In the area of health insurance, there is an increasing need for providers to streamline the process of securing coverage for their clients. With this, technology is at the center of innovation, and so providers will need to secure wider adoption of helpful tools and applications to ease up the workflow.
For sure, evaluating a client’s risk profile as well as processing accident claims are just two of the most tedious tasks insurers will have to handle. Other than that, insurers will also need to maintain their profit margins to ensure the seamless delivery of insurance services.
It is against this background that insurers will need to invest considerably in terms of acquiring the needed technologies and/or update their current equipment inventory.
The first step to this would be identifying which technologies to adopt and to make sure that such technologies can help in the long run.
Claims management software
Insurers that offer retirement plans will find it essential to use the right software and web applications to better deliver their services. Along these lines, it is best to opt for software that has the substantial features that are valuable for recording client information and relevant details in the event that a client wants access to their claims.
Also, insurers will need to implement systems capable of handling large amounts of data seamlessly. Finally, with a proper system in place, insurers can use certain features to accurately calculate total costs per claim. Indeed, an insurance claims management system can be a powerful tool that can help insurance providers cut costs, shorten waiting times, and avoid fraudulent claims through a more systemic yet faster validation process.
Risk assessment software
Before getting covered by an insurance product, it is imperative for clients to undergo a risk assessment process. Such a system provides a whole range of benefits to independent agents as well as hospitals. Accuracy, after all, is a key concept in the health insurance industry. So, making sure your patient’s records are free from errors can also lead to a more streamlined process.
What’s more, having the capability to perform risk assessment forms an important part of what this software can do to the bottom line. At least, with such a system insurers can essentially save on operating costs and avoid possible legal costs in the event of an error.
Like retail and education before it, a major shift is underway in the healthcare industry that is putting power back in consumers’ hands. Similar to how retail outlets are delivering custom experiences based on consumer preferences, or how there is more attention to individual needs in the classroom, patients are able to play a more active role in their healthcare administration and decision-making than ever before. This means participating in a shared decision-making model with physicians, seeing their needs and preferences reflected in the course of their treatment, and easier access to their medical data, made readily available to both the patient and his or her medical team.
This article will explore the phenomenon that is PCC, a paradigm shift changing the healthcare industry at its core. So much so, PCC is driving adoption of three technology related trends that are in line with its principles. They include: telemedicine, cloud computing and mHealth.
Patient Centered Care and 2016 Healthcare IT Trends
While many assumed in-facility care would remain the norm after house calls faded from popularity decades ago, that may not be the case. Increasingly, telemedicine — or remote consultations, diagnoses, and treatment performed by medical professionals — is becoming a standard practice in the healthcare industry.
For example, the below ad from Anthem BlueCross and LiveHealth Online was released by one of the nation’s largest insurance agencies promoting remote consultations states the “doctor is always in” and sessions are “quick and easy with no appointments and no driving.”
In line with the principles of PCC, telehealth promises greater access to care for patients who don’t live in close proximity to a healthcare facility. For the greater population, telehealth offers convenience and the comfort of care delivered in a patient’s natural environment. Administering care in a patient’s environment instead of a traditional healthcare setting can also facilitate better care in some cases. Fierce Healthcare provides the example of blood pressure screening – taking a patient’s blood pressure in a natural setting, like their home or workplace, may more accurately reflect their blood pressure on a daily basis.
Telehealth and the benefits this practice offers to patients are perfectly in line with the patient-centric approach favored today. In light of this, it wouldn’t be surprising if telemedicine adoption continues to rise in the coming years, along with the demand for technology that can facilitate remote care.
Guest post by Will Hayles, technical writer and blogger, Outscale.
Last year, 2014, was the year the wearables market really took off. No end of wearable technologies were released, each promising to hook users into the personal analytics and quantified self trends. Of course, many of those releases went nowhere, and even some of the big companies saw their wearable devices fizzle rather than pop — the obvious example being Google Glass, which received an unprecedented amount of attention, much of which was negative. But there were many successes, and later this year Apple will be entering the fray with the Apple Watch and its bundle of sensors.
Last year the wearables industry was worth around $2.8 billion. Over the next five years it’s expected be to worth more than $8.3 billion. But there is a market with the potential to dwarf the consumer fitness monitoring market, and that’s chronic illness management, which has, unfortunately, if understandably, seen far less attention from startups. As J.C. Herz notes in a Wired article on the subject, the entire market for fitness trackers is vastly outstripped by the size of the market for blood glucose test strips, which are an essential tool in the monitoring of diabetes.
Herz takes a harsh tone with an industry that has failed to focus research and development on solutions for people who stand to benefit the most, but I’m more optimistic. Healthcare outside of the fitness sphere is a difficult market, with a heavy — and necessary — regulatory burden and entrenched ideas about treatment and patient monitoring. Unity Stoakes, co-founder of StartUp Health, recognizes both the challenges and the potential for innovation that can significantly improve people’s lives:
“Unlike other industries, healthcare is plagued by regulation and longer product development timelines. Bringing successful products to market is challenging for both large industry players and digital health entrepreneurs. Startups need access to advisors, peers and dollars, while large companies need ‘batteries included’ entrepreneurs fueling innovation. The unprecedented level of change gripping the healthcare industry today presents both challenges and opportunities for both.”
There is recognition both within the healthcare industry and among technology companies that monitoring tools and other applications of wearable and mobile technology offer an opportunity to substantially change healthcare and the lives of people who suffer with chronic illnesses.
According to a recent study from the Health Research Industry, 42 percent of healthcare providers are comfortable relying on at-home test results for prescriptions. Sixty-six percent thought mobile solutions have the potential to help with the management of chronic diseases. And as we’ve discussed on this blog several times before, mobile technology and wearables are helping caregivers better collaborate and coordinate care.
Guest post by Travis Good, M.D., CEO and co-founder of Catalyze, Inc.
Even if a bit delayed, the power and value of cloud-based technologies is starting to seep into healthcare. With each new cloud-based technology piloted or taken to scale by a healthcare organization, other institutions and corporations become more willing to roll the dice on deploying cloud-based technology. While still slow, it is happening, but not where you may think. Instead of found in the typical core applications of EHR or practice management systems, we find cloud-based technologies being introduced into the innovative health technology areas of virtual care delivery and patient self-reporting. Those areas are breaking down the barriers to cloud adoption in healthcare and that pace is increasing.
Cloud-based technology acceptance, along with everything else in the healthcare industry is moving faster than ever before. Accountable care, bundled payments, patient satisfaction, continuous care and the consumerization of healthcare are catalyzing changes to a very large, slow moving, highly regulated and risk averse industry. Technology and technology enabled services are essential for riding out these waves of change.
Every healthcare segment has seen these paradigm shifts and is trying to carve out a piece of the new pie. Large medical centers and health systems want to commercialize tools created in-house. Payers are building technology geared toward new forms of care delivery and price transparency, while biopharma is building technology to deliver continuous care powered by data from its core products – devices and medicines. All three of these healthcare segments can build technologies that utilize cloud computing and thus reap the following benefits:
A more nimble organization
Consumption of only the resources needed
Access to technology and apps across geographic barriers
Compliance and Cloud Computing
With recent changes to HIPAA that went into affect as part of the HITECH and HIPAA Omnibus Rule in 2013, a surge in compliance interest has developed, especially with compliance as it relates to cloud computing. The HIPAA Omnibus Rule created a new segment within the string of compliance leading back to covered entities. The new “subcontractor” segment is something of which every healthcare compliance officer must be aware. In much the same way as a business associate processes, transmits or stores ePHI for a “covered entity,” a subcontractor will also process, transmit, or store ePHI for “business associates.” And, subcontractors, like business associates, are required to sign business associate agreements (BAAs). These agreements outline the obligations of each party in meeting different aspects of HIPAA compliance rules, and delegate the risk based on different types of possible ePHI breaches.
In creating this new “subcontractor” entity, the Omnibus Rule accounted for the paradigm shift in technology development and cloud computing. The most commonly used example of a subcontractor is found in a cloud hosting provider like Amazon (AWS) or Rackspace; yet, many other types of services exist that could be considered subcontractors.
As data and services are being accessed via Web services (typically APIs), a huge number of BLANK-as-a-Service offerings have emerged. Many modern applications utilize third-party APIs for features and functionality to speed time-to-market, while adding value to users. Using simple to consume APIs, modern applications can tap into databases, messaging (SMS, Push, email or voice), usage metrics, logging, customer support, data sources, backup and so forth.
Cloud computing services are increasingly moving into the future in healthcare. However, the protection and security of private data are two of the main reasons why the healthcare sector is generally slow to adopt new technologies. According to market researchers at MarketsandMarkets, healthcare will invest $5.4 billion in the cloud by 2017.
The “Healthcare Cloud Computing (Clinical, EMR, SaaS, Private, Public, Hybrid) Market – Global Trends, Challenges, Opportunities & Forecasts (2012 – 2017)” analyzes and studies the major market drivers, restraints and opportunities in North America, Europe, Asia. According to the report, Market researchers estimate that last year at least 4 percent of healthcare is in the cloud. This year, this share is expected to grow to 20.5 percent.
According to Cloud Times, “Cloud computing offers significant benefits to the healthcare sector; doctor’s clinics, hospitals and clinics require quick access to computing and large storage facilities which are not provided in the traditional settings, moreover healthcare data needs to be shared across various settings and geographies which further burdens the healthcare provider and the patient causing significant delay in treatment and loss of time. Cloud caters to all these requirements thus providing the healthcare organizations an incredible opportunity to improve services to their customers, the patients, to share information more easily than ever before, and improve operational efficiency at the same time.”
Guest post by Aaron Weiss, director of marketing for HP LaserJet Enterprise Solutions.
Throughout my career, I’ve worked with many small-to medium-sized businesses (SMBs) to improve workflows and efficiency by using technology. Across all of the SMBs in various industries that I’ve helped, healthcare offices often experience the most debilitating pain points, resulting from an overflow of documents like patient and medication information.
From scheduling appointments and providing medication information to keeping track of patient history records, employees of office-based physician practices are expected to meet high demands. In the midst of diagnosing illnesses and managing administrative responsibilities, disorganization, security issues and time management often become pain points for practices.