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Friday, September 26

Friday, September 5

  1. tag_del 2012 Agenda untagged ltpac hit
    6:54 am
  2. tag_del 2012 Agenda untagged 2012 agenda
    6:54 am

Sunday, June 22

  1. page Connected Worker edited 2014-2016 Road Map Themes: CONNECTED WORKER Goal: To Connect workers to the people, processes a…
    2014-2016 Road Map Themes: CONNECTED WORKER
    Goal:
    ToConnect workers to the people, processes and information they need to be successful. To help LTPAC/SS
    Rationale/Background:
    ...
    tools allow enterprisesorganizations to link in-person and virtual teams physically, virtually across place
    ...
    transformation. The collaborativeCollaborative believes that
    ...
    tools support learning in place,just-in time learning, task and
    ...
    accountability, teamwork, learning, and attention.
    ...
    empowerment. As the human sensorselement, their assessment andassessments are feed back into systems andsystems; their knowledge is
    ...
    them to further add value
    ...
    hospitality services. ThisProperly engaged and supported, workers can provide the needed high-tech and high-touch. The Connected Worker is a
    Key Priorities:
    Promote LTPAC/SS care and service delivery innovation approaches that presume connected workers as a baseline. Metric: proportion of workforce equipped with real-time connection.
    ...
    Policy-maker:
    Other:
    _-_
    NOTES:
    2014-2016 Road Map Themes: CONNECTED WORKER
    Enables Connected Teams (Collaborative Teams)
    A “device
    Next Steps: (Hold for every worker” (real-time connection wherever they are) becomes a platform for
    Connected clinical delivery processes
    Not focusing on work flow outside of a connected environment
    Real-time (constant) data observation and response
    Point of care decision-support (Full clinical decision support, analytics, evidence-based practice integration at the point of care that is patient specific) (Learning in place)
    Education
    Teach how to do great “technology assisted” care
    Teach how to use the information to improve outcomes, experiences and …
    How to use analytics to enhance decision-making
    The best technology is invisible (built on analytics)
    Discussion/Notes: Bring a message home to the provider community by illustrating through examples and case studies – e.g. key quality areas, application of technology for care delivery. Calling to move beyond thinking of an EHR enhanced process, to a process in which knowledge informs at every step of the process. Most of workforce extensively uses mobile technology for their home life and as soon as they come to work they are asked to put their technology aside and step back twenty years. Virtual care teams overlap between Connected Worker and Connected Partners. A connected worker may be a virtual nurse who is monitoring data from telehealth devices. The emphasis that we are trying to make with this theme is “real-time connection” wherever they are. They don’t have to go to their desk to connect to a computer or where the desktop is located, etc.
    _
    Connected worker brainstorming:
    Equipped Worker
    Consumerization of technology
    Transformative technology in workplace
    Patient Centeredness
    Informed Worker
    Behavior Change
    Engaged Worker
    Empowered Worker
    How to improve workflow
    Presumption to envison and reenvison organizational function
    Assumption, frontline workforrae has the fools
    Rethinking workflow
    Workflow is in transition in healthcare delivery
    Metrics
    Betweenness
    Information handlers
    Centrality measures
    Information workflow
    Usability, effectiveness
    Decision Support
    Interfaces
    Manager, DON might look at quality measure reports to effect workflow
    Data timeliness
    How does this topic overlap with other terms in the Roadmap
    What is the outcome of the transformations that are occurring?
    What are the 5-6 things that are transformative?
    What are the steps to getting people connected?
    Work does not occur in straight line, quantum organizations, complex adaptive organizations
    Big data and human intelligence
    Collaborative Interactions
    __
    Goal:
    Rationale:
    Key Priorities:
    Objectives and Strategies to Pursue:
    Next Steps:
    Summit)
    For Provider Community:
    For Vendor Community:
    Policy-maker:
    Other:

    (view changes)
    3:36 pm
  2. page Health Intelligence edited ... 2014-2016 Road Map Themes: HEALTH AND BUSINESS INTELLIGENCE Goal: ... population health. …
    ...
    2014-2016 Road Map Themes: HEALTH AND BUSINESS INTELLIGENCE
    Goal:
    ...
    population health.
    Rationale/Background:
    Health intelligence is concept that describes how people, organizations, systems and populations are deriving knowledge from analysis and transformation of high quality healthcare and related data into actionable information to support real time and near real time decision-making. Enabled by health information tools, technologies and processes, stakeholders and innovators are exploring, analyzing, mining, reporting, and visualizing data in ways not capable in the past.[1]
    Health Intelligence has a number of facets – for LTPAC and other healthcare providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics to support decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, the business environment, and financial risk.[2] At a population level, health intelligence relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of the aging population served by LTPAC.[3]
    For the patient and their caregiver, health intelligence provides dynamic analytics to drive action and inform our decision-making.The Quantified Self movement (the use of technology to acquire data on aspects of a person's daily life such as inputs (e.g. food consumed), states (e.g. mood), and performance (physical))[4] along with other sensors, devices and tele-health tools provide new opportunities for redefining the patient-caregiver relationship to analyze, monitor, and manage care anywhere at any time.
    ...
    business landscape.
    Key Priorities:
    Embrace person-centered, technology-enabled quantified health movement is informing a new consumer - healthcare practitioner relationship impacting the broad health care continuum including opportunities in LTPAC.
    ...
    Deep understanding of an organization’s health and financial information that makes LTPAC a trusted care delivery partner
    4. Begin to change organizational culture and build an infrastructure to integrate health intelligence in the care delivery and workflow process for all workers.
    5. Deploy information governance strategies to:
    Implement and maintain an information governance program, infrastructure, and decision-making.
    Assist with understanding the available health and business intelligence resources and identify those needed to support an evolving care delivery and business landscape.

