Opening Keynote Address: The Race to Digital Health (Monday 9:00-9:30 am)
(Angela Yochem, Novant Health)
Lightning Talks (Monday 11:45 am – 12:15 pm)
This session will feature five-minute presentations from a variety of leading healthcare companies.
Keynote Address (Tuesday 9:00-9:30 am)
(Hector Rodriguez, Microsoft)
Closing Plenary Session (Tuesday 2:00-2:45 pm)
Blockchain & Healthcare Interoperability: Use Cases for Enabling Secure Transport of Patient Data (Monday 9:45-10:30 am)
Blockchain technology has the potential to transform healthcare by placing the patient at the center of the healthcare ecosystem and improving the security, privacy, and interoperability of health data. But how does blockchain work and what are the key components of blockchain system architecture? What factors should health systems weigh when evaluating the use of blockchain to improve interoperability? This presentation will provide an overview of the foundational elements of a distributed blockchain ledger, how it operates, and key considerations for real-world healthcare use cases. The use cases to be discussed are: 1) utilizing blockchain as a tool for data provenance, and 2) combining the power of standardized interoperability with a smart contract-based incentive structure to empower a global community supporting international standards. (Jason Rosenzweig, Burwood Group & Massimiliano Masi, Tiani Spirit)
Analyze This! Using Data Analytics Tools to Improve Quality of Patient Care, Assess Outcomes & Evaluate Utilization (Monday 9:45-10:30 am)
The mission of the PDC Outcomes Research Team (PORT) within Duke Health’s Analytics Center of Excellence group is to design, develop and deliver data analytics solutions that provide doctors and other medical staff with actionable insights for clinical decision making within a three-month project period utilizing agile SDLC methodology. Presenters will discuss three case studies which utilized Tableau, SAP Business Objects (universes and WebIntelligence reports), and UniverseBridge to provide clinicians with actionable insights for improving the quality of patient care, assessing clinical outcomes, and evaluating resource utilization in very different areas. Through these case studies, session participants will learn the pros and cons of the different technologies, some of the obstacles and challenges they may encounter that are inherent to working with EHR data, and lessons learned. (Heidi Banks & Andrew Stirling, Duke Health)
Opioid Crisis and Potential Role of Cognitive Analytics (Monday 9:45-10:30 am)
Since 1999, opioid-related overdose deaths in the United States have quadrupled, with more than 15,000 individuals experiencing prescription drug-related overdose deaths in 2015. In that year, 3.8 million individuals aged 12 years or older reported current nonmedical use of prescription opioids. Two million individuals had a prescription opioid use disorder (OUD) in 2015. IBM Watson Health has been conducting OUD-related research including identification of people with OUD from claims data, access to treatment, cascades of care, Medication Assisted Treatment, and treatment guidelines for various federal agencies. This presenter will provide information on Watson’s current OUD research portfolio along with a discussion on the potential role of cognitive analytics. Learn how Watson and cognitive analytics technology can contribute to identifying people with OUD, creating and monitoring treatment plans, and linking patients to the right providers. (Mustafa Karakus, IBM Watson Health)
Exploring Opportunities to Improve Health & Healthcare by Creating a Regional Learning Health System (Monday 10:45-11:30 am)
Launched as a concept by the National Academy of Medicine in 2008, the realization of Learning Health Systems is gaining ground as pockets of activities are springing up around the globe and more organizations are beginning to include the concept in their strategic planning. NCHICA, with its collaborative environment and broad membership, has an opportunity to launch a regional LHS effort as is happening in Michigan and Indiana. Learn more about the LHS concept and efforts currently underway; discuss the business case needed to demonstrate ROI for providers, payers and individuals; and explore how NCHICA members can participate.
