Medical Informatics Update 2013 Program

a New York State Center for Advanced Technology at Columbia University

Wednesday, October 16, 20138:30 AM to 4:30 PM

IBM Thomas J Watson Research Center1101 Kitchawan Rd, Yorktown Heights, NY 19598

Medical Informatics Update 2013:Analytics and Tools for Care Coordination

A one-day meeting for local and regional healthcare

specialists to discuss advances,problems, and solutions

in various medical informatics venues. The session will

provide an opportunity to meet and talk with leading

specialists at the forefront of care coordination.

The event is organized by the Center for Advanced

Information Management* at Columbia University and the

IBM Health Informatics Research Department.

* The Center for Advanced Information Management at Columbia University is a New York State Center for Advanced Technology (CAT) sponsored by Empire State Development’s Division of Science, Technology and Innovation (NYSTAR).

WWW.CAT.COLUMBIA.EDU 650 West 168th Street, Suite B-130, New York, NY 10032 Tel: 212 305 2944 Fax: 212 305 0196

12:30pm

Program ScheduleTime Event

8:15am

8:45am

2:45pm

9:30am

12:30pm

1:45pm

2:45pm

11:00am

4:00pm

9:30am

9:00am

Medical Informatics Update 2013

Registration

Workshop Co-Chairs Welcome and Introductory RemarksShahram Ebadollahi, PhD; IBMGeorge Hripcsak, MD, MS; Columbia University

Care Coordination – IBM ViewpointsGuruduth Banavar, PhD, VP Industry Solutions Research, IBM ResearchRobert Merkel, VP Healthcare and Life Sciences, Global Business Services, IBMKaren Parrish, VP Industry Solutions, Software Group, IBM

SESSION A: Patient Centered Care CoordinationIntegration of Care Coordination and IT in a Multi-Specialty Group PracticeScott D. Hayworth, MD, FACOP /Alan B. Bernstein, MD, MPH Mt. Kisco Medical Group

Serving our Veterans Virtually: Perspectives on VA Telehealth Technology and PolicyCathy Cruise, MD; Veterans Integrated Service Network

KEYNOTE: The Role of Health IT in Integrated Care (remote)Nirav R. Shah, MD, MPH; NYS Department of Health

COFFEE BREAK

SESSION B: Impact of Care Coordination on CostCost Considerations in Care CoordinationRainu Kaushal, MD, MPH; Weill Cornell Medical College

Care Coordination in the Era of Value Based Care DeliveryPeter N. Bowers, MD: Anthem Blue Cross/Blue Shield in Connecticut

LUNCH / DEMOS / POSTERS

SESSION C: Metrics and Analytics in Care CoordinationImproving Care Coordination with Big Data, Analytics, and TechnologyPaul Contino, New York City Health and Hospitals Corporation

Data Quality and Metrics for Care Coordination [tentative)Craig A. Jones, MD; Vermont Blueprint for Health

PANEL: Care Coordination in the Region: Clinical Organizations Using Technology to Support Better CareModerator: Jacqueline Merrill, PhD, MPH, RN; Columbia University

Panelists: Holly Miller, MD; MedAllies/Taconic IPASusan Northover, RN, MPA; Visiting Nurse Service of New YorkWalter Sedlazek, IBM CúramSimeon Schwartz, MD; WESTMED Medical Group

Adjourn to coffee and mixer

10:30am

11:00am

11:30am

Cost Considerations in Care CoordinationRainu Kaushal, MD, MPHCenter for Healthcare Informatics and Policy, Weill Cornell Medical College

With expertise in quality, patient safety, and health information technology, Dr. Kaushal will discuss measuring the effects of health IT on health care quality and costs with a view toward optimizing the value of health care in the current environment. Examples will be presented from recent empirical studies of different technologies and models of healthcare delivery, including EHRs, HIE, and PCMH.

