By Abhinav Shashank, co-founder and president, Innovaccer.
Consider a situation where healthcare is not just an industry term — a situation where EHRs are not an integral part of physicians schedule but just a support to providing care. All considered, imagine a situation where patient-centric care actually involves the patient, and patient engagement is not just a buzzword but a reality. Unfortunately, all these imaginations were supposed to be a reality, but still, healthcare managers and organizations are struggling with the problems such as the lack of patients’ adherence to medication, varying trends in the population health, and a lot more. Patient population, nowadays, expect the same on-demand delivery convenience from the healthcare organizations as they get from the other companies, like Netflix.
Why is Patient Engagement the Core of Providing Patient-centric Care?
To understand the value of the patient in the entire care continuum, let us take an example. Consider a patient, Marcus, who works at an IT firm and is affiliated to a Commercial ACO in his county. Marcus is a 65-year-old male suffering from comorbidities like Type 1 Diabetes, and diabetic retinopathy. He is at constant risk of sporadic elevated blood pressure.
In the year 2016, Marcus visited the ED approximately five times. Considering the situation, his primary care physician referred him to a specialist and prepared a schedule comprising at least two monthly visits.
The year 2017 started with a lot of workload for him at his firm, and he was unable to keep up with the prescribed schedule. Because of improper communication between his PCP and him, his physician was not able to keep track of Marcus’s health. As a result, the ED utilization rate for Marcus increased from five times to nine times. Because of enhanced stress and improper quality of care, the sporadic episodes of elevated blood pressure turned into a constant problem of hypertension. Also, the overall cost of care for Marcus increased drastically.
Challenges in Achieving True Patient Engagement
Patient engagement, in itself, is not as simple as ABC. It is not just bringing patients in the cycle of care continuum but enhancing the patient’s skills, ability, knowledge, and most importantly, willingness to participate in the task of managing his own care. The concept of providing care with “engaged patients” sounds great theoretically, but it is not that smooth sailing. According to a survey, nearly 87 percent of the patient population believes that communication with their doctor apart from their scheduled appointments is really important.
The major flaw is the lack of awareness among the patients regarding their care procedures. Many patients are ignorant of the clinical processes which a physician follows, and they might miss out on major health details. With no actual knowledge of the disease symptoms, patients might not report to their physicians which might lead to reduced patient engagement, not to mention the increased risk of developing a chronic disease.
Care teams play a vital role in engaging the patients through regular follow-ups. Irregular and fragmented workflows of care managers and lack of personalization might lead to the generation of ineffective care plans for the patients. Reduction in patient engagement could also be the result of under utilization of technologies to analyze the massive amount of patient data that care managers have at their disposal. Through building more personalized care plans, patients can be engaged at a more grass-roots level.
Driving Effective Engagements through Value-based Care
Predictive population health analytics is the answer to nearly every problem linked with patient engagement. Advanced predictive analytics tools will help in dealing with the problems of disparate data systems and can pinpoint the exact area on which healthcare organizations can focus. Leveraging the insights obtained by data analytics, care teams can prepare the statistical models to prioritize each patient and can take necessary measures to engage patients in the process of decision-making. Understanding the patients’ habits by the care teams increases the chances of preparing personalized care plans for them and enhancing the level of patient satisfaction.
Intiva Health is the first truly integrated career platform for healthcare professionals. It redefines the medical credentialing process by making it faster, more efficient and more secure.
Intiva Health provides healthcare professionals with a single place to manage their credentials,continuing education, new job opportunities, secure messaging needs and more. It is built on the Hashgraph digital ledger platform, which means it is faster, more secure, and more error proof than blockchain.
Intiva Health was founded in 2006 as a staffing agency for surgical services and emergency rooms. Today the Austin, Texas company it has reinvented itself as a digital health startup featuring a next generation blockchain technology that cuts the time it takes for the medical credentialing process from months to seconds, improves HIPAA compliance,and makes document tampering or theft almost impossible.
Intiva Health focuses its marketing and PR efforts on licensed medical professionals (LMPs), practice managers, and the facilities where they work including medical groups, hospitals and professional associations.The company launched a new brand awareness campaign in March 2018 that included the introduction of the Intiva Token, a new cryptocurrency that LMPs can use to purchase continuing education classes, cyber insurance and other services.
Intiva is also partnering with the National Osteoporosis Foundation to test the advantages of using the IntivaToken for charitable donations.
