Imagine your favorite football team is in a real neck-to-neck with another team, and the game could tip in anyone’s favor. It is the last minute, and in an insane turn of events, the quarterback throws the ball in the air, hoping the player in the end zone could make a touchdown. Instead, the reckless throw results in confusion, the guy in the end zone gets tackled, and the game ends in disappointment.
Now, let’s step out of football and look at these statistics that show a little picture of referrals in healthcare:
Only about 50% of referrals result in a completed appointment
Less than 25% of referrals are completed as intended by the referring provider
In case one, the player didn’t score a touchdown, and in the second case, the patient didn’t end up with the right provider and the treatment. The reason being the process— a reckless throw and an inefficient referral procedure.
Most healthcare organizations lose about 30% to 60% of patients on account of inefficient referrals. Value-based care is expected to become the leading payment model by the year 2020, and healthcare organizations cannot afford losing more than half of their revenues due to reduced referral leakages.
How do you know that your referral management needs healing?
Imagine a situation where a patient, in his early 60s, suddenly suffers from severe abdominal pain. He goes to his doctor, and the doctor directs him to a specialist she knew out of her professional knowledge.
Now the situation can unfold in many ways, where the patient might end up getting treated or the exact opposite of it. In all the scenarios, the part where things might go wrong is the process of referring the patient. The problems that these stakeholders might face include:
The inability to identify in-network providers
Lack of proper patient information
Limited access to information flow among providers
Reliance on age-old techniques of fax-based referrals
… and many more.
Now the question is: ‘What is the solution?’
It all boils down to just one thing— having the right data. Imagine you visit your doctor. The moment you tell him your problem, he looks into his screen to look for the right specialist. In just one click, he gets all the correct specialists in a listicle format. And all he has to do for the rest of the story is just click on the ‘Refer’ button.
Seems undoable? Actually, all we need is a data-driven strategy.
Don’t just plan your data but also your approach
It is never about just knowing the patients but understanding them, their health, their socio-economic condition, and their care journeys. All of this is not possible if we do not have access to the right data. Whether it be a lab test or spiking blood pressure— nothing should be left undetected.
Easier it is for providers to understand, efficient will be the referral
You cannot expect the rest of the process to be perfect if the beginning is imperfect. If the provider is stuck finding the information, not only will this delay the referral but also increase the chances of errors. What they need is a single screen view of specialists in a list that includes every detail such as geography, specialist ranking, availability, and fees, among others.
Connecting communities and care teams to deliver the best care
It is crucial that care teams and communities remain aware of the events happening in the patients’ care journeys. They need a streamlined tracking of patient referrals at the clinical or patient level. It will reduce the turnaround time for escalations.
The patient lost in the process is the revenue lost
The right referral strategy includes two significant aspects:
Increasing the visibility into the process to the patient
Using advanced analytics tools to develop a lens into the referral process
What they need is a simple reminder that enlists all the details regarding the visit and gives timely updates to them regarding the specialist and the appointment date. Organizations can increase patients’ access to telehealth services by allowing plans to propose the use of telehealth services instead of promoting in-person visits.
Over the last few years, hospitals and healthcare practices throughout the country have started adopting new technology that helps them provide better care to their patients and make life easier for their employees.
For example, 64 percent of physicians now send electronic messages to their patients via text or email. Meanwhile, 63 percent allow their patients to view their medical records online.
Are you looking for new ways to bring your practice into the 21st Century? Listed below are seven of the top healthcare technology trends you ought to know about and consider implementing in your practice.
Electronic Medical Records
Electronic medical records (or EMR for short) are one of the most popular tech trends in the healthcare world.
Lots of practices have started using EMR to simplify the process of searching for patient records. EMR has also made it easier for patients to access their medical records online.
Even though plenty of practices are making use of EMR, there are still a lot of them that haven’t made the switch yet. The sooner you start making your files available in a digital format, the sooner you’ll start reaping all the benefits of EMR.
For example, EMR provides immediate access to patient records. It also helps physicians make better decisions about their patient’s care.
They can spot patterns more easily when everything is in front of them. This, in turn, allows them to choose the best treatment approach and avoid missing something important.
Blockchain has started to make its way into the healthcare world, and it’s not showing any signs of leaving.
Blockchain technology allows healthcare practices (and other businesses, for that matter) to store digital information without taking up a ton of space. It also allows them to store their information in a more secure way since it cannot be copied.
In the digital age, patient security and privacy protection are of the utmost importance to many healthcare professionals.
Blockchain systems allow practice owners and managers to ensure they’re keeping patient records and information safe. It also helps them to avoid expensive and harmful (on many levels) data breaches.
In 2019, many people are looking for new ways to get things done without leaving their homes. They have groceries delivered to their door, for example, and they communicate with friends and family via video chat.
Lots of healthcare practices are jumping in on this trend and are making it easier for patients to have their medical needs met from the comfort of their own homes as well.
Telemedicine allows patients to talk to doctors, receive medical advice, and even have prescriptions filled, without having to make a special trip to the doctor’s office.
Physicians are also using these same technologies to communicate with each other in more effective ways and come up with better, more comprehensive solutions for their patients.
Artificial intelligence is for way more than gaming. It’s also one of the biggest healthcare trends of 2019.
Physicians and researchers have started or have plans to start using artificial intelligence in a variety of ways.
As artificial intelligence technology becomes more refined, it will be easier for healthcare professionals to monitor their patients and provide better diagnosis and treatment.
It will also likely enhance the telemedicine world as well, as it will make it easier for physicians to see their patients without having to be in the same physical location as them.
Wearable health monitoring devices are not new. However, they’ve become more popular than ever, and they’re also becoming more advanced.
As these devices become more accurate and able to provide more details about the wearer’s health, it’s likely that many physicians will start relying on them to gather information about their patient’s health and daily habits.
More than 100 C-Suite and director level executives voted and then ranked the top 10 critical challenges, issues and opportunities they expect to face in the coming year, during this week’s HCEG Annual Forum. The HealthCare Executive Group (HCEG), a 31-year old networking and leadership organization, facilitated interactive discussions around such issues in their 2.5 day marquee event in Boston.
Executives from payer, provider and technology partner organizations were presented with a list of over 25 topics. Initially compiled from webinars, roundtables and the 2019 Industry Pulse Survey, the list was augmented by in-depth discussions during the Forum, where industry experts explored and expounded on a broad range of current priorities within their organizations. The HCEG Annual Forum concluded with HCEG Board Members announcing the results of the year-long process that determined the 2020 HCEG Top 10.
2020 HCEG Top 10 Challenges, Issues and Opportunities
Costs & Transparency — Implementing strategies and tactics to address growth of medical and pharmaceutical costs and impacts to access and quality of care.
Consumer Experience — Understanding, addressing and assuring that all consumer interactions and outcomes are easy, convenient, timely, streamlined, and cohesive so that health fits naturally into the “life flow” of every individual’s, family’s and community’s daily activities.
Delivery System Transformation — Operationalizing and scaling coordination and delivery system transformation of medical and non-medical services via partnerships and collaborations between healthcare and community-based organizations to overcome barriers including social determinants of health to effect better outcomes.
Data & Analytics — Leveraging advanced analytics and new sources of disparate, non-standard, unstructured, highly variable data (history, labs, Rx, sensors, mHealth, IoT, Socioeconomic, geographic, genomic, demographic, lifestyle behaviors) to improve health outcomes, reduce administrative burdens and support transition from volume to value and facilitate individual/provider/payer effectiveness.
Interoperability/Consumer Data Access — Integrating and improving the exchange of member, payer, patient, provider data and workflows to bring value of aggregated data and systems (EHR’s, HIE’s, financial, admin and clinical data, etc) on a near real-time and cost-effective basis to all stakeholders equitably.
Holistic Individual Health — Identifying, addressing and improving the member/patient’s overall medical, lifestyle/behavioral, socioeconomic, cultural, financial, educational, geographic and environmental well-being for a frictionless and connected healthcare experience.
Next Generation Payment Models — Developing and integrating technical and operational infrastructure and programs for a more collaborative and equitable approach to manage costs, sharing risk and enhanced quality outcomes in the transition from volume to value. (bundled payment, episodes of care, shared savings, risk-sharing, etc).
Accessible Points of Care — Telehealth, mHealth, wearables, digital devices, retail clinics, home-based care, micro-hospitals; and acceptance of these and other initiatives moving care closer to home and office.
Healthcare Policy — Dealing with repeal/replace/modification of current healthcare policy, regulations, political uncertainty/antagonism and lack of a disciplined regulatory process. Medicare-for-All, single payer, Medicare/Medicaid buy-in, block grants, surprise billing, provider directories, association health plans, and short-term policies, FHIR standards, and other mandates.
Privacy/Security — Staying ahead of cybersecurity threats on the privacy of consumer and other healthcare information to enhance consumer trust in sharing data. Staying current with changing landscape of federal and state privacy laws.
As technology continues to improve, using virtual connections in place of face-to-face meetings has surged in popularity. The healthcare industry is no different – the telehealth industry is predicted to be worth more than $130 billion by 2025. While telehealth offers many benefits to patients, particularly those who are unable to leave their homes, the technology raises several serious security concerns.
These problems primarily stem from the lack of security controls when it comes to the collection and sharing of data. During a conversation between a patient and doctor, for example, sensitive, personal patient data is often shared. When the connection between patient and doctor is virtual, it is possible that an unsecured connection could be interrupted, and patient data leaked. Home telehealth devices and sensors may also collect data that a patient would prefer to keep private, including times that the home is unoccupied. If devices are storing and transmitting this data, it is possible that it could be accessed by third parties.
These concerns have left a lingering question: how can patients still reap the benefits of telehealth while ensuring their connections and data remain secure? The answer may lie in another technology that healthcare providers have only started to adopt – blockchain.
Enabling Secure Data
Blockchain at its most basic level simply enables secure, immutable and anonymous transactions, allowing cross-network communications to take place through mutually agreed upon interactions between parties. For healthcare providers, this opens up an efficient means of transferring data and communicating between different organizations that handle patient data. Medical records can also be stored using blockchain, allowing providers to create a more complete patient history by keeping larger amounts of data and information securely encrypted in fragmented systems.
The ability to securely share data and control who has access to it will surely help to increase consumer confidence when it comes to telehealth. Blockchain requires that data is approved by both the patient and doctor before it is entered into a computer. The data must also be verified against a previous ledger, so no single party ever has total control. This ensures multiple checks are in place and reduces the chance that an unauthorized party could access sensitive patient data, which is one of the main concerns when it comes to using telehealth.
Regulating Sensitive Communications
While it offers many solutions, federal organizations have not officially decided how regulations would apply to blockchain, including the Health Insurance Portability and Accountability Act (HIPAA). HIPAA outlines rules for ensuring the privacy and security of patient data, as well as the secure transfer of data, but it does not apply to patients; ensuring blockchain users remain compliant will be the responsibility of healthcare providers.
HIPPA guidelines for telehealth require that healthcare organizations communicate electronically protected health information (ePHI) through regulated channels to ensure security. This means that tools like Skype or unencrypted email cannot be used to communicate ePHI, limiting what could be used for cost-effective telehealth.
In the age of internet and online shopping, striving to make it into the future by relying on traditional or outdated practices will get you nowhere! Thanks to the younger generations, various private and public departments are favoring online presence more now and we think, healthcare department should follow suit!
According to a survey by Accenture, the younger generations (millennials and Generation Z) will likely prefer new care models like retail clinics and virtual visits over the traditional methods. This spells trouble for the healthcare department since they still lack the tools to embrace the digital culture.
Digital Transformation in the Healthcare Sector
There is nothing wrong with the traditional health IT sector. It is just that many of the younger generations are outgrowing the traditional methods and now expect a different standard of service.
In the age of self-diagnosis from Google and WebMD, the young individuals constantly express dissatisfaction with the existing healthcare models. They are more comfortable with researching healthcare options online and are more likely to utilize non-traditional methods of engaging with the health department. Because of the reliance on the latest cutting-edge options, healthcare must understand that there is a need to adopt advanced techniques.
Currently, we are living in the digital age and the consumers are always on the lookout for a digital front-end experience. Since the internet has blurred boundaries, the younger generation is more aware of what they want and how they want it. At this point, the healthcare department seriously lacks the necessary digital tool to provide a better experience.
In a way, it is not just about the adoption of certain tools. Instead, we are talking about a complete transformation that will provide the healthcare department with the boost it needs to make things easier for the upcoming generations. The redesign will mean that high-quality, accessible, affordable, and effective healthcare can be provided through digital tools.
Definitive Healthcare released results from its 2019 Outpatient Telehealth Study. In this survey, Definitive Healthcare polled physicians and healthcare administrators to determine to determine telehealth adoption trends, technology, and services.
• Adoption Remains Flat 2018 to 2019: Adoption rates of telehealth solutions/services by outpatient physician practices remained relatively flat from 2018 to 2019, lingering at about 44 percent. However, the mix of telehealth technology solutions did shift this year, with an increase in two-way video/webcam, mobile applications for concierge services, and clinical grade remote patient monitoring devices.
