Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.
Abhinav Shashank
Since 1966, Americans have received more Nobel Prizes in Medicine than rest of the world combined with astonishing advancement in medical treatments, but how much of it reflected on ground level is still a troublesome figure. The soaring costs of healthcare; the amount spent on healthcare is approximately 20 percent of the country’s GDP and the amount spent on one person per year is going to be roughly $10,000 in 2017; much higher than any other country. Despite ACA, more than 30 million people in the U.S. are still uninsured. With so many concerns, the healthcare industry needs innovation to change this bleak picture.
Innovative solutions have emerged in these aspects – the delivery of treatments to patients, the technology as well as the business aspects. A few innovations in healthcare are here to stay, resulting in a more convenient and effective treatment for patients today, where time is of the essence and providing patients a better future is a priority.
Big Data. Big Use. Big Outcomes
Data-driven innovations are poised to do wonders in healthcare industry. Big data has been used to predict diseases, find their cure, improve the quality of care and avoid preventable deaths. From increasing awareness in patients to transforming data into information, big data offers healthcare a paradigm shift. Instead of analyzing a single patient’s data, we can now explore entire patient population and predict patients’ health trend.
Some healthcare leaders have already extracted value from big data and are already putting them to good use. Many value-focused healthcare organizations are working to improve healthcare delivery and healthcare delivery and patient outcomes by making an integrated technology system that will allow practices to deliver evidence-based care that is more coordinated and personalized.
Nursing is increasingly becoming as “high tech” as it is a “high touch” profession.
Today’s nurses have more technology at their disposal than any nurses ever before, and as one might expect, it’s considerably improving patient care. #Nursing explains all the necessities as well as the advantages and benefits of selecting nursing as a career.
Today’s nurses have more technology at their disposal than any nurses ever before, and as one might expect, it’s considerably improving patient care. #Nursing explains all the necessities as well as the advantages and benefits of selecting nursing as a career.
One area where nurses are putting technology to use is in informatics. Officially known as the study of information, in the world of health care, health informatics is the management of health information. Using electronic medical records, devices that collect health information electronically, and other electronic information standards, health informatics nurses are responsible for managing, interpreting, and communicating the data that comes in and out of health care facilities, all with one primary purpose: Improving the quality of patient care.
But how does that happen, specifically? How are nurses using informatics as a way to improve the care they — and their colleagues — provide to patients? As it turns out, there are several key ways that informatics is part of that effort.
Improved Documentation
Documentation has long been considered an important part of the nursing profession, but it’s more vital than ever to the delivery of quality care. While the theory and practice of nursing, the standards of nursing practice, legal and ethical considerations, and other points that are taught in advanced nursing programs all influence the practice of nursing, it’s information, and specifically, electronic documentation, that is having the greatest influence on modern nursing.
Modern nursing care is driven by individual patient needs and history — information that is collected and organized in electronic patient records. By documenting a patient’s condition, and sharing that information electronically, nurses are able to more effectively manage care, and by extension, improve the quality of that care.
A great deal of documentation takes place automatically thanks to connected devices, which collect specific information in real time and transmit it to patient records. By looking at the documentation of a patient’s condition over time, nurses can make better decisions about how to provide care and when changes or adjustments need to be made.
Reduced Medical Errors
Patient safety is a primary concern of any health care provider, and nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems. Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe.
Nurse practice error allegations and patient complaints are one of the leading causes of nursing board license investigations, disciplinary actions and malpractice lawsuits. Complaints have been surging in recent years due to the ease of filing complaints online. Health informatics allow standardizing many patient care decisions which makes it easier for healthcare organizations to limit their liability and assure compliance with the Nursing Practice Act and other medical care standards.
In fact, in a study by the Agency for Healthcare Research and Quality (AHRQ), a majority of nurses reported that when they have access to EHRs, they have fewer problems with getting patients ready for discharge, fewer medication errors, and better quality of care. And when it comes to transfers between departments, nearly 15 percent of the nurses surveyed reported that information was more likely to be shared and less likely to “fall between the cracks” when electronic systems are used.
Do you know how tech is disrupting the traditional healthcare market? Well, we do, and we have gathered all the information you need to know about this topic in one infographic. Today technology is constantly evolving and starting to take over surprising segments of our lives. The leading health tech accelerators, startups, companies and minds are doing their best to make this industry grow. Every day med tech makes people feel safe and more comfortable, it helps us to have more control over our health and body. We’ve made a research on the biggest challenges of the health tech sector, on global investment in health tech companies, on health tech influencers to follow, on the reasons of health tech industry growth and more interesting stuff.
It didn’t take much time for investors to see the perspectiveness of the health tech sector and to start investing in it. Such companies as Y Combinator, Dreamit Ventures, GE Ventures, Google Ventures, Rock Health and many others started to invest into dozens of health tech startups. At the same time a lot of different governmental programs were established, with the purpose to support health tech development and healthcare innovations. Canada founded a new $20 million Health Technology Innovation Evaluation Fund to support made-in-Ontario technologies. In Australia $4 million Mental Health Innovation Fund supports health tech startups to come up with health-driven innovations fighting with mental illness. At the same time, with $4.5 billion funding from the government, 2015 became the year of digital health for the US.
The biggest challenges of the health tech sector are: difficulty of market entry for new generation drugs; misuse of USB ports can cause medical devices to malfunction; robotic surgery: complications because of insufficient training; and other factors. A lot has been done yet there is still much to accomplish. So the following infographic about health tech and its role in healthcare industry attempts to give you important information in a creative way. We hope you’ll like it.
Guest post by Priya Sapra, chief product officer, SHYFT Analytics.
Priya Sapra
As the healthcare industry continues to become simultaneously more patient-centered as well as more performance-oriented, healthcare organizations and biotech companies alike are taking a closer look at how they can improve clinical quality measures. Although the industry has been widely criticized for a lack of meaningful, uniform industry standards, there’s no denying the link between understanding clinical effectiveness and improving overall patient outcomes. To truly assess quality, organizations need to make sense of the myriad of real-world evidence (RWE) data they already have at their fingertips.
RWE data enables a comprehensive understanding of data physician utilization patterns, patient treatment options, drug comparative effectiveness and more. However, the current, typical approach to RWE – a vast array of siloed databases, services-dependent, with access restricted to just two or three “power users” – has shown to be utterly ineffective. In fact, market estimates suggest big pharma spends $20 million dollars on average annually on RWE, but they are still no closer to fully understanding the real-world impact of pharmacologic and non-pharmacologic treatment on patients.
The problem is not a lack of data, but rather an inability to access RWE data quickly by the very people who are best suited to make sense of the information. Current strategies and tools simply cannot access, analyze, and deliver insights quickly enough for the information to be of use to the organization. However, new approaches to data analytics are ready to eliminate these historical roadblocks and transform RWE data into meaningful insights that can help measure clinical quality effectiveness.
Leveraging cloud-based analytics is one such approach. These solutions are increasingly becoming a critical tool to uncover how quality care initiatives are progressing. Unlike tools of the past, cloud-based offerings can provide rapid access to the data and derived insights in the language that resonates most when measuring quality. For instance, delivery via the cloud enables the real-time scalability necessary for RWE data. As the variety, volume and velocity of RWE data continues to increase, on-premises solutions simply cannot scale quickly enough to contend with terabytes of data and the analytic demands of its users.
The Internet of Things (IoT) is taking hold in nearly every aspect of our lives. No longer are we content with simply connecting via a computer or mobile device. These days, our homes are filled with connected devices, all purporting to make our lives easier, more efficient, and in many cases, more entertaining.
However, the IoT’s creep isn’t limited only to our homes. One area where IoT is already taking hold and is expected to grow even more is in the health care industry. Often referred to as Medical IoT (or just connected medical devices), the adoption of connected devices is already at impressive levels and the trend is for even more devices to be accessible via the internet in the future.
For example, it’s not uncommon to find patients using wearable devices to collect and transmit data about their blood sugar, blood pressure, heart rate, and oxygen rate to their physicians, or to find wireless devices within hospitals that automatically transmit patient vital signs and other monitoring data straight from the hospital room to hospital staff, no matter their location. The assumption is that thanks to such continuous monitoring and real-time data, physicians can provide better quality care and improve patient outcomes.
Undoubtedly, the IoT certainly creates a great deal of opportunity within health care to deliver better outcomes. At the same time, though, there is also the question of the true value of connected devices in every circumstance. The fact is, while there is a certain “cool” factor associated with IoT technology, and a sense of wonder at the fact that a device can transmit data wirelessly, there is also a concern that developers will attempt to include connectivity just because they can. Unless the technology aligns with user expectations and behaviors, is reliable, and delivers actual meaningful outcomes — and doesn’t just add an unnecessary feature to the device — it is unlikely to be successful.
Therefore, when developing connected medical technology, it is just as important to consider why you are connecting it as it is to consider how you will connect it. Often, the how isn’t nearly as complicated as one might think, thanks to relatively inexpensive and widely available microcontrollers and applications. The why, on the other hand, is more complex, and requires developers to consider not only the potential benefits of connecting a medical device, but several other key points as well, among them the potential for data overload, the security of the devices, and addressing potential malfunction, to determine whether a device can benefit from connectivity.
Chief Concerns for Connected Medical Devices
While there are plenty of points to consider when developing any type of medical device, when the device is designed to be connected to the internet, there are additional things to think about.
Guest post Ken Perez, vice president of healthcare policy, Omnicell.
Ken Perez
On October 14, the Centers for Medicare & Medicaid Services (CMS) released a 2,171-page final rule for the implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS had issued a proposed rule on April 27 and in the intervening period, more than 100,000 physicians and other stakeholders attended outreach sessions and CMS received more than 4,000 public comments on the proposed rule, with many of the expressed concerns pertaining to the start date for MACRA’s first performance period.
MACRA’s Quality Payment Program replaces the unpopular sustainable growth rate formula and defines how physicians in physician practices—not hospitals—will be reimbursed by Medicare. It features two alternative, interrelated pathways: the Merit-based Incentive Payment System (MIPS) and advanced alternative payment models (APMs). MIPS is designed for providers in traditional fee-for-service Medicare, while the advanced APMs are for providers who are participating in specific value-based care models, such as accountable care organizations (ACOs).
Small physician practices with less than $30,000 in Medicare charges or that see fewer than 100 Medicare patients per year are exempt from MIPS. According to an analysis by the American Medical Association, 30 percent of physicians are below one or both of these thresholds. In addition, providers new to Medicare in 2017 are also exempt (though just for the first year).
The proposed rule specified Jan. 1, 2017, as the start date for the first performance period under MIPS, which would drive calendar year 2019 payment based on performance in 2017 across the four MIPS categories: Quality, Advancing Care Information, Clinical Practice Improvement Activities, and Cost/Resource Use. The final rule allows providers to start collecting performance data anytime between Jan. 1 and Oct. 2, 2017, with data due to CMS by Mar. 31, 2018.
Under MIPS, physicians can earn in 2019 a payment adjustment that is neutral, up to 4 percent positive, or up to 4 percent negative, depending on their level of participation, the amount of data submitted, and the length of the performance period reported. The adjustment increases to plus or minus 5 percent in 2020, plus or minus 7 percent in 2021, and plus or minus 9 percent in 2022. CMS projects that 592,000 to 642,000 clinicians will submit data for MIPS during the first performance year.
Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.
Abhinav Shashank
A new complex rule is about to change the entire US healthcare industry. It will replace the Sustainable Growth Rate (SGR) and streamline the three programs. The NPRM for MACRA was passed in 2015 and after the comments and feedbacks from numerous healthcare experts, the final rule with comment period has been released by CMS.
In the final rule, CMS has responded to more than 4,000 comments in a document which is more than 2,300 pages long. Some of these comments have been implemented in the law. As a result of this feedback friendly approach, substantial changes have been made.
