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McKesson [Course title]

Interoperability, HIEs and the Future of Homecare

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As care collaboration becomes the

cornerstone of quality healthcare, the

clinical success of your agency is just as

important as its financial success. The

Affordable Care Act is marching forward,

and standing still to wait for change to

subside is not an option if you want your

agency to survive and thrive. The question,

then, is how best to position your agency for

the changes that need to happen.

Over the last several months, McKesson

Homecare Talk has featured a number of

blogs that focus on two major areas:

Collaborating for Success and Putting HIEs

to Work for You. We’ve compiled this

e-book to provide insight into how you can

demonstrate value to your partners and

interpret healthcare data intelligence.

We believe that home health will be central

to the success of whatever may be the next

trend, care model or healthcare innovation.

Home health brings value to the

community, but you must be at the table to

be considered. You can be taking

extraordinary care of your patients, but if

the wider world doesn’t know about your

agency, your opportunities for growth will

be limited.

If your home health agency is not

partnering with other care providers,

tracking key metrics and carefully observing

outcomes, you have some catching up to do.

And let’s not forget the vital role home

health agencies can play in the ACO model.

Accountable care is at the forefront of the

healthcare debate because it aligns

incentives in a patient-focused way.

However, care transitions and hospital-at-

home programs also are gaining in

popularity. Home health and hospice

agencies are a critical, but often overlooked,

component of the care continuum. How will

you raise the profile of your agency and

position it for greater success?

As Randy Hyun, general manager of the

Extended Care Solutions Group at

McKesson, states in his contribution to this

e-book, interoperability will define the

future of healthcare because “all health care

is local.” Not only will health information

exchanges (HIEs) help improve clinician

workflow and satisfaction, but involving

patients in their own care also will help

improve outcomes and strengthen ties with

the homecare community.

The importance of data and analytics will

continue to grow. Using evidence-based

practices and tracking key performance

measures are critical to an agency’s success

within any collaboration effort. To succeed

in the next few years, we’ll all need a strong

focus on both technology and process. Real-

time information across the care continuum

is the ultimate goal, and if we work

together, we will get there.

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Table of Contents

Collaborating for Success .................................................................... 3

Standing Still Not an Option for Home Health Agencies ........................................ 4

Three Reasons Why Home Health Will Define Healthcare’s Future ....................... 5

Three Ways to Get Noticed In Your Market……………………………………………………..6

Home Health Needs to Roll With the Changes ........................................................ 7

ACO Models Focusing on Certain Conditions ......................................................... 8

Local Research Can Pay Dividends – Literally ....................................................... 9

Agencies Must Show Value to ACOs ...................................................................... 10

Putting HIEs to Work for You ............................................................. 12

Four Healthcare Truths in 2020 ............................................................................ 13

Is It Time to Join a Health Information Exchange? .............................................. 14

Interoperability Defines the Future of Healthcare ................................................. 15

More Data, More Movement, Fewer Errors .......................................................... 17

HIEs Can Improve Clinician Workflow, Satisfaction ............................................ 18

Turning on Tap: PHRs Improve Patient Communication and Engagement ......... 19

Leverage Data to Show Your Value to Referral Sources ....................................... 20

Sharing More Data? Ask More Questions. ........................................................... 21

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Collaborating for Success

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Standing Still Not an Option for Home Health Agencies

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Today’s care and reimbursement

environment is one of constant change. I’m

not telling you anything that you don’t

already recognize during each work day.

But you may not realize that standing still

to wait for the change to subside is not an

option if you want your agency to survive

and thrive in the future. The question, then,

is how best to position your agency for the

changes that need to occur.

According to Troy Langsdale, partner in the

healthcare practice at CliftonLarsonAllen,

the first step is to conduct a strategic

analysis of your agency and your market,

then develop an action plan to improve

organizational performance and take

advantage of new opportunities. Your plans

“have to be in tune with local culture,

customs and delivery patterns,” Langsdale

says.

Key strategies include:

Decide whether to lead, follow or

resist

Prepare to assume risk

Use technology better

Align provider interest

Connect quality to value

Build new relationships

An agency owner interested in growing, for

example, could become involved with

community health initiatives. Then, if a new

care model such as an ACO is formed, the

owner would naturally be part of the

conversation. Likewise, you probably

already are doing disease management in

your agency, but are you calling it that? A

simple name change and the capturing of

data will help show your value to partners

and potential partners.

