Guest post by Steve Wilson, vice president of product management and marketing, Accusoft.
Steve Wilson
It’s no surprise that the healthcare industry is one of the most highly-regulated industries in the United States. Therefore, maintaining compliance is no easy feat. Paperwork and documentation often hinder the productivity of even the most advanced healthcare facilities. Fortunately, with the digital revolution, a majority of these inefficiencies can be solved with document automation.
More healthcare companies are utilizing the software to help ensure compliance, reduce risk and focus on providing better patient care. It does so by providing facilities with the ability to set up digital checklists with due dates, reminders for task completion, and more. Whether it’s used in daily operations or staff and patient-related work, document automation makes the process simple. Here’s how:
Daily Operations
With all that goes on in a single healthcare facility, there are certain details that can often be overlooked or forgotten. Daily operational tasks, such as completing vendor contracts and purchase orders, keep the facility running – yet the Journal of Contract Management report found that more than 70 percent of companies lose or misplace 10 percent or more of signed contracts.
A modern workflow software manages these important recurring documents and contracts with an automated process. Furthermore, with electronic signatures, repeating or bulk documents, such as facilities requests, can also be signed. Easing the burden of daily operations helps to significantly free up valuable time to focus on providing the best patient care.
Staff Operations
Better patient care begins with better staff operations. Document automation provides a centralized location to keep all important templates — from physician agreements and credential documents to time sheets and other organizational forms. Instead of relying on hard copies of documents, which are susceptible to damage or misplacement, everything is digital. No matter the size or complexity of the staff, as healthcare facility staff sizes can range from 42 to more than 11,000, digital processes help maintain compliance by ensuring credentials and certifications are standardized and up-to-date.
Patient Operations
Patient care is the driving force behind the massive growth of the healthcare industry. While nearly all facilities offer good care, the most distinguished are recognized for their outstanding commitment to offering the best care. When facilities and operations are efficient and compliant, health staff can focus their attention on providing that care, instead of managing paperwork and processes. Workflow software can easily set periodic reminders to inspect and maintain emergency generators, eyewash stations and fire extinguishers to ensure they are always in working order in case of emergency.
New applications of telehealth that enhance existing provider-to-provider communications are revealing a new way for healthcare organizations to ensure patient care remains in-network. As hospital M&A activity accelerates and organizations strive to glean the most value from their investments in technology and human resources, telehealth is recognized for its role in keeping communications and care in-network.
Telehealth is increasingly being leveraged to offer providers immediate in-network specialist expertise and to reduce ad hoc out-of-network referrals. These kinds of applications make the in-network choice convenient for providers and patients while driving increased patient engagement and more integrated care across the broader care team.
Providers are seeing that telehealth applications can be complementary – instead of disruptive – to their workflows and provide them with a new approach to practicing medicine via technology.
Immediate Communications with Colleagues
Video-based technology can help providers optimize their current workflows by facilitating faster and more flexible consults with on-demand access to in-network specialists. A provider’s network of experts can be built into the technology, which enables a provider to immediately reach the designated, first available specialist for answers. Instead of wasting valuable seconds and minutes looking for the names and contact information for specialists, providers can use telehealth to expedite provider-to-provider interactions which accomplish the critical objectives of doing what is both right and timely for the patient’s situation.
For example, a provider may be examining a patient and realize that the patient’s condition requires specialist expertise. With telehealth, the provider can immediately reach out to an in-network specialist. The specialist accepts the virtual consult request, from anywhere and on any device. During the virtual consult, the specialist can evaluate the patient and communicate the appropriate next steps. All stakeholders – the provider, the specialist, and the patient – benefit from the immediacy, efficiency, and effectiveness of a virtual consult conducted in real time.
The broader healthcare organization (whether a medical practice, a hospital, or a health system) will benefit from an increase in in-network referrals. By leveraging the organization’s network to drive better patient outcomes faster, providers can deliver lasting value for the healthcare organization and enhance its overall reputation.
