SlideShare a Scribd company logo
1 of 54
Download to read offline
The Meaningful Care Organization –
Developing Patient Engagement Strategies
to Weather the Perfect Storm of 2013

Timothy Kelly, MS, MBA
Dialog Medical

A Standard Register Healthcare Company

2013 TxHIMA Annual Meeting & Convention
Omni Fort Worth Hotel
June 28-30, 2013
2013 – A “Perfect Storm”
Four Converging Legislative Initiatives
Cash for Clunkers
and Meaningful Use

Cash for Clunkers
<$3 billion

Grassley seeks accounting of 'Cash for
Clunkers' costs. The Washington Post.
January 7, 2010.

“Meaningful Use”
(Healthcare Information Technology)

~$36 billion

Rock and a hard place: An analysis of the $36
billion impact from health IT stimulus funding.
Price Waterhouse Coopers. April 2009.
HITECH Act
Meaningful Use (MU)
American Recovery and Reinvestment Act of
2009

HITECH Act

Meaningful Use
HITECH Act
“The changes we’re
announcing today
will lead to more
coordination of
patient care…and
greater patient
engagement in their
own care”
Health and Human Services Secretary Kathleen Sebelius
announcing the Stage 2 Final Rule. August 23, 2012.
HITECH Act
 $12.6 billion in incentives paid
to date (program inception
through February 2013)
 85% of eligible hospitals are
participating in the EHR
Incentive Program
 75% of eligible hospitals have
received an incentive payment
to date
Source: CMS Fact Sheet: A Record of Progress on Health Information
Technology. CMS Media Relations. April 23, 2013.
Accountable Care Organizations

Accountable Care Organizations (ACOs)
Patient Protection and Affordable Care Act of
2010

Medicare Shared Savings Program

Accountable Care Organizations
Accountable Care Organizations

Accountable Care Organizations (ACOs)
Voluntary groups of physicians, hospitals and other
healthcare providers:

 Responsible for care of a clearly defined Medicare
population
 Designed to foster patient-centered, coordinated care
 If it succeeds in providing high-quality care while
reducing cost, it shares in savings achieved for
Medicare
Source: Berwick DM. N Engl J Med 2011;365:1753-1756.
Accountable Care Organizations

Three Goals of ACOs
 Better care for individuals
 Better health for
populations

 Slower growth in costs
through improvements in
care
Berwick DM. N Engl J Med 2011;364(16):e32.
Accountable Care Organizations

Accountable Care Organizations (ACOs)
Currently part of an
ACO?

Plan to implement or join and
ACO?

Yes - 11%
No - 39%
No - 89%

Yes - 61%

Source: January 2012 survey of hospitals, physician organizations and health
systems reported in: Tocknell MD. The Unsettled State of the ACO.
HealthLeaders Media Intelligence Report. April 2012.
Accountable Care Organizations
 Over 250 ACOs
 106 on January 1, 20131
 1 in 10 Americans is covered under
an ACO2
 Federal savings from this initiative
could be up to $940 million over four
years.1

 Top Driver for creating an ACO – To
engage physicians
 56 percent of the respondents that
are or plan to be part of an ACO3
2

HHS News Release. January 10, 2013.
1
Gandhi N, Weil R. The ACO Surprise. New York: Oliver Wyman, November 2012.
3Tocknell MD. The Unsettled State of the ACO. HealthLeaders Media Intelligence Report. April 2012.
Hospital Readmissions
Reduction Program

 National average readmission
rate (Medicare patients): 19%
 Cost to Medicare is
$17.5 billion annually

 2,217 hospitals will face
penalties of over $280 million
in 2013
Source: Rau J, Kaiser Health News, October 12, 2012
www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx
Hospital Value-Based
Purchasing (VBP) Program

Goals of Hospital VBP Program:
 Improve patient experience

Patient
Satisfaction (30%)

 Better clinical outcomes
1 percent Medicare Holdback

 $ 850 million in 2013

Hospital Value-Based Purchasing Program Fact Sheet.
Department of Health and Human Services. ICN 907664
November 2011.

+

Core Measures (70%)

VBP Performance
Score
Readmissions
Reduction Program

H
I
T
E
C
H

Patient-Centered
Communications

Hospital
VBP Program

A
C
O
s
Meaningful Use Objectives
Stages of Meaningful Use
Stages of Meaningful Use
Meaningful Use Objectives

Meaningful Use Objectives
Stage 1 Objectives for Hospitals
 14 Core Objectives, 10 Menu Objectives (attain 5)
 First eligible payment year: 2011
Stage 2 Objectives for Hospitals
 16 Core Objectives, 6 Menu Objectives (attain 3)
 First eligible payment year: 2014
 Effectively incorporate all of the Stage 1 objectives,
along with additional objectives and higher
measurement thresholds
Meaningful Use Objectives

Stage 2 Meaningful Use Objectives
Core Objectives
Patient
Demographics
Input
Vital Signs
Clinical Decision Support
CPOE
Transitions of Care
View, Download and
Output
Transmit to Third Party
Privacy and Security
Smoking Status
Input
Lab Results into EHR
Patient-Specific Education Output
Medication Reconciliation Input

19

Core Objectives
Generate Patient Lists
Immunization Registries
Lab Results to Public
Health Agencies
Syndromic Surveillance
Menu Objectives
Imaging Results
Advance Directives
ePrescribing
Electronic Notes
Electronic Lab Results
Family Health History

Patient

Input

Input
Why Focus on Patient-Centered
Strategies that are “Output” or
Communication-Oriented”?
Output/CommunicationOriented Strategies

