Data Mining: How to Protect Patient Privacy and Security When Using Data

Now that electronic health records have become the norm, healthcare providers — as well as healthcare systems and insurers — have access to unprecedented amounts of patient data. As a result, the practice of data mining, or analyzing data sets to identify trends and patterns, has become commonplace in healthcare, with the ultimate intent of improving patient care, improving efficiencies in the delivery of care, and reducing costs. Simply put, data mining has the potential to save lives and save money, but that doesn’t mean that it isn’t without risk.

As you might expect, using patient data for any purpose beyond providing care for the individual patient brings with it some tricky issues regarding privacy, and keeping the information from falling into the wrong hands. There are significant legal issues related to the use of patient data in data mining efforts, specifically related to the de-identification, aggregation, and storage of the data. Failing to take the appropriate steps when using personal health data as a tool for population health could lead to serious consequences, including a violation of HIPAA.

The question, then, is how to protect patient privacy while still gaining the insights that data mining can provide.

Protecting Patient Privacy for Data Mining

One of the major security concerns related to data mining is the fact that many patients don’t even realize that their information is being used in this way. Considering the way in which mined information can be used, this is of concern to many privacy advocates.

For example, in one noted example, Carolinas HealthCare, which runs more than 900 care facilities in the southern U.S., has purchased consumer data on more than two million people, which they use in algorithms to determine the risk for illness. The data includes purchase information collected from credit cards and consumer loyalty programs, as well as public records, to determine which people are at the most risk of getting sick. Providers can potentially use this information to remind patients to visit the gym more often, or encourage them to stop eating so much fast food. Other hospitals have used general demographic information about home and vehicle ownership or family makeup, to gain insight into a patient’s health and well-being, as well as identify potential barriers to care.  However, what sets this type of data mining apart from healthcare data mining is that it’s data collected via other sources, and therefore not covered by HIPAA rules.

Still, many patients who have been contacted as a result of this type of data mining have noted that the practice feels intrusive.  Even more intrusive is the potential for their personal health data to be used in this way, especially without their permission. Under HIPAA rules, data mining is a secondary, future use of health data, and thus requires the explicit permission of the patient before being used.

By the very definition, data mining is the process of looking for previously unknown patterns in data, so there is no way of knowing from the beginning what data is useful, or what relationships will be uncovered, meaning that there is potential for identifying information to be used or revealed. This highlights an important consideration when it comes to collecting and using personal information for data mining: Permission from the individual. Privacy advocates recommend offering patients the option to opt-in, opt out of specific uses, or opt-out entirely.

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Important Tips to Successfully Implement CMMS in Your Healthcare Facility

Guest post by Lindsey Walker, marketing manager, NEXGEN Asset Management.

Lindsey Walker
Lindsey Walker

Running a healthcare facility is a herculean task even with the most experienced staff. Most studies on the state of healthcare industry decry the high cost of equipment maintenance and it is also the greatest challenge that every hospital administrator deals with. Breakdown of hospital equipment can lead to fatalities and this is why you need to leverage preventive maintenance software to avoid legal issues and costly repairs.

Computerized maintenance management system (CMMS) will help reduce hemorrhage of hospital revenues through unforeseen equipment breakdowns. This system is used to schedule preventive maintenance at the healthcare facility thus avoiding downtime of the machines. With this software, all of the hospital’s assets are tracked and monitored and all of this information is presented on one single dashboard. As the facility manager, you have instantaneous access to information about the condition of all the equipment. With such access to information the maintenance procedures are easier to execute, which saves the institution from financial loss and also improves the quality of patient care provided.

To appreciate why you should invest in such a maintenance system, consider the folowing benefits:

Improved Patient Care

The patients are the top priority in a healthcare facility and as such all efforts should be directed towards providing quality care. By adopting the CMMS software, you will have preventive measures in place in case of equipment failure. The health of patients is in your hands and situations such as power outages and equipment failure must be averted, as they can result in fatalities. You are able to come up with contingency plans in case of emergencies and the system also helps in case of evacuations. By providing for real-time communication between members of staff, this software improves the level of service offered at the facility.

Improved Asset and Inventory Management

A vast healthcare facility receives lots of supplies daily, and these are crucial in offering appropriate health services. Tracking all these supplies manually is very tricky and tedious, but with an automated system you can keep track of what is available and what needs to be replenished, quite easily. You can also monitor which departments are consuming more supplies and make relevant decisions based on such information. This system also helps you keep track of the equipment in the facility. If there are any due repairs, it is easier to alert the concerned parties to avoid downtime.

Risk Assessment

A hospital environment provides unique challenges and risk assessment is crucial to avoid accidents. The best maintenance management software also enables you to assess the potential risks in any project and equipment. By receiving such information beforehand, you are able to preempt any risks and avoid accidents. You can also carry out quality safety inspection to ensure every department is prepared for any unanticipated risks.  Continue Reading

Interest in Alternate Payment Models Remains Steady

Guest post by Lea Chatham, editor, Kareo’s Go Practice Blog.

Healthcare providers continue to face new and growing challenges across the marketplace. From the release of the MACRA final rule to the consumerization of healthcare, there is a lot to balance and manage. It can be hard to keep up while also trying to provide quality care and get paid. As a result, providers continue to look at alternate payment models according to a new survey from Kareo and the American Academy of Private Physicians (AAPP).

The survey shows that 25 percent of practices are now using some kind of direct pay, concierge, or other membership model in their practice. This number stayed steady from the 2015 study to the 2016 study. Most do not have all their patients on one of these models, but 30 percent have completely transitioned their practice. The results show that many practices are testing these models while still offering patient other options like traditional fee-for-service. This may suggest that physicians want to see how successful the models before shifting their entire practice.

Another 35 percent of providers say they are considering a change in part or in whole to an alternate model like direct pay or concierge. The reasons are consistent with the results from the 2015 survey. The top reason cited was to separate from the insurance payer system, closely followed by spending more time with patients and improving work/life balance.

The survey indicates that those physicians who do switch see improvements in those areas. Physicians using direct pay, concierge or another membership model spend more time with patients, see fewer patients each day at longer visits, and work fewer hours than their fee-for-service counterparts.

This infographic shows the details of both the differences and the similarities when physicians use private pay models versus fee-for-service models.

Healthcare’s New Mobile Age

Guest post by Edgar T. Wilson.

Edgar Wilson

Mobile technology is impacting every element of American healthcare–from insurance and billing to documentation and caregiving, the impacts are being felt. The truly transformative element of the mobile revolution is not the technology itself, or the way it changes the look and feel of the tasks it affects. Despite complaints of the depersonalizing effect of technology, the ultimate value of mobile in the sector will be how it enhances and encourages communication.

Providers are Going Mobile

Already, flexibility and functionality have already drawn providers to mobile devices and solutions. Voice-to-text technology and similar automated solutions are in the offing to relieve the documentation burden that has dampered some amount of enthusiasm toward digitization. Bolstered by these advancements, caregivers will go from subjects of their EHRs to masters of patient encounters.

One of the huge benefits of mobility — as opposed to simply being networked on desktop computers or having a digital health records solution — is the capacity for greater native customization and app development. Native apps are like the currency of the mobile, smart device world providers are entering. Developers can deliver personal, branded interfaces that allow doctors to choose precisely how they want their dashboards to look, giving their EHRs a custom touch that has been sorely lacking throughout their implementation.

App-centric development will further reduce the friction of adoption and utilization, giving doctors a sense of empowerment and investment, rather than the bland inertia that has carried digitization thus far.

The personalization of the technology through app development will help boost adoption, and return the focus to what the technology enables, rather than how it looks or what it has replaced. Mobile technology’s strength will be in reconnecting doctors and patients, and creating bridges of data and communication across the continuum of care.

Patients are Going Mobile

Patient-facing health apps and mobile point of access to care combine convenience and cost-saving with a learning curve. Increasing the visibility of EHRs through mobile portals gives patients greater reason to develop some basic health literacy, and levels the playing field during doctor encounters. The more providers use mobile solutions, the more incentive patients will have to do the same.

When apps are connected to prescription management and can monitor adherence to treatment plans, mobile devices provide a two-way mirror enabling doctor and patient to remain connected long after the encounter is over. This can allow providers to better anticipate and intervene where drug abuse is at risk, as well as to prevent ED admissions and re-admissions beyond what telehealth has been able to achieve.

Even without connecting providers, mobile health apps will also support personal health management, with an eye to prevention as well as education. From diet-planning to workout tracking and even disease management, patients have more ways than ever to study their bodies and better understand their unique wellness needs. As providers and their EHRs evolve to integrate mobile patient-generated data, the potential for customization will make each encounter more conversation-driven, using data as a platform to educate, engage, and advance communication.

All these personal, data-rich conversations will help push prevention and population health into front of mind for a generation.

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Healthcare “Digitization”: Integrating Health Tracker Device Data in the Healthcare Enterprise

Guest post by Joel Rydbeck, director, healthcare technology and strategy, Infor.

Joel Rydbeck

Healthcare is undergoing rapid “digitization” – a move toward an integrated ecosystem of mobile applications and data exchange that integrate consumer data into the enterprise. For healthcare, this could enhance patient engagement and enable care to become more efficient and “real time”.

Nonetheless, moving to a more digital healthcare enterprise presents a series of challenges:

We’ve all visited a doctor and been asked “How are you sleeping?” and “Are you getting exercise?”. If you are among the growing number of people with a fitness tracker, you may think, “Hold on, I have that recorded”. So, you pull out your mobile phone and respond “I am getting six to seven hours of sleep a night and about 11,000 steps a day. Is that good?” While your doctor may understand your quick synopsis of the data, imagine if they were getting the data real-time. Would they know what to do with it? What if it contains disturbing trends? It would be unfortunate if crucial information wasn’t put to good use. But how?

Interactions like these prompted Washington University’s Olin School of Business and Infor Healthcare to collaborate on improving the usability of personal tracker data. This collaboration included conducting a small survey of 39 physicians from a broad spectrum of specialties asking their thoughts about the use of tracker data for clinical care.

The survey uncovered differing views on what information would actually be useful, showing:

The survey also asked providers what factors would enhance their likelihood of using tracker data for patient care. Majority would like to see better integration with their electronic health record (EHR), more patients using the devices, and additional data, such as blood sugar, being collected.

Physicians reported lack of education as a barrier to effectively using the data. About 50 percent believed that education, in the form of a short presentation or discussion, would be useful while 31 percent thought that a short guide would suffice.

While two-thirds of providers were open to discussing personal trackers with their patients, they did express concerns in using the data for care. The data must be proven accurate before physicians will place trust in it. Inconsistent or inaccurate data could lead to unnecessary anxiety and possibly harm. Also noted is that extraneous data can clutter the EHR and complicate patient care. Many of the providers mentioning drawbacks to using device data stated that the devices might work best as motivational tools for patients. More study towards interpreting tracker data for clinical use is needed.

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How IT Will Transform Healthcare In the Coming Years

Guest post by Vlad Kostanda, CEO, Adoriasoft.

Vlad Kostanda

Healthcare is one sector where information technology is yet to be exploited to its fullest. Medical science has gained a lot from computers and information technology but healthcare is still being run mostly without it. The basic healthcare process entail the patient thinking something is wrong with them and going to a doctor. It depends too much on people’s own observances and not enough on science. Our medical equipment has gotten better and we are able to cure and manage more diseases than before but the basic healthcare regimen is still the same. That will not be true for many more years because healthcare is slowly starting to embrace information technology.

The biggest roadblock for technology in healthcare is that failure is unacceptable. In most other areas you can afford some mistakes or errors. Sometimes your Netflix doesn’t load, sometimes your phone may drop a few calls, perfectly acceptable. The same cannot be afforded when it comes to healthcare. So while we are not happy that IT is not being full used in healthcare right, we are happy that we are focusing on ensuring everything works perfectly before implementing it in a medical setting.

Health monitoring will save lives and change how we communicate with doctors

The diseases that most people die of are perfectly curable or manageable. Even most cancers are curable – as long as they are caught in time. That is why so many people still die from cancers. You can have cancerous growths in your body and not show any symptoms. By the time people get in front of an oncologist it is often too late to fully cure their issues. This is also why the deadliest cancers are also the ones that are the hardest to detect. There’s a special type of gallbladder cancer which doesn’t exhibit any symptoms until it metastases. Aside from cancers there are many other diseases which can be reversed in the beginning. Many forms of diabetes as well as heart problems can be reversed if caught early simply through diet and exercise.

Another problem is that people do not know what symptoms to be worried about and often do not go to doctors because they don’t realize what is wrong with them. We can’t blame people either; only doctors know what symptoms to be worried about and it takes them a decade worth of education to reach that level. We cannot expect people who did not pursue a medical education to instantly realize that something is wrong with them. There are many simple things which indicate big problems as well. Things like fatigue and a lack of desire to eat seem like just one of those things that happen to everyone sometimes, but they can be symptoms of serious illnesses as well.

Sensors and trackers will capture medical information in real time

All this is about to be changed thanks to information technology. Medical sensors are already a consumer product but they are limited. Products like Fitbit have been available in the market for years but they only measure basic vital signs such as pulse and the amount of exercise you are getting. As we get better at making sensors smaller we will soon begin seeing similar devices which can monitor many other things in our bodies and let us know if anything is wrong. These devices are proving to be quite popular as well; in this year’s Consumer Electronics Expo there were 32 new health monitoring products unveiled by companies like HTC, Philips, Samsung, and Intel.

Another huge application of such devices is providing vital information to doctors. Doctors need your medical history in order to make the correct diagnoses. Since most of us do not know what is medically significant we aren’t very good at self reporting what is wrong with us. Medical sensors, trackers and mHealth apps will be able to tell doctors exactly what has changed in our bodies and when the changes started. Doctors will have more information about our bodies than ever before which will allow them to make more accurate diagnosis than ever before. The devices will also be connected to the internet and will be able to contact emergency services when needed. Heart attacks, seizures, accidents, anything that requires immediate medical attention will automatically hail an ambulance to your location. This is huge because a big problem is ensuring that people who live alone get the medical help which they need without needing there to be someone else in the room with them to call 911.

Preventive care will get the focus it deserves

There’s a big problem with the way we treat the healthcare system in the world. We focus a lot on curing diseases but do not focus on preventing diseases. We came to this system not because we are stupid – it was just the most viable way to do things. We only begin fighting diseases when people come to the doctor because that was the only way we had to detect a problem. Now, thanks to the developments in information technology, we will soon have the means to focus on preventive care properly. There are already sensors which can tell you if there are any harmful gases or particles in your home.

Such monitoring devices will get more advanced and become a great way to detect diseases earlier and will allow us to prevent them completely. Imagine getting a notification on your phone that goes “You have consumed 10 tablespoons of sugar and 500 grams of fats per day for the past month. Continuing this pattern will cause many diseases and medical problems. Would you like to switch to a healthier diet?”. Information technology will give us the ability to detect problems as they are being formed and fix them. This will also substantially lower our medical expenses. The effects of such monitoring and its aid for preventive care are mind boggling. Ever year more than 3 million skin cancer cases are diagnosed; most of these could be prevented just by ensuring that people do not spend too much time out in the sun. Cardiovascular diseases are the leading cause of death in the developed world, more than all the cancers combined. Yet, most cardiovascular diseases can be prevented entirely through diet and proper exercise.

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The Future of Health Informatics in 2017 – And Beyond

Kyle Martin, content coordinator, Florida Polytechnic University.

Kyle Martin

The impact of the digital revolution is widespread, but arguably few industries have felt the impact more than the health informatics field. From medical mobile applications to vital-monitoring wearables, smart technology is taking the health care world by storm and remodeling patient care delivery.

Over the years, health informatics has strengthened provider-patient relationships and empowered patients to take control of their health care. But that’s just the beginning. Here’s a look at how health informatics will take shape in 2017 and continue to be one of the most promising fields for STEM careers.

Improving Patient and Hospital Information Security

Cybersecurity is top of mind for health care specialists as the world grows increasingly reliant on technology. From large retail chains to voting polls, cybersecurity breaches are on the rise. And hospitals are no exception. Earlier this year, a hospital in Kansas reported a cyber attack in which the hackers forced the hospital to pay a ransom in exchange for unfreezing their data.

Understandably, hospitals are desperately seeking new ways to improve the security of their data. Hospitals are addressing vulnerabilities by making security a part of their existing governance, risk management and business development initiatives. By building more secure network infrastructures and educating all staff, hospitals are able to better protect their information in the short term. In the longer term, it will come down to hiring more security specialists to identify and correct security threats. This is why the cybersecurity field is taking off and more individuals are earning cyber security degrees to gain entry into the field.

Decreasing Healthcare Costs in the Long Run

Before things get better, they tend to get worse—and that seems to be the case with healthcare costs. At first, the cost of health care will rise as hospitals and physicians’ offices purchase and implement new systems. But once the upfront cost has been covered, these new systems and machines will decrease operational costs for hospitals by simplifying daily processes.

On the other hand, individuals seeking health care will see the long term benefit thanks to the increased efficiency of electronic health records (EHRs). Since EHRs provide a comprehensive overview of health history, it will become easier to identify potential health risks and administer treatments early on with fewer doctor visits. Early detection and diagnosis is key to lowering health care costs and, ideally, making us a healthier population.

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How the ACA Changed Healthcare Analytics

Guest post by Syed Mehmud, associate of the Society of Actuaries (ASA), MAAA, FCIA, Wakely Consulting Group.

Syed Mehmud

The Affordable Care Act (ACA) produced a wealth of data from its first two years in operation. Health actuaries voraciously consumed that data, using predictive modeling techniques to solve healthcare industry problems that have never been seen before. While we don’t yet know how the ACA may change, I know actuaries will find solutions, because we thrive in the realm of the uncertain.

Actuaries have always been in the business of data. Centuries ago the work involved scanning clerical ledgers to create the first mortality tables. Today, human activity, including healthcare, is far more complex. Every two days, we create more data than was created from the dawn of civilization through the year 2000[1].

A significant portion of my recent work has involved studying ACA data, particularly deconstructing a health plan’s performance using the prism of risk adjustment.

Risk adjustment used to be a niche on the spectrum of a healthcare actuary’s work. However, since the ACA risk adjustment program is now a permanent fixture – for the time being – in commercial individual and small group markets, it is the focus of many actuaries’ every day work. Risk adjustment involves adjusting a health plan’s revenue based on a measure of morbidity of the average member enrolling with the plan. It aims to mitigate incentives to select low-risk populations, and instead re-focus the basis of competition on other factors such as quality, efficiency, and benefits delivered.

The program presents a great opportunity for actuaries to apply predictive modeling concepts on large scale data to deliver actionable insights to clients and employers. From the predictive modeling work, actuaries have learned that risk adjustment renders seemingly intuitive notions of health plan performance and profitability rather meaningless. For example, sicker and costlier individuals may have threatened a health plan’s viability in the past. But that may not necessarily be the case going forward.

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Hands-on Experience Leads to Better Data Mining

Guest post by Andrew M. Webster, MS, ASA, MAAA, Associate of the Society of Actuaries, actuary, Validate Health.

