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The 2018 Healthcare Informatics Innovator Awards: Co-Third-Place Winning Team—Rhode Island Quality Institute

February 20, 2018
by David Raths
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Rhode Island Quality Institute’s care management dashboard connects opioid treatment teams
RIQI's Care Management Team

Healthcare providers’ response to the opioid crisis has been hampered in part by the lack of information sharing between organizations. Opioid treatment centers and primary care providers often have no idea that their patients have had multiple recent emergency room visits.

A dashboard tool created for nurse care managers by the Rhode Island Quality Institute (RIQI) is changing that dynamic in the Ocean State. Users of its Care Management Dashboard (CMD) have seen their patients’ emergency department return visits within 30 days reduced by 16 percent. For this effort, RIQI has been named a winner of one of Healthcare Informatics’ Innovator Awards for 2018, Providers Division.

Starting in 2015, RIQI set out to create a tool to deliver information in a timely and organized way to help nurse care managers with transitions of care, explains Elaine Fontaine, RIQI’s director of data quality and analytics. “We thought that we would help them be more efficient and reduce patients’ likelihood of being readmitted or return to the ER, but the dashboards’ full potential is actually bigger than we had imagined.”

The dashboards allow nurse care managers to see— in real time— who among their patients has just been admitted to or discharged from any emergency department or acute care hospital in Rhode Island. They know who is in the ED or is hospitalized, their reason for admission, and such critical details as the patient’s room number, which nurse care managers can spend inordinate amounts of time tracking down.

Hospitals were already sending some of this information via fax, but there were many ways in which this data was falling through the cracks, Fontaine says.

Nurse care managers were surveyed in October 2016 before implementation and again in October 2017 after CMD was in use. “We were stunned by how much time nurse care managers spent hunting for data as opposed to taking care of patients,” Fontaine says. “Before the dashboard was implemented, more than 50 percent of respondents said they spent 10 or more hours per week hunting for information. After the dashboard, not one was spending more than 10 hours per week. They reported that their satisfaction in their work significantly increased. That was phenomenal.”

Today all of the community mental health organizations and opioid treatment programs in Rhode Island as well as a large number of primary care practices are using the dashboard, which is offered as a subscription service.

Linda Hurley, president and CEO of CODAC, a Cranston, R.I.-based nonprofit provider of treatment, recovery and prevention services, says the dashboard enhances communication between behavioral providers and those in other care settings. Coordinating with other medical service facilities is critical to safe and effective care, she adds, yet before the dashboard was in use, nine out of 10 times that one of CODAC’s patients was in the ED or admitted to the hospital, CODAC did not get that information in a timely fashion. The institutions are busy and the methods of communication were not effective, she says.

“The dashboard really is a solid step in changing our culture so we are not operating in silos and so that mental health and substance use disorders are not something tucked aside,” Hurley says. The enhanced communication actually serves to educate providers, she adds. “We learn more about the needs of those providing the medical care, and they learn more about our needs in providing behavioral health so we can provide optimal care for the individual who is receiving care from both of us.”

Laura Adams, RIQI’s president and CEO, recalls a primary care physician’s response to the initial installation of CMD in his practice. “He was watching the data come up and said, ‘Wait a minute — that patient is 28 years old. Why are there so many hospital admissions in six months? What is going on?’ His office reached out to that person, who was definitely experiencing problems with opioids. They were able to get that young man into treatment. Here is a primary care doctor who had no knowledge of anything going on with their patient until he was able to see a pattern of admissions that came in real time in our dashboard,” Adams says. “You not only get real-time information, but you get the history over the last six to 12 months.”

Opioid treatment centers and community mental health centers often find that patients have a “window of willingness” to reconnect with providers right after an overdose. “They have a new opportunity to intervene if they can get connected with them,” Adams says. But sometimes they wouldn’t find out about an overdose or even multiple overdoses. They were particularly interested to know when that was happening so they could do an immediate outreach.

The tool also allows patients to designate a person to be contacted if they are admitted, discharged, or seen in an ED, and that could be a family member, peer counselor or provider. “You have the opportunity to influence who is part of your care team,” Fontaine says, “and that is really exciting.”

When RIQI did a return on investment analysis on its portfolio of products and services in November 2017, it demonstrated a $13.3 million savings on $6.3 million in spending, with the CMDs and alerts contributing the lion’s share of the savings, despite having been built for only a little over $500,000. Also, RIQI stresses that the dashboards’ value isn’t limited to caring for those with addiction disorders. They also are used in the care of children with asthma, people with diabetes, and elderly patients with multiple co-morbidities. Nurses can get alerts for admissions and discharges from long-term care and nursing homes, as well as hospitals and EDs.

