by Jacob Luria

Health Care Reform

With an on-again, off-again alphabet soup of legislative mandates and variants moving forward – ACHA, BCRA, GCHF – health care organizations are doing their best to plan for an uncertain future. What this means for the solution providers – ourselves included – is that we need to invest in flexible, scalable frameworks to deploy new outputs in support of this rapidly changing landscape.

Going Forward

Without a crystal ball to know the future, I am certain of one thing – the questions that organizations ask in the future are unknown today. No registries and data maps written five years ago are as applicable now. We need to continuously improve on these and be ready for what’s next. One example of unknown rules – 3 years ago Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the associated Quality Payment Program (QPP) did not exist. On the other side - Meaningful Use did exist and > 200 products came into existence to meet those requirements. Now those products are having internal meetings about how we use medication reconciliation data to learn about providers – trying to align solutions into new problems – in our view an exercise destined to fail. We believe that solutions which require a single vendor to modify data mappings, drop-down boxes, registries, and models all-together with a change-order and 90-120 fulfillments times creates lags that health systems – especially in a changing world can not afford. Our solutions are built for open and commoditized frameworks (some favorites that we know and use below) accelerating the ability to be ready for change, model impacts in days, not weeks, and support our clients who value SPEED from their analytics programs.

Supporting Observations

A client organization experienced this challenge first hand with their population health management tool selection and implementation process. After conducting a 12 month RFP and subsequent implementation process, the client selected clinical programs based on population trends. From these trends, the clinical committees selected women’s health including mammography and colonoscopy components. Unfortunately, the tool did not have a discrete registry for these studies and did not have the tools to self-develop a solution and utilize the processes just implemented.

Conclusions

We believe situations like this will increase as more members / patients come under value-based care and specific, targeted cohorts need to be identified, engaged, and measured. Taken together, we invest and support our clients with fully open, modifiable, and transparent algorithms and do the hard work of integrating elements into core workflow products. Sometimes