New Cancer Care Payment Model Benefits Doctors and Patients

Submitted by Physicians News on 09/11/2014 – 8:35 AM

By Anju Sikka, M.D.

A new study shows that changing the way insurers pay for cancer care can lower costs by 34 percent without affecting the health outcomes of the patient.

UnitedHealthcare conducted the study with five medical oncology groups around the country over a course of three years.  The study covered 810 patients with breast, colon and lung cancer, which are among the most common cancers in the United States, according to the National Cancer Institute.

The pilot program compared the traditional “fee-for-service” payment model with a bundled payment model.  Under the traditional fee-for-service payment model, oncologists are paid for each service they perform and drug they prescribe.  Instead of rewarding quality care, the fee-for-service model tends to reward volume of care and the use of more expensive drugs.

Under the new payment system, UnitedHealthcare paid oncologists upfront for an entire cancer treatment program, based on the expected cost of a standard treatment regimen for the specific condition as predetermined by the doctor.  The oncologists were paid the same fee regardless of the drugs administered to the patient – in effect, separating the oncologist’s income from drug sales while preserving the ability to maintain a regular visit schedule with the patient. Patient visits were reimbursed as usual using the fee-for-service contract rates, and chemotherapy medications were reimbursed based on the average sales price.

The oncology groups collaborated with UnitedHealthcare to develop more than 60 measures of quality and cost to compare the performance across groups and determine how to improve quality and reduce costs over the course of the study. There were no differences between the groups on the quality measures evaluated, which challenges the assumption that any reduction in resources, such as medical staff, would result in worse outcomes for patients.

Researchers evaluated the treatment regimens based on the number of emergency-room visits, incidence of complications, side effects and, most importantly, health outcomes to determine which treatment regimens do the best job of helping to fight cancer. By measuring the comparative effectiveness of different treatment options, the program aimed to uncover best practices, and identify and reduce unnecessary drug administration that does not improve the patient’s health.

The upfront fee to the oncologists covered the standard treatment period, which is typically six to 12 months. In cases of cancer recurrence, the bundled payments were renewed every four months during the course of the disease, which allowed the doctor to continue overseeing his or her patient’s care even if drug therapy was no longer effective. The payments also were continued for patients who were no longer receiving chemotherapy or who enrolled in hospice care.

This approach was designed to reward oncologists at current levels for patient care while simultaneously severing the link between drug selection and income. Physicians could earn increased episode payment by improving their patient results. UnitedHealthcare did not play a role in determining which treatment plan the oncologists chose.

With a 34 percent reduction in costs and no adverse effects on patient health, the results of the study suggest that the new cancer care payment model have the potential to benefit patients, doctors, insurers and the entire health system.

The details of the study were published in the Journal of Oncology Practice.

Empowering Engagement through the Adoption of Patient Portals

Who is using your patient portal? What is the health literacy of your population? Has your organization reaped the incredible benefits of actively engaged patients? If not, the time to act is now!

Patients who have more knowledge, skill, and confidence in managing their health, and who are more adept at navigation and using the health care system, appear to incur lower costs.

According to the Robert Wood Johnson Foundation, people who are actively engaged in their health care are more likely to stay healthy, while those who lack the skills and confidence to manage their own care often require more of it and incur up to 21 percent higher health care costs.

Utilization of patient portals is also a key exercise for satisfying Meaningful Use (MU) requirements.

Now patients must participate in order for the EP to meet Meaningful Use Stage 2.

Consider these new measures for 2014:

• More than 5% of patients must send secure messages to their EP
• More than 5% of patients must access their health information online (via a patient portal)

Are you satisfied with your Return on Engagement?

Health engagement, and in particular bolstering activation and health literacy, delivers a win-win for individuals to achieve optimal health outcomes.If you are looking for a new and innovative approach, mHealth Games can help! Health information can confuse anyone. mHealth Games helps patients and caregivers better understand and act on health information. 

Consider the power of a universal language such as games...

A recent study from the American Journal of Preventative Medicine examined the effects of gaming on health outcomes, and video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 46% of clinician skills outcomes, 42% of health education outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. 

