Data Security: Securing Community Healthcare Data and Devices

David Reynolds
David Reynolds

Guest post by David Reynolds, IT systems manager, Rhode Island Blood Center.

Maintaining blood supplies to meet the needs of the hospitals in the region is a key mandate for the Rhode Island Blood Center. The Center collects 250 pints of blood from donors to meet this commitment. To make it easy for donors, more than 3,000 mobile blood drives are held annually throughout the community.

While we have nurses and lab technicians to take care of the donors’ physical needs, it is my job as the IT Systems Manager at Rhode Island Blood Center to take care of their personal information. We gather this information from each donor at the mobile clinics and store it on laptops, so it is essential that we have safeguards in place to ensure the data is properly secured.

Data security is a key concern for the majority of healthcare organizations in the US.  And like most organizations, Rhode Island Blood Center must follow regulatory guidelines and protect patient data.

My department is responsible for the IT and telecommunications equipment used at the remote blood drives and the six Center locations. The typical set-up includes a large number of Center-owned laptops where donor information is stored.

While most people arrive at a clinic and see the positive results of a community coming together and helping each other – all I see are laptops loaded with confidential information for which Rhode Island Blood Center is ultimately responsible. I know if even one laptop is lost or stolen, confidential donor information could be at risk.

Data at Risk

Reviewing daily healthcare news, it is clear that data breaches are a huge issue for healthcare organizations across the US, but bad press isn’t the only issue – many organizations face large non-compliance fines and damage to their reputation that can never be restored.

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Why HIE is Frightening

Judy Chan
Judy Chan

Guest post by Judy Chan, president, HealthPro Consulting.

Burgeoning EHR implementations nationwide attributable to the meaningful use incentive program have created a surge in HIO and electronic health information exchange (eHIE).

Having health information available for electronic exchange is generally accepted as beneficial to patients, providers and payers. Providers can access patient information from other providers when they need it where they need it. Providers are able to avoid duplicating lab tests, scans and x-rays that save the payers dollars. Additionally, patients don’t need to remember what treatments were administered or drugs prescribed and can avoid unnecessary exposure to radiation.

In emergency situations, the benefits of having a patient’s health information available to emergency room staff are obvious. Patients who have experienced referrals in the course of diagnosis and treatment also readily see the advantage of not having to hand-carry all of their medical records from one doctor’s office to the next. The electronic exchange of health information among providers eliminates faxes, paper work and phone calls.

Patient’s perspective

What makes the exchange of health information frightening to patients?

1. Your health information is available to others who have a legitimate need.

2. Consent must be given by the patient to share their information

3. You must trust the distributor of your information

4. You should monitor your data on a regular basis and make corrections when necessary

5. Information could be accidentally released without your permission.

6. Your consent is electronically recorded by multiple systems.

Do these risks sound familiar? They should because they are not very different from the risks that credit rating agencies that have recorded your financial transactions for years.

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Mobiquity Study: 70 Percent of People Track their Health and Fitness Daily with Mobile Apps

A recent study by mobile engagement provider Mobiquity, Inc has found that while 70 percent of people use mobile apps on a daily basis to track calorie intake and monitor physical activities, only 40 percent share data and insights with their doctors.

Working with an independent research firm, Mobiquity’s “Get Mobile, Get Healthy: The Appification of Health & Fitness” study reveals the opportunity for healthcare professionals and organizations to leverage mobile to drive positive behavior change and healthier patient outcomes. According to the survey, 34 percent of mobile health and fitness app users said they would increase their use of apps if their doctors actively recommended it.

Here’s an infographic from Mobiquity with the findings: http://www.mobiquityinc.com/mHealth-infographic-2014.  It’s also pasted to the right.

Mobile drives healthier lifestyles

According to Mobiquity’s research, 73 percent of people claim to be healthier by using a smartphone and apps to track their health and fitness. Fifty three percent discovered they were eating more calories than they realized. Sixty-three percent intend to continue, and even increase, their mobile health tracking in the next five years; 55 percent of today’s mobile health app users also plan to introduce wearable devices like pedometers, wristbands and smartwatches to their health monitoring in coming years.

