first in costs per capita and the rate US healthcare costs have soared as a percentage of GDP, the call to action is clear:
To adapt to these challenges, our healthcare system is rapidly pivoting:

  • Risk sharing models that reward better outcomes and motivate quality, but requiring better methods/tools.
  • Implementation of healthcare reform and legislation like the Affordable Care Act which require accountability, data analytics, and sophisticated reporting.
  • Emergence of evidence-based medicine creating needs for larger scale data aggregation and analysis.

These all require a data-centered approach in which healthcare lags behind other industries. The announcements of this past week along with activities across the US indicate that “incremental changes” in healthcare are possible through data and better methods, but require unprecedented coordination. Neither the government nor the private sector can do it alone.
Among the passionate individuals, referred to in the beginning of this post are leaders within the Health Data Consortium (HDC) and I thoroughly enjoy my participation on its Advisory Board. The HDC was formed to encourage the creation of a health data “ecosystem” and foster collaboration among government, non-profit, and the private sector organizations working to advance the availability and innovative use of data to improve health and care.

 
Good Bye New Orleans…..Orlando Awaits!
It’s is back to the normal business routines (ok, perhaps not as my days are hardly every routine). Orlando will be the site of HIMSS14 and there is much work to be tackled in the interim as well as focus on leveraging available internal and 3rd-party data sources/stores answer questions such as:

  • Which patients are most likely to require interventions that will avoid costly future medical procedures?
  • How can behavioral pattern data correlate to more efficient disease management?
  • How do we improve medication adherence?
  • How to manage care with the financial risks of capitation and bundled payments?

I will continue in discussions and pondering the optimal method to integrate better data and analytic insights into areas like:

 

  • Decisions at the Point of Care.
  • Patient Monitoring.
  • Better Interventions.
  • Clinical Trial Designs.
  • Purchased Care.
  • Population Health Management.

Don’t wait until we are next together in Orlando, drop a comment to keep the discussion going!

Read more on HIMSS13:

 

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HIMSS13 Day Three: Human Touch and Innovation

As I think back on the winding course of my career, I am struck by the perspective each organizational-stop and its staff had as to its “fit” within the broader healthcare objective of compassionate care. Some of the finest and hard-working individuals I had the privilege of knowing always seemed to stay grounded in the human perspective no matter what our underlying business model may have been. I have tried to do the same. When Dr. Connie Mariano, CEO Center for Executive Medicine and White House Physician for 9 years, observed early in the morning that “it is the journey that defines us”, I nodded in reflective agreement as did many others.

Any conference with the attendance and breadth of HIMSS13 is ensured that there is at least one day jam-packed with “feel good” sessions that enable laughter when considering the progress made and consensus to continue the commitment toward further improvement. When Dr. Mariano suggested Wednesday that HIMSS should stand for human touch, innovate, mentor, serve and succeed, her personal journey resonated with the audience and the day proceeded with encouraging sessions by Paul Begala, political pundit, and President Bill Clinton.

Serve a Higher Purpose
Dr. Mariano’s personal journey is certainly one to be admired. It was her life lessons in leadership and medicine that made the early morning start worth the wake-up call. Her advice to “speak from your voice, say what you believe not what you think others want to hear” has served her well and is an excellent cornerstone for anyone regardless of age and experience. Her lessons in leadership involved:

  1. Keeping the mission first.
  2. Respect all within the chain of command.
  3. Take care of everyone on your team.
  4. Don’t burn bridges.
  5. Always be prepared to do more with less (timely given sequestration).
  6. Serve a higher purpose, your patients/customers.

Given these caveats, I was not surprised. Her lessons in medicine encompassed never practicing in a vacuum, seeking expert advice, your responsibility despite team approaches, and learning from past lessons. Her work now is to focus on executive behaviors to align her healthcare delivery model will gain advantage by applying engagement analytics to gain even greater linkage between care instruction and compliance.

“A society is judged by how it treats its most vulnerable.” Hubert H. Humphrey
Paul Begala, political strategist & pundit, presented a humorous analysis of the overall political landscape today as well as insight into opportunities for healthcare’s continued progress. Center to his observations were both former Vice President Humphrey’s focus on the countries “vulnerable” and the importance to stay engaged with elected officials regardless of one’s opinion of their effectiveness. The demographics of support for each party over the past two presidential elections are reflective, per Begala, of a changing America and “the more diverse we are, the more competitive we are and can be on the global stage”.  He pointed out that advancements and utilization of analytics particularly by individuals such as Nate Silver were changing the political game forever and such should continue to be true for healthcare. Mr. Silver will deliver a keynote presentation at the SAS Government Leadership Summit May 21, 2013 at the Newseum, Washington, DC.

