Wednesday, September 28, 2016

The Healthcare Executive Group Annual Forum – A Truly Unique Healthcare Event

In honor of the National Health IT Week promoted by HIMSS, I’d like to share some information about a very unique organization I’ve been privileged to work with the last couple months: The Healthcare Executive Group (HCEG). I’m sharing info about the HCEG because I feel it embodies the National Health IT Week spirit of sharing information and collaborating on healthcare topics.

National Network of Healthcare Executives

The HCEG bills itself as

a national network of select executives from across the entire healthcare spectrum; coming together to continually learn, grow, share and reshape the industry.” 

Membership in the group is largely comprised of executives leading mid-market healthcare payers and health system providers. HCEG’s purpose is to gather and support an intimate learning environment for professional growth and development. Member organizations have the opportunity to tap into the knowledge and expertise of a network of qualified peers, organizations and industry thought leaders. Their raison d'être is to drive industry-wide innovation and transformation.

How Does HCEG Drive Innovation and Transformation?

Members benefit from HCEG membership and healthcare innovation is driven in three primary ways:

1. Facilitate Member Collaboration

HCEG provides its members with opportunities for ongoing discussions via formal and informal events, access to insights from sponsor partners, white papers, mentoring and other opportunities to share best practices, ideas and what has worked – or not worked – in other member organizations.

2. Personal Development

Through its sponsor partnerships and other connections, HCEG offers its members monthly educational initiatives including webinars, virtual panels, and research opportunities; among other options.

3. The Annual Forum

Each year, HCEG hosts a 3-day event where members are provided direct access to industry thought leaders and solutions providers, with unique opportunities to learn, grow, share and reshape the healthcare industry.

See here for additional info on the Healthcare Executive Group.

The HealthCare Executive Group Annual Forum

I had the privilege of attending this year’s Annual Forum in New York City two weeks ago. It was an amazing experience. (To be sure I get really excited about sharing and learning about healthcare and information technology so maybe HCEG’s Annual Forum was merely ‘astounding?’) 

What Makes HCEG's Annual Forum So Unique?

The HCEG event is unlike any other conference or institute event I’ve known about or been involved with over my 20+ years in healthcare. It’s not an online-only webinar discussion group or crazy large conference like HIMSS; nor is it just focused on a narrow topic area or intended for a specific target group; like health plans with AHIP. It’s not an overly structured, rapid-fire agenda event like many ‘niche conferences.’ And it’s definitely not a loosey-goosey, anything goes forum like many of the smaller, emerging ‘unconferences.’

Here's What's Unique About This Healthcare Conference

Everything’s Included in this Healthcare Event

Indeed, the coup de grâce of being an HCEG member is attendance at their annual forum. In addition to all the benefits HCEG members enjoy year-round, attendance for two people at HCEG’s Annual Forum is included in HCEG’s annual membership fee.

Great Venue That's Not Too Large & Distracting

Fittingly, the Annual Forum was held at the Renaissance Mid-Town Hotel in New York City: New York City’s first “Living Digital Hotel”

Qualified Healthcare Speakers

Presentations were made by Constance Sjoquist from Gartner, Henry Chao, Former Deputy CIO & Deputy Director of CMS, and Claire Levitt – Deputy Commissioner at New York City Mayor's Office of Labor Relations. In addition, several other healthcare industry luminaries presented to the HCEG members. See the entire list here.

Digital Handouts

One really cool aspect of the Annual Forum was that each attendee was given (to keep) a personalized Kindle Fire HD tablet that contained all conference presentations and other materials. Also, “Top 10 Challenges” that HCEG is famous for were ideated, discussed and ranked by forum participants via a survey app contained on the tablet. Additionally, other content was pushed to attendees during the conference.

The Top 10 Challenges, Issues & Opportunities

HCEG is known for developing a yearly Top 10 list that its members feel are – or soon will be - their primary challenges going forward. As just noted, the 2017 Top 10 list was developed during the Annual Forum. This Top 10 List then serves as the basis for The Industry Pulse survey developed via a partnership between HCEG and Change Healthcare. Stay tuned for more on this Top 10 list and The Industry Pulse.

Intimate Collaboration w/ Smart, Like-Minded People

One of the unique aspects about the HCEG in general and apparent at the forum in particular was the intimate, congenial atmosphere and relationships members and sponsors enjoyed. There were several formally scheduled and informal, casual opportunities for interaction during the forum with each session of the three-day conference including ample time for Q & A between the speakers and participants.

Great Food and Drink!

Of course no event would be whole without great food and drink. The organizers of HCEG’s Annual Forum really hit it out of the park in this regard.

Looking Forward to More

The HCEG is investing in its knowledge management and member collaboration facilities and promises to provide even more value to its members. For more information on the HCEG and its membership opportunities, check Why Join HCEG? You can also follow HCEG on Twitter where they tweet as @HCExecGroup.

Monday, September 26, 2016

Optimizing Payer and Provider Communications: A Necessary Burden or Strategic Advantage?

Exchanging data between healthcare providers and health plans/payers has been a contentious subject throughout the 23 years I’ve been working in healthcare IT. Physicians have long expressed dissatisfaction with the time they and their staffs spend interacting with health plans. And all the federal and state mandates laid on providers and health plans over the past decade have not improved matters.

