Guest post by Chris Strammiello, vice president global alliances and strategic marketing, Nuance Communications.
Chris Strammiello
Every healthcare IT professional is already thinking about mobility and security in general, but not all consider their relation to document management. A single piece of paper could contain immeasurable amounts of sensitive data and even protected health information (PHI) that, if somehow found in the wrong hands, could present major HIPAA violations. So, how will document imaging impact healthcare technology?
The Mobile Game-Changer
As healthcare organizations transition their processes from paper to electronic workflows, mobile device use will increase. From patient registration to discharge and beyond, mobile technology simplifies patient communication via e-prescriptions, online scheduling and automated appointment reminders.
Productivity-enhancing capabilities like barcode scanners, e-forms and e-signatures also benefit practitioners by improving on-the-ground access to clinical documents and reducing manual document handling. Plus, mobile devices can curb printing costs through the implementation of pull printing, which holds a print job on a server until the user authenticates its release at the output. Ultimately, for the patient, all of these advantages translate into more time for quality interactions with their doctor; for the hospital, significantly streamlined processes and lower costs.
We also expect to see an increased use for mobile devices in medical instrumentation. Take, for example, the advancements brought to speech therapy with the utilization of a tablet’s microphone during a session. Previously, patient testing would have been done with a much larger and more complex device that would produce less data about the quality, pitch and frequency of the voice. Not only are mobile devices simplifying day-to-day workflow within the healthcare industry, but they will also revolutionize the actual healthcare practice.
Smarter, Simpler and Even Spoken Security
Alas, as with all technological advancements, security remains an essential question mark. Unfortunately, the smartphones, tablets, laptops and even multifunction printers (MFPs) that increase access to patient information are also some of the biggest security vulnerabilities in EHR implementations. In fact, theft or loss of portable and unencrypted devices is the leading source of reported HIPAA data breaches and fines. Even further, as the U.S. Department of Health and Human Services now defines office copiers and printers to be actual workstations, IT professionals must secure them in the same way they do computers.
With all this in mind, both physical and technical safeguards must and will be improved in the near future, starting with the embrace of solutions that provide two-factor authentication. Commonly used in financial services, two-factor authentication combines a password with something you know, like the answer to “What is your mother’s maiden name?,” or something you have, like a fingerprint. We can expect such biometrics, including voice commands, being more commonly used as a second authentication factor in the near future. Long gone are the days of scanning your ID card to credential a print release – users will simply speak to the printer to verify who they are.
The healthcare industry remains at a crossroads as providers and healthcare IT professionals confront a rapidly changing business and regulatory landscape. With factors like rising patient cost obligations, growing payer complexity, and the inevitable shift to a value-based payment environment weighing on them, medical practices nationwide are in search of new IT solutions to support them. The rapid pace of cloud adoption across all sectors is a prominent example. The market for cloud solutions is one of the fastest growing areas within healthcare, but it’s not solely a private sector phenomenon; the federal government’s cloud-first strategy finally gained traction in 2015, prompting a FCW analyst to predict accelerating momentum for federal cloud initiatives over the next three to five years.
One of the strongest factors driving cloud momentum among medical practices today remains security concerns: with growing IT complexity increasing security risks, cloud options remain an attractive plug-and-play alternative to on-site servers that allows healthcare providers to minimize vulnerabilities. But modern cloud solutions also allow providers to maximize practice management capabilities and offer faster time to value. And, with features like pay-as-you-go pricing, cloud solutions don’t require a big upfront investment, making them a popular choice with budget-conscious healthcare organizations.
Another key factor driving practice adoption of modern, cloud-based solutions is the need more efficient workflows to support effective patient billing. The patient share of healthcare costs is growing rapidly in the US. According to a Kaiser Family Foundation report, out-of-pocket costs have grown three times as fast as overall healthcare costs. And, the average deductible has skyrocketed from $584 in 2006 to $1,318 in 2015. Practices need solutions that can help them implement controls and analytics as patients become responsible for a greater share of costs.
As a result of these and other factors, cloud technology now plays a pivotal role in healthcare, and cloud-based healthcare IT solutions are becoming increasingly important in helping practice successfully navigate this new environment. So what’s in store for 2016? Here are some healthcare IT trends to watch:
A more modern, intuitive software experience: The consumerization of healthcare IT has begun in earnest, and that means practices are looking for design-centered products that deliver intuitive solutions. Cloud-based healthcare IT solutions that move beyond Web 1.0 to provide a consumer-focused user experience (UX) will be the clear winners.
Even with electronic decision-support technology and responsive, knowledge-based medical software built into modern electronic health care record (EHR) systems, it is critical for physicians and clinicians to recognize the primary focus is still treating the patient. In an effort to survive escalating costs of care and declining reimbursements, modern health care delivery models shifted from a patient-centric care model toward a financially motivated business model.
With the push toward value-based reimbursements and rigorous quality measurement reporting mandates, hospitals and medical organizations today must balance the need to remain financially solvent with improving patient outcomes and experiences throughout the health care journey.
Business Process Outsourcing: Revenue Cycle Management (RCM) and Value-Based Care
End-to-end RCM in the healthcare industry explores cost per transaction beyond salaries and benefit packages. Administrators examine productivity volumes, idle time, workforce utilization ratios and patient flow as key factors that directly influence revenue potential.
Business process outsourcing (BPO) has gained popularity in recent years as a way for hospitals and practices to control operating costs without compromising patient care or satisfaction levels. It is a win-win proposition for all stakeholders. The RCM software and services market, which includes BPO, now garners more than $12 million, annually. There are many reasons to consider BPO, including streamlining internal efficiency, expediting third-party payer reimbursements, and reducing data entry errors that stifle cash flow and frustrate consumers.
Analytics, Document Management and BPO
Improving document management is critical. Leading technology enables collecting vast amounts of data, data that can be used to improve patient outcomes, and financial performance. However, data is only valuable if it can be rapidly accessed, analyzed, organized and converted into actionable information. Digital Documents, which is a company that provides outsourced document management services, says document processing services essentially convert information to digital assets.
Those assets may translate into higher profit margins. One study showed hospitals that outsourced most of their RCM operations in 2014 saw an average revenue increase of 5 percent to slightly more than 6 percent. Revenue increases are expected to continue to grow over the next few years, especially in the health IT outsourcing area, which according to Reportstack should see an annual compounded growth rate of almost 9 percent through 2019.
With the yearly bluster and promise of HIMSS, I still find there have been few strides in solving interoperability. Many speakers will extol the next big thing in healthcare system connectivity and large EHR vendors will swear their size fits all and with the wave of video demo, interoperability is declared cured. Long live proprietary solutions, down with system integration and collaboration. Healthcare IT, reborn into the latest vendor initiative, costing billions of dollars and who knows how many thousands of lives.
Physicians’ satisfaction with electronic health record (EHR) systems has declined by nearly 30 percentage points over the last five years, according to a 2015 survey of 940 physicians conducted by the American Medical Association (AMA) and American EHR Partners. The survey found 34 percent of respondents said they were satisfied or very satisfied with their EHR systems, compared with 61 percent of respondents in a similar survey conducted five years ago.
Specifically, the survey found:
42 percent of respondents described their EHR system’s ability to improve efficiency as difficult or very difficult;
43 percent of respondents said they were still addressing productivity challenges related to their EHR system;
54 percent of respondents said their EHR system increased total operating costs; and
72 percent of respondents described their EHR system’s ability to decrease workload as difficult or very difficult.
Whether in the presidential election campaign or at HIMSS, outside of the convention center hype, our abilities are confined by real world facts. Widespread implementation of EHRs have been driven by physician and hospital incentives from the HITECH Act with the laudable goals of improving quality, reducing costs, and engaging patients in their healthcare decisions. All of these goals are dependent on readily available access to patient information.
Whether the access is required by a health professional or a computers’ algorithm generating alerts concerning data, potential adverse events, medication interactions or routine health screenings, healthcare systems have been designed to connect various health data stores. The design and connection of various databases can become the limiting factor for patient safety, efficiency and user experiences in EHR systems.
Healthcare Evolving
Healthcare, and the increasing amount of data being collected to manage the individual, as well as patient populations, is a complex and evolving specialty of medicine. The health information systems used to manage the flow of patient data adds additional complexity with no one system or implementation being the single best solution for any given physician or hospital. Even within the same EHR, implementation decisions impact how healthcare professional workflow and care delivery are restructured to meet the constraints and demands of these data systems.
Physicians and nurses have long uncovered the limitations and barriers EHRs have brought to the trenches of clinical care. Cumbersome interfaces, limited choices for data entry and implementation decisions have increased clinical workloads and added numerous additional warnings which can lead to alert fatigue. Concerns have also been raised for patient safety when critical patient information cannot be located in a timely fashion.
Solving these challenges and developing expansive solutions to improve healthcare delivery, quality and efficiency depends on accessing and connecting data that resides in numerous, often disconnected health data systems located within a single office or spanning across geographically distributed care locations including patients’ homes. With changes in reimbursement from a pay for procedure to a pay for performance model, an understanding of technical solutions and their implementation impacts quality, finances, engagement and patient satisfaction.
Guest post by Khomushka Andrey, project coordinator, Sciencesoft.
Health professionals will hardly ever love documenting. By making tedious tasks easier and eliminating paperwork, medical apps spare time for doctors to focus on their patients more. However, physicians would rather use paper charts and sticky notes than try to figure out what goes wrong with the software.
The reason why mHealth for medical practices, clinics, hospitals and other care organizations might stay unused is that developers tend to build monolithic mobile copies of medical desktop solutions, trying to adapt the complex functionality to smaller screens. Off-the-shelf software vendors generally stick to this large-screen approach, as their goal is to cover the needs of as many customers as possible.
According to Healthcare IT News and the AMA (American Medical Association), however, physicians welcome a more customized approach. “Physicians have found that most EHRs lack usability and interoperability as necessary features for supporting high-quality patient care,” says James L. Madara, MD, CEO of the AMA.
So thinks the AAPS (Association of American Physicians and Surgeons), which represents the end users of such apps. Executive director Jane M. Orient, MD, states that “The costly, clunky systems the government demands are worsening the problems and even driving some software experts back to paper.” And just to emphasize it, according to Healthcare IT News, 80 percent out of 571 physicians surveyed feel that EHRs impede patient care and almost half claim that patient safety is at risk.
Guest post by Mark Ott, vice president of product, RoundingWell.
Mark Ott
As 2016 unfolds, the move from fee-for-service to value-based care is entering a more advanced stage. As the process evolves, priorities for healthcare providers of resources, teams and tools becomes more convoluted. To keep on track, both for healthcare organizations and CMS changes, providers should keep in mind the following:
The care management/coordination record rises in importance, especially as team-based care models expand
Some call it a care management medical record and others call it a care coordination record. Regardless of the term, the concept is essentially the same. EHRs are basically encounter management systems, but as care expands beyond the in-person encounter, capturing and tracking what happens between patient visits will be of utmost importance. In addition, enabling care teams to stay on the same page about a patient’s care plan, track action steps, and reduce the friction of working together will be crucial to succeeding in a value-based world. Expect to see the Care Management Record concept start catching fire in 2016.
Demand will increase for consumer-grade user experiences in healthcare enterprise software
For so long, clinicians on the frontlines of care delivery have had to struggle with software that’s hard to use, difficult and downright frustrating. The biggest culprit for poor user experiences in healthcare software has to do with the enterprise purchasing process. Vendors build for buyers, like the C-suite, who aren’t also the end users. If the end user and the buyer were the same, you’d see healthcare software vendors value user experience like what we see in other B2B industries, not to mention B2C industries. Regardless, in 2016 we will see more buyers value products with consumer-grade user experiences. Much of this has to do with end users’ reluctance and sometimes outright resistance to adopting technology in their worklife. Clinicians often get a bad wrap for being technology averse. But in reality, it’s not that they’re averse to technology; it’s that they’re averse to bad technology.
Integrating wearables and their data into care delivery processes will remain a niche activity
The enthusiasm around wearables, trackers and remote monitoring is exciting and there is enormous potential for device data to impact the delivery of care in ways that benefit both patient and provider. But the technology hasn’t caught up with the promise of what they can be, and that won’t change in 2016. Not only is the technology not yet able to deliver, but the incentives and processes to support wide-scale deployment are not in place yet. Though all signs point to wearables becoming an integral part of delivery of care, this won’t happen next year.
Thanks to remarkable innovations in healthcare technology, the days of having to wait for a doctor’s appointment and travel to their surgical practice are becoming a thing of the past. We have now entered an age where, instead of patients having to attend at a medical practice, their doctor can now visit them virtually in hologram form. It sounds like something out of the realms of science fiction, but this is now a wonderful reality. Welcome to the healthcare of the future!
Home Healthcare Adaptations constructed this infographic, which takes a look at the route that healthcare is set to take in the foreseeable future. The virtual healthcare method outlined above has the potential to create vast savings for the healthcare industry, both financially and in terms of human hours. Indeed, an average reduction of just five minutes in ambulatory visits could possibly free up $58 million in physician capacity.
This new virtual healthcare world could prove highly beneficial both for doctors and the general public. Healthcare professionals can save time on treating patients, which in turn enables them to treat a larger number of patients, and it also reduces the need for them to physically visit a patient’s home, as they can now do so through a hologram from their surgical practice. For patients, it means they don’t have to spend time travelling to a surgical practice and, with doctors able to tend to patients more quickly, it will also reduce patients’ waiting time to receive vital treatment.
Despite these obvious benefits, there is still some resistance to virtual healthcare, with a viewpoint that it will be costly to implement and will require medical professionals to become licencsed telemedicine practitioners. However, as the world becomes more technologically advanced in all aspects, it is hard to see these wonderful new medical practices not becoming regularly used in the near future.
Guest post by Adam Hawkins, vice president client services, CynergisTek.
Adam Hawkins
HIMSS 2016 is right around the corner, and I’m sure everyone is excited about the prospects of conferencing in Las Vegas. This location certainly has a lot going on to keep everyone busy, on and off the exhibit floor. There should be many new healthcare technology players to see and learn about, and it is always interesting to visit the innovation area. Hopefully, we’ll get to hear what folks like KLAS, HIMSS Analytics and other research organizations are working on in 2016 as well.
For instance, KLAS is continuing its work toward including security vendors as its own category, and has a new study underway to look at service providers in this space. That study won’t be completed in time for HIMSS, but they should be able to preview what they hope to accomplish with the study and what its report will include. I think it will be an important read for everyone in our industry.
Interoperability is a huge area of concentration in healthcare at the moment with the Office of the National Coordinator, Health & Human Services and HIMSS all very much involved in this discussion. There are sure to be several presentations on this and related topics. Hopefully we will hear how security and privacy will be addressed, as they are critical components of making many of our health initiatives successful and rely heavily on interoperability for success.
