By Dr. Giovanni Colella, CEO and co-founder, OODA Health.
Giovanni Colella, MD
2018 was another year of rapid changes in the healthcare industry. Over the past twelve months, I’ve had fascinating conversations with executives in the provider and payer community and they have described the challenges they face and their visions for the future. One thing has become clear among everyone in the healthcare ecosystem: expectations are changing.
Patients are looking for a retail-like experience for their treatment, and sure enough, a number of new, innovative providers are gaining traction by leading with convenience and patient-centricity. Patients are embracing alternatives to the traditional doctor’s office or the local hospital. Unwilling to wait for an appointment, patients are eager for more responsive, high-quality treatment options.
Healthcare providers are becoming more innovative in an effort to improve the quality and efficiency of patient care while continuing to look for ways to reduce costs. Payers are exploring new approaches to improve their back-office systems and are willing to partner with third-party vendors to accelerate this improvement, rather than trying to develop everything in-house.
I am confident that this year will be full of important change in the industry and that these changes will touch the lives of millions. Of course, there is still a long way to go since the healthcare industry is historically slow to embrace change – it is often difficult to break through a culture that normally stays with the status quo. However, the desire for change is definitely there. If I were to list my top three predictions for trends in healthcare in 2019, they would include the following:
1) Health plans will get much more serious about improving member experience and predictability.
Health plans are eager to improve their member experience, partially because of the emergence of new consumer-centric plan models. As the market becomes more competitive with new entrants, traditional health plans will continue to partner with agile startups to deliver an improved member experience. These partnerships will enable health plans and startups to pilot projects and scale them quickly, leveraging the strengths of both organizations.
2) Employers are focusing on providing access to targeted healthcare solutions that meet specific therapeutic needs.
As of 2018, 83 percent of employees say healthcare is very or extremely important to/for staying in a job or changing a job. Given the importance of healthcare to their employees, and that the average company spends $10,000 on healthcare annually for each worker, employers will recognize the need to invest in specific solutions in areas where traditional networks fall short. These include programs for infertility, women’s health and behavioral health.
Data is the future of healthcare, especially when it’s combined with new technologies like artificial intelligence and machine learning. As we generate more and more healthcare data, we increase the potential for us to discover deep insights that might otherwise have gone undiscovered.
Data analysis can be used to enhance drug discovery by running simulations and identifying areas of potential research. It could also be used to provide a kind of Netflix of healthcare which provides personalized recommendations for every patient based on what’s worked well for other, similar patients.
And of course, it can also be used to improve employee engagement. After all, it’s these front line employees that are interacting with patients and acting as the face of your organisation. An engaged employee can make all of the difference, both to your bottom line and to the patient’s prognosis.
Here are seven tips to help you to get started.
Monitor engagement
You can’t track whether your efforts are having an impact if you’re not tracking employee engagement in the first place. Bernice Winters of XpertWriters.com recommends using 360-degree feedback programs at regular intervals and adds that you can never gather too much data. “Even if you don’t need that data today,” she says, “you never know when you might need it in the future.”
Choose the right metrics
If you try to measure too much, you stretch yourself too thin and spend more time logging the data than acting on what you’ve learned. If you measure too little, you find yourself with insufficient data to make effective decisions. You’ll also want to ask questions that are specific to your business so that you can dig deeper.
Provide data-led training
Edward Laws of CareersBooster.com says that any company that isn’t providing training is failing to invest in its own future. In the healthcare industry, employers have a responsibility to provide training to staff so that they’re providing the best service possible. Data-led solutions can help you to identify weaknesses and to help employees to address them before it’s too late.
It has become clear in the last few years that when it comes to cybercrime, hackers are not fussy about which organization or sector they focus on – if there’s profit to be made, anyone is a potential target.
However, there are of course institutions which will always be of particular desirability to cybercriminals. Financial institutions, banks and retail are among the most targeted because the goal of most cyberattacks is financial gain, and organizations in these industries are the most lucrative targets for cybercriminals. The healthcare sector is also heavily targeted because of the personal data it holds. This data may be stolen and used for different purposes, including fraud. As a consequence, the focus on healthcare institutions by hackers has ramped up in recent years.
This increased attention on the health sector is because of hackers seeing it as an inexhaustible source of money. On multiple occasions, media reports have described leaks of data from medical centers, followed by a ransom demand sent to clinic management and patients.
There are a number of other ways criminals can monetize attacks on healthcare equipment and applications. These include threatening patient health by altering stored information; using stolen data to fraudulently obtain access to medical care or controlled medications; leveraging personal information on patients and their family members; and sabotaging websites and/or infrastructure on behalf of unscrupulous competitors. Attacking healthcare institutions also allows criminals to resell stolen data to third parties such as insurance companies, healthcare providers, banks, and others, who can use this valuable information for a number of purposes (such as advertising, research, or even discrimination based on pre-existing conditions).
One such specific way that criminals can carry out attacks is by exploiting advancements in health technology and equipment in recent years. We’ve seen an increasing number of medical devices such as pacemakers, drug pumps (like insulin infusion devices), implantable defibrillators, and other devices implementing wireless connectivity for doctors to control and fine-tune their work and update firmware. This makes these devices potentially incredibly dangerous for patients. A criminal could research and reverse communication protocols and exploit vulnerabilities in a simple piece of software used in those tiny devices, for example changing the heart rate controlled by pacemakers, injecting incorrect doses of drugs or even making them show the wrong data — leading doctors to the wrong conclusions and causing them to make mistakes in their treatment.
A good set of teeth makes all the difference, not just for the purpose of smiling, but it also has a huge impact on self-esteem and overall confidence. Having broken, missing or unsightly looking teeth makes it hard for people to express themselves effectively and clearly.
As more and more people are realizing the importance of dental health and its impact on their lives, whether at a personal or professional level, an increasing number of people are also deciding to get dentures, dental implants, braces and other dental appliances.
With this in mind, it is not surprising to know that according to the American Academy of Implant Dentistry, the dental implant and prosthetic business in the United States is projected to reach a lucrative estimate of $6.4 billion by the end of 2018.
The dental implant industry has been consistent in making breakthroughs and finding more innovative ways to improve the overall quality and standards of its products. Indeed, the recent developments in dental technology make getting dental implants more and more attractive for consumers. Here are just some of the most recent innovations in the field of implant dentistry.
Computer-designed implants
For every dental implant procedure, the ultimate goal is to have satisfactory bone stability. This is because with the current state of dental technology, crestal bone loss is still an unavoidable result. As a consequence, bone resorption and/or bone loss still poses a threat to successful dental implants, especially to short dental implants.
With this ultimate goal in mind, clinicians and dental practitioners have long researched different approaches that can be taken to avoid bone loss. According to recent studies, a new development is now seeing the light, with dental implants that can encourage zero bone loss with the usage of computer aided design and computer aided manufacturing (CAD-CAM).
This technology aims to create exact duplicates of the missing teeth which can immediately be replaced in the mouth. Once the defective biological tooth comes out, the replica is then placed in the empty space. The best thing about this technology is that it offers patients a symptom-free healing process, which also in turn is advantageous for dentists as it gives them a more effective and efficient way to create dental implants.
Disease and illness are running wild these days and individuals are more aware than ever of the need to make lifestyle changes. There has been an increase in the number of people who are interested in getting educated about their health and ways to improve it. Beyond dieting, exercising, and getting enough sleep, patients are digging deeper to find out what’s going on.
To know what’s going on, one must first have a clear understanding of their family history. While some may know of a few generations and medical histories, many are clueless as to their bloodline and how it can impact their health or efforts to improve. Fortunately, modern technology has made it possible for individuals to have a clearer picture.
DNA tests for family history and its increased accessibility to the average consumers have cultivated a new method for improving health and wellness. With a full breakdown of a person’s genetic makeup, medical providers and private companies are able to learn a lot about an individual and what steps need to be taken to enhance their well-being. Here’s a look at some of the data derived from DNA testing:
Dietary Options – When it comes to eating right, what works for one individual may not work for another. Genetic testing can give patients insight on what they should and shouldn’t be eating. Results can conclude things like how much protein a person should eat, which fats are best, your food sensitivities, nutritional deficiencies, and the types and how much carbs you should be consuming.
Disease Risks – It is believed that there are some genetic components tied to the development of certain diseases like high blood pressure, diabetes, osteoarthritis, cancer, and more. Advanced DNA tests, however, now reveal whether or not a patient is at risk of developing certain diseases based on their genetic coding. This knowledge can help patients to get proactive and start making more efficient changes to their lives to prevent the diseases.
Weight Management – Not every patient is successful in losing weight simply by eating good foods and exercising. For some, there is a genetic link that hinders them. Whether it be the love of sweets, addictive traits, some underlying disease relating to weight, or a family history of obesity, it can be discovered through DNA testing. Armed with this information patients can then make more effective decisions and get support in areas they weren’t aware they needed it to finally shed the pounds and keep them off.
Efficient Medicine – From treating mental illness to life-threatening diseases, doctors rely on modern medicine to help improve the lives of their patients. However, as with most things, what works for one patient may not be as effective for another. DNA testing, however, changes that because they now have a clear picture of their patient’s genetic makeup and how it is impacted by certain medications. This provides healthcare providers with a more accurate means for prescribing the right medication and dosage with fewer side effects and more effective results for their patients.
Thanks to the advancements of modern technology like DNA testing healthcare providers and their patients are equipped with data that can increase the quality of life. Though it is still crucial to be observant, eat right, exercise and take medications as prescribed, the use of such data makes it possible to get more detailed in each category on what will work most effectively for each person. This reduces the risk of disease, enhances treatment options, and reduces the unhealthy state of patient health today.
By Jayne Warwick, director of market insights, PointClickCare.
Jayne Warwick
The Patient Driven Payment Model (PDPM) is more than just a new name attached to Medicare payment reform. The shift from Resource Utilization Group (RUG) IV to PDPM moves the skilled nursing reimbursement model away from therapy provision as its main driver. Instead, payment will be determined by the provision of nursing care with higher rates being attached to more clinically complex patients.
PDPM will also align reimbursement with the industry-wide shift to value-based care (as opposed to volume).
It is designed to:
Incentivize treating the needs of the whole patient
Refocus care on good clinical practices
Decrease focus on the volume of services that the patient receives
Reduce administrative burden on the provider
Why do we need it?
The skilled nursing industry has advocated for payment reform for years. In response to requirements in the IMPACT act of 2014 and the resulting PAMA act, post-acute care must have a unified prospective payment system by 2024. Different post-acute settings use different data to determine payment. PDPM is the beginning of unifying the data tied to reimbursement.
In addition, the Medicare Payment Advisory Commission (MedPAC) and the Office of the Inspector General criticized the current RUG IV system for incentivizing therapy over the provision of clinical care. Essentially, the more therapy minutes provided, the higher a skilled nursing facility would be reimbursed. Since the majority of minimum data sets (MDS) that were submitted in the highest RUGs categories were within five minutes of the 720-minute threshold, the RUG IV system was scrutinized for promoting the threshold as a goal for care, rather than the outcomes of the therapy.
Also, RUG IV has been criticized for its strenuous administrative requirements. Providers needed to complete many assessments for a single Medicare A stay. For many years, CMS has been under pressure to reduce the administrative burden associated with RUG IV.
These factors illustrate the need to link reimbursement to patient need, as well as the imperative to focus on good clinical care.
Timeline
The Resident Classification System, Version 1 (RCS-1), was proposed in May 2017. In May 2018, RCS-1 was replaced with PDPM. It was finalized on July 31, 2018 and will go into effect on October 1, 2019.
Benefits
A reduction in scheduled PPS assessments from five to one required assessment and only two unscheduled assessments, the IPA and the Discharge PPS assessment
More focus on the clinical characteristics of the resident
Utilization of ICD-10-CM documentation to drive reimbursement process for therapies and non-therapy ancillaries
Opportunity to increase reimbursement with proper co-morbidity capture
Shifting resident population away from rehab-intensive focus to more clinically focused care
How you can start preparing now
To adequately prepare for PDPM, there are several activities facilities can begin performing to ready themselves for the transition. These steps to change management for PDPM will help any facility succeed through the immediate shift in payment. They will also strongly position a facility to readily adapt to future payment reforms or shifts that may be imposed as all payors transition to the PDPM methodology.
To start, facilities need to understand the plan and the financial, cultural and operational impact it will have on their business. Providers need to consider their current state, as well as areas they want to be successful in once PDPM goes into effect. Homes should be looking at staff skills and competencies to support the shift to a more clinically driven patient population and determine where changes, education, or upskill training is required.
Facilities need to understand the impact of the conversion. For example, will they have the right mix of residents and needs to support revenue goals? This is also the time homes should examine how they capture required documentation and ICD-10 coding practices. Do they have the right information to code appropriately? To get the right code? To accurately code the MDS? This is the foundation for being successful with PDPM.
After facilities understand PDPM and its impact on their business, it is crucial that they standardize their processes and content to capture the right data elements. This will better enable facilities to gain insights into what else they may need to change to be successful, as well as identify gaps, level the playing field for staff care provision, and make possible the measurement of expected outcomes against actual outcomes. This standardization will also serve homes well in the future. PDPM affects Medicare A residents in 2019, but when CMS retires the PPS item set in 2020, homes that have mastered the move to standardization will find the shift to PDPM for all payers much smoother.
By Amy Sklar, SVP of advanced manufacturing communities, UBM.
As reported by Rock Health’s Midyear Funding Review, 2018 got off to a roaring start with $3.4 billion for digital health funding in the first six months of the year. All indicators point to continued momentum in 2019, as startups and veteran companies alike work to unlock the potential of digital health technology to increase efficiencies in healthcare delivery and improve patient outcomes.
In the coming year we will see innovations including smart, connected products offering opportunities for new functionality, consumer engagement, and higher product utilization. The industry will additionally see startups enter the space leveraging new capabilities for data collection and analytics to better apply insights to make medicine more precise. To learn more, a panel of experts will expand on this topic, speaking to the evolving nature of digital health at MD&M West Anaheim 2019.
Miniaturization
While nanotechnology isn’t anything new, we will see continued interest in developing the space with an anticipated move toward more catheter-based and minimally invasive procedures. Medical devices are getting smaller with the demand for technology-driven advancements, and rapid developments are being made in design options to enable drug delivery. In particular, breakthroughs in new drugs and biologics are increasingly seeking localized delivery for better therapeutic effects.
Surgical robotics
Medical robotics has an exciting future. At the Medical Design and Manufacturing (MD&M) 2019 conference in Anaheim, we are seeing a significant increase in companies impacting the surgical robotics field. A few key players include Intuitive Surgical, TransEnterix, Medrobotics, Medtronic with its acquisition of Mazor Robotics and Neural Analytics. Robotic-assisted surgery has the potential to improve patient care and vastly increase the efficiency and accuracy of healthcare teams. We are entering a world where surgical robots are more than just a robotic arm. It consists of intraoperative-imaging, surgical navigation, 3D imaging, pre-surgical planning software, among others, that all mesh seamlessly into the surgeon’s workflow to enable improved outcomes.
Augmented reality and virtual reality: Changing the face of healthcare
One of the most exciting areas of development in the medical technology arena is augmented and virtual reality. While augmented reality (AR) and virtual reality (VR) have a variety of benefits, we will see these technologies expanding access to healthcare in 2019. Telemedicine is still in its infancy, but with population health on the forefront of medical technology conversations, 2019 will see major strides in advancing virtual care to support the two thirds of the world’s population that doesn’t have access to safe or affordable surgery.
The technology available to diagnose and treat a wide variety of illnesses and ailments continues to improve with every year. While these developments are undoubtedly contributing to increased rates of recovery and preferred patient outcomes, doctors and other medical professionals continue to rely on a relatively basic set of guiding principles when determining the probable causes of disease and the best methods of treatment.
Simply put, physicians learn to pay attention to their patients and watch closely for the signs and symptoms of various illnesses and ailments. More times than not, a trained doctor can make an accurate diagnosis based on physical examination and conversation.
With this in mind, regular folks can easily improve their ability to monitor loved ones for signs of illness by simply improving their observational skills. While we do not advocate for armchair diagnosis — the opinion of a licensed physician is always recommended — the ability to pay attention to the right clues can go a long way in making sure you and those around you are not turning a blind eye to something serious.
For instance, if you’re married to someone who suffered from alcohol or drug dependence in the past, there may be numerous telltale indications of relapse. According to a leading center for drug rehab in Georgia, addicts often retreat from the people in their lives. They often start making excuses for things and neglecting their responsibilities. They often become alienated from their relatives and from society in general. If your husband or wife behaves oddly any time he or she consumes alcohol, then that may denote an issue with alcohol addiction. Addiction to alcohol is a problem that plagues people all around the globe. It plagues people young and old as well. Pinpointing common signs of addiction can do a lot for people who want to help their loved ones nip serious issues in the bud.
A good set of teeth makes all the difference, not just for the purpose of smiling, but it also has a huge impact on self-esteem and overall confidence. Having broken, missing or unsightly looking teeth makes it hard for people to express themselves effectively and clearly.
Disease and illness are running wild these days and individuals are more aware than ever of the need to make lifestyle changes. There has been an increase in the number of people who are interested in getting educated about their health and ways to improve it. Beyond dieting, exercising, and getting enough sleep, patients are digging deeper to find out what’s going on.