By Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC, AGACNP-BC, FAAN, chief nurse, Wolters Kluwer, Health Learning, Research and Practice.
These are the days we never thought we’d see – unimagined times, pushing our nurses and healthcare workers to the brink with the demands of COVID-19. They’ve stepped up with unbelievable courage and resiliency. They’ve done so without many of the resources they’ve traditionally had, such as personal protective equipment (PPE) and medical equipment. But one thing that’s undoubtedly made a difference is technology.
Patients have been able to interact with their primary care provider and nurses via telehealth ensuring that patients are able to continue with the medications and treatment plans for chronic conditions and new issues.
In the acute care space, it has enabled patients to visit with their family through digital technology, and providers and nurses have been able to update the families on patients’ progress.
After patients are discharged with COVID-19, the patient is in daily contact with a nurse to make sure their condition isn’t worsening, and they understand how to care for themselves. This works to ensure patients have follow-up care and the family is supported. And those are just a few ways.
While the survey was taken prior to the pandemic, the results give insight into the role of technology as it applies to both next-generation nurses (those with less than 10 years of practice) and more experienced ones. The survey conducted by Wolters Kluwer aimed to explore the mindset of today’s nurses and healthcare workers, so hospitals can respond accordingly.
Digital natives versus techno-phobes
When looking at next-generation nurses, we should keep in mind that many of them grew up in a time with widespread use of the internet, social media, and mobile communication. Many nurses with longer tenure began their careers when the internet was in its infancy and computers weren’t an integral part of a hospital’s operations.
Next-generation nurses are, for the most part, digital natives. That comfort level does tend to influence their opinions: when care is better, next-generation nurses think it’s because of technology. 84% believe clinical-decision support systems at the point of care are making it easier to make the most informed, evidenced-based care decisions.
In addition, 84% feel specialized systems that provide treatment recommendations and integrate with electronic health records (EHRs) have a positive impact on how care is delivered.
Their understanding of technology may be a factor in them spending less time in EHRs than their more seasoned counterparts; 69% report spending too much time in EHRs, compared to 81% of more experienced nurses.
Next-generation nurses are fans of artificial intelligence (AI). 63% say they are optimistic that the use of AI will help providers get the information they need to make better care decisions.
Experienced nurses weren’t as convinced, with only half agreeing that AI will help in making better care decisions. (This insight should alert hospital leaders of the need to educate staff on how AI can improve clinical decision making so that implementation of AI will be viewed as a positive and not as a negative.)
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law in March, has provided a lifeline for many businesses — including healthcare organizations. Amid the grim reality of medical equipment shortages and limited hospital beds, the CARES Act provides the healthcare industry much-needed relief.
Considering a significant number of practices are struggling to keep their doors open, and hospitals have experienced significant revenue loss from elective procedures being cancelled or postponed, the act has been pivotal in providing critical aid.
However, at over 800 pages, understanding the full impact of the act can be challenging. Below, I’m sharing how the CARES Act can benefit healthcare providers, as well as additional steps medical practices can take today to ensure the financial security of their organizations.
What You Need to Know About the PPP
By now, the Paycheck Protection Program (PPP) has been in place for a few weeks, and many healthcare practices with fewer than 500 employees have likely already submitted their applications. Whether you’ve already applied for the PPP or are weighing your options, here is some need-to-know information to consider.
At its core, the PPP gives businesses an incentive to keep their staff employed. Funds dispersed from this program can be used to cover up to eight weeks of payroll costs and other eligible expenses, such as rent, utilities and mortgage interest. This loan can provide practices with the necessary funds they need to keep their staff employed and continue serving their communities.
While the initial funding for the PPP from the CARES Act quickly ran out, another law passed in April 2020 provided another welcome injection of funding in the program.
With the spread of COVID-19, strict social distancing and shelter-in-place policies, the practice of working remotely and implementing applications that limit in-person interaction have become the new norm.
Hospitals and health systems are at the forefront of this shift, and many are struggling with managing the IT infrastructural challenges created by the sudden massive demand for remote technology needed to cope with the global crisis.
Those able to work remote may not be used to working outside of the office, nor do they have the proper equipment or office space to comfortably and efficiently work from home.
We assume that in 2020 each employee has access to a decent internet connection, but how can you really make sure they do? What about your infrastructure? Are you confident that your systems currently in place can withstand a different workflow? Do you have the right security measures in place? How do you trust that your employees are still being productive?
As health organizations continue to provide the same high quality of care and service while also keeping clinicians safe and healthy, we see IT challenges arising in numerous areas. While there is a great deal of depth to this topic, the following outlines a few of the major considerations for health organizations and IT teams shifting to a remote workforce.
When was the last time you evaluated key areas and were provided with recommendations for improvements in your IT environment? Take this opportunity to ensure you have the systems in place to facilitate strategic shifts and new initiatives like working remotely.
Network and remote access: to meet dynamic business needs, an organization’s network environment needs to be efficiently architected to facilitate high-performance at the right cost. As end users and devices accessing a network remotely increase, this service becomes a more important and critical responsibility. Optimize and manage bandwidth to ensure your network can withstand the rapid influx of traffic. Also, don’t forget to account for the number of licenses you will need to support your remote connections.
Virtual desktop infrastructure: remote workers can be deployed faster and supported more easily by using a Virtual Desktop Infrastructure (VDI). VDI allows for a consistent and simplified computing environment both locally and remotely. With VDI, IT support staff are better equipped to manage desktop computing due to centralized management tools that ease the burden of software updates, endpoint security, end-user support, endpoint replacement and future expansion
By Juan Pablo Segura, president and co-founder, Babyscripts
In the past several months, novel coronavirus 2019 (COVID-19) has risen from humble beginnings in a Wuhan farmer’s market to international status: dominating the news cycle, exhausting the world’s hand sanitizer resources, and generally monopolizing the mental real estate of the developed world.
As new cases continue to be identified in the U.S., politicians are giving coronavirus the attention it deserves, responding to initial accusations of inadequacy with proposals for funding and reimbursements for testing and other precautionary measures.
One of the primary targets of this emergency funding is telehealth. New York’s Governor Cuomo and the NY Department of Financial services released a directive encouraging insurers to develop telehealth programs with participating providers.
Arizona Rep. Ruben Gallego announced he was introducing a bill that would allow Medicaid to cover all COVID-19-related charges, including virtual appointments.
Major health industry groups like the Connected Health Initiative and the American Medical Association advocated for the Department of Health and Human Services to expand access to telehealth and offer Medicaid reimbursements for telemedicine in emergency situations.
Many have cited this pandemic as the “put me in coach” moment for telehealth — digital innovation that has lagged in adoption because of cumbersome restrictions, red tape, and lack of funding, among other things. And it’s obvious why telehealth is the tool for this moment.
At its most basic level, telehealth can provide accurate information about the virus — what it is, what the symptoms are, and how to protect against it. It’s low-hanging fruit in the rank of benefits, as disinformation seems to be spreading faster than the virus itself.
A local Costco suffered a run on toilet paper and paper towels, while the soap aisle remained surprisingly undisturbed: “Are we prepping for a snowstorm or a virus?” one shopper wondered.
A viral (no pun intended) tweet from CNN stated that “38% of Americans wouldn’t buy Corona beer ‘under any circumstances’ because of the coronavirus.” The tweet sparked a rash of sardonic responses. “Thirty-eight percent of Americans shouldn’t be allowed to roam free,” wrote one Twitter user.
The statistic was later debunked in a statement by the CEO of Corona, but it proves how quickly and easily even the most ridiculous rumors can take hold in panic mode.
The simple security of receiving information from a trusted care provider through a mobile app or text notification can dramatically reduce the panic that rises from disinformation, and clear up confusion around prevention and precautions (and what beer you should be avoiding).
“Innovate or die” has taken on a whole new meaning in the last month thanks to COVID-19. From building ventilators with car parts to hospitals repurposing video conferencing apps for patient engagement, a pandemic changed the world and innovations changed the delivery of healthcare. In a post-pandemic world, failing to have a virtual engagement strategy isn’t just unwise, it’s potentially fatal; for patients, staff and a sustainable business model.
Necessity is the mother of invention, and while telehealth was “invented” a long time ago, it’s here now, and it’s here permanently out of necessity. There’s been much written about this recently, but we also have to acknowledge all the other ways healthcare will need to be ready for what’s next. Because one thing is for sure – healthcare will never be the same.
As of May 12, there are currently 1.4 million cases of COVID-19 in the US, and 82,799 deaths due to the virus. By the time I’m done writing this, those stats will be higher. By the time this article is published, those stats will be higher still.
While our minds immediately go to those in healthcare who are fighting COVID-19 on the front lines – the doctors, nurses, technicians, and countless support staff in hospitals and clinics – it’s important to remember that all of healthcare is suffering in some way. While half of healthcare is working long hours in dangerous conditions without proper PPE, the other half of healthcare is out of work.
There are few elective procedures right now, which displaces all the staff associated with those types of hospitalizations – surgeons, surgical nurses, etc. Healthcare as an industry is learning to cope out of necessity. But hopefully we’re also learning some valuable lessons about what’s possible for the future. And some of those lessons will set the new standards of care.
While it took years and massive federal investment for healthcare to adopt technologies like EHRs, in mere weeks we’ve seen an exponential increase in use of virtual/digital engagement tools.
Patients are embracing the convenience and safety of “distance medicine” enabled by these solutions. Whether patients were simply unaware of the option or maybe distrusted telehealth, their fears and hesitations about it are gone.
By Vikram Savkar, vice president and general manager of the medical segment, Wolters Kluwer’s Health Learning, Research, and Practice business.
The COVID-19 crisis has placed a burden upon every aspect of our society. But nowhere is the burden more immediate and urgent than across the hospital sector. As the number of patients requiring critical care in a short period of time grows into the hundreds of thousands and perhaps beyond, clinicians are confronted with the mission of handling a challenge whose scale far exceeds our standing capacity.
The medical community is rising to that challenge with personal heroism. Every city and town has stories of clinicians who are prepared to work around the clock, despite having inadequate supplies and a high possibility of contracting the very disease that they are treating. If there was ever a time when the average person took their community’s medical infrastructure for granted, that time has now passed.
We will always, those of us who are living through this period, remember the many healthcare professionals and first responders providing COVID-19 care who “ran toward the fire,” as the saying goes, when the rest of us did our part and remained locked away from it. I am hopeful that we will come through this crisis stronger, as the many lessons learned from this pandemic are addressed by health systems, hospitals, and governments.
And in fact the disruptions of COVID-19 at present extend even beyond our hospitals to every other aspect of the medical world as well, including medical schools. Some of these disruptions are temporary, some long-lasting.
Since my company, Wolters Kluwer, works closely with most of the medical schools in the U.S. as well as in many global markets through our digital and textbook solutions, and we are in daily touch with most of them to help them navigate through this turbulence, we have insight into what these changes may be.
By Matt Henry, senior manager consultant, Denver, Point B; Talia Avci, managing consultant, Chicago, Point B; and Ashley Fagerlie, managing consultant, Phoenix, Point B.
As the COVID-19 crisis disrupts traditional care delivery, digital tools such as telehealth are making it possible to deliver care outside your facility’s walls. Here’s how to prepare your organization both now and in the future.
Amidst the COVID-19 pandemic, healthcare has literally left the building. With millions of Americans under orders to stay home, in-person care delivery and elective procedures have been effectively shut down, elevating the need for alternative care delivery options.
Health systems are in a crisis, balancing heroic action to ramp up and support their communities through the COVID pandemic with existential threats to established service line revenue and cost structures. The importance of using technology to extend reach and effectiveness of your mission has never been greater.
While other industries have spent years disrupting traditional operating models to deliver online engagement to meet customer needs, healthcare has lagged due to many practical, economic, regulatory, cultural and quality of care reasons.
As health systems prepared for a surge in infectious patients, many have leveraged their digital front door as a way to deliver credible information, guide care, and deliver safe and effective services to patients.
Taking lessons learned, the time is now to plan for your post-COVID plans and how your digital front door can extend your mission as you intentionally re-open your care facilities.
Re-imagine access: As you build your strategy, consider how new front door solutions are being offered by non-traditional ‘providers’, like Anthem, Walgreens and CVS/Aetna, to address gaps in the primary care landscape.
These gaps include inaccurate online health information, lack of access to personal health information, long wait times for appointments, lack of price transparency and other issues that impact patients along their care journey.
Barriers can be addressed by tools that assist in triaging, medication adherence, capacity management as well as two-way patient communication via websites, patient portals and apps.
Anthem has partnered with a digital health start-up, K Health, to offer symptom triaging to their 40 million members to provide care guidance and access. Members provide their symptoms to an AI-enabled algorithm and can text directly with providers for advice. Walgreens, with locations that are accessible by 78% of the U.S. population, has launched Find Care, which offers everything from lab tests to virtual consults.
CVS/Aetna has spent nearly 10 years building out digital health tools, focusing on medication adherence, with the power to leverage data as a pharmacy, payer and retail clinic to connect with their patients. Other organizations are launching chat bots for assessments and triage or more deeply leveraging remote patient monitoring for care. Each of these digital front door tools is changing how patients access care.
The scale of the coronavirus pandemic is impacting every facet of daily life. As COVID-19 continues its global spread, authorities are restricting large gatherings of people and enforcing stay at home protocols. This crisis is forcing us to adapt to a “new normal,” and technology is taking center stage to help us through the transition.
In fact, as the popularity and usefulness of video delivery over the internet grows, reports reveal that live streaming has already attracted 47% more users than this time last year. Through the influx of telehealth, remote learning, remote video conferencing and canceled events, live streaming has become a versatile — and essential — tool that is changing the way we stay in contact with others, particularly in the age of social distancing.
Live streaming is gaining in popularity across many different industries. Until the advent of live streaming technologies, 911 operators only had one source of information to assess an emergency situation: the caller. Now, thanks to advances in live streaming technologies, 911 operators are empowered with unprecedented access to emergency situations via live video.
Carbyne, a technology company that delivers actionable data from connected mobile devices to emergency communications centers, uses live streaming to enhance critical response capabilities. Through the combination of real-time video and location data, Carbyne provides emergency personnel with a more accurate assessment of the scene before they arrive, reducing emergency response times by more than 60%.
While Carbyne’s technology has proven beneficial across the globe for several years, the COVID-19 pandemic has brought additional benefits to the technology. Carbyne is effectively able to remotely evaluate potential COVID-19 cases and forward potentially infected individuals to medical professionals via telehealth services while maintaining HIPAA compliance.
Additionally, the Carbyne platform has been used in some cities to help track COVID-19 cases, delivering a heat map that details coronavirus-related calls so the municipality can better allocate resources and prevent the disease from spreading. As one hotspot hit hard by the virus, New Orleans uses Carbyne’s COVID-19 service to manage emergency calls and help individuals who have contracted the virus contact telehealth professionals instead of flooding emergency rooms. Carbyne has been fielding 70% of the city’s emergency calls, a majority of which were related to COVID-19 symptoms.
By Grant McCracken, head of security operations, Bugcrowd.
For some time now, COVID-19 has dominated every aspect of civilian life. The global workforce, healthcare systems, and international news cycles have all been impacted by the pandemic, which wreaked havoc in every area of what was once normal life.
COVID-19 is top of mind for cyberattackers too. The combination of the financial downturn and universal chaos creates the perfect storm for criminals looking to make a quick buck. At the end of the day, attackers run their own businesses too and we should always expect assailants to capitalize on chaos. Targeting healthcare systems, hospitals and workers on the front line are no exception, especially given the mass influx of patients at hospitals, longer work hours and general uncertainty.
Financial gain is the strongest motive for cybercriminals and healthcare is already a vulnerable target; healthcare assets are exceptionally attractive by default, with sensitive information, delicate infrastructure and the fact that these systems cannot experience downtime.
Just last month, the WHO reported a five-fold increase in cyberattacks on its employees. Around 450 WHO email addresses and passwords were leaked, as well as information of thousands of people currently working on COVID-19 responses. Since then, the agency has begun to relocate affected systems to a more secure arrangement, including the utilization of a safer authentication process. This is only the tip of the iceberg.
In late March, a group of attackers impersonated WHO staff in emails and targeted civilians in attempts to obtain donations to fraudulent COVID-19-based nonprofits. While the source of the attack was not confirmed, it is possible that an accomplished hacking group called DarkHotel was behind the attack, according to a Reuters report.
On top of that, attacks across industries have spiked exponentially. Google observed more than 18 million malware and phishing emails related to COVID-19 a day during the first week of April and Zscaler reported a whopping 30,000% increase in COVID-19 themed phishing incidents, malicious websites, and malware attacks since January 2020.
By Heather Annolino, senior director healthcare practice, Ventiv.
As hospitals are working vigorously to address the health care needs of its patient population during the COVID-19 pandemic, they are unintentionally leaving themselves and their patients exposed to cybersecurity risks.
Measures implemented to protect workers and patients, including expanded use of telehealth and telemedicine, remote work and bringing new equipment such as ventilators online can leave data exposed, and institutions vulnerable to hackers and scammers. These cyberattacks can affect supply chains and the ability to leverage healthcare data from the COVID-19 pandemic for use in the future for other crises.
In March 2020, the Office for Civil Rights announced it would not enforce penalties for HIPAA noncompliance against providers leveraging telehealth platforms that may not comply with privacy regulations. This measure rapidly expanded the use of telehealth and telemedicine over the past several weeks, allowing providers to utilize videoconferencing platforms, including WebEx, Zoom and Skype.
The use of telemedicine improves patient access and assists with alleviating the additional burden on healthcare systems by limiting in-person care during the COVID-19 pandemic. If any incidents do occur, they should be entered into the facility’s health care risk management/patient safety software system. This technology is designed to help healthcare organizations see all of their data in one place, making it easier to learn from the incidents through analysis. While doing that now might be difficult, it is essential to capture this data to improve preparation for the next disaster and prevent patient harm.
Although telemedicine presents a lower risk from a risk management perspective, it is still important to provide consistent processes and protections to mitigate potential threats. During these uncertain times, telemedicine is the best option for providers to continue treating select segments of their patient population, as well as triage potential COVID-19 cases. Whether health care organizations are looking to expand (or even begin) the use of telemedicine capabilities, it is crucial to outline best practices for consent, credentialing, and security and privacy to assist with mitigating potential risks.
Here are a few strategies facilities should consider:
Security and Privacy
Under normal circumstances, healthcare facilities have difficulty bringing key equipment online securely. As facilities are currently working tirelessly to address COVID-19 patients’ needs in addition to continuing to provide care to non-COVID-19 patients, there is a potential increase of security risks as additional medical equipment and medical IoT devices integrate into the network.
By investing in and deploying cybersecurity procedures and protections, including backup and downtime procedures, healthcare facilities can reduce the risk of potential phishing and ransomware attempts. These measures should include ensuring all practitioners are using communication apps recommended by the U.S. Department of Health & Human Services Office for Civil Rights and secure telephone connections as well.