Consortium News

  • 27 Jul 2015 10:19 PM | Denny Brennan (Administrator)

    Use SNOMED-CT to avoid headaches of new code set transition.


  • 27 Jul 2015 10:17 PM | Denny Brennan (Administrator)
  • 21 Jul 2015 3:58 PM | Deleted user

    Published: July 20, 2015  |

    Click here for full Press Release.

    Seasoned Healthcare IT Executive to Lend Expertise & Counsel to Situational Awareness Company

    BOSTON, MA, Jul 20, 2015 (Marketwired via COMTEX) -- Aventura, the leading provider of situational awareness technology for the healthcare industry, today announced the appointment of healthcare veteran John Glaser, PhD, to its board of directors. Glaser is a senior vice president at Cerner Corporation CERN, -0.61% and is responsible for driving its technology and product strategies, interoperability and government policy development. Previously, Glaser was CEO of Siemens Health Services, a company acquired by Cerner in February 2015.

    "John has spent his career working in and helping to define the healthcare technology space, particularly with respect to interoperability and the technology needed to transform the industry," said John Gobron, CEO, Aventura. "We are delighted to add John to our board at this stage in our company's growth and look forward to leveraging his proven experience and knowledge."

    Prior to joining Siemens, Glaser was vice president and chief information officer at Partners HealthCare, Inc. Previously, he was vice president, information systems at Brigham and Women's Hospital. Glaser was the founding chairman of the College of Healthcare Information Management Executives (CHIME), and is the former chairman of the eHealth Initiative Board and the Board of the National Alliance for Health Information Technology. He is a former senior advisor to the Office of the National Coordinator for Health Information Technology (ONC). He is also past president of the Healthcare Information & Management Systems Society (HIMSS), and is a fellow of HIMSS, CHIME, and the American College of Medical Informatics.

    Aventura situational awareness technology is being utilized across the U.S. by healthcare providers to help address strategic initiatives pertaining to Meaningful Use, Electronic Health Record (EHR) adoption and value-based care. Most recently, the company introduced Sympatica(TM), a platform for integrating the EHR with third-party applications at the point of care. Leveraging Aventura's awareness computing capabilities, Sympatica delivers patient-centric, contextual views from analytics and performance measurement applications. As a result, relevant and useful clinical information is brought directly to providers in real-time.

    "Situational awareness of the user, patient, location and device type has significant potential to improve care delivery, increase provider productivity and enhance operational efficiency. The introduction of awareness to a clinician's interaction with an EHR not only brings gains today but also will evolve to transform the user experience and the EHR from a static application to one that is dynamically configured based on context," said Glaser. "I am looking forward to working with a terrific management team, an exceptional board and a great current and future customer base."

  • 16 Jul 2015 9:33 AM | Deleted user

    From  |  July 15, 2015  |  Rajiv Leventhal

    The Centers for Medicare & Medicaid Services (CMS) has reported that the agency’s advanced analytics system, the Fraud Prevention System, identified or prevented $820 million in inappropriate payments in the program’s first three years.

    The Fraud Prevention System uses predictive analytics to identify troublesome billing patterns and outlier claims for action, similar to systems used by credit card companies.  The system identified or prevented $454 million in calendar year 2014 alone, a 10 to 1 return on investment, CMS reported.

    The Fraud Prevention System was created in 2010 by the Small Business Jobs Act, and CMS has extensively used its tools, along with other new authorities made possible by the Affordable Care Act, to help protect Medicare trust funds and prevent fraudulent payments. The system helps to identify questionable billing patterns in real time and can review past patterns that may indicate fraud, CMS said.

    In one case, one of the system’s predictive models identified a questionable billing pattern at a provider for podiatry services that resulted in Medicare revoking the provider’s payments and referring the findings to law enforcement. The Fraud Prevention System also identified an ambulance provider for questionable trips allegedly made to a hospital. During the three years prior to the system alerting officials, the provider was paid more than $1.5 million for transporting more than 4,500 beneficiaries.  A review of medical records found significant instances of insufficient or lack of documentation. CMS also revoked the provider’s Medicare enrollment and referred the results to law enforcement. 

    "We are proving that in a modern healthcare system you can both fight fraud and avoid creating hassles for the vast majority of physicians who simply want to get paid for services rendered. The key is data," CMS Acting Administrator Andy Slavitt said in a statement. "Very few investments have a 10:1 return on taxpayer money."

  • 10 Jul 2015 2:45 PM | Deleted user

    Register for a free Webinar Thu, Jul 30, 2015 1:30 PM - 2:30 PM EDT to explore #PopulationHealthManagement and learn #CareCoordination best practices.

    This webinar, which is the second in a series of three, will focus on providing strategies and guidance for adoption and implementation of Population Health Management, covering the various methods of care coordination, the value of risk stratification and the basics of data analysis. 

    We will touch upon the various methodologies of care coordination, such as: 

    • Risk Stratification: Primary or Secondary 
    • Disease-based Stratification 
    • Practice-based care coordination 
    • In-Patient or Out-Patient 
    • Centralized vs. De-centralized 
    • Practice Embedded Case Managers 
    • Psycho-social 

    We will discuss some best practices for combining risk stratification and care coordination, honing in on the most useful types of reports that can be generated. We’ll also share our own risk stratification process and classification: 

    • Using an algorithm based on industry standards and claims data to risk-stratify 
    • We stratify into populations based on: 
    • high-risk groups (with complex care needs) 
    • moderate-risk or rising-risk groups (with chronic conditions), and 
    • low-risk groups (preventive services/wellness). 

    Next, we will cover the types of data, and how to present that data to facilitate care coordination, from the various reports that are generated such as utilization reports, quality measures, drug & lab, cost reports, ER, trends and distribution. 

    We will explore what the analytics from these various reports mean to your organization, with results explaining what has happened, what could happen, and what to do about it. Finally, we’ll uncover how the data in these reports can have the most impact on a care network utilizing this predictive modeling process. 

    The Speakers: 

    • Laura Tompkins, RN, BSN, Nurse Care Coordinator, Allegiance Health Group
    • Denny Brennan, Executive Director, Massachusetts Health Data Consortium
    • Dr. Anthony Akosa, Chief Medical Officer, HealthEC®
    Thu, Jul 30, 2015 1:30 PM - 2:30 PM EDT 

  • 07 Jul 2015 2:56 PM | Denny Brennan (Administrator)

    The Health Care Transformation Task Force, a consortium of patients, payers, providers and purchasers, released a white paper on best practices for identifying costly patients with complex needs who might benefit from targeted care management, ultimately improving care and reducing total costs for the entire health care system.

    Read the white paper...

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