Take the mHealth Challenge

Have you been considering gamification? If so, we can help you for free! Visit us online at www.mhealthgames.com to find out how you can partner with mHealth Games to create something awesome!

Samsung unveils wristband that can measure health, fitness

Samsung Electronics Co Ltd moved deeper into the wearable technology market on Wednesday as it unveiled a wristband that it claims can give a range of real-time health and fitness information.

At a press event in San Francisco, the world's biggest handset maker announced Simband, a new "investigational" device that can be used to measure body temperature, blood oxygen levels, motion and other metrics on a continuous basis.

The prototype "smart" band is not intended to be sold as is but serve as a "foundation" for third party developers to build a device that incorporates "optical, acoustic and electronic sensors," Samsung's vice president of digital health Ram Fish said.

Young Sohn, president and chief strategy officer for Samsung Electronics, speaks in San Francisco. Photo: AP/Ben Margot

"We want to bring in talent from the outside," said Young Sohn, president and chief strategy officer for Samsung Electronics' Device Solutions.

Samsung unveiled the Simband at a time when Apple Inc is said to be developing its own wrist device to compete in the wearable technology sector.

Executives for the Korean company said Simband features a shuttle battery, which charges when the wearer is inactive, and is equipped with Bluetooth and Wi-Fi.

The device was developed in concert with researchers from Belgium-based IMEC and the University of California San Francisco.

This new platform goes hand-in-hand with Samsung Architecture Multimodal Interactions ("SAMI"), a "bank" to store sensitive health data on the Galaxy S devices. The goal for SAMI is to gather data from various health and fitness applications, and offer "insights" to consumers, Samsung said.

Ram Fish, Vice President of Digital Health for Samsung Electronics, displays the Simband he is wearing on an overhead screen in San Francisco.Photo: AP/Ben Margot

"Samsung doesn't own the data, you do," said Fish. "We are a custodian of it."

Samsung plans to market SAMI by hosting a developer challenge and setting aside a $50 million fund for early-stage digital health entrepreneurs. Sohn said the company has already begun investing, recently providing funding to an early-stage entrepreneur building a noninvasive glucose monitoring solution.

The company has struggled to woo developers in recent years, notably with Tizen, its operating system that competes with Google Inc. Samsung may fail to gain much traction with wearable device makers, sources said.

Sohn declined to comment on Apple, which is rumored to be building its own wearable iWatch.

Ram Fish, Vice President of Digital Health for Samsung Electronics, gestures while speaking in San Francisco. Samsung executives are outlining their vision for sensors that track fitness and other gauges of health. Samsung is pushing for a common system so that different manufacturers can interchange key parts such as the wristband. Photo: AP/Ben Margot

Samsung's announcement could be seen as a preemptive move, with Apple hosting its much-anticipated developer conference in less than a week.

Samsung plans to provide more specific information about both new platforms at its own developer conference, which is expected to take place in November. Sohn said the research and development teams are already exploring "locations" for wearable devices other than the wrist.

http://www.hindustantimes.com/technology/gadgets-updates/samsung-unveils-wristband-that-can-measure-health-fitness/article1-1223993.aspx

Video games of to adapt to players' mood

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IANS

San Francisco, April 26 (IANS/EFE) A team of engineers at Stanford University has developed a hand-held controller that allows video games to adapt to a player's level of engagement.

For instance, if a player's heart rate, blood flow, rate of breath and other physiological signals show he or she is bored with an unchallenging game, the controller can gather that information from the individual's hands and increase the level of difficulty.

 

When players are engaged, their heart rate and breathing generally become faster, Gregory Kovacs, a professor of electrical engineering at Stanford and head of the laboratory where the prototype controller was developed in collaboration with Texas Instruments, told EFE.

 

The engineers removed the back panel from an Xbox 360 controller and replaced it with a 3-D printed plastic module equipped with sensors that measure gamers' blood pressure, heart rate, temperature and breathing rate and depth.

 

Users' arms and hands transmit signals that indicate what is happening internally, the professor told EFE.

Created in Kovacs' laboratory under the leadership of doctoral candidate Corey McCall, the controller has sparked the interest of several companies in the video game and entertainment industry.

 

This non-invasive system for measuring autonomic nervous system activity has numerous applications beyond the world of gaming, Kovacs said, noting that it could be used to prevent traffic accidents.

