Industry Watch – October 2017

Sept. 26, 2017


Q&A with Jonathan Porter

Senior Vice President, Network Services, athenahealth

Q: What are athenahealth’s population health initiatives?

Population health is such a broad, all-encompassing term; even vendors specialize in a few different ways. First, there are vendors that concentrate on the analytics of population health management, i.e., analyzing a population of data and slicing it so focus areas can be found and targeted. Second, we have those who specialize in clinical interoperability—who extract data out of systems and provide a single view of a patient. And third, there are the workflow-oriented vendors, who concentrate on performance and driving results. athenahealth does all of these, but we do the workflow extremely well.

We are 100,000 providers on a national network and we’ve taken on the responsibility of helping providers make the shift from managing episodes of care to managing the entire patient journey across the full ecosystem of care.

Care management is moving beyond the hospital into outpatient resources like urgent care centers and virtual consults. With so much of what matters occurring between visits, care managers need that full, 360-degree view of patients and an ability to engage them and coordinate care at every step.

We have an outreach manager service within our population health solution that allows providers to connect with patients via phone/email campaigns. We take on much of the work of identifying and addressing gaps in care by aggregating the data, determining the gaps, and launching outreach campaigns on our clients’ behalf. Live athenahealth operators schedule appointments freeing staff from time-consuming manual outreach to concentrate on higher priority duties. To date, the campaigns average a 40% patient schedule rate.

We’ve also invested big time in the patient space, equipping patients (and caregivers) with the tools and resources to become capable, empowered, and active participants in their own care.

We have a patient self-management app (athenaWell) that works on any device and provides patients with care plans they can engage with on their own time. A typical approach would be to enroll the top 5% of the riskiest Congestive Heart Failure (CHF) patients in care plans supported by care managers. However, the predictors aren’t always accurate and the health system doesn’t always follow the “right” 5%. Instead, athenaWell puts all CHF patients on a care plan—not just the top 5%. We know care managers can only monitor a small subset of patients, so the idea is to lever them up. For example: Every day when a CHF patient steps on a smart scale, it syncs with athenaWell. The care manager will only get an alert if the patient’s weight is out of range and can reach out immediately to touch base. Using athenahealth technology, we surface the most at-risk patients while monitoring the entire population, thereby making care managers more efficient and taking work off their plate.

Q: Where is the future of population health going?

Everything is moving toward the consumer, and we’re seeing an uptick in patient engagement tools to help manage populations.

To be frank, it can be difficult to establish and support the free flow of patient information across settings and get that 360-degree view, particularly when 50% or more of care is considered “out-of-network.” By building a healthcare network that seamlessly interoperates, athenahealth has taken a crucial first step toward overcoming this challenge to connectivity and sharing data critical to successful health outcomes. Population health programs must move beyond the single health system to be truly patient-centric.

In the near future, when we partner with an organization to drive outcomes, anyone involved in the patient’s care—in or out of network—will be able to use our tools. No organization can be an island, nor can vendors be stingy about access. Industry-wide, I predict a lot more of this. Healthcare systems must realize even though there’s stiff competition in market, they must work together to be successful in their population health goals.


App detects pancreatic cancer from the whites of your eyes

Pancreatic cancer has a very low survival rate, with just 9% of patients surviving past five years. A major contributor to this rate is the fact that once those with pancreatic cancer start to show symptoms, the disease is usually already quite advanced. But researchers at the University of Washington have come up with a simple and incredibly accurate way to test for the cancer that people can administer themselves.

Courtesy of Dennis Wise

The team developed an app called BiliScreen and with a smartphone’s camera, it uses computer vision algorithms to detect levels of the chemical bilirubin in the whites of a person’s eyes. With pancreatic cancer, bilirubin levels start to increase and eventually, it turns the whites of the eye yellow, which is also the case for hepatitis. However, when that yellowing becomes noticeable, the cancer is already very developed.

BiliScreen is able to detect very low levels of bilirubin and provide users with an assessment of whether their levels are high enough to indicate possible disease. This is easier and cheaper than a blood test, which is the traditional test for the cancer, and can be done before any symptoms start to show.

In order to take lighting into account, the app can be used with either a special box that blocks out ambient light or paper glasses with colored squares around the edges to which the app is calibrated. With the box, BiliScreen was around 90% as accurate as a blood test in identifying concerning levels of bilirubin in a small, 70-person clinical study. University of Washington


Survey reveals majority of patients struggle to pay medical bills, foregoing care due to cost

The West Insights & Impact Study titled, “Optimizing Revenue: Solving Healthcare’s Revenue Cycle Challenges,” reveals more than half of Americans are delaying payment on medical bills—citing high-deductible health plans and confusion over insurance coverage as the primary reasons. The study also uncovers the financial impact on providers who are finding it more difficult to drive timely payments, grow revenue and maximize reimbursements.

As the financial impact of value-based payments becomes more evident, the study also examines where providers may be missing out on opportunities to leverage existing resources—like technology-enabled communications—to solve revenue cycle challenges.

Study highlights include the following:

Healthcare costs fuel payment problems.

  • 79% of patients say affordability is the biggest problem with healthcare.
  • 93% of healthcare consumers believe healthcare is too expensive.
  • Two-thirds (67%) of patients say their financial situation makes it difficult to pay their medical bills on time.
  • 42% of patients delay payments for medical bills because of unexpectedly high deductibles.
Courtesy of West

Healthcare providers are facing significant revenue challenges.

  • 56% of Americans delay paying their medical bills at least some of the time.
  • 77% of patients say high insurance deductibles impact how often they visit their provider.
  • 75% of patients say high deductibles impact how often they see their provider.
  • 95% of providers recognize that patients may delay bill payments because of their financial situation.

Providers are missing opportunities to solve revenue challenges. For example:

  • Only 23% of providers make it a habit to discuss each patient’s ability to afford healthcare prior to delivering services.
  • Just 21% send automated reminders to notify patients that a payment is due.
  • A mere 15% of providers currently send messages—either by phone, text or email—to explain bills and let patients know what portion of the cost is covered by insurance. West


Pharmacogenomic application integrates drug-gene and drug-drug data into single screen interface

Translational Software (TSI) announced a new pharmacogenomic application called Medsreview to help healthcare providers review and reconcile drug-gene and drug-drug interactions using a single screen interface to guide clinical decision making, minimize adverse reactions, and enable physicians to prescribe the most effective medications in real-time.

Developed as an application for use with TSI’s Fast Healthcare Interoperability Resource-based PGx application programming interface, the single screen user-interface allows healthcare providers to quickly understand all drug-gene and drug-drug issues for each tested patient within the existing clinical workflow, eliminating the need to print out lengthy PDF reports or toggle between separate drug-gene and drug-drug analytical systems to determine patient therapies. Physicians and pharmacists can access and review color-coded alerts for all known medications for which treatment regimens should be personalized on the basis of the patient’s genetic test results, coupled with recommended medication alternatives.

Medsreview integrates FDB Cloud Connector, a web service that delivers FDB’s drug-drug interaction content via the cloud for use with TSI’s pharmacogenetic knowledge base and interpretation platform. Available through TSI’s provider portal or as an embedded application via the company’s PGx API, the application enables labs, healthcare facilities, and information system vendors to incorporate PGx capabilities into existing electronic health records, e-prescribing, and medication management systems without specialized knowledge or extended development. Business Wire

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