Langsdale also stresses the importance of

operational efficiency, eliminating waste

wherever possible, maximizing value-added

offerings and minimizing anything that

doesn’t bring value to the organization.

“You need to build processes around the

norm, not the exception,” Langsdale says.

And you should actively solicit ideas from

among your staff, he notes. Your employees

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are on the front lines with patients,

providers, payers and community members.

He suggests setting up a specific email

address for ideas and monitoring it

frequently.

Despite the myriad changes in the industry,

Langsdale says, “On the post-acute side, I’m

bullish. The industry is well-positioned in

healthcare reform.”

The industry may be well-positioned, but is

your agency? That’s a question that only

you can answer. And answer it you should.

Three Reasons Home Health Will Define Healthcare’s Future

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

If I had a crystal ball and could accurately

envision what the future of healthcare will

look like, I could retire a rich woman.

Unfortunately, I don’t.

But I do know that home health will be

central to the success of whatever may be

the next trend, care model or healthcare

innovation.

Here are three reasons why home health is

uniquely positioned:

We understand our patients in a

holistic way that most other care

providers don’t.

We know about and have access to

community resources.

We have feet on the street with a

mobile workforce that can reach

these patients, day in and day out,

wherever they are.

That may be one reason home health

spending increased 8.4% from January

2012 to January 2013, according to Altarum

Institute, a nonprofit health systems

research and consulting organization.

Admittedly, the amount spent on home care

is relatively small compared to what’s spent

on the big three (hospitals, physicians and

prescriptions take 60 cents of each

healthcare dollar). But the month-to-month

percentage increase for home health was

considerably higher than those other

categories.

That’s not to say we don’t face our own

challenges. The biggest obstacle I see for

our industry is a lack of data to show our

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value to care partners. If your home health

agency is not partnering with other care

providers, tracking key metrics and

carefully observing outcomes, then you

have some catching up to do. A reliable

clinical management system is the best way

to collect and interpret valuable home

healthcare data intelligence.

This is not the time to stand by and hope

the changes impacting the healthcare

industry will go away. They won’t. It is the

time to try new things, expand on what

works and change what doesn’t. You will be

judged not only on your outcomes, but on

your ability to show the value that your

home health agency provides.

Three Ways to Get Noticed in Your Market

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Make no doubt about it – we are in a

relationship business. However, many

people confuse relationships or

partnerships with friendships. They are not

the same.

There should be some formality in a

relationship, with expectations on both

sides. In the homecare space, that means

your home health agency should have

performance measures at hand to share

with partners or potential partners. At the

same time, you should know what to expect

from your partners, including how to get

out of a relationship if it’s not working for

your agency.

In order to increase the number of

relationships you have with potential

partners, you need to get their attention. In

my view, there are three ways to get noticed

in your market:

“Shoot some bullets”

Get engaged in your community,

state and regions

Build brand recognition

What I mean by “shoot some bullets” is for

you actively to explore new partnerships

and new care offerings. Is your local

hospital concerned about care transitions?

What about medication reconciliation or

the ongoing treatment of chronic conditions

to prevent hospital admissions and

readmissions? Every state now has an ACO,

and there’s likely some type of alternative

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care model being explored or activated in

your community. You have a crucial part to

play.

The second point is fairly straightforward.

Various local, regional, state and interstate

community entities are trying to tackle

community healthcare challenges. Are you

aware of the groups active in your area, and,

more important, are you involved in them?

Home health brings value to the

community, but you must be at the table to

be considered.

Finally, you must understand the

importance of brand recognition. Your

agency should have a mission, a vision and

organizational goals that every member of

your agency understands and can articulate.

And you must have effective branding. Do

you have a company logo? Do you use it

consistently? Do you have a presence on the

web? Increase brand awareness by doing

such things as sponsoring the local health

fair or other community events.

I know that you didn’t get into the home

health business to become a marketer.

Unfortunately, you can be taking

extraordinary care of your patients, but if

the wider world doesn’t know about your

agency, your opportunities for growth will

be limited.

