As someone passionate about patient engagement and using health IT and other technologies to improve care, I continue hear a great deal about how solutions can actually benefit population health. Even at the most recent HIMSS conference, “patient engagement” as a term clearly has become one of this year’s biggest buzz phrases.
Conference sessions were dedicated to the topic, vendors marketed their services to solving some of the issues associated with it and seemingly everyone in attendance had an opinion for what needs to be done or at least has some strategies for bringing more patients — or their data — directly into the care sphere.
Problem is, from my perspective, that, unfortunately, too much is still being said about population health and not nearly enough about individual health. In theory, I understand why this must be, but in practicality, I don’t understand the seemingly lack of attention individuals are receiving. Obviously, if population health outcomes improve then that must logically mean individual health outcomes are improving.
And while I understand that not everyone or every need can possibly be addressed, that doesn’t mean we shouldn’t be trying to fill those needs. The current conversations about improved population health remind me of a common business/life solution when addressing a major problem: How does one eat an elephant? One bite at a time. Likewise, it would seem the same approach could be taken to achieve improve population health outcomes: One individual patient at a time.
That said, I asked some folks within the health IT community how technology affects individual patient outcomes. Though some of the ideas here are still high level, perhaps they are a step in the right direction. Here are some of the responses I received:
What are the real-world benefits of electronic health records, for example, to a specific individual? To answer that question, let’s take a look at a fictional person we’ll call “Bill.” Bill is quite elderly and has a variety of age-related illnesses. He lives in Ohio, and decides spend the winter with his daughter in Florida.
Bill’s daughter, Susan, arranges for her father to be seen by a local specialist during his stay. Susan tries to get a voluminous paper file transferred from Ohio to the new doctor in Florida, but there are delays: phone messages are missed, handwriting is misread, and no one has time to copy and mail 100 pages of medical records.
In the end, Susan is unable to get her father’s records transferred in time for the appointment with the new physician. As a result, an unnecessary test is performed, and a drug is prescribed that had caused an allergic reaction in the past.
In the future, EHRs will enable the Florida clinic to have electronic access to the same records available in Ohio. Already, Medicare and some commercial carriers have websites that list physician visits, patient complaints, diagnoses made, lab/diagnostic tests performed, and drugs prescribed. Eventually, such websites may include a full medical profile, including doctor’s notes, lab results, x-ray images and more.
Dean Wiech, managing director of Tools4ever, a global provider of identity and access management solutions, has worked in healthcare for more than 25 years. Here, he discusses how IAM enhances the ROI for health systems, and how the solutions make patient care more efficient, how they work in healthcare, and how systems and records can be made more secure — for patients and providers — because of the technology.
Tell me about yourself and your experience in healthcare.
I have been actively selling software solutions in the healthcare market for 25 years. I have sold and/or managed teams in about 50 percent of the country. I have always focused on solutions that provided a definable ROI based on productivity and time savings.
Tell me about Tools4ever. How does the company serve the space? Tell me about your products and how they are used in healthcare.
Tools4ever is a company that focuses on the identity and access governance space. We assist the healthcare market in insuring that the lifecycle of user accounts are managed in a timely and accurate manner. We also have solutions that save care providers time by eliminating repetitive login tasks and avoiding the need to call the help desk for password resets
How is Tools4ever different than some of the competitors in your space?
I believe our primary differentiator is time to implement. We can get the basics up in running in a few days to a few weeks, depending on the solution. The majority of our competitors take months to years to complete an install. The result is the healthcare organization can realize a much quicker benefit from the product and a quicker ROI.
What’s your footprint like in healthcare and who are some of the organizations you work with? How do you help them?
We have numerous hospitals and long-term care providers across the country. One example is South County Hospital in Rhode Island. It utilizes our Self Service Reset Password Management (SSRPM) solution to allow end users to reset forgotten network passwords. We then synchronize that password to several other solutions to allow a reduction in the number of credentials the employee needs to remember.
Another example is a major university hospital in New York City. It uses our user management solution for several tasks. The most recent example is provisioning patients to the network to allow them to view their records on a mobile device provided by the hospital for the duration of their stay. We also implemented a password self-service reset function to allow the patients to reset their passwords without a further burden on the help desk.
