TEMPE, Ariz. (Oct. 23, 2018) – Sonora Quest Laboratories, Arizona’s leading provider of diagnostic testing and information services, has released a new technology based analytics product called Actionable Insights Management™ (AIM). AIM is a software-based solution that provides near real-time data and insights to identify risks within patient populations; close gaps in healthcare; and track individual patients facing chronic conditions including diabetes and chronic kidney disease.

Sonora Quest partnered with Commonwealth Accountable Care Organization to generate actionable patient data featured in their newly published whitepaper to improve communications with providers and deliver a data-focused care model. The white paper reveals the powerful functions of AIM analytics and how it assists with improving collaboration and outcomes in healthcare.

Download the press release to read more.

A CRISIS IN HEALTH CARE: A CALL TO ACTION ON PHYSICIAN BURNOUT: Best Practices

Physician burnout is a public health crisis that urgently demands action by health care institutions, governing bodies, and regulatory authorities. If left unaddressed, the worsening crisis threatens to undermine the very provision of care, as well as eroding the mental health of physicians across the country. While an exhaustive list of solutions to this crisis is beyond the scope of this report, the recommendations presented here represent concrete opportunities to stem the tide of the crisis both in the short and medium terms, while setting the stage for long-term improvement in both physicians’ “joy in work” and health care more broadly — the “Quadruple Aim.”

Best Practices

• Support- Support proactive mental health treatment and support for physicians experiencing burnout and related challenges. Improved access to appropriate mental health care will benefit all physicians and medical students.
• Better standards- Improved EHR standards with strong focus on usability and open APIs. Given the widespread use of EHRs, improvements in their usability will have a broad impact on medical students and practicing physicians.
• Chief Wellness Officers- Appoint executive-level chief wellness officers at every major health care organization. CWOs would play a particularly important role with respect to medical students, residents, and fellows, who are especially pressured in this stage of medical training.

The full report can be downloaded below.  

3 Ways to Make Electronic Health Records Less Time-Consuming for Physicians: Best Practices

Physicians in the United States are justifiably upset by the amount of time they spend using electronic health records (EHRs). This is true across primary care physicians and specialists, and it contributes to physician burnout. The annual cost of physicians spending half of their time using EHRs is over $365 billion (a billion dollars per day) — more than the United States spends treating any major class of diseases and about equal to what the country spends on public primary and secondary education instruction. This is a problem that can be solved now by taking three steps.

Best Practices

• Standardize and reduce payer-imposed requirements - A big part of the problem is the documentation requirements that payers impose on providers. Making matters worse, these requirements vary from payer to payer in the United States. Standardizing and rigorously reviewing their utility is essential. The U.S. Centers for Medicare and Medicaid Services (CMS) is beginning to make strides in reducing requirements with its Patients over Paperwork initiative, and we believe that private payers should adopt the same principles and agree on a set of standards, requiring documentation only when it truly adds clinical value.
• Continuously improve EHR workflows - This is something every provider can do right now. There is significant potential to improve user workflows without any regulatory changes or technology innovation. Colleagues who have seen EHR implementations across multiple organizations estimate that there is the potential to improve workflows in the EHR by about 20%, on average, by removing steps that don’t have any value. For instance, Geisinger, which serves communities in Pennsylvania, streamlined the work to get patients to the right musculoskeletal provider from a frustrating multi-click process (or a five- to 10-minute phone call) to one that simply asked two questions: What is the patient’s complaint? and What is the location of the injury? This led to significant increases in provider satisfaction and decreased time for patients to be seen.
• Unleash innovation - Tech advancements — such as voice recognition, digital scribes, and connected devices — are already beginning to further automate and reduce time spent entering information into the EHR. But once all of the information is in the EHR, clinicians still need help with the other half of the problem: the EHR user experience, which is widely viewed as being many years behind that of other industries.

The full Harvard Business Review article can be viewed at this link.  

Implementation of Patient Engagement in the Netherlands: A Stimulating Environment within a Large Academic Medical Centre- Best Practices

Patients are the official third party of the Dutch healthcare system, apart from healthcare providers and insurers.  Radboud university medical center (Radboudumc) is a regional centre for specialized secondary care in the Netherlands.  Here innovation is recognized as a decisive factor when it comes to the implementation of patient engagement.  Therefore, all employees are invited to innovate, experiment, fail and implement promising innovations into practice.  In this paper, we demonstrate how this stimulating environment led to a rich collection of patient engagement activities in organizational (re-)design and in educational programs for students and employees.