Many of us inquired what it is going to take to get a “dysfunctional” Congress to get working again. His response: “both parties need more individuals who run on ‘I am for compromise and I am still a principled individual’ stance because that’s how we operate in our own real lives!” And the remedy for the glut of misinformation on the internet? Consumers need to challenge “information” more.
“It is what YOU DO, that matters!”
Such was the charge and assertion made by President Bill Clinton as he led the audience through focused observations about the US healthcare’s journey through change.  The President emphasized the high promise of healthcare IT but cautioned that methods of development, implementation and consistent adoption will determine ultimate stability and sustainability both within the US and globally. He also reminded those struggling with the various components of the Affordable Care Act that at some point in the life of every nation, every major program gets “long-in-the-tooth” and needs revision. He asserted that, given the out-of-balance cost/outcomes relationship, not doing so was not an option with the fiscal concerns the country has been facing.

The President’s foundation has opened the door for health advancements in some of the most impoverished countries of the world such as business models to get HIV drugs supplied shifted from high price low volume to low price high volume.
“The beginning of empowerment is understanding!”
President Clinton called for continued analysis on disparities in access within the US as well as increasing models that focus on the science over the art of care. I  see analytics within evidence-based care, comparative effectiveness, and patient engagement supporting the industry in this effort yet there is even more to do in attacking the cost-outcomes balance conundrum within the US compared to other modernized nations.
As The President closed his formal remarks, he asked the audience along the lines of Humphrey’s quote nearly 50 years ago, “Don’t you want good healthcare to be there for everybody?!?”  To achieve such, we cannot afford unexamined healthcare systems and cannot allow the lack of transparency.
On the business side
It was far from an all-high-level message day. HHS disclosed aggressive objectives to expedite health information exchanges and utilization of meaningful-use incentives. The department also announced further work to ensure enhanced sharing of information via collaboration with the Department of Veterans Affairs and 400+ other health organizations.

Day three in the books . . . the end is near, but not the journey of the human touch balanced with innovation, mentoring, serving and succeeding.

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“Homo-Distractus” HIMSS Day Two

A fast-paced keynote by Eric J. Topol, director of the Scripps Translational Science Institute and a man named one of twelve “Rock Stars of Science” by GQ Magazine, not only awakened me to the possibilities of individualized medicine and care, but also reminded me how far we’ve come regarding access to information. In 9 years, new products and services led the general population to rely on iPods, iPhones, iPads, YouTube, Skype, LinkedIn, and Google. Dr. Topol now refers to our on-the-go info-at-the-tip-of-our-touchpads lifestyles as a new species:  “Homo-Distractus”

In 1998, the average attention span was in the 12 minute range. Ten years later in 2008, it had decreased to 5 minutes. I imagine by now, it has shortened even further which means, as attention to the written word can be shorter, I may have already lost yours!

A different day, a different tactic
Today’s post is in the spirit of those with short attention spans. Here are my takeaways from Tuesday’s HIMSS discussions:

  • Individualized medicine is here, patient-centric care is a must. Analytics will drive unique insight versus bland ineffective recipes. (TOPOL, Keynote)
  • Collaboration Leadership for a new Interoperability Organization leads to unique bedfellows with potential for dynamic exchange and use of health information.   Move carefully as sharing information is still sharing historical information. Care can be improved even further with predictive analytic views.
  • Annual Physical = Net Harm? (TOPOL, Keynote) Engaging the patient in new ways can change effectiveness of routine care. Analytics have driven successful advancements in engagement.
  • CMS update on Insurance Market Exchanges emphasized availability and use of Data Services Hub. No cost to any state regardless of exchange structure. (State-run; Fed-run; Hybrid)  (KAHN, CMS)
  • For anyone who’s been on a deserted island without their devices recently, an update: Market Exchanges live enrollment October 1, 2013 and coverage starting Jan. 1, 2014. This CANNOT be postponed by CMS. Congress would have to do it. (KAHN, CMS)
  • VA IT Initiatives continuing focus on shortened project time (6 months or less) and increasing delivery rate. (CONSTANTIAN, VA)
  • VA IT Initiatives mirroring the industry with focus on TeleHealth expansion, Electronic Health Record enhancements, and broadening care workflow management systems. (CONSTANTIAN, VA)
  • “Clinic in Hand”: A  VA pilot in DC now provides tablets to patients and their caregivers. (CONSTANTIAN, VA) The study of their use and correlation is a great opportunity for predictive analytics to make pilot phase 2 even more focused.

Time’s Up!
A full agenda is on tap for Wednesday with addresses by Paul Begalia and President Bill Clinton.

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With the beat of the drums, HIMSS13 has begun!