The image provides a pretty concise view on some of the prevailing thoughts on the use of consumer’s mobile technology and how perceptions of the technology might potentially improve patient outcomes.
Not surprising, one third of smart phone users look up health information on their devices via the web. Most surprising to me, though, is that according to the graphic, 25 percent of low-income adults own a smartphone; I shouldn’t be surprised given people’s passion for the latest devices. Hopefully, though, this will help improve their care and outcomes, individuals who, of course, would likely fall into the class of people most likely needing care but not receiving it or receiving it through non-traditional means.
If nothing else, as Aetna suggests through the image is that technology and personal devices may allow greater access to care and to information to improve care.
Such technology, and its use, is clearly the future of individual care and actionable outcomes for individuals. I only wonder what it will take to harness and implement real programs that help real people received sustainable care and guidance at the individual level, and how long it will take to become wide spread
Patient-centered healthcare technology is putting the power of good health into patients’ hands. All of the changes in American healthcare regulations point to one top priority, and that’s patient centered care. Why does this matter? Because patients who are empowered to manage their own health are more likely to be proactive and, theoretically, therefore healthier.
Knowledge in the world of healthcare can be a great thing, and the technology community is responding with thousands of apps and other healthcare IT initiatives, such as activity tracking devices and websites designed to help consumers keep close track of their wellness.
Researchers at the Mayo Clinic provided FitBits to 149 post-surgical heart patients. The researchers determined that using the FitBit to monitor mobility wirelessly was “easy and practical, and led to a significant relationship between the number of steps taken in the early recovery period, length of stay and dismissal disposition. The research indicates that an activity monitor such as a FitBit could positively affect post-discharge outcomes by empowering patients to take their recovery into their own hands. Better discharge outcomes leads to lower costs in the long run. This is just one example of many.
Received the following study recently that is quite interesting; thought it worthy of sharing:
Emergency department physicians are less likely to admit patients to the hospital when they have readily available electronic access to those patients’ health records, Weill Cornell Medical College researchers have found.
Its study, published March 12 in Applied Clinical Informatics, illustrates the value of combining multiple providers’ digital patient charts into a single source for health care providers – particularly in an urgent setting like the emergency department. With information such as previous test results, prescriptions and other patient history immediately accessible, providers are able to treat patients more efficiently and effectively than when they lack that data.
“New York State has made significant investments in health information exchange,” said Dr. Joshua Vest, an assistant professor at Weill Cornell and the lead author on the study. “Our study shows that providing physicians, nurses and allied health care professionals such as physician assistants real-time access to community-wide, longitudinal health records does in fact benefit patients.”
With federal and New York State government backing, hospitals and medical practices across the state are investing millions of dollars to make health records sharable among physicians when they need the information. The digitized charts contain doctors’ notes from every patient visit; family medical history; immunization records; lab results; medication history; allergies; reminders for preventative care and more.
Billed as “a dynamic conversation exploring the burning issues in healthcare IT and how they will drive transformation in the year ahead,” Dell’s most recent think tank event titled, “At the Crossroads: Technology and Transformation in Healthcare,” is, if nothing else, an interesting, and pretty decent, conversation about some of the biggest issues currently facing health IT.
Featuring some of the usual health IT thought leader suspects — including John Lynn, Brian Ahier, Shahid Shah and Dr. Wen Dombroski, among others — the roundtable discussion provides a good deal of insight; some of it very high-level and forward-thinking and some of it table stakes.
Patient engagement continues to be a hot topic, as well as healthcare analytics, data and using it to improve quality and outcomes. Nice to finally see conversations focusing on the individual and not just the population; something I’ve long hoped for and tried to push when I worked on the vendor side of things. Like many of the thoughts expressed at the event, however, we may still be a long way off from actually realizing that goal and that’s a shame for all of us.
I must admit, though, that it’s nice to hear a lot of conversation around the fact that EHRs are finally reaching the point that they’re foundational and not the next big thing — that’s become a tired conversation. Foundational technology yes, but like many of the panelists expressed, it’s time we move beyond talking about them as silos and rather how EHRs will help to improve care through the care sphere.
