Alan Portela, CEO of AirStrip, has more than 25 years of experience in bringing medical technology solutions to market. Portela originally joined AirStrip as a senior advisor and member of the board of directors prior to his appointment as CEO in 2011. Prior to joining AirStrip, he was CEO and principal of Hybrid Clinical Transformation, LLC, where he developed EHR adoption strategies for the U.S. Military Health System and much of the Veterans Health Administration. He also served as president and chief strategist at CliniComp, Intl., and in senior executive roles in several innovative healthcare technology and service organizations.
AirStrip provides a vendor and data source-agnostic, enterprise-wide mobile interoperability platform that advances care collaboration and serves as a catalyst for health system innovation. Here he discusses mHealth trends; why and how it needs to change; interoperability; security and protecting against breach;and the biggest issues facing healthcare in the next year.
Can you tell us about yourself and your background prior to starting AirStrip? Why healthcare?
Prior to joining AirStrip, I was the president at CliniComp and responsible for the implementation of high acuity EHR systems at the U.S Military Health System, Veterans Health Administration (VA) and a number of prestigious healthcare organizations in the private sector. In my more than 25 years of experience in the healthcare industry, I have held several senior executive roles with innovative healthcare technology vendors and helped pioneer an mHealth company more than a decade ago that came out of UCLA Medical Center Department of Neurosurgery (Global Care Quest). Leading the industry via disruptive and continuous innovation has become a true passion. Each day I see how technology improves patient care, and I enjoy being an active part of that transformation.
What do you think the mHealth industry needs to change to better support doctors and patients today?
Mobile technology and clinical decision support tools will undoubtedly be the biggest contributors to the needed clinical transformation revolution, providing physicians with a means to deliver proactive quality care to millions of patients throughout the continuum of care. However, for clinical transformation to occur, the industry needs to establish – and enforce – interoperable standards so that data and technology can move seamlessly across systems and provide clinically relevant patient information at the moment of care regardless of where the caregivers and the patients are. Interoperability will remove the data silos that currently impede access to information, and allow for clinical decision support that lets clinicians provide the best care, improving overall patient outcomes and well-being. The fact that legacy vendors are not sharing data means that innovation is being stifled. Unfortunately, both the federal government and a handful of legacy vendors seem to be driving us deeper into the crisis by carrying the flag of interoperability, but only limiting requirements to minimal clinical data sets, which do not contribute to the move from volume to value-based reimbursement.
Joe Petro is senior vice president of healthcare research and development, where he provides leadership for all of the research and development required to bring Nuance Healthcare products to market, including: Dragon Naturally Speaking, eScription, Dictaphone (Enterprise Express/iChart), Radiology Platform, Radiology Reporting & Decision Support, SpeechMagic, Critical Test Results Reporting and innovations such as cloud offerings, CLU, and CAPD. Prior to joining Nuance, Joe was SVP of product development at Eclipsys Corporation. While at Eclipsys, he also served on the executive staff and was a reporting officer, where he was responsible for the development of more than 30 products from ADT, departmental, inpatient, ancillaries, patient financial management and outpatient products. Petro received a Bachelor of Science in Mechanical Engineering from University of New Hampshire and a Master’s Degree in Mechanical Engineering from Kettering, graduating both with Summa Cum Laude accolades.
Here he discusses Nuance, the evolution of technology in health IT, trends and changes, the patient response, meaningful use’s hamstringing and the biggest obstacles patients face.
Describe Nuance Communications and your role.
Nuance is the market leader in creating clinical understanding solutions that drive smart, efficient decisions across the health information technology industry. More than 500,000 clinicians and 10,000 healthcare facilities worldwide use our technology and solutions. Nuance clinical speech and understanding products are deeply embedded in EHR solutions, such as Cerner, Epic, Meditech, etc., enabling them to deliver innovations that provide a seamless user experience to their clinicians.
I’m the senior vice president of engineering, Research and Development, for Nuance’s healthcare division. I am responsible for the research and development of the entire Nuance Healthcare product portfolio. When not leading the engineering teams, I spend time with clients trying to understand how to improve existing products and devise brand new ideas that someday will become part of our extensive product portfolio.
How is Nuance changing healthcare today and in the future? Where do you see the company, and health IT going?
I think the health IT industry is approaching an inflection point where technology shifts from being viewed as a mandated requirement to more of a ”necessity that I must have in order to get my job done.” We are finally reaching a point where the cloud is enabling the kind of form-factor agnostic experience that we all thought made a lot of sense from the very beginning, but which was challenging to deliver because all of our “things” were not connected.
When it comes to tech adoption, particularly in healthcare, there needs to be a catalyst—we saw that with CMS regulations and meaningful use. Now, we are starting to see perspectives shift: Physicians are asking seemingly obvious questions like “Why can’t I access this data on my smart phone…?” or “Why can’t I do the same things on my phone as I can using the computer on wheels in the hospital?” This kind of shift is creating massive opportunities for a company like Nuance because the ability to get data into the mobile device (and easily access it) can be profoundly impacted by the technologies that we build. And sure there are plenty of challenges, but the industry is becoming more adroit and agile, creating solutions that serve the specific needs of the individual physician – and not just the technology to address government imposed regulations.
Dr. Sol Lizerbram has been co-founder and chairman of the board of HealthFusion since its inception in 1998. HealthFusion develops web-based, cloud computing software for physicians, hospitals and medical billing services. HealthFusion’s fully integrated solution includes MediTouch EHR and MediTouch PM. Dr. Lizerbram was a co-founder of a national physician practice management company, and served as chairman of its board of Directors from 1986 through July 1998. Dr. Lizerbram has been in the healthcare industry for more than 35 years, received a degree in pharmacy in 1970 from Long Island University, School of Pharmacy, and was licensed as a registered pharmacist in the states of New York and Pennsylvania. He obtained a medical degree from the Philadelphia College of Osteopathic Medicine in 1977.
He is board certified in family practice and is licensed as an osteopathic physician and surgeon in the states of Pennsylvania and California. Dr. Lizerbram was recognized by NASDAQ/Ernst & Young as the 1996 Entrepreneur of the Year in the healthcare industry. He was a trustee of the US Olympic Committee and is active as a committee member in the Jewish National Fund. Dr. Lizerbram was appointed by the California Insurance Commissioner to the Governing Committee of the Workers’ Compensation Insurance Rating Bureau, and appointed by the California Governor as a Commissioner to the Health Policy and Data Advisory Commission.
Here, he discusses HealthFusion, the technology he helps develop and how it’s being used by physicians, the future of health IT, interoperability and the rise of consumerism and the cloud, the survival of EHR companies.
Tell me more about yourself and your background. Why healthcare?
I was a pharmacist prior to attending medical school in Philadelphia. After completion of my medical training I moved to San Diego, where I practiced as a board certified family physician. After several years in practice, I was appointed as the medical director of Prudential PruCare in San Diego. Soon after, I began to see the need for software that would assist doctors in improving the health of our population.
In 1998 I helped to found HealthFusion with Dr. Seth Flam, our CEO and a fellow family physician, to make the practice of medicine simpler for physicians and their staff by finding novel methods of utilizing the Internet.
Our job is to create the software tools used by physicians to further the health of their patients. We are honored that each day thousands of providers use our healthcare software to help make someone’s life a little better.
I come from a family with a strong healthcare orientation; my brother and six cousins are all physicians. As a result, I had an interest in helping people with their healthcare needs and found it very interesting.
What do you see as the sector’s biggest issues and, technologically, how can we solve them?
One of the biggest issues in healthcare right now is interoperability, the ability to seamlessly exchange patient data between physicians, hospitals, diagnostics centers, etc. This communication has been a challenge in healthcare because it needs to be accomplished between disparate systems, but it’s vital to garnering full value from digital healthcare information for patients, and for improving population health.
I’m glad to say that we are already accomplishing this with HealthFusion’s MediTouch; as an example, we provide data exchange successfully between Miami Children’s Hospital systems and MediTouch in the community doctors’ offices.
Amazing Charts, a provider of electronic health records and practice management solutions, issued its healthcare predictions for 2015. Some interesting predictions here I thought you might find worthwhile. Concierge medicine, which I’ve said for some time is going to have a lasting impact, especially in the era of the Affordable Care Act, made the list.
Patient engagement, and consumerism of healthcare– somewhat of a slam dunk — appears here, too. I believe we’ve get some clarification on what that movement means this year. Amazing Charts agrees.
Also, wearables (oh, wearables, will you become more than a fad?) makes this list, and telehealth is here, too; I think we’ve finally reached the saturation point of telemedicine. This year should show strong results that I hope will validate its role at the point of care. We’ll finally get to see if payers get the message.
Here’s the full list of healthcare predictions for 2015 from Amazing Charts:
Membership Medicine Comes on Strong: The patient membership approach to medicine will grow in all forms, including value-based Direct Primary Care (DPC), high-end concierge medicine and primary care services contracted directly by employers. Market-driven medicine, fueled by changes occurring in healthcare today, such as inexpensive health plans with very high deductibles, will continue to encourage consumers to explore more cost-effective alternatives for primary care.
Patients Help Define the Experience: The patient, in partnership with the provider, will help define the care experience going forward. This trend will be powered by technologies that enhance face-to-face interaction in the exam room. One example is the projection of an EHR onto a large display screen to facilitate information sharing between provider and patient. This in turn will help reduce errors and misdiagnosis, as well as motivate patients to take a renewed interest in their own healthcare and treatment options.
EHRs Get Personalized: The EHR market will further mature and become customizable for individual patient needs and treatment plans. Intuitive data analytics will play a critical role here, helping clinicians measure, assess and manage their specific patient populations to better define specific gaps in clinical care and introduce the latest evidenced-based treatment procedures or diagnostic techniques.
In today’s dynamic healthcare industry, it is important that providers embrace modern information technology and innovations to achieve organizational success. It’s no surprise that the health IT landscape is changing rapidly, driven by the interrelated trends of mobility, cloud, security and big data. This will fundamentally change the way that healthcare organizations communicate and collaborate moving forward. But, these health IT trends are not only driving change, they are also serving as the path to deal with many of the new dynamics created in today’s office environment.
In turn, healthcare organizations will need a “new style of IT” that helps them become more agile and efficient while reducing operational costs. In addition to these megatrends, changes to government regulations are driving an industry-wide shift to improve healthcare IT, which have increased healthcare IT spending projections to $34.5 billion in North America.
There will be an abundance of technology resources available to help healthcare providers facilitate this transition; however, IT decision makers must be able to identify the technologies that will work best for their business. The following three strategies are key consideration points when looking for new technologies to help you manage IT megatrends.
Benefit from Healthcare Big Data
Regulatory changes associated with the Patient Protection and Affordable Care Act (PPACA) will create a surge of newly insured patients. The Congressional Budget Office expects that the PPACA will cover around 14 million of the uninsured in 2014 and 25 million by the end of the decade. There is a significant financial opportunity with these new patients, but it is important to consider that the number of practitioners will not immediately increase to accommodate this influx.
Investing in technology and tools designed to specifically address big data and the vast amounts of patients’ personal information will help healthcare organizations provide more personalized care to these newly insured patients. By selecting tools that help collect, store and search for patient information, healthcare organizations can increase productivity by significantly reducing time spent managing patient records. Converting documents into searchable digital formats is an important part of this process, and educating staff on how to properly scan and organize documents in their digital form will help make patient data more accessible and usable.
Fo r the last several years, there has been an increasing emphasis by the federal government on digitizing the healthcare industry. The allocation of meaningful use dollars to physician practices for converting to electronic health records was only the beginning. The Affordable Care Act (ACA) was the seminal event that demonstrated without a doubt that electronic management of patient information was going to be an absolute if hospitals and health systems are to survive.
The ACA puts healthcare organizations at financial risk for duplication of services, lapses in care coordination and questionable patient safety practices. Population health management demands that electronic patient records be accessible for planning, managing and tracking care coordination. But the fact is fully managing the continuum of care for a patient cannot be achieved without data collection both inside and outside the hospital’s walls. This is a trend that will take on increased importance as healthcare reform rolls out in 2014.
Health systems with forward-thinking HIT executives saw the writing on the wall after the ACA became law and began converting their organizations to electronic medical records. Systems that are considering becoming accountable care organizations (ACOs) – and accepting value-based reimbursement, which will become the predominant reimbursement model – need to find ways to track the health status of individuals in their community before they become patients. How? By embracing the use of technology that closes the healthcare loop before people even know they need those services.
Over the past year, economic pressure and regulatory changes have increased scrutiny around areas of inefficiency within the healthcare industry. With new policies like the Affordable Care Act creating the need to improve patient outcomes and prevention, 2014 will be the year for much needed efficiency upgrades across the board at hospitals. And with mounting pressure to cut costs amidst anticipated physician and other major shortages, new and innovative ways to leverage technology will be called upon to usher in changes for the healthcare industry.
The business of care will continue to be a major area of focus for hospitals in 2014. Preventable, adverse events because of medical errors cost the healthcare industry more than $29 billion in 2013 and have led to between 50,000 to 100,000 deaths each year. Healthcare professionals and hospitals cannot afford to continue accepting medical errors as balance sheet losses, which are not only jeopardizing profitability, but patient care. To save money and improve patient care at the same time, hospitals will look to learn from technology being used successfully by other industries in 2014 to enhance real-time analysis and, thereby, prevention and outcomes.
One of the greatest sources of information that depicts the changes in health IT trends across the industry landscape is from Michael Lake, healthcare technology strategist. Through his monthly reports on the state of health technology, published by his company Circle Square, he provides succinct highlights from throughout the last month. Possibly, what’s best about these reports is that they cover such a diverse segment of the ecosphere.
For example, in one of his most recent reports, the focus was the EHR vendor sphere, cloud EHRs and their importance to independent practices, the use of faxes in hospitals, vendor news and transactions and practice portal insight, among other news.
According to his most recent report, cloud-based EHRs with integrated billing are quickly becoming a key to a practice’s future success as an independent practice. In his report, he cites Black Book as ranking solutions that seamlessly integrate electronic health records (EHR), revenue cycle management (RCM) and practice management (PM). Kareo tops on the list, per KLAS.
However, most practices feel that billing and collections systems and processes need upgrading (87%) and more than 40 percent (42%) are considering an upgrade to RCM software in in the next year . Most practices (71%) are considering a combo of new software and outsourcing services for improvement.