integrated health partners: population health informatics ......sep 25, 2018 · the current state...

Integrated Health Partners:

Population Health Informatics Overview

September 25, 2018

© 2018 Integrated Health Partners | 2

Pressures Facing FQHCs and CINs for Analytics and Reporting

*Source: Premier, Population Health Informatics & Technology Overview

Clinically Integrated NetworkFederally Qualified Health Centers

• Contract negotiation

• Demonstrating outcomes to payors

• Developing a value proposition for

participating health centers

• Capital funding for clinically integrated

network (CIN) initiatives

• Scaling infrastructure across at-risk contracts

• Meeting requirements for Clinical Integration

(feedback / monitoring / accountability)

• Regulatory and reporting requirements

• Multiple IT systems and data sources

• Standardizing clinical workflow and data

capture

• Overall financial health / IT investment in

hardware and staff

Balancing these

pressures can

be challenging


Notable Comments from IHP’s Network

Analytics is

currently

not an

organizational

competency

We want to

spend time

analyzing and

acting, not

validating

Price is

important for

a pop health

tool

We’re trying

to figure out

what to

report, to

remain

competitive

Our #1

priority today

is improving

provider

productivity

We work for

data…we want

the data to

work for us

No one

understands

Next Gen’s

database and

the expertise

is too

expensive to

hire

We are

preparing for

payment

reform even

though we are

still in FFS

Data has not

been a strong

point for us

All health

plans aren’t

created equal

for reporting

and analytic

needs

Big focus on

changing

culture to one

focused on

performance

improvement

The current state of population

health informatics & technology

(PHIT) for IHP suggests a need for:

• Further consensus and collaboration

across the network to define an

enterprise PHIT strategy

• Evaluation of a population health

informatics platform for the network to

aggregate and normalize data from

multiple sources



Target State for IHP’s PHIT Solution

• Demonstrating value of the CIN to payers and other customers- Aggregate data across CIN (maximize 360 degree view of services rendered)

- Report metrics as a CIN for quality, utilization, expenditures, risk scores, regulatory requirements, clinical outcomes

• Moving to greater data acquisition, processing, and automated reporting- Leverage IHP network to negotiate with payers, hospitals, health information exchanges, and others to improve accessibility and format of data


• Establishing a collaborative learning system for reporting,

analytics, and performance improvement. Capabilities include:- Improve content, accuracy, and timeliness of payer data and reports

- Targeted patient outreach based on accurate coding and attribution

- Improve data accuracy by standardizing data capture workflows and data models

- Evaluate effectiveness of care management workflows based on risk stratification or

population segmentation algorithms from integration of claims and clinical data

- Implement and optimize standardized dashboards and performance feedback

mechanisms for clinicians and care teams

Invest in a population health informatics platform

to support the clinically integrated network and health centers by:


PHIT Selection Process - Recap


Kick-off

Phase 1:

FOCUS

Assessment

Phase 2:

RFI, Scoring,

Selection

Phase 3:

Participation

Commitments

WE ARE HERE

Phase 1May – June 2017

Premier assessed current

state of the network,

defined IHP and health

center PHIT goals and

provided recommendations

for priority data platform

capabilities (see appendix)

Phase 2June 2017 – June 2018

Himformatics facilitated

the evaluation and

selection process of

potential PHIT solutions

Phase 3June 2018 - Current

IHP RFI Committee evaluated

vendors based on prioritized

capabilities. Board voted to

select the best PHIT solution

for IHP’s network:

Arcadia

Arcadia Overview


Arcadia Assessment

• Himformatics analysis: Arcadia has strong analytics and Master Patient

Index (MPI) capabilities. It makes sense if…– The current priority is on analytics and reporting and care management will grow over time as

needs dictate

– IHP collaborates with knowledgeable team of stakeholders across the network to strategically

deploy with clear focus and articulate plans to use analytics to drive action

• Key highlights– Features: MPI configuration, calculation engine for standardized measures, Chronic Illness and

Disability Payment System* (CDPS) risk-adjustment algorithm, risk navigator for registries to track

trends in risk coding, self-service analytics database

– Analytics Modules: quality improvement, cost and utilization, patient management registries, care

management workflow tools

– See next slides for descriptions of capabilities

* https://www.resdac.org/sites/resdac.umn.edu/files/Risk%20Adjustment%20in%20Medicaid%20Using%20CDPS%20%28Slides%29.pdf

https://www.resdac.org/sites/resdac.umn.edu/files/Risk Adjustment in Medicaid Using CDPS (Slides).pdf


Arcadia Analytics Capabilities

*Source:


Capabilities by User Group

Value-Based Care

Organization

Executives &

Admins

Quality Measure

Improvement

Cost and Utilization

Management

Patient Registries

Coding & Risk Workflow

Tools

Contract Analytics

(The Bindery)

Patient Outreach

Campaigns

Analysts & Gurus

Self-Service Toolkit

Replica Database

Care Team

Patient Registries

Contract Analytics

(The Bindery)

Previsit Planning Reports

Care Management

Analytics

Actionable

Insights

Legend

*Source:


Analytics for Executives, Admins & Care Teams

Analysis

Capabilities

Users of

OutputDescription

Quality

Measure

Improvement

Executives,

Admins

• Library of 400+ national quality metrics routinely updated for new specifications

• Performance based on integration of claims and EHR data refreshed nightly

• Compare across providers and practices and generate outreach lists

• Measure sets include: HEDIS, HRSA UDS, Regional P4P, PCMH, CMS ACO

Cost and

Utilization

Management

Executives,

Admins

• Visualize utilization and expenditure data by contract and in aggregate

• Inventory of cost PMPM, events/1000 readmits and avoidable ED visits

• Risk-adjusted metrics using EHR data

• Leakage metrics for network analysis

• Google maps integration for advanced hot-spotting and community engagement

Patient

Registries

Executives,

Admins,

Care Team

• Unified patient registry presents patient complexity across 85 condition categories

• Track patient risk and identifies documentation gaps for under-represented acuity

• High cost and high risk prioritization

• Pre-built decision support rules and alerts to highlight quality gaps

• Integration with scheduling data from the EHR for pre-visit planning reports

• Customizable lists to share with care team members

Coding and

Risk Workflow

Tools

Executives,

Admins

• Workflow tools to support collaboration between admins, coders and practices

targeted to improve performance on risk-based contracts

• Documentation and annotation of coding gaps feed clinical workflows downstream

Contract

Analytics

(The Bindery)

Executives,

Admins,

Care Team

• Publishing and distributing platform for complex ACO contract analytics and

provider scorecards

• Contain secure links to interactive patient-level content

The Bindery:

Quality Dashboard:

*Source:


Actionable Insights for Executives, Admins, Care Teams

Actionable

Insights

Users of

OutputDescription

Patient

Outreach

Campaigns

Executives,

Admins

• Configure and enable dozens of passive patient

engagement messages to close gaps and trigger

volume

• Library of hundreds of rules for messages based on

contracted quality measures and risk/coding needs

Previsit

Planning

Reports

Care Team • Patient-level gap and utilization report based on

scheduling into

• Aggregates risk, quality, utilization and medications

in one screen

Care

Management

Care Team • Aggregates patient data and interactions across care

settings and clinical systems to reduce friction in

handoffs

• Impactability scores calculate best candidates for

specific programs and assigns patients to queues

Patient Outreach Message:

Care Management Screen:

*Source:


Self-Service Analytics for Analysts & Data Gurus

• Self-service toolkit

– Library of dashboards and scorecards

with Tableau visualization layer on top

– 10-table schema for complex analysis

with minimal training

• Replica Database

– Database with 11 reporting domains for

expanded self-service analytics

– Simplified de-normalized data model

Data Models:

*Source:

Arcadia Implementation Overview

IHP Proposed Implementation Overview


Proposed Scope of IHP Contract

• Contract scope assumes 365 physicians, 130K+ IHP covered lives,

total population at each site, and 5-year agreement

• Data Sources:

• Phased implementation by cohort for EHR integration and launching

of modules (see next slides for details)

Data

Sources

Interface

QuantityInterface Description

EHR 10 Success EHS, eClinicalWorks, Allscripts, Intergy, athenahealth, RPMS, NextGen

Claims 3 Molina, Care1st, Inland Empire Health Plan

Lab 2 Quest, LabCorp

HIE 2 San Diego Health Connect, Manifest MedEx


Proposed Next Steps for IHP PHIT Strategy

September to December 2018:

• Arcadia Site Visit with IHP and Health Centers - Sept

• Convene IHP Informatics & Technology Committee – Oct

• Contracting – Oct to Nov

- Finalize contract negotiations with Arcadia

- Determine funding sources for Arcadia

• Schedule additional deep dive product demos – Oct to Dec

• Implementation Planning – Oct to Dec

- Develop and seek approval of implementation plan and timeline

- Assess mapping algorithms

- Create Arcadia training plan

Appendix


IHP’s Target Capabilities for Vendor Evaluation

integrated health partners: population health informatics ......sep 25, 2018 · the current state...

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