CSC Insights

	The Massachusetts health insurance exchange features an interactive website that educates consumers on state law and enables them to browse and purchase affordable health insurance.			To receive the financial incentives, eligible physicians and hospitals must achieve "meaningful use" of an electronic health record (EHR).

	Proposals for healthcare payment reform represent a transition to a system that ties reimbursement to high-quality, tightly coordinated care.			Take Advantage of Stimulus Dollars: The incentives are time-limited and by qualifying early, providers will get higher payments, but organizations need to start now to prepare.

Provider Industry Insights

Tomorrow's Healthcare System Using Today's Technology Technology is no longer the barrier to quality patient-centric care; it is here and available today. It is the practice of healthcare that needs to change to make this a reality, hopefully greatly enabled by healthcare coverage and financing reform.
Creating a Financially Sustainable Health Information Exchange Statewide Health Information Exchanges take more than public funding to be financially sustainable in the long-term.
Meaningful Use for Hospitals: The Top Ten Challenges The HITECH provisions of the American Recovery and Reinvestment Act of 2009 provide an estimated $45 billion dollars for the adoption and use of Health Information Technology (HIT) by Medicare and Medicaid providers over the next ten years. To receive the financial incentives, eligible physicians and hospitals must achieve "meaningful use" of an electronic health record (EHR). Understandably, much attention is now focused on meaningful use; what it is and how to get there. In this paper, CSC first reviews meaningful use as defined for the hospital and then the top ten challenges that hospitals need to focus on and master to achieve truly meaningful use.
Towards Coordinated Care: Healthcare Payment Reform Proposals for healthcare payment reform represent a transition to a system that ties reimbursement to high-quality, tightly coordinated care. In this paper, we outline the four underlying concepts behind payment reform proposals and discuss how provider organizations can prepare for these new models.
The Massachusetts Health Connector: Lessons Learned from the Builders of the Health Insurance Exchange The Massachusetts health insurance exchange features an interactive website that educates consumers on state law and enables them to browse and purchase affordable health insurance. In this paper, CSC details the lessons learned from designing and implementing a health insurance exchange for the state, including customer service and consumer outreach, and offers recommendations for those involved in similar efforts across the country.
US Health Care in the Year 2015 The U.S. health care industry is at a crossroads in 2009 and the next five years promise to be a time of upheaval and transformation as the entire industry redefines itself to deliver health care that is safe, effective, and high quality to enough people at a sustainable cost. The magnitude of these changes will affect every sector of the U.S. health care economy and providers, hospitals, and payer organizations that anticipate, prepare for and embrace these changes are the ones that will survive and succeed.
HITECH's Impact on Health Information Exchanges: Key Decision Points for Privacy and Security Health Information Exchanges (HIEs) enable authorized caregivers, patients, public health authorities, and other providers to share electronic patient health information across different settings and geographical areas. In this paper, we describe the key decision points related to HIE privacy and security, and explain the relevance and impact of the new provisions and requirements contained in the HITECH Act.
Accomplishing EHR/HIE (eHealth): Lessons from Europe The U.S. is poised to make substantial progress in implementing EHRs and HIEs to support healthcare reform. Our experiences in helping Denmark, The Netherlands, and three regions in the UK implement their eHealth solutions provide guidance and shared experiences for U.S. efforts.
Large-Scale eHealth Initiatives: Decision Points and Best Practices Large-Scale eHealth initiatives are needed to support healthcare reform programs to lower costs and improve care and access. Our experiences in Europe and the U.S. have identified the top decision points, best practices, and lessons learned.
CPOE: Getting Order Management Right To achieve meaningful use and qualify for HITECH stimulus incentives, hospitals today must get CPOE right the first time in a smooth, timely transition. Achieving this requires getting order management right.
Maximizing Space Productivity in the ED CSC’s Space Productivity, a measurement concept adding an additional dimension, enables a hospital to interpret these traditional operational and financial benchmarking metrics with an understanding of how effectively space is being utilized.
The Leapfrog Group's CPOE Evaluation Tool This paper provides a look at a CPOE Evaluation Tool pilot program at Northwestern Memorial Hospital in Chicago.
Evaluating CT Capacity Using Space Productivity™ Instead of expanding capacity through the purchase of additional equipment or an extension of operating hours, what if your current CT scanners could be used more efficiently to increase throughput and capacity?
Love the Ones You're With Rethinking. Freezing. Putting on hold. Resizing. Scaling down. Deferring. This is the current state of budgets, projects and plans in hospitals across the country. Unfortunate? Absolutely. But also opportunistic. The economic climate creates a circumstance to look at what you have with new-found appreciation and care. Properly applied to people, technology and facilities, this mindset should increase productivity. Love the ones you’re with refers to the machines and buildings, but most of all the people who do their job every day.
