Accountable Transitions for Accountable Care

As we venture further into 2014, we start to see healthcare delivery organizations investigate their care delivery capabilities and costs associated with delivering high quality care to their patient population, and they may do this at a cost that is higher than they have seen in the past. Now more than ever, healthcare organizations would have to understand and change the way in which they deliver care and improve their processes greatly in order to cut out redundant processes and improve their operational workflow.

Some of the innovations that may already be prevalent in many other industries, but may be appropriate to adopt within care delivery providers are solutions around the visibility to organizational projects through an executive dashboard that would give operational, clinical and information technology leadership opportunities to transparently collaborate on initiatives like the ICD-10 transition, EMR implementations and optimizations and of course Meaningful Use initiatives organization wide.

Politically and culturally within the industry, these kind of initiatives are not easy to implement as it would require a cultural shift in the way the organizational environment operates. Can you influence your clinical leadership to understand that a “red” status may not always be a bad thing, depending on how you look at it. The ability to shift resources towards mission critical initiatives in an agile way will give a provider organization the nimbleness to move at the speed that the new paradigm requires of them.

The organization that can implement this in a well thought out way, will need to bear in mind the lessons of the past of things such as in-network and out of network costs to the member of a payer organization and keeping in mind what’s best for the patient might not always be what’s best for the care delivery provider organization.

Utilizing technology for such things are multidisciplinary clinic meetings to track progress through teleconferencing and be able to treat patients only with certain health concerns may be a first step in the process improvement arena before rolling out much more exhaustive improvement list.

The question to ask is where does the continuum of care end for an Accountable Care Organization? As we develop a models for payers and providers collaborating for both theirs and the patient’s benefit. An example of a great collaborative initiative is last week’s announcement in Healthcare IT News that Sutter Health joined Heritage Group and Kayne Anderson Capital Advisors (both VC firms) to collaborate in a $23.6 million deal with the telehealth software company MDLIVE, which touts itself as a cloud based, HIPAA compliant platform. Such innovations and development of out of the box thinking is the future of healthcare and will help healthcare organizations contain costs and build the collaborative tools that healthcare in the United States can finally regain the leadership in the information technology arena that was needed for many years.

Empathy and the Patient Experience

How is the experience of patients tied to the overall empathy index of an individual? As healthcare provider organizations move forward with their Patient Engagement initiatives, where does empathy play a part in this overall initiative? How will the interaction between a physician and a patient affect the overall patient experience with technology such as portals and smartphone apps. You will see this theme over a series of blog postings that will post soon. I am fortunate to have the opportunity to know an expert in the field of empathy.

Roman Krznaric is a cultural thinker and writer on the art of living. He is a founding faculty member of The School of Life in London, which offers instruction and inspiration on the important questions of everyday life, and advises organisations including Oxfam and the United Nations on using empathy and conversation to create social change. He has been named by The Observer as one of Britain’s leading lifestyle philosophers.

He regularly speaks at public events on topics such as empathy, the history of love, the future of work, and the art of living. Recent appearances include the Edinburgh International Festival, the Latitude Arts Festival and the London Design Festival. His media work ranges from articles in the Guardian and Wall Street Journal to interviews on BBC Radio 4’s ‘Today Programme’, Channel 4 and PBS television in the United States.

During this year, I’ll collaborate with Roman and get his thoughts to share with you, about empathy’s influence and footprint within the healthcare technology landscape with some insights from him and his musings of the state of the world we have been living through and what he sees are technology’s effects on healthcare delivery both nationally and internationally from his home in the U.K. He has also just launched the world’s first online Empathy Library .

How will patients deal with both their providers and technology in the 21st Century? Britain’s experience with healthcare technology has been mixed and there the patient population is much smaller and there is only one payer in that nation, unlike in the United States.

With Meaningful Use initiatives in Stage 2 for many organizations, the country is set for a new wave of healthcare patient care and technology adoption culture that continues the initiatives started earlier and gains momentum in 2014 with paradigm shifting healthcare organizations. Get yourself ready for a new state of mind.

Healthcare Calibration, Communication and Collaboration

Watching my son play basketball, I reflected on how great team dynamics was the cornerstone of a good game. Making sure you understand the basics; traveling, defense, backing up your offense when you are making the shot and being prepared for those rebounds that invariably will come your way. Sometimes, you’ll know the players on the other team, because they are friends with you at school and sometimes, at away games, you don’t, so you are all that more cautious.

During a recent healthcare provider project of mine, we leveraged an opportunity to go back to the basics as we interacted with some of the local community healthcare Project Managers to make sure we didn’t re-invent the wheel and collaborated on strategy and planning and tips on better methods of execution for the projects that were all ICD-10 Transitions. The organization that was ahead of the rest due to the fact that they started their ICD-10 project prior to CMS delaying this mandate by a year from October 1st of 2013 to October 1st of 2014, shared their Integrated Test Scripts that they used prior to their Dual Coding go live was awesome for community collaboration.

Calibrating your plan for the year through a collaborative and communication filled approach and thinking about how to make it a winning, long term strategy will have you getting better over time and not forcing improvements, but subtly progressing it will give you change through small, but important increments, rather than a faster, big bang approach that will cause challenges with your physician and clinician community is always the biggest obstacle for technology adoption. The Dual Coding period that many medical record departments will be in by around 6 months prior to October 1st 2014 will be good for the provider community to finally transition to this new 21st century coding system and bring the United States on par with the global community.

As I type this, the team is down on points, but I know that they have made tremendous strides since that first game. Now, the team and coach better understands each players strengths and weaknesses and are able to calibrate their game accordingly.

For more information about the ICD-10 Transition this upcoming October 1st, 2014, go to

Your Smartphone App will see you now! Has Telemedicine come of age?

Welcome to 2014 and the future of healthcare IT.

My blog has been about how to make understanding healthcare and the information and technology that surrounds it as easy to understand as I can make it! Whether you are from IT, healthcare or an interested stakeholder as only a patient can be.

One of the areas that has taken on new life is telemedicine. Formerly reserved for the likes of NASA or inter-governmental assistance such as helping far away earthquake disaster victims get medical attention, telemedicine is taking on new life due to the pervasiveness of smartphone and secure messaging technology.

An article recently published about how patients are using an application on their smartphone to be able to find a community physician, securely communicate with them, share photos of an injury for instance and then get advice, such as scheduling an MRI for a potentially broken ankle, from the comfort of their homes.

One question that comes to mind is how will these patient encounters get billed (or will there be a certain number of “free encounters”) before a claim get generated? How will patients react to being billed for these encounters as this will relate directly to the patient experience and patient engagement initiatives?

This is the next frontier of healthcare IT.

Welcome again to 2014!