By Ken Perez, vice president of healthcare policy, Omnicell, Inc.
Transparency has been a popular concept for many years. While some would call it a buzzword, the Trump administration has made it a repeated theme of several of its pronouncements regarding healthcare reform.
Executive Order (EO) 13813, “Promoting Healthcare Choice and Competition Across the United States,” issued by President Donald Trump on Oct. 12, 2017, promoted transparency by aiming to “improve access to and the quality of information that Americans need to make informed healthcare decisions, including data about healthcare prices and outcomes.”
Five months later, at HIMSS18, Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma promised “to put patients at the center of the healthcare delivery system and empower them with the data they need to make the best decisions for themselves and their families.”
And on June 24, President Trump issued an almost 1,600-word EO, “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First,” that has as its purpose “… to enhance the ability of patients to choose the healthcare that is best for them” by providing them with access to useful price and quality information, which enables them to find and choose low-cost, high-quality care. Patients will be able to compare prices across hospitals. Posting of standard charge information will apply to all services, supplies, or fees billed by the hospital, and hospitals will be required to regularly update the posted information.
Moreover, this EO mandates that the Departments of Health and Human Services, Treasury and Labor produce a proposal to require healthcare providers, health insurance issuers, and self-insured group health plans to provide or facilitate access to information about expected out-of-pocket costs for items.
The Trump administration is thus taking a consumer-driven approach to try to reduce healthcare costs. As former Rep. Ernest Istook (R-Okla.), president of Americans for Less Regulation, said, “Everything is based upon the theory that consumers would wade through the data to decide whether to seek care from different hospitals or doctors and would pay less.”
But would they? Gallup surveys have shown that Americans are increasingly feeling overwhelmed with the abundance of information. Consequently, consumers take shortcuts to ease the burden. For years, newspapers have lamented that nobody reads their stories, with most readers simply looking at the headlines and skimming a few articles. CNBC reports that about half of the visitors to its website quit after reading the first three paragraphs of a story.
By Patricia Hyle, vice president of product commercialization, StayWell.
Fast Healthcare Interoperability Resources or FHIR was introduced in 2014 as a data standard for electronic health records to adopt, enabling improved access in sharing health data. The move was predicated by new standards set for the with the passing of the Affordable Care Act in 2015 but supports the standard framework for EHR systems to ensure patient information be accessible in an effort to deliver quality care.
FHIR aims to simplify implementation without sacrificing information integrity. It leverages existing patient models to provide a consistent, easy to implement, and rigorous mechanism for exchanging data between EHR applications. This move gained ground when it earned support and adoption from Epic and Cerner, two of the largest EHR systems in the industry. With more than 80 percent of hospitals and health systems now using EHRs on the FHIR platform, it has become the standard for EHR vendors to meet ONC certification criteria.
Addition of apps to FHIR
Following the adoption of FHIR as the new universal standard operating platforms for EHR systems, the launch of SMART (Substitutable Medical Applications, Reusable Technologies) quickly followed to enable to launch of apps within the FHIR platform. When the two platforms came together it became known as SMART on FHIR, allowing software engineers and clinicians to create open-source tools for app developers.
With the addition of these plug-in apps, clinicians can pick and choose which apps they want to integrate into their EHR system. This allows apps to use the standard type of data to build profiles, deliver tools, create reminders, or share data within a fully connected set.
One example of this type of app on is Krames On FHIR. Launched in 2017, this app delivers recommended patient education materials based on inputs from the patient’s EHR record. The material also includes video resources, interactive tools, and health tips that can be sent directly to patients via the patient portal and provides a patient engagement dashboard that allows physicians to track engagement for greater treatment adherence.
Impact of consumer applications to FHIR
When SMART on FHIR initially launched, it was intended to be a set of app standards for developing apps within the closed FHIR network. The end user would be interfacing with an EHR system, and ideally the end user was a care provider or administrator in a health care setting. However, after a few years of use, more users and developers saw the potential use of extending limited access to the network to the patient.
By Karly Rowe, vice president, new product development, care & identity management, Experian Health.
This year could be the year that paved the way for a major change in the healthcare industry. In June this year, the U.S. House of Representatives voted in favor of lifting the decades-old ban on federal funding for all U.S. citizens to be given a Universal Patient Identifier (UPI), which would follow them throughout their lives.
Why is this so monumental? It’s estimated that around 30% of patient data held in electronic health records is incomplete or inaccurate, and up to half of all patient records may not be linked correctly. Unreliable patient data presents some huge problems for health systems, from flawed diagnoses and treatment errors to unreliable analytics and billing mistakes.