Care Coordination in the Era of Value Based Care DeliveryPeter N. Bowers, MDAnthem Blue Cross and Blue Shield in Connecticut

Care coordination is a necessary, but not sufficient element of value based care delivery. Value based care delivery is defined as higher quality at lower cost and is enabled by care coordination, payment redesign, enhanced access and actionable data at the point of care. The future of accountable care delivery will support team based care with real time data that will shape practice transformation. Our quality measures will advance from process to outcomes measures while simultaneous affordability and sustainability pressures will drive lower cost through greater adoption of transparency tools coupled with value based benefit design. Patient- and family-centered, assessment-driven, team-based activity designed to meet the needs of patients and their families or care givers that addresses interrelated medical, social, developmental, behavioral, educational, and financial needs in order to realize the promise of value based care delivery.

Improving Care Coordination with Big Data, Analytics and TechnologyPaul Brian ContinoNew York City Health and Hospital Corporation

As we rapidly move toward a healthcare landscape with increased EHR adoption and interoperability standards for clinical data exchange, how do we leverage technology and data to effectively impact care coordination and patient engagement.

Data Quality and Metrics for Care Coordination [tentative]Craig Jones, MDVermont Blueprint for Health


Abstracts

The Role of Health IT in Integrated Care Nirav R. Shah, MD, MPHNew York State Department of Health.

Health technology plays a significant role in the evolving health care delivery model, which demands more clinical integration for better care. Dr. Shah will discuss Health IT innovations in New York, and how health IT will improve patient care and support the patient-centered medical home. He will also discuss the State Innovation Model Plan and the federal funds that are helping the state test six new models of care.

Integration of Care Coordination and IT in a Multi-Specialty Group PracticeScott D. Hayworth, MD, Alan B. Bernstein, MD, MPHMount Kisco Medical Group, PC

The Mount Kisco Medical Group, PC is a multi-specialty group practice with 300 physicians, 25 office sites and 300,000 patients. The Group currently has contracts involving discrete care coordination functions with three carriers. As a result, the Group has built a care coordination department and utilizes multiple sources of information technology. Based on MKMG experience, we will recommend future needs for IT to assist with our care coordination functions.

Serving our Veterans Virtually: Perspectives on VA Telehealth Cathy Cruise, MDVISN 3 Virtual Health and Rehabilitation Programs, Veterans Administration

Dr. Cruise will explain how the VA Telehealth Services uses health informatics, disease management and telehealth technologies to target care and case management to improve access to care, improving the health of veterans. Telehealth changes the location where health care services are routinely provided. The value VA derives from telehealth is not in implementing telehealth technologies alone, but how VA uses health informatics, disease management and telehealth technologies to coordinate and manage care, facilitate access to care and improve the health of veterans]

Abstracts (cont.)


Panel Presentations

Care Coordination in the Region: Clinical Organizations Using Technology to Support Better Care Moderator: Jacqueline Merrill, PhD, MPH, RN; Columbia University

Four representatives from practice areas will focus on how clinical information systems are being used in their organizations to address coordination:

1) Within care teams 2) Across care teams 3) Between care teams and community resources 4) For continuous familiarity with patient across time 5) For continuous proactive and responsive action between visits 6) For supporting providers consider the needs, preferences, of patient7) For shared responsibility-between patient and caregivers

The panel will comment on how their organization has handled barriers to effective use of technology, data exchange and/or availability of important information. There will also be opportunity for the audience to ask questions.

Care Transitions in a Patient Centered Medical NeighborhoodHolly Miller, MD, MBA, FHIMSS MedAllies/Taconic Independent Practice Association

A brief overview of new technologies for managing care coordination and transitions of care across a patient centered medical neighborhood.

Driving Improved Outcomes through Informatics Susan Northover, RN, MPAVisiting Nurse Service of New York

VNSNY Strategy and Care Coordination – Current and Future State: Post-Acute care strategies and associated case studies, and using Care Coordination technology platforms to manage patients and populations to improve quality outcomes

Programs of CareWalter Sedlazek, MBAIBM, Cúram

The discussion will highlight a human centered HIT platform approach to integrating medical, behavioral, and social care and enabling community-based teams to deliver programs of care for vulnerable populations.