Smartphone health tracking trumps social networking

For many, using a smartphone to track their health and fitness is more important to them than using their phone for social networking (69 percent), mobile shopping (68 percent), listening to music (60 percent) and making/receiving phone calls (30 percent).

But there’s room for improvement

What’s stopping people from using their health and fitness apps more? Doctor recommendations would be a big motivator, said 34 percent. Privacy was also a concern for 61 percent. But the chief reason people quit using these apps is simply because they forget – something that could and should be addressed by app developers to ensure health apps are less disposable.

“Our study shows there’s a huge opportunity for medical professionals, pharmaceutical companies and health organizations to use mobile to drive positive behavior change and, as a result, better patient outcomes,” said Scott Snyder, president and chief strategy officer at Mobiquity. “The gap will be closed by those who design mobile health solutions that are indispensable and laser-focused on users’ goals, and that carefully balance data collection with user control and privacy.”

Mobiquity commissioned independent research firm Research Now to survey 1,000 consumers who use, or plan to use, health and fitness mobile apps. The study was conducted between March 5-11, 2014.

Mobiquity’s study “Get Mobile, Get Healthy: the Appification of Health & Fitness” can be downloaded here: http://www.mobiquityinc.com/mHealth-report-2014.

 

 

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The Effects of Meaningful Use Stage 3

Darin VanderWell

Guest post by Darin VanderWell, Director of Product, DocuTAP.

Rumors about the next phase of the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program has prompted concern among healthcare providers. To truly understand meaningful use Stage 3 and its impact, it is important to differentiate between the rumors and the truth.

The final rule for meaningful use Stage 3 has yet to be published, so discussion on its effects are based on available drafts. Even those drafts are in question since the December 2013 announcement that Stage 3 would be delayed until 2017. One reason cited was to allow more time to research the impacts of Stage 2 before finalizing Stage 3. The delay will be particularly important for that research, since compared to Stage 1, 2011 Edition, there are so few Stage 2 vendors certified currently.

As for what is expected, the attention turns from data capture and access (Stage 1) and information exchange (Stage 2) to improved outcomes in Stage 3. One expected goal is to simplify and reduce the reporting requirements on those attesting. Some of that change can be achieved by consolidating the program’s current objectives, which I expect hospitals and providers will welcome, provided it truly reduces the reporting burden and does not coincide with other, new objectives and reporting requirements.

Stage 3’s goal of improving outcomes will be incredibly interesting – through November 2013, CMS had disbursed nearly $18 billion in incentive payments. Until now, the program’s success has been judged by the number of participants adopting certified EHRs. At some point during Stage 3 (or thereafter), we will know whether those payments have truly improved outcomes.

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The Benefits and Challenges of Connected Healthcare

Edward Keiper
Edward Keiper

Guest post by Edward Keiper, president and CEO of Velocity Managed Services.

For physicians’ practices in the 21st century, connectivity is the buzzword. Getting doctors connected to data, patients connected to healthcare providers, and practices connected to networks are just a few of the web-fueled scenarios coming down the pike.

The Health Information Technology for Economic and Clinical Health (HITECH) Act is a game changer and affects just about every aspect of modern medical care. HITECH, part of the American Recovery and Reinvestment Act of 2009, promotes the adoption and meaningful use of health information technology.

As is often the case with a shift this monumental, there are both benefits and challenges of connected healthcare that practice groups will have to address. First, let’s take a look at some of the benefits.

1. Join the Digital Revolution. Just as other industries that went digital years ago, healthcare benefits from the streamlining offered by a networked environment. Clinical interoperability of healthcare IT lowers costs and enhances efficiency by facilitating the comprehensive exchange of health information between care providers, hospitals and patients.  The trend is toward innovation in healthcare as the industry as a whole responds to consumer demands and government reforms.

