| The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS), in conjunction with the HHS Office of Inspector General (OIG) announced a policy of enforcement discretion to allow compliance flexibilities regarding the implementation of the interoperability final rules announced on Mar. 9, 2020, in response to the coronavirus disease (COVID-19) public health emergency. ONC, CMS, and OIG will continue to monitor the implementation landscape to determine if further action is needed.
“ONC remains committed to ensuring that patients and providers can access electronic health information, when and where it matters most. During this critical time, we understand that resources need to be focused on fighting the COVID-19 pandemic. To support that important work and the information sharing efforts we are already seeing, ONC intends to exercise enforcement discretion for 3 months at the end of certain ONC Health IT Certification Program compliance dates associated with the ONC Cures Act Final Rule to provide flexibility while ensuring the goals of the rule remain on track.” – Don Rucker, MD, National Coordinator for Health Information Technology.
“Today’s action follows the extensive steps CMS has taken to ease burden on the healthcare industry as it fights COVID-19. Now more than ever, patients need secure access to their healthcare data. Hospitals should be doing everything in their power to ensure that patients get appropriate follow-up care. Nevertheless, in a pandemic of this magnitude, flexibility is paramount for a healthcare system under siege by COVID-19. Our action today will provide hospitals an additional 6 months to implement the new requirements.” – Seema Verma, CMS Administrator
For the CMS announcement, visit: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index
For the ONC announcement, visit: https://healthit.gov/curesrule.
For the OIG announcement, visit: https://oig.hhs.gov/reports-and-publications/federal-register-notices/index.asp |
By Christopher Maiona, M.D., SFHM, chief medical officer, PatientKeeper, Inc.
With all that the healthcare system has to worry about these days, perhaps it’s time to hit the “Pause” button on health IT deployment.
Or not.
While it’s certainly true that provider organizations can ill afford any disruption or downtime in their health IT infrastructure right now – one could argue a massive EHR replacement project might not be advisable at this moment – it’s equally true that effective, practical health IT is needed now more than ever. Clinicians on the front lines of the COVID-19 response need accurate and relevant patient data from the EHR system, instantly (meaning with one click, not dozens); and they need to be able to collaborate with their colleagues on urgent patient care issues at a moment’s notice, anytime, anywhere.
To that end, nothing could be more practical or timely amidst the COVID-19 patient surge than patient data access and care team collaboration capabilities on mobile devices. Smartphones and tablets are the information access and communication tools of choice for most clinicians, wherever they may be – within the hospital, in a triage tent, quarantined at home, or anywhere in between.
But for hospitals under the gun in the midst of this pandemic, is implementing such functionality really feasible?
Let’s back up, and consider a fundamental truth of healthcare IT: EHRs aren’t supporting doctors the way they were intended to, and are diverting valuable time that could be spent with patients.
Ironically, before the EHR, a physician’s biggest pain point was not having access to enough data. Patient information was siloed, typically in dusty paper charts buried in the basement or out of reach in off-site storage. Physicians didn’t have a comprehensive view of the patient. Now with EHRs, providers should have better access to patient information. Alas, that often is not the case, as vital information is buried in a sea of redundant or irrelevant data within electronic clinical notes.
It is crucial that the healthcare industry empowers physicians with tools that will make them better. Unfortunately, forcing physicians to wait their turn for one of too-few hospital workstations is not making them better. The inexplicable persistence of UIs that fail to effectively parse information in a manner consistent with a physician’s workflow or thought process isn’t helping. Obtrusive, non-emergent automated queries that foster alarm fatigue aren’t helping. System design predicated on a one-size-fits-all user experience strategy hinders delivery of care.
On the other hand, well-designed mobile apps, which afford ready and actionable access to relevant patient data, can accelerate care. And if such apps are (a) an extension of the existing EHR, and (b) as intuitive to use as any consumer app on your phone today, then training and adoption shouldn’t be a problem.
The value of “mobilizing” the hospital EHR goes far beyond effectively caring for patients under crisis conditions. It has become essential for provider collaboration on patient care generally, as physicians today are as “siloed” as patient records once were. We are not all in the same hospital at the same time. Remote access to records and the ability to easily communicate with each other within the context of a patient chart are key to the kind of collaboration that fosters better care.
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By April Gill, senior vice president, solution management, Welltok.
The future of COVID-19 remains a giant question mark right now. But what is clear in this uncertain time is the significant impact everyday factors, commonly called social determinants of health (SDOH), have on a person’s health. Literature shows that up to 70% of a person’s overall health is driven by SDOH, including factors like race, income, education level and more. Knowing about these factors can improve how providers keep patients healthy year-round, but also how they engage, counsel and treat patients as individuals during a crisis like the one we are currently experiencing.
If providers understand what kinds of SDOH their patients are facing, they can better understand what health risks they have today, as well as to anticipate their future needs and risks. They can use this insight to tailor what information they share with whom, using the most effective communications channels.
Consider an elderly patient who does not own a car and relies on public transportation for everyday needs. Before COVID, a provider may have leveraged this insight to connect them to Lyft to get to a clinical appointment.
Now, a provider with this insight would likely do much more – have a telehealth appointment instead, connect them with local volunteers who will deliver groceries so they can maintain a healthy diet without leaving home, and email them facts about how to minimize risk while using public transportation to pick up a prescription, if absolutely necessary. This is just one example of how providers can improve patient care and support by understanding what they experience every day.
But are patients aware of the impact SDOH have on their own health? To find out, Welltok conducted a survey of over 2,000 consumers earlier this year, to get their views on what factors they think affect health, and which ones they would share with their provider. Surprisingly, consumers underestimated how much SDOH influenced their overall health and wellbeing – responding that they only make up about 50% of a person’s overall health. (It’s really 70%). They did have a good understanding of some factors that drive health status – like type of work or who they live with – but not more than half did not understand how daily factors like length of commute also play a role.
Not surprisingly, three out of four people also told us they experienced a change in life in the last year that impacts health. The top ones were a change in 1) stress level, 2) annual income and 3) the amount of debt they have. With most provider interactions being episodic in nature, the opportunity to get to know patients at a personal level and/or stay apprised these changes is extremely difficult. Building off this, consumers were asked to list who they would share these life changes with.
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By Kayla Matthews, freelance journalist, Productivity Bytes.
As COVID-19 cases push hospitals around the country to their limits, medical facilities are facing challenges beyond sick patients. Long hours and an uptick in cyberattacks are putting serious strain on existing cybersecurity defenses. Without the right practices, these defenses may fail, exposing patient and hospital data to hackers and cybercriminals.
Here is why security remains key as the coronavirus outbreak grows more severe — and how hospitals can rise to meet current cybersecurity challenges.
Why Healthcare Data Security Remains Important
While cybersecurity may seem overshadowed by other healthcare concerns, the current crisis makes hospital data security more essential than ever.
Many hospitals and health systems are currently expanding or introducing COVID health data collection programs to get the information needed to combat the novel coronavirus. Many of these same systems are also ramping up data-sharing between institutions to ensure that medical providers around the country have the best possible information to work with.
New operating conditions — like hospitals that set up tents in parking lots to expand their number of available beds — have also changed how hospital systems, like electronic health records, are used and secured.
At the same time, hackers are stepping up their operations and trying to take advantage of the chaos. Security researchers have already noticed a serious rise in attacks like phishing emails, as well as new malicious health tracking and COVID-19–related apps.
Current stress on staff may make hospitals more vulnerable to hacks. Cybersecurity professionals were, on average, overworked before the crisis began — an issue that has likely gotten worse as the crisis has progressed. Doctors, nurses and hospital administrators are working overtime, and organizations are bringing on new workers to manage the increased need for professionals. Existing staff may struggle to keep up with good security practices, and new team members may not receive the full training they need to keep data safe.
New information collecting schemes are critical for medical providers — but if the data they collect isn’t secured, it may also put a lot of patients at risk. This patient information may not seem like the most valuable target for hackers — but health data is actually widely sought after by cybercriminals. These hackers use health information, along with other personal information, to construct comprehensive identity packages about individual patients.
What Hospitals Can Do to Handle Security
There are steps hospitals can take to ensure that patient and hospital data stays as safe as possible — even while the staff is under immense pressure.
During the crisis, operational security will become more critical. Doctors, nurses and hospital staff should be highly aware of what they are sharing on social media. Personal information should be kept private, and employees must take note of any information in the background of the photos they take. A cybercriminal scouring the posts of doctors and hospital workers may find what they need to break into a network — like a password taped to a monitor.
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By A.J. Hanna, vice president client advocacy, SYKES.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of our survey on attitudes toward telehealth. Telehealth, in its purest form, has existed for decades. Physicians, whether by phone, radio, or other forms of transmission, have been calling on clinicians from outside of their communities to assist them with second opinions or provide specialty expertise for many years.
And while the internet has opened up new and more expansive opportunities for telehealth — including making it easier for the remote caregiver and the patient to interact via both video and audio — regulatory restrictions, reimbursement inconsistency, attitudes toward effectiveness and other factors have prevented it from finding its full promise.
COVID-19 and its ability to spread easily and rapidly has pushed the healthcare system in the United States and around the world to take a more expansive view of how telehealth can be used. Given the growing importance of this tool for triage of those potentially infected by the novel coronavirus, we wanted to first assess how many people even knew what telehealth was.
When presented with the question, “Telehealth is the use of communication technologies to support long-distance health care, instead of an in-person appointment. Are you familiar with telehealth?,” over 42 percent of those contacted for this survey were not even aware of the service (in excess of 1400 people). While usage of telehealth services has increased over the last several years, there are still many people who do not equate services available to them as being telehealth.
Of those few in our survey who knew what telehealth was and had actually used the service, satisfaction rates were very high. This follows trends from other studies that find that telehealth satisfaction levels exceed other parts of the healthcare industry. And not surprisingly, the primary benefit that they cite is the ability to avoid being with others in a clinical waiting room. But for those who had not been engaged in a telehealth visit, or had not considered the service, some expressed concern that telehealth would only be effective for minor illnesses and diagnoses. Others felt that a diagnosis would be difficult without the “touch and feel” aspect of a care visit.
Perhaps not surprisingly, respondents in the 55+ age group were less likely to have used telehealth or expressed concerns about its effectiveness. Because many in the upper level of this age group are likely Medicare beneficiaries, and because coverage by Medicare has been restricted to specific conditions, geographic regions and care settings, this is not surprising. Recent decisions by the federal government to relax restrictions for Medicare coverage of telehealth as a result of the novel coronavirus pandemic may help to close the gap in utilization represented in our survey.
If there is any outcome of the current pandemic as it relates to telehealth, it may be that it will encourage more people to consider using it. Nearly 60 percent of respondents indicated that COVID-19 has made them more likely to consider using a telehealth service in the future. Almost 25 percent of our respondents had not linked COVID-19 to their opinion of using telehealth. However, those numbers will surely change as the health system in the United States continues to utilize all means necessary to care for the health of people in ways that prevent further spread of the disease.
By Carlos Meléndez, COO, Wovenware.
Chatbots, or conversational AI, seem to be everywhere in our daily lives and go-to solutions for digital transformation initiatives. From banks to insurance companies and e-commerce sites, these automated assistants offer help, answer our questions and guide us – often without our really even knowing it. In today’s 24/7 environment, they fulfill the need for always-on service, anytime and anywhere, since it can be a challenge to staff call centers or customer service departments around the clock.
While we’re getting used to chatbots in customer service, there’s an emerging role for them in healthcare – helping to address the COVID-19 crisis.
Knowledge is Power — Easing Public Concerns One Bot at a time
The ability to provide information at a moment’s notice, anytime, anyplace and alleviating the burden on healthcare staff has made chatbots an important tool at Providence St. Joseph Health in Washington State. This health facility treated the first COVID-19 case in the U.S, and it implemented chatbots to help address the public’s demand for information, while at the same time, freeing up their overtaxed healthcare providers from having to deal with a deluge of calls from sick people and the “worried well.”
Providence Saint Joseph Health turned to technology to help it more effectively manage three critical stages of care: triage, testing and treatment, relying on chatbots to particularly assist during the triage phase of the process. By visiting its Coronavirus Assessment Tool online, people can find out more about which symptoms might indicate the virus, and figure out if they should be seen by a health professional. This chatbot is connected to a virtual patient care visit which enables people to discuss their symptoms with a nurse practitioner. It has had overwhelming success with the public; in its first day of use alone, more than 500,000 people used the chatbot.
Chatbots have been able to step up and meet these types of needs because they combine natural language processing with machine learning capabilities. This allows them to understand and communicate in a free flowing, conversational discussion. Because of the benefits it provides, market opportunities for the technology is growing rapidly: the global market for chatbots is predicted to reach $15.7 billion in 2024, up from $4.2 billion in 2019. And the market for chatbots in healthcare is expected to be over 314 million by 2023.
It’s no wonder that conversational AI has a bright future in healthcare. In an industry where professionals are busy and continually strapped for time, chatbots can provide and collect information, conduct outreach, send reminders and schedule appointments. It can also provide support to patients, their families and the public and offers the convenience of meeting consumers wherever they are – whether it’s on their phone, through messaging, social media or elsewhere.
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By Drew Ivan, chief product and strategy officer, Lyniate.
It is becoming increasingly popular to move healthcare outside of the clinic and into the community and the home with the use of telemedicine platforms, apps, and other digital means — and the coronavirus pandemic has dramatically accelerated that trend. Counterintuitively, this healthcare crisis has the potential to attenuate the relationship between the patient and the healthcare system, putting provider organizations at increased risk from “digital disruptors” like Amazon, Google and Apple, whose ambitions to take over consumer relationships in healthcare are stronger than ever.
As patients re-orient during the pandemic around other points of care (hospitals, urgent care, pharmacy, etc.), the relationship patients have with their PCPs (which is one of the health system’s biggest and most meaningful advantages against the advancement of healthcare disruptors), can lose value to the consumer. As such, it behooves health systems — who are understandably all hands on deck working to address the COVID-19 crisis today — to be giving serious consideration to ways of fending off digital disruptors as their big challenge in a post-COVID-19 world.
This means focusing on leveraging the unique strengths and assets they have and getting smart about aggregating and using the disparate consumer/patient data sets they manage, to deliver a consumer experience only they can provide.
Digital disruptors excel at delivering exceptional digital customer experiences by using the massive data sets at their disposal that render rich insights into customer trends, needs, behaviors, preferences, proclivities, etc. With that said, hospitals and health systems have an advantage in their exclusive access to patient data and their in-depth medical knowledge.
Health systems need to thoughtfully but aggressively leverage these advantages if they want to successfully retain primacy in the consumer’s healthcare brand relationships. With non-emergent care rapidly shifting to the digital space, digital brands have a golden opportunity to disrupt the traditional patient-health system relationship should provider organizations miss the opportunity to reinforce those relationships by delivering much more personalized digital interactions.
It’s important to remember that healthcare organizations do not need to match the digital sophistication of the big data-driven consumer tech giants. They just need to use what they already know about patients, communities and medicine to create the kinds of experience for patients that only they can.
As hospital leaders aim to protect their organizations from digital disruptors in the post-coronavirus aftermath, these three considerations should be top of mind:
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Poor indoor air quality is associated with various short-term health effects, including headaches, dizziness, eye irritation and throat irritation, as well as long-term health complications like heart disease, respiratory diseases and cancer, according to the Environmental Protection Agency.
With the average American spending approximately 90 percent of their time indoors, maintaining indoor air quality is an important health concern in all American households, and more so for those with very young children or seniors who are more susceptible to the effects of pollution. As a homeowner, you must constantly take action to get rid of indoor air pollutants like smoke, chemicals, particulates and varnishes, even though you may not see them with the naked eye. Luckily, there are various smart technologies that have been designed to do just that.
Smart air conditioning systems
Smart air conditioners typically use internet and Wi-Fi technology to allow you to control your air conditioning in a variety of ways – whether you’re at home or not. Smart air conditioners are usually mounted to walls and windows and can be operated remotely using a smartphone, tablet or computer. Some smart air conditioners can also be connected to smart home assistants such as Google Home or Alexa for easy voice control. Just like in traditional air conditioners, air filters size measurements vary, and in a smart air conditioning system, this matters a lot. You must ensure that you have an appropriately sized air filter, or else you risk putting a strain on your air conditioning system and pumping dirty air back into your home. Improve air quality with 14×24 air filters. Smoke, pollen, dust, dander, and mold don’t stand a chance against the powerful electrostatic charge of this pleated filter.
Smart sensors
Climate Zone, an air conditioning company from London, points out that there are a lot of things that people can do to improve indoor air quality, but without the relevant data, most remain in the dark about potential dangers in their homes and end up not taking these actions. This is where smart sensors come in: different sensors can provide alerts when pollutant levels become too high inside, allowing the homeowner to take the appropriate action before they start causing adverse health effects.
One of the smart sensors that have become a must-have in every home is the carbon monoxide monitor. Since the poisonous gas is colorless and odorless, the only way to know when you have it in your home is by installing smart carbon monoxide sensors, especially in the kitchen. Once carbon monoxide is detected in your home, the smart sensors can send alerts to your phone or sound an alarm, allowing you to open your windows to get rid of it.
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