Most of us know someone who has been diagnosed with cancer and understand first hand the tidal wave of emotions and questions that come immediately after diagnosis. One question that sticks out to providers is the seemingly simple: “How many patients have you seen who are just like me?” and perhaps even more important: “Why are you confident that I can reach the magical five year survival rate?”
Unfortunately, with systems of record like the electronic health record, neither of these questions is easy for the provider to answer. The challenge is, in today’s oncology world there is both a combination of clinical confidence based on peer-reviewed data and the artistic necessity to understand what could work based on perceived comparable patients. Oncologists do incredible work to save lives, however, there is more to be done to help support the people who are making the most important decisions at the most critical inflection points.
Meaningful data to improve cancer care
Prior to the creation of EHRs, physicians stressed that they did not have enough access to data. While data is now being stockpiled within the depths of EHRs, physicians still do not have access to everything the data has to offer. The available data in EHRs is often fragmented, disorganized, and sometimes simply incomplete, making it difficult to glean any real value from this information after it is collected.
Essentially, the EHR can be compared to a messy bureau in your bedroom. While bureaus are intended to organize your clothes — socks in one drawer, t-shirts in another, etc. — sometimes socks windup in the pants drawer. All of the valuable information and data is in the EHR, but is sometimes lost in the wrong “drawers,” making it hard for clinicians to find the important information and make sense of it to impact patient care. While physicians are doing the best they can by adding information into EHRs, technology has not caught up to allow physicians to extract insights and put that data to use.
Fortunately, with the use of outside technology, we can pull real-world data (RWD) and real-world evidence (RWE) from the EHRs. This can unlock the insights hidden within the available data and uncap the potential for improving and personalizing cancer care, while reducing overall costs.
Unlocking hidden insights
The technology available today knows how data should be arranged. It knows when something is misplaced, and knows how to make sense out of it. Through advanced algorithms and clinical input, technology can essentially sort and gather RWD from EHRs and then group together similar patients based on their own biology, disease states, and other phenotypic factors, allowing for insight into treatment plans and potential outcomes.
Technology will forever be advancing, therefore, so will the medical world. As we understand more about technology, we understand more about our bodies and how we can best help ourselves to live a long, happy, and healthier life. Physicians that work in the podiatry setting have found many ways to use technology to improve foot health. If you need to see a podiatrist for any reason, understanding the latest technology can aid you in making a choice about which physician and clinic are right for you.
Sound wave therapy
Sound wave therapy is used for many different medical purposes and is an alternative form of therapy. This kind of therapy uses sound energy to restore vibrational energy in the body. The frequencies and waves that are omitted by sound wave therapy machines produce resonance. Physicians have found that sound wave therapy can be used to treat many foot issues in patients and improve overall foot health. One example of this is reducing the pain caused by foot conditions such as plantar fasciitis, which is the most common cause of pain in the heel. For those who have a sprained ankle, sound wave therapy can promote healing and reduce any discomfort.
In addition to sound wave therapy, you can also get a pair or shoe insoles that are specifically designed for plantar fasciitis, such as the ones from Protalus.com.
Video gait analysis
Your posture and the way you walk can cause many feet or ankle issues that mean your doctor sends you to see a podiatrist. If this is the case and your issue is down to walking or exercising, a physician in the podiatry department may watch you walk on a treadmill, assessing your gait. Your gait is the manner in which you walk and can often determine the cause of a range of foot issues. Although a physician may be trained in podiatry, this doesn’t mean they can see everything, and this is where video gait analysis comes in. As the name suggests, a camera can record your every movement, making it easier than ever for a physician to understand exactly what is going on. If you are diagnosed with a gait problem, such as walking on the side of your feet rather than the soles, you may have to wear insoles for over-pronation.
Laser removal of fungal infections
Fungal infections can be very embarrassing and extremely irritating. If you are suffering from a fungal infection, visiting a physician who uses laser removal means a quick and painless procedure that can get rid of your infection in no time. As the name suggests, this machine uses a laser to target any fungus on the foot or around the nail beds. One of the most common forms of fungal infections that are cleared up with the use of laser therapy is onychomycosis.
If you are suffering from any form of foot problem, speaking to a physician who is trained in podiatry is the first step to recovery. Finding a clinic that uses the best forms of technology means you will get quicker and more precise treatment to restore your foot health sooner.
Today’s healthcare workforce is increasingly mobile. The industry has seen a dramatic increase in the use of mobile devices by both staff and patients, but often as single point solutions that do not solve for the fragmentation of clinical workflow at the point of care. Health system IT and clinical leadership are responding with a more strategic approach to clinical communication and collaboration to improve the care delivery experience at scale.
PatientSafe Solutions partnered with HIMSS Analytics to survey more than 300 healthcare leaders about the current state and future plans for mobile communication in their organizations. The vast majority of hospitals (77 percent) have invested in some form of mobile app to support communication amongst the care team, the most commonplace being secured messaging. However, clinical workflow suffers from the continued use of multiple, single-point device and applications. The average care team member — from physicians to nurses to allied health professionals – must use as many as five different devices or modalities to communicate and execute a defined plan of care.
The study also found that that nearly 50 percent of respondents plan on standardizing and consolidating onto a smartphone platform to streamline care collaboration. We all know by now that smartphones present the opportunity to deliver care at the bedside in a more effective, personalized and productive manner. However, despite investment in secured messaging and the desire to move towards smartphone-based platforms, the care team’s communication, care collaboration and documentation workflow still can be disorganized, incomplete and at worse, not secure.To address the clinical mobility challenge, PatientSafe developed the Mobile Maturity Model for Healthcare as common framework to assess the current state of mobile adoption in your health system and align the various people, technologies and processes to be successful with mobility at scale. Our goal? To get industry-wide participation in using and evolving the healthcare mobile maturity model – so clinicians and patients benefit from a streamlined, secure, context-rich mobile care experience.
The Mobile Maturity Model seeks to assess and categorize an organization’s proficiency in six key capabilities: infrastructure management, mobile device management, integration planning, application selection, workflow design and outcomes management.
Infrastructure management – To support mobility at scale, it is important to avoid underestimating infrastructure investments. Elements to consider when it comes to infrastructure include an organization’s wireless network, telephone systems and data center.
Mobile device management (MDM) – The choice of mobile device is a key consideration in mobile adoption, but equally important is the consideration of how to successfully manage and support an entire fleet of mobile devices. Jamf, the standard in Apple device management, recently surveyed 600 global healthcare IT professionals and found that 78 percent of healthcare organizations have an MDM in place, but over 50 percent lack satisfaction, 70 percent had concerns around security and compliance, and 90 percent think their MDM can be doing more. It’s important to invest in an MDM that aligns with overall mobility strategy and are experts in the device platform selected for an organization. An MDM should have an integrated partner ecosystem for devices, applications and infrastructure and training, services and support. Indicators like customer retention and CSAT are also helpful. Most importantly, the MDM should be nearly invisible to end users, as if an approach to deployment and management hinders usability of the device an organization wants to use to improve its patient care and clinical communications, it’s not the right fit.
Proven technology and digital communications are being used to leverage decades of health industry knowledge and speed access to care among Hispanic communities. These solutions and digital access align with Hispanic use of new technology tools: 84 percent of all Hispanics are online and Hispanic internet smartphone usage is 10.5 hours per week – 25 percent more than the national average.
Now, these innovative technologies are enabling a growing number of Hispanic consumers to access several cash-based primary care and pharmacy solutions, such as:
A medication voucher program that gives consumers the ability to pre-purchase generic medications at affordable price points. They can be purchased for personal use or gifted to a friend or family member either domestically in the U.S. and Puerto Rico, or internationally.
A free prescription savings card model allows cash-pay consumers to save a significant percent on brand name and generic medications across a wide network of pharmacies.
An end-to-end clinical solution for patients with diabetes, hypertension, asthma, and obesity that includes vouchers for medications, peripherals, testing supplies, tablet, apps, and access to lifestyle coach consults.
A bilingual telemedicine platform, which helps under served populations access the healthcare they need with more ease.
Solutions such as these are simplifying access and delivery of quality health and wellness products. Thanks to these technology platforms, individuals are enjoying improved access to care, opportunities to learn about their health, determine their wellness needs, purchase lower cost medications, manage their chronic conditions and engage in behavior modification solutions to help them lead healthier and more productive lives.
These solutions also give Hispanics access to products and services anywhere and at an affordable price, whether it’s domestically in the U.S. and Puerto Rico, or internationally in Mexico, Guatemala, Honduras and El Salvador, in either English or Spanish, and without the need for any type of insurance or third-party payment.
This level of innovation holds great promise for closing gaps in care for under- and uninsured Hispanics in the United States, meeting cultural needs and with respect for affordability of care.
Vital, the AI-powered software increasing productivity and improving patient health in hospital emergency rooms, today announces a $5.2 million Seed round led by First Round Capital and Threshold Ventures (formerly DFJ Venture). Vital uses artificial intelligence (AI) and natural language processing (NLP) to triage patients before they see a doctor, making it easier and faster for providers to coordinate care and prioritize patients.
Raised to help grow the Vital team of engineers and data scientists, and to bring its secure, cloud-based software to emergency rooms across the United States, the round also includes Bragiel Brothers, Meridian Street Capital, Refactor Capital and SV Angel, with angel investment from Vivek Garipalli, CEO of CloverHealth; and Nat Turner and Zach Weinberg, founders of Flatiron Health. Josh Kopelman, founder and partner at First Round Capital, will join Vital’s board of directors.
Aaron Patzer
“The HITECH* Act was well-intentioned, but now hospitals rely on outdated, slow and inefficient software – and nowhere is it more painful than in the emergency room,” said Vital founder and CEO Aaron Patzer in a statement. “Doctors and nurses often put more time into paperwork and data entry than patient care. Vital uses smart, easy tech to reverse that, cutting wait times in half, reducing provider burnout and saving hospitals millions of dollars.”
Patzer brings capital to Vital from his success with Mint.com, which transformed bank data into an easy consumer product. The decision to take on an even higher-stakes, more regulated industry came after seeing firsthand the antiquated software hospitals use. Teaming up with Justin Schrager, doctor of emergency medicine at Emory University Hospital, Patzer invested $1 million and two years of peer-reviewed academic study, technical research and development to create Vital.
“Vital successfully built software with a modern, no-training-required interface, while also meeting HIPAA compliance. It’s what people expect from consumer software, but rarely see in healthcare,” said Kopelman. “Turning massive amounts of complex and regulated data into clean, easy products is what Mint.com did for money, and we’re proud to back a solution that’ll do the same in life and death situations.”
*The ACA’s Health Information Technology for Economic and Clinical Health
By Joe Polaris, senior vice president of product and technology, R1 RCM.
Joe Polaris
This year promises many new opportunities to apply technology to improve the healthcare revenue cycle. The recent HIMSS conference, for instance, featured many exciting use cases for machine learning and artificial intelligence (AI). However, before rushing to implement any of the latest solutions, let’s step back for a moment.
While there is plenty of emerging revenue cycle technology, there is also still a fair amount of complexity when it comes to implementing these capabilities. Most organizations typically have a significant amount of disorganization to deal with on the back end of their billing processes, as well as disparate technology systems that don’t work together. Many organizational leaders also are growing tired of only achieving incremental improvements to the revenue cycle through stand-alone revenue cycle management (RCM) technology, especially with rising total administrative costs and cost to collect.
That means we simply cannot afford to implement “quick-fix” RCM technologies that fail to support future goals. In an industry known for emphasizing quarter-by-quarter financials, we must begin taking a longer view. Rather than trying to establish 2019 implementation priorities, think about using the rest of 2019 to set the foundation for a holistic RCM transformation.
Perhaps the question to ask this year is: “Where do we want to be in three years – in terms of process efficiency, cash flow and an experience that delights our patients?”
Map RCM to the patient journey
Answering that question requires a holistic assessment of the entire revenue cycle, especially as it relates to the patient journey. Although that’s not a small undertaking, it allows healthcare organizations to build a thoughtful, realistic roadmap for long-term RCM transformation. In turn, such planning helps organizations realize greater value from all their RCM technology investments. Consider these four steps:
Evaluate: Although some healthcare organizations are further along when it comes to more efficient and patient-centered RCM, most are just starting to explore due to a wide variety of situational limitations. Escaping such constraints will require you to map out the entire patient journey end-to-end. Then, look at the map to identify areas of potential revenue cycle satisfaction for patients, as well as their most significant pain points.
Plan: After evaluating your RCM strengths and weaknesses, prioritize those processes in which technology has the greatest potential to remove waste, create capacity or give back operational expense. When deciding which solutions to implement, remember to take a broader, longer-term focus. Your organization should avoid the temptation of “quick wins” and instead focus on a viable long-term path that will meet your holistic, collective objectives. By generating a long-term plan, you will also incrementally create business value and move toward a more well-defined end-state vision. The most impactful digital transformation might come from phasing in the adoption of a comprehensive platform, as well as combining digital self-service technology and other automation capabilities — some of which may take hold quickly, while others may require more time.
By Paurakh Rajbhandary, senior biomedical engineer, VitalConnect.
Paurakh Rajbhandary
The need for hospitals and physicians to recognize and react to patients showing early signs and symptoms of clinical deterioration has resulted in the creation of a rapid response system (RRS). Patient deterioration prior to adverse events including cardiac arrest and ICU admission has been reported with hemodynamic antecedents in 60 percent of critical events. For example, patients who develop cardiopulmonary arrests exhibit clinical deterioration such as respiratory distress as early as eight hours in advance of arrest in 84 percent of the patients.