 

Sleepy drivers continue to be a major cause of car crashes, he said, adding that many lives could be saved by using sensors on the steering wheel to monitor motorists' level of alertness.

 

 

 

http://www.ianslive.in/index.php?param=news/Video_games_of_to_adapt_to_players_mood-420408/SCI-TECH%20and%20HEALTH/36

 

 

 

 

Medical advice without visit to a doctor

E-visit a doctor: A new service allows patients to send an electronic message to Sanford Clinic, hear back from a doctor and have a prescription sent to a pharmacy. Reporter Jon Walker interviews a Sanford official and a patient 

A visit to the doctor now comes without the visit.

Sanford Health has begun offering an electronic option in clinical care. A patient with a health problem can sit at a computer, type a summary of symptoms, attach a credit card number and hit the send key. A response from a Sanford provider with a prescription or medical advice comes back in four hours or less. It costs the patient $55.

The format depends on a patient’s skills in self-diagnosis and the medical system’s ability to respond without any conversation or face-to-face interaction, but it’s mostly a bow to consumer convenience in the computer age.

“It’s so a patient can receive information they can trust as opposed to just Googling,” said Louise Papka, a physician assistant in acute care for Sanford.

Michele Kleinwolterink, 44, said it helped her. She could feel a sinus headache developing two weeks ago as she drove to her job as executive assistant at Bluestem, a private equity company in downtown Sioux Falls.

“I knew I needed to go to the doctor but it was a busy day,” she said. “Sinus headaches don’t just go away. You need meds as soon as possible.”

From her desk, she logged on to her account at My Sanford Chart, the health system’s online records platform. A prompt directed her to an e-visit page, where she answered questions and described her condition in a box allowing a narrative up to 250 characters.

“You answer the same questions you would in the doctor’s office and tell them about your pain,” she said.

It took her 10 minutes. She filed her request and waited.

Sanford pledges a response within four hours but says the average is half that time. It was shorter for Kleinwolterink.

“It only took 10 minutes ... to get an email back from a doctor and they said, ‘You have a prescription waiting for you at your pharmacy that you selected,’” she said.

Sanford has been doing a trial run with the program and last week began offering it to all patients in South Dakota, Iowa and Minnesota. It hopes to add North Dakota this summer. Patients filing an e-visit likely are not communicating with their own doctor but with someone in Sioux Falls who is either a physician or an advanced practice provider such as a physician assistant or nurse practitioner. Sanford has been receiving 20 to 30 requests a week.

7 nonemergency conditions covered

It’s only for adults, only for patients enrolled in the My Chart program and only for seven conditions that are not emergencies. The seven are sinus headache, pink eye, urinary tract infection, vaginal discharge, diarrhea, cough and back pain.

Helping patients control their health

Self-diagnosis plays to a Sanford goal of having patients take ownership of their own welfare, which is one pillar of the national health reform movement. Patients still will visit clinics to see doctors, and they still can call for what still is free advice over the telephone. The e-visit is an option for those with relatively minor problems, who prefer texting and don’t want to sit in a waiting room.

“A lot of problems, a patient is looking for confirmation,” said Dr. Dan Heinemann, chief medical officer at Sanford Clinic. “They don’t have anything serious that they can’t continue to manage at home. ... If I have chest pain, this is not going to do it. But if I have a cough, it’s relatively easy.”

Medicare doesn’t cover an e-visit, but some insurers do. Kleinwolterink said she paid $25 of the $55 fee with a credit card and that Blue Cross Blue Shield covered the rest.

The health charts are a secured format requiring membership and a password entry to ensure privacy. Identity fraud is always a concern in health care, with the intent usually to misuse insurance. The e-visit, though remote, is reliable communication, said Terri Carlson, vice president at Sanford Clinic.

“Our risk folks prefer this over telephone calls. We have objective data in the questions patients have answered,” Carlson said.

Sometimes intimate details in writing

Still, the e-visit marks a cultural shift for patients to commit to writing private details about their health in order to communicate with a website. Some of the seven conditions, such as sinus headaches and back pain, are generic problems, while the others are more intimate.