Behavioral Analytics Role in Assuring Data Security (Monday 10:45-11:30 am)
Today’s approaches to collecting and using personally identifiable information requires fresh approaches to assure confidentiality of sensitive data. Traditional monitoring of user activity using compliance-based systems suffer from lack of flexibility and accuracy. This program will explore advances in user and entity behavioral analytics (UEBA) that provide powerful tools to identify anomalies in the use or disclosure of data by monitoring user accounts across information systems, endpoint devices or embedded applications and networks. Participants will learn the pros and cons of deploying UEBA tools, and tips for effective UEBA implementation. (David Holtzman, CynergisTek & Robert Lord, Protenus)
Barriers & Facilitators for Telehealth Implementation in a Rural Setting (Monday 10:45-11:30 am)
RTI researchers studied eight frontier critical access hospitals (CAHs) in the midst of a CMS-funded demonstration program to provide cost-based reimbursement for providing access to telehealth services. Researchers reviewed applications and progress reports for the demonstration program and conducted in-person site visits. Barriers to implementation included the availability of distant providers, workflow challenges and provider acceptance. The main facilitator to implementation was external support, including additional funding and resources. Lessons learned from this study can be used to inform other telehealth implementations in rural settings. (Saira Haque, RTI International)
Enterprise Imaging: A Journey to Simplification (Monday 1:45-2:30 pm)
Learn how UNC Health Care System has leveraged technology, innovation and governance to drive down costs and work toward a single imaging record. With over nine PACS replaced, UNC has expanded its enterprise imaging solutions to over ten hospitals and networks, converted over six million exams, and has upwards of 600 users per hour viewing studies within a single enterprise diagnostic clinical viewer integrated with the enterprise EHR. The presenter will discuss: what Enterprise Imaging means for UNC; past, present and future initiatives; infrastructure and communication technologies used (e.g., DICOM, HL7, and XDS); and governance structures that support keeping costs down. (Bradley Cook, UNC Health Care)
The 21st Century Cures Act & the Future of Healthcare (Monday 1:45-2:30 pm)
The 21st Century Cures Act, touted by Congressional leaders as a “once-in-a-generation, transformational opportunity to change the way we treat disease,” was signed into law on December 13, 2016. The Cures Act is aimed at modernizing and personalizing healthcare by encouraging innovation and streamlining the process for discovery, development, and delivery of new treatments and technologies to those suffering from illness. Importantly, the legislation provides for significant funding to advance these goals, to the tune of $4.8 billion to the National Institutes of Health, $500 million to the Food & Drug Administration, and $1 billion in grants to states for opioid abuse prevention and treatment. This presentation will provide an overview of key components of the Cures Act and highlight implications for the future of healthcare. Areas of focus will include the following, particularly as related to digital health technologies: Precision Medicine Initiative, Cancer Moonshot, streamlining FDA regulations for medical technologies, and national data sharing and interoperability. (Carrie Nixon, Nixon Law Group)
Deciphering Reimbursement for Remote Patient Monitoring (Monday 1:45-2:30 pm)
Remote patient monitoring (RPM) is not a new concept. For the last 21 years, thousands of patients have received RPM services with outstanding clinical and financial outcomes. On January 1, 2018, the reimbursement opportunities for RPM changed dramatically with the release of the Medicare Physician Fee Schedule Final Rule. In this session you will learn:
- What you can do to improve patient engagement and quality of care while getting paid for providing RPM services.
- Key requirements and clinical workflow adjustments necessary to bill the “unbundled” stand-alone CPT Code 99091.
- How CMS’s 2018 Quality Payment Program Final Rule for MACRA allows for additional revenue.
- How to use other care/monitoring services/codes for Chronic Care Management, Transitional Care Management and Behavioral Health Integration while getting reimbursed for RPM.
(Bonnie Britton, Reconnect4Health)
Data Integration for the Next Frontier: Value-based Care (Monday 2:45-3:30 pm)
High-quality data and analytics are essential to survive and succeed in value-based care models. Meaningful analytics require improved data integration and quality. The presenter will:
- Demonstrate how Coastal Carolina HIE addressed data integration through infrastructure deployment and workflows, and helped provider entity stakeholders make substantial improvements in care transition.
- Provide an overview of reporting challenges and sharing best practices for improving data accuracy and completeness to elevate quality reporting and advanced population health initiatives, including identifying missing or non-standard data and working to resolution.
- Outline approaches to addressing the clinical and technical challenges of reporting quality measures moving to value-based models.
