Last month, KaMMCO Health Solutions—a subsidiary of the Kansas Medical Mutual Insurance Co. (KaMMCO) and an affiliate of the Kansas Medical Society—announced a partnership with the Medical Association of Georgia (MAG) to provide the physician advocacy group’s members with actionable intelligence via the use of data analytics. A MAG physician-led advisory board will soon be formed to work with KaMMCO Health Solutions in establishing a private health information exchange to facilitate connected physicians in sharing real-time patient information, while employing analytic reports designed to help improve clinical outcomes, reduce inefficiencies and positively impact patient safety. A formal launch of the new MAG-sponsored entity is anticipated later this summer.
“The Medical Association of Georgia is the first medical society we’ve partnered with outside of our own here in Kansas,” said Kurt Scott, KaMMCO chief executive officer, who also shared that KaMMCO Health Solutions is in the final stages of deliberation with several other state medical associations to partner in a similar way it has with MAG. “MAG is endorsing our technology and service, will help promote it and help their members build their own health-information-exchange networks.”
Initially formed in June 2014, KaMMCO Health Solutions has licensed health information exchange technology developed by the Kansas Health Information Network (KHIN), a 501(c) (3) not-for-profit organization. KHIN is widely considered one of the largest, most successful health information exchanges in the nation. KaMMCO Health Solutions partners with healthcare providers, integrated delivery networks, accountable care organizations and others who face the challenges of the new healthcare marketplace and value-based payment structures to not only deliver this interoperability technology, but to also deliver valuable data analytic reporting required for clinical integration, care coordination, quality reporting and new payment models.
The KaMMCO Health Solutions technology infrastructure allows disparate electronic health record systems to communicate with each other. Data flows back-and-forth across this platform and provides access to critical clinical information out of the electronic record to providers at the point of care, regardless of where that care is being provided or what electronic medical record system that particular hospital or physician is working on.
“KaMMCO Health Solutions’ mission, whether it be on the professional liability side or the healthcare delivery side, is about improving care, improving patient safety, managing care in the most cost-effective way possible,” Scott said. “We are able to advance that mission in different ways, using different data sets in order to accomplish that.”
As part of its services, KaMMCO Health Solutions offers to build and maintain a data warehouse for its client organizations. The warehouse would be able to store clinical data from electronic health record systems or health information exchanges as well as claims data and other sources of client data. The data is capable of being normalized and populated into a standard data architecture that can be used to create custom reports, registries and benchmarks.
“Physicians work in an environment [where] they often do not have all the information that they need,” explained Joe Davison, MD, KaMMCO Health Solutions board member. “An example of that would be, even though ordered x-rays and CTs are good, they don't give a complete picture about the patient. Yet physicians still have to act. They have to operate. They have to prescribe. They have to do something to help their patients. Participating in a health information exchange lets me place more of the pieces of the jigsaw puzzle together in real-time.
“I really love the fact that I can look at my patient population and see those patients who are in trouble. I may not have known they were in trouble, but when I look at analytic reports that represent my panel of patients, I see I have a certain number of patients who have poor to no control of their diabetes, for example. I can identify those patients. I can develop a list of those patients. Then I can act on that information. Health information, specifically with analytics, is a hugely powerful tool.”
In addition to offering healthcare professionals real-time data to better manage patient risk, KaMMCO Health Solutions clients have access to the company’s in-house analytics staff, who create the data reporting services necessary for true clinical integration, care coordination, quality reporting and value-based payment structures that are going to be critical to meeting the new reimbursement standards created by the Patient Protection & Affordable Care Act of 2010 and the Medicare Access & CHIP Reauthorization Act (MACRA) of 2015. These federal reimbursement standards are intended to further advance the healthcare delivery system from a fee-for-service system towards a merit-based incentive payment system where clinicians and organizations are reimbursed for meeting four performance categories: quality, advancing care information, clinical practice improvement activities and cost.
“I believe data sharing and the resulting data analytics will be a critical component of success for physicians and other healthcare providers who are looking for a path that leads to a successful transition to working under the proposed MACRA legislation,” Davison said. “Accurate data is powerful in the mission to improving patient outcomes, realizing a sustainable business model under the new guidelines and leading effective negotiations with payers.”
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