“The single biggest problem in
communication is the illusion
that it has taken place.”
George Bernard Shaw
Output/CommunicationOriented Strategies

For the first time in 2012
Consumer Reports
rated hospitals.
Output/CommunicationOriented Strategies

Communication was
consistently the most
poorly rated category.
Output/CommunicationOriented Strategies

Patient
Satisfaction
 These metrics
are moving
beyond the
government
sites to
mainstream,
consumer sites
Source: Kelly T. HIStalk, August
8, 2012
http://histalk2.com/2012/08/08/re
aders-write-8812/ (Accessed
5/10/13)
“Output-Oriented” Meaningful Use
Objectives
“Output-Oriented” MU Objectives

Patient-Specific Education
Patients who are provided patientspecific education resources
Number of unique patients admitted to
the hospital’s inpatient or emergency
departments during the reporting period

> 10%
“Output-Oriented” MU Objectives

View, Download and Transmit to Third Party
 2 Measures for this Meaningful Use objective
 Both must be satisfied in order to meet the objective
“Output-Oriented” MU Objectives

View, Download and Transmit to Third Party
Patients whose information is available
online within 36 hours of discharge
Number of unique patients discharged
from the hospital’s inpatient or emergency
department during the reporting period
Patients who view, download or transmit to a
third party the information provided online
Number of unique patients discharged
from the hospital’s inpatient or emergency
department during the reporting period
*This measure was 10% in the Proposed Stage 2 Rule

> 50%

> 5%*
Best Practices for Patient-Specific
Education Materials
Best Practices

American College of Surgeons
The informed consent discussion conducted by the surgeon should
include:
1. The nature of the illness and the natural consequences of no
treatment.
2. The nature of the proposed operation, including the estimated
risks of mortality and morbidity.
3. The more common known complications, which should be
described and discussed. The patient should understand the
risks as well as the benefits of the proposed operation. The
discussion should include a description of what to expect during
the hospitalization and post hospital convalescence.
4. Alternative forms of treatment, including nonoperative
techniques.
American College of Surgeons Statements on Principles. Revised September 18, 2008.
http://www.facs.org/fellows_info/statements/stonprin.html#anchor171960 (Accessed 5/10/13.)
Best Practices

Argument for Informed Consent
 Only 39% of 3,269 closed claims against
anesthesiologists were judged to have
adequate informed consent1
 Inadequate informed consent was pursued as
a secondary cause in more than 90% of
ophthalmologic malpractice cases2
 Lack of informed consent is one of the top 10
reasons for hospital malpractice claims3
1Caplan

RA, Posner KL. ASA Newsletter 1995;59(6):9-12.
2Kiss CG, Richter-Mueksch S, Stifter E, et at. Arch Ophthalmol 2004;122:94-98.
3Glabman M. Trustee 2004;57(2):12-16.
Best Practices

Argument for
Informed Consent
 Needs to be
electronic
 Can’t be a
“Medical Miranda
Warning”
Best Practices

WHO Surgical Safety Checklist
Best Practices

Argument for
Informed Consent
 Need the consent for the
Pre-Procedure
Verification and/or the
Time-Out
 Verification of the
consent is one of the
most effective practices
for avoiding wrongpatient/wrong-procedure/
wrong-site surgery1
1Clarke

JR, Johnston J, Finley ED. Ann
Surg 2007;246:395-405.
Best Practices

Argument for
Informed Consent
Best Practices

Pre-Procedure Instructions
 Reduce the risk
of potentially
life-threatening
perioperative
complications.
Tea C. Perioperative concepts
and nursing management. In:
Smeltzer SC, et al, eds.
Brunner and Suddarth’s
Textbook of Medical-Surgical
Nursing. Philadelphia, PA:
Wolters Kluwer
Health/Lippincott Williams &
Wilkins; 2010:422-483.

Courtesy of the Baltimore VA Medical Center
Best Practices

Pre-Procedure Instructions
 Lower the incidence of
preventable surgery
cancellations.
Henderson BA et al. Incidence and causes
of ocular surgery cancellations in an
ambulatory surgical center. J Catarct
Refract Surg. 2006;32(1):95-102
Pletta C et al. Efficiency improvement plan
through patient education on thyroid
imaging procedures. J Nucl Med.
2008;49(Supp 1):426P

Courtesy of the Baltimore VAMC
Best Practices for Viewing, Downloading
and Transmitting Patient Information
Best Practices

Discharge Instructions
 Providing
patients with
incomplete
information at
discharge can
result in patient
harm.
Pennsylvania Patient
Safety Advisory. 2008.
Jun;5[2]:39-43.

Courtesy of the Portland VA Medical Center
Best Practices

Discharge Instructions
 Reduced the 14-day
readmission rate
three-fold by
employing procedurespecific discharge
instructions (4.1 per
1,000 outpatient
procedures to 1.5 per
1,000).
Boast P, Potts C. PS&QH.
2010;7(1):14-16.

Courtesy of the Portland VA Medical Center
Best Practices

Discharge Instructions
 Most valuable if
they are sent well
prior to the 36hour threshold
 Provided prior
to admission
 Paper as well
as electronic
Developing Initiatives in Your Own
“Meaningful Care Organization”
The Meaningful Care Organization

Resources
 Making Good on ACOs’ Promise — The Final Rule for the
Medicare Shared Savings Program. N Engl J Med
2011;365(19):1753-1756. November 10, 2011.
 http://www.nejm.org/doi/pdf/10.1056/NEJMp1111671

 Meaningful Use – The Whiteboard Story – Stage 1 Final Rule
Meaningful Use Objectives and Measures Compared to Stage
2 Final Objectives and Measures... Created as a reference tool
for public use and convenience by The Advisory Board Company.
 http://www.advisory.com/~/media/Advisory-com/CampaignItems/MUStage-2-White-Board-Story-Poster-2.pdf

43
Stage 1

Stage 2
The Meaningful Care Organization

“Meaningful Care” Checklist

Yes

 Is the initiative patient-centered?

