This report describes examples of electronic health record (EHR) related burden, as well as strategies and recommendations that HHS and other stakeholders can use to help clinicians focus their attention on patients rather than paperwork, when they use health information technology (health IT).
“Usable, interoperable health IT is essential to a healthcare system that puts the patient at the center, like President Trump has promised,” said HHS Secretary Alex Azar. “We received feedback from hundreds of organizations and healthcare providers on this new burden-reduction strategy, and the input made clear that there are plenty of steps still necessary to make IT more usable for providers and maximize the promise of electronic health records.”
The development of the report, required under the 21st Century Cures Act, was led by the HHS Office of the National Coordinator for Health Information Technology (ONC) in conjunction with the Centers for Medicare & Medicaid Services (CMS). The initial draft, issued in November 2018, represented HHS’s assessment and response to feedback heard from a wide variety of health IT stakeholders, from practicing clinicians to health IT developers.
The report released today reflects additional input from the more than 200 comments submitted in response to the draft strategy and recommendations. The report outlines three primary goals and offers recommendations to:
Reduce the effort and time required to record information in EHRs for health care providers when they are seeing patients;
Reduce the effort and time required to meet regulatory reporting requirements for clinicians, hospitals, and health care organizations; and
Improve the functionality and intuitiveness (ease of use) of EHRs.
“The strategy we are releasing today takes a hard look at ways that the federal government and stakeholders can work together to reduce the administrative and technological burdens experienced by healthcare providers,” said Don Rucker, M.D., national coordinator for health IT. “Patients will benefit from these efforts because their physicians will spend more time focused on them instead of their keyboards.”
Specifically, ONC and CMS looked at four key areas and offered strategies to address each area:
Clinical documentation
Health IT usability (or ease of use of health IT tools and systems)
Federal health IT and EHR reporting requirements
Public health reporting (including coordination with prescription drug reporting programs and electronic prescribing of controlled substances).
Seema Verma
“The taxpayers made a massive investment in EHRs with the expectation that it would solve the many issues that plagued paper-bound health records,” said CMS Administrator Seema Verma. “Unfortunately – as this report shows – in all too many cases, the cure has been worse than the disease. Twenty years into the 21st century, it’s unacceptable that the application of Health IT still struggles to provide ready access to medical records – access that might mean the difference between life and death. The report’s recommendations provide valuable guidance on how to minimize EHR burden as we seek to fulfill the promise of an interoperable health system.”
The report explains that different types of administrative burden can affect different healthcare providers, but is focused on those healthcare providers that are directly involved in delivery of patient care. Those may include physicians, nurses, and other clinical staff; practice managers and other administrators immediately engaged in the management of care delivery; and care delivery institutions, such as hospitals.
Verizon and Emory Healthcare have entered into a strategic partnership to develop and test 5G Ultra Wideband-enabled use cases that could transform the healthcare industry. As part of the partnership, Verizon lit up the Emory Healthcare Innovation Hub (EHIH) with 5G Ultra Wideband service, making it the nation’s first 5G healthcare innovation lab.
EHIH is a healthcare advancement and commercialization program committed to improving the patient care and provider experience. EHIH does this by leveraging the 11TEN Innovation Partners’ “demand driven innovation” approach to solving the most pressing problems facing health care. Verizon will collaborate with Emory Healthcare and its nine Innovation Hub partners, including founding partner Sharecare, to help spur the development of healthcare solutions powered by 5G.
The massive bandwidth, super-fast speeds and ultra-low latency of Verizon’s 5G Ultra Wideband network have the potential to help redefine patient care with real-time data analytics, giving researchers the ability to explore solutions such as connected ambulances, remote physical therapy and next-generation medical imaging.
EHIH will be able to test how 5G could enhance augmented and virtual reality (AR/VR) applications for medical training, enable telemedicine and remote patient monitoring, and provide point of care diagnostic and imaging systems from the ambulance to the ER.
