Startups are taking the world by storm; it seems like now, you can’t possible go through the day without hearing the word, especially given that many—such as Joyable and Ruby Cup—are making a positive impact in the world. Still, you’d be surprised to find that there’s one industry in particular where startups get mixed results: healthcare. Like finance, law and education, healthcare is a field with one of (if not) the most extensive regulations.
It makes sense, given that lives are literally on the line. Equally as intriguing is that we are talking about a multi-billion-dollar industry (investors gave $16.1 billion to healthcare in 2015 alone), loaded with opportunity for tech startups to become successful while saving lives, improving hospital work flow, and speeding up research. That being said, we’ll examine the ways startups are succeeding in the healthcare industry, as well as why a startling number of them fail.
Startups that Are Doing It Right
Flatiron Health is one of a handful of successful startups that aced the healthcare industry. As reported by Inc., the young startup created a tech platform that shares data collected from cancer patients (information remains anonymous) with research and pharmaceutical facilities. As of now, 260 clinics use Flatiron Health’s cloud-based invention.
By sharing health information more easily, hopefully cutting-edge cancer treatments and medical options can be more readily available.
Majority of Healthcare Startups Are Not Cutting It
While Flatiron Health and other startups succeed in the world of healthcare, a majority are barely making it—if that. Forbes reports that as many as 98 percent of startups funded by angel investors fail in the healthcare industry because of a poorly thought-out business marketing strategy and uninspiring business model.
The Story of Healthcare.gov
Nonetheless, the tech startups that do succeed can make a huge difference in individuals’ lives. As is the case with Marketplace Lite, a young tech startup, rebuilding healthcare.gov from the ground up. As told by The Atlantic, healthcare.gov originally was a failing website. On launch day, only six people were able to sign up for healthcare insurance. The reason for such the low signup numbers had more to do with the site’s poor login features than the number of people trying to sign up.
Guest post by Karyn Mullins, executive vice president and general manager, MedReps.com.
From artificial intelligence developments to updated EHR technology, the future of health IT looks brighter with each passing year. As new developments and new technologies rise to the forefront of healthcare, health IT pros — new and accomplished — will need to do the same.
While medical sales remains a challenging and demanding career, my company’s 2017 Medical Sales Salary Report found sales reps are being rewarded for their efforts. Of course, there are a few different factors playing into a each reps’ earning potential.
The topics we examined are: product, market, job title, travel, and location.
With technology careers are in high demand, my team wasn’t surprised to find health IT sales reps are in the top three of the highest average total compensation category.
Whether you’re hoping to get started in the field, are still considered a ‘newbie,’ or are a veteran looking to kick your career up a notch, our report has key insights that can take anyone to their highest earning potential.
Here’s what the future of health IT sales looks like and how you can get to the top:
What they’re earning
The earning potential for any medical sales representative is impressive to most job seekers. To top off their large salaries, bonuses, and commissions, they’re also receiving added benefits like expense accounts, company cars, quality health benefits, and even 401k matching.
Topping the charts are those in health IT and software sales.
These reps make an average of $176,012 a year. To break it down, around $108,750 of that is base salary with an added average of $68,157 in bonuses or commissions. Biotechnology and medical/surgical devices were head-to-head for second and third place with average total compensations of $162,544 and $159,130.
How they’re doing it
There is no set mold for any particular medical sales job — and health IT is no different.
The MedReps report found many different factors affect the success of any medical sales job. Aside from the product category, market segments largely impact reps’ paychecks.
We found surgery/OR, pharmacies, and hospitals are all close competitors for those wanting to earn top dollar. Surgery/OR came in at the top with a total average compensation of $160,991, with pharmacies at $159,293, and hospitals rolling in closely behind in third with $158,155.
As most of us already know, medical sales is a challenging, but rewarding market for many reasons. Getting acquainted with products, learning the jargon, and gaining the trust of your customers takes patience, time, and dedication.
In time, this particular attack did manage to spread internationally from Europe over to America, but that only provided further evidence that ransomware, and cyber attacks more broadly, are a threat of seemingly unlimited potential. The failings of American healthcare to get its data safely organized look far less damning when the scale of cyber risk is made explicitly global, and even the NSA is caught off-guard by their own tools being turned into weapons in enemy hands.
