Guest post by James Bindseil, president and CEO, Globalscape.
Health IT has reached a pivotal crossroad: On one end, consumers’ expectations for more timely care and instant access to health files and records continue to skyrocket; on the other, security and compliance risks are more complex and threatening than ever before.
This leaves health providers in a precarious position: should they prioritize security and compliance, or productivity and care?
In a perfect world, the answer would be all four. Unfortunately, today’s health IT landscape — which is going through a rapid and significant transformation to keep up with evolving compliance mandates, new demands around access to patient files, changing government policies, sophisticated security threats and new technologies — is far from perfect.
One of the most pressing issues lies within the policies and technologies provided by today’s IT teams. In fact, in many instances, the policies and tools implemented by IT to keep patient data safe and secure often end up having the opposite effect: they make it incredibly difficult for providers to deliver fast and efficient care in a secure, compliant manner.
For example, let’s imagine a day-in-the-life of a hospital care provider, who faces immense pressure to deliver top-notch care to as many people, and in as little time, as possible. On day one, an off-duty doctor is called at home to provide his take on the best care plan for a specific patient. How will he review the pertinent information while working remotely? In another scenario, the doctor is running from patient to patient, and is unable to take the necessary time to record his actions. Taking the work home on a USB drive seems like the best option. The next day, the hospital needs to quickly share files with the patients’ previous provider to care for an urgent medical issue.
There it lay. Faded graphite thoughts etched from corner to coffee-stained corner. Face down. Buried under strata of paperwork—the paper feedback form. Once a hallmark of modern medicine, the paper feedback form is now a relic. Yet patient feedback itself lives on, transformed into red ninja stars—the kind you would see on Yelp—headed straight for your healthcare organization.
Patient feedback is yet another element of society that has been transformed by the Internet. Where feedback used to be written privately on pieces of paper, it is now being left as reviews for the world to read on the Internet. The change in patient feedback stems from three technological, social and financial trends. This article identifies these three trends and serves as a conversation starter for healthcare IT leaders to engage other departments in a strategy to leverage online reviews for growth in 2015, and beyond.
Trend 1 – Technological
In 1999, America fell in love with the online review. Within six months of its invention, 1,146,201 reviews had been created for sports teams, products, etc. Doctors largely flew under the radar until 2007 when the Centers for Medicare and Medicaid Services (CMS) began publishing a list of all US doctors. Now, 70+ websites like Yelp regularly copy the CMS’s list of doctors onto their websites for consumers to leave reviews. This is why online reviews show up on nearly every search for a doctor’s name, even when patients aren’t seeking reviews out specifically.
Trend 2 – Social
It seems counter-intuitive that patients would believe the words of a stranger on the Internet over a trusted friend. Yet, a 2011 survey by CONE Research survey revealed that 89 percent of consumers check online reviews before making expensive purchases—even after receiving a recommendation from a trusted friend. Also surprising was the number of people who would take the time to write reviews. According to an August 2014 interview with Jeremy Stoppelman, CEO of Yelp, “Skeptics initially scoffed at the idea that people would feed Yelp free reviews of local businesses.” Those skeptics were wrong. Yelp has accumulated 61+ million reviews.
What must be done before you walk out of the office for the last time before the stroke of midnight Jan. 1, 2015? It’s a simple question with many possible responses. Each healthcare organization, based on its needs and priorities likely has a fix what it needs to do, though, perhaps those things are not necessarily what it wants to do. Like people, the final couple weeks of the year are different for everyone and practices are no different.
So, if you’re making a list and checking it twice, here are a few suggestions that you might want to add to it to be well prepared for the new year, based on your practice’s business needs, of course.
Review the ONC Federal Health IT Strategic Plan
Chris Boone
At Health Data Consortium, we have three must-do items before we close the door to 2014. First, we urge the health IT community to review the recently released ONC Federal Health IT Strategic Plan 2015-2020. Public comments are open until February 6, but don’t let your response get lost in the start of the year flurry. Second, we are preparing for the arrival of the 114th Congress and the opportunity to share Health Data Consortium’s public policy platform for 2015. Our platform will have an emphasis on the key issues that affect data accessibility, data sharing and patient privacy – all critical to improving health outcomes and our healthcare system overall. Finally, on January 1 we’ll be only 150 days from Health Datapalooza 2015. We are kicking off the new year and the countdown to Health Datapalooza with keynote speakers and sessions confirmed on a daily basis. We’re already making the necessary preparations to gather the innovators who are igniting the open health data revolution. As 2014 comes to a close, we look forward to hit the ground running in 2015.
