Survey of PoPulation HealtH analytic and data integration SyStem needs and impressions among Pca/Hccns

Transcription

1 Survey of PoPulation HealtH analytic and data integration SyStem needs and impressions among Pca/Hccns Based on the experiences of 6 responding organizations. This piece reflects the aggregated responses of 6 organizations who chose to participate through a call for responses to Primary Care Associations and Health Center Controlled Networks in late 06 and early 07. Responses are anonyomous, are shared asis, and reflect the views and experiences of the respondent(s) only. If you have experiences to add, please respond to the survey or us!

2 table of contents number of respondents reviewing each system... 3 ratings on selected functions... 4 comments provided related to selected functions... 6 data storage and management for each system... 4 access to raw data downloads... 6 features most important when assessing/ selecting a system... 8 other priorities... 9 Reasons for making selection, vendor specific... reasons for making selection, general... three main lessons you d like to pass on as a result of this experience?... 3 general comments... 4

3 over the course of your work with your networks, what PHm analytics systems have you considered/assessed for possible adoption and what year was each product reviewed? vendor/ System Acuere QOL Allscripts CareInMotion Arcadia Athena Healthagen Azara BridgeIT Cerner HealtheIntent eclinicalworks CCMR Epic Healthy Planet GE Caradigm Greenway Analytics ii Lumeris MediQuire MEDITECH READY NextGen Healthcare (Analytics module) Optum Orion Health Truven Health Unify Visalutions Wellcentive Other Specify: (Health Catalyst, Meridios, CGM Analytics, CenturyLink) networks that considered/ assessed vendor What year was each product last reviewed/ assessed? format: year of assessment(number who report assessing system in that year) 06(), 04() 07(), 06(0), 05(), 04() 05(4) 07(), 06() 06() 06(3) 06() 06(9), 05(4), 04() 06() 06() 06() 06() 06() 07(), 06(), 05() 06(4) 06(4) Those in grey received no responses or feedback, and are not included in subsequent sections. All information included herein are the opinions of respondents only. If you have recently tried or used any of these and you would like to share what you learned, take the survey! 3

4 for each of the ProductS assessed, rated on its ability to Perform the following functions Scale: fully capable = 3 Partially capable = not capable = Insufficient information provided = N/A Scale for columns marked WitH *: greater than average = 3 average = below average = Insufficient information provided = N/A functions that only received one rating = light grey text Access data extracts for complex data analysis and/or predictive analytics Facilitate health information exchange Provide patientlevel planning reports Share data with external systems Create bidirectional interfaces with external systems Interface with multiple EHRs Cost* Difficulty (or perceived) of implementation* Difficulty (or perceived) of everyday use* Quality of customer support* Familiarity with community health center model* Acuere QOL Azara BridgeIT eclinicalworks CCMR Epic Healthy Planet.5.5 GE Caradigm Greenway Analytics.0 ii Lumeris MediQuire.5 NextGen Healthcare (Analytics module) Optum.0 Visalutions Wellcentive Those in grey received only one response and therefore, unlike the others, are not an average. All results reported are the opinions of respondents only. If you have recently tried or used any of these and you would like to share what you learned, take the survey! 4

5 for each of the ProductS assessed, rated on its ability to Perform the following functions fully capable = 3 Partially capable = not capable = Insufficient information provided = N/A functions that only received one rating = light grey text Identify patient subpopulations by user selected parameters Examine detailed characteristics of patient subpopulations Create and send notifications Track clinical performance measures Create custom reporting and tracking Integrate data (from multiple sources) Allow for HCCNs/PCAs to administer for multiple health centers Aggregate data from multiple health centers for comparison and/or HCCN/ PCA use Track and report financial quality metrics Integrate practice management data (e.g., scheduling, financial, claims records, billing) Integrate adjudicated claims data Acuere QOL.7.7 Azara BridgeIT eclinicalworks CCMR Epic Healthy Planet.5 GE Caradigm Greenway Analytics.0 ii Lumeris.0.0 MediQuire.5 NextGen Healthcare (Analytics module).0.0 Optum Visalutions Wellcentive.7 Those in grey received only one response and therefore, unlike the others, are not an average. All results reported are the opinions of respondents only. If you have recently tried or used any of these and you would like to share what you learned, take the survey! 5

6 comments related to ability to identify patient subpopulations by user selected parameters examine detailed characteristics of patient subpopulations Create and send notifications azara: Still learning the system and how to use all the parts Customization is very limited, so only canned population parameters are available for example Azara creates alerts within its product but does not send notifications to outside products like Outlook. ii: Highly flexible patient search capability using almost any data element from PM or EHR. The ii PopIQ product is aggregated deidentified patient data for use at the Network Level. PopIQ s data is deidentified so the ability to send notifications is not possible since no patient level data is available. acuere Qol: Was still in its infancy when we reviewed the technology. It has likely improved its capabilities to identify and examine subpopulations. general comments: I did not look at the create and send notifications function [as it was not a critical function for us]. We are still in the early stages of exploring different vendors, so have only gotten canned demos at this point. Notifications are sent for alerts in the visit planning tool but not automatically sent to patients. 6

7 comments related to ability to track clinical performance measures create custom reporting/ tracking integrate data from multiple sources azara: Too early to see what all the capabilities are Customization is limited to scorecards and measure reports that the PCA asks for; it is not possible to create reports Custom report scorecards can be created but you are not able to create a new measure that isn t already programmed in the system. However they have an extensive list of measures included and can add measures at an added cost. ii: The standard interface is from the EHR, PM. We are working with them now around integrating payer data but not a proven capability for us, though they have done it with other groups. ii is working towards integrating payer data but currently not available We currently have of our health centers publishing data to PopIQ. These represent 4 different EHR systems (NextGen, ecw, Allscripts, and Success EHS). Currently working on another health center that uses the Vitera Intergy EHR. 7

8 comments related to ability to azara: Too new, just finished with verifying the UDS reporting system Piloting the financial piece other: All except CenturyLink required subscription cost from the health centers ii: epic Healthy Planet: allow for Hccns/Pcas to administer for multiple health centers aggregate data from multiple health centers Track/ report financial quality metrics ii Tracks was primarily designed for health center level use there is some retrofitting going on to make it more possible for Networks to have access to patient identified data and full capabilities. Pop IQ is the network level data warehouse that is directly accessible for networks, but is a limited data set. Data aggregation is possible through PopIQ. It is possible to track and report financial data, but limited. Last year we were involved in a project to bring in financial data from one system our health centers use. ii and the vendor developed a semiautomatic feed from this system and ii also developed a template that could be uploaded. Only one of our health centers actively participated in the project. Additional work is needed to have our health centers standardize the way they are using the financial system so that like information can be compared. ii allows aggregate data by the administrating organization like the HCCN, but not the ability to get the details behind that like some other products do. ecw: eclinical Works: We have been working with ecw for years on developing the network level benchmarking and comparison. This was something that was promised to us during the sales pitch, but was not delivered. eclincal Works: In 04 when we reviewed these systems, none were able to meaningfully incorporate financial data. ecw now sells another module to view financial quality metrics. For Epic s solution, the ability to use across sites and to benchmark data is dependent on the host site that the health center is using Epic through, since almost no health centers are direct customer of Epic and able to make these determinations on their own. Additionally, it is dependent on which hosts they are using Epic through and who chooses to contribute data to benchmark on if the above categories are possibleit is not a limitation of the Epic product itself. 8

9 comments related to ability to integrate practice management data (e.g., scheduling, claims, billing) integrate adjuncted claims data Work with free text/unstructured data azara: Have only used the UDS, PCMH, MU reporting modules They can look for certain key words in free text for areas like referrals ii: Tracks has good capability to take relatively unstructured data and turn into normalized, structured data not with full free text in a note but with free text in structured fields. Adjudicated claims data available in the future The claims data integration is in process. Free text from text boxes can be categorized and mapped to a certain extent. Natural Language Processing is not possible. To my knowledge ii does not provide this although based on my experience with the tool and vendor this would be possible. general comments: I m pretty sure these vendors were able to integrate with PM data, but wasn t confident enough in giving a concrete answer. 9

10 comments related to ability to azara: I wrote not capable for data extracts because, even though a lot of patient level detail can be extracted, there is not enough flexibility to extract variables of interest to make the data usable for true analytics access data extracts for complex data analysis/ predictive analytics facilitate health information exchange Provide patientlevel visit planning reports ii: Our network uses PopIQ which is not at the patient level. I believe ii s Tracks system which is at the health center level and provides patient level information is capable of this. ii data extracts with details can only be done at the health center level, not across the network. epic Healthy Planet: It is a misnomer to say Epic Healthy Planet for this category. It is Epic as a larger product that allows for the above actions, as Healthy Planet is a layered application focused on population health management. eclinical Works: The only feature that is useful to the end user is the ability to look at a dashboard for previsit planning purposes. ecw recently deployed a single signon from within the EMR which should lend to higher rates of usability. At this time, our health centers are not using the tool, as the filters are complex and don t stick and they have to log in through a separate portal. The tool doesn t offer enough value to them to entice them to spend time outside the EMR learning how to navigate the complexities of the tool. 0

11 comments related to ability to Share data with external systems create bidirectional interfaces with external systems interface with multiple ehrs azara: Possible with custom development At this time we are not using these functions, just new to Azara ii: I believe that ii can establish bidirectional interfaces with payers, but that collaboration is in the early phases. ii has been working to share bidirectional data with health plans using their Tracks system. This is something we are considering but have not started this project as yet with our health centers. eclinical Works: ecw has told us that they can interface with nonecw EHRs but we have not yet seen this functionality.

12 comments related to cost Difficulty (or perceived difficulty) of implementation Difficulty (or perceived difficulty) of everyday use azara: Very easy to use The difficulty is average, not that the experience is greater (better) than average eclinical Works: We selected ecw because >80% of our health centers are using ecw, so it was easier in that way. We have spent countless hours with their development team attempting to hold them accountable to deliver what was promised to us. It has been challenging and we have not yet seen a value to our customers. Very easy to use every day. I m not sure how costs compare, it s based on patient encounters for a yearly fee. general comments: Assuming Greater than average means the cost is higher and the difficulty is higher. So for these Below average is better.

13 comments related to Quality of customer support familiarity with community health center model ii: ii has been involved with FQHC s and population health management for many years and has great knowledge in their needs. eclinical Works: The Population Analytics implementation team has been great, but on average, support from ecw has been below average for our customers. epic Healthy Planet: Customer support for Epic again depends on the host site [generally a hospital or health system], since almost none of the health centers have customer support directly from Epic. 3

14 vendor/ System HoW did each of these ProductS Handle data Storage and management? (number shown = # of respondents reporting this is how data is stored by this vendor) Acuere QOL Allscripts CareInMotion Arcadia Athena Healthagen Azara BridgeIT Cerner HealtheIntent eclinicalworks CCMR Epic Healthy Planet GE Caradigm Greenway Analytics ii Lumeris MediQuire MEDITECH READY NextGen Healthcare (Analytics module) Optum Orion Health Truven Health Unify Visalutions Wellcentive Other Specify: (Health Catalyst, Meridios, CGM Analytics, CenturyLink) cloud based local server (e.g. utilizing ehr server) cloud based for additional cost local server for additional cost 9 Those in grey received no responses or feedback. All results reported are the opinions of respondents only. If you have recently tried or used any of these and you would like to share what you learned, take the survey! 4

15 comments How did each of these products handle data storage and management? azara: It s really none of the above [shown on prior page]. The data are stored remotely, and the application interfaces with it. This is a bit different from the cloud as well. ii: Data warehouse is cloud based; health center level system uses a local server. There needs to be a local server hosting ii which connects directly to the EHR and then populates to the cloud. ii Tracks is located on a separate local server; PopIQ is cloudbased. PopIQ is cloud based. ii Tracks is installed on an additional local server at the health center 5

16 through the PHm SyStem, do you Have access to raw data downloads and in WHat form can you access that data? (number shown = # of respondents reporting this is how data can be accessed from this vendor) vendor/ System onscreen dashboards pr o vided by PHm excel downloads of raw data X ml do wnloads of raw data ac cess da tabase do wnload of raw data SQl database do wnload of raw data don t know other Acuere QOL Allscripts CareInMotion Arcadia Athena Healthagen Azara BridgeIT Cerner HealtheIntent eclinicalworks CCMR 3 3 Epic Healthy Planet GE Caradigm Greenway Analytics ii Lumeris MediQuire MEDITECH READY NextGen Healthcare (Analytics module) Optum Orion Health Truven Health Unify Visalutions Wellcentive Other Specify: (Health Catalyst, Meridios, CGM Analytics, CenturyLink) 3 6

17 comments does the system provide access to raw data downloads, and in what form can you access that data? azara: The raw data is usually prefiltered or preaggregated and contains a limited selection of fields however. Cannot access raw data. ii: Vendor can provide this, but not a standard part of network or health center access. However, there is great access through the tool to data elements within the PHM system. You are able to download PopIQ reports in both XML and Excel. It retains the formatting of the report. 7

18 PleaSe rate each of the following criteria/measures on its importance to you WHen assessing/ Selecting a SyStem Rated from 05 stars, where is not at all important and is very important. criteria/ measures average from respondents Ability to track clinical performance measures Ease of everyday use Ability to identify patient subpopulations by user selected parameters Ability to interface with multiple EHRs Ability to create custom reporting and tracking Familiarity with community health center model Ability to examine detailed characteristics of patient subpopulations Quality of Customer Support Ability to integrate data (from multiple sources) Cost Ease of implementation Ability to share data with external systems Ability to create bidirectional interfaces with external systems Ability to create and send notifications general comments about most important features: Ability to work with HCCN on changing needs for reporting and raw data extracts. Also, flexibility of quick turnaround when needed. We wanted a company that had worked with FQHCs before and knew how they operated. Data stored in single location with details accessible by the HCCN administrator. The biggest dealbreaker for us was the ability to do our own custom reports and tracking. If a system did not do that, they were removed from consideration. Customer support is key to successful adoption and use. 8

19 other priorities vendor Specific comments azara: Performance, ability to stay up to date on changing reporting requirements Product that is staff friendly Vendor already selected prior to joining PCA We didn t have a say in the selection of this tool. ii: Ability of individual health centers to create custom registries and reports without additional cost. Experience with working with health centers Years the product had been in use Health centers in our HCCN use several different EHRs, so interfacing with multiple EHRs was critical. Standard performance measure reporting (UDS) was important, but health centers wanted the flexibility to create custom reports and patient searches iitracks excelled in this area. orion Health: Data validation and testing procedures; pricing allinclusive or cost for each change/report request; security; data warehouse offering 9

20 WHat technology did you ultimately Select for PoPulation HealtH management WitHin your network? (respondents were told to select all that apply) vendor/ System Acuere QOL Allscripts CareInMotion Arcadia Athena Healthagen Azara BridgeIT Cerner HealtheIntent eclinicalworks CCMR Epic Healthy Planet GE Caradigm Greenway Analytics ii Lumeris MediQuire MEDITECH READY NextGen Healthcare (Analytics module) Optum Orion Health Truven Health Unify Visalutions Wellcentive Other number of respondents that reported selecting this system (see below) other responses: None CenturyLink Still using internally created software 0

21 reasons for making selection vendor Specific azara: ii: orion Broad availability of Most attractive to health center members. Health: Experience with working with health cen ters, years the product had been in use, and was the cheapest measures and reports in the tool, high level of customer service and expert support, soft ware as a service, ability to control security settings/define access levels Part of our state HCCN program Health Centers in our HCCN voted and chose ii. Health centers wanted the ability to generate custom reports Azara did not give them that ability. In 0 we implemented PopIQ as part of a pilot funded by Blue Shield of California Foundation. Many of our health centers were using iitracks and we had a good relationship with ii. That first year we implemented 6 of our 7 health centers. EHR dependent These comments represent comments asis provided by respondents in the survey. This was not a required question, so respondents who selected other systems or did not choose one of these chose not to provide responses. This should not be taken to mean that no other systems were chosen.

22 reasons for making selection general comments Price, dashboards, cloudbased. Product is geared toward health centers, easy to use, provides benchmark data across centers, sites and providers, exports patient level data to Excel and high level of customer support. Best Price, Service, and Product Tracking quality measures, dashboards, HCCN access to details, cloudbased, vendor s track record, and information from other HCCNs. We have not yet made our selection. The current finalists for RFP are ii, Health Catalyst, and Relevant. We choose Azara as an HCCN, but we do have Health Centers also utilizing Epic and Visualuations separately. We liked Azara for a few reasons, mainly based on their CHC experience and focus, the ease of use of the system, and the prebuilt and populated regulatory measures. We have not made a selection yet Decisions ultimately made by the participating health center members on a case by case basis. Currently we have health centers connected to ii PopIQ. Many health centers are already on Azara through a different grant and individual evaluations, and the system has the best clinical tracking capabilities and we re most confident in its data accuracy. Price and functionality. They offered predictive analytics and all desired quality measure reporting. Vendor already selected prior to joining PCA We selected ecw s CCMR product as 88% of our network participants use ecw s EHR product (we believed implementation would be more efficient) and the cost was not prohibitive.

23 What are the three main lessons you d like to pass on as a result of this experience? vendor Specific (though many are generalizble!) azara: Data quality is complex and not primarily a technical challenge, but it can make or break adoption. Training and adoption efforts need to be ongoing, on not just provided upon golive. Ensure your trainer is very knowledgeable, must ensure accuracy of mapping, time factor for staff involved Make sure you re clear about what you want and that you test for yourself whether you the vendor can deliver Take your time selecting. Ask questions, if you can t ask questions ask other Health Centers or PCAs first. Don t get duped. ii: Needs change so the product needs to be able to have flexibility and responsiveness the balance between health center needs/wants and network needs/wants is challenging the technology is only a small part of the overall process of generating and using good data. Ask to see their road map for the next 3 years. The data quality/mapping process is extremely important. Do not rush this step.. Health centers must prioritize their implementation using a team model this is not only an IT project. 3. It is critical for the PCA/HCCN to have inhouse expertise in the software system. Health centers are not aware of all that is possible, so it is helpful for the PCA/ HCCN to know what is possible with the system in order to provide coaching to support health center transformation. Systems will only ever be as good as they are set up to be. A lot of mapping to existing data repositories and custom report building which requires specialized staff that can do the work needed to set up the back end properly. orion Health: Know what you want to do with your data. Agree on security requirements. Be aware of all cost points. 3

24 general comments about Selection:. Slick looks does not mean high functioning product.. Ask detailed level questions about initiatives that your state requires and the product s ability to produce those reports. 3. Ask other PCAs and HCCNs their experiences with product.. Talk to a health center and a PCA and/or HCCN who has installed and is using the product.. Find out if there are additional costs that you will incur from the EHR vendors. 3. Have people representing different positions review the products. Need to determine whether need a pop health solution or a data warehousing solution. Determine what the desired outcome is. Very hard to compare across systems. Hard to understand when failure to adopt/optimize use of a system is due to a health center s error or system limitations. Ongoing expenses should be easily captured. Contact others who have implemented this product, not just the references provided by ecw but other HCCNs. The product was not fully developed and we have devoted significant resources in working with their development team as a partner to support them in delivering what was promised. No system is perfect and they won t be able to fully meet all expectations even if they claim they can. There needs to be a clear understanding in the organization about the use of the analytics system. The health centers won t all agree on a system.. Vendors are expensive but have a lot of room to negotiate.. Go to the vendors with your budget first to reduced wasted time. 3. Do not accept an out of the box product. 4. Design your RFP to reflect each elements and quality measure desired.. Know and prioritize your intended use cases of the system with your network participants.. Ensure you choose a PHM that has the highest one or two of those capabilities fully built (be cautious if it is in development ). 3. Ensure your contract is clear on deliverables from the vendor and in specific timelines. 4

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