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An Interview with an Expert on Interoperability in Healthcare

Posted on by Grace Keeling

According to HIMSS (Healthcare Information and Management Systems Society), interoperability “is the ability of different information systems, devices and applications (systems) to access, exchange, integrate and cooperatively use data in a coordinated manner, within and across organizational, regional and national boundaries, to provide timely and seamless portability of information and optimize the health of individuals and populations globally.”

As extensive as that definition is, its length pales in comparison to its importance. Without interoperability, patients’ medical records can be lost in the continuum of care, timely admission, discharge, and transfer information isn’t timely at all, and real-time care notifications are nearly impossible.

Quite simply, interoperability is the key to unlocking coordinated healthcare.

That’s why, here at Bamboo Health, we’re making a substantial investment in it. We’re accessing and storing data, delivering it when and where it’s needed most, and making sure it’s seamless and shareable for payers and providers alike.

At last month’s HIMSS22 conference in Orlando, FL, Jitin Asnaani, our VP of Strategy and Development, sat down with Haley Walters, our Digital Marketing Manager, to discuss the specifics of our interoperability efforts. Here’s a partial, rough transcript of that conversation.

Haley
“As a nation, we’re now more connected than ever. Why might our audience not be feeling the benefits from that [level of interoperability in healthcare]? Why are we still having this fragmented care?”

Jitin
“We are actually really well connected, largely, as a country. The issue is, we’re now at this inflection point, where the emphasis has to turn towards, how do you utilize that data in a way that’s actually driving an action for me? I’m going to call this actionable interoperability. We’ve not actually started doing work so that me, as a provider, as a payer, as a patient, as whoever, I can see my workload drop. The data just didn’t get exchanged; It got exchanged at a time, at a place, to the person, with the right technology around it, so that it actually scheduled the patient. So that it actually did things for me [automatically and electronically], which I do today in a manual way.”

Haley
“Can you tell us where actionable data actually benefits the end user, the patient?”

Jitin
“Until about three years ago… If you were almost at the leading edge of interoperability, what you were doing was connecting two points together. I’m a PCP. Somebody from the emergency department is pushing me a discharge summary. Maybe a specialist is pushing me a clinical chart. That was the state of interoperability, and it took a long time for us to get there. That’s where maybe a lot of U.S. healthcare in interoperability still is. Now, if the right person [on a care team] knows at the right time that I have got to follow up with that patient, and get them to the PCP, I’ve suddenly done two things. I’ve done work for them, taken work off their plate so they can handle more patients. Not only that… The PCP is now getting this scheduled patient with information from the care manager. Now they actually have context.”

Haley
“Where could you see interoperability transforming into and going?”

Jitin
“I see three things happening:

1. That spigot is only open to providers. The data has to flow to all of the other stakeholders too, public health, payers, etc.

2. It really comes down to adoption. Providers, digital health companies, existing technology organizations, state governments, and so on must adopt it.

3. A full job is done from the moment the patient leaves the ED to the point they’ve been scheduled and referred—there are gaps that we’ve closed—and the provider has done nothing but spend time with them on the clinical aspect. The administrator has done nothing but collect the right payment information. That is end-to-end interoperability that the [end] user will feel.”

To see Haley’s full interview of Jitin, click here.

To learn more about us and our interoperability-related solutions, click here.

Celebrating National Doctors’ Day with One of Our Own

Posted on by Grace Keeling

A Q&A with Our Chief Clinical Officer, Dr. Nishi Rawat

In honor of National Doctors’ Day, we asked Bamboo Health’s Chief Clinical Officer Nishi Rawat, MD, MBA, a few questions about her role as a doctor and how we can support healthcare providers. After all, offering the right support in the right place is a key ingredient in our company’s vision to revolutionize care collaboration.

How has your role as a physician influenced the work you do today?

