Slides

Plenary Sessions

Opening Keynote Address: Transforming Healthcare through Open Innovation (Monday 8:30-9:00 am)

Presenter: Michael Levy (Bluedoor)

Lightning Talks (Monday 1:15-1:45 pm)

This session will feature five-minute presentations from a variety of leading healthcare companies:

Breakout Sessions

Learning Health: Foundations, Future & Provocations (Monday 9:15-10:00 am)

In this session, the presenters will discuss the foundations and context of learning health systems, including background and relevance to interoperability, evidence generation, bridging of healthcare and research, systems-level improvement, population health, and levels of scale from local to national. They will also pose ten provocative questions about learning health and future potential intended to fuel thought, engagement, and creativity from the attendees.
Presenters: Erich Huang, MD (Duke University School of Medicine) & Shelley Rusincovitch (Duke Clinical and Translational Science Institute)

OCR HIPAA Audit Program: How to Use Lessons Learned to Prepare for an Audit or Compliance Review (Monday 9:15-10:00 am)

The Office for Civil Rights (OCR) will soon enter the third year of its permanent program to audit healthcare providers, hospitals and employer-sponsored group health plans to measure their compliance with the HIPAA Privacy Rule, Security Rule, and breach notification requirements. OCR’s audit program was expanded to include reviews of business associates to measure their compliance with the Security Rule and how they approach their obligations under the Privacy and Breach Notification Rules. As OCR conducts more targeted compliance reviews and audits, it is imperative that HIPAA covered entities and business associates have the tools to prepare. This presentation will review the 2017 audit process, look back to lessons learned from the 2016 desk audits, and explain the steps organizations can take to prepare.
Presenter: David Holtzman (CynergisTek)

A Regional HIE: Using Data to Improve Patient Care (Monday 10:15-11:00 am)

In healthcare today, providers face increased pressure to improve the quality of care and reduce costs.  A regional HIE offers a wealth of support from the data needed to deliver better care coordination to the quality reporting needed to meet reimbursement requirements and the opportunity to improve patient interactions.  Recently, Coastal Connect HIE began performing validation tests on data within the HIE to help ensure the richest possible data is collected.  In addition to providing real-time access to clinical information and an unambiguous source for predictive analytics, data collected by the HIE is being utilized to provide notifications for at-risk and difficult-to-resolve situations.
Presenter: Blair Kraft (Coastal Connect HIE)

U.S. Health Care Reform: Will it Rise from the Ashes? (Monday 10:15-11:00 am)

Health care reform is in flux once again. With a new Presidential administration and Congress, the future of the Affordable Care Act (also known as the ACA or ObamaCare) is uncertain. So what comes next, under a refine, repeal and/or replacement of the Affordable Care Act? What might be the fate of the more than 200 CMS Innovation Center projects underway in North Carolina? What are the strategies proposed by the new Administration and Congress, and will they work any better? What do we know about their likely impacts on health care? Is the problem too much regulation? Or does the Affordable Care Act demonstrate the failure of the market to deliver affordable access to health care? Available evidence on the effectiveness of proposed concepts, including high-risk insurance pools, health savings accounts, tax credits for private insurance purchase, and availability/marketing of insurance products across state-lines, will be reviewed.
Presenter: Leslie Greenwald (RTI International)

Using HIE to Improve Data Integration and Patient Care Delivery (Monday 11:30 am-12:15 pm)

Carolinas HealthCare System CareConnect has been connecting providers to multiple sources of clinical information since 2011. As a regional HIE, CareConnect provides clinical data to participants in our region, state, and beyond. We have connected over 250 physician practices, 30 hospitals, continuing care organizations, and home health agencies to patient information at the point of care. In our presentation, we will share usage statistics and real-world case studies where clinical care has been improved through multiple source data integration. We will expand on our experiences cooperating with would be competitors to make patient information available to those that need it in a timely, electronic format in order for patients in our region to receive more coordinated care. We’ll cover the multiple ways we can make data available be it through a consumer portal, integration with a participant’s electronic medical record, or via Direct Trust message exchange. HIEs can play a key role in supporting population health management and clinically integrated networks – we’ll review how CHS is doing that today and in the future with our CIN, Carolinas Physician Alliance.
Presenters: Tonya LaLande & Jonathan Sherman (Carolinas HealthCare System)