 Does it reduce risk?



 Does it enhance safety?



 Does it leverage the patient?



 Can you utilize HIT (EHR or
other systems)?



 Does it support Stage 1 or
Stage 2 Meaningful Objectives?
45





No
Will a Focus on Patient-Centered
Communications Impact the Selection
of Treatments/Procedures and
Potentially the Efficiency of an ACO?
Potential Impact on Efficiency?

Dartmouth Atlas Project
 A series of nine reports of elective surgical procedures,
released in late 2012, found wide variations in the
treatments provided.

Improving Patient Decision-Making: Regional Series. The Dartmouth
Atlas of Health Care.
http://www.dartmouthatlas.org/pages/decision_making_series (Accessed
5/10/13.)
Potential Impact on Efficiency?

Dartmouth Atlas Project
 Mastectomy rates range from 0.3 per 1,000 female
Medicare patients in the San Francisco area, to 2.3 in
Grand Forks, ND
Potential Impact on Efficiency?

Dartmouth Atlas Project
 The report authors surmise that patients may not
understand their full range of options and choices may
be unduly influenced by providers and not patient
preferences.

Improving Patient Decision-Making: Regional Series. The Dartmouth
Atlas of Health Care.
http://www.dartmouthatlas.org/pages/decision_making_series (Accessed
5/10/13.)
Will a Focus on Patient-Centered
Communications Impact Readmissions
or Patient Satisfaction?
Potential Impact on
Readmissions/Satisfaction?

Press Ganey HCAHPS Analysis
 Press Ganey analysis of hospital readmission penalty
scores vs. patient satisfaction scores.

 Positive patient experience correlates well with low
readmission rates and high readmission rates
correlate well with poor patient experience.

The Relationship Between HCAHPS Performance and Readmission Penalties.
Press Ganey. http://healthcare.pressganey.com/content/201211-PIReadmissions
(Accessed 5/10/13.)
Potential Impact on
Readmissions/Satisfaction?

Press Ganey HCAHPS Analysis
 The relationship
between patient
satisfaction and
readmissions is
not causal.
Rather it is most
likely predictive of
an environment
stratified by
patient-centered
communications.
The Meaningful Care Organization

Health Information
Technology

Stage 1
Stage 2 MU Objectives
Stage 3

Patient-Centered
Communications

Patient Education
Informed Consent
Pre-Procedure Instructions
Discharge Instructions

Greater Patient
Satisfaction
Lower Readmission
Rates
More Efficient ACOs
Questions?

www.standardregister.com/healthcare
www.dialogmedical.com
www.EngagingPatient.org (slides posted here)
Robbie Beck robbie.beck@standardregister.com
Tim Kelly tkelly@dialogmedical.com

More Related Content

What's hot

3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINOCNseg
 
Health Care Reform 2009 W Medicare Info
Health Care Reform 2009 W Medicare InfoHealth Care Reform 2009 W Medicare Info
Health Care Reform 2009 W Medicare InfoCKiskaden
 
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_Care
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_CareSuraj_Jaladanki_Research_Paper_Cost_Effective_Health_Care
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_CareSuraj Jaladanki
 
Impact on Health Reform on Device Development and Funding
Impact on Health Reform on Device Development and FundingImpact on Health Reform on Device Development and Funding
Impact on Health Reform on Device Development and FundingUBMCanon
 
Risk Managing "Meaningful" Consent
Risk Managing "Meaningful" ConsentRisk Managing "Meaningful" Consent
Risk Managing "Meaningful" ConsentEngagingPatients
 
American Medical Home Runs (1)
American Medical Home Runs (1)American Medical Home Runs (1)
American Medical Home Runs (1)Jeffrey Kang
 
Pediatric Adverse Drug Events Presentation
Pediatric Adverse Drug Events PresentationPediatric Adverse Drug Events Presentation
Pediatric Adverse Drug Events PresentationJordan Gamart
 
Physician Practice in the Dynamic Health Care Environment Physician Practic...
Physician Practice in the Dynamic Health Care Environment 	 Physician Practic...Physician Practice in the Dynamic Health Care Environment 	 Physician Practic...
Physician Practice in the Dynamic Health Care Environment Physician Practic...MedicineAndHealth
 
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd 10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd Healthcare consultant
 
Money Your Practice May Be Throwing Away
Money Your Practice May Be Throwing AwayMoney Your Practice May Be Throwing Away
Money Your Practice May Be Throwing Awaye-MedTools
 
8ª CONSEGURO - SCOTT RUSHING
8ª CONSEGURO - SCOTT RUSHING8ª CONSEGURO - SCOTT RUSHING
8ª CONSEGURO - SCOTT RUSHINGCNseg
 
Evolution in Health Care Delivery- Urgent Care Centers PPP
Evolution in Health Care Delivery- Urgent Care Centers PPPEvolution in Health Care Delivery- Urgent Care Centers PPP
Evolution in Health Care Delivery- Urgent Care Centers PPPDebbie Fernando
 
Sep oct 2012 partners press-ganey
Sep oct 2012 partners press-ganeySep oct 2012 partners press-ganey
Sep oct 2012 partners press-ganeyBradKruger
 
Single Payer Healthcare Research Paper
Single Payer Healthcare Research Paper Single Payer Healthcare Research Paper
Single Payer Healthcare Research Paper Nicholas Niesen
 
