Category: Editorial

Medical Tourism and The Value Of Technology In Medicine

By Brooke Faulkner

The phrase “medical tourism” has been coined to describe the millions of Americans who are traveling across the globe to have surgery or other medical procedures performed. According to Visa and Oxford Economics, this trend is growing at a rate of 25 percent per year.

Healthcare in the U.S. has become increasingly expensive — to the point that some necessary treatments are entirely out of reach for the average American. Combine that with rising health insurance premiums and high deductibles, and it’s no wonder 1.4 million people traveled abroad last year to get the medical care they needed.

Additionally, many countries offer more advanced technological solutions and experimental treatments that are not yet available within the U.S. Better, more advanced care that is less expensive sounds like an attractive reason why so many Americans are taking advantage of overseas healthcare.

Healthcare implications

The reason these countries can offer above-standard care for less money is that the doctors are paid less and hospitals charge less than in America. Plus, the insurance costs are a fraction of U.S. expenses. The result is that some U.S. health insurance companies now support overseas treatment and even pay for the travel along with the cost of the procedures.

Talk of improvements to the U.S. healthcare system becomes popular during an election year, but unfortunately, things don’t seem to improve; they continue to get more expensive for the average American.

The Affordable Care Act of 2010 was in part meant to discourage traveling outside the country for healthcare by making it easier for all Americans to be able to afford their own treatment. Unfortunately forcing everyone to have health insurance only increased health insurance premiums, hospitals and physician fees and complicated the issue making affordable healthcare further out of reach.

U.S. Medical Technology: How Does It Measure Up?

In the U.S., healthcare professionals have a number of factors to consider when implementing technology. They must consider cost, leadership buy-in and other keys to successful implementation. Unfortunately, because of the excessive investment cost for medical technology implementation here in the U.S., America is sorely lagging behind countries like Canada, China, India and England. These countries have access to bigger budgets, fewer government bottlenecks, and a more streamlined approval process to get medicine and devices out into the market faster.

The United Kingdom, China and Canada are all investing serious money in biotechnology and experimenting with pharmaceutical cures that are years beyond the technology produced by U.S. companies. Lawmakers in those countries are invested in supporting and funding new technologies to lead the pack in innovation and medical history.

The difference is that in many of these locales, the government solidly backs the research and development of medical technology solutions rather than private companies. In the U.S. most of the advancements come from the private sector and are not government sanctioned or funded.

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Pillo Health Launches Home Health Assistant to Dispense Medication, Track Adherence

Pillo Health, a Boston-based company bringing medication adherence to the forefront of healthcare, announces the launch of Pillo, a voice-activated in-home companion with facial recognition that lets consumers better manage their health and stay connected to their caregivers. Pillo helps users better adhere to medication regimens, reminding them about dosages at set times, and offers them research-backed care plans to remain active and empowered in improving their health.

Six in 10 Americans live with at least one chronic condition, a leading driver of healthcare costs across the country. Adhering to medication to treat those conditions is especially challenging for those who have detailed, regimented care plans to follow. Medication non-adherence amounts up to $289 billion in wasted costs annually and a higher mortality rate in the U.S.

Emanuele Musini
Emanuele Musini

“Pillo is redefining how the industry addresses medication non-adherence and is giving people some of their independence back,” said Emanuele Musini, CEO of Pillo Health. “Managing chronic conditions can create immense stress on patients and their families as day-to-day care plans can be difficult to follow and time-consuming. I wanted to create an in-home companion that helped alleviate this issue, which impacts millions of lives, particularly in the aging baby boomer population.”

Pillo provides the following core services:

Pillo, which is HIPAA-compliant and registered as an FDA Class 1 medical device, is already attracting attention in the healthcare community. The company received funding from Hackensack Meridian Health System’s Innovation Center fund, focused on helping the startup commercialize and go-to-market in the acute care space. The company also completed an in-home test focused on diabetes management in partnership with AARP.

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Preventing Medical Billing Cash Flow From Becoming A Flat Line

By Ethan White, MDVision.

From last few years, there have been significant modifications in the rules in addition to guidelines that medical coding and billing firms must achieve. The medical billing vendor that is fully compliant in all under HIPAA are authoritatively business associates of most ideal healthcare clients. This means they never reveal private information, take substantial deterrents with client data, and shield the uprightness of the client.