 

The World of eConsults (Monday 2:00-2:45 pm)

ECU Physicians and Vidant Health are jointly participating in the AAMC (Association of American Medical Colleges) sponsored Project CORE (Coordinating Optimal Referral Experiences). eConsults are sent from primary care providers to designated specialists with an expected turnaround of less than 72 hours. The eConsult is an order from the patient’s PCP with their precise clinical question and pertinent clinical information regarding the patient’s current condition. A successful eConsult saves time for the patient, costs less and is a quick and easy way for the specialist to turn their curbside consult into a documented encounter in the electronic health record. We credit the PCP and the specialist with wRVU’s. Enhanced referrals are simply ambulatory referrals to said specialties with templated information pertaining to the patient’s history, symptoms and testing. With the addition of this clinical information, the specialist can eliminate costly tests and/or subsequent visits to the specialist. ECU Physicians and Vidant Health are anticipating positive impacts on specialty access as well as patient satisfaction. This project is one of the spokes in the wheel of analyzing our referral patterns and other referral metrics.
Presenters: Tommy Ellis, MD & Mary Thompson (ECU Physicians)

Artificial Intelligence Challenges the Status Quo (Monday 2:00-2:45 pm)

People are consumers of products driven by technology, but most are not aware of the ways it is used nor how dependent they have become on what technology can do. The term “artificial intelligence” is confusing and misunderstood, but forward-thinking organizations understand its importance. During the past several years, major companies such as Google, Apple, Facebook, Amazon, and Microsoft have been increasing their capabilities in AI, with several rapidly expanding into the health care market. Although the federal mandate for nationwide use of electronic health records has had a significant impact on the way health care is delivered, the health care industry is still in the early stages of transformation to automation. AI is a term frequently used in discussions about ways to use the increasing volume of electronic health care data for predictive medicine and clinical decision making. This presentation will explore what AI is, how it is currently being used, how it challenges the way medicine is practiced, and the future of health care.
Presenter: Vivian West (Duke Center for Health Informatics)

Energizing (or Re-energizing) Your Information Governance Program (Monday 3:15-4:00 pm)

This session will present opportunities and best practices in information governance to support value-based care. Topics will include:

  • The importance of extending “data governance” to a more comprehensive “information governance” model
  • Adopting a measurable information governance structure that works in your organization’s context and culture
  • Developing a collaborative information governance team jointly driven by the Legal, Compliance, Analytics, and Information Technology functions and working with key clinical and finance stakeholders
  • Educating key stakeholders – especially senior business and clinical executives – regarding effective information governance, i.e., understanding how to mitigate organizational risk without impeding timely access to actionable information
  • Creating an information governance model that delegates decision rights as much as possible to front-line subject matter experts while satisfying executive risk mitigation concerns
  • Using a use-case-driven approach to build engagement and to demonstrate measurable progress early and often

Presenters: Richard Pro & Laurie Norton (Cone Health) and Paula Edwards (Himformatics)

Patient Portal Usage: A Study of Its Antecedents & Patient Outcomes (Monday 3:15-4:00 pm)

Patient portal usage is a significant research topic because of the ongoing proliferation of patient portals driven by the need for providers to comply with Meaningful Use mandates and other legal requirements. Portal proliferation has also been driven by motivations to address the rising costs and improve the quality of healthcare, factors important in the current political and economic environment and of great importance to both small and large businesses as they struggle to reduce costs. Despite these motivations, a majority of Americans are either unaware of or do not have access to digital tools to better manage their health care. The motivating factors of portal usage remain unclear, hampering healthcare providers from being compliant and from exploiting the full potential of the technology. Our research study will investigate the factors that influence patient portal usage and its impact on health-seeking behaviors and health outcomes.
Presenters: Reginald Silver, Antonis Stylianou & Chandrasekar Subramaniam (UNC Charlotte)