TBASimeon Schwartz, MDWestMed Medical Group

Speaker Profiles

Nirav R. Shah, MD, MPHCommissionerNew York State Department of Health

Dr. Shah has been the 15th Commissioner of the New York State

Department of Health since 2011. A native of Buffalo, he graduated with

honors from Harvard College. He has an M.D. and M.P.H. in medicine

and chronic disease epidemiology from Yale University. He is board

certified in Internal Medicine. Dr. Shah heads one of the world’s leading

public health agencies with an annual budget of more than $58 billion.

During his tenure, the Department led the transformation of the state’s Medicaid

program, which resulted in more than $4 billion in savings in just the first year while

improving population health and quality of care. The Department also spearheaded

the creation of a health benefit exchange that will give 1.1 million New Yorkers health

insurance coverage and drafted an evidence-based Prevention Agenda for improving

the health of all New Yorkers.

Alan B. Bernstein, MD, MPH, FAAPSenior Medical DirectorMount Kisco Medical Group

Alan has been the Senior Medical Director at Mount Kisco Medical

Group overseeing the Group’s Accountable Care Organization (ACO)

activities for one year. He is also a Clinical Associate Professor of

Family and Community Medicine at New York Medical College. He

has extensive experience in hospital care, medical group practice

and managed care. He has served as the Chairman of Pediatrics at

two academically affiliated community hospitals, the President/Chief

Medical Officer of several medical group practices, and Medical Director at multiple

managed care plans in the Northeast. Most recently, Dr. Bernstein was the Chief

Medical Officer at the Greater Hudson Valley Family Health Center in Newburg, NY.

He is a graduate of the New York University School of Medicine, the pediatric

residency program at Columbia Presbyterian Medical Center/Babies Hospital, and

the UC Berkeley School of Public Health. He has served on the Board of Directors of

Inspire, the United Cerebral Palsy Center of Orange County and the Maternal Infant

Services Network of Orange, Rockland and Sullivan Counties. He was Editor of

Seminars in Medical Practice and Consulting Editor in Pediatrics, Journal of Clinical

Outcomes Management both Turner White Publications.

Speaker Profiles (cont.)

Peter N. Bowers, MDChief Medical OfficerAnthem Blue Cross and Blue Shield in Connecticut

Peter is Chief Medical Officer at Anthem Blue Cross and Blue Shield in

Connecticut. He is responsible for development and execution of medical

management, cost of quality care and clinical support for sales in the

Connecticut marketplace. Additionally, he has served as the Medical

Director for Anthem National Accounts and WellPoint’s Payment

Innovation. He joined Anthem Blue Cross and Blue Shield in 2006 from

the faculty of the Yale University School of Medicine where he was active in teaching,

clinical practice and biomedical research. He directed the fellowship training program

in pediatric cardiology and won the pediatric resident teaching award in addition to an

active clinical practice in both the outpatient and inpatient settings.

With continuous funding from the National Institute of Health and the Howard Hughes

Medical Institute, he investigated embryonic cardiovascular development and identified

genetic causes of SIDS and congenital heart disease. He is widely published and has

received awards from the Society of Pediatric Research, the American Academy of

Pediatrics, the American College of Cardiology and the American Heart Association.

A native of Connecticut, Dr. Bowers is a cum laude graduate of Colby College and the

University of Connecticut School of Medicine.

His post graduate medical training in pediatrics is from the University of Rochester and

his fellowship training in pediatric cardiology and human molecular genetics is from Yale

University. He lives in Guilford, CT with his wife, an obstetrician/gynecologist and two

daughters.


Paul Brian ContinoCorporate Chief Technology OfficerNew York City Health and Hospitals Corporation

Paul is Corporate Chief Technology Officer at the New York City Health & Hospitals Corporation. He is an accomplished healthcare IT executive with over 20 years of experience in technology development and management. He has held numerous leadership roles in healthcare, education and academic medicine. At the New York City Health and Hospitals Corporation (HHC), paul is responsible for strategic direction in the areas of enterprise architecture, business intelligence and data

warehousing, interoperability and health information exchange. He provides technology leadership for many of HHC’s key patient care initiatives including PCMH, Health Home, Medical Home, ACO and EMR/PHR (patient portal)