“It’s a sign of the times to be using technology ... to be making that connection between the consumer and the health care market,” said Lorna Saboe-Wounded Head, assistant professor of consumer affairs at South Dakota State University. “With the social networks, maybe people are more willing to explain the problems they have, even if it’s very personal.”

Safeguards for prescriptions

Randy Jones, executive director of the South Dakota Board of Pharmacy, said health providers are allowed to prescribe drugs by electronic format without seeing a patient. It should be an established patient-doctor relationship that includes safeguards to prevent prescriptions that are improper or premature, he said.

“If they say I’ve got this hacking cough, do they know if it’s viral or bacterial without a lab exam? The answer is no. I would have some concerns,” Jones said. “If the prescriber has valid concerns, they should require that patient to come in for a physical exam and potential lab tests.”

Sanford says it has those safeguards in place. Under those circumstances, “it can be done with care,” Jones said.

Heinemann said the questions a patient must answer serve as a filter.

“If a patient says in an e-visit, ‘I’m really short of breath, I have pain when I breathe,’ those are red flags and probably the individual needs to get in to see a doctor,” Heinemann said. “Most of the time ... I think we can do a pretty good job without seeing the patient.”

http://www.argusleader.com/article/20140325/NEWS/303260002/Medical-advice-without-visit-doctor

Google Glass could be a powerful tool for disruptive innovation in healthcare.

I joined the Glass Explorer Program and have started using Google Glass with a focus on finding medical uses for this type of wearable computing technology. While I believe that it is analytics capabilities that will allow us to realize the value of health information technology, the convergence of hardware and software combined with an explosion of wearable sensor technology is providing powerful opportunities for some disruptive innovation in the healthcare marketplace and the practice of medicine.

Charles Webster, MD got me really interested in the potential with his presentation Google Glass and Healthcare Information and Workflow at the 2014 Healthcare Systems Process Improvement Conference held immediately before HIMSS 2014. Chuck has been posting about Google Glass for some time and one of his posts on the HIMSS Future Care blog is well worth reading. Some of the insights he brought in the post are:

"There’s lots of interest in Glass use by surgeons, EMTs, and nurses, for hands-free and real-time access to critical information. It’s justified. But there’s also been negative speculation about threats to patient privacy. What will patients think when they see their physician wearing Glass. In my opinion, it will become just another tool they associate with healthcare workers (less obtrusive than the head mirror that used to be a symbol of the medical profession). The bigger question should be, what will physicians and others think when they see a patient wearing Glass?"

I decided it was finally time to take the plunge and become a Google Explorer and got my Google Glass just in time for the annual HIMSS conference to end. For those who have not yet seen Google Glass or don't understand how they work, it is basically a computer strapped to your head in the form of a pair of glasses. It has a heads up display, voice activation and growing number of apps. Check out the Google Glass homepage to learn more. When you think about having all of the technology of a smartphone, and then some, incorporated into a pair of glasses it boggles the mind as to the various use cases for healthcare. I want to outline just a few and then think about what other innovative possibilities this type of technology could bring to the industry.

Last year Dr. Rafael Grossman, a surgeon and one of the Google Explorers based in Maine, used Google Glass during a Percutaneous Endoscopic Gastrostomy procedure. He was careful to not stream any sensitive data out via Google Glass and wrote about theexperience on his blog. He said, "Obviously, the one of the main concerns regarding the use of Google Glass during surgery, with live streaming of data, would be to take every measure and to ensure the privacy of the patient’s health information." Using Glass in healthcare certainly faces some serious privacy and security considerations. But this technology also seems to be very well suited to solving some vexing industry problems such as emergency medicine, some surgery applications, and telemedicine to name a f.

Steven Horng, MD MMSc at BIDMC
John Halamka, MD pointed out to me that over the past few months, Beth Israel Deaconess Medical Center has been the pilot site for a new approach to clinical information technology, wearable computing. In the Emergency Department, they have developed a prototype of a new information system using Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor. When a clinician walks into an emergency department room, he or she looks at a QR code on the wall. Google Glass immediately recognizes the room and then the ED Dashboard sends information about the patient that is in that room to Glass. The clinician can speak with the patient, examine the patient, and perform procedures while still seeing problems, vital signs, lab results and other data in view on the Glass screen. Beyond the technical challenges of bringing wearable computers to BIDMC, there were other concerns: protecting security, evaluating patient reaction, and ensuring clinician usability. I appreciate the measured approach BIDMC has taken in developing the potential for Google Glass and am looking forward to seeing how this works out.