Increased Patient Engagement
Technology can also help providers optimize their current follow-up processes and easily check in with patients after a hospital stay or outpatient procedure. Providers can use telehealth to offer patients appropriate follow-up care at their own home via video. This allows providers (or providers’ in-network resources) to reach out to patients based on those patients’ preferred contact methods (e.g., email or text) and languages (e.g., Spanish, German, etc.) to remind them of their upcoming video visits. The result is increased patient engagement in their ongoing treatment plan. Travel time, related transportation expenses and appointment no-shows are minimized due to this efficient method of follow-up care.
For example, a provider can facilitate a virtual visit with a patient to ensure understanding and adherence. During a virtual visit, the provider (or related in-network care team members) can evaluate the patient’s progress, answer questions in real time, provide patient education, and re-emphasize the treatment plan – all while the patient stays comfortably at home and the provider remains conveniently in the office. All stakeholders – the provider, the care management team members, and the patient – benefit from timely conversations which can drive better adherence and overall outcomes.
James Smith is a blogger with Centra Care, an urgent care center in Tampa.
Healthcare services from across the world are teaming to create better facilities for patients. This is leading to the better and faster provision of seamless patient care with fewer medical errors and improved quality of healthcare while allowing for lower costs.
Accountable organizations are increasingly turning information technology to deliver quality care to patients while ensuring that an unnecessary duplication of services is avoided. Collaboration is key to getting the maximum effectiveness from IT led healthcare solutions, for all stakeholders involved.
Health IT has made it possible for healthcare providers to better accomplish stellar patient care through the safe use of health information while also sharing them confidently.
The evolving protected and private electronic health records are making health information available electronically as and when needed. The result is significant improvements in the quality of care. IT collaborations also help reduce the distances between care providers and patients, improving workflow and services delivered.
Here are the latest IT related collaborations in the world of healthcare.
Medtronic and American Well
Announced in October 2017, this collaboration seeks to bring about an exciting new revolution in telehealth and the way it is used to facilitate chronic, comorbid patients.
Together the companies will provide patient with reliable access to American Well’s telemedicine solutions, using the video-enabled platforms provided by the Medtronic Care Management Services. Information gathered from these remote patient monitoring systems will also be given to clinicians registered with the American Well service.
All in all, this IT led collaboration aims to enhance patient access to healthcare, and clinicians’ access to relevant information easier.
CVS Health and Epic
This exciting new initiative has a very ambitious goal. When CVS Health collaborates with Epic’s Healthy Planet services, the result is prescribers with more power. The collaboration aims to get access to information and analytics that will give prescribers additional resources to find lower cost drugs for their patients.
The resulting platform also aims to gain valuable information and insights into dispensing patterns and medication observance.
The definitive goal of this collaboration, however, is a lot more versatile. It will enable prescribing healthcare providers to find cheaper alternative medication and figure out if the patient’s insurance covers it. Also, pharmacists will get better information regarding medicines so they can make better-informed decisions regarding patient care plans.
Allscripts and Zocdoc
Another exciting new IT-related collaboration in the field of healthcare happened between the scheduling software maker Allscripts and Zocdoc the online scheduling platform for healthcare providers and clinicians.
The API based integration is making it possible for patients to book appointments online with their preferred physicians. The services are available to new and existing practices that are using Allscripts or Zocdoc.
The result will hopefully lead to maximum effectiveness of the physician’s time. It will also improve the efficiency of the office staff while also improving access to healthcare, creating a more connected and streamlined experience for patients.
People perform better if they have a vested interest in the outcome of a given situation. Employees who are given an ownership stake in their company historically perform better and enjoy a higher degree of satisfaction from their respective jobs than do their non-stake-holding counterparts.
Recent research has shown that a similar premise holds true in healthcare. Patients who are engaged in their own care generally have better outcomes and enjoy higher satisfaction in the care they received. According to the American Journal of Managed Care, “A growing body of research has established the benefits of patient activation, which is defined as the knowledge, skills, confidence and motivation to make effective decisions and take action to maintain or improve one’s health.”
According to a 2016 New England Journal of Medicine survey of 340 U.S. healthcare executives, clinician leaders and clinicians at organizations directly involved in healthcare delivery, 42 percent of respondents indicated that less than a quarter of their patients were highly engaged, and more than 70 percent reported having less than half of their patients highly engaged. And to underscore the importance of this result, 47 percent of those surveyed revealed that low patient engagement was the biggest challenge they faced in improving patient health outcomes.
