By Angela Kennedy, director of strategic operations, medical specialty societies, IQVIA.
In 2016, the 21st Century Cures Act (Cures Act) resulted in new regulations that fundamentally changed the way deidentified patient data is accessed and utilized. However, data quality and interoperability between the various healthcare stakeholders has been a major hurdle.
When it comes to implementing the Cures Act, the Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS) each must administer the law’s requirements. Therefore, each agency has released a final rule over their respective jurisdiction.
Information blocking is a primary focus of the ONC final rule, which also requires that developers certified by the ONC Health IT Certification Program must have standardized Application Programming Interfaces (APIs) and implement Fast Healthcare Interoperability Resources (FHIR) technology, enabling individuals to access structured electronic health information securely and easily.
These advancements will only make information sharing easier. The CMS Interoperability and Patient Access final rule also focuses on API interoperability, requiring federal payers to make provider directory information publicly available. Specifically, it encourages interoperability and patient access to health information.
In a major step to ensure open sharing of information, the ONC introduced the US Core Data for Interoperability (USCDI). Since ONC is the certifying body for EHRs, providers must be prepared to transition to a new “Cures Edition” version of its software before the end of 2022.
What is USCDI?
USCDI encompasses a standard for data creation, a set of defined data classes and elements that Electronic Health Record (EHR) vendors must be able to provide. This creates an expectation for open and free access to healthcare data by industry stakeholders, including physicians, insurers, labs, registries, and the patients themselves. CMS requires that payers share the USCDI data they maintain with patients via the Patient Access API and with other payers via the Payer-to-Payer Data Exchange.
While some organizations have used APIs to aid the exchange of data, experts in the healthcare industry have been aware that for a truly free and open data exchange to work, modern technology and standards need to be put in place. This is where FHIR comes in.
What is FHIR?
FHIR is based on a new iteration of Representational State Transfer (REST) designs, which uses HTTP to enable the exchange of information between applications. That means if two applications adhere to the standards outlined for REST technologies, it makes it easier for two applications to exchange and manage healthcare data regardless of how it is stored. Not only do these applications now speak the same language, but FHIR has also created categories for certain healthcare interactions to further refine the data exchange by making it easily identifiable within each system.
Throughout history, there has always been a sort of reverent mysticism surrounding healthcare providers. Oftentimes, the patient would turn to their doctor – a person who, curiously enough, might not have had extensive healthcare knowledge working with live individuals – with their chief complaint in tow. Then, following their appointment and the revelation of their concerns, they would blindly follow the recommendations offered by the medical professional, without questioning it.
These days, however, the dynamic between the patient and the doctor has largely shifted. In turn, this allows for both remarkably enhanced communication and considerably superior treatment outcomes, especially when compared to just a mere decade or so ago. While there are a vast myriad of reasons that can be attributed to this change, it’s fair to attest that technology has been a driving catalyst for these emerging developments.
Gone are the days when patients lacked the resources to cross-reference any healthcare advice, and with doctors focusing on bolstering their own training and understanding through continued education (CE) coursework, we’re starting to see a marked improvement in this interaction. And no doubt, as this change continues to proliferate and spread across a wide range of healthcare fields, we can hope to see satisfactory outcomes across the board.
A Focus On Communication
In many ways, the methods that different social groups employ to interact among one another can be traced back to the application of their own unique languages. The healthcare sector is no different. While most doctors in the Western world do speak English with proficiency – albeit with a hearty dose of Latin sprinkled throughout it – it can still come out as a foreign, jumbled mess when the words meet the patient’s ear.
Even when the healthcare provider themself is sincerely trying to speak slowly and enunciate in the exam room, it’s far too easy for the message to become convoluted in their discourse. Technology, however, is striving to change this gap in interpersonal linguistics. For instance, if a diagnosis is uploaded to a patient’s portal, they can peruse it at their own leisure and even research it extensively during their downtime.
Electronic health records (EHR) are also making it easier for patients to follow up on any prescribed treatment options, affording them the ability to break down acronyms and lofty language into layperson’s speech. From there, the patient is then able to touch base with their provider and receive clarification on any questions that may have arisen following their appointment, and the doctor can just as easily respond to them.
Hearing loss has long been one of the most common health issues of all. At the very least, it is one of those conditions that will affect the majority of people in their later years. This has long been the case, and remains unchanged. But there are a lot of changes in hearing loss around the world, and charting these proves quite insightful and informative.
As it happens, hearing loss across the globe is on the increase, and as we are about to see, there are a few possible reasons for this being the case. Let’s dive into it in a bit more detail.
Hearing Loss Is Rising
In general, the world is seeing a sharp increase in hearing loss in all demographics and more or less every nation on Earth. Why this might be is hard to say, but part of the problem might be something to do with the use of devices alongside earbuds and headphones.
With these becoming more and more prevalent, and with there being a known correlation between their use and hearing loss, it’s hardly surprising that there is quite so much hearing loss these days, and that it is happening pretty much everywhere around the world.
Chronic pain is often a result of an injury or accident, but it can also be a persistent and ongoing condition unrelated to an accident or injury. In cases like these, the pain can become chronic or persist for years in some cases. Many people who deal with chronic pain often feel isolated and alone, and they do not know what to do to relieve their pain. It is not as simple as it may seem and can be a challenge to manage when it comes to chronic pain.
To manage chronic pain, compassion, support, and understanding are needed. Patients can often experience other issues compounded or exacerbated by their chronic pain or even have chronic pain related to the original ailments. But knowing the best approach for your patients suffering from chronic pain and taking the time to understand their situation can help you get the best treatment for them while supporting them when they need it.
Understanding a patient’s reaction to their chronic pain
It’s not always easy to understand why someone is experiencing pain, and it’s even harder to know what to do about it. It’s important to note that pain is subjective, and every person experiences it differently. There is no one “right” way to feel about or respond to pain, and this is why it is so important to be patient and compassionate with each person you meet with. There are a few things medical professionals can do to help patients understand why their pain is happening and help them find ways to cope with it.
Seniors, until relatively recently, might not have considered the possibility of aging in place, meaning they stay in their homes. Instead, there was often the automatic assumption that older people would move in with family or they would go to an assisted living community or nursing home.
This isn’t inherently true anymore. More seniors and their families are seeing the benefits of aging in place.
There are still programs where people can receive home care and services, but they remain in an environment that’s familiar and comfortable for them.
Technology has made a lot of this possible even though just a decade ago, it might not have been.
If you’re a senior and you hope to age in your home and remain independent, or you’re helping a loved one plan for their future, understanding the available technology can help you figure out the best strategy.
The Benefits of Aging in Place
There’s a reason staying in your home is becoming the preferred option for so many Americans.
First, you can stay in a place that’s comfortable and familiar for you. Moving can be physically and mentally stressful. For older people, it can cause more confusion, and it can also lead to mental health symptoms like depression.
When you’re in your home, even if you need some help along the way, you can also retain your sense of independence and empowerment. That’s important, and it’s key for aging with dignity and continuing to enjoy a good quality of life.
Financially, it can also make more sense. Assisted living and nursing facilities can be incredibly expensive. There are programs that can cover some of the costs of in-home care, which is almost always going to be less expensive than out-of-the-home options.
If you have grandchildren and family members who come visit you often, you might also want them to have a home where they come to and make memories rather than visiting you in an impersonal place.
An unexpected side effect of the pandemic is how the health industry quickly realized the extraordinary advantages stemming from the rapid adoption of advanced, end-to-end telehealth solutions.
In 2020, when doctors’ offices, hospitals, and other nonessential places were closed, physicians and their patients began to use telehealth solutions at a pace never seen before and not only discovered their ease and convenience, but the impact it had on their overall bottom lines.
To illustrate this point, and according to Healthcare IT News, adopting Digital health services has the potential to save $46 billion a year in health spending. Furthermore, a recent survey from the COVID-19 Health Care Coalition Telehealth Workgroup revealed that 67% of patients saw lower costs with their telehealth visits compared to in-person visits. In addition, 78% of patients believed their telehealth visit addressed their health concerns. Innovative telehealth solutions can save patients, providers, and hospitals time and money.
Now, as the pandemic hopefully continues to subside—decreased cases and providers’ offices open to in-person visits—patients will have greater freedom on doctor visits and medical care. They can schedule an appointment through traditional avenues, delve into the time-consuming check-in process via paperwork, forms, and waiting rooms, or streamline the process from familiar home surroundings with the ease and convenience of telehealth services.
Telehealth digital front doors provide patients with a seamless health journey via an array of enhanced services such as asynchronous or synchronous visits, automated symptom checkers, search tools, and even intelligent chatbots that can assist a patient in determining the best source of care based on simple question and answer surveys. Doctors can then respond by using the same platforms, creating and beginning a treatment plan for the patient.
By using a digital front door, logistics can be streamlined and made efficient by linking patients, their providers, payers, hospital systems, and electronic health records into a single connected ecosystem.
In addition, telehealth maximizes provider logistics and care to patients during moments of crisis and emergency.
Medical care marketing can be challenging. Most people try to put medical appointments out of their minds until the day of — it’s not something they aim to engage with daily.
When marketing your ophthalmology practice, connecting with and engaging potential patients is the key. Here are some powerful marketing tips to help reach your target audience and connect in an impactful way:
Having identified the existing prior authorization process as a burden with wide-ranging impacts across multiple healthcare domains – contributing to provider burnout and care delays that put patients at risk – the Office of the National Coordinator for Health IT (ONC) is seeking solutions that leverage its Health IT Certification Program to advance electronic prior authorization (ePA).
