As part of the Masters Program in Health Informatics, I produced videos on The Role of Informatics for Accountable Care Organizations. Links are below. I will be updating this post with videos each week.
Key Learning Objectives are:
Link: Medicine's future?
Daniel Kraft offers a fast-paced look at the next few years of innovations in medicine, powered by new tools, tests and apps that bring diagnostic information right to the patient's bedside.
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Daniel's presentation is fascinating - there are a significant number of new technology applications on hte market, some still in clinical trials. However, he shows us the potential changes that can come from their use in medicine with real examples, including those for Telemedicine.
Video Link: Informatics and Technology
Internet resources can provide benchmarks and analysis for Medicare Populations.
The CMS Chronic Conditions Data Warehouse website is located at www.ccwdata.org. As described on the site, the warehouse provides Medicare and Medicaid beneficiary claims and assessment data, linked by beneficiary across the continuum of care. This website provides dashboards that provide the ability to look at chronic conditions, by age, by location, or demographics. Other websites provide dashboards of health outcomes by state and zip code.
The amount of data collected by ACOs will grow rapidly over time and become a critical source for measuring quality of care, costs and operational efficiency. Generally, ACOs need to either build or outsource development of a central data warehouse to gather, store and analyze data. Development of a data warehouse happens to be one of the challenges of a big data implementation. Three characteristics of big data include size, complexity, and technologies. EMRs are optimized for rapid data input of transactions. Often there are a number of standard reports that can be produced for a given period of time, or as of the date they are run. A key aspect of transaction systems is also the amount of “care and feeding” they require. For example, updates, backups, disaster recovery, etc.
Link: ACO Informatics Video
Accountable Care Organizations have the task of gathering patient data from wherever it may originate. Care Coordination may also occur wherever the patient is located. Successful strategies for care coordinators begin even before a patient is discharged from the hospital.
Managing large amounts of data requires a robust infrastructure of databases, networks, and the ability to exchange data among ACOs. Analyses of large databases typically use regression analysis techniques for prediction and forecasting. Regression analysis may identify clinical predictors of health that alert staff to declining health situations or when interventions are needed. One of the biggest successes noted by ACO executives was to use predictive analytics to identify high-risk patients for proactive care.
Challenges and barriers related to informatics and technology are often reflective of the knowledge needed to use tools to analyze data. Other barriers include financial investment and operating costs. In addition, hospitals and clinics must be able to exchange patient data for episodes of care in the emergency department, in-patient stays, or clinic visits. Many ACOs use HIEs or Health Information Exchanges to share data not only from hospitals and clinics, but also from specialty providers. CMS Claims data is received monthly and should be stored in a database for analysis. Registries, CMS Reporting, GPRO and performance data sites require secure Internet access. The HITECH Act provides regulations to ensure Privacy and Security of protected health information using various technologies. Of course it should be noted that none of these technologies come without their share of operating costs and can become barriers when knowledgeable staff are not available.