Memorial Sloan Kettering Cancer Center is replacing an often manual process with a tech platform that streamlines data transfer and verification from its EHR to platforms used by clinical trial sponsors.
Memorial Sloan Kettering Cancer Center (MSK) is embracing new technology designed to enable clinical trial sponsors to quickly and easily pull relevant patient data from MSK's EHR.
The New York City health system is partnering with IgniteData, a UK-based developer of electronic data transfer solutions, to provide data integration between MSK's EHR platform and the platforms used by two major clinical trial sponsors. The company will deploy its Archer technology through the MSK Innovation Hub.
The goal is to streamline and improve what is often a manual process of pulling and verifying data from sometimes different EHRs to support cancer research, boosting the efficiency of these trials, improving the process for selecting and monitoring participants, and eventually leading to better outcomes.
The technology is designed to enable research staff to quickly transfer regulatory grade data such as vital signs and labs—which typically account for as much as half of the data needed—into the sponsor's study database, reducing data entry errors and source data verification and query resolution times.
“Today, a typical phase 3 oncology study generates an average of 3.6 million data points," Dan Hydes, IgniteData's co-founder and CEO, said in a press release. "More than half of this eSource data already exists in patients’ electronic medical records, yet it is still being painstakingly transcribed into study databases, burdening research staff and creating inefficiencies and delays."
“This collaboration aspires to automate the routine tasks performed by our research teams and quicken the pace of clinical trial execution, driving us toward our ultimate goal of changing how the world treats cancer through research," added Joseph Lengfellner, MSK's senior director of clinical research informatics.
Once the process is worked out, officials said they would expand interoperability to other clinical trial platforms.
AdvancedMD's Amanda Hansen outlines what providers should consider as they pursue partnerships with private equity firms.
The turbulent nature of the current financial climate for private practice owners makes the concept of partnering with a private equity (PE) firm appealing.
Practicing independently can be liberating, but it can also come with burden that is currently being exacerbated by challenges like staffing shortage.
It's no surprise then that there's plenty of activity happening in the PE space as practices explore the possibility of selling and joining a larger group.
"Private equity activity, it can be exciting," says Amanda Hansen, president of cloud medical software company AdvancedMD. "There can be a draw, you can feel like there's going to be good financial payout and reducing that administrative person. But I think doing an honest assessment and making sure that if it is something you're considering that, similar to choosing a new vendor, you would do even more diligence on the PE firm that you're looking at."
For those wanting to take the leap into private equity M&A, Hansen detailed to HealthLeaders the five steps practices should take:
Clean up your KPIs
"The most important thing to help a process go smoothly and help PE firm make an educated informed decision is data," Hansen says. "If you don't measure it, you can't impact it. So make sure as a business you're measuring the right things to help a PE firm or anyone else understands how valuable the business actually is."
Those key performance indicators (KPIs) can be broken up into three different areas:
Clinical outcomes: Measure over time and show improvement in areas like no-show rate, preventative care measures, and patient satisfaction.
Financial health outcomes: On the billing and coding side, look at areas like revenue growth rate, net revenue per visit, operating margin, and collection rate.
Productivity data: Show that the physicians and staff are maximizing their time by measuring aspects like patient visits, average patient wait time, and billing and coding accuracy.
Improve your practice's financial health
Once practices measure their KPIs, it will become easier to see where the gaps and opportunities are to improve financially.
One of those areas of opportunity is often revenue cycle management (RCM). "Practices, providers, and physicians are leaving hundreds of thousands of dollars on the table by having poor revenue cycle management processes," Hansen says.
To improve RCM, practices can make sure they've negotiated favorable rates with payers, as well as making sure they're following up, working denials, and cleaning up denials on the front end.
"A really important one is enhancing your patient experience, which will drive better retention and it will drive more visits and more opportunity in the future," Hansen says.
Audit your workflow processes
Practices can drive efficiency by ensuring they don't have time or resources going unused.
"That can be looking at your operational effectiveness from the registration, from a check-in perspective, documentation," Hansen says. "It's automating administrative tasks that will help improve efficiency for your staff."
This could involve allowing patients to schedule appointments online themselves and making sure your schedule is updated so patients can be called if there are openings. Or it could mean allowing patients to upload their insurance card as part of the registration process so that they don't have to scan every time they go for an appointment.
Embrace innovation
Innovation became even more important during the COVID-19 pandemic, when healthcare still had to happen while everyone was sheltering in place.
That gave rise to telehealth, which went from a secondary option to the primary form of delivery of healthcare.
Being able to maximize value by coming up with and implementing similarly innovative solutions will allow practices to generate the most operating income possible.
"As a practice, it's making sure that you're evaluating what you do have and trying to find the best available out there in order to better position. It just makes the whole business look more attractive when you can do things efficiently and you're doing it with the least expense possible."
Implement the right technology
Finally, practices need to put in place technology that makes the most sense, which can be tricky with the wide range of options available.
Finding the right fit for your practice requires vetting, both of your own processes and of the vendor you're considering. After implementing the technology, practices also need to help staff understand why and how to use the system.
"There's some sort of balance that comes from making smart adjustments to your workflow to meet the system, but also making sure the system is customizable enough that it can also meet the needs of your workflow without having to disrupt your entire business," Hansen says. "So it takes a lot of diligence on the front end and the people that we've seen do that have had a lot of success down the road."
Following these five steps will benefit practices in both the short term and the long run, M&A activity or not.
"It's going to better position you to have a more successful business regardless of whether there's some sort of divestiture involved in that," Hansen says.
Researchers in Pittsburgh found that an AI tool outperformed the three most common practices for analyzing ECGs of patients being treated for chest pain, reclassifying one of every three patients.
An AI tool used in three Pittsburgh hospitals was able to diagnose and reclassify 33% of patients being treated for chest pain, improving on the standard practice for identifying heart attacks and potentially saving lives.
The technology, developed by researchers in Toronto, analyzes ECG readings for subtle clues that are often overlooked, leading to delays in detection and treatment. Researchers from the University of Pittsburgh compared the model against the three gold standards for assessing cardiac events and found that the AI tool performed better than all three.
“When a patient comes into the hospital with chest pain, the first question we ask is whether the patient is having a heart attack or not," Salah Al-Zati, PhD, RN, an associate professor in the Pitt School of Nursing and of emergency medical and cardiology in the School of Medicine, said in a press release issued by UPMC. "It seems like that should be straightforward, but when it’s not clear from the ECG, it can take up to 24 hours to complete additional tests. Our model helps address this major challenge by improving risk assessment so that patients can get appropriate care without delay.”
Al-Zaiti was part of the team that tested the technology on 4,026 patients treated for chest pain at the Pittsburgh hospitals and co-authored the results of the study, which was recently published in Nature Medicine. Those results were independently validated with 3,287 patients from a different health system.
The study compared the technology against experienced clinician interpretations of an ECG, commercial ECG algorithms, and the HEART score, which factors in age, risk factors, and other considerations prior to diagnosis. The model outperformed all three standards, reclassifying one of every three patients into low, intermediate, or high risk.
The study has implications not only for ED treatment, but for those who are first on the scene to treat patients with chest pain.
“This information can help guide EMS medical decisions such as initiating certain treatments in the field or alerting hospitals that a high-risk patient is incoming,” Christian Martin-Gill, MD, MPH, chief of the Emergency Medical Services division at UPMC and co-author of the study, said in the press release. “On the flip side, it’s also exciting that it can help identify low-risk patients who don’t need to go to a hospital with a specialized cardiac facility, which could improve prehospital triage.”
Martin-Gill and his team are testing that concept in the next phase of their research. They're working with the City of Pittsburgh Bureau of Emergency Services to deploy the model through the cloud to hospital command centers, which can direct risk assessments back to EMS teams in the field for more timely diagnosis and treatment.
EHR platforms are complex and costly and require a lot of planning to make sure they're a good fit for a health system. Here are 8 recommendations for organizations looking to transition from one EHR to another.
Electronic Health Records platforms have been around since the first EHR was unveiled by the Regenstrief Institute in 1972. And while there are just as many horror stories related to EHRs as successes, there's little doubt that the technology is integral to a health system's growth and development.
As with any technology, EHRs have evolved considerably since their first iteration, with new tools and capabilities that can address key healthcare pain points, both administrative and clinical, and address new capabilities like interoperability, virtual care, and even AI. The market has also grown, with new companies that can tailor EHRs to specific specialties.
With that in mind, health systems need to think carefully about their EHR investment, whether they're purchasing a new platform or transitioning from one to another. It's an expensive undertaking, not only for the initial software purchase but also in staffing, training, and workflow adjustment, as well as down time and the inevitable problems that come with a new tech installation.
Many health systems are now considering switching EHRs, either because they've outgrown the legacy platform they started with or they're not satisfied with the product.
"Such a transition requires a substantial investment in planning, preparation, and execution," says Ezio Castellani, vice president of healthcare and life sciences at IT consultancy company DataArt. "The prices of purchasing the new system, hiring additional staff, and providing training increase, and healthcare organizations’ budgets may not have room for large-scale IT projects. Furthermore, it will likely significantly impact patient care and the hospital's financial performance, so the decision needs thorough consideration and budget planning."
Key to that transition is data migration. Health system leaders need to develop a reasonable timeline for the transition, he says, with the understanding that this will be time-consuming. Aside from integrating all of a health system's technology, from software platforms to devices, into the new system, they also have to adjust workflows and train everyone on the new system.
"Rushing the switch to a new system can lead to errors and negatively impact patient care, while prolonged transition can increase costs and frustrate staff," Castellani says.
For healthcare organizations considering this move, Castellani offers eight recommendations:
Develop a detailed plan before beginning. Include detailed timelines, roles, and responsibilities for everyone involved, and be sure to build in contingency plans and time considerations for the inevitable unexpected issues and delays.
Consider outsourcing integration assistance. Not all health systems have the technical expertise on hand to manage a project this complex. A third-party system integrator can assist with or even handle many of the tasks associated with the transition, from project management to data migration to customizations. It's vital that this be considered early on in the process, so that time spent reviewing vendors and associated costs are included in the budget.
Get everyone involved. Key stakeholders, including physicians, nurses, and IT staff, need to be part of the process from the planning stages, so that everyone understands the transition and can offer input on how it will affect their departments. There are plenty of stories about new technologies that have failed because the end-user wasn't included in the planning process.
Test, then test again. Technology installations rarely go as planned. Putting the new platform through repeated tests enables everyone involved to see how the technology will work and spot potential issues or pain points. This includes testing data migration, user interfaces, functionality, and customizations.
Don't skimp on training. Make sure everyone who will use the new platform gets the training needed to understand how it works, including instruction on what to do when something goes wrong. A fully prepared workforce reduces the lag time when the new platform is launched and improves the chances of a smooth transition.
Ensure data integrity. Perhaps the most important aspect of the transition is ensuring that all data moves from one platform to the other, and that it can be located and used accurately and consistently in the new system. This is not only a functionality issue, but a patient safety issue as well. Have protocols in place to ensure that all data has migrated, with no gaps or errors, and have procedures in place for data backup and recovery.
Keep an eye on the EHR. Once the new platform is up and running, it's essential to monitor how it's working and how it's used. Establish processes and protocols that will enable management to quickly spot and address any issues before they become much larger problems.
Create a support network. Establishing a help desk and/or technical support team ensures that anyone using the EHR knows who to contact in an emergency. This will cut down on a lot of the stress and frustration associated with using the technology and ensure that problems are quickly addressed.
"Changing EHRs can be challenging and require extensive planning, preparation, and execution," Castellani points out. "Healthcare organizations must carefully consider the challenges and potential risks of transitioning to a new system before deciding to do so. Adequate planning, training, and budgeting can help mitigate potential risks and ensure a successful transition."
The agency says the innovative program that allowed EMS providers to seek alternative care pathways instead of the routine ED transport didn't get enough participants or interventions.
An innovative alternative payment model for emergency transports is ending early due to a lack of participants and interventions.
The Centers for Medicare & Medicaid Services (CMS) has announced it will shut down the Emergency Triage, Treat, and Transport (ET3) Model at the end of this year, two years earlier than planned.
"Current and projected number of interventions are lower than the number anticipated when the Model was designed," the agency said in a notice to participants. "This affects the cost of operating the Model relative to its expected benefits, the ability of CMS to conduct a robust quantitative evaluation of the Model’s impact, and the Model’s ability to achieve the estimated Medicare savings in the Model’s design. For these reasons, CMS has determined that it is not in the public interest to test the Model in Performance Year 4 (Calendar Year 2024) through Performance Year 5 (Calendar Year 2025) and has good cause to unilaterally amend the Agreement to modify its Performance Period."
