By Ken Perez, vice president of healthcare policy, Omnicell, Inc.
Ken Perez
On June 24, President Donald Trump
issued an almost 1,600-word executive order (EO), “Executive Order on Improving Price and
Quality Transparency in American Healthcare to Put Patients First.”
The EO’s overall purpose is
“… to enhance the ability of patients to choose the healthcare that is best for
them” by providing them with access to useful price and quality information,
which enables them to find and choose low-cost, high-quality care.
This EO aligns with previous pronouncements by the Trump administration, including Executive Order 13813 of October 12, 2017, (Promoting Healthcare Choice and Competition Across the United States) and Centers for Medicare and Medicaid Services Administrator Seema Verma’s promise, announced at HIMSS18, “to put patients at the center of the healthcare delivery system and empower them with the data they need to make the best decisions for themselves and their families.”
Central to this latest EO is the
assumption that valid price comparisons can be made for “shoppable” services,
defined as common services offered by multiple providers through the market,
which patients can research and compare before making informed choices based on
price and quality.
Shoppable services are significant. Per
a study cited by the Council of Economic Advisers in its 2019 Annual Report, of
the categories of medical cases requiring inpatient care, 73 percent of the 100
highest-spending categories were shoppable, and among the categories of medical
cases requiring outpatient care, 90 percent of the 300 highest-spending
categories were shoppable.
In addition, improved price transparency
could help protect patients from surprise billing, which occurs when patients
receive unexpected bills at highly inflated prices from out-of-network
providers they had no opportunity to select in advance. Other benefits of
improved transparency included competition, innovation, and value in the
healthcare system.
The EO specifies that within 60 days
of the date of this order, the U.S. Department of Health and Human Services
(HHS) shall propose a regulation to require hospitals to publicly post standard
charge information, including charges and information based on negotiated rates
and for common or shoppable items and services, in an easy-to-understand,
consumer-friendly, and machine-readable format using consensus-based data
standards that will meaningfully inform patients’ decision making and allow
patients to compare prices across hospitals. Posting of standard charge
information will apply to all services, supplies, or fees billed by the
hospital, and hospitals will be required to regularly update the posted
information. HHS will establish a monitoring mechanism to ensure compliance.
The EO also specifies that within 90
days, there will be rulemaking (by HHS, the Department of the Treasury, and the
Department of Labor) on a proposal to require healthcare providers, health
insurance issuers, and self-insured group health plans to provide or facilitate
access to information about expected out-of-pocket costs for items.
In addition, the EO specifies that within
180 days, HHS shall issue a report describing how the federal government or the
private sector are impeding healthcare price and quality transparency for
patients, and providing recommendations for eliminating these impediments
in a way that promotes competition.
The
EO also included mandates regarding the establishment of a Health Quality
Roadmap and standardization of quality measures, as well as HHS providing the
private sector with increased access to de-identified claims data from taxpayer-funded
healthcare programs.
The Trump administration is choosing
a consumer-driven approach to try to reduce healthcare costs. As former Rep.
Ernest Istook (R-Okla.), president of Americans for Less Regulation, said,
“Everything is based upon the theory that consumers would wade through the data
to decide whether to seek care from different hospitals or doctors and would
pay less.”
Because of its breadth—spanning
pricing and out-of-pocket costs for all services, supplies and fees—in striking
contrast to the Trump administration’s previous railing against the burden
imposed on the healthcare industry by the prior administration and the
Affordable Care Act, this EO would also impose a heavy regulatory burden on
hospitals, physicians, and health insurance companies. Not surprisingly, the
price and quality transparency provisions are opposed by the American Hospital
Association (AHA), the Federation of American Hospitals (FAH), and America’s
Health Insurance Plans (AHIP). The provisions could prove to benefit companies
such as Castlight Health, ClearCost Health, and Healthcare Bluebook that
aggregate and present price and quality information for use by the public and
employers.
