Why It’s Critical For Doctors To Customize Their EHR

If you ask doctors, you’ll hear that electronic health records (EHR) have been both the best thing and worst thing to happen to medicine in the past 40 years. Having real-time information at your fingertips is an incredible advancement, but it’s only helpful if you can see what you need to diagnose and treat your patient. Healthcare providers consistently state their frustration with the lack of consistent, accurate data within the EHR system.

Without accurate data in the patient’s chart, doctors struggle to provide accurate and appropriate care. That’s why clinics and hospitals need to go the extra mile and customize their records in the following ways:

Invest in consulting to configure software

It’s too much to ask of our healthcare providers for them to become IT and software experts. Accessing records of earlier care and making accurate diagnoses is dependent on doctors and providers’ ability to input and extract relevant information quickly.

Even a lively family physician practice needs assistance to set up and configure an electronic healthcare record system. Even with technical staff, it’s unrealistic to expect them to configure and customize a highly complex software system to suit a unique workflow. As organizations upgrade or adopt new technology, they are relying on artificial intelligence or a technical sales support representative to migrate data.

Data is only as good as the input

Without expert configuration and data migration, the accuracy of the data is in question. Patient records need to be correct, and it needs to appear in the right place in the record. Relying on a software program to migrate data accurately may preserve your data, but if it doesn’t populate the proper fields, it’s not useful.

Efficiency is key

With only 20 minutes to see each patient, the data needs to be more than accessible. Many small offices find it cost prohibitive to fully take advantage of the software system’s features and discover it’s even more challenging to configure and customize the software to meet its full potential. Although the cost is a prominent factor, the value of a properly configured and deployed EHR is priceless.

Hire a consultant

Setting up an electronic health record is a complex endeavor. Innovative software design makes it possible to customize fields, provide reporting, and give alerts. Used efficiently, an EHR can help doctors reach conclusions more quickly and show information in a way that leads to faster diagnoses.

If the EHR isn’t configured efficiently, or if the data isn’t captured in a way that providers can access and leverage it to make smart clinical decisions, it becomes more of a roadblock than a powerful tool. Apathetic software users create inaccurate or missing data.

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ABA and IT: The Best Strategy for Autism Spectrum Disorder

By Drs. Will Brandon, PhD., president and CEO of Learning ARTS, and Michael Harrington, PhD.

Dr. Will Brandon
Dr. Will Brandon

About one in 59 children has been identified with autism spectrum disorder (ASD), according to recent estimates from the Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring Network.

Though it is still unclear whether the difference is primarily due to increased incidence of such disorders or more accurate screening procedures, ASD has become a national priority. The demand placed on treatment service is outstripping availability. One organization, Learning A.R.T.S., is turning to information technology to meet this soaring demand.

Founded in 1994 and based in California, Learning A.R.T.S. has embraced applied behavior analysis (ABA) and its focus on in-home, one-on-one instruction to improve patients’ social and life skills. It has enjoyed rapid success expanding to 11 regional locations spread across the state.

Learning A.R.T.S. programs help teach patients skills—from tying shoes to writing résumés—and foster an information- and communication-rich environment. Initially, as the organization expanded its services, the challenges were to communicate and coordinate operations across geographically dispersed facilities and client locations using traditional paper and telephone-based communication.

Applied behavioral analysis and treatment programs involve Board Certified Behavior Analysts (BCBA), specialists, and technicians. Coordination between team members is central to success of ABA, placing a premium on the flow of information among them.

Increased demand has doubled the organization’s caseload, however. To meet this demand, Learning A.R.T.S. developed a new case management strategy driven largely by the adoption of an information management technology system by Laserfiche.

Previously, Learning A.R.T.S. dealt with volumes of paper forms and data records that needed to be authenticated, reviewed, duplicated, stored and retrieved. The organization now works with the same records in digital form stored in a central computer repository. This transition required the digitization of hundreds of thousands of existing paper records, and then training staff to work with the information in a new, digital format.

The effort resulted in seemingly endless opportunity to apply new technologies for information management that could not be applied to paper records. More importantly, those opportunities mean many more ASD children and families are getting the timely assistance they need.

For example, Learning A.R.T.S. field workers can now use mobile devices, such as tablets and smartphones, to gather and file patient information in real time, on location. The data is managed through digital workflow processes that eliminate reams of redundant paperwork, and can be stored in archives and accessed immediately through a central server. This translates into significant efficiencies in HR management of staff, accounting and billing, as well as in faster delivery of client services.

The organization has seen cost savings in terms of staff accounting, new employee onboarding, payroll and billing. But one benefit outweighs any monetary return: better patient care and more positive results.

Learning A.R.T.S. has found that response times are critical to successful treatment. ASD patients frequently act out in frustration, often becoming violent, which also can be emotionally draining for field staff. Treatment response involves not only accurate and timely communications, but also a considerable amount of orientation and training relevant to the technician’s functions.

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HL7 Announces New Board Members, Fellows and Volunteer of the Year Awards

Image result for hl7 logoHealth Level Seven (HL7) International, the global authority on interoperability of health information technology with members in 55 countries, announced election results for its board of directors at the 32nd Annual Plenary and Working Group Meeting in Baltimore, Maryland. The 2018 class of HL7 Fellows and the 2018 recipients of the W. Edward Hammond, Ph.D. volunteer of the year awards were also recognized at the event.

Incoming Board Chair

Walter Suarez, M.D., M.P.H., executive director, health IT strategy and policy, Kaiser Permanente, was selected by the membership to serve as the chair-elect in 2019 and as the board chair, 2020-2021.

HL7 Board Member Elections

Four members were elected to the HL7 board of directors for the 2019-2020 term:

2018 HL7 Fellows

The HL7 Fellow Award was presented to five individuals during HL7’s 32nd Annual Plenary and Working Group Meeting in Baltimore. The award was established to recognize HL7 members with at least 15 years of active membership as well as outstanding service, commitment and contributions to HL7. The 2018 recipients of the HL7 Fellowship Award include:

HL7 Volunteers of the Year

HL7 honored three members with the 22nd annual W. Edward Hammond, Ph.D. Volunteer of the Year Award. Established in 1997, the award is named after Dr. Ed Hammond, one of HL7’s most active volunteers and a founding member as well as past board chair. The award recognizes individuals who have made significant contributions to HL7’s success. The 2018 recipients include:

About the Volunteers:

Brett Marquard, has been a member of HL7 since 2008. Brett has held several positions throughout his 10-year tenure at the organization. For seven years, he co-chaired the HL7 Structured Documents Work Group. In addition, Marquard has served as the vice chair of the HL7 US Realm Steering Committee since 2016 and has chaired the newly established CDA Management Group since 2017. He is active in the effort to advance HL7 Fast Healthcare Interoperability Resources (FHIR®) and works with the ONC within the context of addressing their HL7 requests. Finally, Marquard been instrumental in the standards development process as the primary editor of the Consolidated CDA (C-CDA) and US FHIR Core implementation guides.

Ulrike Merrick, has been an active member of HL7 since 2008. She has served as a co-chair of the Orders and Observations Work Group since 2014 and was recently appointed to HL7’s newly established Version 2 Management Group. In addition, Merrick was elected to serve on the HL7 Technical Steering Committee beginning in January 2019 as the co-chair of the Administrative Steering Division. Much of her involvement in HL7 is focused on lab testing and reporting, and she has used her background in this area to engage the CDC in HL7 initiatives. Merrick has leveraged her broad network in the laboratory community to provide input from subject matter experts in relevant HL7 specifications, such as the HL7 Specimen Domain Analysis Model.

Bryn Rhodes, has participated in HL7 for several years and joined as a member in 2018. He serves as an interim co-chair of the Clinical Decision Support Work Group. Rhodes has also been involved in the efforts to extend HL7 FHIR into the clinical decision support and clinical quality measurement domains. He is the co-author of several HL7 specifications including the following: Clinical Quality Language (CQL), FHIRPath, FHIR Clinical Reasoning Module, QI Core/Quick and the CQL-based HQMF. In addition, Rhodes oversaw the transfer of the CMS electronic quality measure (eCQM) work using the CQL across multiple measure developers. Finally, he was instrumental in the Centers for Disease Control and Prevention (CDC) Adapting Clinical Guidelines for the Digital Age project’s incorporation of FHIR clinical reasoning and FHIR resources into the CDS L3 output and operationalizing the process by use in a CDC opioid management clinical guide.

