Representatives Diane Black (R-TN) and Peter Welch (D-VT) introduced bipartisan legislation to build upon the progress of Accountable Care Organizations (ACOs) in shifting the reimbursement of health care providers away from the traditional “fee for service” model to a focus on improving the health outcomes of patients. The ACO Improvement Act (H.R. 5558) will improve the ACO model by providing additional incentives focused on health outcomes, increasing collaboration between patients and doctors, and providing ACOs with additional tools.
“As a nurse of over forty years, I know firsthand the challenges facing health care professionals as they seek to provide their patients with the best care possible,” said Congressman Black. “It is unfortunate that the current fee for service payment system does little to encourage and incentivize providers and patients to use the most appropriate and effective health care options. By incentivizing providers to focus on improving health care outcomes instead of increasing the quantity of services provided, this legislation will help improve care coordination, increase efficiency, and mostly importantly, ensure the patient receives the best care possible.”
Rep. Peter Welch
“If we are going to reduce health care costs and increase quality, the incentives built into the provider payment system need to be changed. In short, we need to reward value, not volume,” said Rep. Welch. “Paying health care providers based on improvements in patient health rather than the number of procedures they perform is the way of the future. Our legislation will advance these payment reforms and is based on the experience of ACOs in Vermont and around the country.”
An ACO is a collaborative of health care providers working together to improve the quality and efficiency of patient care, rather than increase the number and type of services performed. The goal of ACOs is to drive down health care costs and improve patient health outcomes by creating financial incentives to provide better, more cost-effective care. Rep. Welch is the author of a provision in the Affordable Care Act that created a nationwide Medicare ACO program.
Guest post by Jason Lee, healthcare and security forums director, The Open Group.
The healthcare industry produces an abundance of data that, we are beginning to understand, can be used in a variety of ways to improve the health and wellness of populations and the quality and efficiency of Healthcare delivery to patients. Unfortunately, there are substantial (but not insurmountable) barriers to overcome. To take just one example, as mobile medical devices and wearables collect personal health information, how will these data be exploited to achieve the goals of improved health and wellness?
Health informatics professionals—in collaboration with many stakeholders in the healthcare system — build the capability for collecting and warehousing large amounts of data, but a “new breed” of data experts is needed to analyze and meaningfully interpret the data to produce useful, capability-expanding knowledge. A new workforce, with these skills, will help turn healthcare information into action and improve, outcomes and quality and reduce risk and overall costs.
One of the key issues when it comes to healthcare data is the lack of interoperability in the industry and, more often than not, the different parts of the data puzzle are not fitting together. The information from wearable devices, for example, can be used to keep people well – but only if the data so collected is properly integrated with additional clinical/personal data located in providers’ electronic medical records and payer’s administrative database. The skills of the recently trained data analyst, combined with the proven skills of healthcare informaticians, will increasingly help ensure increased interoperability.
Guest post by Peter Mansfield, director of marketing, QLess.
Healthcare is one of the primary economic engines of America’s cities and a sector where technology innovation remains a high priority. However, recent findings from a ClickSoftware study conducted by Harris Poll, revealed that Americans feel healthcare is one of the country’s most frustrating industries — because of the amount of time spent waiting to be served. So, where’s the disconnect?
It’s no secret, there are a few worse places to wait in line than the doctor’s office or urgent care, surrounded by coughers and sneezers. To this end, healthcare facilities must take a step back and ask themselves the question: How efficient are you?
For most healthcare professionals that’s a tough question. The truth is, it’s well worth giving serious consideration to the operational aspects of your healthcare practice or clinic. After all, inefficiency directly impacts your bottom line in a multitude of ways. Worst of all, a poorly run area of your business can foster a negative influence that permeates other aspects of your practice. One poorly focused or lackadaisical area will frustrate not only your patients but also your team and the employees who really want to push a practice forward.
Where to start? From hospitals to urgent care centers, healthcare businesses usually require the coordination of many different moving parts. That includes your team, systems, payers, and of course, patients. It’s worth thinking through the life cycle of a typical patient visit to identify critical points that help define and assess the overall experience your facility provides.
Health wearables and fitness tracking devices have created an unprecedented opportunity for the healthcare community to collect valuable data that could greatly impact patient care and health insurance premiums. Still, adoption rates for such devices remain low in the U.S. adult population.
While the use of health and fitness tracking devices has more than doubled in the last two years, a new nationwide survey conducted by TechnologyAdvice shows that only 25.1 percent of adults are currently using either a fitness tracker or a smartphone app to monitor their health, weight or exercise. However, the survey also shows that nearly half of those not using such a device would be more likely to use one if it were provided free by their physician or health insurance company.
“Healthcare providers and health insurance companies are two of the largest stakeholders in the promotion of fitness tracking devices, and they have an opportunity to greatly influence their use,” said the report’s author, TechnologyAdvice managing editor Cameron Graham. “This survey revealed there are few real barriers to using health wearables, and also indicated adoption rates would increase if their use was incentivized by the healthcare community. If healthcare providers worked in tandem with health insurance companies, both stakeholders could benefit from the collected population health data.”
Nearly 44 percent of respondents did not have a specific reason for not tracking their fitness, while another 27.2 percent cited a simple lack of interest in wearing a fitness tracking device. Cost, data privacy, and device design did not prove to be overly impactful concerns. With these limited barriers to use, almost half (48.2 percent) of non-tracking adults said they would use a free fitness tracking device provided by their physicians, while 46.1 percent said they would use one provided for free by their health insurance company.
MedWand Solutions develops and distributes the MedWand solution, a patent-pending telemedicine device that easily connects to a PC or mobile device, like a cell phone or tablet. MedWand contains a set of fundamental, easy-to-use vital sign measurement and examination devices integrated into a single wand about the size of a large electric toothbrush. It includes a pulse oximeter, an otoscope camera for ear examinations with attachments to also allow views of the eyes, throat, or nose, an in-ear thermometer, a digital stethoscope and provision to support optional third party Bluetooth wireless devices, such as glucose meter or blood pressure monitor. In addition enabling remote examinations, MedWand can assemble all measurements and required information into a secure electronic health record, enabling a clinical-quality, interactive, at-home telemedicine experience for both patients and their doctors.
Elevator pitch
With all the advancements we have experienced in technology, routine telemedicine still doesn’t allow examination capabilities for all patients. With MedWand, no matter where the location, patients can experience remote examinations like never before.
Product/service description
MedWand is the first handheld telemedicine device that allows doctors to examine patients and gather important medical vitals, remotely, via secure Internet channels on tablets and personal computers. In the rapidly growing industry of telemedicine, the majority of remote consultations are limited to audio and video without the possibility of direct physician examination. Now, with a MedWand, doctors can listen to a patient’s heart, lungs, and abdomen; look at skin and into ears, nose, and throat with an embedded high-definition video camera; obtain basic vital signs, including blood oxygenation; and even obtain a thre-lead EKG – all remotely, with a single unit that can be cradled into the palm of a hand. In addition, MedWand provides continuous medical vitals monitoring services with alerts when patients may be headed in the wrong direction.
Founders’ story
The MedWand telemedicine device was conceived by former Pebble Beach house doctor Samir Qamar, a family physician and founder of MedLion Direct Primary Care, one of the nation’s leading direct primary care companies. It was after being dissatisfied with current limitations of telemedicine that Dr. Qamar came up with the idea to build a compact telemedicine device capable of remote patient exams. After an extensive search, Dr. Qamar approached engineer Robert Rose, founder of Cypher Scientific engineering, formerly of Red Digital Cinema, who agreed to join the project. Together, on a mission to advance telemedicine, Dr. Qamar and Mr. Rose created the MedWand.
Marketing/promotion strategy
MedWand appeals to the entire telemedicine industry. Having already been approached by branches of the U.S. military and many large telemedicine companies worldwide, MedWand will soon be helping hospitals, accountable care organizations, and companies control healthcare costs by allowing real-time examinations to telemedicine services. A major computer manufacturer has offered to be a launch partner for MedWand, and MedWand is ripe for international distribution. Eventually, the MedWand will be distributed directly to patients and their families worldwide.
Guest post by Kim Scanlon, manager, infrastructure and environment, Advocate Health Care.
Advocate Health Care (AHC), based in Illinois, is the Midwest’s largest health system. It includes 13 hospitals, two physician groups, a home care company, a laboratory joint venture and more than 200 sites that provide care. AHC typically serves about 3.4 million patients annually – as you can imagine, that results in a lot of patient data. As such, we recently adopted a single platform approach and standardization of processes for storing and sharing information that enables us to manage patient data in a more timely, cost-effective and streamlined manner.
Patient data is the lifeblood of our IT infrastructure. Given the size of our organization, it’s essential that we have a shared vision on how we manage, access and share information across all sites. Our health system exists to provide a full spectrum of care, so it’s vital that we have a data management system in place that helps ensure patient data meets compliance requirements and is quickly recoverable. Additionally, AHC has the state’s largest physician network of primary care physicians, specialists and sub-specialists, so this organized approach to managing data serves to connect patients with providers and vice-versa, ensuring no relationship is left unmatched.
Advocate Health Care maintains a bank of internal data from payroll, financial and HR applications, as well as clinical apps. As a result, it was producing an extreme amount of information on a daily basis that needed to be stored and managed by our corporate information system. Not all data management companies and solution providers understood our desire to integrate this data into one holistic platform. When it came time to find a new data management partner in 2011, many vendors recommended disparate systems or processes that siloed, rather than integrated, our in-house data management initiative.
Although most accountable care organizations (ACOs) have the health information technology (HIT) to improve clinical quality, poor interoperability across systems and providers remains a barrier, according to an ACO survey conducted by Premier, Inc. (NASDAQ: PINC) and the eHealth Initiative. Access to data from external organizations was challenging for 100 percent of respondents.
The survey, fielded in July-August of 2014, collected responses from 62 ACOs, including members of Premier’s PACT Population Health Collaborative.
Compounding the challenge of accessing and sharing data is the fact that 88 percent of the ACOs face significant obstacles in integrating data from disparate sources, and 83 percent report challenges integrating technology analytics into workflow – barriers that become more acute as ACOs add new platforms or build on their expansive network of medical settings. As ACOs collect data from more sources, they also report concerns about interoperability and data management. Interoperability of disparate systems is a significant challenge for 95 percent of organizations using HIT, and could be limiting the abilities of ACOs to exchange data.
Guest post by Chris McNabb, general manager, Dell Boomi.
Many healthcare IT organizations find themselves caught between a regulatory rock and a technological hard place. The breadth and increasing complexity of today’s healthcare regulatory compliance is putting tremendous pressure on them to rapidly and efficiently establish interoperability between the variety of systems, applications, data sources and devices that populate the diverse healthcare ecosystem of providers, payers, government agencies, labs and more. However, most of these IT departments don’t have adequate budgets, resources and bandwidth to make major investments in new technology while also maintaining expensive legacy systems and trying to manually consolidate their highly fragmented data silos. Instead, they remain mired in outdated application integration strategies based on traditional middleware solutions that require long and costly development cycles, making it impossible to satisfy the new and ever-changing regulations anytime soon.
There is a better way. Integration Platform as a Service (iPaaS) enables the rapid and economic integration of applications in cloud-to-cloud, cloud-to-on-premises, and on-premises-to-on-premises integration scenarios. Because iPaaS is offered as a service, similar to the way Software as a Service (SaaS) is delivered, the barrier to entry is dramatically lower and the shift from CAPEX to OPEX delivers predictable costs. And because the integration will work with existing applications, IT will be able to focus immediately on meeting the challenges of the most significant new regulations, such as meaningful use, accountable care and the ICD coding standard. Let’s examine these regulations for their application integration challenge and see how iPaaS can help.
Meaningful Use
Even as healthcare organizations work to digitize their medical and clinical records, the requirement for meaningful use of certified electronic health record technology (CEHRT) means that the use of patient records needs to directly benefit patients through greater portability across health and insurance systems. This in turn requires IT to establish new, complex processes for recording patient information as structured data and exchanging summary care records. Several system providers and consulting firms offer solutions designed to overcome the portability challenge, but their proprietary interfaces can be a significant downside. As a result, the healthcare industry has been slow to attain compliance with the “meaningful use” requirement for EHR technology.
Accountable Care
Accountable care organizations (ACOs), which are designed to dramatically improve patient services, come with a new payment model. Instead of direct payments for services rendered, ACOs get paid based on the overall health of a population within the boundary of a defined community. Actually receiving payment, however, requires the ACO to produce a new set of metrics that must be collected from multiple systems, including EHRs, the Physician Quality Reporting System (PQRS), a variety of legacy on-premises applications, and the many new cloud applications that health organizations are adopting. The data must then be rapidly integrated for analytics and measurement. If this integration can’t be done rapidly, securely, and at a relatively low cost, the ACO model simply won’t work.
