HIStalk Practice Interviews Brian Yeaman, MD Chief Administrative Officer, Coordinated Care Oklahoma
Brian Yeaman, MD is chief administrative officer of Coordinated Care Oklahoma, an HIE based in Norman, OK.
Tell me about yourself and the organization.
I am a family physician still actively practicing, and have done work as a hospitalist in the past. I was CMIO for Norman Regional Health System for 10 years and have been doing work with health information exchange for 10 years. I am currently the chief administrative officer for Coordinated Care Oklahoma.
I’m particularly intrigued by CCO’s decision to implement/offer MyDirectives. How will this be marketed to physicians and their patients? How will these directives integrate with the HIE?
This is a project we have been passionate about for over three years. As a family physician, I recognize that when an elderly patient presents to the hospital, they frequently do not come with an advance directive. Usually, their healthcare proxy is not necessarily there at the same time, and at that point, without a current up-to-date copy of the advance directive, we have to fully resuscitate, even if that was not what the patient necessarily wanted. Providers rapidly understand the problem we are trying to solve; hospitalists and emergency room physicians are especially embracing this approach. We have begun outreach to patients with a simple message for encounters on individuals over 45 years of age.
Why did CCO feel the time was right to implement secure messaging technology?
A lot of form factor drove this decision. We started doing a lot of work in the post-acute care space connecting many SNFs, nursing homes, home health and hospice. The HIE is basically doing automated medical record requests, but we still have to talk to one another. With RAC and MACRA/MIPS we have to talk to larger and larger care teams that are outside a health system that is acutely discharging a patient. Secure messaging across regions and universal contact lists was just a no brainer. Providers love Backline. Bringing HIE data into the mobile form factor in Backline makes a lot of sense for providers who are mobile across orgs, facilities, and patient homes.
Is the organization working on any other healthcare IT implementations?
Oh yes, sitting still is not what we do. We are going live with LightBeam analytics right now, and that should be fully launched by Q1 2017. We are also working with Nuance and their PowerShare application to launch image sharing in parallel with CCO using the power of our master patient index. It is going to knock people’s socks off.
What sort of IT adoption challenges are unique to HIEs?
Interop equals challenges. The biggest one is actually trying to meld federation and centralized data connections in being a hybrid HIE data consumption model and delivering some of the services. The MPI provides a tremendous anchor and the way we stage and time connections is obviously key to add federated connection data to some solutions or add on solutions to the HIE core service.
How is the HIE helping its provider members – particularly independent physician practices – overcome interoperability challenges?
We help providers care for their patients – it is just that simple. We crossed the threshold years ago when providers began to demand the HIE data to expedite and have more complete medical record requests and sharing. We check the boxes on MU and with MACRA/MIPS coming, we add an integral service there. At the end of the day though, if we do our job right and deliver a comprehensive HIE service with the right add-ons, quality and cost organically improve and patients get much more coordinated care. That is our ultimate goal and mission.
How do you see HIEs fitting into the new MACRA landscape? What role will they play in helping the healthcare industry transition to value-based care/payment models?
Obviously, they’ll help with requirements around data sharing, completing quality reports, and helping enhance condition management tasks. We help by bringing data forward and soon-to-be images forward to avoid duplicative tests and improve savings, and we help avoid complications by sharing drug allergy information, etc.
Do you have any final thoughts?
I think HIE is a funny thing in the marketplace right now. Everyone now knows it has to mature into a business and leave the more academic and grant-based foundation we all started on. I see HIEs evolving into two models – one that is service oriented and leverages the MPI and data to enhance additional services that directly impact care and outcomes. This is a bedside-up approach to administrative tasks and analytics, and is focused on treatment and operations.
The second model is one that is more focused on monetizing the clinical data and is heavily focused on payer initiatives. This approach around payment makes a lot of sense on the surface and represents an analytics down-to-the-bedside approach to healthcare reform. This model has additional challenges as you start to drill down into consent models, how the patient consent was administered, and how that holds up as the data is moving to more and more third parties separated from the original patient consent for care under TPO. Throw in to this mix ACOs and health systems that compete … the politics and logistics start to become extremely complicated. Keeping it simpler and delivering HIE like a service – just like cable and Internet providers with the privacy and security necessary in healthcare.