    Next Steps:
    For Provider Community:
    (view changes)
    3:32 pm
  3. page Health Intelligence edited ... For the LTPAC sector to seize opportunities to use health and business intelligence to gain dy…
    ...
    For the LTPAC sector to seize opportunities to use health and business intelligence to gain dynamic knowledge and actionable insights that: 1) improves the quality and delivery of care, clinical decision-making, and coordination; 2) redefines the provider-patient relationship through new patient (and caregiver) engagement to improve their health and wellness; 3) supports business operations, strategy and partnerships; 4) improves transparency to support quality measurement and public health; and 5) advances population health.
    Rationale/Background:
    ...
    the past.[1]
    Health Intelligence has a number of facets – for LTPAC and other healthcare providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics to support decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, the business environment, and financial risk.[2] At a population level, health intelligence relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of the aging population served by LTPAC.[3]
    ...
    performance (physical))[4] alongalong with other
    Effective health and business intelligence is integral to and supports all of the other LTPAC Health IT Road Map strategies for connected patients, workers, partners and the evolving business landscape.
    Key Priorities:
    ...
    Advance the use of health intelligence to transform the worker, their workflow processes, and the organization to support an empowered information worker that is equipped with context about their patient’s personalized care needs, goals, and preferences.
    Accept responsibility for information stewardship and governance to ensure the value of health intelligence can be realized because the foundation data that transformed to knowledge was trusted and accurate.
    ...
    by LTPAC.
    Objectives and Strategies to Pursue:
    Take a leadership role in the healthcare industry on the need for and value of a Virtual Care Team supported by both an interoperable health IT platform and health intelligence to drive effective care coordination and pathways across the continuum to respond to a consumer's need for health service.
    ...
    [3] Public Health Online Resources for Careers, Skills and Training. http://www.phorcast.org.uk/page.php?page_id=36
    [4] Quantified Self. Wikipedia. http://en.wikipedia.org/wiki/Quantified_Self (Accessed 5/2014)
    Goal:
    For LTPAC to embrace information as an asset moving to data-driven practices that provides critical insights and intelligence that improves care delivery, clinical decision-making and coordination; engages the patients (and
    caregivers) their health and wellness; supports business operations, strategy and partnerships; improves transparency to support quality measurement and public health; and advances population health. The use of health intelligence
    provides greater health awareness and healthcare transparency by delivering data-driven information about trends and best practices, improved decision-support practices, and quantified self.
    Rationale/Background:
    Health intelligence is concept that describes how people, organizations, systems and populations are deriving knowledge from analysis and transformation of high quality healthcare and related data into actionable information to support real time and near real time decision-making. Enabled by health information tools, technologies and processes, stakeholders and innovators are exploring, analyzing, mining, reporting, and visualizing data in ways not capable in the past.[1]
    Health Intelligence has a number of facets depending on the stakeholder or perspective. For LTPAC and other healthcare providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics to support decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, and financial risk.[2] On a population level, health intelligence information relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of different populations.[3] This can also be achieved through the collection and reporting of quality measures.
    Health intelligence also encompasses patients and provides new opportunities for LTPAC and the patient-caregiver relationship. Quantified Self is a “movement to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (e.g. food consumed), states (e.g. mood), and performance (physical).”[1] This level of self-monitoring/self-sensing is achieved through wearable sensors and computing that track and analyze data.
    For LTPAC providers, health intelligence provides new opportunities leverage data and analytics to drive action and inform our decision-making, support improvements in clinical care practices, and define a new relationship between the patient and their LTPAC caregivers. The use of sensors, devices, and monitors leverage a telepresence infrastructure and provides an opportunity to monitor and manage care anywhere and anytime. The effective use and analysis of intelligence provides an opportunity for an LTPAC provider to be a tremendous partner in care delivery and coordination supporting all other LTPAC Health IT Road Map strategies for connected patients, workers, partners and evolving business landscape.
    Key Priorities:
    Embrace person-centered, technology-enabled quantified health movement is informing a new consumer - healthcare practitioner relationship impacting the broad health care continuum including opportunities in LTPAC.
    Continue to advance person-centered (not provider-centered) assessments, quality measures, and standards that cut across the silos of care delivery and empower consumers to make decisions and improve care.
    Use health intelligence to engage LTPAC and improve care coordination/care pathways, quality outcomes, and financial management across spectrum and support the emergence of virtual care teams, emerging care delivery/payment models and their ability to respond to a patient’s need for health services.
    Advance the use of health intelligence to transform the worker, their workflow processes, and the organization to support an empowered information worker that is equipped with context about their patient’s personalized care needs, goals, and preferences.
    Accept responsibility for information stewardship and governance to ensure the value of health intelligence can be realized because the foundation data that transformed to knowledge was trusted and accurate.
    Recognize the opportunities for new innovations and relationships with consumers by using health intelligence to transform population health by linking patterns, analytics, disease study, and outcomes for aging patients served by LTPAC.
    Objectives and Strategies to Pursue
    Next Steps: (Hold for Summit)
    For Provider Community:
    For Vendor Community:
    Policy-maker:
    Other:
    [1] Quantified Self. Wikipedia. http://en.wikipedia.org/wiki/Quantified_Self (Accessed 5/2014)
    [1] Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009. http://www.inhcc.com/Health_Intelligence.html
    [2] AHIMA, Health Intelligence Definition. 2014
    [3] Public Health Online Resources for Careers, Skills and Training. http://www.phorcast.org.uk/page.php?page_id=36
    Notes:
    Health Intelligence
    Goal:
    For LTPAC to embrace information as an asset moving to data-driven practices that provides critical insights and intelligence that improves care delivery, clinical decision-making and coordination; engages the patients (and caregivers) their health and wellness; supports business operations, strategy and partnerships; improves transparency to support quality measurement and public health; and advances population health. The use of health intelligence provides greater health awareness and healthcare transparency by delivering data-driven information about trends and best practices, improved decision-support practices, and quantified self.
    Rationale/Background:
    Health intelligence is concept that describes how people, organizations, systems and populations are deriving knowledge from analysis and transformation of high quality healthcare and related data into actionable information to support real time and near real time decision-making. Enabled by health information tools, technologies and processes, stakeholders and innovators are exploring, analyzing, mining, reporting, and visualizing data in ways not capable in the past.[1]
    Health Intelligence has a number of facets depending on the stakeholder. For LTPAC providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics which supports decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, and financial risk.[2]
    The quantified health movement is…
    For LTPAC, The kind of intelligence a provider has is the kind that makes it a tremendous partner (enhanced partnerships) and quantified health - applied to connected consumer, worker and partner.)
    Scope: Health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics which supports decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, and financial risk —all critical success factors in improving health, improving care and managing costs.
    Define health intelligence, quantified health/self, integration of big data
    What is Health Intelligence:
    - Healthcare Intelligence is the name given to the technology that enables the management of data for the purpose of analysis, exploration, reporting, mining and visualization ( Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009)1 (InHCc)
    - Health Intelligence is responsible for capturing and utilising knowledge to support decision-making to improve the health of the population.2 (Collins)
    - Healthcare Intelligence provides direct and easy access to information using interactive, graphical dashboards linked across disciplines within your organization. With it, you can drill down to detail levels to understand performance drivers and healthcare data solutions.3 (Siemens)
    - People working in health intelligence and information are involved in collecting, analysing, interpreting, synthesising and communicating health intelligence. This information relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of different populations. Roles for those working in health intelligence and information range from senior information management roles in NHS Trusts, to research and intelligence work for public health observatories or data management in specific programmes and projects.4 (PHORCaST)
    What is Quantified Health/Quantified Self:
    - The Quantified Self is a movement to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (e.g. food consumed, quality of surrounding air), states (e.g. mood, arousal, blood oxygen level ), and performance (mental and physical). 5 (WIkipedia)
    For LTPAC Providers: Includes Sensors, Cloud - delivered any where any time; driven by intelligence and analysis of patterns; leveraging infrastructure for telepresence.
    Health intelligence is linked to business innovations - see disruption in existing business models. Parsing out the healthcare challenge into the components that are directly tackled by the new entrepreneur.
    Key Priorities:
    1. Person-centered, technology enabled, quantified health movement is informing a new consumer - healthcare practitioner relationship that is impacting the broad health care continuum including LTPAC.
    2. Continue to move to broad person-centered quality measures and break down the silo's. Expect to move away from the process silo's. Success of measures empowers consumers to make decisions and improve care, not focused on the provider.
    3. Coordination of care across spectrum - must be person centered; expect health intelligence to drive effective coordination of the virtual care team that responds to a consumer's need for health service. (how the consumer experiences navigation and components of system leverage each other) and the meaning of care pathways in an information rich world across the continuum. (new care delivery model means LTPAC must fully understand their services, costs and relationship to the overall model; the other providers must recognize the value, data, services, costs,care delivered in LTPAC; need to collect/package, information in a way that is desirable; Key message is that there is rapid change in business information as well as health information - need to deliver a higher bar around business information and work flow information.The kind of intelligence a provider has is the kind that makes it a tremendous partner);