In enhancing the dashboard in 2017, RIQI added real-time risk score adjustments for patients, because there is often lag time before providers get risk score updates from insurers. The organization also wants to provide relevant social determinant information. “When you are prescribing a medication, a patient may not be able to afford it or have transportation to pick it up,” Adams says. “We want to be able to bring them that actionable information.”

For government and health system leaders grappling with the opioid crisis, RIQI’s contribution is much appreciated. “Rhode Island Quality Institute is once again leading the nation in healthcare innovation with a tool to help people struggling with addiction get their lives back on track,” said Rhode Island Sen. Sheldon Whitehouse in a statement e-mailed to Healthcare Informatics.  Sen. Whitehouse, who helped launch RIQI when he was Rhode Island’s attorney general, added that “the Institute’s Dashboard allows healthcare providers to respond immediately when a patient has been treated for an overdose in an emergency room or hospital, giving the patient the best possible chance of getting the treatment they need to begin the path to recovery.”  

Adams says the success of RIQI’s HIE (health information exchange) depends on providing more than just access to lots of data. She recalls one physician saying to her: “When I am in the midst of treating a patient, I am looking for a needle in a haystack, and you keep adding more hay.” She says RIQI recognized it needed to build “sift-and-serve” technologies. “We want to give providers information that otherwise would take time to synthesize and sift through and instead give it to them right now when it is actionable to them.”

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Survey: Healthcare Orgs Ramping up Investment in AI, Confident about ROI

November 16, 2018
by Heather Landi, Associate Editor
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The majority of health care executives (91 percent) are confident they will see a return on investment (ROI) on artificial intelligence investments, although not immediately, and foresee the greatest impact of AI will be on improving health care, according to an OptumIQ survey.

Most (94 percent) health care leaders responded that their organizations continue to invest in and make progress in implementing AI, with 75 percent of healthcare organizations say they are implementing AI or have plans to execute an AI strategy, based on OptumIQ’s survey of 500 senior U.S. healthcare industry executives, primarily from hospitals clinics and health systems, life sciences organizations, health plans and employers. OptumIQ is the intelligence arm of data and analytics of Optum, an information and technology-enabled health services business that is part of UnitedHealth Group.

While many healthcare organizations have plans, progress is mixed across sectors. Of the 75 percent who are implementing AI or have plans to execute an AI strategy, 42 percent of those organizations have a strategy but have not yet implemented it. Employers are furthest along, with 22 percent reporting their AI implementations are at a late stage, with nearly full deployment.

The average AI implementation is estimated to cost $32.4 million over five years. The majority of respondents (65 percent) do not expect to see a ROI before four years with the average expected period being five years. However, employers (38 percent) and health plans (20 percent) expect ROI sooner, in three years or less, according to the survey.

The survey found that health care leaders universally agree the greatest impact of AI investment will be on improving health care. Thirty-six percent expect AI will improve the patient experience; 33 percent anticipate AI will decrease per-capita cost of care; and 31 percent believe AI will improve health outcomes.

Most health care leaders believe AI can make care more affordable and accessible. Ninety-four percent of respondents agree that AI technology is the most reliable path toward equitable, accessible and affordable health care.

AI will make care more precise and faster, according to respondents. The top two benefits respondents expect to see from incorporating AI into their organizations are more accurate diagnosis and increased efficiency.

The survey found that respondents are looking to AI to solve immediate data challenges – from routine tasks to truly understanding consumers’ health needs. Of those health organizations that are already investing in and implementing AI: 

  • 43 percent are automating business processes, such as administrative operations or customer service;
  • 36 percent are using AI to detect patterns in health care fraud, waste and abuse; and
  • 31 percent are using AI to monitor users with Internet of Things (IoT) devices, such as a wearable technology

With more organizations seeing the benefit of adopting an AI strategy, 92 percent agree that hiring candidates who have experience working with AI technology is a priority for their organization. To meet this need, nearly half (45 percent) of health care leaders estimate that more than 30 percent of new hires will be in positions requiring engagement with or implementation of AI in the next 12 months. However, health organizations seeking to hire experienced staff will likely face talent shortages.