Tami Erwin
“The potential of Verizon 5G Ultra Wideband combined with mobile edge computing to transform healthcare is limitless,” said Tami Erwin, CEO of Verizon Business Group. “Which is why Verizon is partnering with Emory to explore the 5G future of patient care. With 5G, doctors should be able to do things like create holographic 3D anatomical renderings that can be studied from every angle and even projected onto the body in the OR to help guide surgery.”
“The healthcare industry, driven by value-based care and increased consumerization, is set for a paradigm shift that will put a much greater focus on connectivity and access to data,” said Scott D. Boden, MD, Vice President for Business Innovation for Emory Healthcare. “Across every facet of healthcare, from care innovation to reimbursement model transformation to decentralization of care, speed to data is critical to the digital evolution of health,”
This engagement is part of Verizon’s broader strategy to partner with customers, startups, universities and large enterprises to explore how 5G can disrupt and transform nearly every industry. Verizon operates five 5G Labs in the U.S. and one 5G Lab in London that specialize in developing 5G uses cases in industries ranging from health care to public safety to entertainment. While this is the first 5G lab Verizon has set up on-premises for a customer, it will be part of an ongoing initiative to co-develop 5G-related use cases to help customers transform their industries.
In addition to providing EHIH with 5G, Verizon will offer network and security services, project management, professional consulting services and managed infrastructure and sit on the Emory Hub Executive Advisory Board.
The ribbon cutting for the new 5G healthcare innovation lab takes place Friday February 28th from 10a-12p ET at One Glenlake Parkway, NE, Atlanta, GA. If you’re interested in attending and speaking to Verizon and Emory executives on site please contact the below Verizon spokesperson.
Nuance Communications, Inc announced the general availability and accelerated delivery of the Nuance Dragon Ambient eXperience (DAX) solution, an ambient clinical intelligence (ACI) solution for a wide array of medical specialties. Working in tandem with electronic health record (EHR) systems, the Nuance DAX solution revolutionizes the physician-patient experience by securely capturing and contextualizing physician-patient conversations and powering the exam room of the future where clinical documentation writes itself.
Innovated by Nuance and Microsoft, the Nuance DAX solution is built on decades of healthcare experience, in-depth research investments in conversational AI, and enterprise-focused cloud services. Nuance DAX leverages and extends the proven power of Nuance Dragon Medical, already relied upon by more than 500,000 physicians globally, with the latest advancements in ambient sensing technology and AI to create a fully voice-enabled and ambient exam room environment.
As part of a multi-year joint development effort, Microsoft has come together with Nuance to enrich Nuance DAX’s capabilities with AI and cloud capabilities from Microsoft, including the ambient intelligence technology, EmpowerMD, which will come to market as part of the Nuance DAX solution.
The accelerated delivery of the Nuance DAX solution is driven by the healthcare industry’s need to mitigate what the World Medical Association is calling a “pandemic of physician burnout,” with 51 percent of physicians reporting frequent or constant feelings of burnout caused by a staggering administrative workload of electronic paperwork to document patient care and which is required for insurance coverage, financial reimbursement, and medicolegal liability protection.
Burnout is a serious barrier to improving the cost and availability of healthcare services. A recent study published by the Annals of Internal Medicine reported that physician turnover and reduced clinical hours are attributable to burnout costs of $4.6 billion, or about $7,600 per physician, in the United States each year.
“It is essential to develop technology that empowers clinicians so that they can get back to doing what they trained for and love. It is equally important that we return to patients their doctors’ undivided attention,” said Joe Petro, CTO, Nuance. “Our development of Nuance DAX began with a deep understanding of how doctors need and want to work. We’ve delivered an unobtrusive solution that is as present and available as the light in the exam room – and already producing meaningful results for clinicians and their patients.”
Novant Health, Rush University Medical Center, and SSM Health are among the many leading healthcare organizations that have chosen the Nuance DAX solution to improve the physician and patient experience. Organizations of varying sizes such as Nebraska Medicine are already realizing increased efficiency and patient throughput, higher satisfaction scores, and reduced provider burnout after using Nuance DAX. Provider satisfaction scores for clinical documentation increased approximately 88 percent, and patient consent rates exceeded 90 percent, within only two weeks of using Nuance DAX.