Physican payment options power point 07-18-16
Physican payment options power point   07-18-16Physican payment options power point   07-18-16
Physican payment options power point 07-18-16Singlepayerhawaii
 
Survey Shows the Role of Technology in the Progress of Patient Safety
Survey Shows the Role of Technology in the Progress of Patient SafetySurvey Shows the Role of Technology in the Progress of Patient Safety
Survey Shows the Role of Technology in the Progress of Patient SafetyHealth Catalyst
 
Why Clinical Quality Should Drive Healthcare Business Strategy
Why Clinical Quality Should Drive Healthcare Business StrategyWhy Clinical Quality Should Drive Healthcare Business Strategy
Why Clinical Quality Should Drive Healthcare Business StrategyHealth Catalyst
 

What's hot (20)

Op-ed samples
Op-ed samplesOp-ed samples
Op-ed samples
 
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO
3º FÓRUM DA SAÚDE SUPLEMENTAR - CARMELLA BOCCHINO
 
Health Care Reform 2009 W Medicare Info
Health Care Reform 2009 W Medicare InfoHealth Care Reform 2009 W Medicare Info
Health Care Reform 2009 W Medicare Info
 
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_Care
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_CareSuraj_Jaladanki_Research_Paper_Cost_Effective_Health_Care
Suraj_Jaladanki_Research_Paper_Cost_Effective_Health_Care
 
Impact on Health Reform on Device Development and Funding
Impact on Health Reform on Device Development and FundingImpact on Health Reform on Device Development and Funding
Impact on Health Reform on Device Development and Funding
 
Risk Managing "Meaningful" Consent
Risk Managing "Meaningful" ConsentRisk Managing "Meaningful" Consent
Risk Managing "Meaningful" Consent
 
American Medical Home Runs (1)
American Medical Home Runs (1)American Medical Home Runs (1)
American Medical Home Runs (1)
 
Pediatric Adverse Drug Events Presentation
Pediatric Adverse Drug Events PresentationPediatric Adverse Drug Events Presentation
Pediatric Adverse Drug Events Presentation
 
Physician Practice in the Dynamic Health Care Environment Physician Practic...
Physician Practice in the Dynamic Health Care Environment 	 Physician Practic...Physician Practice in the Dynamic Health Care Environment 	 Physician Practic...
Physician Practice in the Dynamic Health Care Environment Physician Practic...
 
PAYMENT MODELS
PAYMENT MODELSPAYMENT MODELS
PAYMENT MODELS
 
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd 10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd
10 top patient safety issues for 2016 by Dr.Mahboob ali khan Phd
 
Money Your Practice May Be Throwing Away
Money Your Practice May Be Throwing AwayMoney Your Practice May Be Throwing Away
Money Your Practice May Be Throwing Away
 
8ª CONSEGURO - SCOTT RUSHING
8ª CONSEGURO - SCOTT RUSHING8ª CONSEGURO - SCOTT RUSHING
8ª CONSEGURO - SCOTT RUSHING
 
Evolution in Health Care Delivery- Urgent Care Centers PPP
Evolution in Health Care Delivery- Urgent Care Centers PPPEvolution in Health Care Delivery- Urgent Care Centers PPP
Evolution in Health Care Delivery- Urgent Care Centers PPP
 
Sep oct 2012 partners press-ganey
Sep oct 2012 partners press-ganeySep oct 2012 partners press-ganey
Sep oct 2012 partners press-ganey
 
Rich Saver, "Financial Conflicts of Interest and Transparency Regulation: Imp...
Rich Saver, "Financial Conflicts of Interest and Transparency Regulation: Imp...Rich Saver, "Financial Conflicts of Interest and Transparency Regulation: Imp...
Rich Saver, "Financial Conflicts of Interest and Transparency Regulation: Imp...
 
Single Payer Healthcare Research Paper
Single Payer Healthcare Research Paper Single Payer Healthcare Research Paper
Single Payer Healthcare Research Paper
 
Physican payment options power point 07-18-16
Physican payment options power point   07-18-16Physican payment options power point   07-18-16
Physican payment options power point 07-18-16
 
Survey Shows the Role of Technology in the Progress of Patient Safety
Survey Shows the Role of Technology in the Progress of Patient SafetySurvey Shows the Role of Technology in the Progress of Patient Safety
Survey Shows the Role of Technology in the Progress of Patient Safety
 
Why Clinical Quality Should Drive Healthcare Business Strategy
Why Clinical Quality Should Drive Healthcare Business StrategyWhy Clinical Quality Should Drive Healthcare Business Strategy
Why Clinical Quality Should Drive Healthcare Business Strategy
 

Viewers also liked

Fictional Law Firm
Fictional Law FirmFictional Law Firm
Fictional Law Firmthaliapa
 
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]IAB uruguay
 
Stage2mu part2-ptengagementtochie-121005114900-phpapp02
Stage2mu part2-ptengagementtochie-121005114900-phpapp02Stage2mu part2-ptengagementtochie-121005114900-phpapp02
Stage2mu part2-ptengagementtochie-121005114900-phpapp02Carla Pitcher
 
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01Carla Pitcher
 
Vintage 2009 Kemblefield Estate Winery
Vintage 2009 Kemblefield Estate WineryVintage 2009 Kemblefield Estate Winery
Vintage 2009 Kemblefield Estate WineryEIT
 
Stage2mu final-120925161818-phpapp01
Stage2mu final-120925161818-phpapp01Stage2mu final-120925161818-phpapp01
Stage2mu final-120925161818-phpapp01Carla Pitcher
 