Not Alone, but Not Ahead
Of course, that American hospitals weren’t the primary targets for once doesn’t remotely get them off the hook; nor does the jarring impact of this particular incident reflect a growing resilience among health data security in the U.S. American health data may not be alone in its vulnerability or attractiveness to thieves, but neither are our health systems leading the pack in protecting against ransomware, or any other form of cyber attack. Sadly, this wakeup call seems more likely to be heard outside of healthcare than within it; the scale makes it almost universally noteworthy, but otherwise it resembles a new status quo for data leaks in modern health systems.
Credit card data is relatively to protect; thieves are easily and quickly locked out of accounts, if not caught, thanks to everything from increased scrutiny by lenders and processing companies as well as consumer-facing transparency and 24/7 account monitoring via mobile credit card alerts and apps. Health data, by contrast, remains largely vulnerable. Clinics are not particularly good at recognizing fraud when thieves have a person’s medical data; hospitals have proven themselves no better at keeping that data secure in the first place. So compared to traditional identity theft leveraging plastic, digital health data presents a softer and more lucrative target end to end.
In the present age, finding a professional and reliable medical billing professional is very hard. Every physician knows the importance of an expert medical biller for the management of cash flow. It would not be wrong to call online medical billing and coding the bloodline of the medical facility.
In this age of technology, hiring a medical biller is not appropriate when you can use the software to get the work done quickly. You have to make sure that you select the best medical billing practice management system that will work for you for decades. All you have to do is enter your practice and the method you use for testing and it would be easy for you to manage everything.
Recently it has been found that most of the physicians have just started their practice and they do not find it important to get the healthcare consulting services. What they do is simply divide the tasks among their employees. As a result, they might save some money but most of the time it is hard to manage data.
Medical billing is not an easy task because there are many particulars that you have to take care of. A mistake in a single figure will disturb the entire calculations and you will have to suffer. Apart from that, you will waste your time and money.
So it is better that you get the online medical billing and coding tools. Here are some of the things that you must consider before selecting the management system.
1. Timely filing
When you are dealing with the insurance companies, you will get only a few days to file the claims. In case you have missed the deadline, you will not be able to appeal a denial.
When the insurance companies miss the services, it gets even worse because the claims are often sent on time. It means you will have to deal with a denial. Such kinds of issues occur when the services are sent in a batch. The insurance company sent you five services and it skipped the second one accidentally and now the company will not pay for it.
With the help of online medical billing and coding system, you can have the detailed records of the time and date when services were sent. They will help you to prove the mistakes and so your denial will be appealed. It would be easy for you to get the payments on time. Most of the workflow analysis in healthcare use the clearinghouse system for the accuracy of the results. It makes the results more effective. The best feature of the billing system is that they provide guaranteed results and you will not have to deal with the errors in the billing or filing.
2. Follow up on denied claims with online medical billing and coding
The insurance companies use different methods for denying the claims and they will easily give you a solid reason for it.
The issues comes when your employees to do not pay attention towards the follow ups
All they do is submit the appeal and get another denial and show you they have done the job
With the help of the online system, you can even appeal four times and it will let them know that they have to pay the claim.
With the help of online medical billing and coding, 90 percent of your claims will be paid.
3. Improve your communication with providers
When you have to log and compile the medical bill you have to make sure that the billing system and provider company are in-step. The healthcare revenue cycle management system has given a specific code to every patient. With the help of billing tools, you will be capable of expediting this category. However, you have to ensure that you maintain and check the system regularly.
With the help of electronic billing system you will get the following benefits:
Information sharing policy
Top-notch security for data and system
You will never have to deal with virus or data hacks. It will help you to keep your contracts up-to-date with your insurance and provider company. It will manage everything from the requirements of HIPAA to billing compliance.
Guest post by Ken Perez, vice president of healthcare policy, Omnicell.