The RRS system, aimed at detecting precursors to and reducing such avoidable adverse events, comprises of track-and-trigger or afferent (detection) component for event detection, and efferent (response) component comprising of rapid response team (RRT) or medical emergency team for intervention and prevention of patient deterioration. Rapid response systems also comprises of administrative components and continual process improvement.
MET criteria is commonly used as an afferent triggering metric currently in many healthcare systems, but MET criteria is based on threshold of single vital or physiological measurement. The need of a good afferent component to RRS has been previously pointed out. Early warning score (EWS) combines multiple vital measurements to create a more comprehensive yet simple unified score that has been clinically validated to indicate increased risk of patient deterioration.
Among several different versions of early warning scores currently used in different healthcare settings, National Early Warning Score (NEWS) is standardized and endorsed by National Health Services (NHS) and Royal College of Physicians (RCP) in an effort to eliminate lack of consistency in the clinical workflow.
NEWS is an aggregate score calculated based on six physiological parameters: respiratory rate, oxygen saturations, temperature, systolic blood pressure, pulse rate, level of consciousness, and whether the patient is using supplemental oxygen. A sub-score within from zero to three is allocated to each of these parameters, giving an aggregated NEWS score between zero and 20 reflecting how patient status varies from the norm. The sub-score contribution criteria for each of the parameters has been determined and validated clinically by the NHS and Royal College of Physicians. The NEWS score dictates clinical urgency, the magnitude of response as well as frequency of clinical monitoring of the patient.
NEWS has demonstrated superior performance in determining patients at risk of cardiac arrest, unanticipated intensive care unit (ICU) admission or death within 24 hours of a NEWS value compared to 33 other early warning scores. Sensitivity and specificity performance of early warning scores dictates the trade off between alarm fatigue and ability to flag all deteriorating patients. Studies have shown that NEWS provides the best compromise between sensitivity and specificity allowing hospitals and healthcare providers to predict and reduce the aforementioned deterioration and improve patient outcome.
National Health Service (NHS) has been pushing to implement NEWS in all of its hospitals since its initial launch in 2012, having achieved implementation at 70 percent of acute trusts in England and with other forms of early warning scores in the remaining trusts. Variation in early warning scores systems can lead to confusion and potentially compromise performance of the detection of patient deterioration, patient safety and positive outcome. With this in mind, NHS are launching a campaign to increase NEWS use to 100 percent at acute and ambulance settings by March 2019.
The statistics related to chronic disease management are staggering. According to the US National Center for Health Statistics, 40 percent of the US population have chronic conditions and almost one-third of this patient population has multiple chronic conditions. It’s a struggle to manage and engage these patients and keep the “sickest of the sick” at home, receiving care, vs. returning to the hospital or another facility. These high-risk members are also the most expensive. The treatment of patients with chronic conditions accounts for three-quarters of the $2.2 trillion in healthcare spending, with roughly 96 cents per dollar spent in Medicare and 83 cents per dollar in Medicaid, according to the CDC.
Unfortunately, these patients may be “frequent fliers” in a health system; they typically need more attention between care appointments and often rely on emergency medical services and/or the emergency room to answer questions and provide care in non-critical situations. Significant opportunities exist for technology and touchpoints to bring ongoing care and support closer to these patients. Virtual care technology can improve care coordination and increase patient access to convenient care 24/7. Frequent touchpoints can continually engage chronic care patients, resulting in better disease management, improved outcomes and reduced costs.
Post-acute care organizations are embracing the use of a virtual care communication platform to engage chronic care patients and optimize their agency’s available resources. Using a combination of a video-based platform and readily available smartphones, tablets and PCs, home health clinicians can quickly connect, communicate and collaborate with patients – and colleagues — to ensure patients are actively monitored and motivated in their care without a series of in-home visits.
Ongoing messages and a series of virtual visits can augment – and even replace – many traditional in-person visits, effectively reducing the costs and liabilities associated with nurses driving to each patient’s home. The virtual visit can also include a clinician, a pharmacist and even an interpreter, depending on the patient’s needs. During virtual visits, home health providers can use video to detect potential patient issues before an in-person consult is needed and deliver preventive care during the call, minimizing the need for an immediate in-person intervention.
To address the clinical mobility challenge, PatientSafe developed the Mobile Maturity Model for Healthcare as common framework to assess the current state of mobile adoption in your health system and align the various people, technologies and processes to be successful with mobility at scale. Our goal? To get industry-wide participation in using and evolving the healthcare mobile maturity model – so clinicians and patients benefit from a streamlined, secure, context-rich mobile care experience.
