Session Descriptions

Plenary Sessions

Cognitive Computing in Healthcare: Current Capabilities and Future Directions (Monday 8:30-9:30 am)

Healthcare data generation is occurring at an unprecedented volume from such disparate sources as: structured and unstructured EHR data, journal articles, clinical guidelines and wearables. This challenges clinicians to provide personalized, evidence based care in a timely manner. Cognitive computing technologies provide previously unavailable data insights for individual patients, as well as larger health populations. Learn about currently available cognitive computing solutions that address these challenges, as well as exciting near-term technologies such as medical image interpretation.

Session Objectives:
· Describe the general principles of cognitive computing
· Explain the reasons to consider cognitive computing in healthcare
· Discuss current state applications of cognitive computing in healthcare
· Describe future directions

Rick Francis, MD (IBM Watson Health)

Lightning Talks (Tuesday 10:00-11:30 am)

This interactive session will feature five-minute presentations on a variety of topics, followed by an audience Q&A session. Topics include:

  • The Critical Functions of Any PMO (Mark Faggion, Shepherdwise)
  • Addressing Insider Threats Using Analytics (Mark Johnson, Iatric)
  • The Empowered Patient: The use of Social Networks, Social Media and Technology to Activate Patients for Better Health Outcomes and Lower Healthcare Costs (Tala Mirzaei, UNC Greensboro)
  • Designing a Research Request System to Access Health Data from the Self-Generated Health Information Exchange (Michael Chen, UNC Chapel Hill)
  • Top 10 Meaningful Use Questions Answered (Bruce Eckert, KPMG)
  • Using Simulation Modeling to Make Evidence-based Operational Decisions in the Emergency Department (Thomas Bohrmann, Roundtable Analytics)
  • Big Data in Healthcare (Craig Lukasik, Zaloni)
  • The Antidote to the Toxic Clinical Inbox (Dr. Sanaz Cordes, healthfinch)
  • The Many Faces of Diabetes: The Terminology Challenge (TJ VanderHeiden, Wolters Kluwer)
  • A Glimpse at the Future of Predictive Analytics in Healthcare (Mike Fulcher, Dell)
  • Intel in Healthcare and Life Sciences (Kawa Chang, Intel)

Breakout Sessions

A Platform for Innovation: SMART, FHIR and HealthKit (Monday 9:45-10:45 am)

In order to accelerate the pace of healthcare innovation it is imperative that healthcare technology vendors adopt simple, open, and secure standards to access data; but getting the data and offering compelling visualizations and/or decision support isn’t enough. Those innovations must then be incorporated into the patient or provider workflow in a meaningful way that will not require use of disparate systems. Learn what Duke has done to implement technologies such as Apple’s HealthKit and the SMART on FHIR platform to enable a new generation of data generation and access. See a demo of SMART on FHIR, including integration of an open-source app, closed-source app and self-develeped app, all running within the desktop EHR environment as well as the mobile EHR environment.

Session Objectives:

  • Describe several cutting-edge technologies that will streamline data generation and sharing
  • Witness how these technologies can be integrated into an EHR environment
  • Examine how your institution might be able to take advantage of these technologies now

Ricky Bloomfield, MD (Duke Medicine)

CommonWell Health Alliance:  Interoperability for the Common Good (Monday 9:45-10:45 am)

CommonWell Health Alliance is a not-for-profit trade association with the vision that a patient’s health data should be available to individuals and providers regardless of where care occurs. CommonWell believes that provider access to this data must be built-in to the system the provider uses at a reasonable cost. Many current health information exchange strategies have focused on connecting provider organizations within a defined geographic region. Although these models provide benefit to providers in a limited geographic region, they fail to capture the full picture of a patient’s medical data. Since patients are mobile – moving, seeking second opinions, travelling – most patients have data that is both inside and outside of the Health Information Exchange (HIE). As a consequence, in order to fulfill the vision of making a patient’s records available wherever they seek care, new connections and capabilities are required that are not able to be provided by any regional HIE. The presenter will show how both regional and national health organizations are utilizing CommonWell to enhance their existing regional connectivity strategies and enable the vision of ubiquitous health data availability for their patients.

