For two days, Concordium 2016 brought together the best and brightest in the fields of health data and delivery system transformation. The meeting showcased innovation and emerging science and promoted collaboration in an effort to improve health.
The conference kicked off with welcome remarks from AcademyHealth’s President and CEO Dr. Lisa Simpson and Senior Director Erin Holve, and Director of the Agency for Healthcare Research and Quality, Dr. Andy Bindman.
Key takeaways from selected sessions are recapped below by AcademyHealth staff:
Opening Plenary: Right-Sizing Measurement for Health Care
Moderator: Eduardo Sanchez, American Heart Association ; Panelists: Santi Bhagat, Physician-Parent Caregivers; Helen Burstin, The National Quality Forum; Darshak Sanghavi, OptumLabs
Monday’s opening plenary tackled how to measure achievements in providing better health at lower costs. Each panelist provided a different perspective and focused their comments on different measurements and tools being used by the field, including those that add value to care and those that do not. Several common themes emerged, including a discussion around the number of measures; the alignment of measurement’s purpose to improve health, and the need to look at health outcomes from a large population level. Dr. Bhagat represented the patient community and reminded attendees of the importance of recognizing health inequities in all demographics.
The panel’s Q&A included conversation about the deimplementation of low value care, the neglect of access in the conversation about quality health, and effective measurements.
This session aligned with AcadmeyHealth’s commitment to addressing quality and value in health care.
Meaningful Use: Developing Computer Algorithms to Identify Potential Adverse Events from Electronic Medical Record Data
Moderator: James Naessens, Mayo Clinic; Discussants: Earl Etienne, Howard University and Jonathon Nebeker, University of Utah School of Medicine and Department of Veterans Affairs; Speakers: James Moriarty, Mayo Clinic and Hongfang Liu, Mayo Clinic.
This panel positioned existing approaches for detecting hospital adverse events (HAE) that are based on manual chart review or administrative data against the rapid adoption of electronic medical records (EMRs) and the accelerated advance of health information technology (HIT). The panel discussed their efforts to detect HAEs by applying advanced analytics on EMRs offering a potentially powerful alternative to either administrative data or labor-intensive manual chart reviews for HAE surveillance.
Discussion topics included:
- Data that is deliberately missing from the patient chart must be taken into account when investigating HAEs
- Natural Language Processing (NLP) as a way to incorporate chart reviews into the EMR
- Why utilization and publication of NLP have not increased in recent years
This session aligned with AcademyHealth’s pursuit to improve patient care through evaluation and management of adverse events, and incorporates the use of patient data and HIT in quality improvement.
Multi-Sector Community-Based Data Sharing Collaborations
Moderator: Peter Eckart, Illinois Public Health Institute; Panelists: Alison Rein, AcademyHealth; Karen Hacker, Allegheny County Health Department; Melinda Buntin, Vanderbilt University, Nashville, TN
Data Across Sectors for Health (DASH) and the Commmunity Health Peer Learning Program (CHP) joined forces once again at Concordium for a presentation on their collaboration project, All In: Data for Community Health. The session began with an overview of DASH and the CHP Program and their commitment to sharing information across sectors in order to build capacity drive community health improvement through the All In network. The overview was followed by presentations from two communities: the Allegheny County Health Department and the Nashville Infant Mortality Project. The Q&A session touched on the factors of motivation for collaboration and evidence-based community interventions.
This session, and the CHP Program, align with AcademyHealth’s belief that both the production and use of evidence from health services and policy research can improve health, health care, and public health.
Lunch Plenary: Leadership, Data Science, and Culture Change in Health
Chair: David Chambers, National Cancer Institute; Panelists: Bechara Choucair, Trinity Health, former Commissioner of the Chicago Department of Public Health; Vivian Lee, University of Utah School of Medicine; Glenn Steele, xG Health Solutions
Over lunch, attendees heard from a panel of leaders from different settings including academia, government and the private sector. The panel highlighted panelists’ leadership and culture change challenges and successes in delivery system transformation efforts. Discussion on the panel ranged from the philosophical – how to combine purpose, mastery and autonomy to motivate physicians – to the specific – publicly posting patient satisfaction data to improve quality and using social media to encourage reporting of food borne illnesses.
Questions from the audience included:
- How can systems work with patients to ensure their perspective is included in culture change efforts?
- What is the responsibility of the health care system to help patients develop appropriate goals that encourage quality care?
- What are the best methods for disseminating innovations to others?
This session aligned with AcademyHealth’s mission to move knowledge into action by drawing on the expertise of a vibrant and diverse community.
Telehealth: An Idea Whose Time Is Still Coming?
Chair: Margo Edmunds, AcademyHealth; Panelists: David Cattell-Gordon, the University of Virginia; Neal Sikka, the George Washington University Hospital; Bernadette Loftus, he Permanente Medical Group
With the telehealth market growing fast, consumers are beginning to expect health care professionals to use the same technologies that other industries are already using, including videoconferencing, mobile apps, and web portals. But there are still a lot of myths and misperceptions among providers about what it takes to provide remote services to patients, and many providers have been slow to adopt these new technologies. In this session, three early adopters of telehealth shared their experiences with telehealth, including how and why they got started, what services they provide, and fielded questions from the audience.
Questions from the audience included:
- How do telehealth methods affect the patient-provider relationship and what can be done to ensure that relationship remains effective?
- What role should patient satisfaction metrics play in measuring the effectiveness of telehealth services?
- How can telehealth extend the number and capacity of caregivers who might otherwise lose their ability to contribute?
This session aligned with AcademyHealth’s efforts to address the needs and concerns of the filed in a changing environment for health and the health care system.
Unleashing the Power of Patient Registries through Harmonized Outcomes: An Early Test of the Outcomes Measure Framework in Atrial Fibrillation
Moderator: Elise Berliner, Agency for Healthcare Research and Quality; Speakers: Richard Gliklich, Better Outcomes; Paul Wallace, AcademyHealth; Lara Slattery, American College of Cardiology
In the panel’s opening, Dr. Berliner explained that there is currently significant variation in both the types of information collected and the types of outcomes measured in patient care, even within a given clinical area. Therefore, the Agency for Healthcare Research and Quality (AHRQ) is attempting to address fragmentation and variation by supporting a more harmonized and standardized approach to defining outcome measures and usage by developing a patient registry. The conceptual foundation for this work lies in the AHRQ-funded development and refinement of the Outcomes Measure Framework (OMF), a conceptual model for classifying outcomes relevant to patients and providers across most conditions. The Challenge Workshop was used as a forum to test the feasibility of using the OMF for classifying and ultimately harmonizing outcome measures by applying it to a clinical area test case – atrial fibrillation (AFib).
Question/discussion topics included:
- Do the relevant outcome measures for AFib fit within the OMF?
- Are there ‘cross-cutting’ outcome measures that are relevant for AFib (i.e., outcome measures that are also used in other condition areas)?
- What is the “right” level of clinical specificity for data definitions? What are the tradeoffs in achieving consistency versus meeting individual registry needs?
This session aligned with AcademyHealth’s work to minimize data silos and improve health outcomes through appropriate identification and efficient use of patient data.
Exchanging Data to Improve Population Health: Infrastructure Protection Meets Consumer Protection
Moderator: Robin Strongin, Amplify Public Affairs, LLC Panelists: Peter Levin, Amida Technology Solutions; Kshemendra Paul, White House Information Sharing & Access Inter-agency Policy Committee
This concurrent session shed light on the bright spots in health and information sharing despite persistent barriers and public concerns. Kshmendra Paul discussed the evolution of open data in government and the many interactions between the health community and the Department of Health and Human Services. Peter Levin emphasized the move to value-based care and how data sharing will feature in that shift. This interactive panel was followed by a vibrant Q&A session, during which participants asked questions about:
- The challenges in achieving interoperability because of concerns over security and privacy
- Linking criminal justice and health data
- The shift from a confrontational relationship to an aligned one between insurers and patients
This session aligned with AcademyHealth’s organizational goal to advance the science of health services and policy research production and use.
Day two brought more data-related challenges and opportunities to the fore with sessions on access, practical considerations of large data projects and the use of storytelling to communicate complicated data.
Plenary: No Wrong Door: Improving Health Access Across Sectors
Moderator: Gilbert Salinas, Rancho Los Amigos National Rehabilitation Center Panelists: Karen Hacker, Allegheny County Health Department; Ivor Horn, Seattle Children’s Hospital; and Jerry Krishnan, University of Illinois Hospital and Health Sciences System
Day two’s lunch plenary focused on the role of data and service integration in improving health access and optimization across sectors. Gilbert Salinas framed the conversation with a call for greater attention to metrics and data collection around underserved communities, and an evaluation of how the health industry is performing around disability competent care. Panelists provided examples of the difficulty behind integrating social determinants of health in efforts to optimize health. Common themes included health care access, trust issues within data sharing partnerships, and challenges associated with government inaction. The Q&A included discussion around community leadership in health system reform and social influencers of health.
This session aligned with AcademyHealth’s belief that diverse perspectives lead to richer and more nuanced understanding of issues related to health and the performance of the health system.
Implications of Health Policy for Research and Clinical Practice
Moderator: Richard Dutton, US Anesthesia Partners; Speakers: Natalia Chalmers, DentaQuest Institute; Prashila Dullabh, NORC at the University of Chicago; Jonah Geddes, Oregon Health & Science University; Jill Huppert, AHRQ.
This panel explored the (often unintended) consequences of developing a data stream and managing it. An example of work done across the dental network in Maryland, Kentucky, and Rhode Island was presented and showed increase use of emergency rooms as a safety net for oral care. Panelists also explored emergency department practice decisions and guidelines for screening cervical cancer in young adults.
Question/discussion topics included:
- When you take on a large data intensive project, how are you able to manage the costs and realize utility?
- When representing complicated information to patients and their surrogates, it is important to make information accessible and meaningful.
- Do guidelines really lead to practice change? Yes, it looks like they do in hospital settings, but less locally.
This session aligned with AcademyHealth’s work to explain and inform policy implications in practice and in the development of research.
Plenary: We're All Data Consumers: Personal Health Technology and Storytelling
Chair: Erin Holve, AcademyHealth; Panelists: Anjali Jain, the Lewin Group; Amy Abernethy, Flatiron Health; Megan O’Boyle, Phelan-McDermid Syndrome Foundation
Big or small, all data is personal. The final session of this year’s Concordium acknowledged that science and evidence are most effective when they reflect individual stories and experiences. Panelists represented varied viewpoints highlighting the roles of clinicians, patient advocates, and researchers in bringing data, data use and its impact together. Comments from the panel and the audience highlighted challenges of conducting and translating science in reliable and valid ways while paying careful attention to lived experiences of individuals.
Topics discussed included:
- What is the key ingredient to narratives that work?
- How does data completeness (or incompleteness) affect our ability to translate science in compelling ways?
- What role does professional training or patient education play in getting more meaningful data that results in more powerful stories?
This session aligned with AcademyHealth’s goal to promote the visibility and relevance of health services and policy research.