Christiana Care Health System has been awarded $10 million from the Center for Medicare and Medicaid Innovation to design a new care model harnessing information technology to transcend the gaps that currently exist within health care to provide more coordinated care and greater value for patients with chronic heart disease.
Christiana Care’s “Bridging the Divide” model – was one of only 107 projects chosen by the competitive Center for Medicare & Medicaid Innovation grants program. The new innovation center vetted more than 3,000 applications nationwide.
Patients with chronic heart disease who experience higher rates of health complications and hospital readmissions will benefit from ‘Bridging the Divide’ Program. The program includes a comprehensive care team to respond quickly and effectively to the patients, enabling them to recuperate in their homes and manage their symptoms to avoid unnecessary, costly readmissions.
To support the new care model, Christiana Care is designing an electronic patient portal and personal health record. That record will enable patients to communicate with their care management team in order to respond to their health problems.
“This breakthrough opportunity will truly transform care to significantly improve the value of the care we deliver and most importantly improve the quality of life for the patients we are privileged to care for,” said Robert J. Laskowski, M.D., president and CEO of Christiana Care. “Our Bridging the Divides model enables us to tailor the delivery of health care to the unique needs of our patients, allowing them to remain in the comfort of their homes. CMMI’s decision to recognize our proposal also gives health care systems across the nation the opportunity to learn from this new model of care.”
Christiana Care’s ‘Bridging the Divides’ program includes:
- Using predictive analytics to identify patients who are more likely to experience readmissions, develop complications and need a higher level of care.
- Comparing patient-specific outcomes with evidence-based recommendations in managing heart disease.
- Using a software-driven care management program to improve patient outcomes.
“The work under this grant can serve as a model for the nation as we work together to deliver high quality affordable health care to Delawareans,” Gov. Jack Markell said. “Christiana Care is building on the considerable investment we have made in Delaware’s healthcare information infrastructure. Technology, information, and innovation are critical to reducing health care costs and improving quality of care. Christiana Care will help us move from a sick care system to a health care system.”
While the care management of heart and vascular disease patients by and large has been delivered in the same way to every patient in order to achieve optimal results, Christiana Care’s model is aimed at identifying whether resources can be applied to small segments of the population who need them the most in order to use the resources most prudently and effectively.
“The Affordable Care Act allows us to increase access to affordable, quality care by finding innovative ways to get better health outcomes for less money,” U.S. Sen. Tom Carper said. “This federal funding, made possible by the Affordable Care Act, will help Delaware’s doctors and nurses to use new technologies and electronic health records to better coordinate care for Delawareans, especially those with heart disease. This project helps to improve patients’ health and reduces unnecessary visits to emergency rooms and hospitals, increasing the quality and efficiency of health care services in Delaware while also lowering costs. I applaud the Administration’s efforts to support this initiative and congratulate Christiana Care on receiving this much-deserved grant.”
“When it comes to stopping heart disease, prevention is the best and most cost-efficient option we have,” U.S. Sen. Chris Coons said. “With this federal grant, Christiana Care will help keep Delawareans healthier and lower healthcare costs by facilitating stronger communication between our state’s care providers. It’s important that the government and medical community continue to work together to stem the tide of this rapidly growing disease that is currently the number one cause of death in Delaware. I congratulate everyone at Christiana Care on winning this grant, and look forward to seeing its positive impact on our communities.”
“Making better use of data is key to improving the quality of care that patients receive, as well as reducing healthcare costs,” Congressman John Carney said. “Investing in this data hub will ensure that doctors and nurses have the information they need to help a patient manage heart disease and access important resources for effective care, while avoiding unnecessary and expensive visits to the hospital. I applaud Christiana Care for taking the initiative to develop this system, and I look forward to the positive impact it will have for Delaware patients.”
Christiana Care Health System is uniquely suited to develop this care model because of the Delaware Health Information Network (DHIN). The network functions as a data collector for all Delaware hospitals and collects more than 92 percent of lab results statewide. DHIN allows health care professionals to access the most current, critical information on patients.
“This model wraps the patients’ information around the patient to close the divide that hinders the delivery of effective, high quality, sustainable patient care,” said Randall Gaboriault, the chief information officer for Christiana Care and the chair of the Delaware Health Information Network. “We are using information and technology to change the way care is delivered in a way that is meaningful, evidence based and outcome driven.”
“Both Christiana Care and DHIN are innovators and leaders in health care and this award is another validation of our success in working together,” added Bettina Riveros, Secretary of DHIN and chair of the Delaware Health Care Commission. “We may have won the CMMI grant, but the Delawareans that our dedicated health care professionals treat each day are the true beneficiaries of this award, as it will lead to better care and better outcomes.”
Christiana Care’s partners in the project include the American College of Cardiology, the Society of Thoracic Surgery, the Delaware Health Information Network and the University of Delaware. The partners also include several doctors in the community.
The federal Centers for Medicare and Medicaid Services created the CMMI to improve the health of Medicaid, Medicare and CHIP patients – and by extension all Americans – while combating escalating costs. The $1 Billion Health Care Innovation Challenge – funded through the passage of the Patient Protection and Affordable Care Act in 2010 – carries a triple aim: better health, better health care and reduced costs. The Innovation Challenge provides 3-year grants of $1 million to $30 million to health care providers, payers, local government entities, and public-private partnerships, including collaborative efforts among multiple payers.