The healthcare system is in the early stages of a transformation as the patient centered care concept gains more traction. Buzzwords such as Accountable Care Organizations (ACO’s) and Medical Home are being used to describe the future of healthcare delivery, yet how those terms translate into an actual care model is still being defined. Ultimately, the goal is to deliver better quality care in a more efficient manner, which will benefit patients, providers and payers.
Value Based Agenda
The patient centered medical home (PCMH) concept is an attempt to address the fragmented delivery of care by promoting a value-based agenda. Two cornerstones for increasing value in cancer care are standardizing processes so every patient receives the most appropriate care, and managing treatment side effects to reduce emergency department visits and inpatient care.
The assertion is that payers would pay physicians for providing the services that keep patients out of the emergency department and hospital, thereby reducing their total health care costs significantly.
Oncology Patient Centered Medical Home Example
Consultants in Medical Oncology and Hematology (CMOH), a community oncology practice in suburban Philadelphia lead by Dr. John Sprandio, is the first oncology clinic in the country to be recognized as a level 3 medical home, the highest designation possible. CMOH has been featured in Oncology Times and Community Oncology as an example of how oncology clinics can put the patient centered medical home concept into practical use.
To apply the PCMH model to oncology, Dr. Sprandio focused on the following aspects of care delivery:
Gena Cook
The editors of Value-Based Cancer Care Magazine asked Gena Cook, Navigating Cancer’s CEO, to contribute a guest article for their August edition, which is now available online. In it, Gena provides an overview of how information technology (IT) can be a pathway to improving healthcare and achieving the goals of patient centered care.
Here’s an excerpt from the article:
With widespread adoption of information systems and interoperability within systems, it is conceivable that the healthcare system can be transformed. Providers and patients can envision a system that can produce better outcomes, higher quality, and lower costs than today.
In tomorrow’s system, patients will have the ability to see parts of their healthcare record, understand their laboratory values in a longitudinal way, and receive more information about their health to minimize disease and actively manage it when diagnosed with cancer or other illnesses. Patients will be able to use technology, and most likely be required to manage the transactions of their care online, such as requesting prescriptions, appointments, and laboratory testing.
Click here to read the full article.
Related links
- Patient Portals: the Gateway to Patient Centered Care and Meaningful Use
- Stage 1 Meaningful Use Rules: the Basics
- Navigating Cancer’s Oncology Patient Engagement Portal Solution
Here’s an inspiring talk from patient advocate Dave deBronkart, who after being diagnosed with a rare cancer went online and found the treatment that would save his life from a group of fellow patients. Dave has since become a vocal advocate for patient empowerment, encouraging patients to connect with each other online, get access to their health records, and become active participants in the health care process. We couldn’t agree more, and have developed our website and oncology patient portal to enable our community to do just that.
Do you know of other patient empowerment examples? Have you discovered new treatment information through your own patient empowerment? Leave a note below in comments, or join the discussion in our community.
Related Links
- More patient empowerment resources
- Learn more about Navigating Cancer’s patient portal for oncology clinics
Multi-site oncology practice improves quality of care, efficiency and patient satisfaction while reducing costs.
Below is a summary of a case study conducted with Hematology Oncology Consultants in Orlando, Florida after their adoption of our patient portal. For a free download of the full case study with more detailed information including cost savings, registration completion percentages, and patient satisfaction survey results, please join our Meaningful Use newsletter on the right side of this page, send a request to info@navigatingcancer.com, or call 800-925-4456.
Challenge
Hematology Oncology Consultants, P.A. is an established practice with six oncologists and two locations in the Orlando, Florida region. They had not yet adopted an electronic health record system (EHR) and were looking for a solution that could help them achieve three goals:
Patient Portal: the Gateway to Patient Centered Care and Meaningful Use
Healthcare reform, whether it’s HITECH or impending ACO legislation, will have a large impact on patients. One of the government’s health care policy priorities is to use technology to engage patients more in the health care process. The theory is that patients will need to be a part of the care model to truly transform the healthcare system, improve quality, and make care more efficient.
