I’m not unique in that during this time of year I love to take a look at predictions made by some of the industry’s “best” and see if their predictions make sense, are surprising in a good way or if they are surprising in a stupid way.
With that in mind, I came across an interesting piece in Canadian Manufacturing of all places that features several intriguing predictions by analyst firm Gartner that I think are worth a look here as they have peripheral relation to healthcare.
So, here we go. Gartner’s top IT predictions include:
By 2015, big data demand will reach 4.4 million jobs globally, but only one-third of those jobs will be filled. According to the report: “The demand for big data is growing, and enterprises will need to reassess their competencies and skills to respond to this opportunity. Jobs that are filled will result in real financial and competitive benefits for organizations. Note that enterprises need people with new skills—data management, analytics and business expertise and nontraditional skills necessary for extracting the value of big data, as well as artists and designers for data visualization.”
In a market like healthcare, where highly skilled jobs are often difficult to fill, we should understand this prediction to be very true and one not to take too lightly. Some of these job vacancies will be at health system that needs the data to meet federal reporting requirements. The individuals with these skills will have a great deal of clout as they eventually move into the job market.
Employee-owned devices will be compromised by malware at more than double the rate of corporate-owned devices. “Corporate networks will become more like college and university networks, which were the original “bring your own device” (BYOD) environments. Because colleges and universities lack control over students’ devices, they focus on protecting their networks by enforcing policies that govern network access. Gartner believes that enterprises will adopt a similar approach and will block or restrict access for those devices that are not compliant with corporate policies. Enterprises that adopt BYOD initiatives should establish clear policies that outline which employee-owned devices will be allowed and which will be banned.”
BYOD continues to rear its head so don’t be caught unawares. AS Gartner predicts, you must have a plan for mobile device management and personal device use in the workplace. Ignorance is not bliss, in this case, and since employees are currently using their own devices in the healthcare setting where very important personal information can be exposed, develop a policy, stick with it and let your employees know you have one in place. Circulate it!
By 2016, wearable smart electronics in shoes, tattoos and accessories will emerge as a $10-billion industry. “The majority of revenue from wearable smart electronics over the next four years will come from athletic shoes and fitness tracking, communications devices for the ear, and automatic insulin delivery for diabetics. CIOs must evaluate how the data from wearable electronics can be used to improve worker productivity, asset tracking and workflow.”
Healthcare will play a role in how wearable electronics and traceable devices are used to track the health of individuals, especially in outpatient and in-home care. The data from these devices will flow directly into your EHR and become part of the patient record. Physicians will be forced to learn the benefits of these devices and patients are going to need to accept it.
By 2014, market consolidation will displace up to 20 percent of the top 100 IT services providers. “The convergence of cloud, big data, mobility and social media, along with continued global economic uncertainty, will accelerate the restructuring of the $1 trillion IT services market. By 2015, low-cost cloud services will cannibalize up to 15 percent of top outsourcing players’ revenue, and more than 20 percent of large IT outsourcers not investing enough in industrialization and value-added services will disappear through merger and acquisition. CIOs should re-evaluate the providers and types of providers used for IT services, with particular interest in cloud-enabled providers supporting information, mobile and social strategies.”
The prediction smacks of the ongoing discussion about the EHR vendor market and how much longer it can contain the number of players. Certainly, we’re seeing deterioration of this segment now, though it has been expected to erode more quickly than it has. Expect there to be fewer EHR vendors in the next 12 months, and realize that no vendor is too big to fail (see Allscripts). Prepare early and do your due diligence before signing the dotted line.
I’d love to know your thoughts. Do you agree with these predictions and my assessments? What are yours?
In a great new white paper, “Essential Enterprise Mobile Security Controls,” sponsored by Blackberry and posted by Tech Target, mobile device security is the feature show. As it continues to be the main event for mobile technology, mobile devices will continue to be used to carry high-value personal and company information, as expected.
When personal devices are disconnected from company networks, security risks were relatively low, according to the report, but as the technology permeates and its use becomes even more closely connected to the work environment, the risks to security increase significantly.
Apparently things have been pretty slow until now, but that’s not likely to last. The turning point is here and hackers are on the move, including on iPhones, as well as the Android market place. Given these continual threats, and the importance of the data healthcare organizations protect, the need for improved mobile security controls an imperative for any organization looking to leverage mobility for competitive advantage.
According to the report, “A key challenge for improving mobile security is to understand what tools are available and how they can be leveraged.”
The following is a list of must-have mobile device security controls to protect workers and organizations, again according to Blackberry:
Device security. Remote lock, wipe and backup/recovery can help reduce the risk associated with lost or stolen devices. According to SearchSecurity.com, lost and stolen devices rank among organizations’ top mobile security concerns, and for good reason: “The easiest way to lose data via a mobile device is to lose the device itself. Every enterprise sanctions (or doesn’t prohibit) BYOD must ensure that any supported device can be locked and erased remotely, and that valuable data is backed up to a location under the organization’s control.”
Network security. The increased number of smartphones and other devices that are carried into the enterprise by end users increases the threat to corporate networks.” Attackers have started seeking ways to use unsecured mobile devices as a means to leapfrog into otherwise protected areas of the network, including databases.
Malware defense. The oncoming wave of mobile malware requires protection, like antivirus, personal firewalls, Web filtering and anti-spam. “It’s becoming necessary to invest in mobile add-ons from traditional antimalware vendors, or consider a mobile device management (MDM) product that can, among other things, facilitate the extension of anti-malware to a variety of mobile devices.”
Threat intelligence. Large enterprises should invest in threat monitoring tools and research teams, and train them on how to not only identify mobile threats, but enable rapid response. These functions can be closely tied to existing log analysis and security information and event management (SIEM) processes. “The most important tactic here is to develop a baseline of “normal” mobile device activity and use analytics and real-time monitoring to spot deviations that may be a sign of an attack.”
Centralized management. Central management tools provide a “single pane of glass” to set and enforce policies and perform many other security-related functions across all mobile devices. This is becoming an increasingly important capability in organizations where multi-platform support is essential.
Data encryption. Files, contacts and email need to be encrypted on mobile devices in the event of loss or theft. Each platform comes with different encryption challenges, some requiring additional encryption application for the data that lives on the device. While the market for mobile encryption for data in motion is immature, new options are emerging all the time.
Over-the-air capabilities. Mobile security requires over-the-air provisioning and configuration to ensure that workers always have the latest security capabilities without burdening IT, forcing them to physically touch each device. As demand grows for an increasingly diverse landscape of mobile devices, this feature is crucial for enterprises that need to scale their mobile security provisioning efforts.
According to the report, and this is a nice summation of the report (and I quote): “Mobile security is still in its infancy, but the trends around connectivity, device evolution and worker mobility means organizations must start planning their mobile security strategy now, and that process begins with assessing what mobile security controls are needed and developing a plan to put those controls into action.”
Wolters Kluwer recently released a gem of a survey fit for the bandwagon of health IT topics currently underway.
On its head, the survey results are intriguing and the data does provide some insight into what the American public is thinking when led to think a certain way about a specific topic that, quite frankly, most don’t know much about.
Now, I’m not saying Wolters Kluwer data is flawed. On the contrary, the firm, which makes its living producing qualified data, knows what it’s doing. What I’m implying is that Wolters Kluwer is producing a survey with data collected by an audience that doesn’t truly understand the topic in which it’s responding to.
Let’s dive in and I’ll explain.
According to the survey by the Philadelphia-based company, 80 percent of consumers believe the greater “consumerization” of healthcare – or the trend of individuals taking a greater and more active role in their own healthcare – is positive for Americans.
“Survey data suggests many Americans feel that a greater role in their care is not only good, but necessary, with 86 percent of consumers reporting that they feel they have to take a more proactive role in managing their own healthcare to ensure better quality of care.”
Let’s start here. As a member of the healthcare community, I’ve helped produce similar reports based on surveys I have even helped write, produce, analyze and release to the public. Does that mean my data was a good as Wolters Kluwer? No, not at all.
My point is that there is nothing new here. Nearly every survey of the American public about healthcare tends to suggest that they need to be more involved in their care. All Americans want to take greater control of their car until, seemingly, it’s time to do so.
Even the results suggest that Americans have the information and tools available to them to take on more responsibility.
“Most consumers also say they feel prepared to take on a greater role in managing their own healthcare, with 76 percent reporting that they have the information and tools to take a more proactive role in healthcare decisions ranging from choosing healthcare providers to researching treatment options. Despite feeling prepared, only 19 percent report that they have their own electronic Personal Health Record (PHR).”
Well, there’s the catch. There always something holding people back; no, it’s not the fact that when it comes time for the rubber to meet the road no one is ready to actually start their journey. If only everyone had access to a PHR, everyone would clamor to be more involved in their care.
Certainly, most of us know that this is simply an excuse so no one has to take responsibility for their actions. And, when PHRs are readily available, some other hurdle will keep Americans from moving forward with their engagement.
Finally, of the 1,000 respondents, Wolters Kluwer suggests that a mind boggling 30 percent of Americans want the same experiences with their physicians as they have with other consumer interactions, such as while shopping, traveling or lodging, complete with choices and control.
Here’s where my suspension of disbelief ceases. There’s just no simple to explain this nor is there very much credibility in the statement. The flaw in this piece of detail, in my opinion, is that we’ll never be able to have the same experiences with our physicians as we can with our travel agent or the baker in the local supermarket.
Physicians, after all, develop a much more intimate with their “consumers.” I mean, physicians see us naked and stick us with needles and get a lot closer than the clerk at your local department store. There is simply no way the relationship nor the experience is going to be the same. Which brings me back to my original point: the survey just seems to try to be so much more than it is seemingly as a result of trying to be part of a larger conversation.
But, to mitigate against the risk of you thinking I’m holding out on you, here are the remaining results. Let me know if you agree with my assessment:
According to Wolters Kluwer: “When it comes to choices about physicians, assuming that experience levels and care reputations are similar, consumers rank costs of visits and procedures (20 percent); technologically advanced offices, including the ability to communicate via email with doctors and nurses, schedule appointments online (19 percent); location of practice/office (19 percent) and friendliness of staff (14 percent) as the top four factors influencing their decision.”
Among other findings from the survey:
Women (85 percent) are more likely than men (74 percent) to believe the “consumerization” of healthcare is positive
More women (81 percent) than men (72 percent) feel that they have the information and tools to make their own healthcare decisions
More women (59 percent) than men (50 percent) strongly agree that they need to take a more proactive role in managing their care to ensure better quality of care
Consumers aged 35-54 (60 percent) are the most likely to strongly agree that they need to be more proactive about their care, with those aged 55+ (56 percent) coming in second and younger adults (47 percent) being least likely to agree
I’ve long been an advocate of HealthIT.gov, which I’ve profiled here multiple times for the guidance the site provides about electronic health records and ways to use the technology.
A new addition to the site is guidance for physicians about mobile health technology, which is beginning to pervade the healthcare landscape.
As healthcare workers and professionals continue to use mobile devices in the care setting, they’ll need accurate and helpful information to protect them and their patients from issues such as security breeches.
To that end, it’s nice to see the Department of Health and Human Services to assemble a series of tips and information to the public’s greater good.
The site features several articles and videos designed to offer support and education about using mobile device in healthcare.
For example, articles include topics such as:
How Can You Protect and Secure Health Information When Using a Mobile Device?
You, Your Organization and Your Mobile Device
Five Steps Organizations Can Take To Manage Mobile Devices Used By Health Care Providers and Professionals
For those who prefer video, topics covered include:
Worried About Using a Mobile Device for Work? Here’s What To Do!
Securing Your Mobile Device is Important!
Dr. Anderson’s Office Identifies a Risk
A Stolen Mobile Device
Can You Protect Patients’ Health Information When Using a Public Wi-Fi Network?
In addition, there’s also frequently asked questions and downloadable materials. All in all, the site is filled with a great deal of rich content.
On top of that, there’s a plethora of other information including tips for integrating privacy and security into a medical practice, building a health information privacy and security plan, information about health IT security resources, cyber security and mobile device security.
Simply put, this is a great resource for all of us in healthcare, patients included. Well done, well done, HealthIT.gov.
Every leader of a competing electronics health records vendor probably jumped for joy once they heard the news that Glen Tullman was ousted by Allscripts, the company that he made what it is. Or, maybe I’m wrong. Perhaps leaders of competitive companies would have liked to have kept him around because of what he did to the organization following the acquisition of Eclipsys.
The man, for the most part, has been considered a genius. Peers in the industry gave his performance praise, patted him on the back and showered him in adulation through the maneuvered takeover of the hospital health IT giant. At the time, in 2010, the move made by Allscripts was hailed as a magnificent effort.
It was the kind of move that was supposed to have turned the industry on its head. Many thought it would, and many eyed the effort with envy for such a move was powerful and assertive.
It did rock the industry. Competitors shook in slight fear with the announcement of the news, and many feared for their longevity. In this fact I am serious. I know. I was at a competitor. The whispers went something like this: “Will this new monster kill us all?”
Though all of we worked to secure our shores, many of us were fearful of the coming tide.
But, from the beginning, there was always a sense that Allscripts, and Tullman specifically, was positioned as too big to fail. Perhaps we should have seen a previous merger, the failed move to integrate Mysis, as a harbinger of things to come.
There was even a point in which I had dubbed him the king of health IT. I referred to him as such during internal meetings in my effort to create the queen of health IT, who was a president of another firm in which I worked.
There was a level of pomp and circumstance about everything he seemed to do through his promoted PR moves and image building to his constant appearances and associations with Washington’s power elite, including the president.
I can’t imagine Tullman saw this coming during his rise to the top. Just 18 months ago he was on top of the health IT world, seemingly unafraid of the world in which he lived, or so it seemed from my outside position.
Hindsight is 20/20, though, and it’s easy to question failed policy after decisions have been made.
When the recent takeover bids failed to take the Allscripts private, the company had but one choice and he and other leaders of the company had to go. It’s a common scenario in the world of politics, another world which Tullman is known to frequent. As things grew worse for the once mighty giant, everyone associated with the debacle had to go.
And, even in lands where great kings have ruled, even their glory days come to an end.
But, does it surprise me that he and others at the disheveled vendor are gone? Gone from the vendor that positioned itself as too big to fail? Gone from the vendor that asserted itself upon the market; that worked to take over a market in which its ambitions were bigger than its capabilities?
No, I’m not surprised.
In many ways Tullman died at the hand of his own sword.
And, as we’ve seen countless times and will see again, no company nor its mascot is too big to fail. No kingdom too vast to conquer, no land immune from the trials of the nations it builds.
And so, the king of health IT is no longer king, but neither is he a pauper. And, like most who have achieved his heights, it’s safe to say we probably haven’t seen the last of him.
I continue to be a fan of quality reporting from publications such as Physicians Practice, and I’ve cited their reports in several of my blog posts in the past. Today is no different. As regular reader here may know, I’ve spent a good bit of time on the subject of patient engagement, specifically how physicians and practice leaders can engage patients to improve their care outcomes and their health.
In the piece, Nelson discusses “meaningful use incentives, increased profitability or improved quality of care.” In exacting terms, she makes a call for patient portals and how it can get “patients engaged in their own care and satisfy just about any goal.”
Though I’m somewhat of a skeptic at the party for patient portals (I don’t think that in their current status they’ll actually lead the patient engagement charge), she offers six pretty interesting and solid tips for helping practices lighten their administrative loads.
Thanks, Rosemarie. It’s hard to argue these points:
Self-registration: “Invite and encourage patients to self-register on the portal. It will save your front-desk staff time, reduce costs, and patient data will be more complete and accurate. When patients call to schedule appointments use that time to introduce them to your patient portal, and explain that advance online registration will save them time on the day of their visit, because their paperwork will already be filled out. Advance registration on the portal provides your practice with three core requirements to meet meaningful use too.”
Collect patient data. “A tightly integrated or interfaced patient portal and EHR will deliver data back to the patient from their encounter. Push the patient’s medication list, medication allergies, problem list, and diagnostic test results from the EHR into the portal and patients almost naturally become more engaged in their healthcare.”
Report patient data. “There has always been a mystery surrounding that paper medical chart for patients. By delivering key components of their health information to them automatically, you can satisfy their curiosity and engage them in their own healthcare. As your nurse discharges the patient at the end of the office visit, use that discharge instruction time as an opportunity to introduce patients to the kind of information they will be able to find on the portal.”
Provide clinical summaries. “The integration/interface from the portal to the EHR allows for automation of data exchange after the patient visit. Clinical documentation is completed and made available to the patient without any action from your staff. In addition to further engaging patients in their own care, you’ll have achieved two more core requirements of meaningful use.”
Secure messaging. “Once you’ve got your patients using the portal to access information, you can begin to communicate with them via the secure online messaging function. Communicating online instead of on the telephone will streamline your practice operations significantly, even if all of your patients aren’t using the portal. Your staff can use the portal to deliver automatic reminders to patients regarding preventive care and/or follow-up care. No more manual logs or tickler files and no more mail merges to process. Developing HIPAA-compliant processes and standard messages frees up your staff to provide direct patient care.”
Provide patient education materials. “Secure messaging can also be used to direct each patient to educational information that is specific to their own individual needs and conditions. Your practice will achieve greater percentages of patients meeting quality measures and your patients will feel as well cared for as their pets. Three more requirements for meaningful use can be checked off, too.”
Though there no longer necessarily a “season” for trend and projection pieces, but given our place in the calendar year, it’s appropriate that analyst firm Gartner recently released its latest piece, “Healthcare IT Trends to Embrace/Health IT Trends to Avoid,” published recently on CIO.
The following tips are part of a larger article about big data that, other than being a bit of a clumsy read, is worth a look. One of Gartner’s top healthcare analysts, Vi Shaffer, opines about the current state of healthcare and how those in it can begin to embrace the changes ahead.
So, without further ado, here’s some of the things you should definitely do (according to Gartner, that is), if you’re seeking ROI. I’ve made some edits to the list in points not relevant to this blog.
Big data. Along with big data, you need to make sure you’re making a move to structured data collection. In its most simple terms, you need to make sure that all of the data being collected in the practice is being collected in the same fashion, and that all of the same data is being collected. Once your data gets “bigger,” you’ll be better able to work with and analyze it. According to Gartner, “This may take time to implement, but it will have a “transformational” benefit and organizations that implement all facets of big data by 2015 can expect to start to outperform their competitors by as much as 20 percent.”
E-visits. “This facet of telemedicine is catching on now that EHR systems and patient portals include secure messaging. Success comes with setting expectations and enforcing policies,” Gartner says.
Wireless health asset management. Putting RFID chips on anything that moves—equipment as well as patient wristbands—is an “increasingly routine component of cost and patient care quality management.” Since there’s a lot to monitor, CIOs must collaboration with clinical engineering or biomedical device departments.
According to Gartner, the following are four healthcare IT trends to avoid. For various reasons, I don’t agree with any of these reasons, do you?
Patient decision aids and personal health management tools. These appear largely in the form of interactive apps that educate patients or help them make care decisions, such as seeking treatment or undergoing surgery for a particular ailment. Though, Gartner says their effectiveness is questionable and adoption remains low, I’m not sure I’m convinced that they should be avoided. There is some value to these programs, especially if they help with patient engagement and education.
Personal health records. “The concept is attractive, as it gives patients ownership of their data, but poor usability and vendor disinterest have hindered adoption. Only with a government mandate, as is the case in Australia, does PHR adoption seem to catch on, Gartner says. Patient portals, which connect patients directly to their caregivers, are more popular.” Not only are they more popular, they are required through meaningful use and, if leveraged properly, can be quite effective in helping drive engagement and education.
The patient-centered medical home. “There’s been much discussion of making this a reality, especially in light of the accountable care organization model, but information exchange challenges and a reimbursement model unfavorable to insurers hinder adoption.” Again, not sure if I agree with Gartner. I don’t have any hard reasons why except that for some, they actually have proven successful. Check out this piece for more about a practice that clearly has leveraged the PCMH successfully.
Patient self-serve kiosks. “While these can streamline patient registration and payment collection, the ROI isn’t there, Gartner says. Most organizations are better off focusing on meaningful use or the conversion to the ICD-10 code set, which must be done by Oct. 1, 2014.” Again, for some organizations, these are simply good tools help streamline the patient intake process. They may not improve ROI, but they can get people into the practice more easily and to their physician without the cumbersome paper and pen approach.
Can a business model be beautiful? Yes, it can, according to Hello Health’s Steve Ferguson, vice president of marketing.
The business model, and the way things get done, at Hello Health are what set it apart from other electronic health records in the market place, Ferguson said.
Hello Health was built from the ground up and launched by the private company Myca in 2008. It made its meaningful use certified EHR available in 2011. The Hello Health system includes everything needed to run a small practice, the area of the ambulatory market in which the company focuses.
Originally designed for single doc practices, the system now scales up, with practices of as many as 10 physicians using it.
At its most basic, Hello Health is a web-based EHR and patient health record, and it’s free to for qualified physicians to use. A qualified practice is typically one with 1,500 active patients on its panel. Unlike Practice Fusion, another well-known free cloud-based electronic health record, it’s not powered by ads, but instead is a revenue source for practices as monthly access subscriptions can be sold to practices’ patients, allowing the patient to access the system’s patient portal, where their personal information is kept.
The patient subscription model allows patients to schedule appointments, view lab results, communicate with their physicians through the HIPAA-compliant portal and, in some cases, view their complete record including visit notes.
Steve Ferguson, vice president of marketing at Hello Health
Those patients that don’t subscribe are still allowed limited access to the portal, but they can’t access all of the information available to them. Cost of monthly subscriptions range between $3 and $10, Ferguson said, but the average is closer to $5.
The annual revenue earned through patient subscriptions is $10,000 per practice, he said, with 30 percent of patients, on average, signing up in each of the practices Hello Health serves. In some cases, more than 50 percent of a practice’s patients have signed up for access to their health information.
Currently, the typical age of a Hello Health subscribing patient is 57 years old and has at least on chronic condition. The “indestructible” 30-something is less likely to subscribe to access to the portal, said Ferguson.
In some cases, patients are able to skip a practice visit or an in-office consult because of their prescription to Hello Health, Ferguson said, and practices are okay with it because they can still bill for the visit.
It’s a simple model, and with the number of portals currently available and the likelihood that access to them will increase alongside meaningful use stage 2, it’s a wonder why other vendors are not creating similar strategies.
“Companies are so in grained in the license model, and on paper it may seem easy to change, but it’s tough to change a business model,” Ferguson said.
Among another key difference between Hello Health and competitor systems is that it doesn’t charge for training and allows as much training as is needed so practice employees are comfortable using the system and are able to educate patients about the value of subscribing to the patient portal.
“Practices really have a partner in Hello Health,” he said. “We take extra time to implement and train employees so they can educate patients to use the systems and better understand the benefits of it.”
Ferguson said Hello Health is experiencing explosive growth, though, would not confirm the number of practices using the system nor the number of patient subscribers because the company is private. However, it is currently available in 27 states, with concentrations of users in New York, New Jersey, Texas, California, Georgia and Florida.
The value proposition to physicians is Hello Health’s business model and the fact that it is a revenue driver.
“Our differentiator is our business model,” Ferguson said. “Everyone tries to sell to the physicians, but most physicians are forced to push back because they can’t afford another bill.”
The fact that the system is free to implement and offers unlimited training is also a plus, he said.
