News

The cyber-threats are increasingly hitting healthcare organizations with great effectiveness, and the OCR is preparing to assist executives seeking to better protect their data and systems.

Making the healthcare system more patient-centered is the disruption the industry needs, said David Feinberg, MD.

Under the new Accountable Care Organization, Cigna will reward doctors for healthier populations and reduced expenses. 

The pressure to shift to value-based care means providers must understand their patients more deeply than in the past. Achieving that as part of a population health management program demands rethinking existing processes.

The number of chief nursing informatics officers has increased in health systems over the past five years, with more designated CNIO-positions than ever before. The bump comes at a time when the need to bridge the gap between clinical and informatics increasing, according to a recent report commissioned by the workforce search firm Witt/Kieffer.   The research team surveyed 100 respondents from medical centers, independent hospitals and hospitals part of a larger health system to examine the evolving role of the CNIO and whether organizations are recruiting for the position to support the informatics landscape. These results were compared to a similar survey conducted in 2011.   Overall, there are 10 percent more CNIOs in place in organizations than compared to 2011, according to Chris Wierz, principal, Witt/Kieffer Information Technology Practice. While some organizations have created the position of CNIO, others have modified roles to incorporate the CNIO title.   "CNIOs now have a 'seat at the table," Wierz told Healthcare IT News. "From a CNIO perspective, it's so much about collaboration and consensus building; getting those groups of people together when it comes to IT. It's always been about trying to bring disparate groups together to understand the workflow around the electronic medical records and today's IT."   "Communication is a very large role, as well," she added, "acting as a translator between IT and my clinical staff. The ability to articulate your knowledge of IT and clinical is critical in this role."   Depending on the organization, the CNIO is responsible for EMR implementation, clinical IT, optimization of nursing strategy as it relates to IT, and creating a picture of day-to-day operation on clinical IT matters, Wierz said.   Despite the need to bridge these departments, Wierz said there are still many barriers to overcome before the role becomes more commonplace. "One of the reasons this role isn’t gaining enough traction is that there's an IT resistance to it."   Some organizations are lacking the funding for establishing the CNIO position, while other hospitals indicated their organization wasn't big enough to require one, according to the survey.   "Some people will say the reason why they're not implementing a CNIO is because then are you going to need even more "chief" roles," she added. "It's going to be interesting to see whether the CNIO turns into a chief clinical role to help with daily operations."   Twitter: @JessieFDavis Email the writer: jessica.davis@himssmedia.com

CIOs and innovation officers point to companies such as Ikea, Lego, Oxo -- and how they have conducted observational studies to effectively understand UX and deliver products accordingly. 

Lake Health, with 14 facilities, staffed by more than 600 physicians and 2,700 healthcare professionals, will be rolling out a Cerner EHR. The goal: support the Lake Health system and its employed providers, as well as create greater integration with its community physician network and to provide the best patient experience possible. Also, patients will benefit from a single health record accessible from a patient portal. “A strong relationship with our medical staff is the cornerstone of who we are, evidenced by their role in our mission and vision statements and in working with us to provide high-quality patient and family-centered health care in Lake County,” Jerry Peters, VP and CIO for Lake Health, said in a statement. The EHR will enable the health system to share and receive patient health records with affiliated providers, other area hospitals and participating healthcare entities nationally. Patient data is produced, managed and stored across multiple care organizations in Lake County, Peters noted, and Lake Health was focused on selecting an IT platform that could collect and analyze data from multiple disparate systems. “Lake Health determined that Cerner’s EHR and Healthelntent population health management platforms were the best choice to support its future initiatives and business model,” Peters said. “Understanding that this investment would most likely shape the future of Lake Health and the care we provide to patients, we completed a thorough evaluation of leading health IT suppliers and collaborated with our physicians and ultimately determined that Cerner was the right choice to support our needs now and into the future.” Peters did not reveal the anticipated cost of the technology. Cerner’s Healthelntent platform aggregates and normalizes data from various sources in near real time, regardless of EHR supplier and is designed to provide physicians and mid-level providers with meaningful data to identify and stratify populations to locate gaps in care.