An internal communication at BIDMC states that staff has definitely noticed them and responded with a mixture of intrigue and skepticism. Those who tried them on briefly did seem impressed. I would be very interested in knowing how patients respond. Already, even bars in San Francisco are banning Google Glass so I can imagine that as word gets out there will be some consternation among certain patients visiting the ER. However, they have fully integrated with their EHR's ED Dashboard using a custom application to ensure secure communication and privacy safeguards. They also replaced all the Google components on the devices so that no data travels over any Google servers and all data stays within the BIDMC firewall. They will soon begin a trial of Google Glass for all providers in the Emergency Department and study patient and clinician impressions, and the usage patterns of staff.

"Over the past 3 months, I have been using Google Glass clinically while working in the Emergency Department. This user experience has been fundamentally different than our previous experiences with Tablets and Smartphones. As a wearable device that is always on and ready, it has remarkably streamlined clinical workflows that involve information gathering," said Steven Horng, MD MMSc who teaches at Harvard Medical School and works in the ED at BIDMC. After a patient presented with a massive brain bleed and was unable to communicate information concerning medications and allergies, there was serious danger to the patient. "Google glass enabled me to view this patient’s allergy information and current medication regimen without having to excuse myself to login to a computer, or even loose eye contact. It turned out that he was also on blood thinners that needed to be emergently reversed. By having this information readily available at the bedside, we were able to quickly start both antihypertensive therapy and reversal medications for his blood thinners, treatments that if delayed could lead to permanent disability and even death. I believe the ability to access and confirm clinical information at the bedside is one of the strongest features of Google Glass," said Dr. Horng via email.

Google Glass is also being used at Rhode Island Hospital’s emergency department. As reported in the Providence Journal they will use Google Glass technology to stream live images of a patient’s medical condition to a consulting specialist located elsewhere. If this pilot is successful, project coordinator Dr. Paul Porter envisions an ambulance crew someday responding to a stroke victim, using the eyeglass technology to provide real-time video and audio to a neurologist back at the hospital who could then order a clot-busting, brain-saving drug immediately. "That would be like the Holy Grail," says Porter."“But we’re just at the beginning; you have to start somewhere."

Hospital spokeswoman Ellen Slingsby says the emergency room sees about 100 patients a month with skin afflictions who require a dermatological consult. That should be a sufficient pool of prospective volunteers, Porter says, to adequately test Glass in the next six months. The team proposed the research to the hospital and later received funding for the project and so far the results are encouraging. They are using a solution from start-up technology company Pristine which created a Google Glass application that protects patients and meets federal laws for privacy so that no images or videos can be saved to the device.

RI Hospital begins using Google Glass technology

Pristine makes the app EyeSight, which enables physicians and nurses to transmit live video and audio of wound patients from Google Glass to authorized computers, smartphones and tablets. Since last October, Pristine has also been testing EyeSight through a pilot program with surgeons and anesthesiologists at UC-Irvine. The technology allows for more effective communication between UCI anesthesiologists and surgeons in the OR and allows for greater supervision of doctors-in-training. "We could be supervising two residents at the same time," says anesthesiologist Leslie Garson. Garson also said Glass has proved useful during the 15 or so surgeries he has worked on so far, especially because he often monitors two or even three surgeries simultaneously.

"A resident could have Google Glass on, they could be looking at a monitor, and I could have a tablet down the hall and could see exactly what they're seeing," he said. "They can send me an alert -- 'Take a look at this,' 'Is this something I should be concerned about?'"

Dr. Patrick Hu (pictured at left) is an anesthesiologist at UC-Irvine and can share EKG information with other doctors via Google Glass. UCI Medical Center's anesthesiology department has been instrumental in pushing for this technology, according to the hospital.


