As we head into Christmas, and 2015, millions of Americans have hopes for a bright holiday willed with hope, health and happiness. And while America’s consumer engine is in full force, presents are getting bought, wrapped and covered with ribbons and bows, it’s hard to image that there’s little that can’t be bought and given in the spirit of good cheer for the betterment of man and for the greater good. But, as in all areas of life there are a few things that won’t fit nicely in the stocking or under the tree.
If only everything we wanted and needed could be placed in our stocking to be unwrapped on Christmas morn, but there’s just too much on the list. The list would be long for those in healthcare – interoperability, improvement of policies, better communication with care providers, and even more, qualified employees to join healthcare-related ventures.
If only some of these Christmas wishes could be packaged and stuffed in the stocking. Here are a few ideas from several healthcare folks who wish they could make the world’s dreams come true.
Allen Kamrava, MD, MBA, attending staff, Cedars Sinai Medical Center, Department of Surgery, Division of Colorectal Surgery
Common language between all healthcare electronic health records (EHR) systems, such that they can communicate with each other and patient notes may be accessed between all providers. We have gone digital, but none of the systems communicate with one another. This does not make any sense. Patients should be able to elect to have their records “shared” between systems when they visit other physicians, and more so to have their accounts sync’d between systems so that all physicians are up to date with all tests, procedures and visits. For now, the only thing EMRs have provided for is more legible notes that are inundated with information required by national standards regulations. Healthcare is far beyond the rest of the IT world. Indeed, it functions in the pre-internet era – we have electronic systems, but they do not communicate in any meaningful way. Healthcare IT is still functioning as if we are in the 1990s.
Bill Marvin, president, chief executive officer and co-founder, InstaMed
Bill Marvin
Health IT Christmas wish: Interoperability. By integrating technology and processes across heterogeneous environments, providers automate administrative processes and simplify compliance requirements, resulting in lower operational costs.
I would love to see a fully functional telemedicine capability in every hospital and office across the country. What I mean by fully functional is that reimbursement hurdles have been cleared, apps are standard, we have a maturity and adoption model in place all so that patients are receiving the best care from the right clinician in the most optimal manner possible.
Charles Settles
Charles A. Settles, product analyst, TechnologyAdvice
There are a myriad of things I’d like to find in my figurative “stocking” come Christmas morning, but perhaps the one I’d like to see the most is more widespread patient, provider and payer use of health wearable devices or fitness trackers, i.e. Fitbit, FuelBand, Jawbone, etc. The spread of these devices is something we are keeping a close eye on here at TechnologyAdvice; we recently surveyed nearly 1,000 adults about their use of fitness trackers and uncovered several key insights. Perhaps the most actionable of those insights was that nearly 60 percent of adults would use a fitness tracking device if it would help reduce their monthly health insurance premiums. Of course, there are potential benefits to payers and providers as well — in the push to switch the healthcare reimbursements from a fee-for-service to a outcomes-based model, these devices could provide invaluable information to physicians that would aid in health maintenance, preventative care, and overall population health modeling. As these devices evolve and are able to track more and more biometrics, they could enable less expensive and higher quality telemedicine.
It’s obvious from the varying responses below that there are a plethora of health IT issues affecting a number of areas in and throughout hospitals. In reviewing a number of healthcare issues, the following thought leaders offer what they feel are the top IT issues in healthcare.
As is often the case in profiles such as this, the responses are diverse and varied. Do you agree with their assessments?
I work with hospitals nationwide and I find that the top issues facing the hospital are:
1. How to align the interests of the physician with the hospital in a world where the hospital takes risk? Physicians used to get paid by “time and material” in the old world and the hospital got paid by “contracted costs.” The new reality has both the physician and the hospital getting paid a fixed amount to then manage the cost of healthcare on a “fixed price” for lack of a better word. IT challenges: The tools in the “time and material” world are unsuitable to manage the new reality in a “fixed price” world. This is a top challenge.
2. Real-time P & L — If you ask a hospital CFO what the profitability of the current patients in Unit 10, they would give you a blank stare. This is because the do not know what they are going to get paid (the DRG or diagnosis-related group reimbursement) much less what their current costs are. Thus, the lack of visibility into managing costs creates havoc. IT challenges: Systems that can develop a view into costs and projected revenue require a lot of specialized people to provide the information even in hospitals that have a partial solution. Most hospitals do not know where to turn for new ways of thinking. This is a big IT challenge.
Doug Nebeker, owner and technical expert, Power Admin LLC Staying on top of compliance and auditing tasks is a top issue facing hospital IT departments today. As more and more data moves into the digital space, IT departments can easily become overwhelmed as staff gets bogged down with the tedious task of trying to keep track of what’s happening where in the system. Network monitoring software is seeing a boom as a result, quickly becoming an IT necessity for managing increasingly complex network auditing and compliance processes. Technology is meant to help, not hinder, and so as we continue to utilize it in new ways we must ensure our process management keeps pace.
Hospitals and other healthcare organizations will always have the need to exchange “unstructured” data. While there is a large focus on meaningful use, ICD and other mandates, many hospitals and organizations are not taking into account the need to quickly, affordably and securely transmit unstructured data while also staying HIPAA compliant. One of the main issues is that public cloud services are not HIPAA compliant. Healthcare organizations can work around this by extending their existing fax server solutions to the hybrid cloud, allowing both custom and popular EHR applications to communicate with each other via a private secure network, guaranteeing delivery with military grade end-to-end encryption. By eliminating the need for costly and cumbersome network fax systems, such as fax boards and recurring telephony fees, hospitals can leverage the hybrid cloud to swiftly manage all business-critical fax communications while staying HIPAA compliant.
David Finn
David S. Finn, CISA, CISM, CRISC, ISACA professional influence and advocacy committee member, health IT officer, Symantec
Healthcare is undergoing fundamental changes in reimbursement, care delivery models and the technology required to make these changes. Technology and information is no longer an adjunct to the business of healthcare — it is a strategic imperative. This information, however, is among the most regulated and protected information under the law. The data must be shared more widely with more people and organizations, all the while with stricter security and privacy controls. At a high level, the most critical issues facing health IT are:
1. Security and Privacy
Healthcare, historically, has not invested in nor staffed appropriately in terms in of Privacy and Security. Providers and business associates need to catch up with other regulated industries and those targeted for the value of their data.
2. Data Management
The digitization of healthcare has led to the massive collection of data. As healthcare becomes more dependent on this data, the storage, protection, back-up and recovery of the data is critical. It must include disaster recovery/business Continuity.
3. Interoperability and Information Exchange
Affordable Care Organizations (ACO), health information exchanges (HIE) and new care delivery models (home care, remote monitoring and other requirements) will drive information exchange.
It should come as little surprise to me that no matter the healthcare sector — long-term care, ambulatory or in patient, for example – most of the worries faced are the same or very similar. Many of the same levels of attention is given to many of the highly complex usual suspects – interoperability, health information exchange, accountable care, HIPAA and even mandates like meaningful use. The murmurs of those working here are often similar and there is a fairly deep collective holding of the breath in regard to advancements or developments in these areas regarding the blowing winds of how these and other issues sway constituents throughout the marketplace.
The general sentiment of individuals, those leading large hospitals and multi-location care facilities, who express their opinions and concerns to organizations like HIMSS, to name one, are the same as the concerns voiced by many of the attendees at PointClickCare’s annual user meeting, to name one, in Orlando Nov. 2-5, 2014. These same sentiments also are expressed at variety of other meetings of the minds throughout the US in similar constituent groups or with vendor and other allegiances.
Educational and work sessions held at these gatherings always have the same look and feel; the same as those expressed at PointClickCare’s Summit 2014. Engagement, connection, care; ACOs, HIEs, and managing their relationships; EHRs, interoperability, and managing this relationship and the flow of information (or doing so when the information does begin to flow); and change management strategies that provide guidance and advice for … managing change.
The information exchanged in venues such as these and the sessions themselves are valuable, of course, and needed to fill an enormous information void. Most importantly, these healthcare education sessions draw together folks seeking guidance and those needing insight, as well as provide a dash of leadership at times when much seems to be lacking. Finally, these educational sessions – quick and concise as many of these sessions may be – alleviate fear during a scary and tumultuous time in healthcare.
Twenty percent of American adults already own a wearable technology device and the adoption rate – on par with tablets in 2012 – is quickly expected to rise, according to PwC’s Consumer Intelligence Series – TheWearable Future report – an extensive U.S. research project that surveyed 1,000 consumers, wearable technology influencers and business executives, as well as monitored social media chatter, to explore the technology’s impact on society and business. In the last three decades, PwC has examined how technological innovation plays an increasingly prominent role in helping brands set themselves apart in their respective industries and how wearable technology can offer brands an opportunity to establish themselves, particularly in the entertainment, media and communications (EMC), health, retail and technology industries. In conjunction with The Wearable Future report, PwC’s Health Research Institute (HRI) launched a separate report, Health wearables: Early days, further examining consumers’ attitudes and behaviors toward health wearable technology.
While fitness bands, smart watches and other wearables are already established in the market, many of them have under-delivered on expectations. Consider that 33 percent of surveyed consumers who purchased a wearable technology device more than a year ago now say they no longer use the device at all or use it infrequently. Price, privacy, security, and the lack of “actionable” and inconsistent information from such devices are among consumers’ main apprehensions with the bourgeoning category. In fact, 82 percent of respondents were worried that wearable technology would invade their privacy and 86 percent expressed concern that wearables would make them more vulnerable to security breaches.
That said, 53 percent of millennials and 54 percent of early adopters say they are excited about the future of wearable tech. Among the top three potential benefits:
Improved safety: Ninety percent of consumers expressed that the ability for parents to keep children safe via wearable technology is important.
Healthier living: More than 80 percent of consumers listed eating healthier, exercising smarter and accessing more convenient medical care as important benefits of wearable technology.
Simplicity and ease of use: Eighty-three of respondents cited simplification and improved ease of technology as a key benefit of wearable technology.
And for wearable technology to be most valuable to the consumer, it needs to embrace Internet of Things opportunities; transform big data into super data that not only culls, but also interprets information to deliver insights; and take a human-centered design approach, creating a simplified user experience and an easier means to achieve goals.
“Businesses must evolve their existing mobile-first strategy to now include the wearable revolution and deliver perceived value to the consumer in an experiential manner,” said Deborah Bothun, PwC’s U.S. advisory entertainment, media & communications leader. “Relevance is the baseline, but then there is a consumer list of requirements to enable interaction with the brand in a mobile and wearable environment.”
The term “patient engagement” has emerged as this year’s buzz phrase much the same way “patient portals” were a couple years ago and even similar to “electronic health records” and “meaningful use” before that. Volumes of articles, case studies, white papers and educational sessions have been dedicated to the topic of patient engagement and even at this years’ annual HIMSS conference patient engagement as a topic discussed was the rule and not the exception. With every step through the maze of booths in Orlando it seemed as if the words – “patient engagement” — were whispered and shouted from every direction.
Patient engagement is now synonymous with health IT, yet the topic is proving to be one of healthcare’s stickiest wickets because no matter whom or how many people you ask there seems to be a different response or definition to the term and how it is achieved.
With all of this uncertainty and confusion about patient engagement, I set out to see if I could define the term by asking a number of health IT insiders what they thought “patient engagement” meant, or what it meant to them. Their insightful and educational responses are what follow.
Implementation of electronic health records is considered a national priority in this era of healthcare reform. However if EHRs are not implemented correctly they can be painful.
EHRs that are not implemented effectively can affect productivity and revenue. The extra documentation requirements and intricate workflows create distance between physicians and their patients. Physicians have reported that they spend too much time on EHRs and that they don’t get enough time to interact with their patients. But physicians often communicate that spending time on EHRs is crucial to creating a trusted set of structured data that can guide their business. Every click that providers make creates important data points that can be used to inform the efficient delivery of their practice.
Every EHR saves a large amount of data inside it regarding patient health, effectiveness of treatments, system efficiency and provider tendencies. Despite the extra time and effort that is dedicated to electronic documentation, many practices and physicians do not make full use of this precious data set that they have produced.
If a practice can get its EHR adoption right they can make a number of positive results, some of which are mentioned below:
Revenue Gains
By overcoming the difficulties providers can see more patients and will be able to generate more billed revenue using its existing staff. Furthermore, if a provider is using its EHR efficiently then the improved documentation produces billing at higher rates, combined with increased patient flow. This represents significant potential revenue.
Quick Cash Flow
Many of the practices work on revenue cycle management, but few make it flawless. With increased charge accuracy and reduced time for denials, there will be an increase in the yield with timely reimbursements by the payers.
Guest post by Keith Boyce, vice president of business development, RxOffice.
The recent postponement of the implementation of ICD-10 is nothing but good news. Moving the deadline to next year gives providers an opportunity to conduct further research and select the software that is compliant and the least disruptive of their existing processes while keeping the best interest of the patient in mind.
ICD-10 was the first step by the Obama administration’s healthcare plan, Obamacare, which revealed the need for a universal software platform that could work in all medical areas. Some professionals say the ICD-10 and other requirements of the new healthcare plan will cause physicians to spend more time on paper work and less time with patient care. If that is the case, healthcare providers will need a system that will cut down on the amount of time needed for paperwork. With the extension in ICD-10’s implementation, now is the time to make decision about keep or modifying current systems or investing in new ones.
The new regulations proposed through Obamacare will have more of an effect on small to mid-size healthcare providers and the IT companies that cater to them. Larger IT firms are not affected as much because their clients are the hospitals and large research clinics that do not have to adhere to the requirements of ICD-10. This means that these firms are less likely to understand and provide compliant software to smaller, special medical centers, such as diabetes, mental health and podiatry to name a few.
Healthcare providers should look for systems with the following characteristics:
Doximity is the largest medical network with one in three U.S. physicians as members. Physicians use Doximity to instantly connect with other healthcare professionals, securely collaborate on patient treatment, grow their practices and discover new career opportunities.
Its vision is a future where medical communication is effortless — fast, simple, seamless and secure. Its mission is to “help physicians transcend the fragmented U.S. healthcare system and succeed in the care for their patients.”
Doximity was founded by Jeff Tangney, co-founder and former COO of Epocrates (EPOC), and launched in March 2011. Based in Silicon Valley, it’s backed by Emergence Capital Partners, InterWest Ventures, Morgenthaler Ventures (now Canvas Fund), Draper Fisher Jurvetson, T. Rowe Price and Morgan Stanley Investment Management.
Here, Alexander Blau, MD, vice president of physician marketing and medical director for Doximity — responsible for marketing and user acquisition teams oversees the development of clinical programs, including a socially curated medical literature filter and case-based discussion forums, manages the aggregation, analysis and product integration of diverse healthcare data in charting the first-ever nationwide clinical expertise map — discusses the company, its future and what he’s seeing from his perch.
Give us the short story on what you do and how you came to health IT?
My background is as an emergency physician. During my training, I was drawn to the latest in mobile health technology and eventually built my own app for medical interpretation. From that moment, I knew I was hooked on health tech. Three years ago, I joined Doximity to join a larger team to develop yet more tools that help doctors practice medicine every day.
Tell me about Doxmity. There’s been some press lately about how it’s really innovating the space. What are you doing that makes for such success? Care to share the secret sauce?
Doximity is the first health tech company really built for physicians — as opposed to hospital administrators, billing departments, etc. In just three years, we’ve grown to be the largest network of verified physicians in the US, thanks to our focus on what doctors truly need from technology. Our focus on doctors is the secret sauce.
What are some of the misconceptions you face? Obstacles you must overcome?
There’s a misconception that physicians aren’t technology savvy, which is absolutely not true. Doctors have been among the earliest adopters of all kinds of communication technologies starting with pagers and the first smart phones. When it comes to social media, doctors are necessarily skeptical about privacy and HIPAA compliance. The great thing is that Doximity is specifically built to address physician privacy requirements and enable them to communicate professionally on the mobile devices they rely on.