Antipsychotics & Risk of Crisis (Monday 4:15-5:00 pm)

Non-adherence to antipsychotic medications, especially among people with severe mental health disorders, is one of many factors linked to increased use of crisis and hospital services among this population. The Antipsychotic Medication Adherence (AMA) Project was a solution driven by Cardinal Innovations’ newly-formed Data Sciences and Business Analytics (DSBA) department for the Clinical Operations Department and staff pharmacist to proactively identify members most at risk for a crisis event or non-adherence to their medications, despite the serious time lag in available pharmacy data. Using advanced statistical methodology, Cardinal Innovations’ DSBA team produced strong guidance for clinical teams to identify members most at risk, and also provided a foundation for establishing program efficacy. The AMA Project provided Cardinal Innovations’ Clinical Operations, Care Coordination, and Pharmacy teams the capability to proactively identify and effectively assist members most at risk for the severe consequences tied to non-adherence to antipsychotic medications.
Presenters: Erin Drucker & Brent Matthewson (Cardinal Innovations Healthcare)

Real World Evidence & Analytical Use Cases (Monday 4:15-5:00 pm)

Use of Real World Evidence (RWE) to address population health issues and for comparative effectiveness research continues to gain interest. Real World Data (RWD) become more accessible from various sources, and open source applications help to transform big data into common data models for researchers to use. This presentation will highlight two use cases: one focusing on patient profiling using comorbidity risk scores such as Charlson index, Elixhauser index or LACE index; the second identifying incident (newly diagnosed patients) vs prevalent cases (existing or established patients) in a cohort to compare subgroup outcomes for a given treatment.
Presenters: David Olaleye & Xiao Yang (SAS)

Building a Security Culture to Counter Emerging Cybersecurity Threats (Tuesday 9:00-9:45 am)

During 2016, the healthcare industry experienced a proliferation of new cyberattack vectors. Hackers are changing their approach to exploit new technologies and immature controls, and look for ways to rapidly monetize their successes. Many healthcare providers are discovering that traditional back-office security controls are not adequate to address these emerging threats. The security culture is a critical control and is often overlooked. As budgets are squeezed, it is important for everyone to understand that technology cannot defeat hackers without buy-in from all levels of management. We will provide guidance on strategy will include how to enhance security architecture and mitigate controls, as well as practical tips on how to improve security posture and program effectiveness.
Presenters: Clyde Hewitt (CynergisTek) & Chuck Kesler (Duke Health)

Improving the Experience of Specialty Care through Scheduled Virtual Encounters (Tuesday 9:00-9:45 am)

Cone Health continues to put patient experience first, by going beyond telehealth for urgent care to implementing scheduled virtual encounters for specific patient populations in primary care, oncology, and cardiology. In working with its virtual care partner, MDLIVE, Cone was able to build a deep level of integration between their Epic MyChart portal and the MDLIVE virtual care platform. This technology allows patients visiting Cone specialty practices to schedule virtual follow-ups with their providers using technology they were already familiar with, Epic MyChart. Beyond the technology, Cone used this implementation as an opportunity to further demonstrate to patients that experience matters and is an integral part of their care.
Presenters: Jake Fochetta & John Jenkins, MD (ECG Management Consultants)

The Hacker Identity: Behavioral Threat Modeling (Tuesday 10:15-11:00 am)

The use of advanced threat modeling and incident response exercises are becoming a common approach for assessing real-world risk in the financial and technology sectors. In this presentation we will discuss the need for an approach within both healthcare providers and healthcare technology firms, and how to carefully account for and monitor patient risks during these types of exercises. By testing both the people skills and IT systems simultaneously, an effective red team and APT exercise will highlight areas of deficiency that the typical healthcare or IT security risk analysis alone may not uncover. The safety of biomedical devices is a critical element for any healthcare cybersecurity program and must be included in all red team and threat modeling exercises. We will discuss effective security analysis and management of these devices and their associated applications, utilizing clinical security best practices and factoring in international security, privacy and manufacturing regulations. Presenter: Ray Hillen (Agio)

