The world is a big place. However, since the introduction of the internet, the world just seems to get progressively smaller because of our ability to communicate with people who are leagues away. We are able to share information to a vast audience without any delay. And with the budding concept of “the internet of things”, it’s not a far-fetched idea that we should soon find that we’re able to control devices over an internet connection.
While the ability to share information has always been our strongest trait as a species, a lot of specialists, especially in the medical field, are severely limited by one thing — distance. Despite our ability to share information, we cannot completely transfer skill and experience from one person to another. Skilled doctors are sought all over the world because they carry something that they cannot simply transfer over the internet — their skill. There are many things that simply cannot be taught, such as how to maintain a steady hand during complex procedures or how to remain composed during a high-risk medical operation.
This was exactly the problem that the Da Vinci Medical robot was meant to address, and since its introduction in 2000, it has done exactly that. Because of this technological development, distance was no longer an issue when it came to providing skilled medical assistance. Because of the Da Vinci Medical Robot, skilled physicians were able to conduct complex and risky procedures despite being miles away from the actual patient.
Other times, instead of being able to emulate the movements of a doctor who’s miles away, robots can also serve to assist the doctor. This is the case with the first dental surgical robot, Yomi. This robot, unlike the Da Vinci Medical robot, is designed to help dentists perform procedures more accurately.
Yomi is a robot that was built by Neocis, a company that hails from Miami, Florida. It was recently approved for production by the FDA. The robot is programmed to plan out dental procedures based on the results of a patient’s CT scan results. Apart from this, the robot is also able to guide the drill as the dentist performs the procedure.
As the healthcare industry is strongly focused on efficient workflow, mobile apps are what can help doctors and patients interact on the go. According to a survey, 90 percent of medical institutions already use or plan to use mobile apps for patient treatment and/or internal management. With the growing number of hospitals that start to launch mobile apps, there has increased a need to shift away from the one-app-fits-all model to systems that serve to accomplish specific tasks. Urgent care clinics are the first in line to try enhance the efficiency of their work by turning to mobile applications.
To provide preventive care to more patients, most healthcare systems have created retail and urgent care clinics for people to visit and arrange an appointment on the same day. While retail centers provide mostly basic services, for instance, chronic conditions treatment, urgent care clinics deal with more serious cases. Also, such clinics typically have labs and offer X-Ray services. That’s why it is very important to provide these medical centers with appropriate software that will serve the overarching goal – effective patient treatment. So why not use a mobile app to improve the entire workflow? Let’s weigh up all the pros and cons.
Benefits and drawbacks of custom mobile apps for urgent care
If you plan to get a custom mobile app for an urgent care center, thoroughly consider finances, time and energy that you are going to invest in the project. If an app is developed to serve doctors, then all the risks are worth taking. Apps for smartphones and tablets speed up urgent care delivery and help doctors find the fastest solution in code blue situations.
Another matter is getting a mobile app to serve patients. The urgent care market focuses quite narrowly on doctor-on-demand apps for patients. Moreover, most patients turn to urgent care less than 2 times a year. So is the effort justified? Apps may be installed when needed and removed if not needed any more. That’s why it seems reasonable to download an app from the App Store or use a website to get the updated patient information.
What is the best solution for urgent care providers
Though custom mobile apps for urgent care centers may be optional, there is always a strong need in other software. Clinics demand healthcare management information systems (HMIS), custom imaging and visualization apps, patient administration systems, electronic health record (EHR) systems and other medical software to improve patient outcomes and meet the needs of a certain clinic and its staff. Healthcare policy management software can aid the facility in its short- and long-term management goals while considering the stringent regulations and healthcare standards.
McKinley County, New Mexico, is the namesake of the assassinated 25 U.S. President William McKinley. Many locals, particularly those Native Americans of Navajo decent living on reservations, have also been the victim of assassination, but in character in addition to physical attacks. Three decades ago Gallup, New Mexico, which borders on the Navajo Reservation, was known as “Drunk Town, USA.”