At UC San Francisco cardiothoracic surgeon Pierre Theodore, MD is using Google Glass during surgery. pre-loads CT and X-ray images needed for a procedure, and calls them up in his Google Glass to compare a medical scan with the actual surgical site. "Often one will remove a tumor that may be deeply hidden inside an organ – the liver, the lung – for example," said Dr. Theodore, who’s also an associate professor in the UCSF School of Medicine. "To be able to have those X-rays directly in your field without having to leave the operating room or to log on to another system elsewhere, or to turn yourself away from the patient in order to divert your attention, is very helpful in terms of maintaining your attention where it should be, which is on the patient 100 percent of the time." 

He is the first surgeon to receive clearance for the use of the tech device as an auxiliary surgical tool in the operating room by a local Institutional Review Board (IRB), an independent ethical review board designated to approve, monitor and review biomedical research involving human subjects. He was introduced to the idea by Nate Gross, M.D., co-founder and medical director of Rock Health, a San Francisco-based digital health accelerator. Last summer Rock Health's 5th class had a few winners who are focused on Google Glass and the digital health sensor market.Other uses for this technology begin to stretch the bounds of my imagination. Just about anything we are using mobile devices for in providing healthcare could be possibilities for using this type of technology. Bedside medication verification, accessing patient health information, and overlaying information at the point of care, as well as all of the interesting pilots underway now. I am just getting started using my pair of Google Glasses and connecting with folks in the healthcare industry who are pioneering this technology. The next couple years will be some exciting times on this front. I'd love to get your thoughts on what some of the challenges and opportunities are in using Google Glass in healthcare.

http://www.ahier.net/2014/03/google-glass-in-medicine.html

Health Literacy means Better Health! Play "2014 Health-e Olympics" Today!

Join Dr. D and Natalie as they host the 2014 Health-e Olympics!

2014 Health-e Olympics

"Welcome to the Village! Dr. D. and Natalie are so honored to be hosting this year's event. TEAM Health needs your help to reach the top of the mountain first! See you at the top..."

If your up for the challenge click the link to launch the game:

2014 Health-e Olympics

Innovative Pitt Competition Aims to Solve Health Problems through Patient Engagement

PITTSBURGH – In a creative, community-wide competition to spark fresh ideas that engage people in their own health care, the University of Pittsburgh is offering $300,000 in funding to three winners in its first Pitt Innovation Challenge, or PInCh.

Just as a reality TV show gives contestants an opportunity to share their inventions, PInCh will give scientists and other community members a venue to be creative and develop new ideas, said CTSI director Steven Reis, M.D., who also is associate vice chancellor for clinical research, health sciences, and a professor of medicine at the University of Pittsburgh School of Medicine. PInCh’s inaugural question is: “How do we empower individuals to take control of their own health outcomes?”

“Instead of trying to figure out the molecular mechanisms of hypertension, for example, the team might try to figure out how to reduce the rate of high blood pressure in a specific region,” Reis said. “We want to encourage researchers to approach their work in a different way. Rather than conducting experiments focused on scientific details, they must look at the big picture to try to solve a problem that has public health or clinical importance.”

According to PInCh program director John Maier, M.D., Ph.D., director of research and development and assistant professor, Department of Family Medicine, Pitt School of Medicine, the first step in the competition requires submitting a two-minute video by March 2 that introduces the team, defines the health problem that is being tackled and briefly outlines the creative solution. Early round winners will be invited to a final round of judging in May at a public event in which teams will make short presentations to a panel of judges.

“This will be a great opportunity to get new or risky ideas in front of judges who have experience in science, business, technology and other fields, so participation itself should be rewarding and fun,” Maier said. “We plan to have a ‘People’s Choice’ award, too, so everyone will have a chance to vote for projects that appeal to them.”

Anyone can enter, and teams that bring together collaborators from different perspectives, institutions and disciplines are encouraged, but at least one member of the team must be a Pitt faculty member. If needed, PInCh organizers will help community members connect with a member of the faculty. The solution could be a device, a software application, an intervention strategy or any other approach that could address the health problem the team identifies.

