# How Providers and Plans are Using Data: Pursuing the Triple Aim and ROI
| Chet Burrell President and Chief Executive Officer, CareFirst BlueCross BlueShield, Former Executive Vice President, Anthem Health Plans, Former Executive Deputy Commissioner, New York State Office of Mental Health, Former Deputy Director, New York State Office of Health Systems Management, Baltimore, MD |
David T. Feinberg, MD, MBA President and Chief Executive Officer, Geisinger Health System; Former Chief Executive Officer, UCLA Hospital System, President, UCLA Health System and Associate Vice Chancellor, UCLA Health Sciences, Danville, PA |
| James L. Madara, MD Chief Executive Officer, American Medical Association; Former Chief Executive Officer, University of Chicago Medical Center and Thompson Distinguished Service Professor and Dean, Pritzker School of Medicine, University of Chicago, Chicago, IL |
Patrick Conway, MD, MSc Deputy Administrator for Innovation and Quality & CMS Chief Medical Officer; Director, Center for Clinical Standards and Quality (CCSQ) and Center for Medicare and Medicaid Innovation (CMMI), Center for Medicare & Medicaid Services (CMS), Washington, DC (Moderator) |
AMA – James Madara
Many Medical schools don’t let their students use an EHR. So AMA is introducing a learning EMR.
Created a relational ontology for CPT Codes. Doing the same for SnoMed, RxNorm, ICD.
Then will build a functional normalization.
Barriers: Not recognizing regional variations.
You need a well defined problem rather than just a good idea.
Actionable data in real time that supports more time with patients makes a real difference.
Dartmouth group: half of Physicians time is spent on keyboard rather than with patients.
Chet Burrell – CareFirst
Uses data in Patient-Centered Medical Home.
- Risk Stratification
- Created Drug Volatility Score.
- Profile specialty care.
- Health Risk Assessments
Payers use the data they have. Drug data is critical.
50% of members use no services
Measures of Physician engagement is critical to achieving good outcomes.
Investing in Video visits. Expect use to explode in next 3-5 years.
Barriers: Rapid growth of High Deductible plans. People are reluctant to seek care until the problem gets worse.
Incentives more than shift of risk has been more effective.
More focus on incentive and insight rather than risk.
Doctors are competitive and want to deliver good care. When you give them data they do things that you couldn’t regulate them to do.
Geisinger – David Feinberg
Using genomics to inform care.
We often fail to bring patients in to the mix.
Bringing patients in to the data discussion has made a big difference.
The near future is to anticipate the needs when the patient arrives at the facility. No waiting rooms.
Barrier: Completely worried about “our own turf”. It’s never been the year of the patient. A huge dose of selflessness.
We have been too focused on the diabetes reading rather than the social determinants that are the root cause.
[category News, Health]
[tag health, cloud, ONC, opendata, hdpalooza, bluebutton]
Mark Scrimshire
Health & Cloud Technology Consultant
Mark is available for challenging assignments at the intersection of Health and Technology using Big Data, Mobile and Cloud Technologies. If you need help to move, or create, your health applications in the cloud let’s talk.
Blog: http://2.healthca.mp/1b61Q7M
email: mark@ekivemark.com
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Disclosure:
I am currently HHS Entrepreneur-in-Residence and CMS BlueButton Innovator working on an assignment to update BlueButton for Medicare Beneficiaries.
The views expressed on this blog are my own.
I am also a Patient Engagement Advisor, CTO and Co-Founder to Medyear.com. Medyear is a powerful free tool that helps you collect, organize and securely share health information, however you want. Manage your own health records today.
Medyear: Less Hassle, Better Care.
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