Behavioral health has a supply demissue. Can virtual care help?

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Throughout the COVID-19 pandemic, researchers clinicians have pointed to behavioral health as a particularly effective use case for telehealth virtual care.  

But what about after the public health emergency? In a HIMSS21 Global Conference Digital fireside chat, two experts will explore behavioral telehealth’s long-term potential – how it can meet existing challenges in the industry today.

According to Michael Hasselberg, senior director of digital health at the University of Rochester, the behavioral health sector has faced a supply-and-demissue for quite some time: too many patients, not enough clinicians.

And the demand, he says, has only grown since the pandemic began.  

In his discussion with Julie Rish, clinical psychologist director of design best practices at the ClevelClinic, Hasselberg will explain the ways in which virtual care can fill those gaps in behavioral healthcare.   

People who live in parts of the country with few clinicians, he says, can have access to specialists in more saturated regions.  

Hasselberg will outline the behavioral telehealth model developed at the University of Rochester, inspired by the eight-month wait list he faced in 2012 as a practicing geriatric psychiatrist.

Given his concerns about patients needing those services – to say nothing of the long distances they needed to travel to get to his clinic – Hasselberg obtained a grant that allowed him to bring a so-called tele-mentoring model to the state of New York.

The program focused on supporting primary care doctors in managing older adults with mental illness.

What the team found out, Hasselberg says, was two-fold: New York’s rural primary care doctors are voicing the need to get mental healthcare services into the state’s nursing homes, those doctors wanted the ability to present telehealth cases across the board, not just for older patients.  

Hasselberg will discuss with Rish what he’s learned in the near-decade since that pilot program – what changes needed to be made in order to continue meeting patients’ needs.

Hasselberg Rish’s conversation, “Advancing Tele-Behavioral Health: Meeting Exploding Need Maintaining High-Quality Care,” will be available on demas part of HIMSS21 Digital starting Monday, August 9. You can find it, along with other sessions, here.

 

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.



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NCQA launches program to streamline quality reporting

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The National Committee for Quality Assurance announced a program this week geared toward ensuring the validity of clinical data used for quality reporting other initiatives.  

The Data Aggregator Validation program is aimed at giving health plans, government entities care delivery organizations confidence in the validity of their clinical data. It does so, says the NCQA, by evaluating how organizations ingest, transform output that data.  

“We invested heavily over the past two decades to digitize clinical data in this country, we aren’t yet getting full value from that investment because the data are inconsistent, incomplete unvalidated,” said Dr. Brad Ryan, NCQA chief product officer, in a statement.   

“NCQA’s Data Aggregator Validation program brings trust, comparability utility to clinical data streams for use in [Healthcare Effectiveness Data Information Set (HEDIS)] beyond,” Ryan added.  

WHY IT MATTERS  

As Ryan notes, HEDIS reporting – frequently relied upon for quality-improvement measures – increasingly uses data from health information exchanges, care delivery organizations other data aggregators.  

According to the NCQA, data streams validated through the DAV can be used as standard supplemental data in HEDIS reporting – which sidesteps the need for primary source verification during the HEDIS audit process.  

In turn, says the committee, provider organizations health plans can save time money.  

As part of the pilot early adopter programs, four organizations – Hixny, HealtheConnections, HEALTHeLINK Manifest MedEx – had data streams validated.   

The association is now continuing to validate streams through a series of cohorts, the first of which began in July. Participants include:

  • Azara Healthcare LLC
  • COZEVA by Applied Research Works, Inc.
  • CyncHealth Diameter Health 
  • Healthix 
  • HealthShare Exchange
  • Kansas Health Information Network, Inc.
  • KPI Ninja
  • Los Angeles Network for Enhanced Services
  • Stellar Health 
  • Wisconsin Statewide Health Information Network   

“The Data Aggregator Validation program is important to HealtheConnections our participants, particularly clinical practices health plans, because it provides real value in support of our ongoing work in quality measurement,” said Rob Hack, president CEO of HealtheConnections, in a statement.   

“Additionally, the program demonstrates HealtheConnections’ commitment to data quality, data governance process that expands beyond the realm of quality measurement,” he continued.  

