Category: Editorial

Tackling Patient Safety with Real-Time, Data-Driven Clinical Intelligence

Guest post by Adam Klass, chief technology officer, VigiLanz.

Adam Klass
Adam Klass

Here are some downright chilling patient safety statistics keeping healthcare leaders up at night: Each year more than one million hospital patients – that’s 136 per hour, every day – are affected by sepsis, and 280,000 die. In addition, 82 people in hospitals are affected every hour, every day, by hospital-acquired infections (HAI), and 217 experience a preventable Adverse Drug Event (ADE).

The good news is that an emerging category of technology known as enterprise intelligence resources (EIR) can empower clinicians to more quickly and effectively tackle these infections and ADEs – and even prevent them from occurring in the first place. By integrating and analyzing massive amounts of data generated by multiple sources, EIRs are not only able to identify at-risk patients, but also to tell frontline clinicians in real-time what is happening – and likely to happen – with their patients. Equally important, the EIRs fit seamlessly into clinicians’ workflows, generating only essential alerts.

Built on flexible, interoperable data architectures, EIR platforms extend the value of existing EMRs by integrating real-time clinical and business intelligence with predictive analytics to address sepsis, HAIs and ADEs as well as a wide range of other patient safety and public health risks such as deep vein thrombosis (DVT), venous thromboembolism (VTE), C. difficile (C.Diff), MRSA, surgery site infections, Ebola and MERS. Armed with EIR-provided actionable insights, clinicians can optimize appropriate interventions that improve patient outcomes, reduce patient safety risk and support quality initiatives.

Measurable benefits

Time is of the absolute essence in addressing patient safety risk, particularly in the case of sepsis. Research has shown that the earlier the intervention, the significantly lower the mortality and morbidity.  EIRs can help significantly reduce sepsis risk by enabling clinicians to:

Implementing this approach has been shown to reduce sepsis occurrence by double digits.  Most importantly, patients’ lives are saved. At the same time, reducing sepsis occurrence can also significantly reduce costs, given that sepsis accounts for 40 percent of ICU spending and nearly $29 billion in healthcare expenditures.

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How the Internet of Things Will Reshape Healthcare: One Experience at a Time

Guest post by Puneet Gupta, chief technology officer, Brillio.

Puneet Gupta
Puneet Gupta

For those in the healthcare industry, the future feels at once full of promise and always just out of reach. Transformational advances in technology are on the horizon and fast approaching—but anticipating and adopting new tech can seem like an impossible task.

Perhaps the most promising tech trend for healthcare is the Internet of Things (IoT): the increasingly interconnected network of intelligent devices and objects that share data and enable the physical world to be integrated into digital systems.

While nearly every industry can employ IoT systems to create greater efficiencies and support new business models, the healthcare industry is particularly poised for major gains. According to a recent report, IoT in healthcare alone will be a $117 billion market by 2020.

IoT technology and digital integration has enormous potential to create meaningful experiences and better outcomes for patients, doctors, and healthcare professionals. And yet, amid all this promise, the current state of healthcare IoT leaves a lot to be desired.

How Healthcare Companies Need to Re-Imagine Change

Why is IoT adoption still lagging in the healthcare industry, despite all this potential? Many companies are simply thinking about technological change the wrong way.

Naturally, most people try to think about such changes from a 30,000-foot perspective. IoT is such a huge strategic transformation, it’s easy to get overwhelmed and not know where to begin.

I prefer to look at things differently. Instead of surveying major paradigm shifts from a million miles away, let’s flip the model and focus in on micro-experiences—small, concrete touch points along a user’s journey where technology can make a meaningful intervention.

By building from the ground up in real-world contexts—instead of from the top down in the abstract air—you’ll be able to quickly implement a number of IoT solutions and see the impact. Overarching systems will organically develop up over time as you create valuable micro-experiences on the ground.

While contemplating a global shift only generates new questions, breaking IoT down into bite-sized, tangible moments grounded in reality opens the door for immediate achievements. That’s what we call the art of the possible.

4 Examples of IoT Micro-Experiences in the Healthcare Industry

 In the spirit of focusing on context and individual instances, let’s look at four real examples of how we’ve deployed IoT micro-experiences in healthcare.

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Aligning the Patient Financial Experience to Retail Best Practices

Guest post by Laurie Hurwitz, executive director revenue cycle, Gundersen Health System.

Laurie Hurwitz
Laurie Hurwitz

Research indicates that happy patients are also patients who pay their bills; in fact, research from Conance suggests that they are twice as likely to pay their bills in full versus their less satisfied counterparts. In the age of rising deductibles and patient responsibility, this statistic underscores the importance of patient satisfaction.  Healthcare CEO’s are feeling the pressure; in a recent ACHE study, patient satisfaction was a top 5 concern for this group of healthcare leaders. Patient financial experience is an area of focus as it links directly to satisfaction and loyalty.

Though providers are motivated to improve satisfaction, real-life application is another issue. Influenced by best practices in retail, travel and other verticals, consumer expectations and a provider’s patient financial experience are typically quite different.  Providers who have mitigated this mismatch have been able to achieve above-average results for patient satisfaction, payments and even staff utilization.

At Gundersen Health System, we have used the patient financial experience as a winning differentiator across our five-hospital integrated health network and more than one million encounters across Wisconsin, Iowa and Minnesota. I tend to be conservative in execution of my duties as executive director of revenue cycle at Gundersen, but I also knew that some major shifts would be necessary to align our patient financial experience to patient expectations. We believed that optimizing post-service billing engagement would improve patient satisfaction which in turn would improve our rate of collections.

We felt passionately that hospitals oftentimes create a vicious cycle of poor bill payment experiences with their patients. If only half as many patients paid their bills in full because they did not understand their statements, and if patients were half as likely to return for service if they weren’t satisfied with their billing experience, we were losing revenues and market share due to a totally preventable problem. Happier patients are more likely to pay; as such we needed to ensure that our patients were happy with our billing experience. As a result and in partnership with Simplee, we took inventory of best practices in bill pay and payments cross-industry and explored how to bring these best-in-class experiences to Gundersen’s patient financial experience.

It was obvious that retail payment experiences are designed to make the payment easy, a fundamental difference from health care. Retail facilitates secure guest payment experiences, which eliminated login hurdles. Bills are clear and avoid technical speak, which is practically the antithesis of a typical healthcare experience. Installment plans are flexible and self-service made it incredibly easy for users to stay committed to a payment plan. Retailers also wisely survey clients almost immediately post-transaction, mitigating issues like survey response bias and transaction-survey match confusion.

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3 Ways Big Data and IoT Can Improve Our Health

Guest post by Alexandra Roden, content editor, Connexica.

Alexandra Roden
Alexandra Roden

Just a few years ago, big data and the Internet of Things (IoT) were terms generally unheard of. This year they continue to revolutionize technology and the ways in which we acquire and process data, but what do they mean for the healthcare industry?

Xenon Health describe IoT as “a phenomenon through which the operational aspects of the physical world become increasingly integrated with digital platforms, enabling information to move seamlessly toward the computational resources that are able to make sense of it.” Essentially, IoT goes hand-in-hand with the mobile age and the diversity of data that is currently being retrieved from agile and mobile locations.

Big data is a related concept – it addresses the ever-increasing amounts of data that are created every second of every day and recognizes that these figures will only continue to grow. For example, in the “social media minute” every single minute there are 277,000 tweets are sent, Whatsapp users share 347,222 photos and Google receives more than 4,000,000 search queries. These figures are remarkable even for those of us caught up in the social media hype, and most shocking of all is the realization that the global Internet population now represents 2.4 billion people. That’s a lot of people creating a lot of data – the question now is how we can utilize this data in a meaningful way.

IoT has revolutionized many industries and will continue to do so in the foreseeable future, but what about healthcare? Organisations within this industry tend to adopt new technologies slowly, relying upon solid evidence and demonstrable impact and efficiency before committing to any such change. The shift towards IoT is, however, beginning to take place, and increasing amounts of available patient data are beginning to inform decision making processes within this sector.

What will this mean for the future of our health?

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What Benefits Do Health IT Professionals Want Most?

As the healthcare industry continues to grow, so does the need for health IT talent. The question is, how do you attract this talent in today’s increasingly competitive job market? Apparently, the answer is simple: Offer a competitive benefits package comprised of the benefits and perks that health IT workers want most.

The infographic below, compiled by HealthITJobs.com, the largest free job search resource for health IT professionals, shares findings from its 2016 Health IT Job Perk Report. The report covers health IT job benefits and satisfaction, the profile of top earners, and where health IT pros search for jobs — everything you need to know to convince top talent to take your job (and keep it).

Some highlights include:

Check out the full infographic below to learn more about what attracts today’s health IT talent:

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Key RIMS Observations and Their Industry-Wide Implications

Guest post by Mitch Freeman, chief clinical officer, Mitchell International, Pharmacy Solutions.

Mitch Freeman
Mitch Freeman

Another gorgeous San Diego spring, no surprise there. Another enormous RIMs convention hall packed with Insurers, TPAs, and service providers, no surprise there either. San Diego is probably the most prime location for this venue of all. Convention hall on the waterfront, luxury accommodations, views of the harbor and Coronado, a teeming Gaslamp district keeping the attendees in tight proximity for after-conference networking with great food and libations, what could be better?

I’m a believer that the terms like “changing,” “different,” or even “same” should not imply the assumptive application of the terms “better” or “worse.” Plainly said, I observed a few notable differences or trends with this conference that I have not seen in the past and that has no bearing on the conference being better or worse than previous conferences.

WC service providers are less prominent in the overall convention

RIMS has always been a conference heavily attended by workers’ compensation insurers and TPAs “WC payers.” This is the conference where WC payers get the chance to meet with prospects or existing customers and win new business, or solidify existing relationships. WC service providers offering pharmacy benefits management (PBM), medical bill review, and ancillary services have historically exhibited in hope to network with the multitude of attending WC payers. This year, there were noticeably less prominent booths from WC service providers and some chose not to exhibit at all.

Why?

A recent shift has occurred from the “good ole days” of relationship-based selling to selling on value. Payers are more focused on what a service provider actually delivers than how much they wine and dine, all be to an extent. Furthermore, many contract decisions are now being driven by procurement departments within payers. That’s not to say that relationships within the industry are not still important, it just means that exhibiting is a less critical component of the recipe to winning or retaining business.

Property loss prevention is filling the void

I observed far more property loss prevention service providers than I have ever seen exhibiting at RIMS. There were several flood recovery providers present, ServPro and their competitors. I experienced first-hand virtual reality by donning “Oculus Rift” type goggles and toured a research facility where the company can essentially recreate your building and burn it in front of your face in 3-D. This type of marketing push outside of WC has not been seen before at RIMs.

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Collaboration of Data Key for Healthcare Interoperability

By Darin M. Vercillo, MD, chief medical officer and co-founder, Central Logic.

 Darin M. Vercillo, MD
Darin M. Vercillo, MD

Healthcare has been changing rapidly for the last 60 years and advances have now reached record speed, including in the realm of data intelligence. In trying to keep pace as well as to protect and advance their own businesses, many processes and systems have understandably been organized into silos.  That era must come to a close.

Care coordination teams need rich collaboration of data and must now be connected.  Hospitals, clinics, home health care workers, primary care physicians, vendors, and others must speak with each other, in the same language, and completely share patient data with an open, collaborative attitude. The industry is all abuzz with this uncharted territory called interoperability. It is clear that data warehouses, now bursting with valuable information, must be streamlined for three very simple reasons: patient safety, cost-effective healthcare delivery and overall population health management. A happy byproduct when data intelligence becomes actionable and systems work collaboratively is a financial benefit, but as a physician, I believe excellent patient care always wins the day, and should be the driving factor.

Reducing Re-admissions

Consider that about one-fifth of Medicare beneficiaries are re-admitted within 30 days of discharge and upwards of one-third are re-admitted within 90 days. One study by the American College of Physicians showed that 20 percent of patients have a complication within three weeks of leaving the hospital, more than half of which could have been prevented. In all, Medicare spends $26 billion annually on re-admissions, $17 billion of which could be “preventable.”

At the risk of this being looked at as “just a financial issue,” consider also that hospitalization is generally a marker for severe illness. Our goal is a healthier population. As we (patients and providers) succeed collectively with hospital treatment and post-acute care, then re-admissions will naturally decrease, and patients will live healthier, more satisfied, lives. Ultimately, this is our goal.

Appropriate, timely sharing of vital patient information will not only address re-admission rates that have clearly become egregious, but improved collaboration of data needs to happen to better inform decision making at the point of care. Without a keen eye to patient safety and success, it is too easy for details to slip through the cracks. All too often, history has demonstrated that hand-off points are the riskiest for failures in patient care.

