By Christopher Maiona, M.D., SFHM, chief medical officer, PatientKeeper, Inc.
With all that the healthcare system has to worry about these days, perhaps it’s time to hit the “Pause” button on health IT deployment.
Or not.
While it’s certainly true that provider organizations can ill afford any disruption or downtime in their health IT infrastructure right now – one could argue a massive EHR replacement project might not be advisable at this moment – it’s equally true that effective, practical health IT is needed now more than ever. Clinicians on the front lines of the COVID-19 response need accurate and relevant patient data from the EHR system, instantly (meaning with one click, not dozens); and they need to be able to collaborate with their colleagues on urgent patient care issues at a moment’s notice, anytime, anywhere.
To that end, nothing could be more practical or timely amidst the COVID-19 patient surge than patient data access and care team collaboration capabilities on mobile devices. Smartphones and tablets are the information access and communication tools of choice for most clinicians, wherever they may be – within the hospital, in a triage tent, quarantined at home, or anywhere in between.
But for hospitals under the gun in the midst of this pandemic, is implementing such functionality really feasible?
Let’s back up, and consider a fundamental truth of healthcare IT: EHRs aren’t supporting doctors the way they were intended to, and are diverting valuable time that could be spent with patients.
Ironically, before the EHR, a physician’s biggest pain point was not having access to enough data. Patient information was siloed, typically in dusty paper charts buried in the basement or out of reach in off-site storage. Physicians didn’t have a comprehensive view of the patient. Now with EHRs, providers should have better access to patient information. Alas, that often is not the case, as vital information is buried in a sea of redundant or irrelevant data within electronic clinical notes.
It is crucial that the healthcare industry empowers physicians with tools that will make them better. Unfortunately, forcing physicians to wait their turn for one of too-few hospital workstations is not making them better. The inexplicable persistence of UIs that fail to effectively parse information in a manner consistent with a physician’s workflow or thought process isn’t helping. Obtrusive, non-emergent automated queries that foster alarm fatigue aren’t helping. System design predicated on a one-size-fits-all user experience strategy hinders delivery of care.
On the other hand, well-designed mobile apps, which afford ready and actionable access to relevant patient data, can accelerate care. And if such apps are (a) an extension of the existing EHR, and (b) as intuitive to use as any consumer app on your phone today, then training and adoption shouldn’t be a problem.
The value of “mobilizing” the hospital EHR goes far beyond effectively caring for patients under crisis conditions. It has become essential for provider collaboration on patient care generally, as physicians today are as “siloed” as patient records once were. We are not all in the same hospital at the same time. Remote access to records and the ability to easily communicate with each other within the context of a patient chart are key to the kind of collaboration that fosters better care.
By April Gill, senior vice president, solution management, Welltok.
The future of COVID-19 remains a giant question mark right now. But what is clear in this uncertain time is the significant impact everyday factors, commonly called social determinants of health (SDOH), have on a person’s health. Literature shows that up to 70% of a person’s overall health is driven by SDOH, including factors like race, income, education level and more. Knowing about these factors can improve how providers keep patients healthy year-round, but also how they engage, counsel and treat patients as individuals during a crisis like the one we are currently experiencing.
If providers understand what kinds of SDOH their patients are facing, they can better understand what health risks they have today, as well as to anticipate their future needs and risks. They can use this insight to tailor what information they share with whom, using the most effective communications channels.
Consider an elderly patient who does not own a car and relies on public transportation for everyday needs. Before COVID, a provider may have leveraged this insight to connect them to Lyft to get to a clinical appointment.
Now, a provider with this insight would likely do much more – have a telehealth appointment instead, connect them with local volunteers who will deliver groceries so they can maintain a healthy diet without leaving home, and email them facts about how to minimize risk while using public transportation to pick up a prescription, if absolutely necessary. This is just one example of how providers can improve patient care and support by understanding what they experience every day.
But are patients aware of the impact SDOH have on their own health? To find out, Welltok conducted a survey of over 2,000 consumers earlier this year, to get their views on what factors they think affect health, and which ones they would share with their provider. Surprisingly, consumers underestimated how much SDOH influenced their overall health and wellbeing – responding that they only make up about 50% of a person’s overall health. (It’s really 70%). They did have a good understanding of some factors that drive health status – like type of work or who they live with – but not more than half did not understand how daily factors like length of commute also play a role.
Not surprisingly, three out of four people also told us they experienced a change in life in the last year that impacts health. The top ones were a change in 1) stress level, 2) annual income and 3) the amount of debt they have. With most provider interactions being episodic in nature, the opportunity to get to know patients at a personal level and/or stay apprised these changes is extremely difficult. Building off this, consumers were asked to list who they would share these life changes with.
As COVID-19 cases push hospitals around the country to their limits, medical facilities are facing challenges beyond sick patients. Long hours and an uptick in cyberattacks are putting serious strain on existing cybersecurity defenses. Without the right practices, these defenses may fail, exposing patient and hospital data to hackers and cybercriminals.
Here is why security remains key as the coronavirus outbreak grows more severe — and how hospitals can rise to meet current cybersecurity challenges.
Why Healthcare Data Security Remains Important
While cybersecurity may seem overshadowed by other healthcare concerns, the current crisis makes hospital data security more essential than ever.
Many hospitals and health systems are currently expanding or introducing COVID health data collection programs to get the information needed to combat the novel coronavirus. Many of these same systems are also ramping up data-sharing between institutions to ensure that medical providers around the country have the best possible information to work with.
New operating conditions — like hospitals that set up tents in parking lots to expand their number of available beds — have also changed how hospital systems, like electronic health records, are used and secured.
At the same time, hackers are stepping up their operations and trying to take advantage of the chaos. Security researchers have already noticed a serious rise in attacks like phishing emails, as well as new malicious health tracking and COVID-19–related apps.
Current stress on staff may make hospitals more vulnerable to hacks. Cybersecurity professionals were, on average, overworked before the crisis began — an issue that has likely gotten worse as the crisis has progressed. Doctors, nurses and hospital administrators are working overtime, and organizations are bringing on new workers to manage the increased need for professionals. Existing staff may struggle to keep up with good security practices, and new team members may not receive the full training they need to keep data safe.
New information collecting schemes are critical for medical providers — but if the data they collect isn’t secured, it may also put a lot of patients at risk. This patient information may not seem like the most valuable target for hackers — but health data is actually widely sought after by cybercriminals. These hackers use health information, along with other personal information, to construct comprehensive identity packages about individual patients.
What Hospitals Can Do to Handle Security
There are steps hospitals can take to ensure that patient and hospital data stays as safe as possible — even while the staff is under immense pressure.
During the crisis, operational security will become more critical. Doctors, nurses and hospital staff should be highly aware of what they are sharing on social media. Personal information should be kept private, and employees must take note of any information in the background of the photos they take. A cybercriminal scouring the posts of doctors and hospital workers may find what they need to break into a network — like a password taped to a monitor.
By A.J. Hanna, vice president client advocacy, SYKES.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of our survey on attitudes toward telehealth. Telehealth, in its purest form, has existed for decades. Physicians, whether by phone, radio, or other forms of transmission, have been calling on clinicians from outside of their communities to assist them with second opinions or provide specialty expertise for many years.
And while the internet has opened up new and more expansive opportunities for telehealth — including making it easier for the remote caregiver and the patient to interact via both video and audio — regulatory restrictions, reimbursement inconsistency, attitudes toward effectiveness and other factors have prevented it from finding its full promise.
COVID-19 and its ability to spread easily and rapidly has pushed the healthcare system in the United States and around the world to take a more expansive view of how telehealth can be used. Given the growing importance of this tool for triage of those potentially infected by the novel coronavirus, we wanted to first assess how many people even knew what telehealth was.
When presented with the question, “Telehealth is the use of communication technologies to support long-distance health care, instead of an in-person appointment. Are you familiar with telehealth?,” over 42 percent of those contacted for this survey were not even aware of the service (in excess of 1400 people). While usage of telehealth services has increased over the last several years, there are still many people who do not equate services available to them as being telehealth.
Of those few in our survey who knew what telehealth was and had actually used the service, satisfaction rates were very high. This follows trends from other studies that find that telehealth satisfaction levels exceed other parts of the healthcare industry. And not surprisingly, the primary benefit that they cite is the ability to avoid being with others in a clinical waiting room. But for those who had not been engaged in a telehealth visit, or had not considered the service, some expressed concern that telehealth would only be effective for minor illnesses and diagnoses. Others felt that a diagnosis would be difficult without the “touch and feel” aspect of a care visit.
Perhaps not surprisingly, respondents in the 55+ age group were less likely to have used telehealth or expressed concerns about its effectiveness. Because many in the upper level of this age group are likely Medicare beneficiaries, and because coverage by Medicare has been restricted to specific conditions, geographic regions and care settings, this is not surprising. Recent decisions by the federal government to relax restrictions for Medicare coverage of telehealth as a result of the novel coronavirus pandemic may help to close the gap in utilization represented in our survey.
If there is any outcome of the current pandemic as it relates to telehealth, it may be that it will encourage more people to consider using it. Nearly 60 percent of respondents indicated that COVID-19 has made them more likely to consider using a telehealth service in the future. Almost 25 percent of our respondents had not linked COVID-19 to their opinion of using telehealth. However, those numbers will surely change as the health system in the United States continues to utilize all means necessary to care for the health of people in ways that prevent further spread of the disease.
By Drew Ivan, chief product and strategy officer, Lyniate.
It is becoming increasingly popular to move healthcare outside of the clinic and into the community and the home with the use of telemedicine platforms, apps, and other digital means — and the coronavirus pandemic has dramatically accelerated that trend. Counterintuitively, this healthcare crisis has the potential to attenuate the relationship between the patient and the healthcare system, putting provider organizations at increased risk from “digital disruptors” like Amazon, Google and Apple, whose ambitions to take over consumer relationships in healthcare are stronger than ever.
As patients re-orient during the pandemic around other points of care (hospitals, urgent care, pharmacy, etc.), the relationship patients have with their PCPs (which is one of the health system’s biggest and most meaningful advantages against the advancement of healthcare disruptors), can lose value to the consumer. As such, it behooves health systems — who are understandably all hands on deck working to address the COVID-19 crisis today — to be giving serious consideration to ways of fending off digital disruptors as their big challenge in a post-COVID-19 world.
This means focusing on leveraging the unique strengths and assets they have and getting smart about aggregating and using the disparate consumer/patient data sets they manage, to deliver a consumer experience only they can provide.
Digital disruptors excel at delivering exceptional digital customer experiences by using the massive data sets at their disposal that render rich insights into customer trends, needs, behaviors, preferences, proclivities, etc. With that said, hospitals and health systems have an advantage in their exclusive access to patient data and their in-depth medical knowledge.
Health systems need to thoughtfully but aggressively leverage these advantages if they want to successfully retain primacy in the consumer’s healthcare brand relationships. With non-emergent care rapidly shifting to the digital space, digital brands have a golden opportunity to disrupt the traditional patient-health system relationship should provider organizations miss the opportunity to reinforce those relationships by delivering much more personalized digital interactions.
It’s important to remember that healthcare organizations do not need to match the digital sophistication of the big data-driven consumer tech giants. They just need to use what they already know about patients, communities and medicine to create the kinds of experience for patients that only they can.
As hospital leaders aim to protect their organizations from digital disruptors in the post-coronavirus aftermath, these three considerations should be top of mind:
By Rick Halton, vice president, marketing and product, Lumeon.
Since it was first recorded late last year in China, the spread of COVID-19 has accelerated around the world, rapidly creating a global pandemic. The number of new cases is increasing exponentially, putting the western hemisphere in particular on a frightening trajectory, as health systems struggle to battle the virus.
Though billions of individuals around the world are undergoing mandated lockdowns and committing to physical distancing, hospitals continue to be engulfed in an onslaught of COVID-19 patients. One of the most significant impacts of this virus is how rapidly it is overwhelming health systems, consuming critical resources including inpatient beds, intensive care ventilators and importantly, care teams themselves.
Fortunately, technology has incredible potential to help automate and coordinate care communication and tasks. By taking advantage of agile technology platforms, health systems can rapidly deploy new use cases to help deal with the crisis – from early risk identification, screening and patient sign-posting, to helping patients reduce anxiety and self-manage their symptoms.
By leveraging automation, health system leaders can control the curve far more efficiently than ever before. The promise of automation is to ease the COVID-19 burden on staff and resources, giving them the arsenal to fight this disease and ensuring that any future outbreaks never get the chance to evolve from an epidemic to a global pandemic. When it comes to applying automation in the fight against COVID-19, four particular use cases come to mind:
Automated Awareness Campaigns
Tech capabilities that are already prevalent in the public-health sector can also play a critical role in controlling the current pandemic and future outbreaks. For instance, most health systems use Population Health Management (PHM) or Business Intelligence (BI) software that can quickly create and segment cohorts of patients. These solutions can help to identify people and communities at highest risk of COVID-19 complications, based on variables that go beyond the patient’s medical history. Different cohorts with varying degrees of risk can be created, such as the elderly, those with a pre-existing disease including respiratory problems, or those residing in high-risk locations.
Campaigns can then be directed at these cohorts and tailored to address their frequently asked questions or wide-spread myths surrounding COVID-19, as well as advising on how to protect against the virus and self-manage symptoms. Campaigns might also include tips for social distancing or advice about the risk in their specific communities. A critical consideration is how effectively the data can be anonymized with respect to the patient’s consent, along with opt-in/out preferences.
Depending on communication preferences – often found in the Electronic Health Record (EHR) system – email, voice and SMS campaigns can be sent out to each cohort. Using these communication tools while targeting specific cohorts of the community can go a long way toward providing reassurance and preventing panic visits to health centers and hospitals.
Automated Screening
Automation technology can also enable more comprehensive screening solutions that proactively assess risk. In this use case, a cohort of vulnerable patients is automatically engaged with a survey that screens for symptoms and, depending on the results from the survey, may then be proactively monitored for the next several weeks. If a patient’s symptoms increase in severity or frequency, they might then be directed to a nearby clinic, with the system automatically generating a list of potential locations based on the patient’s zip code.
This form of automated proactive screening can significantly improve detection of the highly contagious virus and eliminates exposure by allowing doctors to evaluate patients’ symptoms and triage without direct contact. It also limits hospital intake to patients who are most likely to be diagnosed with COVID-19, instead of flooding providers unnecessarily and straining limited resources.
HypeLabs, a software-only mesh networking provider, announces the launch of CovidApp (CovidApp.org), an easy-to-use selective quarantine white label solution that has been proven to prevent the continuous spread of the novel coronavirus. The system is ready for immediate deployment and will be free to all states and countries that wish to use it.
CovidApp is a private and anonymous contact tracing system that detects physical proximities between smartphones and works in conjunction with hospitals and governments to inform users, even those without an internet connection, about their likelihood of a COVID-19 exposure if they have crossed paths with someone who has already contracted the virus. This software uses random ID numbers that do not require any database or private information of any individual.
Smartphones that have the app installed will be capable of exchanging Bluetooth and Wi-Fi signals when the devices are within range of one another, even without internet or mobile data. Records of those encounters will be stored in the device for up to 14 days and subsequently sent to a central server.
If someone has tested positive for COVID-19, others that were in proximity contact with that person will be alerted to be tested or to initiate a preventive quarantine immediately. Web portals for both health and government officials allow authorized officials to distribute information to the end-users, from important announcements to health recommendations for containment of the virus. Only authorized medical personnel can interact with the health web portal and update the health status of tested citizens.
“It is important to emphasize that no one will ever see the users’ private information,” said Carlos Lei, co-founder and CEO of HypeLabs. “Only the Unique Device ID is visible to government authorities. CovidApp can help cities and countries turn their economies back on as soon as possible.”
CovidApp has already been tested and deployed in some countries in Latin America such as Colombia, the first nation to adopt the system showing the lowest numbers of infected patients in the region and is managing the flattening of the curve.
In addition to helping virologists gather important data to prevent future pandemics, contact tracing can be used as a general private analytics tool to improve transportation systems and help to design a more efficient flow of entire cities.
With the continued spread of COVID-19, it’s more important than ever for healthcare organizations to continue implementing ways to keep employees and patients safe, while improving patient care and keeping patient data secure. Many healthcare organizations are turning to KVM (keyboard, video and mouse) solutions to help with the increasing need for smarter and safer healthcare solutions.
A few examples:
Remote IT admins – IT admins can access critical servers when working remotely. Remote desktops only allow one connection to one server at a time, but a KVM provides a Windows explorer view of ANY server connected to that KVM.
Remote lab automation – Employees can stay safely away from contaminated areas using a KVM over IP device to access devices in lab areas.
Remote nurse station monitoring – video extenders and KVM extenders allow nurses to obtain real-time patient data from a remote station without being physically inside the room with the patient. This allows for a controlled, clean and secure environment.
Command and control through security and surveillance – Security employees can monitor all entry ways, control opening/closing and locking or unlocking doors from a distance.
Trends in Smart Healthcare
A few trends driving the need for these solutions include:
IoMT and Connected, Integrated Smart Healthcare Systems
The Internet of Medical Things (IoMT) is a connected infrastructure of medical devices, software applications and health systems and services. Integrating different healthcare delivery systems into one mechanism has created the concept of smart healthcare. Not only has this pushed the focus from just caring for the sick to promoting the general health and well-being of people, but it has driven technological advances that connect various health IT systems for ease of control and communication.
Smart technologies, such as virtual health, wearables, sensors and biometrics are already driving this transition to new healthcare delivery models that focus on streamlining processes and making use of cutting-edge digital innovations and information systems. Such developments, including those in artificial intelligence, cognitive technology and robotics are accelerating automation, while telehealth, digital medicine and remote monitoring are already part of larger connected, integrated smart healthcare systems.
Increasing Demand for High-Precision Medical Imaging
Reliable video has always been an important component to healthcare IT, predominantly related to the exponential growth in picture archiving and communication systems (PACS) used to securely store and digitally transmit electronic images and clinical reports. As the volume of digital medical images grows, and data analytics of those images becomes more prevalent, the demand for video at the highest possible resolutions for the most detailed images continues to increase.
The seamless and stable transmission of high-resolution video has become a prerequisite that medical imaging systems are expected to handle (up to 4K), and delivery must be low latency across long distances with no signal degradation. In addition to high-precision audio video signal extension devices, other infrastructure equipment, such as KVM switches, must be able to support the required resolutions and refresh rates.
Digitization Driving Demand for Increased Security
The move toward patient-centered healthcare models and medical information systems is requiring unprecedented levels of security and data protection. Alongside the digitization of healthcare records of electronic medical records (EMRs) is the push for paperless hospitals and the increasing government regulations surrounding data management and patient privacy. Secure KVM switches that are commonly seen in government and military environments are now enabling medical staff to easily switch between sensitive patient data and non-private applications on the hospital network.
Healthcare Use Cases
Medical Imaging: Live Surgery, Remote Monitoring and MRI Diagnostics
A hospital decides to implement a state-of-the-art medical imaging transmission system to enable doctors to perform surgeries and real-time diagnoses more effectively. The solution needs to transmit content, such as live surgery video from the doctors’ head-mounted cameras, patient vitals, medical records, MRI equipment and a picture archiving and communication system (PACS), accessible from various locations inside the hospital.
The challenges:
Medical imaging needs to be instantly accessible from various locations throughout the hospital.
Requires clear and stable video images for monitoring.
Compatibility with a wide range of medical equipment in a hospital environment.
A tailored solution for medical-grade applications with easy-to-use media distribution management software.
The solution: Integrating seamless switching will deliver instant and stable video over long distances over a single cable, while converting various resolutions to ensure top quality. Additionally, adding HDBaseT KVM extenders will allow MRI equipment to be accessed and operated with zero latency while uncompressed video with pixel-to-pixel quality is reliably delivered to the operator’s room for real-time diagnosis.
With all that the healthcare system has to worry about these days, perhaps it’s time to hit the “Pause” button on health IT deployment.
The future of COVID-19 remains a giant question mark right now. But what is clear in this uncertain time is the significant impact everyday factors, commonly called social determinants of health (SDOH), have on a person’s health. Literature shows that up to 70% of a person’s overall health is driven by SDOH, including factors like race, income, education level and more. Knowing about these factors can improve how providers keep patients healthy year-round, but also how they engage, counsel and treat patients as individuals during a crisis like the one we are currently experiencing.
As COVID-19 cases push hospitals around the country to their limits, medical facilities are facing challenges beyond sick patients. Long hours and an uptick in cyberattacks are putting serious strain on existing cybersecurity defenses. Without the right practices, these defenses may fail, exposing patient and hospital data to hackers and cybercriminals.
People’s knowledge of telehealth isn’t necessarily leading to usage — at least, that is what we found at SYKES as a part of 
It is becoming increasingly popular to move healthcare outside of the clinic and into the community and the home with the use of telemedicine platforms, apps, and other digital means — and the coronavirus pandemic has dramatically accelerated that trend. Counterintuitively, this healthcare crisis has the potential to attenuate the relationship between the patient and the healthcare system, putting provider organizations at increased risk from “digital disruptors” like Amazon, Google and Apple, whose ambitions to take over consumer relationships in healthcare are stronger than ever.
Since it was first recorded late last year in China, the spread of COVID-19 has accelerated around the world, rapidly creating a global pandemic. The number of new cases is increasing exponentially, putting the western hemisphere in particular on a frightening trajectory, as health systems struggle to battle the virus.
HypeLabs, a software-only mesh networking provider, announces the launch of CovidApp (