THE LARGER TREND  

The NCQA has undertaken several initiatives in recent years to make quality measurement more trustworthy easier.   

This past summer, as telehealth use skyrocketed throughout the United States, it adjusted the measures used for HEDIS scores to reflect the “new normal” of broadly available virtual care.   

Still, the current quality measurement system has weaknesses – as the NCQA noted in a series of recommendations to President Joe Biden when he took office.

Although HEDIS has given leaders the ability to identify areas for improvement, the model is largely retrospective, as well as fragmented inconsistent.  

“This digital quality future requires a lot more than [simply] digital measures or the standards that are evolving,” said Ryan in an interview with Healthcare IT News at the time. “It requires the implementation of those standards making those real.”  

ON THE RECORD  

“We are proud to partner with NCQA in leading this important transformation effort to streamline data sharing provide high-quality data for health plans providers,” said Claudia Williams, CEO of Manifest MedEx, in a statement about the DAV program.   

“Reducing the burden of HEDIS reporting enables plans providers to focus on what matters most – caring for patients their communities,” she said.

 

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.



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Geisinger’s tips for smart device communications

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Healthcare is in dire need of easy communication tools smart devices that make information actionable at the point of care.

Savvy health systems, such as Geisinger, are already using secure communication to mobilize emergency teams, ensure the right physicians nurses are aware of the status of critical lab results, help manage transitions of care much more.

These innovations include Life Geisinger Geisinger at Home, which are helping Geisinger better facilitate care for their high-risk patient population, lowering costs for patients improving the overall quality of care.

“A best practice that we try to follow is to always have our approach to mobile device communication strategies align with our larger institutional objectives,” said Dr. Jordan Olson, division chief of clinical pathology informatics at Geisinger. “Providers having more secure, rapid effective ways to communicate is one solid way we can do that.”

Olson, who will address the topic Friday at HIMSS21 this week along with Dr. Jonathan Slotkin, associate chief medical informatics officer at Geisinger, said modern healthcare systems are highly matrixed organizations with many layers across the clinical administrative environments.

“The clinical problems our patients have the treatments they need are becoming more more complex,” he noted. “Oftentimes, the biggest challenge is quickly connecting the cross-system group of people needed to make both small large treatment decisions the right way.”

While previously that would have taken a dozen emails or six or more pages phone calls, now secure collaboration tools allow them to make synchronous decisions quickly with all of the right stakeholders involved.

He explained that one of the best ways to correlate app usage with measurable outcomes is to assess a topic of interest both before after you implement a new app or approach.

“The problem is that many times folks do not think to or aren’t able to ask those questions before the new technology is implemented,” Olson noted. “When that is not possible, the next best thing is usually to compare the area or group where one is implementing a new technology to a similar area or group that does not have the technology.”

He noted a large issue that so many providers face is that most every healthcare system has a handful or a dozen or more improvement initiatives taking place at any one time.

“Attribution – which initiatives helped or not  becomes really hard in those environments,” he said. “So, assessing metrics at baseline before implementation whenever possible has become that much more important.”

Dr. Jordan Olson will share his insights on smart devices their impact on care delivery at HIMSS21 in a session titled “Transforming Care Delivery With A Smart Device Communication Strategy.” It’s scheduled for Friday, Aug. 13, from 10:30-11:30 a.m. PT in Venetian Marco Polo 701.

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Building a digital health workforce requires upskilling, academic alignment

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Investing in current future workforce member skills will be critical for the digital transformation across all healthcare sectors: The question is how to prepare the wide range of healthcare workers, from digital natives to industry veterans, with the digital literacy capacities needed to follow through with large scale goals.

In a HIMSS21 digital panel moderated by Ruth Schleyer, RN, chief nursing informatics officer for Legacy Health, Mountasser Kadrie, director of the George Washington University School of Medicine Health Sciences, Shenita Freeman, senior director of analytics informatics at Centurion, Scott Cullen, managing director chief innovation officer at Accenture, discussed a variety of strategies.

Both Kadrie Freeman pointed to the need for professionals with digital competency skills, noting how Covid has changed the landscape, in part through data visualization.

