• Principle Healthcare Associates


    Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

    Contact us at PHA email and be sure to visit us at PHA Website

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Collaborating for Population Health Management Strategy

Collaborating for Population Health Management Strategy

In response to value-based purchasing incentives and the proliferation of risk-sharing structures, the recent article, 5 Ways Population Health is Transforming Hospital Strategy, points out that hospitals that fail to align their strategies for growth and relevancy will quickly lose market share.  Specifically, Molly Gamble recommends the following tactics for tackling the issue head on:

  1.  While there should always be a place for the acutely and episodic ill, the new mantra should be keeping patients healthy (and out of the hospital).  Implementing disease registries and disease management programs coupled with virtual and urgent care will facilitate this goal.
  2. Design user friendly sites and services similar to retail and banking, giving patients the ability to access their data and schedule appointments in a safe and simple manner.
  3. Embrace mobile, telehealth and telemedicine in order to engage patients and improve the quality and safety of care delivered.  Successful execution of this tactic requires the ability to curate and share data in a seamless manner while protecting the privacy of the very individuals that you seek to help.
  4. Hospitals that deliver multidisciplinary care with providers matched to their competencies will improve access and population health.
  5. Look beyond the four walls of the hospital to collaborate with community, public health, government agency and payer organizations to improve the health of the people in the communities you serve.

Engaging in a near one hundred and eighty degree turn will prove challenging for the most agile health system; however, collaborating with entities, some former adversaries, outside the realm of standard organizational influence might be the most daunting feat yet. One community committed to this challenge is Tulsa, Oklahoma.  Together, the University of Oklahoma and the Kaiser Family Foundation have developed the OU School of Community Medicine – a first in the nation – for the distinct purpose of improving the health status of the underserved  in rural and urban Oklahoma communities.  Through this unique joint venture, the medical community is participating in one of seven national pilots  fostering the development of patient centered medical homes for the Medicare and Medicaid populations.

Additionally, the medical school operates MyHealth, a health information exchange with more than 150 participating healthcare organizations committed to improving care coordination and healthcare data exchange. While all may not be appropriate for size and scope of your entity, programs developed within this initiative that hold great potential for population health management include:

  • Outreach psychiatric and rehabilitation team care of those with most severe mental illnesses – current savings estimated at $15k
  •  Palliative Care teams – LOS reduced by 2 days
  • 75,000 secure web-based primary care/specialist consults – reduced face to face evaluations by 35%.
  • Acute Care Evening Clinic
  • Longitudinal Chronic Care Clinic – using Patient Centered Medical Home Model
  • FQHCs – Physician Assistant student Patient Centered Medical Home clinics (ACA – HRSA grant), Teaching Health Center (ACA – HRSA application)

Given their rural presence, it is encouraging to see the state ranking the highest on the primary care access challenge promoting mid-level providers in their healthcare service delivery strategy.  And with Kaiser’s commitment to mobile health, it will be interesting to learn more about this Beacon community’s utilization of such an important technology.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

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Collaborating with Big Data to Innovate Healthcare

Collaborating with Big Data to Innovate Healthcare

As Dr. Bonnie Feldman, former dentist, health consultant and sell-side equity analyst notes, “the enormous variety of data – structured, unstructured and semi-structured – is a dimension that makes healthcare both interesting and challenging.”  In her recent report, Big Data in Healthcare Hype and Hope, she also identifies six ways big data is being applied in healthcare:

  • Support Research – Genomics and Beyond
  • Transform Data to Information
  • Support Self-Care
  • Improve Patient Care
  • Increase Awareness
  • Pool Data to Build a Better Ecosystem

According to the report, healthcare stakeholders have different goals and hopes for big data and analytics:

  •  Patients want customer-friendly service, one-stop shopping, and better coordination for error-free, compassionate and effective care.
  • Providers want real-time access to patient, clinical and other relevant data to support improved decision-making and facilitate effective, efficient and error-free care.
  • Researchers want new tools to improve the quality and quantity of workflow – e.g. predictive modeling, statistical tools and algorithms for improved design and outcomes while successfully navigating the regulatory approval and marketing process.
  • Payers are moving from fee-for-service to pay-for-performance, and want to use Big Data to help stratify population risk and incorporate wellness management, data analytics and API platforms.
  • Pharma companies want to identify etiology of diseases, target appropriate candidates and implement successful clinical trials.Government is trying to reduce costs, enforce regulations and maximize the social value of data.

Based on the McKinsey Global Institute (MGI) estimates, harnessing big data can deliver savings of roughly $300 billion per year in US healthcare.  Specifically, MGI believes that big data could help reduce waste and inefficiency in the following three areas:

1. Clinical Operations ( $165B)

  • Comparative effectiveness research to help determine more clinically relevant and cost-effective ways to diagnose and treat patients.
  • Clinical decision support systems to provide real-time information to emergency technicians, nurses and doctors to improve triage, diagnosis, treatment choice, prevent iatrogenic infections and readmissions, prescription and other medical errors.
  • Other areas include increasing transparency about medical data, remote patient monitoring, and predictive analytics to identify individuals who would benefit from proactive care.

2. R&D  ($108B)

  • Predictive modeling could help produce a leaner, faster, more targeted, and lower attrition R&D pipeline in drugs and devices.
  • Statistical tools and algorithms could improve clinical trial design and patient recruitment
  • Analyzing clinical trials and patient records to identify follow-on indications and discover adverse effects before products reach the market.
  • Ultimately, personalized medicine, emerging from the analysis of large datasets to help match the right medicine to the right patient at the right time.

3. Public Health

  • Analyzing disease patterns and tracking disease outbreaks and transmission to improve public health surveillance and speed response.
  • Faster development of more accurately targeted vaccines, e.g., choosing the annual influenza strains.
  • Turning torrents of data into actionable information that can be used to identify needs, provide services, and predict and prevent crises, especially for the benefit of lower income populations.

So, what does this mean for providers and hospitals?  Tune in to Autonomy VP, Dr. Alan Stein’s, recent TED talk to learn more about bringing big data and personalized medicine together to transform healthcare.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Engaging Consumers for Improved Cost, Quality and Outcomes

Engaging Consumers for Improved Cost, Quality and Outcomes

Following closely on the heels of the mHealth Summit, the Bipartisan Policy Center (BPC) recently released the research report, “Improving Quality and Reducing Risk in Health Care:  Engaging Consumers Using Electronic Tools”.  Arriving in the shadows of the fiscal cliff discussion, the report notes that healthcare spending currently places a considerable burden on our economy.  And with a focus on cost reduction, implementing the right measures to improve quality and individual health remain tantamount as well.

Originally identified in the 2001 report, “Crossing the Quality Chasm: A New Health System for the 21st Century”, the Institute of Medicine (IOM) promoted patient-centeredness as one of six key aims for the nation’s health care system, thereby making it well-established and widely embraced today.  And building on the January 2012 report, Transforming Health Care: The Role of Health IT, the BPC identified six attributes that emphasize patient engagement’s role in supporting high performance organizations:

1. Organization-wide focus on the needs of the patient

2.  Strong organizational and clinical leadership

  • Bring the patient’s perspective to the design, delivery, and management of care.
  • Patients are involved in governance and advisory boards to provide input.
  • Create organizational culture that focuses on the needs of the patient and encourages continuous learning and improvement

3.  Access to information to support efficient, coordinated care

  • Successfully coordinate care across providers, settings, conditions, and time
  • Care teams and patients have access to an individual patient’s records across settings in which care and services are delivered.
  • Patient preferences and status are included in the record to inform clinical decision-making
  • Reminders and alerts for both clinicians and patients help eliminate medical errors as well as gaps and duplications in care
  • Privacy and security are carefully managed

4.  Timely access to care

  • High-performing organizations provide multiple avenues for patients to receive timely care.
  • Care teams are available when needed, whether by phone, by mail, online, or in person, including nights and weekends.

5.  Emphasis on prevention, wellness, and healthy behaviors

  • Recognize that providing educational resources and self-management tools to promote prevention and wellness, as well as management of chronic conditions can lead to better health outcomes

6.  Accountability, alignment of incentives and payment reform

  • High-performing organizations continuously measure and take actions to continually improve performance on the cost and quality of care, including patient experience of care and health outcomes.
  • Clinical, administrative, and patient-generated data inform goal-setting, the identification of areas needing improvement, and the effectiveness of interventions.
  • Financial incentives are aligned with better outcomes in cost, quality, and patient experience.

In efforts to support cost and quality goals, there have been a number of new models being tested by the Centers for Medicare and Medicaid Innovation (CMSI), including the Medicare Shared Savings, Advanced Payment and Pioneer ACO models, as well as the, Comprehensive Primary Care Initiative Demonstration.  Together with the Partnership for Patients:  Community Based Transition Care program, these arrangements are helping demonstrate that patient engagement, activation and communication are all associated with lower cost and better outcomes.

Despite the forward movement, significant challenges continue to exist for patient-centered care and patient engagement.  Such challenges include the need to expand patient engagement in medical education, post-graduate training and continuing medical education.  Making a fundamental shift in practice and reimbursement will not only improve physician-patient interaction, but also help to align participant goals with health, wellness and prevention.  And as Susannah Fox, Associate Director, Digital Strategy, Pew Internet & American Life Project, outlines below – organizational culture should embrace the “e” in e-Patient, since engagement is an instrumental step towards achieving the IOM goals.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Collaborating for Mobile Health Innovation

Collaborating for Mobile Health Innovation

As we begin to think about holidays, visions of sugar plum health related apps danced in the heads of the mHealth participants attending the 2012 summit, recently held in Washington, DC.  Billed as the largest event of its kind, the 4th annual mHealth Summit brought together leaders from across the mHealth ecosystem to advance collaboration in the use of wireless technology for improving health outcomes in the United States and abroad.  In efforts to differentiate itself from last year’s event, this summit contained a focus on mHealth research for the purpose of facilitating development and commercialization of empirically-supported solutions for specific disease states in addition to highlighting emerging best practices and sustainable business models for mobile health.

As part of the research track, Dr. Richard Pettigrew, National Institute of Biomedical Imaging and Bioengineering Director, moderated a session entitled, “State of the Science in Research on Mobile Health Technologies.”   During this presentation, Dr. Joseph Cafazzo, Senior Director at the University of Toronto’s University Health Network, stressed the need to streamline processes for mHealth app usability testing, which are often mired in funding and randomized clinical trial requirements.  And together with his co-panelist, Dr. Bonnie Spring, Professor in Preventive Medicine, Psychiatry and Behavioral Sciences at Northwestern University, his comments reinforced the need to establish the utility and value of mHealth technologies.

So, how do we cross this bureaucratic chasm, moving successful design to action?  Being a fan of collaborative innovation, I was delighted to see that George Washington University is already tackling this question.  With representatives from GW faculty in clinical medicine, public health, biostatistics, and engineering, the George Washington mHealth Collaborative has received grants from government, industry, and private foundations to develop and test mobile and electronic health applications for smoking cessation, hypertension, bipolar disorder, diabetes, peritoneal dialysis and prenatal health.  Together with their government and commercial partners, the GW mHealth Collaborative is engaging patients in the use of these solutions.

As so many have noted, physician alignment and leadership is integral to the successful delivery of mHealth.  In the video below, Dr. Joshua Cohen, Professor of Medicine and Director of Endocrinology at George Washington Hospital, aptly points out that the ultimate goal is for apps to be successfully integrated with one’s electronic health record in order to provide a comprehensive, detailed overview within a broader healthcare network.  In the absence of mHealth efficacy studies demonstrating the ability for real people to improve their health, better engage in their care, and enhance communication with their providers, much like the Nutcracker’s Clara, one has to wonder why haven’t we accelerated mHealth collaboration from dreams to reality?

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates that stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website