2. Safety in Numbers. As of 2013, more than 323,000 American medical practices and hospitals adopted EHRs and attested as meaningful users, indicating a 266 percent increase over 2012, according to CMS statistics. However, even with this upsurge in participation, those numbers represent only a small percentage of US hospitals that currently keep electronic records and contribute to the health information exchange. So, while the risk of being an early adopter is largely gone, your practice group could still be near the front of the adoption wave.

3. It’s easier. As you can see from the statistics in the previous point, healthcare IT adoption is in an early phase, and for most practices, there is a lack of centralization. To help elucidate the complexity of the system, look no further than the state of Florida, where there are at least 672 EHR vendors. Connecting health information digitally creates a central database that greatly simplifies the process of storing and retrieving all patient data. It’s like finding the needle in the haystack every time.

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Health Data Consortium: The Emergence of Data as a Driver of Health Systems Innovation

Dwayne Spradlin
Dwayne Spradlin

Guest post by Dwayne Spradlin, CEO, Health Data Consortium.

Earlier this year, Mobile Future released an infographic about the current state of digital health. The graphic detailed impressive statistics: Now, more than 247 million Americans have downloaded a health app for their mobile phones and 42 percent of U.S. hospitals utilize digital health technology. These numbers are increasing every day.

These impressive statistics would not been achievable without the liberation of enormous amounts of health data over the last few  years, which has help catalyzed a new era of health innovation by giving innovators and entrepreneurs the resources to develop new products and tools to help the everyday consumer make better, more-informed choices about their health. The digital health arena has also become a major economic driver and is on an upward trend with no ceiling in sight. Rock Health reported in April that venture capital funding for digital health in Q1 of 2014 totaled almost $700 million, an increase of 87 percent from Q1 of 2013.

From the successful implementation of the Affordable Care Act through Healthcare.gov to newly released Centers for Medicare and Medicaid Services (CMS) data, both the demand for and ability to create new products that service consumer needs are at the forefront of investors’ minds. But with new opportunities for innovation also comes new risks and challenges. Along with privacy and security issues regarding the distribution of patient data which has been a hotly discussed public topic the last few months, concerns about storage, access, and sharing are on the minds of data distributors and data users alike.

At the Health Data Consortium (HDC), created as a public-private partnership, has the support of government, nonprofit and private sector organizations who all believe in liberation of health data for the public good. HDC has made a multi-stakeholder commitment to health data, which was reflected in the diversity of constituencies that attended our Health Data Leadership Summit in November last year. This leadership summit resulted in the release of our whitepaper on the multi-stakeholder perspective of health data priorities in the U.S. healthcare system.

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Discontinuing a Patient from Your Practice

Linda Mangels's picture
Linda Mangels

Guest post by Linda Sue Mangels, BSED, MSED, CPHRM, senior risk management/patient safety specialist, the Cooperative of American Physicians.

Doctors often get into the field of medicine because they love helping people (their patients). However, from time-to-time, a patient’s behaviors and actions may require the physician to sever ties. Non-compliance with the treatment plan, rude, abusive behavior, repeatedly not showing up for appointments, drug-seeking behavior and non-payment of services rendered are all reasons physicians terminate their patient relationships. A good relationship/partnership between the physician and patient is essential for optimal treatment outcomes.

If, for whatever reason, it is not possible to establish this partnership, it is best for the patient to seek treatment elsewhere.

However, a physician can’t simply stop providing care to a patient. In fact, once the physician-patient relationship is established, the physician must continue to provide care to the patient to avoid allegations of abandonment until one of the follow occurs:

1)    The patient terminates the physician-patient relationship.

2)    The patient’s condition no longer requires the care of this particular physician.

3)    The physician agreed to treat only a specific condition or agreed to treat only at a specific time or place.

4)    The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

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Tips to Prepare for ICD-10, and For Boosting Coder Morale and Productivity

Michele Hibbert-Iacobacci
Michele Hibbert-Iacobacci

Guest post by Michele Hibbert-Iacobacci, vice president, information management and client services, Mitchell International.

