by Brett Kinsler | Jan 31, 2018 | Uncategorized
This month’s issue of Western New York Physician Magazine features an article highlighting Strategic Interests’ work to transform primary care in preparation for payment reform. Through programs with the New York State Department of Health, CMS and New York eHealth Collaborative (NYeC), Strategic Interests partnered with the Greater Buffalo United Accountable Care Organization (GBUACO). As the first Medicaid ACO in the state, GBAUCO is ever embracing ways to raise care quality, reduce costs and improve the delivery of care. Strategic Interests is assisting the ACO through two separate programs to accelerate their efforts and improve the knowledge and workflow of their provider network. SI is the only firm that supports NYeC in all four transformational programs offered.
For more information on the NYS transformational programs, see: https://strategicinterests.com/nyshealthcare/
by Brett Kinsler | Jan 24, 2018 | innovation
Digital Rochester is hosting a round table discussion on making Rochester, NY a national leader in the digital health market and Strategic Interests’ president Al Kinel is serving as a panelist. The event is to be held at Irondequoit Country Club on Friday, February 9, 2018 and is presented by DR’s Healthcare Technology Special Interest Group. “Transforming Rochester into a Powerful Digital Health Ecosystem” will cover how entities such as the local or state government, universities, investment community and private sector providers can collaborate to make Rochester an innovative healthcare ecosystem.
Panelists will discuss successes to date along with how the community can come together to create a thriving healthcare ecosystem in Rochester that will benefit the private and public sectors. A thriving healthcare ecosystem will ensure graduates stay in town and provide a digital health experience to the local community without investing a large amount of resources.
Panelists Include:
· Aaron Burton – VP of Innovation, Rochester Regional Health
· Ray Dorsey – David M. Levy Professor of Neurology and Director of the Center for Health + Technology, University of Rochester
· Vincent Esposito – Regional Director, Empire State Development
· Rami Katz – COO, Excell Partners
· Al Kinel – CEO, Strategic Interests
· Sujatha Ramanujan – Managing Director, Luminate Accelerator
· Ken Rosenfeld – CEO, eHealth Technologies
Registration, refreshments and networking begin at 7:30. The presentation and panel discussion will go from 8:00 to 9:30, followed by networking until 10 am. This event is sponsored by DR’s Healthcare Technology SIG sponsors New York State HIMSS and iVEDix.
To register for the event, go to https://digitalrochester.com/event-calendar/#!event/register/2018/2/9/transforming-rochester-into-a-powerful-digital-health-ecosystem
by Strategic Interests News | Dec 15, 2017 | HIT Strategy, Practice Transformation, Quality Care
Healthcare Information and Management Systems Society (HIMSS) Analytics has recognized Rochester Regional Health hospitals with HIMSS Stage 7 validation. Achieved by only approximately six percent of hospitals nationwide, HIMSS 7 validation is the industry’s highest standard for electronic medical record adoption and implementation. 
Getting there is a multi-year, eight stage process that requires collaboration and coordination of team members at every level of the health system.
Rochester Regional’s are the only hospitals in the Upstate New York that have achieved HIMSS 7 and actually comprise one third of all hospitals in New York State to have achieved Stage 7 designation.
Outside of Manhattan, Rochester Regional comprises four of the five hospitals that have achieved this distinction.
Not only was the milestone achieved, but Philip Bradley, regional director of North America for HIMSS Analytics stated, “Rochester Regional Health has accomplished an excellent deployment of a comprehensive acute care EMR. The case studies of quality and efficiency improvements are among the best we have ever seen.”
Strategic Interests has been working diligently with Rochester Regional for years in their EHR and healthcare technology transformation process. We’ve provided grant guidance, implemented population health programs, given DSRIP support, developed interoperability strategies, support data normalization initiatives — and a lot more.
HIMSS Stage 7 validation is based on the Electronic Medical Record Adoption Model (EMRAM). Stage 7 signifies the transition from paper charts to only using electronic medical records. There are eight stages (0-7) that measure a hospital’s implementation and utilization of information technology applications. The final stage, Stage 7, represents an advanced patient record environment.
HIMSS Analytics will recognize Rochester Regional Health at the 2018 HIMSS Conference & Exhibition, held from March 5-9, 2018, at the Venetian-Palazzo-Sands Expo Center in Las Vegas, and Strategic Interests will be there to cheer our client on!