“Artificial intelligence has the potential to transform health care by helping predict disease and putting the right insights into the hands of clinicians as they treat patients, which can reduce the total cost of care,” Eric Murphy, CEO of OptumInsight, said.

“Analytics isn't the end, it's the beginning – it's what you do with the insights to drive care improvement and reduce administrative waste,” Steve Griffiths, senior vice president and chief operating officer of Optum Enterprise Analytics, said. “For AI to successfully solve health care’s biggest challenges, organizations need to employ a unique combination of curated data, analytics and health care expertise... We are already seeing a race for AI talent in the industry that will grow as adoption continues to increase.”






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Breaking: The 2019 Healthcare Informatics Innovator Awards Program is Open

November 15, 2018
by the Editors of Healthcare Informatics
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Providers and vendors can now submit their entries to the Healthcare Informatics Innovator Awards Program

The 2019 Healthcare Informatics Innovator Awards Program is now open for submissions. As always, it’s a great privilege and pleasure for us to sponsor this program.

And as many readers know, the concept of team-base recognition, which began with the 2009 edition of the program, has encompassed numerous sets of multiple winning teams that our publication has recognized for their achievements across a very broad range of areas.

As it always does, the Healthcare Informatics Innovator Awards Program recognizes leadership teams from patient care organizations—hospitals, physician groups, clinics, integrated health systems, payers, HIEs, ACOs, and other healthcare organizations—that have effectively deployed information technology in order to improve clinical, administrative, financial, or organizational performance.

The Innovators Program, as it has in the last few years, also recognizes vendor solution providers who are asked to describe their core products or services in five categories. We are asking vendors to submit their innovation in one of five critical health IT areas: Data Security; Value-Based Care; Revenue Cycle Management; Data Analytics; and Patient Engagement.

Indeed, again this year, the Innovator Awards program will again include two tracks for innovation recognition—one for healthcare provider organizations and one for technology solution providers.

The submission form link for both tracks is right here. The deadline for submissions is January 4, 2019.

What’s more, the winning teams will be featured in an upcoming issue of Healthcare Informatics, and winning vendor teams will be awarded free digital distribution of whitepapers to all HIT Summit Series attendees.

At Healthcare Informatics, we are honored to be able to showcase these kinds of case studies from both providers and vendors, which we believe embodies the spirit of innovation around adaptive change that will light the way for their colleagues from across the industry.

At a time of extraordinary change in healthcare, now is as great a time as ever to showcase your innovations. Please consider submitting an entry to our program, and good luck in your entry!

--The Editors of Healthcare Informatics


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New Blockchain Project Sets to Tackle Provider Credentialing

November 12, 2018
by Rajiv Leventhal, Managing Editor
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A group of five healthcare enterprises—National Government Services, Spectrum Health, WellCare Health Plans, Inc., Accenture, and The Hardenbergh Group—are linking up to participate in a distributed ledger program aimed at resolving administrative inefficiencies related to professional credentialing.

The project, Professional Credentials Exchange, is being developed by ProCredEx and Hashed Health, a blockchain innovation consortium. The exchange leverages “advanced data science, artificial intelligence, and blockchain technologies to greatly simplify the acquisition and verification of information related to professional credentialing and identity,” according to officials.

In an announcement, officials noted that credentialing healthcare professionals “is a universally problematic process for any industry member that delivers or pays for patient care.  The process often requires four to six months to complete and directly impedes the ability for a healthcare professional to deliver care and be reimbursed for their work.”

They added, “Hospitals alone forfeit an average of $7,500 in daily net revenues waiting for credentialing and payer enrollment processes to complete.  Further, nearly every organization required to perform this work does so independently—creating a significant administrative burden for practitioners.”

As such, the groups, via the exchange, will aim to address the time, cost, and complexity associated with these processes by facilitating the secure, trusted exchange of verified credentials information between exchange members.

Included in the collaboration are WellCare Health Plans, which serves about 5.5 million members, and Spectrum Health, a 12-hospital health system in western Michigan. National Government Services is a Medicare contractor for the Centers for Medicare & Medicaid Services (CMS), and processes more than 230 million Medicare claims annually.

"A fundamental component of developing the exchange lays in building a network of members that bring significant verified credential datasets to the marketplace," Anthony Begando, ProCredEx's co-founder and CEO, said in a statement.  "These are the leading participants in a growing group of collaborators who bring data and implementation capabilities to accelerate the deployment and scaling of the exchange."

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