For many years Northwest New Mexico’s Gallup ranked number one nationally in the number of alcohol-related deaths. This reputation also killed many resident’s spirits, contributing to addiction, joblessness and homelessness, further highlighting the need for behavioral health care in this region. Native American youth have the highest rates of alcoholism of any racial group in the country, according to the National Institutes of Health.
McKinley County Is One of Poorest in U.S.
There are many stories like this. Addiction’s partner is the adjunct poverty of McKinley County, one of the poorest counties in the U.S. In Gallup there is a large population of Navajo and Na’nizhoozhi Indians. It is the most populous city in the county with 22,670 residents and is situated between Albuquerque and Flagstaff with 61 percent living below the federal poverty line and unemployment at 8.4 percent.
The Indian Health Service (IHS), an operating division within the U.S. Department of Health and Human Services (HHS) is the principal federal health care provider for Indians. Its mission is to raise their health status to the highest possible level. However, there are still issues such as the life expectancy for Indians being approximately 4.5 years less than the general population of the United States, 73.7 years versus 78.1 years.
Data from a 2014 National Emergency Department Inventory survey also showed that only 85% of the 34 IHS respondents had continuous physician coverage. Of these 34 sites surveyed, only four sites utilized telemedicine while a median of just 13 percent of physicians were board certified in emergency medicine. Another behavioral health related disease afflicting the territory is diabetes. In 2016, diabetes was the sixth leading cause of death for New Mexicans and the seventh leading cause in the U.S.
RMCHCS Hospital Fights Addiction with Behavioral Health Apps
Despite the drumbeat of bad news and discouraging statistics, organizations such as Gallup’s Na’ Nihzhoozhi Center Inc.’s (NCI) has 26,000 admissions every year and is the nation’s busiest treatment center with many repeat customers. The detox center was the result of an effort 30 years ago which began when more than 5,000 people marched from Gallup to Santa Fe to demand assistance from state lawmakers and received a $400,000 for a study to build a detoxification center. The hospital then received two-million-dollar ongoing yearly federal grant out of which NCI was born.
The leader of that effort in the ’80s and ’90s was David Conejo who returned in 2014 as the CEO of Rehoboth McKinley Christian Health Care Services (RMCHCS) where he leads the fight against addiction with traditional tactics, but also behavioral healthcare innovations that have captured the attention of the healthcare industry.
Turing the Tables on Addiction
When he became CEO of RMCHS a few years ago, he took a financially failing hospital and turned it around with the help of William Kiefer, Ph. D who is the hospital’s chief operating officer. Recognizing the root cause of the region’s health problem was addiction, Conejo revitalized a former rehab building on the hospital’s grounds and with some fundraising he launched the Behavioral Health Treatment Center.
The center is operated by Ophelia Reeder, a long-time healthcare advocate for the Navajo Nation and a board member of the Gallup Indian Medical Center. Bill Camorata, a former addict, is the behavioral special projects director. He opened “Bill’s Place,” an outdoor facility where he and hospital volunteers treated the homeless with meals, clothing and medical triage as part of Gallup’s Immediate Action Group that he founded and serves as president. The center has treated more than 200 addicted residents since the center opened in 2015 and has a staff of 30 who manage resident’s case work, provide behavioral health services and are certified in peer support.
By Brooke Faulkner, a writer in the Pacific Northwest; @faulknercreek.
Healthcare is in a constant state of updating. From new technologies to the latest scientific research, nothing stays the same for long. If it does, there’s almost certainly someone, somewhere, attempting to find a better way.
Right now, though, more than just the medicine is changing. The way we interact with our doctors and the way our doctors interact with each other is redefining what patient care looks like. Slowly but surely, the communication and management of healthcare data is joining the rest of us in the 21st century and going digital. Doctors are available on demand, medical records can be accessed without waiting for a courier, and the amount of information available to the public is growing by the second.