Bringing Advanced Technology to Specialty Pharmacy

By Eric Sullivan, SVP, Inovalon.

Eric Sullivan
Eric Sullivan

Included amongst the segments of healthcare such as post-acute care that until recently had been mostly overlooked, specialty pharmacy now is in the spotlight as a key area of healthcare utilization and spend in the U.S.  Critical, expensive and often life-sustaining medications for high complexity disease states, as well as care management programs that help patients through their healthcare journey, are at the core, driving nearly $175 billion in drug spend for the 2 percent to 3 percent of the U.S. population considered medically complex. Specialty pharmacy operations typically involve a cross-functional staff of insurance experts, patient care coordinators, nurses and pharmacists that interact with patients and stakeholders to ensure therapeutic success in a historically fragmented, manual process-driven model.

Challenges in specialty pharmacy operations

As with many aspects of the healthcare system, specialty pharmacy operations are fraught with many pragmatic, economic, and clinical care challenges.

Operational, pragmatic challenges include:

These process challenges are creating an economic strain for the pharmaceutical industry, the payer, the provider, and most importantly the patient – where insurance benefit and funding source determinations often create confusion between overall coverage and patient out-of-pocket costs.  This is compounded by complex coordination of benefits, billing and payment processing of medical and pharmacy claims, as well as other sponsored funding sources.  Increasing patient cost share can make specialty drugs unaffordable for many patients which impacts medication adherence and ultimately patient outcomes.

The resulting clinical challenges make it difficult for critical patient care information to be easily shared (e.g. labs, patient assessments, medication profiles, side-effects, etc.).  Additionally, treatment objectives often overlap among specialty pharmacy channel providers, resulting in crossed communications and patient confusion.  In the end, key success metrics (both economic and clinical) are not easily measured, and often not operationally and clinically aligned.

The power of data accessibility and real-time analytics

Compressed specialty pharmacy margins require significant technology investment to offset operating costs and increasing service expectations.  Technological advances help to address several of these challenges and as a result drive improvement in patient care and satisfaction, lower operating costs and more informed clinical decision-making.

Several of these technological advances that are showing early evidence of changing the historical paradigm include:

Impact across the continuum

The application of advanced capabilities in connectivity and analytics in the specialty pharmacy space creates a more efficient system and a better result for all involved. Successful implementation of these technologies accelerates patients onto the most appropriate therapy, optimizes patient treatment plans and improves the overall patient experience which support medication adherence goals. It can also help establish innovative and more productive relationships between health plans, employers, providers, specialty pharmacies, pharmaceutical manufacturers and patients.

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Global IT Consulting Firms In Healthcare: In Search of the New Killer App

By Paddy Padmanabhan, healthcare growth strategist, Damo Consulting, and the author of The Big Unlock: Harnessing Data and Growing Digital Health Businesses in a Value-Based Care Era. 

Paddy Padmanabhan
Paddy Padmanabhan

Global IT consulting firms, especially those with an India heritage, have had a long run at high growth rates, fueled by one idea: Outsourcing information technology (IT) operations to countries with low labor costs and a skilled engineering talent pool with a strong English language proficiency offered a huge arbitrage opportunity. The Indian IT services industry monetized this idea with a single-minded focus over the past 25 years and is now estimated to be more than $150 billion. Over the past decade or so, many western multi-national firms, including end-user clients for these companies, have jumped on the labor arbitrage model.

My firm has been focusing on how global technology consulting firms have been doing in the healthcare markets, and reviewing their financial and operating performance since 2015. Our latest mid-year review of 11 publicly held global technology consulting firms indicates that organic growth from the healthcare vertical is trailing overall company growth for most consulting firms, and is slowing down relative to previous quarters. Three of the 11 firms we cover in our report have seen leadership exits for the healthcare business, and the Board of Directors of one high-profile firm is looking to replace its CEO. No major contract signing in healthcare has been reported by any of the firms.

Where is the whole sector headed next? No one knows for sure, but the labor arbitrage model is now surely past its sell-by date. The question therefore is: what’s the next killer app for global IT consulting firms ?

If one were to go by the term most-often used by these firms in earnings calls, annual reports, and marketing messages, it would seem that the new killer app goes by the all-encompassing name of “digital.”

However, unlike a clear concept like low cost labor, digital is much harder to understand. In much the same way as that other overused term – artificial intelligence or AI — the technology vendor market has whipped itself up into a frenzy of “digital” offerings, with each firm defining “digital” in its own way.

However, the global IT consulting firms, and in particular the India heritage firms, seem to discuss a common theme when referring to digital. They are mostly referring to automation when they say digital. These firms are betting on intelligent automation (IA) as the killer app for the future of their business model.

Consulting firm KPMG has released a report declaring that IA is fueling the next generation of outsourcing. As IT operations move to the cloud, automation targets the same IT operations that substituted high-cost labor pools a generation ago, and is eliminating the low-cost pools with even lower cost robots a.k.a robotic process automation or RPA. The implications are like a double-edged sword: Automation is a new revenue opportunity, but it is one that necessarily cannibalizes a current revenue opportunity. The implications reach far beyond the board rooms of multi-billion dollar tech firms, and raise questions about a low-cost labor-pool based model of IT services.

In other words, the killer app of tomorrow is killing the jobs of yesterday, a fact that the KPMG report delicately refers to as a “negative though not significant (at least in the near term) impact on the use of traditional outsourcing and shared services.” However, the Schumpeterian principle of creative destruction may be at play here, with an entirely new class of jobs and entirely new revenue opportunities on the horizon arising from the increasing savings and efficiencies brought about by automation.

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Health IT Startup: Datica

Image result for datica logoThe Datica platform manages all ongoing compliance and security burdens not covered by AWS and Microsoft Azure. Through the platform, customers deploy cloud-native applications and integrate with EHRs. The HITRUST CSF Certified Datica platform services all who handle PHI in the cloud, from startups to the Fortune 100.

Elevator Pitch

Datica removes the risks for digital health in the cloud.

Founders’ story

Travis Good, MD
Travis Good, MD

When CEO Travis Good, MD, and co-founder Mohan Balachandran, began solving healthcare’s universal hurdle in building applications in the cloud — HIPAA — the two entrepreneurs solved the problem. Along the way, they realized that other development companies had also been trying to solve the same problem. They thought: Why should any of us reinvent the wheel? With the compelling market need in front of them, they built their HIPAA-compliant platform and made it available to other development teams, and eventually enterprises. Knowing that trust, security, and compliance would remain the pillars to their platform, the founders sought certifications and audits through HITRUST, SOC 2, and GDPR to make the Datica Platform the most trusted foundation on which to build applications in the cloud.

Marketing/promotion strategy

Datica helps healthcare enterprises and digital health vendors accelerate innovation to improve healthcare through the use of its HIPAA compliant platform. We promote Datica to both market segments through outbound and inbound channels, direct outreach through webinars and local/national presentations around the company’s framework for digital health success, as well as through its podcast, quarterly reports, and executive speaking.

Market opportunity

The market opportunity for the Datica platform is extensive, touching all B2B healthcare stakeholders who store, manage and transmit personal health information in the cloud. Our target audience is 60/40 enterprise (healthcare providers, pharma, and payors), as well as digital health vendors. World-class companies like Johnson & Johnson, Zipnosis, Healthloop, Propeller Health, Methodist Le Bonheur, Stony Brook Medical, Optum and more, trust Datica to remove the risks of digital health in the cloud.

Who are your competitors?