Employee morale is a constantly at the forefront of the healthcare industry because of on-the-job stress, do more-with-less mentalities and a consistent cost containment focus. With the introduction of ICD-10, employees who work in healthcare as medical coders will be expected to maintain productivity and produce quality coding. We are changing the communication language used between payers and providers and have an expectation that everyone speak the same language as of a specific date.

Although difficult to attempt in a short time frame, this language change has been coming for many years and we should be ready by October 1, 2015. While the industry has been given more time to prepare, this transformation will still have an effect on the medical coding professional from a morale perspective, let’s face it – do coders know ICD-9 or what? Most have ICD-9 memorized so change will be a very new condition for the medical coder to deal with.

Steps to mitigate morale issues should be reviewed and/or introduced to minimize pushback and employee attrition. Skilled coding professionals are needed in the industry, they are valuable and the ICD-10 language barrier is one that requires specific steps to maintain medical coder involvement.

Having worked as a coder for many years, I can attest to the following as ways of boosting morale:

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Sustainable Growth Rate Reform: Close, But No Cigar

Ken Perez
Ken Perez

Guest post Ken Perez, vice president of healthcare policy, Omnicell.

“Politics is the art of the possible.” -Otto von Bismarck

This was supposed to be the year for permanent repeal of the sustainable growth rate (SGR), a formulaic approach intended to restrain the growth of Medicare spending on physician services. There was the rare cosmic convergence of bipartisan and bicameral support for SGR reform proposals at the end of 2013, and cost estimates by the Congressional Budget Office of a long-term “doc fix” reached new lows earlier this year.

But those hopes were dashed, as permanent SGR reform bills from both sides of the aisle died in the Senate. Instead, Congress agreed upon yet another short-term SGR patch. On March 27, 2014, the House, under a suspension of normal rules, approved via a voice vote a one-year patch to the SGR that would avoid a 24.4 percent reduction to Medicare’s Physician Fee Schedule (PFS) slated to take effect April 1, 2014 (replacing it with a 0.5 percent increase to the PFS for 12 months). Then on March 31, the Senate approved the patch via a roll-call vote, and President Barack Obama signed the bill into law that same day.

Why did the efforts to pass a permanent doc fix fail? The aforementioned bipartisan and bicameral support of SGR reform proposals was limited to “policy,” i.e., the future system by which physicians will be reimbursed by Medicare. Congressional Democrats and Republicans did not see eye to eye on the so-called “pay-fors” that would offset the increased government spending that would result with repeal of the SGR and allow the reform legislation to be deficit-neutral.

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Today’s Healthcare Collaboration Technologies No Longer Bound by Time or Location

Brent Lang
Brent Lang

Guest post by Brent Lang, president and CEO of Vocera Communications.

There have been dramatic changes to the look and feel of healthcare communication and collaboration technologies over the past few years. The demands of healthcare reform have shaped new challenges not previously seen or imagined, and in turn have spawned the development of entirely new solutions to meet those needs.

As healthcare professionals discover new and broader uses for healthcare technology in patient care, one goal remains – driving efficiencies that bring the nurse back to the patient’s bedside, which in turn improves both the quality of care and patient experience. In doing so, technology solutions must also defy the four walls of the hospital to connect clinicians across the care continuum whether or not they are physically on site.

As healthcare communication technology has progressed, the topic of mobility has become hotter than ever. Today’s hospital workforce needs to be increasingly mobile and collaborative. This requires solutions that are no longer defined by time or location. Healthcare employees are constantly on the move, and must be able to securely connect from anywhere to answer questions and respond to emergencies. Naturally, communication systems that can keep up are in high-demand. When a clinician has the ability to instantly locate the resources and information he or she needs, while in transit, treatment delays and medical errors are prevented.

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Health IT Thought Leader Highlight: Adnan Ahmed, CNSI

Adnan Ahmed
Adnan Ahmed

Adnan Ahmed is co-founder and president of CNSI. He is responsible for the overall health of the company and leads CNSI’s management with an emphasis on identifying new strategic markets and leveraging relationships with customers and partners. Under Ahmed’s direction, CNSI has experienced extensive growth in the healthcare and federal markets. Ahmed is credited for CNSI’s expansion into several new verticals, including the State Medicaid and CMS Medicare markets.