(Cory Bovair, Coastal Carolina HIE)
Third-Party Risk Management: Taking Privacy & Security Beyond the Four Walls (Monday 2:45-3:30 pm)
How confident are you that your organization has a complete and accurate inventory of business associates (BA) and other third parties that receive, transmit, process and retain company-sensitive information? How much visibility do you have into the privacy and security practices of these third parties? What is the right level of risk management and oversight to apply to them? Who should lead the third-party risk management program? With over 70 percent of healthcare breaches reported in recent years involving a BA, covered entities must expand their privacy and security programs beyond the four walls to address BA/third-party risk in a structured, consistent, repeatable and programmatic manner. For many organizations, this is an enormous task as BA/third-party relationships number in the several hundreds or more. Organizations that have started down this path cite scalability and sustainability as the most significant challenges. As with other aspects of privacy and security programs, a third-party risk management program is implemented in evolutions. This session introduces the imperatives and business case for establishing a third-party risk management program, including the fundamental “must have” program elements and a case study illustrating the implementation of a third-party risk management program in a large ambulatory services provider operating in 30+ states. (J. Scot Eibel, US Renal Care & Stephanie Crabb, Immersive)
The Future of the EHR: A Market-based Analysis (Monday 2:45-3:30 pm)
KPMG’s Healthcare Solutions team recently completed an analysis of the EHR vendor marketplace in the US and globally. From this analysis, we draw a number of conclusions relevant to both EHR vendors and users. A key conclusion is that the US EHR market is rapidly consolidating to become a very stable duopoly. This has significant implications for EHR purchasers and users, including choice, interoperability, training and of course, cost. Presenters will discuss their research on the strengths and weaknesses of major US EHR vendors and their projections on the future of the EHR marketplace. They will also provide an overview of EHRs globally, including differences in EHR priorities in other countries, EHR adoption around the world, global EHR vendors, and how this global environment is likely to influence the US EHR vendors and market. (Bruce Eckert & Dennis Puls, KPMG)
Solving Legacy EMR Data Access with Interoperability (Monday 4:00-4:45 pm)
Hospital and medical group mergers and acquisitions are dominating the landscape today. This presents a major problem of how to effectively transfer the clinical data from the legacy EMR into the surviving EMR. In this session, the presenter will share lessons learned from the six times he has implemented this process with a vendor-agnostic approach, using CCDAs to transfer the data from one EMR to another. Learn about typical timelines and the types of decisions and actions that need to be accomplished to make this successful. (Tom Wilson, Sentara Health)
People, Process & Technology: Integrated Approaches to Medical Device Cybersecurity (Monday 4:00-4:45 pm)
Medical device cybersecurity requires a holistic approach. In this session, the presenter will discuss the human, process and technology challenges facing healthcare delivery organizations and possible solutions. Solutions discussed include: integrated network-level security and mitigating controls, machine learning-based security monitoring and kill chain; vulnerability testing and management; and enterprise asset management. (Andrew Sweet, Nuvolo)
Patient Progression: A Hospital-Wide, Multi-Disciplinary, Data-Driven Approach (Monday 4:00-4:45 pm)
High emergency department (ED) length of stays, ED crowding and inefficient management of hospital patient throughput can negatively impact patient safety, patient care, and patient satisfaction. In addition, patients who leave an ED without being seen by a medical provider can lead to potentially harmful outcomes. Duke Regional Hospital set a strategic priority to improve hospital-wide patient progression. Our goals were to provide safe, efficient and timely movement of patients from admission to discharge, and to decrease patient wait times at transition points. Learn about the multi-disciplinary, data-driven approach Duke Regional used to improve hospital-wide patient progression. (Nancia Odom, Duke Regional Hospital)
Opening Plenary Session (Tuesday 9:00-9:30 am)
(Hector Rodriguez, Microsoft)
Implementing Technical Security Is Not Enough to Adequately Protect PHI (Tuesday 9:45-10:30 am)
This session will discuss how to organize and implement a focused risk structure. The presenter has led companies through the process of establishing a Risk Management Organization focused on clinical, privacy, compliance, information security and quality risks. He will walk through the creation of this organization, including board involvement, cybersecurity certifications (including HITRUST), metrics/reporting, and improvement tracking. (Gerard Scheitlin, RISQ Management)
20/20 Vision: Enabling Visual Analytics to Enhance Patient Experiences at the Duke Health Eye Center (Tuesday 9:45-10:30 am)
The Duke Health Eye Center’s main campus routinely sees on average 500 complex patients per day. Overall, the Department sees over 187,000 patients per year. To track a patient’s clinical activities during a visit, Eye Center staff implemented event and status timestamp logging within the EHR and clinical workflows that timestamp patient movements and times at each diagnostic location within their visit (i.e., check-in, check-out, photography exam, etc.). Leveraging the use of these timestamps with other clinic visits, patient and staff data, the Duke development team created an interactive Tableau dashboard containing targeted visualizations that allow for prompt yet thorough analysis of visit types, technician work-up time, and patient wait time. As a visual analytics tool, the dashboard provides clinicians with actionable insights to make decisions that will decrease patient cycle time and increase patient, provider, and staff satisfaction. (Patti Gorgone & Pam Barth, Duke Health)
Blockchain in Health: Is It Hype or Is It Real? (Tuesday 9:45-10:30 am)
