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Data Integrity ACTIONS

Data Integrity ACTIONS

Data standards and integrity are arguably the two most critical ingredients when you consider achievement at either the (individual) human or (collective) global scale. There is no causation absent data (information) and there is no consequent execution unless it has been purposefully structured and validated for sharing. Healthcare Reform promises innovation in care delivery by increasing the transparency of data and quality metrics but how can you improve on something that doesn’t ideally exist yet?

When the OIG released its report, The Medicare Payment System for Skilled Nursing Facilities Needs To Be Reevaluated, they noted a 29% margin (overpayment) for therapy service reimbursement. Further, Skilled Nursing Facilities (SNFs) increasingly billed for the highest level of therapy even though key beneficiary characteristics remained largely the same. Achieving information access and coordination throughout the “Continuum of Care” requires a call to action for better interoperability and data management practices if we want to be successful in the future value based / bundled payment systems. Common standards for (1) assessment/documentation, (2) secure exchange of EHR/PHI and (3) compliance/accountability across the Continuum of Care (Hospital to Skilled Nursing & Rehab to Home) need to be pioneered further before they can be adopted and enhanced. The Electronic Health Record (EHR) is arguably at the root of this opportunity but all business information has relevancy.

Introducing The 4th Industrial Revolution

As thought leaders on the world stage prepare us for the Fourth Industrial Revolution and Web 3.0 (The Semantic Web), we are reminded of the inequity gap that exists between enterprise level organizations, technologists and the remaining 99% of data users. That it to say that if best practices in knowledge management trickled down to Healthcare delivery the marketplace could be transformed very quickly. We get a glimpse of the future of work and mobile health when we watch a TED Talk or purchase a personal device with updated features but when will mainstreet be touched by technology that addresses productivity and information sharing in a more meaningful way?

Senior Living – as a subordinated subset of established industry classification(s) represents a now distinct and emerging asset sector, yet uniquely representing a blend of real estate; healthcare services; and hospitality. Everyone chatters about technology, disruption and innovation but we fail to emphasize two clear imperatives;

  1. Simple, shareable language makes everything technically possible.
  2. Business challenges have frequently been met and overcome in adjacent spaces (as the YouTube clip above intimates) if we only had the eyes to see them.

We must look to other industries to inform data initiatives that drive and define our evolving identity and moonshots. Of all the data we amass, what is more relevant to quality and compliance than the MDS? And how does that documentation relate to an EHR or related Protected Health Information (PHI)?

Stepping out of the Sandbox

There are too many languages in the medical community and they often represent overlapping or redundant concepts. Consider this post’s leading sub-title that suggests how innovation is intrinsically connected to interdisciplinary thinking. For example, IF we operate in a SNF setting and have a Medical Director as part of our Quality Assurance and Performance Improvement (QAPI) Committee but don’t understand either (1) the correlation between Quality Measures on Nursing Home Compare and the corresponding fields on each Minimum Data Set submission, or (2) the relationship between those measures and the 254 quality measures that CMS identified for the PQRS in 2015 (mapping to the U.S. National Quality Standard (NQS) health care quality domains), THEN, it is clear in this one trite example that we really need to rely on each other’s knowledge if we are going to make this work. Is it possible that there is a future scenario on the horizon where a more connected and semantic web will learn how to navigate and connect these complexities for us? The question becomes, how much accountability should we have for understanding and correlating all of these terms and frameworks? Leading from behind is not the sustainable solution.

The Need for Interoperability Standards

You are likely consuming this blog entry on a mobile device that is connected to the Web. The internet works because it operates upon open standards that have been established by the World Wide Web Consortium (W3C). If you are a designer or developer, you understand that you cannot create anything successfully without employing these interoperability standards in your own work product. On the other hand, we business consumers remain steeped online and in conferences with little emphasis on the need for knowledge to transfer.

The following clip references a government commissioned the JASON report that identifies what we have been getting wrong in our industry and prescribes an approach for fixing it:

It is clear that brilliant people endeavor to solve our problems beneath the surface-level chatter of our practice and headlines. They need our insight if the solutions they develop are to be (1) fast-tracked and (2) widely distributed. Our more active and collective engagement and collaboration will help make this happen.

Next Steps?

The challenges we confront in our sector (and frankly the majority of business industries) are downstream of lacking interoperability standards; inadequate reporting capabilities; and too few safeguards to ensure data integrity. The commodity of business intelligence is the new currency
of sustainable business success.

The call to action is simple. We need to be alert to exhibiting trends and become better data managers. We offer the following recipe for ACTIONS:

  • A – ssess and appraise current information systems capabilities.
  • C – orrect conditions of inadequacy, inaccuracy and redundancy of data gathering.
  • T – ransition reporting capabilities to achieve full integration for all users.
  • I – nterpret data intelligence routinely to inform best practice management.
  • O – pen and share data with collaborative partners to promote new prospects.
  • N – urture systems reporting to foster data integrity and build business bridges.
  • S – eek outside resources to develop and maintain data integrity.

Providers in our sector who best capture, manage, share and act upon reliable business data will be the survivors and prosper. New standards like FHIR promise to transform the way we conduct business and deliver quality outcomes but they represent future solutions. Data integrity defines not only your business identity, but importantly, your performance history and ratings in the marketplace. The Five Star Rating system in the skilled nursing sector is a good example of how reported data defines a business brand. Take charge of this information flow; ensure its integrity; and manage it to your advantage now before it is too late. That constitutes leading from the front.

Need guidance with your ACTIONS? Contact us to learn how we can help.

Sixty is the new Sixty

Sixty is the new Sixty

By Christine Benton 

Until recently, society, in general, has regarded aging as a problem. This view on aging has impacted all aspects of life for the older generations, including healthcare, the workplace, housing, and end-of-life issues. However, a change in society’s attitude towards aging is gradually taking shape as people are living longer, healthier lives. The realities of modern-day aging are slowly but surely overcoming the various myths relating to this time of life.

It’s Not About Aging: It’s About Living

American culture has for too long glorified youth, resulting in a society-wide meme that growing older is something to be dreaded. Now, aging people themselves are showing the rest of society that they are not going to be consigned to a rocking chair but instead are fully capable of realizing greater potential and seizing new opportunities to learn and grow. Society is being forced to reach a newer, more life-affirming understanding of what getting older is really all about. It’s definitely the right time to reimagine aging so that seniors are regarded as integral and inspirational assets to be leveraged by our evolving society.

What Older People Can Accomplish

It’s a fact that plenty of people hike the Appalachian Trail after the age of fiftythe oldest thru-hiker was a seventy-four-year-old woman. If we want to disrupt or redefine aging we should focus on and celebrate the amazing feats of others who are defying the stereotypes of aegism. Want to get a sense of what is possible? Here is a list of twenty-five older individuals who did not sit around waiting to get older but went out and accomplished a variety of things that they had always wanted to do – 25 Oldest People To Accomplish Amazing Feats.

Against Ageism

If you want to get a quick pulse on what other thought leaders are saying, an influential book is Ashton Applewhite’s engaging work, This Chair Rocks: A Manifesto Against Ageism. The book is dedicated to Applewhite’s mentor, the pro-aging activist Dr. Robert Butler. It sets out the case for ending age-based discrimination and Applewhite drives home her points with the use of some trenchant language:

  • “My darkest nightmare was the possibility of ending my days drooling under a bad botanical print in some ghastly institutional hallway.”
  • “Take ‘middle age,’ to which so many cling like flotation cushions, although who knows where the middle lies anymore?”
  • “The Helen Mirrens and Judi Denches of the world are forging a footpath that needs to become a highway.”
  • “I used to think that those [‘senior moments’] quips were self-deprecatingly cute, until it dawned on me that when I lost the car keys in high school, I didn’t call it a ‘junior moment.”
  • Applewhite proudly embraces the role of “Old Person in Training,” stating that the process to become one “acknowledges the inevitability of oldness while relegating it to the future, albeit at an ever-smaller remove. It swaps purpose and intent for dread and denial. It connects us empathically with our future selves.”

Is Sixty Really the New Forty?

What about all those ads proclaiming that “fifty is the new thirty” or “sixty is the new forty”? This is a nice sentiment, but, in reality, people in their fifties or sixties face different challenges than the younger people they are being compared to. Their motivations are shaped by the wisdom they have gained from experiencing the ups and downs of life that younger people still have to find. They don’t necessarily want to be thirty again – they are more purposeful individuals because of what they have experienced in the years between thirty and sixty.

A New Third Age

Today’s older people are a generation of makers and doers who continue to explore their possibilities and to celebrate discovery over decline. Their opportunities are not limited by age, and their experiences have real value. Of course, society needs to ensure that Medicare is strong enough to provide people with access to care and services to enable them to lead long, healthy lives; and that Social Security will provide them with the financial support to match their longer lifespans. As Jo Ann Jenkins, CEO of AARP states: “At AARP, we truly believe that age and experience can expand life’s possibilities for every member of our society. When we disrupt aging and embrace it as something to look forward to, we can begin to discover the real possibilities for becoming the person we’ve always wanted to be.”

What Can Older People Learn From All This?

  • Own your age. Be proud of telling people that you are seventy-two because the important thing is who you are, and what you do – not how old you are. Embrace your age and feel good about where you are in life.
  • Just as an individual should not be defined by race or sex, don’t let yourself be defined by age. Don’t let society decide what’s possible or not possible for you because of your age.
  • Look forward to your years ahead instead of looking nostalgically backward.

Society’s concept of aging is changing because seniors themselves are forcing it to evolve. “The possibilities for society of this new third age can hardly be seen now, obscured as they are by misconceptions and prejudices –– age-as-‘problem.’ They have to be seen as the solution and not just the problem for change to be possible. And we have to name our own need to move in society in new ways in age to make it happen.” — Betty Friedan, The Fountain of Age, 1993