By George Mathew, chief medical officer, North America, DXC Technology.
George Mathew
Consumer technology has given rise to 21st century digital citizens who are reinventing their lifestyles ? one smart device at a time. They are also reinventing healthcare.
The 21st century digital citizen monitors their daily calorie intake, sleep patterns and heart rate during exercise. They have used a DNA testing service to access their genetic information, and they know their risk level for conditions such as Alzheimer’s disease or cancer. They have become empowered consumers of healthcare.
Healthcare organizations are exploring ways to capture this new wave of patient-generated data, integrate it with other clinical and non-clinical data sources and gain insights into improving health management for individuals and populations. The key will be to create a digital foundation that can radically improve data flow and deliver contextual, actionable insights across the entire healthcare ecosystem.
21st Century Outcomes
Consumerization has made it possible to get a more complete picture of what patients need to better manage their health, and to provide care beyond the walls of a hospital or clinic. Insights can be gleaned from a variety of internet of things (IoT) devices ? from cameras linked to video analytics systems to assess people’s behaviors, to communication and conversational artificial intelligence (AI) devices that can interact with patients in their homes.
Consider what this means for patients who are managing a chronic condition such as diabetes or hypertension. Those individuals receive advice when they visit their doctor or nurse practitioner. But how can providers keep patient engagement going between those visits? Now, after garnering the appropriate approvals, providers can use patient-generated data and virtual health services to monitor patients and ensure they have the information needed for their care without requiring an office visit. Increased interactions between practitioners and patients helps to increase engagement, which is often difficult to achieve between visits. Better-engaged patients will positively impact patient satisfaction scores — a key consideration in the value-based care system.
Additionally, collecting more types of data enables organizations to better understand the dynamics of the entire population. Patients with similar profiles can be identified, successful care paths can be determined, and emerging patterns can be recognized to help in finding the most effective interventions. And, healthier populations will result in less expense to the healthcare system overall.
Without a doubt, data is the driving force for innovation within healthcare. It has allowed for processes to be streamlined, busy work to be automated, and medical professionals to have more time with their patients. This data within health informatics is giving doctors, nurses, and the like access to better patient information and allowing more precision within their work.
This patient information includes data on socioeconomic, environmental, biomedical and genetic factors. Data insights are transforming the healthcare industry, and experts point to artificial intelligence (AI) as the future of medical tech. One thing agreed on across the board is that, with these advancements, medical professionals will be able to treat patients with better accuracy.
These innovations are disrupting two arenas within the industry: patient care and institutional structure. Not only do these innovations in healthcare informatics better inform doctors and allow patients to receive an improved quality of care, but they can ensure that healthcare facilities run more smoothly. Here are a few ways that innovations from data informatics have been changing the world of healthcare.
More Patient-Focused Care
Data has allowed medical care to become more patient-focused. This means more time and effort is given to patients individually. Doctors have less paperwork to do because a lot of the organizational work is automated. But patients are also able to take care of themselves at home, or at least effectively communicate with doctors about their condition.
There are many applications for telemedicine and remote patient monitoring. We are seeing sexual health, disease symptoms and concerns, heart rate, dietary problems, and mental health counseling being addressed with apps or telemedicine practices.
For instance, rather than waiting for regularly scheduled checkups, some patients are able to take their own blood pressure and report it to their doctor using a mobile app. This is done through a process called computerized provider order entry (CPOE). Some doctors are wary of this practice, which has inspired conversations about the trustworthiness of patients. But it could be incredibly helpful for those with limited means of transportation or who rely on a caretaker.
AI is able to operate with expert precision and analyze patients in a way that doctors have never been able to. For instance, AI can accurately detect skin cancer. In the past, doctors would have to determine this from dermoscopic images. AI is able to analyze patients and provide a more accurate result. This advancement could have incredible consequences for cancer prevention.
With the sheer number of people who have fallen victim to the opioid epidemic, friends and family may be left with many unanswered questions and feelings of helpless about what to do when they notice suspect their loved one may have an addiction. The abuse of opioids is not a recent phenomenon as it has been a prevalent concern starting around the turn of the century, making headlines since the nineties with thousands of victims who have perished from its misuse. While traditional treatment methods can still be considered effective, those who suffer from opioid addiction and are looking to get onto the road recovery can take advantage of the technological advances that make the process easier.
The challenge with opioids is that they are available in various forms, with some of the most accessible being prescription drugs. Fentanyl, morphine, codeine, hydrocodone, and other synthetic, man-made opioids can be easily found in the medicine cabinets of everyday people. While the intended purpose of these formulations has been pain relief for patients suffering from a variety of physical ailments or discomfort, an unintended side effect for many of these medications has resulted from its highly addictive qualities.
Because opioids are prescribed routinely following both major and minor surgeries, as well as for managing conditions that cause chronic pain, it should come as no surprise that the soothing anesthetizing properties could potentially become addictive. A major step on the road to recovery is recognizing signs an addiction and taking action before the issue escalates. Some of the warning signs include patients who do not follow their doctor’s instructions, demonstrations of mood swings, voluntary isolation, questionable hygiene practices, changes in appetite, and any significant changes in one’s typical routine following certain types of opioid use.
Traditionally those suffering from opioid addiction would likely need to depend on the intervention of loved ones or community members once a situation has grown beyond their control. Another potential solution has been to admit oneself to professional rehabilitation. While those are still effective methods, those recovering from opioid addiction can also take advantage of the most powerful form of communication now available at the tap of a screen, click of a mouse, or push of a button, for even more ways to access different types of opioid treatment options.
One of the most common pathways to addiction is not necessarily from obtaining the infamous illegal forms of opioids such as heroin. Oftentimes a patient may begin using a prescribed opioid responsibility but may find a low dosage to feel ineffective or inadequate. With the world wide web at a patient’s disposal, he or she can easily explore alternative medications for pain relief, such as acetaminophen or ibuprofen, that are less addictive. There are also several drug-free methods to explore. Whether a patient is interested in high-tech treatments such as those that utilize electrical signals and radio waves, surgical procedures, localized injections of anesthesia there is a wealth of information available.
When somebody is suffering through an addiction it can become tempting to become physically isolated and cut off from the world in general. Today, online forums can help prevent that from happening. Dedicated websites not only allow users to discuss and get support for virtually any topic that comes to mind, but many even allow users to post in an anonymous format if desired. This can be useful for individuals who are more private and may feel hesitant to share their struggle with friends and family who know them personally and can be done on forums specifically aimed at drug rehabilitation, or in general online Forums with user-generated content.
While pharma companies have grown to become effective direct-to-consumer (DTC) marketers, hospital systems and other large providers lag behind the rest of the industry when it comes to creating highly efficient, measurable and accountable DTC marketing programs. Why?
First, they have never needed to compete historically. With light competition and reasonable levels of reimbursement for decades, everything was fine until the cost of healthcare began to spiral out of control. In response, payers began to push back by negotiating lower levels of reimbursement in-network. In addition, payers, including CMS, have denied claims creating losses and cash flow issues for many providers.
There is also a rapid rise of chronic conditions ranging from arthritis to diabetes to dementia. These chronic conditions are expensive to treat for healthcare providers. They are an even greater challenge to treat profitably in an environment of declining reimbursements.
At the same time, advances in medical treatment and care have extended life spans and placed additional burdens on our healthcare system, including the extraordinary cost of heroic and end-of-life care.
To help offset rising costs and declining reimbursements, large scale providers need more new patients to cover fixed costs. As a result, most of these providers have added DTC marketing to the mix. This usually takes the form of a website, some SEM and a little local advertising. Unfortunately, many any of these marketing tactics are often random acts of marketing without the marketing insights and strategy required to efficiently compete and effectively reach their target audience.
However, even when these marketing tactics produce a modicum of qualified leads, here is where the provider marketing model breaks down: attribution. Often, leads from marketing campaigns are funneled to the same phone number or web form. By aggregating these leads into one pool of potential new patients, it is virtually impossible to determine which marketing tactics produce the best results. It is therefore almost impossible to optimize marketing spending, which invariably persists with built in under performing media. The old advertising joke about only half of ads working no longer applies today with accountable media except in the case of healthcare provider DTC marketing. This needs to change.
By Ashmi Shah, senior vice president, finance, Talix.
Ashmi Shah
The healthcare industry has experienced significant changes over the last few months. According to a recent report by Deloitte, physicians are increasingly being asked to provide cost-effective and quality care in an effort to curb rising healthcare costs. While they have traditionally been mainly focused on delivering the quality of care, physicians are now required to deliver the best results while also making sure to properly manage the use of resources to do so.
Talix helps the healthcare industry transition from fee-for-service models to value-based care tied to patient health outcomes. As a cloud-based risk adjustment platform, the company equips U.S.-based healthcare insurers and providers with the ability to use complex patient data to improve the accuracy and speed of claims, eliminating error-prone manual work in a heavily regulated environment. By doing so, insurers are able to leverage actionable intelligence that drives better patient outcomes, accurate reimbursements and improved efficiencies.
However, efficiencies also had to start within. Talix was looking for a robust and sophisticated financial management and planning system that could allow the company to achieve huge gains in scale, speed and generate valuable business insights. Its financial operations traditionally relied on Quickbooks and Excel, which proved to be inefficient and provided limited visibility to the company. In addition, the use of Excel spreadsheets, especially when multiple revenue components are involved, can be very time consuming and prone to mistakes. The tools did not allow Talix to track activities at a deeper level and it increasingly became a challenge for its three-people team to make the three-week close period.
The company then implemented Sage Intacct’s financial management platform, which allowed it to generate deep reporting to support the company’s data-driven decision-making, track profitability and other key business metrics at a highly granular line of business and product level, as well as streamline multi-element revenue and other aspects of its accounting function.
By doing so, Talix was able to reduce the time it took to track revenue from a four day period to just one day. The company also introduced new efficiencies through the platform in the form of automated processes, mainly in its billing function which had two significant impacts: they were able to process bills in half a day as opposed to five days and dramatically cut its days sales outstanding (DSO) from five months to 45 days. By introducing these efficiencies, Talix was able to generate new cash flow that left the company with $3 million in unanticipated cash at the end of 2018.
Data from AMGA’s 2019 Medical Group Compensation and Productivity Survey shows physician compensation increased in 2018, while changes in work relative value unit (wRVU) productivity remained low.
The survey, conducted by AMGA’s subsidiary, AMGA Consulting, found that overall physician compensation increased by a median of 2.92%, compared to a 0.89% increase the previous year. Productivity increased by 0.29%, compared to a 1.63% decline in 2017. Compensation per wRVU ratio increased of 3.64%, compared to a 3.09% increase the previous year.
“The 2019 survey shows that physician compensation in 2018 rebounded from a stagnant 2017,” said Fred Horton, M.H.A., AMGA Consulting president. “While productivity also increased, it did not increase enough to surpass the decline we saw in last year’s survey, meaning productivity still has not risen since 2016.”
Primary Care
In 2018, median compensation for all primary care specialties increased by 4.91%, up significantly from 0.76% in 2017. While compensation increased more than it had over the past several years, productivity was flat, with wRVUs increasing by only 0.21% in 2018. As a result, the median compensation per wRVU ratio increased 3.57%, the largest increase for primary care specialties in four years.
Fig. 1 Change from 2017-2018: Primary Care
Type
Compensation
wRVUs
Compensation per wRVU
Family Medicine
6.25%
1.23%
3.53%
Internal Medicine
5.90%
-0.34%
3.95%
Pediatrics
-0.04%
-0.96%
3.04%
All Primary Care
4.91%
0.21%
3.57%
“As healthcare organizations move from volume-based to value-based payment models, we’ve observed increased scrutiny on primary care performance. Medical groups continue to focus on delivering care in the most appropriate setting with the greatest efficiency—and often place primary care providers at the center of this strategy,” said Elizabeth Siemsen, AMGA Consulting director. “Concurrently, in recent years, the AMGA survey has shown a slow uptick in the proportion of primary care physicians reported at less than a 1.0 clinical FTE, indicating an increase in part-time providers. In order to recruit and retain the primary care workforce, it may be that the market demanded a compensation course correction this past year.”
Specialty Care
Medical specialties saw an increase of 1.9% in median wRVU production over last year’s survey. The compensation per wRVU ratio increased by 2.65%, and the overall median compensation was up for medical specialties by 3.39%. A sample of medical specialties with more remarkable changes to the compensation per work RVU ratio are cardiology, dermatology, gastroenterology (GI), hospitalist–internal medicine, and psychiatry.*
Many people are struggling with alcoholism and addiction to different drugs across the world. Unfortunately, some of the people that need treatment for substance use disorders don’t get it. And, even after undergoing treatment, some individuals have difficulties maintaining sobriety. Fortunately, there are technological innovations that are making things a little easier for people that need help to fight addiction.
Today, some mobile apps or tools can help individuals quit drinking or fight drug addiction. These apps are ideal for individuals that are trying to cut down their alcohol intake or stop drinking completely. Some of these apps enable users to personalize their recovery process and stay sober. The emergence of these tools has changed how people see and handle addiction treatment, as well as aftercare. Some of them even provide constant links to support, expertise, and encouragement.
These apps come as an addition to AddictionResource drug and alcohol hotlines. Hotlines have been available for quite some time. These are toll-free phone numbers that people call whenever they need information, advice, support, or help with addiction. They are answered by friendly and knowledgeable representatives with experience in handling addiction and treatment. They answer questions relating to addiction and recovery. They also provide useful information on the available treatment options.
According to facts and statistics from the National Institute on Alcohol Abuse and Alcoholism, about 88,000 people die from alcohol-related causes every year. About 20.8 million individuals met the criteria for diagnosing substance use disorder in 2015. And 1 out of 12 Americans needed treatment for substance abuse. Alcohol is also one of the major causes of preventable deaths in the U.S.
Drug information hotlines are just part of the technology that can be used to fight addictions in the contemporary world. App developers have combined technology with evidence-based research to come up with apps that enable people to fight addiction with ease. These are more appealing to individuals in the current digital age. Here are some of the most useful apps for individuals trying to fight addiction.
Sober Grid
This app is designed to connect individuals in recovery and those who want to quit drinking or using drugs with people whose focus is on sobriety. You can also use this app as your source of support or to give other users support. Regardless of your motive, this app provides a chance to stay sober while assisting others within the network.
This app can also help users locate sober friends when traveling, whether in a new city or at the airport. It provides a network that connects the local people and individuals from different parts of the world. Its newsfeed enables users to share their experiences, thoughts, triumphs and struggles with sobriety and recovery. The first step of the recovery journey is accessing the peer support and tracking process. This is also another use of this app.
Plastic surgery is on the rise: in 2019, the American Society of Plastic Surgeons (ASPS) published new findings about the increasing popularity of plastic surgery, Their data indicates that nearly 18 million people underwent cosmetic procedures in the United States in 2018, almost a quarter of a million more procedures compared to the previous calendar year. Part of the reason cosmetic surgery is growing so rapidly is because the options have improved: new technology has increased the demand for minimally invasive procedures that require little down time and scarring.
Preventative Cosmetic Care
The cosmetic surgery industry, especially dermatology, is anticipating the effects of time with technology that prevents signs of aging and discoloration before they happen. So-called preventative dermatological procedures are designed for patients who exhibit a likelihood of developing skin problems later on, particularly wrinkles and discoloration due to aging. Anti-aging injections prevent facial lines (wrinkles) by blocking the signals from your nerves to your muscles and inhibiting specific muscles from contracting. Anti-aging injections are suitable for persons over the age of 18 who are looking to offset the development of wrinkles with a minimal disruption.
Computer-Assisted Imaging
Computer-assisted imaging offers exacting, 3-D representations of the target outcome for patients before undergoing surgery. For example, computer-assisted imaging is commonly used in craniofacial surgery to correct skeletal deformities in infant facial bones. With imaging, surgeons can not only reconstruct the affected areas in infants, but they can also help the tissues grow with the child. For cosmetic procedures, computer-assisted imaging ensures that a surgeon and their patient will have the same understanding of the finished result by having a version of it right there in front of them, so everything from a facelift to a full reconstruction can be more effectively mapped out and agreed upon before the surgery takes place.
With the sheer number of people who have fallen victim to the opioid epidemic, friends and family may be left with many unanswered questions and feelings of helpless about what to do when they notice suspect their loved one may have an addiction. The abuse of opioids is not a recent phenomenon as it has been a prevalent concern starting around the turn of the century, making headlines since the nineties with thousands of victims who have perished from its misuse. While traditional treatment methods can still be considered effective, those who suffer from opioid addiction and are looking to get onto the road recovery can take advantage of the technological advances that make the process easier./CMO-Joe-Grace.jpg?width=300&name=CMO-Joe-Grace.jpg)
Plastic surgery is on the rise: in 2019, the American Society of Plastic Surgeons (ASPS) published new findings about the