Healthcare Data Is Bigger Than You Think

By Chris Astle, CEO, QSR International.

Chris Astle
Chris Astle

Data has been regarded as the new, shiny object in every industry for the last several years—the secret key to all your unanswered questions. The healthcare industry has been no stranger to this language, but has not had as much opportunity to put data to use as other industries. With fast-paced, “ready for anything” schedules, hospitals, EMTs and private practices have had to leave data analysis to the researchers.

A 2017 Bankrate survey found that one in four Americans do not seek medical care when they need it. The survey results cite cost as the main reason for this. While healthcare providers cannot control insurance coverage and healthcare legislature, they can control the experience patients have when they seek care. A patient is much more likely to return for an annual check-up or seek medical care when sick if they hold healthcare to be positive and important. By giving patients the chance to voice their opinion, to feel heard and capturing and analyzing this powerful data, you will create a positive atmosphere. This will then lead to things like patient retention and positive online reviews.

With technology ever advancing, data analysis is simplifying. It is becoming something that a person with no research experience can do and find benefit. Take, for example, open-ended survey analysis software. Most data software analyzes the quantitative or number-based data. This includes the numerical details that you gather like a patient’s vitals. Data is much more than that. Imagine being able to analyze not only quantitative data, but qualitative too, including things like open-ended answers. This opens the possibility to hear directly from patients, doctors, and nurses, not only to better customer service, but importantly, care.

Mixed-question surveys provide health practitioners a simple way to gain new insights. Have patients answer a few questions through your medical portal or while at your office that ask basic questions like, “Rate your experience,” and, “How likely are you to recommend our practice to others?” But do not feel restricted by these types of questions, there is much more to learn beyond whether someone has had a generally good or bad experience. Ask them why. Ask for suggestions of how to improve care. Ask patients to describe their symptoms or the side effects of their medication. Each answer becomes part of a data set that you can analyze and cross-examine to give you new ideas and findings, and contribute to providing a higher standard of care for patients.

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How To Improve Your Healthcare Organization’s Business Intelligence

By Jim Buckheit, consultant, Freed Associates.

As healthcare organizations pursue improvements in productivity and clinical outcomes, they are also increasingly turning to business intelligence (BI) systems and staff to provide the data and tools needed to achieve and sustain such gains. The problem is, many organizations’ BI teams – tasked with a myriad of urgent and competing internal demands – often lack the experience, bandwidth and/or big-picture strategic and analytical skills needed to adequately respond to their organizations’ heightened needs.

That was the dilemma faced by a health maintenance organization (HMO) that had doubled its membership and found its BI team ill-equipped to respond to its growing technology needs. The HMO’s experience in recognizing and addressing its BI issues provides a template that other organizations can follow when confronted with similarly pressing BI demands.

The Four R’s of Quality BI Performance

The greatest positive emerging from the HMO’s BI issues was a wholesale reassessment of its BI team’s role, responsibilities, responsiveness and resources. You can call these the four fundamental R’s of well-functioning BI team performance:

Role – Rather than being focused on “doing,” a well-functioning BI team should also consider itself to be a vital strategic partner in the health care organization’s business. Attitudinally and functionally, a BI team needs to operate as a key part of the organization’s business team.

The HMO installed a new BI leader who immediately focused on mentoring and developing existing staff, overseeing and assisting with business analysis and reporting functions and defining a strategic path for the team to meet the HMO’s organizational strategy. This leadership change quickly stabilized the BI team’s performance and enhanced its ability to more effectively respond to internal requests. Your BI team’s leadership should be capable of achieving similar performance.

Responsibilities – Instead of simply being “order-takers” and “project fulfillers,” well-functioning BI team members should be high-quality strategic and process partners with internal clients. Creating and having in place service level agreements (SLAs) between a BI team and its business clients is crucial for establishing expectations for timing, deliverables and process improvement measurement.

For the HMO, the BI team’s new SLAs defined responsibilities for each business team member involved in project requests, performance objectives, documentation and sign-off requirements at milestones. The SLAs also provided project quality measurement standards, project success definitions and internal satisfaction reporting. Do your SLAs provide similar levels of accountability and clarity?