My experiences as a critical care physician inspired the first technology solution I helped co-found with my father, OpenBeds. As I treated patients in the ICU, I began to see more and more patients with mental health challenges and substance use disorders. I helped them recover from the overdose medically, but because of silos between physical and behavioral health, I lacked the ability to refer them to appropriate treatment programs and providers to help them resolve the underlying issue that led to my care in the first place. I felt I could better serve patients by developing OpenBeds, a provider-led technology that helps break down the barriers.

That work has only expanded now that OpenBeds is part of Bamboo Health, where we are revolutionizing care collaboration and looking for ways which technology can better support the work of physicians and many other healthcare clinicians to deliver whole person care to patients.

The COVID-19 pandemic has taken a toll on the healthcare workforce. In addition, fatal drug overdoses have reached historic highs. The combination has heightened burnout within the profession. What are ways we can support doctors and other healthcare providers?

Over the past 2+ years, we’ve all faced challenges in regard to loneliness, isolation, and lack of connection. While physicians, nurses, and healthcare providers and staff still showed up every day for the jobs—often on the front lines of seeing the devastation of COVID-19 and drug overdoses in their community—those same feelings were still present, coupled with grief and even frustration. I believe the best way we can support each other is to engage, reach out, and listen.

Physicians have reported that bureaucratic tasks contribute to burnout. What ways can technology help alleviate this burden?

Healthcare data is often siloed in different systems—electronic health records, health plans, health systems, with providers, with states, etc.—which makes it easy to miss vital information about patients. Technology can help to close those gaps in care by both building bridges to bring data together and by helping surface salient data for the clinician, so it is not overwhelming and is more usable. The solutions we already have and are building at Bamboo Health strive to close those gaps, increase physician satisfaction, and improve whole person care.

What’s one of the next big things in healthcare, something that will be felt by patients and providers alike?

I could go in a few different directions here, but I think collaboration tops the list. We’re in an era, like we discussed, where not only data is coming together, but also the people behind the data. More than ever, patients are in tune to their care, providers are aware of the pandemic’s lasting effect, and payers are aiming for the most cost-effective, proven care. This requires a higher level of collaboration, communication, and information sharing in one convenient place. And it’s a positive sign for the sake of whole person care.

Use Case Spotlight: How Kintegra Health is improving transitions of care and succeeding in value-based care programs through real-time ADT notifications

Posted on by Grace Keeling

Kintegra Health is a Federally Qualified Health Center (FQHC) that provides healthcare services, health education, and preventive care services to patients, regardless of their ability to pay. Kintegra has over 25 practices across ten counties in North Carolina and offers a wide range of services including adult and pediatric primary care, dental care, vision care, behavioral health counseling, pharmacy services, chronic disease education programs, Medication Assistance Treatment, nutritional counseling, women’s screening clinics, and HIV/AIDS case management.

We sat down with Lavondia Alexander, Chief Quality Officer at Kintegra to discuss how her team approaches the shift towards value-based care, challenges they face in this endeavor, and how Bamboo Health helps to improve their care coordination efforts and patient outcomes.

What are some of the trends you are seeing in the shift towards value-based care?

The healthcare delivery system has evolved. There is now a focus on treating patients holistically through proper care coordination amongst varying providers and community partners. The Centers for Medicare and Medicaid (CMS) led the innovation of value–based care through various programs such as Meaningful Use and Accountable Care Organizations (ACOs). There has been a shift where payment for quality is emphasized. There are similar movements for Medicaid and commercial payers participating in value-based care programs and ACOs.

As an FQHC, we serve as a safety net of healthcare for the uninsured and underserved populations. Historically, FQHCs have had limited opportunities in participating in value-based initiatives. Fortunately, we are now able to participate in value-based care reform because our commercial population is increasing, and Medicaid is moving towards value-based care efforts in which we can participate. Kintegra began its journey into value–based care through participating in quality management through incentive programs that included our uninsured population.

We have found that it is challenging to provide value-based care without access to data and analytics regarding how effective we are in coordinating care for our patients. Since this need is identified across the healthcare delivery system, population health analytics tools have become very popular and are imperative to include in your operational plan.

What are some of the care coordination initiatives your organization focuses on?

