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Thought Leaders Share Innovative Ideas, “Shark Tank” Style

Three Pitches

Healthix hosted its own version of “Shark Tank” where top health care executives, clinical leadership – all members of a newly formed Healthix Focus Group – and a panel of HIE experts presented and judged “pitches” for the most innovative use of health information exchange services.

Value-Based Program – Gaps in Care Team

The Pitch:
Accountable care programs, like NYS Medicaid Health Homes must be responsible for performance on HEDIS quality and utilization measures for their attributed populations. Having the capability to identify select members from a specific Health Home cohort and determine if services were performed outside of the network, as well as the clinical details related to gaps in care, can help providers meet HEDIS measures and ensure reimbursement.

The value proposition: Understanding where an organization’s attributed members are having services performed can support:

  • Improved coordination/engagement and sharing relevant data
  • Care team facilitation of additional, appropriate services
  • Enhanced reimbursement for meeting measures by closing gaps in care

Clinical Event Notification Enhancement for Population Health Management

The Pitch:
Population Health and care management teams that seek to prevent avoidable hospitalizations can receive Healthix alerts that signal when a member has been discharged from the hospital ER with a diagnosis associated with a potential hospitalization in the future. These alerts would enable providers and care teams to identify high, medium or low risk patients and collaborate closely with the primary care providers to minimize readmissions.

The value proposition for these “smart” alerts can support:

  • Quality and financial incentives for providers who keep patients out of hospitals, especially those hospitalizations that are deemed avoidable
  • Identification/stratification by diagnosis type to enable focused interventions by providers
  • Minimization of preventable hospital readmissions

Targeted Patient Data Query:  An API Solution

The Pitch:
Providers can avoid sifting through a myriad of irrelevant clinical data in a separate portal and quickly access key information via a user-friendly API solution. The API would enable the clinician to apply filters for clinical data and time parameters, and use key words, to generate condition-related data on demand. Important clinical decisions for treating patients are often dependent on information from previous episodes of care. As an example, when a patient presents with certain symptoms, a provider would not be able to discern whether the patient is re-infected with a previously diagnosed virus unless recent labs and diagnoses are easily obtainable. Searches driven by conditions and disease states would aptly leverage the millions of patient records available in Healthix that are continually updated with each encounter.

The value proposition for needle-in-a-haystack identification of data can support:

  • Faster and more accurate diagnoses
  • Efficient and proper patient management