Veterans Day Speech At ACCC
Veterans Day Speech At ACCCVeterans Day Speech At ACCC
Veterans Day Speech At ACCCBenjamin
 

Viewers also liked (7)

Fictional Law Firm
Fictional Law FirmFictional Law Firm
Fictional Law Firm
 
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]
El modelo de la nueva agencia - Martín Hazán [IAB Forum Uruguay - 2013]
 
Stage2mu part2-ptengagementtochie-121005114900-phpapp02
Stage2mu part2-ptengagementtochie-121005114900-phpapp02Stage2mu part2-ptengagementtochie-121005114900-phpapp02
Stage2mu part2-ptengagementtochie-121005114900-phpapp02
 
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01
Mobilityforpatientexperience boston-technology-corporation-130808003328-phpapp01
 
Vintage 2009 Kemblefield Estate Winery
Vintage 2009 Kemblefield Estate WineryVintage 2009 Kemblefield Estate Winery
Vintage 2009 Kemblefield Estate Winery
 
Stage2mu final-120925161818-phpapp01
Stage2mu final-120925161818-phpapp01Stage2mu final-120925161818-phpapp01
Stage2mu final-120925161818-phpapp01
 
Veterans Day Speech At ACCC
Veterans Day Speech At ACCCVeterans Day Speech At ACCC
Veterans Day Speech At ACCC
 

Similar to Meaningfulcareorg txhima6-30-13-130925145004-phpapp02

The Meaningful Care Organization: Developing Patient Engagement Strategies
The Meaningful Care Organization: Developing Patient Engagement StrategiesThe Meaningful Care Organization: Developing Patient Engagement Strategies
The Meaningful Care Organization: Developing Patient Engagement StrategiesEngagingPatients
 
Joint Commission- SBAR Pt2- Dec10 copy
Joint Commission- SBAR Pt2- Dec10 copyJoint Commission- SBAR Pt2- Dec10 copy
Joint Commission- SBAR Pt2- Dec10 copyMichael Woods, MD, MMM
 
Medicare Spending Report
Medicare Spending ReportMedicare Spending Report
Medicare Spending ReportDenise Enriquez
 
Diagnostic Error Reprint PLUS Journal April 2015
Diagnostic Error Reprint PLUS Journal April 2015Diagnostic Error Reprint PLUS Journal April 2015
Diagnostic Error Reprint PLUS Journal April 2015Paul Greve
 
Questions On The Environment And The Healthcare Industry
Questions On The Environment And The Healthcare IndustryQuestions On The Environment And The Healthcare Industry
Questions On The Environment And The Healthcare IndustryChristina Padilla
 
Strategy and digital health
Strategy and digital healthStrategy and digital health
Strategy and digital healthShiv ognito
 
Please follow instructions carefully. Thank you so kindly. Ass.docx
Please follow instructions carefully. Thank you so kindly. Ass.docxPlease follow instructions carefully. Thank you so kindly. Ass.docx
Please follow instructions carefully. Thank you so kindly. Ass.docxmattjtoni51554
 
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine LecturePeter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lectureuabsom
 
Reply 1 he safety of our patients is an important.docx
Reply 1 he safety of our patients is an important.docxReply 1 he safety of our patients is an important.docx
Reply 1 he safety of our patients is an important.docxwrite30
 
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION,
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION,
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, DioneWang844
 
Pwc emerging-mhealth-full
Pwc emerging-mhealth-fullPwc emerging-mhealth-full
Pwc emerging-mhealth-full3GDR
 
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docx
CHAPter3ConneCting tHe strAtegiC Dots  Does Hit mAt.docxCHAPter3ConneCting tHe strAtegiC Dots  Does Hit mAt.docx
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docxmccormicknadine86
 
Ethics, Informatics and Obamacare
Ethics, Informatics and ObamacareEthics, Informatics and Obamacare
Ethics, Informatics and ObamacareBarry Smith
 
#HCAQofQ DrJonathan B Perlin
#HCAQofQ DrJonathan B Perlin#HCAQofQ DrJonathan B Perlin
#HCAQofQ DrJonathan B PerlinRebecca Pullen
 
#HCAQofQ Dr Jonathan B Perlin
#HCAQofQ Dr Jonathan B Perlin #HCAQofQ Dr Jonathan B Perlin
#HCAQofQ Dr Jonathan B Perlin Rebecca Pullen
 
Question of Quality Conference 2016 - Jonathan B. Perlin
Question of Quality Conference 2016 - Jonathan B. PerlinQuestion of Quality Conference 2016 - Jonathan B. Perlin
Question of Quality Conference 2016 - Jonathan B. PerlinHCA Healthcare UK
 

Similar to Meaningfulcareorg txhima6-30-13-130925145004-phpapp02 (20)

The Meaningful Care Organization: Developing Patient Engagement Strategies
The Meaningful Care Organization: Developing Patient Engagement StrategiesThe Meaningful Care Organization: Developing Patient Engagement Strategies
The Meaningful Care Organization: Developing Patient Engagement Strategies
 
Joint Commission- SBAR Pt2- Dec10 copy
Joint Commission- SBAR Pt2- Dec10 copyJoint Commission- SBAR Pt2- Dec10 copy
Joint Commission- SBAR Pt2- Dec10 copy
 
National Health Care Reform 2009
National Health Care Reform 2009National Health Care Reform 2009
National Health Care Reform 2009
 
Medicare Spending Report
Medicare Spending ReportMedicare Spending Report
Medicare Spending Report
 
Diagnostic Error Reprint PLUS Journal April 2015
Diagnostic Error Reprint PLUS Journal April 2015Diagnostic Error Reprint PLUS Journal April 2015
Diagnostic Error Reprint PLUS Journal April 2015
 