But another utmost and instantaneous requirement is to influence the company’s profits as to make certain you file the medical claims as rapidly and swiftly as possible. For this determination, you can farm out the situation to a medical billing vendor as they promise to adhere to a strict round-the-clock turnaround for medical claim filing. Also, they have the real strength and aptitude to make available the flexible times for patient queries from outpatient ambulatory surgery centers to large hospitals.

Nonetheless to share your medical billing success story across healthcare landscape, some essentials should be think through in accordance of what’s being said, demonstrated and delivered at any stage:

Medical Bill Repricing Solutions

It is for this reason, the top medical billing vendor companies are certainly in a successful partnership attitude that lay emphasis on prompt, practical and a patron-centric billing approach. The objective ought to provide excellence attention to injured worker’s compensation claims and effectual charge clarifications. It always starts by real-time bill review besides fake finding for self-insured houses, third-party administrators in addition to insurance companies. Such practices prevent excessive payments and endorse an equitable repricing level for reimbursement.

Non-Network Negotiation

The non-network negotiations possibly will continue to establish the average for fair and reasonable reimbursement aimed at medical billing claims. But getting the substantial discounts on non-network claims and to regulate 100 percent in excess of provider sign-off to ease the risk is always an ideal method used by medical billing vendors. The supplementary healthcare cost suppression approach can be used for any other reporting type in delivering fair and equitable money to the paymaster and reasonable payment to the provider as well.

Fragmentation into coordination

An outsourced medical billing claim service means that you have a complete squad of professionals who make sure that your entitlements get treated swiftly and precisely, sendoff your practice minus at risk to interruptions in cash-flow. When a physician confidence the chosen billing service company and works self-possessed with billing prerogative team, they develop long-lasting benefits like.

Monitoring and Analytics

Your days in A/R, or revenue cycle period has a noteworthy impression on your bottom line. A medical billing service mete out their overheads transversely the all-inclusive client based on providing an economy of scale, monitoring and analytics. Thought, such medical billing vendors can have the funds to chartering with the best staff potential, so that you pay a smaller amount for the comparable and frequently complex collection percentages. In addition to the uninterrupted fiscal advantage of greater returns as well as decreased costs.

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Health IT Startup: Intiva Health

Intiva Health LogoIntiva Health is the first truly integrated career platform for healthcare professionals.  It redefines the medical credentialing process by making it faster, more efficient and more secure.

Elevator pitch

Intiva Health provides healthcare professionals with a single place to manage their credentials,continuing education, new job opportunities, secure messaging needs and more. It is built on the Hashgraph digital ledger platform, which means it is faster, more secure, and more error proof than blockchain.

Founders’ story

Intiva Health was founded in 2006 as a staffing agency for surgical services and emergency rooms. Today the Austin, Texas, company it has reinvented itself as a digital health startup featuring a next generation blockchain technology that cuts the time it takes for the medical credentialing process from months to seconds, improves HIPPA compliance,and makes document tampering or theft almost impossible.

Marketing/promotion strategy

Intiva Health focuses its marketing and PR efforts on licensed medical professionals (LMPs), practice managers, and the facilities where they work including medical groups, hospitals and professional associations.The company launched a new brand awareness campaign in March 2018 that includedthe introduction of the Intiva Token, a new cryptocurrency that LMPs can use to purchase continuing education classes, cyber insurance and other services.

Intiva is also partnering with the National Osteoporosis Foundation to test the advantages of using the Intiva Token for charitable donations.

Market opportunity                                                                                    

The Intiva Health Platform automates the burdensome tasks of credential and licensure management, continuing education, and discovering job opportunities for healthcare professionals. Intiva Health’s new ReadyDoc™credential verification solution, built on top of the Hashgraph distributed ledger technology, disrupts the existing broken, slow, and error-prone healthcare credentialing system, which today can take weeks or months to verify credentials, and is subject to tampering.

Intiva believes that ReadyDoc can replace the current processes of credentialing and primary source verification by storing documents and credentials in a Hashgraph-based distributed ledger. Providers and facilities can obtain information that is pre-verified, securely stored, and readily available, creating an ongoing, self-auditing verification of provider work history and clinical reputation.

