CareSpark TOP |
Slide 1: CareSpark: Working to improve health in the central
Appalachian region through the collaborative use of health information
|
CareSpark TOP |
Slide 2: Tri-Cities TN / VA Regional Medical Service Area
Image: Map showing the
Tri-Cities TN/VA Regional medical service area
|
CareSpark TOP |
Slide 3: TN / VA Regional Health Problems
Image: National map showing
the age-adjusted death rates by HSA, 1988-92
|
CareSpark TOP |
Slide 4: TN / VA Regional Health Problems
Image:
1. Line graph showing
all cancer mortality trends in the US in general and in the TN/VA
Region
2. Line graph showing
the diabetes mortality rates in the US in general and in the TN/VA
Region
|
CareSpark TOP |
Slide 5: Worst Health Status in U.S. : Drives Estimated $2,400
Cost PMPY
Image: Map showing the
scores for the mental and physical health of veterans and non-veterans
across the country, broken into regions.
|
CareSpark TOP |
Slide 6: National Health Expenditures per Capita
Image:
1. Line graph showing
the national health expenditures per capita.
Source: CMS
Caption:
1. Bedard [CEO Crown
Laboratories] added that if he had known how unhealthy Johnson City
was several years ago, he probably wouldn't have moved his company
here."
Source: Johnson City Press
|
CareSpark TOP |
Slide 7: Delivering Healthcare Value -The Whole Is Greater Than
Any Part
Image:
1. A circle showing the
different parts of healthcare: MD office, lab, ED, hospital, rehabilitation,
pharmacy and home care.
|
CareSpark TOP |
Slide 8: Delivering Healthcare Value -The Whole Is Greater Than
Any Part
Image: Circle representing
RHIO CareSpark within another circle representing zone of cooperation.
|
CareSpark TOP |
Slide 9: What Is CareSpark?
CareSpark is a not for
profit organization committed to better health in the central Appalachian
region through collaboration, innovation, and wise use of health
information.
- 14 year history of
health improvement projects
- Regional leaders
concluded major improvements require regional health information
exchange (HIE)
- 2 ½ years on current
project; $600,000 raised in 9 mo
- Formed as 501c3 not
for profit organization
|
CareSpark TOP |
Slide 10: Innovative Regional Cooperation To Improve Health
- Active, representative
membership, including
- Eastman Chemical
Company
- Blue Cross Blue
Shield, John Deere Health
- Mountain States
Health Alliance, Wellmont Health System, James H. Quillen VA,
Medical Center, Johnston Memorial Hospital, Laughlin Memorial
Hospital
- Frontier Health
- Holston Medical
Group, Highlands Physicians, State of Franklin Healthcare Associates,
Mountain Region Family Medicine, Clinch River Health Services
- East TN State University
and Medical School
- Public health departments
in TN and VA
- Kingsport Tomorrow
|
CareSpark TOP |
Slide 11: Strategic Planning Process
Image: A continuous improvement
cycle continuum with core strategies followed by core tactics, strategic
planning and implement.
|
CareSpark TOP |
Slide 12: CareSpark
Mission: To improve the
health of people in Northeast Tennessee and Southwest Virginia through
the collaborative use of health information
Vision: To be a world-class,
quality-driven, clinically integrated, efficient health and wellness
system for the people of our region
|
CareSpark TOP |
Slide 13: CareSpark
- Values:
- Regional Cooperation
- Community Accountability
- Privacy
- Integrity
- Continuous Improvement
- Inclusiveness
- Stakeholder Parity
- Goals:
- Improve clinical
practice
- Coordinate clinical
care
- Personalize care
- Improve population
health
- Create an efficient
health system
|
CareSpark TOP |
Slide 14: Targeted health issues
We are targeting the
health issues of greatest impact on quality of life and cost:
- Diabetes
- Hypertension / stroke
- Cardiovascular disease
- Lung disease / asthma
- Preventive immunizations
/ screenings
|
CareSpark TOP |
Slide 15: Tactical plan
To address health issues,
we propose to provide technical capability and encourage clinical
process improvement in the following areas:
- Prescription Medication
- Diagnostic (lab, imaging)
Services
- Preventive Medicine
(immunizations / screenings)
- Chronic disease management
|
CareSpark TOP |
Slide 16: Principles
- Work for the good
of the community
- Enable clinicians
to provide better outcomes
- Assure cost-effective,
coordinated care delivery
- Provide necessary
support through transition to an electronic health record system
(EHR)
- Engage all purchasers
willing to cooperate
- Engage all providers
willing to cooperate (both large and small groups)
|
CareSpark TOP |
Slide 17: Principles
- Ensure ratio of investment
and return is fair for all parties
- Share savings through
incentives for all participating stakeholders
- Implement the full
scope of project in a practical way
- Sequence implementation
by introducing new programs over time with coordination to insure
functional and fiscal soundness
|
CareSpark TOP |
Slide 18: CareSpark Facilitates Wise Use of Health Information
- Provide health information
on demand at the point of service
- Encourage use of evidence-based
guidelines defined by community consensus
- Provide selected aggregate
data for regional improvements
- Enable individuals
access to personal health information through a secure internet
interface
|
CareSpark TOP |
Slide 19: Health Information Exchange
Image: Showing the pathway
of health information being exchanged between providers, hospitals,
public health officials and other health organizations.
|
CareSpark TOP |
Slide 20: Projected Tri-City TN-VA Health Expenditures
Image: Bar graph showing
the projected Tri-City TN-VA Health Expenditures
|
CareSpark TOP |
Slide 21: Regional Economic Impact
Image: Bar graph showing
the financial impact of the CareSpark program on the TN-VA region.
|
CareSpark TOP |
Slide 22: Medication and Diagnostic Services Improvement Savings
Model Projections
Image: Bar graph showing
the projected medication and diagnostic services improvement savings
|
CareSpark TOP |
Slide 23: Opportunity: Programs Covered In This Model
- Medication Improvement
- 1st of several
"layers"
- 3-year cost: $12.6
M
- Technology required
- Web-based electronic
health record with e-prescribing capabilities
- Health Information
Exchange not required
- Diagnostic Services
Improvement
- 2nd of several
"layers"
- Small incremental
cost: $2.7M
- Technology
- Physician Order
Entry Module required
- Health Information
Exchange required
|
CareSpark TOP |
Slide 24: Cost-Benefit Projections
Image:
1. Bar graph showing
cost-benefit projections for 2005, 2006 and 2007
|
CareSpark TOP |
Slide 25: Possible Investment and Reward Scenarios
- There are multiple
"investors" who can invest different resources in different proportions
- "Investors" may invest
effort, risk, and expense
- Rewards should be
shared equitably and proportionately
Scenario |
Purchasers/
Insurers |
Physicians/
Health Systems
|
Others |
A |
67% |
33% |
|
B |
33% |
67% |
|
C |
50% |
50% |
|
D |
33% |
33% |
33% |
|
CareSpark TOP |
Slide 26: 3 Year Incentive Scenario Summary
Image: Table showing
four scenarios for a three year incentive
|
CareSpark TOP |
Slide 27: Progress to Date
- Technical inventory
and feasibility study completed
- Strategic business
plan developed
- Non-profit organization
formed, board of directors in place
- Funding commitments
of $75,000 (April 2005)
|
CareSpark TOP |
Slide 28: Next Steps
- Finalize partnership
agreements (May - July 2005)
- Secure $3M in funding
for development and execution through June 2006
($600K by July 1, 2005; $2.4M by Sept 1, 2005)
- Secure staffing for
development and operations
(Executive Director, administrative assistant, project manager)
by May 15, 2005
- Define technical specifications,
conduct vendor selection process (July - Aug 2005)
|
CareSpark TOP |
Slide 29: The Decade of Health Information Technology
Office of the National
Coordinator for
Health Information Technology (ONCHIT)
http://www.hhs.gov/healthit/
- Appointed as the first
National Health Information Technology Coordinator on May 6, 2004
- To execute the actions
ordered by President George W. Bush in the Executive Order that
he issued on April 27, 2004
- Widespread deployment
of health information technology within 10 years to help realize
substantial improvements in safety and efficiency
|
CareSpark TOP |
Slide 30: ONCHIT: Framework for Strategic Action
Four overarching goals
http://www.hhs.gov/healthit/frameworkchapters.html
Goal I: "Inform Clinical Practice." This goal centers
around efforts to bring electronic health records directly into
clinical practice. These tools will reduce medical errors and duplicative
work, and enable clinicians to focus their efforts more directly
on improved patient care.
Goal II: "Interconnect Clinicians." Interconnecting clinicians
will allow information to be portable and to move with consumers
from one point of care to another.
Goal III: "Personalize Care." To personalize consumer
health care decision making, using Personal Health Records (PHRs)
will be encouraged, providing for better information to assist with
consumer choices will be promoted, and increasing the use of telehealth
systems will all be strategies to personalize care.
Goal IV: "Improve Population Health." Population health
improvement requires the collection of anonymous, timely and standardized
clinical information that can support reporting for public health
monitoring, bioweapon surveillance, post-market adverse event tracking
and quality benchmarking.
|
CareSpark TOP |
Slide 31: RHIO Characteristics
Criteria for a RHIO (Regional
Health Information Organization)
- Multi-stakeholder,
trusted entity
- "Harmonization of
federal / state / local laws governing privacy, security
- Ability to assure
security, policies to enforce compliance among participants
- Alignment of financial
incentives
|
CareSpark TOP |
Slide 32: Tennessee initiatives
- Volunteer E-Health
Initiative (Vanderbilt / Memphis)
$5M federal, $5M state funding, $5M inkind hospital-based medications
for TennCare
- Shared Health (BlueCross
BlueShield of TN)
proposed central warehouse for all TennCare records
- etHIN (Knoxville)
Four hospitals sharing digital images through network
- Initial meeting in
Chattanooga
|
CareSpark TOP |
Slide 33: Virginia initiatives
- HIT Task Force appointed
by Gov. Warner
- Carillion pilot linking
hospital / MD / public health
$40K state funding for public health link
- Pilot linking hospitals
in Richmond
$40K state funding
|
CareSpark TOP |
Slide 34: Potential Policy Change
- Standards for technology
(open-source)
- Clinical standards
(evidence-based protocols)
- Privacy (patient "opt-in"
vs. opt-out)
- Financial incentives
for providers ("pay for use", "pay for performance", technology
subsidies, RHIO funding)
- Governance (RHIO structure)
- Liability (among those
sharing data)
- Role of federal /state
/ local entities
|
CareSpark TOP |
Slide 35: Get Involved!
For more information
or to help
Visit our website at
www.carespark.com
Contact Liesa Jenkins,
project director
423-246-2017
ljenkins@carespark.com
|
CareSpark TOP |
Slide 36: CareSpark
Image: Picture of the
Appalachian mountains.
Caption: Together we
can make a difference in the health of central Appalachia!
|