Questions On The Environment And The Healthcare Industry
Questions On The Environment And The Healthcare IndustryQuestions On The Environment And The Healthcare Industry
Questions On The Environment And The Healthcare Industry
 
Summary of Top Ten Health Industry Issues
Summary of Top Ten Health Industry IssuesSummary of Top Ten Health Industry Issues
Summary of Top Ten Health Industry Issues
 
Strategy and digital health
Strategy and digital healthStrategy and digital health
Strategy and digital health
 
Please follow instructions carefully. Thank you so kindly. Ass.docx
Please follow instructions carefully. Thank you so kindly. Ass.docxPlease follow instructions carefully. Thank you so kindly. Ass.docx
Please follow instructions carefully. Thank you so kindly. Ass.docx
 
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine LecturePeter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
Peter L. Slavin, M.D., 2015 Leadership in Academic Medicine Lecture
 
Reply 1 he safety of our patients is an important.docx
Reply 1 he safety of our patients is an important.docxReply 1 he safety of our patients is an important.docx
Reply 1 he safety of our patients is an important.docx
 
Roshni Bag Thesis [PDF]
Roshni Bag Thesis [PDF]Roshni Bag Thesis [PDF]
Roshni Bag Thesis [PDF]
 
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION,
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION, MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION,
MHA6999 SEMINAR IN HEALTHCARE CASES-- WEEK 2 LECTURE, DISCUSSION,
 
Pwc emerging-mhealth-full
Pwc emerging-mhealth-fullPwc emerging-mhealth-full
Pwc emerging-mhealth-full
 
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docx
CHAPter3ConneCting tHe strAtegiC Dots  Does Hit mAt.docxCHAPter3ConneCting tHe strAtegiC Dots  Does Hit mAt.docx
CHAPter3ConneCting tHe strAtegiC Dots Does Hit mAt.docx
 
READMISSION
READMISSIONREADMISSION
READMISSION
 
Ethics, Informatics and Obamacare
Ethics, Informatics and ObamacareEthics, Informatics and Obamacare
Ethics, Informatics and Obamacare
 
#HCAQofQ DrJonathan B Perlin
#HCAQofQ DrJonathan B Perlin#HCAQofQ DrJonathan B Perlin
#HCAQofQ DrJonathan B Perlin
 
#HCAQofQ Dr Jonathan B Perlin
#HCAQofQ Dr Jonathan B Perlin #HCAQofQ Dr Jonathan B Perlin
#HCAQofQ Dr Jonathan B Perlin
 
Question of Quality Conference 2016 - Jonathan B. Perlin
Question of Quality Conference 2016 - Jonathan B. PerlinQuestion of Quality Conference 2016 - Jonathan B. Perlin
Question of Quality Conference 2016 - Jonathan B. Perlin
 

Recently uploaded

Physiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisPhysiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisNilofarRasheed1
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...Ganesan Yogananthem
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communicationskatiequigley33
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
General_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingGeneral_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingAnonymous
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Vaikunthan Rajaratnam
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 

Recently uploaded (20)

Physiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid ArthritisPhysiotherapy Management of Rheumatoid Arthritis
Physiotherapy Management of Rheumatoid Arthritis
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communications
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
General_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_WellbeingGeneral_Studies_Presentation_Health_and_Wellbeing
General_Studies_Presentation_Health_and_Wellbeing
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 