Because of this opposition by nonprofit
and for-profit hospitals, as well as health plans, the rulemaking processes for
the price and quality transparency initiatives will surely be contentious and potentially
lengthy, possibly resulting in a narrowing of the breadth of services subject
to the transparency requirements, rollout across multiple stages, an extended
phase-in period, etc. Conceivably, the hospital and health plan groups could
ask for offsetting relief from other regulatory requirements.
To that end, the Health Quality
Roadmap and standardization of quality measures would be well received by the
healthcare industry, and the increasing access to data could be a boon to
healthcare providers, healthcare IT vendors, healthcare consulting firms, and
health plans—especially in support of improved population health management,
given the vast amounts of Medicare and Medicaid claims data.
Cerebral palsy is a neurological condition caused by damage to the brain during, or soon after birth. This damage stops the brain from developing properly during the first few years of a child’s life resulting in developmental issues.
Many parents don’t start suspecting their child has cerebral palsy until they start progressing from newborn, to baby, to toddler, often missing developmental milestones along the way. However, the earliest signs of cerebral palsy can sometimes be spotted from birth.
What causes
cerebral palsy?
Common causes of cerebral palsy include:
Birth asphyxia – oxygen
deprivation before, during, or after birth
Head injury just after birth or
during the first few years of an infant’s life
Infections caught by the
infant, such as meningitis
Infections caught by the mother
during pregnancy
Bleeding in the infant’s brain
or neonatal stroke
What are the
effects of cerebral palsy?
Cerebral palsy tends to result in problems
with movement, muscle tone, coordination, and gait and the severity of symptoms
varies from person to person.
Cerebral palsy is a lifelong condition, but
fortunately it is non-progressive, meaning it won’t get worse as time goes on
(although symptoms may vary throughout a person’s lifetime).
Very early signs of cerebral palsy can be
spotted from as early as within a few weeks of birth, although children are
only usually diagnosed in the first few years of life because the symptoms vary
from child to child. Some very early signs include:
Muscle stiffness or floppiness
Slow movements
Muscle spasms
When held, the child feels like
they’re pushing away from you
When picked up, the child’s
legs go stiff or crossed
As the child gets older, further developmental
issues may start becoming more apparent, for example:
The child cannot roll over
They begin to favour one side
of their body, such as only using one hand to reach out
Difficulty with hand-eye
coordination
Difficulty bringing their hands
together
Poor reflexes
Swallowing or feeding
difficulties
Poor visual attention
In many cases, cerebral palsy becomes
particularly obvious when it causes children to lag behind ‘normal’ childhood
development. For example, infants are expected to first start sitting up at
around 6 months and start walking by 18 months.
If parents notice any of these symptoms in
their child, or are concerned about their child’s development, they should see
their GP or health advisor for a referral for a specialist assessment.
Do you need
advice about a birth injury resulting in cerebral palsy?
If your child has been diagnosed with
cerebral palsy following a birth injury, which you suspect was caused by
someone else’s negligence (for example, a medical professional at the delivery),
you may be able to claim medical negligence compensation.
Medical negligence claims can be complex. You will always need expert evidence (such as a doctor specializing in cerebral palsy) to support your claim. Therefore, you should always consult a medical negligence solicitor with specialist experience in birth injuries for advice on the merits of your case, to assess how much compensation you could receive if your claim is successful, and to conduct your claim on your behalf.
Prescription drug shortages are an epidemic across the U.S health care system. According to the U.S. Food and Drug Administration (FDA), shortages continue to increase. They have grown more persistent and long-lasting (some active drug shortages have lasted for more than eight years), and the intensity of shortages remains high. So do the effects.
Drug shortages create serious negative impacts on patient care. Shortages
of critical or life-saving medications can compromise or delay medical
procedures. They can also cause medication errors and patient harm, according
to the American Society of Health-System Pharmacists (ASHP). A survey
conducted by the Institute for Safe Medicine Practices (ISMP) in
2017 revealed that 71 percent of respondents were unable to provide patients
with a recommended drug. Seventy-five percent also stated that patient
treatments had been delayed due to drug shortages, and 21 percent were aware of
at least one medication error related to a drug shortage in the six months
leading up to the survey. A more recent study
from Vizient found that 38 percent of respondents said that at least one of
the medication errors they recorded from July 2018-December 2018 were
related to a drug shortage.
