On the first day of HIMSS 2014 in Orlando, I stepped into a bewildering echo chamber. “We’re doing population health,” repeated everyone, be they physicians at a hospital whose EHR system my company implemented, the IT directors of other hospitals looking to update their EHR system or competing EHR experts. Everyone was interested in buying it, and everyone was interested in selling it. On one particular walk of the floor a colleague quipped, “Will there be a prize for the one millionth person to say ‘population health?’”
Despite this obsessive buzz nobody seemed able to define what population health is. It’s the proverbial elephant described by touch rather than sight. Is it a concept of health or a study of the various factors that affect health? Is it a course of action for the treatment of the population in its entirety or individual patients only?
The Affordable Care Act, which cites population health as an essential component of its mandate, aims to expand access to the healthcare delivery system, improve the quality of care, enhance prevention, make healthcare providers responsible for outcomes, and promote disease prevention at the community level.
All of this is commendable, but, in the end, what is population health? What does it look like? Will we recognize it if we achieve it? A friend of mine on the payer side observes that vendors claim it’s everything and providers don’t know exactly what they want it to be. Put those together and the term becomes meaningless.
There are additional questions about population health that remain unanswered. Is it an outcome, as the ACA approach suggests, or is it a foundation built on big data, analytics, ACO tools, bundled payments, systems consolidations or something else? At every HIMSS booth, the answer to these questions was a resounding “Yes.”
Guest post by Darin VanderWell, Director of Product, DocuTAP.
Rumors about the next phase of the Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program has prompted concern among healthcare providers. To truly understand meaningful use Stage 3 and its impact, it is important to differentiate between the rumors and the truth.
The final rule for meaningful use Stage 3 has yet to be published, so discussion on its effects are based on available drafts. Even those drafts are in question since the December 2013 announcement that Stage 3 would be delayed until 2017. One reason cited was to allow more time to research the impacts of Stage 2 before finalizing Stage 3. The delay will be particularly important for that research, since compared to Stage 1, 2011 Edition, there are so few Stage 2 vendors certified currently.
As for what is expected, the attention turns from data capture and access (Stage 1) and information exchange (Stage 2) to improved outcomes in Stage 3. One expected goal is to simplify and reduce the reporting requirements on those attesting. Some of that change can be achieved by consolidating the program’s current objectives, which I expect hospitals and providers will welcome, provided it truly reduces the reporting burden and does not coincide with other, new objectives and reporting requirements.
Stage 3’s goal of improving outcomes will be incredibly interesting – through November 2013, CMS had disbursed nearly $18 billion in incentive payments. Until now, the program’s success has been judged by the number of participants adopting certified EHRs. At some point during Stage 3 (or thereafter), we will know whether those payments have truly improved outcomes.
Tonic was founded by a collaboration of scientists, consumer marketing experts, user interface designers and software programmers to finally solve the crippling challenges of medical data collection, including poor response rates, low patient engagement, high cost and limited ability to personalize care based on a patient’s answers.
So we went out and built a medical data collection platform for clinicians, providers and researchers collecting and using patient information everywhere.
Tonic Health is the world’s best patient data collection platform: fully customizable, super fun and friendly, and accessible anywhere, it solves all the major data collection headaches for hospitals and health systems everywhere.
Tonic is the world’s best patient data collection platform: we integrate extreme patient engagement, robust CRM capabilities and real-time predictive analytics to dramatically improve the process of gathering, analyzing and using patient data.
Used by 10 of the Top 15 largest health systems in America, Tonic provides a Disney-like experience to a wide range of data collection needs, including patient intake, patient screening and risk assessments, patient satisfaction, patient-reported outcomes, patient education and much more.
Prior to co-founding Tonic, I (Sterling Lanier) founded a company called Chatter (www.chatterinc.com), which is a leading market research firm that works primarily with Fortune 500 brands. During a pro-bono project I was doing for a breast cancer research program at UCSF, I realized the way that most healthcare professionals were collecting and analyzing data was woefully behind the best practices used in the corporate world. Engagement was pitiful, turnaround times were glacial and patient care was suffering.
So I teamed up with my co-founder Boris Glants (who is the technical brains behind our success) and we set out to flip the whole system on its head.
In a change of pace, and in the spirit of patient engagement, the following graphic from Primacy speaks to the importance, and the need to engage patients online to educate them and bring them to a practice’s door.
According to Primacy, an award-winning agency known for creating digital experiences with impact: “Investing money in your hospital’s website can drive traffic online and to your door.”
Primacy analyzed the traffic and paid search activity of five hospitals during 2012 to see if any patterns emerged. It turns out some did. Take a look at the infographic below to see which clicks matter the most.
In the new healthcare ecosystem that is increasingly migrating to cyberspace, who can healthcare consumers rely on? Who in the healthcare service supply chain will prevail? Who will be the next Amazon or Yelp? Chances are it will be the organization that can deliver and mediate a centralized consumer experience – connecting healthcare consumers not only with care and treatment options, but also with pharmacists, labs, therapists, clinics, wellness coaches and other resources along the care chain.
More today than ever before as the care conundrum continues, fewer and fewer crave office visits, hospital stays or trying to reach physicians by phone. When we’re well, we see no reason to visit a physician. When we’re sick we increasingly wait until we’re sicker. And when we’re somewhere in between, we avoid calling because we know we’ll be put on hold. If there were a better way to consume healthcare, most of us would likely take it.
Interestingly, within this conundrum lies an opportunity for the myriad of healthcare players – from payers and providers at one end of the supply chain to wellness tacticians, retailers and mobile tool providers at the other end – to create a sustainable dialogue with healthcare consumers.
Guest post by Mike Hoaglin, a fourth-year medical student at the University of Pennsylvania School of Medicine.
“Patient engagement” is a phrase that reinvigorates the doctor-patient relationship and prioritizes the patient experience. With many designers scrambling to “engage” patients in their healthcare journeys, it is easy to get lost in the chaos. But what lies at its core is simple: healthcare leaders need to find easy methods that better connect people with the environment and the technology.
One way this is already proving effective is with the smartphone physical. Led by medical students from John Hopkins and University of Pennsylvania, quick diagnostic tests using devices connected to a smartphone are changing the face of the traditional physical and begging the question as to why modern medicine struggles to become more patient-centric.
The smartphone physical uses a series of peripheral devices attached to a smartphone to measure and analyze patient data ranging from weight to blood pressure to even heart activity. Patients are then able to receive an overall health picture and potentially electronic health record (EHR)-ready results from the smartphone physical immediately after the experience. Essentially these robust handheld digital devices are re-engaging patients because they promote more personalized, data-driven decision-making at the point of care.
Money magazine offers five things to know about electronic health records. It’s a very high-level overview, mostly for the consumer market, and is a piece designed to get some skin in the healthcare game. The piece pithy and concise, which is good, as the publication is clearly unable to dig into health IT topics like a site like this, but is it worth the ink?
You decide. Let us know. Tell us if it’s a “me too” moment, which I happen to believe is the case. I think the magazine should stick to covering money and leave health IT alone, but that’s a lone opinion.
And so, without further ado, here are five things to know about electronic health records, if you don’t already:
Chances are, patients will see them, if they have not already and will ask about them.
According to Money, “more than half of physicians have started keeping electronic medical records, the federal government announced this year. About 80 percent of hospitals have gone digital, too, with urban institutions leading the way.”
After having spent several days in a hospital recently caring for a loved one, I can unequivocally say that there is no comparison for patient engagement – in relation to meaningful use and in regard to health IT such as EHRs – between the hospital setting and the ambulatory practice.
Simply put, there is no comparison between the amount of attention given to the topic of patient engagement in ambulatory practice and in hospital care, at least as far as the patient experience is concerned.
The report suggests that 16 percent of surveyed U.S. doctors say that patients should be able to update some demographic information in their EHR and 5 percent say that patients should not have the ability to update any demographic data.
“Sixty-seven percent of surveyed U.S. doctors say that patients should be able to update all family history information in their EHR, while 21 percent say that patients should be able update some family history data and 12 percent say that patients should not have the ability to update any family history information,” according to the study.
Twenty-five percent of surveyed U.S. doctors say that patients should be able to update all of their laboratory test results in their EHR, while 28 percent say that patients should be able to update some lab test results and 47 percent say that patients should not have the ability to update any lab test data.
On behalf of Accenture, Harris Interactive conducted the online survey of 500 U.S. physicians between November 2012 and December 2012.
This is an interesting topic that seems to have many foes and fans, and I can see the perspective from each side. On one hand, allowing access to a personal record may allow for breeches of information, HIPAA violations and may create a slippery slope to a movement for patients to have full editorial access to their records. Obviously, doing so creates more many more problems than it solves.
The benefits to such a move – allowing patients to input their demographic data into their personal health record – may lead to greater patient engagement, which seems to be healthcare’s sticky wicket, and it may help practices struggling with being overwhelmed administratively to streamline some of their intake and the management of their information and “pass along the cost,” so to say.
It seems as new solutions come to pass and as we as an industry seek ways to moderate, streamline and create new efficiencies, questions such as the one raised by this survey will be asked more and more. As the questions become more well circulated and discussed, the issues they address will move toward the acceptable and standard practice as they gain ground within the society we have created.
As such, though there may be initial resistance, like all cultures built to change, what was once unacceptable will become standard practice.
Given the issue raised by these questions, I wonder what level of change we’ll see in regard to this in the near term. My hunch is that in an effort to include more people in the process, to streamline and to offload some of the administrative responsibility, we’ll see tactics such as these be incorporated more often, and more “power” given to the patients.
I wonder what your thoughts are on this subject, and what your perspectives are. Do you agree with the survey results? Should patients be allowed to change any of the data in their records or does it make sense to include them in the administrative management of the record?