Session Objectives:

  • List the requirements for a nationwide network
  • Describe the mechanisms to manage patient identity across geographies
  • Discuss the value of secure, ubiquitous access to patient records

Scott Stuewe (Cerner)

From “Risk Scores” to “Impactability Scores”: Innovations in Care Management (Monday 9:45-10:45 am)

As provider organizations take on increasingly greater financial risk for total cost of care, they need to be able to identify opportunities for preventing avoidable spend, and determine expected return on investment for deploying care management interventions.  Many tools currently exist for stratifying patient populations or identifying patients at risk for future high cost/utilization. While these may serve as a helpful starting point for care management, knowing that an individual is likely to have an event does not mean that the event can be prevented, and may actually divert resources away from true opportunities for impacting patient outcomes. Positive financial return on investment for care management interventions is highly dependent on intelligent targeting of resources to patients most likely to benefit. Community Care of North Carolina has accumulated over 15 years of care management experience with a diverse, statewide population, and has learned a great deal about which patients actually experience measurable benefit. As a result, CCNC has begun implementing “impactablility” scores which move care management from focusing on risk to focusing on clinical opportunities likely to have the greatest impact on future cost and utilization. The models behind these scores utilize any available data, including claims history, medication use history, illness burden, and demographic factors; as well as what is known about the characteristics of patients and situations where care management interventions have demonstrated a savings benefit. The generated score estimates the dollar savings that could be achieved from care managing that individual. We will illustrate the concept and development of such “impactability” scores and present data showing the power of such tools to find the clinical opportunities with the greatest return on investment.

Session Objectives:

  • Describe the various types of tools that currently exist for targeting care management
  • Explain the difference between risk and impactability
  • Discuss how CCNC is implementing new impactability scores for targeted care management

Carlos Jackson (CCNC)

Visualization of Health Care Data (Monday 11:00 am – noon)

With the burgeoning amount of electronic data in health care, the potential for knowledge discovery is significant if this large amount of data, or big data, is managed in innovative ways. Data visualization provides a means to identify information in big data that might otherwise not be obvious and is beginning to be of interest for the ways in which the information can be seen. A 2 ½ year study exploring novel visualization of health related data was funded by the Department of Defense for research conducted at the Duke Center for Health Informatics (DCHI). This presentation will review the historic trajectory of visualization of healthcare data; the terms and techniques using this technology; the research conducted by DCHI and findings from innovative visualization of health care data; and the potential of visualization technology for transforming care delivery.

Session Objectives:

  • Define data visualization
  • Discuss techniques that can be used to visualize health care data
  • Describe how data visualization might be used to facilitate care delivery

Vivian West (Duke Center for Health Informatics)

Successful HIE Strategies that Improve Coordinated Patient Care (Monday 11:00 am – noon)

Georgia Regional Academic Community Health Information Exchange (GRAChIE) covers just under a million patients. That may not seem like a large amount. The combined populations of Savannah, Augusta and Macon are roughly 420,000 people. The other half million patients are scattered across eastern Georgia – some of the poorest and most rural parts of the state – where health information exchange is most needed. Now that GRAChIE is live with 11 sites, only two of which use the same EHR vendor, this truly EHR-agnostic information exchange allows patient medical records to be available to providers no matter where care is delivered. In the last six months, GRAChIE has grown 450 percent in data sources and 250 percent in its system utilization. During this session the presenter will discuss the strategies they deployed to develop and implement an EHR-agnostic health information exchange and the lessons learned along the way.

Session Objectives:

  • List the strategies to develop and implement a successful health information exchange
  • Describe the challenges that may need to be overcome when implementing a health information exchange
  • Discuss how these strategies can be applied to your organization and beyond

Tara Cramer (GRAChIE)

Merging a Health Care System with An Information System Install: How to be Successful with Governance and Project Management (Monday 11:00 am – noon)