If the lift is approved, what could the implementation of a UPI mean for healthcare organizations and consumers?
The clinical side would see improved care
No one expects a quick fix for the industry’s challenges, but a UPI is the first critical step in improving patient identity management, with innumerable benefits for patient safety and care coordination.
If you’re not 100 percent confident about the identity and medical history of each patient who walks through your doors, how can your clinical teams be sure they’re offering the right treatment to the right patient? Without reliable records, patient safety becomes a gamble.
Identity errors would be reduced which also leads to cost savings
Patient misidentification also lands a financial blow for healthcare organizations. Healthcare organizations are suffering the costs of not having an adequate solution to accurately match patient identities and must rely on manual intervention and support, which is costly. For providers, millions of dollars are lost as the industry deals with costly errors, wasted physician time and denied claims, all of which could be reduced or eliminated if the data held for each patient was current and correct. In fact, around a third of claims are denied on the basis of inaccurate patient identification, costing an average of $1.5 million per hospital. Pharmacies also suffer the costs of an inadequate solution, estimating that as many as 50 percent of electronic prescriptions do not match to a patient record and the remediation cost is more than a dollar per record.
Patient data will be better safeguarded with integrated systems
Despite the advantages of a UPI, let’s not overlook the original worries that led to the funding ban in the first place. Concerns about the exchange and security of healthcare data are understandable. Safeguarding patient privacy is paramount, and the healthcare technology industry is evolving to provide ever-stronger identity proofing and data security tools.
Patient data integrity experts from Just Associates, Inc., a nationally recognized leader in patient matching and health information data integrity and management, will be at the 2019 Annual AHIMA Convention & Exhibit to provide insights into best practices for Master Patient Index (MPI) clean-up. During the conference, taking place September 15-18, 2019, at McCormick Place Lakeside Center in Chicago, Just Associates (Booth #2012) will also showcase IDManage, which delivers ongoing support to maintain an MPI’s data integrity without draining internal resources.
IDManage leverages both technology and Just Associates’ unique data integrity expertise to rapidly identify, validate, and reconcile duplicate records before they can infiltrate and contaminate downstream and outside systems. IDManage can deliver cost savings as high as 40%. It is the focus of “IDManage: An Innovative Approach to Ongoing Duplicate Record Management,” which takes place on September 17 at 12:15 p.m. (CT) in the McCormick Place – HIM Expert Theater Andersonville. Presented by Rachel Podczervinski, MS, RHIA, Just Associates’ Director of Identity Solutions, and the HIM Assistant Director of a large west coast health system, the presentation examines the benefits the health system has experienced from turning ongoing MPI management over to Just Associates.
“Duplicate records remain an intractable problem throughout the healthcare industry. Recently, Black Book Research projected that the typical MPI has a duplicate rate of 18%, which can cost nearly $1,200 per record in added clinical and administrative expenses,” said Lora Hefton, Just Associates’ COO and Vice President of Operations. “Just Associates offers a new approach that starts with crafting a creative, cost-effective MPI management strategy to quickly resolve numerous possible duplicate records and then delivers solutions to maintain the ongoing integrity of patient data.”
To learn more about Just Associates’ MPI clean-up services and IDManage, visit Booth #2012 at AHIMA and speak with one of the firm’s data integrity experts. While at the booth, play the “Money Tree Trivia” game for a chance to win prizes, including Apple AirPods.
There comes a time in all of our lives where we need to get our teeth checked and cleaned. As much as we dread a visit to the dentist, a visit to their office is much like death and taxes in that it’s inevitable. But then, there’s a lot more to the world of dentistry than just dentists. In fact, many different professionals deal with the responsibility of taking care of our pearly whites, all with their own specialties and reasons for existing. You might even have seen signs for one or two of them while driving around.
Ever curious what those other dentists are up to? Here’s the scoop:
This type of dental professional deals with everything related to the straightening of teeth. In practice, this is most often the installation and maintenance of braces, but jaw alignment and other miscellaneous fine-tuning of the structures in the mouth for a straighter overall look are well within the job description of an orthodontist.
Not everyone has the luxury of reaching the end of their lifespan with all of their teeth. When a tooth needs to be artificially replaced, it’s a prosthodontist you’ll be relying on. They focus on all dental prosthetics such as veneers and implants. All of these are made under the watchful eye of a prosthodontist as they work with a dental lab.
As technology continues to improve, using virtual connections in place of face-to-face meetings has surged in popularity. The healthcare industry is no different – the telehealth industry is predicted to be worth more than $130 billion by 2025. While telehealth offers many benefits to patients, particularly those who are unable to leave their homes, the technology raises several serious security concerns.
