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Other resources offering insight to accountable care analytics were the Group Practice Improvement Network and the American Medical Group Association, where Spencer has been able to network with peers who have been pursuing population health analytics longer than Crystal Run has.
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Like other providers, Crystal Run saw the shift coming from fee-for-service to accountable care and took early opportunities to get its hands on claims data and learn how to work with it, Spencer says. Crystal Run also adopted the Crimson Population Risk Management service from the Advisory Board Company, which incorporates technology from Milliman Inc. Since 1999, however, Crystal Run has incrementally left Excel behind and built population health analytics reporting tools on top of its NextGen electronic health record software, Spencer says. You can really do a lot with what you have, probably immediately." "People shouldn't wait for the killer app that's out there that's fancy and has a slick user interface. "The basics can be done with available tools," Spencer says. Like numerous other healthcare organizations, Crystal Run's first foray into population health analytics employed Microsoft Excel spreadsheets. There is overlap with the registries, since a list of patients due for their colonoscopy is a kind of registry that needs to be 'worked' to get those patients compliant." Care gaps look at all patients who have not had a certain recommended service.
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"Registries are mostly condition- or disease-specific lists of patients who satisfy a certain criteria: diabetics, patients with vascular disease, kids with asthma. "Usually that is not something that many EMRs do well," Spencer says. Thus, some sort of aggregator function is needed. "It's not optimized for reporting groups of patients, so to kind of get that rollup, you have to have another layer on top of that to gather it up." "There are frequently registry functions within EHRs, but the EHR is set up at the patient level," Spencer says. "Having that near-real-time data is really going to be extremely helpful to us."Īnalytics tools produce the patient registries that identify gaps in care, not just to meet ACO objectives, but also to meet the requirements of meaningful use stage 2, which takes effect in 2014, says Gregory Spencer, MD, a practicing general internist and chief medical officer at Crystal Run Healthcare, a multispecialty practice with more than 300 physicians based in Middletown, N.Y. "As a geriatrician, this is the most exciting time in my career, because I've always felt that fee-for-service medicine was the bane of good geriatric care because it rewarded volume rather than quality," O'Neil says.
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"This has been resolved through a licensing agreement-Loopback also has a licensing agreement with FAU to bake INTERACT tools into software programs."īoth Brookdale and its hospital partners are using a common population health analysis dashboard and software provided by Loopback Analytics.
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INTERACT is an acronym for Interventions to Reduce Acute Care Transfers, a free quality improvement program for which FAU holds the trademark and copyright. In dealing with the two universities, O'Neil says, "We had to resolve some issues related to intellectual property to incorporate INTERACT into electronic information systems," he says. "Once we've developed a relationship with one entity and had success, it's much easier to engage other entities within that system." The biggest hurdle in O'Neil's experience with population health analytics has been engaging with the hospital C-suite to craft the business associate agreements necessary to manage populations.