By Susan Yeazel, Donna Hazen and Michelle Auchter, consultants, Point B.
It’s a familiar story among healthcare payers: Their companies spend significant time and money to roll out new digital capabilities for their employees, only to have the effort fall short or even fail altogether. The reason? People simply don’t engage, adopt or use the new tools and systems as expected.
While this problem didn’t begin with COVID, the pandemic has intensified the need to solve it. With remote work likely to be part of the new normal and employees relying more than ever on their companies’ digital infrastructure, existing gaps and new needs have surfaced. The challenge is especially complex in healthcare. As digitalization increasingly shapes the healthcare ecosystem, payers are looking to integrate new digital communication tools that support their ability to play a central role across the many different parties and layers of systems they serve—including customers, providers and partners.
There’s often an assumption that employees will naturally adopt new tools and technology simply because “they’re better.” But it takes more than the promise of a ”new and improved” tool to get people on board. We help companies take proven steps to improve digital adoption in ways that boost administrative efficiency, reduce costs, retain valuable talent, and improve the customer experience, which in turn leads to business growth. As an example, a company recently launched a digital program that employees rated 4.67 on a scale of 5 as being mission critical. That same program delivered a 263 percent increase in employee behaviors considered key to success. These numbers reflect high employee understanding and buy-in—both key to successful digital adoption.
Think, plan and invest in the employee experience
Think about the level of effort your organization puts into ensuring that externally-facing digital tools or web features are a success with your customers. How do you think, plan and invest to ensure that success?
While customer experience (CX) typically steals the spotlight, employee experience (EX) is nearly always the unsung hero to ensuring that companies succeed in engaging customers and driving growth. Companies that plan and invest in digital advances with this inside-out mindset are at a competitive advantage. We find they have a few key success factors in common:
Inspired and organized leadership: This is the #1 predictor of a successful digital adoption. Leaders need to be out in front – seen, heard and enthusiastically championing the value of the digital transformation.
Thoughtful preparation: Successful companies spend time upfront to really think through how they’d like to see this change unfold. What will success look like?
Active engagement: Inspiration and open, two-way communication are essential to engage heads, hearts and hands. Leadership can do much to support teams with the tools, capabilities and campaigns to make the digital journey as fun and rewarding as possible.
Make it clear: strategy, alignment and leadership
Before employees will invest in the “how” of digital adoption, they need to understand the “why.” Leadership must share a clear vision, articulate the drivers for change, explain the rationale for timing, and illustrate the alignment to corporate strategy.
When it comes time to start a family, you need to be prepared. Aside from the initial excitement of finding out you’re expecting, you also need to think about your newborn’s safety. As soon as your baby is born, you need to ensure he or she is safe with and without you. This means being able to monitor them when they’re sleeping or when you return to work. Thankfully, technology has made it easier than ever to keep tabs on your little one.
Even if they’re only sleeping in the next room, peace of mind is important and that can come at a cost. Technology is expensive, but you have a few options. You can work on reducing monthly expenses and one way is to remove expensive life insurance premiums. You can consider cashing in a portion of your life insurance policy to provide security now. There are plenty of guides online that explain how you can sell your life insurance policy, however, you should still talk to your insurance broker before making a final decision. In most cases, you need whole life coverage in order to cash out. The specifics will depend on the type of policy you have and how long you’ve been paying into the plan.
Video monitors are changed so much since they first came out. Some are so advanced that now you can even see your baby when the room is pitch black. Some even keep track of your baby’s respirations, which dramatically reduces the likelihood of sudden infant death syndrome, or SIDS. In addition, video monitors also have sleep trackers installed, which can help you sleep train your baby when the time is right.
The prevalence of obesity and undernutrition in children is a cause for concern; around 17% of US children between the ages of 2 and 19 are clinically obese, and approximately 13% of US children are considered to be malnourished. Although obesity rates among preschoolers have been falling in recent years, overweight children are five times more likely to become obese adults, putting them at risk of type 2 diabetes, heart disease, and many other diseases which may require diagnosis and treatment by a primary care physician.
