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The #HCBiz Show!

The #HCBiz Show!

The podcast dedicated to unraveling the business of healthcare.

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Interoperability 2.0 with Niko Skievaski

The interoperability promise of a shared, longitudinal medical record has so far focused on connecting health systems to each other. With the growing investment and constant new entrants of SDOH solution vendors, a new wave of interoperability challenges are becoming apparent. How does your health app connect to an EHR? Will new anti-data blocking legislation help or hurt SDOH startups? In this wide-ranging conversation, Don Lee and Shahid Shah talk with Niko Skievaski, President and Co-Founder of Redox, about his team’s solution to interoperability and why health information exchanges (HIEs) are only part of the answer.

Highlights

  • One API to link them all.
  • FHIR is a language, not an API.
  • Redox helps you scale your integration infrastructure without scaling your team.
  • Interop with Epic: Then and Now.
  • B2B relationship building through Interface Analysts.

HIEs are designed to facilitate the movement of data to follow a patient, Redox shares data between health systems and their business associates.

  • The competing interests between Value-Based Care and Consumerism.
  • Where is the government investing in health tech?
  • 2020 will be a big year for interoperability.
  • Implications of the Blue Button Breach.
  • Will the Cambridge Analytica problem come to Healthcare?
  • 21st Century bugs need a 21st Century solution.

Niko Skievaski. President and Co-Founder

As president and co-founder of Redox, Niko Skievaski leads his team in helping healthcare organizations fulfill the promise of digital health with an integration platform that securely and efficiently exchanges data. Prior to co-founding Redox in 2014, he worked at Epic, a multi-billion-dollar healthcare technology company. After Epic, he co-founded 100state, Wisconsin’s largest co-working community. He is also a board member at Prime Health, a Denver-based non-profit designed to accelerate the adoption of emerging healthcare technologies that address community and safety net needs. Niko has an MA degree in economics from Boston University and a BS degree in economics and international business from Arizona State University’s W.P. Carey School of Business. He lives in Boulder, Colorado with his collection of mountain bikes.

Redox

Redox accelerates the development and distribution of healthcare software solutions with a full-service integration platform to securely and efficiently exchange healthcare data. With just one connection, data can be transmitted across a growing network of 600+ healthcare delivery organizations and 250+ independent software vendors. Members of the Redox Network exchange more than 7 million patient records per day, leveraging a single data standard compatible with more than 40 electronic health record systems. Redox exists to make healthcare data useful and every patient experience a little bit better.

Links, Resources, and Related Episodes

LinkedInhttps://www.linkedin.com/in/skievaski/

Twitterhttps://twitter.com/niko_ski

Websitehttps://www.redoxengine.com/

The Redox Podcasthttps://www.redoxengine.com/blog/category/podcast/

Shahid Shah on The Redox Podcast

Trusted Exchange Framework and Common Agreement (TEFCA)

FHIR At Scale Taskforce (FAST) and the DaVinci Project

January 15, 2020

Headwinds Impacting the Shift to Value-Based Care with Kyle Swarts and Dr. Matt Lambert

Health systems have been working hard to lay the foundation for taking on a larger case mix of value-based contracts. 75% of health systems surveyed said they are ready to accept downside risk in the next two years, up from 42% in 2015. As health systems are discovering, value-based care reimbursement is more complicated and requires a new level of specificity in documentation. The question is, are health systems really ready to take on downside risk while continuing to manage FFS contracts?

Today we have Kyle Swarts, Chief Growth Officer, and Matt Lambert, MD, Chief Medical Officer from TrustHealthcare to help us answer that question. We discuss challenges and opportunities facing health systems as they embrace the shift to value. Enjoy!

Highlights from Headwinds Impacting the Shift to Value-Based Care

  • It's time for providers to take on risk.
  • Everyone has a population health department but fee-for-service is still driving your overall strategy.
  • The threshold for making the jump to VBP.
  • Why it's so difficult to get doctors on board with VBP.

"It's not how sick your patients are, it's how well you document how sick your patients are."

  • The risk of moving slowly to VBP.
  • The promise of 60 minute home visits with a physician finally has a reimbursement model.
  • Where we will see new consolidation in response to VBP.
  • The two big reasons specificity in documentation is key to successful downside risk contracts.
  • Reimagining EHR design to foster VBP.
  • AI success is all about physician adoption.

Kyle Swarts, Chief Revenue Officer

Kyle is a growth-minded leader who has overseen sales, marketing, and business development at healthcare consulting, revenue cycle management and information technology companies for the past 12 years.

Matt Lambert, MD, Chief Medical Officer

Matt brings over twenty years of experience as a clinician, CMIO, and change leader to value-based care, ensuring that patients receive more comprehensive care and that payers and providers better capture the value of their services.

TrustHealthcare

Founded in 2018 by a team of healthcare veterans and clinicians with private equity funding from Windrose Health Investors, TrustHealthcare’s mission is to empower healthcare provider organizations and health plans to successfully navigate from fee-for-service to value-based care. The TrustHealthcare platform seamlessly integrates with the electronic health record and leverages more than 500 proven clinical rules – while also connecting CDI specialists, clinicians, and coders in one simplified workflow. With TrustHealthcare, providers and health plans can rest assured that they are capturing the full value of patient care in real-time.

Links and Resources

TrustHealthcare Website

TrustHealthcare Linkedin

Unrest Insured by Matt Lambert, MD

A Primer on HCC codes and Risk Adjustment

Related Episodes:

Top 10 Things to Ensure Success in a Value-based Healthcare World

Value-based Payment: Progress, Trends and Direction w/ Jason Helgerson

The Future of Value-Based Payment w/ François de Brantes of Remedy

January 9, 2020

A Playbook for Social Care Providers with Juliette Price

The quantification of how social determinants effect health has finally put enough pressure on healthcare organizations to force action. Finally discovering what social workers have known for years, the health sector is on the verge of providing a permanent revenue stream for Social Care Organizations who previously relied on grants and charitable donations. For your organization to develop health partnerships, Juliette Price from Helgerson Solutions Group says you need to answer three questions as clearly and completely as possible.

First, What problems are you trying to solve and how do you propose solving it?

Second, Who is your target population?

And Third, How do you measure your impact?

Clarifying this value proposition is the only way to allow hospitals and health systems to calculate how much money you will actually save them and ultimately how many lives will be improved.

This is a wide ranging conversation and with lots of great takeaways. Enjoy!

Highlights from "A Playbook for Social Care Providers"

  • Cross sector learning networks - who already solved your problem?
  • Doctors are not trained to solve hunger and homelessness. Social referrals are not the same as medical referrals.
  • A common language to share your mental model of the system.
  • Hospitals are nonprofits. Applebee's is a community based organization. If you provide social care, honor yourself with the title: Social Care Organization.

"This is really the moment for social care providers to start understanding their value in this ecosystem... Define what you do, define the value you bring, and then ultimately bring that to a healthcare partner.

  • The huge opportunity for Social Care Organizations: It’s not just housing or employment or criminal justice, it’s everything.
  • This is about designing a better community.
  • If someone had figured it out, we would have replicated it by now.
  • The difference between charity and system change.
  • Philanthropy in a value based word.

"The age of big data has washed over us and we have been left drowning in data and starving for insight."

Juliette Price, Solutions Architect - Social Determinants of Health

Juliette is working to bring health care and social sector partners together in new ways to deliver results for end users.

Juliette previously served as the director of The Albany Promise, a cross-sector, collective impact partnership of 100+ organizations in Albany, New York that focused on improving economic mobility for the city’s most vulnerable youth and families using shared vision, collective action, and rigorous continuous improvement. The partnership was widely recognized as leading the nation in the field of collective impact. Juliette was awarded the White House Champion of Change award in 2016 from the President Barack Obama Administration for her work in this field.

Previously, she worked for the Chancellor of the State University of New York, the nation’s largest, most comprehensive system of higher education, managing various aspects of the education pipeline and multiple initiatives related to teacher education, statewide education policy, and led the development and implementation of the New York State Master Teacher Program, a program which created a state-wide network of the highest-performing STEM teachers that are dedicated to sharing expertise with peers and attracting the brightest minds to a career in STEM. She staffed Governor Andrew M. Cuomo's New NY Education Reform Commission, which brought together nationally-recognized education, community, and business leaders to recommend reforms to the state's education system in order to improve performance in the classroom so that all of New York's students are fully prepared for their futures.

Helgerson Solutions Group

Helgerson Solutions Group is an international consulting firm dedicated to finding solutions to today's most complex large-scale challenges in health care, social care, and education in communities around the world. 

Links and Resources

Addressing the Social Determinants of Health in a Value-Based Payment World: A Playbook for Social Care Providers

Juliette Price on Twitter

Helgerson Solutions Group on Twitter

Helgerson Solutions Group Website

December 18, 2019

Designing an Innovator Network for Hospitals with Amy Stevens

For long time listeners of this show, you know we’re in the business of helping entrepreneurs understand how to create use case alignment, how to get over the hump of defeating good marketers with a not so good solution, and how to get the right tools in the hands of people who need them. The hurdles involved with getting permission and building consensus around which new tech to bring in slows down diffusion and implementation of needed solutions.   

Well today we’re looking at a new platform that gets targeted information to health system leaders who are driving meaningful change in their organization. On this episode, Don and Shahid speak with Amy Stevens, Executive Vice President of Provider Solutions and Avia Connect at Avia. In addition to the platform, Amy also gives us an update from earlier episode we did with David Smith, on the Medicaid Transformation Project and how the first couple behavioral health and community health projects are going. Enjoy!

Highlights from, “Designing an Innovator Network for Hospitals with Amy Stevens"

  • How do you run a better health system using digital solutions that let you scale?
  • Avia’s unique approach to helping health systems identifying the right tech.
  • The marketplace solution that levels the playing field between digital startups and incumbents.
  • What got you here, will get you there: using your network for vetting and implementing innovations.
  • Who is moving the fastest to digital? Why and How.  
  • Why Avia isn’t a “digital PBM”.
  • Building relationships and understanding buyer intent.
  • Why aren’t best practices and successful programs rolled out in all 50 states? Why can’t you scale in Medicaid?

“We have buyers who you didn't think existed because you didn't think that people would invest in Medicaid.”  

  • Finally, a collaboration that shifts the flow of dollars to where care is being provided.
  • Penn Medicine’s impact model – tackling a structural issue with real time joint problem solving.
  • A quick look at next years plans for new ways of building integrated care networks.
  • How Avia Connect connects payors and providers.
  • Using your network as an asset:

“Hear what the health systems are saying are their greatest pain points, where they've tried solutions and it hasn't been able to scale. And hearing not just one health system at a time is moving those entrepreneurs out of being stuck in ‘business development process’. As they hear need and concern, you bring them much earlier into the actual design and strategy process that will create real change.”

Call To Action:

The best way for our members to learn more about your company is to claim your profile on AVIA Connect.

Amy Dirks Stevens, Executive Vice President Provider Solutions

Amy has held significant leadership roles across the healthcare spectrum, including health systems, clinical integration organizations, ambulatory services, and physician practice management. She has been responsible for operations, strategy, and growth at local, regional, and enterprise levels for large, multi-national for-profit health systems with academic and quaternary centers, as well as community faith-based, non-profit systems. She was instrumental in receiving FTC-approval for one of the nation’s vanguard clinical integration organizations and later became its President, managing the MSO services and a network of over 50 healthcare entities, 6000 providers and 30 performance-based contracts with employers, commercial and government payers. Prior to healthcare, Ms. Stevens was a sought-after consultant in the energy and environmental sectors for contentious projects with high public visibility and business impact.

Amy Dirks Stevens LinkedIn

AVIA

AVIA is the leading partner for digital health insights, strategic guidance, and consulting services. Members of the AVIA Innovator Network solve pressing challenges with digital solutions that deliver outsized financial and clinical results. AVIA provides strategic focus, unique market intelligence, and proven resources that accelerate digital transformation throughout healthcare.

Avia LinkedIn

Avia Twitter

Links, Resources and Related Episodes

AviaHealthInnovation.com

The Medicaid Transformation Project (MTP)

AVIA Launches Partner Network to Expand Industry Access to Digital Insights

Join AVIA Connect

AVIA Raises $22 Million in New Funding

National Maternal and Infant Health Crisis Spurs 30 Health Systems to Take Action

Maternal Mortality in the United States Is on the Rise

Episodes 107 and 108: The Medicaid Transformation Project with David Smith Part 1 and Part 2

December 4, 2019

The State of Remote Patient Monitoring w/ Sam Liu of VivaLNK

The design solutions from the consumer wearable market are making this next generation of remote patient monitoring devices ready for mass adoption. With the solutions you’ll hear about today and CMS finally finding a method to pay for them, hospitals and patients will soon agree that remote monitoring could be the key to a more holistic healthcare solution.

