This is an exciting time in healthcare. The field is changing in terms of how and where care is delivered, who is providing those services, even how the care is financed. As the world around us becomes increasingly digital, the medical industry needs to keep up. I believe patients deserve convenient access to the best doctor for their particular case, no matter where that doctor is located. They deserve personal attention and a firsthand look at the images and results their doctor sees.
This is why I was honored to join other national telehealth leaders in the HX360 panel discussion, the Telehealth Turnabout, during HIMSS15 in Chicago. The group brought together divergent perspectives on the future of telehealth, including market opportunities for new entrants, novel opportunities for providers to extend care, capture new patients or establish a new revenue stream using telehealth.
At Optimized Care Network (OCN), we are challenging the healthcare industry to imagine having every world-class specialist available in one office — no matter where you are located. We are moving the industry and the people we serve away from reliance on brick and mortar offices.
Personalized digital healthcare is the future of quality medical care. New developments in technology are making healthcare providers more accessible than ever before. As the digital domain grows, providers and patients alike must be clear on the differences between telemedicine and personalized digital health. Telemedicine can involve seeking treatment over the Internet via a video conference, and personalized digital healthcare enhances your traditional office visit by adding state-of-the-art image sharing equipment and lifelike communication linking the patient in one location with the doctor who could be hundreds of miles away. The digital healthcare delivery offered in an Optimized CareSpace takes digital healthcare to the next level by personalizing it. You meet with a nurse, look your doctor in the eye via exclusive video technology, and you can see the medical images your doctor sees, giving you, the patient, a complete view of your healthcare.
Guest post by Alexandra Sewell, executive director, enterprise marketing, Comcast Business.
Meaningful use is one of the largest drivers of healthcare IT, with the potential for far-reaching effects. Many healthcare organizations are well on their way to achieving meaningful use, working through related cost, training and resource challenges.
But there is still work to be done. Meaningful use can require significant network infrastructure investment to support electronic health records (EHRs) and other technologies. At the same time, budgets are shrinking, so providers must be strategic about how they allocate IT dollars.
Improving Patient Outcomes
EHRs give doctors a complete view of the patient — from demographics and vital signs to medications, allergies and more. EHRs are a central component to complying with meaningful use Stage 1 requirements and help doctors easily view and transmit records, which can lead to more accurate patient diagnosis and treatment.
Hospitals with EHR systems can better capture data regarding patients’ co-morbidities and other risks. This helps clinicians manage patients, resulting in more positive clinical outcomes and improving mortality rates for heart attack, respiratory failure, and lower intestine surgery. EHRs can help improve the overall quality of patient care.
Integrating PACS
Picture Archiving and Communication System (PACS) technology provides economical storage and convenient access to a range of images from multiple imaging devices, transmitting them digitally and eliminating the need to manually file, retrieve or transport film jackets.
To comply with Stage 2 of meaningful use, healthcare providers must offer patients the ability to view, transmit, and download their health information. And while not explicitly mandated by meaningful use core objectives, many organizations are integrating their PACS and EHR systems so images, such as MRIs and CT scans, can be shared between physicians and with patients through patient portals. However, the size and volume of these imaging files place stress on hospital networks, creating data capacity and data center connectivity issues.
David Caldwell is the vice president of sales and marketing at Transcend Insights, a wholly owned subsidiary of Humana Inc., dedicated to simplifying population health. Transcend Insights helps manage the complexities of population health through community-wide interoperability, real-time healthcare analytics and intuitive care tools. The company’s HealthLogix platform provides healthcare systems, physicians and care teams with valuable clinical insights that enable more informed decisions at the point of care, enhance the patient experience and reduce costs.
Here, Caldwell discusses how the firm serves its clients; the benefits of analytics and its impact on ACOs; population health initiatives; and the future of the company.
Tell us a bit about your product offerings and the role that they play in the health care technology space.
Transcend Insights is a population health management company that provides health care systems, physicians and care teams with advanced community-wide interoperability, real-time health care analytics and intuitive care tools designed to simplify the complexities of population health. The new company represents the merging of three leading health care technology businesses—Certify Data Systems, Anvita Health and nliven systems. We integrated Anvita’s health care analytics into Certify’s HealthLogix™ platform to provide physicians and care teams with the real-time insights necessary to improve health outcomes and reduce costs. In addition, we made these insights accessible at the fingertips of physicians and care teams through a mobile point of care solution, a technology we gained from nliven.
Today, Transcend Insights works with more than 130 health systems, serving at least 600 hospitals and over 20,000 physicians. Through community-wide interoperability, we help large health care systems gain access to both acute care and ambulatory data that reside in various silos across the care continuum.
We analyze 2.3 billion clinical data points on 10.8 million patients every day. Our analytics engine offers more than 33,000 evidence-based clinical rules and last year identified over 36 million opportunities to improve care and helped our clients close 4.3 million gaps in care.
Lastly, we leveraged nliven’s expertise in mobile health technology to develop a mobile point of care solution that allows physicians and care teams to not only visualize data but also gather and assimilate patient data in real-time.
Who are your customers and what level of clinician typically accesses your product on a day-to-day basis?
The vast majority of our customers are multi-hospital, integrated health care delivery networks that have purchased our product to help them move from a fee-for-service to a value-based care delivery model. Our customers utilize the HealthLogix platform to reach both contracted and affiliated physicians, and to piece together disparate electronic health record (EHR) system data across the care continuum.
Guest post by Devin Jollimore, training coordinator, Mission Safety Services.
We live in an age where the use of technology dominates our lives and these technological developments have had an amazingly positive impact on the healthcare industry. Healthcare technology has heavily influenced the improvement in our health and the increased life expectancy we are seeing today.
In particular, the progress we have made in cancer research and the greater survival rates have been heavily influenced by developments in technology. It’s amazing that healthcare technology played a role in saving 1.2 million lives between 1991 and 2009 thanks to progress in cancer treatments and detection.
Malaria is thought to have killed more people than all wars put together and technology is helping reduce this startling statistic. Something as simple as a bed net with insecticide has reduced malaria in children under 5 by 20 percent.
Also, stem cell research has limitless possibilities to save lives. We are still progressing with this development, but diseases, such as heart disease and Alzheimer’s, may be hugely reduced through stem cell research and we are already making good progress.
Let’s not forget the importance of the Internet and how it has increased healthcare efficiency. Healthcare facilities are reaching patients through social media and doctors have access to thousands of medical books at the touch of a button.
This infographic from Mission Safety Services outlines the progress we have made, the work that is being done, and possible future developments in technology that have potential to make real change.
More than 33 million Americans who have high-deductible health plans, also known as “HDHP” policies, struggle to find local doctors within their budget because healthcare costs have previously remained mysterious, until after one reaches the specialist’s office. To solve this dilemma, Doctible.com has launched a search platform that lists the costs of procedures and checkups upfront so that patients understand prices before booking their appointments. Plus, clients can also quickly search for and compare doctors by price, reviews, location and specialty.
Founded in 2013, the “Doctible” website now serves the San Diego area — with future plans to expand and eventually create a nationwide healthcare search engine to help people make faster, better and more affordable decisions about their options for a wide variety of medical services. Here are the principles that make it work and the positive changes it can lead to:
The solution lies in the search engine’s transparent facts
The Doctible medical-services search engine instantly pulls together all the key information about the type of doctor someone is looking for in a list that takes less than a minute to scan, allowing users to find the right doctor and make a booking more quickly and efficiently without regretting their decision later. The design is simple and powerful. Anyone can get fast results by just entering their zip code, the type of doctor they need to see and the type of procedure they want. Instantly, visitors get a list of doctors that shows exactly how far away they are from one’s home, how much the doctor charges in cash for the procedure, their average insurance price and their ratings based on past reviews from real patients.
At HIMSS this year, multiple speakers laid out visions for a future where parents could consult with a pediatrician via a telemedicine encounter during the middle of the night, take their children to receive immunization shots at a retail clinic, and have all of this information aggregated in their primary care provider’s record so that providing an up to date immunization record at the start of the next school year is as simple as logging into the PCP’s patient portal and printing out the immunization record. In short, multiple speakers presented visions of a truly interoperable future where patient information is exchanged seamlessly between providers, healthcare applications on smartphones, and insurers.
While initiatives such as the CommonWell Health Alliance, Epic’s Care Everywhere, and regional health information exchanges attempt to address the interoperability challenge, these fall short of fully supporting the future vision described above. Today’s solutions do not address smartphone applications and still require manual intervention to ensure that suggested record matches truly belong to the same patient before the records are linked. This process is costly but manageable in an environment where a low volume of patient records are matched between large provider organizations. In a future world where patient data is available from a multitude of websites, smartphone applications and traditional healthcare organizations, it would be cost prohibitive to manually review and verify all potential record matches.
Of course, one solution to this dilemma would be to improve patient matching algorithms and no longer require manual review of records before they are linked. However, for this to be possible, a standard set of data attributes would need to be captured by any application that would use or generate patient data. In a 2014 industry report to the Office of the National Coordinator for Health Information Technology, first name, last name, middle name, suffix, date of birth, current address, historical address, current phone number, historical phone number, and gender were identified as data attributes that should be standardized. Many of the suggestions in this report were incorporated into the Shared Nationwide Interoperability Roadmap that the ONC released in January 2015.
The proposed rule for meaningful use Stage 3 was announced on Friday, March 20, 2015, and is now available for comment by stakeholders. Here are five highlights of the Stage 3 proposed rule and what I see as three provider wins:
Highlights
2017 is now a Flex Year– Meaningful use Stage 3 was originally slated to begin in 2017 for providers that had completed Stage 2; now 2017 is a flex year. This means that providers who would have progressed from Stage 2 to Stage 3 in 2017 now have the option to stay in Stage 2 an additional year. Only providers who use an EHR certified to the 2015 ONC standards will be allowed to attest to Stage 3.
Every provider will be Meaningful Use Stage 3 in 2018 even if 2018 is the provider’s first reporting year – In order to simplify the meaningful use program, all providers will be in the same stage. This will allow group practices to focus on a single set of measures for all providers.
Meaningful Use Stage 3 is the final stage of meaningful use– However, CMS is clear that because it expects technology and care standards to evolve over time it will consider (and we expect) that there will be future rulemaking related to meaningful use Stage 3 somewhere down the line.
All providers will report for one calendar year – in an effort to continue to align meaningful use with other government reporting programs such as PQRS, all providers will report for a full year based on the calendar with one exception. Medicaid first year providers will still be allowed to report based on a 90-day period measurement period. In the past CMS has shortened measurement periods based on provider feedback and we expect that to be true about this year. This year (2015) was slated to be a full year for most providers, but we expect it to be scaled back to a quarterly measurement period because of the continued side effects of the poor implementation of Stage 2 last year. For 2017 and beyond, we expect the implementation will be smoother and we don’t foresee more flexibility on measurement periods beginning next year.
There are eight objectives and some objectives have more than one measure – the total number of measures that providers will be required to report is 16.
Wins for Providers in the Meaningful Use Stage 2 Proposed Rule
I see three wins for providers in the meaningful use Stage 3 Rule, including:
In the following conversation, Jim Lacy, CFO and general counsel of ZirMed, discusses the company’s mission, goals and growth; his passion for healthcare and serving those who work in it; ZirMed’s transition from a clearinghouse to a revenue cycle management, population health and predictive analytics firm; why privacy has become the biggest issue very few are seriously talking about; and the changing face of healthcare as a whole.
Tell me more about ZirMed, the brand, its solutions, and your mission for it.
Our core mission is to help healthcare providers, hospitals and health systems get paid. It sounds simple, but efficiently and effectively getting providers paid for their services and supporting their mission in an ever-evolving technological, regulatory, and clinical environment is incredibly complex.
ZirMed is uniquely positioned to deliver a comprehensive end-to-end platform of cloud-based financial and clinical performance management solutions. That means that at every point in the revenue cycle, we have solutions that support healthcare providers in collecting monies from payers and patients, and do it as quickly, efficiently, and cost-effectively as possible. Our solutions address the challenges of the current fee-for-service and consumer-driven payment systems, and also support fee-for-value reimbursement, broadly defined as population health management.
ZirMed’s solutions are logically oriented to address the revenue cycle needs of providers ranging from small physician practices and durable medical equipment providers to the largest hospitals and health systems. At the front end, we offer Patient Access solutions focused on registration and check-in to streamline pre-registration, estimate patient responsibility, accurately verify eligibility, and more.
Core to our mission of getting hospitals and health systems paid for services provided is our Charge Integrity solution. We use big-data and predictive analytics to identify and capture charges, resolve process inefficiencies, improve coding compliance, and ensure the complete integrity of all inpatient and outpatient billing.
Our claims and A/R management solutions include robust edits and rules aggregating claims across an entire system, and provide highly efficient claims and receivables workflows, reduce preventable denials, and deliver insights into financial performance for critical decision support.
With the ability to process vast amounts of data and provider metrics across an organization, our cost and utilization solutions benchmark provider performance, stratify risk, and support fee-for-value reimbursement programs.
Population health management has come to hold very different meanings across different organizations. Our population risk management solutions combine clinical and financial information, enabling insights into patient populations while identifying risk, analyzing discharges for readmission risks, and managing referrals across an integrated system.
And, of course, healthcare is always about the patients. We offer a comprehensive suite of Patient Engagement solutions including consumer-friendly billing and payment options and a patient portal offering online payment, statement management, and two-way messaging between the patient and provider.
What about you? What keeps your passion for this mission, and organization, alive? Tell me more about what excites you about your work and why you love what you do?
I love what I do, and couldn’t design a better job for myself than this one: I get to be a CFO, counsel and influence product design, all within the course of a normal day.
My roles are seemingly very different and one person holding them is rather non-traditional; however, there is logic to the fit. ZirMed develops financially focused software solutions in a highly regulated healthcare environment. We deal with billions of transactions and hundreds of billions of dollars annually with an extreme focus on privacy, security and compliancy. My background from the provider side of healthcare prior to joining ZirMed directly influences the types of solutions we build and how we deploy them to positively impact provider organizations.
Ric Sinclair, our VP of product, and his team excel at designing and delivering great software that’s beautiful, powerful, and easy to use. Their role is to take all this complexity and make it as simple and easy as possible for users and managers in client organizations. My role is to weave my experiences into the design of our products and support the role of the client in everything we build.
So I’m doing what I love and working with incredibly smart, talented people every day. That makes it easy to stay passionate and excited about my work and about ZirMed.
