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CMS care-delivery project shows mixed early results

States participating in Round 1 of the Centers for Medicare & Medicaid Services State Innovation Models Initiative relied heavily on data-sharing and health information technology to enhance care delivery. Problems arose, says a CMS report on the  program’s second year.

The report summarizes the policies and strategies used by the six states in the program–Arkansas, Maine, Massachusetts, Minnesota, Oregon and Vermont.

Maine’s goals, for example,  included connecting behavioral-health providers to the state’s health information exchange and piloting patient access to medical records via the Blue Button project. Financial support went to behavioral-health organizations to improve their electronic health record technology.

In Minnesota the aim was to increase EHR and HIE use among providers in ACOs and the broader community and create an eHealth Roadmap to expand use of such tools by behavioral-health providers.

In Arkansas it was to use the state’s HIE to send emergency and admit-discharge-transfer information to Medicaid patient-centered medical home providers.

In Massachusetts it was to create a portal, Community Connect, for caregivers and beneficiaries to access home care records.

In Oregon it was to implementing an HIE system, CareAccord, for secure messaging.

And in Vermont, it was to look into telehealth solutions.

The report notes several challenges faced by each of the states. Massachusetts, Maine and Oregon, for instance, had trouble incorporating innovations into provider workflow.

“Oregon’s direct messaging technology has seen little uptake by providers, many of whom already have a preferred internal secure messaging system,” CMS wrote.

The accuracy and completeness of data has been an issue for states; in Arkansas, for example, a “lack of patient-specific behavioral health data” hindered provider efforts to treat patients.

CMS Principal Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., wrote that it’s “too early to attribute specific quantitative results” to the initiative. However, he believes the findings  show that progress is being made by states, as shown in  declines in ER visits and inpatient readmissions.

 To read the CMS report, please hit this link.

To read a FierceHealthcare  news article on this, please hit this link.

The growing good of health-information exchanges


Here’s a look around America  by MedPage Today at how health-information exchanges (HIEs) — some regional,some statewide — “help clinicians avoid productivity-sapping phone calls and faxes, and meet some challenging Meaningful Use requirements.”

It notes that “the forces that are making these HIEs essential include streamlining workflow utilizing Integrating the Healthcare Enterprise’s EHR-to-EHR integration and Direct secure messaging connectivity built into meaningful use–compliant EHR software, exchanging summaries of care when EHR integration is not yet present, and responding to business pressures such as accountable care.”

But one observer noted:

“The payers and the state are really critical, because the HIE doesn’t have an automatic business case. In fact, a lot of people, including some imaging centers and hospitals, don’t want to see it succeed, because sequestering data makes their lives easier and more financially productive.”

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