Over the past few years, we have seen the healthcare industry shift toward cloud-based services to improve workflow, patient care and access to information. In fact, a 2014 HIMSS Analytics Survey estimates 80 percent of healthcare providers use the cloud to share and store information today. A cloud network allows physicians, referring providers and specialists at many different sites to simultaneously and securely access patient information in real-time on any Internet-connected device to provide urgent care to patients. This technology is changing how information is exchanged to meet the needs of both physicians and patients. Specifically, using cloud-based services for medical image and report sharing can be a game changer when it comes to advancements in quality of care.
Patient care before the cloud
The best way to explain the benefits of cloud-based image and report sharing is to look at life without the cloud. For providers not using this technology, medical images are stored on a physical CD, and the patient is responsible for carrying it from facility to facility – or, even worse, providers rely on couriers and the postal service to ship discs (which takes days and delays patient care). Most physicians will attest that 20 percent of these CDs are lost, forgotten or corrupt. When this is the case, not only is all the information stored on the CD lost, but time and money is wasted having to repeat the imaging procedure.
Josh Pavlovec, PACS administrator at Children’s of Alabama describes the challenges physicians faced to read CDs before the facility moved to a cloud-based image exchange. “In the middle of the night, if a trauma surgeon needed someone to look at a CD that couldn’t be opened properly, that surgeon or a resident, would physically run the patient’s CD down the street, knock on doors and find a radiology resident to view that study; and then run back to their OR and start treating the patient.”
Another challenge arises when a complete profile is not made available to the entire patient care team. For example, if a patient is sent by a primary care physician to a larger hospital for an exam, and the hospital sends the patient to an outside specialist – that specialist will likely not get the patient’s full medical history, and will certainly not receive that information prior to the patient’s arrival. Children’s emergency physician, Dr. Melissa Peters explains, “Having the reading that’s associated with the transferred images is something that’s very helpful to us. When we have a child that’s transferred, our pediatric radiologists interpret the films, and they need the reading from the other facility in order to create a comprehensive report.”
The absence of readily available images and reports creates silos of patient information within healthcare leading to costly delays and repeat testing and, limiting the quality and efficiency of care provided by teams.
Guest post by Paul McRae, director of business development, healthcare, AirWatch by VMware.
The evolution of mHealth has caused a dramatic increase in the use of mobile devices across the healthcare landscape. Mobile innovations are now positioned to vastly improve both the quality and quantity of the lives of human beings. New technologies and applications are helping organizations lower costs and provide higher quality service to patients. Mobile deployments in the healthcare industry enable clinicians and healthcare IT professionals to access medical records, diagnose illness, integrate with existing providers, enhance patient engagement and improve EHR interoperability.
As EHRs and the growth of deployed mobile devices and apps become increasingly popular, the need for mobility management and security is paramount. To embrace mobility, healthcare organizations must provide secure, easily accessible apps for staff and IT departments must manage devices while remaining HIPAA compliant and protecting patient records.
Enter containerization, an emerging class of management tools that carve out a separate, encrypted zone on the user’s smartphone within which corporate apps and data can reside. Policy controls apply only to what’s in the container, rather than to the entire device. Mobile containerization offers a way for hospitals to securely deliver apps and data to clinicians without interfering with the users’ ability to access their personal content.
Currently, the end user is divided into two separate personas – the personal and the corporate. Duality provides two different levels of security for very different forms of information present on a device. For example, the corporate security measures might require compliance with federal or HIPAA regulations, a form of monitoring that would be seen as invasive to employee privacy.
Mobile platforms are beginning to integrate containerization into their frameworks, which allows for more secure and tighter amalgamations of data with their corresponding operating systems. OEM’s are placing containers for work use with the underlying OS for greater efficiency, better feature support and improved user transparency. This embedded form of containerization allows IT to maintain consistent security policies to mitigate threats on every mobile device, from smartphones and tablets to laptops, peripheral devices and emerging machine to machine (M2M) technologies.
Containerization allows healthcare organizations to remain compliant with the stringent security requirements they must meet, while providing employees a consistent user experience across multiple platforms. However, each mobile operating system presents its own security challenges, such as Web-based malware or the ability to download apps outside of designated app stores. Securing corporate information that has been accessed on personal devices from applications and content repositories remains a major challenge, especially to ensure data loss prevention (DLP) if the device is stolen or the employee leaves the organization.
Tapan Mehta, global healthcare lead, Cisco, brings more than 15 years of healthcare information technology, marketing and business development leadership as Cisco’s global healthcare lead. Mehta is responsible for managing the development and marketing efforts for healthcare solutions including clinical workflow improvement, telemedicine, patient safety, regulatory requirements and EHR integration.
Here he discusses the demand for telehealth, the changing role of hospital health IT, wearable technology and patient monitoring and what Cisco is doing to serve its healthcare clients.
Tell me about Cisco and how it serves healthcare.
At Cisco, we see the healthcare industry as ripe for technology disruption. After doing things the same way for years, we think technology can be the catalyst that brings positive changes to how care is delivered. Drawing from our experience as the worldwide networking leader, Cisco is well positioned to help improve the future of healthcare through networked technologies that transform how people connect, access and share information, and collaborate. New healthcare technologies, like those offered by Cisco, benefit everyone – from patients to providers, payers to life sciences organizations.
What is your role, specifically, and what is the most challenging aspect of it?
I have a global marketing role where my team is tasked to develop healthcare specific solutions, go-to-market strategy and field enablement, as well as serve as the “voice of the customer” by bringing the outside-in view to Cisco and its various business groups. Healthcare is at a very critical inflection point in the industry whereby there are several key underlying currents in areas such as mHealth, telehealth, data analytics, wearables, etc. While there are several interesting opportunities to pursue, what makes it difficult is to prioritize them as each segment has substantial market opportunity and growth prospects.
What inspires you and does this translate to your leadership style?
Healthcare is very personal. It touches everyone in the society in some shape or form. I have been in the healthcare space for the past 15 years and I am extremely fortunate that I am in an industry that is going to go through a transformational change over the next decade. Historically, healthcare has fundamentally lagged behind most industries when it comes to technology adoption, but I perceive that changing over the next several years. Healthcare “consumerism,” combined with government mandates around the globe, is going to force the industry to adopt technology if it truly wants to improve quality of patient care and workflows throughout the continuum of care. I am really excited to be part of this healthcare eco-system, whereby I can make a difference in how our customers do their business and more importantly how quality of patient care can be vastly improved.
Healthcare IT professionals’ greatest concern around mobile health technologies is the potential of a breach of patient data, according to a recent survey of HIMSS14 attendees conducted by Axway, a market leader in governing the flow of data.
Conducted at the HIMSS annual conference in Orlando, the poll found that 45 percent of individuals surveyed believe the greatest barrier to mobile health adoption is the risk of a data breach, followed by meeting regulatory and compliance requirements for the privacy and security of patient data.
Other key findings include:
44 percent of those surveyed believe the integration of disparate health IT systems is the most challenging IT issue facing healthcare organizations;
53 percent believe that improved access to healthcare information is the most important benefit driving mobile health adoption;
38 percent believe that the widespread adoption of mobile health services is one to three years away, and nearly 90 percent believe it will occur within five years.
The results demonstrate the rising trend of mobile health services and reflect growing concerns of healthcare professionals on the risks associated with new services.
“Mobile health is not only helping improve clinical outcomes and lower medical costs, it is also becoming a way to differentiate services and win over new customers as they are given more choices for insurance and providers,” said Rob Meyer, vice president of solutions, vertical marketing and management, Axway. “The risk of data breaches, HIPAA compliance, and reliability have been some of the biggest issues for the hundreds of payers and providers we’ve worked with. But they do not have to be a barrier. Together we have repeatedly been able to put in place the technology and processes needed to avoid breaches and ensure compliance in major mobile health initiatives.
The Axway poll was conducted at HIMSS14 Annual Conference & Exhibition in Orlando, Florida and includes responses from 39 healthcare IT and business professionals. Axway healthcare solutions enable organizations to securely integrate and exchange private healthcare, administrative and financial information across disparate platforms. For more information, visit: http://www.axway.com/industries-customers/industry/healthcare
Axway (NYSE Euronext:AXW.PA), a market leader in governing the flow of data, is a global software company with more than 11,000 public- and private-sector customers in 100 countries. For more than a decade, Axway has empowered leading organizations around the world with proven solutions that help manage business-critical interactions through the exchange of data flowing across the enterprise, among B2B communities, cloud and mobile devices. Our award-winning solutions span business-to-business integration, managed file transfer, API and identity management, and email security– offered on premise and in the Cloud with professional and managed services.Axway is registered in France with headquarters in the United States and offices in 19 countries. www.axway.com
Sending text messages has become a common method of communication among teenagers, adults, and more recently, medical professionals. Physicians are discovering that texting provides a quick and efficient way to communicate with colleagues, patients, and office or hospital staff. A recent survey by QuantiaMD of 38,000 physicians found that approximately “83 percent of physicians own at least one mobile device and about one in four doctors are ‘super mobile’ users who leverage both smartphones and tablet computers in their medical practices.”
As patients and healthcare providers increasingly use mobile devices to communicate with each other, concerns are raised about the security of electronic protected health information (e-PHI). The Health Insurance Portability and Accountability Act (HIPAA) Security Rule allows healthcare providers to communicate electronically with patients, but it also outlines standards to protect individuals’ e-PHI with appropriate safeguards to protect confidentiality, integrity and security of e-PHI. The following identifies security issues raised by texting of PHI between healthcare providers or provider and patient and how unsecure texting may violate the HIPAA Security Rule and create liability for healthcare providers.
As a general rule, texting of PHI by healthcare providers is strongly discouraged. Texting, or traditional short message service (SMS) messaging, is non-secure and non-compliant with HIPAA because data stored on personal mobile devices is not encrypted and is usually stored within the computer memory or on a smartphone SIM card or memory chip. The lack of encryption and the easily accessible storage methods allow any e-PHI communication on a mobile device to be retrieved and shared by anyone with access to the mobile device. This means that messages containing PHI can be read by anyone, forwarded, remain unencrypted on phone company servers, and stay forever on the sender and receiver’s phones.
Another reason why physician-patient texting is discouraged is that standard texting/SMS limits the message to 160 characters. This limited text field may cause critical information or options to be eliminated. According to a recent policy statement from the American College of Physicians and the Federation of State Medical Boards, physicians should understand text messaging is “not analogous to e-mail because of its abbreviated format and the greater possibility of missed messages.” Physicians are urged not to use text messaging even with established patients “except with extreme caution and with patient consent.”
HIMSS Analytics publishes the results of the 3rd Annual HIMSS Analytics Mobile Survey, examining the use of mobile devices in provider patient care improvement initiatives. For the first time this year, the survey questions were modified to closely align with the six areas of the mHIMSS Roadmap, a strategic framework for providers to implement mobile and wireless technologies.
The roadmap sections encompass key areas of consideration healthcare organizations should focus on when developing and implementing a mobile strategy within a healthcare organization: New Care Models, Technology, ROI/Payment, Legal & Policy, Standards & Interoperability and Privacy & Security.
The survey findings offer examples of the progress made and hurdles that providers face when integrating mobile technologies into their facilities to improve patient care. Respondents indicated that the top benefit to having mobile technologies in their facilities was increased access to patient information and the ability to view data from a remote location. Funding limitations topped the list for barriers. Many providers are also still early in their adoption and implementation of mobile technology. For example, 69 percent use a mobile device to view patient information while only a third (36 percent) use mobile technologies to collect data at the bedside.
“The mobile health market is one of the fastest growing areas in the health IT space. We recognize the growing importance of mobile technologies and its impact to transform the delivery of patient care,” said David Collins, senior director of mHIMSS. “The survey reflects mobile technology as a transformational tool, as demonstrated by nearly all of the respondents supplying mobile technology to clinicians. This is a great example of how providers are integrating mHealth into today’s healthcare workflows. There is still work to be done by formally embracing mobile implementation strategies and measuring ROI.”
Guest post by Barbara Casey, Senior Executive Director for Healthcare Business Transformation at Cisco.
Imagine taking your car in for a routine service, only to be told you’ll need to visit five or six more garages on your own to procure an accurate assessment and treatment of the problem(s). In our current healthcare climate, this disconnected and complicated process is what most patients experience in assessing and treating their health conditions. Many of the most compromised patients, those that are elderly, co-morbid or chronically ill, are alone in their experience, left to connect the dots from cardiologist to radiologist to primary care. Layer in the emotional experience of, for example, being told you have stage four cancer and it’s difficult to focus on, let aloneremember, what the oncologist or surgeon says to do next. Yet, the onus falls solely on the patient, family member or caregiver to create continuity in the care experience.
So, as healthcare professionals, how do we help patients navigate the continuum of care when they are seeing an array of physicians and specialists in currently disconnected care settings? We need to treat the patient more like a true customer, which means upgrading the tools and methods we use to interact with them to be more intuitive and user-friendly so we touch base with them on a more regular basis.
Take for example the retail industry—Amazon and Netflix invest in complex algorithms to understand us better as individuals. As online businesses, they have enough information to recommend the next Father’s Day gift or determine if we prefer science fiction to drama. Can we apply that same logic to healthcare? Wouldn’t you want your own doctor and healthcare network to know you as well as Amazon does—for example, the medications you take, what you’re allergic to and the surgeries you’ve had—so they can recommend what you need to do next to advance your health and wellbeing?
It’s our obligation as technology experts and partners to those in the healthcare industry to find the answers and provide patients guidance in what they need before they need it. So in the end, patients can make the choice about how to approach their health can make the choice. After all, where else would you want to be known more intimately as an individual than in your own healthcare network?
mHealth, video and collaboration tools offer an opportunity to create a true continuum of care and a more seamless patient experience. Communication tools which integrate voice, video and data can also help deliver healthcare more effectively and efficiently. If these mechanisms are in place, the patient is more in control of where, when and how to communicate with care providers. She has the choice of how she wants to connect and communicate with her caregiver—the only question is will it be live in a doctor’s office, via video from her home living room, from a desk chair at the office, or from the path where she’s fulfilling a lifelong goal to hike the Appalachian Trail?
Guest post by Garrett Taylor CEO of Uplift Comprehensive Services.
My organization, Uplift Comprehensive Services (residential services) is fully involved in “mhealth.” We use mobile high-definition video conferencing, which allows our doctors and clinicians to care for patients in geographically remote areas of North Carolina, and gives them full access to electronic health records and an easy way to collaborate each other. Along the way, we’ve improved patient service, enhanced productivity, and cut travel and office costs.
By combining video conferencing technology with a bring your own device (BYOD) mobile strategy, Uplift saves at least $500 for each scheduled physician visit. The thousands of dollars we save each year can be used instead to find grant opportunities for better patient care.
It’s not as hard as you might think to use video conferencing in a mhealth strategy. What follows is an explanation of Uplift’s mobile video conferencing approach.
Uplift Comprehensive Services has been in business for 12 years, covering 15 counties across North Carolina. We offer community-based assistance for children, adolescents and adults, with services substance abuse prevention to mental health treatment. Our treatment options include multi-systemic therapy, outpatient therapy, and medication management, among others. Continue Reading
Patients are not the only ones who will become more engaged as mobile devices continue to infiltrate healthcare; physicians, too, are reaping the so-called rewards.
As the debate continues to rage about the efficiencies created when EHRs are used in a practice setting, there seems to be little argument as to whether tablet PCs, smart phones and even applications like Skype actually improve the business of communication and interaction with patients and their physician partners and physicians with their colleagues.
A physician whom I very much respect, Dr. David DeShan, is one such physician who communicates with patients and colleagues via Skype from his mission outpost in Moscow, Russia.
Spending weeks at a time in Russia each year, he also maintains his status as a partner and practicing physician at a growing OBGYN clinic in Midland, Texas. As an early adopter of the virtual visit, DeShan is able to maintain contact with his patients if they need a consult, and he’s also able to maintain his connection to his practice so he can check labs, review diagnosis and provide counsel to his practice mates should they request it.
By his own admission, he works a full-time practice schedule from abroad in addition to his full schedule as the leader of a major international mission. By partnering Skype and his EHR, DeShan is essentially a full-time practicing physician without a need to be restricted by the brick and mortar location of his practice. At the same time, he’s able to dedicate himself to his medical mission work in Russia and serve individuals throughout the world’s largest country in places that would never receive even the most primitive of care without him and his network of medical volunteers.
But, I digress. I’ll save DeShan’s story for another day.
The point I’m trying to make is in support of CDW Healthcare’s article “Momentum Surges for mHealth,” which cites a recent IDC Health Insights observation that shows clinicians use more than six mobile devices in the care setting each day.
Accordingly, as the mobile world continues to open new opportunities in all aspects of life, physicians, like all of us, know that they will come to rely more on these devices to practice, communicate and collaborate.
Clinicians and practice leaders continue to embrace the devices in the care setting, and they expect practices to allow them in their work. When technology delivers upon its promise and actually makes life easier, it is obviously going to be supported and used, like DeShan has done with Skype.
The technology helps him bridge gaps and essentially eliminate a half-the-world-away gap between himself and his practice. But, in some places, there are policies in place to inhibit this type of care offering. (Policies in opposition to this type of approach should be considered archaic and simply regrettable.)
The CDW piece goes on to state that according to a University of Chicago School Medicine study, providing tablet PCs to residents actually reduced patient wait times in hospitals. Likewise, the study found that the same residents did not have to look for an open computer for medical charting and actually allowed the residents to spend more time with patients.
Novel concept. Technology working as promised. Not so unbelievable when spelled out so clearly as this.
As I said, mobile health will continue to grow in popularity. If internal policies are not supported and encouraged, you’ll quickly find yourself in a BYOD environment, which is not such a bad thing.
In fact, if it develops or if you’re unable to support your own internal mobile device initiative, set some rules and let it bloom.
According to CDW, “You need to establish and enforce policies for mobile users including setting up passwords, separating personal from corporate data on devices … and you need to educate users on how to securely use mobile devices.”
When managing a population that’s more likely to use or own a mobile device like a tablet PC than the rest of the consumer population, the infiltration is well underway so it’s time to begin reaping your mobile rewards.