ReadyDoc will act fluidly between health systems and facilities across the U.S., allowing organizations to instantly verify work history and clinical reputations. In the event of an emergency like the Houston hurricane, facilities will be able staff up by vetting the credentials of qualified providers instantly. ReadyDoc eliminates redundancy and the need for third party verification organizations, letting medical professionals get to work sooner.

Who are your competitors?

We believe that Intiva Health is the first integrative platform to manage healthcare career information from one seamless dashboard. It is certainly the first to use the Hashgraph digital ledger technology and offer a cryptocurrency utility token. However, Doximity also offers a career management application for medical professionals.

How your company differentiates itself from the competition and what differentiates Intiva Health?

Intiva Health can replace the current processes of credentialing and primary source verification by storing documents and credentials in a Hashgraph-based distributed ledger. Providers and facilities can obtain information that is pre-verified, securely stored, and readily available, creating an ongoing,self-auditing verification of provider work history and clinical reputation.

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VigiLanz and Cincinnati Children’s Partner to Commercialize Solution to Minimize Acute Kidney Injury in Pediatrics

VigiLanzVigiLanz and Cincinnati Children’s Hospital Medical Center announces a collaboration that leverages Cincinnati Children’s research on pediatric nephrotoxic kidney injury and VigiLanz’s capabilities to commercialize a solution for Acute Kidney Injury (AKI) in pediatric patients. Dubbed NINJA, or Nephrotoxic Injury Negated by Just-in-time Action, the solution enables real-time identification and monitoring of patients at risk for AKI due to exposure to nephrotoxic drugs.

Dr. Stuart L. Goldstein
Dr. Stuart L. Goldstein

“Pediatric acute kidney injury is a serious problem that traditionally could not be identified in real-time, which impacted our ability to identify the patients who most needed treatment,” stated Dr. Stuart L. Goldstein, MD, FAAP, FNKF, Director of the Center for Acute Care Nephrology and primary researcher on NINJA.  “By partnering with VigiLanz, Cincinnati Children’s is applying our unprecedented research to a commercially-available solution that accurately characterizes pediatric AKI epidemiology, reducing AKI and improving patient outcomes.”

Commercially available to hospitals and health systems focused on mitigating pediatric AKI, NINJA automates a time-consuming manual screening process that includes evaluating patients for exposure to 57 nephrotoxic medications, imaging contrast dye, and recent renal testing. For medications, manual screening is limited to the last 24 hours, while the contrast dye evaluation requires reviewing records for the previous seven days to determine if it was received by the patient.

Leveraging NINJA algorithms built into VigiLanz rules, an AKI monitoring dashboard lists all patients that meet the NINJA exposure criteria, as well as the criteria that put the patient in the at-risk category. These criteria include medication exposure, serum creatinine data and patient history of AKI. When patients meet at-risk criteria, they are placed on the monitoring list in real time, where they remain until 48 hours after their risk has passed.

The platform also features metric outputs that can be customized with respect to service lines and time periods, while robust reporting tools provide the ability to trend conditions over time via automated run charts. It also enables automatic and customizable data extraction for all metric elements, including inpatient census by location or service line.

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Interoperability: The Key To Enhanced Care and Becoming A Preferred Provider

By B.J. Boyle, vice president of product management, PointClickCare.

B.J. Boyle
B.J. Boyle

Interoperability, as it was envisioned, should be built on transparency and connectivity, allowing a patient’s critical health information to be easily accessible, regardless of where treatment is being administered. By creating an infrastructure that supports the sharing of patient data along the care continuum, hospitals, skilled nursing facilities (SNF) and long-term post-acute care (LTPAC) facilities can offer the best care possible. As a result, organizations that participate in interoperability best practices are positioned to become preferred providers.

Unfortunately, interoperability is still a work in progress for many organizations. While more than 95 percent of hospitals and 90 percent of office-based physicians are now utilizing electronic health record (EHR) platforms, many struggle with — or have reservations around — sharing information outside of their facility. As such, silos represent a great barrier to realizing a fully implemented state of interoperability.