To achieve this goal, HITECH requires doctors to give patients electronic access to their healthcare information and to engage them in their care. If patients have a role, they can improve care coordination and be an active participant in their care. They can ask better questions and provide better feedback to their healthcare team, which should improve care and reduce costs.
To engage patients in their care and give patients electronic access to their health information, a practice will need to implement a patient portal that integrates with their EMR. As the final stages of Meaningful Use are finalized and rolled out, the requirements for engaging patients in their care will increase, making patient portals a larger part of the overall solution.
For example, in Stage 1 of the Meaningful Use criteria, doctors are required to give a subset of their patients timely electronic access to their health information, clinical care summaries of their office visit, and specific educational resources based on their disease using certified technology. The proposed requirements in Stage 2 and 3 require doctors to provide more patients with their health information and clinical summaries but also engagement tools like online secure messaging and care management tools. Patients will need a user-friendly patient portal to access this data.
Today we made some improvements to the home page navigation for members when they are signed in. The blue navigation box now has a Manage Treatment link where Treatments, Medications and Health Documents are now located. Previously they were located under Health Records. This change will make it easier for members to update this information. Below is a screen shot of the new navigation menu.
medical history form menu
Health Records are now located under History and Forms, which also has an improved Summary page so you can see which forms you still need to complete, if any. Below is a screen shot of the new summary page.
medical history form summary page
As always, we value your feedback and encourage you to contact us with any questions or comments. Our Community Manager, Becky Walker, is available by phone (800-925-4456) or private message via her profile to answer your questions.
Navigating Cancer CEO, Gena Cook, and VP of Business Development, Greg Maxfield, will be attending the 2011 ASCO annual meeting in Chicago this weekend, June 3 – 7. Gena and Greg will be demoing our patient portal solution and the many benefits it offers to both clinics and advocacy groups. If you’d like to schedule a time to learn more and see a demo, please send an email to greg@navigatingcancer.com. See you in Chicago!
In March, Navigating Cancer CEO, Gena Cook, spoke at the 2011 Association of Community Cancer Centers (ACCC) annual meeting about the HITECH Act Meaningful Use rules, and what impact the new technology will have on patients and their families. Value-Based Cancer Care Magazine covered the meeting and published a recap of Gena’s presentation in their April issue. You can read the article at the link below.
Implementing the HITECH Meaningful Use Rules in Oncology Practices
ACCC also has a link to a pdf download of the slides from Gena’s presentation on their website, as well as links to slides from all the other presenters.
Related Links
Cancer and the Environment
Today is Earth Day, an opportunity to reflect on the impact we each have on the planet (as individuals and as companies), but also a day to consider how the products and foods we consume can have an impact on us. Living organisms all share three common bonds, they eat, breathe and grow. Be it micro-organisms, plants, trees, animals, or people, we all take sustenance from the earth, and by the transitive property, what goes into the earth/water/air goes into us.
Cancer and Environmental Risk Factors
The National Cancer Institute has a section of their website dedicated to education about cancer and the environment, highlighting factors that can increase your risk of cancer, many of which can be minimized based on lifestyle choices. The following are the top avoidable environmental risk factors and the proportion of cancer deaths that have been linked to each. For example, 29-31% of cancer deaths can be linked to tobacco.
- Tobacco 29-31%
- Diet 20-50%
- Infections (bacteria, viruses) 10-20%
- Ionizing and UV light 5-7%
- Occupation 2-4%
- Pollution (air, water, food) 1-5%
Researchers have estimated that as many as 2 in 3 cases of cancer (67%) are linked to some type of environmental factor. However, environmental exposure on it’s own does not cause cancer. It’s the gene-to-gene interactions that occur inside each of us that can cause cancer in one person, and not in another, when both are exposed to similar environmental factors.
Have you made “green” changes in your lifestyle habits?
While much of the focus for Earth Day is on preserving our natural resources and the health of the planet, we encourage you to also think about how you can reduce the environmental factors that increase your risk for cancer.
- Have you made any changes in your lifestyle to reduce your environmental cancer risks? If so, what?
- Did you make the changes before or after you were diagnosed?
- If after, how big an impact did your diagnosis have on your decision?
Related Links
Meaningful Use Rules: The Basics
Over the past couple of months, I’ve been invited to speak about HITECH and Meaningful Use at a number of oncology state society meetings (Texas/Colorado/Oklahoma/New Mexico, Florida, North Carolina, Alabama) and at the ACCC annual gathering, and have received a number of questions about what Meaningful Use is and what it means for oncology clinics. While I’ve been speaking on what it means for patients and their families, it’s clear that healthcare professionals have different levels of understanding about the new legislation and what it means for their practice. Overwhelmingly, most healthcare professionals I speak with have a desire to receive the incentives. The timing in which each practice will qualify for the incentives is more varied, with some practices striving to meet the objectives this year and others that are just starting to learn about what they need to do.
To help answer some of those questions and provide more clarity, I’m going start posting my thoughts here on our blog, and invite the oncology and health IT community to use this as a forum to raise questions and discuss the topic. To follow the conversation you can subscribe to our blog via email (join via right side bar), rss feed, or bookmark the meaningful use tag to see all blog posts on the topic.
Meaningful Use History
In February 2009, President Obama signed into law the American Recovery and Reinvestment Act (ARRA), a multi-billion dollar stimulus package that included incentives for the health care industry to integrate information technology into their daily operations. Specifically, the Health Information Technology for Economic and Clinical Health (HITECH) Act, allocates $19 billion to encourage the adoption of electronic health records (EHR’s) with the goal of improving the quality, efficiency and safety of the nation’s healthcare system.
Stages of Meaningful Use
There are three stages to meaningful use, and each stage will come with additional rules and measures to qualify for incentive payments. Stage 1 began in 2011, Stage 2 will begin in 2013, and Stage 3 will begin in 2015.
Stage 1 is focused on capturing health information electronically in a structured database, using that information to track conditions, communicating that information for care coordination, and starting the reporting process of clinical quality measures and public health information.
Stage 2 will expand on Stage 1 in the areas of disease management, clinical decision support, medication management support, patient access to their health information, transitions in care, quality measurement, and bi-directional communication with public health agencies.
Stage 3 will focus on achieving improvements in quality, safety and efficiency, focusing on decision support, patient access to self-management tools, access to comprehensive patient data, and improving population health outcomes.
Meaningful Use Incentives, Penalties and Timeline
Carrot vs. the stick. Photo by D Sharon Pruitt on Flickr
“Nineteen billion!” you exclaim, “How much of that can I qualify for?” Eligible physicians who implement an electronic health record system can receive up to $63,750 if they primarily treat Medicaid patients and $44,000 if they primarily treat Medicare patients.
To receive the maximum incentive payments, Medicare eligible professionals must begin participation by 2012. Penalties for not complying begin January 2015, and are equal to a one percent reduction of the physician’s annual Medicare payments per year up to five percent.
More information is available on the EHR Incentive Program page on the Centers for Medicaid and Medicare Services (CMS) website.
Meaningful Use Rules
In order to receive the payments, you must show that you’ve put the system to “meaningful use” in your practice. To establish the criteria for determining if a system is being used in a meaningful way, the CMS issued the final rules for Stage One in July of 2010. These rules outline a set of standards and conditions for the implementation of an electronic health record system. For Stage One, there are 25 rules total, 15 that make up the “core set” which every clinic must meet to qualify for the incentives, and 10 that make up the “menu set”, of which clinics can pick any 5 of the 10. A regulation buffet, delicious!
So that brings us to where we are today. In future posts, I’ll talk about the 25 specific meaningful use rules that need to be implemented, the measures you must meet to qualify for the incentive payments, what to look for when evaluating solutions, why patient portals will need to be part of the overall solution, and more.
If you’d like to jump ahead, you can see all the rules on our meaningful use rules page, or you can download a copy of the meaningful use rules for future reference.
Questions? Ideas for future posts? Meaningful use specifics you’d like to know more about? Please leave questions and ideas in comments below and I’ll address them as I can.