Our largest competitors in the compliant cloud space aren’t other PaaS vendors but rather managed service solutions on one of the major IaaS vendors like Amazon’s AWS or Microsoft’s Azure. With Datica, developers can deploy application workloads to their Datica environment instead of directly to another IaaS to eliminate the burden of compliance. With the Datica Platform, a customer gets the benefits of AWS, Azure, or other infrastructures as the foundation of our platform, plus Datica automates all DevOps and DevSecOps requirements in the cloud. Developers can deploy services & workloads in minutes that are fully in compliance with HIPAA and HITRUST.

How your company differentiates itself from the competition and how Datica differs.

Datica differentiates itself in two ways. The first is through open source resources. Datica has a strong belief in open source resources as the fastest and best way to promote healthcare innovation. Datica open sourced its company policies and resources early in the company life. During HIMSS18, we also announced that the Datica platform now uses Kubernetes (an open source system for automating deployment) as its underlying container orchestration, granting customers greater technical flexibility.

Second, Datica stands apart from other PaaS competitors through its firm commitment to third-party audit and verification of the Platform’s trusted security. Datica is HIPAA compliant, HITRUST CSF Certified and has certifications for SOC 2, GDPR, and GxP.

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Recognizing Risks of Healthcare Technology

By Brooke Faulkner

There’s no question that the forward march of medical technology has improved personal and public health, creating lasting positive change for humanity. New technology, however, sometimes comes with risks. While those risks rarely outweigh the potential advantages, fully exploring and preparing for them is an important responsibility.

New Solutions Pose New Dangers

One demonstration of this relationship occurred as we were developing medical devices meant to be used inside the human body. Using medical devices internally presents the problem of contamination from external sources, and we learned that killing bacteria isn’t enough — specifically, we discovered that the endotoxins produced by dead bacteria can also be harmful.

That particular issue, we’ve already solved. It is, however, an excellent example of how new benefits can present dangers that we hadn’t contended with before: our ability to kill bacteria presented a new problem as our technology continued to improve, and we started putting medical devices inside the body. We realized that some types of dead bacteria are still dangerous, and that our sterilization standards had to improve.

This relationship between new advancements and new risks continues today, although it takes different forms. The hot-button issue these days has more to do with data and privacy, which while not directly health related, has significant risks when breached.

Healthcare Data Innovations and Breakthroughs

Our ability to collect, process, and draw conclusions from ever larger amounts of data has been a huge boon to the medical industry.

This method of tracking and categorizing physical assets, as well as patients, can be very useful in preventing serious accidents caused by miscommunication. Even life-threatening mistakes, such as wrong-site surgery, can be prevented by good data management. Timing, types, and amounts of medication can also be streamlined with this process, which could for example automatically sweep a database for potential adverse reactions or conflicts before a drug is prescribed to a patient.

On both a wide and individual scale, the applications of our improving data technology are saving lives and improving the quality of life of patients.

All this integration, however, comes with those pesky risks. Not nearly enough to warrant halting progress but enough to need heavy consideration.

Cybersecurity in Healthcare

The problem with health data is it’s often some of the most private and consequential data about human beings. That, unfortunately, makes it some of the most profitable to identity thieves, and even advertisers with few scruples. Healthcare data can be held to ransom, used for identity theft, or even insurance fraud. As DeVry University notes: “Your name, address, date of birth and Social Security number are all in one convenient location — ripe for stealing. Cybercriminals can take your private health information (PHI) and sell it for high prices. In fact, stolen medical records sell for 10 to 20 times more than stolen credit card numbers.”

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Great Resources For A Career in Medical Assisting

By Nate Marks, writer, Unitek College.

Without a doubt, medical assistants play a vital role in healthcare. Not only do they assist physicians and allow them to see more patients, but they also interface with various groups on a regular basis. More often than not, they are the first and last face a patient will see during their visit. If you have chosen this rewarding career, you might be in need of some great MA resources. After all, medical assistant training isn’t always enough to stay current.

Check out our handy list of organizations, blogs, and more:

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HIPAA: A Primer And A Reminder For Those In Healthcare

By Vikash Kumar, manager, Tatvasoft.

A relentless parade of fronts from communication to banking, shopping seems to be unfolded, all thanks to the emerging technology. But somehow healthcare used to stay behind because many of you believed it was too complicated to be fixed. Well, that’s just not true! Now, more than ever, technology has not just succeeded in improving the consumer experience but also has removed the unnecessary cost from the entire healthcare system.