    4. Empowered by information - every human worker in the continuum is being transformed into an information worker that is equipped with context, resident goals, care processes that allows them to personalize and humanize and make effective the care processes of the organization. (e.g.gaps are rich in data, but not rich in context and how to think of the information in context). Increasingly want every worker not to be a cog in the system, but to be on top of it and optimize.
    5. Stewardship and governance of the information - (garbage in/garbage out should not just be around the transactional information). Have a responsibility to provide value, weight and trust - stewards for the patient and therefore all of the workers and partners (member of coordinated care team).
    6. Optimism of Watson-like innovations are creating powerful ways of dealing with an aging consumer by linking to quantified health to genomics to pattern matching/analytics/disease study. There is particular work need to be targeted to the aging consumer - particularly Alzheimers (potentially others) - seeing steady progress in disease prevention and mortality increases, but then diseases like Alzheimer's rise). (CDC mortality study) (LTPAC, CCRC's, etc. have tremendous potential to manage diabetes, heart disease, Alz., moving away to being residentially defined spaces. How to offer presense, coaching, etc. as part of daily life)
    Objectives and Strategies to Pursue:
    Next Steps:
    For Provider Community:
    For Vendor Community:
    Policy-maker:
    Other:
    Literature Review/Resource:
    Footnotes:
    1 http://www.inhcc.com/Health_Intelligence.html
    2 http://www.collinsdictionary.com/submission/2391/health%20intelligence
    3 http://usa.healthcare.siemens.com/infrastructure-it/healthcare-it/business-intelligence-hs
    4 http://www.phorcast.org.uk/page.php?page_id=36
    5 http://en.wikipedia.org/wiki/Quantified_Self
    2014-2016 Road Map Themes: HEALTH INTELLIGENCE
    - Quantified Health – person centered quality view
    Moving to an age of analytics to drive action and inform our decision-making
    People are able to do more and more testing, gathering data, etc. and that is driving a stronger information base for clinical care processes.
    - Harmonizing formal quality measures and assessment (from the top down perspective – this is an important area on how providers are able operate in the continuum of care).
    Longitudinal, person centered quality measures and assessment are the preference.
    - What is the role of data analytics and e-intelligence in supporting health and wellness and clinical practice (e.g. Watson)
    E.G. Applying intelligence to alert care givers
    Personalize the role of health intelligence from a generalist to role-specific and person specific modalities.
    Right now analytics is mainly focused on reporting and visualization and driven by regulatory response.
    Solutions that we are really talking about grow up through the quantified health movement and evidence-based practice.
    There are analytics around medication in this space.
    - Data quality and management (Information Governance)
    Advancing information governance processes and strategy
    Organizations must have and maintain a trust framework
    Discussion/Notes: Quality measures – should have various measures, shouldn’t be all punitive. There is work being done on value sets for some quality measures that use SNOMED. We are still not seeing a movement toward longitudinal measures (we are seeing LTPAC measures). The quality measure space appears to still be the Wild West. We would like to see LTPAC maintain places a the table and make sure that there is an emphasis on longitudinal, person centered measures. We want to advocate that measures are articulated in quantifiable ways consistent with measures for this space. We want to see where competing measures are developed that there are ways to harmonize. We want to allow for new types and ways of measures. The analytic tools will get smarter – there are emerging tools in data analytics to get out of tight structuring and controlled data by looking for useful patterns. Crafting information on the role of e-intelligence. We have not had a lot of emphasis on data quality and management. We will have device data and patient data that needs structure to analyze and combine.
    Recent literature has discussed how traditional healthcare providers are not aware of how Apple, Google, Walgreens, etc. are looking to disrupt to the healthcare continuum on many levels.
    "Better" app by Mayo
    [1] Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009. http://www.inhcc.com/Health_Intelligence.html
    [2] AHIMA, Health Intelligence Definition. 2014
    [1] Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009. http://www.inhcc.com/Health_Intelligence.html
    Define health intelligence, quantified health/self, integration of big data
    What is Health Intelligence:
    - Healthcare Intelligence is the name given to the technology that enables the management of data for the purpose of analysis, exploration, reporting, mining and visualization ( Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009)1 (InHCc)
    - Health Intelligence is responsible for capturing and utilising knowledge to support decision-making to improve the health of the population.2 (Collins)
    - Healthcare Intelligence provides direct and easy access to information using interactive, graphical dashboards linked across disciplines within your organization. With it, you can drill down to detail levels to understand performance drivers and healthcare data solutions.3 (Siemens)
    - People working in health intelligence and information are involved in collecting, analysing, interpreting, synthesising and communicating health intelligence. This information relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of different populations. Roles for those working in health intelligence and information range from senior information management roles in NHS Trusts, to research and intelligence work for public health observatories or data management in specific programmes and projects.4 (PHORCaST)
    What is Quantified Health/Quantified Self:
    - The Quantified Self is a movement to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (e.g. food consumed, quality of surrounding air), states (e.g. mood, arousal, blood oxygen level ), and performance (mental and physical). 5 (WIkipedia)
    For LTPAC Providers: Includes Sensors, Cloud - delivered any where any time; driven by intelligence and analysis of patterns; leveraging infrastructure for telepresence.
    Health intelligence is linked to business innovations - see disruption in existing business models. Parsing out the healthcare challenge into the components that are directly tackled by the new entrepreneur.
    Key Priorities:
    1. Person-centered, technology enabled, quantified health movement is informing a new consumer - healthcare practitioner relationship that is impacting the broad health care continuum including LTPAC.
    2. Continue to move to broad person-centered quality measures and break down the silo's. Expect to move away from the process silo's. Success of measures empowers consumers to make decisions and improve care, not focused on the provider.
    3. Coordination of care across spectrum - must be person centered; expect health intelligence to drive effective coordination of the virtual care team that responds to a consumer's need for health service. (how the consumer experiences navigation and components of system leverage each other) and the meaning of care pathways in an information rich world across the continuum. (new care delivery model means LTPAC must fully understand their services, costs and relationship to the overall model; the other providers must recognize the value, data, services, costs,care delivered in LTPAC; need to collect/package, information in a way that is desirable; Key message is that there is rapid change in business information as well as health information - need to deliver a higher bar around business information and work flow information.The kind of intelligence a provider has is the kind that makes it a tremendous partner);
    4. Empowered by information - every human worker in the continuum is being transformed into an information worker that is equipped with context, resident goals, care processes that allows them to personalize and humanize and make effective the care processes of the organization. (e.g.gaps are rich in data, but not rich in context and how to think of the information in context). Increasingly want every worker not to be a cog in the system, but to be on top of it and optimize.
    5. Stewardship and governance of the information - (garbage in/garbage out should not just be around the transactional information). Have a responsibility to provide value, weight and trust - stewards for the patient and therefore all of the workers and partners (member of coordinated care team).
    6. Optimism of Watson-like innovations are creating powerful ways of dealing with an aging consumer by linking to quantified health to genomics to pattern matching/analytics/disease study. There is particular work need to be targeted to the aging consumer - particularly Alzheimers (potentially others) - seeing steady progress in disease prevention and mortality increases, but then diseases like Alzheimer's rise). (CDC mortality study) (LTPAC, CCRC's, etc. have tremendous potential to manage diabetes, heart disease, Alz., moving away to being residentially defined spaces. How to offer presense, coaching, etc. as part of daily life)
    Objectives and Strategies to Pursue:
    Next Steps:
    For Provider Community:
    For Vendor Community:
    Policy-maker:
    Other:
    Literature Review/Resource:
    Footnotes:
    1 http://www.inhcc.com/Health_Intelligence.html
    2 http://www.collinsdictionary.com/submission/2391/health%20intelligence
    3 http://usa.healthcare.siemens.com/infrastructure-it/healthcare-it/business-intelligence-hs
    4 http://www.phorcast.org.uk/page.php?page_id=36
    5 http://en.wikipedia.org/wiki/Quantified_Self
    - Quantified Health – person centered quality view
    Moving to an age of analytics to drive action and inform our decision-making
    People are able to do more and more testing, gathering data, etc. and that is driving a stronger information base for clinical care processes.
    - Harmonizing formal quality measures and assessment (from the top down perspective – this is an important area on how providers are able operate in the continuum of care).
    Longitudinal, person centered quality measures and assessment are the preference.
    - What is the role of data analytics and e-intelligence in supporting health and wellness and clinical practice (e.g. Watson)
    E.G. Applying intelligence to alert care givers
    Personalize the role of health intelligence from a generalist to role-specific and person specific modalities.
    Right now analytics is mainly focused on reporting and visualization and driven by regulatory response.
    Solutions that we are really talking about grow up through the quantified health movement and evidence-based practice.
    There are analytics around medication in this space.
    - Data quality and management (Information Governance)
    Advancing information governance processes and strategy
    Organizations must have and maintain a trust framework
    Discussion/Notes: Quality measures – should have various measures, shouldn’t be all punitive. There is work being done on value sets for some quality measures that use SNOMED. We are still not seeing a movement toward longitudinal measures (we are seeing LTPAC measures). The quality measure space appears to still be the Wild West. We would like to see LTPAC maintain places a the table and make sure that there is an emphasis on longitudinal, person centered measures. We want to advocate that measures are articulated in quantifiable ways consistent with measures for this space. We want to see where competing measures are developed that there are ways to harmonize. We want to allow for new types and ways of measures. The analytic tools will get smarter – there are emerging tools in data analytics to get out of tight structuring and controlled data by looking for useful patterns. Crafting information on the role of e-intelligence. We have not had a lot of emphasis on data quality and management. We will have device data and patient data that needs structure to analyze and combine.
    Recent literature has discussed how traditional healthcare providers are not aware of how Apple, Google, Walgreens, etc. are looking to disrupt to the healthcare continuum on many levels.
    "Better" app by Mayo
    __