At the other end of the scale, undernutrition in children can cause stunting of physical growth and cognitive development issues; undernutrition can prevent children from reaching their full potential, and leave them more vulnerable to infectious disease. (1)(2)(3)
Technology is thought by some to be a contributing factor for childhood weight issues; here, we explore the link between some common child entertainment technologies and weight impacts:
The rise of social media, where people can present a heavily curated impression of their ‘perfect’ life, is thought by some to have a negative impact on children’s self-esteem. A 2011 study carried out by the University of Haifa found that higher levels of social media exposure contributed to increased rates of eating disorders and body image issues in young women. Researchers reported that the more time which young women spent on Facebook, the more likely they were to experience anorexia, bulimia, and unhealthy relationships with food. Clinically integrated networks can help determine an appropriate holistic treatment by connecting patients and their parents with a network of doctors in different fields. (4)
While video game addiction is thought by some to contribute to various physical and mental health issues in young people, the scientific community is conflicted about whether this is an accurate assessment. More study is needed to conclude whether video games are addictive or a legitimate health concern; however, some studies have shown tentative causation between video games and weight issues in children. The results of a Swiss study published in the Obesity Research journal indicated that for each hour a child spent playing video games, the likelihood that they were obese allegedly doubled. A recent review of 26 studies examining the link between video games and obesity reported that while 14 studies concluded no association between video games and obesity, 12 studies reported finding a link. Further research is required in this area. (5)(6)(7)
Hospital-acquired infections are a challenge to clinicians as they increase the mortality and morbidity rate. Sources of infections in hospitals include pathogens from patients, inanimate environments, and medical personnel. In any healthcare delivery setting, infection control and prevention standard precautions should be taken into account. It is everyone’s responsibility to exercise the following tips to preventing exposure and contamination in hospitals. This way, they can avoid causing unnecessary suffering and pain to patients and their loved ones.
Regular cleaning of surfaces in the hospital is among the common practices that ensure hygiene is maintained. Many people visit the hospital daily, including patients, medics, suppliers, or family members visiting their loved ones. Everyone comes from different settings where there are high chances of exposure to germs and environmental elements like dirt and dust. These are among the leading causes of infection in hospitals.
Every hospital must hire cleaning services to ensure that every surface is free of dirt. Provide clean water, detergent, and equipment to make cleaning efficient and fast. Thorough cleaning eliminates over 90% of microorganisms and bacteria by suspending them in the cleaning fluid and removing them from the surfaces.
Healthcare workers come into contact with many patients and hospital equipment as they go about their duties. They are, therefore, the most frequent drive for nosocomial infections, and hand hygiene is an ideal preventive measure. Hand hygiene involves disinfection and regular hand washing. Washing hands thoroughly with running water and soap eliminates over 90% of most or all of the superficial and flora contaminants.
When your hands are dirty, use antimicrobial soap for hand-washing to reduce transient flora, but when you come into contact with an infected patient, use medicated soap or an alcohol-based hand-disinfectant. During an operation, many gloves tear; disinfect your hands with a long-acting disinfectant before wearing gloves.
Infected patients’ isolation
Patients with nosocomial infections should be kept in isolation as a first essential measure. There are different kinds of isolation depending on the extent of risk of infection. For extremely infectious diseases, such as diphtheria and hemorrhagic fever, isolation measures are stringent, while infectious diarrhea and less-infectious respiratory infections aren’t as stringent.
Since isolation is a labor-intensive and expensive process for healthcare workers and patients, it should be adapted to causative agents and disease severity. Practice standard precautions of isolation by wearing protective equipment and keeping patients in private rooms away from other patients. Also, minimize interaction with isolated patients by ensuring they are tended to by a few medical personnel and hospital staff.
Telehealth services, health tracking devices, cloud-based electronic health records: these are just some of the healthcare services and technologies that have seen a surge in consideration and use because of the COVID-19 pandemic. Since the start of the pandemic a year ago, telemedicine alone in the U.S. increased 20-fold, according to a RAND Corporation study.