In order to maintain standards of care and improved outcomes for patients, hospitals and medical centers, technology is providing ever-smarter ways like never before. Enacted by the U.S. Congress in 1996, HIPAA was introduced because of the increasing need to address growing technological changes and problems. According to the HIPAA Privacy rule, saving, accessing and sharing of medical and personal information is prohibited. Moreover, it specifically outlines national security standards to protect health data created, received, maintained or transmitted electronically (ePHI — electronic protected health information).

Apart from this, there are a few primary components one needs to be concerned with:

Privacy rules emphasize on what qualifies as PHI (protected health information) and who is mainly responsible for ensuring that nothing would get disclosed improperly. It includes covered entities ranging from health plans to health care clearinghouse, health care providers who have the right to transmit any health information electronically regarding the Department of Health and Human Services (HHS). Other than covered entities, privacy rules even encompass of business associates (anyone who stores, collects, maintains, or transmits protected information on behalf of a covered entity).

On the other hand, security rules relate specifically to electronic information and set guidelines for how to secure PHI. Administrative, physical and technical are the three main categories in which it is broken down. As the name implies, administrative revolves around access control and training, physical safeguards are for actual devices, and technical relates to the data itself.

HIPAA Breach Notification Rule is basically a set of standards that covered entities and business associates must follow in the event of a data breach containing PHI and ePHI. This rule, in particular, emphasizes on two kinds of breaches; minor breaches and meaningful breaches. As a result, organizations are required to report all type of breaches, regardless of size to HHS OCR, but the specific protocols for reporting change depending on the type of breach.

Omnibus Rule: This rule was enacted in order to apply HIPAA to business associates, in addition to covered entities. According to the rule, business associates must be HIPAA compliant.

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Healthcare’s Needed Overhaul Means Moving To Blockchain

By Karim Babay, CEO, HealthSapiens.

Karim Babay
Karim Babay

We can all agree the healthcare system in the United States is in dire need of an overhaul. Technological advances propel us into the twenty-first century, but the way data is created, maintained, and shared is archaic and confusing (and deliberately-so.) Instead of collaboration and transparency, healthcare is (in the eyes of many) a confusing minefield littered with smoke and mirrors.

Many people (even those with insurance) forgo treatment through choice or necessity–hoping things will get better–and instead end up in the emergency room. This adds bloat to an already-overtaxed, inefficient ecosystem, and patients end up footing the bill.

What does this have to do with blockchain? Well, blockchain thrives in an environment where lots of parties (who don’t trust each other) need to have consensus on the “correct” version of the truth. Broadly-speaking, blockchain helps integrate layers of trust and efficiency that have otherwise been missing in healthcare. It is essentially a distributed database that can’t be “gamed”, as any attempts by bad actors to change records to “bend the truth” are impractical and improbable.

Put another way: blockchain rewards desirable behavior (truth, accuracy, information flow), while helping to mitigate undesirable behavior (ex: lying, cheating, stealing.) Truth and accuracy breed possibility.

Imagine a world where every single ingredient inside every single pharmaceutical you take is traced from start to finish, so you know you’re not being poisoned, misled or ripped-off. Imagine having verifiable reviews from actual doctors based on verifiable outcomes to help you compare healthcare procedures and practitioners just like you would compare insurance or blenders.

Imagine being compensated for taking better care of your own health, or for securely-sharing your medical data to help advance research. All of this is possible with blockchain technology (and more.) Long-term, blockchain technology has tremendous potential when paired with technologies like artificial intelligence (AI), where meaningful healthcare research can be advanced, shedding new light on trends and unlocking a holistic, real-time picture of the global healthcare landscape.

With all its positives, blockchain isn’t itself a magic, one-size-fits-all solution to the many problems plaguing healthcare. However, what blockchain technology can do is provide a framework that opens up the secure flow of information between healthcare consumers, practitioners, and everyone else in between. Access to more and better information helps streamline inefficiencies, thus reducing costs and elevating the level of care that can be provided.

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