Roji Intel Blog

Robert McNutt, M.D. 0
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Registry ScienceResearch
November 15, 2016

Bedside Viewpoint: Why Watson Will Never Know Enough to Replace Your Physician

Every conversation with a patient is an exercise in big data analysis. Your patient’s appearance, changes in mood and expression, and eye contact are data points. The illness narrative is rich in semiotics: pacing, timing, nuances of speech and dialect are influenced by context, background and insight, which, in turn, reflect religion, education, literacy, numeracy, life experiences and peer input. To all this, add personality traits such as recalcitrance, acceptance and personal philosophies. Taking a history generates a wealth of data. Mix in physical findings of variable reliability, laboratory markers of variable specificity, imaging bits and bytes, and you have…
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Thomas Dent, M.D. 0
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Future of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
October 11, 2016

Physician Culture Must Transition from Defensiveness to Performance Improvement

Physicians undergo long and arduous training, with good reason. Lives are at stake. Learning to make the correct diagnosis, to expertly perform the appropriate procedure and to properly treat conditions is essential. Mistakes or flaws are scrutinized and not tolerated. Being wrong may cause greater harm to the patient—and lead to malpractice litigation. In short, physician culture places a premium on individual performance and responsibility. Steeped in those values, most physicians take great pride in the quality of care they deliver to patients, in the examination room or the surgical suite. Teams who provide specialized services, such as Emergency Departments,…
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Robert McNutt, M.D. 0
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Performance ImprovementPersonalized MedicinePopulation HealthRegistry ScienceResearch
August 30, 2016

Personalized Medicine v Population Health: Opposites or Complements?

If personalized medical care is the goal, how does that fit with the concept of “population health,” the darling of the health care industry’s drive toward better results and lower costs? Are these two concepts really at odds, or do they work in tandem? This is not a rhetorical question; in the current environment of keeping costs under control, lives are at stake. How Personalized Medicine Should Work We know that best outcomes occur when individuals are appropriately assessed and allowed to make choices based on their personal characteristics. Personalized medicine is not a concept of averages; it is a…
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Robert McNutt, M.D. 0
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Future of Health CarePersonalized MedicineRegistry ScienceResearch
August 9, 2016

Personalized Medicine Can’t Wait for Genomic Data

Personalized medicine is off and running. The effort to enroll one million people who will volunteer their genomes for science by the year 2019 kicked off recently with an event featuring President Obama that included more than 150 of the first volunteers. But this effort is not for my patient. It will be either too little, or too late, and certainly not enough. While personalized medicine is an old concept, the new push for personalization focuses on genes or gene products. These, it is hoped, may be better predictors of an individual’s outcome of a disease condition. The new efforts may…
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Thomas Dent, M.D. 0
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Clinical Data RegistryMACRAMedical Decision-MakingMerit-Based Incentive Payment System (MIPS)Performance ImprovementQualified Clinical Data Registry ReportingRegistry ScienceResearch
July 19, 2016

MACRA Match-up: How EHR Source Data Will Benefit Registry Research

At the core of MACRA and MIPS requirements, Electronic Health Record (EHR) source data will soon become a key component for Registry research. Specifically, Clinical Performance Improvement Activities (CPIAs) are a required component of MIPS. Performance improvement efforts will no longer be optional. Quality data will be essential. EHRs present an excellent data resource, but the data is not flawless. Registries are well suited for validating data and assessing performance using a continuous improvement model—testing an idea by changing a practice and measuring its impact. When done on a small scale, testing performance improvement activities and the feasibility of population-based…
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Theresa Hush 0
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ACO ReportingClinical Data RegistryFuture of Health CarePerformance ImprovementRegistry ScienceResearchValue-Based Health Care
April 26, 2016

Your Health Care IT Investments: How to Purchase for Performance Improvement

Health care technology (HIT) is frequently oversold. That may be a surprising message coming from a Registry CEO, but it’s the truth. In the quest for answers, too many providers search for a system that can “do it all,” a dream technology that exists, well, only in your dreams. There is intense pressure on providers to prepare for undertaking the financial risk of patient care, while maintaining or improving patient quality and outcomes. Two factors are driving the push for HIT purchases to meet this demand: providers’ strong wish for easy and straightforward solutions that can mesh with existing technology,…
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Robert McNutt, M.D. 0
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Clinical Data RegistryRegistry ScienceResearch
April 19, 2016

Does Data Say All You Need to Improve Health Care Performance?

Can data lie? In a word, yes. The answer also depends on whom you ask. That goes for all forms of data analysis, including how we evaluate health care. This presents a tough dilemma for providers, patients and other stakeholders at a time when the industry and government are heavily invested in using data to compare provider performance, attach payment to “good” providers and penalties for the others. The fact is that the health care data “revolution” is in its infancy, and it is not so easy to identify two key facts: what causes outcomes, and what fixes them. Situations…
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Robert McNutt, M.D. 0
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Clinical Data RegistryFuture of Health CareMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
March 1, 2016

First, Ask Questions: How to Harness CDR Data for Better Patient Outcomes

As more and better clinical data becomes available and demand grows for better outcomes, the Clinical Data Registry is positioned to fulfill the role of data manager—a vital mechanism for improving care. The CDR is the engine driving a smoothly running system toward better outcomes. This involves much more than data collection. A high quality management function for CDR data requires making inferences from the data it collects. But drawing inferences from present data sources presents significant challenges, no matter how big the data source. As a medical journal editor, I have reviewed many papers from countries with massive data…
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Theresa Hush 0
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Clinical Data RegistryMedical Decision-MakingPerformance ImprovementRegistry ScienceResearchValue-Based Health Care
February 9, 2016

Plenty of Data, Not Enough Answers: What We Need to Improve Health Care Performance

If you read the industry hype, you might believe that we’ve left the data wasteland for the data land of plenty. Some health care technology and analytics companies allege that, with all this enhanced data capability, you can now discover everything you need to know about your operations and patients that will lead you to higher profitability. But if that’s so, why are health care costs continuing to increase? Why are providers still not able to succeed under risk-based payment models? Why don’t we know more about what actually works to improve patient outcomes? It’s true that we have access…
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Thomas Dent, M.D. 0
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ACO ReportingAlternative Payment Models (APM)Clinical Data RegistryFuture of Health CareMeaningful UseMerit-Based Incentive Payment System (MIPS)Performance ImprovementRegistry ScienceResearchValue-Based Health Care
February 2, 2016

All Together, Now: Why Specialists Need the CDR Edge for Bundled Payments

With the advent of Bundled Payments for selected procedures and conditions, providers and institutions must collaborate to meet both cost and quality targets. No longer will each provider bill and receive payment separately for services when these bundles become mandatory—as most experts believe will happen. All providers participating in a set “bundled” price must focus on coordinated performance improvement or face penalties. Key to that effort: a Clinical Data Registry (CDR) that tracks patient outcome data over time and pinpoints success or failure of interventions. CDR Performance Improvement Tools Are Essential for Bundled Payments Success The CDR fulfills two fundamental…
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