Healthcare consumers are increasingly expecting simpler, faster, and easier ways to interact with providers and retrieve their healthcare information. Healthcare organizations must evolve their IT operations to meet these patient expectations, while operating more efficiently in a digital-first world. A common denominator across healthcare digital transformation initiatives – and a key driver of efficiency – is the cloud.
However, a 2020 survey looking into the impact of cloud adoption as a result of the pandemic found healthcare solidly in the middle of the pack in terms of adoption. While 19 percent of respondents implemented or plan to implement cloud because of COVID-19, a full 22% say they have no plans to implement.
What’s the challenge to further adoption? Technology is only one part of the answer. Deciding on the right cloud provider, negotiating a contract, and having in place the proper cloud management solutions to govern cloud use are key pieces of adoption, but people and process have a dramatic impact on every organization’s success in the cloud.
Fortunately, healthcare organizations can look to familiar partners to learn how to modernize their IT infrastructure through cloud adoption: the U.S. Centers for Medicaid and Medicare Services (CMS), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH). In each case, these federal institutions focused on three areas to achieve successful cloud adoption: human-centered design, agile methodology, and training and upskilling.
The CMS modernized the Medicare Payment System by building a new cloud environment to process claims. They developed the “Blue Button” API that opened Medicare claims data to third-party developers, giving both beneficiaries and their providers a full view of the patient’s history. And they launched the Quality Payment Program that digitized documentation of value-based care quality metrics, which were previously submitted to CMS by fax and took months to return feedback and payment.
At the CDC, the Surveillance Data Platform created a one-stop location for state and local health departments to send data, where automation is used to route data to the appropriate CDC program. The National Syndromic Surveillance Program connects local, state, and national public health agencies to data from across the country, leading to earlier alerts for health events and quicker responses. And The Digital Bridge Project is piloting electronic case reporting, which reduces manual work processes and improves routine outbreak management.
Last year, the NIH made genomic data about the coronavirus publicly accessible to researchers in the cloud, allowing quick access at no cost. Its STRIDES Initiative allows NIH to explore the use of cloud environments to streamline NIH data use by partnering with commercial providers, providing cost-effective access to industry-leading partners to help advance biomedical research.
Each of these advances starts with the foundational idea that adopting new technology must put the end user experience first.
“In almost everything that we do, human-centered design is a central component and we start with that,” Rajiv Uppal, CMS’ IT Office Director and Acting CIO, said at the AFCEA Bethesda Health IT day in January 2021, Federal News Network reports.
For example, CMS’ aforementioned Quality Payment Program has a human-centered design process that engages the clinician community for whom programs and services are created. Studies gather feedback from the community on an existing design, new concept, or interactive prototype. The QPP can also explore feature use to understand any pain points or gather clinicians’ perspective on a specific topic.
The CDC partnered with the Lab at the Office of Personnel Management (OPM) for a groundbreaking pilot that paired candid interviews with struggling veterans with data to bring a different perspective to develop transformative ideas on caring for those veterans.
“Human-centered design can be deployed in big ways to address sticky issues in public health,” Leah Chan, a team member and Public Health Advisor at the Injury Center, told The Commons. “But it also can be applied in small ways to make a meeting better or engage a partner in a new way. It’s making sure that we are putting people at the center of what we do.”
By Ken Perez, vice president of healthcare policy and government affairs, Omnicell, Inc.
During the 2020 presidential election campaign, the top dozen or so health policies advocated by the Biden-Sanders Unity Task Force Recommendations, the Democratic Party Platform, and the Joe Biden for President Campaign Website fell into two distinct categories: ambitious progressive policies that would probably require a “go-it-alone” approach by the Democrats; and more moderate bipartisan policies that could be passed under the current rules in the Senate as an outcome of traditional political compromise.
Pursuit of the former approach is fashionable, as many Senate Democrats have advocated elimination of the filibuster. In addition, Senate Parliamentarian Elizabeth MacDonough recently determined that Democrats may be able to employ a fast-track process known as budget reconciliation multiple times before next year’s midterm elections, potentially allowing them to pass a bill with a simple majority, assuming that all 50 Democrats fall in line and Vice President Kamala Harris casts the tie-breaking vote as president of the Senate.
Nevertheless, there are key players in the Senate dedicated to pursuing bipartisanship.
By Devin Partida, technology writer and the editor-in-chief, ReHack.com.
Many aspects of modern health care are increasingly dependent on IT professionals. Here are five challenges those experts are likely to encounter this year and some potential solutions.
1. Addressing the IT Needs of Rural Facilities
Many modern hospital processes require the internet. However, many hospitals are not in areas known for reliable internet access. These are typically rural facilities that often lack large IT teams.
However, these medical centers play substantial roles in the surrounding areas. Estimates suggest that rural communities account for 20% of the United States’ population. Hospitals are often among the primary places of employment for residents there.
Some IT obstacles at rural facilities relate to communication silos. However, a clinical mobility assessment could break down some of the barriers between IT professionals and clinicians. Moreover, investing in managed services can relieve the burdens at hospitals without large IT teams.
2. Coping With Too Many COVID-19 Vaccine Passport Standards
With COVID-19 vaccination programs rolling out in many countries, merely getting the appropriate number of shots is insufficient. People must also prove they did so. For now, they usually have paper vaccine cards with handwritten details.
However, several companies are working on digital vaccine passports. Those could prove vital for helping vaccinated individuals attend a concert or sporting event, travel abroad, or even dine in a restaurant.
People with knowledge of the matter say a primary issue is that there are currently four standards used for these projects and no sign of world leaders agreeing to stick with just one.
A related matter is that the United States alone has dozens of public vaccination databases. Implementing a system where a passport app could retrieve information from all of them requires one standard.
It’s also not clear whether people will need different vaccination apps depending on their desired activities. Since so many details remain unknown, the best thing for health IT professionals to do now is stay abreast of progress and consider how developments could affect their work.
The providers at Boice-Willis Clinic adore their eClinicalWorks EHR, but with 67 of them in seven locations and 10 practice areas, fast electronic consent signing is critical to the organization’s efficiency. It was a major goal of IT director Matt Reams to eliminate the workaround for e-signatures his team had been forced into.
The problem was an incompatibility between eClinicalWorks (eCW) and the signature pads the Rocky Mount, NC-based organization had purchased a few years prior.
eCW 11e, the browser-based version of the EHR used at most of the multi-specialty clinic’s registration desks didn’t recognize the previous pads being used, so the IT team utilized an enterprise content management system called Laserfiche as an intermediary. Patient consent forms were accessed through this software, and patients signed using the signature pads. The e-signature was stored in Laserfiche and sent to the medical records fax inbox. One of the health information management (HIM) staff had to then manually move it from the inbox into the patient document.
Complete Compatibility, Plus Plug-and-Play
Today, Boice-Willis has a new system using signature pads that’s saving HIM at least 10 minutes on every signed consent, and they process what Reams calls a “significant number” of forms per day.
Knowing that every front desk in the organization used the browser version of eCW which was incompatible with the old devices, Reams and his EMR manager searched eCW user forums for possible solutions. Upon seeing that multiple organizations had successfully changed to these signature pads, Reams ordered a unit to test.
The test showed that not only are the devices compatible with all versions of eCW, but they’re completely plug-and-play, not even requiring a driver download.
By Deborah Hsieh, chief policy and strategy officer, Ciox Health.
Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) in 1996. In the 25 years since, healthcare and technology have advanced beyond what any of the original writers of HIPAA could have imagined, creating innovative new tools and mechanisms to share information and to better engage individuals in their healthcare.
Recognizing the challenges in ensuring HIPAA remains relevant for technology, business practices, and patient needs of today, the U.S. Department of Health and Human Services (HHS) released proposed updates to HIPAA’s regulations. The proposed changes include needed flexibilities to promote information sharing, but fail to ensure patient privacy protections remain relevant for the changed context, and, in fact, encourage actions that could expose patients’ healthcare data. Rather than strengthening healthcare privacy protections, the proposal creates a new pathway for non-HIPAA-covered entities to freely access and exploit patients’ healthcare data.
In the proposed rule, HHS seeks to go beyond the existing statute and regulations that ensure patients have a right to direct a covered entity to transmit an electronic copy of their protected health information (PHI) in an electronic health record (EHR) to a designated person or entity of the patient’s choice (also called “patient directive”). HHS now proposes to create a wholly new, unprotected and unauthorized pathway enabling so-called personal health applications — third parties that meet a minimal set of criteria – to gain free access to electronic and paper-based data.
While HHS creates and encourages use of this new pathway for personal health applications, HHS is not able to regulate what these applications do. Because a personal health application “is not acting on behalf of, or at the direction of a covered entity,” it is not subject to HIPAA rules and obligations. Health data that a patient directs to a personal health application is no longer protected by HIPAA and patients are left to fend for themselves.
HHS states personal health applications are managed and controlled by the individual; however, there is no requirement that patients be informed their data is no longer being covered by HIPAA and what that means. Patients will lose their ability to control their access to and the use of their healthcare data and may be fully unaware that third parties may use personal health applications as a backdoor to gain access to millions of patients’ private health information for their own commercial purposes.
Over the course of my career, working in a variety of industries, I have developed certain design patterns when modeling data that guide my approach to tackling a new data domain. One simple example is how I choose the right data type for a given value an application will capture.
While it may sound straightforward, interesting nuances can quickly surface during the data modeling step that necessitate a shared language and vocabulary between the functional experts and the software engineers. In other words, we need to figure out how to work together and speak the same language in order to solve the problem well.
The importance of nuanced semantics may be illustrated with the example of how an anesthesiologist documents the administration of an antibiotic. . The type and timing of antibiotic administration is a key metric that anesthesia providers have historically had to report to Centers for Medicaid and Medicare Services (CMS) since it correlates with both patient outcomes and healthcare costs.
As I analyzed the paper anesthesia record used, I noticed an “antibiotics” checkbox, accompanied by an antibiotic name, an amount, a unit of measure, and the route of administration. These all made sense to me, and I proceeded to incorporate these concepts into my data model. For the antibiotics checkbox, I naively interpreted it as a simple boolean value, and I named it Antibiotics Administered Indicator. In my mind, that simply indicated that the antibiotic denoted on the form was either administered (true), or not administered (false).
During a review of the model, I learned that a clinician interprets this checkbox to mean an “indication for antibiotics”; in other words, antibiotics were or were not determined as a necessary course of action given other clinical conditions. A true value didn’t mean that antibiotics were administered, only that they were indicated, and thus needed to be given. That is obviously a completely different understanding than the one at which I had arrived. Needless to say, this was eye opening for me, even having been down the road of developing a functional understanding of data domains many times before.
The illustration highlights the importance of having both functional (i.e., the doctors) perspectives and technical perspectives present and engaged during software design. A purely technical survey of a subject area will certainly be valuable, and in some cases may provide decent coverage in terms of establishing a foundational understanding of that domain. In most cases, however, a functional perspective will also be required to complete the picture and add the necessary insight required to create an accurate and intuitive user experience.
In fact, healthcare may serve as the poster child for just how challenging, complex, and unforgiving software design can be. Clinician dissatisfaction and fatigue with existing electronic health report software is well documented, and the explanations are plentiful: failed interoperability, difficult user experience, inefficiency with simple tasks, onerous data capture burden, etc. Perhaps the common denominator is a failed understanding of complex and poorly defined clinical workflows being interpreted and standardized in software by technical experts working in isolation. The real issue here is that foundational errors propagate as the software evolves, and there is no easy way to reverse course once construction begins.