What a momentous few days in Washington were observed at the end of July! On July 25, Senator John McCain (R-AZ), dealing with brain cancer, made a dramatic entrance into the Senate Chamber and delivered an impassioned plea to return to regular order and bipartisan compromise, suggesting a process that would begin with the Senate Committee on Health, Education, Labor and Pensions (HELP) under chairman Lamar Alexander (R-TN) and ranking member Patty Murray (D-WA) holding hearings and producing a bill that incorporates contributions from both sides.
McCain’s suggestion was applauded by many senators on both sides of the aisle. The Senate voted to debate repeal and replacement of the Affordable Care Act (ACA), 51-50, with Vice President Mike Pence casting the tie-breaking vote.
The following day, the Senate rejected a bill to repeal the ACA without replacement, 45-55, and in the early hours of July 28, the Senate rejected the “skinny repeal” of the ACA, the Health Care Freedom Act of 2017 (HCFA), 49-51, with Republican Senators McCain, Susan Collins (ME), and Lisa Murkowski (AK) joining the 48 Democrats to defeat the bill. The skinny repeal would have repealed the individual and employer mandates, temporarily repealed a tax on medical devices, defunded Planned Parenthood for a year, provided more money to community health centers, and given states more flexibility in complying with ACA regulations. Thus apparently ended the Republican quest to repeal and replace the ACA, as Senate Majority Leader Mitch McConnell (R-KY) conceded, “It is time to move on.”
In the wake of the HCFA’s defeat, supporters of the ACA were euphoric, but two sobering challenges facing the U.S. healthcare system—one short term, the other long term—loom like imposing mountains.
The Short-term Challenge
The immediate concern is how to stabilize the troubled ACA individual health insurance marketplaces, clearly the Achilles’ heel of the health reform law. Health insurers continue to leave in droves, with 80 departing this past year and Anthem announcing on August 7 that it will leave Nevada’s ACA marketplace in 2018. Premiums are rising many times the growth of both the Consumer Price Index and U.S. healthcare inflation. Moreover, President Donald Trump is threatening to cut off the ACA’s cost-sharing subsidies, which work to prop up the marketplaces and shield some individuals from the premium increases. Obviously, such a move by the Executive Branch would not encourage bipartisanship.
The Long-term Challenge
Even more daunting than the travails of the marketplaces is how to bend the healthcare cost curve. The ACA has not materially slowed the growth of national health expenditures, which will rise by 5.4 percent versus 2016 and reach $3.5 trillion this year. To put $3.5 trillion in perspective, it amounts to 18.3 percent of the nation’s gross domestic product (GDP) and translates to almost $11,000 per person.
Additionally, nominal national health expenditures (not adjusted for inflation) are projected to increase by an average annual rate of 5.6 percent from 2016 to 2025, almost 1.5 times as fast as the growth in nominal GDP over the same period. As a result, healthcare costs will constitute a staggering 20 percent of GDP in 2025.
With the stalled effort to repeal and replace the ACA, Congress still must grapple with the hemorrhaging of the health insurance marketplaces and unacceptably high rates of healthcare cost inflation. Scaling these two mountains will require the kind of bipartisan compromise and collaboration that Senator McCain so passionately advocated.
Why should physicians and providers care about the possibility of a ransomware attack? There are several reasons. First, it is disruptive both to patient care and to the revenue cycle. Second, it is costly in terms of time, IT capital, and if the attacker is paid, money. Finally, the time it takes to correct the attack, implement paper charting and communication, and subsequently revise the electronic medical record system can be arduous.
To understand the necessary precautionary measures and what to do in the event of an attack, it is first necessary to identify what ransomware is and how it works. A common definition of ransomware is “a type of malicious software designed to block access to a computer system until a sum of money is paid.” A ransomware attack may target a business or an individual. The two categories of attacks are Denial of Service (“DoS”) and Distributed Denial of Service (“DDoS”). A DoS attack affects a single computer and a single internet connection, while a DDoS attack involves multiple computers and connections. According to PC World, three types of ransomware programs top the list – CTB-Locker, Locky and TeslaCrypt.
A common question that arises is whether or not to pay the ransom in order to have the data returned. The FBI advises not paying the ransom, advice that has been echoed by statistics.
“Kaspersky’s research revealed that small and medium-size businesses were hit the hardest, 42 percent of them falling victim to a ransomware attack over the past 12 months. Of those, one in three paid the ransom, but one in five never got their files back, despite paying. Overall, 67 percent of companies affected by ransomware lost part or all of their corporate data and one in four victims spent several weeks trying to restore access”
This leads us to the best ways to defend against an attack, as well as steps that should be taken if an attack occurs.
Proactive steps include: educating employees about social engineering, phishing and spear phishing, continuously making sure that software updates are installed, creating a layered approach to security defenses, limiting access to the network, making sure that policies and procedures are comprehensive and updated, and ensuring that data is backed up daily.
According to FBI Cyber Division Assistant Director, James Trainor, “These criminals have evolved over time and now bypass the need for an individual to click on a link. They do this by seeding legitimate websites with malicious code, taking advantage of unpatched software on end-user computers.” Hence, recognizing the avenues that cybercriminals use to gain access and taking appropriate administrative, physical, and technical precautions can reduce the risk of an attack.
As the healthcare landscape evolves, today’s community health providers are in a unique position to design new care delivery initiatives that can support healthier individuals, families, and communities, powered by adopting innovative technology tools. According to a study on factors influencing healthcare service quality, published in the International Journal of Health Policy and Management, healthcare outcomes are enhanced when patients and healthcare providers collaborate in a supportive environment.
Care coordination is a vital component in improving the delivery of patient-centered healthcare and social services. This is especially true for high-risk populations, such as those going through transitions of care and those who belong to certain populations. Transitions of care include the time period around hospital discharge or transfer to a new healthcare setting, such as a long-term care facility or home health. These transitions leave at-risk patients vulnerable to loss of continuity of healthcare.
Populations requiring additional considerations include homeless, children in foster care and patients who over-utilize the emergency department for non-emergencies, to name a few. The goal of care coordination for these populations is to anticipate needs, collaborate with all providers of services, and to coordinate the wide array of health, social and supportive services for each group. The main goal is to improve the quality of care while avoiding costly hospital admissions and re-admissions.
To help optimize critical coordination efforts, technology solutions can help the entire care team of providers in various locations collaborate across the care continuum, raising awareness of an individual’s physical, behavioral, and social factors and driving whole-person care. Organizations like Community Health Partnership (CHP) – a Colorado Springs-based collaborative of local health providers – aim to align many care management activities throughout the community.
Here are some strategies healthcare providers and organizations should consider when designing innovative care delivery initiatives:
Throughout the technological age we are currently living in, the advances in medical technology have gone far beyond what was once considered possible. Thanks to the introduction of the Internet and smart phones, information has become more readily available then ever before. Social media platforms have also made it possible for us to personally connect with people across the globe. These advances have shaped the way medical field has stored and held information. Medical providers are increasingly realizing the advantages of switching to electronic heath records (EHRs) as opposed to traditional pen and paper patient records. EHRs allow patient records to be more readily available, allowing for better office efficiency and patient relations.
The Old: Provider-centric EHR Software
However, patient convenience is still a factor within EHR technology that needs improvement. In today’s society, it has become the expectancy to be able to find information on the go at the touch of our fingertips. This is especially true when the information they are in search for is relevant and relates to them. Unfortunately, EHR features have become focused on billing and coding, as opposed to being more patient centric. This is a result from physicians being typically paid based on the exams and procedures performed during an office visit. Physicians need their software to document complex billing codes to ensure they’re properly paid.
It’s Time for EHR Software to be Patient-centric
It’s time EHR vendors stride towards the next evolutionary step to becoming patient-centric. This problem can be solved by following the lead of an outside innovator in sharing and viewing information about individuals: Facebook. Facebook is the front-runner for social media platforms, and their results show. Facebook is the fourth most valuable brand in the world; so clearly, there is something about this technology and interface that people appreciate.
Guest post by Gavin Robertson, CTO and senior vice president, WhamTech.
As technology continues to permeate healthcare in different ways, it is becoming increasingly important for providers to have access to the data generated and retained by these technologies. With insurance providers, hospitals and clinics using a variety of electronic health records (EHRs), patient portals and databases, it can be difficult for all providers to have access to all relevant and most recently updated patient information. Differences among EHR vendors and systems make data access, sharing and interoperability nearly impossible.
