Optimizing Your Communicable Disease Outbreak …

Webinar SeriesSession 2:

Optimizing Your Communicable Disease Outbreak Management

Workgroups comprised of subject matter experts from HMA and

HealthEC met over several months in 2019 to discuss ways in which

healthcare consulting and advisory services such as those offered by

HMA and population health management (PHM) and analytics

applications such as those offered by HealthEC could be leveraged more

effectively by government agencies, healthcare providers, and payers to address critical needs in select focus

areas.

1. Health Equity

2. Communicable Disease

Outbreak Management

3. Opioids Program Supports

4. Supports to Small/Midsize

Health Plans

5. VBP Contract Supports

6. MCO/ACO Performance

Management

7. HHS Service and Data

Integration

Health Performance Accelerator™

Tailored consulting and advisory services that can be coupled

with tailored PHM and analytics platform deployments

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HMA - HealthEC Collaboration

Opportunity Focus Areas Outputs

Confidential & Proprietary | © 2020 HMA and HealthEC. All Rights Reserved.

Jenifer Leaf Jaeger, MD, MPH

Senior Medical Director - HealthEC

Desmond Banks, PhD, MPH

Senior Consultant - HMA

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Today’s Speakers


• The COVID-19 pandemic has revealed the inadequacy of the data to management and analytics infrastructure currently deployed at the state and local levels to prepare for, respond to, transition out of, and provide for ongoing surveillance to prevent major outbreaks of infectious diseases

• Ideally, state and local public health agencies would have a cohesive suite of information systems connected as needed

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The Challenge

PREPARE

SURVEIL

RESPOND TRANSITION


• $500 million in funding for public health information system modernization authorized by the CARES Act

• In conjunction with other funding such as MMIS funding, creates what could be a once-in-a-generation opportunity for public health and other agencies to invest rapidly in information technology that enable moreeffective communicable disease management

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Funding Channels


Surveillance Preparation

Response Management

Transition Management

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The Solution


Only six stateshave released COVID-19 testing data by race/ethnicity:

1. Delaware

2. Illinois

3. Indiana

4. Kansas

5. Nevada

6. Utah

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Why Surveillance, Preparation, Response & Transition Management are Important


Optimal surveillance requires data on all three:oTesting

oCases

oDeaths

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Failure to include testing data can lead to skewed results:

o A higher number of cases and/or deaths in Population A versus Population B could be

attributable to disproportionately higher number of tests conducted among Population A

versus Population B.

▪ It can be difficult to accurately identify health disparities without optimal surveillance.


Representative Sample: “How well does this sample population represent the overall population?

o Age

o Sex

o Race & Ethnicity

o Education

o Income

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Representative Sample = High External Validity = Generalizable Resultso “This sample/subset of the populations is representative of the overall population, so we can

conclude that the data/outcomes for this sample/subset with be generalizable to the overall population”.


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As of September 2, 2020

Incidence Rate238,643 / 4,119,973 = 5.8%

Fatality Rate8,091 / 4,119,973 = 0.2%

Case Fatality Rate8,091 / 238,643 = 3.4%


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White = 60.8% Hispanic = 17.5% Black = 14.6%

47.8%

30.4%

8.7%

7.3%

Overall Illinois State Population Demographics

24.3%

27.0%27.4%

14.9%

26.6%

1.7%

45.9%

20.2%



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47.8%

30.4%

8.7%

7.3%

24.3%

27.0%27.4%

14.9%

26.6%

1.7%

45.9%

20.2%

Illinois COVID-19 Testing and Cases by Zip Code

Zip Code # Tested # Positive Cases Incidence Rate (%)

60004 17,033 578 3.4%

60007 7,398 520 7.0%

61801 45,568 225 0.5%

61822 20,341 210 1.0%

62859 750 29 3.9%

62865 331 28 8.5%



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Impact and Strategy

COVID-19 Positive

Risk Stratification

Disease Patterns

Disease Surveillance

COVID-19 Assessments

Outreach/Telemedicine

Social Determinants of Health (SDoH)

Medication Therapy Management (MTM)

Care ManagementBusiness Intelligence

Analytics

HealthEC Platform

OPERATIONS

Plan uses platform to support/improve operations

Platform provides functionality to support reporting (KPI, metrics, regulatory)

for plan operations

HMA/HealthEC

support each other

in the engagement

Consulting/advisory services are geared to improving operations using HealthEC’s platform

or outputs as needed.

