Guest post by Daniel Piekarz, vice president of life sciences business development at DataArt.
The life sciences industry will be defined in 2014 by the growing market demand to apply newly developed technology, including big data analysis, to healthcare and medical device practices. While many of the amazing technological advances in the space are driven by a desire to aid humanity, the industry is also caught between increased economic and regulatory pressure that is forcing many to electronically collect heaps of data while looking for custom technology solutions that will allow them to leverage this valuable data and adhere to new industry standards.
Over the next year, trends that reflect newly available technology will start to develop. The adoption of healthcare big data technology will become a major theme in the sector this year, just as it has in several other industries. Many new technology offerings have been created to tie together data from multiple sources that can be accessed by researchers and physicians to allow them to easily exchange information. This also aids in research and development practices by offering another valuable tool to gather and analyze data.
Tied to the big data trend is the emergence of personal healthcare data aided by physicians’ adoption of EHR technology. By allowing patients to own and access their healthcare data on a healthcare information dashboard, patients can more easily understand risks and preventable care options. Pooling anonymized patient data together can also lead to better analysis, and physicians are already starting to work with vendors to develop big data diagnostic tools. These new technology advancements have started to create a generation of patients more committed to their own healthy future than ever before. Through an intelligent system database, patients and physicians can better understand patterns and symptoms that affect their healthy lifestyles. While this type of big data solution is gaining a foothold, there is still resistance from some doctors due to their concern over critical review of their procedures.
Today’s healthcare IT departments have a relatively tall order when it comes to effective EHR data management. In an environment that often requires them to be simultaneously budget-conscious, growth-minded and patient-driven, healthcare IT must also address the often-competing data management needs for:
Access
Instant
Secure
Anytime, anywhere
Availability
Security
Data sharing
Data at rest
Privacy
Compliance
HIPAA
PPACA
CFR
Data protection
Backups
Operational recovery
Disaster recovery
Capacity planning
Archival
Growth
Data mining and analytics
Popular EHR system vendors have made significant strides to address several of these data management issues. Unfortunately, they can only go so far given the current state of many healthcare IT environments. Some departments may still require custom software applications, complete with specially configured servers, storage and network hardware to support them.
Guest post by Shameem C. Hameed, founder of ZH Healthcare.
The past five years have seen monumental changes in the world of healthcare information technology. As 2013 comes to a close, it seems appropriate to look forward to the developing trends for 2014 and beyond and how they will impact vendors, providers and patients.
Open Source Technology Use and Development Will Accelerate
The continuing acceptance and use of open source software is the most important healthcare trend, since it ties directly into every point on this list. Open source software has become part of the healthcare mainstream and is used in many areas of the healthcare industry. Open source software is behind everything from the EHR system doctors use to enter patient data to the web browser or smartphones and tablets patients use to check their records through patient portals. Even the much talked about Healthcare.gov website utilizes open source software.
The benefits of open source development over proprietary software will continue to fuel its expansion over the next few years. Open source software has many advantages for providers and patients, including interoperability, speed of problem resolution, flexibility and more frequent updates.
An example of how open source software provides these benefits can be found in the area of EHR systems. One of the most common complaints by physicians and staff about EHR software is that the software is difficult to use. Now that EHR adoption has become widespread, there is much more thought and resources going into refining the user interface. With proprietary software, the amount of developer resources that can put into refinements may be limited to that one vendor’s resources. With open source software, countless companies and individuals are constantly collaborating to make the software easier to operate and more user-friendly for everyone.
Guest by Michael Charest, vice president healthcare, insurance and financial Services, GMC Software Technology.
Healthcare organizations today are pursuing a wide range of health IT initiatives in the hopes of reducing costs, improving efficiencies and, most importantly, enhancing patient care. While a great deal of attention is being paid to high-profile health IT topics, such as electronic health records (EHRs) and health information exchange (HIE), there are basic aspects of the workflow at healthcare organizations that can also play a key role in driving healthcare efficiencies. One of these is the patient discharge experience.
How well patients are communicated with upon discharge is a leading threat to a healthcare organization’s top-line revenue, as well as an endangerment to the patient experience. With Medicare/Medicaid regulations now making it difficult to collect revenue for a patient’s second visit for the same problem within 30 days, special attention needs to be paid to how well healthcare organizations are preparing the patient when they walk out the hospital door—and at home following their release. Patients need to be able to understand their at-home instructions for post-visit care so they don’t have to return to the healthcare facility for more treatment or instructions, which will negatively impact the hospital’s revenue and the patient experience.
