Gain insight into how you can best position your homecare or hospice agency for success in an environment of change by reading this e-book.

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Interoperability, HIEs and the
Future of Homecare
McKesson
[Course title]
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As care collaboration becomes the
cornerstone of quality healthcare, the
clinical success of your agency is just as
important as its financial success. The
Affordable Care Act is marching forward,
and standing still to wait for change to
subside is not an option if you want your
agency to survive and thrive. The question,
then, is how best to position your agency for
the changes that need to happen.
Over the last several months, McKesson
Homecare Talk has featured a number of
blogs that focus on two major areas:
Collaborating for Success and Putting HIEs
to Work for You. We’ve compiled this
e-book to provide insight into how you can
demonstrate value to your partners and
interpret healthcare data intelligence.
We believe that home health will be central
to the success of whatever may be the next
trend, care model or healthcare innovation.
Home health brings value to the
community, but you must be at the table to
be considered. You can be taking
extraordinary care of your patients, but if
the wider world doesn’t know about your
agency, your opportunities for growth will
be limited.
If your home health agency is not
partnering with other care providers,
tracking key metrics and carefully observing
outcomes, you have some catching up to do.
And let’s not forget the vital role home
health agencies can play in the ACO model.
Accountable care is at the forefront of the
healthcare debate because it aligns
incentives in a patient-focused way.
However, care transitions and hospital-athome programs also are gaining in
popularity. Home health and hospice
agencies are a critical, but often overlooked,
component of the care continuum. How will
you raise the profile of your agency and
position it for greater success?
As Randy Hyun, general manager of the
Extended Care Solutions Group at
McKesson, states in his contribution to this
e-book, interoperability will define the
future of healthcare because “all health care
is local.” Not only will health information
exchanges (HIEs) help improve clinician
workflow and satisfaction, but involving
patients in their own care also will help
improve outcomes and strengthen ties with
the homecare community.
The importance of data and analytics will
continue to grow. Using evidence-based
practices and tracking key performance
measures are critical to an agency’s success
within any collaboration effort. To succeed
in the next few years, we’ll all need a strong
focus on both technology and process. Realtime information across the care continuum
is the ultimate goal, and if we work
together, we will get there.
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Table of Contents
Collaborating for Success .................................................................... 3
Standing Still Not an Option for Home Health Agencies........................................ 4
Three Reasons Why Home Health Will Define Healthcare’s Future .......................5
Three Ways to Get Noticed In Your Market……………………………………………………..6
Home Health Needs to Roll With the Changes ........................................................ 7
ACO Models Focusing on Certain Conditions ......................................................... 8
Local Research Can Pay Dividends – Literally ....................................................... 9
Agencies Must Show Value to ACOs ...................................................................... 10
Putting HIEs to Work for You ............................................................. 12
Four Healthcare Truths in 2020 ............................................................................ 13
Is It Time to Join a Health Information Exchange? .............................................. 14
Interoperability Defines the Future of Healthcare ................................................. 15
More Data, More Movement, Fewer Errors .......................................................... 17
HIEs Can Improve Clinician Workflow, Satisfaction ............................................ 18
Turning on Tap: PHRs Improve Patient Communication and Engagement ......... 19
Leverage Data to Show Your Value to Referral Sources ....................................... 20
Sharing More Data? Ask More Questions. ........................................................... 21
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Collaborating for Success
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Standing Still Not an
Option for Home
Health Agencies
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
advantage of new opportunities. Your plans
“have to be in tune with local culture,
customs and delivery patterns,” Langsdale
says.
Key strategies include:
Use technology better

Align provider interest

Connect quality to value

According to Troy Langsdale, partner in the
healthcare practice at CliftonLarsonAllen,
the first step is to conduct a strategic
analysis of your agency and your market,
then develop an action plan to improve
organizational performance and take
Prepare to assume risk

But you may not realize that standing still
to wait for the change to subside is not an
option if you want your agency to survive
and thrive in the future. The question, then,
is how best to position your agency for the
changes that need to occur.
Decide whether to lead, follow or
resist

Today’s care and reimbursement
environment is one of constant change. I’m
not telling you anything that you don’t
already recognize during each work day.

Build new relationships
An agency owner interested in growing, for
example, could become involved with
community health initiatives. Then, if a new
care model such as an ACO is formed, the
owner would naturally be part of the
conversation. Likewise, you probably
already are doing disease management in
your agency, but are you calling it that? A
simple name change and the capturing of
data will help show your value to partners
and potential partners.
Langsdale also stresses the importance of
operational efficiency, eliminating waste
wherever possible, maximizing value-added
offerings and minimizing anything that
doesn’t bring value to the organization.
“You need to build processes around the
norm, not the exception,” Langsdale says.
And you should actively solicit ideas from
among your staff, he notes. Your employees
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are on the front lines with patients,
providers, payers and community members.
He suggests setting up a specific email
address for ideas and monitoring it
frequently.
Despite the myriad changes in the industry,
Langsdale says, “On the post-acute side, I’m
bullish. The industry is well-positioned in
healthcare reform.”
The industry may be well-positioned, but is
your agency? That’s a question that only
you can answer. And answer it you should.
Three Reasons Home
Health Will Define
Healthcare’s Future
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
If I had a crystal ball and could accurately
envision what the future of healthcare will
look like, I could retire a rich woman.
Unfortunately, I don’t.
But I do know that home health will be
central to the success of whatever may be
the next trend, care model or healthcare
innovation.
Here are three reasons why home health is
uniquely positioned:

We understand our patients in a
holistic way that most other care
providers don’t.

We know about and have access to
community resources.

We have feet on the street with a
mobile workforce that can reach
these patients, day in and day out,
wherever they are.
That may be one reason home health
spending increased 8.4% from January
2012 to January 2013, according to Altarum
Institute, a nonprofit health systems
research and consulting organization.
Admittedly, the amount spent on home care
is relatively small compared to what’s spent
on the big three (hospitals, physicians and
prescriptions take 60 cents of each
healthcare dollar). But the month-to-month
percentage increase for home health was
considerably higher than those other
categories.
That’s not to say we don’t face our own
challenges. The biggest obstacle I see for
our industry is a lack of data to show our
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value to care partners. If your home health
agency is not partnering with other care
providers, tracking key metrics and
carefully observing outcomes, then you
have some catching up to do. A reliable
clinical management system is the best way
to collect and interpret valuable home
healthcare data intelligence.
This is not the time to stand by and hope
the changes impacting the healthcare
industry will go away. They won’t. It is the
time to try new things, expand on what
works and change what doesn’t. You will be
judged not only on your outcomes, but on
your ability to show the value that your
home health agency provides.
Three Ways to Get
Noticed in Your Market
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Make no doubt about it – we are in a
relationship business. However, many
people confuse relationships or
partnerships with friendships. They are not
the same.
There should be some formality in a
relationship, with expectations on both
sides. In the homecare space, that means
your home health agency should have
performance measures at hand to share
with partners or potential partners. At the
same time, you should know what to expect
from your partners, including how to get
out of a relationship if it’s not working for
your agency.
In order to increase the number of
relationships you have with potential
partners, you need to get their attention. In
my view, there are three ways to get noticed
in your market:

“Shoot some bullets”

