Corepoint Health Start Newsletter Fall 2011

8/3/2019 Corepoint Health Start Newsletter Fall 2011

1/8

PuttingHealthcare Back Together

THE DEBATE OVER ACOs

I ssue 5 F A LL 20 1 1

The health IT journal or

the Integration Generation

HEALTH STANDARDS

Integrating a HealthcareEnterprise

5 QUESTIONS

Joe Moore, RadiologyConsultants of Iowa

INSIGHTSNorth KansasCity Hospital

IN THIS ISSUE


2/8

Are ACOs Just21st Century HMOs?

Supporters argue that the introduction o ACOs will bring

long-overdue change to patient care, shi ting t he ocus backto the quality o care the patient receives. Health care provid-

ers will be encouraged to coordinate care throughout the ACO

to the beneit o the

patients health, other-

wise they wont qualiy

or certain rewards.

The many detractors

o ACOs believe they are

a utopian big-govern-

ment dream destined to

ail. Many arg ue that ACOs are simply the 21st Century versiono HMOs which were almost universally di sliked by patients

that will produce lower-quality care with ewer choices and

higher prices.

In the 1990s, HMOs, or health maintenance organizations,

were common health insurance plans that restricted patients

to receive care rom

designated in-network

physicians and reused

to pay or procedures

they deemed unneces-

sary. HMOs still exist

today, but arent nearly

as common; however, the near universal disli ke o HMOs led to

insurance plans easing the restrictions they place on patients in

regards to treatment and choice o physician.

There are, however, key dierences between the proposed

ACO model o care and the care patients received rom HMOs in

the 1990s. The main dierence is in the accountability o care

in an ACO, health care providers, not an insurance company, are

responsible or quality o care. The ACO caregiver will have the

I you are in or around health care, its

impossible to avoid the ongoing debate

over the changes that Accountable Care

Organizations (ACOs) will bring to the

industry. Much like the political rancor over

the Patient Protection and Aordable Care Act o 2010 that rstmentioned ACOs, the new model o care has passionate support-

ers and detractors within the health care industry.

An ACO is a network

o health care provid-

ers and hospitals that

sha r e r e sp o n si b i l i t y

or providing care to

patients. According to

the Centers or Medicare

and Medicaid Services,

an ACO agrees to be accountable or the quality, cost a nd over-all care o Medicare beneciaries who are enrolled in the tradi-

tional ee-or-service program who are assigned to it.

The rationale behind this new model o care i s that the cur-

rent delivery o health care in the United States is ra gmented. Its

not unusual or a patient to visit dierent hospitals, doctors and

other health care orga-

nizations or the same

medical condition, with

very little or no com-

munication between the

caregivers. As a result,

there oten are too many

expensive tests and diagnostic procedures perormed, repeated

procedures and a lack o ollow-up with the patient.

The government is encouraging health organizations to

participate in the ACO model o care by nancially rewarding

caregivers or meeting certain quality o care benchmarks that

include ewer repeat visits or readmissions and patient adher-

ence to standard, preventative care visits, such as an annual

physical or a mammogram.

Its not unusual for a patient to visitdifferent hospitals, doctors and otherhealth care organizations for the samemedical condition , with very little or nocommunication between the caregivers.

Supporters argue that the introductionof ACOs will bring long-overdue change to

patient care, shifting the focus back to the

quality of care the patient receives.

by Chad Johnson, Corepoint Health


3/8

Join the conversation on Twitter

Tweet Chat for Health IT, every Monday, 8:00 PM CT. Use #HITsm and participate.

lexibility to contract with other ailiated ACO caregivers or

organizations without the reliance on an insurance represen-

tative who may make care decisions that are not in the patients

best interest.

Another key dierence is that patients will not in itially real-

ize they are receiving care in an ACO. HMOs are insurance plans,

so patients were acutely aware o their existence, rom t he lim-

ited choice o physicians they were given to the insurance cards

they were required to present or payment. Patients in an ACO

can choose the physician o their choice, and that physician will

reer patients to other caregivers within the large network o

aliated ACO organizations. Patients may only become aware

o the ACO ater care is complete and the ACO asks the patients

permission to allow Medicare to sha re their claims data with the

ACO or shared savings determination.

The goal o ACOs is to pay providers i n a way that encourages

them to work together, to pay providers in a way that does not

encourage demand or unwarranted care, and to create an orga-

nization that is rewarded or providing high quality care.