Drug shortages also contribute to higher costs due to changes in hospital
inventory control practices, the use of more expensive alternative medications
and added labor costs related to shortage management. The Annals of Internal
Medicine reported that prescription drug shortages cause an estimated $230
million in additional costs each year because of the rising prices of drugs
under shortage and the higher costs of substitute drugs. Labor costs, according
to the Vizient report, cost U.S. hospitals at least $359 million a year.
Drug shortage drivers
While quality and manufacturing issues are the most common cause of drug
shortages, consolidation among manufacturers, intermittent lack of raw
materials, recalls, regulatory enforcement, product discontinuations and
natural disasters all play a role. Spikes in demand caused by changes in
therapeutic guidelines, new indications and rapid disease progression also
drive spikes in drug utilization that can lead to shortages.
Strategies for managing shortages
While hospital systems cannot prevent the larger issues leading to
shortages and escalating pharmaceutical prices, they can control how they
prepare for and respond to shortages. The first step is awareness. Hospitals
that receive earlier notification of shortages have an advantage because they
have more time to find additional supply before the amount on hand is depleted.
Once alerted to a shortage, clinical pharmacy teams need to act fast so
they can protect limited supplies of life-saving drugs for critical patients, provide
guidance about accurate dosing for alternative medications and implement
temporary guidelines and usage restrictions during a shortage. In order to
implement those strategies effectively, clinical teams need timely information
about how much of the medication is available, as well as visibility into
ordering, prescribing and dispensing practices.
Technology solutions
Health systems often rely on manual methods of tracking, calculation and
communication, including spreadsheets and whiteboards, and piecing together
that information without the right technology solutions is time consuming and
costly. Finding clinically appropriate alternatives/substitutions, balancing
shortages with other clinical priorities and communicating the shortage to
clinicians all take time and resources. This manual approach also increases the
risk of error and drives up personnel costs required to manage the multiple
pharmacy automation systems and electronic health record (EHR) system changes
that must be adjusted in the face of a drug shortage.
What health systems need is a solution that quickly and automatically
assesses inventory and provides clinicians the data and early warning necessary
for making informed decisions, including;
How ordering and dispensing trends are impacting
current supply
All workflows in the EHR driving usage of the
medication
Common clinical indications for the drug
Which clinicians are ordering, prescribing and
dispensing medication, including individual top users and departments or
individual hospitals with highest use
One solution that helps hospitals mitigate the impact of shortages and manage them more efficiently when they can’t be avoided is The Drug Shortage App from LogicStream Health. This solution alerts hospitals to shortages and helps them manage inventory levels, minimizes disruptions to patient care and controls costs by providing all the data and insights in the list above.
The Drug Shortage App allows clinicians to access the data they need and adjust their computer systems without requesting time-consuming reports from IT and informatics teams. Hospital pharmacy teams can efficiently determine and manage the clinical and financial risk associated with a drug shortage without additional support from IT because temporary guidelines and restrictions can be quickly implemented to EHR workflows and tracked within the app and just as easily undone when the shortage has passed.
The app’s algorithm tracks shortages and automatically calculates the impact for each hospital or health system based on available inventory and ordering patterns. For a health system with eight to 10 hospitals, our customers tell us they’re saving upwards of two FTEs since they no longer have to scour external websites for shortage data and match up that information with internal data.
Macro-level fixes
What can be done to reduce the threat of drug shortages? Increasing
competition, expanding manufacturing capabilities and taking legislative action
all have been suggested and debated as potential long-term, macro-level
approaches for curbing the problem. In the short term, hospital systems with
solutions in place to efficiently manage shortages are best positioned to
minimize the impact on patients, staff and financial viability.