This presentation will cover an overview of the University of North Carolina Health Care System and focus on how we were able to create a governance and decision-making process to bring together an academic medical center, two community hospitals (Rex Hospital and Chatham Hospital) and all the ambulatory clinics and drive toward a common vision of “One Patient ID, One Problem List, One Medication List, One Bill.” We will cover how our governance helped us implement the Epic health information system within 16 months and under budget. We will also review the key decisions and guiding principles that helped guide the initial implementation. Our ability to use a governance structure, guiding principles and project management lead us to a successful implementation of Epic at UNC. The governance structure was a ground-up process that allowed subject matter experts to work with the Epic core team to ensure that the project moved aggressively forward. The use of key decisions and guiding principles allowed many decisions to be made rapidly. For those groups that could not come to a decision, the next level of decision making were committees of peers. When decisions were not made at that committee level, it was then taken to the executive level Epic Steering Committee where a decision was made. We will also cover how the Transformational Management Office (Our PMO organization) played a valuable role in managing the complexity of rolling out three hospitals and over 300 ambulatory practices at one time. There were six project managers who worked closely with five operational managers to escalate issues to the governance process.

Session Objectives:

  • Describe one aspect of the governance process and how you can use it in your organization
  • List a key decision and how that principle can be used
  • Describe how project management can make a project successful

Mary Jo Nimmo & Wayne Hadley (UNC Health Care)

Cybersecurity Risks: Trends from the Trenches (Monday 1:30-2:30 pm)

With an evolving, opportunistic threat landscape, security risks come in all forms.  Unfortunately, many organizations pursue complex and often costly solutions while overlooking the fundamentals of information security.  Maintaining compliance, albeit critical, does also not always equate a strong security posture.  We’ll show you how to accomplish both. In Agio’s presentation we’ll review the current threat landscape, discussing recent “real world” examples of breaches to e-PHI, as well as common challenges the healthcare industry faces, along with how to combat these challenges with straightforward tactics, policies, procedures, and solutions that significantly reduce cybersecurity risk. By prioritizing efforts, we help you stretch your dollars; by emphasizing the importance of a mutually supportive relationship between compliance and the information technology team, we ensure your weakest link isn’t so weak anymore; and finally, with Agio’s “back to basics” approach we offer a roadmap that results in a stronger security posture, while meeting current regulatory demands.

Session Objectives:

  • List typical threats to the confidentiality of patient records, based on recent breaches of e-PHI
  • Identify the common high impact vulnerabilities to your environment, as identified by the Office of the Inspector General for CMS
  • Identify the low hanging fruit of techniques, policies, and solutions that are relatively painless to implement, but can significantly reduce risk of data exposure

Ray Hillen (Agio)

Turning Information into Action: Emergency Room Teams Leverage a Regional HIE (Monday 1:30-2:30 pm)

Emergency Room Case Mangers, Hospitalists, Clinicians and other key care support roles are given access to a regional Health Information Exchange to leverage access to community data to target care intervention for high utilizers, to follow trauma, and optimize care plan for general admission patients. A look at healthcare and data at the local level to recognize patient utilization across communities, receiving care from multiple hospital facilities for many times the same health issue. Realizing the value in the management of medications when a clinician can view the medication prescribed at neighboring facility; decreasing test duplication when results can simply be queried and retrieved; improving patient encounter experiences; and rethinking the workflow around when the access to community data brings the most impact to an emergency room encounter.

Session Objectives:

  • Define use cases for ER access to regional HIE
  • Discuss pre and post clinical workflow for each ER staff role
  • Measure the value to patient experience, reduction in utilization and increase in care transition management

Yvonne Hughes (CCHIE) & Jeff James (Wilmington Health)

A Graphical and Analytics Approach to Understanding Hospital Readmissions in North Carolina (Monday 1:30-2:30 pm)

The US healthcare system is a complex and ever-changing industry and the readmission policies recently enacted by CMS, in concert with the Patient Protection and Affordable Care Act (PPACA) of 2010, have demonstrated the US government commitment to risk-sharing with healthcare delivery systems across the country.  This, along with the historical behavior of commercial insurance payers following suit with CMS actions, have driven healthcare systems to renegotiate contracts with payers.  Given this context, we have been examining hospital readmissions in North Carolina using graphical and analytical techniques.  We focused on heart failure, pneumonia, acute MI, hip & knee replacements, and COPD.  Discharge data from North Carolina hospitals were obtained from the Healthcare Utilization Project (HCUP) (administered by the Agency for Healthcare Research & Quality (AHRQ)).  Overall, for COPD, characteristics of the patient who is most likely to be readmitted include: Female gender, being 60-65 years of age, having stayed 5-7 days in the hospital, having 10 or more chronic conditions, and being discharged to a skilled nursing facility or home health agency.  These results will be discussed for all selected conditions.  Of particular interest was whether or not high-risk patients were more or less likely to be readmitted given extended travel time to the hospital, or going to a hospital different than the initial admission for the particular condition.  Finally, Tableau was used to display and dig deeper into counties that had higher readmission rates AND higher levels of poverty, examining total costs for these admissions.

Session Objectives:

  • Demonstrate using HCUP data the predictors, annual burden and cost of care of readmission for selected conditions (heart failure, pneumonia, acute MI, hip & knee replacements, and COPD)
  • Illustrate Tableau as a useful tool for examining readmissions by county
  • Present a framework for studying readmissions in light of current policies, data availability, and provider/payer relationships

William Saunders (UNC Charlotte)

Legacy Archiving: How Many Lights Do You Leave On? (Monday 2:45-3:45 pm)

Join Himformatics and two North Carolina health systems in a discussion around their data management efforts to ‘turn off the lights’ on legacy applications. Determining whether an application is eligible for retirement is a fundamental tradeoff between the business value the application provides and the ongoing fees of supporting and maintaining the application. There are many risks associated with decommissioning each system and the total cost of ownership with each application differs. Organizations are so busy acclimating, supporting, and upgrading their complex new enterprise systems that their legacy applications often remain live years after they have been replaced. Topics Covered:

  • Governance: The role and importance of cross-functional membership
  • Requirements: State, Federal and internal organization requirements
  • Reduction of Operational Expenses: Total Cost of Ownership for legacy applications
  • Inventory & Analysis: Billing and clinical data will often require different ‘long-term housing’ considerations
  • Healthcare Data Retention Vendor selection
  • Phased implementations & go-live

Session Objectives:

  • Outline the major business drivers of implementing an application decommissioning strategy
  • Describe the framework that each health system leveraged
  • Describe the specific activities that have led to an improved application portfolio, cost reductions, and preservation of data for clinical, legal, and compliance purposes

Tom Chase (Cone Health), Wendy Laposata (Himformatics)

NC DHHS Public Health Meaningful Use Update (Monday 2:45-3:45 pm)

For Stage 2 of Meaningful Use, EHs must attest to three core objectives related to population or public health: ongoing electronic laboratory reporting, immunization registry reporting and syndromic surveillance data transmission. Similarly, EPs must attest to the core objective of ongoing immunization registry reporting, and may select up to three menu measure options involving submission to state cancer registry, other disease registries and syndromic surveillance data transmission.  The purpose of this presentation is to provide updates on the Stage 2 public health requirements and reporting options in North Carolina for two public health systems included in Meaningful Use Stage 2: electronic laboratory reporting (ELR) to the North Carolina Electronic Disease Surveillance System (NC EDSS) and reporting to the North Carolina Central Cancer Registry (NCCCR). The ELR Implementation team will provide updates on the on-boarding process including the number of on-boarding hospitals and where they currently are in the process. The presentation will also include a review of common challenges and issues that can arise during implementation of an ELR interface for reporting to NC EDSS.  The NC Central Cancer Registry will present the processes established in order to recruit providers into meaningful use electronic cancer reporting, particularly those providers whose cancer cases would otherwise go unreported. The presentation will focus on current updates, operational efforts in leveraging secure transport mechanism to receive data, testing and validating the CDA messages using the validation tools. Further, the presentation will also discuss the successes and challenges in recruiting physicians, tracking and monitoring cancer reporting from multiple physicians and the consolidation of EHR data for integration into the cancer registry database.

Session Objectives:

  • Describe two of the four public health systems in NC included in core Meaningful Use requirements (NC EDSS, NCCCR)
  • Describe the status of NCCCR and NC EDSS with respect to Meaningful Use standards and implementation requirements
  • Describe next steps for Meaningful Use public health reporting in Stage 2, Year 3

Anne Hakenewerth, Chandrika Rao, Nigar Salahuddin & Sumana Nagaraj (NC DHHS)

Risk-based Monitoring Using Episode-of-Care Analytics: Derivation and Validation of a Prediction Model (Monday 2:45-3:45 pm)

Effective intervention to reduce potentially avoidable complications (PAC) associated with management and treatment of clinical episodes, although feasible, is often expensive to implement under the current fee-for-service model in contrast with value-based episode-of-case (EC) model. A predictive model that allows for risk-based monitoring of PAC under the EC analytic framework is proposed. The objective of the session is two-fold: (1) employ validated episode-of-care (EC) profiles of patients with same clinical episodes for risk monitoring of PAC; and (2) construct a predictive model based on EC framework to identify variations in care and potentially avoidable complications (PAC) within the group.  This is a retrospective cohort study of patient population insured under a commercial health plan between Jan 1. 2009 and March 3, 2012. We constructed EC profile for three conditions of interest: diabetes, asthma, and knee replacement. For each condition, we used the episode definition and clinical rules to construct EC profile for each patient by grouping related health care services provided to treat the condition over a defined time period. The EC data along with the attributed provider and attributed costs were used to develop the risk-adjustment model for predicting the likelihood of PAC using two-thirds and one-thirds of the sample as the derivation and validation cohorts, respectively. For each condition, the EC profile is used to display all clinically related services, different event indicators such as clinical trigger events that initiated the index episode and associated PACs on a timeline. Based on the derivation cohort model, predicted risk scores for experiencing PACs are computed for each patient, and then used to evaluate gaps and care variation across patients in relation to attributed providers.

Session Objectives:

  • Use clinical episodes analytics to evaluate differences in risk profiles of your patient population
  • Identify areas to target for patient quality of care improvement and minimize potentially avoidable complications
  • Utilize predictive models to uncover insights, care patterns, gaps in care, and quality measures tracking in episode-of-care centered longitudinal view of your patient population.

David Olaleye & Lina Clover (SAS Institute)

Setting the World on FHIR (Tuesday 8:30-9:30 am)

The pursuit of true interoperability has become the focus of many groups.  Patient-centered care, data sharing, big data, pragmatic clinical trials, and precision medicine are just a few examples whose success depends on interoperability.  Center to these activities is the ability to transport and use data among disparate groups.  Health Level Seven (HL7) has introduced a new standard called Fast Healthcare Interoperability Resources (FHIR) that shows great promise in enabling true interoperability.  This presentation introduces FHIR, defines what it is, and gives some specific examples.  We will discuss what makes FHIR an exciting choice, including who and how it is being implemented.  The current state of FHIR development will be included.

Session Objectives:

  • Describe the importance of interoperability in accomplishing many of the goals in current healthcare funded activities
  • Explain FHIR and what potential role it will play in healthcare
  • Discuss what you might do to contribute to the development and expansion of FHIR

Ed Hammond (Duke Center of Health Informatics)

Healthcare IT and the Ecology of Medical Care: Leave No Doc Behind (Tuesday 8:30-9:30 am)

While market consolidation has increased the number of primary care practices owned by hospital systems, most people continue to receive their primary care in independent community practices. Although it is sometimes assumed that larger systems can provide more efficient care, emerging evidence suggests that small and independent physician-owned practices actually perform better with regard to lower rates of avoidable hospitalizations and lower total costs of care.  Yet small practices face a number of unique barriers to participation in accountable care contracts or other value-based healthcare payment strategies. Principal among those is limited financial means for investment in health information technology and analytics. Under a variety of state, federal, and private funding mechanisms, Community Care of North Carolina is deploying a shared services infrastructure to support practices statewide with the analytic and reporting tools needed to understand cost and quality drivers, to implement and assess quality improvement initiatives, to identify patients most likely to benefit from targeted care management interventions, and to adhere to regulatory reporting requirements. In this session, speakers from the NC Community Health Center Association and Community Care of North Carolina will discuss challenges faced by safety net practices related to health information technology adoption, health information exchange, and the meaningful use of health data. We will describe challenges faced and strategies deployed related to data connectivity, normalization, and integration; as well as the solutions implemented to date, including chronic disease and preventive care registries;, and user applications for examining cost, utilization, and care opportunities.

Session Objectives:

  • Describe the safety net and independent practice footprint on the healthcare and population health landscape, and the need for reliable and affordable care solutions that are not hospital-centric in the current environment of healthcare transformation
  • Describe the safety net provider perspective, specifically with respect to the EHR adoption and meaningful use as necessary components for success in the evolving healthcare environment
  • Discuss the technical challenges, opportunities, and solutions for assuring availability of data analytic tools to support safety net and independent practices in population health management strategies

Annette DuBard (CCNC), Robert Eick (NC CHCA) & Marya Upchurch (CCNC Services)

Population Health Analytics Strategy (Tuesday 8:30-9:30 am)

The promise of Big Data and analytics in managing population health is one of the most hyped, yet least understood opportunities in health care today. The Center for Health Analytics and Insights at SAS hopes to change that by offering practical advice to help health care leaders create a winning strategy for their organizations.

Session Objectives:

  • Describe the technological capabilities you’ll need to adopt Population Health Analytics (PHA)
  • Identify some of the challenges you’ll overcome with PHA
  • Outline the many benefits you’ll receive from adopting PHA

Laurie Rose (SAS)

HIPAA in the Cloud: How to Effectively Collaborate with Cloud Providers (Tuesday 12:30-1:30 pm)

Like businesses across industry, healthcare organizations are rapidly adopting outsourced technologies, including Cloud Computing, to more effectively accomplish their data operations mission. However, the flexibility offered by the Cloud also comes with a price: the need to trust your provider with your sensitive data.  We will discuss the intricacies of negotiating and doing business with a cloud provider in a manner that ensures auditable HIPAA compliance. This discussion will include the following: Key concerns for with working with cloud providers including ensuring media sanitization, coordinating compliant encryption, planning security incidence response, and the provider’s subcontractor management. Main points of conflict that arise during the business negotiation with cloud providers including business associates agreements, indemnification, limitations of liability, privacy injury liability and insurance. Coordination of technical risk management including how to divide responsibilities between the customer and the IT provider and how to handle “gray” or “fuzzy” requirements of HIPAA.

Session Objectives:

  • Describe the challenges confronting adopters of cloud technologies for healthcare related businesses
  • State the key concerns for working with Cloud Service Providers in maintaining HIPAA compliance
  • Discuss how healthcare related businesses and cloud providers negotiate and collaborate to maintain HIPAA compliance

Chad Kissinger (OnRamp)

Eliminating Barriers to Genuine Health Information Exchange (Tuesday 12:30-1:30 pm)

Health information exchange is of critical importance to healthcare today for a multitude of reasons:

  • Improving access, quality and safety
  • Helping organizations coordinate and manage care across diverse settings
  • Leveraging data to improve operational efficiency and better manage populations of patients through analytics
  • Engaging and encouraging patients to become active participants in their care

Unfortunately, technological and cultural barriers interfere with organizations’ ability to achieve seamless health information exchange. Electronic health record systems typically are unable to share data with other vendors’ solutions. Access to patient data often requires clinicians to log into and out of multiple applications—an inefficient approach that de-motivates them from accessing critical patient health information.  These obstacles have gained national attention. Last fall, the New York Times ran a story quoting physicians distressed they have invested millions in their EHRs to reduce costs and improve care coordination; these technologies, however have proven incapable of sharing information with competing systems. The Office of the National Coordinator expressed similar concerns, and a survey of Accountable Care Organizations (ACO) conducted by Premier found the lack of interoperability between data sources is keeping them from reaping the full benefits of HIT. This presentation will explore the barriers posed by lack of interoperability and provide use case examples of organizations succeeding with new models of care and reimbursement such as value-based care and ACOs. The organizations have adopted interoperability platforms that aggregate and organize data from scores of disparate clinical systems (including EHR, RIS and LIS), and deliver a comprehensive, semantically harmonized patient record to clinicians within their native workflow. Access to this data ensures the clinician has the “full picture” when delivering care to individual patients, improves transitions of care across settings, and enables the use of population health analytics for better outcomes and compliance with emerging quality measures.

Session Objectives:

  • Discuss current trends in healthcare and the critical need for health information exchange among clinicians
  • Describe the technological and cultural barriers to achieving interoperability and data exchange
  • Discuss strategies being employed by healthcare organizations across the country to success with emerging care and reimbursement models.

Michael McAfee & Kathy Cohen (Allscripts)

Use of Novel Predictive Models to Improve Hospital Readmission Program (Tuesday 12:30-1:30 pm)

UNC Hospitals has many programs to continuously improve clinical operations and patient care. One program identifies patient clinical and socioeconomic, behavioral, and lifestyle factors and advanced analytics to identify patients at highest risk of readmission. The predictive models enable clinicians to deliver more personalized health care and improve healthcare quality for their patients. In this presentation we’ll focus on the technical and analytical methodology.

Session Objectives:

  • Describe the process of integrating EHR and socioeconomic, behavioral, and lifestyle factors behind the hospital’s firewall
  • List the variables that were found to be meaningful
  • Explain the predictive modeling methodology and the similarities and differences with claims-based models

Michael Cousins (Forecast Health) & Jason Burke (UNC Center for Innovation)

Achieving a Functioning Learning Health System by 2024 – The Challenges and Benefits of a Successful Journey (Tuesday 1:45-2:45 pm)

Having first been articulated by the Institute of Medicine in 2007, the concept of a Learning Health System (LHS) has gained visibility and increasing support as a vision of what our health and healthcare system should be.  The LHS builds on the increasing use of digital data, informatics, and analytics, and the potential that big data brings to the aggregation of hundreds of millions of encounters and outcomes to derive knowledge that will inform individual clinical decisions at the point of care.  The panel will address each of the significant, clinical, research, technical, and policy components to realize this vision.

Session Objectives:

  • Describe the goal to achieve an operational LHS by 2024 that ONC has established as a core objective in its 10-year plan
  • Describe the steps the research community is taking to identify, assemble, analyze and make data available to support an LHS
  • Discuss the work of clinical, legal, and operational experts who have been charged to develop a policy and governance framework that will engender accountability and trust in the LHS

Holt Anderson (Learning Health Strategies) & Ed Hammond (DCHI)

Improving Healthcare Using Lean Principles (Tuesday 1:45-2:45 pm)

In our rapidly changing industry, Lean is growing in popularity. This presentation shares the ways in which Lean principles have successfully been applied in clinical and administrative areas and health IT to create management systems that promote shared leadership, shared problem solving, and staff development at UNC Health Care. By continuously focusing on the customer’s requirements with structured communication, teams meet deadlines and implement accurate improvements more rapidly.

Session Objectives:

  • Describe the principles of our Lean Management Systems
  • Describe the Lean Tools that were used and how they were integrated
  • Explain the implementation process of these systems
  • Discuss our successes using Lean Management Systems

Nelson Nauss & Beth Willis (UNC Health Care)

NC State Health Plan: Spectrum of Health (Tuesday 1:45-2:45 pm)

The Spectrum of Health is a clinical classification scheme that segments a population into six major categories. The distribution of a population across the Spectrum describes the health status of the population. The Spectrum of Health categories are: Healthy, Healthy-at-Risk, Minor Chronic, Major Chronic, Complex Chronic and Catastrophic. In addition to the six major categories, members may have concomitant acute illness, trauma or maternity episodes. Members who are healthy-at-risk are assigned based on risks determined from health assessment data. Members in the catastrophic category are assigned based on costs above a pre-determined threshold. A population’s Spectrum of Health can be benchmarked against what would be expected based on a book of business database adjusted for demographics. The Spectrum of Health can be used to understand how health care utilization and spend segments across the categories. Insights can be obtained by studying a cohort and analyzing how they change their Spectrum of Health category over time. Among the insights: Two thirds to three quarters of high cost claimants regress to the mean in the following year. Members who are healthy because they have no claims are highly unlikely to be ticking time bombs. The vast majority of them are healthy the following year. Are we identifying and engaging the right people in population health programs? Identification and engagement rates by Spectrum of Health category can shed light on this.

Session Objectives:

  • Describe the methodology used to segment members into their Spectrum of Health Category
  • Explain the significance of a cohort’s migration between Spectrum of Health categories year to year
  • Analyze the effectiveness of population health management identification and engagement by analyzing these rates across the Spectrum of Health categories

Paul Mendelowitz (ActiveHealth Management)

There is no other place that you can hear the critical issues happening in the North Carolina healthcare and technology world like NCHICA’s annual conference. The quality of the programming is matched only by the quality of the conversations you can have with other attendees.

— 2013 Conference Attendee

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