Monday, September 16
Opening Keynote Address (8:30-9:30 am)
Concurrent Breakout Sessions (9:45-10:30 am)
Knowledge Management in Healthcare Analytics
Greg Nelson (Vidant Health) & Monica Horvath (UNC Health Care)
The promise of actionable analytics in healthcare poses an inherent challenge as we seek to accelerate the time it takes to go from question to insight to action. The velocity of change, the demand for bigger data, the allure of advanced algorithms, the need for deeper insights, and the cost of inaction make knowledge capture and reuse an all too elusive goal.
In an evolving environment, healthcare organizations need to find ways to make greater use of prior investments in analytics products by reusing the commonalities of proven designs, metadata, business rules, captured learnings, and collaborative insights and applying them to future analytics products. By doing so in a strategic manner, they will be able to create rapid and efficient analytics processes and better manage time to value and reuse.
In this presentation, authors from two very different health systems with two very different patient populations will share their perspectives of the value of knowledge management and discuss the role of analytics in driving towards a learning health system. The authors will highlight opportunities and challenges using examples across clinical, financial, and operational domains.
Towards 2030: How to Transform Your Organization into a Connected Enterprise to Deliver Patient-Centered Care
Michael Kirby (KPMG)
The healthcare industry is facing major demographic changes that will dramatically impact which services are needed and how they are delivered. As Millennials, Generation X, and Baby Boomers enter new life stages at the same time, there are simultaneous demands for lower cost, convenient care and better management of chronic illness and outcomes. Concurrent with these population changes are such market factors as the growing needs to quantify value, align with consumer access preferences, and respond to the ever-present threat of technology disruption.
Our hypothesis is that as healthcare organizations seek to put the consumer at the center of healthcare delivery, they must align the front, middle and back office to create an omni-channel or “connected enterprise.” This approach is also critical to develop a layered delivery network through which patients can access care at various points ranging from retail clinics to virtual portals to their own homes. By creating a consumer-driven system, the aspiration is that patients can move seamlessly throughout the system as they age and their needs evolve. Our hypothesis is that there are eight critical capabilities that all organizations must have to create connected healthcare organizations and achieve our patient-centered objectives by 2030.
NCHICA Session TBD
Details coming later.
Concurrent Breakout Sessions (11:00-11:45 am)
Patient Outreach & Care Gap Closure: Observational Analysis of a Digital Health Engagement Program
Jiaqi Huang (Lumeris)
The timely delivery of preventative services contribute substantially to the improvement of patient outcomes and to overall health plan quality ratings. Scarce internal resources and high administrative costs are two substantial challenges healthcare organizations face when trying to provide timely and sustainable patient engagement at scale. This study examines the impact of a collection of digital health engagement programs targeting multiple different gaps in care. We analyze the effectiveness of these outreach programs on closure of multiple types of care gaps.
Details coming later.
Creating a Regional Learning Health System and Integrating Precision Health
Holt Anderson (Learning Health Strategies) & Sara Imhof (NC Biotechnology Center)
Launched as a concept by the National Academy of Medicine in 2008, the realization of Learning Health Systems (LHSs) is gaining ground around the globe. The momentum and investments in precision medicine may benefit from the structure of LHSs. This session will explore the LHS and precision health concepts, what is necessary for a regional system (literal or figurative), provide examples underway elsewhere and the potential for NCHICA’s members to join in a leadership effort to explore this concept and map a strategy for achieving success. An important area of great potential impact with an operational LHS in our region would be in the area of precision health. The goal and ultimate success of this effort would be improved decisions at the point of clinical interaction through knowledge gained by participation in an LHS that incorporates precision health knowledge.
CIO Reverse Pitch (12:00-1:00 pm)
A panel of CIOs will discuss their biggest concerns and priorities.
Concurrent Breakout Sessions (2:00-2:45 pm)
Developing a Data Strategy for Health Care Organizations: Techniques and Tips for Improved Organizational Performance and Better Patient Outcomes
Gerhard Pilcher (Elder Research)
Data underlies all of our best efforts to evolve health care practices. Data, and lots of it, now come in many forms and from many sources. Data is the catalyst for the transition from volume-based, episodic care to value-based, personalized care. A workable data strategy has to account for a variety of data forms and sources. A good data strategy bakes in empathy for each individual represented by the data. And, a great data strategy ensures that any movement of data within the organization is reliable, timely, and makes provision for increased data asset value. Great data strategy is the foundation for improving the delivery and outcomes of our healthcare experience.
