Serving the home health, home care and hospice industry since 1999.

by Darcey Trescone, RN, BSN

The 2019 U.S. National Health IT Week is September 23rd-27th and HIMSS has a calendar of events to acknowledge this week available on-line. The focus of the week's topics is on Supporting Healthy Communities, driving transformation of our health and wellness ecosystem to promote better health outcomes and health equity. To demonstrate how information and technology can transform health and create healthy communities, the 2019 U.S. National Health IT Week outlined the following "Points of Engagement:"

  • Advancing Public and Population Health
  • Modernizing the Public Health Infrastructure
  • Accelerating Workforce Development
  • Expanding Access to Broadband and Telehealth
  • Addressing Social Determinants of Health

Upon further reading on each of the "Points of Engagement" outlined, all of them discuss sharing of data through technology to achieve better health outcomes. Open data sharing and the ability to leverage that data helps providers predict declines, prevent negative outcomes, treat patients, and ultimately improve outcomes. With PDGM right around the corner, innovations in technology are entering our industry at a faster than normal pace.

I caught up with WellSky CEO Bill Miller as he was finishing his company's annual user conference, CareForum, to discuss the quickly changing landscape of technology, why this is occurring, and data sharing in the post-acute space.

What is your perspective on the current state of interoperability and healthcare?

"Compared to other industries, the healthcare industry has been slower to adopt interoperability. Privacy is one of the chief reasons, but we have also seen competitiveness between some of the key stakeholders that traditionally ruled the roost around the sharing of health data. There are organizations that sought to monetize data in the post-acute space over the years, and they believed it was not in their best interest to make their systems open to accommodate interoperability. But I think the industry’s approach to data sharing is evolving.

"As an industry, healthcare is developing interoperability standards. We're seeing both the government and the private sector make moves that leave us optimistic about where things are headed. Of course, it is slower than what you or I would like to see or expect as consumers of technology, but we're on the right path."

Why is the healthcare space so slow to invest in innovation such as interoperability?

"I've spent some time with Berkshire Hathaway and, if you look at all the things that they've invested in, it is only in the last couple of years that they've made a modest investment in healthcare. When I asked them why, they said it's because there is not always a perfectly straight line between supply and demand.

"The governmental and regulatory interventions that occur in reimbursement can scare traditional capital. Sometimes the deployment of that capital is utilized for solving symptoms, rather than root causes that legitimate interoperability, for example, could address. It's been hard for investors to understand the return on investment (ROI).

"Even the big companies, including Microsoft and others, have largely struggled with the business models in healthcare. I believe we haven't seen as many pure investments in technology and standards development because healthcare business models aren't completely consumer driven, and because there are twisted lines between supply and demand through reimbursement (whether it be governmental or private insurance).  

"The government is pushing away from this under the Obama administration and now the Trump administration. Our keynote speaker at our CareForum conference was Aneesh Chopra, who served as the first and former Chief Technology Officer of the United States under the Obama administration. During our keynote discussion, I asked him the following: "Why is it that we are still making progress when a lot of the inertia in this administration is to tear down the last administration?" He told some pretty optimistic stories about it, and the core belief that we need to share data and that we can't afford to keep having a race towards 20% of our GDP going to healthcare is universally agreed upon at a bipartisan model. I came away from my time with Aneesh Chopra optimistic that within both Congress and the Senate, there is bipartisan support for doing the right thing with health data."

We hear the terms "Population Health" and "Big Data" used a lot. What is driving the recent investments and growth in innovation around technology in healthcare?

"Payers are driving providers to be more accountable, and leveraging data helps providers measure and prove the value they deliver. The federal government is also driving that through value-based care scenarios or in bundles, which ensures providers only get paid based on positive outcomes.

"As a provider, the next logical question is, "How do I drive the best outcomes?" It isn't by just having a slightly better EHR, and it isn't by slightly improving your staff that you can achieve this. Instead, providers must pay attention to what the data tells us to drive the best outcomes, and technology is a critical piece of this endeavor.  

"Sharing data and innovating to use that data to improve care can help us answer complex questions we cannot address with traditional dashboards and reports:

  • 'How can we make the biggest difference in interventions?'
  • 'How can we see challenges on the horizon using predictive analytics?'
  • 'What is happening in my patient population, and how can I have an impact?'
  • 'What is happening with this patient, and what has been successful for other similarly presenting patients?'

"With the current investments and advances in technology, post-acute providers can finally address this key question using data: "What should we do next to avoid bad outcomes at a high cost?" Providers need to collaborate with quality technology partners that can share data openly, have a strong vision around data science and can take population data down to the individual practice level and patient level. At WellSky we focus on delivering innovative, intelligent technology that allows our customers to focus on what matters most: elevating care."

Many providers want to elevate care, but they're not quite sure how to do it, and they just can't think outside the box as far as technology comes into play. Would you agree, and what are you doing to combat this?

"Yes, in fact, at our CareForum conference, we helped providers challenge the status quo and discover new ways to deliver quality care. At the conference today, you would have seen 1,500 people watching a live demo of our innovative analytics technology. WellSky brings analytics directly into clinicians' workflows so providers can do exactly what they want — which is elevate care. WellSky makes it easier for providers to train their clinicians too. We help providers and patients thrive and give them reliable tools so they can achieve even better outcomes.

"Because providers who use WellSky are working from data that's benchmarked against best practices, they can better serve patients that have similar comorbidities and/or exhibit a similar behavior. They can also see what processes have been successful in caring for these populations. WellSky helps providers predict declines, prevent adverse outcomes, and deliver the most appropriate treatments to improve patient outcomes.

"At CareForum, the audience was visibly excited about this innovation, and the technology sparked a lot of interest. Because we have several hundred clients already utilizing our advanced data analytics technology, we believe the adoption of these and similar innovations across the industry will catch on fire and take off."

We hear the trend in conversation around interoperability, predictive analytics and future AI. Do you have any thoughts around this?

"At WellSky, we have a formidable team of data scientists dedicated to building algorithms using artificial intelligence (AI) and machine learning to improve care. In fact, 3.5 million machine learning calculations and analytics already occur in our customer install base each day. And well over 30 percent of our total research and development budget year over year is directly invested in predictive analytics, machine learning and AI.

"We're focused on making data easy to understand, yet also extremely powerful. We deliver clinicians meaningful insights based on historical data from more than 7 million home health patient episodes, longitudinal data, and other data sets that we brought forward to create a clinical compass for better care coordination and outcomes."

You have an extensive background in IT working for some large well-known companies. How do you feel this experience is beneficial to the healthcare changes we are seeing in the post-acute space?

"I've worked in healthcare for more than 20 years, and my background and learning experiences mirror what's going on in the industry. I spent seven years at Cerner working on big health systems and was there during some of the most tremendous growth and adoption of electronic health record systems. Then I spent 10 years at Optum during the reform period and Obama administration, really understanding how value-based care payment models would play out for providers, how payers were driving the change, and how technology and clinicians would need to adapt. While I was at Optum, we were the single strongest healthcare analytics organization in the world, and I got the benefit of running many of those analytic businesses inside of the company. That combination of my strong backgrounds working with providers, working with payers, and working in analytics reflects what's now happening in the post-acute care environment with payment reform.

"These days, providers are more conditioned to adapt. They understand how their technology solutions must flex and how to respond to the pressures of a changing reimbursement environment. Providers' adoption of new technologies and tools is already moving quickly, which is why, at WellSky, we are kinetic about innovation."

What is WellSky doing to get involved in National IT week?

"WellSky has joined CommonWell Health Alliance, and we are actively involved with some of the governing bodies around the standards. We also have developed client advisory boards and focus groups to discuss what matters most to providers. We work on technology topics, but the groups are compliance and regulatory focused as well. Ultimately the providers ability to thrive and grow will be a function of understanding the quality of care they provide, their patients, and how to best stratify them at the population level and the patient level. The technology innovation and advancements needed to deliver what matters most to providers is our full-time job at WellSky, and we are not slowing down."


©2019 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.