By George Mathew, chief medical officer, North America, DXC Technology
Connected consumers, and their data, will play a critical
role in transforming the next era of healthcare. In fact, global industry analyst IDC
that by the end of 2020, 25 percent of the data used in medical care will be
collected and shared with healthcare systems by patients themselves.
Using devices, such as wearable fitness trackers,
biometrics, implants and digital voice assistants, patients will generate
real-time information about their diet, fitness and sleep habits, mood and purchasing
behavior. Providers will be able to access and
analyze a more complete picture of each patient, enabling them to make better
care decisions, faster.
However, for this trend to truly drive
transformation, organizations will need innovative approaches to care delivery
that engage patients to actively share their healthcare data and participate in
directing their own health services.
Patient-friendly Care Delivery
As increasingly empowered consumers,
patients are demanding a shift from the traditional reactive model of
healthcare toward one that is more proactive, continuous and collaborative in
delivering the most relevant care when and how it is
needed. Recognizing this trend, many healthcare organizations are investing in
tools that are designed to provide more personalized patient experiences.
care tools can include electronic portals, mobile applications, wearables,
chatbots or patient relationship management systems that capture more data and enable
patients to conveniently access their health information. Patients can also use
these digital tools to more-readily monitor their care plans, communicate with
providers, access support networks, request appointments and prescription
refills, and support behavioral changes through push notifications that guide
them toward the next-best actions for maintaining their health. They can become
more involved, and engaged, in managing their own health and building a robust
record of actionable data.
For health organizations to maximize patient-driven insights, they can prioritize digital platforms that automate data collection, integration and measurement to reduce patient effort, and to ensure that analytics capabilities are as predictive as possible to amplify preventive services.
Transparency and Collaboration
will also need to earn and maintain patients’ trust by approaching care decisions collaboratively
and being transparent about how patient data may be collected and used to drive
health outcomes. Healthcare organizations may consider creating an information
base of health data with shared access by patients, providers and third-party
communities where the patient feels a strong affinity, such as their fitness
center or employee wellness program. Through proper consent and individualized access
based on role, multiple entities can contribute and extract from this pool of
data, driving richer insights for acute health concerns or providing
“dashboards” for longer-term well-being and family health.
Additionally, providers can
view patients as partners in working toward shared incentives in value-based
care. For example, digital health apps could be used to analyze all available
data and bundle health services into care-plan options that optimize provider
resources. This approach helps patients personalize a plan based on their
desired outcomes, budget and lifestyle goals.
providers may also consider establishing official partnerships with
self-organizing patient cooperatives designed to collate their data and work as
a group to trade aggregated information for discounted health services and
financial incentives. This type of model could, for example, allow the
cooperative to pool their data to pre-buy services or procedures directly from
both examples, providers can offer affordable, personalized care while
strengthening their relationships with patients and, ultimately, creating a
truly connected healthcare system.
no question that patient-generated health data has become a valuable resource
for providers. Healthcare organizations that can engage patients to collect and
share their personal health data will derive rich, new insights that positively influence
clinical decisions and drive higher quality care. To do this successfully,
providers can prioritize personalized inpatient, outpatient and virtual
services that combine consumer-friendly technologies and innovative incentives.
patient experiences and clinical effectiveness will create new opportunities
and imperatives to advance the future of care.
HIMSS Analytics releases its latest Essentials Brief. The 2014 Patient Portal Study is the first in the HIMSS Analytics series of Essentials Briefs to focus on patient engagement.
In addition to voice of customer (VOC) insight from healthcare IT executives across the country, the 2014 Patient Portal Study incorporates data from the HIMSS Analytics Database to provide a comprehensive view of the market as it pertains to this technology. Topics in the brief include market utilization, vendor market share and trajectory, as well as the relationship between meaningful use Stage 2 and patient engagement.
“Patient engagement is more than just today’s hot topic – it is foundational to the future of healthcare,” said HIMSS Analytics Research Director, Brendan FitzGerald. “The patient portal study is the first in our series of Briefs dedicated to patient engagement, and we wanted to go beyond the statistics and delve into the executive mindset.”
Key findings of the study:
• Show patient portals typically come from the EHR vendor currently used by the organization
• Indicate room for improvement, as IT executives did not display a high level of passion for their organization’s current solution
• Highlight cultural issues within organizations as a major challenge to overall patient engagement initiatives
HIMSS Analytics Essentials Briefs are complimentary for hospitals and health systems, and are available for a fee to all other interested parties. To request a copy, please email email@example.com from your employer’s email domain.
HIMSS Analytics collects, analyzes and distributes essential health IT data related to products, costs, metrics, trends and purchase decisions, delivering it to healthcare delivery organizations, IT companies, governmental entities, financial, pharmaceutical and consulting companies.
Guest post by Martin Edwards, MS, CHC, CHPC, compliance officer, Dell Healthcare.
Patient portals offer an unprecedented opportunity to engage consumers, provide a customized care experience and potentially change behavior. Yet they also introduce new security concerns for both patients and providers.
A question we often hear from healthcare providers regarding security is: How much protection against negligence does meeting the HIPAA requirements really provide? That question is particularly germane to patient portals, which create an additional entry point and more risk to the security of protected health information (PHI). The laws and regulations in these cases can be confusing.
Fortunately for providers, “safe harbor” is offered in those cases where the provider can prove that they have properly encrypted all devices that contain PHI. Under the HIPAA security rule, as long as PHI is encrypted according to National Institute for Standards and Technology (NIST) guidelines, it is no longer considered “unsecured” and providers are effectively exempt from improper disclosure being considered a “breach.” Thus, the HIPAA breach notification rule doesn’t apply, and, by extension, the provider can avoid potential fines from the Office for Civil Rights (OCR). Since most breaches of PHI reported to the U.S. Department of Health and Human Services (HHS) to date have related to the theft or loss of unencrypted mobile devices, encrypting the data is a primary defense against data loss and against the consequences of improper disclosure.
While patient portals add risk, they also confer many benefits to healthcare organizations, including enhanced patient-provider communication and empowerment of patients. Some studies have found that portals can also enable better outcomes for patients. These benefits are behind the HIPAA privacy rule’s “right of access,” which allows individuals to examine and obtain a copy of their PHI. Meaningful use requirements also require eligible professionals to exchange secure emails with at least 5 percent of their unique patients. Since portals are an ideal way to meet this requirement, organizations seeking to comply with Stage 2 criteria have an incentive to adopt them.
Increased engagement through patient portals remains a health initiative and a benchmark for meaningful use incentives, yet a large number of patients report being unaware of their ability to access medical information and communicate with healthcare providers through this medium.
A recent study by TechnologyAdvice shows nearly 40 percent of patients are unsure if their primary care physician has a patient portal website available, while another 11 percent are confident their physician “does not” offer one. In all, less than half of the 430 patients surveyed — 49.2 percent — report actually being shown a patient portal by their primary care physician either during a visit or outside a visit.
“With incentives tied to digital patient engagement and a general shift to integrated platforms taking place, all signals point to patient portals becoming increasingly prominent in the patient-physician relationship. However, it appears many physicians are not doing enough to educate patients about their portals and provide incentives for their use,” said TechnologyAdvice editorial coordinator Cameron Graham, who authored the study. “This lack of patient portal awareness appears to be slowing down a significant digital switch in patient-physician communication, considering the study also shows there is little change in the way patients prefer to interact with their doctors.”
Nearly 43 percent of patients say they prefer that doctors contact them by phone for general communication and to provide test results. These preferences are true even for the 18 through 24 age group, though, the younger respondents did report a greater preference for scheduling appointments online.
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.
Guest post by Ed Simcox, healthcare business leader, Logicalis US.
Healthcare is undergoing a significant transformation today, and so is healthcare IT. As a result, healthcare providers and their IT departments need to brace themselves for change – which is happening faster than they might realize – in five business-critical areas: healthcare IT infrastructure, mobility and BYOD, business continuity and disaster recovery, storage and vendor-neutral archives, and patient portals and mobile applications.
With pressure mounting to meet new regulatory requirements and ICD-10 deadlines, as well as the increased demands being placed on IT departments for interactive communications among patients, providers, and payers, healthcare CIOs need a set of “best practices” to help them navigate this IT transformation and arrive at the data-driven, value-based future of healthcare from where they stand today.
We call this IT transformation a “journey” because it isn’t something that happens overnight. This is a multi-stage process requiring significant evaluation of not only IT systems, but also of what the future workflows and business processes will be and how healthcare providers, patients and payers can all seamlessly share time-critical data. It’s a journey that is taking healthcare IT to the new levels of IT sophistication needed to support a substantial business change from volume to value, and there are five important milestones that every healthcare IT department is going to have to tackle along the way.
HIT Infrastructure — Of all the technical capabilities healthcare IT professionals are being asked to master today, the key is an ability to rapidly adapt to change. As a more technology-oriented generation of doctors and tech-savvy patients take their place in healthcare’s future, IT is going to be drawn increasingly into the actual delivery of health services. As a result, healthcare IT professionals won’t be spending the bulk of their time caring for their IT infrastructures. The good news is that if the IT infrastructure is transformed from today’s siloed systems into a virtualized, automated IT-as-a-Service resource, then the IT department will be able to focus its efforts directly on using technology to help doctors and nurses care for their patients and allowing patients to electronically manage their own care and wellness.
One of the quite enlightened (though likely also overwhelming) healthcare initiatives directed at making healthcare more transparent and understandable is the Medicare and Medicaid electronic health record (EHR) incentive program. This is an act that forces all healthcare providers servicing Medicare and Medicaid patients, and by extension pretty much every patient, to use or expand their EHR systems for a large set of requirements, including making their notes, prescriptions, test results, diagnostic images and additional information all available to their patients on a web-based portal. And, unlike many other regulations that have no enforcement, this act not only requires that providers make these services available to their patients, it also measures and compensates providers on what percentage of their patients actually use said services.
As we all know, however, leading a horse to water is not enough. One of the most important and critical factors that all providers are facing is how to make their patients actually use these portals. Studies already indicate that a large percentage of the public wants more complete access to their medical records and doctor’s instructions electronically, via the web. It also makes sense that access to more complete information regarding your health status increases the odds that you’ll do what is necessary to do to get better.
The good news: We have technology to make that available. Unfortunately, it’s not working as well as it should.
By the time the market is ready to move, the technology they’ve been told to move to won’t exist as it has been depicted.
This is much the same thing as technology that has been developed that upon its arrival has been pronounced dead. An example of this was the iPad. Before it hit the market analysts and naysayers said the technology – which I don’t have to tell you is essentially a hand-held, touch screen computer – was worthless. No one had a need for PC that one could carry about wherever they went; we had laptops after all. But they failed to see the upside.
For example, iPads are the ideal technology for busy physicians (as you well know) making rounds jumping from patient to patient throughout a practice, as well as have had a profound effect on the treatment and education of individuals with autism and other developmental disabilities.
For example, tablet devices have opened the door for children with special needs, many of whom use them easily and effectively. Not only have they become a learning tool for many of these children, they have also become communication devices. According to Mashable, students using an iPad advance more quickly than those who did not use them. Even in education, there are currently more than 2 million tablets, like iPads, being used and the number will increase dramatically as the technology becomes more accessible and affordable.
As of December 2012, there are more than 20,000 apps for mobile devices that teach communication, speech, language, motor skills, social skills, academic skills, behavioral skills and more than 900 apps for students with disabilities, including autism.
I believe something similar will happen to the patient portal market. Heavily pushed on physicians by EHR vendors for the last three years, this has led to their increased popularity. Meaningful use hasn’t hurt either.
However, by the time the market adjusts to their availability and the reasons for their existence – bill administration, appointment scheduling, viewing records (in some cases) and communicating securely with physicians – the technology as we now know it will no longer exist.
Monique Levy, vice president of research for Manhattan Research recently made an interesting point about the future use of patient portals and I think it’s hard to disagree with her: Today, patient portals are most commonly used for scheduling appointments, viewing medical results and sending messages to doctors or nurses, Levy says. But many more advanced features are not only possible, but are available and waiting to be implemented. This includes access to video chat with a healthcare professional, pre- or post-operative care instruction videos and consolidation of all of a patient’s medical data from multiple sources in one place.
For instance, mobile health technologies will feed patient data directly to the patient portal to improve care and treatment options.
In a lot of ways, this sounds a lot like a Hootsuite interface that used to collate and track all of our social media channels. For example, I can track my Twitter feeds and Facebook pages as well as can interact, post and broadcast content through it. Patient portals are likely moving in this direction and will end up being so much more than the base model systems currently being implemented.
Most likely, the standard bi-directional portals that current vendors produce are likely going to be passé in short order and new systems and interfaces are likely to crop up and take over the market, changing the landscape once again.
Simply stated, perhaps it’s best not to believe all that we’re being told. It may benefits us to think about where our decisions regarding technology investments take us.
To follow the belief that the stale portals of today will match what in the future will most likely be vibrant interfaces may be similar to denying the viability and importance of devices like tablet PCs in healthcare and beyond, though, many thought them worthless at the point of issue.
According to a recent Pew Research report, adults prefer to track health data “in their heads” over tracking it digitally. Currently, only 20 percent of Americans track their health digitally using a variety of tools available to them, Pew reports.
The report was compiled through a national phone survey conducted by the Pew Research Center’s Internet & American Life Project. The results of the survey found that 69 percent of U.S. adults keep track of at least one health indicator, such as weight, diet, exercise routine or other symptom. Of those, half of the respondents track “in their heads” while one-third keep notes on paper and one in five use technology to keep tabs on their health status.
When the respondents were asked to think about the health indicator they pay the most attention to either for themselves or someone else, 49 percent of trackers in the general population say they do so “in their heads” with men being more likely to keep track in their heads than women.
According to Pew, the report results are “surprising given the growing availability of digital health tools available to the consumer to monitor and track their health. It also validates the challenges many digital health developers face when creating digital health tracking tools.”
Another 34 percent of trackers in the general population say they track the data on paper, like in a notebook or journal as women are more likely than men to track health data using pencil and paper (40% vs. 28%) as are older adults (41% of those ages 65 and older, compared with 28% of those 18-29 years old).
One in five trackers in the general population (21%) says they use some form of technology to track their health data, which matches the previous 2010 findings. Other key findings specific to the technology adoption of tracking include:
8 percent of trackers use a medical device, like a glucose meter
7 percent use an app or other tool on their mobile phone or device
5 percent use a spreadsheet
1 percent use a website or other online too
The results of the report came from a nationwide survey of 3,014 adults living in the United States. Telephone interviews were conducted by landline (1,808) and cell phone (1,206, including 624 without a landline phone).
Interesting that this is the case especially given all of the recent attention a variety of health tracking tools and patient portals are getting. Most likely, this falls into the category of one of two things: 1). the condition is so minor that it only needs to be tracked in someone’s head or 2.) as younger patients “enter the market” we’ll see a considerable uptick in the number of people using technology to track their conditions.
Or, maybe patients will never care about such things and firms like Pew will continue to produce reports telling us the results of their surveys.
What say you? Will we see an uptick in the use of technology to track health data or not? Why?
According to a recent report issued by KLAS Research, “Patient Portals 2012: The Path of Least Resistance,” published by HIT Trends health systems and practices are turning to patient portals more than ever before. Meaningful use is an obvious reason, but convenience and “the ease of integration that comes from having an established relationship with an EHR vendor are the primary factors providers use to choose a patient portal.”
In light of the expanding need of patient portals, the KLAS study focused on solutions that providers use, and what role the portals play in the long-term strategies each organization for patient engagement. The report included respondents from a mix of health systems, hospitals, and clinics.
“Providers are feeling increased pressure to engage with their patients at deeper levels than ever before. About one-half of interviewed providers already had a portal in place, primarily from their current EHR vendor. Providers needing to connect a number of disparate EHRs were the only group more likely to opt for a best-of-breed solution.”
“The existing EHR vendor relationship appears to be more important than any other factor when choosing a patient portal,” said report author Mark Allphin. “While functionality and ease of use are important to providers, they take a backseat compared to providers’ desire to manage fewer vendors and interfaces.”
Although many providers are choosing to stay with incumbent EHR-based patient portals, KLAS did report significant interest and engagement with third-party vendors.
Access to the patient clinical record is the most implemented function. Other functions in place or planned include: appointment scheduling, provider messaging, bill pay, online registration and patient education.
Of those interviewed for the report, 57 percent of providers surveyed report a patient portal in place.
According to Michael Lake, publisher of the monthly healthcare IT newsletter, HIT Trends sums up the report this way: “Providers are putting patient portals in place to meet meaningful use requirements for access and messaging. Some are looking at kiosks and mobile solutions, too. In single EHR organizations, using portals from their current vendor makes tactical sense. Niche solutions may fare better when providers look at long-term strategies and required functionalities.”
From my perspective, and probably yours, serious portal conversations have taken place for about the last three years, and with the mandates of meaningful use, it was only a matter of time before they started to proliferate the market.
Even as practices look to engage their patients more, portals will likely be the first tool considered to do so. As the report suggests, the biggest question here may be whether to add a portal from your current vendor or to find a third-party solution.
Are you going through a portal implementation? What’s your strategy going to be?