“We hope to de-risk wild ideas to solve clinical or public health problems by providing funding and project management to take them to the next level,” Reis said. “We think some amazing ideas will come out of this process, and we hope the PInCh model can be used in future competitions to stimulate innovative solutions to challenging issues.”

http://gantdaily.com/2014/02/03/innovative-pitt-competition-aims-to-solve-health-problems-through-patient-engagement/

A Sustainable Healthcare System Depends on Equal Access to Quality Education

“Without continual growth and progress, such words as improvement, achievement, and success have no meaning.” – Benjamin Franklin

HCMS

Health Care Management Systems was created to provide free, high quality, on-demand learning to all of those involved in the frontlines of healthcare!

Why?

Because we have proven that “equal access to high quality education” is the missing link in the healthcare equation.  Yes, proven through a unique double blind study that you have probably never heard of…

You see, this story begins about 3 years ago on the Texas gulf coast when two unlikely partners teamed up to change the way managed care was delivered to a certain Medicare population.

The strategy was devised from a simple physics theory – to influence the greatest amount of change in the shortest amount of time possible – equal pressure must be applied in all directions.

Education was the single greatest variable that was common to all groups – so our hypothesis was built on the assumption that through simultaneous and continuous education at the point of care, we could make a measurable impact on both the cost and the experience of care!

The project was a huge success from both a financial and cultural perspective. Two years later that “little experiment” is now out funding larger markers  – all without ever auditing a chart!

Lighting in a Bottle –

Okay, so our hypothesis was a success, but where do go from here? We were so amazed and excited about the outcome that we wanted to find a way to offer it to everyone – anywhere, anytime, anyplace and on any device!

So, we developed a vehicle: Global Health Care Management Systems (globalhcms.org) – an innovative learning platform that can deliver our proven education to everyone on the frontlines!

Anyone involved who wants to learn is invited to join the HCMS Academy!

To ensure that this tool will continue to be available to all of those we serve, we have teamed up with other healthcare leaders to provide employer sponsored learning as well.

A big THANK YOU to all of our partners and sponsors – without them none of this would be possible….

To learn more about our pilot program please visit: www.ermconsultinginc.com.

To find out how you can partner with us to ensure equal access to quality education email: kgifford@ermconsultinginc.com.

How Do I Sign Up?

HCMS ACADEMY-

We invite everyone currently working on the frontlines or those contemplating a new career in healthcare to register for the HCMS Academy. Register for free courses and receive certifications in Medicare Risk Adjustment, ICD-10 Coding and Rapid Practice Innovation. As a member of the Academy you are invited to join our conversation on the “Innovation X-Change.” The X-Change provides a secure, HIPPA compliant meeting space for visionaries to share ideas and collaborate on future projects. Join a group or start your own. Register today at www.globalhcms.org – What are you waiting on – it’s totally FREE!

SPONSOR E-LEARNING-

Are you involved in health care? If so, we invite you to join us in our mission! By sponsoring e-learning for your employees or industry partners you can help ensure that everyone has equal access to high quality education.

By partnering with HCMS, you extend our proven education to your organization at no cost and we are able to provide you with state of the art analytics including dashboards to track implementation and progress across large organizations in real time. This system was built on an API that accepts up to 5 data sources which potentially allows us to measure and analyze financial, educational and utilization data together for the first time. All of this at a fraction of the cost of traditional analytics.

To learn more about how we can partner for a better tomorrow, please contact: kgifford@ermconsultinginc.com

www.globalhcms.org

Can you GAME your way to 5 STARS?

On-Demand E-Learning for Your Entire Office

Medicare plans and providers face a crucial task each year: achieve the highest Medicare star ratings possible or face the consequences. With major revenue and competitive positioning at stake — including the possibility of losing Medicare contracts if certain measures earn fewer than three stars for three consecutive years — Medicare Advantage and Medicare Part D prescription drug plans must take every step possible to maximize performance on all of the star rating quality measures. 

But what if we could game our way to a 5 STAR Rating? 

What if we could make all of these initiatives in healthcare fun?

How could we influence both the experience and the outcome of healthcare through innovative learning?

Log on today, for FREE...

Click the logo below to launch the game....

Welcome to Zappos-Style Health Innovation

Rushika Fernandopulle1/14/14

But there’s another unusual aspect to this clinic. Many of the patients will be paying for care out of their own pockets, thereby sidestepping the administrative overhead and pressures caused by health insurance.Zappos CEO Tony Hsieh’s effort to revitalize downtown Las Vegas includes last month’s launch of a new clinic, run by Iora Health and spearheaded by physician Zubin Damania. Stanford-trained, Damania also happens to rap by the name of ZDoggMD. So it’s no wonder the project has drawn attention.