Ahmed brings vast experience in federal government and strategic growth areas. Prior to founding CNSI, Ahmed started the federal product sales division for INET Inc., a government systems integrator, growing it to $30 million in three years.

Adnan Ahmed is a board member of the Tech Council of Maryland (TCM), The Organization of Pakistani American Entrepreneurs of North America and is an active supporter of The Citizens Foundation, USA (TCF-USA).

Tell me about CNSI and its relation to healthcare. What’s your footprint and what are some of the organizations you’ve worked with?

Happy to do so and thank you for the opportunity to engage in this dialogue.

CNSI delivers business transformation and business technology solutions to a diverse base of federal and state government agencies. Some of the agencies we are working with include health and human services departments for Michigan, Maryland, Utah and Washington. Within that space and working with those agencies, healthcare takes up the majority of work we are involved in today.

For every project we undertake, our mission is to deliver high-quality, innovative solutions that improve performance. In the healthcare industry, our goals around performance are twofold: we aim to introduce solutions that dramatically cut down on costs and also make for a stronger, more connected experience between the people administering and receiving healthcare services.

From your dealing in the space, what are some of the most pressing issues you’re seeing? What needs to be addressed that’s not receiving the attention it deserves? Anything overblown?

With healthcare poised to make up a fifth of our total economy by the year 2020, the industry and each individual it serves has a lot to gain from the implementation of cutting-edge, cost-saving technological solutions.

One area we’ve seen as having so far prohibited the full potential health IT has to offer has been around interoperability. A lack of industry standardization makes it difficult to share and utilize information across platforms and deters a complete capture of standardized healthcare data.

The more interoperability, the more opportunity for healthcare systems, primary care providers, specialists and patients to benefit from avoiding from duplicitous tasks and capitalizing on available information.

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Health IT Startup: Tonic Health

Sterling Lanier - Co-founder and CEO of Tonic Health
Sterling Lanier

Tonic was founded by a collaboration of scientists, consumer marketing experts, user interface designers and software programmers to finally solve the crippling challenges of medical data collection, including poor response rates, low patient engagement, high cost and limited ability to personalize care based on a patient’s answers.

So we went out and built a medical data collection platform for clinicians, providers and researchers collecting and using patient information everywhere.

Elevator Pitch

Tonic Health is the world’s best patient data collection platform: fully customizable, super fun and friendly, and accessible anywhere, it solves all the major data collection headaches for hospitals and health systems everywhere.

Product/Service Description

Tonic is the world’s best patient data collection platform: we integrate extreme patient engagement, robust CRM capabilities and real-time predictive analytics to dramatically improve the process of gathering, analyzing and using patient data.

Used by 10 of the Top 15 largest health systems in America, Tonic provides a Disney-like experience to a wide range of data collection needs, including patient intake, patient screening and risk assessments, patient satisfaction, patient-reported outcomes, patient education and much more.

Founder’s Story

Prior to co-founding Tonic, I (Sterling Lanier) founded a company called Chatter (www.chatterinc.com), which is a leading market research firm that works primarily with Fortune 500 brands. During a pro-bono project I was doing for a breast cancer research program at UCSF, I realized the way that most healthcare professionals were collecting and analyzing data was woefully behind the best practices used in the corporate world. Engagement was pitiful, turnaround times were glacial and patient care was suffering.

So I teamed up with my co-founder Boris Glants (who is the technical brains behind our success) and we set out to flip the whole system on its head.

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Participation Rises in Medicare Physician Quality Reporting System and Electronic Prescribing Incentive Program

The Centers for Medicare & Medicaid Services (CMS) today released the 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Experience Report, showing a significant increase in participation in two key programs that allow eligible professionals to earn incentive payments through voluntary participation.

“Our physician and other clinician quality programs reached new records this year with over 430,000 professionals participating in the Physician Quality Reporting System and over 340,000 e-prescribing,” said Patrick Conway, M.D. deputy Administrator for innovation and quality and chief medical officer at CMS. “Clinicians are actively measuring and reporting on quality, and CMS is in the beginning stages of adding this information to the Physician Compare website, which can be viewed by patients. Measuring, transparently sharing, and improving quality performance is key to a better health system.”

The full report can be found at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2012-PQRS-and-eRx-Experience-Report.zip

The Physician Quality Reporting System (PQRS) has been using incentive payments, and will begin to use payment adjustments in 2015, to encourage eligible health care professionals to report on designated quality measures. The Electronic Prescribing (eRx) Incentive Program used a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals.

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For Practices, Bridging the Health IT Technology Gap Does Not Mean Starting From Scratch

Sean Morris
Sean Morris

Given the recent focus on the value of health IT (HIMSS recently asked those of us covering the space to respond to its importance; you can see my response here: HIMSS Asks: What is the Value of Health IT?), the topic remains an intriguing one. With ever-present changes to the landscape, we’re in the midst of major and continual upheaval about how technology can serve, yet improve care quality and outcomes.

The use of electronic health records, for example, continues to permeate the space. But even as pervasive as the technology is — during 2006 through 2013, the percentage of physicians using any EHR system increased 168 percent, from 29.2 percent in 2006 to 78.4 percent in 2013, according to the CDC.  Nearly half of physicians (48.1 percent) were said the be using the more comprehensive “basic system” by 2013, up from 10.5 percent from 2006, but that doesn’t mean the solutions are completely meeting the needs of physicians.

That said, I asked Sean Morris, director of sales for Digitech Systems, for some perspective. He’s worked in health IT for more than 20 years. He agrees with me, that penetration of EHRs remains less than 50 percent. Even so, as physicians have moved aggressively toward the technology, in large part because of meaningful use, not all of the systems that have been deployed are working as expected.

“EHRs were the new shiny thing and everybody wanted to chase after them,” Morris said. “But issues came up as people began to evaluate and use the technology. They discovered that there’s really no bridge from the information stored in EHRs charts and other records outside the EHR. They need to bring it together without killing their practice.”

As the age of EHRs begins to fade past its prime and as practices begin to evaluate second generation solutions, Morris said history is likely going to repeat itself unless practices begin to deploy solutions that help them use all of the data stored in the records.

Morris said that in many cases, current EHRs don’t actually need to be replaced, rather built upon.

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Mobile Healthcare Trends: Daniel Kivatinos, Co-founder, drchrono Offers His Perspective

Daniel Kivatinos
Daniel Kivatinos

Mobile healthcare trends, they’re only going to get more prevalent. That said, drchrono provides its official take on the top six mobile healthcare trends that are on the minds of physicians, business leaders and patients.

Daniel Kivatinos, COO and Co-founder, drchrono throws his hat in the ring and takes a look at some noteworthy mobile healthcare trends and issues that will be headlines this year.

Consumer Accountable Care – Today’s mobile devices allow consumers to become more accountable for their care. As high deductible healthcare plans become more popular, consumers are empowered now more than ever with access to reviews of physicians and can also track comparison of prices for healthcare procedures. Education about how to manage their own health is now easier, so patients are savvier and more informed with access to more apps and websites.

Here are a few examples of some popular tools and apps that consumers are using to be more responsible and own their health:

Less is Now More – As physicians get paid less, physicians are finding tools to do more with less. For example, with just an iPad a physician can run its practice, accessing and managing patient data. According to a recent article in The USA Today, as the demand for healthcare goes up and as a shortage of 45,000 primary care physicians is predicted by 2020, more non-physicians are doing some of the work, such as nurse practitioners, pharmacists and physician assistants. Quality metrics software pushed through EHRs can also simplify digital health and assist with reimbursements, as well as quality and efficiency standards.

There is so much data coming at physicians on paper, they generally skim a medical record, sometimes missing key information. Organizing all of the data in a digital format flagging the most critical, relevant data pertaining to a patient is a key time saver. The reality of the situation is that with paper medical records this workflow isn’t possible.

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