Responsiveness – Delays in responsiveness to client requests are not only inappropriate, they detract from a BI team’s professionalism. Established operational guidelines should delineate proper responsiveness for members of your BI team.

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Quality Engineering: The Challenges of Digital Transformation in Healthcare

Guest post by Manish Mathuria, CTO and co-founder, Infostretch.

Manish Mathuria
Manish Mathuria

Digital transformation means different things to different industries. On the consumer front, Amazon didn’t even have to transform itself, because it was born in the digital age. On the other hand, for pharmaceutical and medical device manufacturers, much of their innovation is heavily dependent on the move from a physical, analog world to a digital world.

This brave new digital world is fraught with perils, partly because of the necessary regulation, and partly because many digital advances represent new ground, so there may be no precedent for assuring product quality (which in this example translates to patient safety). Indeed, topping the complexities facing many healthcare companies is the fact that they are operating in a regulated environment, both in the U.S. and globally. The U.S. FDA and other regulatory agencies worldwide require them to maintain strict vigilance on the testing of products, while at the same time they want to be doing rapid development.

Take LifeScan, for example, an operation of Johnson and Johnson. With a long history in the medical devices field, its blood glucose monitoring (BGM) line is one of the most-prescribed brands in the industry. LifeScan is taking the conventional BGM device full-bore into the digital era, with a concentration on mobile. As you might expect. their market is growing at a healthy rate (much as diabetes is growing at an “unhealthy rate”), and they face competition both from established companies and innovative newcomers, notes Ed Hein, Manager – Digital Verification and Validation at LifeScan.

LifeScan is enabling patients to track their blood glucose readings on their mobile devices and online; their healthcare providers and health management companies can access their data via API interfaces. This provides faster access to the data and more accurate tracking and trending. Being able to present that data to the patients, their providers and loved ones more accurately lets them live a normal life.

Like other companies in the healthcare field, LifeScan’s competitive advantage and market position was strengthened by its ability to accelerate cycle time to get new software-based capabilities to market faster and more efficiently. This meant changing its software testing approach from traditional –often manual– Quality Assurance (QA) to a more proactive Quality Engineering (QE) process that integrates software testing and development and leverages automation.

This transition has been common in some industries but is rather new in healthcare. The good news is that it is driving innovation and, because of more efficient and effective testing processes, accelerating product approvals (READ: time to market).

By integrating QA more tightly with the development process, LifeScan has also been able to integrate its organizational structure as well. This has provided additional visibility to additional opportunities to accelerate the development lifecycle.

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How AI Can Help Improve Healthcare Efficiency

The healthcare sector is hopeful for the future, as innovations in the IT sector will continue to provide opportunities to improve the deliverability of crucial services. One thing’s for sure, more and more companies will continue to realize just how big of an impact HITs can bring, and the situation alone is urging companies to invest more on new software and technologies — even as these innovations are still in the works.

Several key innovations in this area, such as 3D printing and artificial organs, are still being tested and developed. It would take time before these breakthroughs can penetrate the market. What’s important, meanwhile, is the fact that AI will continue to drive technological adoption in the healthcare industry.

As technological tools have become increasingly sophisticated, the demands for these tools are also becoming more complex. Still, organizations are in the right when they invest a huge bulk of their resources in AI-based solutions. Apparently, they know all too well that these products are capable of improving the delivery of care and other services.

They help healthcare providers to thrive

End users will certainly reap the benefits that AI entails. If anything, effective software and IT products are being sought by businesses that want to get the most out of their investments. Analytics plays an important role in maintaining the efficiency of an organization, whether it involves using organizational psychology to retain productive employees or managing the workflow of hospital staff.

One thing that makes HITs relevant is the fact that they lighten the workload and that they simplify complex processes. With the use of AI, healthcare organizations can accelerate their services without compromising quality. This would allow healthcare managers to focus on exploring ideas for expanding their bottom lines.

