Healthcare ransomware attacks have become more common in recent years, and in many cases, caused considerable damage. At least 148 U.S. healthcare organizations fell victim to a ransomware attack in 2021, the most attacked industry, according to a March 2022 HIPAA Journal report.
With increasing threats from overseas, growing cybercriminal organizations, and the COVID-19 pandemic, it’s no surprise a sharp rise in breaches and healthcare ransomware attacks has occurred across the healthcare ecosystem.
As the situation grows more volatile, it’s vital to understand why threats like breaches and healthcare ransomware attacks exist and ways ambulatory practices can work to reduce cybersecurity risks.
The Most Valuable Record
It’s not just because the patient health information (PHI) the record contains that makes it valuable to cybercriminals, but the other information that accompanies PHI, such as addresses, birth dates, social security numbers, and even more obscure data such as insurance policy numbers, all of which someone can use to impersonate patients and commit identity theft.
With this stolen information, a cybercriminal can more easily steal someone’s identity because they now know important information no one else does. It’s what makes health records so valuable — not always the record itself, but what can be done with the information.
The average healthcare industry breach is so expensive because of the costs of remediation, recovery legal actions, and regulatory fines. In 2021, the average cost of a healthcare breach was $9.23 million, up 29.5% from $7.13 million the previous year, according to IBM Cost of a Data Breach Report 2021.
Taking it a step further, by failing to keep patient records private, an ambulatory practice could face substantial penalties under HIPAA’s Privacy and Security Rules, cause potential harm to its reputation, and patient safety can be severely impacted. A hacker’s access to private patient data not only opens the door to steal information but they can possibly even alter the data — severely impacting patient health and outcomes.
Greenway Health launches the Greenway’s 21st Century Cures Academy to serve as a resource center for providers navigating the 21st Century Cures Act, its legal requirements, and its effects on the entire healthcare industry. Greenway’s 21st Century Cures Academy is a free resource available to anyone looking to learn more about the 21st Century Cures Act and its requirements.
The 21st Century Cures Act aims to improve the healthcare ecosystem and empower patients by requiring healthcare provider interoperability and patient data access for both patients and providers. The bipartisan legislation will require all healthcare providers, healthcare IT developers, and health information exchanges (HIEs) to be 21st Century Cures Act-compliant by Dec. 31, 2022.
“We consistently heard providers and industry leaders voice concerns and confusion surrounding the 21st Century Cures Act and its future requirements for compliance,” said Dr. Michael Blackman, Chief Medical Officer at Greenway Health. “We knew we needed to create the 21st Century Cures Academy as an educational series and resource center aimed to alleviate confusion, guide providers, and highlight the benefits this legislation will have on the entire healthcare system.”
Greenway’s 21st Century Cures Academy resource center provides easy-to-digest materials including checklists, quick guides, webinars, and other resources to assist healthcare providers in discovering the value the 21st Century Cures Act has to offer their practice.
TigerConnect, maker of healthcare’s most powerful software collaboration suite, announces it has received a significant strategic growth investment from Vista Equity Partners, a leading global investment firm focused exclusively on enterprise software, data, and technology-enabled businesses. TigerConnect will leverage the partnership with Vista to continue its mission to improve patient care through real-time, contextual communications.
“At TigerConnect, we are laser-focused on improving the care experience for providers and patients, beginning with access to real-time and contextual communication and collaboration throughout every step of the care journey,” said Brad Brooks, co-founder and chief executive officer of TigerConnect. “We believe that Vista’s expertise in partnering with founder-led and market-leading enterprise software businesses, coupled with our shared values, align strongly with our mission to provide advanced collaboration technologies that improve care delivery.”
“In 2010, the notion of a universal communication and workflow platform for healthcare did not exist, and TigerConnect transformed that,” said Andrew A Brooks, M.D., FAAOS, co-founder and chief medical officer of TigerConnect. “Together with Vista, TigerConnect’s vision remains to improve outcomes for patients and enhance the daily lives of physicians, nurses, and everyone involved within the healthcare system.”