“Healthcare providers are going to need to have strong digital competency skills in the future, I am confident academic institutions will align their programs to meet this demand, which will be on a local, regional, global level,” Kadrie said.

Freeman added that many public health workforce do not feel confident they have the necessary tech skills for the environment they work in today.

“This is not the future, we’re talking about right now people don’t feel they have the skills to do the work they need to, they feel a little overwhelmed with the amount of data,” she said. “For a lot of people who entered the profession, they never thought technology would be lynchpin in this way.”

Kadrie said he expected to see a bigger focus from healthcare organizations on upskilling their workforce by looking at other practices used by other industries how they can be applied to healthcare.

Cullen pointed to the biggest deficit among organizations is in understanding the capabilities of analytics.

“We’re seeing a big pull a skills gap for those workforce skills focused on analytics, which are needed to really grow your footprint in that area,” he said.

He also said proficiency with telehealth tools pose a particular challenge, as organizations are still in a place where telemedicine was a standup emergency measure. 

Freemon also pointed out how critical telehealth became during Covid, including mental health needs, noted something that makes telehealth tech enjoyable is that patients practitioners know how to use the technology. 

“It’s not just on the IT side of the house, it’s everyone’s responsibility to ensure secure safe telehealth experiences for our patients,” she said. 

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Moderna CEO predicts another 12 to 18 months of coronavirus mutations

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LAS VEGAS – When the COVID-19 pandemic first began to set off alarm bells among epidemiologists in late 2019, Moderna had 800 employees. That year, it had made 100,000 doses of product. It planned to launch its first vaccine around 2024.

But when Chief Executive Officer Stéphane Bancel got the call to develop a vaccine against the emerging disease, he felt confident that the company could go from a genetic sequence of the virus to a clinical-grade product in a matter of months.  

“They all thought I was nuts – the funny French guy with the French accent,” Bancel said during a HIMSS21 “view from the top” session on Wednesday, hosted by VMware president Sumit Dhawan.

Fast forward to a now familiar story: millions of Americans have been vaccinated against COVID-19, many of them with the mRNA vaccine that Moderna produced.  

We’re of course not out of the woods. The Delta variant has torn through the world. And although unvaccinated people feel the effects particularly severely, vaccinated people are also experiencing breakthrough infections.

“The virus is never going to go away from the planet,” said Bancel. He guessed that it would continue mutating “a lot” through the summer or the end of 2022.   

“I think there’s another 12 to 18 months of … mutations coming,” he predicted, those mutations could combine. The so-called Beta variant, first identified in South Africa, the Delta variant are likely to do so soon.  

“The good news is the vaccines are working well at preventing hospitalization severe disease,” he said.

Moderna’s team, he said, is working on booster shots tweaking the sequence to try respond to those variants.  

“The next 12 to 18 months are still going to be pretty intense, pretty complicated,” he said. 

After that, he sees a future in which few enough people get infected that the mutation rate slows – that, similar to the flu, people will get a shot every year aimed at protecting them from the most recent variant.  

In fact, one of Moderna’s goals is to create a vaccine that would combat both respiratory illnesses.

In the meantime, he said, it’s important for unvaccinated people to get inoculated, “because the virus is only going to grow more more virulent, more more infectious.”  

Bancel also described initiatives at Moderna to enhance digital capabilities, such as its partnership with a California university to get all employees up to speed on artificial intelligence machine learning.  

“We as leaders in enterprise have to understthat sometimes technology is way ahead of where the human brain is, part of our job is to get people to the place where they can embrace leverage it,” he said.  

Looking ahead, Dhawan noted advances in 5G as a heartening signal of innovation, saying VMware is investing in research development as well as working with telecommunication providers to expconnectivity.   

For his part, Bancel foresees what he called a democratization of healthcare.   

“I believe the pandemic made a lot of people realize that they didn’t know much about [their] health,” he said.

He predicted the development of technology that provides actionable, customized advice to patients based on their individual circumstances.

Even with the challenges posed by the last few years, “It’s an exciting time to be alive … to contribute to science technology to make the world a better place.”

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: [email protected]
Healthcare IT News is a HIMSS Media publication.



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