Most likely, in one of the few lucid moments you have in your hectic, even chaotic schedule you contemplate healthcare’s greatest problems, its most pressing questions that must be solved, obstacles and the most important hurdles that must be overcome, and how doing so would alleviate many of your woes. That’s likely an overstatement. The problems are many, some of the obstacles overwhelming.
There are opportunities, of course. But opportunities often come from problems that must be solved. And, as the saying goes, for everyone you ask, you’re likely to receive a different answer to what needs to be first addressed. So, in this series (see part 1 and part 3), we examine some of healthcare’s most pressing challenges, according to some of the sector’s most knowledgeable voices.
Without further delay, the following are some of the problems in need of solutions. Or, in other words, some of healthcare’s greatest opportunities. What is healthcare’s most pressing question, problem, hurdle, obstacle, thing to overcome? And how that can be solved/addressed?
Lynn Carroll, chief of strategy & operations, HSBlox
Preventable medical errors are the third leading cause of death in the U.S., and frequently can be linked to inaccurate patient data, according to a study by Johns Hopkins University. Machine learning should be used to solve patient-matching challenges by analyzing and consolidating patient data from multiple systems, such as EHRs, medical charts, e-prescribing technologies, clinical documentation solutions and revenue cycle management platforms, and by creating longitudinal patient records that can be transparently shared among the patient’s care team, optimizing care coordination. The patient-matching solution is then combined with blockchain to disseminate the relevant patient data to all parties who have permission to view it.
Extending care coordination beyond the hospital walls heavily burdens providers and healthcare administrators. As the industry continues to shift from fee-for-service to value-based care, optimizing care teams to address social determinants of health and drive patient engagement is paramount. Today’s health systems must leverage an agile workforce and intuitive technology to deliver 360-degree patient-centered care.
Dr. Samant Virk, physician, founder and CEO, MediSprout
As a practicing physician for the last 15 years, I had a growing frustration with the fact that more than 70 percent of my time was consumed by administrative tasks that took away from my ability to help patients. The biggest challenge of healthcare right now is that we’ve lost touch with that physician and patient connection. Question: How can we reconnect physicians with patients — tech has driven a wedge between us and it’s time to fix this. Doctors would love to spend more time with the patients that need them the most while getting paid for follow-up care and communications that eats up their day. We believe that technology is the solution here.
Healthcare must shift its focus from viewing patients as “customers” and instead consider patients as “partners” within the broader healthcare ecosystem. All of the exciting innovation underway (including the increased adoption of virtual care and telehealth) should reflect what is required for the patient/partner to better manage his/her healthcare throughout the care continuum. To solve for healthcare that is truly consumer-centric, the broader healthcare ecosystem needs to identify the best investments to make which will drive quicker and better outcomes for the individual consumer (e.g., the patient/partner), overall population health, healthcare professionals, and healthcare organizations.
Price transparency for the Employers and the patient. The explanation of benefits (EOB) does not contain real financial payments between the payer and the provider. The real numbers are considered proprietary. A patient nor employer benefit plan cannot control their healthcare costs if they do not know how much was paid and for what service. At a grocery store, each item is tagged with the name of the product and the price. In healthcare the service and or product is not presented to the patient prior to the receipt of service and the services are not itemized on the bill. What to do? Make is illegal for payers and providers to have proprietary payments on healthcare goods and services.
The most pressing problem for US healthcare is improving quality of care while reducing cost. Intelligently leveraging clinical information — for predictive analytics, precision medicine, population health analytics and other analytic purposes — is critical to solving this problem. The largest impediment to actionable analytics is dirty clinical data entered by more than four million clinicians into more than one hundred certified EHRs resulting in a clear and present need for scalable technology to normalize, de-duplicate and enrich clinical data so that data scientists can spend more time identifying actionable insights from data, and less time fixing clinical data.
I see our shortage of primary care physicians as the biggest challenge the American healthcare system faces over the next 20 years. PCPs are crucial to the patient experience, and preventative care that can help drive value. Tied to this is my concern is the lack of investment/acceleration in technology designed to improve physician experience and utilization. PCPs spend way too much time entering data when there are opportunities like voice assisted scribe or authentication that reduce data entry and allows them to spend more time completely focused on patients providing quality care.