This is not only true for hospitals, but also for specialty care practices. In these environments, it is imperative that practices understand the very specific needs and behavior of their patients, so they can determine how best to conduct effective outreach that will increase patient engagement and patient portal utilization.
Importance of User Interface
A results-driven (or high performance) patient engagement platform helps turn patients into partners in their own healthcare. In addition, a proper next-generation solution supports compliance with MIPS (Merit-based Incentive Payment System), a component of MACRA (Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act), and with meaningful use (MU), by providing patients the ability to view, download or share their medical record. Payback is many-fold: In addition to helping providers meet regulations through a user-friendly interface, patients are freeing up time for caregivers to spend with them by self-populating data fields that would previously have been handled by caregivers. This streamlining of the patient intake process delivers significant time and cost savings to the practice.
Equally important is a patient portal that helps patients remain engaged while enabling practices to comply with government requirements under meaningful use and the MACRA regulations, thereby increasing Medicare payments and minimizing takebacks. It is imperative that the patient portal seamlessly integrates with the organization’s electronic health record (EHR), health information exchange (HIE) and accountable care organization (ACO), if the practice is participating in one. Ideally, the solution should be able to adapt to any healthcare facility’s IT system—not the other way around. Patient engagement initiatives should permeate the practice’s entire healthcare ecosystem.
Guest post by Ken Perez, vice president of healthcare policy, Omnicell, Inc.
Ken Perez
Though largely overshadowed by the continued pursuit of repeal and replacement of the Affordable Care Act by the Trump administration and congressional Republicans, the concept of a single-payer healthcare system is gaining popularity, and a referendum on it is already starting to take place.
According to a June 2017 national survey by the Pew Research Center, 60 percent of the American public feels it’s the federal government’s job to provide healthcare coverage for all Americans, and a third of the public favors a single-payer health insurance system run by the federal government.
On September 13, Sen. Bernie Sanders (I-Vt.) introduced the Medicare for All Act of 2017. In striking contrast with his previous solitary introductions of this approach, this time 16 Democratic senators—one-third of the party’s Senate caucus—identified themselves as co-sponsors, including Senators Cory Booker, Kirsten Gillibrand, Kamala Harris, and Elizabeth Warren, all possible presidential candidates.
Medicare for All Defined
Per Sanders, Medicare for All would create a federally administered single-payer healthcare program that provides comprehensive coverage for all Americans, spanning the entire healthcare continuum, “from inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments.” Every doctor would be in network, and saliently, there would be no deductibles, copays or cost-sharing requirements of any kind.
Estimating the Cost of a Single-Payer System
One admittedly simplistic way to estimate the cost of a single-payer system would be to assume that the federal government would pay for the nation’s entire national health expenditures (NHE), which the Centers for Medicare and Medicaid Services projects will reach about $3.5 trillion in 2017, which would be equivalent to a more than tripling of the roughly $1.1 trillion the federal government will spend this year on Medicare, Medicaid, the Children’s Health Insurance Program, health insurance subsidies and related spending, and Veterans’ medical care.
Single-payer advocates argue that administrative savings and decreased waste would reduce spending, generally by 20 percent to 30 percent, but such savings would likely be offset by the cost of covering the approximately 25 to 30 million Americans without health insurance, as well as higher demand (from those currently with coverage), resulting from the elimination of all cost-sharing requirements, which tend to curb overutilization of medical services. Per a landmark 1982 Rand Corporation study that examined the spending patterns of patients with insurance that covered 100 percent of expenses versus those with copays and deductibles, patients without out-of-pocket fees spent 30 percent more for medical services. A 30 percent increase in demand for medical services would add more than $1 trillion to the nation’s annual healthcare bill.
Citing the lower per capita costs of healthcare in other industrialized countries with single-payer systems, Sanders argues that NHE would actually decrease under his single-payer plan, by $6 trillion over 10 years. Sanders’ white paper, “Options to Finance Medicare for All”— which outlines a dozen tax revenue-generating ideas —presents $16.2 trillion as the implied expected increase in federal expenditures over a 10-year period under Medicare for All.