HHC is a $6.7 billion integrated healthcare delivery system with its own 385,000 member health plan, MetroPlus, and is the largest municipal healthcare organization in the USA. HHC serves 1.4 million New Yorkers every year of which more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, four skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality

Cathy Cruise, MDDirectorVeterans Integrated Service Network

Cathy is Director, of the Veterans Integrated Service Networks (VISN), Virtual Health and Rehabilitation Programs. A psychiatrist, she graduated from the New York University School of Medicine and completed a residency in Physical Medicine and Rehabilitation at the Rusk Institute of Rehabilitation, New York University. She is responsible for the development and implementation of the Health and Rehabilitation Programs in Veterans Integrated Service Network #3,

which encompasses New York City, Long Island, Westchester, the Hudson Valley and New Jersey.

In this capacity, she embraces a culture in which access to care is facilitated through the use of telehealth technology. Dr. Cruise works closely with Telehealth Services in VA Central Office.



Scott D. Hayworth, MD, FACOGPresident and CEOMount Kisco Medical Group

Scott is President and CEO of the Mount Kisco Medical Group,

a 285-physician multispecialty medical group, since 1996. He is

also a Clinical Assistant Professor of Obstetrics, Gynecology, and

Reproductive Sciences at Mount Sinai School of Medicine and a

Consultant for the Vincent Memorial Obstetrics & Gynecology at

Massachusetts General Hospital. In addition, he is Head of the

Board of Directors of the Ambulatory Surgery Center of Westchester; a member of the

Foundation Board of Northern Westchester Hospital; and President and a member

of the Board of Directors of Bedford Physicians’ Risk Retention Group. His many

other organizational leadership roles include being Past Chairman of the Board of the

American Medical Group Association, National Treasurer and former Chairman for

District II of the American College of Obstetrics and Gynecology, and a member of

ACOG’s national executive board.

He also serves as one of nine physicians on the national advisory board for Aetna

Insurance, Senior Advisor at Arsenal Capital Partners, and advisor to WIRB-

Copernicus. He has served on the Board of Directors of Community Mutual Savings

Bank and as a Consulting Editor for Contemporary OB/GYN. His writings have been

published in various medically-related magazines. He received his A.B. in Biology from

Princeton and M.D. from Cornell University Medical College in 1984.

His honors include “Best Doctor” listings in New York and Westchester magazines,

the “Best Doctors in America” publication, and “America’s Top Obstetricians and

Gynecologists”. Dr. Hayworth was the 2002 recipient of the American College of

Obstetricians and Gynecologists District Service Award


Craig A. Jones, MDDirectorVermont Blueprint for Health

Craig is the Director of the Vermont Blueprint for Health, a program

established by the State of Vermont, under the leadership of its

Governor, Legislature and the bi-partisan Health Care Reform

Commission. The Blueprint is intended to guide statewide

transformation of the way that health care and health services are

delivered in Vermont. Currently, Craig serves on several committees

and workgroups including the Institute of Medicine’s Consensus Committee on the

Learning Healthcare System in America, and the Roundtable on Value and Science

Driven Healthcare. Prior to this, he was an Assistant Professor in the Department of

Pediatrics at the Keck School of Medicine at the University of Southern California,

and Director of the Division of Allergy/Immunology and Director of the Allergy/

Immunology Residency Training Program in the Department of Pediatrics at the

Los Angeles County + University of Southern California (LAC+USC) Medical Center.

He was Director, in charge of the design, implementation, and management, of the

Breathmobile Program, a program where mobile clinics deliver ongoing care to inner

city children in at their schools and at County clinics.

He was an Executive Committee and Board Member for the California Chapter of

the Asthma & Allergy Foundation of America, as well the chapter President. He is

a past president of the Los Angeles Society of Allergy Asthma & Immunology, and

a past President and a member of the Board of Directors for the California Society

of Allergy Asthma & Immunology. He received his undergraduate degree at the

University of California at San Diego and MD degree at the University of Texas

Health Science Center in San Antonio, Texas.