The proposed ACO model is still being reined and likely

will have its air share o problems. However, thats not stop-

ping health care organizations who are taking huge steps, at

signicant nancial cost, to qualiy to become an ACO such

as implementing electronic health records and creating seam-

less interoperability between aliated organizations. Forward-

thinking organizations are determined to remain protable and

at the oreront o patient care, regard less o the requirements.

There are several obstacles to the success o the ACO model,

including overcoming patients who may see ACOs as a new

orm o HMO. I patients believe ACOs are going to restrict their

choices simply to save money, the model wil l be met with oppo-

sition, which is detrimental since a la rge part o ACOs success

depends on patients voluntary participation in preventative

medicine.

There is little doubt that ACOs will alter the health care land-

scape by changing the way health care providers measure suc-

cess. Patient care will again become the main ocus, placing the

current ee-or-service model in the past, alongside HMOs.

Common IT Challenges of ACOs

Interoperability

ACOs will dramatically increase interface demand to con-

nect the patient data through the ACO workfow.

Connectivity

ACO provider organizations will need to send data through

a shared, secure network.

EHR Record Analysis

ACOs will need to leverage clin ical IT for intensive care

management and data analysis. Creating disease regis-

tries will help caregivers and patients manage diseases to

prevent emergency department visits.

Emphasis on IT

ACO IT measures will need to be included in organiza-

tional strategic plans.

For more HIE resources, visit

corepointhealth.com/START.

The many detractors of ACOs

believe they are a utopianbig-government dream

destined to fail .
http://corepointhealth.com/STARThttp://corepointhealth.com/START


4/8

IHE is a group of health care industry representatives that work to improve the way health care

systems share information electronically. The group was formed in 1998 as a cooperative venture

by the Healthcare Information and Management Systems Society (HIMSS) and the Radiologic Society

of North America (RSNA) with the goal to promote interoperability among imaging and health care

information systems. Today, IHE membership includes more than 200 global health care professiona

associations and health care vendors.

IHE encourages the use of established interoperability standards such as HL7 and DICOM. Systems developed in accordancewith IHE communicate with one another better, are easier to implement and help health care providers use information more

effectively and, ultimately, provide better patient care.

What ca ie d r ath i pra?Creating interfaces between systems is a key challenge faced by many health care IT departments. Understanding the differing

implementation of standards in various vendor systems and creating a way to share information between those vendors is

challenging.

IHE offers a common framework for vendors and IT departments to understand and address clinical integration needs. IHE

Proles, described below, are not just data standards, they describe workows, which makes them more practical for use by

healthcare IT professionals and more applicable to their day-to-day activities.

Because IHEs membership includes a wide array of end users, it focuses on solving relevant integration issues. These

solutions provide vendors with many benets including:

horter, less costly implementations.

Cross-system dataow out of the box.

moother, complete workows.

ie prIHE strives to solve specic integration problems faced by its membership in the real world through Integration Proles. These

proles dene the systems involved (i.e., actors), the specic standards used, and the details needed to implement the solution

Each prole offers developers clear communication standards that have been reviewed and tested by industry partners.

C ud ath i ie pr r itrrat

XDmCRoss-eneRpRise DoCumen meDi ineRCnge: WH I E R: ccording to IHE, M

transfers documents and metadata using Cs, B memory or email attachments. his prole supports environments

with minimal capabilities in terms of using Web ervices and generating detailed metadata. his standard is utilized by

the irect Project.

EMPE: sing secure e-mail, a physician e-mails the patients CC to the patients Microsoft Healthvault e-mai

account for uploading to the patients online PHR.

Health Standards:Integrating the Healthcare Enterprise (IHE)

by Rob Brull, Corepoint Health


5/8

Your Resource Center.

Go to HL7standards.com to read

practical insights and viewpoints.

XDRCRoss-eneRpRise DoCumen Relible ineRCnge: WH I E R: he exchange of health

documents between health enterprises using a web-based, point-to-point push network communication, permitting direct

interchange between EHRs, PHRs and other systems without the need for a document repository.

EMPE: nurse at Hospital enters a patients information in the local EHR, and then sends the CC directly to Hospital

Bs system.

XDs.bCRoss-eneRpRise DoCumen sRing: WH I E R:he sharing of documents between any health

care enterprise, ranging from a private physician ofce to a clinic to an acute care in-patient facility, through a common

registry. Medical documents can be stored, registered, found and accessed.

EMPE:

1. Hospital has a document to store. Hospital creates a description and metadata for the document and submits

it to the HIE Repository.