It’s not all so optimistic, though. Concerns about privacy exist in tandem with the benefits of increased access, and medical facilities can be vulnerable to a variety of cyber attacks. Whether you’re considering public health on a global scale or just going to the doctor for a yearly wellness check, digital health data is changing the way we see medical care.
Public Health Opportunities
Increased connectivity in the medical world makes more data available to more people. It’s easier than ever to track disease outbreaks, compare national statistics, and identify trends in global health. In the United States, the field of public health research is expected to spend more than $3.7 trillion in 2018 alone.
We have fewer communicable disease epidemics now than at any time in recorded history. Diagnosis and treatment protocols are more sophisticated, but more often than not, we don’t have to worry about smallpox, measles, or rubella thanks to vaccinations. Instead, many of the health concerns facing Americans are preventable, non-communicable diseases borne of unhealthy lifestyles. In 2017, more than 36 percent of the adult population was obese and 9.4 percent had type II diabetes.
With the data recorded by fitness trackers, electronic food diaries, and other health-focused devices, public health researchers can paint a clearer picture of the lifestyle choices that lead to illness. Public health campaigns can become more targeted and an emphasis placed on follow up and plan adherence through personal technology. By crunching the numbers generated from various populations, researchers can compare and contrast differences among nationalities, noting genetic trends and trying to tease out nature from nurture.
Dental health has always been an important aspect of your overall well-being. While most people may perceive dentistry as a means to improve one’s aesthetic, this is but an extra perk of visiting your dentist regularly. There are a wide variety of diseases and they all function the same way —through infection.
When a pathogen is able to gain ingress into your body that is called an infection. And one of the means of ingress are the teeth. A tooth cavity or an abscess are both dangerous in the sense that they are infections waiting to happen.
In the digital age, daily life is enhanced by the technology that we have. For one instance, traditional X-ray images had to be printed on a metal sheet and processed the way you would a camera film. Today, thanks to digital photography, the image is instantly projected onto monitors and saved to a database. There’s no longer the waiting phase. It goes straight to the diagnosis phase.
In previous iterations of the technology, the way that orthodontic diagnostics were performed was that dentists had to make a temporary mold of the patient’s crown (to be replaced) while the permanent mold of the crown would be made back at the lab.
Because of digital photography and 3D printing, dentists simply have to scan the crown that they intend to replace and add it to the database. The computer then simply prints out the replacement crown on the spot.
And while this technology seems impressive, there has been one piece of tech that has been on everyone’s lips for the past few months — artificial intelligence.
It first became publicly known when Google introduced it with its new line of Pixel phones. The artificial intelligence found in these phones was able to significantly improve the photo quality taken by the phone camera. A plethora of phone manufacturers, such as Asus, Huawei, and Oppo, followed suit thereafter.
What most people don’t know is that in the medical field, AI is currently being used to make the process of diagnosis more efficient and more accurate. IBM brought its Watson platform into the picture and it is currently used to help doctors make the best diagnosis and recommend treatment based on the patient’s medical history.
The software is even being further developed for it to be able to schedule medical procedures based on its estimated procedure durations. What this does is that it helps improve the efficiency at which hospitals operate by ensuring that time is used in the best way possible. So, this translates to an overall higher number of patients treated.
The same application can be brought into dentistry. A program known as VisualDX allows dentists and doctors alike to input images onto a computer. The computer is then able to produce a full list of all possible diagnoses.
In the area of health insurance, there is an increasing need for providers to streamline the process of securing coverage for their clients. With this, technology is at the center of innovation, and so providers will need to secure wider adoption of helpful tools and applications to ease up the workflow.
For sure, evaluating a client’s risk profile as well as processing accident claims are just two of the most tedious tasks insurers will have to handle. Other than that, insurers will also need to maintain their profit margins to ensure the seamless delivery of insurance services.