He completed his internship and residency in pediatrics at LAC + USC Medical

Center, where he also completed his fellowship in allergy and clinical immunology.


Speaker Profiles (cont.)Rainu Kaushal, MD, MPHDirectorWeill Cornell Medical College

Rainu is the Director of the Center for Healthcare Informatics

and Policy; the Frances and John L. Loeb Professor of Medical

Informatics at Weill Cornell Medical College, the Director of Pediatric

Quality for the Komansky Center for Children’s Health at New

York-Presbyterian Hospital, and the Executive Director of the Health

Information Technology Evaluation Collaborative (HITEC) for New

York State. She is an international expert on the effectiveness, cost-effectiveness

and comparative effectiveness of health information technology, health information

exchange and novel health care delivery models. She has published more than 80

scholarly publications, has served on numerous national advisory committees,

has formally consulted with other researchers as well as with policy makers, and

has served on editorial boards for health care journals as well as on several study

sections for the Agency for Healthcare Research and Quality. She is a frequent

invited national and international speaker.

Rainu is an expert in quality, patient safety and health information technology

(health IT). She has particular expertise in pediatric medication safety and in

measuring the effects of health IT on health care quality and costs. She is engaged

in research, patient care, management and operations activities at Weill Cornell

Medical College and New York-Presbyterian Hospital, all geared toward using health

IT to optimize the value of health care today.

She attended Harvard Medical School, and then completed her residency at

Brigham and Women’s Hospital and Children’s Hospital in Boston, attaining

double board certification in Internal Medicine and Pediatrics. She then completed

the Harvard Clinical Effectiveness Fellowship while obtaining a Masters in Public

Health from Harvard School of Public Health. She joined and remained on faculty

at Harvard Medical School until 2006 when she joined the faculty of Weill Cornell

Medical College

PanelistsHolly Miller, MD, MBA, FHIMSSChief Medical OfficerMedAllies, Taconic Independent Practice Association

Holly currently has two roles: She is the Chief Medical Officer of MedAllies, providing operational, tactical, and strategic collaborative leadership on all MedAllies projects. She is also the medical director of the Taconic Independent Physicians Association (IPA), where she works to optimize strategic implementations of certified EHR systems to improve patient quality and outcomes, support PCMH transformation

and enhance care coordination. She was formerly a Vice President and CMIO of University Hospitals and Health Systems, in Northern Ohio. Prior to joining UH, she worked as an HIT Managing Director for the Cleveland Clinic where she also maintained a clinical practice in General Internal Medicine.

She has been active in healthcare informatics research, and has been a co-investigator on multiple grants. A member of HIMSS since 1999, Dr. Miller was on the HIMSS US Board for 4 years, and served as a Vice Chair of the HIMSS Board. She is also an immediate past inaugural member of the HIMSS World Wide Board. She is active in a variety of current and previous S&I ONC committees, and other State and Government HIT committees

Susan Northover, RN, MPAVice PresidentVisiting Nurse Service of New York

Susan is currently the Vice President of Intake Services, Enterprise Market Development for VNSNY, the country’s largest not for profit organization providing in-home nursing care, therapy, hospice and palliative services and managed health plan services to New Yorkers. Ms. Northover supports the growth of business across the organization by promoting optimal solutions; including innovative care delivery models to meet

the needs of integrated health systems, physician organizations, nursing facilities and community based organizations.

Previously, as Vice President for Amedisys Home Health Care, she led operational and sales efforts for homecare in multiple locations throughout the northeast. She led program and resource development to address market trends, including implementation of a Transitional Care model to improve Care Coordination from facility to home.

Prior to Amedisys Ms. Northover was General Manager for Tender Loving Care offices in Connecticut. She was responsible for all operational, clinical, regulatory and sales efforts for the organization. Ms Northover is a graduate of the Memorial University of Newfoundland School of Nursing and is a Registered Nurse. She also holds a Master’s Degree in Health Care Administration from the University of New Haven.


Panelists (cont.)