SSM Health, a Catholic non-profit integrated health system serving communities throughout the Midwest, plans to pilot this technology in some of its specialty clinics in St. Louis, Mo., Oklahoma, and Wisconsin, beginning in March. “With the Nuance Dragon Ambient eXperience solution, our providers can spend more time with their patients and less time on administrative tasks,” said Ann Cappellari, MD, Vice President and Chief Medical Information Officer, SSM Health. “This helps providers and patients communicate more clearly and build stronger relationships. That results in better care, which is everyone’s goal.”
Said Greg Moore, corporate VP, Health Technology and Alliances, Microsoft, “As AI continues to improve, we expect it will empower our health system partners to turn their observations into actions — to reduce risk, flag concerns, and even help guide clinicians to the most effective care plans. By working together with Nuance, and applying the power of Azure and Azure AI, we aim to positively transform the day-to-day life of front-line care providers – ultimately empowering them to provide optimal health for their patients.”
The Nuance DAX solution is built on Microsoft Azure, a highly secure HITRUST CSF certified platform, compliant with the HITECH Act, and that has implemented the physical, technical, and administrative safeguards required by HIPAA. The Nuance DAX solution is now available for an array of medical specialties and includes:
• Ambient device: A purpose-built ambient device with a highly optimized microphone array, large interactive display, integrated biometrics, and multi-sensory capabilities, capable of reliably capturing a multi-party conversation within an exam room setting.
• Ambient documentation: An automated clinical documentation solution powered by deep-learning-based AI and certified through a quality review process.
• Ambient skills: A growing list of integrated Dragon virtual assistant capabilities through a hands-free access point that will enable care teams to complete tasks in real-time within their EHR and other third-party applications.
Artificial intelligence (AI) is transforming healthcare, especially on its clinical side, where 62% of providers have already adopted an AI strategy. The American Hospital Association recently reported that when successfully implemented, clinical AI can improve patient outcomes and lower costs at each stage of the care cycle, from prevention and detection to diagnosis and treatment. Expect to see continued growth in AI adoption in 2020.
Here are a few of the most exciting AI trends to watch for:
Social Determinants of Health (SDoH) will become a core focus for healthcare AI solutions: AI has significant potential for helping reduce socioeconomic barriers to care. Across 2019, we have seen investment by CMS in the Accountable Health Communities Model, which is the first model to include social determinants of health. This model codifies what we already know — that socioeconomic factors influence an individual’s health and risk. Emerging AI technologies are actively creating value for patients by helping to make sense of large socioeconomic and environmental datasets, driving meaningful investments and action that will help to prevent avoidable utilization and guide effective distribution of community resources.
We will start to move into the “Slope of Enlightenment” within the Hype Cycle: Healthcare AI will move out of the “Trough of Disillusionment” as more evidence of AI’s ability to improve health outcomes emerge. AI-related topics will continue to gain prominence in research and the media. And the results of funded projects and pilots will become available to the broader industry.
The AI discussion will broaden beyond imaging and natural language processing: With the exponential increase in patient data, it’s only logical that it’s time for AI – the best way to synthesize that data – to have its moment. While imaging and natural language processing have dominated the healthcare AI conversation over the past few years, 2020 will mark an expanded understanding of AI solutions to include those focused on clinical decision support. These solutions integrate into existing clinical workflows to help direct resources to modifiable patients at risk of a target adverse event. Expect to see more investment and discussion around these solutions across 2020.
Vyne, a market leader in health information exchange and electronic healthcare communication management, announced today that it has acquired Renaissance Electronic Services, LLC, an Indianapolis-based technology company providing EDI products and services to dental practices across the United States.
This strategic investment bolsters Vyne’s current dental portfolio, which includes the market-leading FastAttach electronic claim attachment platform from NEA Powered by Vyne.
The acquisition brings together two leading dental technology solution providers to create a single source for the electronic management of dental claims and claim attachments. Benefits to dental practices include integrated workflows, lower operating costs, enhanced revenue cycle operations and improved practice communications.
“Vyne’s investment in Renaissance enables us to expand offerings for our dental clients, partners and payers,” said Vyne president and CEO Lindy Benton. “This growth opportunity represents a natural extension of our business following our 2019 acquisition by The Jordan Company.”
According to Benton, “Vyne and Renaissance share a common goal of empowering providers with technology solutions to better run their businesses. Uniting our companies means we’re able to strategically offer dental practices the unique opportunity to partner with a single organization that possesses more than 50 years of combined experience developing cutting-edge dental technology solutions.”
By Sara Laporte, vice president of orthopedics and surgical services, Landmark Hospitals.
Sara Laporte
Now more than ever, it is critical for information across the care continuum to be accurate. Data plays a crucial role in patient care, from electronic health/medical records (EHR/EMR) to predictive analytics. Digitization has been widely adopted and successful in improving workflow efficiency, enhancing the accuracy of communications, mitigating risk and improving safety for the benefit of patients.
There has been one communication tool that’s remained a final, manual holdout from a bygone era: patient room information displays. Communicating key information such as a patient’s diagnosis, allergies and DNR info, these signs are often printed on paper or handwritten on whiteboards.
What is the solution? Hospitals need to bring digital signage into the 21st century.
Why digitize information room displays?
• Handwritten = prone to human error. According to The Joint Commission, communication errors with patients or administrators are cited as one of the top three core factors underlying hospital sentinel events. In addition, anyone in a rush is more likely to input the wrong information, or scribble something that can easily be mistaken by another caregiver.
• Double the work. The information nurses are inputting onto these signs is exactly what’s already in their database. Having to access the data and re-input it manually amounts to grunt work that distracts nurses from what they do best, which is caring for patients. Over any given twenty-four hour period, manually re-inputting information can amount to forty-five minutes to an hour of precious time — potentially more if the patient’s condition is complex.
• Instant Translation. Another advantage of digital signage is that it’s multilingual at the touch of a button. The latest census indicates that twenty percent of Americans speak a language other than English at home. With digital signage, patient information can cross the language barrier at the push of a button.
At Landmark Hospitals, we looked to digital paper, a new Hospital of the Future solution allowing hospitals 21st century digital signage. Known by most people as the screen in their eReader, digital paper mimics the look of printed paper and provides the advantages of digital media. Made by E Ink, digital paper has particles within microcapsules coated onto a thin film layer, which act as a form of ink that can be digitally updated.
Why hospital of the future digital paper?
• Versatility. E Ink screens are now available in a range of formats, from medical admission forms, to patient door signs, to bedhead and bedside patient care signs, to large-format patient communication boards.
• Connected. E Ink-enabled signage is linked to hospital databases, allowing for automatic information updates without the need for manual updates by time-pressed nursing staff. Each individual sign integrates with the system as a whole, so information on the patient care signs, door signs, and patient communication boards is always up-to-date and consistent.
• Sustainable. Digital paper screens require 99% less power to operate than LCD screens. Most hospital signs made with digital paper require only small batteries to operate, making them easy to deploy. The low battery usage allows for continuous use in patient environments, all day and night, with the comforting look and feel of paper and no light pollution.
• Non-light-emitting. Some companies have introduced digitized whiteboards, with EHR/EMR data automatically updated onto a TV screen in patient rooms. The light pollution from these screens, however, is a significant concern. The bright lights of LCD screens can disrupt a person’s circadian rhythm, essentially resetting their personal clock to disrupt sleep patterns.
By Salman Rashid, creative marketer, RightPatient.
Budgets and costs regarding IT are expanding more than ever- healthcare providers are increasingly focusing on requirements that demand up to date facilities as well as stability.
This is the conclusion of a survey by the firm Navigant Consulting and also explains a few more insightful details. Health systems are confidently financing in spaces such as improved EHR systems, process automation, better revenue integrity, as well as attaining improvements in revenue cycle via third parties.
This survey was conducted via HFMA (Healthcare Financial Management Association) and its sample included more than 100 CFOs and revenue cycle members from health systems, as well as hospitals.
One of the main takeaways from the survey is that almost two-thirds of the sample stated that they face problems primarily related to EHR systems- either they underutilize their EHR systems, or else they are facing challenges with EHRs like getting better results or else cannot cope with the continuous upgrades. However, even with all these, patient misidentification persists within the healthcare system of the US and is still a top concern for most providers.
Payment concerns like out of pocket payments are also another challenge, according to the respondents- 85% of respondents feel that lack of insurance will be detrimental for the healthcare providers since they rely heavily on insurance payments. However, even in these cases, they face denied claims when patients are misidentified.
To face all these issues altogether, almost 70% of the sample agreed that increasing the budget is necessary to overcome them. However, fifty percent of the respondents stated that they are collaborating with third parties to maintain revenue cycle costs, better patient identification, as well as challenges like denied claims.
By Simon Mikail, co-founder and head of operations, 405 Ads.
Providing quality care and achieving better clinical outcomes for patients are two goals that drive most physicians and healthcare providers. Effective communication between patients and healthcare professionals including physicians, nurses, lab technicians, etc. is critically important for achieving these two goals.
Here in this post, we will share with you the top seven tips to improve communication at your healthcare practice:
Keep It Simple
Using simple, non-medical language can help establish a doctor-patient relationship that leads to better patient outcomes.
Patients are more likely to trust healthcare professionals who use simple language and common vocabulary that everyone can easily understand.
Anyone who interacts with patients at your healthcare practice should be advised to avoid using cryptic jargon including medical abbreviations, terminologies, and scientific terms.
The medical jargon does not help build trust and confidence; on the contrary, it leads to confusion.
Feedback Loop
When communicating with patients, doctors and other healthcare professionals may take a smile or nod to mean they ‘got the message.’
To make sure patients aren’t disappointed with treatment results in the future or silently doubt recommended treatment regimens, create a feedback loop in order to assess how well a patient understands the information concerning symptoms of a medical condition, doctor’s advice, diagnosis, and treatment options.
A feedback loop helps ensure that patients process the conversation more effectively; it can help bridge the communication gap and improve comprehension.
How you can create a feedback loop to improve communication at your healthcare practice:
Feedback Loop With Open-ended Questions: These are the questions asked during a medical interview that cannot be answered with a static response, or with a ‘yes,’ or ‘no.’ Open-ended questions can help you toobtain important information and quickly evaluate the degree of a patients’ understanding of the information conveyed during a conversation.
Feedback Loop with Teach-Back Method: After providing patients with an explanation about the symptoms, condition, precautions, or treatments, you can ask them to ‘teach you back’ what you just said. The teach-back method is helpful especially when you are dealing with patients who are aged and others, who demonstrate a lack of ability to process information conveyed by a doctor or support staff.
Feedback Loop With the Ask Me 3 Method: Created by health literacy specialists, the ‘Ask Me 3’ method encourages patients and their family members to ask three specific questions from healthcare service providers to better understand their condition and how they can stay healthy. These questions are – 1. ‘What is my main problem?’ 2. ‘What do I need to do?’ 3. ‘Why is it important for me to do this?’
Train Your Staff
In most healthcare organizations, big or small, fresh recruits participate in a mandatory training program.
As part of the ongoing efforts to strengthen the relationship between patients and their doctors, the U.S. Department of Health and Human Services (HHS) issued the Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs. 
Verizon and Emory Healthcare have entered into a strategic partnership to develop and test 5G Ultra Wideband-enabled use cases that could transform the healthcare industry. As part of the partnership, Verizon lit up the Emory Healthcare Innovation Hub (EHIH) with 5G Ultra Wideband service, making it the nation’s first 5G healthcare innovation lab.
Nuance Communications, Inc
Vyne