If you have some time, these videos are worth taking a look at. You can view them here, or below.
As expected, M*Modal has filed for bankruptcy protection. Here’s the release from the company announcing the news:
M*Modal, a leading provider of cloud-based clinical documentation and Speech Understanding solutions, today announced it has filed voluntary petitions for relief under Chapter 11 of the United States Bankruptcy Code in the U.S. Bankruptcy Court for the Southern District of New York. M*Modal expects to use the Chapter 11 process to align the Company’s debt structure with its vision, strategy and operations to better position the Company for long-term success. The Company has been – and remains – in constructive discussions with its lenders and bondholders regarding the terms of a consensual financial restructuring plan and is focused on achieving a resolution as expeditiously as possible. M*Modal’s worldwide operations are expected to continue in the normal course throughout the restructuring process.
Duncan James, M*Modal’s Chief Executive Officer, said, “When M*Modal was taken private in 2012, the acquisition was financed with a capital structure aligned with a specific set of assumptions that are no longer relevant. As a result, there is a need to restructure the company’s balance sheet to better align with changing market dynamics and refinements to our strategy. We intend to use the Court process to significantly strengthen M*Modal’s balance sheet and improve the company’s financial flexibility by reducing our debt burden and establishing a capital structure that supports our investment in the future.”
James continued, “Throughout this process we are not changing our operational execution or strategy, and our operations will continue as normal. Importantly, we will continue what we are known for: providing innovative technologies and offering healthcare providers a superior choice when selecting their clinical documentation and speech understanding technology partner. M*Modal has solid revenue, strong operating margins, cash flows consistent with industry norms, a large and growing customer base, and we are continuing to invest in the future. We intend to emerge with a strong financial footing so we can continue growing our market share and delivering innovative solutions to our customers.”
The company expects that its cash on hand, combined with funds generated from ongoing operations, will provide sufficient liquidity to continue operating in the ordinary course throughout this process.
Dechert LLP is serving as legal counsel, Lazard Frères & Co. L.L.C. is serving as investment banker, and Alvarez & Marsal is serving as financial advisor to M*Modal.
About M*Modal
M*Modal is a leading healthcare technology provider of advanced clinical documentation solutions, enabling hospitals and physicians to enrich the content of patient electronic health records (EHR) or electronic medical records (EMR) for improved healthcare and comprehensive billing integrity. As one of the largest clinical transcription service provider in the U.S., with a global network of medical editors, M*Modal also provides advanced cloud-based Speech Understanding™ technology and data analytics that enable physicians and clinicians to include the context of their patient narratives into electronic health records in a single step, further enhancing their productivity and the cost-saving efficiency and quality of patient care at the point of care. For more information, please visit www.mmodal.com, Twitter, Facebook and YouTube.
The American College of Emergency Physicians (ACEP) and Florida College of Emergency Physicians (FCEP) have sent a formal response to Marilyn Tavenner, the Administrator and Chief Operating Officer of the Centers for Medicare & Medicaid Services (CMS), supporting CMS’ planned hearing to address Florida’s restriction of emergency department use to six visits per year for Medicaid beneficiaries which ACEP asserts is a violation of the prudent layperson standard. ACEP calls the hearing notice “a welcome commitment of federal oversight of beneficiary protections.”
Alex Rosenau, DO, FACEP, president of ACEP, and Michael Lozano, president of FCEP, issued a statement:
“Florida’s action is a violation of the prudent layperson standard that may result in serious and potentially deadly outcomes. Its use of the six-visit limit is yet another example of states using short-sighted approaches to saving money that can hurt the very people they are supposed to protect. As CMS itself has stated, Medicaid beneficiaries use the emergency department at an almost two-fold higher rate than the privately insured, but that is not inappropriate given their generally poorer health. At least two studies found that the majority of emergency visits by non-elderly Medicaid patients were for symptoms suggestive of urgent or emergent medical problems.
Received the following study recently that is quite interesting; thought it worthy of sharing: