By Chris Martini, chief provider officer, PatientPoint.
In today’s U.S. healthcare system, patients often find themselves in a perplexing situation where the quality of clinical care can be excellent, but the overall patient experience may fall short.
As the system increases its focus on value-based care and improved health outcomes, the patient experience and value-based care must be considered as interconnected entities. In fact, three value-based care quality metrics—patient satisfaction, preventive care screenings, and care coordination—are directly impacted by the overall patient experience.
The good news is that there are a number of digital tools that can play a pivotal role in fostering better awareness, comprehension, communication, and overall better care experiences. These enhancements ultimately translate into tangible benefits to support value-based care.
Empowering Patients Through Information
According to the 2023 PatientPoint Patient Confidence Index nearly half (48%) of Americans report feeling anxious before healthcare visits (an increase from 39% last year). This anxiety can be attributed to factors such as insufficient information and education, limited knowledge about healthcare providers, and hesitation to discuss health concerns with providers. Additionally, a third of Americans admit to regularly leaving appointments confused. Taken together, these anxieties hinder effective care.
When thinking about factors that could enhance their confidence in discussing their health, more than half (55%) of Americans highlighted the importance of receiving health education during appointments. Another 43% expressed interest in pre-visit education to increase confidence. Given that most patients spend approximately 14 minutes in the waiting room and an additional 12-13 minutes in the exam room without an HCP present, substantial opportunity exists to educate and empower patients while they wait.
Providers can maximize patients’ time in their offices and support value-based care by leveraging digital signage to disseminate relevant health information. Showcasing digital content in the waiting room prepares patients for important healthcare decision-making moments before they enter the exam room and has been proven to drive patient utilization of vital health services including mammography, colon cancer screening, flu vaccination, tobacco cessation counseling, and STI screening. The more personal nature of the exam room environment enables digital signage to deliver tailored information to patients, further motivating them to engage with their providers and take proactive steps for their health such as utilizing patient portals, scheduling preventive screenings and vaccinations, or discussing new treatment options.
To bridge language barriers and make healthcare more inclusive and transparent for patients who speak Spanish, the American Medical Association (AMA) now offers Spanish language descriptors for more than 11,000 medical procedures and services.
The consumer-friendly descriptors in Spanish were added to the newly released Current Procedural Terminology (CPT) 2024 code set, the nation’s leading data-sharing terminology for medical procedures and services.
The consumer-friendly descriptors are an important resource that many hospitals, health plans, medical offices and other CPT users already incorporate into English-language medical documents, insurance forms, price sheets, and patient portals. Including CPT consumer-friendly descriptors in Spanish that are clear and straightforward will help CPT users better engage and assist many in the Latinx community.
“Navigating medical care and paperwork can be especially challenging for Latinx patients who do not speak English or speak English as a second language,” said AMA senior vice president of health solutions Lori Prestesater. “Providing approximately 41 million Spanish speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their own care.”
Other changes to the CPT code set
The annual update to the CPT code set created 349 editorial changes, including 230 additions, 49 deletions and 70 revisions. With 11,163 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology.
Changes to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel, an independent body convened by the AMA that collects broad input from the health care community and beyond to ensure CPT content reflects the coding and data-driven demands of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
We have all heard the staggering statistics of the current workforce issues happening across the healthcare industry, and one of the biggest segments facing staffing issues is nursing. The Bureau of Labor Statistics projects 203,200 openings for RNs each year through 2031 when nurse retirements and workforce exits are factored into the number of nurses needed in the U.S.
While there are many factors around why we have a nursing shortage currently, one of the areas that is often overlooked are the issues facing nurses who just graduated college and are transitioning into practice.
Following the COVID-19 pandemic, the divide between the demands of nursing programs and requirements of working in health systems has only grown. We are increasingly seeing an alarming number of young nurses leaving the profession shortly after receiving their degree partially because they are not receiving the hands-on experiences needed to prep them for this transition. Even if they are interacting with patients, they often aren’t forced to navigate the care of multiple patients at once like they would in a real-world care setting.
Because of this gap, technology can be a critical tool in helping the next generation of nurses get ready for their day-to-day professional lives. Specifically, virtual reality (VR) is giving us the ability to put multiple, diverse patient cases and hospital situations directly into the hands of nursing students – giving them experiences they have not had access to previously before they reach the bedside.
VR transports nurses to the hospital floor
COVID-19 forever changed the healthcare industry in countless ways and many of the opportunities that were available to students preparing for a career in healthcare, such as in-depth clinical rotations and managing a caseload of multiple patients, before the pandemic are now limited. One of the most important and formative times of a nursing student’s education is their clinical experiences – when the students go into the healthcare setting to see and react to patients alongside experienced nurses.
Good physical and mental health provides a foundation for a good quality of life. In particular, an “even keel” enables a person to weather life’s obstacles and move forward. Sometimes, however, men, women, and even children may need help for mental health challenges that cause concern and disruption.
Today, mental health services provider aptihealth offers all-acuity virtual therapy to all New York State residents. The company’s easy-access platform, combined with fast patient therapy integration, makes aptihealth an increasingly popular choice.
Better Mental Health Services Access is Needed
Throughout the United States, demand for mental health services continues to grow. Today, approximately 50 million United States adults cope with mental health challenges.
Until recently, however, fewer than half of them received treatment. Even worse, nearly three-quarters of US residents think unequal services access is the norm. Almost half of Americans think their care options are limited.
Perceived Barriers to Mental Health Care
Three perceived barriers to mental health care have fostered these beliefs. These perceptions exist across geographic and demographic categories.
Minimal Services Awareness
Some individuals have expressed interest in mental health services but lack the knowledge to search for solutions. To find information, younger individuals are more likely to turn to low-credibility social media platforms.
Social Stigma About Services
Almost one-third of the US population has been worried about being judged for seeking mental health services.
Long Waits and Long Drives
Approximately 96 million Americans have had to wait several weeks (recent data suggests over 6 weeks) for mental health services. Almost half of US residents have driven, or know someone who has driven, over an hour roundtrip to receive services.
People in rural areas, and with lower incomes, are least likely to have easily accessible mental health services. These individuals are more likely to visit their primary care provider (who isn’t qualified to provide this type of care) for services.
Canada’s overwhelmingly troubled healthcare system continues to dominate conversations among many, particularly those residing in the province of Ontario. While there is no one-size-fits-all solution to tackle these issues, actionable steps can be implemented to enhance healthcare quality for all.
What has led our healthcare system to deteriorate to this extent? We’ve all seen the headlines, the collateral damage from the COVID-19 pandemic has been severe.
One of the most significant ongoing challenges continues to be the excessive waiting periods endured in Emergency Rooms. Once again, Canadian ER’s face another summer of record-setting wait times and closures.[1] In addition to the array of other commonly discussed substantial concerns—including the extensive waitlist for specialists, physician burnout, critical shortages in nursing staff and other health professionals. We’ve reached an unprecedented low.
It’s time to restructure the healthcare system. We must initiate tangible and immediate actions at all tiers of the healthcare framework to bring about substantial improvements.
Necessary adjustments must be implemented to safeguard emergency healthcare services for all Canadians, along with our healthcare providers who consistently bear the weight of the demand for critical care. Frontline workers received widespread recognition across government bodies throughout the pandemic and its aftermath for their unwavering commitment and tireless efforts. Why are they left to continue carrying the brunt of this ongoing crisis?
One of the pillars of healthcare that remains in a massive backlog as a result of the pandemic is diagnostic imaging.[2] Fortunately, some government bodies have begun to take important steps to improve Ontario’s healthcare system. Ontario, being the most populated province in all of Canada, is home to almost half of all Canadians at 40%.[3] Earlier this year, Bill 60, Your Health Act, was passed through the Ontario Legislature. This crucial bill will allow Independent Health Facilities to expand the scope of their imaging license to MRI and CT, which is a significant move towards addressing the backlog and improving timely access to diagnostic imaging services.
Whether it be MRI, CT, X-Ray Mammography or Ultrasound, these services are indispensable as they play a large role in the diagnosis, prognosis, and treatment of serious conditions. While the accessibility of diagnostic imaging remains only one of the many ongoing issues in Canada’s current healthcare system, there is no doubt that expanding access is imperative to preserving and prolonging the health of Canadians.
We must continue to find innovative ways to broaden healthcare access for all Canadians, as the capacity of our current system has certainly been hit. This is why we must look to expanding healthcare access through the collaboration of both private and government players. Enabling privately owned facilities to conduct procedures usually performed in public hospitals helps alleviate the strain on overworked radiology groups, understaffed hospitals, and overall shortages in emergency care. However, ensuring quality care, adequate staffing, seamless public-private collaboration and cost-effectiveness is vital for sustainable and effective implementation.
[1] Duong D. Why are emergency departments closing? [news]. CMAJ 2022; 194:E1138–E1139.
[2] Agarwal M, Udare A, Patlas M, et al. Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study. CMAJ Open 2020;8(3):E568-E576.
[3]“Population and dwelling counts: Canada, provinces and territories “Statistics Canada” Population and dwelling counts: Canada, provinces and territories”. Statistics Canada. February 9, 2022. Retrieved February 9, 2022.
The digital revolution has brought significant advancements in the healthcare field, revolutionizing how medical professionals provide care to patients. Telemedicine and remote patient monitoring have emerged as powerful tools that allow doctors to deliver healthcare services remotely, transcending geographical barriers and improving access to care. In this article, we will explore the synergistic approach of telemedicine and remote patient monitoring and how they are transforming the landscape of virtual healthcare.
The Rise of Telemedicine
Telemedicine, or telehealth, refers to the remote delivery of healthcare services using telecommunications technology. This approach lets patients connect with healthcare providers virtually, allowing convenient and efficient care without needing in-person visits. Telemedicine has gained traction recently due to its numerous benefits, such as reduced travel time and costs, improved access to specialists, and increased patient satisfaction.
One notable component of telemedicine is remote patient monitoring. This entails using technology to collect and transmit patient data, including vital signs, symptoms, and medication adherence, from the patient’s home to the healthcare provider. Through remote patient monitoring, healthcare professionals can closely monitor patients’ health conditions, identify any changes or trends, and make timely interventions or adjustments to their treatment plans.
Remote Patient Monitoring: Managed By Current Procedural Terminology (CPT) Codes
Remote patient monitoring is managed by CPT codes, a standardized system for reporting medical procedures and services performed by healthcare providers. These codes enable healthcare organizations to accurately bill for remote patient monitoring services and ensure proper reimbursement.
By utilizing CPT codes, healthcare providers can seamlessly incorporate remote patient monitoring into their practice, ensuring quality care and financial sustainability.
AGS Health, a leading provider of tech-enabled revenue cycle management (RCM) solutions and strategic growth partner to healthcare providers across the U.S., announced today the release of Intelligent Authorization, a single-source solution that automates and optimizes the financial clearance process and avoids prior authorization-related denials.
Part of AGS Health’s AI Platform, Intelligent Authorization streamlines and expedites processes by up to 90% through a variety of configurable automation solutions that improve operational efficiency, reduce costs, and enhance the patient experience.
“Half of all denials can be traced back to prior authorization and other front-end revenue cycle issues, jeopardizing provider organizations’ financial health and negatively impacting the patient experience by limiting transparency and delaying access to care,” said Matt Bridge, senior vice president of RCM Services, AGS Health. “Intelligent Authorization addresses the underlying issues causing prior authorization-related denials while streamlining and accelerating financial clearance processes. Customers report doubling production volumes and tripling the number of days in advance their patient access teams can secure authorizations, which in turn expedites appointments to better support patient needs and fill open time slots – resulting in improved revenue growth and an enhanced patient financial experience.”
A platform-agnostic solution, Intelligent Authorization prevents denials, reduces aged A/R, improves net revenue reimbursements, and increases clean claim rates across a variety of specialties, including radiology, oncology, occupational and physical therapy, surgery, and infusion/diagnostics. Compared to manual processes, it enhances productivity and reduces the time required for financial clearance activities, delivering:
75%-85% faster eligibility and benefit determinations
85%-90% improvement in authorization determination time
65%-80% less time spent on authorization initiations
75%-85% shorter authorization follow-up times
Up to 80% faster price estimations
Intelligent Authorization achieves these outcomes by automating eligibility and benefits determination processes, including order entries, scheduling, rescheduling, and monthly and annual re-verification processes. It automates authorization status via robotic process automation (RPA) and generates good faith estimates based on the fee schedule and embedded payer- and client-specific rules, which are then transferred back to the EMR.
Finally, Intelligent Authorization offers insightful and actionable analytics including self-service reports, customized dashboards, and flexible data management that enables users to view insights across different dimensions, create action plans, and make decisions faster.
“Smart workflow tools feature fast, flexible data transfers to the EMR through HL7, simplified task management and automated case assignment, and enhanced document management and accessibility, all of which come together in Intelligent Authorization to eliminate financial clearance issues created by error-prone, time-consuming manual processes,” said Suhas Nair, director of product management, AGS Health. “By leveraging the latest advances in RPA and AI technologies, Intelligent Automation helps healthcare organizations implement the tools needed to strengthen their financial footing and better service their patients.”
Harris Data Integrity Solutions, the leading provider of best-in-class patient data integrity services and software, announced today the appointment of Eric Helbig as vice president of sales.
He brings more than two decades of executive leadership to his role overseeing sales operations and designing and implementing sales strategies to expand the firm’s footprint among the nation’s leading hospitals and health systems.
“Eric’s expertise in change management, strategic marketing and sales planning, and performance optimization make him a great addition to the Harris Data Integrity Solutions leadership team,” said Lora Hefton, executive vice president of Harris Data Integrity Solutions. “His impressive track record of designing highly effective sales strategies and optimizing team performance are an asset as we continue to focus on expanding the reach of our innovative data integrity services and solutions.”
Helbig has deep roots in advanced sales, operations, Entrepreneurial Operating System (EOS), leadership team management, and national sales. Previously, he was director of enterprise sales and strategic partners for MedPro Inc., where he launched two new product verticals, expanded the company’s business and government process outsourcing footprints, and increased overall revenues by 19% in one year.
Past positions also include executive vice president with Pharma Logistics, regional franchise management-Midwest sales for ClearPayFS, and regional director of sales for EMG-First American Payment Systems. He holds a bachelor’s degree in international business management from Saint Louis University and is Six Sigma Yellow and Green Belt certified, as well as Sandler Sales Certified Silver and Bronze.
“I am thrilled to be joining Harris Data Integrity Solutions and working to expand its footprint in the critical patient data integrity market,” said Helbig. “Not only are patient identification and patient the foundation of quality patient care and safety, but a clean MPI is integral to effective revenue cycle management and advancing interoperability, as well as optimizing the impact of advanced health IT. I’m honored to have the opportunity to continue raising the profile of Harris Data Integrity Solutions and its ground-breaking suite of advanced technology solutions and services that address the many challenges associated with patient matching and data integrity.”
To bridge language barriers and make healthcare more inclusive and transparent for patients who speak Spanish, the American Medical Association (AMA) now offers Spanish language descriptors for more than 11,000 medical procedures and services.
By Samantha Moyer, senior technology product manager, 
AGS Health