• Provider

management

• Claims processing

• Quality

management

• TPL management

• UM

• Financial

management

• Program integrity

• Care management

• PHM


• Predict and model the impact of COVID-19 on members, providers, service utilization, and costs

• Tailor care management strategies and protocols

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Analytics & Modeling


• Rapid implementation allows your organization to assess the risk of vulnerable populations to allocate the right resources

• Comprehensive chronic care management and supplemental patient assessments

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Rapid Response Package


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Outbreak Objectives


✓ Truly proactive population health

management

✓ Optimization of care management protocols

✓ Timely development of care plans and timely

action on care plan changes

✓ Improved compliance monitoring

✓ Better modeling of financial impacts

✓ More precise documentation and reporting of

the outbreak’s impact on quality and other

performance measures

• Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines, published research, global field experience, and our predictive data analytics were incorporated into our risk stratification model:oAge, selected for all person's 65+ years of age; highest mortality risk persons

80+ years of age

oCo-morbid conditions: cardiac disease (hypertension, coronary artery disease, and congestive heart failure), diabetes, pulmonary disease

oRisk Score: Johns Hopkins Prospective and Likelihood of Hospitalization Score, Hierarchical Condition Category (HCC), C3 score for Oncology

oAdditional factors: smoking, obesity, exposure risk, immunosuppression

oAdmissions, ER visits, Cost, and Frailty Indicator (Johns Hopkins) data

COVID-19 High Risk Stratification


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Intervention WorkflowCOVID-19 high-risk patient lists uploaded into HealthEC’s population health management (PHM) platform.

High-risk patients are stratified to prioritize outreach and assessment.

The COVID-19 Patient Risk Assessment Survey generates a risk score mapping to 1 of 4 risk levels and associated Action Plans.

Action Plans are managed within the Care Plan for each patient.

Recommendations are linked to Goals and Interventions within the COVID-19 Program with alerts for scheduled follow-up.

Data on utilization and costs of this COVID 19 cohort of patients is analyzed and correlated to interventions as they are recorded

• Geo-maps are produced mapping high-risk patients and COVID-19-positive patients by ZIP code, provider or facility.

• COVID-19 test results (positive & negative) are used to identify susceptible and infected members for ongoing care management, cluster analysis, assist in resource allocation.


© 2020 HealthEC, LLC | Confidential & Proprietary 20

Care Manager COVID-19 Workflow

Care manager selects patient

from the list to bring up

assessment.

Care manager

administers assessment.

System generates a patient-level

COVID-19 risk score.

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Care manager selects COVID-19 program to bring up the

COVID-19 assessment list.1

3

4

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Actionable Intervention WorkflowCOVID-19 Risk

ScoreActionable Intervention Required Action Due

≥ 9

ACTION 1: Call medical provider AND go to local emergency room

for further evaluation. Symptoms may be related to COVID-19 or other

severe condition requiring immediate evaluation.

Today

5 ‒ 8

ACTION 2: Stay at home, monitor symptoms, and contact care

coordinator or medical provider within next 24 hours or with any

worsening; take steps to prevent spread within your home.

Tomorrow

2 ‒ 4

ACTION 3: Stay at home, monitor for symptoms, and contact your

care coordinator or medical provider within next 24 ‒ 48 hours or with

any worsening; take steps to prevent spread within your home.

2 Days

0 ‒ 1

ACTION 4: Stay at home, monitor for symptoms, and contact your

care coordinator or medical provider if symptoms worsen; take steps

to prevent spread within your home.

Reassess

in 1 Week


Intervention Screen

Interventions can be edited using the pencil icon


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High-risk and COVID Positive Geo-mapping

Clicking on “High Risk Patients” and

“COVID-19 Positive” data layers shows

the locations and relative

concentrations of high-risk members in

relation to COVID-19-positive members.


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Upcoming Webinars


Tuesday 9/8Thursday 9/10

Tuesday 9/15 Thursday 9/17 Tuesday 9/22

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Retrospective Analysis Predicting Future Resource Needs

Monitor encounters, ADTs, lab resultsRemote monitoring: thermometers and pulse oximeters

Weeks 31 4 8 322 16High-risk Patient

• 65-year-old male

• Hypertension

• Diabetes

• COVID-19 positive

True incubation period Immune status followed by antibody titers

Infectious period followed by viral load testing

Data query

High-risk pts identified

Initial C/O: COVID-19 survey & assessment

Trigger is COVID-19 test, regardless of whether positive or negative

CM program initiated

First symptoms indicate need for testing

COVID-19 test COVID-19

test positive

Look back after Trigger

• • • • • • • • • • • •

Serial antibody titers ( )and serum testing of viral load ( ) to be repeated at decreasing frequencies as determined by provider


The patient assessment for

COVID-19 is adapted for HealthEC’s mobile

app.

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Mobile Assessments

SAMPLESAMPLE


Optimizing Your Communicable Disease Outbreak …

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