Unveiled in 2021, the five-year project was designed to give EMS providers more flexibility in addressing the emergency care needs of their patients. Participants, ranging from EMS and healthcare providers to local governments, were encouraged to identify alternatives to the standard ED transport, such as urgent care centers, physician offices, and telehealth.
In March of 2021, CMS unveiled a list of 184 public and private ambulance providers and suppliers selected to take part in the program, as well as plans to seek $34 million in funding to support the model.
Participating ambulance providers and suppliers are paid by Medicare based on the level of service provided— Basic Life Support (BLS-E) or emergency Advance Life Support, Level 1 (ALS1-E) rate—plus mileage and quality adjustments. The qualified healthcare practitioner is also paid the current Medicare rate if the practitioner can treat the beneficiary in place.
The model had been delayed by one year due to the pandemic, and CMS adjusted the model to include more locations for transports during the public health emergency (PHE).
CMS' decision doesn't affect participation in the model or the ability to bill for ET3 interventions or receive performance-based payments through the end of this year.
"Emergency Medical Services remain an area of focus for CMS, and we believe that the lessons learned from the ET3 Model can aid in the development of potential future initiatives," the agency said.
OU Health has achieved low turnover in the health system's supply chain team by hiring the right leaders as well as having clear roles and responsibilities, says Josh Bakelaar, MBA, vice president of supply chain.
Bakelaar has been vice president of supply chain at OU Health since May 2020. His prior experience includes serving as system director of strategic sourcing for UW Medicine.
HealthLeaders recently talked with Bakelaar about a range of issues, including the challenges of leading supply chain at OU Health, lessons learned during the coronavirus pandemic, and the role of physicians in the OU Health supply chain. The following transcript of that conversation has been lightly edited for clarity and brevity.
HealthLeaders: What are the primary challenges of serving as vice president of supply chain at OU Health?
Josh Bakelaar: I have been here about three years, and one of the biggest challenges is that our supply chain team had lots of opportunities for improvement. I have addressed three things. The first focus was governance. Our hospitals were functioning pretty independently in their decision making around supply chain. We had centralized services, but a lot of the decision making was happening at the site level as opposed to the system level. We addressed that so we could realize economies of scale and other benefits of being a health system.
Second, there was a lot of tribal knowledge around our processes. We didn't have a lot of documentation. So, there were many opportunities to close gaps around processes and efficiencies.
Third, there was a leadership and talent gap. Our hospitals were largely making independent decisions—they each had individual supply chain leaders. Plus, we had an off-site warehouse that had a different leader. There was not a singular guiding force across all of our supply chain teams strategically.
HL: How did you improve leadership across the supply chain?
Bakelaar: It was mainly redesigning the org chart. When we divested from HCA about five years ago, one of the things that was apparent to me coming in was that a lot of the central back-office functions just did not exist as part of OU Health. We did not have a complete supply chain. For example, we did not have inventory control. We only had a couple of contracting people and one value analysis person. There were limited informatics capabilities. We had to scale up and build out an end-to-end supply chain team.
Josh Bakelaar, MBA, vice president of supply chain at OU Health. Photo courtesy of OU Health.
HL: You became vice president of supply chain at OU Health during the beginning of the pandemic. What were the primary lessons you learned from leading the health system's supply chain during the pandemic?
Bakelaar: I started here in May 2020, a couple of months after the pandemic hit the United States, but it had not hit Oklahoma yet. What I learned was the importance of good supply chain leadership. We had to have a good governance structure in place around how decisions were made. You need to have clear roles and responsibilities. Sometimes, a disaster hits and there is scrambling to figure out who is going to do what. Having that ironed out ahead of time is valuable.
Remote working was an issue. Right now, there is a debate in this country about the feasibility of working remotely. When I started at OU Health and came in for my first day, there were only about three or four people in our supply chain office. Everyone else was working from home. I came into the office every day for many months, got to learn the operation but I also had to build a lot of relationships on Zoom and Teams.
Over the past three years, we have built our team in a largely hybrid and remote environment. Our purchasing team is classified as remote. Our informatics team is classified as remote—the director of that team lives in Florida. Our sourcing team is classified as hybrid—they work remote most of the time. With all of this remote work, we have thrived.
You have to have good documented processes for backorders and substitutions. Early on in the pandemic, personal protective equipment was not available but everything else was fine. Eventually, multiple suppliers started making PPE, and we had it coming out of our ears but we were running out of other supplies. So, going into the pandemic, it would have been better for us to have more documentation of the backorder and substitution processes.
HL: What have been the keys to success in having so many people working remotely?
Bakelaar: Leadership is critical. You need to have the right people in the right seats with the right mentality of how to manage people in the work environment. We round on our people regularly. For the people who report directly to me, we talk informally several times per day. We call each other on Teams. We put a lot of emphasis on having the camera on and being engaged as if you are working in person. We communicate informally but intentionally.
We make sure we are hearing from our teams—what's making them happy and what's not. We look for opportunities for improvement. Our turnover is really low.
HL: Why do you think you have low turnover in your staff?
Bakelaar: I have heard the phrase that people don't quit their jobs, they quit their bosses. I believe strongly in hiring the right leaders, getting them the right seats, and having clear roles and responsibilities. We also have done a tremendous amount of work around process discipline and process documentation. The expectation on our team is that we all get on the same page about what a process is, and we stick to it.
I have worked in supply chains where not everybody was on the same page, or there were different priorities. We have been intentional about removing things that are frustrating. We are accountable to creating a positive work environment.
HL: How does your group purchasing organization function?
Bakelaar: Vizient is our GPO, and there are several areas of benefits in working with them. First is cost savings. We have partnered with them and implemented cost savings over the past couple of years.
Vizient describes themselves as a performance improvement company, so they look beyond just the traditional GPO supply chain functions. They work on quality with their databases as well as patient safety. We are partnering with them to tackle catheter-associated urinary tract infection and central line-associated bloodstream infection reductions. We are tackling patient safety issues and clinical documentation improvement.
We use Vizient to help solve some of our governance challenges. They helped us get some governance models created around the supply chain function.
HL: How do you engage physicians in the supply chain?
Bakelaar: Physicians played a key role in the governance work that we did with Vizient. We set up some service line clinician-led groups. These service line groups meet monthly. Supply chain will facilitate the conversation, but, ultimately, we look to our physicians and clinicians to make data-informed decisions around the supplies we are going to contract for. At any given meeting, we might talk about some new products that are coming to market. Most meetings focus on looking at our portfolio of contracted products and making strategic decisions that maximize cost, quality, and outcomes for our patients.
HL: Your background includes experience in strategic sourcing and inventory control. How did this background help to prepare you to serve as a supply chain leader?
Bakelaar: I have come up through the ranks. I started in healthcare supply chain soon after high school. So, I have been doing this work for a long time. I have done many of the frontline jobs such as supply chain technician work, ordering, and receiving. I moved up through different management positions along the way. This experience has allowed me to lead with a lot of empathy when it comes to my team—I can put myself in their shoes.
When I round on the team and hear the frustrations that they have, it takes me back to when I was in their shoes doing that work. I make sure frustrations get fixed.
I have worked in supply chains where the senior leadership said "yes" to everything that came their way. That created pressures, and workload management issues would arise. What I try to do as a supply chain leader is to be mindful and protect my team along the way. If an executive asks me whether we can do something, I don't just say "yes." I say we can do it, but I may say that we will need more resources, or we may need to slow down another process. I am mindful to make sure that we are not over-promising and under-delivering. I am mindful to make sure we are not putting too much on our plate and stressing our folks.
The executive vice president and chief information & innovation officer at Children's Hospital & Medical Center is committed to an innovation strategy that will keep the Omaha-based hospital on the cutting edge of children's care.
Healthcare innovation might seem like a slow and steady process, marked by methodical pilots that gather data and lead to system-wide adoption.
Jerry Vuchak would like you to know that isn't the case in pediatric care.
"We frequently want to go faster than [technology vendors] want to go," says the executive vice president and chief information & innovation officer at the Omaha, Nebraska–based Children's Hospital & Medical Center. "We're moving forward at a pace that they're not used to."