Walter Sedlazek, MBADirector, Product Strategy IBM Cúram

Walt is Product Manager at IBM Cúram. He reports to the Cúram brand CTO and helps to define future product plans and innovation initiatives, including joint research activities with IBM’s Watson research labs and IBM’s Smarter Care development programs. Walt has been with Cúram for eight years and has supported the launch of multiple major new products for its health and human services clients and has participated in health information technology standards work for the US government.

He brings over 20 years of experience in managing COTS-based enterprise software solutions for clients in the public sector as well industries such as insurance, retail, telecommunications, and manufacturing.

Prior to joining Cúram, Walt led product management and strategy teams at Oracle for ten years developing CRM, case management, customer service and call center applications and government vertical applications. In addition, he has led quality management and business process reengineering initiatives using lean manufacturing and six sigma techniques while working for system integration and product vendors supplying solutions to the public sector and telecommunications industries. He has a BSEE from Georgia Tech and a MBA from the University of Virginia, Darden School.

Simeon A. Schwartz, M.D.President and CEOWESTMED Medical Group

Simeon is founding President and CEO of WESTMED Medical Group and the CEO of WESTMED Practice Partners (WPP). The group is a 250+ physician primary care focused multi-specialty practice. He has been committed to improving both operational and clinical efficiency with a focus on quality. To accomplish this, Dr. Schwartz and WESTMED have been early adopters of healthcare IT and have worked with many IT vendors with process and system redesign to improve care. WESTMED

Practice Partners, established in 2011, is a management services company that has evolved from the success of the WESTMED Medical Group. The mission of WPP is to provide comprehensive, turnkey solutions for advanced ambulatory care sites.

Dr. Schwartz is a hematologist and oncologist. He received his undergraduate degree from the Massachusetts Institute of Technology and his medical degree from Yale University School of Medicine in New Haven. Dr. Schwartz then completed his internship and residency at The New York Hospital-Cornell Medical Center and a fellowship in hematology and medical oncology at Memorial Sloan Kettering Cancer Center


Demonstrations

Organizing Committee

Automating Big-Data Analysis for the ICU of the FutureDaby Sow with Alain Biem, Peter Kirchner, Raju Pavuluri, Robert Saccone, Deepak Turaga

Care Plan Workbench for Evidence Driven Coordinated Care Jianying Hu, Guo Tong Xie

Cervical Cancer Solution Michal Rosen-Zvi

Cúram Abha Keshava

Patient Care and Insights David Gotz / Kenny NG

Patient Centric Analytics for Enhanced Care Coordination and ManagementNirmal Mukhi, Nirmal Mukhi, David Gotz, Jianying Hu

Watson EMR Application - Patient Record Summarization Marty Kohn, Murthy V Devarakonda

Shahram Ebadollahi, PhD Program Director, Health Informatics ResearchIBM Research

George Hripcsak, MD, MSChair and Vivian Beaumont Allen Professor of Biomedical InformaticsDirector, Center for Advanced Information Management, Columbia University

Paul Goldfarb, MBA; CAIM Director of Business Development

Joseph Jasinski, PhD; IBM Distinguished Engineer and Global Industry Executive, Healthcare and Life Sciences

Shilpa Mahatma, MS; Senior Research Engineer, IBM T. J. Watson Research Center

Jacqueline Merrill, PhD, MPH, RN; Associate Professor of Nursing (In Biomedical Informatics), CAIM Clinical Director

Adler J. Perotte, MD, MA; Associate Research Scientist, Biomedical InformaticsCAIM Assistant Director for Technology

Daby M. Sow, PhD; IBM T. J. Watson Research Center

Vincent Tomaselli, PhD; CAIM Executive Director

Conference Chairs

Posters (cont.)

This study explores the impact of electronic based patient engagement tools (kiosks, portals, mobile phones, and clinical decision support alerts) on decision-making, adherence to care plans, and clinical, and financial outcomes.

We explore adoption rates, workflow implications, and analytic approaches to predict which tools work best with various populations. Engaging patients to take action through meaningful use of technology is an integral part of health care transformation, contributing to better health, better healthcare, and lower costs.

