Future of Data and Analytics in Healthcare Debated at National Forum At this year’s eHealth Initiative Nation Forum, held in Washington, over two-dozen panelists discussed the current and future role data and analytics in healthcare. Topics ranged from secondary use of data and managing chronic conditions with data to leveraging predictive analytics in accountable care organizations (ACOs). During the morning keynote, Siemens’ John Glaser focused on two big trends he sees converging to make this unlike healthcare reforms of the past. Despite the re-emergence of familiar mantras like “bending the cost curve” and “improved care coordination” current changes in reimbursement mechanisms and the advent of the “Fifth IT revolution” make this a unique time for healthcare, Glaser said.
For instance, now it is a certainty that providers will be paid less for care delivery; providers have to prove quality, safety and efficiency to a degree previously unknown; and the payment reforms currently in progress are more holistic than those of the past. Additionally, Glaser noted that there is increasingly too much to know in the healthcare field; data is coming in from all directions, he said.
5th IT Revolution
Next, Glaser explained that every ten years, since the 1960s, there has been a shift in IT that changes the world. He mentioned mainframe computing, minicomputers, personal computers, and the World Wide Web as being predecessors to the current IT revolution. Now, we are entering a time when 1) every person and thing has powerful processors and 80 percent of them are not in cell phones or computers 2) networked computing allows us to send and receive data seamlessly and 3) a phenomenal amount of data is being produced and increasingly harnessed to make decisions.
Glaser noted a shift in EHR technology that is oriented towards transactions to a technology that is intelligence oriented. He used the phrase “In-Silico Intelligence” to discuss how predictive analytics can help providers focus on those patients who have the highest readmission risk, for example. He said this era will enable the use of large data volumes to perform “real world” analysis and experiments, orchestrate complex processes and deliver new services such as location aware / invariant services.
Glaser’s slides, as well as other presentations at the eHI National Forum
Telehealth Takes Center Stage during IOM Workshop The Institute of Medicine held a workshop recently, organized by the Health Resources and Services Administration (HRSA) in order to focus on telemedicine. The goal of the workshop was to: 1) look forward and determine what the Department of Health and Human Services (HHS) should do next to encourage adoption and use of telemedicine, 2) understand what the special implications of telemedicine are for rural areas and 3) determine what evidence-based interventions work in telemedicine. According to experts who attended the event, an estimated 10 million patients in the United States are served by telemedicine each year, but expanding its reach further and making it an integral part of the health care system will remain a challenge without changes in reimbursement policies and state licensing. Specifically, panelists explained that telemedicine faces problems in operating across state lines because doctors generally must obtain licenses in each state where they practice, despite practitioners who may practice in multiple states and providers that are forming nearly national systems. Additionally, the Centers for Medicare and Medicaid Services (CMS) restricts Medicare reimbursement for telemedicine services for patients in metropolitan areas even if the area is underserved, causing the use of such technology as part of an ACO strategy – something CMS openly supports – to be difficult. Mary Wakefield, HRSA administrator, said she wants to encourage the discussion of telehealth’s role in the healthcare overhaul. “The importance of this will continue to grow, especially as more and more people in rural and isolated areas across the United States are able to seek a full complement of health care services,” she said.
Operating Rules for Healthcare Electronic Payments Could Save $9 Billion Over the next ten years, the healthcare system could save over $9 billion in administrative costs by adopting operating rules for electronic payments. Most of the savings from these electronic payments would result from the inclusion of explanations for payment adjustments leading to less back office work for healthcare providers. According to studies, physicians spend an average of three weeks a year on insurance-related tasks and billing issues. “These new rules will cut red tape, save money and ensure doctors spend more time seeing patients and less time filling out forms,” said HHS Secretary Kathleen Sebelius in press release.
Creating a framework for electronic payment is a requirement under the Affordable Care Act as many physicians’ offices currently receive and deposit paper checks, which makes it difficult for the offices to track the status of payments and to determine if an insurance provider will cover certain procedures. As of January of this year, HHS adopted health care electronic fund transfer (EFT) standards to start a path to savings on administrative costs. The operating rules announced this week follow industry best practices for collecting electronic funds, including a requirement for “insurers to offer a standardized, online enrollment for EFT and ERA so that physicians and hospitals can more easily enroll with multiple health plans to receive those transactions electronically,” according to the HHS press release. More about the rule.
Information Available for 2012 Reporting Pilot Program for Stage 1 CQMs This week, CMS released information for theEHR Incentive Program 2012 Reporting Pilot, a voluntary electronic reporting option, for eligible hospitals and critical access hospitals (CAHs)to report Clinical Quality Measures (CQM) for the EHR Incentive Program.
Currently, there are three ways to satisfy the CQM portion of Stage 1 according to the QualityNet website:
- Attest, using the attestation toolprovided by CMS to report CQMs.
- Submit Quality Reporting Document Architecture (QRDA) Category Idata during the submission period for episodes of care occurring in federal Fiscal Year 2012. For each of the 15 CQMs, all Medicare patients for the applicable EHR reporting period must be successfully submitted to the Centers for Medicare & Medicaid Services (CMS) data warehouse via MyQualityNet. A declaration of zero (0) patients for measures in which no patients were seen must be made in QualityNet, if applicable.
- Both attest and submit CQMs electronically through the pilot. NOTE: If this option is elected, payment will be based on the attestation results.
Eligible hospitals and CAHs will receive incentive payments if they satisfy all meaningful use requirements regardless of which method they use to report CQMs.
CHIME Advocacy Calendar & Events
Convergence: Cutting-Edge Healthcare Research in Real World Settings – Advocacy Webinar w/ AHRQ’s Jon White, August 16, 2012 @ 11am ET – Register NOW!!
CHIME Advocacy Documents
- CHIME Comments on NwHIN Governance RFI (July 2012)
- CHIME Comments to ICD-10 Delay (May 2012)
- CHIME Comments to CMS for Meaningful Use (May 2012)
- CHIME Comments to ONC for Standards & Certification (May 2012)