Continual Care Solutions and Strategic Interests announce a partnership to bring Digital Transformation to Human and Social Services Organizations
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imPowr, a software platform thoughtfully designed for human and social services organizations, and Strategic Interests, a healthcare IT consulting firm with a proven record of leading change, are announcing a partnership to bring Digital Transformation to human and social services organizations. This will help improve sustainability and resilience in 2021 and beyond.
Leveraging the comprehensive imPowr platform with Strategic Interests’ experience and expertise in successful digital planning, implementation and optimization, the partnership allows community based organizations and others to quickly adopt best practices, gain insights and make better decisions.
Often, the purchase of a software platform is only part of the complete solution needed for organizations to gain the full value of this effort. In order to be able to capture, manage and optimize data to drive better performance and increase revenue opportunities, an organization needs a digital strategy, an implementation plan, well-designed reports and dashboards and support to make it all “stick”. This deliberate approach helps organizations avoid costly mistakes, reduces delays and provides a sound basis for participation in valuable contracts and collaborations.
“We are excited to be collaborating with Strategic Interests since their innovative thinking and understanding of customer needs will complement the mission behind our imPowr platform. They are trusted leaders in the industry and together we will be able to serve more human services organizations with excellence.”
– Sean Ossont, President, Continual Care Solutions.
“The partnership between SI and imPowr will bring customers a highly coordinated process to plan, deploy, and apply best in class solutions to improve their performance based on their unique needs, objectives, and an understanding of how the organization functions.”
– Al Kinel, President, Strategic Interests.
This partnership brings not only a best in class platform but the strategy and support to quickly realize meaningful and measurable benefits.
About imPowr
imPowr by Continual Care Solutions is a comprehensive software solution designed specifically for non-profit human services organizations, bringing together data into a single integrated database. The imPowr solution provides organizations with financial growth, improved efficiencies, and risk mitigation so that they can focus on advancing their mission and serving the community with excellence.
Strategic Interests, (SI), is a Global HIT consulting firm with a personal touch.Our trusted transformation consultants focus on our clients’ best strategic interests and success. Vision, innovative thinking and collaborative relationships drive the SI philosophy. SI consultants have expertise, capabilities and deep networks that can be deployed in flexible, blended teams to help reduce costs and target client needs.
Join your friends from Strategic Interests, Excel Partners and TechRochester at the R2I (Rochester to Israel) Virtual Exchange where you will learn about exciting healthcare technology from Israeli startup companies.
November 18th, 2020 11:00am – 1:00pm EST No cost to register
By Brett Kinsler, Strategic Interests, Partner, Clinical Services & Informatics
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By Ken Kleinberg, Point-of-Care Partners, Practice Lead, Innovative Technologies
In our previous post, we discussed the importance and some of the challenges of a consent management program. Now, let’s look at some other areas that require examination and decisions in the consent management process:
Major Consent Considerations
Here are some of the most important issues that organizations need to consider for robust implementation in support of meaningful patient consent management:
Authorization Models: range from opt-in or opt-out (may be at the organization or the state level, and may have huge implications for adoption/success with opt-out being the preferred approach), and hybrids that require opt-in for sensitive information, such as HIV or controlled substances or other specific PHI (personal health information) or demographics related to age or guardianship.
Initiating Party: consent initiation may be performed by the provider, the patient, or either, in addition to a parent/guardian or healthcare proxy (how this consent is verified and passed from stakeholder to stakeholder is a key challenge in consent management).
Initiation Domain: may be at the point of care, online, or a mixture of options. COVID-19 has led to waiver programs that temporarily change these policies. Such changes may become permanent. Areas subject to natural disasters (e.g., hurricanes, tornados, flooding, wildfires) may want to specifically plan for such occurrences.
Data Sharing: basic choice to share all data or can be more granular to select certain types of data by sensitivity level (a key challenge here is that omission of data, such as a diagnosis for mental illness, may still be discerned if other information that is shared, such a medication used to treat mental illness, is included for medication reconciliation safety purposes).