Rhapsody announces that the company will merge with Corepoint Health, the supplier of the Best in KLAS healthcare integration platform. The transaction will bring together two companies at the forefront of interoperability and create a dynamic combination of technology, talent, services, and trusted customer relationships to address the most complex healthcare interoperability challenges.
Both
companies will continue to support and advance their respective solutions,
while the combined entity will also devote its expanded resources to addressing
the growing need for interoperability among regional, national and
international healthcare providers and vendors.
“Corepoint’s platform offers incredibly fast, turn-key operations for provider organizations, HIEs and OEM partners, all with industry leading customer satisfaction. Complementing this with Rhapsody’s fully customizable and multi-platform capabilities creates great synergies for our current and future customers,” said Erkan Akyuz, president and CEO, Rhapsody. “Both entities share great technical depth and breadth and both have maintained long-standing customer relationships, which together yields a broader foundation on which to build the future of interoperability in healthcare. Together, we can better support our customers to fulfill all of their changing and future needs.”
Available on premises and as a cloud-based service, the Rhapsody and Corepoint interoperability platforms offer comprehensive routing and transformation functionality for every operating environment, offering highly differentiated features, applications and end customer focuses.
The two platforms also support commonly used messaging standards and protocols such as FHIR, HL7 V2, CCD/C-CDA and DICOM. These integration engines are among the most secure technology platforms in the healthcare industry, with customer bases that include the entire healthcare ecosystem and across the globe, including provider organizations, technology vendors, HIEs and public health systems.
“We are entering a new era in
healthcare where the emphasis will be on expanding ecosystems and establishing
new data trading partner relationships to optimize clinical and operational
workflows. These initiatives will be powered by interoperability and data
management: healthcare organizations that can excel in these areas will have a
significant competitive advantage,” said Sean Cassidy, CEO of Corepoint Health.
“The combination of Rhapsody and Corepoint enables our customers to continue to
get tremendous value out of the products and services they love, while having
the confidence that their interoperability partner is heavily invested in
helping them confront the challenges they will face in the future.”
“We move decisively when perfect opportunities present themselves,” said Philippe Houssiau, operating partner at Hg. “The opportunity to bring Corepoint and Rhapsody together was incredibly compelling. Our investments in these two phenomenal companies demonstrate how excited we are about the future of interoperability. Rhapsody is off to an amazing start as an independent company: joining forces with Corepoint will enable the combined team to accelerate the delivery of FHIR-based services, cloud-based integration solutions and support for regional and national interoperability frameworks.”
Netwrix released an infographic based on the findings of its global 2019 Netwrix Cloud Data Security Report for the healthcare industry. The infographic provides an industry perspective of the data that healthcare organizations store in the cloud, the state of their cloud data security and their plans for using cloud technology.
The 2019 Netwrix Cloud Data Security Report revealed that 32 percent of healthcare organizations store a wide range of sensitive data in the cloud, including healthcare data and personally identifiable information (PII) of customers and employees. In addition, the number of those who are ready to adopt Cloud-First approach has increased by 31 percent since 2018, and the number considering becoming 100 percent cloud-based has grown by 12 percent. Unfortunately, their IT teams might not have enough resources to properly protect this sensitive data in the cloud, as 85 percent of them did not see an increase in their cloud security budgets in 2019.
Other findings revealed by the research
and shown in the infographic include:
26 percent of healthcare organizations had at least one security incident in the cloud during the past 12 months. These organizations have two things in common: None of them classified all the data they stored in the cloud, and all of them store all their sensitive data in the cloud.
The majority of IT teams at healthcare organizations plan to strengthen data security in the cloud by encrypting data (70 percent) and monitoring activities around data (50 percent). However, one third of them do not receive any financial support from their management, which makes it more difficult for them to improve security in the cloud.
18 percent of healthcare organizations would consider moving their data from the cloud back on premises. Their main reasons include security concerns (56 percent), reliability and performance issues (22 percent), and high costs (22 percent) for the cloud. If they decide to make this move, they will start by migrating healthcare data (33 percent), customer data (33%) and employee data (11 percent).
“Prioritizing security efforts is the key to ensuring data security in the cloud, especially if budgets are tight, as is common at healthcare organizations. When organizations know exactly what data they have in the cloud and have classified it according to its value and level of sensitivity, they are in a better position to choose appropriate controls within their budgetary constraints and protect sensitive data more effectively,” said Steve Dickson, CEO of Netwrix.
“By 2022, more than 30 percent of the hospital data centers will be based in the cloud. Healthcare systems have been skeptical about adoption of cloud, but cost pressures and the need to reduce capital expenditure have been changing that mindset. After enduring several high-profile breaches and realizing the maturity of various cloud providers (both in expertise and scalability), healthcare systems are finally less skeptical than they used to be about the cloud.” — Gartner, “Forecast Overview: Healthcare Provider Market, Worldwide, 2018,” by Anurag Gupta, July 13, 2018.
Global Care Administrators announced that its deep learning health intelligence platform will go to market under the name Global Care Analytics (GCANA). According to company president, Scott Guilfoyle, the platform gives healthcare management a tool for key management insights within claims-and-cost and clinical data, and solid predictive analytics from local and/or global data via the desktop.
Scott Guilfoyle
“Global Care gives the C-suite of health systems,
hospitals, and medical groups the power to conduct deep analytics, and
predictive analytics, of their data. The CEO, COO, or CFO can execute precisely targeted, complex queries
on massive data sets with real-time or near-real-time responses by dragging and
dropping preset queries into the engine,” says Guilfoyle.
“We have a patented hyper-ingestion engine that can take in a
million datasets a minute, which is amazingly fast and accurate. Then our
hyper-digestion process uses neural networks to analyze the oceans of data, and become more
and more accurate as it learns to refine its ability to make connections.”
Guilfoyle, the former CTO of PayPal,
and CIO of LendingTree,Bank of
America Card Services, and GE’s Aircraft Engine Services, Aircraft
Engines eBusiness, and Plastics Americas, believes the
company’s deep analytics platform gives healthcare executives access to
billions of data points for better organizational management, delivery of care,
and population health. “Plus, there is enormous value in access to our global
health data exchange. Each time we onboard a new client, and each time any and
all clients query the platform, the ocean of collected health data in our
exchange grows larger, and our platform grows more knowledgeable and more
accurate.”
Global Care was founded by former senior healthcare executives who all, according to CEO Kevin Sullivan, “Understand the enormous value of the data trapped within a healthcare organization. This is the intelligence engine I wish I’d had in my former senior operations positions. The value of deep analytics will radically transform day-to-day healthcare management for the better. When executive management has desktop power to identify gaps in care or delivery of care services, outcome metrics, and the most complete real-time picture of the health of their patient populations, they can speed up more knowledgeable decision making. Speed, precision, deep knowledge, and agility through predictive analytics are tools they can use to radically change their landscape.”
Guilfoyle says the analytics technology will be followed by what most healthcare management think of as “unobtainium:” A frictionless transaction (billing-claims-reimbursement) systemthat authenticates the patient, authorizes the procedure, files the claim with the payor, and reimburses the provider in real-time as care is delivered. Imagine providers being paid before the patient leaves the facility.”
He says company’s Global Care Pay technology could help eliminate some of the $147bn – $510bn of waste in administrative complexities and manual transactions. “Global Care Pay applies smart contracts and blockchain technology to make the transaction frictionless, immediate, highly accurate, and secure. It’s our next big step and one we’re really excited to bring to market in the near future.”
Sullivan says the two-year-old, privately-held company is raising capital, and it plans to build out the pay system on the foundational success of the analytics platform. “We’re way out front on blockchain pay technology, and our work with clients on deep learning analytics gives us the kind of real-world environment we need to fine-tune the Global Care Pay for a soft release in the next 12-14 months.”