The New MACRA after changes
The law aims to bring in unified policies that will add greater value to the healthcare system through the new Quality Payment Program (QPP). The program rewards for value in two ways:
Merit-based Incentive Payment System (MIPS)
Advanced Alternate Payment Models (Advanced APMs)
Chance to adapt
To help the physicians get used to the program CMS has declared the first year — 2017 — as “transition” year. There will be four options available to physicians in the transition year:
Clinicians can choose to report one measure in the quality performance category; one activity in CPIA or report the measures in ACI to avoid the negative adjustments. Alternatively, if they choose to report none, they will receive negative adjustments of 4 percent.
Report for minimum 90 days more than one quality measure, more than one CPIA or more than the required ACI to avoid negative adjustments and qualify for possible MIPS positive adjustments.
Ideally, report for a year or more than 90 days and maximize the chances to receive higher positive adjustments.
Participate in the Advanced APMs program, and if can to see ‘sufficient’ portion of the Medicare Patients, they will be able to qualify for 5 percent bonus incentive payment to be paid out in the year 2019.
Merit-based Incentive Payment System
Under this program, eligible clinicians will get payment adjustments based on the quality, cost and other measures related to care. This program will see the “sunset” of three existing programs namely:
When we talk about technology disrupting healthcare, we aren’t just referring to changes in the accuracy of health records or the convenience of mobile care; the real disruption comes in the form of fundamental challenges to traditional scopes of practice.
What Should We Do?
Scope of practice, broadly, is determined by a combination of liability and capability. Lead physicians carry greater liability than the bedside nurses assisting in patient care, because the care plan is directed by the lead physician. Likewise, the extra years of education and practice are assumed to increase the capacity of physicians to lead their care teams, make decisions about how the team will go about its work, and parse all of the information provided by the patient, nurses and other specialists involved with each case.
In every other industry, productivity increases come from technology enhancing the ability of individuals and teams to perform work. Email saves time and money by improving communication; industrial robotics standardize manufacturing and raise the scale and quality of output. Every device, app and system allows individuals to scale their contribution, to do more and add more value. Word processing and voice-to-text enable executives to do work that might otherwise have been performed by a secretary or typist. Travel websites allow consumers to find cheap tickets and travel packages that would previously have required a travel agent to acquire.
In healthcare, technology is changing the capacity of the individual caregiver, expanding what can be done, and often how well it can be done. These improvements, along with a growing need for healthcare professionals and services, are challenging traditional notions of scope of practice–for good and bad.
New Beginnings
Some of the changes to scope of practice are positive, necessary, and constructive. For example, technological literacy is necessary at every point in the care continuum, because interoperable EHRs and the vulnerability of digital information means that everyone must contribute to cyber security. In a sense, caregivers at every level must expand their scope of practice to incorporate an awareness of privacy, security,and data management considerations.
By extension, all caregivers are participating as never before in the advancement of clinical research, population health monitoring, and patient empowerment simply by working more closely with digital data and computers. As EHR technology iterates its way toward fulfilling its potential, caregivers and administrators are being forced to have difficult conversations about priorities, values, goals and the nature of the relationship between patient, provider, system, and technology. It is overdue, and foundational to the future of healthcare.
Is There A Nurse in the House?
The trend in healthcare toward prevention and balancing patient-centered care with awareness of population health issues puts primary care in a place of greater importance than ever. This, in turn, is driving a shift in the education of nurses to promote more training, higher levels of certification, and greater specialization to justify relying on nurses to fulfill more primary care roles. They are becoming better generalists and specialists, capable of bolstering teams as well as leading them.
Nursing is increasingly becoming as “high tech” as it is a “high touch” profession.
The Internet of Things (IoT) is taking hold in nearly every aspect of our lives. No longer are we content with simply connecting via a computer or mobile device. These days, our homes are filled with connected devices, all purporting to make our lives easier, more efficient, and in many cases, more entertaining.