Best Practices

• Support experimentation - Support the non-homogeneous evolution of engagement in which employees are free and motivated to experiment.  Allow initiatives to fail.
• Involve patients - Build long-term relationships with patients by involving them from the beginning until the end.
• Create a comfortable environment that makes involvement meaningful - For patient engagement at the organizational design and governance levels, ensure that patients stay in their role of patient, guaranteeing that they make a unique and complementary contribution.  For patient engagement at the level of direct care, ensure that each patient is seen as a person, with a unique and complementary perspective on healthcare.
• Prepare and organize - Prepare patients for their efforts in patient engagement and organize patient engagement in a professional manner to ensure that it is valuable to the organization.

The full article can be downloaded below.  

Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients

HHS convened the Task Group in May 2017 to plan, develop, and draft this guidance document. To ensure a successful outcome and a collaborative public–private development process, HHS engaged a diverse group of health care and cybersecurity experts from the public and private sectors. Participation was open and voluntary. HHS collaborated with the HPH Sector Government Coordinating Council, the HPH Sector Coordinating Council, the Department of Homeland Security (DHS), and the National Institute of Standards and Technology (NIST).ii ii Participants included subject matter experts with backgrounds and experience in the following roles: chief executive officer; chief information security officer (CISO) and/or IT security professional; chief information officer; chief risk officer or other risk manager; office of technology leader or hospital administrator; doctor, nurse, and other health care practitioners The Task Group’s approach to the guidance document:

1. Examines current cybersecurity threats affecting the HPH sector;
2. Identifies specific weaknesses that make organizations more vulnerable to the threats; and
3. Provides selected practices that cybersecurity experts rank as the most effective to mitigate the threats.

This document provides best practices regarding risks such as:

• E-mail phishing attacks
• Ransomware attacks
• Loss or theft of equipment or data
• Insider, accidental or intentional data loss
• Attacks against connected medical devices that may affect patient safety

The full Health and Human Services document can be downloaded below.  

6 strategies for successful workforce technology implementation​: Best Practices

Healthcare staffing and scheduling is complex and time-consuming. It requires constant attention by managers, including navigating layers of internal and external variables that influence daily outcomes. These multifaceted processes may require contemporary strategies and integrated technology solutions for effective management. This article offers a practical guide for implementing integrated data-driven workforce management technology.

Best Practices

• Establish the project team - Clear roles and responsibilities are foundational for success.
• Determine the how - Define how the project will be implemented.
• Assess the organizational structure - Organizational assessment provides insight into critical aspects of the project, including how to build and design the technology to align with organizational workflow, define roles based on end-user needs, and develop training. 
• Consider the timing - The success of a project depends on the organization’s ability to develop a realistic timeline that considers the project’s scope, resources, and team size.
• Standardize project documents - Standardizing activities and documents improves efficiency for the project team.
• Pre- and post-go-live support activities - Pre- and post-go-live support activities engage end users and encourage them to adhere to new technology. Users can voice concerns to the project team and share information about challenges that require modification. 

The full article can be downloaded below.  

Healthcare establishments as owner-operators of digital billboards: making the most of excellent roadside visibility and high traffic counts to better connect with patients- Best Practices

Digital billboards offer significant advancements over their static counterparts and, when paired with excellent sites located on the premises of healthcare institutions, myriad communications possibilities result. By installing and operating digital billboards onsite, health and medical establishments gain extraordinary communications power and utility, permitting the active engagement of passersby in immediate proximity to their given facilities. Courtesy of their robust size and vibrant displays, these modern outdoor advertising platforms garner significant attention, something enhanced further by the ease of modifying their advertising messages, permitting new content to be delivered instantaneously. Location and resource requirements certainly will prohibit some facilities from pursuing such, but for those healthcare institutions which have suitable sites and the associated means, digital billboards offer an avenue of extreme communications opportunity.

Long-time user and proponent of billboard advertising, Willis-Knighton Health System, in seeking to amplify its promotional efforts, arrived at the notion of taking advantage of the excellent roadside visibility and high traffic counts characterizing its campuses by installing this relatively new outdoor advertising technology at several locations, effectively becoming an outdoor advertising company of sorts. The institution’s experience as an owner-operator of digital billboards has been highly fulfilling, prompting executives to plan additional installations in the near future which will further bolster the institution’s ability to engage audiences. Through the guidance supplied in this article, healthcare entities desirous of following a similar course have at their disposal a detailed roadmap for doing so, along with information regarding associated opportunities and potential obstacles. Given the importance of communicating with current and prospective patients, especially in light of the competitive nature of the healthcare industry, health and medical establishments would do well to incorporate, when and where possible, innovative communications options. Digital billboards represent one such option worthy of consideration.

Best Practices

• Exploration - This process involves creating a committee, outlining and analyzing goals, assessing institutional readiness, and evaluating potential sites.  
• Formalization - This process involves contacting a sign company, conducting an initial planning session, conducting a tour, requesting formal site assessments, and coming to an agreement.  
• Authorization - This process involves investigating the prospects for a permit and finalizing information for an application.
• Operationalization - This process involves authorizing installation, preparing for activation, and beginning routine matters of operating and maintaining the billboard.  

The full article with detailed protocol can be downloaded below.  

9 major institutions create healthier environment for physicians: Best Practices

About half of physicians report at least one symptom of burnout, which is nearly twice the rate of other American workers. As burnout continues to receive growing attention, more health care organizations and institutions are searching for solutions to improve physician well-being. This year, nine institutions stood out for their commitment to preventing and alleviating physician burnout.

Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand the challenges physicians face.

Best Practices

• Group meetings - Mayo Clinic found that giving physicians a way to gather in small groups for semistructured, private discussions in restaurants, coffee shops or reserved rooms results in measurably lower burnout and social isolation, and higher well-being and job satisfaction.
• Banking overtime - Inspired by the idea of faculty trading favors with colleagues to meet the time demands of work and home, time banking for doctors began as a two-year study at Stanford University School of Medicine to help improve physicians’ lives to minimize burnout-induced departures. 
• Team-based care model - Since implementation in 2014, Bellin Health has seen a significant reduction in burnout across all staff, as well as improvement in patient satisfaction and quality of care. 
• System changes - Leaders at Carilion Clinic—after finding that nearly three in five physicians reported burnout—have pursued seven innovative ideas and initiatives to address burnout. These range from a central well-being committee to put the issue at the top of the agenda to support for interdepartmental exchange of effective ideas to improve well-being.
• Ease click fatigue - To improve physician well-being and prevent burnout, Yale School of Medicine searched for ways to reduce clicks and increase time spent with patients.
• Create a culture of caring and meaning in work - Henry Ford hospital implemented several burnout prevention strategies focused on establishing a culture of caring and creating meaning in work. These include “monthly wellness rounds” educational sessions on topics related to physician well-being.
• Prioritizing physician well-being - Leaders at University of Utah Health (UUH) initiated a multifaceted assessment to help guide their efforts in addressing burnout. Part of the response came in the form of a chief wellness officer and a faculty co-director of the UUH Resiliency Center meeting individually with leadership from each department within the medical school to identify opportunities for improvement.
• Address barriers to team-based care - This care model can drive increases in physician well-being, but obstacles to team-based care had to first be overcome at Cleveland Clinic. These include patient reluctance, physician apprehension and financial concerns. 
• Stress-reducing events - Through monthly wellness events and weekly emails, residents and clinical fellows at Johns Hopkins participate in a variety of activities aimed at improving well-being across the campus.

The full AMA article (with links to detailed information about each of these best practices) can be viewed here.  

How To Create A Workplace That Supports Mental Health: Best Practices

Mental health can have a serious impact on a business. According to the Centers for Disease Control and Prevention, about 80% of adults with depression reported at least some difficulty with work, home, or social activities because of their depression symptoms.

Unfortunately, disorders like anxiety and depression often go undetected for months or years. Unlike physical illnesses, mental health issues are more challenging to pinpoint.

While tackling mental health can be challenging, employers and HR professionals are in a powerful position to help change attitudes and offer a support system. Here are some tangible ways you can help your employees:

Best Practices

• Increase Awareness - Give employees access to education and resources from national organizations such as the American Psychiatric Association, the Depression and Bipolar Support Alliance, Mental Health America and the National Alliance on Mental Illness. Companies can also develop their own initiatives and programs. 
• Training - Provide opportunities for managers to attend relevant training to support staff living with mental health problems and the well-being of all staff. 
• Encourage Work-Life Balance - Work-life balance is an essential aspect of a healthy work environment and employers should offer flexible work options. Maintaining work-life balance helps reduce stress and helps prevent burnout in the workplace. 
• Develop Mental Health Policies - Without proper mental health policies in place, your company is missing out on a huge opportunity. For example, do you have policies to help prevent discrimination (including bullying and harassment) or prevent stigma around depression in the workplace? If you already have some policies in place, review your current policies and see if they can better support employees. 
• Treat People Fair - According to Tomas, fairness is treating people like they want and deserve, rather than the same. 
• Provide Screening Resources - Employers can look out for their employees’ mental health by encouraging participation in free and anonymous online screenings.
• Monitor Employee Engagement - Pay attention to engagement surveys (engagement is the opposite of burnout). When people are engaged, they are enthusiastic, positive, and proud to be a member of the organization. All of these factors forecast positive well-being.

The full Forbes article can be viewed at this link.  

Best Practices in Making a Health System Interoperable​: Rochester Regional Health

Rochester Regional Health (RRH) is a non-profit health system of five hospitals and an outpatient care network. In bringing these hospitals and networks together, RRH was tasked with converging a number of systems, including multiple electronic health records (EHRs), other clinical systems, and the regional and statewide HIEs (Rochester Regional Health Information Organization (RRHIO) and Statewide Health Information Network of New York (SHIN-NY)). Currently, they are able to aggregate data from key sources of clinical data beyond the data found in RRH’s primary EHR system, Epic. They utilize Epic Care Everywhere for links with other Epic providers, public health information exchanges (HIEs), a private HIE, emerging networks like CareQuality, eHealth Exchange, and CommonWell, and other methods such as Direct messaging, single sign-on (SSO), and FHIR and open APIs.

RRH has invested in certain infrastructure and utilities, without which the value of interoperability cannot be attained, including:

• Using an eMPI to accurately identify patients across over 30 health system and community (RRHIO) data sources
• Using consent tracking to note who can see sensitive information and how the patient has authorized RRHIO to share their data (per NYS patient consent regulations)
• Putting forth a large data normalization tool to ensure that ‘system to system’ and ‘system to community’ exchanges have a standard set of clinical data architecture
• Integrating an internal provider identification credentialing process across the entire RRH system
• Handling referrals internally and externally with their partners through standard Epic tools
• Implementing a set of governance advisory councils and groups to guide their internal perspective and represent patients

The resulting interoperability infrastructure has provided the basis for:

• Transitions of Care – Clinicians, working in their native EHR, have a longitudinal patient record view, have a much more complete view of a patient’s encounter activity across the entire community, and not just as their native EHR views the patient.  This insures consistency in clinical data access from ambulatory, to inpatient, to post-acute, to home care.
• Business Intelligence – The collection, aggregation, and normalization of key clinical domains across its private and public HIE clinical data repository…including problems, allergies, medications, immunizations, procedures, vitals, lab results, radiology reports, and clinical documents…feeds a robust, normalized enterprise data warehouse, supporting many of RRH’s business and clinical intelligence initiatives.
• Gaps in Care – An EHR’s view of “Gaps in Care” is typically from its own clinical data repository.  However, a clinically integrated, HIE, combining the enterprise and community view of the patient, insures a more realistic view of a patient’s care needs, while reducing unnecessary, redundant, laboratory testing and imaging studies.
• Patient Engagement – The patient-provider relationship is a more productive conversation when the provider has a broad, longitudinal view of a patient’s medical record, focusing the path forward to better, comprehensive care planning.

As they move from the traditional volume-based economy to a value-based economy, RRH would like to create a value proposition and are strategically focusing on areas such as:

• Network development: Reach their communities through a vast network of touch points for all their care needs
• Patient experience: Build and deliver a signature experience for patients anywhere in their system. Patients need an experience where they are part of their own healthcare
• Operational excellence & Integration:  Strive to make the organization better, knowing that when RRH thrives, their patients thrive
• Innovation & Population Health: Improve the health and wellness of the people in their region through innovation

As the healthcare industry experiences a digital health revolution, RRH recommends the following considerations for success for turning innovation into something meaningful for the healthcare industry:

• Learn from peers and other industries outside of healthcare who are successful and leading the way
• Form new relationships at the local, state, and federal level to synch strategies
• Empower patients and clinicians
• Develop a purpose-driven approach that includes understanding the problem, engaging end-users early in the process, and tailoring the approach to fit the workflow
• Do not design technology until an organization has understood the problem, listened to customers, and thought about the workflow

These best practices and considerations for success were discussed as part of a presentation by Rochester Regional Health during eHealth Initiative’s September 2018 Technology & Analytics Workgroup meeting.