Greenway Health announced that its Board of Directors has named Pratap Sarker as chief executive officer effective January 1, 2022. Mr. Sarker, who has served as President of Greenway Health since August 2020, succeeds Richard Atkin who has served as CEO since 2018. Mr. Atkin will transition to the role of Executive Chairman of the Greenway Health board.
“Pratap Sarker brings the ideal combination of leadership, experience and vision as the new Greenway Health CEO for this next chapter in the evolution and growth of the company,” said Atkin. “As we continue to enhance our product offerings, invest in our technology platform and deliver measurable client outcomes, we are uniquely positioned for continued growth in 2022. With a seamless transition to CEO, Pratap’s leadership will continue to be invaluable to the expansion of solutions we offer our clients nationwide.”
Sarker joined Greenway Health in 2020 as president. His vision and ownership for client relationship building and his passion for growth has revolutionized the Greenway brand, helping to actualize the company’s purpose of creating successful providers and empowering patients, resulting in healthier communities. Prior to joining Greenway Health, Sarker spent three years as president at Conduent, where he led a multi-billion-dollar business in mission-critical technology and BPO services.
“Greenway Health is primed for growth and market opportunity,” said Sarker. “Together with a strong senior management team, we will continue to evolve our company and transform the healthcare technology sector with products and services that enhance practice growth and deliver innovative, client-centric solutions. I look forward to guiding Greenway Health into its next phase as an industry leader in this exciting market.”
Sarker, who holds a Bachelor of Science degree and a Master of Business Administration degree from Savitribai Phule Pune University, has over 25 years of experience and achievements garnered from helping organizations drive results through strategic development and a focus on execution.
Greenway Health, a leading health information technology services provider, today announced enhanced offerings with Greenway Revenue Services (GRS), which provides revenue cycle management support to clients. Due to clients placing a stronger emphasis on the revenue cycle in response to the COVID-19 pandemic, the company announced GRS Select earlier this year, which delivers more flexible support options for swift and targeted relief to healthcare practices. Greenway will continue to expand GRS services over the next 12 months to further assist clients with their financial relief strategies. The company will also further leverage AI automation and build additional GRS analytics that improve productivity and efficiency within the revenue cycle.
According to a recent MGMA study, 44% of healthcare leaders reported their 2021 visit volumes are below their pre-pandemic levels and ambulatory practices are still facing negative financial impacts due to the pandemic. Greenway developed its GRS offerings based on such emerging needs of its clients, to further help ambulatory care practices improve their financial health. The company is already seeing significant interest, with longstanding EHR clients such as Tier 1 Institute Orthopedic and Neurosurgical adding GRS.
To lead this expansion, Greenway has appointed its Chief Compliance Officer, Susan Kohler, to a new role as senior vice president of Revenue Services. A tenured employee with more than 15 years of experience leading healthcare operations in revenue cycle, claims, payer and provider network management, and electronic data interchange (EDI), Kohler will now oversee operations for both GRS and Greenway Clearinghouse Services.
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.
The electronic health record (EHR) industry continues to undergo a significant transformation, with many physicians asking themselves whether they consider their EHR a friend or a foe.
In too many cases, medical staff feel their EHR works against them, not for them. In fact, according to Medical Economics’ 2019 EHR score report, 60% of physicians said their current EHR system was harming their ability to engage with patients. In addition, The National Academy of Medicine found that as many as half of American physicians and nurses experience substantial symptoms of burnout. And, the same study found that poorly designed technology is a major contributing factor due to the increased amount of time needed to keep systems properly updated.
This should not be the case, and it’s time to change this narrative.
As we near a new year and a new decade, it’s time to focus on advancing EHRs to make the lives of physicians easier, while assisting in improving the patient experience, increasing engagement, enhancing administrative burdens, and more.
Required features and functionalities of EHRs in the next decade include:
Legacy EHR’s are typically thought of as outdated and lacking customization. Custom forms take months to build, cost extra and users ultimately lack control over the functionality. This is not acceptable by today’s standards. Every healthcare practice and specialty is different. So, the EHR must be customizable to fit each practices’ needs in order to optimize efficiency in data entry and management.
In addition, medical trends and challenges are constantly evolving. For example, opioid addiction has risen to epidemic levels in the United States, with the Centers for Disease Control and Prevention (CDC) estimating that more than 130 people die from an opioid overdose every day. Fortunately, health information technology has emerged as a powerful tool for tracking prescription activity.
EHR’s hold a tremendous amount of data – data that can help physicians provide better care to a specific patient or population. Armed with these analytics, a practice can gain insight into population health — along with reporting requirements for government incentive programs and data to optimize billing and cash flow.
The EHR of the next decade should be a tool for decision making. EHRs need to utilize advanced artificial intelligence (AI) and machine learning to make smart suggestions based on data.
An EHR should not just track if a patient is following their care plan, but alert providers when a patient has missed certain critical elements and make suggestions on how best to proceed. As such, the technology can be used to play a larger role in lowering no-show rates and helping predict which patients will have the most success – or biggest challenges – with certain treatment plans.
EHR’s should also be capable of helping physicians make the best financial decisions for their practices. In addition to increasing practice efficiencies and costs, EHRs assist in offering reduced drug and treatment plans with expected costs.
Like so many industries in today’s Third Industrial Revolution, the pace of innovation in healthcare today is fast and ever-changing. New technologies – like artificial intelligence (AI), machine learning, big data, the Internet of Things (IoT) and voice recognition – are at the heart of applications and tools that are becoming demanded by patients and more ingrained in clinicians’ daily workflows.
For vendors developing new solutions based on these technologies, it appears they find themselves in a ‘race,’ striving to be first-to-market in order to establish their competitive edge. But being on the bleeding edge of innovation isn’t always easy. The healthcare industry has not been immune to this rapid quest for first-mover advantage. Often when this occurs, these new solutions sacrifice the quality and functionality required to deliver on promised improvements.
Think about the initial introduction of the electronic health record (EHR). Billed as a way to make practices and physicians more efficient, many early EHR solutions had the opposite effect – creating a significant learning curve and adding to physicians’ workloads overall. While EHRs may have made great strides toward digitizing medical records, taking paper and manual processes out of the equation, they often created new problems that placed different burdens on practices, providers and patients. In fact, in the early days, physicians reported spending more than half of their workday – an average of six hours – using the EHR, plus another 86 minutes after hours.
But EHRs are not the only healthcare technology solution attributing to this challenge – it transcends innovation across the entire health IT sector. As an industry, we must take a step back and slowdown to ensure all new technology can deliver meaningful change to practices, providers and patients.
How to Design New Healthcare Technology with the End-User in Mind
A key to ensuring healthcare technology delivers true benefits is considering how it will fit into day-to-day operations of the end-user – whether that be a patient, a nurse, a surgeon or a billing manager. Before introducing any new technology to the market, make sure your first intention is to get it right.
To do that, engineering teams must employ “user-centered design,” a concept that emerged in the mid-1980s. This approach, defined by the International Standards Organization, “aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, usability knowledge and techniques.” The goal ultimately is to enhance effectiveness and efficiency, improve human well-being, user satisfaction, accessibility and sustainability, and to counteract possible adverse effects of use on human health, safety and performance.
User-centered design in healthcare could entail shadowing a nurse to observe his workflow when triaging patients, following a surgeon to see how she develops post-op papers, or interviewing patients to understand how they obtain healthcare information in their daily lives.
With that experience, you can then ascertain what capabilities would make users’ lives easier or more effective. From there, determine if there’s a way to improve an existing product on the market to fulfill needs, or whether a completely new platform is required.
Key Questions to Answer When Implementing a User-Centered Design Approach
There are several questions you must consider when following this method:
As a physician, one of the most rewarding parts of my job is building relationships with my patients. In developing this connection, I’m able to better understand their healthcare challenges and frustrations, which enables me to ultimately help them achieve their health goals.
But establishing strong patient engagement is getting harder, in part due to the ever-changing regulations and daily demands we as physicians must manage.
Consider this: During a 20-minute appointment, physicians spend only about 12 minutes interacting with the patient and 8 minutes documenting their visit on the electronic health record (EHR). Once the patient leaves, we spend another 11 minutes completing documentation in an effort to keep up with payer demands and comply with other requirements.
While healthcare tech – in the forms of EHRs, patient portals, secure messaging or mobile apps – are proven to help foster stronger connections between physicians and patients, it’s the personal touch, the solid relationship between the patient and the provider, that’s most important.
Building a Trusted Relationship: The Patient <> Provider Connection
Despite best intentions, many healthcare practices fail to provide solid patient experiences. Considering today’s healthcare environment where individuals now foot more of their healthcare bill than ever before, patients are seeking greater value and convenience for their money.
According to a recent study, nearly half of all healthcare consumers are frustrated with their healthcare experiences. Why? Because there is a gap in perception between providers and consumers on the quality of experience currently being provided.
To overcome this disconnect, let’s go back to the basics. As a child, you’re taught that it’s proper etiquette to shake someone’s hand and look them in the eyes when speaking with them. This is true for physicians as well.
The first step in building better relationships with patients is to make eye contact with them. In fact, a recent JAMA study found that patients equate engagement with eye contact from the provider. As simple as this seems, many physicians (myself included) sometimes struggle with this due to the fact that we are heads down in our technology systems.
However, eye contact is a powerful form of nonverbal communication and shows our patients that we are giving them our undivided attention. Trust me – patients notice whether or not their doctors make eye contact. If we are constantly looking at our computer or tablet during an office visit, the patient automatically feels the disconnect and will rate their overall healthcare experience much lower.
Overcoming the Pitfalls of Technology to Improve the Patient Experience
While the human element in healthcare is of paramount importance, there is still a role for patient engagement technology, which can enhance and strengthen our personal relationships with patients. However, practices must make sure these tools are integrated and operate seamlessly. While patient engagement technologies look great on paper, when put into practice, they often require patients to use different apps or access a variety of unconnected systems.
Portals are one of the most common technologies that can be used to engage patients, however research shows that more than 56% of patients have said they’ve never been encouraged to use an online medical record by practice staff, and 47% of patients offered access to a portal have never viewed their health info. In addition to making patients aware that these technologies exist, it’s also crucial to discuss the benefits of patient portals, such as simplified processes for refilling prescriptions, scheduling appointments, reviewing health information and more.
Fostering a Successful Technology-Enabled Patient Engagement Strategy
While it’s true that it takes both people and software to truly engage patients, applications of patient engagement technology can be successful when enabled by a compassionate and sincere strategy. Some key considerations when implementing these technologies include:
By Marvin Luz, senior director of revenue cycle management transformation, Greenway Health.
The move to value-based care not only impacts the approach providers take to serving their patients, but it also changes the way they document, account for, and bill patients — quickening billing cycles and creating a need for better cost containment.
Timely revenue cycle management (RCM) is essential for success in this new healthcare realm, but many practices still handle billing as if they were in the fee-for-service age. This leads to critical mistakes that cost them in the long run, including:
#1 – Lack of a defined process
Billing glitches originate in several areas of practice operations, especially during busy times. With many patients coming in and out of the office, important information may be miscommunicated, overlooked, or even lost. Practices must standardize their billing processes as a “cycle” that is clinically driven and embraced by staff.
#2 – Neglecting critical information
While managing every type of information contained in documents that practices require may seem overwhelming, providers must embrace this task to optimize revenue opportunities. For example, when organizations understand the nuances of payer contracts, they are in a better position to fully leverage payment and negotiations. Equally important is staying on top of edit reports, explanation of benefits forms, and other claims issues, while also making sure denied claims are reworked and resubmitted in a timely manner.
#3 – Failing to follow up
Providers employ a variety of strategies to improve collections, including appeals, tracers, collections letters, and payment plans. While these tactics are a good first step, many fall short due to lack of follow-up. Research conducted by Greenway Health found that only 62 percent of practices review delinquent claims, while just 59 percent of secondary claims are filed due to back office time constraints. Often, by the time a practice realizes a patient or payer has not responded, it’s too late to collect the money owed.
#4 Drowning in detail
Details are important, but when billing practices become all about them, organizations can neglect the bigger picture revenue opportunities. For example, if practices look for trends, such as repeated claims denials for the same services or claims that are denied for registration errors, processes can be reworked to avoid those common errors to occur in the future.