We have been steering our approach to value–based care for a while. As mentioned earlier, it is difficult without access to data and analytics regarding how effective we are in coordinating care for our patients. We have partnered with varying population software platforms, including Bamboo Health, to assist in this endeavor. FQHCs have to report varying outcomes to the Health Resources and Services Administration (HRSA) to maintain our funding, including, but not limited to, patient clinical outcomes, cost of care for our patients, patient access, and what services and treatments we are providing them. Previously, our main focuses were on care gaps and trying to help manage chronic conditions.

We joined the Carolina Medical Home Network ACO in 2017 and then the CHESS Value ACO this year. These partnerships allowed us to better put care plans in place, focus on patients getting annual wellness visits, figure out how to risk stratify based on utilization, and analyze admission, discharge, and transfer (ADT) data.

What challenges has your organization faced in succeeding under these initiatives?

Despite establishing those beneficial care coordination and workflow processes through our ACO partnerships, we still struggled with transitions of care. We were dependent on our local hospitals to send ADT data every day, as well as our payers to send it via claims data, which was on a monthly basis with a three-month lag. Even once we received the data, we didn’t have the resources to properly act on it nor the ability to confidently know who to reach out to regarding the outdated patient information.

How has Bamboo Health helped play a role in overcoming some of these challenges?

The ADT data we previously received was contingent on information the local hospitals had regarding our patients. This usually included a primary care provider’s name or the location the patient received their care. The ADT data we get now from Bamboo Health is for our entire population across the ten counties we serve.

The notifications include when our patients go to an outside facility, are in real-time, and are hosted all in one place. We didn’t have this kind of real-time data in a sufficient and efficient manner prior to Bamboo Health. Our staff no longer have extended time frames to follow up and ask a patient how they are or remind them about Kintegra’s available services so that they can conveniently come to us versus the emergency room.

Additionally, the Pings give us the most up-to-date phone number and address so that when we reach out to the patient, we have the best chance of reaching them. We are really happy to get this kind of insight from the Bamboo Health platform and look forward to continued learnings and success through our partnership.

That’s a Wrap on the Inaugural ViVE 2022 Event

Posted on by Grace Keeling

Bamboo Health was proud to be part of the inaugural ViVE event, which just wrapped up in Miami March 6-9, 2022. Our team participated as attendees, booth exhibitors, and a speaker. It was great to catch up with customers, partners, media, and colleagues in person at the event and learn more about how health technology is working to transform the future of healthcare. We were also excited to see so many smiles again (around 5,000!) with recent relaxation of CDC guidelines for COVID.

 

Our Chief Clinical Officer Dr. Nishi Rawat was part of a panel presentation at ViVE on Monday, March 7, titled, “Whole Person Care 101: CH. 1 Behavioral Health.” Bamboo Health’s Chief Clinical Officer Dr. Nishi Rawat joined two other panel members – Dr. Nina Vasan, Chief Medical Officer of Real, and Dr. Ian Tong, Chief Medical Officer of Included Health. Read our summary of the panel highlights in this blog post.

Our team members also staffed an exhibitor booth where they had the opportunity to see some of our customers face-to-face, chat with other health technology companies about future collaboration, and share the work being done at Bamboo Health with future partners and collaborators.

Our team also caught as many of the panel sessions and general sessions as possible. Some of the big themes we heard included:

  • Care collaboration
  • Virtual care and telehealth
  • Data
  • Health equity
  • And more!

With just a few days to rest, the Bamboo Health team is gearing up to head back to Florida, this time in Orlando, for the 2022 HIMSS Global Health Conference & Exhibition. If we didn’t catch you at ViVE (or even if we did), we hope to see you at HIMSS! To learn more about Bamboo Health, our work to support real-time care collaboration, and the progress we’re making to improve whole person care, meet with our team at booth: #4115, March 14 – 18, 2022, in Orlando, FL. We also invite you to attend a presentation by Bamboo Health’s Vice President, Strategy and Corporate Development Jitin Asnaani’s “Harnessing the Power of Interoperability to Cultivate Whole Person Care Collaboration across Providers, Patients, and Payers” on Tuesday, March 15 at 2:45 PM as part of the Interoperability Showcase Theater.