When I attend the HIMSS Annual Conference & Exhibition each year I am always overwhelmed by the magnitude of the gathering.  It was no different Monday morning in New Orleans as 35,000+ began to fill the grand hall within the Ernest Morial Convention Center for the opening session. And then, as we all were just cozily settled into our chairs in the darkened hall with our PDAs of choice, the crash of cymbals and pounding of bass drums of a local marching band entering the hall shattered our cocoons and jolted us into attention . . . HIMSS13 had begun!

Looking back over the activity-packed full day and considering the constant themes of collaboration, innovation, change and transformation, I wonder - was the constant rhythmic beating of the drums a signal of change ahead or just the never-ending drone of the status quo? I know with each session and discussion I joined in on, it was apparent that the difference between attaining innovative permanent advancement and another flavor-of-the-month is meager.

(By the way, a live unannounced marching band in an early morning meeting in New Orleans after an late evening of great food and laughter Cajun-style---really?!----but, seriously, the kids were great!)

“Improvement never ends ... we have to be perfect at always getting better”
Focusing on new and dynamic ways to engage the community to improve the healthcare continuum, Oschner Health System’s CEO Thomas Warner presented a vision in the morning keynote that guided the attendees through the challenges of 2013’s financial circumstances toward controlling one’s own perspective to drive improvement. I was impressed with breadth of Oschner’s objectives to establish innovative care-delivery programs with patient-centric attention to care quality,  safety, new therapies, treatments, great access, and ease of use.

It was a breath of fresh air to hear Mr. Warner’s emphasis on replicating what other industries, such as retail and banking, had done before to drive Oschner’s improvement on engaging the patient, physician and community. I hope to see the vision validated in the near future by mastering the new data sources being leveraged and an emphasis on gaining insight for improvement. At Oschner, the attention is on being perfect at getting better and always making progress toward the not-likely 100% perfect healthcare delivery.

The vision of the 'ought to be'
Being awakened by a marching band was one thing but we were all quickly captured by the discussion regarding the VA’s other uses of shared information primarily through leveraging the Virtual Lifetime Electronic Record (VLER). The vision of the scope of potential opportunities to impact the entire “ecosystem” of care and benefits surrounding the veteran was amazingly simple to comprehend given the complexities of the task. Arthur “Joe” Paiva, Executive Director of VLER, led this breakout session discussing how proactive veteran-centric approaches might  maximize the full continuum of services and benefits available to the veteran. I think at some point we had all “drank from the same fountain” as the crowd constantly nodded in agreement as analytics, directed at understanding behaviors and usage to predict exposures and gaps in service delivery, were clearly the keystone for driving success in the future.

Big data – it is here, it is now
Monday’s discussions were on collaboration to drive innovation and the dialogue focused on the wealth and size of data available within healthcare. DenverHealth CIO Gregory Veltri laid out an engaging best-practice for capturing insight from “Big Data”. I have always been impressed with the work DenverHealth as done in Colorado and the leadership it demonstrates in improving care delivery. I know they will continue in their leadership.

I am concerned that the provider sector may be missing a bit of the message. The volume and veracity of data throughout healthcare is not for the faint-of-heart but so is the opportunity if one approaches big data with a focus of surfacing relevant data. Furthermore, the vision should not only be on performance dashboards with analytics leveraged to summarize the past but, rather, predictive analytics to enable the care delivery personnel to anticipate and alter practices to minimize the potential risk that analytics surface for a specific patient profile, condition, or disease.

As the provider sector begins to shift away from pay-for-volume to pay-for-value, the application of analytics against that big data will prove to be critical in whether or not care can be improved within a new business model. The train has left the station and is on its track; it’s up to us to make sure it’s the right train, on the right track.

Imperatives to drive value
The challenge within the themes of collaboration and transformation while shifting away from the traditional fee-for-service/volume reimbursement model will be understanding the patient population within the care network or organization and to leverage experience to drive delivery specific to that population. Throughout Monday, the discussions heard in the hallways were focused on the “new” delivery world but laced with apprehension.  SAS’ attention is squarely focused on these strategic imperatives to drive value:

  • Establishing a robust analytics foundation.
  • Managing financial risks and incentives.
  • Proactively managing quality and outcomes.
  • Improving efficiency of care delivery.
  • Engaging the patients as unique individuals.

A lot happened on Monday, far too much to take in and yet surprisingly central in theme and direction. Now, as I run downstairs to grab the shuttle to the convention center to start my Tuesday, I look forward to focusing on the discussions that await (and am even ready for the marching bands!).

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Using the H-word

The Denver Post refers to “HMO” in a recent headline ... and the world keeps on spinning!