The current data gap can drastically impact care. For example, a patient experiences a serious medical incident — such as a fall or stroke — and arrives at the hospital where staff may not have access to existing patient data which could inform the best delivery of care. Or perhaps they’re able to access that data, but not right away. Care is now delayed, which can be additionally concerning depending on the time-sensitivity of the patient’s condition.

Taking this example a step further, let’s explore what happens after care at the hospital has concluded. The patient requires rehabilitation, and a continuation of care document (CCD) is issued to a post-acute care facility. From there, the patient’s information is transferred by less-than-foolproof methods such as fax, for example. A glitch as simple as a jammed paper feed could prevent critical information from reaching the appropriate caregiver.

As value-based care and payment-care models are moving toward the forefront, blind handoffs of patient information are no longer viable, as they drastically increase the financial risks hospitals and payer groups are subject to — not to mention the clear detriment the system has on delivery of care.

Closing the gap

The larger question is how does the industry get from Point A to Point B? The easy answer is to liberate the data through a cloud-based infrastructure that supports an efficient, easy-to-access data exchange between all caregivers. An integrated solution would connect stakeholders across the care continuum, providing accurate insights when needed, eliminating data silos between care partners, and enabling more confident decision-making.

These systems would promote:

Overcoming concerns

The concept of interoperability, in some ways, seems contradictory to traditional best practices. Healthcare organizations are charged with protecting patient data at all costs, and the idea of sharing data in a way that opens access to a wider group of stakeholders could give pause. Regulatory infractions for data loss in the healthcare industry can be steep, and the number of well-publicized data breaches in recent years reinforces how valuable health records are to both the organizations who keep them and those who try to steal them.

So, it should go without saying that an EHR “superhighway” must be developed with security in its DNA, taking stringent regulatory requirements into account. The good news is that the newest breed of information exchange platforms is being built with security roles in mind, drastically reducing the possibility of data loss.

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How to Know If Your Software is HIPAA Compliant

By Abbas Dhilawala, CTO, Galen Data.

Abbas Dhilawala
Abbas Dhilawala

The Health Insurance Portability and Accountability Act, known as HIPAA, was enacted in the United States in 1996. The legislation creates data security and privacy requirements for safeguarding medical information. In recent years, HIPAA compliance has become a hot button issue for software developers in the healthcare space, as a number of high profile data breaches compromised millions of patient records across the country.

If you’re developing an eHealth or mobile health app, it is vital that you determine whether your software could be subject to the requirements of HIPAA for medical software applications. Failure to do so could subject you to thousands or even millions of dollars of liability if the use of your application results in an unauthorized disclosure of health information that is protected under HIPAA. Here’s how to tell whether HIPAA applies to you, and how to know if your software is HIPAA compliant.

Does HIPAA apply to me?

Before you start worrying about compliance with the security and privacy requirements of HIPAA, you should determine whether they can be applied to you and your organization. Both the HIPAA privacy rule and the HIPAA security rule apply to all covered entities under HIPAA, such as health plans, healthcare clearinghouses and healthcare providers. The website for Centers Medicade & Medicaid Service offers a Covered Entity Guidance Tool that can help you determine whether your organization is a covered entity.

HIPAA was expanded in 2009 with the introduction of the HITECH Act and again in 2013 with the HIPAA omnibus rule which clarified the responsibilities of business associates of covered entities when it comes to managing privacy and security of patient records. Further guidance was issued in 2016 indicating that cloud service providers would also be covered by the HIPAA privacy, security and breach notification rules.

Software developers in the healthcare space need to tread carefully here – the original regulations of HIPAA that deal with covered entities probably won’t apply to most organizations creating eHealth or mobile health products, but if your app will manage protected health information and share it with any covered entities, such as health plans or doctors, then HIPAA applies to you and you must comply.

If your software collects protected health information from patients but does not share it with a doctor or another covered entity at any point, the HIPAA rules won’t apply to you and you don’t need to worry about compliance.

Required safeguards for software HIPAA compliance

The available data indicates that while theft of computing hardware was the primary cause of healthcare data breaches in 2017, the greatest vulnerability that was exploited was health IT networks. For software developers, the HIPAA security rule is the most likely potential source of compliance issues. The rule mandates three types of safeguards that protect patient data – administrative, physical, and technical. In creating these safeguards, software developers must establish a secure application where authorized personnel have access to the required patient information while unauthorized persons do not. Patient information must also be protected from alteration or destruction.

Administrative safeguards ensure that software administrators who make have access to the data are acting responsibly. If your software stores medical data, anyone with access to that data must be authorized and trained on the ethical and legal requirements of that access. Administrative safeguards include:

Physical safeguards help to mitigate data breaches by ensuring that only authorized users can access the facilities and machines where protected health information is stored. Physical safeguards include managed policies for:

Technical safeguards present the greatest challenge for software developers building HIPAA-compliant products, as software bugs represent the best opportunity for data attacks against your organization. HIPAA does not detail exactly what firewalls, anti-malware devices or encryption tools should be used to secure your software against a data breach, but it does indicate the need for several types of controls:

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Eight Advancements That Have Changed the Face of Healthcare In the Last 10 Years

By Freddie Tubbs, communication manager, Academized.

Freddie Tubbs
Freddie Tubbs

So much has changed in terms of healthcare over the last decade. Technology has advanced and improved processes – what used to take hours can now take seconds. This means a lot both to the medical community and patients alike.

It seems that almost every day, there is a new technological breakthrough.

Here we examine eight of the very best.

Online interaction

So called portal technology. Such a simple idea but so groundbreaking in its application, it simply means both doctors and their patients having access to their medical records and can interact with each other. It gives physicians the benefit of being able to see a patient’s full history while the patient can challenge and question any aspect they feel is incorrect. Acting as a safety net, it helps both sides spot any problems before they arise and gives patients more power over the information that is held about them.

Genomes

Understanding genomes and sequencing has lead to impressive breakthroughs in the treatment of cancers. Patient testing has allowed specialists to tailor treatments entirely towards individual patients, making it much more effective than a one-size-fits-all approach.

Theresa Kelly, a healthcare writer at Stateofwriting and UKwritings, said: “In my opinion this is probably the most relevant breakthrough in healthcare over the last decade. Being able to tailor treatments towards the exact needs of individuals is breathtaking”.

Fighting waiting times

Advancements in technology mean that hospitals and clinics needing to track down specialists, beds and even equipment can now use an electronic kind of tracking device. This made the waiting times much shorter which inherently relieved the stress off both the patients and the medical staff. Things happen quickly and everything is much easier to track.

Safer remotely

Gone are the days when older or vulnerable people have to wear a large buzzer around their neck in case of a fall. Nowadays, with the advancement of voice activated technology, these people have much easier time with all aspects of their lives. As a bonus, everything can be monitored remotely, and medical staff can react faster.

Messaging the smart way

With the advent of smart messaging services healthcare providers can receive the results of urgent test, the moment the are concluded and act upon them fast, especially if there is a need for a surgery or examination.

“Removing some of the anxiety that can build up while waiting for a result is almost as important as having the tests done. Healthcare professionals also get frustrated by long delays so with this advancement, everyone wins”, so says David Evans, a Tech Blogger at Boomessays.

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The Political Plausibility of Medicare for All

By Ken Perez, vice president of healthcare policy, Omnicell, Inc.

Ken Perez
Ken Perez

As widely reported, based on exit polls, healthcare—not the economy—was the top issue on voters’ minds in the 2018 midterm elections. This was due in part to the nation’s sustained economic recovery of the past two years, resulting in the current healthy state of the economy in general. In addition, Democratic Party political advertising emphasized healthcare—61 percent of pro-Democratic House ads from Sept. 18 to Oct. 15 mentioned healthcare, compared with just 10 percent of all Democratic ads in 2016.

According to several analysts, the Democrats’ success in taking back the House was largely due to their riding the “train of healthcare,” with a large proportion of Democrats in Congress supporting the idea of single-payer healthcare as embodied in Independent Vermont Sen. Bernie Sanders’s “Medicare for All” bill that he introduced in Sept. 2017.

