As the coronavirus outbreak limits individual movement across the country, organizations are turning to remote solutions to stay operational.
As a result, demand for telehealth has skyrocketed — prompting health insurance payers, who haven’t always covered telehealth services, to reconsider coverage.
In April, the Centers for Medicare and Medicaid Services (CMS) made one of the most significant changes to Medicare/Medicaid coverage of the past few years. It announced it would expand coverage to more than 80 different telehealth services. Now, some insurers in the private sector are beginning to follow suit.
Here is how the pandemic is changing attitudes toward telehealth — and also the potential long-term impacts of coronavirus and telehealth service expansion.
Medicaid/Medicare and Telehealth Coverage Expansion
Many patients, wanting to reduce their chance of contracting or spreading COVID-19, are electing to avoid doctor’s offices. For some people — like the immuno-compromised and elderly — it’s no longer safe to have a checkup or routine visit. At the same time, many doctors have temporarily shut their practices and begun offering telehealth services to those who still need consultations and regular check-ins.
Others who have kept their practices open aren’t sure for how long it will be possible or responsible to do so.
Early in April, the pressure pushed CMS to expand Medicare and Medicaid to cover 85 additional telehealth codes — including group psychotherapy, physical therapy evaluations and prosthetic training. The move came after Congress passed a coronavirus spending bill that included $500 million in telehealth coverage and several major private insurers announced they would waive copays for virtual doctor’s visits and other telehealth services.
Potential Impacts of Expanded Telehealth
The most immediate impact of the coverage expansion will be making medical services much more accessible. Current research shows that, while in-person visits are typically more effective, telehealth is great at expanding the availability of medical services. It may also help health care facilities reduce costs and improve patient satisfaction.
As COVID-19 cases push hospitals around the country to their limits, medical facilities are facing challenges beyond sick patients. Long hours and an uptick in cyberattacks are putting serious strain on existing cybersecurity defenses. Without the right practices, these defenses may fail, exposing patient and hospital data to hackers and cybercriminals.
Here is why security remains key as the coronavirus outbreak grows more severe — and how hospitals can rise to meet current cybersecurity challenges.
Why Healthcare Data Security Remains Important
While cybersecurity may seem overshadowed by other healthcare concerns, the current crisis makes hospital data security more essential than ever.
Many hospitals and health systems are currently expanding or introducing COVID health data collection programs to get the information needed to combat the novel coronavirus. Many of these same systems are also ramping up data-sharing between institutions to ensure that medical providers around the country have the best possible information to work with.
New operating conditions — like hospitals that set up tents in parking lots to expand their number of available beds — have also changed how hospital systems, like electronic health records, are used and secured.
Current stress on staff may make hospitals more vulnerable to hacks. Cybersecurity professionals were, on average, overworked before the crisis began — an issue that has likely gotten worse as the crisis has progressed. Doctors, nurses and hospital administrators are working overtime, and organizations are bringing on new workers to manage the increased need for professionals. Existing staff may struggle to keep up with good security practices, and new team members may not receive the full training they need to keep data safe.
New information collecting schemes are critical for medical providers — but if the data they collect isn’t secured, it may also put a lot of patients at risk. This patient information may not seem like the most valuable target for hackers — but health data is actually widely sought after by cybercriminals. These hackers use health information, along with other personal information, to construct comprehensive identity packages about individual patients.
What Hospitals Can Do to Handle Security
There are steps hospitals can take to ensure that patient and hospital data stays as safe as possible — even while the staff is under immense pressure.
During the crisis, operational security will become more critical. Doctors, nurses and hospital staff should be highly aware of what they are sharing on social media. Personal information should be kept private, and employees must take note of any information in the background of the photos they take. A cybercriminal scouring the posts of doctors and hospital workers may find what they need to break into a network — like a password taped to a monitor.
Health-tracking wearables — which include monitoring devices like Fitbits and smartwatches — have entered the mainstream. They are providing both consumers and health care professionals alike with unprecedented amounts of data, ranging from info on heart and cardiovascular issues to sleep quality.
These wearables can also offer unique new datasets that could help us learn more about some of the most difficult-to-treat disorders — like Parkinson’s disease.
A new study has highlighted wearables as a potential method of data-collection in the treatment of the disease and could help with Parkinson’s research. Here is how wearable tech could help us learn more about this disorder.
Wearables Help Patients with Parkinson’s Record Data
The study, published in January in Digital Medicine, highlighted how mobile data-collection devices — like wearables — could improve upon the self-report diaries currently used in the treatment of Parkinson’s. They can provide doctors with better data about patient symptoms.
Right now, in the standard course of treatment for Parkinson’s disease, patients are advised to keep motor diaries, fill out questionnaires or participate in structured clinical exams to keep track of the progression of their symptoms. While these strategies can be effective, they also introduce significant room for error.
The study demonstrated that it can be difficult for patients to commit to keeping a motor diary, which requires an entry every 30 minutes that they are awake.
During the course of the study, 38% of patients who maintained a motor diary missed a quarter of entries and had an average delay of greater than four hours. This could potentially degrade the quality of information available, as they recalled the severity of their symptoms hours later.
Self-reports also contained high numbers of false negatives in involuntary muscle movement. Patients also consistently underestimated the severity of their symptoms.
By comparison, automated wearable sensors provided much more accurate data and were able to record information on symptoms more consistently than any other method of symptom-tracking. Consistent data is especially vital in the treatment of Parkinson’s, where symptom severity can vary significantly from hour to hour.
Amazon has been slowly making forays into fields outside of retail, a sector they currently dominate. One of their latest changes is moving into the healthcare and life sciences fields by offering a HIPAA-compliant transcription program.
What does this service provide, how will it change the medical field and when can professionals expect to see this program in their workplace?
Amazon Transcribe Medical
Amazon is putting their machine learning systems and processing power to good use with its Transcribe Medical service, a technology that’s supposed to improve speech-to-text transcriptions for clinical documentation and patient records.
Traditionally, transcription is carried out by the practitioner or assistant. Either way, clinicians spend extra hours each day converting verbal documentation into digital items for storage in the patient’s electronic health records (EHRs).
Transcribe Medical uses machine learning to transcribe a professional’s verbal dictation into digital records. By using its own previous experience to convert data, this software can work more quickly and accurately than human scribes.
Electronic health records have come a long way since first introduced in 1972. Today, more than 85% of doctors’ offices have fully adopted EHRs. Yet many employees say these advances increase their working hours. Amazon Transcribe Medical could be the tool that allows universal adoption of EHRs without increasing physician burnout.
Amazon in Healthcare
Transcribe Medical isn’t Amazon’s first venture in the healthcare industry. Early in 2018, the company started looking for someone to fill a new role — a HIPAA compliance lead. In the last year, the retail giant launched a brand of over-the-counter medications, offered equipment directly to offices and hospitals and even took steps to acquire multiple pharmaceutical companies, such as PillPack in the U.S. and MedPlus in India.
Amazon planned to become a major pharmaceutical supplier for hospitals but backed off in April of 2018 in favor of working with less-sensitive medical supplies.
Regardless of plans shelved or canceled, Amazon has made it clear that it intends to become a significant player in the healthcare industry, even if it means they’re only selling medical supplies and — as Transcribe Medical shows — assisting physicians with their transcription needs.
Although Google first gained prominence as a search engine, it quickly moved into other sectors, like smart home tech and cloud computing. One of the latest projects associated with the brand relates to health care, or, more specifically, electronic health records (EHR).
In early 2019, rumors began circulating about Google’s plans to develop an EHR tool. In late November, the company confirmed with an official blog post discussing the project. It centered on the challenges associated with health data, such as the variety of formats and number of people contributing to files.
Accessible Health Records
In the blog entry, Dr. David Feinberg, the head of health, claims the Google EHR solution will put all health records into a single, search-friendly database. This setup will reduce the time providers spend hunting for information.
A product video accompanying the post featured Dr. Alvin Rajkomar, a product manager and practicing physician. He discussed how providers spend half their days working with EHR interfaces and often need to log into several systems to acquire necessary materials. While Google’s product is still in the pilot phase, it’s available for widespread clinical use.
The video demonstrates how the Google EHR tool offers all patient information needed in one place. For example, a doctor can see data about a patient’s primary complaint, plus the results of lab work, without switching between tools. Users can simply switch between tabs, much like on an internet browser, to see different information.
A search box at the top allows people to use natural-language queries and find what they need. The system also handles potentially misspelled words, similar to searching for something on Google.
Context to Patient Information
The Google EHR tool gives authorized users access to data via tables and charts, allowing them to see how a patient’s condition changes over time. When users import data from another location, it’s highlighted grey to differentiate it. Simply hover the cursor to see the original source.
Although electronic health records (EHR) are firmly established in the medical landscape, ongoing progress necessitates that providers keep up with emerging trends. Here are five of them.
1. Combining Artificial Intelligence and Voice Recognition with EHR
Artificial intelligence (AI) has already shown promise for assisting doctors with making diagnoses or recognizing historical trends about a patient’s condition. However, several companies are investigating bringing AI to EHR via voice recognition capabilities.
At Vanderbilt University Medical Center, providers can query the tools by posing questions in natural language. For example, a physician could ask a voice-enabled EHR system for details about a patient’s last recorded iron levels from blood tests. The system would inform the doctor of those levels, plus tell them whether they’re in a healthy range.
Allscripts and Northwell Health also recently struck a deal for a platform that blends AI with EHR and collects data from clinicians. Using voice commands within patient care could be especially useful for providers who have their hands full.
2. An Increased Emphasis on Mitigating EHR Errors
When the ECRI Institute released its 2020 report containing the top 10 health technology errors to be aware of in the coming year, EHR issues were mentioned multiple times. The first instance related to providers potentially being overwhelmed with notifications from EHR platforms, ignoring some of them and perhaps overlooking a genuine issue with a patient as a result.
The report also brought up the risk of medical data not including information about implants in patients that are sent for medical imaging. The study recommended providing a single place to enter or check for the presence of implant data in an EHR. Finally, the ECRI Institute cautioned that EHR mistakes could happen when a medication administration order sent by an EHR platform does not match the dosage time the provider intended.
This coverage of such mistakes will likely cause health care facilities to assess their systems and see if the issues exist there. If so, they’ll look for ways to reduce those problems.
Precision medicine involves formulating treatments for individualized patients, typically with genetic sequencing that could shed light on the underlying causes of disease. It’s an amazing idea that could substantially reduce the likelihood of the same treatment curing one person and failing to help another.
However, some things still hold precision medicine back. Here are six ways it could advance.
1. Lower Research and Development Costs
Statistics indicate precision medicine is gaining momentum. For example, 70% of cancer drugs in development are precision-based, and 20% of research and development in the pharmaceutical sector relates to precision medicine.
Those are promising signs, but cost remains a significant factor that slows down the advancement of precision medicine. The research and development associated with it is more expensive than standard approaches because it involves genetic testing. Companion testing is often required to find biomarkers, as well as marker-negative patients.
Securing financial backing can be tricky, especially if investors or the financial decision-makers at pharmaceutical companies are still dubious about precision medicine’s potential.
2. More Patient Education
Many patients have heard about precision medicine in passing, but they don’t know what it entails or how to avail of it. Intermountain Healthcare, a Utah-based health system with nearly two dozen locations, found that a lack of patient education restricted its adoption of precision medicine. The organization began automatically referring metastatic cancer patients to a research clinic that used precision medicine.
There, patients had access to a proprietary system that checked for more than 160 genetic mutations associated with cancer by examining portions of a person’s genetic code. Then, people from a molecular tumor board interpreted the results, guiding doctors in setting up treatment plans for their patients.
The U.S. medtech industry is one of the most profitable in the world. In 2016, the sector was worth $147.7 billion and expected to top $173 billion by the end of 2019. One of the reasons that it is so profitable is that new medical technology can be exorbitantly expensive, especially for small practices or solitary practitioners. How can you save money while still procuring the medtech you need to provide the best care possible for your patients?
1. Opt For Refurbished MedTech
If you needed a new car, would you immediately choose a brand new model — complete with a costly car loan — or would you consider purchasing a used but still functional vehicle instead? If you compare purchasing a new piece of medtech to obtaining a new car, the idea of purchasing refurbished equipment starts to make sense.
Purchasing refurbished equipment gives you access to the same sort of medtech that you’d receive if you’d bought it new, for a fraction of the cost. You may also be able to choose the level of refurbishment — choosing between a machine that’s only been cosmetically refurbished rather than one that’s been reworked on a mechanical level, or vise versa.
There are a couple of downsides to purchasing refurbished medtech, such as the lack of a warranty and the possibility of bringing a “lemon” back to the office, but if money is your primary concern, this can be a great way to save quite a bit while still stocking your office with all the necessary equipment.