2. he HIE Repository accepts the document with metadata. It stores the document and forwards the metadata to

the HIE Registry.

3. he HIE Registry receives a query from Hospital B and identies the document as a match based on the metadata.

4. Hospital B retrieves the document from the HIE Repository.

XDs-i.bCRoss-eneRpRise DoCumen sRing foR imging: WH I E R: he sharing of images,

diagnostic reports and related information through a common registry.

EMPE: radiologist accesses the local HIE, in a similar manner as for .b, to nd a MR report conducted and

uploaded to the HIE at Hospital .

pDQ pien DemogRpiCs QueRy: WH I E R: Requesting patient Is from a central patient information

server based on patient demographic information. sed when a system has only demographic data for patient identication.

EMPE: Hospital admits Patient Y, who has not been at the hospital before. Hospital submits a request to the local

HIE, based on demographic information such as name, birthdate, sex, etc., to obtain the appropriate HIE patient I for

Patient Y

piX pien iDenifieR CRoss RefeRenCing: WH I E R: Cross-referencing multiple local patient Is

between hospitals, sites, health information exchange networks, etc. sed when local patient Is have been registered

with a PI manager.

EMPE: Hospital transmits Patient s I information to the HIE for cross referencing. Hospital receives Patient s

local I for Hospital B which they can use to request information from Hospital B, based on need.

IHE Integration Proles provide standards that address specic needs, eliminating ambiguities and ensuring a higher level of

practical interoperability. Because it encourages use of established healthcare standards such as HL7 and DICOM, IHE is in a unique

position to accelerate the process for implementing standards-based interoperability among electronic health records systems.

For more information visit: www.himss.org/ASP/topics_ihe.asp .
http://hl7standards.com/http://www.himss.org/ASP/topics_ihe.asphttp://www.himss.org/ASP/topics_ihe.asphttp://hl7standards.com/


6/8

Quesions

Jo Moor

Chi Inormation Ofcr

Radiology Conltant o Iowa

What chang do yo in radiology a ACO nold?

Jo Moor: More conusion, turmoil and disruption. Imaging has a target on its back due to the

increased utilization and skyrocketing costs.

In the governments usual ashion, they avoid dealing directly with the cause and instead have chosen

the route o making imaging less proftable. This will have little impact on those responsible since they

will just order more tests, and imaging is not their core line o business. Radiologists on the other hand

get all their revenue rom imaging and will be aected signifcantly.

What do yo bliv th radiology IT prioriti ar or 2012?

Moor: Position or survival. Radiology needs to be more exible and embrace a service model that will

make them more vital. The industry o radiology is partly to blame or current trends toward outsourcing imag-ing to large, national groups. Radiology is now a 24x7x365 service and hospital administrators are increasingly

demanding more rom their radiologists.

IT can prepare the practice or the transition to a more complete serv ice model by ensuring their systems can support multiple orga-

nizations, run on networks designed to distribute the workload across the enterprise, interoperate and integrate with many systems,

and adapt to the changing landscape.

What tchnologi ar xciting or radiology right now?

Moor:The most exciting technology today, or my money, is cloud services and virtualization. These technologies support the pri-

orities I mentioned above and are critical to our operation.

Weve made a air amount o progress in my organization virtualizing the data center and many o our desktops. We have what I con-

sider an internal cloud. I look orward to the day when we can virtualize our PACS workstations, which will provide exibility, cus-

tomization, ault tolerance and efciency.

External cloud services can best be utilized to ooad common IT tasks such as spam, virus and web fltering, backup, disaster

recovery and web hosting, thus allowing the internal IT to ocus on technology that is unique to radiology. I dont see us going ully

to external cloud services any time soon, but certainly a hybrid model o both internal and external cloud services is the way to go.

Halthcar intgration and introprability hav alway bn a tratgic initiativ or RCI. What nw

initiativ ar yo ndrtaking? Any HIe involvmnt?

Moor: RCI is involved in a couple o HIE initiatives at the state and local level. We eel that to continue to add more value to our ser-

vice, it is critical that we make our inormation available to all who need it, when they need it, in an appropriately secure ashion. I

think well have to support numerous avenues o integration and interoperability whether it be with PHRs, EHRs, HIEs or whatever

else comes down the pike. This really leads back to our priority o being exible and prepared or the known and unknown changes

coming at us.

Thr ar many nw proional joining th halth IT proion. What advic wold yo giv thm?

Moor: I would say the number one thing to ocus on is the core business or core serv ice you are supporting. Make sure you under-stand the point o view o the clinician.

This transormation isnt similar to other industries. You have to remember that clinicians work impacts peoples lives. When you put

a new application or process in their hands, its important to understand that many o them are horrifed at the thought.

IT should be there to get clinicians over their anxiety and prov ide the training needed to use the new system to its ullest extent. Dont

take criticism personal and never assume you know what a clinician wants; most o the time the opposite is true.

Your success relies on clinicians successul use o applications and ser vices. I the end users are miserable, youre going to be mis-

erable. Take pride in being a ser vice provider. Too many in HIT see themselves at some higher level o intelligence because they work

in a feld that is a mystery to many.

Dont think o the technology as the most important thing. Think about the end result, take pride in being a ser vice provider and have

some patience and respect or your end users.


7/8

BLOGFor insights on health

innovation, debates, a

HITECH.

crepintheth.cm/G

Insights

North Kansas City Hospital

North Kansas City Hospital, a 451-bed acute-care acility in the Kansas City

metro area, chose Corepoint Integration EngineTM

to replace their legacy solu-tion because the innovative platorm requires minimal programming knowledge

to use and maintain and supports continuous data delivery with little down-time

or upgrades. The hospital also chose Corepoint Integration Engi ne because it is a

fexible solution to their unique needs, oering improved auditing, databa se inter-

action and the ability to accommodate a broader set o health care standards (e.g.,

all versions o HL7, X12, and others).

Since implementing the new system, North Kansas City Hospital successully

maintains interaces to applications such as Cerner, McKesson, Dictaphone, and

Sotmed, as well as addresse s new requirements

with medical devices. Along with the solid inte-

gration platorm, the hospital welcomes thesupport and assistance o Corepoint Healths

customer relations team, available 24/7.

There are a lot o changes that will be coming

our way with Meaningul Use, and I expect a lot

o interace needs in the uture. Corepoint Health

will be in the center o these changes, delivering

at each step o the way, said Kelley McFarland,

interace analyst at North Kansas City Hospital.

We have called customer support as needed

since purchasing Corepoint Integration Engine

and our experience has always been positive,

with ast and thorough resolution.

Because it will always be necessary to move

health inormation rom system to system,

inside and outside the hospital, North Kansas City Hospital plans to incorporate

Corepoint Integration Engine into uture IT plans.

One thing I really like, that makes it so easy to develop interaces, is the abil-

ity to test messages while building interaces beore saving anything. That is one

o the most valuable shortcuts I have experienced with the interace engine, said

McFarland. Corepoint Integration Engine is easy to use and it is intuitive. Even

when you dont know how to do something, you can nd inormation in the help

les or online user community.

North Kansas City Hospital is one o the largest employers in the Kansas City

metro area with over 3,000 employees. In January 2011, the Northland Cardiac

Center opened to urther enhance the Hospitals cardiac services in a project

totaling $13 million, ollowed in February by a $17 million project to renovate two

maternity foors.

Read the complete case study atcorepointhealth.com/START.

Because it will always

be necessary to move

health information

from system to system,

inside and outside the

hospital, North Kansas

City Hospital plans to

incorporate Corepoint

Integration Engine into

future IT plans.
http://corepointhealth.com/GENihttp://www.corepointhealth.com/STARThttp://www.corepointhealth.com/STARThttp://www.corepointhealth.com/STARThttp://www.corepointhealth.com/STARThttp://corepointhealth.com/GENi


8/8

Follow US aT:

@crepintheth

fcebk.cm/crepintheth

inkedin

Meeting standards.

Setting new ones.

Corepoint Integration Engine

Ranked #1 by KLAS or 2009 & 2010.Interface Engines Market Segment, Top 20 Best in KLAS Awards:

Software & Professional Services Report.

2010 KLAS Enterprises, LLC. All rights reserved.

www.KLASresearch.com

Corepoint Health Achieves ONC-ATCB Modular EHR

Certifcation by Drummond G roup

First Interface Engine Certif ied for Modular Ambulatory EHR

and Modular Inpatient EHR

www.corepointhealth.com/onc-certified
http://twitter.com/#!/corepointhealthhttp://facebook.com/corepointhealthhttp://www.linkedin.com/company/249286?trk=tyahhttp://corepointhealth.com/productshttp://www.linkedin.com/company/249286?trk=tyahhttp://facebook.com/corepointhealthhttp://twitter.com/#!/corepointhealth

Documents

Corepoint Health Start Newsletter Fall 2011