Home Health Needs to Roll with the Changes

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Were you aware that HHS has approved

259 Accountable Care Organizations

(ACOs) that represent 8% of the Medicare

population? Nearly half are physician-led

and serve fewer than 10,000 Medicare

patients, according to The Advisory Board

Co. With the announcement of the latest

list, at least one ACO now exists in every

state.

This fact serves as another reminder that

the status quo will no longer suffice if you

want your agency to not simply survive –

but to thrive – over the next few years.

Accountable care is coming to the forefront

because it aligns incentives in a patient-

focused way, but care transitions and

hospital-at-home programs also are gaining

in popularity.

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Univita Health is partnering with major

insurers and hospital systems to set up care

transition programs that include both

clinical and non-clinical services. What are

the hospitals, physician groups, insurers

and community-service groups in your area

doing to help folks stay at home?

As a whole, healthcare is moving away from

a fee-for-service environment toward

capitation, which was last seen during the

managed care environment of the 1980s.

That generally was considered a failed

experiment, but the industry has grown

since then in its knowledge of population

health. This growth has been fueled largely

by powerful analytic programs that can

distill huge amounts of data into

manageable, actionable chunks.

And that’s your challenge: Breaking down

what your agency does to help patients

recover from hospital stays, regain mobility

and thrive at home in a way that

demonstrates your value to partners and

potential partners.

Anyone can become constrained by the

business models they’ve trained in and the

regulations they’ve learned. They can lose

the ability to think outside the box, to put

aside preconceived notions and to think

about what’s possible. But if you and your

agency can’t learn to think outside the box,

someone else will.

Home health software can assist your

agency in moving forward with change by

facilitating improved care quality and

documentation.

ACO Models Focusing on Certain Conditions

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

A small number of accountable care

organizations (ACOs) are beginning to focus

on certain diseases or chronic conditions. Is

your home health agency gearing up to

compete?

Florida Blue, the insurer formerly known as

Blue Cross and Blue Shield of Florida, has

established ACOs for cancer patients in the

Miami and Tampa areas during 2012,

according to a report in American Medical

News. The article also mentioned that

dialysis provider DaVita has launched the

Accountable Kidney Care Collaborative and

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is trying to establish an ACO for people with

kidney disease.

The focus of ACOs on specific conditions

may be the low-hanging fruit of the

accountable care world. End-stage renal

disease cost federal and commercial payers

nearly $43 billion in 2010, and more than

$124 billion was spent on cancer treatments

the same year.

Cost savings are shared among providers in

the ACO model, so finding effective

treatments and interventions for a specific

disease can help nearly every patient in the

group. But if the entire ACO were composed

of those with a certain disease, positive

treatments could have far-reaching effects,

both to the quality of life for patients and

significant savings that providers could

share.

Home health agencies can play a vital role

in the ACO model, particularly in terms of

disease management. Some agencies have

developed programs that address specific

morbidities such as diabetes, congestive

heart failure or COPD.

Last year, we held a webinar series that

addressed ACO strategies. The three

webinars are:

ACO Overview

Addressing the Triple Aim

Measures of Success

I know that running your agency can

sometimes feel like a juggling act, with day-

to-day tasks competing with medium- and

long-range planning, personnel issues,

technology challenges and many other

concerns. Talking about ACOs may seem

like piling on, but accountable care

organizations are gaining stature, traction –

and dollars. You need to determine how

your agency fits into an accountable care

world.

Local Research Can Pay Dividends – Literally

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

I try to write about and comment on

happenings of national importance in the

home health and hospice industries. But for

every national initiative I mention, there are

a huge number of local initiatives that also

are important.

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Hospital readmissions continue to make

news on a nearly daily basis. The latest

news is that Medicare reduced penalties for

1,246 hospitals and increased them for 226

others, according to Kaiser Health News.

What are your local hospitals or health

systems doing to decrease readmissions?

And, more important, what role can home

health play in helping them achieve fewer

readmissions?

Collaborative groups of hospitals and

providers have formed all over the country

to tackle common problems such as

readmissions or explore common

opportunities like care coordination and

payment reform. Home health and hospice

agencies are a critical, but often overlooked,

component of the care continuum. You

need to know where you fit in and how you

start.

How closely do you keep tabs on initiatives

being explored by the local hospital or large

provider groups? Make a note in your

calendar to check local news websites on a

consistent basis.

Do you belong to your regional or state

home care association? Bookmark the

website of your closest association and

check it frequently. If you are not active in

the group, you are missing a fantastic

opportunity to not only increase your

knowledge about the industry, but also to

raise the profile of your agency and position

it for greater success.

That’s what we do at McKesson – provide

you with the agency and clinical

management tools you need to be

successful. But home health software

technology can take you only so far – the

rest of the journey is up to you. And it starts

with paying close attention to the local and

national issues likely to affect your agency.

Agencies Must Show Value to ACOs

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Participating in ACOs can be a key growth

strategy, but home health agencies must

know what to expect and how to show their

value, says Mark Sharp, CPA, partner at

BKD, LLP. Sharp was among the featured

speakers at the recent McKesson Home

Health and Hospice Executive Summit.

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Sharp sees four requirements for home

health agencies to participate effectively in

ACOs:

Promote evidence-based medicine

Promote beneficiary engagement

Internal reporting on quality and

cost metrics

Coordination of care

Since hospitals and large physician groups

are driving a majority of ACOs, Sharp says

agencies must cater to their needs, which

include managing transitions from acute to

post-acute care and helping patients

monitor their chronic conditions to prevent

hospital stays in the first place.

Using evidence-based practices and

tracking key performance measures are

critical to an agency’s success within an

ACO. “You have to be able to show

outcomes and cost savings to the healthcare

system,” Sharp says. “It’s not just cost

savings within your agency; it’s cost savings

across the continuum of care.”

A robust home health software solution for

agency management is a must to provide

the level of detail that ACOs require. Quality

metrics should be shown by patient and by

disease state. Data on cost reduction is

critical, as is the ability to handle different

payment methodologies.

Building the strong relationships necessary

to become involved in ACOs is a C-suite

endeavor, although the marketing

department can play a supporting role,

Sharp notes. And an agency must be willing

to cover the geographic footprint of an ACO

– even though it may require either an

expansion of services or a partnership with

another agency.

“You should take a team approach to build

the internal processes you need to

participate in ACOs,” Sharp says. “Then,

you have to get out into your markets, tell

your story and develop the relationships

that you need to succeed.”

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Putting HIEs to Work for You

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Four Healthcare Truths in 2020

By Randy Hyun

General Manager, Extended Care

Solutions Group, McKesson

There’s so much going on in healthcare at

the moment that it seems ridiculous to

focus on anything beyond the near future.

In fact, times of rapid change require us to

take a step back and look at the long-term

possibilities. If we want to succeed, that is.

At McKesson, we spend a lot of time talking

about what 2020 will look like. A few years

back when we started talking about it, it

seemed very far away. Today, that’s no

longer the case. At the National Users

Conference in the spring, I outlined some of

the things McKesson believes we can count

on being true in 2020.

1. Care will be right-sized

2. Patients will expect more

transparency in their care

3. Patient data will flow across the

entire health system

4. Data and analytics will be a forefront

of healthcare

Let’s take those predictions one at a time.

First, when we talk about right-sized care,

we mean a significant shift in where care

takes place. Patients who would have been

hospitalized will be cared for on an

outpatient or homecare basis, conditions

that used to be treated by physicians will be

taken care of at a retail clinic staffed with

nurses, and so on. What’s important to

remember is that although it’s a major shift,

it will happen fairly gradually and will have

a positive impact on healthcare costs.

Second, patients will continue to demand

transparency in the form of personal health

records and patient portals. Patients will

have many more choices about where they

can be treated, and providers that recognize

the importance of transparency early on will

be the winners here.

Third is the flow of patient data. Right now,

this feels like a bit of pipe dream, but we

continue to work toward what we call a

longitudinal patient record—everything

from all providers in one place.

Finally, the importance of data and

analytics will continue to grow. We’ve come

a long way from a decade ago when almost

nothing was automated. By 2020, we’ll have

successfully made the transition to systems

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that not only communicate smoothly with

each other, but provide the exact

information providers need about their

patient populations at the moment they

need it.

