Boost Financial Performance By Improving Patient Outcomes

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March 7, 2023
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Have you ever wondered how some of the leading accountable care organizations (ACOs) could extract and manage their data on such a large scale across the country?

In our recent webinar through the VBC Exhibit Hall, Healthjump and Aledade pull back the curtain to outline how Healthjump data powers Aledade to maximize savings while reducing timelines. 

Aledade ACOs are leaders in the Medicare Shared Savings Program (MSSP) and have contributed $1.2 billion in savings over the past eight years. Healthjump helped generate $390 million of that total Medicare savings in 2021 alone. 

A special thanks to Rani Crozier, Aledade’s Director of Implementation, for her participation in this webinar.

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Healthjump’s data management platform is designed for adaptability, no matter what issues or changes your value-based care organization faces.

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Full Webinar Transcript Below:

Garrett Schmitt: Hello everybody. Good afternoon. My name is Garrett Schmitt and I am the managing editor for VBCexhibithall.com, and I would like to welcome you all to today's live webinar. Hosted by Healthjump and special guest Aledade, which we'll talk about in a minute. And it is titled, boost Financial Performance by Improving Patient Outcomes.

And I'm excited to hear from these folks today. And, I got a little sneak peek when we did our run through, I think there's a lot of great information here for you today. 

A few items of note before we get started, this is a traditional webinar format, so you don't need to worry about muting your microphones or your camera or anything like that. We can't see you or hear you, but we do want to hear from you. So we're gonna have a Q and A session toward the end, where we'll go through as many questions as we can in the allotted time. So if you have a question you have an attendee module and there's a little area for questions there. So it's different than the chat. So go ahead and submit your question at any time. You don't need to wait until the Q and A to do that. So anytime you have a question, go ahead and submit it, and we're gonna get to as many of them as we can. If we don't get to yours, someone will reach out via email afterwards, and we'll make sure to answer your questions. Even if we're wrapping up, go ahead and ask your question. 

And then finally, today's session is being recorded. What's gonna happen is when we're done, maybe an hour or two after the presentation, I'm gonna send out a link to everyone who's registered and you'll have a link to the recording as well as to a place where you can download the slides and some other information so that you'll be able to contact the team.

And so without further ado, I want to introduce our two speakers today. We have Laura Stewart, who is the Director of Product Delivery and Johnathan Evans. And she'll go into a little bit more about herself. And I guess that's a picture of her car down there. And then Johnathan Evans, who is the Customer Success Manager.

So welcome y'all, and I'll be back during the Q and A. 

Meet the Integration Experts from Healthjump

Laura Stewart: Great. Thanks Garrett. 

Good afternoon everyone. Thank you so much for attending the session today. Like Garrett said, I'm Laura Stewart. I'm the Director over our Product Delivery Group at [Healthjump]. Which comprises of our engineers and our customer success managers that take care of our customers through data onboarding and support through the lifecycle of their integrations they have live with Healthjump. I joined Healthjump in 2022 and collectively my team manages over a thousand active integrations every day and growing. Prior to that I spent a lot of years in healthcare data at Cerner and led the services team there in the data and engineering service space. 

In my spare time I love to work on cars. My husband and I have a hobby commercial garage in downtown Kansas City. And we currently are working on three vintage cars. So a little bit about me. I'll let Jonathan share a little about himself. 

Johnathan Evans: Yes. Hi. I'm Jonathan Evans, and I am a customer success manager with Healthjump, and I work on Laura's team.

A little bit about myself. I've been working in healthcare technology for about six years with a company called Cerner. I co- championed the implementation and execution of the largest completely integrated healthcare record for our veterans. I joined Healthjump in 2022. And in my free time, I love to wakesurf, cook, and work out. I also dabble in a little bit of photography there, so it's a little bit about myself.

And I just want to thank Garrett again for introducing us and thank you to everyone for joining us today. In today's presentation, we will cover Aledade and Healthjump's Partnership to create a plan for utilizing people processing technology to generate successful engagements. We'll touch on how Healthjump and Aledade collaborate together to ensure data quality control, and upcoming trends and challenge. Both organizations may face in the near and distant future. As Aledade's CSM I work in conjunction with Aledade as a liaison between both of our organizations, ensuring new implementations, post-production sub issue resolution, and organizational relationships are successful. 