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.
SnapNurse is an on-demand technology platform that connects pre-credentialed nurses directly with healthcare facilities to fill empty shifts. Similar to other popular on-call applications, SnapNurse reduces staffing shortages for the healthcare industry at a moment’s notice.
SnapNurse was created to help solve the critical nursing shortage currently sweeping the globe. In an effort to support healthcare professionals and facilities through this challenging time, Cherie Kloss, founder and CEO with an 18-year history as an anesthetist, launched SnapNurse to offer a more efficient ecosystem for both sides to work together.
After completing a successful 10-year run as a TV producer, Kloss was eager to dive back into the medical industry as a nurse and anesthetist. She quickly realized how difficult it was to land on-request nursing gigs and like many, felt frustrated with the industry’s broken credentialing and hiring process.
Kloss soon tapped her deeply seeded network to fine tune the evolving concept of SnapNurse and to build out her team. The organization’s executive lineup delivers an impressive foundation for its technology and healthcare footprint including founder and former CTO of $22 billion trading platform Intercontinental Exchange (ICE) Edwin Marcial as CTO and former Director of Anesthesia Services at Grady Hospital Jeff Richards as COO.
SnapNurse is fueled by giving the power back to nurses and finding better ways to offer competitive pay, a simple credentialing process and the freedom to work when you want and where you want, thereby driving the rapid adoption of this revolutionary on-demand platform.
SnapNurse connects deeply with both the healthcare institutions and the nurses to offer a better way to work together and fill empty shifts instantly through the SnapNurse talent pool.
SnapNurse has successfully established facility-partner relationships with leading organizations across the country where the need is greatest. This has been accomplished by attending top industry events and tradeshows, speaking at local and national events, and leveraging the team’s experience in the industry to connect with noteworthy contacts that are ripe for SnapNurse’s service.
The pioneering startup has also focused heavily on fostering genuine relationships with nursing communities in various regions by hosting one-of-a-kind meetup events with one of their notable TV-star supporters from Atlanta, having a presence at job fairs, developing superior testimonial videos from SnapNurse users, increasing their social imprint, among other successful strategies.
SnapNurse is used by hundreds of nurses in select cities across the nation, with Atlanta (the company’s beta location) having the highest number of nurses.
SnapNurse is a 21st-century solution to the global nursing shortage the world has been experiencing for years. Beyond nurses, global nurse agencies, hospitals, clinics and home health care businesses, among others (combined $344 billion annual market worldwide) can benefit from SnapNurse’s platform and talent pool. Estimates from the World Health Organization (WHO) show the needs-based shortage of healthcare workers globally is expected to top 17.4 million in 2018, of which more than 9 million are nurses and midwives. SnapNurse will help fill this need by connecting more nurses with healthcare facilities in need. SnapNurse empowers nurses to make more money, create their own schedule, and even get paid after the end of the shift.
Who are your competitors?
Because of the current services and relationships of SnapNurse and the blockchain software (nursetoken.io) it will soon apply to its platform, there are no direct competitors that offer the cohesive offerings we do.
How your company differentiates itself from the competition and what differentiates SnapNurse?
The tech disrupter is a favorite among hospitals and nurse managers for its ability to save time and money, increase contract talent pool and view profiles and provide ratings for available nurses. Always on the cutting-edge, SnapNurse is the first company that will apply a blockchain software (nursetoken.io) for credentialing allowing nurses to carry portable authorization passports for instant approval at new centers.
Intiva Health is the first truly integrated career platform for healthcare professionals. It redefines the medical credentialing process by making it faster, more efficient and more secure.
Intiva Health provides healthcare professionals with a single place to manage their credentials,continuing education, new job opportunities, secure messaging needs and more. It is built on the Hashgraph digital ledger platform, which means it is faster, more secure, and more error proof than blockchain.