Who’s Holding Your PHI? A Strategic Plan to Take Control of Your Security Risk Management
Gerry Blass (ComplyAssistant) & Mike Chirico (New Bridge Medical Center)
Every healthcare provider, regardless of size or complexity, should have a strategy in place for security risk management. With momentous changes in healthcare technology over the past four decades, protected health information is more valuable now than ever before, making it more vulnerable to breach. The burden is on you to ensure your organization, along with every third-party vendor, adheres to agreed-upon standards of security and protection. This session offers a fundamental guide to identify best practices, roadblocks and solutions to build a comprehensive security risk management strategy that works for any healthcare organization, even with size and resource limitations.
- Identify the essential components of a comprehensive security risk management strategy to ensure controls are in place to safeguard protected health information (PHI).
- Examine best practices, gleaned from real-world examples of healthcare security breaches, for creating and enforcing a security risk management strategy that can work for any organization, regardless of size or complexity.
- Discuss the various security frameworks available, and how to choose which framework is right for your organization.
NCHICA Session TBD
Details coming later.
Concurrent Breakout Sessions (3:00-3:45 pm)
EFIcacious: Electronic Frailty Index for Clinical Care in Older Adults
Nicholas Pajewski & Kathryn Callahan (Wake Forest School of Medicine)
Population estimates show that the fastest-growing demographic is adults over 65, with adults over 85 exhibiting the most rapid growth. Frail and vulnerable older adults may benefit from targeted interventions, with recent evidence suggesting that frailty itself may be reversible. Despite the existence of several validated definitions and instruments, measures of frailty have been slow to integrate into clinical care. Based on the theoretical model of deficit accumulation, we have previously developed an electronic Frailty Index (eFI) based on routine data captured in the Electronic Health Record (EHR), including encounters, diagnosis codes, vital signs, laboratory measurements, medications, and functional information from the Medicare Annual Wellness Visits.
In this talk, we will demonstrate the predictive utility of the eFI in two settings. First, we examine the association of the eFI with healthcare utilization, injurious falls, and all-cause mortality in a primary care population affiliated with our Medicare Accountable Care Organization. Second, we explore frailty as a marker for post-operative complications for older adults undergoing elective surgery, including post-operative delirium, inpatient length of stay, and discharge destination. Finally, we will discuss future directions, including integration of the eFI within the EHR, developing automated care pathways for frail older adults, and testing interventions in specific conditions – e.g., diabetes management, cardiovascular procedures, or cancer therapies – that may improve functional as well as medical outcomes for frail older adults.
Got Workflow? Growing and Maintaining an Effective Compliance Program
Elizabeth Hunt (Southeastern Health) & Lisa Fiene (FairWarning)
In this session, learn how the Chief Compliance Officer with a small, rural healthcare system was able to enhance and optimize the workflow of her program’s compliance activities. From this improved workflow, the compliance program at this healthcare system expanded and now provides more comprehensive oversight of access into its EHR, enhanced policies and reporting, more effective and tailored training to staff, and consistent investigations and enforcement actions.
Using Telepsychiatry to Reduce Emergency Departments’ Length of Stay and Enhancing Value
Sy Saeed (East Carolina University)
Many people with mental disorders do not have access to psychiatric services due to the shortage and maldistribution of psychiatrists. This has resulted in patients going to hospital emergency departments (EDs) to seek services, resulting in long lengths of stay (LOS) and boarding of psychiatric patients in EDs. The North Carolina Statewide Telepsychiatry Program (NC-STeP) provides telepsychiatry services in hospital emergency departments to individuals experiencing an acute behavioral health crisis. East Carolina University’s Center for Telepsychiatry is the home for this program that is connecting hospital EDs across North Carolina. NC-STeP utilizes telepsychiatry, which provides the patient with a face-to-face interaction with the provider through real time video-conferencing technology. Videoconferencing is facilitated using mobile carts and desktop units. A web portal has been designed and implemented that combines scheduling, electronic medical records, health information exchange functions, and data management systems.NC-STeP has significantly reduced patient length of stay in EDs, provided cost savings to the health care delivery system through overturned involuntary commitments, and has achieved high rates of patient, staff, and provider satisfaction.
Concurrent Breakout Sessions (4:00-4:45 pm)
Data Strategy and Analytics Beyond the EHR
Shawn Sutherland (Information Builders)
Machine Learning, AI, NLP and IoT are all hot topics in healthcare analytics. These technologies have their place, but where do they fit in solving the “data rich/information poor” dilemma in which many of us are stuck? The challenge for healthcare organizations, post EHR implementation, is constructing the data strategy necessary to move into the world of value-based, consumer-driven care. Learn about the people, processes and technology you need to develop an organizational data strategy that will yield early results and consistent milestones in the pursuit of strategic, enterprise class healthcare analytics. Aligning resources across all departments to this strategy can enable any provider or health plan to become data-driven without adding FTEs. This is essential to achieving the quadruple aim while preparing for a consumer-driven market in modern healthcare.