Provider Data Access: may be granted to a particular provider, organization, or multiple providers (community consent) based on the model deployed. Some models permit emergency access or may blanket restrict all access regardless of an emergency event occurrence. Use of audit trails can be key here to track unwarranted access.
Patient Data Access: models may provide ability to access and/or suggest changes – this access can be more complex based on age (restrictions for teenagers, for example, which can differ by state or organization), family member access (divorced/separated, step-parent), etc. As there can by high complexity here and no easy answers, this can be a major impediment to more sophisticated consent implementation.
Alteration and Revocation: patient changes to consent may be retrospective, prospective, or contain options of either. For example, revoking consent may or may not remove access to some or all historic data. Changes to consent may be entered by the patient, provider, or either and may occur at the local or statewide level – timing may also be an issue (e.g., batch vs. real-time).
Alignment with Federal Policies: HIPAA, TEFCA, Part II regulations, etc., does not necessarily reconcile fundamental policy differences across regions or states.
Data Types: Can include both HIPAA-covered and non-HIPAA-covered data such as advance directives, MOLST (Medical Orders for Life-Sustaining Treatment) data, genetic information, patient generated health data from wearables and home devices, AI/ML generated data, etc.
Additional Technical and Organization Considerations
Among the technical issues of implementing consent management are:
Integration Technologies – leveraging FHIR APIs when feasible and including approaches to integrate with other consent requirements, EHRs, advanced directives, etc.
Authentication and Tracking – Identity management, OAuth/UMA, audit capabilities
Promulgating Consent to Other Entities– Differences in terminology and lack of adequate mapping may contribute to lowest common denominator filtering where granularity of consent is lost
Workflow – including the ability to support authorized queries, and allow patients the ability to view and manage consent preferences online
Organizational considerations include:
Consent Strategy – who in the organization decides what approach the organization should take to consent management – should it be based on what others have done (e.g., identification of best practices) – how should it mesh with state or federal policy – could the organization’s consent approach be a competitive differentiator?
Governance – who has the authority to change, interpret or enforce policies
Changing Landscapes – Keeping up with potential legislative changes, such as concerning the management of sensitive substance use, mental health, and HIV data as well as overall consent models.
Advocacy – what approaches and levers do organizations have to influence policy
Outreach approaches – including provider and patient communication, education, training and activation/engagement.
Conclusion
Effective and meaningful consent that supports information sharing and action requires a balance between a patient’s willingness to provide access to their private information, the need for providers and other stakeholders to access patient data to impact clinical outcomes, population health, the patient experience, and the patient’s willingness and ability to play a larger role in their own health and health information. Better use of technology and processes for consent can enhance the effectiveness and efficiency for stakeholders across regions, states, and the nation. Leveraging the expertise of a team who understands stakeholder alignment, consent management strategy, and is skilled in development and deployment will ensure the success of your organization’s consent program.
By Brett Kinsler, Strategic Interests, Partner, Clinical Services & Informatics
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By Ken Kleinberg, Point-of-Care Partners, Practice Lead, Innovative Technologies
Sign here. On the surface, patient consent is such a simple principle. Patients communicate their desire to share their health information or accept (or deny) a treatment. The most common broad consent is often the only option given to patients, and generally includes the concept of informed consent, emphasizing the patient’s role in the decision-making process and a section to address common patient questions. More granular approaches to consent offer a myriad of options that may specifically assess patient desires and choices to protect privacy and security.
All (Regulated) Stakeholders Take Note
Stakeholders that need to manage consent effectively include health systems, providers, EHR (Enterprise Health Record) vendors, health information exchanges (HIEs), health information networks (HINS), labs, pharmacies, and payers/health plans. Organizations do not necessarily have to have direct patient interaction to be concerned with consent, as is the case with many HIEs that are not patient facing. Patient portals and the newer world of consumer apps are clearly access vehicles where consent may come also into play. The recently finalized rules from CMS and ONC have a lot to say about information exchange and patient access – and while they have yet to be tested, they clearly put a greater responsibility on the patient for managing consent in the permissions they agree to. In many cases, these decisions have implications outside the protections of HIPAA (consumer beware).
The Office of the National Coordinator for health IT (ONC) feels patients need to understand their role and options so that they make meaningful and informed consent decisions – they refer to this as meaningful consent. If patients fail to participate in the process, they risk having too much or too little information shared, leading to potentially dire consequences to their health and private lives. But even once consent is granted, accounting for the responsibility organizations undertake in caring for patients (and their data), leaves much to consider and balance.
Pitfalls of Getting it Wrong
Organizations implementing an effective consent process, including appropriate sharing among multiple stakeholders and regions, face an incredibly complex task. Those who do not have the needed policy/regulatory knowledge, systems, technology, processes, and workflow to properly enable meaningful patient consent may suffer serious repercussions including lawsuits, fines, loss of accreditation, reduction in public trust, or worse. They may also experience loss of revenue, patients, value-based care payments and other incentives.
Poor consent management by industry players may influence the establishment of even greater future barriers and regulations to the exchange of information that truly needs to be shared. We will face the implications of our failure to act responsibly and strategically. Patient advocacy and privacy groups already have a great deal of ammunition regarding lack of patient protections either through mistakes or more purposeful intent, such as sharing information for commercial gain or other purposes beyond what is legal or ethical.
Consent at the State Level
Variations in regulation, approach and methodology to consent within and across states pose challenges to the interoperable exchange of health information. This influences the approaches taken by HIEs that operate in those states or a region that spans states (in addition, cross-state HIE partnerships are not uncommon). Some areas use an opt-in model, requiring patients to consent to the sharing of their data. These systems provide much less information than areas with an opt-out model, whereby default participation and sharing is assumed unless specifically revoked. Certain approaches have been shown to actually increase barriers to health information exchange, placing a greater administrative burden on less technologically advanced organizations. Some providers within and across states may find themselves having to interact with multiple entities to share and access clinical information and, thus, require multiple complex interfaces and workflows to serve their geography well.
Several states have taken a statewide approach to consent, which, while challenging to implement and maintain, provides marked benefits to patients and users. To successfully define and deploy statewide consent capability, a state needs to evaluate and incorporate stakeholder requirements, design solutions (which may include a consent registry) and create an approach to address these requirements that meets the needs of everyone. To ensure successful deployment and sustainability, states need to embrace a funding and program management approach that allows stakeholders to migrate from their current approaches, and solve workflow issues related to the collection and management of consent. This is a complex undertaking that benefits from outside experts to manage the alignment of stakeholders and develop effective and efficient approaches.
In our next post, we will look more closely at the most important issues for stakeholders to consider, especially regional and state HIEs, regarding the implementation of consent including organizational and technical considerations.
The Coronavirus Aid, Relief and Economic Security Act (CARES) that passed on March 27, 2020 was the largest in US history, representing a $2 trillion aid package. Congress was encouraged to provide increased access, funding and guidance for Telehealth and related health IT from the eHealth Initiative (eHi) and other leading organizations. The CARES Act addresses and relieves some of the immediate challenges in delivering quality healthcare during the COVID-19 pandemic.
Telehealth and other health related technology is a natural solution to some of these current healthcare delivery challenges. The CARES Act provides increased telehealth grants by reauthorizing the Health Resources and Services Administration (HRSA) grant funding for 2021-2025 making $29 million per year available. It also eases some of the previous restrictions on Telehealth visits including the requirement that the patient was seen within the past three years for an in person visit.
The range of Telehealth solutions has expanded considerably. The CARES Act acknowledges this by redefining Telehealth beyond just real-time video technology. In particular, the ability to monitor the health and symptom status of a patient remotely will prove to be life-saving technology for patients and providers.
The CARES Act also allows the designation of FQHCs and some rural clinics as Medicare Telehealth “distant sites” to make reimbursement for Telehealth visits easier. Additional appropriations provide funding for specific Telehealth activities and initiatives.
Strategic Interests’ Al Kinel joins panel experts from AT&T and RIT to explore what opportunities are ahead for Rochester as 5G rolls out. Kinel will provide perspectives on how 5G will enhance telehealth and healthcare technology overall.
Event is free. Jan 22, 2020 5:30pm at NextCorps in Rochester
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