Unfortunately, Aledade had a conflict today and cannot join us. But let me start off by telling you a little bit about Aledade as an organization. Aledade is the nation's largest network of independent primary care practices. For 2023, they added 450 primary care practices, including nearly 60 health centers. They cover 45 states, work with about 1500 practices, and they have around 150 VBC contracts. And cover over 1.7 million attributed patients. Data wise, they require 90 plus EHR and PM systems to power their reporting and software needs that they use for their practices and other health centers. 

Healthjump serves as one of Aledade's data partners and we connect to the PM and EHR systems and practice management and clinical data for use in Aledade's applications. We connect to practices and health centers using the Healthjump agent and extract data daily, and the process for that will be covered in a little bit more detail later in the presentation. Before we get started on the people, process, and technology insights, we have a few polling questions for you today.

Polling Question: How long does it take you to onboard a new customer today? 

Onboarding includes practice, connectivity to the database, data extraction, QC, training the practice on the soft ware and things of that nature.

So the results say 44% are not applicable, about 25% are 50 plus, 0 % 30 to 35 days, 13%. 15 to 30 days, and 19% under 15 days. In the industry that most of us are in today, the length of time of the implementation has a direct correlation to our value proposition of our organizations.

Healthjump and Aledade strive to get a practice fully onboarded, meaning data flowing, within about 30 days of them joining Aledade. We'll walk through this and how this is done in consecutive slides.

As we go into the next segment, we'll discuss how Healthjump and Aledade reduce implementation times of our organization.

Reducing Integration Timelines

The implementation process starts with Aledade's integration team. Once the requisite steps are completed, the Healthjump engagement to extract their data for the Aledade application begins. First, the practice gets assigned to a sprint to begin data extraction. Once the raw data is extract extracted, it gets put through both Healthjump and Aledade's quality control processes.

When the data passes its quality control stage, the practice is considered live, and data becomes available within the Aledade Application. Once a practice is live, it has then transferred to post-production support teams managed in collaboration, both between Healthjump and Aledade and this ensures that all data is working and flowing as designed and that all connections are green.

Now that we have discussed our processes at a high level from signing to Aledade to post product support, let's discuss how this process has impacted organizations in 2022. A few points I wanted to highlight here is that in the time, the go-live has decreased in 2021, we had [00:08:00] 283 average days to take a practice live.

And in 2022, last year, we have averaged about 74 days. The total projects that we worked on for Aledade were 148. And in 2022, there are over 221 projects completed. Please note the above timelines are from contract signature to join the ACO to go live on Aledade Solutions. This includes connecting to the database, extraction of data, quality control checks, Aledade onboarding into their platform, practice training, and things of that nature.

Even though the number of total projects completed in 2022 increased by 7.3. Through our collaborative efforts with Aledade to make our processes more efficient, we were able to decrease our time to go live by 209 days. Our goal in 2023 is to reduce that time to 30 days. The reduction in timeline and increase implementations completed can be tributed to a few key points: 1) increasing inter-organizational planning. So Aledade and Healthjump devised a plan to work through a one week sprint where work from all work streams are triaged appropriately for prioritization. Previously, we had work between all work streams, the new implementations, clinical team, and post productions report competing for priority. Now, that we have a triage process, and a prioritization plan, this issue does not occur. 

2) We also improved the resource management. Both organizations have worked to improve to use their human capital more efficiently to improve throughput for implementations and issue resolution.

This has been a big change for us as it improves communication and access between organizations. We have multiple touch bases between our two organizations: two for new implementations, two for post-production report, and one end of the week wrap up. Additionally, we have a real-time communication methods for escalations and where there isn't any communication lag, and this has proven to be very successful for us to ensure that both teams are aligned.

Next, we will go to Rani Crozier, Director of Implementation at Aledade, who will share her thoughts.

Rani Crozier (pre-recorded): Our projects are mostly grouped by installation phase and development phase. Both teams dedicate resources on these phases. Then the PM from each team has an oversight of all the phases. The collaboration and open communication between all team members contributes to the success of our mutual projects. 