These problems primarily stem from the lack of security controls when it comes to the collection and sharing of data. During a conversation between a patient and doctor, for example, sensitive, personal patient data is often shared. When the connection between patient and doctor is virtual, it is possible that an unsecured connection could be interrupted, and patient data leaked. Home telehealth devices and sensors may also collect data that a patient would prefer to keep private, including times that the home is unoccupied. If devices are storing and transmitting this data, it is possible that it could be accessed by third parties.
These concerns have left a lingering question: how can patients still reap the benefits of telehealth while ensuring their connections and data remain secure? The answer may lie in another technology that healthcare providers have only started to adopt – blockchain.
Enabling Secure Data
Blockchain at its most basic level simply enables secure, immutable and anonymous transactions, allowing cross-network communications to take place through mutually agreed upon interactions between parties. For healthcare providers, this opens up an efficient means of transferring data and communicating between different organizations that handle patient data. Medical records can also be stored using blockchain, allowing providers to create a more complete patient history by keeping larger amounts of data and information securely encrypted in fragmented systems.
The ability to securely share data and control who has access to it will surely help to increase consumer confidence when it comes to telehealth. Blockchain requires that data is approved by both the patient and doctor before it is entered into a computer. The data must also be verified against a previous ledger, so no single party ever has total control. This ensures multiple checks are in place and reduces the chance that an unauthorized party could access sensitive patient data, which is one of the main concerns when it comes to using telehealth.
Regulating Sensitive Communications
While it offers many solutions, federal organizations have not officially decided how regulations would apply to blockchain, including the Health Insurance Portability and Accountability Act (HIPAA). HIPAA outlines rules for ensuring the privacy and security of patient data, as well as the secure transfer of data, but it does not apply to patients; ensuring blockchain users remain compliant will be the responsibility of healthcare providers.
HIPPA guidelines for telehealth require that healthcare organizations communicate electronically protected health information (ePHI) through regulated channels to ensure security. This means that tools like Skype or unencrypted email cannot be used to communicate ePHI, limiting what could be used for cost-effective telehealth.
By Kevin von Keyserling, chief strategy officer, Keyfactor.
As value-based care becomes more prevalent, healthcare delivery organizations (HDOs) are continuously looking to transform the patient care model with goals of reducing costs, optimizing patient outcomes and driving better financial performance. As new channels, delivery agencies, and patients taking greater responsibility in managing their care in the continued shift to telemedicine or virtual healthcare, digital security has become an even more important component of this evolving ecosystem.
Given the growth of connected medical devices, the potential for security lapses from release through use is considerable. While implanted devices draw the most attention, the broader universe of medical care gadgets can also warrant concern. In the U.S. alone, hospitals can average anywhere between 10 to 15 connected devices per-bed. With this kind of scale, the number of security gaps can be significant.
Medical devices that feature wireless connectivity, remote monitoring, and near-field communication technology allow health professionals to adjust and fine tune implanted devices remotely and in real-time. Devices capture and transmit data across many channels and receiving parties, but many fail to incorporate data security protocols and standards. Older devices that remain in the field may be using outdated security software. There is also significant ambiguity on who owns the data, which can result in nobody taking the lead on managing current security practices. Put these factors together and it’s easy to understand why healthcare data is highly susceptible to security failures.
Optimizing Data and Device Security
Healthcare has the highest breach-related costs of any industry at $408 per-stolen record. As patients willingly share personally identifiable information (PII) reliable controls must be in place to protect patient privacy. Every identity within an organization must be covered by layers of digital security, and the process can be broken down into smaller bites to ensure you’re setting the stage for optimized data and device security without taking everything on all at once.
Establish necessary barriers: Improve the strength of targeted devices between devices and outside threats and be aware of your device inventory always – no device should ever be left unattended! Don’t leave cell phones or laptops out in open spaces, but if you do, utilize features such as auto-lock. Ensure that all devices are locked in a restricted and secure area when not in use.
Define your security protocol: Make sure to have a regular cadence in which passwords need to be updated and utilize multi-factor authentication when possible.
For the second straight year, ransomware attacks accounted for over 70 percent of all malware incidents in the healthcare sector, according to the recently issued 2019 Verizon Breach Investigations Report. Beazley reported that almost half of the ransomware incidents reported in 2018 involved healthcare companies, while CSO Online estimates that healthcare-related malware attacks will likely quadruple by 2020.
