Are you ready to transition to ICD-10? The countdown is on. As those of us in healthcare know, next week the industry in the United States will (finally) undergo a significant change as we transition from ICD-9 to ICD-10. ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems and is used primarily to document diagnoses in a codified manner. The most recent revision has nearly five times more codes than its predecessor because of its increased complexity and specificity of ICD-10 codes.
Healthcare organizations in the U.S. have been preparing for the ICD-10 transition for nearly five years. Multiple delays, brought on by substantial lobbying efforts against the transition, led to elongated wait time, but the time has come and we’re ready to launch. Personally, I’m glad. I look forward to healthcare moving beyond this conversation; the infighting ICD-10 has caused among members and associations in the community has done us all a disservice. Perhaps, on October 2, the day after the implementation deadline, we can begin to move on to other issues — slowly, of course — so that the brilliant minds in healthcare can once again focus on more pressing, important issues than the dollars and cents of claims and the numbers needed for them to be paid by our payer partners.
As the transition date draws near, make sure you’ve got all your priorities and details in line. ICD-10 is no lightweight matter, as you have likely discovered. Cerner created the following video, “10 Things You Should Know to Get Ready for ICD-10,” that I’m posting here, with the company’s permission. Though my publishing it is a bit last minute, the video offers some tips that might help you prepare for “doomsday.”
This video reviews what Cerner considers the top 10 things you need to do to prepare for ICD-10; it also covers technical pieces related to Cerner’s Millennium solutions, as well as operational pieces to help with the transition. Overall, it’s a nice resource that may provide you a bit of last minute ICD-10 insight and comfort for the change again. Here’s to your ICD-10 health. Enjoy!
Guest post by David Thompson, senior director, product management, LightCyber.
David Thompson
A targeted data breach is one of the most vexing problems facing healthcare organizations today. Just in the first three months of 2015 alone, 99 million patient healthcare records were compromised—that’s about one-third of the entire U.S. population, and those are just the ones we know about. According to some sources, 90 percent of healthcare organizations have already been breached, but we aren’t sure which ones.
The cybercriminals behind a targeted data breach do not want to be exposed—and make no mistake, these breaches are run by people, not autonomous software. Unlike the hackers of earlier days, these operatives want to stay hidden and conduct their work in secret. Even if they have successfully completed their initial goals—let’s say exfiltrate patient medical records—a cybercriminal team will likely want to stay undiscovered to continue to steal more data as it is collected, or leverage this access to break into another company. Often this will involve commandeering valid credentials from the first organization to gain access to another, perhaps a partner healthcare organization, an insurance company, an independent lab or some other entity.
The simple truth is that most healthcare organizations lack the means to detect an active data breach. First, let me define a data breach, since there is so much confusion over the term. A breach is the entire process—from initial network penetration through data exfiltration— cybercriminals go through to achieve their goals.
Often a breach is perceived as only the initial penetration into the network or infection of a machine. This one act is over in an instant, but it is the focus of considerable security resources. In other words, a large proportion of security resources are devoted to preventing single step in the breach process that lasts less than a minute, but is only the first step toward a goal.
Also, initial penetration is not as easy to spot and block as you might guess. Since the way into the network may be accomplished through the use of valid credentials acquired through social engineering or clever spear phishing, detecting the intrusion can be difficult. Effective prevention of intrusions is based on use of statically defined descriptions of software code or behavior (signatures and hashes), so it is successful mainly when known malware is used to conduct a breach. So, preventing an intrusion has a marginal success rate, but it is often seen as the last change an organization has in defeating a targeted breach.
Once an attacker is inside the network, most organizations lack the ability to find them. At the same time, an attacker is inherently at a disadvantage, having landed inside an unfamiliar network. This disadvantage is quickly dissipated since they can often go completely undetected for weeks, months or even longer. The industry average dwell time is around six months, plenty of time for an attacker to explore a network and get at assets.
Why is it that organizations are seemingly powerless to find an active data breach once an intruder has penetrated a network? There are four main reasons.
Guest post by Brett Meyers, senior business analyst and ECM product lead, The Gordon Flesch Company.
In the wake of the recent Ashley Madison hacking scandal, cyber breaches have become a hot-button issue. Poking fun at high-profile people caught in the midst of a scandal has nearly become a national pastime in recent years, but the hack itself is no laughing matter. After all, just six months ago, a data breach at Anthem, Inc. revealed as many as 80 million records had been exposed during what the company characterized as a “very sophisticated external cyber attack.” Certainly, no one was laughing then – not the millions of people whose birth dates, Social Security numbers, addresses and income information were exposed — and certainly not Anthem, which now faces dozens of class action lawsuits. The costs may include millions of dollars in damages and a major hit to the insurance company’s brand and reputation.
One lesson these two very different breaches brought home is that businesses of every type and size are vulnerable to cyber attacks and identity theft. If Anthem were the only health-related business to have been hacked, it would still be a disturbing event; but in fact, the U.S. Department of Health and Human Services maintains an entire website devoted to healthcare-related data breaches of 500 or more records. So far, there are more than 1,300 cases on file, with targets that include individual practices, university-based research facilities, public and private hospitals, and major insurance companies.
In 2012, the U.S. Department of Justice’s Bureau of Justice Statistics reported that 7 percent of the U.S. population 16 and older had been the victim of identity theft, and direct and indirect losses that year amounted to about $25 billion. That’s staggering. What’s even more alarming is that about one-third of those victims spent weeks or months trying to untangle the financial mess long after their information was stolen.
It’s easy to think the impact of identity theft is limited to financial implications, but the government report had one more startling bit of data revealing just how far-reaching the effects of a data breach can be on its victims. According to the data, “Victims who had personal information used to open a new account or for other fraudulent purposes were more likely than victims of existing account fraud to experience financial, credit and relationship problems and severe emotional distress.”
Healthchat is a communications platform that allows patients, physicians and medical staff to communicate and collaborate in a more efficient manner through the use of short videos sent through their mobile phones. This simple and secure application is available to physicians for a low monthly fee and free for patients and medical staff.
Elevator pitch
Healthchat is a HIPAA-compliant video-sharing app to connect healthcare providers and their patients – with speed and convenience.
Founders’ story
Chris Chowquan
Founder and CEO, Chris Chowquan, is an IT veteran, who has spent much of his career managing technology for healthcare payers. After many years of interfacing with physicians and patients he saw the need for a simpler, more efficient communications solution. Healthchat was founded in 2015.
Origin story
As a father and full-time employee who has to take time for doctor visits, he figured there must be a better way.
Marketing/promotion strategy
Healthchat’s sales team will be marketing to physicians directly. In addition, Healthchat will launch an integrated marketing campaign aimed at reaching all three groups who can benefit from this product: physicians, medical staff and patients.
Market opportunity
Despite mandates to improve the patient experience, accessing healthcare services remains highly inefficient. Healthchat addresses the problem – and stands alone as the only HIPAA-compliant, mobile-friendly communications platform for patients and their providers to connect about their healthcare.
Guest post by Terry Edwards, president and CEO, PerfectServe.
Terry Edwards
Each day, healthcare professionals need to communicate with colleagues, patients and others outside of their organization. These communications often contain critical information about dosage changes, requests for a consultation and other healthcare information that can have life-or-death consequences for patients.
From email and texting to calls and overhead pages, there are a dozen different ways healthcare professionals can communicate with one another. Many of these modes of communication are fairly new, and clinicians are still continuing to teach each other the rules of the road and associated etiquette.
But as healthcare transforms to be more focused on value-based care, it’s becoming even more important to get this right. To coordinate patient care across the patient’s entire journey within the health system, clinicians need to know how to reach each other in the best way. Although communication is an essential part of the job for clinicians, a recent survey of 955 healthcare professionals1 conducted online by Harris Poll and commissioned by PerfectServe, shows that clinicians aren’t always communicating in the way that they’d prefer.
Lessons learned:
Find a way to speak in person when possible: For complex or in-depth conversations within their organizations, healthcare professionals say they prefer to speak face-to-face (41 percent for physicians; 37 percent for non-physicians). This preference is particularly strong with nurses, with 55 percent of nurses surveyed saying their preferred method is face-to-face communication for complex or in-depth conversations with physician care team members. Speaking in person allows clinicians to focus on the conversation. Many of the clinicians I work with say taking time to speak in person gives them the opportunity to build a stronger rapport with their colleagues, which can make it easier to foster care coordination.
Think before picking up the phone: Phone calls are by far the most frequent form of communication with care team members outside their organization. More than half (55 percent) of clinicians say they most frequently use a phone call to connect with physician care team members outside of their organizations, and 48 percent most frequently use the phone to communicate with non-physician care team members outside of their organization. But while everyone is picking up the phone, only about a quarter of clinicians actually prefer phone calls for that kind of information sharing (29 percent for brief communications with physician care team members outside of their organization; 25 percent for outside non-physician members). In my work with clinicians, many say that the ring of the phone is an interruption to their work, and more than two-thirds (67 percent) of clinicians reported that they often receive pages or calls that are of low priority, which disrupts patient care.
Guest post by Will Hayles, technical writer and blogger, Outscale.
Will Hayles
Last year, 2014, was the year the wearables market really took off. No end of wearable technologies were released, each promising to hook users into the personal analytics and quantified self trends. Of course, many of those releases went nowhere, and even some of the big companies saw their wearable devices fizzle rather than pop — the obvious example being Google Glass, which received an unprecedented amount of attention, much of which was negative. But there were many successes, and later this year Apple will be entering the fray with the Apple Watch and its bundle of sensors.
Last year the wearables industry was worth around $2.8 billion. Over the next five years it’s expected be to worth more than $8.3 billion. But there is a market with the potential to dwarf the consumer fitness monitoring market, and that’s chronic illness management, which has, unfortunately, if understandably, seen far less attention from startups. As J.C. Herz notes in a Wired article on the subject, the entire market for fitness trackers is vastly outstripped by the size of the market for blood glucose test strips, which are an essential tool in the monitoring of diabetes.
Herz takes a harsh tone with an industry that has failed to focus research and development on solutions for people who stand to benefit the most, but I’m more optimistic. Healthcare outside of the fitness sphere is a difficult market, with a heavy — and necessary — regulatory burden and entrenched ideas about treatment and patient monitoring. Unity Stoakes, co-founder of StartUp Health, recognizes both the challenges and the potential for innovation that can significantly improve people’s lives:
“Unlike other industries, healthcare is plagued by regulation and longer product development timelines. Bringing successful products to market is challenging for both large industry players and digital health entrepreneurs. Startups need access to advisors, peers and dollars, while large companies need ‘batteries included’ entrepreneurs fueling innovation. The unprecedented level of change gripping the healthcare industry today presents both challenges and opportunities for both.”
There is recognition both within the healthcare industry and among technology companies that monitoring tools and other applications of wearable and mobile technology offer an opportunity to substantially change healthcare and the lives of people who suffer with chronic illnesses.
According to a recent study from the Health Research Industry, 42 percent of healthcare providers are comfortable relying on at-home test results for prescriptions. Sixty-six percent thought mobile solutions have the potential to help with the management of chronic diseases. And as we’ve discussed on this blog several times before, mobile technology and wearables are helping caregivers better collaborate and coordinate care.
Physicians can now get reimbursed for the coordination effort that is involved in managing a patient following a hospital discharge. ACT.md’s TCM-specific Health ACT Sets facilitate a structured, standardized, and proven process for optimal care coordination to reduce hospital re-admissions and support TCM billing. The ACT Sets are structured in a way for providers to assess complexity, complete care actions required by CMS, and follow specific time sensitive requirements for care delivery and billing. ACT.md takes the complexity out of the TCM Billing process and pays for itself within months.
Elevator pitch
ACT.md is the platform for team-based care. Care teams need a way to jointly manage medical conditions in concert with behavioral, social, and functional needs. With ACT.md’s high-tech, high-touch platform and project management-like approach, healthcare organizations can engage in collaborative care planning, efficiently manage in-between visit care, and make safe, reliable handoffs across the care continuum. Our customers have seen a 30 percent reduction in the time spent on care coordination activities and improved compliance to care plans through meaningful caregiver and patient engagement.
Product/service description
Through an elegant and intuitive cloud-based technology, the web-based solution connects all members of a dynamic care team, including the patient and their trusted caregivers. We enable our customers to efficiently develop, reliably execute, and securely communicate a patient-centered care plan across their teams. The technology is complimented with a flexible care coordination workforce service offering to ensure nothing falls through the cracks and clinicians are working at the top of their license.
Origin story
Ted Quinn
“At ACT.md we are patients, caregivers, physicians, nurses, public health professionals, engineers, and operational leaders. We have personally experienced the significant challenges associated with managing complex care and are working to make life better for patients and everyone supporting them,” said Ted Quinn, CEO and Co-Founder, ACT.md.
Founder’s story
The company was founded by Ted Quinn along with Ken Mandl, MD and Zak Kohane, MD, both nationally-renowned healthcare informatics experts. The company was incubated at Boston Children’s Hospital and Harvard Innovation Lab.
“We were inspired to launch ACT.md after observing for decades the constant dropped handoffs across the various providers caring for patients. So we created ACT.md as an operating system for team-based care that drives action toward improved outcomes and reduced costs,” said Dr. Kenneth Mandl, co-founder, ACT.md, professor at Harvard Medical School and director of the Boston Children’s Hospital Computational Health Informatics Program.
Marketing/promotion strategy
Kenneth Mandl
Every healthcare entity is dealing with change management around care delivery and care coordination. We’re sharing our vision of team-based care and it is resonating with the market.
We’re proud to work with our world-renowned advisory board – including John Halamka, MD, CIO at Beth Israel Deaconess Medical Center, and Troy Brennan, MD, CMO at CVS Caremark – who help us share our vision with the nation’s leading providers and payers.
Market opportunity
According to Frost & Sullivan, the care coordination software market is expected to grow at a 26.1 percent compound annual growth rate between 2015 and 2020.
How your company differentiates itself from the competition
EMR/EHR vendors are the incumbents in the market, but they are not designed to do this job. Up to 70 percent of provider/patient work is conducted in the informal region outside the EMR, especially work related to the coordination of care. We have heard directly from healthcare organizations we are working with that with the leading EMR there is no way to track the status of handoffs, connect with outside providers and family caregivers, and that they really need a Care Coordination Record. This is the job that ACT.md is being hired to do, and we are getting traction with large health systems across the country.
ACT.md shines in complex care settings. The company is focused on powering team-based care for high-risk, high-cost patients.
Beverly Glass Buchman, senior vice president of marketing, TouchCare.
Beverly Glass Buchman
Numerous studies show that patient involvement in their own healthcare leads to reduced costs and better outcomes. It is especially beneficial for managing chronic diseases, such as diabetes, asthma and heart disease, and it will become even more vital as the industry continues to move from volume-based care to a value-based care system.
Still, in a recent CommonWealth Fund study, 86 percent of providers said patient engagement has been challenging, specifically when it comes to adopting healthy behaviors and being compliant with treatment protocols and standard care recommendations. The challenge lies in continuing the doctor-patient conversation between office visits. Many physicians struggle to stay connected with patients and follow up between office visits, while balancing their ever-demanding schedules and precious time off.
Mobile technology can help. It can serve as a key component for improving engagement simply by adapting to a patient’s lifestyle. Nearly every American owns a smartphone today and daily usage time continues to skyrocket.
Look at the numbers for American smartphone usage:
64 percent own a smartphone (PewResearch Center)
3 hours each day using their smartphones (ExactTarget)
People download three apps per month on average (comScore)
57 percent of smartphone owners use apps every single day (comScore)
Leveraging text messages, digital portals, and telemedicine video consults can engage your patients between appointments in a way that’s both convenient and familiar. For example, a remote video appointment allows a physician to check in between office visits to ensure medication adherence, discuss recent test results or receive patient feedback to help in shared decision making as treatment progresses. And it can be as easy as Skype or Facetime.
Scheduled virtual video consults can provide valuable data that will help tailor delivery of care to improve outcomes, all while saving money for both the provider and the patient.