Meaningfulcareorg txhima6-30-13-130925145004-phpapp02

  • 1. The Meaningful Care Organization – Developing Patient Engagement Strategies to Weather the Perfect Storm of 2013 Timothy Kelly, MS, MBA Dialog Medical A Standard Register Healthcare Company 2013 TxHIMA Annual Meeting & Convention Omni Fort Worth Hotel June 28-30, 2013
  • 2. 2013 – A “Perfect Storm” Four Converging Legislative Initiatives
  • 3. Cash for Clunkers and Meaningful Use Cash for Clunkers <$3 billion Grassley seeks accounting of 'Cash for Clunkers' costs. The Washington Post. January 7, 2010. “Meaningful Use” (Healthcare Information Technology) ~$36 billion Rock and a hard place: An analysis of the $36 billion impact from health IT stimulus funding. Price Waterhouse Coopers. April 2009.
  • 4. HITECH Act Meaningful Use (MU) American Recovery and Reinvestment Act of 2009 HITECH Act Meaningful Use
  • 5. HITECH Act “The changes we’re announcing today will lead to more coordination of patient care…and greater patient engagement in their own care” Health and Human Services Secretary Kathleen Sebelius announcing the Stage 2 Final Rule. August 23, 2012.
  • 6. HITECH Act  $12.6 billion in incentives paid to date (program inception through February 2013)  85% of eligible hospitals are participating in the EHR Incentive Program  75% of eligible hospitals have received an incentive payment to date Source: CMS Fact Sheet: A Record of Progress on Health Information Technology. CMS Media Relations. April 23, 2013.
  • 7. Accountable Care Organizations Accountable Care Organizations (ACOs) Patient Protection and Affordable Care Act of 2010 Medicare Shared Savings Program Accountable Care Organizations
  • 8. Accountable Care Organizations Accountable Care Organizations (ACOs) Voluntary groups of physicians, hospitals and other healthcare providers:  Responsible for care of a clearly defined Medicare population  Designed to foster patient-centered, coordinated care  If it succeeds in providing high-quality care while reducing cost, it shares in savings achieved for Medicare Source: Berwick DM. N Engl J Med 2011;365:1753-1756.
  • 9. Accountable Care Organizations Three Goals of ACOs  Better care for individuals  Better health for populations  Slower growth in costs through improvements in care Berwick DM. N Engl J Med 2011;364(16):e32.
  • 10. Accountable Care Organizations Accountable Care Organizations (ACOs) Currently part of an ACO? Plan to implement or join and ACO? Yes - 11% No - 39% No - 89% Yes - 61% Source: January 2012 survey of hospitals, physician organizations and health systems reported in: Tocknell MD. The Unsettled State of the ACO. HealthLeaders Media Intelligence Report. April 2012.
  • 11. Accountable Care Organizations  Over 250 ACOs  106 on January 1, 20131  1 in 10 Americans is covered under an ACO2  Federal savings from this initiative could be up to $940 million over four years.1  Top Driver for creating an ACO – To engage physicians  56 percent of the respondents that are or plan to be part of an ACO3 2 HHS News Release. January 10, 2013. 1 Gandhi N, Weil R. The ACO Surprise. New York: Oliver Wyman, November 2012. 3Tocknell MD. The Unsettled State of the ACO. HealthLeaders Media Intelligence Report. April 2012.
  • 12. Hospital Readmissions Reduction Program  National average readmission rate (Medicare patients): 19%  Cost to Medicare is $17.5 billion annually  2,217 hospitals will face penalties of over $280 million in 2013 Source: Rau J, Kaiser Health News, October 12, 2012 www.kaiserhealthnews.org/Stories/2012/August/13/medicare-hospitals-readmissions-penalties.aspx
  • 13. Hospital Value-Based Purchasing (VBP) Program Goals of Hospital VBP Program:  Improve patient experience Patient Satisfaction (30%)  Better clinical outcomes 1 percent Medicare Holdback  $ 850 million in 2013 Hospital Value-Based Purchasing Program Fact Sheet. Department of Health and Human Services. ICN 907664 November 2011. + Core Measures (70%) VBP Performance Score
  • 18. Meaningful Use Objectives Meaningful Use Objectives Stage 1 Objectives for Hospitals  14 Core Objectives, 10 Menu Objectives (attain 5)  First eligible payment year: 2011 Stage 2 Objectives for Hospitals  16 Core Objectives, 6 Menu Objectives (attain 3)  First eligible payment year: 2014  Effectively incorporate all of the Stage 1 objectives, along with additional objectives and higher measurement thresholds
  • 19. Meaningful Use Objectives Stage 2 Meaningful Use Objectives Core Objectives Patient Demographics Input Vital Signs Clinical Decision Support CPOE Transitions of Care View, Download and Output Transmit to Third Party Privacy and Security Smoking Status Input Lab Results into EHR Patient-Specific Education Output Medication Reconciliation Input 19 Core Objectives Generate Patient Lists Immunization Registries Lab Results to Public Health Agencies Syndromic Surveillance Menu Objectives Imaging Results Advance Directives ePrescribing Electronic Notes Electronic Lab Results Family Health History Patient Input Input
  • 20. Why Focus on Patient-Centered Strategies that are “Output” or Communication-Oriented”?
  • 21. Output/CommunicationOriented Strategies “The single biggest problem in communication is the illusion that it has taken place.” George Bernard Shaw
  • 22. Output/CommunicationOriented Strategies For the first time in 2012 Consumer Reports rated hospitals.
  • 24. Output/CommunicationOriented Strategies Patient Satisfaction  These metrics are moving beyond the government sites to mainstream, consumer sites Source: Kelly T. HIStalk, August 8, 2012 http://histalk2.com/2012/08/08/re aders-write-8812/ (Accessed 5/10/13)
  • 26. “Output-Oriented” MU Objectives Patient-Specific Education Patients who are provided patientspecific education resources Number of unique patients admitted to the hospital’s inpatient or emergency departments during the reporting period > 10%
  • 27. “Output-Oriented” MU Objectives View, Download and Transmit to Third Party  2 Measures for this Meaningful Use objective  Both must be satisfied in order to meet the objective
  • 28. “Output-Oriented” MU Objectives View, Download and Transmit to Third Party Patients whose information is available online within 36 hours of discharge Number of unique patients discharged from the hospital’s inpatient or emergency department during the reporting period Patients who view, download or transmit to a third party the information provided online Number of unique patients discharged from the hospital’s inpatient or emergency department during the reporting period *This measure was 10% in the Proposed Stage 2 Rule > 50% > 5%*
  • 29. Best Practices for Patient-Specific Education Materials