Mobile Integrated Health Care: Decreasing Frequent EMS Utilization (Tuesday 10:15-11:00 am)

The deployment of EMS resources and use of Emergency Departments for low acuity medical issues is an inefficient and costly use of healthcare resources, yet many patients frequently access healthcare via this form of care delivery. One study found that approximately 16% of EMS calls were considered to be inappropriate while nearly 20% were considered to be “possibly” unnecessary. With each ambulance ride ranging from $224 to $2,204, this quickly results in an excessive amount of healthcare expense that could be avoided. Community paramedicine, which focuses on paramedics being trained to safely and effectively perform in an expanded medical role, is a growing field that marries more highly trained paramedics with the technology used to solve EMS overuse. Learn how one North Carolina EMS reduced unnecessary transports by 90% after implementing a telemedicine pilot into their EMS strategy.
Presenter: Bobby Park, MD (RelyMD)

Enterprise Telehealth Strategy: If You Build It, They Will Come (Tuesday 11:15 am-noon)

Moving pilot telehealth projects from silos into an integrated organizational solution is complex. How the telehealth business is launched can have a long-term impact on how it is perceived, which impacts the sustainability of the telehealth program. To achieve the program goal and objectives, Greenville Health conducted an organizational readiness assessment and developed a sustainable telehealth business plan and strategy that is supported by executive leadership. In this presentation, topics discussed include organizational readiness assessment methodologies, critical assessment factors, and the process of translating the findings into a SWOT analysis. Learn about the key components of developing a telehealth business plan and strategy, including: defining a business model, funding a telehealth program, developing a Pro Forma, and establishing strategic building blocks.
Presenters: Michelle Hager (Blue Cirrus Consulting) & Blix Rice (Greenville Health System)

Risk Stratification and Patient Targeting Strategies (Tuesday 2:00-2:45 pm)

This presentation will cover the pros and cons of several different approaches to risk stratification and their application to various populations. Risk models have evolved over the past few years from pure clinical risk to more emphasis on modifiable risk to avoid preventable utilization and costs. Many providers are trying to incorporate new data and social determinants into data models to enhance the predictive capabilities and understand possible care management levers. Others spend time collecting primary data points, possibly sacrificing time that could be spent on interventions and quality improvement. Learn about important characteristics to consider when evaluating potential models including costs, data factors, time to implement, and various use cases (transitional care management, disease management outreach, during a patient encounter, etc.). Furthermore, this session will include lessons learned in deployment of risk models into population health and care settings offering critical success factors for patient targeting.
Presenters: Mike Rhoades & Marya Upchurch (Blaze Advisors)

Telehealth Strategy and Program Design 2.0 (Tuesday 2:00-2:45 pm)

As Telehealth and Telemedicine has evolved and improved over the past two decades, technology is no longer a major limitation. In this session, learn about current patient-centered delivery models, key success factors, a maturity assessment framework and lessons learned for a health system’s Telehealth program design and implementation. Real-world examples will be presented with an emphasis on what works and what does not. Time-tested examples of use cases from setting up the US Navy’s global telemedicine program, which included 12 medical specialties for 28 ships, 23 hospitals and clinics and three medical centers supported by a program staff of four healthcare professionals.
Presenter: Richard Bakalar, MD & Neha Sachdeva (KPMG)

Extending Reach by Leveraging Virtual Care (Tuesday 2:00-2:45 pm)

The ability to engage and treat patients outside of a brick-and-mortar office eliminates unjust differences in access to care, regardless of geographical and social determinants of health. The ability to engage patients in a meaningful way by using virtual offerings and services is going to drive changes in patient outcome in the future. Virtual care programs and offerings have the ability to increase productivity, access to care, and provide interventions for high risk patients, sooner. Learn about the importance of leveraging virtual care solutions to improve patient access to care and drive outcomes, regardless of the setting of care.
Presenter: Kim Lewis (Lenovo Health)

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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