The Intiva Health Platform automates the burdensome tasks of credential and licensure management, continuing education, and discovering job opportunities for healthcare professionals. Intiva Health’s new ReadyDoc™credential verification solution, built on top of the Hashgraph distributed ledger technology, disrupts the existing broken, slow, and error-prone healthcare credentialing system, which today can take weeks or months to verify credentials, and is subject to tampering.
Intiva believes that ReadyDoc can replace the current processes of credentialing and primary source verification by storing documents and credentials in a Hashgraph-based distributed ledger. Providers and facilities can obtain information that is pre-verified, securely stored, and readily available, creating an ongoing, self-auditing verification of provider work history and clinical reputation.
ReadyDoc will act fluidly between health systems and facilities across the U.S., allowing organizations to instantly verify work history and clinical reputations. In the event of an emergency like the Houston hurricane, facilities will be able staff up by vetting the credentials of qualified providers instantly. ReadyDoc eliminates redundancy and the need for third party verification organizations, letting medical professionals get to work sooner.
Unlocking the genomic code to usher in a new era of medical technology.
The core Shivom team came together after numerous meetings at blockchain and genomics conferences. During these, we frequently reached conclusions on how to solve the current issues in the medical domain, by combining the bleeding-edge of blockchain technology with genomic sequencing.
The fuel that powers the Shivom platform is community involvement. We aim to forge meaningful partnerships with medical groups around the world, which can then interact directly with the Shivom blockchain and its users.
Shivom’s target audience? Everyone. Big data analysis requires big data sets, and in the case of the platform, the more users having sequenced and uploaded their genomic data means that there is a larger pool of information to draw from. Of course, a large part of the offering is the secure storage of this information is securely stored, and the individuals to whom it belongs can choose to monetize it by allowing access to innovators in the medical space.
Who are your competitors?
There are few competitors in this space – somewhat reassuring, as our vision is to unite players in the medical field. However, Nebula is a blockchain platform also occupying the genetic niche.
How your company differentiates itself from the competition and what differentiates Shivom?
Simply put, Shivom is a blockchain storage and analytics platform for genetic information. On top of its core functionality, it also enables users to profit from their data by sharing it with institutions.
Differentiating it from similar projects is its magnitude – a global reach and a unique classification system for genomic ID. On the roadmap are integrated AI protocols for in-depth insights.
Shivom is still in its infancy, although we anticipate that, in moving forward, revenue will be generated by pharmaceutical companies wishing to use data in their research. Additional revenue will stem from a range of apps and services (to glean insights on one’s uploaded data) and the sale of sequencing kits.
Babyscripts is a virtual care platform for prenatal care powered by mobile apps that drive better patient decision making, IOT devices for remote monitoring, and a host of population health tools to give providers access to patient data in real time.
It seems unlikely that two childless bachelors, with no healthcare experience, would start a pregnancy company, but Juan Pablo Segura and Anish Sebastian founded Babyscripts, now the most impactful digital health tool in the obstetrical market. In 2014, with a passion to improve the current healthcare system due to family health struggles, business savvy, and the tenacity to succeed, these two former Deloitte consultants found themselves in front of the Chair of Obstetrics at George Washington School of Medicine & Health Sciences, Dr. Nancy Gaba, which started the journey of Babyscripts.
Babyscripts sells to health systems, private practices, and payers to support women’s health initiatives in pregnancy care. Babyscripts is then delivered by a care provider to an expectant mother at the beginning of her pregnancy. It is deployed through risk-specific modules that are tied to the clinical/social risk of a patient at the point of care.
Each year, 4 million babies are born in the United States. Babyscripts works with the providers of care for these pregnancies – health systems and private practices – to support better access to care and better quality of care. Currently, nearly half of the counties in the United States don’t have access to an OB-GYN, according to the American College of Nurse-Midwives. The American Congress of Obstetricians and Gynecologists estimated that in 2020, there will be between 6,000 and 8,000 fewer OB-GYNs in the country than needed. Babyscripts is the only clinically validated tool that allows doctors to automate aspects of care, enabling there to be greater efficiency in the workflow, enabling doctors to touch more patients in a meaningful way.
Who are your competitors?
Our competition can be categorized in a few areas:
There are Consumer Maternity Apps in the market (ex. What to Expect, BabyCenter, The Bump)
Payer focused apps and programs for maternity (Wildflower Health, Ovia Pregnancy)
Non-Obstetric based clinical apps (ex. Wellpass, Vivify Health, Conversa Health)
How your company differentiates itself from the competition and what differentiates Babyscripts?
Babyscripts is the only platform that connects the clinical provider and patients together using technology, while at the same time lowering the cost of care. By including the provider and all of their guidance, specific information and advice into the equation, it ensures that a patient is getting information that aligns with her provider’s care plan, while keeping engagement high. Additionally, Babyscripts is the only clinical tool that is singularly focused on solving obstetrical problems.
In 2017, a new type of pill bottle was invented that could save $300 billion and 125,000 deaths a year. This is the estimated cost of people forgetting to take their medication. Remembering to take your daily prescription is difficult for anyone, but for people living with decreased memory function, it can be almost impossible.
Not doing so can slow down the recovery process. Technology is now helping to send reminders to take the medication and to keep track of a patient’s dosage intake. This is set to save both lives and money, meaning a win for everyone involved. The addition of internet capabilities to everyday objects is known as ‘the internet of things’ and it could revolutionize the healthcare industry.
The cost of missed prescriptions
For people with serious heart conditions or neurological concerns, medication is essential to their continued well-being and recovery after surgery or other medical procedure. It really is a matter of life or death for many to ensure that they remember to take their prescription pills. The human cost of missed prescriptions is estimated at 125,000 deaths a year.
Then there is the cost to the economy. Pills are a cost-effective way to prevent serious conditions before they arise. If you forget to take one, then you may require additional and expensive medical support. This is estimated to cost $300 billion each year.
What are smart pill bottles?
Many use smartphone reminders to give a daily alert letting the user know that it is time to take a pill. However, this can happen when the person is out and can’t access their pills until later, by which time they may have forgotten. Smart pill bottles have internet capabilities built into them, so they can monitor when the lid is opened and whether a dose has been taken.
This means that the bottle is always aware if a pill is due to the user and can continuously offer reminders. This is simple technology, but this is exactly why it is so effective. Anyone, regardless of tech knowledge, can use this and over millions of cases, it could make a substantial impact.
Smartphone app solutions
Unfortunately, smart pill bottles aren’t yet widely available. However, if you are taking prescription medication and own a smartphone, there are other steps you can take. Apps, such as Patient Partner, are designed, not only to offer reminders but to offer education as well. Understanding why taking pills is so important can help you to remember. It is easy to forget to do something as simple as throwing a pill in your mouth; an action which has no immediate effect and so appears somewhat irrelevant on the surface level. These apps are free to install, easy to use, could make a huge difference in the life of someone who regularly needs to take medication.
By Helen Waters, executive vice president, MEDITECH.
What would you do if you won the lottery? Regardless whether or not you play, you’ve surely pondered the question. Recently, during the frenzy around one mega jackpot or another, I had an interesting conversation with a friend. She told me if she were to win she’d replace everything she owned with the “very best” version of every item. When I asked how she’d know a product was the best, she told me she’d simply choose the most expensive option. In her thinking, she would have money to spare, and buying the products with the highest price tag would guarantee high quality. She admitted she might spend a little more than necessary, but she’d be able to afford it.
My reaction—which I didn’t express quite so bluntly—was, how wasteful and misguided!
As Americans we like to think that the market, uncorrupted by human influence, effectively sets prices for products and services that are in line with their value. But there are many reasons that markets don’t always work this way, particularly in the complex world of healthcare.
The more I thought about it, the more I realized that this kind of thinking guides some of the ways we make purchasing decisions in healthcare. Many patients, for example, feel that brand-name drugs must be superior to their generic counterparts—even when clinical trials demonstrate comparable effectiveness—simply because they’re priced higher and accompanied by persuasive advertising. Patients often lobby their physicians for expensive tests or procedures that have little to no evidence of efficacy for their conditions. And yes, even in our industry, otherwise-savvy executives can spend much more than necessary for healthcare information technology.
Over the past decade, the cost of electronic health record software and services has skyrocketed, far outpacing inflation and becoming untethered from real value. It’s understandable how this began, as the ARRA and HITECH Act infused cash into the market along with strong incentives to adopt the technology (as well as disincentives for falling behind). But those days are long gone. Hospital margins have continued to shrink. To the best of my knowledge, no healthcare facility has won the lottery lately.
Whether you’re buying a new appliance, a new car, or a new EHR, it’s important to do your homework. Look at the data. Perform a real comparative analysis. This means more than simply perusing marketing literature, conducting feature comparisons, or reviewing anecdotal feedback. It means looking at outcomes. Unlike many other products, software is abstract. You can’t touch it or see it to assess its value. You need to evaluate the impact it has and the satisfaction levels of the organizations that use it.