Blockchain in health may be over-hyped, but it has real value when properly applied to healthcare and life science scenarios that help drive Triple Aim/Quadruple Aim objectives. The presenter will provide an overview of blockchain and the challenges of traditional blockchain capabilities, and propose a solution to overcome those challenges – including scalability, security and privacy. He’ll also present a “Blockchain in Health” decision matrix developed by Microsoft and Intel that examines the top scenarios and their potential to increase the effectiveness of healthcare processes and solutions while reducing costs. (Hector Rodriguez, Microsoft)
Best Practices in Securing Sensitive Data while Transitioning to the Cloud (Tuesday 10:45-11:30 am)
Atrium Heath adopted a cloud-first strategy in 2014. With over 900 care locations, Atrium averages 12 million patient interactions each year. The Information and Analytics Services Department works to improve patient experience and ensure the continuity of care through managing over 1,000 applications and 3,000 servers. As a part of the Information Security team, the department is tasked with securing Atrium’s data no matter if it is hosted at the data center or in the cloud. In the past four years, they have learned an incredible amount about securing sensitive data while transitioning to the cloud. The presenter will share lessons learned in understanding the shared responsibility model, establishing and enforcing cloud security policies, double-checking compliance requirements, and personnel training. (Katie Hadley, Atrium Health)
Transforming Validated Clinical Research into a Cerner and EPIC FHIR Application (Tuesday 10:45-11:30 am)
Taking validated clinical research and integrating it into clinical practice takes many years. In the past, integrating custom and traditional clinical pathways into EHRs has achieved some success in changing practice. Unfortunately, the process of doing custom EHR builds can be expensive, take a long period of time, and often these clinical decision tools are not able to be updated quickly. By utilizing the new Cerner App Store and EPIC App Orchard Store, researchers at Wake Forest School of Medicine were able to take a validated cardiovascular pathway and create a SMART FHIR app. The Cerner App Store and EPIC App Orchard utilize new FHIR protocols and enable researchers and hospitals to implement clinical pathways in a cost-effective and timely manner that was never possible before. Further, once these pathways are enabled via FHIR resources, researchers and hospitals can continuously collect clinical data that is pooled for further research or clinical pathway optimization. (Iltifat Husain, Wake Forest School of Medicine)
Add Health Consumer Wearable Ancillary Study (Tuesday 10:45-11:30 am)
The National Longitudinal Study of Adolescent to Adult Health (Add Health) is a longitudinal study of a nationally representative sample of U.S. adolescents in grades 7-12 during the 1994-95 school year. Add Health is jointly administered by UNC-Chapel Hill’s Carolina Population Center and RTI International. The study subjects (“cohort”) are being re-interviewed throughout 2016-2018 to collect social, environmental, behavioral and biological data with which to track the emergence of chronic disease as they enter their fourth decade of life. The Add Health Consumer Wearable Ancillary Study will survey 13,000 individuals drawn from the cohort to capture data on smartphone and consumer wearable device ownership. From eligible respondents identified in the survey, researchers will obtain historical measures of physical activity captured using personally owned wearable devices. This presentation will feature results of the updated study. (Robert Furberg, RTI International)
Top Ten Tips for Securing Your Healthcare Enterprise Beyond HIPAA (Tuesday 11:45 am -12:30 pm)
While achieving HIPAA compliance is necessary for healthcare providers and their business associates, it does not guarantee the security of your data. Organizations must focus on security beyond HIPAA compliance in order to protect information and reduce the risk of a data breach. Presenters will discuss the top ten tips to securing your healthcare enterprise. These are actionable items that every organization should implement. Additionally, they will share recent healthcare data breach statistics and results of a security survey of local healthcare organizations. (Jon Sternstein, Stern Security & Noah Dermer, InstaMed)
Reducing Financial Toxicity for Cancer Patients: A Data Integration Project (Tuesday 11:45 am -12:30 pm)
Cancer diagnosis for many individuals and their families comes with all types of challenges, one of which is the financial burden. A project at Duke Health was born out of the need to connect cancer patients with sources of financial support as they go through their different treatment modalities. A third-party application called “Bridge” was developed by Vivor to be the link between the patients and the different sources of financial assistance. The main challenge was to find a way to identify, curate, translate, and integrate relevant patient data with the Bridge. This sometimes required conversion of data from its original raw form to forms usable by “Bridge” such as ICD-10 and NDC codes. This automated data integration is presently happening across three platforms: REDcap, Duke MeastroCare and Bridge Mobile App. The project is ongoing and helping more than 30 patients. Learn about the project technology, tools, methodology, successes, challenges and lessons learned. (Miji Sofela, Duke Health & Benjamin Gagosian, Vivor)
Connecting Care Communities in a Value-based World (Tuesday 11:45 am -12:30 pm)
By its very definition, value-based care requires visibility into a patient’s entire path through the care continuum. Real-time and accurate clinical data is a critical tool to providing appropriate care and closing information gaps. What’s more, there are care settings such as behavioral health, skilled nursing and home health that are vital to treating the whole person but were not included in the Meaningful Use initiatives. By the very nature of its design, NC HealthConnex provides a central infrastructure for the collection of disparate clinical data and will be providing interoperability solutions to bridge the gaps in current disparate clinical settings. The speakers will discuss the role of the statewide HIE, the needs of the provider and payer communities, challenges to interoperability, and ways to close care gaps and support value-based care in North Carolina. (Christie Burris, NC HIEA & Aaron McKethan, NC DHHS)
View the conference agenda.