Adding salt to the wounds, a private practice in Battle Creek, Michigan, was forced to close its doors in the aftermath of a devastating healthcare ransomware attack in 2019—the first public report of a ransomware-related business failure. Every day we read about another headline breach in healthcare.
Being in the ransomware hot seat is a lot to swallow for an industry responsible for the security of our most sensitive data. And therein lies part of the problem. Cybercriminals are always after the most lucrative targets and they have learned that healthcare providers are more likely to pay the ransom to get their patients’ data back.
CEO of A1care, Percy Syddall, a 25-year healthcare veteran who helps grow and manage businesses in the Home Care field is sharing his story to help others avoid the business disruption and financial woes caused by cybercriminals. Syddall said, “I always strive to do what is best for my clients, which includes leveraging innovative technologies and maintaining the privacy of their personal data. Still, our company was attacked by ransomware, which almost forced us out of business. The cybercriminals threatened to expose private client data if we did not pay the ransom.”
“The hardest thing I’ve ever had to do was call each client and explain that the personal information they trusted my business to protect, may have been compromised. At that time, very little was known about ransomware and I ended up paying the ransom to get my client data back,” continued Syddall.
Even though medical records contain rich personal health information (PHI) that can be sold for high value, cybercriminals are discovering they can get faster payment through ransomware. Unlike stolen medical records that take time to acquire and commoditize, ransomware locks healthcare professionals out of critical systems and demands payment or immediate action.
In healthcare, it seems that nothing is easy — technology, regulation, privacy, and security. And now, pricing. Efforts are underway to make prices more transparent; this is a tentpole issue for the Trump administration, which wants hospitals to begin posting “shoppable” prices online in 2020.
According to reports, some hospitals are facing some challenges for doing so and are trying to figure out how they’ll be able to meet the requirement.
The Centers for Medicare & Medicaid Servics (CMS) offered the proposed rule, which mandates that hospitals publish their payer-negotiated rates for “shoppable services” starting on the first of the year. This is part of CMS’ outpatient payment rule. The proposed rule is expected to be finalized by November 2019.
To read my full report on this pricing transparency battle, check out my article on MultiBriefs here.
Childhood is a funny age. If we ask you to peak in the rear view mirror of your life, what would be the first memory that you’d reminisce? There must be loads of things to look back to, and why not—it is a golden phase in a small, tiny movie of life, but this little fragment of it is unusual. It frames the rest of our life for these experiences mold us as a human being. Now the nature experiences (both good and bad) might vary from one person to another, but it all sums up our lifestyle—there’s no hiding that.
One very crucial aspect of our lifestyle, known as oral health, is something that shapes up our health and routine. We don’t just walk into adulthood and start brushing our teeth, flossing the slits, and rinsing our mouth. This habit is a result of months of routine that was bred into our veins and whisked into our daily grind by our family values and the virtue of good oral hygiene. But this was the story about when we were kids. Now that there are little ones all around us, we’ve got to teach them how to take care of their oral hygiene.
Dental health is no joke, and it has been seen that many kids with improper dental hygiene land into a sticky pool of trouble for long times to come. This problem needs to be prevented before the time comes that it has to be cured. Kids have huge issues with their teeth, and the reason is simple—it’s not a cakewalk to stop them from gluttonous food and sticky, gooey, and sugary stuff. That’s not the only problem, however, as it goes beyond that. Taking kids to the Dentist’s is crucial. They have to be comfortable about the fact that they’ll be coming to these visits now and then and anything else shouldn’t stop them—even if it is nervousness and fear of getting things inside one’s mouth.
It is essential to take kids to the Dentists. It keeps the teeth shining and wise, and these values become the cornerstone of splendid dental and oral hygiene. But that’s not the case for a child, for whom a dentist’s visit is nothing short of a nightmare. Think of it this way—a kid lying on a cold, cushiony chair, in a room full of extraordinary people wearing masks and poking, whizzing and smoking out weird instruments that look like tools for torture. These vibes are exceptional and why not—funny people, strange noises, and unusually cold sensation between the teeth.
Do you know that once your child’s teeth start to fall out and grow, you would have to take a truckload of Dentist’s visits? Every child has to take at least 10 trips (yes, 10!) before kicking off the kindergarten time because that’s when the teeth start to fall. That’s also a common reason why kids are nagging to school. But the question is, how do we take care of kid’s dental health if we do not know how to drive them into the Dentist’s chair?
Here are a few ways which ensure that your kid isn’t scared of dentists anymore and that whenever the Dentist’s date comes in, s/he is ready for the appointment with all smiles and no tears.