To succeed in the next few years, we’ll all

need a strong focus on both technology and

process. Real-time information is the

ultimate goal, and if we work together, we

will get there.

Is It Time to Join a Health Information Exchange?

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

As homecare providers, we know the value

of making a strong connection with a

patient. We also realize, to some extent, the

importance of connecting our business to

the various entities we work with.

In fact, those business connections are

becoming more important every day, and

here at McKesson, we’re seeing many of our

customers joining health information

exchanges (HIEs). In some cases, they are

sharing clinical patient data with a state,

regional or private HIE. In others, they’re

setting up a private HIE for their health

system.

Specifically, healthcare providers can create

a continuity of care document (CCD) that

shows a patient’s problems, vital signs,

medications, allergies and demographic

information. The CCD can be shared with

other providers via the HIE, and

information like new conditions or

medications can be added to the profile and

shared.

Some platforms designed to connect

homecare providers to HIEs also offer a way

to connect patients and families to their

healthcare providers by making a patient’s

health record accessible via the web (using

well-tested security). Once the patient

establishes an account, the homecare

agency can send secure emails to

individuals or broadcast messages to a pre-

defined patient population.

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By connecting with other providers and

patients over the web, homecare agencies

can:

Improve relationships with

community healthcare partners

Increase clinician satisfaction and

productivity by providing easy-to-

access information

Connect patients and their families

to healthcare providers in a secure

manner

Engage patients in their care

process through easier provider

access

Create an agency-branded web

interface that increases patient

satisfaction

Given how interconnected our world has

become in the last few years, it makes sense

for healthcare providers to step up their

efforts in this area. And with strong benefits

like enhanced collaboration and improved

productivity, we expect to see many of our

customers do just that.

Interoperability Defines the Future of Healthcare

By Randy Hyun

General Manager, Extended Care

Solutions Group, McKesson

“All healthcare is local.” We’ve all heard

that phrase used to describe the nature of

healthcare. And it’s certainly true in the

case of care delivered in the home, home

health, hospice and personal care services.

Even in the midst of health care reform and

the Accountable Care Act, healthcare will

remain local, but it will have to break out of

its current silos. As new care models

transform the healthcare industry, clinical

interoperability is critical to the care

process and delivery systems as we all strive

to achieve the Triple Aim of better patient

outcomes, better population health and

reduced costs.

Home health, hospices and personal care

services have never felt the need to be more

connected. The health care system is

seeking to collaborate in real- or near-real-

time and looking to their information

systems to enable and support them,

regardless of whether an agency is free-

standing or part of a health system.

This aspiration brings with it a number of

challenges, not the least of which is the

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immaturity of electronic health information

exchanges. Yet it is clear, with the increased

emphasis on care coordination that’s

required to participate in ACOs and other

emerging care models, providers must have

well adapted, reliable, flexible ways to share

information among partners.

The release of McKesson Homecare™

v13.0, which brings the use of a standard

clinical terminology and evidence-based

practices to the bedside, fully supports the

goals of interoperability using McKesson

Home Health Connect™ and McKesson

Hospice Connect™ to enable the sharing of

demographic and clinical information bi-

directionally with the care teams, regardless

of whether those care team members are a

part of the same health system or not.

McKesson Home Health Connect and

McKesson Hospice Connect are truly game-

changers for homecare agencies. Clinical

interoperability is becoming crucial, so

agencies need to access, share and manage

patient medical data in disparate systems.

Not only do McKesson Home Health

Connect and McKesson Hospice Connect

allow agencies to share information with

partners, they allow secure access with

private, state and regional health

information exchanges (HIEs). The web-

based solutions store data in a secure

environment and feature auditing

protections that track users and allow

patients to specify what records they choose

to share.

With McKesson Home Health Connect and

McKesson Hospice Connect, clinicians can

look at multiple continuity of care

documents (CCDs) either separately or as a

single, integrated document that’s

aggregated from the available CCDs.

Bringing this information together provides

a powerful tool for clinicians as they are

determining the best course of care for the

patient and facing the challenges of having

the most current list of problems, allergies

and medications.