Dr. Nishi Rawat shares her perspective and Bamboo Health’s behavioral health initiatives during panel presentation at ViVE

Posted on by Grace Keeling

Behavioral health and technology took the spotlight during a panel presentation at ViVE on Monday, March 7, titled, “Whole Person Care 101: CH. 1 Behavioral Health.” Bamboo Health’s Chief Clinical Officer Dr. Nishi Rawat joined two other panel members – Dr. Nina Vasan, Chief Medical Officer of Real, and Dr. Ian Tong, Chief Medical Officer of Included Health. Marshall E. Jackson, Jr. from McDermott Will & Emery LLP served as moderator.

The panel covered some of the issues that have led to the behavioral health and substance use crisis – with more Americans facing a mental illness while drug overdose deaths surged to 104,000 lives lost in the last year.

Dr. Rawat shared her perspective that stigma has left behavioral health behind and that breaking down those barriers is critical to moving the needle.

“Stigma is driving the lack of access to evidence-based treatment. It’s driving the lack of recognition of evidence-based treatment. We know what works for many mental health conditions. We know what works for opioid use disorder based on three decades worth of research and yet people can’t get access to evidence-based treatment. Stigma drives the lack of payment parity,” said Dr. Rawat. “Behavioral health is woefully behind physical health. When it comes to access to salient data at the point of care, physical health has figured that out for the most part. We’re being inundated with data at the point of care as physicians. Now we’ve moved on to trying to figure out how to make that data usable. We have to work on data connectivity as well as usability in parallel for behavioral health instead of serially, as we did with physical health. And that’s exactly what we’re doing at Bamboo Health right now.”

Dr. Rawat also shared what she believes are the three types of pain that have led to the substance use epidemic: physical, mental, and economic pain.

  • Physical: “Prescribing by physicians over the past two decades led to the first wave of the opioid epidemic. Now, we’re doing better. We’re getting tighter, but the pendulum is starting to swing back in that other direction. We have to keep our eye on the ball. We have to make sure that non-opioid pain management mechanisms are available to the masses.”
  • Mental: “Prior to the pandemic, 50% of Americans said that they feel alone, that they feel like nobody really understands them in their lives. That’s only been magnified by the pandemic. And we know, there’s been an increase in the prevalence of mental health conditions, depression, anxiety, post-traumatic stress by 30 to 40% in the past 18 months.”
  • Economic: “It’s something that we’re not talking enough about. If you speak to political leaders in the Midwest, they will tell you that the opioid epidemic is ravaging their communities because of number one, idle hands, especially among young males, but also this gap between the haves and have nots, the more the doubling of the gap between the people who have something and don’t have something, and the resentment associated with that gap.”

Finally, the panel covered a broad discussion of promising initiatives in the near future and how their companies were doing work to support those efforts. Dr. Rawat highlighted Bamboo Health’s focus to support initiatives around substance use. She shared four pillars for addressing substance use which include: prevention, access to treatment, harm reduction, and recovery support. Bamboo Health has technology solutions to help support the first two categories.

  • Prevention: “We are the prescription drug modern program for 45 states. For the prescribers out there, when you’re about to prescribe a controlled substance, you check the prescription drug monitoring program (PDMP). We provide software that tells you whether or not the person in front of you has been prescribed or dispensed a controlled substance in the recent past. In the states where checking the PDMP system is mandated, which is about two dozen states, they’ve seen a reduction in opioid prescribing and dispensations, and increased use of non-opioid alternatives for pain management. Finally, they also have a reduction in deaths related to opioids with the exception of fentanyl. This is over an eight-year period. So, that’s fantastic. That shows you the power of technology to prevent.”
  • Access to treatment: “We also are very much focused on treatment. We work with 14 states right now with our OpenBeds system. What we do is essentially create a digital village. These are vexing problems, right? It takes a village, it takes multiple stakeholders across the private sector, the public sector. What Bamboo Health does is bring all of these stakeholders together on this one technology system, so that those who refer into mental health and substance use disorder treatment, they can see the availability of services. They have situational awareness. They can use the tool to get decision support as medical clinicians. You can send digital or referrals and do much more.”
    • Results: “We closely track the people who are being pushed through the cracks, and we report on those data out to the county, the local organizations. In the State in Delaware, we average 800 to 900 referrals per week. When we launched in 2018, there were 200 to 300, and now we see 800 to 900 referrals. We know more people are accessing care, and Delaware is actually one of three states that saw a decrease in their opioid overdose deaths by 7%. Across the US, they went up by 16%. The Lieutenant Governor and the state credit the increase in access to care and decrease in overdose deaths to our system. That’s the power of technology to bring people together. There is still lots of work to do, but the challenges are not insurmountable.”

Re-Imagining Health at HIMSS: Bamboo Health Fosters Interoperable Care Coordination to Improve Physical and Behavioral Healthcare

Posted on by Grace Keeling

The theme of the 2022 HIMSS Global Health Conference & Exhibition centers around re-imagining health – a focus that resonates exceptionally well with us at Bamboo Health. In pursuit of our vision to revolutionize healthcare in the U.S. by connecting every payer, provider, and care team member to address whole person care, we foster care collaboration for the entire healthcare ecosystem to change healthcare for the better. While these words sound aspirational for some, for Bamboo Health they truly capture what we are working toward amid this incredibly unprecedented era in healthcare.

An important part of delivering on this promise is connecting everyone, everywhere through differentiated network reach and interoperability. During HIMSS, Bamboo Health’s Vice President, Strategy and Corporate Development Jitin Asnaani will present a session on “Harnessing the Power of Interoperability to Cultivate Whole Person Care Collaboration across Providers, Patients, and Payers” as part of the HIMSS Interoperability Showcase, which will highlight the real-life impact of enhanced interoperability among providers.

As an advocate for electronic exchange of healthcare information for government, non-profit, health IT, and interoperability systems, Asnaani has been a bridge creator and a collaborator to drive healthcare towards a more coordinated and interoperable future. To date, this work has collectively enabled more than 100,000 clinical facilities – including almost 100% of all hospitals, more than 90% of all ambulatory clinics, and thousands of post-acute and home health facilities nationwide – to share their patient’s data with providers and other caregivers electronically, enabling true transformation of care management and helping to spur the advent of the rapidly-growing digital health industry.

At the Bamboo Health booth, we will also highlight the progress we’re making against the behavioral health and substance use crisis through our Pings, OpenBeds, and NarxCare solutions. This includes our latest company initiatives such as our expanded partnership with Bicycle Health, the leading virtual care provider of evidence-based treatment for opioid use disorder (OUD). By leveraging our Pings and Spotlights solutions for real-time insights into emergency department (ED) and acute inpatient care utilization, Bicycle Health case managers and therapists can better track patients’ care journeys, reach out to re-engage patients that have had care events, increase their level of care or alter their care plan as needed, and analyze utilization measures.

In closing, we look forward to participating and sharing our insights with professionals throughout the global health ecosystem who share the common goal of reimagining health and wellness for everyone, everywhere at HIMSS. To learn more about Bamboo Health, our work to support real-time care collaboration, and the progress we’re making to improve whole person care, meet with our team at booth: #4115 or at the Interoperability Showcase: #8240-75, March 14 – 18, 2022 in Orlando, FL. We also invite you to attend Jitin Asnaani’s “Harnessing the Power of Interoperability to Cultivate Whole Person Care Collaboration across Providers, Patients, and Payers” session on Tuesday, March 15 at 2:45 PM as part of the Interoperability Showcase Theater.

Summary of “988 is Coming!” webinar focused on the new mental health crisis number and how states are preparing

Posted on by Grace Keeling

For Bamboo Health’s February Knowledge for Good webinar, we tackled a timely topic that will soon impact all Americans. On July 16, 2022, individuals will be able to call or text an easy-to-remember, three-digit number, 988, to be connected with trained mental health professionals at 180+ regional crisis centers. The goal of 988 is for it to be the behavioral health version of 911.  

While the new number will go into effect regardless of any other efforts, many states are using the opportunity to change how they respond to mental health crises to better serve and help their citizens. In the webinar, one of Bamboo Health’s state government market leaders, Alycia Sepe, BSN, RN, helped sort out best practices for 988 crisis implementation, where states stand in readiness, and how our OpenBed’s Crisis Management System is being utilized to help states with their rollout. 

Behavioral health has received more intense attention in recent years in our country, with mental health conditions contributing to grim and staggering numbers, including more than 104,000 Americans who died of drug overdoses in the last year. The COVID-19 pandemic has worsened the mental health outlook while behavioral health treatment providers have been strapped for resources. At the same time, stigma around mental health has decreased, contributing to more people seeking support. 

In 2020, federal legislation passed to establish 988 as America’s Suicide Prevention and Mental Health Crisis Lifeline while the Federal Communications Commission adopted rules to implement the transition with the deadline to implement being July 16, 2022. In the two years since, work began to ready the number itself (i.e., transitioning numbers that began with 988 to new numbers) as well as states passing legislation to help support funding and infrastructure for improved crisis response, particularly as demand is expected to grow, with the goal of meeting citizens’ mental health needs and diverting them from emergency departments and law enforcement to care aligned with their needs.  

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), core services and best practices for implementing a crisis response include: 

  • No wrong door access: No matter how the concern comes in, it should be properly rerouted. 
  • Regional Crisis Call Center: Staffed 24/7 by clinical professionals available via phone, text, or chat. 
  • Crisis Mobile Team Response: Trained teams who can respond timely to an individual’s location. 
  • Crisis Receiving and Stabilization Facilities: Short-term observation and stabilization in a home-like, non-hospital environment.  

A successful crisis management system should (SAMHSA): 

  • Standardize crisis care processes and quality 
  • Promote suicide prevention as a core component of healthcare services 
  • Focus on resolving mental health and substance use disorders 
  • Decrease psychiatric bed overuse and eliminate emergency department boarding 
  • Decrease drain on law enforcement 
  • Decrease fragmentation of behavioral healthcare 

But, as highlighted in a December 2021 article in STAT News, “Many states aren’t ready for a 988 crisis line. The deadline is looming.” The author says, “The 988 call system holds great promise for offering all people facing mental health or substance use emergencies the appropriate support, services, and responses to get care and treatment. But that can’t happen until states roll it out effectively. If some states aren’t prepared to roll out 988, or have weaker infrastructure or support for it, the country would end up with a system that perpetuates inequities in mental health access rather than reduces them.” 

Bamboo Health is partnering with several states as a technology partner to meet best practices for their 988 rollout and beyond through our OpenBeds Crisis Management System solution. It provides: 

  • Real-time Impact: Quickly identify and refer patients to the right inpatient or outpatient treatment facility directly from the cloud-based module. 
  • Mobile Dispatch with GPS-enabled Functionality: See the proximity and availability of mobile crisis units, dispatch them, and conveniently communicate a patient’s information directly from the module—expediting the referral process. 
  • Tracking Capability: Track mobile crisis services via GPS on one dashboard and behavioral health services on a second dashboard, providing flexibility for patient referrals. 
  • Bi-directional System to Support a Digital Referral Process and Information Sharing: Avoid frustrating and time-consuming manual processes, make digital referrals, and learn whether a patient is a “Show” or “No-show.” 
  • Data Dashboards with Real-time Outcomes: View clear dashboards with real-time data around crisis call dispatches and response times, referral to treatment and access outcomes, and general use of the system. 
  • Monitoring and Interfacing with a Bed Tracking Inventory System: Connect to providers and organizations in your state and close more treatment loops with bed capacity data from crisis stabilization units, group homes, inpatient SUD treatment programs, opioid treatment programs, and many more. 

Learn more by viewing the 30-minute entire webinar. 

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