    (view changes)
    3:25 pm
  4. page Health Intelligence edited ... Themes: HEALTH AND BUSINESS INTELLIGENCE Goal: For the LTPAC sector to seize opportuni…

    ...
    Themes: HEALTH AND BUSINESS INTELLIGENCE
    Goal:
    For the LTPAC sector to seize opportunities to use health and business intelligence to gain dynamic knowledge and actionable insights that: 1) improves the quality and delivery of care, clinical decision-making, and coordination; 2) redefines the provider-patient relationship through new patient (and caregiver) engagement to improve their health and wellness; 3) supports business operations, strategy and partnerships; 4) improves transparency to support quality measurement and public health; and 5) advances population health.
    Rationale/Background:
    Health intelligence is concept that describes how people, organizations, systems and populations are deriving knowledge from analysis and transformation of high quality healthcare and related data into actionable information to support real time and near real time decision-making. Enabled by health information tools, technologies and processes, stakeholders and innovators are exploring, analyzing, mining, reporting, and visualizing data in ways not capable in the past.[1]
    Health Intelligence has a number of facets – for LTPAC and other healthcare providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics to support decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, the business environment, and financial risk.[2] At a population level, health intelligence relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of the aging population served by LTPAC.[3]
    For the patient and their caregiver, health intelligence provides dynamic analytics to drive action and inform our decision-making.The Quantified Self movement (the use of technology to acquire data on aspects of a person's daily life such as inputs (e.g. food consumed), states (e.g. mood), and performance (physical))[4] along with other sensors, devices and tele-health tools provide new opportunities for redefining the patient-caregiver relationship to analyze, monitor, and manage care anywhere at any time.
    Effective health and business intelligence is integral to and supports all of the other LTPAC Health IT Road Map strategies for connected patients, workers, partners and the evolving business landscape.
    Key Priorities:
    Embrace person-centered, technology-enabled quantified health movement is informing a new consumer - healthcare practitioner relationship impacting the broad health care continuum including opportunities in LTPAC.
    Continue to advance person-centered (not provider-centered) assessments, quality measures, and standards that cut across the silos of care delivery and empower consumers to make decisions and improve care.
    Use health intelligence to engage LTPAC and improve care coordination/care pathways, quality outcomes, and financial management across spectrum and support the emergence of virtual care teams, emerging care delivery/payment models and their ability to respond to a patient’s need for health services.
    Advance the use of health intelligence to transform the worker, their workflow processes, and the organization to support an empowered information worker that is equipped with context about their patient’s personalized care needs, goals, and preferences.
    Accept responsibility for information stewardship and governance to ensure the value of health intelligence can be realized because the foundation data that transformed to knowledge was trusted and accurate.
    Recognize the opportunities for new innovations and relationships with consumers by using health intelligence to transform population health by linking patterns, analytics, disease study, and outcomes for aging patients served by LTPAC.
    Objectives and Strategies to Pursue:
    Take a leadership role in the healthcare industry on the need for and value of a Virtual Care Team supported by both an interoperable health IT platform and health intelligence to drive effective care coordination and pathways across the continuum to respond to a consumer's need for health service.
    Advance longitudinal quality measure reporting by encourage LTPAC associations, organizations, providers, and vendors to work with primary care and acute care associations, providers and vendors to support the advancement of person-centered measures which includes:
    Support the NQF to harmonize quality measurements across the spectrum of care
    Support the Long Term Quality Alliance (LTQA) to propose quality processes, measurements, improvements and outcomes
    Support for the advancement of person centered assessment data
    Support and use of relevant health IT standards and vocabularies
    Use health and business intelligence to successfully respond to the rapidly changing operating and business environment including:
    New care deliver and business models, risk and risk sharing
    How to engage people in the senior living population
    Deep understanding of an organization’s health and financial information that makes LTPAC a trusted care delivery partner
    4. Begin to change organizational culture and build an infrastructure to integrate health intelligence in the care delivery and workflow process for all workers.
    Next Steps:
    For Provider Community:
    For Vendor Community:
    Policy-maker:
    Other:
    [1] Nielson, White, and Parui, Microsoft SQL Server 2008 Bible, Wiley Publishing, Inc., 2009. http://www.inhcc.com/Health_Intelligence.html
    [2] AHIMA, Health Intelligence Definition. 2014
    [3] Public Health Online Resources for Careers, Skills and Training. http://www.phorcast.org.uk/page.php?page_id=36
    [4] Quantified Self. Wikipedia. http://en.wikipedia.org/wiki/Quantified_Self (Accessed 5/2014)

