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Using Technology to Enhance the Exam Room Experience Improve Quality and
Make Pop Health Real
David Voran MDKansas Healthcare Quality Summit
May 10 2017
Orhellip how technology can Improve
Agenda
Quality ndash from a different perspective
Patient engagement ndash the crucial key
Technologyndash the critical tool
Take a circuitous journey that most likely will raise more questions than answer
What is Quality
The Institute of Medicine the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledgerdquo
ConsumersStaying healthy getting better help living with illness or disability and coping with death
Regulators and AdministratorsAdherencecompliance with reporting measures and metrics
Effectiveness
Efficiency
Equity
Patient centerdness
Safety
Timeliness
Carolyn Johnson is a reporter covering the business of health She previously wrote about science at The Boston GlobeFollow carolynyjohnson
23 of total health spending
50
66
7682
97
3
0
10
20
30
40
50
60
70
80
90
100
Top 1 ofhealth
spenders
Top 5 Top 10 Top 15 Top 20 Top 50 Lower 50
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Orhellip how technology can Improve
Agenda
Quality ndash from a different perspective
Patient engagement ndash the crucial key
Technologyndash the critical tool
Take a circuitous journey that most likely will raise more questions than answer
What is Quality
The Institute of Medicine the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledgerdquo
ConsumersStaying healthy getting better help living with illness or disability and coping with death
Regulators and AdministratorsAdherencecompliance with reporting measures and metrics
Effectiveness
Efficiency
Equity
Patient centerdness
Safety
Timeliness
Carolyn Johnson is a reporter covering the business of health She previously wrote about science at The Boston GlobeFollow carolynyjohnson
23 of total health spending
50
66
7682
97
3
0
10
20
30
40
50
60
70
80
90
100
Top 1 ofhealth
spenders
Top 5 Top 10 Top 15 Top 20 Top 50 Lower 50
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Agenda
Quality ndash from a different perspective
Patient engagement ndash the crucial key
Technologyndash the critical tool
Take a circuitous journey that most likely will raise more questions than answer
What is Quality
The Institute of Medicine the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledgerdquo
ConsumersStaying healthy getting better help living with illness or disability and coping with death
Regulators and AdministratorsAdherencecompliance with reporting measures and metrics
Effectiveness
Efficiency
Equity
Patient centerdness
Safety
Timeliness
Carolyn Johnson is a reporter covering the business of health She previously wrote about science at The Boston GlobeFollow carolynyjohnson
23 of total health spending
50
66
7682
97
3
0
10
20
30
40
50
60
70
80
90
100
Top 1 ofhealth
spenders
Top 5 Top 10 Top 15 Top 20 Top 50 Lower 50
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
What is Quality
The Institute of Medicine the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledgerdquo
ConsumersStaying healthy getting better help living with illness or disability and coping with death
Regulators and AdministratorsAdherencecompliance with reporting measures and metrics
Effectiveness
Efficiency
Equity
Patient centerdness
Safety
Timeliness
Carolyn Johnson is a reporter covering the business of health She previously wrote about science at The Boston GlobeFollow carolynyjohnson
23 of total health spending
50
66
7682
97
3
0
10
20
30
40
50
60
70
80
90
100
Top 1 ofhealth
spenders
Top 5 Top 10 Top 15 Top 20 Top 50 Lower 50
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Carolyn Johnson is a reporter covering the business of health She previously wrote about science at The Boston GlobeFollow carolynyjohnson
23 of total health spending
50
66
7682
97
3
0
10
20
30
40
50
60
70
80
90
100
Top 1 ofhealth
spenders
Top 5 Top 10 Top 15 Top 20 Top 50 Lower 50
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Quality and Population Health
Based on data
Data comes from us
claims submissions
compliance forms
investigational data collection amp peer reviewed studies
i2B2 HealthFacts and other large de-identified aggregations
High error rate in medical charts claims and original data
Raises questions about our quality measures
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Population Health and Registry Issues
GIGO (Garbage In Garbage Out)Attribution
Why is this patient on my list
IdentificationWho is this patient
ClassificationHow in the world did this patient get on this registry
Provider registriesWhy am I not on this patientrsquos plan
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
(Crown ISBN 0553418815)
The problem with big data analytics
Depends on models and algorithms
Algorithms Secrete and opaque
Affect a lot of people
Questionable definition of success
Create pernicious feed-back loops
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
How to Improve Original Data
Implement a culture of reconciliation
Requires the patientrsquos attestation
Cannot happen without engaged patients
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
How to engage the patient
Share data
Use technology to bring them into the examination process
Have a little fun
Reach out and encourage participation outside the encounter
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Why Patient Engagement
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Quality
MIPS Merit based Incentive Payment System
hellip not really about quality but about our industryrsquos unsustainable architecture
hellipwersquove priced ourselves out of the marketplace
hellipare being asked to lower the cost of care
Reports reports and more reports
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Replaces PQRS
Accounts for 60 of payment formula
Start collecting data on 112017Must report 6 (or 15) of 271 measures
Affects 2019 Reimbursement
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
First The Exam Room ComputerMore for the patient than the physician
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Encourage Interaction
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Window to the World
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
What about Population Health
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Putting Population Healthin the Critical Path
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
How it looks and how we use it
Registry (population level) Registry (individual level)
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Access to individual charts
Overall Score against peers
Population risk and
organizations (clinics)
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Pick a clinic
Pick a registry
See measures and which ones are important
and met
Pick a clinic
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
See Gaps
Sort by Risk
Choose the Registry
Open Chart
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
View Clinical Information
Open the actual chart
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Notice Registry Component
Internal Health Maintenance
Gaps
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Pre-Visit Planning Report
Other tools
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
And then in the exam room
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Clinic meetings
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Key concepts
Measurement and payment moving from how much or well you do with an individual patient to how well you (and your group) do with all of your patients
Executed by monitoring and identifying individuals within the group with specific needs or care gaps
Tracking and reporting changes of a group over time
Garbage in garbage out ndash diagnoses matter
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
Planted in the office nurtured in the exam room
cultivated online harvested in quality measures
and improved patient follow up satisfaction
Technology is the soil in which all of this occurs
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