A growing number of primary care doctors see this not only as a respite from their increasingly demoralizing work circumstances, but as a chance to do what they dreamed of in medical school. Research has long shown that good primary care is the cornerstone of a cost-effective healthcare system. In this type of setting, they can do more to help their patients—and without working to exhaustion or running up huge costs.

The patients pay for their care out of their own pockets with a modest ($60-80) monthly subscription fee. Annualized, that’s actually lower than many of today’s health plan deductibles. The doctors spend as much time with the patients as needed. They are even accessible 24/7 by phone and e-mail. In addition, each patient gets a personal health coach to help them improve their health. A coach may help diabetics learn to shop for food or help people with respiratory problems learn to allergy-proof their home.

Getting rid of insurance overhead alone cuts costs by as much as 40 percent. Letting the doctors take their time and concentrate on treatment and diagnosis also saves big money in the long run. Iora practices, and others like them, have reported savings in the 20 to 30 percent range so far.

One reason for that: The more time that primary care doctors spend with their patients, the fewer referrals to costly specialists they make, and fewer tests and procedures they need to order. Over the last ten years, the rate of referrals has skyrocketed as primary care doctors have been squeezed to do more in less time. In the 10-to-15-minute window insurance reimburses for, there is often little time to do more than type in a referral.

These newer types of clinics are a growing phenomenon in U.S. healthcare. They are referred to as concierge or direct primary care. The concierge practices are usually high-priced, cater to wealthy patients, and provide extra frills. But price-friendly, subscription-based primary care is now catching on. The number of such offices is growing at a rate of 25 percent per year, according to the American Academy of Private Physicians.

Some big-name investors seem to agree there’s promise in this approach. Hsieh recently invested in our company, Iora Health. Amazon’s Jeff Bezos was an early investor in one of our competitors, Qliance, as were Michael Dell and Drew Carey. We and others have attracted a growing number of venture capital investments as well.

Direct primary care is not just for the rich or middle class. In New York, we are partnering with Grameen PrimaCare to provide health care for members of Grameen America, a microfinance organization founded by Nobel Peace Laureate Muhammad Yunus. Together, we are building a clinic to open in mid-2014 that can meet the needs of even the poorest of New York’s working poor.

What’s driving this trend? Recent reports about insurance rate shock and big out-of-pocket expenses remind us that simply giving people access to health insurance doesn’t make them healthier. If they can’t afford the premiums or deductibles, they won’t get care. Company CEOs are particularly familiar with this problem. They want their employees to be healthy without breaking the bank. In a recent Gallup survey, 30 percent of adults reported skipping needed care because of costs.

Imagine spending as long as you need talking to your doctor about your health. What if your mother’s doctor called the hospital before she was admitted, stayed in close communication with them during her stay, and then saw her the day she was released to review her medications and treatment plan?

A provision in Obamacare even allows insurance companies to offer very low cost policies (wrap arounds) that complement this new enhanced primary care service. These policies only cover the type of specialized care you can’t get in your family doctor’s office as well as tests, hospital care, and medications, making them especially affordable. Will insurance companies see an advantage to offering such plans? Uptake nationally so far has been slow, but we are working with the Nevada Health Co-Op to offer just such a plan for the Las Vegas practice.

The self-pay primary care movement is currently small; only about half a million patients use such a practice today. But the patients who do use it report tremendous satisfaction. Direct primary care could be a big boon for middle-class patients caught between rising costs and shrinking paychecks.

For the working poor, however, such a model could be lifesaving. That’s why we plan eventually to build such clinics throughout the world. Imagine the U.S. exporting affordable care delivery to the rest of the globe? That would certainly get people’s attention.

Rushika Fernandopulle is a primary care physician, former director of the Harvard Interfaculty Program for Health Systems Improvement, and the co-founder and CEO of Iora Health. Follow @rushika1

http://www.xconomy.com/boston/2014/01/14/welcome-to-zappos-style-health-innovation/