There's a reason for that. Roughly $22 billion was raised globally in 2020 for digital health innovation, according to StartUp Health's annual report, yet only $167 million, or less than 1%, was set aside for children's digital health. And a quick online search of "children's hospitals" and "healthcare innovation" finds that many of the 250 or so children's hospitals in the U.S. are actively trying to raise funds that they aren't getting from the National Institutes of Health or other resources.
Whatever the reason for this lack of representation, Vuchak is quick to point out that innovation is alive and well at Children's Hospital & Medical Center. That's because so many care pathways and treatments for children can be made better.
Consider, for example, alarms within the hospital. They're vital to alerting care teams when patients are in distress, yet in children's hospitals they can also be distressing to patients, many of whom are scared to be in a hospital. With that in mind, Vuchak, says, Children's is working on designing new alarms that can alert providers without adding to a patient's discomfort.
Jerry Vuchak, executive vice president and chief information & innovation officer at Children's Hospital & Medical Center. Photo courtesy Children's Hospital & Medical Center.
"Innovation is our first value," he points out. "And it's not just words on a page. We're always thinking about how we can do things better because it's in our culture. It has a huge impact on our patients and their families."
Vuchak's view is shared by many innovation executives at pediatric hospitals across the country. Because so much of the activity in healthcare innovation is geared toward the adult patient, pediatric-based health systems are forging their own paths, creating innovative tools and strategies that apply directly to their young and fragile patients and their families.
This, in turn, makes pediatric healthcare innovation a dynamic arena.
"It's much harder in the pediatric environment," Vuchak says, noting the hospital has even had to build pediatric content into its EHR platform. "But that also makes it much more rewarding."
In many cases, children in pediatric hospitals and their parents are eager to embrace innovation. That's seen in Children's Hospital & Medical Center's digital front door. While national estimates place the number of patients using digital health tools to access care at between 30% and 40%, Vuchak says more than 70% of their patients are digitally active.
"Consumer engagement and experience is [a key factor to] our digital front door strategy," he says. "So it's very important to us that we know if we're thinking about the right things. That's how we'll build our roadmap out beyond 2023."
This roadmap includes mobile health apps that give care providers access to the latest information on chronic diseases like asthma, as well as up-to-date information on the patient, including medications and other treatments; and remote patient monitoring programs that ease the transition from the hospital to the home. One such program focused on young children who've had heart surgery within their first six months. The program boosted clinical outcomes 10%–20% by giving providers access to data that enabled them to intervene more quickly when a patient started trending downwards.
"We're prioritizing access to services," Vuchak says, meaning both how patients and their families can access healthcare and how providers can access resources to improve care. "We have a strategy council, and we have more ideas than we can actually take on."
Aside from augmented and virtual reality, in which Vuchak says "we're just scratching the surface," Children's Hospital & Medical Center is exploring how AI can be integrated into both provider workflows and care programs, and how wearables might be used in pediatric care—a challenge, again, because so many wearables are designed for adults.
Vuchak says he's surprised that so many companies in the healthcare technology space don't have a good innovation strategy. That's why he'll look far and wide for partners that have the right philosophy, and who will pivot quickly and adjust to meet specific and important patient needs.
As with all areas of healthcare innovation, the pandemic was a driving force in the adoption of new ideas and technologies, especially virtual care. For Children's Hospital & Medical Center, there was another unexpected benefit: the shift to working from home opened up 10,000 square feet of space within the health system, which is now being turned into a center for innovation.
This, he says, will help Children's to develop tools and platforms that address not only the patient, but the surrounding support team, including family, friends, and providers. It will also help as the hospital dives into the challenges around social drivers of health and the myriad causes of health inequity and outcomes, which healthcare organizations are now finding ways to address.
"You don't want to slow down because there's so much that can be done," Vuchak says. And that's both an important skillset and a challenge to working in pediatric healthcare.
HealthLeaders Innovation and Technology Editor Eric Wicklund talks with Dr. Mafuzur Rahman, CMIO at SUNY Downstate Health Sciences University, about how the Brooklyn hospital is integrating AI tools into its patient discharge process to improve engagement and care coordination with patients who recently visited the ER or had a hospital stay.
The Midwest health system has developed new algorithms to help its nurse navigators manage their workflows, reducing stress and burnout and improving care management for cancer patients.
OSF Healthcare has designed an AI platform that improves care management for cancer patients by monitoring and adjusting the workflows of nurse navigators.
The Illinois-based health system developed an algorithm that combs through the electronic health record platform and other data sources to map out each cancer patient's journey for the coming week, including new patients. The technology then assigns the new patients to nurse navigators according to characteristics like cancer specialty and a care navigator's existing workload.
The platform not only improves care management for patients by ensuring they're matched with the most appropriate navigator, but also reduces stress and burnout among navigators by helping them manage their workloads.
"Our cancer patient nurse navigators are highly dedicated, and their workload can sometimes be overwhelming," Jonathan Handler, a senior fellow in innovation for OSF Healthcare, said in a press release. "They never want to shortchange the patient, so they shortchange themselves, working extra hours and sacrificing their own well-being to help patients. We hope our system can even out those workloads and improve their work-life balance."
The technology was developed by a team that consisted of researchers from OSF Healthcare and the OSF Innovation group, the University of Illinois College of Medicine Peoria, the University of Illinois Urbana-Champaign, and the Northwestern University Feinberg School of Medicine. It was funded by a grant from Jump ARCHES (Applied Research for Community Health through Engineering and Simulation), a collaborative that includes OSF Healthcare, the University of Illinois College of Medicine at Peoria, and the University of Illinois Urbana-Champaign.
The team's work was recently published in the American Society of Clinical Oncology's Journal of Cancer Informatics (JCO). That report noted that this may be the first time a project like this focused on the individual—including anticipated patient needs, navigator experience, and existing workload--rather than shifts, and the model they created "significantly outperforms the random distribution approach that approximates our current distribution methodology."
"Better workload management may reduce CPN burnout and lead to more effective and efficient navigation assistance for patients with cancer, allowing greater scalability of this vital resource to all oncology patients in need, regardless of geography," the study concluded.
The health system will next introduce the technology into its cancer care program through its OSF Community Connect workflow automation platform.
The proposed Transitional Coverage for Emerging Technologies (TCET) pathway is designed to facilitate Medicare coverage for new treatments that usually need time to develop data proving their value.
Federal officials are proposing an expedited pathway for Medicare coverage of new medical technologies.
In a notice posted in the Federal Register, the Centers for Medicare & Medicaid Services (CMS) is proposing a voluntary Transitional Coverage for Emerging Technologies (TCET) pathway for designated Breakthrough Devices. Officials say the new pathway, developed in a partnership with the Agency for Healthcare Research and Quality (AHRQ), should speed up the process to bring new treatments to Medicare beneficiaries while ensuring those treatments still meet rigorous review guidelines.
"As part of our commitment to fostering innovation and ensuring patient-centered care, CMS created the TCET pathway to provide a mechanism for coverage for certain new, innovative technologies with limited or developing evidence in the Medicare population using a transparent and predictable evidence generation framework that, when appropriate, not only develops reliable evidence for patients and their physicians to make healthcare decisions but also provides safeguards to ensure that Medicare beneficiaries are protected and continue to receive high-quality care," the agency said in a press release.
Officials said the new pathway was developed through feedback from a wide range of sources and based on requests "for CMS to utilize a more agile, iterative evidence review process that considers fit-for-purpose study designs, including those that make secondary use of real-world data."
Candidates for the TCET pathway will include devices that are:
Certain FDA-designated Breakthrough Devices;
Determined to be within a Medicare benefit category;
Not already the subject of an existing Medicare NCD; and
Not otherwise excluded from coverage through law or regulation.
Key elements to the TCET pathway include an evidence preview, or focused literature review, and an evidence development plan (EDP), which would be drafted by the developer to address any evidence gaps spotted in the evidence preview.
Once a treatment has qualified for this pathway, Medicare coverage will remain in place "only as long as needed to facilitate the timely generation of evidence that can inform patient and clinician decision making," along with an additional year to allow manufacturers to finish their analysis. CMS would then launch its updated evidence review.
Public comments on the proposal will be accepted for the next two months.
Josh Bakelaar, MBA, vice president of supply chain at OU Health. Photo courtesy of OU Health.