Laura Stewart: Aledade also spends quite a bit of time cultivating personal relationships with each practice during the onboarding process. Rani's also gonna share how they organize that across their various teams internally at Aledade.

Rani Crozier (pre-recorded): The implementation team manages direct practice relationship during the onboarding process. In partnership with our field team, the implementation team works closely with our practices and guides them through the onboarding process. The goal is as seamless and minimum lift as possible for our practices so they can continue focusing on patient care while we work on onboarding them into our ACO.

Laura Stewart: And lastly as Jonathan explained we also do a lot of interaction between our two teams and Rani's gonna share a little bit from her perspective on how that works.

Rani Crozier (pre-recorded): From the Jump Agent installation Healthjump made available a calendar link where our practices can schedule the installation at the time that is most convenient for them. During the installation, a Healthjump resource guides the practices resource on a step-by-step to perform the installation.

During this install call, the practice will inform the Healthjump resource on the best time when daily data pools should be performed at. From the project management perspective, a project manager from my side partners with a project manager from the Healthjump side. They meet weekly towards the end of the week to decide on the scope of integration for the next week.

My team meets with the Healthjump team twice a week to review the progress of projects in scope for the week and discuss any barriers that need to be addressed.

Healthjump's EHR Integration Platform

Laura Stewart: Outside of the project coordination and building and leveraging relationships, Healthjump utilizes our technology to organize the work. We have what we call our Healthjump app, where all of our customers order new connections or integrations to start the data extraction sending process. This allows our customer when they're ready to tell us that a new connection is on deck.

We will come into the app, select the EHR practice management system that they would like to integrate with. Give us a few details about the practice and then select the quality control playlists that they would like to run against the data. Something we'll dive deeper into here in a bit.

From there, they are able to see the next steps in terms of what needs to happen to get connectivity to the EHR or practice management system. That could include installing the Healthjump Agent where they will receive a link to send to the practice contacts where they can schedule a time that works best from them and get on a quick 30 minute phone call with our system engineer to complete that installation process.

Or it could be instructions on how to access or approve API keys. To send to Healthjump so that we can start an a API extraction process. It varies from system to system but the application and the Healthjump app walks the customer through the next steps that need to take place so that we have minimal time spent. From a practice resource perspective, our goal is always to have as minimal touch as possible so that they can focus on patient care. Once Healthjump receives access to the data, that's when the extraction process starts.

So Healthjump will get connected and then schedule our standard extract scripts to run against that system. So we have over 60 systems out of the box that we support where its plug play and we install our standards, extract the data, and then that data will flow to our AWS data warehouse, which is Redshift. And that's the point when we run our quality control scripts to either find any adjustments that need to be made with the extract. So maybe the practice has a different workflow for recording blood pressures, for example that we need to adjust the scripts and or inform our customer of any data dirtiness that they should be aware of. Once we walk through that process, then we serve the data up for data delivery which we make available to our customers via web hooks, the Healthjump API, or a nightly flat file delivery.

We also provide what we call DBX, which is a data exploration tool that sits on top of Redshift where our customers can write ad hoc sequel queries if they're testing things before data ingestion or looking at support problems and save them to rerun in any given future time.

So once the data is in-house from a data extraction perspective on all new connections, Healthjump works with our customers to run what we call our quality control playlist. We start with our customers, with our standard boiler plate playlists. And then adjust them from there. So we really feel that QA is the key to making insightful decisions in terms of powering software.

And we wanna make sure that the data that our customers take to put into their software to show physicians' care gap areas, to-do list for patients coming in the door that day, et cetera. It needs to be as accurate as possible so they're making good decisions and taking care of patients appropriately.

So here's an example of some of our QA scripts. So we're really looking for two things here. One is the data extract correct and complete? And two, are there any anomalies that our customers should know? And then we make adjustments and add additional scripts as needed with our customers. So if there are certain fields or columns on tables that our customers absolutely need populated every time we need to know about when they're not populated we can write scripts for that. Show them percentages of encounters that maybe don't have a blood pressure, for example or trends if they did 500 flu shots last December, but this December they did a lot less or things like that, so it's very flexible. The output of the quality control is available in the app where our customers can see what passed and failed, and any comments our engineers made while they completed the QC process.

