Chronic Care Management Medicare Reimbursement

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Who is eligible for CCM?

Beneficiaries diagnosed with 2+ chronic conditions expected to persist at least 12 months (or until death) that place individual at significant risk of death, acute exacerbation/decompensation, or functional decline.

Who can bill for CCM?

Physicians (regardless of specialty), advanced practice registered nurses, physician assistants, clinical nurse specialists, and certified nurse midwives (or the provider to which such individual has reassigned his/her billing rights). Other non-physician practitioners and limited-license practitioners are not eligible.

What practice standards must be satisfied to bill for CCM?

The billing provider must utilize electronic health record technology certified by a certifying body authorized by the National Coordinator for Health Information Technology. Such technology must include an electronic care plan accessible to all care team members.

Are there services a provider must furnish to a beneficiary prior to billing for CCM for that beneficiary?

While CMS strongly recommends that a provider furnish an annual wellness visit (HCPCS G0438, G0439) or an initial preventive physical exam (G0402) to the beneficiary, there is no prerequisite service to bill for CCM.

What constitutes a billable unit of CCM services?

CCM services may be billed once every 30 days, provided that at least 20 minutes of non-face-to-face care management services are furnished during that time period.

How is the 20 minutes of service counted?

Time may be aggregated to total 20 minutes, but if two persons are furnishing services at the same time, only the time spent by one individual may be counted. Time of less than 20 minutes over a 30-day period may not be rounded up to meet this requirement.

What role can clinical staff (e.g., nurses, social workers) play in providing CCM?

CMS states it “would expect that the 20 minutes or more of CCM services to be provided by clinical staff directed by a physician or other qualified health care professional.”

What level of supervision is required for clinical staff providing CCM?

To count toward the 20-minute requirement, clinical staff must furnish services consistent with the “incident to” requirements, except direct supervision (i.e., physician present in some suite of offices and immediately available to provide assistance or direction) is not required. Instead, the services may be provided under general supervision (no physical presence requirement). Such supervision may be provided by a physician other than the billing physician.

Does clinical staff have to be directly employed by the billing provider?

No. Clinical staff may be employees or independent contractors to the billing provider.

Can more than one provider bill for CCM for the same beneficiary during the same time period?

No. CMS will pay only one claim for CCM per beneficiary for a 30-day period.

Must a beneficiary

consent to receive

CCM?

Yes. Before furnishing any CCM services, the provider must obtain the beneficiary’s written consent and retain that document in the beneficiary’s medical record. Specifically, the beneficiary must acknowledge that the provider has explained (a) the nature of CCM, (b) how the service is accessed, (c) that the beneficiary’s health information will be among providers electronically for purposes of care coordination, and (d) that the beneficiary will be responsible for any copayment or deductible.

What documentation must be provided to the beneficiary?

The provider must deliver a written or electronic copy of the care plan to the beneficiary, and this delivery must be documented in the beneficiary’s medical record.

May a beneficiary consent to receive CCM from more than one provider?

No, a beneficiary must revoke consent given to one provider before giving consent to another provider.

How may a

beneficiary revoke his or her consent?

A beneficiary may revoke his or her consent to receive CCM at any time by communicating this intent to the provider. However, if the revocation occurs during a current CCM 30-day period, the revocation would not be effective until the end of that period. The provider must document such revocation in the beneficiary’s record.

Are there services that cannot be billed during the same 30-day period as CCM?

Yes, there are three:  transitional care management (CPT 99495 and 99496); home health care supervision (HCPCS G0181); hospice care supervision (HCPCS G0182); and certain ESRD services (CPT 90951-90970).

How should a provider bill for face-to-face services furnished during the CCM

30-day time period?

If a face-to-face visit is provided during the 30-day period by the practitioner who is furnishing CCM services, the practitioner should report the appropriate E/M code in addition to the CCM code(s). This rule also applies to an annual wellness visit.

What will be the payment for CCM services?

CMS has proposed a payment rule of $41.92* per month per qualifying beneficiary.

Event Notification Becoming Integral to HIEs

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Health care providers and insurers across the country are discovering event notification system (ENS) capabilities supply an integral “value-add” to critical information exchange.

 

In Florida, for example, the statewide health information exchange is rolling out an ENS service in which insurers and primary care physicians are notified of transitions of care. The ENS engine was designed by Baltimore-based Audacious Inquiry, which also designed the ENS for Maryland’s HIE, Chesapeake Regional Information System for our Patients (CRISP), and Delaware’s DHIN.

 

CRISP CEO David Horrocks says the ENS was not part of the HIE’s original design, but the organization began thinking about how best to leverage admission-discharge-transfer (ADT) notifications in 2011, after encouragement from Farzad Mostashari, M.D., former national coordinator for HIT.

 

“Farzad recognized that we were ahead of the game with ADTs, and encouraged us to think about what we could do with just those,” Horrocks says. “By the end of 2011 we had ADTs from all 46 Maryland hospitals.

 

“My colleagues at Audacious Inquiry, who have done our HIE program management, and I kept working on ADT ideas and we came up with the ENS concept. The novelty was going to be getting the patient list up front from the primary care physician, rather than relying on the data collected at the hospital, which is often inaccurate, and using Direct. We went live in August 2012, sending just a few dozen alerts a day. It had grown to several hundred daily alerts by the fall.”

 

Today, Horrocks says CRISP sends close to 5,000 ENS alerts each day, with around 3 million people in the patient roster. The service is used mostly by PCPs and care coordinators at health plans. The HIE is also adding care coordinators at hospitals, who are watching for emergency department visits for patients who were recently discharged, and is about to activate the ability to receive discharge summaries as part of a transition of care. Patients can opt out of both parts.

 

Horrocks says the system is rolling out in a slightly different vector than originally envisioned.

 

“We thought a mobile phone alert would be important and built it in, which is almost funny in retrospect because the doctors don’t want to be interrupted for this,” he says. “The practices who have an infrastructure for care coordination seem to make the best use of it, often getting the alerts in a batch early in the morning and maybe again in the afternoon, rather than one at a time throughout the day.”

 

Mack Baniameri, CEO of Scottsdale, Ariz.-based Health BI, which launched its own ENS platform in September 2013, says the new CMS CPT codes (99495 and 99496) for transitional care management services are a huge driver of the ENS market.

 

“ENS becomes very important for the primary care providers, so they can communicate with the patient and get them in,” he says. “On the hospital side, obviously they reduce the readmissions. And the ROI for payers is huge because it reduces inpatient admissions.”

 

Baniameri says the pricing model for the company’s ENS technology varies depending on the customer. Payers like per-member, per-month pricing, while ambulatory and community providers prefer a SaaS-based per-provider, per-month model. The company’s current customers include several clinics and United Healthcare. Baniameri says the company is in the middle of the RFP process with several HIE’s.

 

Technologically, Baniameri says an ENS system must be able to receive ADT messages in various formats, including HL7, CCD, and XML, and must include some kind of internal master patient provider index and a filtering engine.

 

“You also have to have several methods of communication to the providers,” he says, “like fax, secure SMS, portals, and secure e-mail. Everybody is different, so we have to have a variety of mechanisms built in.”

 

CRISP’s Horrocks says the participants recognize the payback they get from the ENS. The system’s development was funded by a portion of the HIE’s operations budget, which at the time was a combination of fees paid by hospitals and grants.

 

“We operate it today on fees from hospitals, and fees from payers which are collected through a state assessment,” he says. “We also use some grant money to implement ENS improvements. The value which participants get from ENS is part of the reason we are able to collect fees, so it is important to CRISP’s sustainability.”

Allscripts Integrates with HealthCollaborate Care Transitions Application

Providerimagess who are using Allscripts EHRs can now seamlessly integrate patient data with Health BI’s HealthCollaborate care transitions management solution. The integration supports automation, transparency and accountability per evidence-based care transition protocols. The results are efficient tracking of patient appointment compliance, reduced number of days to complete post-discharge appointments, advanced notification of no-shows, and rapid interventions.

 

“We are so pleased to be integrated with Allscripts and the opportunity to provide the value of our solutions to the over 180,000 physicians using Allscripts. Our solutions connect acute and post/sub-acute care settings by integrating ADT and EHR data with ambulatory care settings to better coordinate care for patients and foster population health management,” said John Achoukian, Vice President of Product Innovation at Health BI. “The integration of ambulatory Allscripts patient information with our solution provides our customers with seamless automation and empowers them to focus on the patients that need extra attention during the transition from acute to post/sub-acute care, this is an innovation we are very proud of and one that will improve the quality of care for patients.”

 

The HealthCollaborate solution currently automates care transition processes to more than 325 individual providers at 28 locations through integration with hospital facilities and ACOs. Implementations, depending on ACO arrangements, may also include a payor interface. The solution includes analytics which produce patient risk stratification, comorbidity indexes and a customizable population health management dashboard.

Care Transition Transformation Is Here!

Can inpatient and outpatient healthcare providers, operating on disparate EHR platforms, efficiently and effectively exchange clinical information to transition patients to deliver the appropriate care in the right setting? Can payors promptly navigate their members between care settings, support providers with historical claims and clinical patient data, generate risk stratification and ensure that members are following evidence-based and cost-effective guidelines as they transition? Can all of this be done on a single platform? Now it can!


Health BI’s HealthCollaborate platform is being shared by payors and providers across an administratively simple ecosystem and is producing results for providers, payors and patients. The solution delivers seamless transparency and promotes accountability across healthcare stakeholders who have traditionally found integration and the sharing of time sensitive clinical information to be near impossible. The timing for HealthCollaborate couldn’t be any better as providers become more accountable for cost and assume more risk with payors.


HealthCollaborate bridges payor claim data with real-time acute admission and discharge data and assigns evidence-based care transition protocols to risk-stratified patients. Ambulatory providers benefit from having timely patient admit and discharge information along with the steps they need to manage a safe patient transition from inpatient to outpatient care. Furthermore, HealthCollaborate incorporates interactive voice recognition (IVR) phone calls into the care transition protocols thus automating some of the outreach steps and making sure that providers and patients remain engaged.


HealthCollaborate is a value-based system in which data and intelligence are automatically shared in real-time to inform decision making. Health BI helps healthcare clients with transformation to achieve effective and safe care transitions as it is less costly than the high costs associated with poor transitions and hospital readmissions.

Automated post-discharge assessment calls put huge dent in costly readmissions

“High-risk patients are most vulnerable within the first 72 hours after discharge, yet patients are too often discharged from hospitals without follow-ups,” says general surgeon, Dr. Ali Ghazanfari.

 
Patient transitions from the hospital to the outpatient setting involve not only changes to the physicians providing care but also diet, medications and potentially complex drug therapies, exercise, and social factors. All of these changes make the early post-discharge period a vulnerable phase.

 

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As a result, post-discharge assessments with 72 hours of discharge are now deemed an essential component of the treatment of the patients hospitalized for heart failure and other serious conditions.

 

A quick patient assessment call can greatly reduce hospital readmissions. The assessment can catch potential red flags, notify healthcare professionals and initiate rapid intervention to help avoid the need for the re-hospitalization. For example, knowing that the patient is feeling worse, not taking prescribed medications, or just has a question can prompt healthcare provider actions to produce more favorable patient outcomes.

 
The HealthCollaborate Transitional Care Management Solution includes an automated post-discharge assessment IVR module which contacts patients or patients’ caregivers to quickly assess progress. The assessment determines if the patient needs additional patient education, medication review, or just has a question. The HealthCollaborate BI engine analyzes assessment results and sends notifications to the care team if immediate intervention is required.

 
Automated post-discharge assessment calls subsequent to a hospital discharge help reduce preventable hospital readmissions, thereby minimizing the considerable costs associated with those readmissions. Furthermore, the automated post-discharge assessment calls help hospitals and service providers to cover more lives with less resources.

 
Health BI’s HealthCollaborate™ is an end-to-end Transitional Care Management Solution that enables healthcare providers and Health Plans to coordinate, manage and monitor transitions of care for patients from hospitals to multiple post-acute care settings.

Good Samaritan Hospital Selects Health BI’s HealthCollaborate™ Care Transition Management Application to Improve Population Health

Vincennes, IN – May 5, 2014 – Good Samaritan Hospital (GSH), an award-winning 232-bed community health care facility located in Vincennes, Indiana, has selected Health BI’s HealthCollaborate™ Transitional Care Management solution to achieve advances in discharge and aftercare processes. GSH will implement a blend of existing best practices along with HealthCollaborate™ solution capabilities to engage and monitor discharged patients while realizing care coordination efficiencies and improved patient outcomes. HealthCollaborate™ is expected to improve care efficiency by replacing traditionally siloed processes with standard, streamlined, and automated workflows. GSH care managers will have a single dashboard with patient queues to help prioritize activities and quickly identify necessary interventions. Data analytics will provide insight into understanding high-risk patients and help form strategies to address any identified gaps in care.

 

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“HealthCollaborate™ will provide transparency across care settings and support patient interventions sooner rather than later. The solution will enable our care teams to deliver evidence-based care more efficiently and the result will be safer and healthier patients after hospital care,” said Mickey Pagan, Director of Integrated Health Delivery at Good Samaritan Hospital.

 

This decision to select Health BI and HealthCollaborate™ was made after a comprehensive review and evaluation of products on the market.

 

About Health BI
Health BI is a healthcare software company created by a team of Health IT Innovators and physicians to help organizations manage care transitions, improve care and reduce costs. Health BI’s cloud-based HealthCollaborate™ care transition management solution provides insight into patient events and dispositions, enables sharing of information across care settings and supports timely interventions to help reduce avoidable hospital admissions and readmissions. The solution enables care teams to deliver patient care through effective communication and patient engagement to improve outcomes and financial performance. Visit: www.healthbi.com

 

About Good Samaritan Hospital
Good Samaritan Hospital is an award-winning 232-bed community health care facility located in historic Vincennes, Indiana serving southwestern Indiana and southeastern Illinois. Its progressive technology and commitment to excellent health care for all have made the hospital the employer of choice for 1,900 people in and around Knox County, Indiana. Visit: www.gshvin.org

Health BI in the news

logo-hdm-trans

Event Notification Becoming Integral to HIEs

 

Health care providers and insurers across the country are discovering event notification system (ENS) capabilities supply an integral “value-add” to critical information exchange.

 

In Florida, for example, the statewide health information exchange is rolling out an ENS service in which insurers and primary care physicians are notified of transitions of care. The ENS engine was designed by Baltimore-based Audacious Inquiry, which also designed the ENS for Maryland’s HIE, Chesapeake Regional Information System for our Patients (CRISP), and Delaware’s DHIN.

 

CRISP CEO David Horrocks says the ENS was not part of the HIE’s original design, but the organization began thinking about how best to leverage admission-discharge-transfer (ADT) notifications in 2011, after encouragement from Farzad Mostashari, M.D., former national coordinator for HIT.

 

“Farzad recognized that we were ahead of the game with ADTs, and encouraged us to think about what we could do with just those,” Horrocks says. “By the end of 2011 we had ADTs from all 46 Maryland hospitals.

 

“My colleagues at Audacious Inquiry, who have done our HIE program management, and I kept working on ADT ideas and we came up with the ENS concept. The novelty was going to be getting the patient list up front from the primary care physician, rather than relying on the data collected at the hospital, which is often inaccurate, and using Direct. We went live in August 2012, sending just a few dozen alerts a day. It had grown to several hundred daily alerts by the fall.”

 

Today, Horrocks says CRISP sends close to 5,000 ENS alerts each day, with around 3 million people in the patient roster. The service is used mostly by PCPs and care coordinators at health plans. The HIE is also adding care coordinators at hospitals, who are watching for emergency department visits for patients who were recently discharged, and is about to activate the ability to receive discharge summaries as part of a transition of care. Patients can opt out of both parts.

 

Horrocks says the system is rolling out in a slightly different vector than originally envisioned.

 

“We thought a mobile phone alert would be important and built it in, which is almost funny in retrospect because the doctors don’t want to be interrupted for this,” he says. “The practices who have an infrastructure for care coordination seem to make the best use of it, often getting the alerts in a batch early in the morning and maybe again in the afternoon, rather than one at a time throughout the day.”

 

Mack Baniameri, CEO of Scottsdale, Ariz.-based Health BI, which launched its own ENS platform in September 2013, says the new CMS CPT codes (99495 and 99496) for transitional care management services are a huge driver of the ENS market.

 

“ENS becomes very important for the primary care providers, so they can communicate with the patient and get them in,” he says. “On the hospital side, obviously they reduce the readmissions. And the ROI for payers is huge because it reduces inpatient admissions.”

 

Baniameri says the pricing model for the company’s ENS technology varies depending on the customer. Payers like per-member, per-month pricing, while ambulatory and community providers prefer a SaaS-based per-provider, per-month model. The company’s current customers include several clinics and United Healthcare. Baniameri says the company is in the middle of the RFP process with several HIE’s.

 

Technologically, Baniameri says an ENS system must be able to receive ADT messages in various formats, including HL7, CCD, and XML, and must include some kind of internal master patient provider index and a filtering engine.

 

“You also have to have several methods of communication to the providers,” he says, “like fax, secure SMS, portals, and secure e-mail. Everybody is different, so we have to have a variety of mechanisms built in.”

 

CRISP’s Horrocks says the participants recognize the payback they get from the ENS. The system’s development was funded by a portion of the HIE’s operations budget, which at the time was a combination of fees paid by hospitals and grants.

 

“We operate it today on fees from hospitals, and fees from payers which are collected through a state assessment,” he says. “We also use some grant money to implement ENS improvements. The value which participants get from ENS is part of the reason we are able to collect fees, so it is important to CRISP’s sustainability.”

Care Transitions Best Practices

Health BI Newsletter, Spring 2014

 

Every quarter, Health BI publishes a newsletter to share the latest in Care Transitions Best Practices and real-life Transitional Care lessons learned. The newsletter is available to Health BI clients, Care Managers, Care Coordinators and Transitional Care nurses.

 

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Note from a small booth at HIMSS

By: Mack Baniameri

 

Like some of you, I’ve been attending HIMSS in different capacities for many years. And every year, I’m amazed by the size and sophistication of the booths some vendors display during the shows. If you happen to be a small vendor like us, squeezed between the big boys, you are not only overshadowed by the sheer size, you also get a nice tan by catching rays from jumbotron TVs hanging from every corner of these super booths.

 
Some think that small companies with tiny booths have no chance against the big companies at HIMSS. I beg to differ. It’s true that some health IT consumers both on payer and provider sides are looking for mega vendors to address all their technology needs. I say, more power to them. Who wouldn’t want one-stop shopping for all their IT needs? However, most payers and providers are much savvier today and quite capable of telling the difference between marketing and content.

 
Like many smaller health IT companies, we are lean and focused. We are not the jack of all trades. We are not here to boil the ocean and change the world. Small innovation health IT companies are making their impact on healthcare by becoming exceptional at one thing instead of average at everything. Companies like us help clients achieve their goals without turning the organization on its head.

 
Small health IT companies attract early adopters and innovators. We serve CMOs and CIOs who don’t buy into the frenzy and marketing machine of the big vendors. Our clients are rebels and eccentrics. The type of individuals with contagious passion and energy … and that’s what gets us going.

 
In the last few years, we have been fortunate to come across individuals with vision and hunger to change an industry. These individuals inspire us. And we are proud to call them our clients.
So, even though our booths are small and our displays don’t bling, we have the privilege of hosting healthcare visionaries at our booths … and that’s all we can ask for.

 

 

Mack Baniameri is the CEO at Health BI

Population health tools essential to ACO success

January 9, 2014 | By

 

Published In: FierceHealthIT

 

Applications for population health management that integrate claims and clinical data can provide the insights essential to the success of accountable care organizations (ACOs), according a new report from IDC Health Insights.

 

Many healthcare organizations have found that relying on electronic health records systems isn’t enough. In addition to pooling claims and clinical data at the point of care to improve decision-making, ACOs need workflow tools to support the creation and management of care plans and a communications channel to fully engage patients in their care.

 

These other applications might include:

 

  • Computerized physician order entry
  • Admission, discharge and transfer
  • Billing
  • Practice Management
  • Enrollment
  • Care management

Health information exchange technology is required to integrate heterogeneous data from disparate systems such as EHRs, claims, laboratory and pharmacy and present that data in a standardized way in various applications, the report says.

 

Key applications for population management include:

 

  • Analytics for performance measurement, patient identification and stratification.
  • Workflow applications that include the ability to create and manage care plans, track events and scheduling.
  • Patient engagement tools. In the future, these efforts likely will include more than a portal, including other channels such as texting to engage patients.

It urges organizations to spend time to understand their data before making changes based on performance measures and to focus on only a few quality metrics to start.

 

The importance of change management can’t be underestimated, it advises, urging organizations to educate physicians and staff about the importance of proper documentation, for example.

 

“Meeting the objectives of the Triple Aim requires organizational transformation in addition to new technology. Healthcare organizations engaging in accountable care must acquire new skills, introduce new processes, and fundamentally change the way they deliver care,”  the report concludes. “Critical to meeting accountable care objectives are the workflow tools to create communication and engagement strategies and that provide collaboration among providers, care managers, and patients.”

 

At the start of this year, 123 more ACOs have joined the Medicare Share Savings Program to better coordinate care for an additional 1.5 million Medicare beneficiaries. That brings the total to 360 ACOs involved.

 

The number of ACOs is expected to double this year from the estimated 500 currently in operation.

Health BI to Demonstrate HealthCollaborate™ Care Transition Management Application at Upcoming HIMSS14 Conference in Orlando, Florida

Health BI the leading (SaaS) Care Management software vendor will demonstrate the HealthCollaborate™ Care Transition Management Application at upcoming HIMSS14 conference at Orange County Convention Center in Orlando, Florida on February 23-27 at booth 1419.

HIMSS14SaveTheDate
HealthCollaborate™ enables healthcare organizations and health plans to coordinated, manage and monitor patient care transitions anywhere/anytime. This EMR neutral solution, aligns patient-specific transitional care needs with customized care plans, multiple data sources and patented technology to efficiently navigate patients from hospitals to ambulatory and community care settings.

 

Health BI helps its clients to:

 

• Reduce Hospital Readmissions
• Proactively Manage Care for Large Patient Populations
• Automate Care Coordination Manual Processes
• Improve Patient Satisfaction Scores
• Reduce Care Coordination Costs while Improving Outcomes
• Improve Care Coordination Quality Metrics and Reporting

Health BI Launches Transitional Care Readiness Assessment Services for Healthcare Providers and Health Plans

Press Release

 

Scottsdale, Arizona

 

Health BI the provider of Enterprise Care Transition Management Applications, announced today that it has launched its consulting services to help clients assess their organization’s level of readiness to perform Care Transition activities.

 

Health BI delivers actionable plans including strategies, methods, technologies, processes, metrics, resource requirements and best practices to help clients meet their Transitional Care objectives.

 

“Many health plans and healthcare providers are trying to develop strategies to deploy effective multidisciplinary care transition program. Leveraging our experience and knowledge of care transitions technology and processes, we are in a good position to help our clients assess and plan their overall care transitions strategy,” says Mack Baniameri, CEO of Health BI.

 

By analyzing client organizations’ solutions, resources and processes and aligning them with their goals and objectives, Health BI consultants perform a comprehensive readiness assessment and deliver a roadmap to implementing an effective Care Transitions program.

 

Health BI’s Transitional Care Readiness Assessment includes any or all of the below analysis and roadmap deliverables:

 

-        Application, Data, Systems and Interoperability

-        Care Team Structure and Performance

-        Cross-continuum Medical Management

-        Documentation Capture and Sharing

-        Education and Training Needs

-        Forms/Patient Assessment

-        Internal Stakeholder Readiness and Gap Analysis

-        Internal/External (Vendor) Readiness and Gap Analysis

-        Patient Events and Status Monitoring

-        Patient-centered Management and Care Coordination

-        Policy, Procedure, Documentation

-        Recommended Governance Model

-        Transitional Care Projects/Programs Methodology Alignment

-        Workflow Analysis

-        Executive Summary

 

About Health BI

 

Health BI is the leading developer of (SaaS) Enterprise Care Transition Management Applications for the Population Health Management market. Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to improve patient care while reducing penalties and costs. Health BI’s HealthCollaborate™ Care Transition and Coordination Management System is an automated suite of products that enables providers and payers to coordinate, manage and monitor transition of care for patients from hospitals to multiple care settings

Frequently Asked Questions about Billing Medicare for Transitional Care Management Services

Frequently Asked Questions about Billing Medicare for Transitional Care Management Services
Effective January 1, 2013, Medicare pays for two CPT codes (99495 and 99496) that are used to report physician or qualifying nonphysician practitioner care management services for a patient following a discharge from a hospital, SNF, or CMHC stay, outpatient observation, or partial hospitalization. This policy is discussed in the CY 2013 Physician Fee Schedule final rule published on November 16, 2012 (77 FR 68978 through 68994).

 
What should practitioners do if claims for appropriately furnished Transitional Care Management (TCM) have been rejected or denied by Medicare?
We understand that many practitioners have had difficulty being paid for TCM services, which are new services beginning January 1, 2013. In many cases, claims submitted for TCM services have not been paid due to several common errors in claim submission. We encourage practitioners to verify that all requirements for furnishing the service have been met, and if so, to re-submit any unpaid claims. In particular, the practitioner should ensure that the entire 30-day TCM service was furnished on or after January 1, 2013 (i.e. discharge occurred on or after January 1, 2013), that the service began with a qualified discharge from a facility, and that the date of service on the claim is the final day of the period of TCM services (the 30-day period for the TCM service begins on the day of qualified Medicare discharge and continues for the next 29 calendar days. The reported date of service should be the 30th day). We also have made some adjustments to our claims processing systems to better accommodate the unique billing requirements of this new, 30-day service. We believe that with the adjustments that we have made and extra care with billing on behalf of practitioners, that the problems that have been encountered will be alleviated.

 
What date of service should be used on the claim?
The 30-day period for the TCM service begins on the day of discharge and continues for the next 29 days. The reported date of service should be the 30th day.

 
What place of service should be used on the claim?
The place of service reported on the claim should correspond to the place of service of the required face-to-face visit.

 
If the codes became effective on Jan. 1 and, in general, cannot be billed until 29 days past discharge, will claims submitted before Jan. 29 with the TCM codes be denied?
Because the TCM codes describe 30 days of services and because the TCM codes are new codes beginning on January 1, 2013, only 30-day periods beginning on or after
August 21, 2013 January 1, 2013 are payable. Thus, the first payable date of service for TCM services is January 30, 2013.

 
The CPT book describes services by the physician’s staff as “and/or licensed clinical staff under his or her direction.” Does this mean only RNs and LPNs or may medical assistants also provide some parts of the TCM services?
Medicare encourages practitioners to follow CPT guidance in reporting TCM services. Medicare requires that when a practitioner bills Medicare for services and supplies commonly furnished in physician offices, the practitioner must meet the “incident to” requirements described in Chapter 15 Section 60 of the Benefit Policy Manual 100-02.

 
Can the services be provided in an FQHC or RHC?
While FQHCs and RHCs are not paid separately by Medicare under the PFS, the face-to- face visit component of TCM services could qualify as a billable visit in an FQHC or RHC. Additionally, physicians or other qualified providers who have a separate fee-for- service practice when not working at the RHC or FQHC may bill the CPT TCM codes, subject to the other existing requirements for billing under the MPFS.

 
If the patient is readmitted in the 30-day period, can TCM still be reported?
Yes, TCM services can still be reported as long as the services described by the code are furnished by the practitioner during the 30-day period, including the time following the second discharge. Alternatively, the practitioner can bill for TCM services following the second discharge for a full 30-day period as long as no other provider bills the service for the first discharge. CPT guidance for TCM services states that only one individual may report TCM services and only once per patient within 30 days of discharge. Another TCM may not be reported by the same individual or group for any subsequent discharge(s) within 30 days.

 
Can TCM services be reported if the beneficiary dies prior to the 30th day following discharge?
Because the TCM codes describe 30 days of care, in cases when the beneficiary dies prior to the 30th day, practitioners should not report TCM services but may report any face-to- face visits that occurred under the appropriate evaluation and management (E/M) code.

 
Medicare will only pay one physician or qualified practitioner for TCM services per beneficiary per 30 day period following a discharge. If more than one practitioner reports TCM services for a beneficiary, how will Medicare determine which practitioner to pay?
Medicare will only pay the first eligible claim submitted during the 30 day period that commences with the day of discharge. Other practitioners may continue to report other
August 21, 2013 reasonable and necessary services, including other E/M services, to beneficiaries during those 30 days.

 
Can TCM services be reported under the primary care exception? Can the services be reported with the –GC modifier?
TCM services are not on the primary care exception list, so the general teaching physician policy applies as it would for E/M services not on the list. When a physician (or other appropriate billing provider) places the -GC modifier on the claim, he/she is certifying that the teaching physician has complied with the requirements in the Medicare Claims Processing Manual, Chapter 12, sections 100.1 through 100.1.6.

 
Can practitioners under contract to the physician billing for the TCM service furnish the non-face to face component of the TCM?
Physician offices should follow “incident to” requirements for Medicare billing. “Incident to” recognizes numerous employment arrangements, including contractual arrangements, when there is direct physician supervision of auxiliary personnel.
This issue is addressed in greater detail in the Internet-only Benefit Policy Manual, Chapter 15, Section 60 available at: http://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs-Items/CMS012673.html

 

 

During the 30 day period of TCM, can other medically necessary billable services be reported?
Yes, other reasonable and necessary Medicare services may be reported during the 30 day period, with the exception of those services that cannot be reported according to CPT guidance and Medicare HCPCS codes G0181 and G0182.

 
If a patient is discharged on Monday at 4:30, does Monday count as the first business day and then Tuesday as the second business day, meaning that the communication must occur by close of business on Tuesday? Or, would the provider have until the end of the day on Wednesday?
In the scenario described, the practitioner must communicate with the patient by the end of the day on Wednesday, the second business day following the day of discharge.

 
Can TCM services be reported when furnished in the outpatient setting?
Yes. CMS has established both a facility and non-facility payment for this service. Practitioners should report TCM services with the place of service appropriate for the face-to-face visit.

Customized Patient Assessment Forms in the Latest Release of the HealthCollaborate™ Care Transition Management Application

Effective care coordination models include targeted patient assessments that can help the care team to identify risks and determine best care transition workflows. Assessing patients’ clinical conditions, social needs and long-term requirements in acute and post-acute care settings lowers the risk of hospitalization and frequent ER visits.

 

 

Health BI has included a comprehensive Patient Assessment Module in the new release of the HealthCollaborate™ Care Transition Management Application. The Patient Assessments Module is designed to help the care team to assess and deliver accurate multidisciplinary care for patients from hospitals to ambulatory and community care settings. Examples include Readmission Risk, PAM-13, PHQ-9, VR-12 or custom provider or health plan assessments.

 
The HealthCollaborate™ assessments can be delivered to patients via automated telephone calls (IVR) or by manual entry by the care team. The HealthCollaborate™ application can trigger clinical alerts to appropriate care team members based on assessment results. All system-generated assessments are available for monitoring by care team members within the HealthCollaborate™ Application.

 

Note that some assessments require third-party licensing and are subject to copyright terms and conditions.

 

 

About Health BI

Health BI is the leading developer of (SaaS) Enterprise Care Transitions Management Application for the Population Health Management market. Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to improve patient care while reducing penalties and costs. At Health BI, we envision a healthcare system that proactively engage, monitor and navigate patients through the continuum of care and we have built software solutions and services to support this new model of healthcare delivery. Health BI’s HealthCollaborate™ Care Transition and Coordination Management System is an automated suite of products that enables providers and payers to coordinate, manage and monitor transition of care for patients from hospitals to multiple care settings.

API selects HealthCollaborate™ Care Transition Management System to coordinate care for its patient population.

Advance Prosthetics Institute selects the HealthCollaborate™ Care Transition Management System to coordinate care for patients with complex prosthetic cases. Founded by Dr. Jason C. Campbell in Prescott Arizona, API’s visionary approach is to provide a complete and seamless interdisciplinary collaborative effort with all health care providers for optimum wellness for their patients. This includes dentists, physicians, specialists, physical therapists, naturopathic physicians and psychiatrists. API is a comprehensive surgical practice dedicated to prosthetics and complex dental rehabilitation. Dr. Campbell, along with a team of specialists selected by him, provide services offered by API to deliver a patient’s treatment plan and coordinate interdisciplinary care.

 

API will utilize HealthCollaborate™ to communicate, collaborate and share information with partner providers and patients on patients’ cases.

 

HealthCollaborate™ is a Software-as-a-Service Care Transition Management Solution. HealthCollaborate™ helps healthcare providers and Health Plans to effectively coordinate, manage and monitor care transitions for large population of patients in multiple care settings.

 

Built on care coordination best practices, HealthCollaborate™ provides an all-in-one hosted solution that includes: ER/ADT Event Notifications, Transitional Care Management Engine and Dashboard, Patient Engagement Modules, Secure Messaging Platform, Care Transitions Data Analytics/reporting and more.

 

HealthCollaborate™ helps its clients to:

 

  • Reduce Hospital Readmissions
  • Proactively Manage Care for Large Patient Populations
  • Improve Patient Satisfaction Scores
  • Reduce Care Coordination Costs while Improving Outcomes
  • Increase Payments for Transitional Care Management Services

 

About Health BI

 

Health BI is the leading developer of (SaaS) Care Transitions and Coordination Management Technology Solutions for the Population Health Management market. Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to improve patient care while reducing penalties and costs. At Health BI, we envision a healthcare system that proactively engage, monitor and navigate patients through the continuum of care and we have built software solutions and services to support this new model of healthcare delivery. Health BI’s HealthCollaborate™ Care Transition and Coordination Management System is an automated suite of products that enables providers and payers to coordinate, manage and monitor transition of care for patients from hospitals to multiple care settings.

 

Co•or•di•na•tion (kōˌôrdnˈāSHən)

The organization of the different elements of a complex body or activity so as to enable them to work together effectively.

 

By: John Achoukian, PMP

 

While some doctors are uncertain about implementing and using electronic medical records systems (EMRs) and nostalgically remember the good old days when they could hand write and sign an order in seconds, new innovative offerings to address care coordination are cutting across multiple care settings and helping doctors and their staffs effectively share information and collaboratively care for patients.

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Unlike an EMR setup process which requires focused time with physicians and their staff to understand how their practice operates, care coordination systems can provide patient information as part of standard workflows to multiple doctors, nurses and other clinicians who need timely event information such as admissions or discharges but do not necessarily need an entire patient chart.  Care coordination systems certainly support having folders, forms, templates, workflows and other EMR components, but sharing basic “who”, “what”, “when”  and “what’s next” information about patients is proving to be an effective way to efficiently support care transitions and referrals.

 

A care coordination system with a simple user interface minimizes the change required to use a new system in multiple care settings, promotes standard communication and behavior, lowers the learning curve, and increases patient and provider comfort levels.  Imagine staff members at multiple provider offices seeing the exact same patient status – real-time.  They can all see where the patient is in a longitudinal care plan such as readmission reduction, and all steps such as appointments, medication pick-up, and patient assessments are tracked and available for doctors and staff – per privileges – to monitor and act upon as needed.

 

Prior to care coordination and care transition tools and processes, physicians often had little or no indication or information about their patients’ hospitalizations.  Even when discharge summaries were received, information such as test results, treatments, medications, and follow-up plans were missing so physician staffs would have to scramble to find accurate clinical information about the patient in order to properly treat them in an outpatient setting.

 

A care coordination system, with properly configured care flows, supports appropriate follow-up care for patients after going home from the hospital and assists clinical staff in the multitude of settings designated to treat the patient to monitor and act on their assigned tasks.  This promotes an efficient, coordinated system, which ensures that the patient is receiving evidence-based and individualized care while eliminating potentially harmful delays.  While actively involving the patients and caregivers, care coordination tools enable providers, payers and patients to connect electronically and collaborate to eliminate errors, improve the quality of care and better serve patient populations.

 

John Achoukian is Director of Product Management at Health BI and has spent more than 15 years in information technology and healthcare as a solutions architect, project manager and strategist.  John has conducted in-depth studies about many aspects of healthcare and writes about medical information technology, interoperability and care coordination.  Mr. Achoukian holds a Project Management Institute (PMI) Project Management Professional (PMP) Certification and has a Bachelor of Arts degree in Political Science from Wayne State University and is receiving his Master of Healthcare Innovation (MHI) degree from Arizona State University.

Follow @jachoukian on Twitter and find him on LinkedIn.

Health BI Introduces an Event Notification System (ENS) as a part of its HealthCollaborate Care Transition Management Suite of Products.

Press Release

 

Scottsdale, Arizona (PRWEB) September 26, 2013

 

Health BI the developer of SaaS Population Health Management Technology Solutions has announced the introduction of its HealthCollaborate™ Event Notification System (ENS).

 

HealthCollaborate™ Event Notification System (ENS) connects, alerts and updates healthcare providers and payers about patients’ ADT events and outcomes. This approach insures quick deployment of the care team and proactive engagement, monitoring and navigation of patients through the continuum of care.

 

Through integration and processing of HL7 ADT messages, HealthCollaborate™ (ENS) provides real-time or daily batch notifications with critical information to payers, private physicians, care management teams, ACOs–alerting them of their members’ acute encounters with participating hospitals.

 

” Many healthcare providers and health plans are unaware of their patients’ ER visits or hospital admits and discharges. The ability to quickly notify and mobilize the care team can reduce hospital readmissions and avert millions of dollars of spending on preventable hospitalizations,” said, Mack Baniameri, CEO of Health BI.

 

The HealthCollaborate™ Event Notification System can be deployed as a standalone system or as part of the complete Care Transition Management System. All notifications are delivered via HealthCollaborate™ multi-channel secure messaging platform.

 

HealthCollaborate™ Event Notification System helps healthcare payers and providers to:

 

  • Receive timely and relevant notifications of patient care episodes
  • Quickly deploy a transitional care team
  • Timely execution of care plans
  • Improve patient satisfaction scores

Reality Strikes Care Transition Models

Reconciling the Coleman Care Transitions Intervention Model with Healthcare Realities

 

By: John Achoukian

 

Care transitions occur when patients move from one healthcare setting to another based on their treatment or needs.  Examples are transitions from hospitals to outpatient or home care after an acute episode or illness. Typical transition challenges are poor communication between providers, mismatched medication lists and confusing discharge instructions.bigstock_Healthcare_Network_21692141

 

These challenges lead to medication errors, unnecessary and duplicative tests, treating complications that could have been avoided, and providing care in an expensive setting instead of a lower level of care.  Worse yet poor care transitions lead to increased risk for readmission and reimbursement penalties.

 

Evidence-based care transitions models, such as the Coleman Care Transitions Intervention and Naylor Transitional Care Model, were developed to provide patients with access and tools to take an engaging and active role in managing their care.  The models provide a framework for interventions and patients indeed have lower re-hospitalization rates compared to controls.

 

The four-week Coleman model process calls for one hospital and one home visit and then a series of follow-up phone calls with a designated care transition coach (a nurse, social worker, or community worker).  While patients are coached with dos and don’ts they improve their own medication management, health record knowledge and awareness or condition indicators, they are also guided to follow-up care with primary and specialty care providers.

 

The healthcare system has rising costs, limited resources and an aging population with an expanding list of chronic conditions.  Large segments of aging patients require lengthy timeframes (months, years, decades) of monitored care management and expecting care transition coaches to meet the demand for so many patients is not realistic and does not make business sense.  Without question, patients need care coordination to help educate them and guide them through post-acute care settings after discharge and interoperability is required to enable providers, payers and patients to connect electronically to collaborate for better quality.  However, the healthcare industry is now moving from incentives to self-sustaining models and providers and payers are seeking improved financial outcomes which can only be realized with operational efficiencies.

 

While the Coleman model instigates change within healthcare delivery, there are numerous challenges to integrating and sustaining the resource intensive processes and communications.  The model is one-size-fits-all and does not include risk stratification for patients more likely to experience a re-admission scenario.  Dedicated transition coaches are costly and adding FTEs to manage large population of patients requires an investment some facilities are not willing to make.  Unless facilities or health organizations have funds it is difficult to sustain an intensive manual care transitions program.

 

John Achoukian is Director of Product Management at Health BI and has spent more than 15 years in information technology and healthcare as a solutions architect, project manager and strategist.  John has conducted in-depth studies about many aspects of healthcare and writes about medical information technology, interoperability and care coordination.  Mr. Achoukian holds a Project Management Institute (PMI) Project Management Professional (PMP) Certification and has a Bachelor of Arts degree in Political Science from Wayne State University and is receiving his Master of Healthcare Innovation (MHI) degree from Arizona State University.

Follow @jachoukian on Twitter and find him on LinkedIn.

Health BI to Demonstrate the HealthCollaborate™ Care Transition Management System at Western States Health-e Connection Summit and Trade Show.

Health BI the leading (SaaS) Care Transition and Coordination Management Solution provider will demonstrate the HealthCollaborate™ Care Transition Management System at the upcoming Western States Health-e Connection Summit and Trade Show in Phoenix, Arizona on September 10-11 at booth 224 at the Phoenix Convention Center.

2013_logo

HealthCollaborate™ enables Healthcare providers and Health Plans to efficiently and cost effectively transition large population of patients from hospitals to ambulatory and community care settings.

 

Built on care coordination best practices, HealthCollaborate™ provides an all-in-one hosted solution that includes: Transitional Care Management Engine and Dashboard, Patient Engagement Modules, Secure Messaging Platform, Care Coordination Data Analytics/reporting and more.

 

Health BI helps its clients to:

  • Reduce Hospital Readmissions
  • Automate Existing Care Coordination Manual Processes
  • Coordinate Care for Large Population of Patients
  • Increase Care Coordination Team’s Productivity
  • Communicate, Collaborate and Share Information
  • Enhance Transitional Care Management Services

 

About Health BI

Health BI is the leading developer of (SaaS) Care Transitions and Coordination Management Technology Solutions for the Population Health Management market. Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to improve patient care while reducing penalties and costs. At Health BI, we envision a healthcare system that proactively engage, monitor and navigate patients through the continuum of care and we have built software solutions and services to support this new model of healthcare delivery. Health BI’s HealthCollaborate™ Care Transition and Coordination Management System is an automated suite of products that enables providers and payers to coordinate, manage and monitor transition of care for patients from hospitals to multiple care settings.

 

About Western States Health-e Connection Summit

Since 2007, AzHeC has hosted an annual conference in Phoenix, the Western States Health-e Connection Summit & Trade Show, that brings together 300 to 400 health IT professionals, providers, vendors and consumers from the Western region for two days of presentations, networking and learning. The event also features a trade show with over 40 leading health IT vendors.

ACOs, CCOs, where do we go from here?

By: John Achoukian, PMP

 

The Pioneer Accountable Care Organization (ACO) results are in; but what do they mean?bigstock_Bad_Economy_3887910

CMS reported [1] that costs grew by only 0.3 percent in 2012 for the more than 669,000 beneficiaries cared for by Pioneer ACOs, compared to 0.8 percent for a similar patient population.  This resulted in $87.6 million in gross savings for 2012, $33 million of which went to the Medicare Trust Funds.

 

In a Health Affairs blog post [2], Debra Ness, president of the National Partnership for Women & Families, and Bill Kramer, executive director for national health policy at the Pacific Business Group on Health, summarized results from the first year of testing the Pioneer ACOs:

 

          • All 32 of the ACOs met quality performance metrics and performed well on cancer screenings, blood pressure control, cholesterol control for diabetes patients
        • Twenty-five of the 32 had success in reducing hospital readmission rates
        • More than a third reduced costs, producing cumulative savings of more than $87 million and saving Medicare nearly $33 million

 

Although CMS continues to promote the successes of the Pioneer ACOs, the agency recently confirmed [3] that nine will leave the experimental program explaining that seven did not produce savings and intend to apply to the alternative ACO model, the Medicare Shared Savings Program (MSSP).  Two others notified CMS they are leaving the program.

 

Understandably, healthcare industry, media and political analysis and conjecture have been all over the map.

 

So now what?  Are there lessons that can be applied?  Are there alternative models which address deficiencies?  If so, how are they performing?

 

Undeniably, the best approach to produce better results is to build a foundation and infrastructure to support patient-centric and care-giver-centric care.  The only models that will succeed, regardless of what they are called, are those that engage patients and their families in a timely and integrated manner.  Implementing methods to capture and measure patient-reported outcomes while facilitating integrated care coordination and experiences across multiple care settings and provider organizations will lead to increased prevention and care management resulting in better health outcomes, efficient use of services, and ultimately lower costs.

 

One emerging alternative is the Coordinated Care Organization (CCO) model in Oregon which provides healthcare providers financial incentives to monitor the overall health of their members and get paid when patients remain healthy through the help of community health workers and not just when they require healthcare services.

 

CCOs are a network of all types of health care providers (physical health care, addictions and mental health care and even dental care providers) who have agreed to work together in their local communities to serve people who receive health care coverage under the Oregon Health Plan (Medicaid).  CCOs are focused on prevention and helping people manage chronic conditions, like diabetes.  This helps reduce unnecessary emergency room visits and gives people support to be healthy.  CCOs now provide services [4] for 95 percent of the state’s Medicaid program.

 

One example of CCO progress in Oregon is the reduction in emergency room use [5] among Salem area Oregon Health Plan members.  The Emergency Department Intervention Team paired 30 chronic users of emergency departments with community health workers to best address how their healthcare should be delivered.  In 2012, before entering the program, the participants made 41 trips to the emergency room, but since joining, they have used that department only twice.

 

Technologies, budgets, levels of risk, program structure, and unknowns are all factors that will influence movements toward more patient-centered and coordinated care.  While health reform pushes providers to own greater accountability for the Triple Aim goals of lower costs, improved quality, and better health outcomes, healthcare organizations that meet the challenges of care coordination with a focus on patient engagement will be best positioned for the future.

 

URLs in this post:

[1] CMS reported: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-Releases-Items/2013-07-16.html

[2] Health Affairs blog post: http://healthaffairs.org/blog/2013/07/25/the-first-year-pioneer-aco-results-predictable-bumps-in-the-road/

[3] confirmed: http://www.fiercehealthcare.com/story/confirmed-nine-pioneer-acos-will-exit-program-including-university-michigan/2013-07-16

[4] CCOs now provide services: http://www.thelundreport.org/resource/salem_cco_reveals_emergency_use_down_sharply_despite_member_growth

[5] reduction in emergency room use: http://www.thelundreport.org/resource/salem_cco_reveals_emergency_use_down_sharply_despite_member_growth

 

John Achoukian is Director of Product Management at Health BI and has spent more than 15 years in information technology and healthcare as a solutions architect, project manager and strategist.  John has conducted in-depth studies about many aspects of healthcare and writes about medical information technology, interoperability and care coordination.  Mr. Achoukian holds a Project Management Institute (PMI) Project Management Professional (PMP) Certification and has a Bachelor of Arts degree in Political Science from Wayne State University and is receiving his Master of Healthcare Innovation (MHI) degree from Arizona State University.

Follow @jachoukian on Twitter and find him on LinkedIn.

 

CEO of Care Transition Software Company, Health BI, Unveils the Fundamentals of Successful Care Continuity for Patients with Chronic Diseases.

Published by: Digital Journal

 

“For the first time, we are seeing strategic alignment between cost reductions in healthcare and quality of care for patients with chronic conditions,” says, Mack Baniameri, CEO of Health BI. “To improve the quality of care, we used to increase spending and to control spending, we used to compromise the quality of care. These rules don’t apply anymore.”

 

Mack Baniameri notes that patients with complicated health problems often see several health care providers, a number that increases as patients get older and sicker. The patient may be treated by a primary care physician, various specialists in their medical offices, hospitalist physicians, nursing team in the hospital or during a stay in a Skilled Nursing Facility and a visiting nurse in the home.

 

Can care become fragmented when these providers work independently? “You bet,” says, Baniameri. “There is no doubt that these healthcare providers deliver the highest standards of care for their patients. But, the result can be poor if these efforts are not coordinated.”

 

Mack Baniameri explains that Coordinating care and transitioning patients through multiple care settings require planning and execution.

 

“There are a number of excellent care coordination models out there and they all contain the following four elements: Workflow, Communication, Engagement and Measurement,” Baniameri explains.

 

Care Transition Workflow
Health Plans and providers who actively coordinate care for patients often develop several sets of transitional care workflows built on care coordination best practices. These workflows are specific and cover patients based on diagnosis, medical history, conditions, social and cultural status, geography and outcomes. These workflows quickly engage the patient and the care team and effectively navigate the patient step-by-step through multiple ambulatory and community care settings.

 

Communication
Both patients and providers must be fully involved in the patient care. Active communication model creates tight relationships between hospitals, PCPs, specialists and patients … and delivers accurate and timely information to the entire care team. Dealing with multiple silos of patient health records, we have no choice but to develop multi-level communication strategies. These strategies must be based on a proactive model of information sharing among patients and providers. Proactive communication and information sharing include: integration with EMRs, HIEs, ADT, Secure Messaging systems and utilization of Patient Health Records.

 

Engagement
One main challenge is to communicate securely with patients and at the same time accommodating older patients with less access to technology. Elderly and low-income patients are most venerable and often left behind when it comes to the use of technology in healthcare. Care Coordinators must deploy multifaceted technology solutions that connect with patients based on the best method of communication available to the patient. The idea of waiting for patients to access portals to be engaged is a failure. Not all patients have access to computers and smart phones. Your patient engagement strategy should heavily rely on actively pushing and pulling information to and from patients through different means of engagement.

 

Measurement
Organizations must keep track of all transitional care activities. Care Coordination planning starts from the time patient enters the hospital and continues post discharge. Organizations must have methods in place that actively log all care coordination interactions and encounters with patients, caregivers, providers and facilities. At the same time, organizations must continuously improve care coordination performance by reviewing processes, goals, gaps and outcomes. This can occur only if accurate and actionable data is collected.

 

About Health BI
Health BI is the leading developer of Transition of Care Management Technology Solutions for the Population Health Management market. With Headquarters in Scottsdale, Arizona, Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to improve patient care while reducing penalties and costs by automating care coordination, care transitions and patient engagement. Health BI’s HealthCollaborate™ Care Coordination Information System is an automated suite of products that enables providers and payers to navigate patients through the continuum of care while engaging patients in the decision-making process.

Care Transition Program Significantly Lowers Hospital Readmission Rates, According to Data from the Bronx Collaborative

Study Underscores Value of Personal Contact with Patients Before and After Discharge

 

NEW YORK (June 26, 2013) — Personal contact with patients before and after their hospital discharge resulted in significantly lower readmission rates, according to a study conducted by the Bronx Collaborative, a group of hospitals and health insurers in the Bronx, N.Y. The results were presented today at the annual meeting of the Case Management Society of America in New Orleans, where the study received the Society’s annual Research Award. The study was also presented as a poster at the AcademyHealth meeting in Baltimore earlier this week.

 

Among 500 patients who received two or more “interventions,” in a special program to manage the transition between hospital and home, only 17.6 percent were readmitted to the hospital within 60 days of discharge versus 26.3 percent among a comparison group of 190 patients who received the current standard of care, the data showed. Another 85 patients who received only one intervention for a variety of reasons had a higher readmission rate, raising to 22.8 percent the overall 60-day readmission rate for patients in the intervention group.

 

Interventions included intensive pre-discharge education, the scheduling of a post-discharge follow-up appointment with the patient’s personal physician, and post-discharge telephone calls to review medications, identify concerns and verify the completion of the follow-up physician visit.

 

In addition to receiving at least two interventions, the follow-up physician visit within 14 days of discharge appeared to be a key factor in preventing a readmission, according to the research analysis.

 

“These results underscore the value of personal contact with patients before and after their discharge from the hospital and follow-up appointments with their personal physicians to help prevent problems that frequently contribute to readmissions,” said Anne Meara, R.N., M.B.A., associate vice president, Network Care Management, CMO, Montefiore Care Management, who led the Collaborative’s project design team.  “The program was designed to reflect the key concepts of accountable care – improving outcomes and patient satisfaction while lowering costs. We met those goals, and identified opportunities that could possibly be applied successfully at other hospitals.”

 

About the Bronx Collaborative and the study

 

The Bronx Collaborative includes three non-profit hospital systems — Bronx Lebanon Hospital Center, St. Barnabas Hospital and Montefiore Medical Center – and two payer organizations, EmblemHealth and Healthfirst, who came together to address health care issues in the Bronx, one of the most ethnically diverse and economically-deprived counties in the country, with a disproportionate disease burden.

 

Together they developed a uniform Care Transitions Program (CTP) with the aim of reducing readmissions within 60 days following a discharge from the Collaborative’s hospitals. The program was supported by a grant from the New York State Health Foundation and the New York Community Trust.  The hospital systems contributed in-kind services and the health plans agreed to pay a fee for each patient who received at least two of the interventions in the program’s protocol.

 

The CTP was made available to Medicare, Medicaid and commercial members of the two health plans. Patients were selected using a predictive model that identified those most at-risk for a readmission based on their diagnoses and the number of readmissions within the preceding 12 months. All participants were Bronx residents age 50 and older and had a working telephone.

 

Four interventions by nurse care transitions managers were offered to study participants beginning while hospitalized and continuing for 60 days after discharge, including:

 

A pre-discharge educational session with a detailed booklet of discharge instructions, a medication record and a list of symptoms that could indicate a change in the patient’s condition;

 

  • A post-discharge call within 48-72 hours of discharge to identify patient or caregiver concerns, review symptoms and medications and verify that a physician office visit was scheduled for within 14 days of discharge;
  • A call at 7-14 days post-discharge to confirm that the office visit was made and to answer any questions from the patient or his or her caregiver;
  • Calls between 15-60 days post-discharge to check if there were questions and to follow up on open issues.

 

A care transitions analyst at each hospital scheduled follow-up physician visits for all patients in the program and also entered data in a special program developed for the CTP by the Bronx Regional Health Information Organization. A program pharmacist reviewed medication records and worked with patients who were having problems complying with the prescribed regimen.

 

In addition to Ms. Meara, the project design team included Janet Kasoff, Ed.D., B.S.N., CMO, Montefiore Care Management; Jitendra Barmecha, M.D., St. Barnabas Hospital; Isaac Dapkins, M.D., Bronx Lebanon Hospital Center; Joseph Zeitlin, M.D., EmblemHealth; Susan Beane, M.D., Healthfirst.

Health BI Connects Arkansas City Fire Department with Six Local Hospitals.

Care Transitions Software Company, Health BI, has connected Arkansas City Fire Department with six local hospitals. Arkansas City Fire Department uses the HealthCollaborate system to coordinate care with its partner hospitals in Cowley County area.

 

HealthCollaborate is a care coordination and transitional care management system that enables healthcare providers and health plans to automate care transitions for large population of patients from hospitals to ambulatory and community care settings.

 

By creating a collaborative community of healthcare providers, HealthCollaborate system has enabled the Arkansas City Fire Department to transition from manual processes to a fully automated delivering of information to the area hospitals.

 

“This setup shows that automated software solutions like HealthCollaborate can enhance care coordination and improve communication, collaboration and information sharing among all the stakeholders,” says Koorosh Yasami, co-founder and CTO of Health BI.

Health BI kicks off its Healthcare IT internship program with five graduate students from Arizona State University College of Engineering.

Healthcare Innovation Software Company, Health BI, kicks off its Healthcare IT internship program with five graduate students from Arizona State University College of Engineering.

 

The students are provided opportunity to gain hands-on experience in developing healthcare IT applications and standard system protocols, such as HL7, XML and CCOW. The students will be working on projects, which include interoperability and integration solutions with HIEs, leading EMR systems and medical devices.

 

Health BI is a developer of care transitions software solutions, and creator of the HealthCollaborate Care Coordination Information System.

 

“Healthcare IT is highly specialized. We need to start investing on developing software programmers, early on, who understand the complex healthcare systems and workflow. Healthcare IT innovations come from small entrepreneurial companies with people who understand the space. We want to give these folks the opportunity to learn healthcare IT and start using their talents in improving the lives of the patients,” says Koorosh Yasami, Health BI co-founder and CTO.

 

Health BI offers internship to students with strong computer science and software programing background. Internships are available for qualified undergraduate and graduate students and all positions are paid.

Health BI to Demonstrate the HealthCollaborate Care Coordination System at the ACO Summit in Washington, DC

Health BI the developer of Transitional Care Management Technology Solutions for the Population Health Management market will demonstrate the HealthCollaborate™ Care Coordination System in booth #28 at the Accountable Care Organization Summit, June 12-14 in Washington, DC.

 

Health BI’s HealthCollaborate™ Care Coordination System is a fully automated care coordination and transitional care management solution.

HealthCollaborate™ enables ACOs to efficiently and cost effectively transition large population of patients from hospitals to ambulatory and community care settings.

Built on care coordination best practices, HealthCollaborate™ provides ACOs an all-in-one hosted solution that includes: Transitional Care Management Engine and Dashboard, Patient Engagement Modules, Secure Messaging Platform, Care Coordination Data Analytics/reporting and more.

 

Health BI helps Accountable Care Organizations to:

  • Reduce Hospital Readmissions
  • Automate Existing Care Coordination Manual Processes
  • Coordinate Care for Large Population of Patients
  • Increase Care Coordination Team’s Productivity
  • Reduce Care Coordination costs
  • Enhance Transitional Care Management Services

Health BI Announces the Integration of Transitional Care Management Services for CPT Codes 99495 and 99496 in its HealthCollaborate™ Care Coordination Software

HealthCollaborate™ enables Primary Care Providers to effortlessly Transition Medicare Patients from Hospitals to Ambulatory Care Settings and Get Paid for Providing Transitional Care Management Services.

 

Scottsdale, Arizona (PRWEB) April 30, 2013

 

Health BI today announced that it has integrated required TCM service delivery processes in its HealthCollaborate™ Care Coordination Information System. The CPT codes cover services provided when a patient’s condition requires moderate (99495) or high-complexity (99496) medical decision-making as the patient is transitioning from inpatient hospital care to home or another community setting.

 

Health BI has created fully automated care coordination and transitional care management solution that enables healthcare providers and payers to efficiently and cost effectively transition large population of patients from hospital to the ambulatory care settings.

 

Immediately after discharge, HealthCollaborate™ executes the predefined workflow, connecting the provider with the patient, and guiding the patient step-by-step through the TCM workflow. Provider can track the patient’s movement on the navigation dashboard. HealthCollaborate™ then generates reports, capturing all TCM service delivery events and interactions.

 

“This is a collaborative effort between hospitals and PCP groups. It’s a win-win situation for hospitals as they see lower readmissions, for PCPs who will see increase in payments, and for patients who will benefit from better care,” said Mack Baniameri, CEO of Health BI.

 

HealthCollaborate™ TCM track helps Primary Care Providers to reduce the cost of care coordination while increasing payments.

 

Physician Collaboration and Patient Engagement Tools Enhance Patient Care and Reduce Cost in the New Healthcare Era.

By: Ali Ghazanfari, MD, CMIO Health BI

The state of health care in this country has changed. The health of the American people is increasingly being managed by health corporations . Health care has become corporate and like any corporate enterprise it follows the rules of the “bottom” line. So what does this mean for us physicians and our patients. It means that in this new era, doctors cannot provide care based on patients’ best interest. We would no longer be able to practice medicine based on research and scientific rules. We will have to practice medicine base on economic and corporate laws. Physicians have less and less say in how they practice and how they care for their patients.

 

Within a decade, most small community hospitals , family medicine practices and urgent care centers will to be bought and owned by big corporate health care systems. When all the dust has settles, there will only be a handful of large health care systems in the country. This trend is already well on its way to becoming a reality. These healthcare systems are aggressively expanding there domain all over the country. By being the largest and at times the only provider of health in a region or state, these corporations will be able to dictate their terms to physicians, patients, insurance companies and even the government. These terms inevitably will be in the favor of the corporations. They can dictate physician salaries and reimbursement rates and set prices for medical suppliers. They can dictate what medications, supplies and equipment can and cannot be used in the clinics, doctor’s offices ,on the hospital floors and in the operating rooms. Of course the official logic for this policy will always be “cost saving”, when in really it is maximizing profit margins.

 

So what can we do as doctors to ensure our patients get the best care they need and at the same time reduce healthcare costs. I believe the only way to do this is by collaboration among physicians and engaging patients in their own care. If we as professions want to remain advocates for the patients and the public, we need to communicate with one another in an efficient and effective way. Knowing our patients’ medical information and having access to it at all times ensures that they will be receiving the proper care they need.  To achieve this we need to access the new technology that is available today.

 

The internet and web applications have revolutionized the way we communicate. We can harness the power of this new media and by using the right tools we can ensure continuity of care and appropriate treatment plans for our patients. We can engage and monitor our chronically ill patients electronically via the web, and intercept them before they become too sick, and therefore keep them out of the ER. By using these tools we can communicate with each other about our patients plan of care in a concise ,detailed and secure manner. Using HIPAA compliant web apps and secure massaging services we can ensure that the exchange of our patients’ medical information remains secure. This new technology provides enhanced patient care and reduces cost.

 

The healthcare systems want access to the information we have about our patients so they can control the flow of health care delivery. Without it, they will not be able to drive the direction of the patient’s plan of care. We as physicians have access to this data and we can be in control of the care that our patients receive. Your patients’ medical records is the most valuable part of your practice. Keep it secure and use it wisely.

www.healthcollaborate.com

4 Essentials of Effective Care Coordination for ACOs

Fifty percent of Americans over 65 have multiple chronic conditions. According to a report issued by the CMS, care for its beneficiaries with multiple chronic conditions accounts for over 90% of Medicare fee-for-service expenses.

Nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days. The readmission of many of these patients could be avoided if their care outside of the hospital had been better coordinated.

 

On March 31, 2011, the Department of Health and Human Services (HHS) proposed new rules to help healthcare providers better coordinate care for Medicare patients through Accountable CareOrganizations (ACOs). ACOs create incentives for healthcare providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities.

 

While CMS is slowly providing ACOs set of rules on incentives and penalties associated with transitional care management services, many ACOs are struggling to find ways to cost effectively coordinate care for their Medicare population. Effective and cost effective often collide. ACOs must find ways to overcome challenges associated with managing transitional care for their most vulnerable patients while keeping a tight grip on expenses.

 

Here are 4 components of effective care coordination:

 

Transition

The main objective of coordinated care is to keep patients healthy by actively planning, engaging and monitoring patients through the continuum of care.

Most patients with chronic diseases receive care from multiple providers. Many of these providers operate in silos. Multiple brands of EMRs have made these silos bigger and deeper. Transitioning patients through multiple care settings requires strategies that involve patient/caregiver, multiple providers and patient’s data.

 

There is no one transitional care model that fits all. Transitional care workflow must be customized based on patients’ circumstances. Payers and providers who actively coordinate care for patients must develop several sets of transitional care workflows built on care coordination best practices. The workflows should be specific so that it covers patients based on diagnosis, medical history, conditions, social and cultural status, geography and outcomes.

 

Engagement

Patient engagement is a big contributing factor to the success of the Accountable Care model. Patient engagement means different things to different people. But whatever your definition of patient engagement might be, one thing is for certain: without patient participation, there is no patient engagement.

 

Accountable Care Organizations are just beginning to understand challenges that come with engaging patients with chronic diseases in the decision-making process. Many of healthcare organizations assume that a simple access to portals with half-baked information and fragmented medical records will do the trick. Not true.

 

Effective patient engagement strategy creates tight relationships between hospitals, PCPs, specialists, ancillary providers, payers and patients and delivers accurate and timely information to patients. The idea of waiting for patients to access portals to be engaged is a failure. Not all patients have access to computers and smart phones. Your patient engagement strategy should heavily rely on actively pushing and pulling information to and from patients through different means of communication.

 

Communication

Communication is by far the biggest challenge ACOs have when it comes to effective transitional care management. The high volume of patients will no longer allow ACOs to operate in a manual mode. ACOs must devise several methods of communication with their patients and rely on technology to fill the gaps.

 

One main challenge is to communicate securely with patients and at the same time accommodating older patients with less access to technology. Elderly and low-income patients are most venerable and often left behind when it comes to the use of technology in healthcare. ACOs must develop multifaceted technology solutions that connect with patients based on the best method of communication available to the patient. ACOs’ communication strategy must be built on patients’ convenience, not the other way around.

 

Measurement

For the lack of clarity in quality measurements and reporting, ACOs must keep track of all transitional care activities. Care Coordination planning starts from the time patient enters the hospital. ACOs must have technology in place that actively logs all care coordination interactions and encounters with patients, caregivers, providers and facilities. At the same time, ACOs must constantly improve care coordination performance by reviewing processes, goals, gaps and outcomes. This can occur only if accurate and actionable data is collected.

 

Mack Baniameri is CEO at Health BI

Health BI in Healthcare IT News

Posted by: Health BI
http://www.healthcareitnews.com/news/patient-care-coordination-programs-prevent-readmissions-according-jama-study

By: Paul Cerrato

WASHINGTON | March 15, 2013

Medicare healthcare providers have managed to lower 30-day readmission rates and all-cause hospitalization within two years using several evidence-based quality improvement strategies, including care coordination, according to a new study.

 

In the study, published in the January 2013 edition of the Journal of the American Medical Association, clinicians in the participating government-supported programs “pumped up” the care coordination process in several ways. They coached patients to make them more actively involved in their own care; put in place a series of improvements in home care; and used a federal tool kit called INTERACT (Interventions to Reduce Acute Care Transfers) to help manage the status of nursing home residents and improve medication compliance.

 

[See also: HAI monitoring technology use lacking.]

 

 

Among patients enrolled in these experimental programs, readmissions declined by 5.7 percent, compared to 2 percent in comparison communities that did take advantage of these care coordination resources. The study researchers estimated that in a community of 50,000 Medicare beneficiaries, Medicare could save $4 million annually on readmissions for every $1 million spent on these community interventions.

 

Given the demonstrated savings of using care coordination tools, many hospitals and health systems are turning to a variety of plans incorporation such tools to help reach cost-saving goals.

 

The Johns Hopkins Health System is creating a robust call center to reach out “to every patient who is discharged from Hopkins, and update their documentation, in Epic, for all aspects of their experience that are relevant to their long-term care,” said Johns Hopkins’ CIO Stephanie Reel.

 

Reel said that the goal of the health system is “to provide comprehensive documentation, and meaningful information, at one place, in the patients’ completely electronic record, so that all members of the team, past, present and future can see it.”

 

Care coordination tools reduce the likelihood that patients will slip through the cracks in the healthcare system, said Jacob Nguyen, executive vice president of Health BI, the maker of a care coordination software package called HealthCollaborate.

 

All care coordination tools, if used properly, he said, can create the vital links between healthcare facilities that don’t always communicate as well as they should – among themselves and with their patients.

Health BI Strong Showing at HIMSS13

By: Mack Baniameri, CEO

Every year at HIMSS, I come across smart people who are working hard to create products that help patients and providers. This year was no exception. Though there are companies at HIMSS with lots of marketing and not much content, but you can see innovation everywhere.

 

This year Health BI, small company with big products, made its debut at HIMSS. We met great companies with great products who understood the value of population health management. We met with potential customers, investors and some of the thought leaders of population health. We connected with great companies who understood the value of our products and saw potential for partnership. And most importantly, we saw how perfectly our products fit in the overall direction of the new healthcare.

 

I’m proud of the Health BI team and I see great future for our company. Our goal is to grow the business and become the leader in Transitional Care Management Technology. I’m looking forward to the next HIMSS where Health BI is better, faster and stronger … and maybe our booth will grow a little bigger.

Transitional Care Management Software Developer, Health BI, Announces the Relocation of its Headquarters in Scottsdale Arizona

Press Release by: Health BI

Scottsdale, Arizona
2/21/2013

Health BI, a healthcare innovation company in Scottsdale, Arizona has relocated to 7975 N. Hayden Rd, Suite C380 Scottsdale, AZ 85258.

 

“The new office certainly displays our creative and collaborative approach to software design and development for healthcare,” said, Mack Baniameri, CEO of Health BI.

 

Health BI is the leading developer of Care Coordination and Transitional Care Management software for the Population Health Management market. Health BI was created by a team of Health IT Innovators and physicians to fill the need for tools that enable healthcare providers and payers to reduce hospital readmissions, maximize revenue and reduce costs by automating care coordination, care transition and patient engagement.

 

Health BI’s HealthCollaborate™ Care Coordination Information System is an automated suite of products that enables providers and payers to engage, monitor and navigate patients through the continuum of care.

Health BI to Present at the HIMSS13 Health IT Angel Venture Fair

Health Business Intelligence Corp (Health BI), a healthcare software innovation company focused on care coordination, patient engagement, and transitional care management solutions for population health management, is pleased to announce its participation with the HIMSS13 Health IT Angel Venture Fair on Monday, March 4, 2013.

 

”We are excited to be selected among top startups to present at the HIMSS13 Health IT Angel Venture Fair. We believe that the combination of our innovative products, experienced executive team and our strong value proposition will position Health BI to be a solid investment opportunity,” said Mack Baniameri, CEO of Health BI.

 

Health BI develops care coordination, care transition and patient engagement software solutions for healthcare providers and payers. Health BI solutions are designed to optimize population health management and enhance care coordination and patient engagement through better information, workflow, secure communication, mobile app technology, increased care value, best practice modeling, and reducing provider costs.

 

HIPAA-compliant secure messaging questions for vendors

Secure messaging vendor Health BI sent out a press release today offering some security tips and questions healthcare organizations should have already asked their vendors.

Mack Baniameri, CEO of Health BI, alludes to some of the confusion on the part of some organizations regarding HIPAA laws on secure transmission of protected health information(PHI). Baniameri provided advice on some of the misconceptions about health dataencryption, such as that simple encryption of messages and documents makes the transmission of data HIPAA compliant.

Transmission of encrypted data is only a small part of HIPAA compliancy when it comes to secure email and mobile messaging. HIPAA compliant messaging solutions must satisfy a number of requirements:

-All data must be kept in a secure and HIPAA compliant data center.
-The security of data is directly related to the way the server infrastructure is built.
-The infrastructure must be built in a way that it is nearly impossible to access data from outside of the production environment.
-The data must be invisible to those who support the systems.
-The data or traces of data should never reside on support staff’s devices.
-The encryption must be at least 128-bit, preferably 256-bit or higher.

While most healthcare organizations should be well-aware of HIPAA encryption rules, how and where the data resides and whether those regulations apply to mobile messaging can be unclear at times to even the most tech-savvy of organizations. Here are some important questions that Health BI says healthcare organizations must be asking of vendors:

1. Where exactly will messages and documents reside?
2. Explain the data center setup
3. Explain the data security infrastructure
4. What kind of encryption is used?
5. What kind of auditing capabilities are provided?
6. Explain system redundancy and availability strategy
7. Provide HIPAA compliancy documentations
8. Explain how customers are protected against mishandling of data by recipients of messages
9. How much experience does the vendor have in developing solutions for healthcare?

Hopefully, most organizations have already asked and have answers for these questions from vendors. Health BI is basically sending out a reminder of the type of transparency that’s needed when entering into an agreement that involves PHI transfer.

New physician payment for care coordination.

The Medicare program now is accepting two new Current Procedural Terminology codes that facilitate physician payment for care coordination.

The codes cover discharges from a hospital or skilled nursing facility. The American Medical Association’s CPT Editorial Panel created codes 99495 and 99496.

The codes enable reporting of time spent discussing a care plan, connecting patients to community services, transitioning them from inpatient care, and certain procedures to prevent readmission. They are intended to support physicians participating in medical homes, accountable care organizations and other emerging care delivery models that emphasize coordination between providers.

Can Technology Save Care Coordination?

By: Mack Baniameri

It is becoming more evident that Population Health Management will play an important role in the future of the US healthcare system. With implementation of accountable payments and patient centered care model, we see strong signs that the US healthcare landscape will undergo massive changes.

Population Health Management is developed based on the Perato principle, which states that 80% of effects come from 20% of causes. Translating that to healthcare leaves us with understanding that 80% of healthcare expenditure comes from 20% of patients. Well, the numbers might not be exact, but you get the idea.

Population Health Management attempts to solve this problem by managing and coordinating care for this 20% patient population. The idea is that we can save money and improve care by using a single point of contact (care coordinator) to connect patients and providers and navigate patients systematically through the ambulatory phase of care while engaging patients in the decision-making process. Though simple in theory, the task of coordinating care in the current form of healthcare delivery can be daunting.

The reality is that the cost of hospital admissions is breaking the back of the US healthcare system. So, the main goal of Population Health Management is to keep patients healthy and at home. We tend to assume that left to their own devices, most patients do manage their own health affairs. Data does not support that. Dealing with a fragmented healthcare system that provides no care coordination, no collaboration among providers and hardly any patient engagement, patients with chronic diseases are vulnerable and often confused. This confusion stems from the fact that healthcare providers are paid by encounters, which means they bear no responsibility when patient is out of the office and at home. In some situations, patients wait until their condition worsens and use ER as the backdoor entry into ambulatory care. Population Health Management attempts to minimize lapses and shorten periods where patients fall through the cracks.

This is not a new idea. It is actually an old-fashioned way of doing medicine, going back to mid-1900s when primary care physicians were in charge of managing patients’ care. And today, numbers of healthcare organizations and care plans have implemented PHM with positive results.

So what is the problem?! Well, here it is: Care Coordination plays a major part in the success of Population Health Management and ACOs. Let us take a moment to define care coordination. Care coordination is a series of steps performed by care coordinators employed by providers and payers to assure and manage transition of care among healthcare practitioners. The care coordination functionality can be divided into several main domains, which include: patient navigation (care transition), patient engagement, communication and information exchange and performance measurement (BI). Most care coordination today is performed manually. Manual processes are inefficient, costly, inconsistent and labor intensive. Additionally, there are no best practices in place for care coordination, which makes the process disjointed and broken. So, how do we solve this problem? Well, technology certainly can help.

For technology to streamline care coordination, we first need to build care transition processes outside of EMR silos. The most important task for care coordinators is to connect healthcare providers and manage the exchange of patient information. The care coordination system must be connected to HIEs but independent from fragmented delivery of care among EMR systems. The patient navigation processes should be configurable so that care coordinators can collaborate, share best practices and customize existing care plans. The system must contain versatile secure messaging and several different methods of information exchange and communication among providers and patients. The care coordination system must additionally have a comprehensive built-in patient engagement and concierge module so that care coordinators can fully engage, educate, monitor and navigate patients through the post discharge phase of care. And lastly, a data analytics capability to measure performance and results.

Can this be done? Absolutely. We do have the technology to automate care coordination. What needs to happen, however, is for the payers to figure out ways to incentivize providers who actively participate in managing patients’ transition of care.

Mack Baniameri is the CEO of Health BI

Health BI to Present at 2012 Invest Southwest Capital Conference

http://www.prweb.com/releases/2012/10/prweb10017853.htm

Scottsdale, AZ November 24, 2012

Health Business Intelligence Corp (Health BI), an innovative healthcare software company focused on care coordination, patient engagement, and care transitions for population health management, is pleased to announce its participation with Invest Southwest, the premier capital conference in Arizona and the Southwest. Health BI is one of 13 companies chosen to present at this year’s conference on November 28 – 30, at the Fairmont Scottsdale Princess.

”We are excited to be selected among top startups to present at Invest Southwest. We believe that the combination of our innovative products, experienced executive team, emerging healthcare market and our strong value proposition will position Health BI to be a solid investment opportunity,” said Mack Baniameri, CEO of Health Business Intelligence Corp

Health BI designs care coordination and patient engagement software solutions for population health management. Health BI solutions are designed to optimize population health management and enhance care coordination and patient engagement through better information, workflow, secure communication, mobile app technology, increased care value, best practice modeling, and reducing provider costs.

Jonathan Coury, 2012 Chairman of Invest Southwest and partner at Hool Law Group goes on to say, “The companies selected for this year’s conference are a great representation of the kind of industries that are flourishing all over the country. From health tech to green tech, investors will have an exciting crop of start ups to meet this year.”

Roadmap to Better Care Transitions and Fewer Readmissions

HealthCare.gov

http://www.healthcare.gov/compare/partnership-for-patients/safety/transitions.html

Goal: The Partnership for Patients will advance efforts to decrease preventable hospital readmissions within 30 days of discharge, so that by 2013 all readmissions would be reduced by 20% compared to 2010. This would mean prevention of more than 1.6 million avoidable readmissions.

Background on Care Transitions

We are developing a better understanding of what is needed to ensure safe and effective patient transitions from one health care setting to another. An increasing number of governmental and nongovernmental programs, training and learning opportunities, and resources are available to help providers and communities improve their ability to safely and effectively transition patients from one care setting to another. This Roadmap may help providers and communities navigate the processes of care transition and access helpful programs, learning and training opportunities, and resources. The Roadmap will be updated so check back often.

Why should providers care about care transitions?

Care transitions refer to the movement of patients from one health care provider or setting to another. For people with serious and complex illnesses, transitions in setting of care–for example from hospital to home or nursing home, or from facility to home- and community-based services–have been shown to be prone to errors.

Nearly one in five Medicare patients discharged from the hospital is readmitted within 30 days. This translates to approximately 2.6 million seniors at a cost of over $26 billion every year. Readmission rates are also high for patients covered by Medicaid and private insurance.

Medication errors, poor communication, and poor coordination between providers from the inpatient to outpatient settings, along with the rising incidence of preventable adverse events, have drawn national attention. Health care providers and community-based organizations are aware of the negative effects of poor patient care transitions. But many struggle with fragmentation and lack of collaboration across settings, limited resources, and an expanding aging population with multiple chronic conditions.

The Department of Health and Human Services is committed to promoting high quality health care and improving patient outcomes. For one example, the Affordable Care Act calls for progressive reduction in Medicare payments to hospitals beginning in fiscal year 2013 based on high rates of 30-day readmissions for Medicare beneficiaries.

The goal is to ensure that the hospital discharges are accomplished appropriately and that care transitions occur effectively and safely. The goal is not to avoid re-hospitalizations that are the best treatment option for an individual.

Who is at particular risk of poor care transitions and readmissions?

Several factors may affect the risk of unplanned, unintended readmissions. These include patient characteristics (such as demographics, socioeconomic, behaviors, and disease states); activities and events associated with the delivery of hospital care; and environmental factors. People with terminal illnesses and multiple chronic medical and mental health conditions are most prone to harm from inadequate transitions, especially if they have fragile support systems in the community. Issues with housing, transportation, formal and informal supports and services, and other basic needs further complicate care transitions.

Elements of a good care transition

Safe, effective, and efficient care transitions and reduced risk of potentially preventable readmissions require cooperation among providers of medical services, social services, and support services in the community and in long-term care facilities.

Providers that must work together to ensure safe transitions include at least the following: hospitals, clinicians practicing in the ambulatory setting, home care agencies, community service providers, and post acute facilities (such as skilled nursing facilities, rehabilitation, and assisted living). While much of the discussion addresses the transition from acute hospital to home or other post acute setting, the principles and resources are relevant for all transitions from one health care setting to another.

Because the combination of patients’ medical and social situations, preferences, and community resources could create an endless variety of care plans, quality care requires that a patient-centered plan for each patient exists and continues across time and settings. Patients and their families are the most constant element in transitions and their contribution is essential to safe and effective transitions.

Elements for safe, effective and efficient care transitions should include:

  • Patient (or caregiver) training to increase activation and self-care skills. For example, see the Care Transitions InterventionSM, developed by Eric A. Coleman, MD, MPH.
  • Patient-centered care plans–negotiated with patient and family and responsive to the medical and social situation and the availability of services–that are shared across settings of care.
  • Standardized and accurate communication and information exchange between the transferring and receiving provider in time to allow the receiving provider to effectively care for the patient. Examples: Continuum of Care Transfer Form, Georgia Medical Care Foundation (GMCF) (PDF) and Universal Transfer Form, American Medical Directors Association (AMDA) (PDF)
  • Medication reconciliation and safe medication practices
  • Ensured transportation for health care-related travel
  • Procurement and timely delivery of durable medical equipment
  • Ensuring the sending provider maintains responsibility for care of the patient until the receiving clinician/location confirms the transfer and assumes responsibility

Information that should be provided across care settings includes:

  • Primary diagnoses and major health problems
  • Care plan that includes patient goals and preferences, diagnosis and treatment plan, and community care/service plan (if applicable)
  • Patient’s goals of care, advance directives, and power of attorney
  • Emergency plan and contact number and person
  • Reconciled medication list
  • Follow-up with the patient and/or caregiver within 48 hours after discharge from a setting
  • Identification of, and contact information for, transferring clinician/institution
  • Patient’s cognitive and functional status
  • Test results/pending results and planned interventions
  • Follow-up appointment schedule with contact information
  • Formal and informal caregiver status and contact information
  • Designated community-based care provider, long-term services, and social supports as appropriate.

Establishing standard practices and building seamless connections to community-based services are important. Building and connecting the community infrastructure and establishing community standards and priorities are essential to shaping a system that will provide safe and effective transitions of residents across health care settings.

When considering the connections, interactions, and integration needed to consistently ensure safe and effective transitions, communities can be roughly sorted into three groups:

  • those interested in getting started or just beginning to work together
  • those that have developed some working relationships and have some experience in working together on transitions
  • those moving toward more seamless, integrated models

These types of communities are eligible for different programs and require different learning opportunities and resources.

Technology Challenges of Patient Engagement

By: Mack Baniameri

Healthcare innovation companies are just beginning to understand technology challenges that come with engaging patients with chronic diseases in care management and care transition. Many of healthcare IT vendors assumed that a simple access to portals with half-baked information and fragmented medical records will do the trick. Boy… were they wrong!

For the past twenty years, the HIT industry has focused on developing software solutions exclusively for healthcare providers. These companies understand where the money comes from. HIT executives can tell you that patients will not spend a dime on their products. The great Google Health flop was testimonial to this hypothesis. Google, and in some extent Microsoft, naively assumed that patients are indeed interested in managing their own health data. The executives in these brilliant companies sat around large tables in large conference rooms and brainstormed about a population they didn’t know much about. They made some very false assumptions. For example, what patient wouldn’t like to access his/her data? Wouldn’t it be great if patients could have all their data in one place? Why wouldn’t we put patients in charge of managing their own data? How about making patients the custodians of their own information? These questions were logical but uninformed. Google, and again in some extent Microsoft, ignored some fundamental behavioral traits of the patient population.

Under pressure from CMS and private insurers, healthcare organizations are being gently ushered out of the fee-for-service model into the pay-for-performance system which rewards providers for keeping patients healthy and out of hospitals. Finally, after all these years, the concept of patient-centered care model is gaining ground. Patient engagement is big contributing factor to the success of the patient-centered care model. Patient engagement means different things to different people. But whatever your definition of patient engagement might be, one thing is for certain: without patient participation, there is no patient engagement.

Facing stage 2 Meaningful Use compliancy, ICD-10 and HIPAA 5010 requirements, healthcare organizations began to put pressure on their HIT vendors to come up with patient engagement solutions. Healthcare organizations needed solutions that would enable patients to access information online. This was a disaster waiting to happen. So, the executives in these HIT companies sat around large tables in large conference rooms and brainstormed about a population they didn’t know much about. And as a result, patient portals were adopted as the solution to the patient engagement problem. They made the same false assumptions that Google made. For example, why don’t we create patient portals and connect them to our own EMR and PM systems and allow patients to access their medical records, see their lab results, make appointments online, request refills and access patient education materials? Wouldn’t that be great? We even throw in a mobile app.

Well, here is the problem: small number of patients has access to computers and internet. Many of these patients will not login to portals. Patients who are computer savvy require the least amount of engagement and intervention. Computer literate patients take good care of themselves, take their medications on time, make their appointments and stay out of hospitals.

Patient portals leave behind those who need engagement the most. Elderly and low-income patients with chronic diseases have the highest rate of hospital readmissions. This patient population will not touch patient portals. They do not use gadgets, do not have access to smart phones, do not have internet and do not own computers. The same is true for many behavioral health patients. If accessing information through patient portals is our only solution to patient engagement, then shame on us.

Elderly and low-income patients are the most venerable and often left behind when it comes to the use of technology in healthcare. As HIT innovators, it is our outmost responsibility to design products that especially accommodate this patient population. We need to walk away from the concept of accessing information and start thinking about ways to deliver information and education to patients. In addition to patient portals, we must develop products that are simple, cost effective, holistic and easily available to elderly and the low-income patients. We must develop multifaceted technology solutions that connect with patients based on the best method of communication available to the patient. Our patient engagement strategy must be built on patients’ requirements, not ours. The success of the patient-centered care model on the technology side depends heavily on availability of solutions that cover patients from all walks of life without any unintentional favoritism towards certain race, gender, income and age.

Mack Baniameri is the CEO of Health Business Intelligence Corp

www.healthbi.com

Health Business Intelligence Corp Chosen to Present at 2012 Invest Southwest Capital Conference

http://www.prweb.com/releases/2012/10/prweb10017853.htm

Scottsdale, AZ October 17, 2012

Health Business Intelligence Corp (Health BI), an innovative healthcare software company focused on care coordination, patient engagement, and care transitions for population health management, is pleased to announce its participation with Invest Southwest, the premier capital conference in Arizona and the Southwest. Health BI is one of 13 companies chosen to present at this year’s conference on November 28 – 30, at the Fairmont Scottsdale Princess.

”We are excited to be selected among top startups to present at Invest Southwest. We believe that the combination of our innovative products, experienced executive team, emerging healthcare market and our strong value proposition will position Health BI to be a solid investment opportunity,” said Mack Baniameri, CEO of Health Business Intelligence Corp

Health BI designs care coordination and patient engagement software solutions for population health management. Health BI solutions are designed to optimize population health management and enhance care coordination and patient engagement through better information, workflow, secure communication, mobile app technology, increased care value, best practice modeling, and reducing provider costs.

Jonathan Coury, 2012 Chairman of Invest Southwest and partner at Hool Law Group goes on to say, “The companies selected for this year’s conference are a great representation of the kind of industries that are flourishing all over the country. From health tech to green tech, investors will have an exciting crop of start ups to meet this year.”

Care Management Software Tool

By: Mack Baniameri

http://www.youtube.com/watch?v=Mnp9_cytUGM


The success of your healthcare organization depends on your ability to coordinate patient care by fully engaging and navigating patients through the continuum of care. This patient-centered care model can help your organization coordinate care while giving patients active role in the process.

Health collaborate, the most comprehensive care coordination tool in the market, can help your organization to successfully achieve your patient engagement objectives.

Health Collaborate is a web-based solution that creates a tight relationship between your hospitals,… PCPs, … specialists, … ancillary providers, … patients … and payers. We essentially take your organization and turn it into a connected online community of providers and patients on a single secure platform.

By utilizing the latest interactive voice recognition technology,… mobile app, … SMS, … and secure email, Health Collaborate enables your organization to securely communicate, … collaborate, … share information, … navigate and monitor patients.

Health collaborate helps your care coordination team with automatic appointment scheduling.. patient appointment notifications, reminders and follow-ups.. patient home monitoring.. medication reminders and information.. patient education.. alert notifications.. electronic referrals.. patient outreach.. readmission reductions and much more.

The navigation dashboard keeps track of your patients throughout the transition of care and alerts your organization of any interruption to the workflow.

Health Collaborate will help automate care coordination for your organization and provide support for your care coordination team. We will engage your patients through their ambulatory phase of care to achieve the highest level of patient satisfaction.

Care Management Software Product Technology Solution

By: Mack Baniameri

www.healthcollaborate.com

Patients over the age of 60 whom possess one of the six major chronic diseases are costing Medicare and private health insurance companies the most amount of money from hospital admissions and readmissions. The main contributing factor for this out-of-control spending is the lack of community care coordination.

Once patients with chronic diseases are discharged from hospitals, they enter a fragmented and reactive clinical model that does neither engage nor support them throughout the continuum of care.

The current solution to the problem is to wait until the patient reaches the critical point and use ER as patient’s entry back to the system. Health Business Intelligence Corp has created an automated care coordination solution that enables healthcare payers and organizations to reduce costs by fully engaging patients and healthcare providers in managing the continuum of care.

By utilizing the HealthCollaborate™ Care Coordination Information System, providers will increase performance and reduce penalties by identifying and navigating patients with the highest risk of hospital admissions and readmissions through the ambulatory phase of care.

Our automated care coordination tool enables healthcare payers and providers to navigate, monitor and engage patients.  HealthCollaborate™ creates a connected community of providers, patients and payers on a single secure platform and allows all stakeholders to communicate, collaborate and share information.

HealthCollaborate™ delivers care management teams a fully automated care transition workflow that facilitates patient status alerts, appointment scheduling, patient appointment notifications, reminders and follow-ups, home monitoring and data analytics, medication reminders and information, patient education, electronic referrals, patient outreach, readmission reduction dashboard, medical record exchange and much more.

The system is capable of creating interactive communication channels with patients via landline, SMS, secure email and phone app. By pushing information to and retrieving data from patients, HealthCollaborate™ keeps patients continuously in sync with their care plan and engaged with their healthcare providers.

HealthCollaborate™ home monitoring system collects and analyzes data necessary to predict potential health problems before becoming acute.

HIPAA SECURE MESSAGING

By: Mack Baniameri

www.healthcollaborate.com

Meaningful Use Stage 2 requires healthcare organizations to use secure electronic messaging to communicate with patients on relevant health information. At the same time, HIPAA prohibits unsecure transmission of patient information over the internet. Yet, many healthcare organizations send and receive messages containing patient information via email, SMS, social media or forums. The main problem is that most healthcare organizations simply have no control over how their staff sends and receives patient data. Additionally, majority of healthcare providers have no access to a secure platform that facilitates different methods of communication among healthcare providers, patients and HIPAA covered entities. HIPAA requires that all your online and mobile communication that contains patient information meet minimum security requirements, which include:

 

◦Secure Platform
◦User authentication
◦Secure transmission (encryption)
◦Auditing
◦Automatic time-out

 

 HealthCollaborate™ is the most complete HIPAA-compliant enterprise messaging suite in the market. HealthCollaborate™ will provide your organization secure email, SMS, IVR, secure mobile messaging app plus a comprehensive patient engagement portal on a single platform. HealthCollaborate™ is the fastest and most cost effective way to comply with MU Stage 2 secure messaging communication requirements. HealthCollaborate™ interfaces with your clinical and financial systems and enables your organization to securely send/receive messages, documents, images and PHI to providers, patients and HIPAA business associates. Whether your staff is on the road, in the office or working remotely, HealthCollaborate enables them to securely communicate, collaborate and share information.

 

Choose any or all of the below features:
◦Secure Email
◦SMS
◦Interactive Voice Response (IVR)
◦Secure Mobile Messaging App
◦Portal

◦System Integration

HIPAA Secure Messaging Mobile Application Increase Care Coordination and Patient Engagement

http://www.prweb.com/releases/2012/9/prweb9888329.htm

By: Mack Baniameri

Scottsdale, AZ (PRWEB) September 12, 2012

Health Business Intelligence Corp (Health BI), creator of HealthCollaborate and SecureEmailMe.com, announces the availability of its HealthCollaborateTM Secure Messaging Mobile Application. The HealthCollaborate Secure Messaging Mobile App is designed to help healthcare professionals to easily communicate, collaborate, and share e-PHI directly from their smartphones. Compatible with all brands of smartphones, the HealthCollaborate™ Secure Messaging Mobile App provides healthcare professionals mobility, flexibility and secure access to messages and documents containing patient information. The HealthCollaborate™ Secure Messaging Mobile App keeps no records of PHI on the device, requires no investment on infrastructure or application download and can be setup in minutes. Secure messages and attachments can be sent/accessed from smart phones, tablets and personal computers.
Available to both healthcare providers and their patients, HealthCollaborate mobile application will allow care coordinators and patients to respond to care transition programs remotely and enhance the patient experience with care team members.
“The addition of the HealthCollaborate mobile application will help reduce the fragmented gaps in care coordination and patient engagement by connecting all stakeholders with multi-devices and multi-locations,” stated by Mack Baniameri, CEO of Health BI. “Increasing care coordination and patient engagement is paramount to solving care transitions challenges and with the development of HealthCollaborateTM Secure Messaging Mobile Application, we are closer to reducing fragmented care with the use of technology.”
About Health Business Intelligence,
Health Business Intelligence Corporation, Health BI, is the leading developer of care coordination, patient engagement, and secure messaging solutions for the healthcare market. Health BI’s primary focus is on developing solutions and services that help providers transition to patient-centered care model. Health BI’s solutions enable healthcare providers to engage patients in managing the continuum of care.

Keep ePHI off portable devices to secure data: Report

Published In: FierceHealthIT

http://www.fiercehealthit.com/story/keep-ephi-portable-devices-secure-data-report/2012-08-23

August 23, 2012 | By Julie Bird

Data-breach analysis shows portable electronic devices and other easy-to-carry, easy-to-lose items such as CDs and thumb drives pose a growing risk for breaches of personal health information. One consulting group is advising healthcare organizations to avoid storing PHI on those items.

Portable devices, CDs, backup tapes and even X-ray films “may soon pose the greatest risk to [electronic] PHI because they are more prone to loss and theft,” the Florida-based accounting and consulting firm Kaufman Rossin & Co. says in a new white paper.

“We recommend covered entities discourage employees from storing e-PHI on [such] assets and even computers unless necessary, in which case encryption and/or additional controls should be implemented.”

The paper, “HITECH Act Three Years Later: Are Health Records Safe?”, analyzes all breaches of electronic PHI reported to the Department of Health and Human Services in calendar years 2010 and 2011. The 407 breaches that affected more than 500 individuals each compromised the PHI of 19.1 million people, with the largest affecting 4.9 million.
Breaches that involved mobile devices, CDs and backup tapes compromised 9.7 million records, the HHS data showed.

The number of breaches fell from 201 in 2010 to 142 in 2011, but nearly twice as many individuals were affected, the Kaufman Rossin analysts noted. Theft and unauthorized access remained the biggest threat in both years.

The decrease in reported breaches indicates organizations have improved security controls and procedures, with email encryption in particular helping reduce the numbers, the authors said. Organizations still should assess their vendor-management programs to reduce the threat of breaches by business associates, train employees on proper disposal of paper records, and evaluate physical security of laptops and computers, the report concluded.

Kaufman Rossin is hoping to change attitudes such as those highlighted earlier this year in a report from the American National Standards Institute, the Santa Fe Group and Internet Security Alliance, which concluded that safeguarding protected health information is too rarely a top priority of healthcare chief information officers and chief executive officers.

The Carpinteria, Calif.-based IT security firm Redspin Inc. concluded earlier this year that unless curtailed, PHI breaches could “derail the implementation, adoption and usage of electronic health records.”
To learn more:
- read the white paper
- download the ANSI report (registration required)
- see the Redspin announcement

Health Business Intelligence Corp Appoints Jacob Nguyen Executive VP of Business Development.

http://www.prweb.com/releases/2012/7/prweb9702319.htm

Scottsdale, AZ (PRWEB) July 17, 2012

Health Business Intelligence Corp (Health BI), a Healthcare Software Technology solution provider, specializing in Patient Centered Medical Home Technology Solutions and Services today announced that it has named Jacob Nguyen as the company’s Executive VP of Business Development. In his new role, Mr. Nguyen will be responsible for leading, developing and executing Health BI’s Sales and Marketing strategy.
Jacob Nguyen was previously the Senior Vice President of Business Development for Craneware Incorporated with over 1500 provider clients. Jacob brings over 15 years of healthcare information technology experience in the areas of supply-chain and revenue cycle management. Since 2002, Jacob Nguyen built Craneware into an important provider of Revenue Integrity software solutions for many of the leading health systems across the country. Jacob has been instrumental in helping hospitals transform managing their revenue integrity systems that positively affected the hospital’s economic strength and financial position. Jacob also served as Craneware’s Western Region Vice President.
Prior to Craneware, Jacob was the Director of Supplier Relations and the Director of Integration Services at Neoforma. In his role as Director of Supplier Relations, Jacob collaborated with the leading supply chain companies to form Neoforma’s Online Marketplace. As Director of Integration Services, he led development and implementation projects for material management systems to Web-based solutions.
“We are extremely excited to have Jacob joining our Executive team. Jacob’s vast knowledge of the healthcare market, his exceptional work ethic and strategic thinking puts Health BI on the path to dominate the care coordination, patient engagement, BI and PCMH technology space,” said Mack Baniameri the CEO of Health Business Intelligence Corp.
Jacob is an active member of Healthcare Financial Management Association and he was a former diplomat for the American College of Healthcare Executives. Jacob earned a Bachelor of Science degree in General Biology from San Jose State University and he has completed Thunderbird, The Garvin School of International Management – Executive International Management Program for Global Management and Leadership.
About Health BI
Health Business Intelligence Corp is the leading developer of secure online and mobile messaging, care coordination, patient engagement, Business Intelligence, readmission reduction and Patient Centered Medical Home technology solutions. Headquartered in Scottsdale, Arizona, Health BI was created by a group of industry leaders and physicians to fill the need for tools that facilitate secure online and mobile communication, collaboration, care transition and information sharing among healthcare providers, vendors and patients. The success of Health BI’s secure messaging technology prompted the company to introduce a modified version of its secure email solution to business and financial sectors.

www.healthcollaborate.com New Release is Now Available

https://www.healthcollaborate.com

By: Mack Baniameri

Yes, we were at it again. Our developers have worked tirelessly to create a new release of HealthCollaborate for you. The next time you login to HealthCollaborate, you will notice new enhancements, which are based on your feedback and requests. Our goal is to enable your organization to securely communicate, collaborate and share information with partners, vendors and patients. For those users that are not aware, our enterprise level product has always been developed to support your meaningful Use stage 2 and 3 compliance.  As such we have made some major enhancements:

  •  HealthCollaborate now resides on infrastructure that is faster, better and stronger. We have made major investments on faster servers, layers of additional security, load balancers, redundant systems, stronger encryption, larger storage capacity and multiple access points.
  • We have cleaned up the main menu, simplified invites, enhanced notifications, increased the size of document uploads and streamlined processes.
  • We have implemented a comprehensive online patient registration including patient history and simplified the referral process.
In addition, we are just weeks away from introducing the HealthCollaborate mobile application. This application will support all types of smart phones.  You will be able to send and receive secure messages and referrals directly from your mobile phone.
Meanwhile, enjoy this new version. Let us know what you think, and what else can we do to make this tool better.

HIPAA Compliant Email is Available by HealthCollaborate™ for Health Care HIPAA Email Compliance Needs

http://www.prweb.com/releases/2012/4/prweb9377003.htm

By: Mack Baniameri

Scottsdale, Arizona (PRWEB) April 09, 2012

Health Business Intelligence Corp, Health BI, today announced the availability of its next generation secure messaging platform for health care. HealthCollaborate™ secure messaging solution is developed to become health care organizations’ secure online and mobile communication platform. HealthCollaborate™ provides health care organizations with any or all of the below features:

-Secure Email -SecureSMS
-Interactive Voice Response
-Secure Mobile Messaging Application

” Health information data breaches are increasing in number and magnitude. To protect Patient Health Information, HIPAA prohibits unsecure transmission of PHI over the internet. Yet, many healthcare organizations send and receive messages containing patient information via email, SMS, social media or forums. The main problem is that most healthcare organizations simply have no control over how their staff sends and receives patient data. Additionally, majority of healthcare providers have no access to a secure platform that facilitates online communication among healthcare providers and patients,” says Mack Baniameri the CEO of Health BI.

Small practices as well as the largest healthcare organizations can utilize the system to securely communicate, collaborate and share information with providers, patients, payers and vendors. HealthCollaborate™ can interface with existing health care applications and facilitate secure delivery of messages, documents and PHI to HIPAA covered entities.

Patient Centered Medical Home Solutions are Available by HealthCollaborate

http://www.prweb.com/releases/2012/5/prweb9456279.htm

Press Release

By: Mack Baniameri

Health Business Intelligence Corp http://www.healthcollaborate.com announces the availability of its Patient Centered Medical Home solution PCHSYS.Scottsdale, Arizona (PRWEB) May 01, 2012

Health Business Intelligence Corp (Health BI) announces the availability of its Patient Centered Medical Home solution, which is designed to help healthcare providers to connect, collaborate and engage patients in managing the continuum of care. The HealthCollaborate™ PCHSYS provides Patient Centered Medical Home participants a flexible care coordination and patient engagement platform.

HealthCollaborate™ will help both patients and healthcare professionals build relationships to manage acute and chronic illnesses while giving patients a more active role in the process.
HealthCollaborate™ PCHSYS will become an integral part of the PCMH workflow by enforcing collaborative behavior, efficient data sharing, and performance measurements.
HealthCollaborate™ enables PCMH participants to create an online community of providers and patients and to communicate, share information, collaborate, monitor, coordinate and manage the movement of data among the PCMH community members.

“The success of the Patient Centered Medical Home depends heavily on technology solutions that can create a tight relationship between hospitals, PCPs, specialists, ancillary providers and patients on a single secure platform, enabling all stakeholders to easily collaborate and share information,” says Dr. Ali Ghazanfari, Health BI’s CMIO.

HealthCollaborate™ PCHSYS solution portal includes:

 

    • Virtual communities
    • Electronic Referral
    • Online Patient Registration
    • Home Monitoring
    • Appointment Reminders
    • Medication Reminders
    • Pre&Post OP Reminders
    • Readmission Reduction Services
    • Patient Outreach
    • Patient Education Library
    • Medication information Library
    • Personal Health Record (PHR)
    • Collaboration Center
    • Forum
    • SecureSMS
    • Interactive Voice Response
    • Mobile App
  • Data Analytics

 

Health Business Intelligence corporation, Health BI, is the leading developer of care coordination, patient engagement and secure communication solutions for the healthcare market. Health BI’s primary focus is on developing solutions and services that help providers transition to patient-centered care model. Health BI’s solutions enable healthcare providers to engage patients in managing the continuum of care.

Why Patient Portals Fail Most Patients

By: Mack Baniameri, CEO Health BI
www.healthcollaborate.com

I have worked in the Health Information Technology space for a long time. Seventeen years to be exact. Many of those years have been spent in management positions. I have seen moments of brilliance and moments of sheer laziness. I have seen firsthand how the HIT industry rise to the occasion and offer life-saving solutions … and I have seen instances where HIT companies just flat drop the ball and introduce sloppy products to the healthcare market. I have seen the good, the bad and the ugly. To be fair, HIT vendors do lot of good for their customers. Most HIT industry leaders understand that products they design have direct impact on quality of care provided to patients. Most CEOs of these companies have tremendous respect for healthcare providers and the important role they play in our lives. At the same time, CEOs of HIT companies must constantly worry about revenue and stock prices. After all, we are all in business to make money. The truth is that the HIT industry has a lot to be proud of. Healthcare providers today have access to some of the best solutions that the software market has to offer. These solutions make healthcare providers’ jobs a whole lot easier.  Simultaneously, the US healthcare industrial complex has stepped up to the plate to collaborate with HIT companies to make healthcare software products better, faster and stronger. That’s all nice and dandy.

 

However, before we get too carried away and give ourselves a pat on the back, let’s look at what our industry has done for patients. Well, unfortunately, I have to say, NOTHING impressive.

 

For the past twenty years, the HIT industry has spent all its time and effort developing software solutions exclusively for healthcare providers. These companies understand where the money comes from. Any executive can tell you that patients will not spend a dime on his or her products. The great Google Health flop was testimonial to this hypothesis.  Google, and in some extent Microsoft, naively assumed that patients are indeed interested in managing their own health data. The young executives in these brilliant companies sat around large tables in large conference rooms and brainstormed about a population they didn’t know much about. They made some very common-sense but false assumptions. For example, what patient wouldn’t like to access his/her data? Wouldn’t it be great if patients could have all their data in one place? Why wouldn’t we put patients in charge of managing their own data? How about making patients the custodians of their own information? These questions were logical but uninformed. Google, and again in some extent Microsoft, ignored some fundamental behavioral traits of the patient population. Back to PHR in a second.

 

Under pressure from CMS and the looming threat of bankruptcy of the US healthcare system, healthcare organizations are being gently ushered out of the fee-for-service model into the fee-for-performance system which rewards providers for keeping patients healthy and out of hospitals. Finally, after all these years, the concept of patient-centered care model is gaining ground. Patient engagement is one contributing factor to the success of the patient-centered care model. Patient engagement means different things to different people. But whatever your definition of patient engagement might be, one thing is for certain: without patient participation, there is no patient engagement.

 

Facing stage 2 Meaningful Use compliancy requirements, healthcare organizations began to put pressure on their HIT vendors to come up with patient engagement solutions. Healthcare organizations needed solutions that would enable patients to access information online. This was a disaster waiting to happen. So, the young executives in these brilliant HIT companies sat around large tables in large conference rooms and brainstormed about a population they didn’t know much about. And as a result, patient portals were adopted as the solution to the patient engagement problem. They made the same common-sense but false assumptions that Google made. For example, why don’t we create patient portals and connect them to our own EMR and PM systems and allow patients to access their medical records, see their lab results, make appointments online, request refills and access patient education materials? Wouldn’t that be greater? We even throw in a mobile app.

 

Well, here is the problem: small number of patients has access to computers and internet. Many of these patients will not login to portals. Patients who are computer savvy require the least amount of engagement and intervention. Computer literate patients take good care of themselves, take their medications on time, make their appointments and stay out of hospitals.

 

Patient portals leave behind those who need engagement the most. Elderly and low-income patients with chronic diseases have the highest rate of hospital readmissions. This patient population will not touch patient portals. They do not use gadgets, do not have access to smart phones, do not have internet and do not own computers. The same is true for many behavioral health patients.  If accessing information through patient portals is our only solution to patient engagement, then shame on us.

 

Elderly and low-income patients are the most venerable and often left behind when it comes to the use of technology in healthcare. As HIT innovators, it is our outmost responsibility to design products that especially accommodate this patient population. We need to walk away from the concept of accessing information and start thinking about ways to deliver information and education to patients. In addition to patient portals, we must develop products that are simple, cost effective, holistic and easily available to elderly and the low-income patients. The success of the patient-centered care model on the technology side depends heavily on availability of solutions that cover patients from all walks of life without any unintentional favoritism towards certain race, gender, income and age.

Health Business Intelligence Corp, Health BI, Appoints Dr. Gregory Wong Chief Strategy Officer

Health Business Intelligence Corp, Health BI, a Healthcare Software Technology solution provider, specializing in patient-centered technology and services www.healthcollaborate.com , today announced that it has named, Gregory Wong, MD, as the company’s Chief Strategy Officer.  In his new role, Dr. Wong will be responsible for directing the strategy of Health BI’s products and services.

Dr. Greg Wong is a board certified anesthesiologist. He received his Doctorate of Medicine from The Chicago Medical School. He completed his training in anesthesiology, and received his certificate from the integrated program of the University of Arizona Department of Anesthesiology. He is an active member of the American Society of Anesthesiologists and Arizona Society of Anesthesiologists. He practices in several hospitals and specialty hospitals in the Phoenix area, with an emphasis in regional anesthesia. Greg has practiced and managed in successful single specialty anesthesiology group in Arizona for the last 15 years. He has served on the board of Red Mountain Anesthesiologists as the VP of finance for the last 13 years. He was instrumental in the merger and formation of Red Mountain Anesthesiologist in 2001.

 

As Health BI’s Chief Strategy Officer, Dr. Wong will chair clinical advisory groups to provide broad-based input into the strategy of Health BI’s technology and services. He’ll work in concert with Health BI’s Information Technology Services to develop and implement systems supporting the patient-centered care model. Dr. Wong serves as member of Health BI’s ITS Steering Committee, Security Council, and Central Protocol Data Management (CPDM) Board.

 

“We now have the technology to deliver important information or instructions to our patients. Moreover, we also have the technology to extract relevant information back from patients so that we can intervene in a timely fashion. The ability to acquire specific information about our patients’ health, will allow us to provide explicit information or instructions to our patients. This will allow us to better care for our patients, and at the same time reduce the overall cost of healthcare.” Dr. Greg Wong, CSO, Health Business Intelligence Corp
About Health Business Intelligence Corp,

Health Business Intelligence corporation, Health BI, is the leading provider of BI services and developer of care coordination, patient engagement and secure communication solutions for the healthcare market. Health BI’s primary focus is on developing solutions and services that help providers transition to the patient-centered care model. Health BI’s solutions enable healthcare providers to engage patients in managing the continuum of care.

What is secure email and how is it different from email encryption

By: Koorosh Yasami, CTO, Health BI

More than ever, industries such as healthcare, insurance and financial are looking for secure ways to send and receive messages and documents via email or mobile devices. Confidential patient and consumer data breaches are increasing significantly as data trail scatters all over the internet as well as desktops, laptops and mobile devices. Every email with confidential information that is fired from your exchange server will leave a large footprints that includes your own laptop or mobile device, the exchange server, the recipient’s exchange server, the recipient’s laptop or mobile device–not to mention all those whom were copied or your message was forwarded to.

 

There is a great deal of confusion about secure online and mobile transmission of messages and attachments. The biggest misconception is encryption. Many believe that so long as your emails are encrypted and the recipient somehow knows how to decrypt your messages, you are good to go.

 

 A capable secure email system leaves small footprint while delivering your messages and documents securely to recipients. Confidential information, whether encrypted our not, should never reside on your devices or the company exchange servers.  Your messages and attachments should not only be encrypted but also hosted on servers that reside in highly secure data centers. Confidential emails and documents should be sent, received, archived and accessed on the exact same ecosystem. With approach like that, you will not have to worry about calling large number of patients or customers to explain how their information might be compromised because your employee’s laptop or mobile device was stolen or lost.

Understanding HIPAA compliant email and secure mobile messaging

By: Mack Baniameri

Health information data breaches are increasing in number and magnitude. So are the lawsuits and penalties. Patient health information is particularly compromised when transmitted via email, SMS, forums or mobile devices. Chances are good that your organization’s clinical staff are sending and receiving messages containing patient information via unsecure platforms. HIPAA prohibits unsecure transmission of patient information over the internet and mobile devices.  However, many healthcare organizations simply have no control over how their staff sends and receives patient data. Many more have no access to a secure platform that facilitates online and mobile communication and transmission of PHI among healthcare providers.

Every email with confidential information that is fired from your exchange server will leave a large footprint that includes your own laptop or mobile device, the exchange server, the recipients’ exchange servers, the recipients’ laptops or mobile devices–not to mention all those whom your message was forwarded to.

There is a great deal of confusion among healthcare providers when it comes to secure email and mobile messaging apps. Even some CIOs of the larger healthcare organizations are lost when it comes to HIPAA laws on secure transmission of PHI. The major misconception is encryption. Many think that a simple encryption of messages and documents makes the transmission of data HIPAA compliant. That’s not correct.

Transmission of encrypted data is only a small part of HIPAA compliancy when it comes to secure email and mobile messaging. HIPAA compliant messaging solutions must accommodate a number of requirements. You must first make sure that all data is kept in a secure and HIPAA compliant data center. The security of data is directly related to the way the server infrastructure is built. The infrastructure must be built in a way that it is impossible to access data from outside of the production environment. The data must be encrypted and invisible to those who access and support the systems. The encryption must be high grade and impenetrable. Access to the messaging solution must only be possible by tight user authentication. All user information must be accurate and extensive. The system must have strong auditing capability. All activity on the platform must be logged for the future reference. The system must have auto time-out capabilities. And additionally, the system must have business intelligence capabilities for data mining and quick access to important information.

A capable secure email system leaves small footprint while delivering your messages and documents securely to recipients. Confidential information, whether encrypted our not, should never reside on your devices or the company exchange servers.  Your messages and attachments should not only be encrypted but also hosted on servers that reside in highly secure data centers. Confidential emails and documents should be sent, received, archived and accessed on the exact same ecosystem. With approach like that, you will not have to worry about calling large number of patients to explain how their information might be compromised because your employee’s laptop or mobile device was stolen or lost.

Before making investment in your secure email and mobile messaging solution, you must consider all the facts and ask the hard questions. Make sure that your vendors understand HIPAA and will give you all the tools you need to protect yourself and your patients against possible mishandling of important patient information.

Here are some important questions you want to ask the vendors:

1. Where exactly will my messages and documents reside
2. Explain your data center setup
3. Explain your data security infrastructure
4. What kind of encryption do you use
5. What kind of auditing capabilities do you have
6. Explain your system redundancy and availability strategy
7. Provide HIPAA compliancy documentations
8. Explain how am I protected against mishandling of data by recipients of my messages

Patient Portals Fall Short in Improving the Patient Experience

By Gregory Wong, MD, Chief Strategy Officer, Health BI

 

The evolution of patient centered care model is going to change the role of the physician in this process.  We physicians are not only going to be expected to treat our patients effectively, but also to treat them efficiently.  This means we need to educate our patients and provide them with useful information so that we can keep them out of the hospitals. As our patient’s illnesses worsen, it’s important to direct them into our offices before they are being admitted to the hospital. Providing meaningful information to our patients is often a challenging task.  We have so little extra time to customize material for each of our patients that we often ignore the problem all together.  One solution is to let our technology savvy patients search the Internet for the answers themselves.  While this is a convenient solution, we know that this is not a very good idea.  What we are often left with are confused and frustrated patients.  Worst of all, sometimes we have patients whom act on the wrong information they read on the Internet. The current healthcare trend is to provide a patient portal; patients can find the answers to their health related questions.
The problem: patient portals are extremely limited. While the patient portal is a good start to the problem, it doesn’t meet the needs of most patients. Research shows that most patients simply do not use patient portals to fulfill their educational needs. Why? Patient behavior is not the same as ours. Many patients, especially the elderly and chronically ill, do not have access to the Internet.  Many patients have a difficult time navigating or interpreting all the information provided. Many patients just don’t consider it their obligation to search for answers to their illnesses, that’s their doctor’s role. Most importantly, really good healthcare often requires individualized treatment plans.  One size does not fit all.
The Answer: Patient engagement with precise and targeted information delivered directly to the patients.  Using well-designed patient education materials as a data source, we can deliver this information to our patients using technology that they have access to already.  Whether its: secure email, secure SMS, regular SMS, or interactive voice recognition, we now have the technology to deliver important information or instructions to our patients.  Moreover, we also have the technology to extract pertinent information back from patients so that we can intervene in a timely fashion.  The ability to acquire specific information about our patient’s health, will allow us to provide explicit information or instructions to our patients.  This will allow us to better care for our patients, and at the same time reduce the overall cost of healthcare.  As we move forward, think beyond the healthcare portal. We now have the opportunity to really shift the treatment of chronically ill patients away from the hospitals and into the ambulatory setting.

Role of technology in successful patient engagement

By: Koorosh Yasami, founder and CTO, Health BI

Healthcare technology companies have spent most of their time developing solutions for the provider market. This constant interaction with providers both on the clinical and financial sides has paid dividend. Providers today enjoy a large array of options when it comes to selecting technology solutions. The patient population, however, has been ignored. Most healthcare technology companies are clueless when it comes to patient engagement. The problem is that many companies fall in love with their own products. Many more think that they know what technologies are best for patients. In addition, unfortunately, many of these companies think that the more innovative (translation: complicated), their products are, the better they are for the patients. Complicated patient home monitoring solutions and unusable mobile apps are examples of this trend.
Technology needs for patients are completely different from the providers. Patients come in all different shapes and forms. That means there is no such thing as one size fits all. Most patients are older adults with no appetite for technology. Many cannot afford high-tech devices like cell phones and computers. At the same time, those who have access to high-tech gadgets look for convenience.
Healthcare technology companies have found their patient engagement magic bullet in patient portals. The thought process is that patient portals will fix the patient engagement problem. That is just a lazy way of doing things. Studies after studies show that patients do not like to use portals—especially when it comes to engagement in their healthcare related issues. Engaging patients in decision-making process and involving patients in managing their own care requires strategies that must utilize variety of technology sources. Patient engagement is not about providing access to information, but rather, channeling information to and from patients the right way. A complete patient engagement technology solution uses patient portals in addition to secure email, secure SMS, regular SMS, interactive voice recognition, phone app, mobile WAP and the good-old human interaction. A solution like that truly engages patients and does not leave anybody behind.

www.healthcollaborate.com

Secure Messaging: Be Careful of the Pitfalls

By:  Gregory Wong, M.D., Chief Strategy Officer

Its becoming increasing popular for providers to text message patient information among themselves.  The convenience to use SMS to consult a colleague or to check out to a partner on call is overwhelming. The advent of smart phones makes SMS the easiest and mobile feature we have as we navigate our busy practices. We can literally send a question or provide an answer to a colleague in less than 10 seconds, whether the person you are sending it to is busy or not. We can consult someone as fast as we can walk to the next patients room. However, this practice is not legal.  HIPAA does not allow providers to use standard e-mail and standard text messaging to pass patient information to a provider or a patient. In fact, the Health Insurance Portability and Accountability Act allows for a $10,000 fine for every single infraction with an annual maximum of $250,000.

If you are not aware of this problem, the Chief Information Officer (CIO) of the organization you are affiliated, most likely, is aware of this problem.  Your organization should be implementing some sort of solution for your protection and theirs this coming year.  If you are not aware of any pending solution in the near future, you may want to address this with your organization.  The lack of understanding does not protect you from the law. Don’t feel bad if you need to address this problem.  Almost every organization has this same issue as we transition into the electronic massaging and records age of health care.  However, if you do need to find a solution for your organization today, please look for a platform that will also support messaging to your patients securely.  As we start down the road of ACOs and the patient centered care model, it is going to be ever increasingly necessary to communicate with our patients in a secured environment.

www.healthcollaborate.com

Why patients search for health information on the Internet

By: Ali Ghazanfari, MD
http://www.healthcollaborate.com

Like many of my colleagues, I encounter patients on a daily basis carrying folders full of convoluted information on imaginary, self-diagnosed illnesses. Where does this information come from? You guessed it, the internet. More than ever, patients have access to results of unreliable studies and often-inaccurate information on a variety of illnesses. The power of internet in hands of the public looking for medical answers has put us, physicians in an awkward situation. The internet search engines bombard users with misleading information that often result in unnecessary anxiety for our patients. Most importantly, this information or misinformation can jeopardize patient-physician trust and relationship.

Like most of my colleagues, I would like to blame the internet search engines for this unpleasant situation. However, I know better. The problem is not with the internet or the patients. We, the physicians, are mostly to blame. Patients would rather receive information about their illness directly from us.  However, in today’s health care environment, physicians have less and less time to spend with their patients. As a result, patients do not get the information they need. This brings me to the heart of the problem. Lack of attention to a comprehensive patient engagement program sponsored by physicians’ offices often results in patients looking for answers elsewhere. If we pay more attention to this problem with accurate and reliable education materials, our patients can surely be better served.  As physicians, our responsibility is to provide our patients with appropriate and relevant information about their illness. In today’s health care environment educating and engaging patients in their own health care is vital.

Now, here is the major point: accurate and timely information must be delivered to patients. The idea of waiting for patients to access our portals to give and get information is a failure.  Patient engagement software products and applications must give physician offices a variety of options to deliver information to patients. Not all patients have access to computers and smart phones. The patient centered Medical Home must be developed so that all patients are engaged in managing the continuum of care… and that only can materialize when we have options to reach large number of patients and deliver the right information at the right time.

Patient health information must be delivered not accessed

By: Ali Ghazanfari, MD CMIO

Our fragmented solutions to manage care for patients with chronic diseases are bankrupting the health care system of our country. Lack of communication, collaboration and information sharing between patients and multiple providers who manage patients’ care is the main contributor to this failing system. What will solve the problem is a solution that creates tight relationships between hospitals, PCPs, specialists, ancillary providers and patients. This solution must facilitate collaboration and movement of critical data among the main stakeholders. The reality is that accessing data alone will NOT solve the problem. The ability to share data and delivering the right data to right decision-makers will be the answer to our current information sharing snags.  For data to become meaningful in our business, we must allow it to flow from one participant to another. Actionable data must be delivered not accessed.

www.healthcollaborate.com

HEALTH CARE EDUCATION TOOL

HealthCollaborate a web-based collaboration application for health care professionals and patients, has released a patient education tool for healthcare organizations, MCOs, employers and government.

“Studies after studies show that chronic disease management and patient education can lower health care cost by 34% per patient. Insuring that patients receive education about appropriate treatment and prevention will minimize the potential for more costly implications and greatly reduces cost of healthcare delivery,” says Dr. Ali Ghazanfari, Health BI’s Chief Medical Information Officer.

This powerful and HIPAA-compliant patient outreach tool enables health care organizations and businesses to deliver health education, disease management and medication information securely to large number of patients and employees.

The application allows organizations to create prevention and education campaigns and securely send informational messages with attachments while measuring participation. Patients will receive message delivery notifications via email or text messaging and view messages by logging onto HealthCollaborate secure web portal.

About HealthCollaborate
HealthCollaborate™ is a web-based and HIPAA-compliant application designed specifically for healthcare professionals. It enables healthcare providers to securely communicate and transfer health information to colleagues and patients.

Health care providers are using HealthCollaborate™ everyday to securely:

  •     send and receive electronic referrals, authorizations, progress notes, clinical treatment summaries, lab results and medical imaging
  •     collaborate with healthcare providers on patient care and management
  •     participate in healthcare social networking
  •     send patients medication, appointment and follow-up reminders as well as information on  disease management, prevention and marketing info
  •     send discharge summaries and test results electronically to patients
  •     receive medical history, medication list and other important health information directly from patients

PATIENT PORTAL

HealthCollaborate a web-based collaboration application for health care professionals has released a free patient portal and patient secure messaging for medical practices and their patients.
“To better manage patient care, we are providing a powerful free toolset that enables physicians like me to securely communicate, collaborate and exchange patient data with colleagues. And at the same time, we are enabling medical practices to connect with patients and electronically send and receive information,” said Health BI Chief Medical Information Officer, Dr. Ali Ghazanfari.
HealthCollaboratepatient portal enables health care providers to connect with their patients and securely:
_Send appointment and follow-up reminders as well as patient outreach and disease management, billing statements, visit summaries, health records, test results, marketing info,  online registration forms and more.
In parallel, patients will be able to securely:
_Send medical history, medication list, insurance information, messages, requests and more to their healthcare providers.
HealthCollaborate can also be fully utilized by medical practices that have no access to EMRs.
With a single sign-on, patients can connect to all their health care providers.
Patients are notified via SMS or email when new messages are ready to be viewed on  HealthCollaborateTM.

Patient Appointment Reminders

http://www.healthcollaborate.com/ a web-based collaboration application for health care professionals and patients, has released a free patient appointment reminder module for medical practices.“A large number of patients miss appointments because they simply forget. Manually reminding patients of their appointments is costly and time consuming. Outpatient clinics and large private practices can spend hours placing appointment reminder phone calls or send out reminder postcards. That’s just unnecessary expense,” says Dr. Ali Ghazanfari, Health BI’s Chief Medical Information Officer.

This powerful and versatile appointment reminder tool allows health care organizations to send their patients automated appointment reminders via email or text messaging.

HealthCollaborate™ application delivers reminders 24 hours prior to the date and time of the appointment. A tracking dashboard notifies the office if the patient does not view the message prior to the time of the appointment.

HEALTH CARE COLLABORATION SOLUTION

http://www.healthcollaborate.com/ a web-based collaboration application for healthcare professionals and patients, has released a secure healthcare collaboration module.

“Medical organizations, more than ever, need to improve quality of care and reduce cost by collaborating. The time for medical silo operations is over. We must find new ways to collaborate and share information,” says Dr. Ali Ghazanfari, Health BI’s Chief Medical Information Officer.

This powerful and HIPAA-compliant collaboration module enables healthcare organizations and research facilities to securely collaborate on medical cases, research studies and more. Users are able to create collaboration cases and invite select colleagues to participate and share information. Case collaborators can communicate and update the case with new information, attachments and images. The application sends notification messages via email or text messaging to case collaborators when there are new case updates.

Accountable Care Organizations Solution

There is no holistic solution or application that can address all Accountable Care Organizations’ needs. ACO model can be fully implemented by employing a number of different Business Intelligence solutions that work in concert with tools which specifically address certain needs within the ACO workflow.

Though focusing on resolving issues related to reimbursement and reward systems is extremely important, but the full implementation of an ACO model depends heavily on communication, collaboration and information sharing among payers, providers and patients. Tightly integrated relationships between hospitals, specialists, PCPs, ancillary providers and patients are the key components of success of such initiatives.

Disease Management capabilities and Wellness Services are two major parts of any ACO implementation. http://www.healthcollaborate.com/ can provide your organization a complete Disease Management and Wellness Services solution. There are two elements that are essential to these capabilities: First, a predictive data mining capability to identify patients at risk or with chronic conditions. Second, a secure system that enables providers to send these patients follow-up reminders, education, messages, alerts, individualized plan of care and more. Utilizing Health BI’s Business Intelligence capabilities and HealthCollaborate’s secure infrastructure, your organization can proactively identify patients at risk or with chronic conditions and manage their individualized plan of care.

Our business intelligence and data analytics solutions offer patient at risk data mining and a holistic view of fragmented ACO performance measurement that can affect reimbursement and higher rewards. Health BI offers the first and only Business Intelligence architecture to unify reporting, data analysis, data mining and real-time monitoring for Accountable Care Organizations. Our business analytics solution creates a seamless experience for the business users, an efficient and scalable architecture for the hospital IT professionals and a single utility for the CIOs. We will consolidate all your ACO data and scattered procedures into a flawless, reward generating process.