They help in patient outreach

A key trend in HIT is the rise of AI virtual assistants. Doctors normally have their hands full engaging patients with unique histories — considering this, there will always be room for error. This technology can help by automating the way they handle individual cases.

In this case, using automated VAs to organize patient data and notify patients about their appointment schedules and regular medication can ultimately lessen the amount of work doctors will have to handle. As VAs are being developed to become more intelligent and predictive, these innovations will certainly provide ample opportunities to forge stronger patient links.

They make accuracy central

Human error is natural. We are basically prone to make mistakes. But in the healthcare industry, errors can sometimes cost you money or, even worse, a patient’s life.

Indeed, new technologies in the field of diagnostics are helping organizations to identify and analyze diseases more accurately. This, in turn, can help doctors to make the proper prescriptions and suggest the right treatment plans.

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The Future of 3D Printing and Health Data

By Brooke Faulkner

Brooke Faulkner

Medical innovators can’t come up with ways to implement 3D printing into categories of healthcare fast enough. With so many practical applications, 3D printing is quickly becoming a technology realized for its untapped potential and seemingly limitless possibility to transform healthcare.

3D printing alone has many applications across a wide range of industries — for one example, advancements in health data are benefiting nursing and patient care. As 3D printing continues to be combined with the innovations in health data, it will further revolutionize patient care, lower healthcare costs, expand the field of nursing, and improve modern medicine as we know it. How will 3D printing and health data do this?

Below is an extensive look at how innovations in health data are changing healthcare fields, and how 3D printing will further reform these sectors, allowing for advancements in both medical practice and patient care.

Home Healthcare

Home healthcare benefits patients who would like personal care in the comfort of their own home. Elderly and disabled patients don’t have to travel to have minor care done, and patients who have such diseases as HIV and are worried about discrimination or bias can have their privacy. Home-based care allows for specialized care for the patient, rehabilitation, and the close monitoring of vital signs for health and wellness, without the trouble of an in-person office visit. This convenient transfer of data through new technology makes it increasingly easier for caregivers, whether it be family members or professionals, to care for patients on their terms.

Telemedicine

ASU reports, “75.2 percent of nurses agree that telemedicine makes their job easier.” Telemedicine is another sector of healthcare made possible by the accessibility of telecommunication technologies such as videoconferencing. Through videoconferencing, a professional is able to listen to a patient’s concerns and diagnose illness or injury from a remote location. This gives the patient another level of privacy and both parties freedom and independence. Telemedicine cuts healthcare costs, as a physician doesn’t need to physically travel to a patient every time a minor checkup is needed.

EHRs and CPOEs

Electronic health records, or EHRs, are just that: electronic patient health documents that provide real-time information. Medical history, treatments, and diagnoses can be constantly updated along with other details such as allergies and current medications. An infographic by Duquesne University highlights the increased reliance on EHRs while illustrating patient data in the age of technology.

CPOEs, or computerized provider/physician order entries, are a better way to order medication and control the dosage and frequency at which the medication is administered. This efficient method of ordering pharmaceuticals reduces error and abuse, and therefore diminishes illness and injury. As Scott Rupp writes, CPOEs are “foundational for meaningful use. Make sure it’s easy to use and intuitive.”

Involvement of 3D Printing

In its infant stages, 3D printing is being utilized to make hearing aids, prosthesis, skin for burn victim patients, heart and airway splints, and much more. Showing potential for almost every aspect of healthcare, 3D printing, combined with the innovations in health data above, will transform these fields for even more accessible, affordable, and convenient healthcare.

3D printing can be applied to home health care, telecommunications, EHRs and CPOE in a number of ways. A professional can diagnose the atrophy of a leg, order the rehabilitation of walking, 3D print a prosthetic, and monitor the progress all while a patient is at home. In another instance, home healthcare and telemedicine can diagnose that a patient is ill, EHRs and CPOEs will allow for a better determination of what medication to order, and 3D printing can be used to print the medication for a patient

More accessible healthcare means more easily affordable healthcare, and with the involvement of 3D printing home-based care, telemedicine, EHRs, and CPOEs, healthcare will be transformed and turned on its ear. Patients who desire privacy, or are not mobile, will be able to get the care they need at home, while professionals will be able to stay in the office to help people with more immediate and urgent matters.

As mentioned above, 3D printing is in its infancy stages for many of these processes. An argument can be made that 3D printing will make home care, telemedicine, EHRs, and CPOEs more expensive — and that’s true, but only for now. As 3D printing becomes more of a norm in the medical field, and it will with its promising applications, the cost will decrease. As 3D printing becomes a normal process in these fields, it will increase patient care and make healthcare more accessible and more easily affordable.

EHRs Haven’t Necessarily Reduced Paper (Yet), And What Needs to Be Done About It

Guest post by Chris Click, senior healthcare solutions manager, Nuance (Imaging Division).

Chris Click
Chris Click

Many hospitals and healthcare organizations say they’re committed to moving to a paperless or paper-light environment. Greater document digitization is key to a more seamless flow of information within the healthcare enterprise, increasing worker productivity and reducing costs while also enhancing patient data security and ultimately improving quality of care.

Electronic health records (EHRs) are viewed as a foundational component of this strategy. In 2016, more than 95 percent of all eligible and critical access hospitals demonstrated meaningful use of certified health IT including EHRs, according to Health IT Dashboard. The conventional wisdom would lead some to expect subsequent decline in paper usage, but quite the opposite is happening.

Studies have shown that despite the growing adoption of EHRs and other digital technologies, paper in the healthcare enterprise remains prevalent – and is even growing. Experts say hospitals are seeing as much as an 11 percent increase in their annual print volumes driven by the Meaningful Use program, the Affordable Care Act, ICD-10, and the adoption of electronic record-keeping.

Why is this happening? Sometimes we find that physicians to not yet fully trust EHRs. Approximately 27 percent of a doctor’s time is spent with patients, the rest being spent on office work, documentation and EHRs – a common source of physician frustration. Also, disjointed processes of gathering paper-based information from a variety of points within a facility lead to delays in uploading this information to the EHR – leading to physicians keeping copies of patient files on hand.

EHRs alone are not enough to decrease the mountains of paper in hospitals and healthcare facilities. Organizations should consider augmenting EHRs with the following capabilities:

Integrated Document Workflows

Even healthcare organizations that have achieved late-stage meaningful use continue to print and process high volumes of paper for assorted reasons – from patient admissions and discharge, to belongings and consent forms, to prescriptions and pharmacy records. The benefits of EHRs can only be achieved insofar as they are integrated with digitally-based document workflows – the series of electronic steps by which a process is executed.

Consider physicians submitting prescriptions to pharmacies. When the EHR is directly integrated into this process, it can be automatically flagged if the patient is on another medication or has an existing condition which could cause an adverse reaction. If the EHR is not integrated, the entire process is disjointed and not as seamless and safe as possible. Or, consider the discharge process – when the EHR is integrated, discharging physicians have immediate access to patient files and charts – negating the need to print this information. Furthermore, studies show that “hybrid” paper-electronic workflows are ripe for error.

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How Health Policy Played a Role in the Recent Spate of Mega-Mergers Involving National Health Plans

By Ken Perez, vice president of healthcare policy, Omnicell, Inc.

Ken Perez
Ken Perez

“If at first you don’t succeed, try, try again.”

During the first half of 2017, two mergers, each pairing national health plans—Aetna with Humana and Anthem with Cigna, respectively—were blocked by two federal judges, both of whom concluded that the mergers would reduce competition in the health insurance market and, therefore, raise prices.

Departing from the horizontal merger approach, three national health insurers are now involved in proposed or possible vertical mergers. CVS Health announced its intent to acquire Aetna in December 2017; Cigna announced its plan to acquire pharmacy benefits manager Express Scripts in March 2018; and Walmart is reportedly in acquisition talks with Humana. Because of their size, the interesting value delivery chains they would create, and potential synergies, these corporate combinations have been described as disruptive and industry game-changers.