That allows quick and easy data management. You can get back to it, you can see the historical results easily and take care of it from there. And we also, with Aledade, have built a special spreadsheet we also populate for them. That shows a lot of trends in terms of percentages of things that are present or not present within specific data.

What I'm sharing here is an example of the demographic output for a connection where they're looking invalid characters in names or duplicate SSNs where maybe someone's typed in all ones, et cetera that have impact to their software and importing data into their software solution.

So we really believe our quality control process really helps in terms of getting the right data to the right place at the right time. And a lot of people that I've just seen, historically through various roles that I have had in healthcare in the last 13 years looking at data, struggle with this. So as you are building connections or evaluating vendors to do this on your behalf really you wanna ask some key questions because it, it is gonna make or break the end product in the user experience and ultimately the patient quality as well. So the questions you might want to ask are:

  • Does the vendor have a plan for validating data pre-go live of the connection?
  • How are they gonna normalize the data both from a structural and semantics standpoint? 
  • Are you gonna get the same file format regardless of the system that vendor's connecting to? 
  • How are they gonna let you know or inform you of potential bad data that is in the database that they're extracting from?
  • Once the connection goes live, how are you gonna know if there's a problem and what you need to do to resolve it? 
  • And what kind of monitoring do they proactively provide to you from a managed service perspective -what do you own versus what do they own? 

Those are definitely things you wanna think through. And things that we work with Aledade to solve every day in terms of solutions and services that Healthjump provides to make them successful during their journey.

Healthcare Data Boosts Patient Outcomes

Next up, we're gonna have Rani talk about how the software that they use Healthjump data to power makes it easier for physicians to manage their patient loads and know what to do on patients as they come into the door.

Rani Crozier (pre-recorded): Aledade practices use the Aledade Application to improve patient outcomes. Data provided in the Aledade Application is an aggregation of scheduling claims and clinical data that Healthjump extracted from the source systems.

Laura Stewart: Once the application is live, from an Aledade perspective, Healthjump works with Aledade daily to do proactive post go-live support. This includes proactive monitoring of all live connections that Healthjump completes every day for our customers, where we are looking for errors in data extraction, integration's going down, et cetera. And bringing things back up before our customers ever know that there's a problem. In the event that the customer needs to work with the practice to facilitate a resolution, Healthjump will open up a ticket in the Healthjump app where our customers can see all open tickets, what's up, what's down, et cetera.

Like in the view that's on the left here on the slide. And that allows them to easily manage what they need to do in terms of taking care of any problem connections to get the data flowing again. So Healthjump can continue to send data and make use of data from a customer perspective. We also have additional views that will show load statuses into our data warehouse. So you know, when things might still be loading or things didn't load all the way. And then some data warehouse views as well so people can easily see how many new rows were committed or updated or modified any given day to help manage the big data flow that we might be flowing through the data pipelines that Healthjump is sending to our customers.

And now we're onto our next polling question. 

Polling Question: What are you most worried about in solving in 2023? 

It looks as if 23% of you said health equity data, 8% said structural normalization of data, 15% said semantic normalization of data to industry codes, 38% said getting actionable insights in front of physicians, and 15% said other.

Great. Thanks so much for sharing your insights. I think we see a lot of Healthjump's customers staying up at night worrying about the same things. Many of which we try to solve for our customers so that they don't have to worry about 'how am I gonna get the new social determinants of health data?' or 'how am I gonna make sure that all the data looks the same?' Et cetera. Rani's gonna give a few oversights from her perspective some of the things that they worry about as well. And then we can talk a little bit more in depth around some trends that we're seeing coming up next.

Rani Crozier (pre-recorded): Given Aledade's nationwide footprint. The biggest challenge for my team in the integration space is integrating with many practice management, electronic health system, billing system, et cetera. We potentially work with over a hundred combination of software and hosting systems. That's when Healthjump comes in. It helps us with roughly 25 to 30% of them depending on the year because it is difficult to know what system these practices will use. Mostly not until after they sign a contract with Aledade.

Laura Stewart: So from a Healthjump perspective, like I said, we try to solve a lot of that for the customers. So whether it's, you don't know who your next customer is gonna be or next practice is gonna be that signs up. We try to continue to build our data integration library. We are working on another 60 plus systems in 2023 in terms of adding to it based on our customer's demand.