Ideally, turn off not only your lights, but everything — I mean every piece of digital technology and every way digital technology can connect to your organization. That is the only way to assure there are no accidents, glitches, failures or breaches. Here are some other things you can do:
• Fill every open position you can. Have positions and people identified and include backups. The only thing worse than not having a position to fill is having one to fill and leaving it open.
• Address mobility, medical devices and patient engagement, and not just from a security perspective — this is everyone who provides access, information or uses these devices or systems.
• Address the culture and have a plan to include every individual in the organization, if the technology touches them, from BYOD to analytics to privacy to cloud storage.
IT, regardless of the industry, is ultimately about people. In healthcare, it is also about the data itself, which represents your patients. It has to be there, it has to work, it has to be secure.
— David Finn, CISA, CISM, CRISC, is a member of ISACA’s Professional Influence and Advocacy Committee, and the Health Information Technology Officer for Symantec
I remember when the Health Insurance Portability and Accountability Act (HIPAA) passed. I was working for a leading practice management software vendor. Everyone was overwhelmed by what was involved. We developed a huge amount of education and information for our customers. Some people wondered if the healthcare industry could make such a major change.
Today, HIPAA is ubiquitous. Many practices take it for granted. They are not concerned about a breach because they believe they have done everything they need to do. In a recent study by MedData Group of physicians top practice management priorities for 2015, HIPAA didn’t even make the list.
“We instigated HIPPA when it came out, and it is in place and second nature to us,” said Joann Lister, a provider at a family medicine practice in Texas. “We have all worked at the hospital so we had plenty of training on the rules. Our physical space and computers are confidential. Our practice management and EHR software, Kareo, always goes back to login when we are done in a room so the next patient does not see anything. We have limited personnel so it is easier to know that everyone honors the HIPAA rules.”
The question is: Have practices gotten too complacent with HIPAA? With the latest changes to HIPAA in 2014, have they followed through on making changes and updates? The data and experience of industry experts and consultants suggests that there may be a problem with HIPAA compliance.
“The last analysis we did for a practice had 41 pages of regulations that required implementation,” recalled practice management consultant Rochelle Glassman, CEO of United Physician Services. “Most practices do not know what the complete requirements are. They believe that if they have the patients sign the privacy form that is all they need to do. This year there were updates that included the new HITECH Act and the HIPAA Omnibus rule. I can guarantee that many practices have not updated their HIPAA program to include the changes because they do not even know they exist.”
In the first real-world trial of the impact of patient-controlled access to electronic health records, almost half of the patients who participated withheld clinically sensitive information in their medical record from some or all of their health care providers.
Should patients control who can see specific information in their electronic medical records? How much control should they have? Can doctors and other clinicians provide safe, high-quality care when a patient’s preference may deny members of the medical team from seeing portions of the electronic medical record? What is the appropriate balance between individual privacy concerns and health care providers’ need for relevant data?
The Regenstrief Institute, Indiana University School of Medicine and Eskenazi Health (formerly Wishard Health Services) partnered to design and conduct the first real-world trial intended to help answer these and related questions. During the six-month trial, 105 patients in an Eskenazi Health primary care clinic were able to indicate preferences for which clinicians could access sensitive information, in their electronic medical records, such as information on sexually transmitted diseases, substance abuse or mental health, and designating what the clinicians could see.
Regenstrief informatics developers then created a system where those preferences guided what information doctors, nurses and other clinic staff could see. Patients were able to hide some or all of their data from some or all providers. Importantly, the healthcare providers were able to override patients’ preferences and view any hidden data, if they felt the patient’s healthcare required it, by hitting a “break the glass” button on their computer screens. When providers hit this button, the program recorded the time, the patient whose electronic chart was being viewed and the data displayed.
Twenty eight states, three territories and the District of Columbia will receive more than $665 million in Affordable Care Act funding to design and test healthcare payment and service delivery models that will try to improve healthcare quality and lower costs, Health and Human Services Secretary Sylvia M. Burwell announced.
Together with awards released in early 2013, more than half of states (34 states and three territories and the District of Columbia), representing nearly two-thirds of the population are participating in efforts to support comprehensive state-based innovation in health system transformation aimed at finding new and innovative ways to improve quality and lower costs.
The State Innovation Models initiative supports states in planning or implementing a customized, fully developed proposal capable of creating statewide health transformation to improve health care. Example initiatives include:
Improving primary care through patient centered medical homes, building upon current Accountable Care Organization models or integrating primary care and behavioral health services.
Providing technical assistance and data to healthcare providers and payers that are working to advance models of integrated, team-based care, or transition to value-based payment models.
Creating unified quality measure score cards that health care payers and providers can use to align quality improvement and value-based payment methodologies.
Expanding the adoption of health information technology to improve patient care.
Fostering partnerships among public, behavioral and primary healthcare providers.
Strengthening the healthcare workforce through educational programs, inter-professional training, primary care residencies and community health worker training.
Tim Cannon is the vice president of product management and marketing at HealthITJobs.com.
The health IT industry is growing, but it’s also becoming competitive. While a career in health IT is fairly easy to break into, professionals will continually need to increase their value by gaining the knowledge needed to adapt to the evolving technology in the industry.
Fortunately, increasing your credentials and experience in health IT has been simplified by numerous certifications available. In fact, my company’s recent salary survey found that health IT professionals with certifications typically make $10,000 or more than those without.
If you’re looking to boost your career in health IT or increase your salary, here are a few certifications you should look into:
1. CISSP
The CISSP certification is ideal for professionals who work or want to work in information systems security. In any profession that requires the transfer and curation of patent data and confidential records, it’s helpful to have experience keeping information secure. This certification requires five years of paid full-time experience in the field, but one year may be waived with a four-year degree.
2. CCNA
The CCNA certification is for network engineers who are looking to advance their skills in networking. It provides training and education for installing, monitoring, and troubleshooting network issues. Training covers important topics such as IOS, IPv6, IPv4, OSPF, Cisco Licensing, Serial Line Interfaces, VLANs, Ethernet, VLSM, and basic traffic filtering.
3. PMP
The most important one for project managers, this certification is highly renowned in the industry. Professionals with this certification demonstrate the experience and competency needed to lead and direct projects. Project manager was found to be the most lucrative job function in the health IT industry, pulling in an average of more than $111 million annually, according to our survey. The Project Management Institute also found obtaining a PMP certification further increased salaries.
As significant changes continue to reshape the U.S. healthcare system, The Physicians Foundation – a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients – has identified five critical areas that will have major impact on practicing physicians and their patients over the next 12 months. The Physicians Watch List for 2015 is based on the Foundation’s insights into the medical practice landscape, supported by data from its 2014 Biennial Physician Survey of 20,000 physicians and other Foundation research and white papers.
Consolidation Hits the Gas Pedal
An increased rate of consolidation among hospitals and health systems continues to drive smaller, independent medical practices into larger systems. This trend is adversely impacting competition in regions where consolidation is most pronounced, while increasing costs and reducing patient choice. Rapid medical consolidation is also presenting a challenge to clinical autonomy. According to the Foundation’s 2014 Biennial Physician Survey, more than two-thirds of all physicians (69 percent) expressed concerns relative to clinical autonomy and their ability to make the best decisions for their patients. Since the rate of medical consolidation shows no signs of abating, it is imperative that hospitals and physicians work together to ensure that clinical decisions are being made independent of any bureaucratic or organizational pressures that could potentially affect the integrity of medical decision-making.
External Pressures Strain the Physician/Patient Relationship
An inadvertent effect of medical consolidation and the rising emphasis on valued-based payment models is increasing strain on the physician / patient relationship. According to the Foundation’s most recent Biennial Survey, 80 percent of physicians describe patient relationships as the most satisfying factor of practicing medicine. Yet, factors such as growing levels of non-clinical paperwork and rising administrative and regulatory pressures are leading to an erosion of quality face-time physicians are able to spend with their patients.
In addition, these pressures can also limit physicians’ choices in terms of practice type while increasing the amount of time and resources they must spend on negotiating with payers and vendors. As these regulatory and marketplace forces persist, it will be more critical than ever for physicians to identify ways to work with support staff in order to maximize the amount of quality time they are able to spend with their patients.
