Electronic health records (EHRs) were supposed to transform the healthcare industry in the same way that digital technology has transformed the rest of our lives – organize and simplify. EHRs held the promise of easier access to patient health history, greater patient engagement, and improved clinical decision making and outcomes. And yet, despite the potential, electronic health records thus far have proven to be just another industry headache. Doctors contend with complicated and incompatible systems that stifle collaboration and enhanced patient care. Patients lack adequate access to their own records and methods to conveniently communicate with their care team.
While patients and doctors struggle, EHR system vendors benefit from the stagnant and uncompetitive market, charging exorbitant installation and maintenance fees, with no real incentive to innovate. It is a broken system, but it can be fixed, with the tech industry’s penchant for disruptive innovation. There is great opportunity for tech companies to develop fixes that will benefit customers and reignite development in digital healthcare.
Electronic medical records are currently locked away in walled gardens that inhibit vital information exchange between care team members and patients. These walls need to be broken down to allow for the collaboration that patients expect between their care team members. EHRs based on Software-as-a-Service (SaaS) platforms would allow vendors and medical providers to cut installation and maintenance costs, while offering genuine compatibility and simplicity. SaaS platforms are also cost efficient, with transaction-based business models that only require subscription and access fees. A SaaS health record system would be cost-effective, compatible, and ultimately serve the doctors and their patients.
Currently, one patient can have several associated identifiers from different physicians, hospitals and EHR vendors. Data is often duplicated and workflow becomes complicated for providers. An industry-wide standard could work, but there is no guarantee that a solution can be selected and implemented nationwide in a timely manner. An outside approach would offer much-needed perspective and an injection of fresh ideas into the conversation. Silicon Valley could assist by developing simpler, tech-based solutions, with industry stakeholders providing input. For instance, a master patient index, successfully driven by heuristic real-time matching algorithms, would offer similar functionality to the universal account log-ins offered by Facebook and Google and further simplify access to electronic health records.
EHRs should behave more like part of a “clinical network” that combines simplified workflows with stronger communications. Lab tests, referrals, pre-authorizations and results can be delivered instantly, retooling today’s overcomplicated systems with a more effective transactional eco-system. The network simplifies physicians’ day-to-day activities, and aggregates the collected data into an electronic health record. Tapping into the success of social and business platforms, such as Facebook Messenger and Slack, secure communication between patients and their complete care team, built around these universal health records, adds a layer of proactive care management that was previously unattainable.
As any holiday TV-loving baby boomer can attest, the island of misfit toys is not a happy place. In the 1964 stop-motion animated television show, “unwanted” were destined to live out their toy lives without the joy of playtime with the child they were built to please. Unfortunately, some EHR products share certain misfit qualities which can make their use more difficult for a busy provider.
So how do you know if you are using a misfit EHR? Here are a few signs:
There is little to no communication with others or outside entities, and you are stuck with the same, less than perfect software environment that is dysfunctional and aging fast.
No one calls to see how your EHR is doing and no one responds to your outcries for help.
Sound familiar? This is essentially your situation when you have committed to an outdated and under-supported EHR system for your practice. You are land-locked by an older system that is not cloud-based or does not leverage the many cloud resources for communication and interoperability.
So, your technology is old, the code base has been put on the shelf by the EHR vendor and no updates are coming. This is despite the rapid changes surrounding your practice and the healthcare industry in general.
You feel isolated, and when you call for support you get little to no relief, as the vendor has moved on to bigger and better customers. In the TV show, Santa promised to come back to save the misfits, just as your EHR vendor promised customized support, ongoing upgrades and improved efficiency. But the costs are prohibitive and your confidence in the vendor is low.
Maybe it is time to get off the island, and hitch a ride with a new vendor. If a new EHR is on your holiday list, here some criteria you should consider:
Cloud-Based Platform
Leverage the power of the cloud to connect to labs, e-prescribing networks, HIEs and other data hubs such as the Commonwell Health Alliance. With a cloud-based EHR system these connections are built into the application, and any new features or connections to other entities become available to all users, no upgrades, no updates required to your infrastructure.
Don’t buy expensive hardware, servers and IT support staff to manage them. All you need to run a cloud-based EHR is a desktop web browser or mobile device.
By 2050, the world population will grow to more than nine billion people, according to the U.S. Census. As our world grows more diverse, so do the languages associated with different populations. Today, there are at least 6,909 distinct, known languages, and as globalization continues to grow, the number of non-native English speaking people living in the United States will grow in parallel. For the healthcare industry, this means hospitals and health systems must think about how this plays into patient engagement and care. Communication is crucial to managing patient relationships, caring for patients and working with their families to follow treatment plans correctly.
U.S. law requires hospitals to provide medically trained interpreters for patients with limited-English proficiency. This requirement aims to bridge the patients’ needs with how physicians plan to care for these needs.
How do healthcare organizations acquire interpreters?
When it comes to providing interpretive services, healthcare organizations have several options. Some hospitals that have significant limited English proficiency (LEP) populations keep interpreters on staff. Others rely on relationships with interpretation agencies to bring in interpreters as needed. Many facilities use remote, on-demand interpreters either over-the-phone or on video. More often than not a hospital will rely on a combination of these resources.
Perhaps the most important component of any language access network in healthcare is agility. Take the incoming Syrian refugee population – suddenly Arabic interpreters are in demand in areas they never worked in before. Healthcare facilities have to remain nimble to meet their patients’ needs. Interpretation needs can change over night, and hospitals need to be ready to respond.
Guest post by Mohd Haque, vice president and global business head, healthcare, Wipro Technologies.
Mohd Haque
Population health management (PHM) isn’t just the latest buzzword. Or a new initiative mandated by the Affordable Care Act. Implementing a successful PHM program requires a complete shift in mindset from volume healthcare to value-based and outcome-based. PHM can’t be something that your healthcare facility “does,” but it must become the cornerstone of everything related to how your facility practices medicine.
Although the shift in perspective is the first step, it is essential to arm yourself with Population Health Management IT tools as well. According to 26th Annual HIMSS Study, half of the respondents (51 percent) have improved PHM through IT tools with only 38 percent saying that their organization was using specific Population Health Management tools.
By using big data analytics, EHR integration, IT infrastructure and security as part of a PHM program, providers can ensure patients that need high levels of care aren’t overlooked and the lower risk patients don’t get unnecessary care. This will in turn increase quality of care while saving money on interventions needed for low risk patients.
What are the Components of Effective PHM Program?
Since PHM is such a large shift, it is important to know exactly how to go about creating an environment that focuses on outcomes instead of volume. Population Health Alliance recommends the following four components to a PHM program:
Assessment – Evaluate each patient’s health and assign patients to a risk group (high to low)
Stratification – Provide the same interventions for everyone in the same risk group
Person-Centered Intervention – Provide interventions based on each specific patient’s needs, including community health research
Impact Evaluation – Determine the impact of interventions for each risk group as well as each individual patient
However, you can’t simply change the process without changing how each person on the team views healthcare and their patients. It must be a fundamental shift in your facility from the receptionist to the department chief.
Jessica Kane, professional blogger who writes about technology and other gadgets and gizmos aplenty, currently writing for Total Voice Tech.
Jessica Kane
Voice recognition has come a long way since its early days when you had to train a computer to recognize your voice and speak in a very flat and monotone voice. As voice recognition increases in popularity and use, it’s going to increasingly find its way into the medical field. Voice recognition software is used in an increasingly large number of hospitals since it provides an easy to access transcript of past medical history.
The Role of Voice Recognition in Healthcare
Voice dictation software is slowly replacing the role that a medical transcriber used to play. By moving away from a transcriber, the doctor is placed in a position where they have greater control over their patient records. When documentation is more in control of the physician in charge, there is less processing involved and the documents are ready for distribution at a much faster rate. This can be a significant advantage for patients who need to have medical records quickly shared between various doctors. Voice recognition’s main role in medicine is to provide better and more efficient documentation.
The Merits of Voice Recognition in Healthcare
In terms of employment for medical transcribers, the practice of using voice recognition software to quickly transcribe records could be problematic. However, trusting medical transcriptions to a voice recognition program might not be the most responsible solution either. A human being should still review the records before submission to make the records are accurate and suitable for distribution. By incorporating a human component in the document creation process, it helps to reduce the chance for errors in the documentation process while still saving time.
The Reduction of Handwriting Mistakes
The issue of illegible handwriting is a serious issue in medical documentation. When documentation can’t be deciphered, valuable information may get lost or distorted. Speech-to-text methods of creating documentation may create fewer issues, especially if a medical transcriber listens to a recorded version of the transcript to check the medical documentation.
Guest post by Betsy Weaver, Ed.D., president and founder, UbiCare.
Betsy Weaver
At UbiCare, our mission is Making Us All Better—whether that “us” is the hospitals and patients we serve or our employees and the wider community. We invest in caring all year long because it’s good for business and it’s good to work with people who care enough to volunteer and invest in the community.
Volunteering is central to healthcare Giving back is a core part of our UbiCare culture. We believe in translating what we do for the healthcare market—providing access and information to help the patients of our hospital clients improve their health and their lives—to our community. We want nothing less than to change the world when it comes to stepping up and caring. And to achieve this, we have to give back.
All of us who work in healthcare have come to realize that real health comes down to the community. We’re all influenced by—and can influence—the people around us. We believe in supporting them in any way that we can.
Community is important all year, not just during the holidays
UbiCare has a corporate social responsibility (CSR) plan that includes volunteering on-site at a community or nonprofit organization at least quarterly, and often more than that. We also encourage staff to suggest the causes they want to give back to. It helps the rest of us get more excited about a volunteering project when someone we work with is passionate about it.
We designated 2015 as the Year of the Essentials, and focused our volunteer efforts on food, education and clothing. We harvested fruits and vegetables for low-income Boston residents at Revision Urban Farm and packed meals for homebound and critically ill people at Community Servings. We visited a local middle school to talk with students about career preparation and ran career-focused activities through the Partners for Youth with Disabilities’ Young Entrepreneurs Project. We sorted baby clothes at Cradles to Crayons’ Giving Factory. We hosted a blood drive and invited the entire Brewery Complex to participate.
The important thing here is that it’s never a surprise when we announce our next CSR initiative, which we’ve dubbed the “UbiCares” program. It’s already a big part of who we are and what our employees want us to be. Plus, it tells the world and our staff that this is a core value for us and not just lip service.
Though many Medicare and private payer reimbursement programs that require practices to begin moving to value-based compensation already have set sail, most small practices are still treading water near the shore when it comes to this new wave of payment models.
While admirable in their care goals, these quality care-based reimbursement programs can pose some insurmountable challenges for small providers. In fact, they require a whole new way of providing care for some practices, as well as creating new documentation of integrated data analysis, development of care coordination with other providers, payer reporting applications, and often times new technologies that can support these new provisions.
What’s more, all this change also can be quite expensive for small practices and wreak havoc on current business practices.
Set the course
No doubt about it, though, the move to value-based care is on. According to the 2015 Physician Compensation Survey, conducted by Physicians Practice magazine, 63 percent of physician compensation is currently tied to productivity; 37 percent to value metrics and 29 percent to patient satisfaction scores.
The Centers for Medicare and Medicaid Services (CMS), however, has expressed its goals of having more providers participating in value-based plans each year, with a goal of 50 percent by 2018. And it has further incentivized physician participation by specifying increasing reductions in payments for non-participation that began in 2013.
So unless they want to start leaving money on the table, practices have no choice but to take the plunge into such new compensation programs.
Lift the Anchor
Before diving in and potentially draining money and resources to participate in such programs, physicians need to look around and assess their current situation to determine how the new reimbursement model might work in their practice. For example, they need to evaluate current technology, vendors, resources and physician support to determine what changes they need to make, as well as what internal infrastructure they can use.
According to PwC’s Health Research Institute (HRI), 2016 will be a year of firsts for players within healthcare as the industry adapts to the main forces driving the New Health Economy: the rise of consumerism, the focus on value, downward pressure on costs, technological innovation and the impact of new entrants.
In its annual report, “Top Health Industry Issues for 2016,” released today, PwC’s HRI highlights the top 10 forces that are expected to have the most impact on the industry in the coming year and looks back at how trends from the past decade have persisted or evolved. Leveraging results from a survey of 1,000 US consumers and interviews with health industry leaders, 10 issues stand out in the year ahead across three key themes:
Innovation:More and more, health technology in the palm of your hands will mean more than just monitoring – it will also mean diagnosis and treatment. Sixty percent of consumers are willing to have a video visit with a physician through their mobile device, while 58 percent of clinicians would rather provide a portion of care virtually. Additionally, new high-tech databases will allow industry players to analyze data from many sources in novel ways, finally unlocking new insights. Shouldering higher deductibles and rising out-of-pocket expenses, consumers expect to begin to manage their health spending like they manage their retirement savings.
Access to care:In 2016, the US health sector is expected to see a new class of products – biosimilars – introduced to the market, bringing potential savings with them. The New Year may also bring renewed attention to behavioral health, long relegated to the industry’s back burner. However, the issue will be access. More than half of US counties have no practicing mental health clinicians. Additionally, with mounting budget pressures, care may move to the community as health systems pursue lower-cost care settings more aggressively and creatively than before.
Troubleshooting issues in the New Health Economy: With 2016 being a presidential election year, industry issues such as drug pricing will be in the spotlight. Additionally, as insurers, consumers and purchasers are demanding better value, providers may be scrambling to unlock the medical cost mystery and calculate the true cost of services. 2016 should also be a year in which the industry is dramatically reshaped by consolidation, as the insurance market should inch closer to being dominated by three major players. Finally, with the rise of health technology comes the rise of cybersecurity Nearly 40 percent of consumers would abandon or hesitate using a health organization if it is hacked. More than 50 percent of consumers would avoid, or be wary of using, a connected medical device if a data breach was reported.
“After more than a decade of identifying the top health industry trends, we are finally starting to see the creation of a New Health Economy – a health system that is more connected, transparent and patient-centric,” said Kelly Barnes, PwC’s US health industries leader. “2016 will be marked by how well the sector balances greater demand with rising costs, and handles trends such as industry consolidation and the increase of consumer technology in healthcare. But there is much more work that needs to be done in forging new ways of receiving, paying for and delivering care, and it will be businesses that prioritize addressing consumer needs and increasing value that should succeed.”
Additional details on the top 10 business issues that HRI identified include:
