We often think of healthcare as the direct communication between provider and patient in an appointment or clinical setting. However, most of what influences health outcomes sits outside of the doctor’s office: This includes individual health behaviors as well as social determinants of health such as social support systems, access to health education and timely care, physical environment, and financial resources.
As we think about building patient engagement, especially related to preventive care and long-term management of chronic conditions, it’s important to think beyond just the quality of clinical care being delivered. Generally speaking, “engaged” patients are those who feel empowered and actively involved in managing their own health. The specifics of what this looks like may differ by population or condition area, but patient engagement is driven by a few key themes:
– Patient activation: Do patients feel motivated to make choices that will positively impact their long-term health?
– Patient education: Do patients have the information they need to understand how their choices and behaviors impact health outcomes?
– Care navigation: Do patients understand how to navigate the complex healthcare system in order to find and access the care they need?
– Patient support: Do patients have social support systems to help them adopt and maintain positive health behaviors?
In an increasingly technology-driven world, engagement can be improved through strategic and human-centered design of experiences and platforms that help patients manage their health. The following sections outline user experience best practices that can be leveraged to improve patient engagement and influence care quality as a whole.
Patient Activation
Much of the literature around patient motivation and behavior change is built upon theories of behavioral psychology. In her book Engaged: Designing for Behavior Change, Dr. Amy Bucher highlights the different types of motivation that can influence human behavior. These range from controlled (extrinsically imposed “you should…”) to autonomous (intrinsically driven by personal motivations). Understanding patient motivation is key to human-centered experience design.
Health Level Seven(HL7) International, the global authority on interoperability of health information technology with members in 55 countries, announced the 2023 class of John Quinn HL7 Fellows and the 2023 recipients of the W. Edward Hammond, Ph.D. Volunteer of the Year Awards during its annual business meeting at the 37th Annual Plenary and Working Group Meeting in Phoenix.
2023 HL7 Fellows
The John Quinn HL7 Fellowship Award was presented to seven individuals during HL7’s 37th Annual Plenary and Working Group Meeting. The award was established to recognize HL7 members with at least 15 years of active membership as well as outstanding service, commitment and contributions to HL7. The award is named in memory of HL7 founding member John Quinn, who served as the organization’s second board chair, the long-time chair of the Technical Steering Committee and the first chief technology officer. The 2023 recipients of the John Quinn HL7 Fellowship Award include:
Adam Chee, chair, HL7 Singapore
Carmela Couderc, branch chief, Office of Technology, Office of the National Coordinator for Health Information Technology (ONC)
Suzanne Gonzales-Webb
Charles Jaffe, M.D., Ph.D., chief executive officer, HL7 International
Joginder Madra, information technology and management consultant, JOJ Group, Inc.
Mitra Rocca, associate director, Medical Informatics, Food and Drug Administration
Dan Vreeman, D.P.T., chief standards development officer
HL7 Volunteers of the Year
HL7 honored three members with the 26th annual W. Edward Hammond, Ph.D. Volunteer of the Year Award. Established in 1997, the award is named after Dr. Ed Hammond, one of HL7’s most active volunteers and a founding member as well as past board chair. The award recognizes individuals who have made significant contributions to HL7’s success. The 2023 recipients include:
Robert Hausam, M.D., FHL7, consultant and owner, Hausam Consulting LLC
Mark Janczewski, M.D., M.P.H., FAAFP, FAMIA, president and chief executive officer, Medical Networks, LLC
Robert McClure, M.D., FHL7, president, MD Partners, Inc.
Lisa Nelson, senior vice president, Enterprise Integrations, ADVault, Inc.
About the Volunteers:
Robert Hausam, M.D., FHL7, has been an active member of HL7 for 22 years and has served as the co-chair of both the Terminology Infrastructure and Orders and Observations Work Groups. He is a primary leader of the International Patient Summary (IPS) project and is a principal editor for the IPS HL7 Fast Health Interoperability Resources (FHIR®) and Clinical Document Architecture (CDA®) implementation guides (IGs).
Over the years, Dr. Hausam has worked extensively with the HL7 Version 2 and CDA standards and is now active in the FHIR community where he serves as a co-editor for the HL7 FHIR specification and several FHIR IGs. He also assists in the maintenance of the terminology services for the HL7 FHIR specification and IG build environment. Dr. Hausam has volunteered as the IPS and Terminology Services Track Lead at numerous FHIR connectathons, and regularly offers his terminological and clinical expertise as a physician to the FHIR community on the Zulip chat site. In addition, he serves as HL7’s representative on the SNOMED on FHIR Group and as one of the HL7 representatives to ISO TC215.
Mark Janczewski, M.D., M.P.H., FAAFP, FAMIA, joined HL7 in 2009 and has served as a co-chair for the Electronic Health Records (EHR) work group since 2013. He has been a long-standing and consistent champion for health IT and standards development to improve interoperability of health IT systems from a variety of aspects, particularly from the view of the clinician.
Dr. Janczewski’s interests are in the areas of health IT system adoption and implementation, functional requirements development, workflow and decision modeling, HL7 FHIR implementation, metrics and analytics, and artificial intelligence (AI). He is one of the co-authors of the EHR-S Functional Model Release 2, the Personal Health Record System (PHR-S) FM R.2, Data Elements for Emergency Department Systems (DEEDS), and has participated in the development of and/or co-authored several functional profile standards. In addition, Dr. Janczewski is currently facilitating the AI Focus Team’s Project 11 on AI Data Lifecycle, the first-ever AI-based standards development effort in HL7.
Robert McClure, M.D., FHL7, has been active in HL7 for over two decades. He has played an integral role in establishing and participating in the Terminology Services Management Group, serving as liaison to the TSC and enabling many projects in 2022-2023. McClure regularly contributes improvements to the HL7 FHIR publication of HL7 Terminology (THO) and the Unified Terminology Governance (UTG) process for terminology maintenance, ensuring that the policies and tooling surrounding its maintenance supports implementer needs and timelines. As a long-time Terminology Infrastructure Work Group co-chair, he has significantly contributed to HL7 specifications and terminology guidance including “Characteristics of a Value Set Definition” and the gender harmony specifications. In addition, McClure is also the terminology representative on the HL7 US Realm Steering Committee and serves as terminology facilitator for the Structured Documents, Clinical Quality Information, and Clinical Decision Support Work Groups
McClure’s current efforts include leadership of the Gender Harmony Cross-Paradigm Implementation Guide, along with the individual product family IG updates to reflect the gender harmony model. This work will directly make it possible for health care organizations to provide more efficient and accurate gender-affirming care.
Lisa Nelson has been a member of HL7 for 12 years and is an active member of the Structured Documents and Patient Care Work Groups. She has served as a co-chair of the CDA Management Group for the past six years where she has acted as a product manager, documenting the portfolio of the products and creating a process to maintain the information. In addition, Nelson is the author of multiple HL7 CDA implementation guides.
Nelson is passionate about improving patient experience, engaging patients and empowering patients and caregivers. She has focused on advance care planning (ACP) documents, serving as a lead editor on both the CDA and HL7 implementation guides for personal ACP document healthcare data content standards.
Finally, she has also provided valuable testing of the EHR FHIR servers and contributions to FHIR representing the small app vendor perspective.
By Chris Martini, chief provider officer, PatientPoint.
In today’s U.S. healthcare system, patients often find themselves in a perplexing situation where the quality of clinical care can be excellent, but the overall patient experience may fall short.
As the system increases its focus on value-based care and improved health outcomes, the patient experience and value-based care must be considered as interconnected entities. In fact, three value-based care quality metrics—patient satisfaction, preventive care screenings, and care coordination—are directly impacted by the overall patient experience.
The good news is that there are a number of digital tools that can play a pivotal role in fostering better awareness, comprehension, communication, and overall better care experiences. These enhancements ultimately translate into tangible benefits to support value-based care.
Empowering Patients Through Information
According to the 2023 PatientPoint Patient Confidence Index nearly half (48%) of Americans report feeling anxious before healthcare visits (an increase from 39% last year). This anxiety can be attributed to factors such as insufficient information and education, limited knowledge about healthcare providers, and hesitation to discuss health concerns with providers. Additionally, a third of Americans admit to regularly leaving appointments confused. Taken together, these anxieties hinder effective care.
When thinking about factors that could enhance their confidence in discussing their health, more than half (55%) of Americans highlighted the importance of receiving health education during appointments. Another 43% expressed interest in pre-visit education to increase confidence. Given that most patients spend approximately 14 minutes in the waiting room and an additional 12-13 minutes in the exam room without an HCP present, substantial opportunity exists to educate and empower patients while they wait.
Providers can maximize patients’ time in their offices and support value-based care by leveraging digital signage to disseminate relevant health information. Showcasing digital content in the waiting room prepares patients for important healthcare decision-making moments before they enter the exam room and has been proven to drive patient utilization of vital health services including mammography, colon cancer screening, flu vaccination, tobacco cessation counseling, and STI screening. The more personal nature of the exam room environment enables digital signage to deliver tailored information to patients, further motivating them to engage with their providers and take proactive steps for their health such as utilizing patient portals, scheduling preventive screenings and vaccinations, or discussing new treatment options.
To bridge language barriers and make healthcare more inclusive and transparent for patients who speak Spanish, the American Medical Association (AMA) now offers Spanish language descriptors for more than 11,000 medical procedures and services.
The consumer-friendly descriptors in Spanish were added to the newly released Current Procedural Terminology (CPT) 2024 code set, the nation’s leading data-sharing terminology for medical procedures and services.
The consumer-friendly descriptors are an important resource that many hospitals, health plans, medical offices and other CPT users already incorporate into English-language medical documents, insurance forms, price sheets, and patient portals. Including CPT consumer-friendly descriptors in Spanish that are clear and straightforward will help CPT users better engage and assist many in the Latinx community.
“Navigating medical care and paperwork can be especially challenging for Latinx patients who do not speak English or speak English as a second language,” said AMA senior vice president of health solutions Lori Prestesater. “Providing approximately 41 million Spanish speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care.”
Other changes to the CPT code set
The annual update to the CPT code set created 349 editorial changes, including 230 additions, 49 deletions and 70 revisions. With 11,163 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology.
Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel, an independent body convened by the AMA that collects broad input from the health care community and beyond to ensure CPT content reflects the coding and data-driven demands of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
We have all heard the staggering statistics of the current workforce issues happening across the healthcare industry, and one of the biggest segments facing staffing issues is nursing. The Bureau of Labor Statistics projects 203,200 openings for RNs each year through 2031 when nurse retirements and workforce exits are factored into the number of nurses needed in the U.S.
While there are many factors around why we have a nursing shortage currently, one of the areas that is often overlooked are the issues facing nurses who just graduated college and are transitioning into practice.
Following the COVID-19 pandemic, the divide between the demands of nursing programs and requirements of working in health systems has only grown. We are increasingly seeing an alarming number of young nurses leaving the profession shortly after receiving their degree partially because they are not receiving the hands-on experiences needed to prep them for this transition. Even if they are interacting with patients, they often aren’t forced to navigate the care of multiple patients at once like they would in a real-world care setting.
Because of this gap, technology can be a critical tool in helping the next generation of nurses get ready for their day-to-day professional lives. Specifically, virtual reality (VR) is giving us the ability to put multiple, diverse patient cases and hospital situations directly into the hands of nursing students – giving them experiences they have not had access to previously before they reach the bedside.
VR transports nurses to the hospital floor
COVID-19 forever changed the healthcare industry in countless ways and many of the opportunities that were available to students preparing for a career in healthcare, such as in-depth clinical rotations and managing a caseload of multiple patients, before the pandemic are now limited. One of the most important and formative times of a nursing student’s education is their clinical experiences – when the students go into the healthcare setting to see and react to patients alongside experienced nurses.
Good physical and mental health provides a foundation for a good quality of life. In particular, an “even keel” enables a person to weather life’s obstacles and move forward. Sometimes, however, men, women, and even children may need help for mental health challenges that cause concern and disruption.
Today, mental health services provider aptihealth offers all-acuity virtual therapy to all New York State residents. The company’s easy-access platform, combined with fast patient therapy integration, makes aptihealth an increasingly popular choice.
Better Mental Health Services Access is Needed
Throughout the United States, demand for mental health services continues to grow. Today, approximately 50 million United States adults cope with mental health challenges.
Until recently, however, fewer than half of them received treatment. Even worse, nearly three-quarters of US residents think unequal services access is the norm. Almost half of Americans think their care options are limited.
Perceived Barriers to Mental Health Care
Three perceived barriers to mental health care have fostered these beliefs. These perceptions exist across geographic and demographic categories.
Minimal Services Awareness
Some individuals have expressed interest in mental health services but lack the knowledge to search for solutions. To find information, younger individuals are more likely to turn to low-credibility social media platforms.
Social Stigma About Services
Almost one-third of the US population has been worried about being judged for seeking mental health services.
Long Waits and Long Drives
Approximately 96 million Americans have had to wait several weeks (recent data suggests over 6 weeks) for mental health services. Almost half of US residents have driven, or know someone who has driven, over an hour roundtrip to receive services.
People in rural areas, and with lower incomes, are least likely to have easily accessible mental health services. These individuals are more likely to visit their primary care provider (who isn’t qualified to provide this type of care) for services.
Canada’s overwhelmingly troubled healthcare system continues to dominate conversations among many, particularly those residing in the province of Ontario. While there is no one-size-fits-all solution to tackle these issues, actionable steps can be implemented to enhance healthcare quality for all.
What has led our healthcare system to deteriorate to this extent? We’ve all seen the headlines, the collateral damage from the COVID-19 pandemic has been severe.
One of the most significant ongoing challenges continues to be the excessive waiting periods endured in Emergency Rooms. Once again, Canadian ER’s face another summer of record-setting wait times and closures.[1] In addition to the array of other commonly discussed substantial concerns—including the extensive waitlist for specialists, physician burnout, critical shortages in nursing staff and other health professionals. We’ve reached an unprecedented low.
It’s time to restructure the healthcare system. We must initiate tangible and immediate actions at all tiers of the healthcare framework to bring about substantial improvements.
Necessary adjustments must be implemented to safeguard emergency healthcare services for all Canadians, along with our healthcare providers who consistently bear the weight of the demand for critical care. Frontline workers received widespread recognition across government bodies throughout the pandemic and its aftermath for their unwavering commitment and tireless efforts. Why are they left to continue carrying the brunt of this ongoing crisis?
One of the pillars of healthcare that remains in a massive backlog as a result of the pandemic is diagnostic imaging.[2] Fortunately, some government bodies have begun to take important steps to improve Ontario’s healthcare system. Ontario, being the most populated province in all of Canada, is home to almost half of all Canadians at 40%.[3] Earlier this year, Bill 60, Your Health Act, was passed through the Ontario Legislature. This crucial bill will allow Independent Health Facilities to expand the scope of their imaging license to MRI and CT, which is a significant move towards addressing the backlog and improving timely access to diagnostic imaging services.
Whether it be MRI, CT, X-Ray Mammography or Ultrasound, these services are indispensable as they play a large role in the diagnosis, prognosis, and treatment of serious conditions. While the accessibility of diagnostic imaging remains only one of the many ongoing issues in Canada’s current healthcare system, there is no doubt that expanding access is imperative to preserving and prolonging the health of Canadians.
We must continue to find innovative ways to broaden healthcare access for all Canadians, as the capacity of our current system has certainly been hit. This is why we must look to expanding healthcare access through the collaboration of both private and government players. Enabling privately owned facilities to conduct procedures usually performed in public hospitals helps alleviate the strain on overworked radiology groups, understaffed hospitals, and overall shortages in emergency care. However, ensuring quality care, adequate staffing, seamless public-private collaboration and cost-effectiveness is vital for sustainable and effective implementation.
[1] Duong D. Why are emergency departments closing? [news]. CMAJ 2022; 194:E1138–E1139.
[2] Agarwal M, Udare A, Patlas M, et al. Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study. CMAJ Open 2020;8(3):E568-E576.
[3]“Population and dwelling counts: Canada, provinces and territories “Statistics Canada” Population and dwelling counts: Canada, provinces and territories”. Statistics Canada. February 9, 2022. Retrieved February 9, 2022.
The digital revolution has brought significant advancements in the healthcare field, revolutionizing how medical professionals provide care to patients. Telemedicine and remote patient monitoring have emerged as powerful tools that allow doctors to deliver healthcare services remotely, transcending geographical barriers and improving access to care. In this article, we will explore the synergistic approach of telemedicine and remote patient monitoring and how they are transforming the landscape of virtual healthcare.
The Rise of Telemedicine
Telemedicine, or telehealth, refers to the remote delivery of healthcare services using telecommunications technology. This approach lets patients connect with healthcare providers virtually, allowing convenient and efficient care without needing in-person visits. Telemedicine has gained traction recently due to its numerous benefits, such as reduced travel time and costs, improved access to specialists, and increased patient satisfaction.
One notable component of telemedicine is remote patient monitoring. This entails using technology to collect and transmit patient data, including vital signs, symptoms, and medication adherence, from the patient’s home to the healthcare provider. Through remote patient monitoring, healthcare professionals can closely monitor patients’ health conditions, identify any changes or trends, and make timely interventions or adjustments to their treatment plans.
Remote Patient Monitoring: Managed By Current Procedural Terminology (CPT) Codes
Remote patient monitoring is managed by CPT codes, a standardized system for reporting medical procedures and services performed by healthcare providers. These codes enable healthcare organizations to accurately bill for remote patient monitoring services and ensure proper reimbursement.
By utilizing CPT codes, healthcare providers can seamlessly incorporate remote patient monitoring into their practice, ensuring quality care and financial sustainability.
Health Level Seven (HL7) International, the global authority on interoperability of health information technology with members in 55 countries, announced the 2023 class of John Quinn HL7 Fellows and the 2023 recipients of the W. Edward Hammond, Ph.D. Volunteer of the Year Awards during its annual business meeting at the 37th Annual Plenary and Working Group Meeting in Phoenix.
To bridge language barriers and make healthcare more inclusive and transparent for patients who speak Spanish, the American Medical Association (AMA) now offers Spanish language descriptors for more than 11,000 medical procedures and services.
By Samantha Moyer, senior technology product manager, 