McKesson Home Health Connect and

McKesson Hospice Connect also help

patients participate in their own care

through the personal health record that’s

part of the system. The patient portal is

accessible via the web with security, privacy

and auditing protections. Once patients

have created a personal health record, your

agency can send secure email messages to

individuals or broadcast messages to a pre-

defined patient population.

Products such as McKesson Home Health

Connect and McKesson Hospice Connect

used in conjunction with home health

software can help agencies stay on the

cutting edge, adapt to new care

environments and continue on their core

mission – taking great care of their patients.

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More Data, More Movement, Fewer Errors

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Having the best, most updated information

on customers is a priority for virtually every

business. In the homecare industry, that

information can be critically important,

even life-saving.

These days, more patient information is

being exchanged due to care transitions,

care coordination efforts and new payer

models like accountable care organizations

(ACOs). Fortunately, technology providers

are stepping up with health information

exchanges (HIEs) that make sharing

information easier, resulting in smoother

data flow and lower risk of error.

Through HIEs, clinicians can place

diagnostic orders that are electronically

routed to the proper hospital department or

homecare provider. Any test results and all

visit documentation, including the order ID

and the patient ID, are electronically

returned to the clinician’s EMR. As manual

procedures and handoffs are eliminated, the

potential for error is greatly reduced.

HIEs can help home health providers

manage patient identity, patient consent

and privacy rules and clinical terminology

mapping across disparate systems.

Indeed, HIE functions include medical

record sharing, results delivery and

exchange of continuity of care documents

during care transitions. Experts believe that

by ensuring a complete and comprehensive

patient history is available at the point of

care, HIEs can help:

Prevent hospital readmissions

Decrease dangerous medication

errors

Improve providers’ diagnostic

capabilities

Decrease duplicate testing by

ensuring a complete and

comprehensive patient history

HIEs are even more important to providers

moving into new models of care. ACOs,

patient-centered medical homes and pay-

for-performance systems depend on HIEs

to deliver patient-centered care, measure

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and report performance, share health

information and improve the quality,

coordination, safety and efficiency of care.

HIEs Can Improve Clinician Workflow, Satisfaction

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Often, improving clinician satisfaction can

be as easy as making sure they have the

tools they need to do their job. Of course,

today’s home health providers consider data

as important a diagnostic tool as a

stethoscope, which can add a layer of

complexity. Fortunately, health information

exchanges (HIEs) are starting to prove their

worth in this area.

For example, HIEs allow clinicians better

access to diagnostic images, usually with a

single click from within a patient record.

According to a recent article in Health

Management Technology, clinicians are

reporting that digital image exchange

through an HIE is enabling them to

significantly minimize duplicate tests,

enhance quality of care and reduce patient

exposure to radiation.

Of course, it’s not just images that home

health clinicians need at the point of care.

Indeed, they need a combination of

demographic and clinical data about the

patient, including medical history, current

issues, current medications, allergies and

more. A private HIE allows patient

information like this to flow more freely

among hospitals, primary care physicians

and home health providers. It also allows

certain data to be exchanged with regional

and state HIEs for research and other

purposes.

There’s another way that HIEs improve

clinician satisfaction: improving workflow.

Virtually every provider has a goal of

spending more time with patients, which

means reducing administrative tasks; HIEs

provide the means for that. By allowing

providers to abandon paper-based systems

in favor of streamlined electronic forms,

HIEs also reduce the potential for human

error. Today, many in healthcare believe

better data access will ultimately help

clinicians make more precise diagnoses,

better manage chronic diseases, reduce

time spent on administration, and – most

important – spend more time with patients.

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Turning on the Tap: PHRs Improve Patient Communication and Engagement

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Communication, especially with customers,

is the lifeblood of any business.

Unfortunately, security concerns and

government regulations can prevent

communication from flowing smoothly in

healthcare organizations.

There’s good news, however. More

homecare organizations are adopting health

information exchange platforms (HIEs) to

communicate with other providers and

regional health information organizations,

and those platforms enable creation of

personal health records (PHRs).

Through a PHR, patients and their families

can communicate with their homecare

provider and access medication information

and test results using a secure web

connection. Patients can also specify what

data they are willing to share with other

providers.