Hospital Facility Activation CSC defines Facility Activation as the set of activities that promotes the safe and predictable occupancy of new space. Activation, or transition planning, as it is also called, anticipates every minute detail of operations before, during and briefly following the movement of people and things (furnishings and equipment). It is most easily thought of as a multi-dimensional symphony of activity that typically occurs over an 18 – 24 month period.
Embrace the Blur The ability to embrace ambiguity will characterize the next generation of healthcare leaders. Those individuals, committees and boards that view precision as a compulsory precedent for each decision will be stuck in the weeds, while successful organizations will make bold moves that reflect agility born from acceding intelligently to science and their marketplace.
Value-Based Purchasing: Non-Payment for Hospital-Acquired Conditions The CMS HAC (hospital-acquired condition) payment adjustment provision requires hospitals to report POA (present on admission) conditions with Medicare claims, potentially reduces Medicare claims payments, and is forcing hospitals to modify care delivery and documentation practices. It is also being considered for adoption by other payers and is contributing to overall VBP (value-based purchasing) initiatives in healthcare.
Getting Value from IT This paper identifies the characteristics of effective IT governance structures and processes and provides steps for starting the journey to a more agile and results-oriented IT governance program. In addition, case summaries show five health care organizations at various levels of IT governance maturity.
Core Measures: All About the Data Having the patient-specific information required for core measures in electronic form not only benefits quality reporting, but also enables real-time quality management. The finding that much of the information needed for medical and surgical core measures must be derived from physician documentation suggests that hospitals may want to reconsider the typical sequencing of electronic physician documentation late in the EHR roll-out.
Next Generation Patient Self-Care This paper describes the broad categories of technologies that support patient self-care including examples of successful implementations. It concludes with a discussion of changing stakeholder roles and responsibilities and critical success factors needed to enable widespread adoption.
Responding to Recovery Audit Contractors Recovery Audit Contractors (RACs) seek out improper payments made to hospitals as part of the Medicare fee-for-service program. To prepare for RACs, organizations need to take immediate corrective actions to identify and fix overpayment claims and to prevent future errors from occurring.
Green IT - Moving Beyond the 2% Solution This Position Paper presents CSC's overall point of view on Green IT, and sets the stage for additional workbook and case study projects to be conducted in 2008 and beyond.
The Multi-Generational Healthcare IT Workforce Four distinct generations make up the healthcare IT workforce. Healthcare IT management needs to understand the generations and preapre for unique challenges from each, including how to minimize loss of expertise from retiring traditionalist and boomers, prepare GenXers for management, and recruit GenYers.
Touchscreen Check-In: Kiosks Speed Hospital Registration Self-service kiosks increase patient satisfaction and improve operational efficiency by giving patients a convenient way to check in, register for services, pay co-payments and update their personal information. In this report, commissioned by the California HealthCare Foundation, CSC describes how hospital ambulatory and emergency departments are using kiosks and provides a list of best practices for implementation.
Adoption of Advanced Clinical Systems in Massachusetts Hospitals Analysis of a 2008 survey looking at adoption of advanced clinical systems in Massachusetts hospitals.
Saving Lives, Saving Money In Practice: Strategies for Computerized Physician Order Entry in Massachusetts Hospitals The Massachusetts Technology Collaborative contracted with researchers at CSC to compile hospital experiences with supporting the users and the application following the initial rollout of CPOE throughout the hospital. The topics addressed in the report include: ongoing user support, optimizing CPOE, ongoing management of order sets and clinical decision support, CPOE and medication reconciliation, and downtime procedures.
Virtual Desktop Infrastructure Virtual desktop infrastructure (VDI) offers data and access security, HIPAA compliance and end-user flexibility that are increasingly important to hospitals. Successful implementations can be done within a few months yielding a quantifiable ROI in less than one year.
Bridging the Care Gap: Using Web Technology for Patient Referrals (California HealthCare Foundation) To address a major care gap, a growing number of safety net organizations--community clinics and public health systems--are using new Web-based applications to support arranging referral or follow-up care for their patients. A growing number of commercial vendors is providing Web-based applications for this purpose, and some organizations have developed their own applications. Evidence is accumulating that the IT-enabled process is a win-win for patients, referring providers, and receiving providers and that the recommended care happens more consistently.
Moving Medication Safety to the Next Plateau Ensuring that the organization has the capacity to achieving safer medication practices will require building the commitment, culture, executive leadership and management processes that are up to the task.
E-Prescribing and Its Expanding Role in Healthcare Electronic prescribing is about to become a significant preoccupation of healthcare providers, payers and pharmacies for the next several years.
Equipped for Efficiency: Improving Nursing Care Through Technology Nursing staff are the backbone of healthcare delivery and are at the center of communications between patients, care giving staff and auxiliary services.
Next Generation Inpatient Care Hospitals need to prepare for the growing gap between the need for care and the people and facilities available to respond to that increasing demand. Several hospitals have developed solutions to meet these future challenges and there is a growing body of knowledge for others to follow.
Information Security and Privacy: A Component of the Hospital Risk Management Program This white paper discusses the functions, governance and interactions of a comprehensive, proactive information security management program that encompasses the processes and governance structure, and identifies critical success factors and provides practical advice for getting started.
Treatment Plan: Hospitals Respond to the Economic Crisis We interviewed 54 hospital and health system executives to understand what plans they have to respond to the crisis, and where they stand in implementing those plans.
Healthcare Facility Activitation Planning Healthcare facility activation planning is the process of preparing new and renovated facilities for opening and day-to-day operation. Our recommended best practices are dedicated staffing, milestone management, frequent communication, conflict resolution models, a new technology moratorium and thorough testing.
Next Generation Ambulatory Care Serious challenges, including primary care and specialist physician shortages, rising costs, and the misalignment of reimbursement, resources and quality of care, are forcing healthcare providers, payers and industry regulators to transition to a next generation of ambulatory care.
Evolution Framework: Assessing Progress on the Journey to Organizational Excellence Care needs to continually evolve to be safer, more efficient and patient centered and more accountable. We report on the progress 27 leading organization are making to change technology and processes to respond to this challenge.
Next Generation Safety Net The current focus of clinical Information Technology in the hospital is advanced clinical applications, including nursing and physician documentation, electronic medication administration record (eMAR), and computerized physician order entry (CPOE). These applications provide the foundation for more reliable, efficient, and effective care.
Next Generation Efficiency Increasing demand for health services coupled with shortages of skilled care providers are leading organizations to focus on significantly improving operations. Today's technology helps the hospital workforce to maximize productivity by eliminating work tasks, providing a "helping hand" to get work done more quickly, and allowing the patient to complete some tasks.
Telemedicine in the Ambulatory Setting Early adopters of telemedicine have demonstrated that technologies such as remote monitoring and tele-consultations improve access to care, increase efficiency, and effectively manage patients with chronic diseases. Telemedicine will be a part of mainstream medical care in the future.
Health Intelligence for Performance-Driven Hospitals Hospitals are faced with enormous data reporting and performance benchmark pressures to effectively manage the business of health care. New health intelligence applications satisfy the growing need by providing the ability to analyze data from multiple systems and across clinical, financial and operational dimensions.
Health Information Exchanges: Future Prospects, Current Realities Interest in Health Information Exchange (HIE) remains high. Sustainable solutions solve an existing business problem and provide benefits to multiple stakeholders in the community.
Connecting Community Physicans IT options hospitals and IDNs can employ to connect affiliated physician practices include portals, integration, hosted EHRs, and HIE. No one strategy is correct for every hospital and/or practice.
Accountability and Transparency: Building the Information Foundation for Demonstrating Performance Excellence Regulatory agencies, payers, and consumers are demanding more information about outcomes and costs as a means to make providers more accountable for their performance. The ultimate goal is to capture the needed data as part of care delivery and analyze it using a health intelligence solution.
Patient-Centeredness Patient centeredness is the commitment to provide care that respects patients' needs, wants, and preferences, while engaging them to participate in their own care. On-line portals, personalized health education, and patient flow systems can raise patient satisfaction and make care more patient-focused.
Effective Use of Medication-Related Decision Support in CPOE The Leapfrog CPOE standard expects that the CDS tools in CPOE are aggressively applied to avoid potential adverse events that can be detected at ordering. It requires that physicians are entering most orders directly and benefiting from the safety net provided by CDS.
The Leapfrog Group’s CPOE Standard and Evaluation Tool The Leapfrog Group’s CPOE Standard and Evaluation Tool Patient Safety & Quality Healthcare - July/August 2008

Health Plan Industry Insights

Best Practices to Face Medicare Beneficiary Information Challenge Private Medicare plans that implement best practices in the three key process areas of enrollment, eligibility updates and reconciliation can enhance their financial performance by increasing premiums and reducing costs.
Medicare Part D: Get Ready for Changes Changes coming to Medicare Part D will bring fundamental changes to drug development and pricing. Life sciences companies who are lean, truly innovative, and build a compelling business case for each product will succeed.
Health Insurance Reform in Massachusetts In April 2006, Massachusetts enacted landmark healthcare legislation that was designed to ensure all residents in the state had health insurance. This paper looks at what happened – and what didn’t happen – as a result of the law.
Next Generation Health Plan The Four “C’s” of cost, capacity constraints, coverage expansion and changing roles are powerful forces transforming all of healthcare, creating conditions for the Next Generation Health Plan to maximize operational efficiency, systematically address the cost of healthcare, partner with providers and adopt a value-based retail orientation to healthcare.
Mandatory Medicare Secondary Payer Reporting New rules from the Centers for Medicare & Medicaid Services (CMS) make Medicare Secondary Payer (MSP) status reporting mandatory in 2009 – creating significant new data and administrative requirements backed by significant financial penalties for health plans and payers. Deadlines are imminent, and data quality initiatives will be critical to long term success.
Adoption of Electronic Health Record Capabilities in Massachusetts Physician Practices Analysis of a 2008 survey looking at adoption of electronic health record capabilities by Massachusetts physicians.
Medicare Advantage: Time to Brace for a Change This whitepaper provides an overview of the Medicare Advantage program and offers direction for Medicare Advantage plans in light of anticipated policy changes. Demands for reform have increased in recent months, particularly with respect to the costs associated with the Medicare Advantage program, and private sector plans that offer Medicare Advantage products need to prepare now in order to succeed in the future.
FirstPortfolio: Commission and Incentive Compensation System FirstPortfolio Teams with ACom3. This system address the increasing complexity of efficiently and effectively managing the commission and incentive compensation payout process through end-to-end automation.
FirstPortfolio: Changing Times Require Bold New Approaches Market Leading Functionality for Health Plans. FirstPortfolio is a CSC-hosted collection of market-leading applications — a faster, better, more cost-effective way to expand your application portfolio.
Insuring the Future: Health Plans Respond to the Financial Crisis This paper provides an overview of findings from a November 2008 survey of 30 health plan executives about the impact of the current financial downturn on their business.
Medicare Part D: Time for a Checkup This white paper provides an overview of the Medicare Part D program as it enters its fourth year.
Responding to ICD-10: Healthcare Payer Strategy to Achieve Regulatory Compliance and ROI This whitepaper provides an overview of the upcoming regulatory requirement for healthcare payers to adopt ICD-10. A regulation by the U.S. Department of Health and Human Services is mandating an aggressive implementation timeline for healthcare payers to upgrade to ICD-10 diagnosis and procedure codes to replace version ICD-9 in HIPAA transactions. This paper discusses costs and potential gains of ICD-10 implementation, and provides a recommended work approach to achieve compliance and optimize benefits.
Pay-for-Performance Pay for Performance programs (where providers are paid to meet quality metrics) have reached the mainstream. To compete, Health Plans need to have a plan with meaningful incentives, accurate and timely feedback to providers, and incentives for IT adoption.
Green IT - Moving Beyond the 2% Solution This Position Paper presents CSC's overall point of view on Green IT, and sets the stage for additional workbook and case study projects to be conducted in 2008 and beyond.