As technology evolves and there’s more emphasis on streamlining business practices, there’s an increasing reliance on electronic health records. In 2014, private healthcare providers were required to adopt electronic medical records to maintain their existing Medicare and Medicaid reimbursement levels. The move was a part of the American Recovery and Reinvestment Act, which aimed to improve quality, safety, efficiency and reduce health disparities.
The Act also offered financial incentives to those providers who could prove meaningful use in the adoption of electronic health reporting. Non-compliant healthcare providers faced penalties, including a 1 percent reduction in Medicare reimbursements. When it was officially mandated, the U.S. Bureau of Labor Statistics (BLS) predicted a 12 percent growth in employment opportunities from 2014 to 2024. Positions they expected to open up included medical records and health information technicians, computer systems managers, health managers and computer support specialists.
If you’re unsure about the role electronic health reporting can play in your practice, using the following information as a valuable resource. Every practice can benefit from EHR, and it’s important to understand the how and why.
Electronic Medical Records vs. Electronic Health Records
Electronic medical records and electronic health records are often used interchangeably, but there are some key differences. Medical records offer a more narrow view of an individual’s medical history, and it’s used mainly for diagnosis and treatment. They are unique to a specific practice and are not designed to be shared outside of that practice.
Electronic health records, on the other hand, show a patient’s overall history. It is a comprehensive medical chart that’s intended to be shared with other practices. It includes everything from images to allergies to lab results. If the patient were to move across state lines, their electronic medical record would follow them, while an electronic health record stays with the practices they leave behind.
Improved Efficiency and Cost Savings
Electronic health records can provide immense benefits in terms of increased efficiency. This can be demonstrated by current statistics on EHR. One survey found that 79 percent of users stated that EHR allowed their practices to run more efficiently. Of the doctors surveyed, 82 percent reported that sending prescriptions electronically saved time, 75 percent received lab results even quicker, and 70 percent reported increased data confidentiality.
As technology evolves and there’s more emphasis on streamlining business practices, there’s an increasing reliance on electronic health records. In 2014, private healthcare providers were required to adopt electronic medical records to maintain their existing Medicare and Medicaid reimbursement levels. The move was a part of the American Recovery and Reinvestment Act, which aimed to improve quality, safety, efficiency and reduce health disparities.
The Act also offered financial incentives to those providers who could prove meaningful use in the adoption of electronic health reporting. Non-compliant healthcare providers faced penalties, including a 1 percent reduction in Medicare reimbursements. When it was officially mandated, the U.S. Bureau of Labor Statistics (BLS) predicted a 12 percent growth in employment opportunities from 2014 to 2024. Positions they expected to open up included medical records and health information technicians, computer systems managers, health managers and computer support specialists.
If you’re unsure about the role electronic health reporting can play in your practice, using the following information as a valuable resource. Every practice can benefit from EHR, and it’s important to understand the how and why.
Electronic Medical Records vs. Electronic Health Records
Electronic medical records and electronic health records are often used interchangeably, but there are some key differences. Medical records offer a more narrow view of an individual’s medical history, and it’s used mainly for diagnosis and treatment. They are unique to a specific practice and are not designed to be shared outside of that practice.
Electronic health records, on the other hand, show a patient’s overall history. It is a comprehensive medical chart that’s intended to be shared with other practices. It includes everything from images to allergies to lab results. If the patient were to move across state lines, their electronic medical record would follow them, while an electronic health record stays with the practices they leave behind.
Improved Efficiency and Cost Savings
Electronic health records can provide immense benefits in terms of increased efficiency. This can be demonstrated by current statistics on EHR. One survey found that 79 percent of users stated that EHR allowed their practices to run more efficiently. Of the doctors surveyed, 82 percent reported that sending prescriptions electronically saved time, 75 percent received lab results even quicker, and 70 percent reported increased data confidentiality.
EHR Cost Savings
There are immense cost savings associated with EHR. For example, large hospitals can save anywhere between $37 million to $59 million over a five-year period, not including incentive benefits. The majority of those savings come from the ability to eliminate various labor-intensive tasks and other paper-driven responsibilities. With better access to patient data and smart error prevention alerts, the chances of medical errors are greatly reduced. You’ll also experience easier communication across the entire medical channel. You can track electronic messages from staff to labs to other hospitals and clinicians.
