reimagining care delivery: why better data improved care ... · •inconsistent data definition...

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Reimagining Care Delivery: Why Better Data Improved Care Coordination and Patient Engagement November 21, 2016 2:00 3:00 pm ET **Audio for this webinar streams through the web. Please make sure the sound on your computer is turned on and you have speakers. If you need technical assistance, please contact ReadyTalk Customer Care: 800.843.9166.

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Page 1: Reimagining Care Delivery: Why Better Data Improved Care ... · •Inconsistent data definition across/between systems •Inability to tag and capture high value data elements •Inconsistencies

Reimagining Care Delivery: Why Better

Data Improved Care Coordination and

Patient Engagement

November 21, 2016

2:00 – 3:00 pm ET

**Audio for this webinar streams through the web. Please make

sure the sound on your computer is turned on and you have

speakers. If you need technical assistance, please contact

ReadyTalk Customer Care: 800.843.9166.

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Housekeeping Issues

All participants are muted• To ask a question or make a comment, please submit via the chat feature and

we will address as many as possible after the presentations.

Audio and Visual is through www.readytalk.com• If you are experiencing technical difficulties accessing audio through the web,

there will be a dial-in phone number displayed for you to call. In addition, if you

have any challenges joining the conference or need technical assistance, please

contact ReadyTalk Customer Care: 800.843.9166.

Today’s slides will be available for download on the eHI

Resource page at

https://www.ehidc.org/resources/eventsummaries

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About eHealth Initiative

Since 2001, eHealth Initiative has been advocating the value of technology and innovation in healthcare through research and education.

eHI convenes its multi-stakeholder members, from across the healthcare ecosystem, to discuss how to transform healthcare through information and technology.

eHI members released The 2020 Roadmap. The primary objective is enable coordinated efforts by the public and private sector to transform healthcare by the year 2020.

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Multi-Stakeholder Leaders in Every Sector of Healthcare

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The 2020 RoadmapKey Focus Areas in 2016

Interoperability

Privacy & Security

Business & Clinical Motivators

Health IT Policy

Data & Analytics

Innovation

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Upcoming Events

November 30:

– The State of Federal Funding for HIEs today

December 13:

– MACRA: A Payor Provider Perspective

March 21 – 23, 2017:

– eHI Annual Conference

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This webinar was made possible through the generosity and support of

Availity!

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Reimagining Care Delivery: Why Better Data

Improved Care Coordination and Patient

Engagement

Speakers

• Katherine Downing, MA, RHIA, CHPS, PMP

Sr. Director, Information Governance

AHIMA

• Russ Thomas, CEO

Availity

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© 2015

Katherine Downing, MA, RHIA, CHPS, PMP Sr. Director AHIMA IG and IGAdvisors™

2016

Re-imagining Care Delivery: Why Better Data Drives Improved Care Coordination and Provider Engagement

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© 2015

• According to IBM – 2.5 quintillion bytes of data are generated every day and 90% of the data in the world has been created in the last two years

• According to Cisco - Connected healthcare applications such as health monitors, medicine dispensers, first-responder connectivity, and telemedicine … the fastest-growing industry segment in the big data picture.

Healthcare Information Surge

Source: Cisco The Zettabyte Era: Trends and Analysis, July 2016 White Paper

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• Volume is growing on a exponential

path in healthcare.

• The age of big data is here–

massive growth in data volumes

and velocity.

• Only about 25%of data being

stored has real business value.

Information is a High Value Asset

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© 2015

HealthIT.Gov Benefits of the EHR but…

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© 2015

Issues Examples

Data design and capture issues

•Inconsistent data definition across/between systems•Inability to tag and capture high value data elements•Inconsistencies between data in structured and unstructured notes.

Information integrity and quality issues

•Lack of trust in data (impedes ability to utilize for analytics)•Patient identification and patient data from devices, other records•Lack of data quality management efforts / tools•Process breaks / redundancies (shadow records) •Errors found at the ‘end of the line’ in patient portals

Inability to use data for analytics / advanced reporting

•Insufficient knowledge and skill of analysts•Errors found in data are not traced back to source•Siloed ownership at business or clinical level•Little or no ability to report across systems

Lack of interoperability •Cost of interoperability•Systems ability to trade data and information •Trust in inbound information from other organizations

Issues with Information for Care Delivery

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EHR practices contribute to data quality and integrity issues. Risky documentation practices create the potential for patient safety, quality of care, and compliance concerns. Examples include:– Template Challenges

– Patient Identification Errors

– Amendment Integrity

– Copy Paste

– Addendum / Late Entries

Risks to EHR Documentation Integrity

Source: AHIMA Integrity of the Healthcare Record Documentation

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© 2015

• Risks of Copy Functionality– Inaccurate, redundant, or outdated information in

the patient record

– Inability to identify original author

– Propagation of false information

– Inability to follow the care of the patient (inaccurate coding)

– Unnecessarily lengthy and redundant progress notes

– Legal / Liability issues (per the AMA)

– Negative patient outcomes (per OIG)

EHR Copy Function and Information Integrity

Source: AHIMA: A Practical Guide: Information Management and Governance of Copy Functions in EHR

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© 2015

• Financial– Increased operating costs

– Decreased revenues

– Missed opportunities

– Reduction or delays in payments / pay for performance $

• Satisfaction– Patient satisfaction / decreased organizational trust

when portal, billing or other information is incorrect

– Low confidence in forecasting by leadership

– Inconsistent reporting and re-work / validation

– Delayed decision making

The Cost of Poor Information Quality in Healthcare

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© 2015

• Productivity– Duplication in the EHR creating increased workloads,

decreased throughput, increased processing time, or decreased end-product quality.

• Risk and Compliance– Patient safety

– Patient identification (should be 99.99% accurate)

– Potential for fraud

– Data leakage (physicians texting nurses / notes not in chart)

The Cost of Poor Information Quality in Healthcare

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© 2015

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© 2015

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© 2015

1

2 3

4ORGANIZATION-WIDE

ALL TYPES—INFO

ALL TYPES—ORGANIZATION

ALL MEDIA

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© 2015

Robert F. SmallwoodInformation Governance Concepts, Strategies, and Best Practices

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Healthcare strategy How Information Governance Supports:

Reduce Operating Costs

•Reduced data storage costs•Technology decisions based on IG (interdisciplinary) assessment of demonstrated need and cost benefit•Improved data quality improves decision making

Quality and Safety Benchmarks

•Enterprise standards for capturing consistent quality and safety metrics•Desired standards throughout the organization•Trusted data for analytics and business intelligence

Population Health Initiatives

•Reduces obstacles from data silos•Trusted data to evaluate and reengineer processes•Timely and complete information speeds up process

Reimbursement Models

•Reduces obstacles from data silos•Timely, trusted, complete information•Standards based claims•Value based purchasing and MACRA (Medicare Access and CHIP reauthorization act)

Excerpt based on Figure 3.5 (p34) Implementing Information Governance Kloss 2015. Purchase in the AHIMA store: https://www.ahimastore.org/SearchResults.aspx?SearchString=kloss

Quality Information is Vital for Healthcare

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© 2015

Healthcare strategy How Information Governance Supports:

Data Breach Avoidance

•Sensitive information is better protected from corruption, loss, theft, hacking and inappropriate use•Uniform policies for all types of information not just PHI•Mitigation of fines and investigations

Support Mergers,Acquisitions and New Affiliations

•Avoid new risk, redundancy, costs of inefficiency•Quicker transition of information from one organization to another•Standardized use and definition of data and information

Improve Care Management

•Longitudinal information to manage avoidable admissions, readmissions and ED visits •Trusted data•Patients have more confidence (aren’t finding issues via portal)•Better data for supporting chronic disease, research, etc

Excerpt based on Figure 3.5 (p34) Implementing Information Governance Kloss 2015. Purchase in the AHIMA store: https://www.ahimastore.org/SearchResults.aspx?SearchString=kloss

Quality Information is Vital for Healthcare

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© 2015

• Engaging patients to decrease costs and improve outcomes increase the health of your populations

• Map information creation, usage, storage (we can’t keep everything forever!)

• Use industry standard frameworks (AHIMA’s Information Governance Adoption Model (IGAM)) and best practices (e.g., healthcare and beyond, IG Blogs, IG Toolkit)

Focus on the Central Impact

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© 2015

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© 2015

• Core disciplines in a Data Governance program include: – use of data stewards,– data life cycle management, – data quality management, – master and reference data management, – metadata management, – data architecture management, – data development, and – business intelligence management.

Data Governance – A Key IG Competency

Source: Enterprise Information Management and Data Governance, Merida Johns. https://www.ahimastore.org/ProductDetailBooks.aspx?ProductID=17054

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© 2015

AHIMA’s Data Quality Management Model

"Data Quality Management Model (2015 Update)" Journal of AHIMA 86, no.10.

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© 2015

Better Data is a Team Effort

IG Competency Competency Leaders

Information Governance Structure –defining responsibilities and accountabilities for data / info efforts

IG Project Leader, IG Executive Sponsor, Health Information Management (HIM)

Strategic Alignment – aligning data efforts with organization strategies

IG Executive Sponsor, CIO, HIM Director, Quality, Risk, Compliance, CMIO

Privacy and Security Chief Information Privacy & Security Officer(s)

Legal & Regulatory Requirements Compliance & Regulatory Leaders, Attorney

Data Governance IT and Data/Business Intelligence Leaders, CIO, HIM

IT Governance IT, Clinical, CMIO, and HIM Leaders

Analytics IT, HIM and Data/Business Intelligence Leaders

IG and DG Performance Data/Business Intelligence Leaders, Internal Audit

Enterprise Information Management IT & HIM Leaders, Quality, Risk, Compliance

Awareness & Adherence – for all staff Chief Learning Officer, VP/Dir of Human Resources

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© 2015

IG Executive Training Video

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© 2015

IG Executive Video

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© 2015

IGIQ.com – IG Tools and Resources

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© 2015

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© 2015

• AHIMA Information Governance Adoption Model for Healthcare©• AHIMA www.IGHealthRate.com• AHIMA www.IGAdvisors.com• Information Governance Concepts, Strategies, and Best Practices, 2014.

Robert F. Smallwood – available in AHIMA store

• Implementing Health Information Governance, 2015. Linda Kloss, MA, RHIA, FAHIMA – available in AHIMA store

• Enterprise information management and data governance, 2015. Merida Johns – available in AHIMA store

• Images from www.images.google.com

• Cisco The Zettabyte Era: Trends and Analysis, July 2016 White Paper

Resources and Recommended Reading

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© 2015

IG Structure

Strategic Alignment

Privacy & Security

Legal and Regulatory

Data Governance

IT Governance

Analytics

IG Performance

Enterprise Info Mgnt

Awareness & Adherence

AHIMA’s Information Governance Adoption Model Competencies

(IGAM)™

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© 2015

IGAM Competencies Overview

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© 2015

IGAM Competencies Overview

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© 2015

IGAM Competencies Overview

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© 2015

IGAM Competencies Overview

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Healthcare and the provider engagement problem

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Claims

Util. Man.

Network Man.

Elig. & Ben.

$HEDIS,STARS

Primary care

Specialist

Hospital

Fax

25X!

? DATA

MLR

Provider Engagement Platform

• $650B Consumers• 50% CMS VBC

• Transformation• Engagement• Real time data & Analytics• 75% Commercial VBC• Costs

HealthPlanNotRead

y

60%

& Satisfaction

$300BAdminWaste

Right Place, Right Time, In Workflow

© 2016 Availity, LLC. All rights reserved. Confidential and

proprietary—do not distribute.41

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Questions and Answers!

Please use the chat feature to ask questions

Today’s slides will be available for download on our

homepage at www.ehidc.org

If you have any questions, please contact Claudia

Ellison, [email protected]

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This webinar was made possible through the generosity and support of

Availity!