This month’s blog with Dr. John Glaser, Senior Vice President, Population Health at Cerner, touches on the importance of knowing when to make the shift to value-based care. Providers are straddling the line between volume and value and their timing for moving toward the value-end of the spectrum is ripe for risk, but also for reward.

Continue reading “Four Questions Series: Dr. John Glaser, Senior Vice President, Population Health, Cerner”

Kevin Hutchinson, current founder & CEO of MyTaskit shares his insights in the next edition of our Four Questions blog. With an extensive background in healthcare–from being the Former Founding President & CEO at SureScripts to advising multiple growth-stage companies, Kevin’s insights and knowledge are invaluable to Bamboo Health.

Continue reading “Four Questions Series: Kevin Hutchinson, Founder & CEO of MyTaskit”

Welcome to another edition of the Four Questions blog series. This time, we’re sitting down with Sean Cavanaugh, former Head of Medicare to talk care coordination, payment reform, and challenges facing healthcare providers today.

Continue reading “Four Questions Series: Sean Cavanaugh, Former Head of Medicare”

How does Pings help you accomplish your goals?

PatientPing (Pings) helps us in a way that claims data cannot, by providing real-time event notifications across the continuum of care. For our Medicare population, being able to see the movement among post-acute providers was always a missing link. Since partnering with PatientPing (Bamboo Health), we have been able to track admissions and discharges within skilled nursing facilities, home health and hospice settings, and conduct outreach to patients and providers in a much more timely manner.  Our goals involve providing care coordination as an extension of the primary care provider, so PatientPing (Pings) helps us extend those services because we can identify the patient movement.

What do you like most about Pings?

We really love the format and simplicity of how the notification is delivered. Our team is more efficient because they are able to filter by type of provider, point of care, admit or discharge status, etc. It does not require analytical skills to search for information. One of the best features is the ability to connect the assigned care coordinator to the matching provider with enough contact information and/or customized message, so that providers are reminded to communicate with us. That feature has supported increased awareness of our services.

Can you give us a specific example of a time that Pings helped you help a patient?

A patient was admitted to a SNF with an anticipated length of stay of three weeks. About four days after admission to the SNF, the Nurse Care Coordinator observed a PatientPing (Pings) notification of discharge. The nurse contacted the facility and learned that the patient had signed out early—against medical advice—and stated that he was going home. Knowing this to be a high-risk patient, the nurse was able to work with social services to follow up with the patient at his home.  He was open to home health, which was then arranged.

With PatientPing (Pings), we were able to confirm that home health services had been implemented and could make sure they remained ‘active.’ Although there were other care coordination activities, we watched for discharge from home health so that other services could be offered. Had we not seen the early unanticipated discharge from the SNF, this patient would have likely ended up back in the emergency department facing a readmission. Because of this notification, we were able to act and offer other options.

What other technologies do you use (in addition to Pings) to help you accomplish your goals?

We have a population health platform from Wellcentive, which is also where many of our ambulatory care coordinators document or track caseloads. Additional supportive technology includes the John Hopkins ACG for risk stratification and MCG to help with condition specific assessments and care planning.  As a large ACO we also have technology to drive analytics and financial reports.

Thanks so much, Ann! For more information about how Bamboo Health can enhance your care coordination efforts, contact us.

How does Pings help you accomplish your goals?

PatientPing (Pings) provides a central, timely repository for patient ADT information at organizational, practice unit, and provider levels. We use this information to help with transitions of care, as well as to identify trends and opportunities for patient education on subjects such as practice after-hours and same-day appointments.

What do you like most about Pings?

We particularly like the volume of entities contributing to ADT feeds, as well as the support from PatientPing (Bamboo Health) staff.

Can you give us a specific example of a time that Pings helped you help a patient?

The admit and discharge data obtained through the PatientPing (Pings) interface allowed one of our physicians to easily identify a patient who was presenting at the emergency department of a local hospital multiple times in a short time window. Specifically, this patient presented to the ED three times in the span of 15 days.

Using this information, the patient’s primary care provider and staff made it a priority to not only schedule a follow-up with this patient after the first ED visit, but also for education that stressed the availability of same day appointments, after-hours services, and options for additional consultation without a regular scheduled office visit. Since these events, the patient’s condition has been effectively managed and he has not presented to the ED.

What other technologies do you use (in addition to Pings) to help you accomplish your goals?

In addition to PatientPing (Pings), we use the following to help us with our care coordination and engagement initiatives:

•  Patient Registry (Wellcentive)
• Patient Surveys (NRC CAHPS)
• Various cost and quality reporting (payer specific)
• Claims data (payer specific)

Thanks so much, Shay! For more information about Bamboo Health how to optimize your care coordination efforts, click here.

 

How does Pings help you accomplish your goals?

PatientPing (Pings) allows us to coordinate care for our patients as they move from care location to care location. Prior to PatientPing (Pings), we were really in the dark when it came to understanding the where and when of our patients. At that point, the only insight we had into the whereabouts of patients was through outdated claims data or when they showed up on our primary care doorstep or, worse, ended up in the ER again. We lacked the tools to proactively manage our patients. PatientPing (Pings) has allowed us to meaningfully manage our patients in real time so we can give them the right care at the right time, and ensure that their care transitions are safer.

What do you like most about Pings?

PatientPing (Pings) is one of the most user friendly IT tools we have encountered, and we use many, many platforms on a daily basis. PatientPing (Bamboo Health) understands the different customers that are using their product and customizes the data output to match their needs. The PatientPing (Bamboo Health) team is also very receptive to feedback. When users give feedback, the team works hard to make changes to the product that incorporate the ideas from the community. And they always make timely adjustments should any technical issues arise.

Can you give us a specific example of a time that Pings helped you help a patient?

PatientPing (Pings) helps us help patients every single day. By using the tool, we know exactly when our patient is sent home from a skilled nursing facility, as well as which visiting nurse agency will be caring for them at home. This allows our nurses to call the patient on the day of a SNF discharge and ask if he or she has been visited by the nurse. If the nurse has not come within 24 hours, we can then follow up with the appropriate agency to ensure that they care for our patient when he or she needs it most. Prior to using PatientPing (Pings), our patients were more or less on their own until we became aware that they were home. And that was only if we even knew they went to a SNF. Using this tool is a huge leap forward in being able to care for our patients when they need it most.

What other technologies do you use (in addition to Pings) to help you accomplish your goals?

We use quite a few technologies at the ACO. We sit on a huge claims database. We also have multiple risk stratification software applications and analytics, a secure texting platform, and multiple EMR systems.

Thanks so much, Adrianne! For more information about Bamboo Health can enhance your care coordination efforts, contact us.