Response from Oliver Lignell, vice president, virtual health, AVIA
Providers have a new tool to help them combat COVID-19: digital. Health systems are proactively leveraging digital assets to help triage, navigate, and treat cases in ways that address concerns and also reduce the spread of the virus to other patients and providers.
Virtual assistants and chatbots can help consumers explore symptoms, accurately triage their needs, and navigate them to the appropriate site of care. These solutions can both reduce consumer worries and potentially inappropriate use of EDs and urgent care clinics.
Virtual visits are another critical digital tool because they allow patients to complete a visit from the safety and comfort of their home without exposing them to crowded and potentially infectious clinical locations and, just as importantly, reduces wait times and crowds at in-person care sites.
Asynchronous virtual visits (store and forward, text/chat) can also be an important (and low-cost) solution. Consumers can initiate a low acuity visit on-demand, when convenient, ensuring their concerns are addressed when desired – with the added benefit of decreasing wait times, creating a more efficient patient flow, and freeing up provider capacity. Such solutions further reduce the pressure on health systems while improving the responsiveness to patients.
Response from Andrea Tait, vice president of Client Value, Orion Health
Digital tools can play a key role as healthcare providers across the globe struggle to maintain the health of their workforce and the capacity of their organizations. Pandemic response is best supported through triaging, testing and treating the affected. Tools like public-facing screeners, pandemic information sites and chatbots can help evaluate millions of people with little to no clinician support.
By triaging individuals, tools like remote patient monitoring and telehealth can be used to monitor patients from their homes and assure others that sheltering in place is sufficient. Remote monitoring tools allow clinicians to monitor more patients and make decisions about who may require testing. Designated testing sites minimize the need for direct interaction between healthcare providers and patients, preserving both the health and capacity of health service providers.
Integrated care pathways and telehealth tools can help clinicians treat more patients at home and discharge those in hospitals who may be safer receiving treatment for other conditions remotely, all while minimizing their own risk. Home and community delivered care is an increasingly essential component of healthcare system sustainability. Now, more than ever, these tools and strategies are fundamental to the future of the healthcare system.
Digital solutions can be employed in seemingly non-traditional ways to both prepare and respond to the impact of the coronavirus. For healthcare organizations, traditional pre-access telephone dialing metrics can be modified. Hospital registration staff, in addition to financial guidance and scheduling, can screen patients for COVID-19 and obtain additional clinical information in advance of arrival.
By identifying potentially infected patients, even before they enter the hospital, hospitals and clinics are able to communicate effectively within the facility and plan for appropriate patient care, monitor and manage potential for healthcare personnel COVID-19 exposure, and inhibit the spread of the disease both within the facility and community.
Equally important and sometimes forgotten, back-end services provided by both hospital staff and revenue cycle vendors yields the same patient communication opportunities. Discharged patient follow up and screening post-discharge keeps the patients connected and engaged with the hospital as well as preserves an open communication line between the hospital and discharged patient.
Response from Matthew A. Michela, president and CEO, Life Image
The coronavirus has manifested the importance of digital solutions and interoperability in a heightened way. The lack of digital connections to community referral sites will impact the safety of patients and healthcare staff. It is imperative during this public health crisis that attending healthcare workers have as much relevant clinical data in advance as possible through digital connections.
Unfortunately, many healthcare organizations are still deploying outdated technology, such as imaging CDs, and the last thing a provider or hospital should want is a patient who is symptomatic or potentially a carrier of a virus to show up with a CD in hand. This presents a problem on multiple levels, from the lack of care coordination to the risk of disease spread.
The technology is available and many large health systems are set up to support digital exchange, so they need to mandate protocols to exchange information in this manner. In the same way that the public is asked to wash their hands and frontline workers are urged to wear masks, healthcare professionals should insist that medical data is received digitally for fast, efficient care.
As we face the COVID-19 pandemic, it is important for hospital organizations to ensure information is delivered in real time, accurately, and highly customized to the intended audience (patients, visitors, clinicians, etc.). It can be beneficial for hospitals to automatically deliver COVID-19 patient education videos tailored for each patient’s demographics, language, and clinical circumstances.
This also includes educational content and notifications (visitor restrictions, live updates, social distancing practices, etc.) on digital signage locations in public areas throughout hospitals. That content can be delivered in notifications or in response to Real-Time Location System (RTLS) triggers (for example, if a clinician enters the room, the patient’s TV will display hand washing reminders).
RTLS integration can also track and report staff entries into patient rooms so hospital leaders have real-time data about potential exposures, isolation violations, or interactions with non-approved staff. Interactive surveys with branch logic can help guide patients to provide vital feedback and report any hand hygiene breaches. Digital meal ordering, service requests, and virtual visits decrease human-to-human contact while helping patients get the food, care, services, and items they need. Live streaming (either soothing content like an aquarium or information sources) can also provide distraction therapy and education for patients in isolation.
The American Hospital Association (AHA) recently determined that 75% of senior hospital executives endorsed the importance of digital innovation. This is incredible progress for the industry, but there are still key areas within hospitals that need to embrace the new technologies available, for both the health of the hospital and its patients.
One of the most underserved departments when it comes to innovation is the Neonatal Intensive Care Unit (NICU). The lack of investment might come from the assumption that it’s too small of a population, but these infants are one of the most expensive patients in a hospital, with some preterm infants staying in the NICU over 100 days.
Nutrition: The Overlooked Piece in Preterm Infant Health
More than 380,000 babies in the United States are born preterm annually, and according to the CDC, in 2018, one in 10 babies was born too early (before 37 weeks of pregnancy). Today, we can survive infants as early as 22 weeks gestational age.
Preterm infants require round-the-clock care in the NICU, including monitoring of their hearts, lungs and temperature. As survival rates for extremely preterm infants improve, attention is now being focused on improving the quality of survival. Optimal nutrition early in life can positively impact not only physical growth, but neurological development, as well.
However, nutrition is rarely taught in medical school and expertise is limited to dietitians, where present, or a clinical researcher who focuses on nutrition. Optimizing feeding and nutrition management in the NICU remains a major challenge for clinicians.
Implementing a standardized feeding strategy has been shown to improve growth outcomes in addition to reducing adverse events, however most NICUs are still using paper-based feeding protocols and require dieticians to make manual calculations using pen, paper and calculator.
This manual process has been the standard practice for decades. Not only does this provide room for error, it creates more work for clinical care teams and is a drain on hospital resources. While technology in support of life saving measures is rampant in the NICU, the utilization of software has been limited to the implementation of electronic medical record systems, such as Epic and Cerner. Investments in technological innovations have not extended to addressing feeding and nutritional support for the tiniest, most vulnerable patients.
By Priya Sabharwal, practice leader, network operations, HGS.
Priya Sabharwal
Imagine a scenario: A patient looking for a new doctor searches her insurer’s online network directory to find a provider her plan will cover. She selects what seems to be the perfect doctor based on her criteria, which could include gender, office location, languages spoken or other qualifications, in addition to being in-network with her health plan.
But there’s a plot twist: The patient eventually learns the doctor she found is not, in fact, the right option for her – but it took her scheduling and arriving at the appointment for her to realize this. It turned out the entry in her insurer’s directory was outdated, and her doctor had moved offices.
This scenario is hardly out of the ordinary. A 2019 Health and Human Services survey uncovered errors in half of the listings in Medicare plans alone. These significant inaccuracies cause issues not just for patients, but for payers and providers, too:
Poor directories are more than just an inconvenience for a member; they also impede their access to necessary care, and can create unexpected medical costs.
A typical health plan is already regularly contacting providers’ offices for many different types of data requests. When they also call to verify provider directory requests, it can create added pain for both sides of the equation. On the payer side, it can create provider abrasion, which could influence whether the provider keeps doing business with that payer. On the provider side, receptionists and office managers are pulled away from their higher-level tasks whenever they stop to answer the phone, leading to short-term frustration and, potentially, burnout.
Payers risk incurring stiff fines and penalties from federal and financial entities, and/or member lawsuits. For example, as of 2016, CMS regulations now permit the agency to fine health plans up to $25,000 per Medicare beneficiary for errors in Medicare Advantage plan directories, and up to $100 per beneficiary for mistakes in plans sold on the Affordable Care Act exchanges.
Poor provider data management hinders effective patient-provider matching, patient satisfaction, and demand conversion through call centers.
If a health plan’s website does not contain thorough, accurate provider information, or reflect correct provider availability, potential patients may go back to the drawing board and select a provider from a different organization.
A lack of complete and reliable provider data about specialists leads to misdirected referrals, and acts as a barrier to patient retention within networks.
So what are some steps payers and health plans can take to create a solid provider data foundation? It starts with fundamentally changing the way we think about, use, enter and maintain data.
Many people call retirement the golden years, and they look forward to it for decades. However, those who make the wrong decisions before and during retirement could find that it’s not as pleasant as they anticipated. Here are some useful tips to help you start your retirement right and increase your happiness and health.
1. Decide When to Start Getting Social Security Benefits
When you retire, you may not want to start withdrawing your Social Security benefits. People who retire early could have to wait to apply for Social Security benefits, and others might not receive the full benefit. According to the Social Security Administration, you can start getting Social Security benefits when you turn 62, but you’ll get about 30% less every month. If you wait and use your retirement savings alone or continue to work for a while, your benefits will increase.
To prevent hospitals from being overwhelmed, states should focus on preventing the spread of COVID-19 at high-risk sites, such as nursing homes, and in high-risk localities, the COVID-19 Policy Alliance—a group of experts brought together by two professors at the MIT Sloan School of Management—said in a presentation released today.
The Alliance also put online a set of data analytic tools to enable states to identify the highest risk facilities and localities—those with clusters of individuals over 65 or with relevant health issues.
The Alliance analysis indicates that one of the factors possibly leading to the high fatality rate in Italy was that sick people from areas with concentrations of high-risk individuals overwhelmed hospitals, creating a domino effect that led to skyrocketing death rates. The Alliance has developed tools to identify institutions and counties in every state in the U.S. that have the same characteristics as the points in Italy that put its health care system into a tailspin.
For example, the data tools not only show where nursing homes are and how many people reside in them, but show which nursing homes have had the most problems previously with infections. For counties, the tools show not only areas with high numbers of elderly, but also those with high numbers of individuals of all ages suffering from diabetes, obesity and other conditions that create COVID-19 risk.
A 15-minute webinar describing the Alliance’s tools and recommendations for U.S. federal, state and local policymakers is here. The webinar expands on a slide deck that lays out the analysis and guidance.
The COVID-19 Policy Alliance was launched on March 11 by Professors Simon Johnson, the Ronald A. Kurtz Professor of Entrepreneurship, and Retsef Levi, the J. Spencer Standish Professor of Operations Management. They pulled together a team of experts from across MIT and elsewhere to analyze the available data on the pandemic. The tools will be updated as more data and analysis are available.
Levi said, “We want to help states make data-based decisions that can save lives. Focusing on the sites and areas that are most likely to lead hospitals to crash is key.”
Johnson said, “Hospitals are a critical line of defense in the ongoing battle against COVID-19. We must focus now on preventing our world-renowned hospital systems from collapsing.”
By Chrissa McFarlane, CEO, Patientory, and Jonathan Fuchs, FACHE, member of the board, Patientory Association.
As we approach a new decade, there are a plethora of predictions being made around the future of the healthcare industry. Healthcare’s journey to value will, of course, continue, however, industry challenges and boundaries (i.e. competitive pressure, lack of transparency, limited patient access and erosion of trust) are still areas of concern and opportunity as the industry progresses.
My education, experience, and journey as an entrepreneur led me to create Patientory to empower consumers with an application they can use to improve their overall health and well-being. We are the world’s first healthcare cryptocurrency and HIPAA-compliant blockchain network, with more than 50 nodes registered worldwide.
I recently sat down with Jonathan Fuchs, FACHE, veteran healthcare executive, who also serves as a board member for the Patientory Association. With more than four decades of experience in healthcare management and operations, Jonathan’s expertise in health information technology, data analytics has allowed him to focus on assisting healthcare startup companies on reimbursement strategies, the impact of data and analytics on value-based care.
Chrissa McFarlane
Chrissa McFarlane: Jonathan, thank you so much for sitting down with me to talk about Healthcare 2030. Taking a look back at how the healthcare industry has advanced over the past two decades is astounding. However, as we look ten years ahead, I believe a consumer-centric healthcare system will be crucial for industry growth. What do you say to this and how do you believe technologies such as blockchain will lead the way in advancing this mission?
Jonathan Fuchs: Chrissa, of course. To your question, health information exchange will be critical in advancing the healthcare industry and honing in on the consumer-centric approach over the next decade. Blockchain will essentially help with interoperability by streamlining efficiencies, making health care an achievable and cost-efficient reality for all. The ability to transmit patient records safely and securely will, in turn, allow patient data to be viewed by hospitals and other providers in any participating region, city or country meaning the potential of blockchain will be boundary and boundless. In addition to this, the issues of cybersecurity are also top of mind. The ability to encrypt data (specifically on a healthcare blockchain) prevents unauthorized parties from accessing and reading patient data, even if they are able to access the blockchain itself.
Blockchain technology will help create better privacy standards within the industry.
Chrissa: What would you say are some of the roadblocks to Blockchain adoption?
Johnathan: Until the ability for various healthcare information technology systems to exchange, interpret and use data cohesively occur, we will continue to see latency in the adoption of Blockchain. The very structure of the technology enables data exchange to happen at a higher level of transfer. Which, currently, electronic servers and EHR systems are not set up to handle the volume or power requirements. Another roadblock is scalability, blockchain is expensive (for now)and at this point requires more power resources to handle the speed at which it operates. That’s not to say this will always be the case, but it’s definitely true today.
Chrissa: Historically, healthcare has been slow to change. Many would argue that healthcare should be more realistic than futuristic. What do you say to this?
Throughout this challenging time of the COVID-19 pandemic, Glooko, a diabetes software company that enables people with diabetes and clinicians to manage care in real-time, is committed to helping ensure the health and well-being of people with diabetes, their caregivers, and their healthcare professionals. Glooko is therefore taking action to serve the global diabetes community by providing a no-charge remote-care solution that provides live patient-to-clinician connectivity.
As many efforts undertaken in our communities are aimed at reducing the chances of being exposed to and spreading COVID-19, individuals who have chronic conditions like diabetes and contract the virus appear to be at a higher risk for developing complications; as such limiting exposure is critical.
For certain appointments, healthcare professionals may determine that the patient and their care team would be best served by a remote review of the patient’s personal diabetes data and a corresponding telehealth consult, reserving in-office visits only for those appointments where a patient’s medical status truly requires in-person treatment.
To minimize the risk to people with diabetes during this time by broadening access to remote medical appointments with healthcare providers, Glooko is offering its secure, privacy-protected remote-care solution at no charge to medical clinics and people with diabetes as a public service until the greatest threat of the pandemic has subsided.
This public service is being made available to medical clinics and people with diabetes in countries where Glooko technology is already provided. Interested medical clinics and people with diabetes can learn more about how to access the Glooko remote-care solution at www.glooko.com.
GeneratorWorks, a technology company with a suite of healthcare software and hardware products, has announced a partnership with clinical algorithm platform SmartDocMD. Together, they have released SecurePass, a digital COVID-19 risk stratification and screening survey.
With bold and proactive steps, SecurePass creates a solution that effectively surveys patients and healthcare communities to identify possible COVID-19 risks. With this information at hand, healthcare facilities can better inform and remotely support those showing possible high-risk indicators.
SecurePass is powered by SmartDocMD’s clinical algorithms that combine CDC Guidelines for risk assessment, patient symptoms, and medical comorbidities to identify and help segregate higher-risk patients.
The product plugs in patient demographics, geolocation, risk factors, illness symptoms, severity and comorbid conditions that can be viewed in real-time and shared with GeneratorWorks portfolio of products as well as infectious disease teams, including the Center for Disease Control.
SecurePass has the strength of the GeneratorWorks suite of healthcare software and hardware products and is even stronger when tied to:
GetOnHealth, a virtual clinic platform where patients can be assessed and connected via a virtual visit to their primary care or other necessary doctors.
Queue, currently in service to over 50 hospitals nationwide, helps healthcare providers give their patients an overarching positive experience as an organized intake, check-in, and transfer system.
“Our world has changed with the current COVID-19 pandemic, and health systems are becoming overwhelmed” states CEO Blake Squires. “Quick-to-act and scalable digital tools need to be implemented. Understanding community health and provider needs are critical to ensuring the safety and ongoing operations of healthcare facilities and workers. With our collaboration to create SecurePass, we can do just that, while keeping patients informed, connected and safe.”
“As health systems are scrambling to contain COVID-19, bold, collaborative action is our only course,” explains Brian D’Anza, MD, President and Founder of SmartDocMD. “SmartDocMD’s clinical algorithms work within SecurePass to make sure the right patients are being seen at the right time. It ensures health systems can triage patients before they spend hours sitting in the ER, clinic, or another hospital site, which reduces transmission of this highly contagious disease.”
To prevent hospitals from being overwhelmed, states should focus on preventing the spread of COVID-19 at high-risk sites, such as nursing homes, and in high-risk localities, the COVID-19 Policy Alliance—a group of experts brought together by two professors at the MIT Sloan School of Management—said in a presentation released today.