With successful physician adoption strategies like the one we heard from Henry Ford Health System, more developers will be utilizing remote monitoring services from our guest today. In this episode, we talk with Sam Liu, Vice President at VivaLNK.

VivaLNK provides medical wearable sensors designed to monitor human vitals and biometrics. VivaLNK’s IoT sensor platform is quickly becoming the Amazon Cloud of remote healthcare sensors by making it very simple for healthcare developers to capture patient data for their own applications.

Whether you’re looking to implement your own remote monitoring program or you want to see how a great company is building a system around their solution, you’re going to get some great takeaways from this episode. Enjoy!

Highlights from “The State of Remote Patient Monitoring”

  • Building systems around your solution
  • Turning biometric sensors into APIs for easy application development.
  • Combining the two worlds of Consumer health vs medical care.
  • The quality of data needed for a step tracker vs. a fall prevention tool.
  • The current state and best practices of Remote Patient Monitoring.
  • Use case: Neutropenia after Chemotherapy.
  • Who pays for and benefits from remote patient monitoring?
  • Realtime trend spotting with wearables to relieve staffing pressure in post-acute care settings.
  • Remote monitoring as part of your infection prevention program.
  • Continu-omics, continuously captured data for advanced diagnostics and precision medicine
  • How to insulate your device company from privacy issues.
  • The behind the scenes algorithms for interpreting wearable sensors to collect accurate vitals.
  • Working with VivaLNK for your remote monitoring solution.

“Most people are kind of reactionary, but with the right implementation and devices, it comes so easy that patients will be more willing to get proactive about their health.”

Sam Liu, Vice President

Sam Liu is the VP of Marketing at VivaLNK where he is responsible for marketing and business development for VivaLNK’s line of medical wearable sensor and IoHT products. Prior to VivaLNK, Sam has worked in executive positions at multiple startups in technologies including genomics, SaaS/cloud, mobile devices, enterprise software, and IoT sensors. His startup track record includes two IPOs and as many M&As. Sam has an MBA and a BS Computer Science.

VivaLNK

VivaLNK is a provider of connected healthcare solutions for wellness, patient care, and telemedicine. The company’s portfolio includes wearable medical grade devices and data analytics applications that continuously monitor the health and well-being of individuals.

​VivaLNK’s vision is to improve the quality and accessibility of healthcare worldwide by combining technology, data, and analytics into an integrated solution.

Links Resources and Related Episodes

VivaLNK

Episode 80: How to Launch and Grow a Virtual Care Service w/ Henry Ford Health System and Vidyo

 

This episode was made possible by:

VBP Forward 

VBP Forward is building a bridge between community-based organizations and healthcare delivery. VBP Forward: The Conference 2020 will be held in Albany, NY on April 28-30, 2020. Join us as we work to fully leverage the value of community-based organizations to realize healthcare’s loftiest goals AND ensure they are properly funded to continue and expand their efforts. https://www.vbpforward.com/

 

Unblock Health

Are you a leader in health information management who’s passionate about real-world interoperability, dedicated to making sure patients have access to their health information? Do you pride yourself on your organization’s HIPAA practices? Are you ready to level up and separate yourself even farther from the competition? Interoperability, autonomy, & transparency are the patient experience. Unblock Health is revolutionizing patient autonomy & consumerism as we know it. Patients are ready to use Unblock Health to hold our healthcare ecosystem accountable. Are you ready to meet them where they are? If so, head on over to unblock.health and click register.

 

For full show notes, images, and links: https://thehcbiz.com/119-sam-liu-vivalnk-remote-patient-monitoring

November 27, 2019

Addressing SDOH in the Community: Baby Cafés with Rev. Diann Holt

Maternal mortality rates are steadily on the rise in the U.S. – the only developed nation where that’s true. The maternal mortality rate in 48 states and the District of Columbia increased by 26.6% between 2000 and 2014—from 18.8 to 23.8 per 100,000 live births. Hidden in those statistics is great racial disparity, where African American women are 3-4 times more likely to die in childbirth than white women.

The CDC recommends exclusive breastfeeding for about 6 months and cites benefits such as the reduced risk for Asthma, Obesity, Type 1 diabetes, and many more problems that the healthcare system is working earnestly to address.

According to DONA International, a Doula is “a trained professional who provides continuous physical, emotional and informational support to a mother before, during and shortly after childbirth to help her achieve the healthiest, most satisfying experience possible” and that “countless scientific trials examining doula care demonstrate remarkably improved physical and psychological outcomes for both mother and baby. Doulas have a positive impact on the well-being of the entire family.

So, continuous support for women and children before, during, and after childbirth can support healthcare’s efforts in chronic disease prevention, health access, health equity, mental health, and more. And as usual, an ounce of prevention is worth a pound of care. Baby Cafés are sprouting up across the country and can provide these services to mothers and children to prevent problems for a fraction of what we’re spending in the healthcare system to address the problems later. And in doing so, they’re strengthening our communities and putting our children on a pathway to long-term health.

On today’s episode, we talk with Rev. Diann Holt from Durham’s Baby Café in downtown Buffalo. They provide mothers (and fathers!) with birth planning, breastfeeding education and doula services, plus hot meals twice per week, AT NO COST! Rev. Diann tells us all about the benefits of these services, and we explore how the healthcare system can support and benefit from community-based organizations like Durham’s Baby Café.

 

About Durham’s Baby Café

Durham’s Baby Café is a 501c3 non-profit organization and social entrepreneurship founded in 2013 by Rev. Diann Holt.

https://www.durhamsbabycafe.com/

Durham’s Baby Café on Facebook

Rev. Diann Holt: (716) 427-0556

Licensed By Baby Cafe USA

Find a baby cafe near you: http://www.babycafeusa.org/your-nearest-baby-cafe/full-list.html

 

This episode was made possible by:

VBP Forward

VBP Forward is building a bridge between community-based organizations and healthcare delivery. VBP Forward: The Conference 2020 will be held in Albany, NY on April 28-30, 2020. Join us as we work to fully leverage the value of community-based organizations to realize healthcare’s loftiest goals AND ensure they are properly funded to continue and expand their efforts. https://www.vbpforward.com/

 

Unblock Health

Are you a leader in health information management who’s passionate about real-world interoperability, dedicated to making sure patients have access to their health information? Do you pride yourself on your organization’s HIPAA practices? Are you ready to level up and separate yourself even farther from the competition? Interoperability, autonomy, & transparency are the patient experience. Unblock Health is revolutionizing patient autonomy & consumerism as we know it. Patients are ready to use Unblock Health to hold our healthcare ecosystem accountable. Are you ready to meet them where they are? If so, head on over to unblock.health and click register.

 

For full show notes, images and links: https://thehcbiz.com/118-rev-diann-holt-durhams-baby-cafe-sdoh/

November 20, 2019

The #HCBiz Show!

The #HCBiz Show! is the podcast dedicated to unraveling the business of healthcare. We help innovators understand the endless list of conflicting priorities and incentives competing for their customer’s attention. Whether you’re launching a product, improving a workflow, or promoting a best practice, we’ll help you align your value proposition and message with the things healthcare leaders need right now.
View All Episodes

Team

Don Lee

Don Lee

Don helps organizations launch new Health IT products and services. He’s a product and business development consultant and accomplished Health IT expert with a 20-year track record of driving value with technology.

Don began his career as a custom software developer and eventually built and led a team of more than 30 engineers. Later, he was the subject matter expert, product manager and head of sales and marketing for a digital health startup that launched a SaaS-platform focused on administrative simplification in healthcare.

Today, Don is President of Glide Health IT, LLC, a consulting firm that helps forward-looking organizations align their Health IT and business strategies. The firm specializes in business and product development with a focus on data aggregation, interop, analytics, and quality measurement.

Don is a co-founder and partner at VBP Forward, an organization that’s building a bridge between community-based organizations and the healthcare system through educational content, workshops and conferences.
Shahid Shah

Shahid Shah

Shahid N. Shah is an internationally recognized and influential healthcare IT thought leader who is known as “The Healthcare IT Guy” across the Internet. He is a technology strategy consultant to many federal agencies and winner of Federal Computer Week’s coveted “Fed 100″ award given to IT experts that have made a big impact in the government. Shahid has architected and built multiple clinical solutions over his almost 24 year career.

He helped design and deploy the American Red Cross’s electronic health record solution across thousands of sites; he’s built several web-based EMRs now in use by hundreds of physicians; he’s designed large groupware and collaboration sites in use by thousands; and, as an ex-CTO for a billion dollar division of CardinalHealth he helped design advanced clinical interfaces for medical devices and hospitals. Shahid also serves as a senior technology strategy advisor to NIH’s and TATRC’s SBIR/STTR program helping small businesses commercialize their healthcare applications.

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