Over the past decade, the federal government has publicized 115 different ways to measure medical quality in hospitals, from assessing wait times in emergency rooms and noise levels outside hospital rooms to tracking blood clots in surgical patients. But the latest effort, to combine dozens of metrics into one patient-friendly quality indicator, has proven the most contentious. The Centers for Medicare & Medicaid Services recently postponed its plan to release the new rating system, which would award one star to the worst-quality facilities and five stars to those with the best marks. The delay came after a majority of members of Congress signed a letter supporting the hospital industry’s concerns. Hospital leaders who previewed the preliminary rating system say the formula seems skewed against institutions that treat the poorest or toughest patients, meaning those with complex illnesses. The number of stars would be based on 64 different measures, which are posted on Medicare’s Hospital Compare website. The metrics on mortality, readmission, patient experience and patient safety are the most influential, each representing 22 percent of a facility’s rating. Steven Lipstein, president of BJC HealthCare, a St. Louis-based nonprofit that runs 14 hospitals, said the ones in his organization that earned five stars were smaller, located in affluent areas and handled less complicated cases. “They don’t have comprehensive cancer centers, they don’t have major cardiovascular disease, they don’t have neuro-specialties,” he said. BJC’s more advanced hospitals did worse, he said. “That’s not surprising when you look inside the ratings and see how they’re built,” he added. Consumer advocates defend the rating system, saying that while not perfect, it correctly reflects higher rates of problems in some big institutions despite their lofty reputations. They worry that delay and congressional resistance are undermining Medicare’s attempt to help consumers select a hospital based on something more substantive. “The star ratings hopefully will get quality into that decision-making process,” said Andrew Scholnick, a lobbyist for AARP, the advocacy group for seniors. Medicare officials initially said they hoped to release the ratings to the public in July. But in a presentation to hospitals and other interested parties last Thursday, they did not set a firm date. Medicare already has made minor tweaks in the formula to calculate the stars, but it remains a tough grader, the presentation shows. If Medicare releases the star ratings in July, nearly half of the 3,658 hospitals being evaluated would be getting three stars, according to Medicare’s preliminary calculations. Just 100 hospitals would receive five stars, while 135 would receive a single star. Officials indicated they were standing firm in their intention to eventually release the scores. “The Overall Star Rating represents a performance summary designed to facilitate patient and consumer use of Hospital Compare,” the presentation said. Officials plan to update the scores every three months through the end of this year and then twice thereafter. The broader debate about the government judging hospitals has been going on since Medicare began publishing quality ratings in 2005. But it has intensified since passage of the Affordable Care Act, which instructed Medicare to use quality metrics in setting payments. Teaching hospitals as a group have tended to fare poorly from some of these financial incentives. This year, for instance, nearly half of major teaching hospitals are losing 1 percent of their Medicare payments because of high rates of infections and surgical complications. Facilities with more low-income patients, who often face difficulties affording medication, following complicated recovery instructions and getting to doctors regularly, typically have higher readmission rates. Some health care researchers are also skeptical. “If you come out with a rating that says Cleveland Clinic is terrible but podunk hospital in North Carolina, they’re the bomb, there’s a disconnect,” said Ashish K. Jha, a professor at Harvard’s public health school. “If it completely contradicts everything you’ve known, you need to ask yourself, ‘Did I not understand the way hospital care works, or is there a problem with the metric?’” Medicare’s move toward using star ratings is part of a greater focus on easy-to-grasp composite judgments of hospital quality. The Leapfrog Group, a nonprofit patient safety group, uses report-card letter grades to characterize hospital safety based on many of the same individual measures as Medicare. Healthgrades, a Denver-based company, judges hospital quality with one, three or five stars. Consumer Reports calculates a safety score on a 100-point scale. Medicare hopes a star rating from the government will carry even more credibility. “People need this information now,” Scholnick said. “Trying to wait until everyone’s 100 percent happy with everything just delays it further than it needs to be.” This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.  

At Healthcare IT News' inaugural Pop Health Forum 2016 in Boston May 19 and 20, clinicians, technology professionals and healthcare experts from across the country are gathered to explore the key enablers of effective population health management strategies: data and analytics, care coordination, patient engagement and more. Check back here for continuous updates.

Decisio Health, a startup that aims to help acute-care provider organizations continually improve their clinical processes, launched the Decisio Health Clinical Intelligence Platform Tuesday and also announced $4.5M in Series A funding.