Guest post by Cathy Reisenwitz, content specialist, Capterra.
Cathy Reisenwitz
Every year at Capterra we predict the top trends in business technology. Last year we predicted gamification, wearables, telemedicine, mobile medicine, and 3D printing would be the top 5 medical technology trends for 2015.
This year, we expect wearables, telemedicine, and mobile medicine to continue to advance. They’ll be joined by cloud computing, patient portals, and big data.
Telemedicine has come a long way, from remote villagers using bicycle pedal-powered, two-way radios to communicate with the Royal Flying Doctor Service of Australia to helping recovering stroke patients in rural Minnesota avoid hours-long (and often snowy) drives for follow-up care.
As the technology has improved, the investment has increased. Transparency Market Research valued the global video telemedicine market at $559 million in 2013. Today, they predict it will grow to $1.6 billion by the end of 2020. Walgreens, the largest U.S. drugstore chain, and telehealth provider MDLive recently expanded their virtual care collaboration to 20 more states in November, bringing the total to 25.
Telemedicine offers tons of value to a large, growing segment of the population: seniors. Telemedicine improves care by getting it to remote patients who live far from hospitals. It also enables homebound patients to get high-quality care. It makes care cheaper, and allows seniors to stay at home longer. It benefits providers by making their jobs more flexible. And it also eliminates picking up new illnesses in a clinical care setting.
In rural Minnesota, nurses check motor skills by asking patients to push, pull and squeeze with their hands and feet. A doctor, located further away from patients, can advise on care onscreen.
Going back to wearables, their mass adoption has made store-and-forward telemedicine much easier. Devices like Fitbits automatically collect valuable health data. Store-and-forward telemedicine just means that data goes to a doctor or medical specialist so they can assess it when they have time. Watch for more EHRs learning to connect with wearables in 2016.
More EHRs will provide patient portals
Patient portals grew in popularity in 2014 and 2015. Twenty-six percent more patients received lab tests via an EHR patient portal between 2013 and 2014. Patients also received 50% more health and disease education through their portals in that time. “Patient engagement through health technology such as patient portals is rapidly increasing,” Craig Kemp, leader of innovative partnerships for Merck Vaccines, told mmm-online.com.
While about half of physicians offer patient portals right now, almost another fifth of them plan to offer one in the next 12 months. In a 2015 survey of more than 11,000 patients, 237 physicians, and nine payer organizations representing 47 million lives, almost a third of patients said they were interested in using a patient portal to engage with their physician, track their medical history, and receive educational materials and patient support. However, almost 40 percent said they’d never heard of a patient portal.
Educating patients on how and why to use portals will be key to getting them to use them in 2016.
Despite all the advances in technology over the last three decades, many large health payers are still conducting aspects of their business the way they did in the pre-Internet days of the 1980s, relying on manual processes and interactions with members and providers.
That mindset can no longer continue. Between the huge influx of individual members that resulted from the Affordable Care Act (ACA) and the expectations of the customer experience members have based on their interactions with retail, telco and other industries, payers must make significant changes to prepare themselves for success in the 21st century – and beyond.
The days of sprawling campuses housing thousands of employees, acres of call centers and a labyrinth of file rooms archiving mountains of incoming paper documents are going away. Following are some of the key adjustments health plans will start making in 2016.
Deploy robust web portals. The use of self-service web portals has become common in many industries. Consumers can go online to obtain information or complete transactions whenever they want from wherever they are using whatever device they prefer. Health plans will start making this same level of self-service available to their members and providers rather than relying solely on phone, email or snail mail. By providing more answers through online self-service portals, payers can focus call center personnel on answering more difficult, complex questions that provider higher value to members and payers while reducing their costs to deliver that level of service.
Implement 24/7 online claims administration. Most health plans cannot afford the high level of overhead required to staff claims processing or authorization department around the clock. By implementing online claims administration technology, payers will be able to offer continuous, 24/7 processing of incoming claims and authorizations, removing delays and delivering resolution faster. They can also use these technologies to identify exceptions and pass them to the appropriate personnel for immediate review, ensuring they receive the proper attention rather than getting “lost in the shuffle” of paperwork.
Anyone who grew up playing video games ought to have a greater appreciation for the future of healthcare.
When they moved out of the arcade halls and into living rooms, video games became more accessible to more people. And when a wave of fitness-related console titles were released in the late 1990s and early 2000s — Dance Dance Revolution, EyeToy: Kinetic, and Yourself!Fitness/My Fitness Coach — women joined in the fun. By 2014, a study by the Entertainment Software Association revealed that women represented 48 percent of the gaming population in the United States, and the addition of this untapped market allowed the gaming industry to make the pivot that would eventually merge gaming with healthcare.
The title character of My Fitness Coach was Maya, a virtual personal trainer. Maya was the agent who coached couch potatoes and weekend warriors alike to reach whatever fitness goals they might have. A doctor, similarly, knows what’s best for patients and has a reason behind every instruction — and the difference between the virtual video game trainer and the Ph.D. isn’t the vast ocean it once was.
With innovations from FitBit and Jawbone for wearables, Biosensing to Augmedix and Entrada for electronic health records (EHRs) and clinical workflow apps, as well as direct competitors such as Doctors on Demand and TeleDocs, traditional healthcare institutions are facing consumer-direct competitors whose products and services are almost exclusively based on the use of self-care technology. A new wave of innovation is coming soon. Venture funding of digital health companies surpassed $4 billion in 2014, nearly equivalent to the previous three years combined.
So, what’s next?
Self-care apps like FitBit, RespondWell, Caremerge and others that feed a patient’s data into a cloud have the potential to enrich clinical observations in ways that the occasional hospital visit cannot. If you have a device producing conclusive data that says “your heart rate is higher than it should be,” “you’re taking too many pills,” or “you’re walking with a gait,” a physician can say with confidence “something bad is going to happen to you.” Predicting a person’s proclivity for injury and illness is more of a science than ever.
There is an industry-wide surge in providers, payers and post-acute care providers whose needs for transitions-in-care are unmet by their current healthcare IT capabilities. As such, 2016 will likely be the year that referral management comes to the forefront for all stakeholders in the healthcare system.
The moment of referral is an opportune time to engage with patients: with the increase in high-deductible plans and out-of-pocket expenses, patients are extremely motivated to seek care from high-quality, cost-effective, in-network providers. Providing patients with the resources they need, while enabling providers to align their efforts, is a mission-critical need in healthcare today.
There are a few key factors driving improvements in referral management for providers, payers, and post-acute care providers alike:
For providers
With the move to fee-for-value reimbursement, we are seeing a rise in the number of physicians moving to independent physician associations, ACOs, and clinically integrated networks. This is happening for two reasons: first, to negotiate more effectively with payers and second, to equip themselves to take on risk in the future. In order to take on risk effectively, healthcare organizations will need to ensure that patients stay within their systems. In addition, these groups of physicians often have multiple EMRs and are looking for solutions to expand them. Therefore, we have seen an increase in all kinds of provider groups looking for intelligent decision support that guide referrals in a systematic and strategic fashion.
For payers
With the increase in high deductible, narrow network plans, there is a greater need to direct patients to high-quality, low-cost providers. Payers, in partnership with providers, are looking for the ability to navigate patients in this way. Given the cost of specialist visits, payers are also particularly interested in making sure patients get to the most appropriate specialist to receive the care they need.
For example, Carefirst BCBS has pioneered a program, through their PCMH plan, to provide information on specialist costs and quality to inform referrals. They see this as a way to improve quality while, over time, bending the cost curve. This could be the beginning of a broader trend among payers, to acknowledge the importance of referrals and encourage the use of tools designed to implement insightful decision support and a standardized process around transitions-of-care.
For post-acute care providers
As providers have consolidated, so has the post-acute care space. Readmission penalties and bundled payments have further put pressure on post-acute care to ensure a seamless transition from acute care to – and within – different post-acute services.
Patient-centricity , patient centered thinking, and the rise of the “p-suite” in pharma companies continued a trend established over a year ago when Sanofi broke new ground by hiring Dr. Anne Beal, former deputy executive director of the Patient Centered Outcomes Research Institute (PCORI), to the newly created role of chief patient officer. Her new responsibilities included elevating the perspective of the patient within Sanofi and finding better ways to incorporate the unique priorities and needs of patients and caregivers.
Yet as life sciences companies continue the pursuit of a 360-degree view of “customers” typically classified as healthcare professionals (HCPs), a view of patients has been even harder to come by. Partly because of HIPAA and privacy requirements, but also because, unlike healthcare providers and payers who have regular contact with patients, life sciences companies engage primarily at the level of clinical trials and consumer marketing.
Better understanding of the patient is top priority in life sciences for 2016, and executives will continue to push cultural change facilitation, enhanced cross-functional collaboration, and increased employee engagement. But what would a life sciences company consider to be a key patient engagement metric and a measure of ROI?
With data about patients spread across a significant number of sources, including internal, external and social, merely identifying and collating that data can be a challenge – let alone deriving insights that can support patient-centric strategies and programs. Technology exists today to turn patient data into actionable insights for better R&D and commercial efficiency, as well as to deliver better services to the patient. In order to rapidly analyze data and target audience needs with products and services, life sciences will need to close the loop by tracking and monitoring the effectiveness of their offerings. In other words, they have to be both patient-centric and data-driven.
Healthcare Providers and Payers Will Take Data-driven to the Next Level
Healthcare providers and payers have approved access to member and patient data, as compared to life sciences companies, so are able to develop a new breed of data-driven solutions built to serve individuals, employers, providers, brokers and more. These tools, products and services bring value to every stakeholder, and ultimately benefit the patients themselves in the form of better care, lower premiums and improved efficacy.
However, being able to do so requires a significant step up in data management capabilities. Today’s modern data management platforms are not just cloud-based, but include a reliable data foundation that in generations past, used to cost IT teams millions of dollars in hardware, software and implementation resources alone to produce.
Guest post by Joseph Schorr, director of advanced security solutions, Bomgar.
Moving into 2016, healthcare organizations will continue to be one of the most attractive targets for hackers. Last year, attacks against healthcare organizations were up 125 percent from 2010 and cost the industry $6 billion, according to the Ponemon Institute.
As illustrated in the Anthem and Excellus Blue Cross Blue Shield data breaches, hackers are moving beyond phishing attacks and random malware drops, and adopting methods that are more sophisticated. By leveraging third-party access and privileged account credentials (such as those held by IT security professionals, IT managers and database administrators) to exploit IT systems, hackers can gain an unrestricted and unmonitored attack foothold on the network. Once they have this foothold, they are remaining inside the victim’s environment for an incredible span of time – on average more than 200 days.
With this trend continuing, healthcare organizations can expect to see an uptick in these types of attacks within the industry. To combat this rise, healthcare organizations will need to focus on shoring up IT security around vendors and other third parties in the year ahead. The following are areas where they can concentrate attention to aid in this effort:
Reevaluate the legacy
In particular, third parties such as vendors are particularly juicy targets because they often use VPN and other legacy access methods to access systems. Examining and implementing more secure, sophisticated remote access and privileged access solutions is a good place to start strengthening IT security for the new year.
It’s a common misconception that a VPN guide is a secure way to provide third-party vendors with network access. The problem lies in that an organization cannot ensure that third-party vendors’ security policies and practices are as strenuous as internal practices. If a criminal compromises a valid VPN connection, they have an open tunnel to an organization’s network and the sensitive data within.
Be in control
For too many healthcare organizations, vendors have more access than they need or their access can’t be monitored or restricted. It’s a scary question: Does your IT department know who their privileged users are and what level of IT permissions they have? If not, taking stock of those users, the systems to which they need access, and when they must access them is a critical undertaking for 2016. Following that, the organization can set access parameters that allow those privileged users to be productive and gain access to tools, data and systems they need to do their jobs, while limiting risk. Proactively controlling and monitoring access to critical systems can help tighten IT security within healthcare organizations.
Guest post by Scott Jordan, co-founder and chief innovation officer, Central Logic
Scott Jordan
Gone are the days when IT department gurus ran lengthy reports, sifting through numbers and analyzing data until the wee hours of the morning, all in the quest of fancy profit center reports to impress the C-Suite. Especially in hospital settings where lives are on the line, data in 2016 must be delivered in real time, and even more importantly, must be relevant, connected, and able to be understood, interpreted and acted upon immediately by a myriad of users.
Data That’s Right
Today, having the right data intelligence that is actionable is paramount. It’s no longer enough for analytics to only interpret information from the past to make the right predictions and decisions. With the changing healthcare landscape, it’s increasingly important that data intelligence must also be relevant and the tools agile enough to provide an accurate assessment of current events and reliably point to process and behavior changes for improved outcomes … in real time.
All tall order for any IT solution, much less one in healthcare where robust security parameters, patient satisfaction concerns and HIPAA regulations are just the tip of the iceberg a health system must consider.
Data That’s Connected
The good news is data technology tools now exist that offer interoperability features – from inside and outside a hospital’s four walls – this allows providers to exchange and process electronic health information easily, quickly, intuitively and accurately, with reliably replicable solutions.
When users can see the full complement of a patient’s health record, they can more accurately improve care coordination and save lives. Specifically, connected patient records can:
avoid duplication of diagnostic procedures,
properly evaluate test results and treatment outcomes, regardless of where care was delivered,
share basic patient data during referrals and get information after specialist visits,
view medications, regardless of where prescribed, avoiding drug interactions, medication abuse, etc., and
view allergy and pre-existing condition information, especially valuable to Emergency Department transfers.
Guest post by LeRoy E. Jones, chief executive officer, GSI Health, LLC.
The health IT revolution is here and 2016 will be the year that actionable data brings it full circle.
Opportunities to achieve meaningful use with electronic health records (EHRs) are available and many healthcare organizations have already realized elevated care coordination with healthcare IT. However, improved care coordination is only a small piece of HIT’s full potential to produce a higher level synthesis of information that delivers actionable data to clinicians. As the healthcare industry transitions to a value-based model in which organizations are compensated not for services performed but for keeping patients and populations well, achieving a higher level of operational efficiency is what patient care requires and what executives expect to receive from their EHR investment. This approach emphasizes outcomes and value rather than procedures and fees, incentivizing providers to improve efficiency by better managing their populations. Garnering actionable insights for frontline clinicians through an evolved EHR framework is the unified responsibility of EHR providers, IT professionals and care coordination managers – and a task that will monopolize HIT in 2016.
The data void in historical EHR concepts
Traditionally, care has been based on the “inside the four walls” EHR, which means insights are derived from limited data, and next steps are determined by what the patient’s problem is today or what they choose to communicate to their caregiver. If outside information is available from clinical and claims data, it is sparse and often inaccessible to the caregiver. This presents an unavoidable need to make clinical information actionable by readily transforming operational and care data that’s housed in care management tools into usable insights for care delivery and improvement. Likewise, when care management tools are armed with indicators of care gaps, they can do a better job at highlighting those patients during the care process, and feeding care activities to analytics appropriately tagged with metadata or other enhanced information to enrich further analysis.
Filling the gaps to achieve actionable data
To deliver actionable data in a clinical context, HIT platform advancements must integrate and analyze data from across the community—including medical, behavioral, and social information—to provide the big picture of patient and population health. Further, the operational information about moving a patient through the care process (e.g., outreach, education, arranging a ride, etc.) is vital to tuning care delivery as a holistic system rather than just optimizing the points of care alone. This innovative approach consolidates diverse and fragmented data in a single comprehensive care plan, with meaningful insights that empowers the full spectrum of care, from clinical providers (e.g., physicians, nurses, behavioral health professionals, staff) to non-clinical providers (e.g., care managers, case managers, social workers), to patients and their caregivers. Armed with granular patient and population insights that span the continuum, care teams are able to proactively address gaps in patient care, allocate scarce resources, and strategically identify at-risk patients in time for cost-effective interventions. This transition also requires altering the way underlying data concepts are represented by elevating EHR infrastructures and technical standards to accommodate a high-level synthesis of information.
The health IT revolution is here and 2016 will be the year that actionable data brings it full circle.