An analysis by RTI International on behalf of America’s Health Insurance Plans (AHIP) agrees that the ONC’s objective is worthwhile. Published in Evaluation of the Fast Prior Authorization Technology Highway Demonstration, the analysis examined prior authorization transactions before and after implementation of ePA and found the time between request and decision was 69% faster with ePA. Time spent on phone calls and faxes also decreased significantly, and transparency of prior authorization requirements was improved.
To help identify the best approach to leveraging its certification program to advance ePA, ONC in January 2022 solicited stakeholder input on incorporating standards, implementing specifications, and establishing certification criteria for HIT supporting providers and payers likely involved in ePA. The EHR Association responded by recommending a staged approach to establish a glidepath that enables needed flexibility and ensures availability of relevant software support.
ONC’s Reduction Strategy
Prior authorization is a complex process requiring collaboration across multiple domains within an individual healthcare organization and across potentially dozens of health plans covering its patient population. This, according to ONC, results in a process in which “diverse payer policies, provider workflow challenges, and technical barriers create an environment in which the prior authorization process is a source of burden for patients, providers, and payers; a cause of burnout for providers; and a health risk for patients when it delays their care.”
Difficulty in determining whether an item or service requires prior authorization
Difficulty in determining payer-specific prior authorization requirements for those items and services
Inefficient use of provider and staff time to navigate communications channels such as fax, telephone, and various web portals
Unpredictable and lengthy amounts of time to receive payer decisions.
ONC also noted that payers and health IT developers “have addressed prior authorization in an ad hoc manner with interfaces that reflect individual payer technology considerations, payer lines of business, and customer-specific constraints.”
Health Level Seven International (HL7) announces the Office of the National Coordinator for Health Information Technology’s (ONC’s) FHIR at Scale Taskforce (FAST) will transition into an HL7 FHIR Accelerator.
The FAST project was originally founded to identify Fast Healthcare Interoperability Resources (FHIR) scalability barriers and define a common set of infrastructure standards for scalable FHIR solutions. As an Accelerator, FAST will continue its work under the purview of HL7 with a broad range of stakeholders informing and participating in the initiative.
“As a widely adopted standard supported by many of the most notable stakeholders in the health IT community, FHIR is making rapid, real-world progress toward addressing the biggest challenges of health data interoperability,” said HL7 International chief executive officer Charles Jaffe, M.D., Ph.D. “The FAST Accelerator will bring us closer to defining a consistent and scalable approach to deploying FHIR across high-value use cases and disseminating these best practices to the industry.”
FAST will complement and support the work of HL7’s other accelerators. While groups such as Vulcan, the Da Vinci Project, and CodeX develop standards to support specific functional use cases, FAST focuses on scalability approaches that implementers can leverage across use cases to simplify deployment and use of FHIR in disparate environments.
In early 2022, FAST formed a cross-stakeholder team to begin the transition from an ONC-convened initiative to an HL7 FHIR Accelerator. The team has been working to develop a framework for the accelerator’s scope of work, governance principles, and operating and funding models.
As experts in the healthcare industry, we’re all acutely aware of how our health system falls short of consumer expectations. And the gaps in the industry aren’t new – health systems and medical providers have long spent a significant amount of time and resources addressing the barriers to patient access that cause people to fall behind in follow-up and preventative care.
For many patients, today’s healthcare experience is marked by several gaps: gaps in access, gaps in communication, and gaps in control. These disconnects are often coupled with weeks-long wait times for appointments, unnecessarily complicated payment processes, and care that seemingly operates in a silo, separated from other parts of the care experience.
This starkly contrasts with what most people (and health providers) desire in terms of care. People want their healthcare experiences to mirror their consumer ones marked by frictionless, 24/7 access, self-service, and on-demand support. They also want to feel in control of their care, evidenced by Salesforce data stating that 71% of healthcare consumers feel responsible for managing their health. However, only 23% of those respondents said they completely trust the healthcare industry has the technology to enable them to manage their own care—another gap.
While the U.S. healthcare system is a complex puzzle with many pieces, further overlayed onto a pandemic landscape, technology is one element that has the potential to effectively revolutionize care, expand access, and improve the entire patient journey. There are three core areas where healthcare providers should focus today to solve persistent gaps:
One way to mitigate a care gap is to invest in smart scheduling solutions. Solutions that offer centralized scheduling that leverage a rules-based workflow help improve patient-to-provider matching by utilizing provider preferences, sequential scheduling, and automated waitlist management. In addition, offering a self-scheduling solution to patients provides them with greater accessibility, convenience, improved efficiency, and a better user experience for both provider staff and patients. By reducing barriers to appointment scheduling, you make it easier for people to make and keep appointments which boosts patient outcomes.