From a health policy standpoint, what has contributed to these mega-mergers?

First, the specter of a single-payer healthcare system—as most ardently promoted by Sen. Bernie Sanders (I-Vt.)—has been greatly diminished by the election of Republican Donald Trump as president in 2016, continued Republican majorities in both the House of Representatives and the Senate, and perhaps most saliently, the passage of the Tax Cuts and Jobs Act of 2017 (TCJA) in December 2017.

It is a truism in Washington, D.C. that taking back something that has been given to the public is hard, if not impossible. Since a single-payer healthcare system would clearly entail a major expansion of the federal government that would require not only the repeal of the TCJA’s tax breaks for individuals and corporations, but also the imposition of additional tax increases, it would appear to be a political impossibility for at least until 2021.

Second, Medicare Advantage (MA), Medicare’s managed care program, increasingly is where the action is for health plans. Congressional Republicans strongly support MA, and the program is gaining in popularity with Medicare beneficiaries. The Centers for Medicare and Medicaid Services projects that 20.4 million people will enroll in MA for 2018, an increase of 9 percent over 2017, about three times faster than the growth of the total Medicare enrollee population. More than a third (34 percent) of Medicare beneficiaries are enrolled in MA.

The proposed mega-mergers involving Aetna, Cigna and Humana secure control of significant shares of the Medicare population, including sizable shares of the MA enrollee pie.

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Health IT Startup: Fit4D

Fit4DWith a mission to improve the lives of people living with diabetes and chronic conditions worldwide, Fit4D delivers scalable and effective programs through an optimized mix of technology human-based interactions.

Founder’s story:

David G. Weingard
David G. Weingard

At just 36 years old, David Weingard was diagnosed with Type 1 diabetes. With no family history of diabetes, he was confused and overwhelmed about the diagnosis. He had two sessions with his doctor on how to use insulin and that was it. Having received limited support and education on his diagnosis, Weingard was left to manage his diabetes on his own and needed help.

He then found Cecilia, a certified diabetes educator (CDE), who compassionately gave him the correct steps to follow to help him become productive again, personally and professionally. Cecilia sparked an idea for Weingard – to scale the personalized coaching he received, to millions of people living with diabetes, but using a technology platform. With the daily vigilance and management of his diabetes, he left his corporate job and founded Fit4D.

Market opportunity

Fit4D has established business partnerships with clients that include major health plans and providers such as Humana, HealthFirst and several Blue Cross Blue Shield plans, along with major pharmaceutical and medical device companies. The company delivers scalable and cost-effective diabetes management programs through an optimized mix of human-based touch points and technology to deliver measurable outcomes in an affordable manner.

Fit4D is driving improvements in diabetes outcomes across the socio-economic spectrum, achieving a relatively high enrollment rate, lowering blood sugar levels, and delivering significant cost-savings and ROI for clients.

Results include:

Who are your competitors?

Fit4D is unique in that we scale and deliver personalized one-on-one support through the optimization of human touch and technology. There are other companies in the market that are combining patient healthcare services with a heavy focus on technology, such as Livongo and Omada; however, they don’t offer a personalized patient approach to diabetes. Fit4D emphasis on combining human touch with a dedicated CDE throughout the length of the program, allowing the patient to build a strong fruitful coaching relationship. As a result, our service is highly valued for the likes of payers, providers, pharma and medical device companies.

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Lessons from HIMSS 2018: The Need for Cloud, “Killer Apps” and Connectivity, But Are They Already Here?

By Donald Voltz, MD, Aultman Hospital, department of anesthesiology, medical director of the main operating room, assistant professor of anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.

Dr. Donald Voltz
Dr. Donald Voltz

In his HIMSS keynote address, Alphabet’s former executive chairman and now current technical advisor Eric Schmidt warned attendees that the “future of healthcare lies in the need for killer apps.” But he also cautioned that the transition to a better digitally connected health future isn’t just one killer app, but a system of apps working together in the cloud.  He also advocated transforming the massive amount of data held in EHRs into information and knowledge.

Schmidt is correct in his assessments.  There is a need for interoperable “killer apps” for new health IT priorities and procedures. The apps need to deliver better patient outcomes by integrating and optimizing patient data while driving healthcare facility financial incentives such identifying cost savings and streamlining insurer payments. These types of needs are accelerating convergence in the health care sector for interoperability across clinical, financial, and operational systems, not simply EHR connectivity.

One of the cloud “killer apps” that is a strategic component of convergence and hospital growth are Annual Wellness Visits (AWVs). First introduced by private insurers and then by CMS in 2011 as part of its preventative care initiative under the Affordable Care Act (ACA), AWV’s are designed specifically to address health risks and encourage evidence-based preventive care in aging adults.

The typical visit requires a doctor or other clinician to run through a list of tasks like screening for dementia and depression, discussing care preferences at the end of life, asking patients if they can cook and clean independently and are otherwise safe at home. Little is required in the way of a physical exam beyond checking vision, weight, and blood pressure.

On its own merit, some could argue that while this app can greatly contribute to better patient care, it does not significantly impact hospital and clinic growth, but when integrated with other apps, it becomes a key healthcare growth catalyst with its treasure trove of patient data. That data, when streamlined, can enable expedited payments to government and private insurers, help lay the foundation for AI and other knowledge initiatives as cited by Schmidt.

Chronic Care Continuum App     

Another “killer app” is the care continuum integration of treatment for chronic diseases ranging from diabetes to dementia and behavioral and mental health issues such as the U.S. opioid epidemic, heroin addiction, alcoholism and suicide. The ECRI Institute released its “Top 10 Patient Safety Concerns for Healthcare Organizations” in March 2018 and cited the management of behavioral health needs in acute care settings as the 6th highest ranked safety concern.

“Organizations should consider working with other partners, such as psychiatrists, behavioral health treatment programs, clinics, medical schools and teaching programs, and law enforcement,” says Nancy Napolitano, patient safety analyst and consultant, ECRI Institute. “Being able to communicate remotely and seamlessly, assessing risk and complexity, as well as delivering high-quality connected care are critical. Relationships and partnerships are what get you what you need.”

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Infographic: HIPAA Healthcare Data Breaches – Looking back at 2017

By Manisha Kathooria

Over the past 5 years, healthcare data has fallen prey to unethical attacks that compromise sensitive patient information. If you look back at 2015, it was the worst year in healthcare data security when data breaches hit an all-time high by affecting 113 million individuals approximately.

As of today, the number of breaches reported to the Office for Civil Rights (U.S. Department of Health and Human Services) has been consistently increasing. Also, the number of individuals affected does not seem to improve despite regulatory enforcement procedures and laws drafted to put a check on this.

This infographic by Kays Harbor establishes a comparative analysis and infers how data breach patterns have evolved in all these years up to 2017. It highlights the following major findings:

  1. HIPAA data breaches reported in 2017 were more than double the number of breaches in 2016. Though, the individuals that are estimated to be affected by these breaches was much less than the past four years.
  2. Healthcare providers again made it to the top of the list for reporting 231 data breaches – highest in all these years.
  3. Information technology continues to be a major reason for these breaches so far, showing an upward trend in contribution of hacking and IT incidents resulting in data loss.
  4. Kentucky based healthcare organization, Commonwealth Health Corporation reportedly filed a breach confirmation related to theft affecting 697,800 individuals.
  5. While Texas reported maximum hacking incidents, breached entities in California filed maximum thefts two years in a row.

Furthermore, it discusses the trends and predictions by the C-suite in healthcare industry for the coming year. David Muntz, principal at StarBridge Advisors said, “There seems to be a growing gap between the demand and supply of cybersecurity professionals that needs to be addressed. On the positive side, vendors are providing strict countermeasures for vulnerable products and services which will result in HIPAA being perceived as an enabler for data sharing as well.”

As a matter of fact, 2018 has set all hopes high and CIOs are looking forward to a decline in the breached numbers with active cybersecurity measures challenging the perils of vulnerable healthcare systems.

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