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IBM Watson Health and the Central New York Care Collaborative (CNYCC) today announced an agreement to create a cognitive population health platform intended to connect more than 2,000 healthcare and community based providers across six counties in Central New York. The platform will be designed to help improve health for residents across the region, with the goal to reduce costs in the Medicaid system by decreasing the amount of avoidable emergency department visits and hospital readmissions by 25 percent over the course of the program. The population health platform will integrate IBM Watson Care Manager with broader Watson Health offerings and run on the Watson Health Cloud.
The untapped value of insights from health industry data is estimated to be near $300 billion annually.(1) Patient data often resides in multiple siloes, preventing physicians from understanding the full spectrum of health issues that could impact a patient’s care and potential risk factors. For example, an endocrinologist may be unaware that her diabetes patient also suffers from depression, which significantly impacts the risk of non-adherence.(2)
For CNYCC’s Population Health Management (PHM) System, IBM Watson Health will integrate data from a variety of care settings -- primary care, post-acute care, behavioral health, community and acute care and more than 75 electronic health record systems, health information exchanges, and other data sources. CNYCC’s PHM system will aggregate that diverse data and produce holistic patient insights incorporating clinical history, social determinants, and behavioral health. Clinicians can access information about their individual patients from the platform, and opt to connect with a patient to prompt adoption of healthy behaviors relevant to office visits and care management; for example, send a private reminder to pick up a prescription.
“Our mission at CNYCC is to improve the health of our community by coordinating services and building partnerships throughout the healthcare system,” said Virginia Opipare, CEO, CNYCC. “The ability of our providers to access critical healthcare information through a Watson-powered, cloud-based population health management platform is the optimal foundation for this transformational work. The PHM System will meet our current needs and scale to keep pace with the evolving needs of the patient population we serve. And, because it is a cognitive system, it learns as it goes and will return increasing value to the region over time.”
“Central New York is leading the way for a national movement toward an effective, scalable patient-centric approach to population health management and value-based care,” said Anil Jain, M.D., FACP, VP and Chief Health Informatics Officer, Value-Based Care, IBM Watson Health. “This is about identifying high risk individuals and using Watson-based tools and services to help providers engage with patients to improve health. As the healthcare industry shifts away from fee-for-service to a value-based system, care providers need integrated solutions that help them gain a holistic view of each individual within a population of patients.”
Watson Care Manager combines care management best practices and automated workflows enabling care managers to create individualized care plans that address all determinants of health and engage individuals for better health. The system brings together the cognitive computing power of Watson with IBM’s established expertise in population health management and social program management. In addition to surfacing information about a specific individual, it can also run similarity analytics to help clinicians determine potential risk factors that have been found in “patients like this,” drawing on broader health data in the Watson Health Cloud. Importantly, Watson Health’s population health platform provides seamless patient engagement, to close the loop from patient insights to engagement and action.
Sources
(1) McKinsey, retrieved from searchcrm.techtarget.com/feature/In-healthcare-information-silos-block-patient-data-analysis.
(2) Gonzales, J.S., et al. (2008). Depression and Diabetes Treatment Nonadherence: A Meta-Analysis. Diabetes Care (12). Retrieved from ncbi.nlm.nih.gov/pubmed/19033420.
About the Central New York Care Collaborative
CNYCC (cnycares.org) is a non-profit organization that connects more than 2,000 healthcare and community based service providers across six counties in Central New York (Cayuga, Madison, Lewis, Oneida, Onondaga, and Oswego). As a lead agency implementing New York State’s Delivery System Reform Incentive Payment (DSRIP) program, CNYCC works with over 170 organizations to coordinate care and improve access to services for over 200,000 Medicaid beneficiaries and uninsured patients across the region. CNYCC is one of 25 lead agencies across the state of New York, charged with facilitating and coordinating community-level collaborations with a focus on system transformation to reduce avoidable hospital readmissions and emergency department use by 25% by the year 2020. CNYCC is also tasked with preparing healthcare Safety-Net providers for the transition to a Value Based Payment model of care delivery.
About IBM Watson Health
Watson (ibm.com/watson) is the first commercially available cognitive computing capability representing a new era in computing. The system, delivered through the cloud, analyzes high volumes of data, understands complex questions posed in natural language, and proposes evidence-based answers. Watson continuously learns, gaining in value and knowledge over time, from previous interactions. In April 2015, the company launched IBM Watson Health (ibm.com/watsonhealth) and the Watson Health Core cloud platform (now Watson Platform for Health). The new unit will help improve the ability of doctors, researchers and insurers to innovate by surfacing insights from the massive amount of personal health data being created and shared daily. The Watson Platform for Health can mask patient identities and allow for information to be shared and combined with a dynamic and constantly growing aggregated view of clinical, research and social health data.
Contact: BJ Adigun - CNYCC
P: +1 315-703-2966 - E: bj.adigun[.]cnycares.org.
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cgdouglass[.]us.ibm.com 
