@aneeshchopra

www.navhealth.com

Connecting the Dots ~ How Open Data, Connected Apps and

Payment Reform Will Accelerate Care Delivery Innovation

Connecting Dots ~ Payment Reform, Open Data 1

2 The Emerging “Connected Apps” Era

3 Fostering an Ecosystem for Problem Solvers

Agenda for Discussion

David Van Sickle collaborates with Mayor Fisher (Louisville) to micro-target

air quality improvement opportunities; patient inhaler GPS data informs

action to lower particulate matter 10%; results in 27% reduction in asthma

risk area

CareSpark:

Comprehensive

approach to regional

HIE aligned to NHIN

goals; specific

attention to rural health

disparities in region

MedVirginia: EMR adoption

by free clinics with HIE

interfaces for secure

messaging, Rx history, vitals,

aligned with NHIN;

assessment of e-Rx for mental

health providers

NOVARHIO: Access to

patient medical histories in

ERs; comprehensive outreach

campaign for a voluntary web-

based “File for Life” that could

be accessed by emergency

responders

CCNV: Fully funded EHR

implementation at all clinic

sites (15 live today) with

pilot connectivity to public

health services in

Southside

Centra: Nation’s first

outpatient EHR link with

ACC’s outpatient cardiac

registry to benchmark

adherence to practice

guidelines and measures

UVA: Telemedicine

initiative to identify high-

risk poor pregnant woman

to minimize pre-term labor

in the Valley*

*Awarded August, 2008 as part of Governor Kaine’s Productivity Investment Fund

Pioneering UVA Program Delivers Results Pre-term delivery rate dropped 25% through High Risk OB Telemedicine

Open Data via Application Programming Interfaces Democratizing government data from Jefferson to Health Datapalooza

On July 4, 1776, the

weather in Philly was

clear and mild with a

high of 76 degrees

Source: http://celebrating200years.noaa.gov/foundations/climate_data/image1.html; healthdata.gov; iTriage

Source: https://innovation.cms.gov/initiatives/Million-Hearts-CVDRRM/; https://millionhearts.hhs.gov/data-reports/data.htm;

Medicare Reporting Coverage

CMS EHR Incentive Program 2011-2013

Connecting the Dots on Care Delivery Reform “Million Hearts” campaign invokes open data, connected apps, pmt reform

Medicare Program Reveals The Challenge Ahead ACOs incentivized, but not wired, to close feedback loops

Source: NavHealth

Percent of Hypertensive Patients whose Last E&M Visit in 2016 was Conducted by their PCP, an IN provider, or an OON provider

The Search for Simpler IT KLAS survey reveals provider demand for “app store”-like experience

“Privacy and security is by far the biggest concern around adopting apps, although app credibility, concerns regarding ongoing maintenance, and the need for

integration with existing systems are also high on the list.” Source: http://smarthealthit.org/2017/02/connected-apps-report/

PG&E’s CIO leads industry adoption, scaling through national movement

The Emerging “Connected Apps” Era

Source: http://energy.gov/eere/sunshot/sunshot-initiative ; http://www.pge.com/en/myhome/addservices/sharemydata/customers/index.page

http://www.pgecurrents.com/2012/08/14/pg-topic-is-dealing-with-data-that-comes-with-smart-grid/

“Chevrolet Volt…led to his developing the app...in…three months…his electric bill reduced an average 20

percent;” one of 50 registered apps with open access to customer energy data without fees or IP constraint

“All-in” Embrace of Open APIs for Data Exchange Regulations, industry response aligned on technical capability

“The 2015 Edition includes “application access”

criteria…to the Common Clinical Data Set via an

application programming interface (API).”

MU3: “Access to ONC-Certified API”

Certification Criteria (2015 Edition)

Source: argonautproject.org; healthIT.gov; https://www.healthit.gov/policy-researchers-implementers/health-it-legislation-and-regulations;

http://www.vita.virginia.gov/Library/default.aspx?id=6442474293

“The purpose…is to rapidly develop a first-

generation FHIR-based API and Core Data

Services specification…based on Internet

standards and architectural patterns and styles.”

Voluntary, Industry Consensus Effort

Results to Date

Consistent access to data (Common Clinical Data Set)

1

2 Consistent schema in returned data

(Data Access Framework)

3

Open Implementation & Testing

Framework (Sync for Science)

2017 Road Map includes support for

scheduling, provider directory, and “CDS

Hooks” (mechanism for integrating 3rd party

decision support services to workflow)

Opening Up While Locking Down

Source: The Ponemon Institute, “Fifth Annual Privacy and Security of Healthcare Data Report”, May 2015

“Built-in” Security–APIs enforce a

consistent protection mechanism across

all channels with built-in authentication,

authorization, and threat protection

API-first approach to facilitate controlled access to data

1

2 Single point of “truth” for

connected mobile, web apps

3

Real-time analytics to monitor use

vs. shipping “blind” flat files

API vs. “Point to Point”

“API-First” approach adds security protection by monitoring use

Entering the “Burger King” Era – Have it Your Way! Hackensack Meridian Health opens up many digital paths for patients

Multi-stakeholder Alliance to Accelerate Progress CARIN Alliance launches to make consumer-directed exchange work

Source: carinalliance.com

Fostering an Ecosystem for Problem Solvers Framework derived from President’s Strategy for American Innovation

Source: whitehouse.gov/innovation

Invest in (digital) infrastructure 1

2 Convene sectors to design/deploy standards to promote competition

3

Open up data in machine-readable form

4

Make all digital services available “retail” and “wholesale”

5

Reward outcomes, not administer programs