• Telehealth Technologies Regarded Effective: Physician practices with telehealth solutions already in place rated the effectiveness of these technologies relatively high at an average of 6.51 out of 10 – well above the midpoint, and above all other survey categories. This indicates that, despite hurdles that hinder telehealth investment or adoption, these solutions are effective when in use.
• Providers with Telehealth Solutions Likely to Re-Invest: Roughly 65 percent of physician practices with a telehealth solution already in place plan to make further investments, up from 45 percent in 2018. Nearly 90 percent that plan to make an investment plan to do so in the next 18 months.
• No Need to Fix What’s Not Broken: Unlike the inpatient market, the priciness of telehealth solutions was not the primary barrier for outpatient adoption. In this survey, the majority of respondents (20.2%) cited “satisfaction with their practice’s current solutions and services” as their primary barrier when considering adopting telehealth technologies. Another major barrier for respondents, at 12.6%, was uncertainty surrounding reimbursement policies from insurance companies and at the national level.
“Based on these survey results, and the trends we’ve been observing in the market, there are three main hurdles that are currently hindering outpatient telehealth adoption. There is not only a need for more clarity around reimbursement policies, but also a need for more interoperable telehealth solutions that can be accessed through EHR or EMR systems as well as a better understanding about what types of telehealth options are available,” said Jason Krantz, CEO of Definitive Healthcare. “Until some of these issues are addressed, it may be some time before substantial outpatient investment is made in the telehealth arena.”
Today, our healthcare system is changing, and it’s changing quickly.
What’s leading the way for the remarkable shifts we’re seeing in our industry? Record-breaking investments into digital health (more than $14 billion in 2018 alone). Every day, we see digital health leaders working toward more affordable and accessible care for patients everywhere.
However, as we evolve and advance, we can’t ignore the glaring problem that still plagues the industry: clinician burnout. It’s a terrible symptom of a system that’s no longer working. Clinicians are 15 times more likely to experience burnout compared to any other working professional, and they’re killing themselves at alarming rates — the highest of any profession.
I believe the very technology we’re creating to better serve patients can also save clinicians — as long as we’re mindful of how we bring forth change. Here’s how we can do it.
Tech is helping clinicians prioritize flexibility, autonomy and career mobility
Our most recent generation of clinicians are approaching work very differently than their predecessors. Studies show that more Millennials are choosing to stay at home than Gen X before them. Many attribute this to our current economic climate and a changing attitude towards work-life balance.
In healthcare, technology is keeping pace with this cultural shift by empowering clinicians to live on their own terms. How? Currently, one in five physicians use telehealth. That number is expected to triple to more than 60 percent by 2022, with many stating that they plan to adopt new technology because they’re experiencing burnout and want more flexibility.
What does this new work-life balance look like for clinicians? A level of career mobility that hasn’t been available to them until now. For example, with asynchronous medical assessments, the days of darting from exam room to exam are behind us. These software-enabled questionnaires mirror a clinician-patient interaction, so clinicians can review responses on their own time to diagnose and develop a treatment plan in a matter of minutes.
Technology is alleviating the pressure felt from a growing physician shortage
Burnout is intensifying another crucial problem in the healthcare industry: our physician shortage. Recent findings suggest that by 2030, the United States will have a shortage of 120,000.
What does burnout have to do with this? Many clinicians are reducing hours at work to alleviate their feelings of burnout. This is especially true for young clinicians who are starting families. Female clinicians in particular take on a disproportionate share of child care and family responsibilities. To manage this new chapter in life, they’re often faced with taking a “career detour.”
New digital health solutions are shifting this reality, offering options that allow clinicians to work when and where they want. This is a significant win for the healthcare system. We get to retain highly qualified clinicians who might otherwise have no other option but to leave the profession–temporarily or permanently. It’s also a huge win for our clinicians. They no longer have to ask, “is it possible to work,” and instead get to decide “when and how am I going to work.”
Clinicians’ jobs are becoming more and more efficient
One reason we’re seeing the fast adoption of telehealth technology among clinicians is because it’s making their jobs more efficient–not more difficult. We might think it’s a no-brainer that technology should make our lives easier, but in healthcare, that hasn’t always been the case. For example, with past advancements like electronic health records, a common complaint was the cumbersome administrative tasks that came with them.
By Manish Mathuria, chief technology officer and co-founder, Infostretch.
The truism that “prevention is better than cure” is especially true in software, where a defect can have serious, sometimes life-threatening, consequences. Digital health presents a unique set of challenges and opportunities for those operating in this competitive and demanding market. The pressure to innovate and advance is immense, but so are concerns about safety, functionality, cost and privacy, to name a few.
When clinical insights combine with IT brilliance, the results can lead to fascinating health innovations. Radical new approaches, such as wearables and mobile devices which monitor, analyze and diagnose conditions, bring special meaning to the importance of error prevention versus recovery.
Lightning-fast technological innovation, fierce competition and stringent regulation combine to bring special challenges to a tester. The implications of software failure are severe. Another adage, “evolve or die,” springs to mind. The traditional testing function is what needs to evolve in this sector perhaps more than any other.
The quality assurance approach to testing must now make way for quality engineering, a new way of tackling quality control which focuses on improving the inherent design of the product throughout the software development life cycle. Why? Because traditional testing, performed at the end of the SDLC is out of its depth in the new era of digital transformation.
By Chris Jaeger, head of ACO and health system strategy, AristaMD.
Rural hospitals are facing severe challenges in maintaining operating margin, with uncompensated care being a major factor. Telehealth eConsult platform use in local primary care settings to improve “right time, right place, right provider care” have been shown to decrease the number of patients receiving avoidable and unnecessary care within the hospital setting, thus supporting hospital’s ability to mitigate uncompensated care.
Uncompensated care is an overall measure of hospital care provided for which payment was not received from the patient or payer group. It equates to the sum of a hospital’s bad debt — the financial assistance it provides. Financial assistance includes care for which hospitals never expected to be reimbursed and care provided at a reduced cost for those in need. A hospital incurs bad debt when it cannot obtain re-imbursement for care provided; this happens when patients are unable to pay their bills, but do not apply for financial assistance, or are unwilling to pay their bills.
Hospitals, both nonprofit and for-profit, provide uncompensated care for individuals who are uninsured and under insured.
Though there has been a noted decline in uncompensated care since the 2014 passage of the Affordable Care Act and Medicaid expansion, this has not carried over to states not part of the expansion. States that expanded Medicaid to low-income adults under the ACA recognized a 47 percent decrease in uncompensated care costs, on average, compared to an 11 percent decrease in states that did not expand Medicaid.
(Coverage map as of Feb 2019)
Uncompensated care and dropping revenue margins are causing hospitals, especially in rural areas, to close. “While Medicaid expansion has improved all hospitals’ operating margins and total margins, the effect was particularly pronounced in rural areas,” noted a report from the Center on Budget and Policy Priorities. A recent study by the North Carolina Rural Health Research Program (NC-RHRP) at the University of North Carolina Cecil G. Sheps Center for Health Services Research (UNC-CH) showed that since 2010, 89 rural hospitals in 26 states have closed.
Much of this uncompensated care could be prevented through primary care intervention. A report, released by Premier, found that six common chronic conditions accounted for 60 percent of 24 million Emergency Department (ED) visits in 2017; out of that 60 percent, approximately one third of the visits (4.3 million) were likely preventable and could be treated in a less expensive outpatient setting.
Telehealth is a really exciting field with masses of opportunity to build successful companies and to help people quite literally all across the globe. Technology has afforded us the opportunity to administer all sorts of things at vast distances and now that includes medical help. It’s not a field without some issues though and plenty of people will find getting into telehealth quite complex and confusing. So, here are a few tips for starting out in this industry.
Pick an appropriate field
Telemedicine is limitless in some ways, limited in others. This is an area with some limitations. “There are only certain sorts of medicine which it is practical to apply to the telehealth model, not to mention legally speaking,” warns Shane Marlon, career manager at PaperFellows and AustralianReviewer. You have to be able to guarantee that whatever it is you are doing will be of use without needing an ‘in-the-flesh’ consultation. But you’ll be surprised at how long that list of applicable practices is!
Look to the future
Tech development moves very, very quickly so it’s safe to say that telehealth, as a rising industry, will look completely different in ten years’ time. Now, you’re not a prophet, nor are you a trend-predicting supercomputer. However, with a little research you will quickly ascertain which elements of telehealth are set to change and develop. To capitalize effectively on these when the time comes, you need to be preparing now. For example, more detailed consultations of patients will be possible in the future, so the list of applicable fields will increase, and you need to be ready for that.
Find telehealth professionals
Though it is a relatively new field, there are already telehealth specialists who are out there. These people will be immensely useful to you as you try and develop in the industry. It’s vital that you bring in some outside expertise into your team as you develop, since it is such a new field with so few precedents in place to ensure that you are doing the right things.