Q1 2019 Community MeetingMARCH 13, 2019
©2018 LEAVITT PARTNERS 2
Agenda
AgendaWelcome, Anti-Trust Reminder, and New Members Admitted Ryan Howells, Leavitt PartnersDave Lee, Leavitt Partners
12:00pm – 12:05pm
Leadership PerspectivesAneesh Chopra, Care Journey
12:05pm – 12:10pm
Office of Civil Rights UpdateRoger Severino, Director
12:10pm – 12:30pm
CMS and ONC: Proposed RulesSteve Posnack (ONC proposed rule) and Beth Myers (CMS proposed rule)
12:30pm – 1:20pm
VA UpdateDrew Myklegard
1:20pm – 1:30pm
Break 1:30pm – 1:40pm
Patient and Caregiver PerspectivesKristina Sheridan
1:40pm—1:45pm
Market Innovation PresentationKhan Siddiqui, Higi
1:45pm – 1:50pm
Opportunities to Collaborate Facilitated by Ryan Howells
1:50pm – 2:55pm
Next Steps 2:55pm – 3:00pm
Adjourn 3:00pm
Leadership Perspectives
ANEESH CHOPRA, CARE JOURNEY
Updates from OCR
DIRECTOR ROGER SEVERINO
CMS and ONC NPRMs
STEVE POSNACK AND BETH MYERS
VA Update
DREW MYKLEGARD
BREAK
Kristina Sheridan: Patient and Caregiver Experiences
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Kristina Sheridan, eCaregiver
CARIN Alliance Quarterly Meeting
March 2019
Transforming Patient Voices into Hard Data: A Patient Story
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@K_Sheridan1 @MITREhealth
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Our Family
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Distribution unlimited. Case number 17-3405
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The Beginning
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The Decline
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Overwhelmed to Empowered
© 2018 Images Source: Kristina Sheridan
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Our Outcome
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release. Distribution unlimited. Case number 17-3405© 2017 Image Source: K. Sheridan
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© 2017 Image Source: K. Sheridan
Experts
… in everyday living
with chronic disease
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From Rocket Science to Healthcare
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Self-management support
• Symptom management support
• Self-monitoring of symptoms
• Insight into health status
• Drug management support, including reminders
Communication with providers
• More in-depth patient-provider conversations
• Online communication with providers
• Improved follow-up/ coordination of care
eHealth Tech
• Tailored toward patients
• Easy to use technology
• Accessible at home
• Requires as few actions as possible
Huygens, M., Vermeulen, J., Swinkels, I., Friele, R., Van Schayck, O., P. de Witte, L., Expectations and needs of patients with a chronic disease towards self-
management and eHealth for self-management purposes. BMC Health Service Research. 2016; 1472-6963. DOI:
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1484-5
Jerant, A., Friederichs-Fitzwater, M., Moore, M. Patints’ perceived barriers to active self-management of chronic conditions. Patient Education and Counseling.
2005; V 57, Issue 3, Pages 300-2007. DOI: http://www.sciencedirect.com/science/article/pii/S0738399104002605
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Patient Needs
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Workflow
… supporting patient and provider bi-directional communication
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The Patient Toolkit
… transforming the
patient voice into
hard data
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Capturing the Patient Voice
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Sharing for Action
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Barriers to Adoption
[1,3]
[3]
[3]
[2]
[4]
[4]
[2,3]
© 2019 Image Source: Kristina Sheridan
[1] Moore, S.L. et al. A mobile health infrastructure to support underserved patients with chronic disease. Healthc (Amst). 2014 Mar;2(1):63-8. doi: 10.1016/j.hjdsi.2013.12.016. Epub
2014 Feb 5.
[2] Fischer SH, David D, Crotty BH, Dierks M, Safran C. Acceptance and Use of Health Information Technology By Community-Dwelling Elders. International journal of medical
informatics. 2014;83(9):624-635. doi:10.1016/j.ijmedinf.2014.06.005.
[3] Jorie M. Butler, Marjorie Carter, Candace Hayden, Bryan Gibson, Charlene Weir, Laverne Snow, Jose Morales, Anne Smith, Kim Bateman, Adi V. Gundlapalli, Matthew Samore.