    Goal:
    For LTPAC to embrace information as an asset moving to data-driven practices that provides critical insights and intelligence that improves care delivery, clinical decision-making and coordination; engages the patients (and
    ...
    provides greater health awareness and healthcare transparency by delivering data-driven information about trends and best practices, improved decision-support practices, and quantified self.
    Rationale/Background:
    ...
    the past.[1]
    Health Intelligence has a number of facets depending on the stakeholder or perspective. For LTPAC and other healthcare providers, health care intelligence utilizes business and clinical data from a variety of both internal and external sources to enable analytics to support decision making about population health management and outcomes, care coordination, health care quality and safety, patient engagement, and financial risk.[2] On a population level, health intelligence information relates to assessing, measuring and describing health and wellbeing, as well as health risks, health needs and health outcomes of different populations.[3] This can also be achieved through the collection and reporting of quality measures.
    ...
    analyze data.
    For LTPAC providers, health intelligence provides new opportunities leverage data and analytics to drive action and inform our decision-making, support improvements in clinical care practices, and define a new relationship between the patient and their LTPAC caregivers. The use of sensors, devices, and monitors leverage a telepresence infrastructure and provides an opportunity to monitor and manage care anywhere and anytime. The effective use and analysis of intelligence provides an opportunity for an LTPAC provider to be a tremendous partner in care delivery and coordination supporting all other LTPAC Health IT Road Map strategies for connected patients, workers, partners and evolving business landscape.
    Key Priorities:
    ...
    Advance the use of health intelligence to transform the worker, their workflow processes, and the organization to support an empowered information worker that is equipped with context about their patient’s personalized care needs, goals, and preferences.
    Accept responsibility for information stewardship and governance to ensure the value of health intelligence can be realized because the foundation data that transformed to knowledge was trusted and accurate.
    ...
    by LTPAC.
    Objectives and Strategies to Pursue
    Next Steps: (Hold for Summit)
    ...
    For LTPAC to embrace information as an asset moving to data-driven practices that provides critical insights and intelligence that improves care delivery, clinical decision-making and coordination; engages the patients (and caregivers) their health and wellness; supports business operations, strategy and partnerships; improves transparency to support quality measurement and public health; and advances population health. The use of health intelligence provides greater health awareness and healthcare transparency by delivering data-driven information about trends and best practices, improved decision-support practices, and quantified self.
    Rationale/Background:
    ...
    the past.[1]
    Health

    Health
    Intelligence has
    ...
    financial risk.[2]
    The quantified health movement is…
    For LTPAC, The kind of intelligence a provider has is the kind that makes it a tremendous partner (enhanced partnerships) and quantified health - applied to connected consumer, worker and partner.)
    ...
    managing costs.
    Define health intelligence, quantified health/self, integration of big data
    What is Health Intelligence:
    (view changes)
    3:23 pm

Saturday, June 21

  1. page Connected Patient edited 2014-2016 Roadmap Themes: CONNECTED PATIENT Longitudinal care record and care planning is a con…

    2014-2016 Roadmap Themes: CONNECTED PATIENT
    Longitudinal care record and care planning is a consumer-centered service (integration back to new delivery models)
    Personal access to their information
    Bi-directional exchange (also overlaps with Connected Partners) (includes caregivers and family)
    How bi-directional sensors and devices support patient health and wellness and clinical outcomes.
    How does consumerization change practice;
    What role does this data have in LTPAC
    Patient driven outcomes (patient engagement)
    Patient (care giver) as an integral part of community care team
    Long term care services and supports, Programs of All-inclusive Care for the Elderly (PACE Model)
    Discussion/Notes: Longitudinal care record is not built around a provider or regulatory program. The types of data provides the ability to move out of episodic care to preventive and longitudinal health and wellness. Question is about how the personal health sensors/devices/technologies integrate into care delivery and workflow. (Patient Generated Health Data) The vision of longitudinal care seems far in the future – need to use tactics to address the stepping stones to get to this vision. Blue Button on the apps should be in this section. Center quality and success on patient-defined parameters – as we do that, the outcomes we are looking for are the ones that the patient has identified. Stronger patient engagement lead to more successful outcomes – “making the information meaningful to the person”. How do we make this relatable to the LTPAC patients?

    Background:
    LTPAC CONNECTED PATIENT: LTPAC providers, as well as HIT and service Vendors cover a wide patient base. It ranges from residents that reside in Skilled Nursing Homes (SNFs), Nursing Facilities (NF), Assisted Living Facilities (ALF) and Long Term Care Acute Hospitals (LTACs) to short term rehabilitation, Home Care and Hospice Care Agency. All along this spectrum of care LTPAC Providers and Vendors have the opportunity of connecting with the patient and assisting them with their longitudinal care. Longitudinal Care is defined as the care provided in the implementation of the patient centric Longitudinal Plan. The Longitudinal Plan is dynamic in that it covers the patient's health over a long period of time providing analytics, trending, alerts, and goals to assist the patient in being connected. This will require many initiatives including: educating the patient to live within his/her capabilities, setting patient goals and realizing a higher quality of life. Currently this is being accomplished in rehabilitation and other educational and practical functional programs. Current programs are within the current provider centric healthcare system and will offer both providers and vendors a challenge to move into the new healthcare system. It will be difficult as the current payment and quality measure systems are based on the old system. With a new strategic focus on the person and empowering the person to be involved in his/her own care, LTPAC can be a valuable member of the care coordination team.
    ...
    Meaningful Use Stage 3
    Quality Measures
    Notes:
    Longitudinal care record and care planning is a consumer-centered service (integration back to new delivery models)
    Personal access to their information
    Bi-directional exchange (also overlaps with Connected Partners) (includes caregivers and family)
    How bi-directional sensors and devices support patient health and wellness and clinical outcomes.
    How does consumerization change practice;
    What role does this data have in LTPAC
    Patient driven outcomes (patient engagement)
    Patient (care giver) as an integral part of community care team
    Long term care services and supports, Programs of All-inclusive Care for the Elderly (PACE Model)
    Discussion/Notes: Longitudinal care record is not built around a provider or regulatory program. The types of data provides the ability to move out of episodic care to preventive and longitudinal health and wellness. Question is about how the personal health sensors/devices/technologies integrate into care delivery and workflow. (Patient Generated Health Data) The vision of longitudinal care seems far in the future – need to use tactics to address the stepping stones to get to this vision. Blue Button on the apps should be in this section. Center quality and success on patient-defined parameters – as we do that, the outcomes we are looking for are the ones that the patient has identified. Stronger patient engagement lead to more successful outcomes – “making the information meaningful to the person”. How do we make this relatable to the LTPAC patients?

    (view changes)
    9:36 pm
  2. page Evolving Business Landscape edited ... Data obtained from benchmarking, quality reporting, CDSS capabilities and analytic tools as we…
    ...
    Data obtained from benchmarking, quality reporting, CDSS capabilities and analytic tools as well HIE and telehealth can help providers accomplish these goals. We believe that partnerships with hospitals around hospital re-admission reduction program could present an immediate opportunity to pilot test these capabilities and provide an experimentation ground for these types of contractual agreements.
    Providers must document and publish the best practices as well as the outcomes of successful implementation on business, care quality, client satisfaction, utilization and cost to demonstrate the value of health IT-enabled LTPAC providers to the health ecosystem in not only peer-reviewed publications but also as case studies. Associations and the LTPAC Health IT Collaborative should encourage sharing and broad dissemination of provider best practices, lessons learned, case studies and advice to others through various dissemination activities, including shared learning collaboratives.
    NEXT STEPS
    For Provider Community:
    Adopt and use interoperable health IT.
    (view changes)
    9:34 pm
  3. page Evolving Business Landscape edited 2014-2016 Road Map Themes: EVOLVING BUSINESS LANDSCAPE GOAL: LTPAC GOAL LTPAC providers must…
    2014-2016 Road Map Themes: EVOLVING BUSINESS LANDSCAPE
    GOAL:
    LTPAC
    GOAL
    LTPAC
    providers must
    ...
    health information exchange,exchange (HIE), to effectively
    ...
    in quality, continuitycontinuity, and cost of care.
    RATIONALE:

    RATIONALE

    There is
    ...
    improve the healthcarehealth care system by
    ...
    quality and satisfaction),satisfaction); improving population healthhealth; and reducing
    ...
    rise. Efforts arenow underway to
    ...
    value-based and performance drivenperformance-driven payment models,
    ...
    Bundled Payments, aimsaim to manage
    ...
    care across settings,settings while improving
    ...
    to control both spending and improve quality in
    ...
    opportunities, are putting emphasis onemphasizing consumer experience
    ...
    disease management, extra timeand short-term stabilization, rehabilitation, or support services needed by individuals to recover from illness, stabilization, rehabilitation or supportive services.illness. However, in order for LTPAC
    ...
    on short-term acute-careacute care hospitals to
    ...
    for re-admissions, therehospitals are and will be monetary valuecontinue to partners thatseek partnerships with LTPAC providers who can manage, stabilize,stabilize and provide rehabilitation
    ...
    re-admission rates. There are numerous federal, state, and private sector payer programs that encourage and support the formation of partnerships across the care continuum to improve care coordination and reduce unnecessary costs.
    Health IT,
    ...
    telehealth, remote monitoringmonitoring, and shared
    ...
    for providing these services efficiently, cost-effectively,cost-effectively and in
    ...
    to improve care,care and population healthhealth, and reduce
    ...
    other care providers,providers and to
    ...
    in the risks,risks as well
    ...
    in these models that are new to LTPAC providers.service delivery models.. A consumer-oriented
    ...
    satisfaction and costcost, is needed
    ...
    partners. This consumer-orientationconsumer orientation and transparency
    ...
    in the market place.marketplace.
    KEY PRIORITIES:PRIORITIES
    Encourage LTPAC providers to adopt and use health IT, including EHR advanced functionalities like analytics, quality reporting, clinical decision support systems (CDSS) and health information exchange (HIE) capabilities, as well as telehealth to demonstrate that these technologies can help them facilitate the following:
    ...
    initiatives to improveenhance quality of
    ...
    and hospital readmission.re-admission.
    Health Information
    ...
    to support care coordination and continuity of care during shared
    ...
    care models, risk sharingrisk-sharing partnerships with
    ...
    physician groups, ACOsACOs, and payers
    ...
    likelihood of success.Documentingsuccess.
    Documenting
    Results: Document
    ...
    achieved quality outcomes, includingoutcomes (including reduced re-admission
    ...
    satisfaction and costs, as well ascosts), and financial outcomes,outcomes to other
    ...
    STRATEGIES TO PURSUE:PURSUE
    LTPAC providers
    ...
    and hospital readmissionre-admission rather than
    ...
    and billing.
    LTPAC

    LTPAC
    providers must
    ...
    improvement, health ITIT, and how to effectivelythe effective use of these systems
    ...
    of their on-goingongoing quality improvement
    ...
    management efforts.
    Exchange

    Exchanging
    electronic health
    ...
    transitions of care.care is critical.
    LTPAC EHR
    ...
    including the ONC guidance for EHR vendors serving providers ineligible for the EHR Incentive programs (http://www.healthit.gov/sites/default/files/generalcertexchangeguidance_final_9-9-13.pdf) and adopting voluntary certification expected to be proposed by
    Providers should be encouraged to pursue implementing and upgrading to certified interoperable health IT systems.
    ...
    work on implementing HIE, directly
    ...
    the interim.
    Providers

    Providers
    should evaluate
    ...
    of their on-goingongoing quality improvement
    ...
    with other providers,providers to demonstrate
    ...
    interoperability and certification.Engagingcertification. Engaging in this
    ...
    provider partners identifyidentify: gaps in the information they needneeded to exchange,be exchanged and standards required standards,to support information exchange, necessary workflow
    ...
    and future health IT/EHR certification requirements.
    To

    To
    experiment with
    ...
    models, including integrated/coordinatedintegrated and coordinated care models, risk sharingrisk-sharing partnerships with
    ...
    strong competencies, LTPAC providers must:
    Have

    have
    a culture
    ...
    take calculated risk
    Understand
    risk;
    understand
    the population
    ...
    serve, their characteristics andcharacteristics;
    understand how to measure the effectiveness of
    their readmission rates.
    Understand
    programs including the impact of their programs on rates of hospital re-admissions, hospitalizations and emergency room visits;
    understand
    their own
    ...
    efficiently and cost-effectively.
    Understand
    cost-effectively;
    understand
    the operating
    ...
    market(s) and available potential partners and opportunities.
    Understand
    opportunities; and
    understand
    their resources,
    ...
    telehealth can be help providers
    ...
    believe that partnershippartnerships with hospitals around hospital readmissionre-admission reduction program
    ...
    successful implementation on:on business, care
    ...
    and the LTPAC Health IT Collaborative should
    ...
    sharing and broadly disseminatingbroad dissemination of provider best
    ...
    lessons learned, case studies and advice
    ...
    shared learning collaboratives[ma1] .
    Next Steps:
    collaboratives.
    NEXT STEPS

    For Provider Community:
    Adopt and use interoperable health IT.
    Use health IT to effectively drive quality improvement.
    Participate in HIE.
    UnderstandSeek out partnership opportunities with other providers in the care continuum, health IT vendors, payers, and health information exchange organizations.
    Understand
    your strength,strengths, competencies, and
    Measure and document your outcomes.
    Hospitals and physicians must be willing to meaningfully engage in HIE and entrepreneurial partnerships.
    ...
    Work with other vendors, including hospital and physician EHR vendors, integration engines, intermediaries and HIEs to help providers engage meaningfully in HIE.
    Provide adequate training on the use of your product, including advanced features like analytics, CDSS, reporting and HIE capabilities to drive quality initiatives.
    HospitalBe transparent about the costs of and support needed for product upgrades.
    Hospital
    and physician EHR vendors as well as HIEsand HIE Organizations must be
    ...
    and HIE.
    Other: For

    For
    Policy Makers:
    Continue to support development, implementation and adoption of standards and certification programs that are relevant to LTPAC settings.
    Support the identification of quality measures
    ...
    vulnerable populations, particularly related to care coordination, the e-specification of such measures, and ensure supporting the incorporationadoption of such measures across the care continuum including by trading partners’ (hospitalshospitals, physicians, and physicians) EHRs through Meaningful Use, Certification and other mechanisms.
    Incorporate
    LTPAC providers.
    Incorporate the use of
    these measures and standards in innovative
    ...
    that have an LTPAC focus
    ...
    IT emphasis.
    Incorporate the e-specified quality measures in EHR certification criteria.

    Consider grants, low interest loans and financial incentives to smaller, unaffiliated and rural providers who are less likely to have the resources and the partnership opportunities to support their health IT and quality improvement initiatives.
    Provide TAtechnical assistance to support
    ...
    health IT, including usesHIE and the use of these technologies in emerging
    ...
    payment models.
    [ma1]

    {Health IT as a Business Imperative-2014.docx}
    (view changes)
    9:34 pm

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