Nearly everyone has a story where the current system has failed patients — just ask Jennifer Holmes, our CEO. Her father’s healthcare team made an error in medication that ultimately cost him his life. Similar medication errors and decreased duplicate testing can be avoided when a patient’s entire care coordination team has visibility into the data – all the data – to improve care efficiencies and diagnoses.

But all this sharing and playing nice in the sandbox is easier said than done.

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Despite HIMSS Conference “Pledge” Middleware Integration Solutions Gaining Popularity As Interoperability Sling Shot

Guest post by Thanh Tran, CEO, Zoeticx.

Thanh Tran
Thanh Tran

The lack of EHR interoperability continues to pose a serious threat to healthcare initiatives, according to a recent report published by the American Hospital Association (AHA). The report discusses the various aspects of the healthcare industry and care delivery that are negatively impacted by a lack of interoperability.

The report notes that the exchange of health information is critical for the coordination of care. When patients receive care from multiple different providers, physicians should be able to securely send relevant patient information to the practicing physician. However, that tends not to be the case because EHR systems are not interoperable and cannot exchange information.

Last year, the ECRI Institute released a survey outlining the Top Ten Safety Concerns for Healthcare Organizations in 2015. The second highest concern was incorrect or missing data in EHRs and other health IT systems caused by interoperability. For the second year in a row, EHR data is identified as a concern.

The Partnership for Health IT Patient Safety, a branch of the ECRI Institute, has released safe practice recommendations for using the copy and paste function in EHRs that can adversely affect patient safety, such as the use of copy and paste that can overpopulate data and make relevant information difficult to locate, according to the partnership’s announcement.

Meanwhile, a survey of 68 accountable care organizations conducted by Premier, Inc. and the eHealth Initiative found that despite steep investments in health information technology, they still face interoperability challenges that make it difficult to integrate data across the healthcare continuum.

The survey found that integrating data from out-of-network providers was the top HIT challenge for ACOs, cited by almost 80 percent of respondents. Nearly 70 percent reported high levels of difficulty integrating data from specialists, particularly those that are out-of-network.

User Frustration Over Lack of HIE and Interoperability Standards

The Office of the National Coordinator for Health Information Technology (ONC) is once again asking the healthcare community for its thoughts on establishing metrics to determine if or to the extent to which electronic health records are interoperable. The push to achieve interoperability is in response to last year’s mandate by Congress, contained in the Medicare Access and CHIP Reauthorization Act (MACRA). Among provisions of that law is a requirement to achieve “widespread” interoperability of health information by the end of 2018.

When it comes to how Health Information Exchanges (HIEs) handle the challenges associated with interoperability, a recent Government Accountability Office (GAO) report cites the following barriers–insufficient health data standards, variations in state privacy rules and difficulty in accurately matching the right records to the right patient. In addition, the costs and resources necessary to achieve interoperability goals, and the need for governance and trust among entities to facilitate sharing health information.

In its annual interoperability survey of hospital and health system executives, physician administrators and payer organization IT leaders released in April 2016, Black Book Research found  growing HIE user frustration over the lack of standardization and readiness of unprepared providers and payers.

Of hospitals and hospital systems, 63 percent report they are in the active stages of replacing their current HIE system while nearly 94 percent of payers surveyed intend to totally abandon their involvement with public HIEs. Focused, private HIEs also mitigate the absence of a reliable Master Patient Index (MPI) and the continued lack of trust in the accuracy of current records exchange.

Public HIEs and EHR-dependent HIEs were viewed by 79 percent of providers as disenfranchising payers from data exchange efforts and did not see payers as partners because of their own distinct data needs and revenue models. Progressive payers are moving rapidly into the pay-for-value new world order and require extensive data analytics capabilities and interoperability to launch accountable care initiatives.

Those looking at touted standards such as Fast Healthcare Interoperability Resources (FIHR) point out that it is only capable of connecting one medical facility to another and requiring specific end point interfaces to even do that.  For every additional facility, a customized interface must be built.  At the end of the day, FIHR is really a point-to-point customized interface requiring extra steps and ties developers to specific hospitals or EHRs and without universal access.

“Progressive FHIR standards can allow EHRs to talk to other EHRs should standard definitions develop on enough actionable data points as we enter a hectic period of HIE replacements, centering on the capabilities of open network  alliances, mobile EHR, middleware and population health analytics as possible answers to standard HIE,” said Doug Brown, managing partner of Black Book.

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