Many administrative tasks are streamlined, resulting in time reduction. Filling out forms and taking care of billing requests often take up a significant portion of healthcare costs. Electronic health records also provide more information on next best steps, and can automatically siphon information that needs to be shared with various public health agencies.
Augusta University Medical Center reported that it had become a victim of phishing for the second time within a 12-month period although fewer than 1 percent of patients were impacted by the second effort. A trio of cybercrime rings took over 26,000 open MongoDB servers and demanded ransom for the owner to retain the data. A successful intrusion of Medical Oncology Hematology Consultants was detected, with 19,203 compromised patient records; however, by that point, the hackers had been inside the system for 20 days.
Kaleida Health announced that it had been victimized by phishing, with 744 patients affected; actually, though, that was adding to a previous tally – with 3,544 total records accessed. Ransomware brought down Pacific Alliance Medical Center; two months later, the firm said that 266,123 patients were impacted.
What do all of these situations and figures have in common? They are all Health Insurance Portability and Accountability Act (HIPAA) violations that took place in 2017. Also, you don’t want to be that organization. Forget the threat to your credibility (perhaps especially the much-dreaded Wall of Shame; the sheer expense is overwhelming. For any data breach, the average drop in revenue experienced by a healthcare firm is $3.7 million
So, with all that said (i.e., since it is more common than anyone would like, and since these cyberattacks are so incredibly costly), it is only reasonable to look over some HIPAA fundamentals and review security best practices for protecting HIPAA compliant data. With the information you collect, you can strategize implementation of the most strongly protected possible system.
Here are a few tips so that your environment can integrate best practices for securing the protected health information (PHI) that is under your watch:
Encrypt everything
Encryption is critical. Just look at a study published in Perspectives in Health Information Management in 2014. While this research is slightly dated, it is compelling because it is a true big data study that looked at all the breaches of HIPAA-protected files that were currently within the HHS Department’s system. At the time of the report, which used all events through September 22, 2013, 27 million people’s records had been compromised, via successful attacks of 674 covered entities and 153 business associates. Forms of intrusion included hacking, improper disposal, loss, theft, unauthorized access, etc. Breaches occurred in various digital environments both through devices and backends, as well as through hard-copy paper documents.
When you look at the data on types of breaches as pieces of the whole, you see how prominent theft is. Here are the top five types of breach in descending order of volume, with the number of individuals, covered entities, and business associates affected in each case (numbers that have now grown substantially): 1. theft – 12,785,150 people (via 344 CEs and 52 BAs); 2. loss – 7,359,407 people (via 74 CEs and 23 BAs); 3. hacking or IT event – 1,901,111 people (via 59 CEs and 20 BAs); 4. unauthorized access – 1,334,118 people (via 136 CEs and 44 BAs); and, 5. improper disposal – 649,294 people (via 32 CEs and 5 BAs).
The key concern here is that these issues are not just about theft. If it were just about laptops being stolen, that would not be as much of a problem because the criminals would not be able to get anything of them necessarily. All of these cases are ones in which the information on the devices that was stolen was unencrypted. In other words, all you need to do is encrypt that data – and even if it does get stolen, you don’t need to worry about it as a violation.
Assess your risk
Conduct a complete risk assessment of all the elements of your ecosystem that store, process, or transfer ePHI, along with other ways in which your information may be exposed physically. Related to the data center environment (whether it’s internal, third-party or hybrid), you want to ask these questions: Are natural disasters common in the location of the data center? Is there a responsible party associated with all hardware components? Have you assessed the security mechanisms that are now in place and any risks that are present? Have you taken into account all ways in which ePHI is accessed or manipulated within your system? Consider the creation, receipt, maintenance and transfer of this information.
Training is fundamental
It is easy, especially related to electronic protected health information, to become obsessed with the systems and to forget about the huge potential for human error. Your staff must be properly trained, especially since the threat landscape is evolving, with an increasingly sophisticated toolset for accessing the data. A very simple yet devastating mistake that is often made is phishing, when a staff member either clicks on a link or submits data, such as usernames or a Social Security number that, thereby, connects them in to a fraudulent system. It is horrifying but true that something as simple as a fake email could create a point of entry for malware or viruses.