Understanding Adoption of a Personal Health Record in Rural Health Care Clinics: Revealing Barriers and Facilitators of Adoption including Attributions about Potential Patient Portal
Users and Self-reported Characteristics of Early Adopting UsersAMIA Annu Symp Proc. 2013; 2013: 152–161. Published online 2013 November 16.
[4] U.S.D.H.H.S. Patient Provider Telehealth Network – Using Telehealth to Improve Chronic Disease Management. 2012 June.
https://www.healthit.gov/sites/default/files/pdf/RCCHCandPHS_CaseStudy.pdf
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Policy Drivers
…expanding access to empower patients
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MACRA …moving
patients and providers
towards a new paradigm
that rewards patient
engagement
HHS Proposes New Rules
to Improve the
Interoperability of
Electronic Health
Information
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Patient
GP
Caregiver
Psychiatrist
NP PT
One-Directional
Communication
Provider Patient
Current State
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Patient
GP
Caregiver
Psychiatrist
NP PT
Bi-Directional
Communication
Provider Patient
Future State
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Empowered
@MITREhealth
@K_Sheridan1
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Khan Siddiqui: Market Innovations
Ryan Howells OPPORTUNITIES TO COLLABORATE
www.carinalliance.com | @carinalliance | ©2019 Leavitt Partners | 29
“The public sector is now ahead of the private sector. This is a moment for the healthcare industry to step up. We need to see this as a call to action.”
- Governor Mike Leavitt speaking at HIMSSFormer Health and Human Services Secretary
www.carinalliance.com | @carinalliance | ©2019 Leavitt Partners | 30
HOW
Implementation GuidesDa Vinci, Argonaut, CARIN, and others
WHAT
StandardsHL7 FHIR, SNOMED, LOINC, etc.
Fast Healthcare Interoperability Resources (FHIR)
WHO
ImplementersPayers, Plans, Apps, Pharmacies, etc.
www.carinalliance.com | @carinalliance | ©2019 Leavitt Partners | 31
2019 Focus Areas
Trust FrameworkFocus: Develop a trust framework with an enforceable code of conduct for third-party applications to follow that includes a set of self-attested questions for how data will be used by entities not covered by HIPAA.
Eliminating Policy and Business Barriers
Health PlanFocus: Develop a consumer payer data set (similar to Blue Button 2.0) and implementation guide for resources that payers can display via a FHIR API.
Consumer-facing real-time pharmacy benefit check (RTPBC)Focus: Develop a consumer-facing API version of real-time pharmacy benefit check to enable consumer access to drug formulary and benefit information, financial responsibility, therapeutic alternatives, and cash price in accordance with the “Patient Right to Know Drug Prices Act.”
Post-Acute Care Focus: Develop a consumer-facing API related to the post-acute care assessment information that is found in the CMS data element library.
Defining How to Share Data
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2019 Focus Areas
Consumer-facing app storeFocus: Develop a centralized non-platform and non-vendor specific location where payers, providers, consumers, and others can access consumer-facing applications to determine which applications are following the CARIN Code of Conduct and who is connected with which data holder.
API Centralized LibraryFocus: Develop a centralized, non-vendor, non-sector specific location where the API end points can be managed and posted in a machine-readable format for app developers
VA, Blue Button 2.0, and CDC
Consumer ID and AuthenticationFocus: Develop best practices and a framework for implementing the NIST Identity Assurance Level 2 (IAL2) and Authenticator Assurance Level 2 (AAL2) guidelines in health care .
Protecting Digital Identity
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2019 CARIN Quarterly MeetingsMarch 13, May 9, Sept 12, and Dec 10
CARIN in the Community
• March 6: Vizient Medical Leadership Series Webcast
• March 18 – 20: 2019 State Healthcare IT Connect Summit in Baltimore, MD
• March 27 – 28: 2019 Health Datapalooza in Washington, D.C.
• April 8: SKYGEN USA 2019 Summit in Scottsdale, AZ
• April 14 – 16: American Telemedicine Association Conference in New Orleans, LA
• April 30: BCBS 2019 National Summit in Grapevine, Texas
• May 2 – 3: Global Privacy Summit in Washington, D.C.
• May 16 – 17: Association for the Utah Community Health Centers Conference in Utah