Creating a more effective discharge experience for patients requires providing clear, easy to read discharge instructions. Accomplishing this is not always a simple task given that the instructions typically are compiled from a large set of data feeds, gathered from multiple treating physicians and need to be provided in a language that the patient can understand. Health IT can play a critical role in overcoming these hurdles.
Similarly, healthcare organizations will benefit from considering the archival system in place. It is important to have an archival process that will enable the organization to prove that discharge instructions were complete and comprehensive. This will avoid the potential for losing Medicare/Medicaid reimbursements in the event of an audit. Not having the ability to easily retrieve all relevant records exposes the healthcare organization to avoidable revenue loss.
In the new healthcare ecosystem that is increasingly migrating to cyberspace, who can healthcare consumers rely on? Who in the healthcare service supply chain will prevail? Who will be the next Amazon or Yelp? Chances are it will be the organization that can deliver and mediate a centralized consumer experience – connecting healthcare consumers not only with care and treatment options, but also with pharmacists, labs, therapists, clinics, wellness coaches and other resources along the care chain.
More today than ever before as the care conundrum continues, fewer and fewer crave office visits, hospital stays or trying to reach physicians by phone. When we’re well, we see no reason to visit a physician. When we’re sick we increasingly wait until we’re sicker. And when we’re somewhere in between, we avoid calling because we know we’ll be put on hold. If there were a better way to consume healthcare, most of us would likely take it.
Interestingly, within this conundrum lies an opportunity for the myriad of healthcare players – from payers and providers at one end of the supply chain to wellness tacticians, retailers and mobile tool providers at the other end – to create a sustainable dialogue with healthcare consumers.
According to a recent survey conducted by Purdue Healthcare Advisors, a nonprofit healthcare consulting organization, hospital executives are reluctant to implement ACOs — 46 percent — and they have no plans to implement an Accountable Care Organization (ACO)-like model in the near future.
Conducted in October 2013 among 206 hospital executives at a director level and above, the survey also reveals that executives are struggling with finding solutions for lower reimbursements and increased costs, while still maintaining an acceptable level of quality care.
“This survey has identified a significant need for advocacy and education to support hospitals and help them survive the wave of changes brought on by the Affordable Care Act,” said Mary Anne Sloan, director of Purdue Healthcare Advisors. “Hospital executives are charged with enhancing patient care and managing margins with a shrinking workforce and diminishing patient volumes.”
Hospital executives find ACOs to be unstable and financially risky
Executives are waiting for ACO models that are more stable and mature to avoid having to reinvest funds to implement changes or updates, according to the survey. The executives who do not have plans to implement an ACO model in the future (46 percent) cited the following reasons:
Why is the challenge of meeting meaningful use Stage 2 much more difficult, and why are many finding it to be a more rigorous certification process? To start, the requirements are more complex, and vendors are facing challenges in building solutions that are truly interoperable – which is the goal that all EMR/EHR vendors are pursuing as they upgrade their software to meet MU2 requirements.
While MU1 required that patient data be shared with patients or other healthcare professionals, MU2 has more in-depth requirements for sharing that data using advanced document architecture. EHR software needs to electronically connect and securely share data with patients, other practices, laboratories, hospitals, etc. Challenges arise for vendors when trying to build software that will easily integrate with other proprietary clinical systems. This means working with those other entities on their time frame. Because of the large number of EMR systems that need access to these entities, prioritization of these interface requests have led to long wait times and in turn, further delay certification progress.
The casualty claim arena involves evaluating and payment of claims for claimants who have suffered from an auto accident or workers’ compensation injury. This side of the health payment continuum has been omitted from the Health Insurance Portability and Accountability Act (HIPAA) as a covered entity.
This means that casualty claim insurers are not required to abide by the standards set forth in HIPAA and that these standards only apply to the health payer. Omitting the ICD-10 in casualty claims from standards does have merit, but when it comes to standardization, all health claims should be adjudicated and paid in the same manner. Why should a provider charge differently and be paid differently when the payer of the claim is not on the health side? This is a question many casualty payers ask and not being part of the standardization only raises the question more.
There is no option for submission of claims by the covered entity to not be compliant by October 1, 2014 with the International Classification of Diseases, 10 Revision (ICD-10). Why is it a good idea to omit the casualty payer from these standards if the majority of health payments are made using this new standard? In addition, if providers are covered entities, then why would the casualty payer not speak the same code language? It’s almost like trying to communicate in a foreign country without the benefit of knowing the language.