Life Sciences Industry Insights

Master Data Management and Life Sciences A successful Life Sciences Master Data Management (MDM) strategy depends on governance, targeted investment, the use of mission specific MDM tools.
Networking R&D: Using Broad-Based Collaboration to Optimize Life Sciences Research New ways of connecting biomedical researchers will completely alter the landscape of Life Sciences R&D. Broad-Based research collaboration will speed effective new treatments to patients and improve Life Sciences development outcomes.
Controlled Collaboration: A More Productive and User-Centric Approach to Electronic Document Review New technologies have emerged enabling controlled document collaboration that help life science organizations improve productivity while driving compliance across functional areas and with external business partners.
Green IT - Moving Beyond the 2% Solution This Position Paper presents CSC's overall point of view on Green IT, and sets the stage for additional workbook and case study projects to be conducted in 2008 and beyond.
The Next Generation of R&D: Patient-Centric and Semantically Connected The "Blockbuster" era of pharmaceutical R&D is ending. Next generation R&D will use completely new tools to bring targeted therapies and diagnostics to specific patient groups.
Future of Enterprise Content Management in Life Sciences New XML authoring and collaboration tools will combine with robust document management to bring the next generation of ECM to life sciences enterprises.
Managing Information as a Strategic Asset in Life Sciences Managing Information as a Strategic Asset in Life Sciences

HITECH: CSC's Point of View

Update on Incentives The stimulus bill provides special Medicare and Medicaid payment incentives for "Meaningful Use" of EHRs. The payments start as soon as 2011, and penalties for not using EHRs begin in 2016. For a typical 275 bed, hospital payments for Medicare and Medicaid could reach $6 million.
Money Back from Your Downpayment on HIT The U.S. is anticipating major health reform over the next several years. Many aspects of the reform debate remain unsettled, and interpretations vary on their chances of being implemented and having an effect. There seems to be only one thing that all participants and policy makers tend to agree on – from government, to employers, health plans, providers and consumers - more and better use of information technology in health care is essential.
Update on Certification In order to receive incentive payments under the Stimulus Act, hospitals and physician practices must use technologies that have been certified by an approved authority to be named by the National Coordinator (likely CCHIT). In this white paper, we describe the current certification process and recommend what actions provider organizations should take to align themselves with current and future CCHIT requirements.
Update on Meaningful Use The stimulus bill includes opportunities to obtain incentive payments for effective use of IT—but they are available for a limited time. We have prepared recommendations and are ready to assist healthcare organizations and providers to prepare for submission in order to collect available funds to support HIT activities.
Standards The Stimulus Act emphasizes the importance of standards for healthcare IT and authorizes the Office of the National Coordinator (ONC) to endorse a set of standards to be used in developing a nationwide health IT infrastructure. In this white paper, CSC describes the ONC-led standards development process and recommends that hospitals and physicians begin the journey to compliance as soon as possible.
Quality Reporting The stimulus bill includes opportunities to obtain incentive payments for effective use of IT—but they are available for a limited time. We have prepared recommendations and are ready to assist healthcare organizations and providers to prepare for submission in order to collect available funds to support HIT and Quality Reporting Activities.
Meaningful Use The stimulus bill includes opportunities to obtain incentive payments for effective use of IT—but they are available for a limited time. We have prepared recommendations and are ready to assist healthcare organizations and providers to prepare for submission in order to collect available funds to support HIT activities.
Certification In order to receive incentive payments under the Stimulus Act, hospitals and physician practices must use technologies that have been certified by an approved authority to be named by the National Coordinator (likely CCHIT). In this white paper, we describe the current certification process and recommend what actions provider organizations should take to align themselves with current and future CCHIT requirements.
Privacy and Security The Stimulus Act has expanded existing security and privacy requirements surrounding HIPAA business associates, the accounting of disclosures, the sale and marketing of protected health information, and other key areas. In this white paper, we describe what these new requirements mean for the healthcare industry, and recommend how covered entities can achieve compliance.
ONC: How Far will $2 Billion Go? The HITECH provisions of the stimulus bill make the Office of the National Coordinator (ONC) for healthcare IT a formal, legislated and budgeted entity and provide $2 billion dollars to “jump start” health IT efforts. Is this enough?
HITECH Advice to Clients The HITECH provisions of the stimulus bill provide up to $30 billion in incentive payments for "Meaningful Use" of EHRs. This white paper provides advice on how to get started to make sure you qualify for the incentive payments.
Incentives The stimulus bill provides special Medicare and Medicaid payment incentives for "Meaningful Use" of EHRs. The payments start as soon as 2011, and penalties for not using EHRs begin in 2016. For a typical 275 bed, hospital payments for Medicare and Medicaid could reach $6 million.
Taking Advantage of Stimulus Dollars: CSC's Point of View The stimulus bill includes opportunities to obtain incentive payments for effective use of IT—but they are available for a limited time. We have prepared a set of white papers explaining the stimulus bill and how to get your share of the money.

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