Ginger: Conquering Complex Industry Models with Dictionary ToolingJohn Timm, Peter Schwarz, Joshua Hui, Sarah KnoopIBM Research – Almaden

Information models used in healthcare IT data standards are often quite complex. This presents a challenge to implementers who need to efficiently build applications that produce and consume data according to these models but are not themselves expert in the specific standard used. In this poster, we discuss an approach to bridge this gap. We combine a methodology with software tooling to facilitate the creation of sets of clinical data abstractions that insulate application developers from the inherent complexities and steep learning curve posed by the standards.

IBM Big Data Platform for WellnessHaim Nelken IBM Research

The estimated global wellness market is 1.9 trillion. In particular, the workplace wellness market is estimated by 2.7-8.2 billion per year. IBM’s mature Big Data, Cloud and Mobile technologies provide the scale and robustness required by wellness solutions. The proposed Wellness platform combines several IBM Big Data products (Big Insights, Streams, Netezza) and Cognos, with innovative wellness accelerators developed by IBM Research.

Aging Well – Speeding the Adoption of Ambient Assisted Living ServicesHaim Nelken IBM Research

The increase in life expectancy reinforces the need for smart and innovative services that help elderly people to be self-sustaining as long as possible and maintain a satisfactory quality of life. This emerging market of smart services, known in Europe as Ambient Assisted Living (AAL) services, offers many solutions for disease management, support in daily life activities, wellness and social interactions. AAL services are usually a non-trivial composition of software, hardware and human resources. One of the impediments to the adoption of AAL services is the lack of an economically viable market place for the provisioning of such services.


Posters

Targeting and Refining Health Challenges to Improve Medical AdherenceRobert Farrell1, Catalina Danis1, Shih Ping (Kerry) Chang2IBM, TJ Watson Research Center1 and Carnegie Mellon University2

Medical providers are increasingly managing patients with chronic disease by applying risk analysis methods to determine the best course of treatment. However, adherence to long-term treatment plans is low (averaging 50% for prescribed medications and 30% for lifestyle changes.) Our approach is to improve adherence through improved patient engagement in health care processes. We are developing a software solution for mounting engaging Health Challenges that help participants set a goal, track their behavior, monitor their progress towards the goal and evaluate the result.

Challenges can be targeted to individuals or to groups in a particular demographic or with a particular risk factor. We will use data analytics to refine the mechanics of the challenge to respond better to each individual’s performance. We present observations from a first deployment of the solution in a wellness setting and describe a planned deployment to chronic patients who have been advised to lose weight.

Towards Greater Care Coordination: Automatically Identifying Primary Care ProvidersHojjat Salmasian, Rimma Pivovarov, Gregory W. Hruby, Daniel G. Fort, Nancy Chang, and David J. VawdreyDepartment of Biomedical Informatics, Columbia University

Primary care providers (PCPs) can contribute historical context to the hospital team, enhancing continuity of care, if they are notified when their patients are hospitalized. This notification seldom happens, because the PCP is not often identified in the electronic health record. A medical logic module was created to assign PCP status to the author of a PCP-specific encounter note.

We interviewed a 15% subset of providers about accuracy of the PCP status for a sample of patients attributed to them. The intervention increased the percentage of clinic visits where a PCP was assigned from approximately 10% to 90%. Among the 22/34 physicians who agreed to be interviewed, PCP status was correct for 408/414 of their patients. An automated method for identifying PCPs based on clinicians’ electronic documentation is the first step in determining which physician to contact for future automated care coordination efforts.

Patient Engagement: Measuring Technology Impact on Care OutcomesCPP (M Minniti, D Freed, S Cashon, T Blue); IBM (C Danis, M Ball, R Farrell); Jefferson School of Nursing (R Kennedy, I Hilghman, B Thomas, C Dolan, S Nevins; NSIM (M Miller, S Ballen, A Crimm, Z Font)IBM, Care Partners Plus (CPP) and NSIM (Ninth Street Internal Medicine Associate)

It is estimated that patient adherence to long-term medication therapies is in the 40% to 50% range, while estimated rates of adherence to lifestyle-based prescriptions such as increasing exercise and adopting a low-fat diet, range 20% to 30%. Increasingly technology is being used to engage patients; however, there is a paucity of research showing the impact of such technology on patient engagement, adherence to treatment plans and clinical and financial outcomes.

The Health Informatics Research Department at IBM is a multi-disciplinary team of scientists with diverse set of skills conducting research in the broad area of health informatics. Its mission is to provide the scientific underpinnings and thought leadership for IBM’s active presence in the area of health informatics.

Main focus areas are: • Analytics and Big Data in Healthcare and Life Sciences

• Visualization and Decision Support for Healthcare and Life Sciences

• Insights-driven Wellness Management Services

• Data Integration and Platforms

We conduct our research in collaboration with external organizations and are active participants in the scientific community.

Our research in the above areas has applications in Care Coordination (providers, payers, governments) and Real World Evidence (pharma) among many others. In Care Coordination we are interested in using advanced analytics and technologies to enable identification of patients/members at risk, devising management plans, identifying the collaborative team to support the patient/member, addressing adherence and compliance with the suggested plans.

In the area of Real World Evidence, we use our advanced analytics tools and visual analytics to better explain variation in the population (responders vs. non-responders), exploring hypotheses, and design of adjacent services (insights-driven services health and wellness service design).

There are a number of commercial software and services offerings by IBM based on our research. For example see IBM Patient Care and Insights: http://www-01.ibm.com/software/ecm/patient-care/

Organizational Profiles Center for Advanced Information Management650 West 168th Street, B-130, New York NY 10032 Telephone: 212 305-2944

www.cat.columbia.edu

In 1983, New York State established a Center for Advanced Technology (CAT) Program to promote the collaboration between it’s industry base and it’s major research institutions. The goal was to facilitate technology transfer and commercialization using the expertise and resources in academia to benefit companies economically.

Currently, the program continues with 15 CATs at 13 institutions located around the state. Each CAT has a specific technology focus (http://www.nystar.state.ny.us/cats.htm) and approach to helping its partner companies. The CAT program is supported by NYSTAR, the New York State Foundation for Science, Technology and Innovation. NYSTAR currently offers a range of programs to help promote the state’s technology base.

Columbia University’s Center for Advanced Information Management has been a participant in the CAT program since its inception. CAIM’s focus is at the intersection of biomedical science, information technology, and biomedical imaging, with the occasional inclusion of other areas of biomedicine and information processing. It’s main contributing units are the Department of Biomedical Informatics and the Center for Computational Biology and Bioinformatics, both at the medical center (College of Physicians and Surgeons), and the Computer Science Department and imaging group of the Department of Biomedical Engineering, both in the School of Engineering and Applied Science. This broad range of expertise serves CAIM well in allowing for innovative interdisciplinary projects involving specialists from both schools and campuses.

A few of CAIM’s industry-focused activities and offerings are: • Grant program for industry co-sponsored research projects • Specialized workforce training courses and seminars • Technology Forums featuring informative programs focusing on areas of industry interest • External Advisory Board with members from a wide range of companies • Access to other NYSTAR development programs (funding, technology/legal services, etc.)

Department of Biomedical Informatics622 West 168th St. VC5, New York, NY 10032 Tel: 212 305-5334

www.dbmi.columbia.edu

The Columbia University Department of Biomedical Informatics is among the oldest in the nation. Its goals are to discover new information methods, to augment the biomedical knowledge base, and to improve the health of the population. DBMI’s 30 faculty members and 60 students work in a highly collaborative environment, applying informatics from the atomic level to global populations. Areas of application include:

• CLINICAL CARE. Design clinical information systems and mine the electronic health record.

• BIOLOGY. Includes systems biology, structural biology, and virology, on studies in partnership with the Center for Computational Biology and Bioinformatics.

• PUBLIC HEALTH. Design systems to promote and protect the health of communities, improve public health systems, and deploy information technology internationally.

• TRANSLATIONAL RESEARCH. Integrate biological and clinical knowledge and facilitate multidisciplinary science.


650 West 168th Street, Suite B-130, New York, NY 10032 Tel: 212 305 2944 Fax: 212 305 0196

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Medical Informatics Update 2013 Program