Isn’t is time for your health system to achieving the highest quality and efficiency possible using technology? SI can help!
by Strategic Interests News | Dec 14, 2017 | Electronic Health Records, Interoperability, Physician Stress, Practice Transformation
[Strategic Interests consultant Dr. Joseph DiPoala was recently interviewed by Becker’s Hospital Review. The article is reprinted below:]
Dr. Joseph DiPoala is no stranger to electronic medical records (EMRs) and how important technology is in driving effective and insightful communication.
Co-founder of Ridgeview Internal Medicine Group, a four-physician, three-advanced provider practice in Rochester, New York, Dr. DiPoala also knows what a hassle it is to wrangle patient data from siloed sources. Not only does it take time away from patient interactions, but also increases the risk that critical data could be missed, potentially leading to less-effective treatment.
For the past 17 years, Ridgeview has thrived as a private practice. However, remaining independent comes with its challenges: Ridgeview needed to leverage interoperable technologies able to effectively communicate with other systems and share patient information.
Today, Ridgeview is empowered to connect across disparate systems, leveraging athenahealth’s Patient Record Sharing service to communicate with local large systems via CommonWell and Carequality and exchange medical information instantly. This ensures physicians have the appropriate information at the point of care and that this information follows the patient, no matter the care site. Below, he outlines how the new capability has helped fill patient information gaps during day-to-day interactions.
Q: Historically, what has been Ridgeview’s experience with sharing information with outside organizations?
A: We have had the good fortune of having an extremely well-established health information exchange (HIE) in our community with a high participation rate—but there are definitely gaps in terms of the documents that we can receive. For example, when patients get treatment in an outpatient setting for Rochester General, our main referring hospital, those records aren’t accessible through the HIE—this has been a pain point for the past three or four years. Prior to using a record sharing service, we also struggled to onboard new patients because we were unable view complete records that included previous medications and immunizations. We frequently received faxed documents and were unable to input the patient data directly from the continuity of care document (CCD). The process was a nightmare.
Q: As you mentioned, locating previous health data when onboarding a new patient is critical. What was your approach to gathering patient information before a visit?
A: Before having access to the full patient record, we received information through three sources:
• The paper medical history form patients complete when they come in: After check-in, my nurse or myself would have to transcribe the data from that paper document into the EHR.
• Records from previous visits: This was a huge tech hassle. Scanning Epic’s system—if we even had access—to find the right documents, print them out, and scan them into our system was inefficient and time-consuming. It then required a significant lift to search through the records by hand to try and identify the right information.
• Information-gathering when meeting patients for the first time: This involved filling in any gaps in the information obtained in the first two steps, and was extremely labor-intensive.
Q: What do you think is most valuable about increased interoperability?
A: Two things: First, sharing records eliminates much of the above difficulties, fills in gaps in medical histories and ensuring accurate diagnosis and treatment. Second, it brings in structured data through the reconciliation process. This way, when we see a new patient, we can not only view her records, but also import the problem, allergy, medication, and immunization lists. You can’t successfully accomplish that sort of reconciliation solely relying on faxes, information from our HIE, or other sources.
Q: Who are you exchanging records with most often? Who is benefitting from increased connectivity?
A: There are two major health systems in Rochester: Rochester Regional Health (of which Rochester General is a part) and University of Rochester Medical Center. Patient Record Sharing has allowed us to communicate with Rochester General seamlessly and, conveniently, University of Rochester Medical Center joined the network about a month or two ago. It’s been fantastic—there are only two big systems in town, and we can share records with both of them.
Q: How has exchanging patient records across systems and geographies helped you improve care coordination?
A: There is one area in particular where this has proven to be extremely valuable: When one of my patients visits the ED at Rochester General (our affiliated hospital) or at the University of Rochester Medical Center, the ED physician can see what I see as I’m able to share the record. There is peace of mind for the patient knowing no matter where they go or who they see, the physician will have access to their CCD created by athenahealth.
Q: How is interoperability key in helping you remain an independent practice?
A: For an independent practice, efficiency is critical—whenever you’re able to identify areas of inefficiency and take the appropriate steps to rectify, you’re in a better place. And now, with the ability to communicate with those around us, we’re in a much better place. Prior to sharing records, our process for securing the appropriate information at the point of care was timely and burdensome, taking physicians’ time away from focusing on the patients at hand. This is no longer the case: Instead of spending valuable time searching for missing documents and suffering from heightened, unnecessary workloads, our doctors can use that time to deliver quality care to patients.
by Michalene Kinsler | Nov 15, 2017 | Telemedicine
As a market sector, healthcare can sometimes be slow to adopt new and emerging technology but there have been several recent “wins” that give advocates of telemedicine reason for optimism. The passing of the Veterans E-Health and Telemedicine Support Act of 2017 (VETS Act) in the US House of Representatives, is another step toward integrating telemedicine into mainstream healthcare. It allows for telemedicine in the VA to be provided across state lines, moving toward “anywhere to anywhere” healthcare as described by the VA Secretary David Shulkin. This shift forward, if the companion bill passes in the Senate, will likely increase access to telemedicine across other sectors of healthcare as well as it signals an increasing acceptance of the technology. http://www.healthcareitnews.com/news/8-reasons-why-telehealth-gaining-momentum-right-now
This legislation comes shortly after new payment rules were released by the Centers for Medicare and Medicaid Services. The CMS’ Merit-based Incentive Payment System (MIPS) improvements, includes changes which would enable doctors using “non-face-to-face chronic care management using remote monitoring and or telehealth technology” to receive Advancing Care Information (ACI) program points for activities such as sending medication reminders, collecting, monitoring and reviewing patient physiological data and prescribing patient education.
Of concern is the infrastructure needed to support telemedicine. Some aspects of telemedicine, like remote monitoring, use lower levels of internet connectivity and may be easier to deploy. As the standard shifts toward more video conferencing that requires high speed internet at both ends of the visit, a lack of infrastructure can be a barrier to full use of the technology. Many rural communities don’t have the broadband infrastructure that is needed. There is proposed legislation that addresses the problem and, if adopted, could help move the process forward.
While these recent changes are very good signs for the advancement of telemedicine, there is still much about the technology that will need to be supported and understood to realize all the potential benefits. If done well, emerging research is showing both clinical and financial benefits for providers and patients across many different settings. Frequently in healthcare, it is legislation that triggers interest in new technology so expect more and more stakeholders to recognize the growing appeal of telemedicine.
by Brett Kinsler | Oct 21, 2017 | Telemedicine
In a forward to a book entitled Snake Oil, British evolutionary biologist Richard Dawkins stated, “there is no alternative medicine. There is only medicine that works and medicine that doesn’t work.” This was important conceptually because it illustrated that the umbrella of Medicine (with a capital M) encompasses all that is useful in the treatment of patients. Do you remember a time when asking to use someone’s telephone meant they would bring you into their kitchen, hand you a receiver on a coiled wire and make sure you weren’t calling long-distance? Now, if you ask to borrow someone’s phone, they are more likely to reach into their pocket and hand you their portable device. However, we do not necessarily need to specify that we need to borrow a cellular phone or a landline phone — if they work, Dawkins might posit, they are all phones.
Telehealth or telemedicine is the utilization of IT or telecommunication devices to provide health care. The emphasis is on health care — not on the tool used to provide it. In other words, we do not provide stethoscope-type medical treatment. Nobody would ask if your doctor is the blood-pressure-cuff using kind of doctor. Medicine is medicine and the tools used to facilitate it, while integral and vital, do not change the overall category.
Shortly, we will discontinue the distinction between telehealth care and non-telehealth care. It will simply be viewed as a necessary and effective tool used in the usual and customary delivery of treatment to patients. If your organization is ready to embrace a strategy in which this important tool is incorporated into the care you deliver to patients, Strategic Interests can help you develop the strategy, select equipment and vendors, implement and deploy the equipment, and most of all, help your people learn to use these tools to enhance the highest quality of care.
by Strategic Interests News | Oct 11, 2017 | Conferences, HIT Strategy
On October 17, 2017, Strategic Interests president Al Kinel will be a participant in an executive roundtable entitled “Creating a Continuum of Seamless Care – Heart Health” in Washington, D.C.. Sponsored by the eHealth Initiative and Foundation, this session includes presentations from:
- Jennifer Covich Bordenick, CEO, eHealth Initiative
- Ileana L. Piña, MD, MPH, FAHA, FACC, Professor of Medicine & Epidemiology and Population Healthm, Albert Einstein College of Medicine, Associate Chief for Academic Affairs, Division of Cardiology, Staff Heart Failure/Transplant, Montefiore Medical Center
- Brian G. Choi, MD, FACC, Chief Medical Information Officer; Associate Professor of Medicine & Radiology; Co-Director, Advanced Cardiac Imaging, Division of Cardiology at the George Washington University; Member, American College of Cardiology Informatics and Health IT Task Force
- Jessica Paulsen, Branch Chief, Implantable Electrophysiology Devices Branch, Division of Cardiovascular Devices, Office of Device Evaluation, Center for Devices and Radiologic, Health, U.S. Food and Drug Administration
- Susan M. Campbell, MPH, Vice President of Public Policy, WomenHeart: The National Coalition for Women with Heart Disease
- William B. Borden, MD, Member of American College of Cardiology’s Population Health Management Task Force; Chief Quality and Population Health Officer, Associate Professor of Medicine and Health Policy, George Washington University Medical Faculty Associates
- William T. Thorwarth, Jr., MD, FACR, Chief Executive Officer, American College of Radiology (ACR)
Topics of discussion include ways to pair radiology and cardiology as well as new emerging technologies in heart health, prevention and issues surrounding cardiology and women. The event is located at CAQH headquarters, a non-profit alliance of health plans and trade associations developing and leading initiatives that positively impact the business of healthcare.
by SI Transformation Team | Oct 4, 2017 | Advanced Primary Care (APC), Practice Transformation
by Brett Kinsler | Sep 21, 2017 | HIT Strategy, Interoperability
The challenge of exchanging information among health care providers goes far beyond programming. Certainly, EHRs that use differing formats and structures increase the task of meaningful and necessary clinical data communication, but needs reach far beyond simply technology issues. Strategic priorities must be established and aligned in order for delivery of patient care to improve and the transition toward value based care to be accomplished effectively. The struggle to provide access to data is real and one that we talk to people about every day. Most patients, and even many doctors, assume all pertinent data is available to anyone who should be granted access. This is simply not the case in most communities.
Public health information exchanges have attacked some of the problems, providing a public utility of sorts to manage the flow of information. And private HIEs close gaps for some institutions, especially following mergers and acquisitions of practices and health systems, but integral to the process of interoperability is stakeholders achieving alignment with goals, plans and initiatives.
In order to ensure the right data is presented to the right people at the right time, and the creation of a truly integrated EHR is available, a course of action can include multiple tools, APIs, options and approaches. For some systems, a single EHR can be used including add-on modules to incorporate data. In other situations, such as when legacy data is required to be accessible from retired EHRs or when many data sources are using a variety of different systems, custom built or customizable off-the-shelf interface engines might be the best choice.
Decisions abound but one thing holds fast — tackling interoperability strategy shouldn’t be done in a vacuum. Using objective strategic advisors to collect requirements, assess cultural implications, evaluate vendor offerings and help to plan the most effective and efficient path will save costs, headaches, and, in the end, lives through the improvement in patient safety and care quality.
by Brett Kinsler | Aug 13, 2017 | Conferences, DSRIP, HIT Strategy, innovation, Interoperability, Quality Care, Transitions of Care
Chicago, August 2017 — Al Kinel discussing care transition IT strategy at Allscripts Population Health University
As part of the Allscripts Population Health University held August 8 – 10, 2017 at Chicago’s McCormick Center, Strategic Interests president, Al Kinel, led a presentation explaining the improvement of care transitions using information technology. As seasoned implementation agents for Allscripts dbMotion product, SI understands first hand how the timely exchange of pertinent information positively impacts transitions of care from clinical, technical and strategic angles.
Kinel was joined by two SI clients who discussed their experience with interoperability and transitions of care: Erik Jacob, Manager of IT Interoperability at Rochester Regional Health, discussed the projects in Rochester from the Community Diabetes Collaborative through the merger of multiple hospitals and practices. Brian Henderson, Director of Physician IT Services at Sarasota Memorial Hospital presented the project connecting ambulatory community providers to the hospital’s health information exchange, SMHxchange. Finishing the talk, Strategic Interest’s Director of Clinical Services, Brett Kinsler, DC presented the methodology used to identify gaps and prioritize data elements to be exchanged to facilitate a Medicaid DSRIP program.
Chicago, August 2017 — Erik Jacob presented Rochester Regional Health’s interoperability process
Overall, the team defined the value of Health Information Exchange (HIE) with specific use case examples and described how innovative solutions can impact organizations and practices, increase care quality, decrease duplication of services, prevent unnecessary readmissions, and enable innovative payment models while attaining strategic objectives and enhancing partnerships among hospitals, LTPACs and community providers.
We appreciate being invited by Allscripts to present a topic we are so passionate about and are grateful to our client partners from RRH and SMH for bringing real life examples and experience to the discussion.
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