Interoperability is a hot topic in healthcare today. Healthcare providers want to move beyond conventional Healthcare Information Exchanges (HIEs) that generally exist as single application to single application (P2P) data formats. The HL7 standard data model has helped a lot, but (i) it is too complex and extensive for full adoption, (ii) it is, typically, a specific relational or hierarchical implementation, requiring additional transformation, and (iii) there are a number of implementation variations.
Regardless of the improvements associated with the HL7 standard data model, the challenges facing interoperability remain; in that (a) multiple vendors have multiple ways to represent common data, (b) data may be required from more than one application and associated data sources, (c) poor data quality, (d) there may be no unifying view of data from one or more data sources, e.g., single patient view, and (e) there is no ability to write back to/update data sources.
HL7-based FHIR (Fast Health Interoperability Resources) APIs is a recent attempt to standardize access to data sources, but most vendor systems are nowhere close, as it is a different way of representing data from most vendor data schemas; i.e., object vs relational data representation. Also, some FHIR APIs need access to multiple tables in a single data source or in multiple data sources.
To implement FHIR APIs, one approach is to convert between the data source schemas (relational, hierarchical or flat) and the FHIR object model on-the-fly, but it does not address other shortcomings (poor data quality, no federation and lack of master data management (MDM)/single patient view). Another approach, which improves on just converting formats, is to copy and transform data into FHIR-friendly data stores and enable data services on top. However, this introduces additional problems, including latency, security, privacy, no interactivity; e.g., no write back/update to operational systems, additional storage and systems, and time and cost to implement.
Regardless of the approach, FHIR APIs open up interoperability and raise capabilities to new levels. New workflows can be developed and run using simple power end-user applications, such as BPM, reporting, BI and analytics tools. Examples include new smartphone app-driven BPM workflows running against FHIR API services, include write back/updates, on multiple legacy data sources in multiple organizations. Another example being hybrid cloud installations where multiple data sources are both on premise and in the cloud.
Guest post by Sean Hughes, EVP managed document services, CynergisTek.
Healthcare has spent a significant amount of both human and financial capital addressing the security of their environments over the last several years – but have we forgotten a major vulnerability?
Printers and print-related devices (e.g. copiers, fax machines, scanners, etc.) continue to be a major component of our infrastructure and a big part of our clinical and business workflows, yet in most organizations, they continue to represent a gaping hole in our defenses. The advent of the EHR has not equated to the perceived reduction in print, but rather some research shows it’s responsible for an 11 percent increase in print in healthcare over the same time as the implementation of this technology. This increase in print volume brings with it an increase in the number of devices required to process the paper.
The approach most organizations have taken related to the security of these devices falls into one of two categories: segmentation of the network or reliance on manufacturers for “secure” devices. These approaches vary significantly from the approach most organizations have taken for other endpoint computing devices and leaves an organization open to the possibility of negative outcomes.
The industry has seen an increase in the computing power of these devices (e.g. internal hard drives, scan to file or application, residual data on devices, mobile printing, USB-enabled device access, etc.) and the bad guys are aware of this. More and more we see stories in the news of print devices being used as entryways for bad guys to circumvent our protections and put our data and our organizations at risk. According to an article published by BBC News in February 2017, “Hacker Briefly Hijacks Insecure Printers,” a hacker was able to access more than 150,000 printers that were briefly left accessible via the web.
The most effective way to address this threat is to treat these devices no differently than all our other data endpoints, be it a desktop, server, or any other piece of infrastructure. We need to look at these devices and ensure they meet the same security standards.
The most effective way to mitigate risks starts with knowing what the risks are. The first step should be a comprehensive printer fleet security assessment that is part of your overall security program. This can be accomplished either through your internal processes or by engaging a competent third party. Either way, you need to know what you don’t know, and you need to know it now.
The results of that assessment will drive the remediation efforts as well as define the ongoing measures our organizations should take. These steps will be directly related to the vulnerabilities identified but will most likely fall into the following categories: