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.
Thanks to technological innovation, more and more healthcare facilities are now adopting the use of electronic health records (EHRs). Patients now have more opportunities to consult with their physicians about their medical records. Increased access to EHRs also means that providers will now be able to easily share patient information with other providers. The goal of increasing access to medical records is to improve the continuity of care, as well as enhance patient safety.
As more patients are able to access their records, they can impact the accuracy of the information contained within by asking questions about their medical information, by identifying inaccuracies in the information and also by giving additional information that may be useful in improving the correctness of the data. Incorporating feedback from the patients themselves implies that patients indeed do play a crucial role in improving the quality of information in their medical records.
The rewards of keeping up with your medical records are quite obvious.
First, it is the best way to ensure that your physician understands what you communicate to them. It is also a good way for the doctors to ensure that they understand what you communicate. Even though the benefits are clear, many people are often reluctant to request for their medical records. Worse still, countless individuals out there do not know that they can. Every individual is entitled to complete access to their chart from any medical facility that has ever dispensed care.
Not only are you obligated to share more information with your doctors, the information that you give makes a difference in how you respond to the treatment prescribed. Accurate information improves your chances of complying to the therapies prescribed successfully, which will consequently allow you to recover and heal in the shortest time possible.
What is contained in your medical records?
There is a difference between your official medical records and the scribbled notes that are typically handed to you after a consultation. Most scribbled notes simply contain a generic outline of your symptoms and a short prescription often written in a code that many individuals cannot understand. These, are not your medical records.
Your official medical records contain all the juicy details of your medical journey; your lab results, physician’s notes, the past and present allergic reactions and reactions to medicines, blood pressure stats and basically anything that concretely makes up your entire health profile.
At the beginning of their existence, electronic health records (EHRs) were primarily used as a document management system. Now, they have realigned their objectives and value to the physicians and practices they serve, to focus on data intelligence. If specialty practices want to stay independent they need to continue to evolve, prioritize value-based care and stay profitable. Moreover, they need the right partners to help enhance operational efficiency, increase patient engagement and achieve better clinical outcomes. As such, the scope of the EHRs responsibility for the practice’s health, growth, and sustainability has increased exponentially.
How will specialty practices ensure their future? By leveraging the power of clinical and operational data in their EHR and supplemental business applications, working together within the healthcare IT (HCIT) ecosystem. Businesses across all industries analyze data to measure overall industry performance. Metrics are the foundation for any successful business and physician groups are not excluded. Metrics should be the driving force behind every major decision that will boost productivity. However, physicians are not data scientists, but by utilizing the next generation HCIT systems, they can employ technology that will streamline the decision making process.
Challenges turn into opportunities
According to the Centers for Medicare and Medicaid Services (CMS), 171,000 physicians who did not collect and use data to comply with government regulations are looking at a three percent Meaningful Use penalty in 2017. Coupled with a new focus on value-based care requirements playing a critical role in care and outcomes, upgrading their data platform and capabilities should be the number one priority to comply with new industry standards. Data driven HCIT solution providers can prepare specialty practices for these coming changes. They help collect and analyze data to ensure effective treatment plans at lower costs.
Bottom line: This helps improve patient health and satisfaction.
Today’s HCIT systems are considered business tools that help physicians analyze data and reveal insights to use for enhanced decision making. Popular “big-box” HCIT systems try to be all things to all providers, yet they are tailored to hospitals and primary care physicians—many who typically see far fewer patients in a day than specialists. This puts a major burden on specialists, who rely on different clinical and operational data to help maximize outcomes.
Specialists potentially see up to 60 patients a day – and cover surgeries, follow-ups and everything in between. Generic HCIT systems fall short in relation to appointment volume. Combined with the fact those systems make data entry inefficient, impede clinical workflows, and lack business metrics, this is the major argument for specialty-focused HCIT solutions. Some groups acquired by hospitals or health systems have not adopted the integrated systems of their new parent companies. Instead, they stay with their specialty HCIT systems—interoperable with their parent companies’ technology—because of their ability to serve existing, proven workflows.
Data insights and a workflow makeover
Specialty HCIT systems that analyze a variety of data and provide practices with the knowledge to improve their performance will deliver the best outcomes for patients and practices. Analyzing operational data provides an understanding of how to deliver the best patient care at the lowest cost, thereby delivering optimal outcomes and increasing patient satisfaction levels.
Specialists should take the opportunity to re-evaluate their EHR and determine if their goals are helped or hindered by their current HCIT ecosystem. A productivity-boosting HCIT system can harness the power of data to deliver clinical and business applications, workflows, and insight through one user interface and make compliance with reporting requirements simple and straightforward.
Owning and running a practice doesn’t come without its barriers and certain difficulties. That’s why the selection, evaluation, purchase, and integration of a medical software system that is right for you and your practice is of innate importance. Having the correct software system will let your practice run more efficiently and effectively, all while adding to your bottom-line.
Choosing Medical Software that is Perfect for Your Practice
There are several variables to keep in mind when deciding on a software system for your practice; not the least of which are the initial financial investment, overall upkeep and maintenance costs, and the quality of technical support.
A good characteristic to look at when deciding on a software system is comprehensive integration, with data seamlessly connected and shared between scheduling, billing, and electronic medical records. In order to see a rise in efficiency in your day-to-day procedures and routines, your data should be instantly accessible, both onsite and remotely, and formatted to be easily read.
Now let’s talk budgeting: It’s important to properly calculate your practice’s current financial standings so you can have an idea of the system that is right for you. Software options can either be purchased directly or leased to purchase.
Practices will be able to identify outstanding transactions, which will result in more efficient strategies for both collecting income and preventing loss of income.
Track Patients More Efficiently and Increase Productivity within Your Practice
Another element to running a more successful practice relates to maximizing patient workflow and staff productivity. The importance in tracking your patients cannot be understated, and utilizing the right software system is the essential step towards tracking patients most effectively and increasing overall staff productivity within a practice.
As owners of a practice, two things that can be intrinsically frustrating are patient “no-shows” and lost revenue from canceled or missed appointments. Well, utilizing scheduling software can help track and manage your patient’s appointments to avoid these situations from ever happening again. Managing this data under the right system can promote management strategies that can foresee patient trends so practices can plan accordingly. For example, a practice can provide reminders or alerts to those patients with a history of canceling or missing appointments to maintain patient volume.
These medical software systems also have the ability to verify patient eligibility the day they come in, or even before whenever their appointment is scheduled for. Obviously this drastically reduces wasted time within your staff and increases time for patient care, resulting in a far more efficient practice.
Organize Clinical Data with Ease through EHR Integration
Now to talk about clinical reporting within your practice. Organization cannot be easier and more efficient when utilizing a software system to help manage your practice. Below are some practical techniques that can help you see large benefits within your practice:
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.
Advances in technology have fundamentally altered and inarguably improved the way we drive, shop and travel. Just ask anybody who uses Google Maps, Foodler or Uber.
Sadly, however, information technology has failed to deliver so far in the most crucial service of all – healthcare. This is at least partly because electronic health records (EHR) systems grew out of the computer systems that run the hospital’s inner workings — patient scheduling, admission and discharge, staff payroll and accounts receivable. For system designers, physicians’ needs were an afterthought, which is problematic because physicians are, after all, the linchpin of the healthcare delivery system.
To begin pulling healthcare IT out of the past, we must first take a look at how it supports physicians. The short answer today is “not well.” In fact, EHRs are creating as much frustration as benefit. Problems include poor presentation of patient data, fragmented information sources and unwieldy user interfaces that require dozens of mouse clicks or screen taps. It’s no wonder more than half of physicians who responded to a recent survey claimed their EHR system had negative impacts on costs, efficiency and productivity – three things IT should help, not hinder. These issues not only affect physicians’ professional satisfaction, they contribute to the phenomenon of physician burnout, which is a growing concern across healthcare. Studies show some 30 percent of primary-care physicians age 35 to 49 plan to leave medicine, and there’s an expected shortage of 25,000 surgeons by 2025. A Mayo Clinic study released earlier this year directly connected the burnout problem to physicians’ use of EHRs.
Today’s EHRs have done little more than “pave the cow paths.” We’ve gotten rid of paper in the hospital and made processes electronic, which is why EHRs can legitimately claim to have reduced transcription errors. But eliminating paper is just table stakes; the critical next phase is to do for healthcare what Uber has done for transportation: Reinvent the process so it’s optimized for and native to the technology that enables it.
Patients and physicians can and should advocate for such change. Today, patients have access to a vast body of information—the notes a doctor took, quality of care rankings, the level of personalization provided—and it’s only going to increase. As Lygeia Ricciardi, former director of the Office of Consumer eHealth at ONC said, “Getting access to personal health information is the start of engaging patients to be full partners in their care.”
Why do so many small medical practices give up a significant portion of their earnings to outside billers? Depending on its geographic location, volume of billing, and other factors, a practice will pay an average of seven percent of its total revenue to a biller, which could be the difference between profit or loss, maybe even success or failure.
In many cases, the reasons given are that no one in the office has experience with medical billing and the physician doesn’t believe a small staff can handle the added burden of work. But if you dig a little deeper, these assumptions are often wrong.
As a developer of electronic health record (EHR) and practice management (PM) software for small practices, my company hears a lot about billing directly from physicians and staff. We’ve learned exactly who does the billing and how they do it once a practice starts using a PM system for the very first time.
In one case, a medical assistant was able to learn everything he needed to know about billing from the PM product training alone. That’s because the physician specializes in podiatry, so the practice uses a limited set of billing codes. With a relatively light patient workload, this Medical Assistant has more than enough time to handle billing functions during normal office hours.
At another practice, when a gynecologist questioned her staff, she learned that her receptionist was eager to start doing something else, preferably from home so she could care for young children. The receptionist became certified in medical coding at a local community college on her own time, and now uses the PM system remotely and visits the office once a week every few weeks.
In a third practice we know, the pediatrician himself shares the work of billing with two of his part-time staffers, who welcomed the extra hours of pay. One staffer had knowledge of billing from a past job, while another was eager to learn. They all handle billing together as a team, so there’s no burden on any single person.
Guest post by Susmit Pal, healthcare strategist, Healthcare & Life Sciences, Dell EMC
Aging populations and the rising incidence of chronic disease consume a disproportionate amount of healthcare resources. In the United States, about 75 percent of healthcare dollars go to chronic disease care and two out of every three Medicare recipients suffer from at least two chronic diseases. The pressure for relief will grow as the population ages with approximately 10,000 new patients estimated to enroll in Medicare every day for the next 15 years. The current demand for resources for chronic disease care combined with the imminent spike in Medicare enrollment beg for achievable solutions and strategies that address costs, care quality and outcomes in the short term.
Enter the Internet of Things (IoT), also referred to as the Internet of Medical Things (IoMT) within the healthcare industry. IoT is something that most are well-familiar with, but for the sake of clarity, we define it here as the purposeful connection of intelligent sensors, devices, and software to computer networking systems using Bluetooth, Wi-Fi, RFID or M2M wireless technology in order to promote an inter-functionality that serves a greater purpose. In healthcare, that greater purpose is the achievement of less costly and more information-driven and efficient patient care. Think wearable devices and wireless pill bottles, nanotechnology and ingestibles, and network-enabled medical devices like stethoscopes that can transmit cardiac data directly into a patient’s electronic health record (EHR).
The Impact on Chronic Disease Management IoT shows great promise in helping to improve the health of patients with chronic conditions. Combinations of remote monitoring, analytics and mobile platforms have repeatedly cut re-admissions of high risk patients with congestive heart failure (CHF) by more than half. Evermore affordable and easier-to-use devices, such as wireless scales and heart rate and blood pressure monitors are improving overall wellness for the chronically ill. In fact, some researchers estimate that the value of improved health in patients with chronic disease using remote monitoring could amount to $1.1 trillion per year by 2025.
At the consumer level, the rapid increase in the type and variety of personal mobile fitness trackers like Fitbit®, and online fitness applications for consumers demonstrates comfort with IoT to monitor physical health. Their very existence has created an avenue for patients to become more accustomed to tracking and managing their health online. In response, healthcare organizations are beginning to incorporate them into their consumer engagement strategies, while payers are starting to offer discounts and incentives tied to wellness management.
IoT is also helping to spur on some rather exciting new technological advancements in chronic disease management. Connected wheelchairs, for instance, are enabling people with disabilities to engage with care providers on a whole new level, communicating health alerts to care teams and repair notices to manufacturers. A group from the University of Missouri is spearheading a development project to utilize home monitoring sensors in an effort to prevent falls among the elderly by providing alerts to the patient when there is a fall risk, while Dell Healthcare is working with hospitals to leverage the use of tablets with integrated card readers to enable remote healthcare for home-based treatments.
There exists an even greater potential for IoT to impact chronic disease management at a population-level when combined with data analytics. For instance, Health Net Connect (HNC) has initiated a population diabetic management program with the intent to improve clinical outcomes and healthcare savings for diabetes, one of the deadliest and most costly of chronic diseases—and the results are impressive. They captured vitals and blood work from study participants over a 6-month period to measure the impact that routine teleconferencing and patient monitoring had on outcome. Patients in the program showed a significant decrease in key biomarkers, including 9.5 percent lower HB A1C and 35 percent decrease in LDL. To put that into perspective, for every 1 percent drop in HB A1C they estimate an $8,600 annual savings, and for every 1 percent decrease in LDL there is a 1 percent decrease in coronary heart disease, which costs on average a million dollars over a lifetime. HNC is continuing this program, noting that “this project has, and currently is demonstrating return on investment with cost savings, improved access for program members to their physician, improved clinical outcomes, and improved knowledge by program members on their disease condition.”
Is there an unspoken fear among caregivers that the subtext of all this digital disruption is a devaluation of the human element?
In countless industries, workers and analysts alike watch the slow march of technology and innovation and see as inevitable the takeover of human tasks by robots, AI, or other smart systems. We watched as the threat of outsourcing transformed into a reality of automation in industrial sectors, saw drones take on countless new roles in the military and in commerce, and now we hear about how driverless cars, self-checkout kiosks, and even robotic cashiers in restaurants are all waiting in the wings to dive in and displace even more formerly human occupations.
And looking at how EHRs — by virtue of their cumbersome workflows alone, not to mention all the documentation and growing emphasis on analytics and records-sharing–are taking flack for burnout and frustration in hospitals across the country, it hardly seems a reach to suggest that maybe America’s caregivers are feeling not just burdened by technology, but threatened.
Digital records are already changing what doctors and nurses do, how they work, and what is expected of them — it must surely be only a matter of time before their roles start getting handed over to the robots and supercomputers … right?
Change, Not Replacement
While some jobs or roles may face elimination through automation, the more common effect is transformation. In healthcare, that may mean that for many their title is the same — perhaps even the education and certification standards that go along with it–but their actual functions and roles in context will be different.
We see this already with respect to EHRs. The early, primitive documentation workflows and reporting obligations have drawn ire from clinicians who see their autonomy under attack by digital bureaucracy. But this is naturally destined for correction; medicine has advanced through trial and error for centuries, and the 21st century is no different.
All of these trends point to the medical lab as a newly central component of the modern care center, treatment plan, and information hub. The demands all these new technologies and applications put on laboratory professionals requires them to do more learning, adapting, and leading than ever before, especially to integrate the latest and greatest devices and tests available.
Simply put, machines are still fallible, and require assistance in providing critical context, to supplement their ability to accurately read, diagnose, and self-regulate to ensure accuracy and consistency, not to mention proper application in the clinical setting.
It seems increasingly disingenuous to frame health IT as being “revolutionary.”
For one, digitization has already swept nearly every other industry. The iPhone was a revolution in communication, but after generations of iterations and imitations, smartphones are normal, and consumers have adjusted their expectations accordingly.
To bring electronic health records (EHRs) into American hospitals and clinics is less a revolution, and more a remediation. That arguments continue over whether this upgrade will prove practical, valuable, or beneficial to patient care and clinical outcomes at all reflects that this evolution has been a top-down endeavor, rather than a true bottom-up transformation.
Despite rhetoric–and plenty of earnest optimism–the EHR rollout has been incremental, administratively-guided, federally-mandated push toward adoption. It has been a crawl toward process improvement more in the mode of Six Sigma than a grassroots “reset” button on the fundamentals of healthcare.
The true revolution–the one that patients and caregivers alike desperately need–is not merely technological, although technology may be our next best hope for realizing it.
A Mental Problem
Healthcare needs to unify behavioral and physical health, treatment, and discourse.
While physical medicine is climbing the next hill with respect to primary care provider (PCP) shortages, interoperability quagmires, and meaningful use (MU), behavioral health is facing the same primary challenges it has since well before health IT became such a hot topic.
Namely, recognition as a legitimate and necessary component of whole-person wellness and medical treatment.
But on both the side of care providers, and patients, physical health has been rigidly siloed away from behavioral health. Even EHRs have been shoehorned through America’s hospitals while behavioral health clinics have been barred from accessing incentive money. Their exclusion from the development table means fewer solutions and platforms exist at all for those facilities and caregivers who want to embrace digitization, because developers have been preoccupied with MU compliance.