Provider Informatics Team: An Essential Strategy to Enhance Physician Well-being
Shadi Hijjawi (CaroMont Health)
Physician well-being has been an important concern for many health authorities. This presentation highlights potential strategies and important steps that can be utilized by health institutions to help provide better stress-free environment for healthcare providers especially when dealing with the EHR. The strategies concentrate on engaging healthcare providers with a newly established provider informatics team. Engagement strategies include: revamped onboarding and rounding program, 1:1 education sessions, different team coordination, workflow evaluation, outreach and marketing strategies, and leadership engagement. An important component of this structured approach is to continuously measure healthcare providers’ happiness and areas of struggle while dealing with the EHR.
The Reviews Are In: Implementing an Action Plan after a Consumer Usability Review
Charlie Gaddy & Amy Partilla (Atrium Health)
Having a comprehensive usability report created for your consumer and patient portals is an eye-opening experience, but it can also be a daunting one. How do you begin to respond to more than one hundred pages of issues with how patients perceive your organization, and the obstacles they face in getting access to care? Presenters will share the highest-value insights gleaned from the usability report, including the issues patients face in navigating a patient portal that integrates content from multiple EMRs. They will also provide the practical approach to organizing, prioritizing, testing, and implementing functional and usability improvements to the patient and consumer portals.
Tuesday, September 17
Keynote Address (8:30-9:30 am)
Dr. Richard Lord (Wake Forest Baptist Health)
Concurrent Breakout Sessions (9:45-10:30 am)
Beyond California: State Standards for Data Privacy and Cybersecurity
David Holtzman (CynergisTek) & Hugh Harris (NC Dept. of Justice)
The attention given the California Consumer Privacy Act shines a light on the work of states like North Carolina to establish data privacy and cybersecurity standards to safeguard data containing consumers’ personally identifiable information (PII). Every state has its own breach notification laws, with nearly one-half adopting data security and/or data disposal requirements. Others implemented comprehensive cybersecurity requirements that target the insurance and/or the financial services industries. State attorneys general (AGs) have been taking innovative approaches to punish entities for failing to safeguard PII, applying a mix of data protection standards and consumer protection laws prohibiting unfair trade practices. North Carolina has been in the forefront of these efforts to expand consumer protections for PII and take action against companies when their failure to safeguard data results in unauthorized disclosures. State breach notification and data protection laws to safeguard consumer PII have created a patchwork of complex, and potentially conflicting obligations. The penalties and litigation costs for those organizations that do not yet effectively protect their PII could be backbreaking.
COMPASS-CP: An Interoperable SMART on FHIR Application to Generate Care Plans
Pamela Duncan & Umit Topaloglu (Wake Forest Baptist Health)
COMPASS-CP is an interoperable, patient-centered electronic application built with technology for interoperability with any SMART on FHIR-capable electronic health record (EHR). COMPASS-CP captures patient-reported measures of functional and social determinates of health at the point of care and uses algorithms to generate actionable, individualized care plans. It was initially developed through the COMPASS Study, currently ongoing, which has the participation of 40 hospitals across the state of North Carolina. Although designed as an electronic tool to support clinician-users and stroke patients, it has been modified to support other health conditions (e.g. congestive heart failure and cancer), which require chronic management and care planning. With the help of an interdisciplinary team, COMPASS-CP is now integrated into Wake Forest Baptist Medical Center’s EHR, Epic, in an interoperable manner. The team is working to make the solution sustainable after the completion of the study for hospitals, health systems, and payers.
Current State of Healthcare Data and Analytics: People, Process and Technologies
Lee Pierce (Sirius Healthcare)
In this roundtable discussion we will explore the current state of data and analytics in healthcare. We will review and discuss a proven reference architecture for tools and technologies that many healthcare organizations across the country are utilizing and finding useful to communicate the technologies necessary to have successful data and analytics capabilities. We will also discuss the people and process components of a successful data and analytics program in healthcare. Come participate in this collaboration opportunity with peers in healthcare that is sure to be informative and lively!
Concurrent Breakout Sessions (11:00-11:45 am)
Probabilistic Data Integration to Supplement EMR Patient Mortality Status
Peter Leese (UNC Health Care)
Electronic medical records have become more advanced in functionality, documentation collected, and external data integrated. However, EMRs continue to have significant gaps in any data not occurring in direct contact with the respective EMR institution, including medical care, medication usage and adherence, and patient vital status. Typically an institution only knows a patient has expired if the patient dies in some contact with the institution, or through some subsequent, often unpleasant touch-point with the patient’s family such as attempting to schedule follow-up care or collect a payment.
Learn about UNC’s method for using probabilistic matching to integrate the NC Vital Statistics death dataset into the Carolina Data Warehouse to supplement EMR-documented patient vital status. Also learn about the various architectural decisions made when designing the death data table / data mart in order to simultaneously support health care system operations, end-user reporting through GUI-based tools, and research through direct table access.
NCHICA Session TBD
More details coming later.
Healthcare Resilience: New Models for a Changing Environment
Angie Santiago (tw-Security)
During a disaster, the local, regional and federally managed healthcare facilities become the center of reliable information, safety and refuge. Considering the rising risks and costs of natural and human disasters, the current models of business continuity, emergency and crisis management, disaster recovery, HICS, and the federal National Incident Management System (NIMS) hierarchical designs are not flexible enough to meet various types of clinical and operational interruptions. After the disaster is declared, the portability of a patient’s information is critical to reducing post-disaster mortality rates. However, there still remains policy and technical impediments to the availability of electronic patient information before, during, and after a disaster. The standard IT disaster recovery model for the US healthcare information systems are based on 1990s design of client-server architecture and “bare metal restores.” Higher availability and portable information models are needed to support the continuity of care.
Considering the limited authority of the federal government over private sector healthcare providers, HICS and NIMS may cause more harm to the response and recovery of healthcare system. Showcasing post-disaster health system case studies from Florida, Louisiana, New York and Puerto Rico, this session poses an urgent “Call to Action” to healthcare leadership to consider new models of emergency and disaster planning based on the principles of: Do No Harm, Urgent Transparency and Interoperability.
Lightning Talk Plenary (12:00-12:50 pm)
In this fast-paced session, each presenter will discuss one of their solutions for patient engagement.
Concurrent Breakout Sessions (1:45-2:30 pm)
Delivering Patient-Centric Care with Intelligence
Chris Moore & Mary Beth Moore (White Hawk Advocacy LLLC)
As the parents of a medically fragile child, Chris and Mary Beth Moore have extensive experience from the patient perspective across hospitals and specialty clinics. They have received care across the spectrum of delivery from tremendous to negligent. With the unique view of being former military intelligence analysts deeply who understand the need to sift through large volumes of data, Mary Beth and Chris share observations and lessons learned to help medical providers address big data needs without sacrificing the well-being of the patient. They will share from their first hand experiences what creates a great medical team and where others fall short. You will hear frustrations about electronic health records failing to meet real world needs along with suggestions on how to make improvements. This is a one of a kind presentation from two parents who spend significant amounts of time in the North Carolina medical system and understand how to use data and information to drive decisions and create effective delivery teams.
Using NC HIE Services for Population Health Management
Harriet Burns (Piedmont Health Services) & Mark Massing (NC Community Health Center Assn.)
In 2016, the State of North Carolina issued a legislative mandate which required all state-funded providers to connect to NC HealthConnex, the state-wide Health Information Exchange (HIE), by June 1, 2021. In this session, presenters will discuss this mandate, its impact on providers, and how NC HealthConnex value-added services could benefit the community of providers in North Carolina.
As an HIE, NC HealthConnex links disparate health care systems and other regional and state HIE networks to deliver a longitudinal patient record that extends across a variety of health care organizations and patient care settings. This resource provides health care providers throughout the state with patient encounter information including labs, diagnostics, history, allergies, medications and more. North Carolina’s Federally Qualified Health Centers (FQHC’s) have joined hospitals and other outpatient clinics throughout the state as participants and data contributors to NC HealthConnex. As the amount of data integrated into NC HealthConnex increases, providers are faced with understanding how this tool can be integrated in the operational workflows and leveraged to support patient care needs.
Learn about the opportunities and challenges faced by Piedmont Health Services, an early adopter of NC HealthConnex. Also learn about options currently available to support population health management activities, including chronic disease management and care transitions.
Practical A/B Testing for Improving Health System Operations
Joseph Lucas (Lumeris)
In this presentation, learn about a novel analytic approach to A/B testing and its use in a real world trial. This is not an FDA style randomized trial! First, their fundamental question is, “Does the cost of this intervention justify its implementation?” Health plans and health systems have limited resources; implementing one intervention necessarily takes resources that can’t be applied to other potentially beneficial interventions. Answering this fundamental question requires a new analytical approach. Second, this new analytic approach does not require a priori definition of sample size or study duration. This allows them to run A/B tests for just long enough to make a decision, and no longer. Third, because they are working internally with pre-formatted data, there are many features of typical FDA style randomized trials they do not need to think about (or pay for). Data prep, report filing, site specific startup costs, site audits, parallel data streams, and the funding of principal investigators are all unnecessary.
Closing Plenary Session: NCCare360 Panel (2:45-3:30 pm)
View the conference agenda.