It is against this background that insurers will need to invest considerably in terms of acquiring the needed technologies and/or update their current equipment inventory.
The first step to this would be identifying which technologies to adopt and to make sure that such technologies can help in the long run.
Claims management software
Insurers that offer retirement plans will find it essential to use the right software and web applications to better deliver their services. Along these lines, it is best to opt for software that has the substantial features that are valuable for recording client information and relevant details in the event that a client wants access to their claims.
Also, insurers will need to implement systems capable of handling large amounts of data seamlessly. Finally, with a proper system in place, insurers can use certain features to accurately calculate total costs per claim. Indeed, an insurance claims management system can be a powerful tool that can help insurance providers cut costs, shorten waiting times, and avoid fraudulent claims through a more systemic yet faster validation process.
Risk assessment software
Before getting covered by an insurance product, it is imperative for clients to undergo a risk assessment process. Such a system provides a whole range of benefits to independent agents as well as hospitals. Accuracy, after all, is a key concept in the health insurance industry. So, making sure your patient’s records are free from errors can also lead to a more streamlined process.
What’s more, having the capability to perform risk assessment forms an important part of what this software can do to the bottom line. At least, with such a system insurers can essentially save on operating costs and avoid possible legal costs in the event of an error.
By Anne Dabrow-Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN and Dale Schumacher, MD, MPH
When nurses are armed with the latest evidence-based nursing procedures at the point of care and real-time step-by-step guides for clinical decision making at the bedside, Hospital Value-Based Purchasing (VBP) Program scores go up. That was the primary finding of a study undertaken by the Rockburn Institute in partnership with Wolters Kluwer Health, which found that hospitals where nurses used two specific evidence-based Clinical Decision Support (CDS) tools for two years had an average rank that was nearly 25 percent higher than their peers.
The findings are a rare instance where the intervention—in this case Lippincott Procedures and Lippincott Advisor from Wolters Kluwer—can be clearly associated with change in practice and quality improvement. In fact, the study’s findings clearly support the value and use of point-of-care CDS tools in a clinical setting to augment nurses’ substantial knowledge when needed. The results also demonstrate the close relationship between nurse, information, patient and performance improvement, which ultimately leads to improved quality and efficiency.
A VBP Primer
The Centers for Medicare and Medicaid Services (CMS), through its Hospital VBP Program, has incentivized hospitals to improve patient care and minimize costs by structuring its reimbursement system to reward care quality rather than service quantity. To fund the program, CMS reduces each hospital’s base operating payment by up to 2 percent, which hospitals can earn back (along with bonuses) by achieving high VBP performance scores.
In effect, VBP pits hospitals against each other and their own past performance to show achievement and improvement. Performance is currently assessed using four quality domains: 1) Clinical Care, 2) Experience and Coordination of Care, 3) Safety, and 4) Efficiency and Cost Reduction.
Each participating hospital receives an achievement and improvement score for each domain. The higher of the two is selected and weighted accordingly. All domain scores are then summed together to create the VBP Total Performance Score (TPS). This score is then converted into the hospital’s “adjustment factor,” a multiplier CMS applies to a hospital’s base payment covering each patient’s stay during a given time period.
Adjustment factors above 1.0 indicate that a hospital will receive back from CMS their full withholding plus a bonus. Hospitals with an adjustment factor below 1.0 will be assessed a penalty. For example, a hospital with a VBP adjustment factor of 0.9903 would be paid 99.03% of what Medicare usually reimburses for each service. It’s important to note that the VBP program is a mix of withholding repayment and bonus (or penalty) and required by law to be budget neutral.
The Study Methodology
To determine if and to what extent CDS could help hospitals improve performance on key metrics, the Rockburn Institute evaluated data compiled over a three-year period from all U.S.-based hospitals with a CMS Certification Number that participated in the VBP program. From this base of approximately 3,000 hospitals, 41 facilities were identified that utilized both Lippincott Procedures and Lippincott Advisor for the complete 2014 and 2015 calendar years.