Many of the most likely Democratic candidates for president in 2020 have publicly expressed their support of Medicare for All. Five of the seven most likely Democratic candidates from the Senate cosponsored the Medicare for All bill: Cory Booker of New Jersey, Kirsten Gillibrand of New York, Kamala Harris of California, Jeff Merkley of Oregon and Elizabeth Warren of Massachusetts. Some of the possible Democratic candidates from the House (e.g., Rep. Beto O’Rourke of Texas) and current and former Democratic governors (e.g., former Massachusetts Gov. Deval Patrick) are also Medicare for All backers.

At this point, what is the plausibility of Medicare for All becoming law after the 2020 elections?

It would obviously require the election as president of Sanders or a Democratic candidate who supports a single-payer system. In addition, the Democrats would need to retain their new majority in the House, and they would also need to attain a 60-seat majority in the Senate to overcome a possible minority party filibuster by the Republicans, assuming their united opposition. Note that the Patient Protection and Affordable Care Act passed in the Senate by a 60-39 vote, with not a single Republican senator voting for the bill.

A 60-seat Senate majority for the Democrats is not very likely to happen in 2020. Evidently, the Democrats will have 47 seats in the Senate once the 2018 midterm election results are finalized. The most aggressive current projection from a Democratic perspective regarding their Senate prospects in 2020 is a flipping of five seats presently held by Republicans (in Arizona, Colorado, Iowa, Maine, and North Carolina), resulting in a 52-seat majority. However, even that outcome would be eight seats short of the 60 needed. Thus, it appears that it would take some combination of executive branch meltdown (e.g., impeachment proceedings) and retirements by multiple Republican senators during the next two years in order for voters to flip an additional seven seats in the Senate to the Democrats in 2020.

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High Costs in Healthcare Today

By Karim Babay, CEO, HealthSapiens.

Karim Babay
Karim Babay

High-quality affordable healthcare is important to help eliminate healthcare disparities and works to improve the overall health of the population, whereas more expensive healthcare increase the disparity between health of the affluent and the less well-off.

The cost of healthcare varies dramatically around the world. Many health systems are struggling to update aging infrastructure and legacy technologies with already limited capital resources.

As healthcare costs increase, affordability and insurance coverage remain problematic.

In the United States, deductible cost increases are far outpacing increases in costs covered by insurance.

Brazil’s private health insurance sector lost 2.5 million beneficiaries between 2014 and 2016 due to the country’s high unemployment rate. Added to that, companies in Brazil had to cut expenses, and changing their employees’ health insurance plan to a cheaper one was a popular option.

As mentioned previously, lack of access to care causes an increase in hospital and urgent care visits.

According to Centers for Disease Control and Prevention (CDC), 79.7 percent of non-admitted emergency room patient visits were due to lack of access to a healthcare provider. A recent study published in the Journal of American Medical Association estimated $734 billion (27 percent) of all healthcare spending was wasted on unnecessary services, inefficiency and inflated prices.

Similarly, according to Truven Health Analytics, 71 percent of emergency room visits with employer-sponsored insurance coverage are ambulatory sensitive, and could have been managed in an outpatient care center.

Moreover, as shown by the rise in medical tourism as a new industry, there is now a greater cost disparity in accessing healthcare than before. This new industry shows the cost of healthcare is such that patients are increasingly willing to travel overseas in order to take advantage of more competitive pricing for healthcare in other countries.

This makes it easier to connect patients in one geographic location to physicians in another, which can dramatically reduce costs, and create a freer and competitive market for high-quality medical services.

Today’s consumers want to take responsibility for managing their own health. Yet, most feel they don’t have the information and tools to do so. In other industries, customers can easily access comparisons of features, benefits, and costs to guide their purchasing decisions. In contrast, the healthcare industry presents a huge array of confusing choices, contact points, and service flows without any upfront pricing information.

Seventy-five percent of consumers consider their healthcare decisions as the most important and expensive decisions they make. Yet, the process of choosing and paying for medical services can be so daunting that patients often decline treatment simply to avoid the confusion and expense.

To make better decisions, healthcare consumers are increasingly expecting—and demanding—better information and more transparency from healthcare providers. They’re also asking for more of a partner relationship rather than a one-way dialog from medical provider to patient.

At the same time, as healthcare costs continue to rise, consumers are required to assume responsibility for a larger share of the costs of health plan premiums, co-pays, and out-of-pocket expenses, with no way to offset the cost.

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