There can be a lot of good to come from seriously addressing how care is delivered, how safety protocols work or don't, how patients are engaged, and how costs are impacted without jeopardizing quality.

The long ongoing shift of risk from traditional insurer (including Medicare and Medicaid) to the medical-care provider has had many successful programs.

Although the term HMO may stir up negative experiences, technology and the business of health care have evolved since the 1980s.

From patient-centered medical homes to accountable care organizations, payers and providers are beginning to collaborate on the Institute for Health Improvement's triple aim: improve health of the population, improve health care to the patient, and lower costs.

Even as it consolidates power over six hospitals, more than 15,000 employees and billions of dollars in revenue, University of Colorado Health is contemplating a move into the insurance business while preparing for the next revolution.

What do you think?

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Are you ready for new health care payment and delivery models?

For more than two decades, we’ve read and heard about the unsustainable costs associated with our complex and fragmented health care system. We’ve attempted to steer away from the fee-for-service payment model, which pays for volume instead of value. And further, we’ve tried—with limited success—to shift some risk from payers to providers and costs from employers to consumers.  

We’ve reached a tipping point. Every single stakeholder—state and federal governments, private health plans, employers, and consumers—is struggling to cover its portion of the health care expenditures, which now amounts to 18 percent of the US Gross Domestic Product.

And while we thought the market could drive the transformation needed in the health care system, it didn’t happen in a timely manner; so as a result, Congress passed federal legislation to reform the system by serving as the impetus behind the change.

How do we bend the cost curve?
As Michael W. Painter, JD, MD, wrote in the HCI3 Improving Incentives Issue Brief, Bundled Payment Across the US Today, “Our task now is not to stay put or go back but rather to decide what way to proceed. In some ways we are fortunate. We have the urgency of now on our side. Our ongoing health reform debate, as well as the national attention to our ballooning federal deficit and the central role that rising health care costs plays in that deficit problem, all are prompting us to, as they say, ‘bend the health care cost curve.’ How should we do that?”

There are a number of suggested methods for bending the cost curve in the piece of referenced federal legislation—also known as the Affordable Care Act, including alternative payment and delivery models. So, as you consider whether to engage in a bundled payment program and/or possibly an accountable care organization, there are a number of questions you should consider. Some of them are listed below:   

 Leadership

  • Do you have a clear understanding of the new payment and delivery models and their potential benefits and possible unintended implications?
  • Do you have the vision of where you need to go as an organization—what changes need to be made?
  • Do you have the leadership in place to usher in payment reform to all levels—board, administration, medical staff, employees, etc.
  • Can the leadership team drive changes—short- and long-term?
  • Do you have a plan in place to educate and communicate the importance and benefits of payment reform in your organization?

 Financial Viability

  • Is your facility financially stable?
  • What impact will alternative payment models have on facility revenues/finances?
  • What impact will introducing and implementing alternative payment models have on available capital?
  • Do you have goals and metrics in place? Would you be able to realize negative implications quickly?
  • Do you know the equation for financial success with new payment models?
  • Could you juggle multiple payment models?

 Culture

  • Is your organizational culture innovative and entrepreneurial?
  • Do you encourage your employees to challenge the status quo?
  • Do you support risk-taking within your organization?
  • Is it a learning culture?
  • Is your culture collaborative? Does it support “team”?

 Alignment

  • Do you have clear, strong alignment of goals within your organization—alignment at all levels?
  • Are your affiliated physicians—whether employed or not—committed to the success of your facility and aligned as well?
  • Do you have total confidence that your physicians and other providers deliver the best care in the right place at the right time all of the time?
  • Do you have a network of post-acute care providers aligned?

 Patient Population

  • What is your patient mix?
  • What is the current health of your patient population?
  • What is the cost of care for your patient population?
  • Are there opportunities to manage patients differently and more efficiently?
  • What is your market share?
  • Is the hospital prepared to attract and drive new patients to your facility to support new financial models?
  • How would new patients impact financials?

 Resources/Infrastructure

  • Do you have the human resources, skills and knowledge in place to transform your payment model and/or juggle multiple models?
  • Do have the infrastructure and technology in place to facilitate payment reform? If not, do have a plan to cover the costs and implementation?
  • Do you have a data strategy?
  • Do you understand the insights you need to glean from the data you are generating? Can you translate those insights into action?

While we might not have an industry “how-to” manual yet on how to participate in reform, we do know that thorough and thoughtful preparation is going to be the key to mitigating risk during this period of transformation.

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    Welcome to the SAS Health and Life Sciences blog. We explore how the health care ecosystem – providers, payers, pharmaceutical firms, regulators and consumers – can collaboratively use information and analytics to transform health quality, cost and outcomes.
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