The performance of hospitals using the CDS tools—which represented a mix of community-based clinics, hospitals serving large geographic regions and large university-based systems in 20 different states—was compared to the other hospitals that had received VBP scores for 2014 and 2015. Scores of the 41 CDS facilities were then evaluated for 2017 against their previous years’ results.
By Abhinav Shashank, co-founder and president, Innovaccer.
Abhinav Shashank
Consider a situation where healthcare is not just an industry term — a situation where EHRs are not an integral part of physicians schedule but just a support to providing care. All considered, imagine a situation where patient-centric care actually involves the patient, and patient engagement is not just a buzzword but a reality. Unfortunately, all these imaginations were supposed to be a reality, but still, healthcare managers and organizations are struggling with the problems such as the lack of patients’ adherence to medication, varying trends in the population health, and a lot more. Patient population, nowadays, expect the same on-demand delivery convenience from the healthcare organizations as they get from the other companies, like Netflix.
Why is Patient Engagement the Core of Providing Patient-centric Care?
To understand the value of the patient in the entire care continuum, let us take an example. Consider a patient, Marcus, who works at an IT firm and is affiliated to a Commercial ACO in his county. Marcus is a 65-year-old male suffering from comorbidities like Type 1 Diabetes, and diabetic retinopathy. He is at constant risk of sporadic elevated blood pressure.
In the year 2016, Marcus visited the ED approximately five times. Considering the situation, his primary care physician referred him to a specialist and prepared a schedule comprising at least two monthly visits.
The year 2017 started with a lot of workload for him at his firm, and he was unable to keep up with the prescribed schedule. Because of improper communication between his PCP and him, his physician was not able to keep track of Marcus’s health. As a result, the ED utilization rate for Marcus increased from five times to nine times. Because of enhanced stress and improper quality of care, the sporadic episodes of elevated blood pressure turned into a constant problem of hypertension. Also, the overall cost of care for Marcus increased drastically.
Challenges in Achieving True Patient Engagement
Patient engagement, in itself, is not as simple as ABC. It is not just bringing patients in the cycle of care continuum but enhancing the patient’s skills, ability, knowledge, and most importantly, willingness to participate in the task of managing his own care. The concept of providing care with “engaged patients” sounds great theoretically, but it is not that smooth sailing. According to a survey, nearly 87 percent of the patient population believes that communication with their doctor apart from their scheduled appointments is really important.
The major flaw is the lack of awareness among the patients regarding their care procedures. Many patients are ignorant of the clinical processes which a physician follows, and they might miss out on major health details. With no actual knowledge of the disease symptoms, patients might not report to their physicians which might lead to reduced patient engagement, not to mention the increased risk of developing a chronic disease.
Care teams play a vital role in engaging the patients through regular follow-ups. Irregular and fragmented workflows of care managers and lack of personalization might lead to the generation of ineffective care plans for the patients. Reduction in patient engagement could also be the result of under utilization of technologies to analyze the massive amount of patient data that care managers have at their disposal. Through building more personalized care plans, patients can be engaged at a more grass-roots level.
Driving Effective Engagements through Value-based Care
Predictive population health analytics is the answer to nearly every problem linked with patient engagement. Advanced predictive analytics tools will help in dealing with the problems of disparate data systems and can pinpoint the exact area on which healthcare organizations can focus. Leveraging the insights obtained by data analytics, care teams can prepare the statistical models to prioritize each patient and can take necessary measures to engage patients in the process of decision-making. Understanding the patients’ habits by the care teams increases the chances of preparing personalized care plans for them and enhancing the level of patient satisfaction.
Healthcare is in a constant state of updating. From new technologies to the latest scientific research, nothing stays the same for long. If it does, there’s almost certainly someone, somewhere, attempting to find a better way.