This Friday, September 30th, a tweetchat will be held at 10:00am PT/1:00pm ET to discuss “Optimizing Payer and Provider Communications.” The chat is being sponsored by Availity and will be co-hosted by Mark Martin, Director of Product Management for Availity, and me, Steve Sisko.

The chat will explore the communication challenges between providers and payers and the ways in which communications and data sharing between healthcare providers and health plan payers can be improved and optimized.

What are the Topics?

For the list of topics that will be discussed, see this page at Availity’s web site.

What is Provider Data?

Provider data, simply put, is information about individual providers, groups of providers and institutions—who or what they are, how to access them, the services they provide, the health plan networks or products they participate in and other important attributes. These data facilitate everyday business and regulatory transactions, or “use cases,” such as claims processing, credentialing, contracting and licensing, and allow patients to find and access care. While provider data is conceptually straightforward, it is incredibly complex to standardize, manage and maintain.

Which Providers & Health Plans Exchange Data?

The short answer? ALL OF THEM! But several factors do influence the types, volumes and frequencies of data exchanged between health plans and physician practices. These include:

1. Type of Health Plan: Medicare, Medicaid, Commercial, ASO, etc.

2. Product Type: PPO, HMO, POS, HDHP, FFS, etc.

3. Provider Type: Primary Care, Specialist, Imaging Provider, Pharmacy, Lab, etc.

What Type of Data Do Providers & Health Plan Payers Exchange?

The following types of business transactions demand the exchange of data between healthcare providers and health plan payers:

1. Eligibility & Benefit Inquiry
2. Prior Authorizations
3. Contracting including Practice and Provider Directory
4. Pharmaceutical Formularies
5. Billing/Claims
6. Credentialing
7. Treatment Plan Compliance Monitoring
8. Quality Measures

These data may be exchanged at different times – at time of contracting with the provider, pre-patient visit, upon patient check-in, during the encounter, upon checkout, or retrospectively, irrespective of the patient. In addition, certain transactions may not even apply based on the health plan type, product type and provider type.

As Mark Martin notes in Leveraging Technology to Enhance Payer-Provider Relationships, "the key is to forge pathways where these two spheres of data (provider and payer) can overlap and be leveraged to benefit both stakeholders."

Critical Provider Data Use Cases and Common Data Needs
Some Background Materials

The following studies, blog posts, articles and white papers provide additional information about data exchanges between medical practices, providers and health plan payers.

"Provider Data Management"

But Wait! There's More!

For more information on healthcare data, technology and services, consider following me and Mark Martin on Twitter.

Sunday, September 25, 2016

Healthcare Innovation: The X Factors, SMS Nudges & The Three C’s: Cost, Compression and Consequence

This past week, Eric Grossman, CEO of NextHealth Technologies was interviewed in the GuideWell Insights Lounge at the 2016 Oliver Wyman Health Innovation Summit. Kate Warnock, GuideWell Social Media Manager and healthcare innovation inquisitor, teed up several topics for Eric to share his insight and thoughts on:

1. The X Factors driving health plans to exit from the ACA marketplace,

2. Effecting consumer behavioral change via artificial intelligence and SMS messaging,

3. The 3 C’s driving change in the health industry: Cost, Compression and Consequence,

4. "Exponential trends' worth watching for.

The GuideWell Insight Lounge on YouTube!

You can see the entire interview here and all the other great interviews Kate gave during the #OWHIC summit at GuideWell's YouTube channel here. Note: the following questions from Kate and responses from Eric were pulled verbatim from the interview recording. I’ve recently discovered that many YouTube recordings are transcribed and that it’s easy to pull the transcribed text. So while  you may be thinking, "that guy Steve sure does have a lot of time on his hands," this entire post - start to finish - took me about 20 minutes. Hopefully you, my reader, gets as ,much value out of it as I did. 

Kate Warnock Interviews Eric Grossman

Could you have predicted the exit of so many health plans from the ACA marketplace? Could these exits have been avoided?

“You know I think it’s a great question. Hindsight’s 2020 and it’s easy to be a Monday morning, armchair quarterback. Yeah but I think sort of is my answer, you know, I’m first of all I’m a big proponent of market forces versus public policy, sort of driving the market. But we sort of had an untenable situation with all these uninsured Americans."

Two X-Factors

"But I think there were really two X factors that you can I saw as sort of what may drive exit. I think the first is public policy around individual mandate and, unfortunately, it hasn’t been strong enough to keep the healthy people in to drive sort of the fundamentals of insurance which is you’ve got to have a balance risk pool. So without that we, you know health plans, have been left with a lot of expensive risk. And that kind of comes to the second X Factor which is market forces and unfortunately a lot of these smaller health plans, in my opinion, sort of followed the bigger ones in terms of their pricing. And a lot of the bigger ones kinda came in with a low-cost narrow network plan design and unfortunately because of the prior X Factor it created an environment with a lot of losses that little health plans couldn’t sustain so they had to exit."

"So in hindsight those were X-Factors. We didn’t know how they would play out and it’s led to a lot of shake out but you know, as Obama says, I think they’re things that we can improve upon and and correct given that we have so many more people in the system there’s gotta be some benefits."

You [NextHealth] are pros at doing [behavioral analytics] so you give the consumer some nudges to help change behaviors. Could you give us some scenarios where those nudges just might take place for and how they impact behavior?

"The first thing that that we do in in driving consumer behavior changes is find someone among millions of members who the analytics thinks that we can be successful in changing behaviors. You know a lot of people don’t want to change so or they’re too acute, too sick to change. So let’s take out of network usage: so we talked about narrow networks. That’s when you leave the health plans Network and get a higher deductible, a higher copay and higher negotiated rates. Not a good thing but the majority people when they go out a network they don’t know they go out-of-network and it’s could be thousands of dollars to any consumer, a health plan.

Sarah and SMS Nudges

Eric told the story of using analytics and SMS text messaging to help 25 year-old mother Sarah Gomez make better decisions about obtaining care for her two kids.

Listen to Eric tell the story at 3:30 –6:50 in the recording.

Let’s take a little bit look down the road. Okay so there’s some other trends that might disrupt the health industry and, from your perspective, what are some of those things that you think can really help change the way we’re doing business in the health industry?

“I think a block chain is a good example of how sharing data in an open-source, cloud-based environment has helped other industries like Bitcoin and others. I think one of the presenters here Chris K from Humana talked about block chain. But I don’t think there’s a silver bullet around, you know, some sort of sea change events. I do think that the sea change is large enough to drive major change in industry and I I think I like and I like the 3 c’s. So The Three C’s are the first one is cost obviously paying out $8 in claims costs for every one dollar in premium isn’t viable for any health plan regardless of your reserves. So that’s led to the second C which is compression. And you mentioned some of the sort of what’s going on in the market with ACA and then the last C is consequence: whether companies are going out of business or policy change in Washington so I think those three C’s breed innovation and there’s no better drive of innovation than desperation.”

One last question maybe a little bit closer to home. Any other trends worth watching for exponential growth in the efficacy of prescriptive analytics?

"So those are some big words. I’ll tackle those one at a time I typically don’t understand more than three syllables. I would say that the biggest trend is the continued losses stemming from the Affordable Care Act is driving health plans and hospitals to absolutely focus on solutions that are presented at this conference, that drive attributable medical cost savings and consumer behavior change. The word is attributable. How do we know that when I reach in with a screwdriver that it truly was my screwdriver that turned the screw? So that’s attribution. And I frankly don’t think health plan executives really care about the sausage machine; they need outcomes.

And it just so happens that prescriptive analytics or what to do next; the what and how well. And randomized control trials and machine learning are just absolutely no regret investments that you can make in the wake of all the market forces and all the headwind we’re up against."

Check back for more insight on healthcare data, technology and services. And consider following me on Twitter.

Thursday, September 22, 2016

Healthcare’s Transition from B2B to B2B2C and B2C Business Models

The 2016 Health Innovation Summit hosted by Oliver Wyman Health & Life Sciences unit kicked off yesterday in Chicago with the theme of this year’s event being “The Consumer Imperative: Transforming Healthcare From The Outside In.” 

On day one, my friend Kate Warnock – Social Media Manager at GuideWell Health - was at the summit interviewing key individuals at the GuideWell Insights Lounge. This is the 2nd year that the GuideWell Insights Lounge has stationed itself at the OW Summit; the GW Insights Lounge is apparently a new fixture at major healthcare conferences. I gotta say I like how Kate and GuideWell capture, curate and share valuable information about healthcare innovation, thought leadership and trends. 

One of Kate’s first interviews of the event was with Terry Stone - Global Managing Partner for the Health and Life Sciences Practice - at Oliver Wyman. Terry shared with Kate some insight into the difficulty healthcare payers are having with their transition from a business-to-business (B2B) to a business-to-consumer (B2C) business model. Terry also shared how innovators must understand the entire healthcare ecosystem and outlined the 'category' of those who might be in the best position to really disrupt the health market.

Thank's YouTube for Poor Man's Transcription

The following is a transcription I pulled off of the YouTube recording created by the GuideWell Insights Lounge. You can see the entire interview here. You may also want to check out tweets from the summit tagged with #OWHIC.

We've been talking about the consumer in the health industry for a long time yet we still seem to lag behind behind other industries. Why is that and what can we do to fix it now?

"That's a great question. I think in the last three years, in some way shape or form, we've touched on this each year: about where are we and why are we kind of stuck? That actually is a key part of why we focused the conference on what we have this year. Because healthcare does seem to be a little bit stuck.

B2B-B2B2C-B2C (Chromosomal Language of Biz Models)

And I think it's a great question. We've given a lot of thought to it. I'll start by the first, most basic premise being: healthcare has always been a B2B industry versus a real business-to-consumer industry. So in B2B businesses, health plans were selling to large employers. Right? Quite frankly, provider systems were negotiating with health plans and quite frankly the consumer, in some ways, was an afterthought. Okay. But that sounds a little overly simplistic. Like okay. So it's B2B now we have to be B2C. But I think it's really important that people understand what happens when you're in B2B market versus B2C and why does that make it so difficult to change?

Complexity of B2B Market Must Be Turned Upside Down

“So first of all, in a business-to-business market, your buyers are often buying for a lot more like rational logical reasons. You also have very sophisticated buyers buying a complicated service and, in some ways unintentionally I would argue, the product gets more complicated as each side tries to prove to one another that they're adding more value. Right? It's almost the antithesis of what you need for the consumer and that's a really hard paradigm to break and that actually is most pervasive through most of healthcare.

Pharma has Apparently Made the Transition to B2C

I'd argue the drug industry is probably the closest to having found its way once they had access to direct-to-consumer advertising, which gets a lot of backlash for a lot of reasons but they're one of the first parts of healthcare that's really started to have to embrace what it is about the consumer and what they need and how do I meet them where they are?”

How important is it for organizations to really understand the full ecosystem and to be able to connect the dots - another theme here at the summit?

“Sure I'm we talked a lot about the ecosystem and healthcare and it's funny we talk about the healthcare system in the US and I think what someone said it great ones where they commented that we don't have a system what we have is a bunch of parts and pieces that are all stuck together and you get this sort of random ecosystem, if you will."

Carve Out a Spot for Yourself that's Sustainable 

"I think it's really really important that players in the space understand where they sit in the ecosystem and have a consumer view set and how the consumer thinks about interacting with the parts and pieces and how you stitched together in order to add value to the consumer and simplify their life while also making sure you carve out a spot for yourself that's sustainable where you can make money because many of these are going commercial enterprises.”

Who do you think is in the best position to really disrupt the health market?

“It’s sort of the 10 million dollar question. I think if I knew specifically I probably wouldn't be sitting here and I'd be betting my money on someone else. But I will speak kind of categorically that, in my role, I see lots of players in healthcare. I cut across payers, providers, life science companies, health services and tech innovators. And what I have kind of strongly come to believe is that most likely the disruption that really changes things going to come from the outside."

Get B2B Traction with People You Frequently Touch 

"So that healthcare is in some capacity going to be airBNB’d or uber-ized. And by that I don't mean ‘Uber for Health,’ I mean somebody out of left field takes an industry that's kind of not delighting the stakeholders and has excess waste and it's going to kind of disrupt it and shake it out. And that could be in the form of the Apple’s or the Google’s of the world. Right? It could be the Walmart’s of the world. You know that the average Walmart consumer, I believe, goes in more than twice a week, over a hundred times a year.

If you start getting traction with people who have that much of a frequent touch with you, there's a lot you wind up doing. And I think when I advise my clients I say: “You should be watching for the people on the fringe - not your competitor down the street.”

What do you hope is achieved at this year’s summit?

“So what we're hoping to achieve this year is going beyond the basic part of innovation; which is ‘Oh, what's that company do? Or what's that technology? Or that seems really neat. And actually what we've been striving to do for the last couple years is get underneath “what's the magic in what makes that company special? What is it that makes it stick? Why are consumers delighted? And how did we get beyond the basics of the functions and the features and figure out what it is that really makes it sing and what really makes it kind of win. And I think that's a lot of what will be sharing."

Innovation is About Culture, Mindset, and Behavioral Change

"So we'll be talking not only about innovative companies but about culture; about mindset; about how do you drive behavioral change in consumers. So it's just the cut all across the board and we're really excited about how we think it will help our clients, help other stakeholders in the healthcare industry actually have more impact and delight their customers.”

Follow Along for More Insight into Healthcare Marketing

Check back for more insight on healthcare data, technology and services. And consider following me on Twitter.

Tuesday, September 20, 2016

What are Healthcare Executives Focusing on for 2017?

The Healthcare Executive Group is a members-only network of C-suite health plan and health system executives that collaborate with each other and certain other healthcare industry vendors and thought leaders to identify and promote innovation and transformation within the healthcare industry.

Every year for the past six years, the HCEG developed a ‘Top 10 List’ of the priorities and challenges considered "top of mind" for its members and their healthcare organization. The 2017 Top 10 list was recently developed during the group’s Annual Forum held in New York City last week. The HCEG news release announcing the 2017 Top 10 list can be found here.

What's On the HCEG Top 10 List?

My quick take on the Top 10 list reveals five main themes that HCEG members identified as critical to the healthcare industry:

1. Value-based Reimbursement
2. ACO’s and Analytics
3. Consumer Health & Transparency
4. Mobile Health
5. Retail Health and Care Redesign

Another Top 10 List? So What?

While a Top 10 list developed by a group of healthcare executives is certainly interesting, if taken alone it may not be perceived as having huge value. But according to HCEG’s news release today, their Top 10 list forms the basis for “examining critical issues, priorities and challenges for health plans in the post-reform era and will be complimented by a 7th annual national industry-wide survey with executive-level support from HCEG sponsors.

So, depending on how these Top 10 items are fleshed out by HCEG, its sponsors and healthcare industry thought-leaders over the next few weeks, these Top 10 items and the supporting information provided by the HCEG may very well provide unique and valuable insight to those of us working in this era of rapidly changing and advancing healthcare reform.

Check Back for More

As 2016 advances toward 2017, I’ll keep an eye on this Top 10 list and similar industry news; and I’ll be sure to share with the readers of this blog and those who follow me on Twitter. You can also follow the HCEG on Twitter.

Monday, September 12, 2016

Tips for Promoting and Hosting Tweetchats

I consider tweetchats one of the most powerful uses of Twitter since they are a way of learning from crowd-sourced information and ideas about very specific topics. Over the last few years I’ve participated in dozens – probably hundreds – of ‘tweetchats.’ And I’ve hosted more than a few chats.

Recently, several people have reached out to me inquiring about tweetchats: how to promote them, how to host them, and other practical tips about tweetchats. I’ve also reached out to a few people (including @AleishaBrooke) who hosted tweetchats I've participated in. This blog post is for the above referenced individuals.

Promoting the Tweetchat
1. Invite Relevant Guests and Influencers to Participate

Getting an influencer in on the chat can really boost its visibility and authority. Many influencers have large audiences that they will involve in the chat too.

Invite your biggest fans to the chat. Tweeting is the best way to promote a chat to your fans. Typically you should do it 12 to 24 hours before the chat, as people tend to be busy and are likely to forget.

2. Invite People Personally

If you’re certain that a friend, role model, or follower would be the perfect fit for your Tweet chat community, take the time to invite them personally. Make it easy for them to know when the chat will occur and provide them the topics in advance so they can best participate.

3. Promote the Chat Via Channels Other Than Twitter.

If you have a Facebook, LinkedIn and/or other social media account, share information about the tweetchat via those channels

4. Define and register a hashtag

A unique hashtag is a prerequisite for a tweetchat. You can have one without a hashtag. So select a hashtag that is short, unique and easily remembered. And make sure to ‘register’ the hashtag at sites like Symplur

Graphics and Images
1. Incorporate Eye-Catching Visuals at Every Opportunity

There are several ways you can incorporate visuals into your Twitter chats. You can use images to promote your upcoming chats, to convey the questions/topics of the chat, and to provide certain ‘logistical’ reminders before and during the chat.

2. Use Images to Advertise the Chat and for Each Topic/Question

Images are effective ways to convey reminders like being sure to include the hashtag in every tweet, tagging responses to specific topics/questions with the id number (T2, A2, etc.).

1. Provide 'logistical’ messages before, during and after the chat.

Tweets like the following can be prepared in advance and then easily copied and tweeted during the chat. You might also consider scheduling certain tweets.

60, 30 and 5 Minutes before the Chat
The <#chatname> will start in <number> minutes. See here: <link to topics or info on the chat>.

Start of the Chat
Tweet: “It’s time for our chat on <chat theme.>”

Tweet: “We’ll use a T1:A1 format: for each Topic 1 thru 6, begin your response w/ T1-T6. Please include <#chatname> in all tweets”

Tweet a hello/welcome to as many attendees as you can – especially any influencers or ‘special guests.’

During the Chat

1. Use a tool to help identify and manage your tweets.

Consider using a tool like Tweetdeck to provide several channels or streams that can be used to monitor each topic of the chat. For instance, I use Tweetdeck as follows:

2. Welcome the Newbies And Lurkers

Take time to acknowledge newcomers and lurkers. A small effort to help them feel welcome can go a long way to encourage their participation and to help ensure they return for future chats. Many of the “newbies” may someday be your biggest evangelists if you treat them right!

3. Respond to Every Question or Comment Directed to Your Account

Tweetchats are all about engagement. Don’t fail to acknowledge those that tweet at your account.

4. Warn/remind about of upcoming topics:

Get ready for Topic #1 coming up soon! <#chatname>
Topic #2 on its way shortly! <#chatname>
Get ready for Topic #3 coming up soon! <#chatname>
Topic #4 coming in a minute <#chatname>
Get ready for Topic #5 coming up soon! <#chatname>

5. Periodically remind people to include hashtag by tweeting:

“Remember to include the <#chatname> hashtag in each of your tweets.”

6. Periodically remind people of format for responding:

“Remember to begin your response w/ the topic number and include <#chatname> in all your tweets”
7. Two to Three Minutes Before the Chat Ends

"Everyone, please thank @_____ from _____ for adding so much value to our [#chatname]."

At the end of the chat
Tweet: “Thank you all for attending the <#chatname> today!

Thank all the people you can. A group thank you listing multiple participants is good.

After the Chat is Over
1. Recap the Chat

A tweetchat is a great source of information. Information that should be shared with participants who may have missed tweets during the frenzy of the chat. And for others who may have missed the the chat. A tool like Storify can help with this. You can also curate tweets in a blog post; which is my favorite approach.

2. Create a blog post that summarizes and comments on the best tweets on the chat.

3. Share the stats on the chat

If you’ve had a good chat, you may want to share the stats of the chat. If you’ve registered the hashtag for the chat on Symplur, you can pull the stats from there and share.

General Tips
1. Prepare all your tweets in advance so you can just copy and tweet them. This saves you time to address other needs.

In particular you can prepare some tweets that contain links to supporting materials.

2. Understand how others participate in tweetchats

See this post I wrote a while ago about participating in tweetchats:

That’s All Folks!

For more information like the above and to learn more about healthcare data, technology, and services -including the use of social media  - consider following me on Twitter.

Wednesday, September 7, 2016

Importance of Social Determinants of Health Data to Improved Patient Outcomes

source: Dahlgren and Whitehead, 1993
The topic of this week’s #KareoChat on Thursday, September 8 at 9:00 AM PT is Social Determinants of Health Data – specifically the collection and dissemination of data regarding behavioral and social determinants of health in electronic health records. You can find the topics that will be discussed in the chat here

This is a complex subject and I hope to share and collect some good considerations, ideas and approaches. This post presents some background info on the topic of social determinants of health. There are several good reference materials at the end of this post that discuss the capture and use of social determinants and behavioral data in EHR's.

What are Social Determinants of Health?

Most people think their health is ‘fixed’ by the efforts of medical research and procedures performed at their doctor’s office or a hospital; but that’s just not the case.

While 30% of our health outcomes may be ‘addressed’ this way, the greater balance is related to our behavioral health, social determinants, and influences of the environments in which we live and work. Our education level, where we live, how much money we have, and the problems we struggle with have been clearly linked to our well-being, the quality of our lives, our health, and how long we live.

Healthcare Reform and Value-based Reimbursement Demand 

Only in the last few years has collecting data about and addressing non-medical determinants – most all of which are NOT addressed by health care systems – been recognized as key to managing healthcare outcomes and costs. And healthcare reform, value-based reimbursement, the need for increased health system and provider accountability; and the addition of millions of people to the health insurance rolls have finally created incentives to address social determinants of health; but limited availability of data on 
behavioral and social determinants impede widespread health outcomes improvement efforts.

Capturing social determinants of health in the EHR is critical to enable health care providers to better characterize, understand the causes of, and identify appropriate interventions that health care systems (and non–health care systems) can make to improve outcomes across healthcare populations. Unfortunately, such information is currently insufficiently captured in most electronic health records.

Categories of Social Determinants of Health

Social determinants of health fall into a handful of major categories and are evolving in terms of understanding and definition. Here are some primary categories and specific determinants within each category:

Sociodemographic Domains
   Sexual orientation
   Race and ethnicity
   Country of origin/U.S. born or non-U.S. born
   Financial resource strain: Food and housing insecurity

Psychological Domains
   Health literacy
   Negative mood and affect: Depression and anxiety
   Psychological assets: Conscientiousness, patient engagement/activation, optimism, and self-efficacy

Behavioral Domains
   Dietary patterns
   Physical activity
   Tobacco use and exposure
   Alcohol use

Individual-Level Social Relationships and Living Conditions Domains
   Social connections and social isolation
   Exposure to violence

Neighborhoods and Communities
   Neighborhood and community compositional characteristics

Additional Resources

“Sources for Data on Social Determinants of Health”   

“Capturing Social & Behavioral Domains in Electronic Health Records”

”Using Social Determinants of Health Data to Improve Health Care: A learning report”

"Accounting for Social Risk Factors in Medicare Payment: Identifying Social Risk Factors" 

“Systems Practices for the Care of Socially At-Risk Populations” 

“Acting on the social determinants of health – for a fairer distribution of health” 

“Leveraging the Social Determinants of Health: What Works?”  

Healthy People 2020 - Social Determinants of Health
Addressing Healthcare via Non-medical, Community-based Resources and Tools

Come Join Us!


Thursday, September 1, 2016

Using Twitter's 'Collections' Feature to share Information on Healthcare Data, Technology & Services

The following is an example of embedding a Twitter Collection into a web page. I've included both formats - Grid format and List format - with each type referencing the same tweets.

Summary of #HITsm Tweetchat: Acquiring, Managing & Disseminating Health IT Knowledge

On Friday, August 19th, 2016, I hosted the weekly #HITsm tweetchat. The theme of the chat was "Acquiring, Managing & Disseminating Health IT Knowledge." A total of 75 participants tweeted 561 times for 5.2M impressions. Here are the stats from @Symplur

Thanks to all who participated. And special thanks to @HealthStandards who allowed me to host. And thanks to Captain Angela - aka @HealthIsCool - who kept us on track!

What Follows?

The following is a summary of ALL of the tweets made during the chat - except for retweets, the usual 'salutations,' thank you's' and 'have a great weekend' tweets.

Topic 1: What are some of your favorite tools & methods for finding, curating, storing and sharing information?

Fav tools for finding info are peeps on Twitter and info from places like @HealthITNews, @MobiHealthNews, @medcitynews & more.
Twitter and THIS community, also LinkedIN
RSS feeds, Google Alerts, Hootsuite searches & “daily news summaries” are my primary methods.
My favorite tool for finding, curating, storing & sharing information is Twitter. Period. End of tweet.
Not sure I have a good curation strategy though. Mostly skimming articles, finding what interests me. Focus on legal aspects.
For six years now, @twitter has been my key platform for curation & personal/professional learning. The key is a tailored network.
Peeps I follow on twitter, @Tweetdeck, @tweetchat, Google alerts, @HubSpot , @Storify
Twitter, of course! And Twitter lists!
My favs are Buffer and Hootsuite. Also follow #HITsm #HCLDR #HIT100 for thought leaders
Type of tool to use depends a lot on personal preferences, as well as your purpose, who & how many your share with.
Totally agree on @hootsuite. I also use @Pocket to save articles, which you can tag by subject. Then I can read them later.
Finding great content - use @twitter the most - search on key words and follow you people!
Also Google Alerts for info. gathering
Hootsuite is also my "go to" for social content curation
I like to look at who the “top dogs” follow and can usually find good follows/info there.
I also have a @hootsuite tab dedicated solely to conference hashtags to get the good info if I can't be there.
Instead of lists, I curate my followers AND handles I follow to end up with the most informative, accurate, noise free feed~
I rely SIGNIFICANTLY on Twitter lists (and Hootsuite)
Have to say that since I mostly keep a constant eye on Twitter, Tweetdeck one for me. Like autostream.
I typically don't have ANY trouble finding valuable content... It's READING it all that's the challenge!
@nuzzel and @Morning_eHealth help me curate. Twitter helps me share.
Creating tailored feed: I vet every handle that wants2 follow me & every handle I follow up front. Time intensive
Basic Tweetdeck column for each frequently-searched hashtag also helpful.
Tailored network, yes. I started w twitter as my repository of primary references but it quickly evolved @nxtstop1 @twitter
Agree, usually participating in vibrant chats here is a good mechanism to find quality curators to follow @Colin_Hung
Shameless Plug Alert!: We'll be live streaming @MandiBPro's Keynote at #GLHCSummit16 on YouTube next Tuesday!
Agree; More than 5 page articles lose me!
I'm a hoarder...I should start dumping! 
How #DigitalHealth #Startups Can Influence Influencers #hit100 
This is why we still use fax in #healthcare... ? #healthIT #InfoSec #HIT100 #EHR 

Topic 2: What/who are some of your favorite and ‘go to’ resources for #HealthIT information?

Well for sure most of those nominated to the #HIT100 and many in the #HIT500 are good sources of & #HealthIT info.
Hard to list all. As being said, divides between people and publications.
Just joining #HITsm? We are on T2! The rest of the topic questions can be found here:
Fav go-to resources? All outside #HealthIT industry in #BPM Business Process Management industry. (Sorry!)
I like the HIStalk Practice emails @JennDennard puts together.
Also finding podcasts helpful. Like #HITMarketer, #HITcast, @WeekinHealthLaw & @politico #PulseCheck.
My twitter lists, @ShimCode 's blog, #HITsm / #HCLDR / #Telemedicine / #Interoperability / #EMPI / #Alzheimers / #KareoChat
The list is WAY too long to fit in 140. But suffice to say that they all fall within the #HITMC & #HITSM communities!
I’ll be posting a pared down version of my Browser Bookmarks in this folder after the #HITsm chat:
I have to say @HIMSS and @HealthITNews (also HIMSS for news)
RE:Health IT> (or any topic):initial 1rst step: join tweet chats to listen & learn. Gather info, make note of insightful comments.
I find the #HIMSS social media ambassador to be a great resource. Pubs like @medcitynews @HealthITNews @HealthcareScene
I also enjoy podcasts! Great alternative to written content. @healthstandards #HITcast with @JennDennard @OchoTex is a good one.
If you list #HealthIT or other keywords in your Twitter bio, the algorithm will suggest like-minded folks.
I’ve also posted my RSS feeds in a word doc so you can easily see the sources of the #HITsm info I think is good. Same folder I shared
I have been really impressed with the quality of #HIT related content that comes out of pubs like @NewYorker @Forbes & @WSJ
How about this? “RSS feeds of Doctor-Produced #Health and #Medical Information”
I use hashtags for discovery. I use Hootsuite and lists for organizing and reflecting. #hcsm
Modern Healthcare emails alerts are always where I hear breaking stuff first.
I like @HealthITNews @HarvardBiz @Forbes @WSJ to name a few...
Daily News Summaries are great!
“Educational Curriculum Approach to Finding, Creating, & Posting Great #hcsm Content” (Read this, get a PhD)
For deep thought content, I am a crazed Atul Gawande & Joseph Kvedar fan boy!
@histalk is a must read, some #HIT trade pubs, Google Alerts for issues we care about, Twitter #HITsm peeps!
Big fan of Twitter, podcasts, video & blogging. Cover ALL platforms but struggle with consistency of output.
Absolutely one of my go-to's for Health IT News n Views!
Do you guys know about the "one tab" plugin?
I recently started listening to @politico's new podcast Pulse Check - it's great!
Depends on how tweet chat is Storified. If lightly curated > accuracy & completeness kept
You can use @Symplur to search on a specific hashtag and then look at who top tweets are from to find good resources
Agree, though the ‘checkout our sponsors content’ gets a little spammy for me. Prefer organic insights.
My Hootsuite: See OPML & Word file containing & related RSS Feeds
Completely Agree! I SO miss the days of the 3 inch Sunday Paper!
“Finding and Evaluating Online Resources”
Good catch Steve!

Topic 3: What are your preferred media, channels and formats for consuming and conveying #HealthIT info?

My preferred social media? Besides Twitter? #Blab boohoo blubber weep (but #Blab2 is coming I believe!) 
Digital #HITsm
An RSS reader is my primary “dashboard” for reviewing and reading articles and information
Agree with @ElinSilveous on digital. Also like in-person conferences. Face to face interax awesome.
I prefer information that’s formatted in a manner that allows me to easily categorize/index, store it & retrieve it.
So true, Matt! Person-to-Person not to be overlooked.
I like ‘bite-sized’ pieces of info “Get Big Impact from Bite-Sized Content” Info here:
There's no question that Twitter is my preferred medium... I need to do a better job of incorporating other channels.
Twitter lists viewed in Hootsuite and RSS Feeds in Buffer are my primary sources. See this:
Preferred media would be text or video on phone...though #CDA 4 interop.
Agree. Being succinct forces you to distill info. I prefer short posts for general info. Long form good for research 
LOL. Truth is that with chats like #HITsm #hcldr #hcsm you only get full value when you read transcript after @Matt_R_Fisher
"A little information is a dangerous tool" applies. Vet the info- reliability = timeliness & source

Topic 4: What are some considerations u make when assessing the validity, reliability, usefulness of information?

How I assess info? 1 Nature of author 2 Quality of argument 3 Contribution to community goals #ethics  Image here:
The old adage: “Consider the source” is an ‘adage’ for a reason.
Agree with @ShimCode & @wareFLO on considering source. Also vet against my own understanding.
As physician, want to make sure items that I share are from a reputable source, containing relevant info, & hopefully open access
Not always possible to filter out something bad, so if later find it, will correct and flag.
I always consider the source, known biases, and sponsor of content when assessing validity. (Hi all!)
Reputation of the site 1st & foremost. Then author, then relevance of content. So many new authors it's hard to tell good from bad
“Evaluating Internet Health Information: A Tutorial from the National Library of Medicine.” Info here:
Good info here: “Evaluating Internet Resources”
This is why curating one's network up front is invaluable. Weed out inaccurate, biased, spam sources upfront...block ~ 50% handles
If our #HITsm #HCLDR Healthcare community shares, quotes, pays attention to the info being presented
Don't know if you've noticed, but I share. A LOT! I read EVERYTHING first and toss a lot of spam. You gotta kiss some frogs!
What site it's on, Who wrote it, Whether facts are substantiated, Does it read "Salesy"
And here: “Criteria for Assessing Accuracy/Validity of a Website” (See addtl resources in this document:
In #healthIT, in addition to the quality of the content, the layout and design is important. Can't turn me off.
Often I re: email or something where I know I will "touch it" again, easily filed=easily forgotten in my world

Topic 5: What are some of the ways you organize and store the #HealthIT info you obtain?

I print them and store them in my file-o-fax
Bookmarks. Folders of sub-folders of bookmarks.
IMO, there are 3 main options: Spreadsheet/Word doc, Trello/Kanban board, or Content Mgmt System. I use the first two.
How do I organize info? Twitter, Twitter & Twitter. It is my external brain. 
Guess I should have mentioned the @OneTab plugin here!
I'm terrible at this... Can't wait to see how others do it!
Why, in plastic bins, of course. 
As with all references, if I'm truly interested >have a research type blog on going & will add REFs there for future writing ~
Organization is a process- Research is organically chaotic to yield the best results 
One of my multiple Trello boards. Example here:
Though, to be consistent w/my workflow "brand" here is my daily Twitter workflow :)
Haven’t been able to get value from @evernote or @msonenote
Of course a well- organized directory structure – preferably in the cloud – is a basic need.
Totally agree on @Trello. Great especially for visual people.
I love and appreciate the way @nxtstop1 curates our #HITsm transcripts. Keepers!
I often summarize Tweetchats into a blog post. And I’ll do that for this chat too. Check back at my blog w/in a week.
Lots of content in @Dropbox and bookmarks. Been writing #python scripts and #NLP tools to make sense and extract relevant content
Late response. I have a master Google Spreadsheet with all my needed & most-useful #HIT resources
Here’s how I (try to) manage a tweetchat using @Tweetdeck. Image here:

Miscellaneous Topics

“How to engage your patients on social media – without violating HIPAA!”
A bunch of social video services will likely try 2 pivot into #Blab s space, prob is N2N video very expensive 
Isn't it sad that so few people have had the pleasure of newsprint ink on their fingers? 
There is something classic about turning real pages. Hopefully books follow path of vinyl records - cool again @ebukstel @ShimCode
Weird thing is, I've become somewhat allergic to newsprint > #Itchy, used to read 4-5 newspapers a morning...  
Am visualizing your closet Steve. All suits organized by style and color?
Close: All t-shirts, shorts & ball caps organized by size, L, XL, & XXL. Hope to get back into the XL and L one day!
Another good list: “Top 100 List of Health Websites You Can Trust” See here:
This from @wareflo earlier today:
“Communication and Dissemination Strategies To Facilitate the Use of Health and Health Care Evidence”
Yes, like content, not pitch for a service. Tell me about an issue, not what you can do. 

That's All Folks!

I think that all of the above tweets provide great info and ideas for those looking to acquire, manage, and disseminate health IT knowledge - whether beginner or expert. I suggest that if you like something one or more of the tweeps above have shared, that you follow them and/or reach out to them and engage them for more of their insight.

In the meantime, if you're interested in healthcare data, technology and services, consider following me on Twitter where I use the above referenced techniques on a near daily basis.

Thanks again to all those who participated in this #HITsm tweetchat in any way, shape or form.