Predictive modelers working in the healthcare industry need to be one-part physician, epidemiologist, economist, and data scientist.  Because healthcare is offered in a variety of settings, by a diverse set of highly-trained professionals, it requires health actuaries to model future healthcare cost and utilization with a high degree of precision.

It also requires a hands-on approach to data-mining.

During my decade-long career in healthcare, I’ve had the opportunity to work alongside clinicians while programming at an electronic health records (EHR) company and onsite in a hospital’s skilled nursing facility. Through those experiences, I gained firsthand knowledge of patient care delivery.

Because of that experience, I can recognize a sequence of patient events and care transitions when I see them in patient data. Observing how healthcare is delivered helps non-clinicians recognize which problems are most relevant to physicians.

Most clinicians want to know how data analysis will help improve patient outcomes instead of merely focusing on short-term cost reduction. Communicating the modeling results in a way that is meaningful to physicians and integrating results into their daily workflows is essential.  While most physicians are not mathematicians, they are highly trained in the scientific method and ask insightful questions when reviewing modeling results from actuaries and data scientists.

As an example of the benefits of predictive modeling, my team helped a 20-physician independent practice determine which segment of its patient population was the most costly. By mining the practice data, we identified a specific Medicare Advantage Plan for patients with Chronic Obstructive Pulmonary Disorder (COPD).  The medical practice then used the data to redesign its discharge protocol and develop a COPD care management program to help keep patients out of the hospital, improve quality care and lower costs. The solution was effective because of the hands on approach from everyone involved.

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5 Healthcare Predictions for 2017

Guest post by Torben Nielsen, senior vice president of product at HealthSparq.

Torben Nielsen

Significant policy changes are inevitably on the horizon for health care in 2017. Though the question marks about what is next for our industry seem endless, Americans are wondering how health care costs will change, and if their insurance carrier will continue to provide them with the coverage they need. One thing we know for certain is that health care industry disruptors will continue to innovate in a way that we can’t ignore. That’s why it’s important for health plans and hospitals alike to embrace the technology that could simplify the way people interact with the health care industry.

To that, here are my five predictions for the industry in 2017:

  1. Artificial intelligence innovations will help people navigate the healthcare system.

From robots and chat bots, to increasing telehealth options, we’re expecting significant innovations in 2017 for both doctors and patients. On the hospital side, chat bots have the potential to streamline the processes that people often get caught up in when visiting their practitioner, or when dealing with insurance protocol. The chat bots of the future will be able to have meaningful conversation that will help people navigate the system, instead of confusing them. A member could say to their health plan, “I’m looking for a cheaper MRI,” and artificial intelligence can help with a more guided search.

  1. Virtual reality will continue moving into the hospital side of healthcare.

With technology like Oculus Rift and HTC Vibe on the market, people around the world are  getting used to the idea of virtual reality in health care, too, and we don’t expect that interest to die down anytime soon. Surgeons are already utilizing virtual reality to practice upcoming surgeries, and patients are beginning to see the benefits of this technology, too. For example, at the University of Southern California combat veterans experiencing PTSD are being treated using virtual reality gaming as a healing mechanism to help process trauma. As these tools continue to get smarter, both hospitals and patients will continue to see virtual reality extend into their care practices more regularly in the coming year.

  1. Personalization of healthcare technology will help data transfers happen easier.

Block chain technology has potential to help secure EHR data and health plan member information in a way that streamlines the health care journey for both the patient and the provider. Healthcare processes and experiences can feel very stifled and complicated to all parties in the system (that’s why HealthSparq created #WhatTheHealthCare!) because hospitals and health systems are sitting on so much data that is not connected or easily shared. Data fluidity is a goal for the industry, and with new applications of block chain technology, the health care ecosystem may now see data transfers and fluidity happen much more simply, giving everyone a more holistic view of health care status, options and improvement opportunities.

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