Intiva Health was founded in 2006 as a staffing agency for surgical services and emergency rooms. Today the Austin, Texas company it has reinvented itself as a digital health startup featuring a next generation blockchain technology that cuts the time it takes for the medical credentialing process from months to seconds, improves HIPAA compliance,and makes document tampering or theft almost impossible.
Intiva Health focuses its marketing and PR efforts on licensed medical professionals (LMPs), practice managers, and the facilities where they work including medical groups, hospitals and professional associations.The company launched a new brand awareness campaign in March 2018 that included the introduction of the Intiva Token, a new cryptocurrency that LMPs can use to purchase continuing education classes, cyber insurance and other services.
Intiva is also partnering with the National Osteoporosis Foundation to test the advantages of using the IntivaToken for charitable donations.
The Intiva Health Platform automates the burdensome tasks of credential and licensure management, continuing education, and discovering job opportunities for healthcare professionals. Intiva Health’s new ReadyDoc™credential verification solution, built on top of the Hashgraph distributed ledger technology, disrupts the existing broken, slow, and error-prone healthcare credentialing system, which today can take weeks or months to verify credentials, and is subject to tampering.
Intiva believes that ReadyDoc can replace the current processes of credentialing and primary source verification by storing documents and credentials in a Hashgraph-based distributed ledger. Providers and facilities can obtain information that is pre-verified, securely stored, and readily available, creating an ongoing, self-auditing verification of provider work history and clinical reputation.
ReadyDoc will act fluidly between health systems and facilities across the U.S., allowing organizations to instantly verify work history and clinical reputations. In the event of an emergency like the Houston hurricane, facilities will be able staff up by vetting the credentials of qualified providers instantly. ReadyDoc eliminates redundancy and the need for third party verification organizations, letting medical professionals get to work sooner.
Unlocking the genomic code to usher in a new era of medical technology.
The core Shivom team came together after numerous meetings at blockchain and genomics conferences. During these, we frequently reached conclusions on how to solve the current issues in the medical domain, by combining the bleeding-edge of blockchain technology with genomic sequencing.
The fuel that powers the Shivom platform is community involvement. We aim to forge meaningful partnerships with medical groups around the world, which can then interact directly with the Shivom blockchain and its users.
Shivom’s target audience? Everyone. Big data analysis requires big data sets, and in the case of the platform, the more users having sequenced and uploaded their genomic data means that there is a larger pool of information to draw from. Of course, a large part of the offering is the secure storage of this information is securely stored, and the individuals to whom it belongs can choose to monetize it by allowing access to innovators in the medical space.
Who are your competitors?
There are few competitors in this space – somewhat reassuring, as our vision is to unite players in the medical field. However, Nebula is a blockchain platform also occupying the genetic niche.
How your company differentiates itself from the competition and what differentiates Shivom?
Simply put, Shivom is a blockchain storage and analytics platform for genetic information. On top of its core functionality, it also enables users to profit from their data by sharing it with institutions.
Differentiating it from similar projects is its magnitude – a global reach and a unique classification system for genomic ID. On the roadmap are integrated AI protocols for in-depth insights.
Shivom is still in its infancy, although we anticipate that, in moving forward, revenue will be generated by pharmaceutical companies wishing to use data in their research. Additional revenue will stem from a range of apps and services (to glean insights on one’s uploaded data) and the sale of sequencing kits.
Technological advancements have taken healthcare from a basic level to what, in comparison, seems sophisticated and state-of-the-art. For example, MRI, CT, PET and ultrasound technologies have drastically improved diagnostics and treatment in healthcare. Technology’s impact on communication has also radically changed healthcare. Images and information can be sent and received instantly, allowing medical professionals to consult and collaborate with each other regarding a patient’s diagnosis and treatment.
With digital means of recording and accessing patient medical history, continuity of care is easier than ever. With all of the changes technology has brought to the healthcare system, it would seem that patients and providers would be more than satisfied with the level of care and efficiency.
Unfortunately, reality says the contrary. According to a 2017 Gallup poll, over 70 percent of Americans think the healthcare system in the US is “’in a state of crisis”’. Patients, providers, and insurance companies face frustrations daily. Patients struggle to interpret their benefits and get approved for treatment. Denial of benefits and delayed payments plague patients and providers. The problem isn’t a lack of technology, as previously discussed. The problem is a lack of a mechanism to capitalize on existing technology. Information is already digital in the majority of medical offices, and a range of methods for electronic communication already exist. What the healthcare system needs now is a streamlined way of getting information where it needs to go in real time.
Blockchain to the Rescue
At first mention, it may seem far-fetched that blockchain technology would help the healthcare system. Most people know little about what blockchain technology, and if they are aware of it, it’s most often associated with cryptocurrency. Interestingly, the same blockchain technology that makes cryptocurrency possible is being applied in many arenas outside of cryptocurrency due to its ability to securely and efficiently verify and log transactions.
The blockchain is essentially a ledger of events that updates in real time. In cryptocurrency, for example, algorithms verify authenticity of coins, and coins are sent and received once verification is determined. The transaction is then stored in the blockchain. This is appealing to many people for many reasons. One reason is that quicker transfers of currencies are possible when the middle man is eliminated. Algorithms can do in seconds what banks take days to do. Another reason is that information is encrypted, which means privacy and security of information.
In terms of healthcare, a company called Solve.Care has undertaken the challenge of solving the existing problems in the healthcare system using the blockchain. The biggest plagues in healthcare are rooted in the administrative area. Many hours are spent tracking down information that should be easily and instantly available to relevant parties. For instance, it may take days or weeks to receive a letter denying an insurance claim.
According to the Office of Coordination of National Health Information, 50 percent of healthcare dollars are wasted on inefficient processes. Transformative innovation must not only change the current way things are done, it must be disruptive by having a meaningful impact on time, quality, cost and operational effectiveness – it must dramatically simplify and accelerate the process it enables.
There are very exciting ways in which digital technology is creating transformation across the entire healthcare system in areas such as connected health, artificial intelligence (AI), blockchain, mobile data gathering, analytics, digital therapeutics and remote patient monitoring. All of these technological developments will improve healthcare efficiency, but more importantly they will drive the delivery of individualized care and dramatically improve patient outcomes as follows:
Access to Care
Connected health, or telehealth, is enabling the delivery of care to rural areas, where access is often nonexistent or very limited. It is also being used to address growing medical staff and physician shortages by providing access to timely care through collaborative tools such as eConsults. Telehealth delivers faster, less expensive and more convenient healthcare and in doing so significantly improves patient outcomes.
Conventional patient engagement systems display information at the hospital bedside, which is only one of many relevant ways to connect with patients. Companies are now integrating artificial intelligence or ‘virtual’ health coaches into interactive educational platforms, resulting in higher utilization and engagement, and delivering more robust, actionable content.
Remote Patient Monitoring (RPM)
A vast array of innovative wearables and sensors such as the biosensor bra patch, implantable glucose sensor, electronic tattoos and the cardiac mapping vest are revolutionizing remote monitoring capabilities. These remote monitoring systems have the potential to help achieve triple aim goals by leveraging the latest advancements to collect and analyze patient data beyond the bedside. Patients and providers can use smart phones, tablets and apps to remotely assess, diagnose and monitor their patients. Electronic monitoring can be an effective solution to identifying issues as they happen while also enabling more effective tracking of patients post-discharge, improving compliance and adherence, and reducing the number of re-admissions.
Guest post by Fizzah Iqbal, content writer, Incubasys.
After a number of initial coin offerings being launched in the cryptocurrency market, blockchain development companies plan to introduce blockchain technology to the health records (EHR) industry. The Electronic Health Record (EHR) is a digitised version of patient’s medical history maintained by their doctors over a period of time. It includes information on demographics, diagnosis, vital signs, past medical history, progress over time, lab tests and more.
Owing to the de-centralised nature of blockchain system, it securely stores health records and maintains a single version of the truth that cannot be tampered with. This is of significant importance to different medical organisations and individuals like doctors, hospitals, labs, and insurers who can request permission to access a certain patient’s record from the blockchain without involving an intermediary. It offers two-way benefits; first, doctors and medical organisations get access to patients’ details and history without losing any precious time waiting for approvals from any intermediary and provide better patient care based on more accurate data, second, patients have more control over who sees their data.
The biggest challenge faced by healthcare systems throughout the world is how to share medical data with known and unknown parties for different reasons without violating patients’ rights and ensuring data security. Creating a trusted environment for decision-making regarding EHRs is challenging for medical community since each EHR stores data using different workflows which makes tracking data recording rather ambiguous. The growing focus on care coordination and EHR access across the care continuum has raised questions about ways to ensure that multiple providers can view, edit and share patient’s data without violating their rights and privacy in any way.
It’s not only about the problem of data sharing logistics in HER instead every solution that requires serious contemplation in a national healthcare system needs to put patient’s privacy and rights first in their list of priorities. And although laws have made health care data more accessible, vast majority of hospitals and doctors still cannot share data safely and securely. The time has arrived where solutions are needed in which patients themselves control whom to share their data with and where to remain pseudonymous.
Healthcare data is inherently sensitive in nature. Besides that the constant challenges of interoperability, patient record matching, and health information exchange have created opportunities for blockchain development companies to come up with a blockchain-based solution.
Once a blockchain solution is deployed to manage EHRs, it becomes a unified and common backbone for digital health. The biggest advantage of using this backbone is that each hospital or care provider no longer needs a specific version of databases or software to access patient data. Any information presented by EHR on the distributed ledger of a permissioned blockchain would be perfectly reconciled community-wide with the assured integrity throughout without any human intervention.
The use of blockchain technology to manage EHRs reduces the time it takes any medical representative to access patient’s information, enhance system interoperability and improve data quality. It also enables a reduction in overhead costs especially for development and maintenance of legacy health record systems. What blockchain does for everyone in healthcare system is that instead of relying on a designated intermediary for information exchange the de-centralised nature of blockchain allows any approved party to join in and either access information, share or exchange without the need to build data exchange channels between certain organisations.
According to a 2003 report by the World Health Organization (WHO) into medication adherence, about 50 percent of patients with chronic illness don’t take their medications as prescribed. This poor adherence to medication leads to wastage, disease progression, increased morbidity and death, increased burden on medical resources, and is estimated to cost approximately $100 billion per year.
Of course, it can be easy to write this issue off as the patient’s responsibility, and naturally they have a huge role to play in solving this issue. There are, however, myriad factors that contribute to non-adherence of the 4.45 billion prescriptions written in the US each year.
The medication-taking experience is a complex interaction that involves patient, physician and the broader healthcare system, and all of these protagonists need to be functioning together correctly if we are to reach a state where avoidable medical treatment is minimized.
Given that increased adherence would not only greatly improve patient outcomes, but also save the healthcare sector billions of dollars, addressing this pervasive issue should be a priority for the industry. But what really causes it, and how can we improve our approach?
From the patient’s perspective, there are a number of factors that can contribute to the non-adherence of prescribed medication. One overarching theme for patients is patient activation and empowerment. The healthcare system isn’t constructed to ensure patients take on the role in self-management expected of them. Our paternalistic healthcare system can often make patients feel disempowered, and excluded from care decisions.
A poor understanding of both their condition and the medication that has been prescribed can lead to a lack of ownership of and accountability for the management of their condition. In numerous reports, patients are overly concerned about side effects, lack understanding on how to take the medicine safely, and may not understand why it is so important to continue to remain in therapy (especially in asymptomatic non-communicable diseases). Increasing the patient’s understanding of their condition, and the management thereof, can play a significant role in increasing adherence.
Sometimes, of course, non-adherence isn’t a deliberate decision by the patient, but an unintentional side effect due to capacity and resource limitations. For example, problems physically accessing prescriptions, a prohibitive cost, or competing demands on a patient’s time can all result in non-adherence.
Literacy is also a large contributing factor – in the US alone, close to 90 million adults have inadequate health literacy. The consequential lack of understanding puts them at greater risk of hospitalization and poorer clinical outcomes. Their beliefs about and attitudes toward health and treatment effectiveness, together with previous experiences with pharmacological treatments, also affect their level of adherence. Continue Reading