Just like a good physician wants to see evidence of the benefits of a drug, procedure, or care protocol by evaluating patient outcomes, healthcare executives must demand proof that an EHR is improving clinical and financial outcomes at organizations like theirs. Some important questions to ask:
Federal healthcare organizations, such as CMS, have spent billions of dollars over the years trying to bridge the gap between medical data and quality patient care with interoperability requirements and data integration, the mesh used to try and bridge the gap. Many government rules have been written to address the type of mesh needed and many EHR companies have claimed to meet these government requirements and claim the throne of the ultimate mesh maker.
However, hospitals and clinics found the mesh contained many holes, such as enabling hospitals to customize EHRs, but only if the EHR customers purchased the EHR systems for the manufacturers for millions of dollars that hospitals could ill afford. Also issues such as proprietary connectivity to their own brands that left the hospitals’ other EHR systems to serve as dead-end data silos. Rules and solutions came and went, but few had any teeth until now.
Anyone for A Slice Of PI?
To end the lack of interoperability morass and data duplication, the Department of Health and Human Services (HHS) issued 1,883 pages of proposed changes to Medicare and Medicaid. The changes rename the Merit-Based Incentive Payment System (MIPS) Advancing Care Information performance category to Promoting Interoperability (PI).
CMS announced the change as part of a proposed rule that will transform the EHR Incentive Programs commonly known as meaningful use under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The proposed policies are part of the MyHealthEData initiative, which prioritizes patient health data access and interoperability improvements.
But this time the name change wasn’t just that. For the first time a new CMS rule specifically requires providers to share data to participate in the life blood of hospital reimbursement—Medicare and Medicaid. The rule also floats the idea of revising Medicare and Medicaid co-pays to require hospitals to share patient records electronically with other hospitals, community providers and patients — a clear-cut demand for interoperability.
PI also reduces hospital interoperability requirements from 16 to six, revamping the program to a points-based scoring system and is requiring that hospitals make patients’ EHRs available to them on the day they leave the hospital beginning in 2019.
Does Your EHR Have the Right Stuff?
While this news from CMS appears to be a step in the right direction to solve a problem that has plagued the healthcare industry for many years, it must first be made a reality by those ultimately responsible for its implementation—hospital HIT organizations. The days of data obstruction and silo logic must end with a focus on new EHR markets built on interoperability.
Interoperability requires multiple layers to demonstrate an EHR system can be accessed. Meanwhile, every EHR system claims to support some form of interoperability, ranging from web interfaces to API protocols or to the lowest and highest cost HL7. However, healthcare systems will have to demonstrate their operability to CMS to abide by PI and therefore allow access of their EHR systems. Hospitals and clinics can encounter many challenges with this, such as HIPAA compliance and support for their infrastructure for open secure access, requiring an HIE and the funds to support data synchronization and IT support.
With digital information flowing from countless sources, including electronic health records (EHRs), wearable devices and digital maps that monitor global disease outbreaks, the healthcare industry is taking a big data approach to improving patient outcomes and enhancing the daily lives of countless others.
Yet one large part of the healthcare ecosystem isn’t efficiently capitalizing on the vast amount of data that is right at their fingertips: hospital operations. Many leaders and line managers are unable to take advantage of the readily available data sets from the billions of dollars invested in IT systems that would allow them to improve operational efficiency and provide an exceptional level of care. Instead, they rely largely on spreadsheets and back-of-the-envelope math along with first-hand experience to make critical daily operational decisions, such as scheduling operating rooms and reducing emergency department boarding.
Some hospitals have recognized that driving growth starts with superior planning and optimization. These forward-thinking facilities are leveraging their data using a hospital operations management software platform to revolutionize the operational and financial performance of various parts of their organization including ED, inpatient, perioperative and clinics.
The result? Higher resource utilization, better quality of care, satisfied employees and increased revenue.
Tap existing data resources to create growth
The OR suite’s multifaceted nature makes it extremely difficult to optimize for overall efficiency. As a result, millions of dollars are wasted each year. Still, it’s a primary financial driver for most hospitals and presents one of the largest opportunities for increasing profit margins through operational improvements.
In efforts to improve services while reducing expenses, perioperative leaders have been dependent on consultants, manual spreadsheets, and trial-and-error experimentation, leading to results that are often inaccurate, time-consuming, and have significant lag time to understand impact. These traditional methods should be abandoned.
Hospitals must embrace new analytics software platforms to deliver a practical application of analytics to the business of healthcare.
Predictive analytics utilizes the data gathered from existing EHRs, bed management, case management systems and external sources (such as weather) to quickly and easily see the potential impact of scheduling, staffing, and case mix changes. It empowers hospital leaders to develop optimized block and OR schedules that are easily managed and automates the staff planning and assignment process, all the while complementing traditional time and attendance systems.
At a time when hospitals cannot afford to mismanage valuable resources, analytics prevent costly trial and error and help hospitals overcome operational shortcomings in their perioperative suite. By testing “what if” scenarios, facilities can predict and manage the impact of operational changes for little expense or exposure.
Analytics software programs demonstrate measureable impact in OR operations. Impressively, analytics enabled a nonprofit medical center in Boston to increase its annual OR volume by three percent and improve utilization by more than five percent, resulting in an annual revenue increase of more than $3 million. And in New Jersey, a regional medical center used analytics to improve its OR utilization to 71 percent and improve labor productivity by 10 percent.
So you are having some difficulty deciding between cloud-based and client-server based EHR software – don’t worry, you are not alone. If you look at them side-by-side, they both certainly have their ups and downs. The determining factor ought to be how your practice operates.
Let’s go through some of the benefits specifically of cloud-based EHR software to help you better get a sense of its benefits in operation. If it so happens that these benefits seem fruitful for you and your practice, then you might just have your decision made.
First off, utilizing cloud-based medical software, can make managing your software and keeping up with the changes in the medical realm that much simpler. Aside from that view, let’s look at it from an internal perspective, and how it can promote efficiency within your practice.
Installation fees are non-existent when it comes to cloud-based technology. There aren’t any servers or physical systems to install on-site. Therefore, cost is minimal to start with. Limiting headaches that come with the installations at your practice can be a pro in it of itself, but lessening costs along with that are two great benefits collectively.
As many may already know, servers can crash as they are physical pieces of hardware. Cloud-based systems don’t have that issue. When you are dealing with problems, you won’t have to contact someone to come out and take a look at your system. Cloud-based EHR can provide instant updates, resulting in less headaches and worry when having to deal with any issues you may be having.
There is a growing interest among healthcare organizations to leverage actionable analytics solutions to derive valuable insights from data. Advanced, AI-driven predictive modeling is working to build healthier populations that meet the demands of value-based care, and new digital experiences are reaching providers and patients through a diverse array of touchpoints. Digital health solutions, driven by new and emerging data sources, are creating a unique combination of high-touch care management complemented by automated, virtual care.
This digital transformation in healthcare is being driven by the changing nature of the healthcare landscape, as well as the demands from consumers for more say in their care. The healthcare industry is making significant investments in IT to engage and empower patients, enable caregivers and improve operating efficiencies. However, the industry is also facing pushback from the caregiver community, with many physicians feeling that interacting with an EMR reduces their productivity. Physician burnout and unrealized expectations from technology investments have created a mood of caution in digital investments.
However, the digital transformation wave is still coming, since the proven patient health benefits, as well as industry improvements, are simply too great to ignore. Given the abundance of software-driven tools, technology professionals face the crucial task of integrating applications and data among the various players in the healthcare ecosystem including doctors, hospitals, government, device makers, insurers, employers, pharmaceutical companies and patients. Seamless transitions of care between these constituencies, however, are still a major hurdle, and positive patient experience is decided by the totality of patient care carried out by all those — both within and outside — of a health system. Shared processes between clinical entities are only possible if the data can journey smoothly from one system to another.
The problem today is that there is over-engineering in healthcare with overlapping and rich data standards and formats, and implementations that stay locked tightly in proprietary strongholds.
How to Make Interoperability Work
It is imperative that digital transformation initiatives focus on interoperability and integrations through well-defined application programming interfaces (APIs). APIs are designed so that systems with validated credentials can query and access systems widely available on the internet. Systems are then designed to respond to queries from programs with data that is machine-readable.
APIs deliver the ability to securely and efficiently access repositories of big data from wearable devices, social media, curated public datasets, research, and episodic care. They are the key to better understanding patients’ financial, social and behavioral context, and through predictive and prescriptive analytics can reveal trends across populations and micro-populations. With the explosion of disparate technologies, it will be about connecting them all quickly and efficiently to gain a competitive edge in healthcare.