Get engaged in your community,
state and regions

Build brand recognition
What I mean by “shoot some bullets” is for
you actively to explore new partnerships
and new care offerings. Is your local
hospital concerned about care transitions?
What about medication reconciliation or
the ongoing treatment of chronic conditions
to prevent hospital admissions and
readmissions? Every state now has an ACO,
and there’s likely some type of alternative
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care model being explored or activated in
your community. You have a crucial part to
play.
Home Health Needs to
Roll with the Changes
The second point is fairly straightforward.
Various local, regional, state and interstate
community entities are trying to tackle
community healthcare challenges. Are you
aware of the groups active in your area, and,
more important, are you involved in them?
Home health brings value to the
community, but you must be at the table to
be considered.
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Finally, you must understand the
importance of brand recognition. Your
agency should have a mission, a vision and
organizational goals that every member of
your agency understands and can articulate.
And you must have effective branding. Do
you have a company logo? Do you use it
consistently? Do you have a presence on the
web? Increase brand awareness by doing
such things as sponsoring the local health
fair or other community events.
I know that you didn’t get into the home
health business to become a marketer.
Unfortunately, you can be taking
extraordinary care of your patients, but if
the wider world doesn’t know about your
agency, your opportunities for growth will
be limited.
Were you aware that HHS has approved
259 Accountable Care Organizations
(ACOs) that represent 8% of the Medicare
population? Nearly half are physician-led
and serve fewer than 10,000 Medicare
patients, according to The Advisory Board
Co. With the announcement of the latest
list, at least one ACO now exists in every
state.
This fact serves as another reminder that
the status quo will no longer suffice if you
want your agency to not simply survive –
but to thrive – over the next few years.
Accountable care is coming to the forefront
because it aligns incentives in a patientfocused way, but care transitions and
hospital-at-home programs also are gaining
in popularity.
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Univita Health is partnering with major
insurers and hospital systems to set up care
transition programs that include both
clinical and non-clinical services. What are
the hospitals, physician groups, insurers
and community-service groups in your area
doing to help folks stay at home?
As a whole, healthcare is moving away from
a fee-for-service environment toward
capitation, which was last seen during the
managed care environment of the 1980s.
That generally was considered a failed
experiment, but the industry has grown
since then in its knowledge of population
health. This growth has been fueled largely
by powerful analytic programs that can
distill huge amounts of data into
manageable, actionable chunks.
And that’s your challenge: Breaking down
what your agency does to help patients
recover from hospital stays, regain mobility
and thrive at home in a way that
demonstrates your value to partners and
potential partners.
Anyone can become constrained by the
business models they’ve trained in and the
regulations they’ve learned. They can lose
the ability to think outside the box, to put
aside preconceived notions and to think
about what’s possible. But if you and your
agency can’t learn to think outside the box,
someone else will.
Home health software can assist your
agency in moving forward with change by
facilitating improved care quality and
documentation.
ACO Models Focusing
on Certain Conditions
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
A small number of accountable care
organizations (ACOs) are beginning to focus
on certain diseases or chronic conditions. Is
your home health agency gearing up to
compete?
Florida Blue, the insurer formerly known as
Blue Cross and Blue Shield of Florida, has
established ACOs for cancer patients in the
Miami and Tampa areas during 2012,
according to a report in American Medical
News. The article also mentioned that
dialysis provider DaVita has launched the
Accountable Kidney Care Collaborative and
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is trying to establish an ACO for people with
kidney disease.
The focus of ACOs on specific conditions
may be the low-hanging fruit of the
accountable care world. End-stage renal
disease cost federal and commercial payers
nearly $43 billion in 2010, and more than
$124 billion was spent on cancer treatments
the same year.
Cost savings are shared among providers in
the ACO model, so finding effective
treatments and interventions for a specific
disease can help nearly every patient in the
group. But if the entire ACO were composed
of those with a certain disease, positive
treatments could have far-reaching effects,
both to the quality of life for patients and
significant savings that providers could
share.
I know that running your agency can
sometimes feel like a juggling act, with dayto-day tasks competing with medium- and
long-range planning, personnel issues,
technology challenges and many other
concerns. Talking about ACOs may seem
like piling on, but accountable care
organizations are gaining stature, traction –
and dollars. You need to determine how
your agency fits into an accountable care
world.
Local Research Can Pay
Dividends – Literally
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Home health agencies can play a vital role
in the ACO model, particularly in terms of
disease management. Some agencies have
developed programs that address specific
morbidities such as diabetes, congestive
heart failure or COPD.
Last year, we held a webinar series that
addressed ACO strategies. The three
webinars are:

ACO Overview

Addressing the Triple Aim

Measures of Success
I try to write about and comment on
happenings of national importance in the
home health and hospice industries. But for
every national initiative I mention, there are
a huge number of local initiatives that also
are important.
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Hospital readmissions continue to make
news on a nearly daily basis. The latest
news is that Medicare reduced penalties for
1,246 hospitals and increased them for 226
others, according to Kaiser Health News.
What are your local hospitals or health
systems doing to decrease readmissions?
And, more important, what role can home
health play in helping them achieve fewer
readmissions?
Collaborative groups of hospitals and
providers have formed all over the country
to tackle common problems such as
readmissions or explore common
opportunities like care coordination and
payment reform. Home health and hospice
agencies are a critical, but often overlooked,
component of the care continuum. You
need to know where you fit in and how you
start.
How closely do you keep tabs on initiatives
being explored by the local hospital or large
provider groups? Make a note in your
calendar to check local news websites on a
consistent basis.
Do you belong to your regional or state
home care association? Bookmark the
website of your closest association and
check it frequently. If you are not active in
the group, you are missing a fantastic
opportunity to not only increase your
knowledge about the industry, but also to
raise the profile of your agency and position
it for greater success.
That’s what we do at McKesson – provide
you with the agency and clinical
management tools you need to be
successful. But home health software
technology can take you only so far – the
rest of the journey is up to you. And it starts
with paying close attention to the local and
national issues likely to affect your agency.
Agencies Must Show
Value to ACOs
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Participating in ACOs can be a key growth
strategy, but home health agencies must
know what to expect and how to show their
value, says Mark Sharp, CPA, partner at
BKD, LLP. Sharp was among the featured
speakers at the recent McKesson Home
Health and Hospice Executive Summit.
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Sharp sees four requirements for home
health agencies to participate effectively in
ACOs:

Promote evidence-based medicine

Promote beneficiary engagement

Internal reporting on quality and
cost metrics

Coordination of care
Since hospitals and large physician groups
are driving a majority of ACOs, Sharp says
agencies must cater to their needs, which
include managing transitions from acute to
post-acute care and helping patients
monitor their chronic conditions to prevent
hospital stays in the first place.
endeavor, although the marketing
department can play a supporting role,
Sharp notes. And an agency must be willing
to cover the geographic footprint of an ACO
– even though it may require either an
expansion of services or a partnership with
another agency.
“You should take a team approach to build
the internal processes you need to
participate in ACOs,” Sharp says. “Then,
you have to get out into your markets, tell
your story and develop the relationships
that you need to succeed.”
Using evidence-based practices and
tracking key performance measures are
critical to an agency’s success within an
ACO. “You have to be able to show
outcomes and cost savings to the healthcare
system,” Sharp says. “It’s not just cost
savings within your agency; it’s cost savings
across the continuum of care.”
A robust home health software solution for
agency management is a must to provide
the level of detail that ACOs require. Quality
metrics should be shown by patient and by
disease state. Data on cost reduction is
critical, as is the ability to handle different
payment methodologies.
Building the strong relationships necessary
to become involved in ACOs is a C-suite
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Putting HIEs to Work for You
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Four Healthcare
Truths in 2020
By Randy Hyun
General Manager, Extended Care
Solutions Group, McKesson
There’s so much going on in healthcare at
the moment that it seems ridiculous to
focus on anything beyond the near future.
In fact, times of rapid change require us to
take a step back and look at the long-term
possibilities. If we want to succeed, that is.
At McKesson, we spend a lot of time talking
about what 2020 will look like. A few years
back when we started talking about it, it
seemed very far away. Today, that’s no
longer the case. At the National Users
Conference in the spring, I outlined some of
the things McKesson believes we can count
on being true in 2020.
1. Care will be right-sized
2. Patients will expect more
transparency in their care
3. Patient data will flow across the
entire health system
4. Data and analytics will be a forefront
of healthcare
Let’s take those predictions one at a time.
First, when we talk about right-sized care,
we mean a significant shift in where care
takes place. Patients who would have been
hospitalized will be cared for on an
outpatient or homecare basis, conditions
that used to be treated by physicians will be
taken care of at a retail clinic staffed with
nurses, and so on. What’s important to
remember is that although it’s a major shift,
it will happen fairly gradually and will have
a positive impact on healthcare costs.
Second, patients will continue to demand
transparency in the form of personal health
records and patient portals. Patients will
have many more choices about where they
can be treated, and providers that recognize
the importance of transparency early on will
be the winners here.
Third is the flow of patient data. Right now,
this feels like a bit of pipe dream, but we
continue to work toward what we call a
longitudinal patient record—everything
from all providers in one place.
Finally, the importance of data and
analytics will continue to grow. We’ve come
a long way from a decade ago when almost
nothing was automated. By 2020, we’ll have
successfully made the transition to systems
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that not only communicate smoothly with
each other, but provide the exact
information providers need about their
patient populations at the moment they
need it.
As homecare providers, we know the value
of making a strong connection with a
patient. We also realize, to some extent, the
importance of connecting our business to
the various entities we work with.
To succeed in the next few years, we’ll all
need a strong focus on both technology and
process. Real-time information is the
ultimate goal, and if we work together, we
will get there.
In fact, those business connections are
becoming more important every day, and
here at McKesson, we’re seeing many of our
customers joining health information
exchanges (HIEs). In some cases, they are
sharing clinical patient data with a state,
regional or private HIE. In others, they’re
setting up a private HIE for their health
system.
Is It Time to Join a
Health Information
Exchange?
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Specifically, healthcare providers can create
a continuity of care document (CCD) that
shows a patient’s problems, vital signs,
medications, allergies and demographic
information. The CCD can be shared with
other providers via the HIE, and
information like new conditions or
medications can be added to the profile and
shared.
Some platforms designed to connect
homecare providers to HIEs also offer a way
to connect patients and families to their
healthcare providers by making a patient’s
health record accessible via the web (using
well-tested security). Once the patient
establishes an account, the homecare
agency can send secure emails to
individuals or broadcast messages to a predefined patient population.
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By connecting with other providers and
patients over the web, homecare agencies
can:

Improve relationships with
community healthcare partners

Increase clinician satisfaction and
productivity by providing easy-toaccess information

Connect patients and their families
to healthcare providers in a secure
manner

Engage patients in their care
process through easier provider
access

Create an agency-branded web
interface that increases patient
satisfaction
Given how interconnected our world has
become in the last few years, it makes sense
for healthcare providers to step up their
efforts in this area. And with strong benefits
like enhanced collaboration and improved
productivity, we expect to see many of our
customers do just that.
Interoperability
Defines the Future
of Healthcare
By Randy Hyun
General Manager, Extended Care
Solutions Group, McKesson
“All healthcare is local.” We’ve all heard
that phrase used to describe the nature of
healthcare. And it’s certainly true in the
case of care delivered in the home, home
health, hospice and personal care services.
Even in the midst of health care reform and
the Accountable Care Act, healthcare will
remain local, but it will have to break out of
its current silos. As new care models
transform the healthcare industry, clinical
interoperability is critical to the care
process and delivery systems as we all strive
to achieve the Triple Aim of better patient
outcomes, better population health and
reduced costs.
Home health, hospices and personal care
services have never felt the need to be more
connected. The health care system is
seeking to collaborate in real- or near-realtime and looking to their information
systems to enable and support them,
regardless of whether an agency is freestanding or part of a health system.
This aspiration brings with it a number of
challenges, not the least of which is the
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17. ...................................................................................
immaturity of electronic health information
exchanges. Yet it is clear, with the increased
emphasis on care coordination that’s
required to participate in ACOs and other
emerging care models, providers must have
well adapted, reliable, flexible ways to share
information among partners.
The release of McKesson Homecare™
v13.0, which brings the use of a standard
clinical terminology and evidence-based
practices to the bedside, fully supports the
goals of interoperability using McKesson
Home Health Connect™ and McKesson
Hospice Connect™ to enable the sharing of
demographic and clinical information bidirectionally with the care teams, regardless
of whether those care team members are a
part of the same health system or not.
McKesson Home Health Connect and
McKesson Hospice Connect are truly gamechangers for homecare agencies. Clinical
interoperability is becoming crucial, so
agencies need to access, share and manage
patient medical data in disparate systems.
Not only do McKesson Home Health
Connect and McKesson Hospice Connect
allow agencies to share information with
partners, they allow secure access with
private, state and regional health
information exchanges (HIEs). The webbased solutions store data in a secure
environment and feature auditing
protections that track users and allow
patients to specify what records they choose
to share.
With McKesson Home Health Connect and
McKesson Hospice Connect, clinicians can
look at multiple continuity of care
documents (CCDs) either separately or as a
single, integrated document that’s
aggregated from the available CCDs.
Bringing this information together provides
a powerful tool for clinicians as they are
determining the best course of care for the
patient and facing the challenges of having
the most current list of problems, allergies
and medications.
McKesson Home Health Connect and
McKesson Hospice Connect also help
patients participate in their own care
through the personal health record that’s
part of the system. The patient portal is
accessible via the web with security, privacy
and auditing protections. Once patients
have created a personal health record, your
agency can send secure email messages to
individuals or broadcast messages to a predefined patient population.
Products such as McKesson Home Health
Connect and McKesson Hospice Connect
used in conjunction with home health
software can help agencies stay on the
cutting edge, adapt to new care
environments and continue on their core
mission – taking great care of their patients.
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More Data,
More Movement,
Fewer Errors
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Through HIEs, clinicians can place
diagnostic orders that are electronically
routed to the proper hospital department or
homecare provider. Any test results and all
visit documentation, including the order ID
and the patient ID, are electronically
returned to the clinician’s EMR. As manual
procedures and handoffs are eliminated, the
potential for error is greatly reduced.
HIEs can help home health providers
manage patient identity, patient consent
and privacy rules and clinical terminology
mapping across disparate systems.
Having the best, most updated information
on customers is a priority for virtually every
business. In the homecare industry, that
information can be critically important,
even life-saving.
These days, more patient information is
being exchanged due to care transitions,
care coordination efforts and new payer
models like accountable care organizations
(ACOs). Fortunately, technology providers
are stepping up with health information
exchanges (HIEs) that make sharing
information easier, resulting in smoother
data flow and lower risk of error.
Indeed, HIE functions include medical
record sharing, results delivery and
exchange of continuity of care documents
during care transitions. Experts believe that
by ensuring a complete and comprehensive
patient history is available at the point of
care, HIEs can help:

Prevent hospital readmissions

Decrease dangerous medication
errors

Improve providers’ diagnostic
capabilities

Decrease duplicate testing by
ensuring a complete and
comprehensive patient history
HIEs are even more important to providers
moving into new models of care. ACOs,
patient-centered medical homes and payfor-performance systems depend on HIEs
to deliver patient-centered care, measure
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19. ...................................................................................
and report performance, share health
information and improve the quality,
coordination, safety and efficiency of care.
HIEs Can Improve
Clinician Workflow,
Satisfaction
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
Often, improving clinician satisfaction can
be as easy as making sure they have the
tools they need to do their job. Of course,
today’s home health providers consider data
as important a diagnostic tool as a
stethoscope, which can add a layer of
complexity. Fortunately, health information
exchanges (HIEs) are starting to prove their
worth in this area.
For example, HIEs allow clinicians better
access to diagnostic images, usually with a
single click from within a patient record.
According to a recent article in Health
Management Technology, clinicians are
reporting that digital image exchange
through an HIE is enabling them to
significantly minimize duplicate tests,
enhance quality of care and reduce patient
exposure to radiation.
Of course, it’s not just images that home
health clinicians need at the point of care.
Indeed, they need a combination of
demographic and clinical data about the
patient, including medical history, current
issues, current medications, allergies and
more. A private HIE allows patient
information like this to flow more freely
among hospitals, primary care physicians
and home health providers. It also allows
certain data to be exchanged with regional
and state HIEs for research and other
purposes.
There’s another way that HIEs improve
clinician satisfaction: improving workflow.
Virtually every provider has a goal of
spending more time with patients, which
means reducing administrative tasks; HIEs
provide the means for that. By allowing
providers to abandon paper-based systems
in favor of streamlined electronic forms,
HIEs also reduce the potential for human
error. Today, many in healthcare believe
better data access will ultimately help
clinicians make more precise diagnoses,
better manage chronic diseases, reduce
time spent on administration, and – most
important – spend more time with patients.
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20. ...................................................................................
Turning on the Tap:
PHRs Improve Patient
Communication and
Engagement
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
provider and access medication information
and test results using a secure web
connection. Patients can also specify what
data they are willing to share with other
providers.
Perhaps the best news is that PHRs have
been shown to improve patient engagement
in the care process. An article in the
Journal of the American Medical
Informatics Association (JAMIA) said
many trials of PHRs have shown they
improve patient and family access to
knowledge for self-management of health
and wellness issues.
Here are some ways PHRs help improve
patient satisfaction:

Communication, especially with customers,
is the lifeblood of any business.
Unfortunately, security concerns and
government regulations can prevent
communication from flowing smoothly in
healthcare organizations.
There’s good news, however. More
homecare organizations are adopting health
information exchange platforms (HIEs) to
communicate with other providers and
regional health information organizations,
and those platforms enable creation of
personal health records (PHRs).
Through a PHR, patients and their families
can communicate with their homecare
Better communication with
caregivers leads to improved
relationships, which can lead to
enhanced patient/provider shared
decision-making

Access to providers helps reinforce
trust and confidence

Better access helps patients feel more
like partners in healthcare
Although PHRs have not been adopted by
the general public at the rate some expected
(Google Health’s failure to catch on is a
good example), PHRs are popular with the
exact population served by homecare
agencies. According to the JAMIA article,
people with disabilities and chronic
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21. ...................................................................................
conditions, frequent users of healthcare
services, and people caring for elderly
parents tend to have the most interest in
PHRs.
Involving patients in their own care surely
will improve outcomes and strengthen ties
with the homecare community.
Leverage Data to Show
Your Value to Referral
Sources
“Home health and hospice agencies must be
present in the ACO presentation, and you
need to keep telling your story,” says Tecca.
“You need to listen and tell how you
demonstrate value and how you will make
(other participants’) lives simple.”
Basic research agency executives need to
conduct before exploring partnerships
includes:

Learning your agency’s strengths and
how those strengths would benefit
partners
Knowing your competitors and how
your agency is similar/dissimilar

A little data can go a long way, if it’s
leveraged effectively, says Martha Tecca,
founder and principal consultant at M&M
Strategies. In order to participate in
emerging care models, providers need to
have outcomes data, which Tecca admits
can be difficult to obtain in such a way to
create apples-to-apples comparisons with
competitors.
Knowing what data and services
potential partners are looking for

By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson

Bringing the right data to the table
(ask beforehand what data partners
consider crucial)
To learn more about what data hospitals,
physicians and other providers believe are
important, Tecca recommends
bookmarking the websites for the National
Quality Forum, the Center for Medicare &
Medicaid Innovation and the Dartmouth
Atlas of Health Care.
Tecca sees “a huge opportunity” for home
health agencies to develop medication
reconciliation programs. There may not be
a bright line to reimbursement for this
service at the outset, but it would be a way
for an agency to differentiate itself and open
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22. ...................................................................................
doors to provide other services for which it
would be reimbursed. At that point,
medication reconciliation would be a valueadd offering while a clinician is in a
patient’s home.
Another good resource is the Home Health
Care CAHPS survey, Tecca says. “A lot of
folks submit HHCAHPS data but don’t care
to delve further into it or engage it,” she
notes. “But it can be a hugely valuable tool.”
Sharing More Data?
Ask More Questions.
By Karen Utterback
Vice President, Product Marketing
and Strategy, McKesson
As you share more data more often, security
rises to the top of your list of concerns – as
well as it should. Asking questions is the
best way to familiarize yourself with
security terminology and become
comfortable with what constitutes a secure
connection to an HIE.
At a minimum, HIEs must be fully
compliant with HIPAA and the statespecific privacy regulations in their region.
They should also have readily available,
detailed information on their security
policies.
For example, HIEs must consider the
following:
Physical security

Access to the production facility

Power quality and backup power

Smoke detection and redundant
HVAC (heating and air)
Network security


Sharing data is becoming a common
occurrence for home health and hospice
agencies, whether you’re exchanging
specific patient data with another provider
or more general data on your patient
population with a state, regional or private
health information exchange (HIE).
Redundant firewalls
Site autonomy

Restricted electronic access to the
data center
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23. ...................................................................................
System security

Protection against electronic attacks

Hardening and monitoring of web
servers, integration servers and file
transfer servers.
Access control

Controlled access requests

In a nutshell, any entity you exchange data
with should be able to prove to you that it
has well-tested physical/network security,
that its facilities and processes are audited
periodically, and that it has taken all
potential patient privacy concerns into
consideration.
Strict security account policies
o
Encrypted remote access
o
Auditing
Application security

Input validation

Strict authentication

Credentials management

Exception management
Data security

Data separation (PHI never sent or
received without being encrypted)

Data auditing

Data backup

Data destruction
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24. ...................................................................................
For more news and insight from the
hospice and home health industry,
visit McKesson Homecare Talk.
www.mckesson.com/homecare
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