By Dr. Jeremy Corbett, divisional chief health officer, Envolve Health.
Dr. Jeremy Corbett
Facing a severe shortage of primary care physicians — as many as 55,200 by 2032, according to the Association of American Medical Colleges — means we must humanize technology-driven approaches in healthcare. Why? To improve efficiencies and ensure patients are getting the care they need, where and when they need it.
In an ideal world, physicians would play a prominent role in designing digital patient experiences, but according to a recent survey by Kyruus, they often feel excluded. Thus, we end up with a model where technology “happens” to physicians, rather than physicians cocreating the places where technology can align with them to promote better care.
The implications for our physician shortage are significant: Studies show the number of physicians in a community correlates positively with health and, inversely, with mortality rates and health costs. Yet despite the important role primary care physicians play, medical school graduates are often choosing other paths. In 2019, the National Resident Matching Program offered a record number of primary care positions, but the number of those positions filled was the lowest ever recorded.
Salary plays into this trend, as does work-life balance and the lack of automation. Physicians today are working harder than ever, and technology is increasing their burden, not lightening it. They’re seeing more patients, clicking more boxes, filling out more forms, and interacting with an increasing number of electronic systems — not to get ahead but to simply stay afloat.
Ready or Not, Here Comes Technology
Increasing the number of primary care physicians may seem like the solution, but according to an AAMC report, the answer actually lies in making better use of technology.Through communication modalities and access to real-time data, physicians could spend more time with patients who need it while simultaneously providing less hands-on guidance (via virtual touchpoints) to those who don’t.
Additionally, an overall mindset shift involving healthcare is needed. First, physicians must shake their insecurities involving technology. Yes, it’s likely patients will one day receive prescriptions from a kiosk or a drone and adapt, ultimately, to AI-facilitated care. But will they collectively determine that they have no need for the physician-patient relationship? Not likely. Healthcare is a personal, intimate space, forever requiring a human touch. Accordingly, patients will always seek a curated experience led by a physician.
Patients, too, must shift their expectations and mindsets, particularly for garden-variety ailments and concerns. Just as humans now expect less personal interactions at the bank or supermarket, they must expect the same with healthcare. Consider the evolution of a filling station: There was a time when we would pull our car in to get our windows wiped, tank filled, and tire pressure checked — all for the price of gas. That’s no longer the case, and we’ve adapted.
The jury’s still out on the idea of texting our doctor or responding to a video message. However, as the world changes and our needs evolve, the way services are delivered across all industries is changing and must be adapted to best fit the needs of the end user.
A Vision for the Future of Healthcare
While possibilities for technology and healthcare are vast, making clinically relevant data available in real time is particularly valuable. Still, it requires access to the right biometric data as well as an elegant provider-facing interface that makes efficient, correct intervention second nature.
Machine learning will play an increasingly large role here. Consider diagnostics. A radiologist may read 100 chest X-rays a day, but a machine can process millions of images instantaneously, “learning” in real time how to distinguish a nodule from something less sinister. Could this potentially free up that same radiologist to manage more subtle (or acute) patient needs?
In other words, organizations would benefit from utilizing technology to maximize their most expensive and valuable commodity: their physicians. With technology, we can provide physicians with the exact data points (delivered at the right time) that will lead to significant long-term improvements to patient care.
QuickCred, the credentialing division of MedTrainer, Inc., announces its partnership with athenahealth, the leading provider of network-enabled services for electronic health records (EHR), medical billing and care coordination. The collaboration will enable medical practices to take advantage of QuickCred’s state-of-the-art compliance and credentialing system while optimizing revenue cycle management through athenahealth.
By merging the strengths of QuickCred and athenahealth, medical practices can solve three of their biggest challenges today: administrative strain, clinical efficiency and financial performance. QuickCred and athenahealth’s partnership seeks to help practices dedicate more time to patient care with steady cash flow and full revenue potential by supplying practical, streamlined ways of managing provider credentialing, payer enrollments and privileging.
Regarding the partnership, Steve Gallion, CEO, MedTrainer, the parent company of QuickCred, said, “Provider credentialing is essential to success. Proper credentialing management helps practices avoid the adverse effects of payment delays that quickly compound into serious issues. By joining QuickCred’s streamlined and intuitive compliance and credentialing platform to athenahealth’s revenue cycle management solutions, we are mutually diversifying our messages and bringing greater marketplace benefits to all our customers.”
Ted Gottis, senior vice president, QuickCred, said, “While both companies have very different software solutions, we share a common goal to bring the value-add of a trusted relationship to our mutual customers, helping them streamline and optimize their medical practices. QuickCred’s credentialing services pair perfectly with the need for athenahealth’s clients to deploy credentialing programs that are executed correctly and consistently in order to increase the quality of patient care, ensure proper revenue cycle management and defend against potential litigation.”
Parkland Center for Clinical Innovation (PCCI), which improves healthcare for vulnerable populations with advanced data science and clinical expertise, has developed a predictive model that in two years has helped prevent more than 2,000 adverse drug events (ADEs) for hospitalized patients, delivering a potential savings of more than $17 million by reducing re-admissions and eliminating ADEs.
The program, Patients at Risk for Adverse Drug Events (PARADE), is a partnership between PCCI and Parkland Health & Hospital System. During the two years of implementation, PARADE has demonstrated positive results combating ADEs, a problem that impacts more than 450,000 patients nationwide and increases the risk for re-admissions, lengthens the stay of patients by two to three days and adds almost $4 billion in extra hospital costs annually. The most common drug classes associated with ADEs include anticoagulants, diabetes medications, and opioids.
PARADE screens all adult patients at the point of hospitalization and flags high risk individuals who can benefit from pharmacist intervention. To score a patient’s level of risk, PARADE captures a patient’s medical history, including medications and disease complexity, prior healthcare utilization, demographics and social determinants of health. It then provides results in real-time, with seamless integration into a patient’s electronic health record.
During its two years of implementation at Parkland, the PARADE program has screened more than 87,000 patients, with 8,731 high-risk patients identified. Of the high-risk patients, 16 percent received timely pharmacy intervention and more than 2,000 ADEs were prevented. For high-risk patients receiving a consult, the 30-day re-admission rate was cut by 23.5 percent.
“Close collaboration with Parkland’s front-line pharmacy team from idea to implementation has been critical for the success of PARADE,” said Manjula Julka, MD, PCCI’s vice president, clinical innovation. “PARADE has proven to improve quality of care by helping the pharmacy team to identify and intervene with high risk patients within 24 to 48 hours of admission. Upwards of 50 percent of ADEs are detectable and preventable and PARADE gives us a potent tool to help hospitals stay ahead of a difficult problem that causes longer stays and drives significant costs for hospitals.”
Kristin Alvarez, PharmD, BCPS, Associate Director Clinical Advancement/Best Practices for Parkland and Brett Moran, MD, Chief Medical Informatics Officer for Parkland, led implementation of PARADE at Parkland. Due to the model’s high accuracy and real-time user-friendly information, Parkland has adopted PARADE as a primary tool for pharmacist daily workflow for consult identification with demonstrated impact on preventing potential ADEs.
PCCI’s strategic partner Pieces Technology, Inc. is supporting the commercial deployment of PARADE and other similar models.
The Wisconsin Health Information Organization (WHIO) and its technology partner, SymphonyCare, today announced the launch of WHIO 2.0, a next generation All Payer Claims Database (APCD) aimed at delivering informational assets with greater flexibility, analytical innovations and user-friendly applications to meet the emerging needs of their customers.
The WHIO serves provider systems, health plans, employers, state agencies, researchers and others looking for healthcare business intelligence to guide their strategic and operational decisions. The only statewide voluntary APCD in the nation, WHIO 2.0—launched in July—includes more than 4.2 million patients, 265 million claims and $108 billion in billed charges.
Dana Richardson
“Our clients have a variety of information needs so we know that there’s no ‘one-size-fits-all’ solution,” said Dana Richardson, CEO of WHIO. “We wanted a partner that aligns with our focus on improving the value of care in Wisconsin and can meet our members’ current and future needs.”
The search for the right technology partner to develop WHIO 2.0 took approximately two years. WHIO carried out extensive research with current customers, conducted a landscape assessment of other analytical systems and technologies and completed a Request for Proposal process, ultimately selecting SymphonyCare.
“WHIO’s work to improve the transparency in healthcare costs and quality is incredibly valuable,” said Ravi Kalla, founder and chairman of SymphonyCare. “We’re proud to support them and partner with them to create a cutting-edge APCD for the state of Wisconsin.”
Factors contributing to the partnership with SymphonyCare included the company’s ability to quickly ingest, integrate and analyze clinical and claims data from multiple sources, the speed at which they can return analytics for WHIO’s customers and SymphonyCare’s dedication to being a true partner in advancing technologies now and in the future.
Not so long in the past, you had to wait in long queues at the hospital or clinic before your turn arrived. The documentation process was long, and people felt the pain, as they survived the wait that tired them more than the issues they were facing.
Healthcare was unavailable in the rural areas, and certain inaccessible locations people could not bring themselves to get accustomed to the latest technologies. However, things have transformed with new mobile healthcare technologies. With a mobile app, you can seek appointments, get remote care, and even enjoy the latest care.
At present, 32% of the mhealth market at a global level is covered by traditional players such as hospitals, health insurers, and pharma companies and 28% of the market is occupied by mhealth app companies as well as the accelerators.
The global mobile health (mHealth) app market is projected to be valued at US$28.32 billion in 2018 and is expected to reach US$102.35 billion by 2023, growing at a CAGR of 29.30% during the period. It is a huge market, and you cannot ignore it at this point. You can see a lot of startups focusing their energies on getting the unorganized market more set and organized.
The idea behind having mhealth technology is to improve patient care and boost your chances of offering encrypted records and taking innovating approaches towards better caregiving facilities. Let’s talk about mhealth a bit in detail.
What is mHealth?
Mobile health, as it is known, is more personalized and customized towards the end user’s preferences. Every single person is bound to use their mobile phones, and accessing a health app makes it easier for them to keep records of their health and know how they are doing.
Localization of healthcare is possible with mHealth, which makes it easier for your caregiver to give personalized solutions, and increase health support for you.
Challenges in the mHealth segment
With the kind of reach mobile health has, it has become necessary for you to adopt it. However, no field is complete without a few challenges. The mHealth segment offers the following challenges, and we have come up with solutions that can help overcome them.
The first issue is launching a secure app solution. When it comes to mobile healthcare apps, there is a lot of information that is close to the patients, which might get leaked. Cyber attacks can release the information within minutes to unwarranted sources. You need to build a mobile storage as well as retrieving system that will handle the data, and ensure complete security. You should plan to develop apps that are HIPAA compliant.
You need to make your mobile apps compliant with the existing software solutions. It is crucial to integrate the important parts of healthcare into the mobile app. As easy as it sounds, knowing that everyone is using a mobile, the complexities involved in the integration process cannot be warded off. You need to make it possible for the mhealth apps to integrate with the existing systems, collect data and help with real-time decision making, easy and less complicated. To overcome this situation, study the existing systems well, and develop an app that is in line with the existing system. Take your time to develop this app.
When you are developing a mhealth app, you are looking for ways in which you can connect the doctors with the patients, while understanding the needs of the patients. However, in many cases, the app becomes a one-sided conversation, and it does not engage the patients as it should. As a result, your app won’t be downloaded by the target group, and eventually, you will lose out on patients. Understand why the target market needs a mhealth app, know what kind of solution they are looking for, and deliver it accordingly.
The usability of the app solution is not always taken into account. You need to first understand the target users for the mobile app solution. If it comes with a bigger learning curve, and you are not sure whether it is intuitive enough for the target market, you might face heavy usability issues. The best way to overcome this problem is by researching usage behavior for the target market and design an app interface by their needs.
“Pop health is still a pretty manual process. Having a dedicated solution, let alone a dedicated analytics platform, to address pop health is not as widespread as one might think.” — Brendan FitzGerald, research director, HIMSS Analystics
When I first heard this line, a number of thoughts came rushing into my mind around the different population health management strategies deployed today. In my experience, I’ve noticed a lot of variance in these strategies, and somehow, all of them traced back to data integration.
Some regions focus on leveraging their existing EHRs solutions. Other areas attempt to find the best point solutions and try to integrate them together. Many other organizations are looking for partners to help build and deploy more targeted solutions. Ultimately, these organizations are trying to find the right solution to achieve sustainability in these changing times.
Healthcare data: The problem of plenty and inefficient solutions
One problem that I usually see is that there has been a lot of talk around providing a holistic solution — and the industry isn’t even close. Healthcare organizations have already drained millions of dollars in the hopes of improving outcomes through new technologies, and I think there is a dire need for a change in what we promise to deliver. What organizations need now are infallible strategies that focus on achieving a better outcome.
It is never about just integrating the healthcare data!
There is a buzz in healthcare around aggregating data. However, they are far from making sense of this data.
The question which we should be asking right now is how we can help save money and continue to deliver better care. The easiest way to analyze the progress of organizations is by examining the returns on investment in terms of outcomes and revenue. And this return is only possible if organizations are successful in activating this data to ensure that every member is utilizing it to their fullest potential.
Unless healthcare members have a holistic pool of information regarding every activity in their healthcare network, they cannot ensure that they remain at the top of every process.
Taking long leaps to establish transparency in healthcare
A few months back, a tweet from the CMS Administrator, Seema Verma, took everyone by surprise, and the concept of siloed healthcare took a significant hit. Value-based care is the future, and #WheresThePrice laid the foundation for transparency in terms of cost, expenditure, quality, and data.
It is time we took this concept of transparency to a broader level, moving beyond merely the pricing to ensure the transparency of healthcare data. After all, only the right access to the correct data can result in the right outcomes.
Modern technology can be seen as a blessing and a curse, especially when it comes to the technology used in healthcare. Some of the medical technological advancements seen today are astonishing. They are there to improve our quality of life and to make us live longer, healthier lives, but everything good comes with risks. The technology we deal with today is rapidly developing and as it does, new threats are being presented to both doctors and hospitals. Today, we will be taking a look at six technologies currently being developed that could potentially become hazardous in the field of medical technology.
Network Shutdown
As we become more and more reliant on electronic medical records, the susceptibility of a hospital suffering a cyberattack or struggling because of a network failure is continuing to increase. To reduce the risk of this happening, all hospitals will need to have an extremely complex network security system that is resistant to hackers. They also need to make sure they have back-up files in case they have to deal with network failure.
Telemedicine
Telemedicine is the practice of remote patient care, so the patient and the provider won’t be physically present with each other. This modern technology has been developed to enable consultations with patients over easy and robust telemedicine software. Although this is convenient, it may create challenges when trying to ensure the quality of care. If things go wrong, then a lawsuit could be filed for medical negligence. In these cases, a Miami medical malpractice attorney should be contacted.
Wearables
Recently, there has been a huge development in medical device technology and there is a wide range of medical devices on the market. These wearable sensors are constantly transmitting a vast amount of health information to doctors. This has already been proven to increase the expectations of patients because they believe doctors are constantly monitoring and will act upon this.
At first glance, the healthcare field seems to be a goldmine for digital innovation. An overextended workforce, outdated protocols, hundreds of wasted hours in administrative tasks, a patient population that is wide open to digital solutions, a multitude of inefficiencies and redundancies — the opportunities for digital overhaul in healthcare are myriad. Yet every year the graveyard of digital health tools gets more crowded as innovators fail to overcome healthcare’s uniquely complex barriers to their adoption.
Goldmine and graveyard, the tremendous opportunities for digital transformation in healthcare and the seemingly insurmountable barriers to its adoption are two sides of a coin. They spring from the same root causes: the lack of financial incentives to implement digital solutions; the high stakes that necessitate a cautious approach; and most significantly, providers’ seeming unwillingness to abandon proven workflows or sunk costs to take a chance on a disruptive solution.
This last cause is often the greatest barrier to getting innovation through the door. Clinicians are the primary end-users of digital health, and a clinical champion can make all the difference in whether a solution is adopted. But in the face of the physician shortage in the United States, doctors don’t have time to trade out their proven workflows to take a risk on a solution that may or may not be successful, and will almost certainly take time to learn and implement into their practice. The majority of providers are already at capacity — eighty percent have no time to see more patients or take on more duties. Thus what seems like an unwillingness to change is often an inability to find the time to change.
Many physicians agree that digital tools and solutions are worthwhile in theory, but with an average workload of 40 to 60 hours a week, they don’t have the space in their schedules to evaluate these solutions. As it is, the amount of patients that a physician sees in a day (the most rewarding part of their jobs, according to 80% of doctors) has been reduced in recent years to make time for the mountains of non-clinical paperwork and administrative duties that they are responsible for.
Because of their packed schedules, physicians often default to the status quo for sanity’s sake: forty percent of physicians see up to 20 patients per day, with another 40% seeing more (anywhere from 21 to over 70); and all spend almost a quarter of their day on administrative duties like inputting data into EHRs. If physicians do have a chance to sit down with innovators, it’s in the margins of their day — instead of an exciting opportunity for change, a pitch-meeting with an innovator represents another 15 minutes they have to take from their family at the end of a long day, an extra 10 minutes of sleep lost in the morning to get into the office early, the interruption of the small respite of a lunch break.
It’s no surprise that in a 2018 survey conducted by the Physician’s Foundation, eighty-nine percent of physicians polled felt that they had somewhat to very little influence on changes in healthcare — they have no time to research chances to optimize their practice, and thus essentially no voice in its improvement. Yet only a physician has the kind of intimate knowledge of his or her needs and workflow that can drive effective innovations. Perhaps digital innovations have failed to take hold because the people making decisions around tools to help doctors are not doctors.
If we are going to break the barriers to digital transformation in healthcare, we need to expect physicians to think critically about how their job needs to evolve. And no one can do this without time to reflect on and evaluate the status quo. In the corporate world, executives and other employees are encouraged to do research, to take time in their schedules for professional development. Many tech giants — most famously Google, but also Facebook, Linkedin, Apple, and others — employ the 20 percent time model, where roughly one-fifth of an employee’s schedule is focused on personal side projects (those side projects have turned into Gmail, Google Maps, Twitter, Slack, and Groupon, to name a few). This is the model that we need to embrace in the healthcare system.
Mobile health, as it is known, is more personalized and customized towards the end user’s preferences. Every single person is bound to use their mobile phones, and accessing a health app makes it easier for them to keep records of their health and know how they are doing.
Modern technology can be seen as a blessing and a curse, especially when it comes to the technology used in healthcare. Some of the medical technological advancements seen today are astonishing. They are there to improve our quality of life and to make us live longer, healthier lives, but everything good comes with risks. The technology we deal with today is rapidly developing and as it does, new threats are being presented to both doctors and hospitals. Today, we will be taking a look at six technologies currently being developed that could potentially become hazardous in the field of medical technology.