  • 30. Best Practices American College of Surgeons The informed consent discussion conducted by the surgeon should include: 1. The nature of the illness and the natural consequences of no treatment. 2. The nature of the proposed operation, including the estimated risks of mortality and morbidity. 3. The more common known complications, which should be described and discussed. The patient should understand the risks as well as the benefits of the proposed operation. The discussion should include a description of what to expect during the hospitalization and post hospital convalescence. 4. Alternative forms of treatment, including nonoperative techniques. American College of Surgeons Statements on Principles. Revised September 18, 2008. http://www.facs.org/fellows_info/statements/stonprin.html#anchor171960 (Accessed 5/10/13.)
  • 31. Best Practices Argument for Informed Consent  Only 39% of 3,269 closed claims against anesthesiologists were judged to have adequate informed consent1  Inadequate informed consent was pursued as a secondary cause in more than 90% of ophthalmologic malpractice cases2  Lack of informed consent is one of the top 10 reasons for hospital malpractice claims3 1Caplan RA, Posner KL. ASA Newsletter 1995;59(6):9-12. 2Kiss CG, Richter-Mueksch S, Stifter E, et at. Arch Ophthalmol 2004;122:94-98. 3Glabman M. Trustee 2004;57(2):12-16.
  • 32. Best Practices Argument for Informed Consent  Needs to be electronic  Can’t be a “Medical Miranda Warning”
  • 33. Best Practices WHO Surgical Safety Checklist
  • 34. Best Practices Argument for Informed Consent  Need the consent for the Pre-Procedure Verification and/or the Time-Out  Verification of the consent is one of the most effective practices for avoiding wrongpatient/wrong-procedure/ wrong-site surgery1 1Clarke JR, Johnston J, Finley ED. Ann Surg 2007;246:395-405.
  • 36. Best Practices Pre-Procedure Instructions  Reduce the risk of potentially life-threatening perioperative complications. Tea C. Perioperative concepts and nursing management. In: Smeltzer SC, et al, eds. Brunner and Suddarth’s Textbook of Medical-Surgical Nursing. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010:422-483. Courtesy of the Baltimore VA Medical Center
  • 37. Best Practices Pre-Procedure Instructions  Lower the incidence of preventable surgery cancellations. Henderson BA et al. Incidence and causes of ocular surgery cancellations in an ambulatory surgical center. J Catarct Refract Surg. 2006;32(1):95-102 Pletta C et al. Efficiency improvement plan through patient education on thyroid imaging procedures. J Nucl Med. 2008;49(Supp 1):426P Courtesy of the Baltimore VAMC
  • 38. Best Practices for Viewing, Downloading and Transmitting Patient Information
  • 39. Best Practices Discharge Instructions  Providing patients with incomplete information at discharge can result in patient harm. Pennsylvania Patient Safety Advisory. 2008. Jun;5[2]:39-43. Courtesy of the Portland VA Medical Center
  • 40. Best Practices Discharge Instructions  Reduced the 14-day readmission rate three-fold by employing procedurespecific discharge instructions (4.1 per 1,000 outpatient procedures to 1.5 per 1,000). Boast P, Potts C. PS&QH. 2010;7(1):14-16. Courtesy of the Portland VA Medical Center
  • 41. Best Practices Discharge Instructions  Most valuable if they are sent well prior to the 36hour threshold  Provided prior to admission  Paper as well as electronic
  • 42. Developing Initiatives in Your Own “Meaningful Care Organization”
  • 43. The Meaningful Care Organization Resources  Making Good on ACOs’ Promise — The Final Rule for the Medicare Shared Savings Program. N Engl J Med 2011;365(19):1753-1756. November 10, 2011.  http://www.nejm.org/doi/pdf/10.1056/NEJMp1111671  Meaningful Use – The Whiteboard Story – Stage 1 Final Rule Meaningful Use Objectives and Measures Compared to Stage 2 Final Objectives and Measures... Created as a reference tool for public use and convenience by The Advisory Board Company.  http://www.advisory.com/~/media/Advisory-com/CampaignItems/MUStage-2-White-Board-Story-Poster-2.pdf 43
  • 45. The Meaningful Care Organization “Meaningful Care” Checklist Yes  Is the initiative patient-centered?  Does it reduce risk?   Does it enhance safety?   Does it leverage the patient?   Can you utilize HIT (EHR or other systems)?   Does it support Stage 1 or Stage 2 Meaningful Objectives? 45   No
  • 46. Will a Focus on Patient-Centered Communications Impact the Selection of Treatments/Procedures and Potentially the Efficiency of an ACO?
  • 47. Potential Impact on Efficiency? Dartmouth Atlas Project  A series of nine reports of elective surgical procedures, released in late 2012, found wide variations in the treatments provided. Improving Patient Decision-Making: Regional Series. The Dartmouth Atlas of Health Care. http://www.dartmouthatlas.org/pages/decision_making_series (Accessed 5/10/13.)
  • 48. Potential Impact on Efficiency? Dartmouth Atlas Project  Mastectomy rates range from 0.3 per 1,000 female Medicare patients in the San Francisco area, to 2.3 in Grand Forks, ND
  • 49. Potential Impact on Efficiency? Dartmouth Atlas Project  The report authors surmise that patients may not understand their full range of options and choices may be unduly influenced by providers and not patient preferences. Improving Patient Decision-Making: Regional Series. The Dartmouth Atlas of Health Care. http://www.dartmouthatlas.org/pages/decision_making_series (Accessed 5/10/13.)
  • 50. Will a Focus on Patient-Centered Communications Impact Readmissions or Patient Satisfaction?
  • 51. Potential Impact on Readmissions/Satisfaction? Press Ganey HCAHPS Analysis  Press Ganey analysis of hospital readmission penalty scores vs. patient satisfaction scores.  Positive patient experience correlates well with low readmission rates and high readmission rates correlate well with poor patient experience. The Relationship Between HCAHPS Performance and Readmission Penalties. Press Ganey. http://healthcare.pressganey.com/content/201211-PIReadmissions (Accessed 5/10/13.)
  • 52. Potential Impact on Readmissions/Satisfaction? Press Ganey HCAHPS Analysis  The relationship between patient satisfaction and readmissions is not causal. Rather it is most likely predictive of an environment stratified by patient-centered communications.
  • 53. The Meaningful Care Organization Health Information Technology Stage 1 Stage 2 MU Objectives Stage 3 Patient-Centered Communications Patient Education Informed Consent Pre-Procedure Instructions Discharge Instructions Greater Patient Satisfaction Lower Readmission Rates More Efficient ACOs
  • 54. Questions? www.standardregister.com/healthcare www.dialogmedical.com www.EngagingPatient.org (slides posted here) Robbie Beck robbie.beck@standardregister.com Tim Kelly tkelly@dialogmedical.com