It’s hard to understate how much the internet has benefited society. It distributes knowledge to the world, it allows us easy access to myriad services, and it makes it easy to communicate with people the world over, bringing us all closer than ever before. And that’s just the basic things the World Wide Web provides.
But, wonderful though it may be, the internet also holds its own perils. Cybercrime has turned into one of the greatest threats to businesses and by extension the whole of society. In 2018, a hacking attempt took place somewhere in the world about every 40 seconds. Billions of dollars in damages are attributed to cyberattacks every year. The health industry has become a favored target for hackers, mainly because of patient data which is valued more than financial information.
It’s a sad fact, then, that many businesses do not take cybersecurity, the only line of defense against this online onslaught, as seriously as they should. Around half of all businesses admit that they do not consider cybersecurity a very high priority.
That is a mistake that could cost a company everything. This infographic, brought to us by HostingTribunal, serves to warn everyone about the incredible danger that are hackers. It lists all the most devastating and notorious cyberattacks to take place in recent history. These hacks caused monumental harm to their victims, and this visual journey details the exact extent of the damage as well as how the attacks happened — and lots more. So read on if you wish to learn about the biggest hacks in recent history.
Solo or small medical practices are disappearing at a rapid rate. The reasons for this are simple: most are unable to stay afloat because of rising operational costs, reduced payments for services rendered, and the introduction of new regulations. Thankfully, if you want to remain in practice and continue to provide quality care to your patients, there are solutions.
Lack of
Insurance Companies
The reduction in
available health care options makes it difficult not only for patients to find
a doctor but also for doctors to receive adequate payments. It seems the only
one making out on the healthcare front is the insurance companies. Because of
their limited numbers, they can pretty much dictate who a patient can see and
how much a doctor can charge. This can put a person at a much higher health
risk and cause a doctor to lose a large percentage of their income. On top of
that, insurance companies can retract a payment previously made within the
first 3 months.
What Follows
As a result of
reduced payments for doctors, they aren’t able to provide a wealth of care.
Usually, a visit to any doctor’s office requires a patient to wait for over 30
minutes just to get into an exam room. Then the doctor comes in, reviews the
patient’s chart for a minute, and takes a glancing look at the patient while
they ask what’s wrong. Doctors can no longer afford to chit-chat with their
patients to find out what’s truly going on with their health. Instead, they
have to schedule as many appointments as they can to reduce their losses.
Adapting to
the New Way of Practice
It’s not likely that the current health insurance system will change anytime soon. It’s up to you to make a few changes in order to continue to pay your bills and your staff and to do what you set out to do when you first opened the office doors: provide exceptional care to patients. However, there are ways to cut costs and improve care. One way is to train employees for more than one position.
This will allow your practice to function efficiently and will also enable you to have fewer people on staff which, in the end, translates to reduced overhead expenses. Another way to keep up with the changing regulations and improve your bottom line is to use healthcare consulting services. These companies can provide the assistance you need to get your business organized, improve your billing process, and offer suggestions for implementing new services that can add revenue.
Show You Care
Many people shy away from traditional primary care physicians in lieu of healthcare clinics. The main reason for this is the clinics’ hours of operation. Healthcare clinics usually open earlier, stay open later and have Saturday hours. Changing your business hours to offer convenience shows your patients that you understand that not everyone can visit their doctor between 9 a.m. and 3 p.m.
Even having flexible hours once a week, say on Wednesday, where you remain open until 7:00 p.m. will allow people to schedule an appointment for after work. In addition, get back to traditional standards where you provide a follow-up call or text to see how patents are doing.
Presence on
the Web
Another way to
add new clients is to have a website/blog. This allows your clients to keep in
touch with the practice and give honest reviews of their visits. In turn, it
will let you make changes based on the remarks you receive. In addition, having
a presence on social media will bring traffic to your website/blog and help you
gain new clients.
Whether you have
an existing practice or are making the decision to end a hospital residency and
venture out on your own, having your own
medical practice call be both profitable and rewarding.