Perhaps the best news is that PHRs have

been shown to improve patient engagement

in the care process. An article in the

Journal of the American Medical

Informatics Association (JAMIA) said

many trials of PHRs have shown they

improve patient and family access to

knowledge for self-management of health

and wellness issues.

Here are some ways PHRs help improve

patient satisfaction:

Better communication with

caregivers leads to improved

relationships, which can lead to

enhanced patient/provider shared

decision-making

Access to providers helps reinforce

trust and confidence

Better access helps patients feel more

like partners in healthcare

Although PHRs have not been adopted by

the general public at the rate some expected

(Google Health’s failure to catch on is a

good example), PHRs are popular with the

exact population served by homecare

agencies. According to the JAMIA article,

people with disabilities and chronic

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conditions, frequent users of healthcare

services, and people caring for elderly

parents tend to have the most interest in

PHRs.

Involving patients in their own care surely

will improve outcomes and strengthen ties

with the homecare community.

Leverage Data to Show Your Value to Referral Sources

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

A little data can go a long way, if it’s

leveraged effectively, says Martha Tecca,

founder and principal consultant at M&M

Strategies. In order to participate in

emerging care models, providers need to

have outcomes data, which Tecca admits

can be difficult to obtain in such a way to

create apples-to-apples comparisons with

competitors.

“Home health and hospice agencies must be

present in the ACO presentation, and you

need to keep telling your story,” says Tecca.

“You need to listen and tell how you

demonstrate value and how you will make

(other participants’) lives simple.”

Basic research agency executives need to

conduct before exploring partnerships

includes:

Knowing what data and services

potential partners are looking for

Learning your agency’s strengths and

how those strengths would benefit

partners

Knowing your competitors and how

your agency is similar/dissimilar

Bringing the right data to the table

(ask beforehand what data partners

consider crucial)

To learn more about what data hospitals,

physicians and other providers believe are

important, Tecca recommends

bookmarking the websites for the National

Quality Forum, the Center for Medicare &

Medicaid Innovation and the Dartmouth

Atlas of Health Care.

Tecca sees “a huge opportunity” for home

health agencies to develop medication

reconciliation programs. There may not be

a bright line to reimbursement for this

service at the outset, but it would be a way

for an agency to differentiate itself and open

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doors to provide other services for which it

would be reimbursed. At that point,

medication reconciliation would be a value-

add offering while a clinician is in a

patient’s home.

Another good resource is the Home Health

Care CAHPS survey, Tecca says. “A lot of

folks submit HHCAHPS data but don’t care

to delve further into it or engage it,” she

notes. “But it can be a hugely valuable tool.”

Sharing More Data? Ask More Questions.

By Karen Utterback Vice President, Product Marketing and Strategy, McKesson

Sharing data is becoming a common

occurrence for home health and hospice

agencies, whether you’re exchanging

specific patient data with another provider

or more general data on your patient

population with a state, regional or private

health information exchange (HIE).

As you share more data more often, security

rises to the top of your list of concerns – as

well as it should. Asking questions is the

best way to familiarize yourself with

security terminology and become

comfortable with what constitutes a secure

connection to an HIE.

At a minimum, HIEs must be fully

compliant with HIPAA and the state-

specific privacy regulations in their region.

They should also have readily available,

detailed information on their security

policies.

For example, HIEs must consider the

following:

Physical security

Access to the production facility

Power quality and backup power

Smoke detection and redundant

HVAC (heating and air)

Network security

Redundant firewalls

Site autonomy

Restricted electronic access to the

data center

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System security

Protection against electronic attacks

Hardening and monitoring of web

servers, integration servers and file

transfer servers.

Access control

Controlled access requests

Strict security account policies

o Encrypted remote access

o Auditing

Application security

Input validation

Strict authentication

Credentials management

Exception management

Data security

Data separation (PHI never sent or

received without being encrypted)

Data auditing

Data backup

Data destruction

In a nutshell, any entity you exchange data

with should be able to prove to you that it

has well-tested physical/network security,

that its facilities and processes are audited

periodically, and that it has taken all

potential patient privacy concerns into

consideration.

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For more news and insight from the

hospice and home health industry,

visit McKesson Homecare Talk.

www.mckesson.com/homecare