So regardless of what you need data out of, we will go and do that work to get that data for you. Whether it's all the moving parts and pieces from an industry perspective in terms of social due determinants of health adds, USCDI, FHIR specification, et cetera. Healthjump works to support that so you don't have to worry about the technology pieces of it so that you can be successful.

We continue to see a lot of demands in terms of data, and those demands growing. I don't think that's gonna stop in the near future or even in the mid-term or long-term. And, that's why we're here in terms of being able to connect and send data efficiently. So some of the things you definitely want to think about as you build your data strategy as an organization from 2023 forward are the amount and of data and the type of data that you might need is gonna change over time as well.

And lastly, we've got a couple other insights from Rani in terms of our partnership with Aledade that she would like to share as closing thoughts since she couldn't be here with us today. And then we'll have plenty of time to do Q and A and help answer any questions you might have on building your data strategy to improve patient outcomes.

Rani Crozier (pre-recorded): Healthjump's competitive advantages from my point of view, are the number of system they can already integrate with and affordable integration cost. The predictability of when most of our projects will be completed is why we made the right decision on this partnership.

I think it will make integration projects for many of them very easy to accomplish. And one thing that I'd like folks to know about Healthjump is definitely predictability at an affordable cost.

Laura Stewart: And lastly, she's got one last insight here. She would love to share with you.

Rani Crozier (pre-recorded): The minimum lift on the Aledade side and most importantly on the practices side is also great value added for Healthjump. In most cases, existing scripts that the Healthjump team developed for various system can be used across the board. Which helps to create a more predictable turnaround time on when we can expect to begin receiving data once the Jump agent has been installed at the practices environment.

Laura Stewart: Great. I think we're at the point of Q&A, so I'm gonna turn it back over to Garrett to help facilitate. 

Integration and Data Extraction Q&A

Garrett Schmitt: There's a lot here, obviously, and thank you guys for this wonderful presentation. We did have a bunch of questions that came in, so we will go ahead and jump into these in no particular order.

If you do have a question that you'd like to submit- if you missed the first little explanation of that- you have an attended control module. So please submit your question there under the little questions area, and then we're gonna get to as many as we can. If we don't get to yours, we'll make sure to reach out via email and and answer your question.

First question here is can you please expand on the initial information sent to a practice regarding patient extraction?

Laura Stewart: Sure we'd love to help answer that. So we work with our customers to arm them with a packet of information that they can send to practices. In many cases, a lot of our ACO customers have field reps that kind of own that relationship, or account reps that do that physician liaison with both the physician and IT teams.

And so we'll send them information on what is the Healthjump agent, how does the extract process work? What does the security look like? Which is what a lot of people have questions on in terms of how secure is it and what certifications do you have? Those types of things to help calm any fears or any questions.

And then from there, typically that is enough for a practice to feel okay with moving forward in terms of database connectivity. And then we just walk them through the right steps based on the system they're connecting to for them to start the integration process with Healthjump.

Garrett Schmitt: Very good. Alright next question here, let's see is: I see Healthjump is NCQA DAV certified. What does that mean to data quality? 

Laura Stewart: Sure. Great question. Healthjump went through NCQA's DAV certification program last July and received certification in December. What that means is that NCQA and their third party data assessor has certified several systems that Healthjump does extracts from for data quality and it's an kind of an intensive six month cycle. That includes both process and technical review along with primary source validation. Like any other HEDIS audits you might go through to ensure that the data extracted also meets the data on the front end. We already felt very confident that our data was high quality. And the certification just shows it.

It also allows our customers if they would like to use Healthjump for insurance submission that they can use our systems that we've got DAV certified and not have to do post-motion audits with insurance companies or health plans.

Garrett Schmitt: Okay. Wonderful. All right, moving right along. Next question is if there is a system you don't currently integrate with, what is the process to connect with that system? 

Laura Stewart: Sure, great question. And when we get somewhat frequently. We support all of the major systems out of the box that you probably have 80% or more of your practices and health facilities using.

But there are still hundreds of certified EMRs out in the marketplace that people are using. A lot of 'em are niche and specialty based solutions, and Healthjump's guarantee to our customers is if you can get us access, w

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