Rapidly advancing technology has made its presence felt in many branches of the healthcare sector, causing dramatic and drastic changes. Healthcare professionals today rely on technology in many different ways – from maintaining documents and keeping records to optimizing patient out-times and remote treatments. Not to mention the ability to provide more accurate diagnoses.
After years of effort to sort out PR, regulatory, and reimbursement challenges, telemedicine appears to be on the right track of becoming commonplace, ready to represent a sizable portion of care delivery. That near-term future has crafted a new term – virtual hospitals.
Catch the definition, if you can
Now, what does that term actually mean? We’re certainly talking about telemedicine, but that can mean a lot of different things to different people. Is it about iPad chats between doctors and rural patients, or about the implementation of IoT technology for AI-powered remote monitoring? The fact is that even professionals who’ve been involved with connected health technologies for over 20 years are not able to catch the definition by its tail.
The meaning behind “virtual hospital” usually varies by organization. In most cases, it stands for the group of intensive care physicians who are working in a call center environment. There’s a lot of screens and technology involved, but mostly to guide other users in remote places. Many smaller institutions, besides the fact that they’re difficult to reach, also don’t have full-time specialists. Doctors from virtual hospitals can prevent the waste of time by guiding the staff through medical procedures in an emergency or in critical cases.
Other organizations have embraced the concept of virtual hospitals as central freestanding facilities staffed with healthcare professionals. The best-known example of this concept is the St.Louis-based Mercy Virtual Care Center, opened in 2015 and labeled as the first virtual hospital. Their aim is to reduce the time it takes patients to meet their healthcare providers, but also to eliminate the need for very sick patients to come into hospitals frequently.
Efficient access across the globe
The term ?virtual? may not be the best pick since it sounds like it’s not real, while the provided care is very real. The point is that clinicians can be located anywhere across the globe. Although almost none of them dub themselves as a virtual hospital, around 65% of U.S. hospitals connect patients and practitioners remotely.
On the other hand, a recent survey carried out in Australia has shown that nearly 50% would never visit a virtual hospital. And this is not just because they have Medicare – it’s also about the lack of knowledge on the topic, resulting in the fear that they won’t get the same quality of care as an in-office visit.
To spread across the globe, it’s obvious that this puzzling term needs to be pinned down and explained. So, what does it all boil down to? Its core value is about two things — access and efficiency, and they need to work together.
Rising healthcare promises have been tied to cloud technology in the most recent tech-talks of the town. While the majority of care providers are not holding their breath due to previous disappointments, we wanted to translate the often vague statements made into discrete simplified processes for healthcare.
Healthcare is riding a wave of digital transformation that has brought about revolutionary processes of data management and care delivery. Moving from paper-based records to a digital format, the first wave took us from disconnected facility-based care to integrated smart care with increased coordination and population health activity.
The second wave enabled better patient experience with omnichannel communications and interoperable data sharing applications. Empowering patients and clinicians with analytics, the recent wave has health organizations leveraging real-time data-driven solutions, artificial intelligence, and cloud services to align with the culture of preventive and wellness-centric care.
The cloud will be central to future digital transformations in healthcare. What is uncertain for many is what specific, new cloud services will be developed and why are healthcare organizations now – and foreseeable future continuing – to opt for cloud-based technologies.
Why are health organizations leveraging the cloud?
We have been in the process of transitioning from fee-for-service to value-based care over the past decade. The industry is further planning to move from disease-based episodic care to preventive care in future years. To achieve that goal, several additional factors need to progress.
The healthcare system of the future will be more consumer-centric and value-driven. It will use real-time data to generate actionable insights, and data technology will play a crucial role. Cloud technology promises to improve performance enhancement and healthcare data analytics overall.
Health systems have a need for increased data capacity, and the cloud promises almost unlimited data storage, easy accessibility, and enhanced cybersecurity. As health organizations are expanding into a variety of digitized services such as virtual care, wearable devices, telemedicine, and smart AI assistance, the data per patient expands.
The cloud is a single point of access to patient information, to multiple doctors and medical services at the same time, that boosts not only real-time coordination but also ensures data security for hospitals and patients.
Gartner, in a recent healthcare cloud services report, highlighted how provider leadership has moved from skepticism to acceptance of the cloud as a service delivery model. In what ways is the cloud benefiting the healthcare industry?
By Justin Hunt, MD, MS, head of psychiatry, Ginger.
From banking to healthcare to grocery delivery—businesses and organizations across multiple industries are pivoting to leverage text messaging as a way to reach consumers. And in behavioral healthcare, text-based coaching is paving the way for increased access to support. Traditionally, mental healthcare providers have only offered in-person appointments for individuals seeking care. Today, virtual services like teletherapy and telepsychiatry are gradually growing in popularity among an increasingly tech-savvy population. Now, services like text-based behavioral health coaching offer another meaningful way for individuals to get in-the-moment care.
Consumer Expectations Have Shifted
Consumers today expect instant access to mobile-first, on-demand services. A recent survey by the Harris Poll on behalf of Ginger revealed that Americans–especially Millennials–are more comfortable with the idea of being able to text for mental health support as a way to get access to care. Two-thirds of Americans (66%) say that if they were struggling with stress or life challenges, they would prefer to text immediately with a certified mental health coach who is trained to provide support if given the choice, while 34 percent would choose to wait three weeks to meet with a licensed therapist in person. This trend is strongest with the Millennial population: 69 percent would prefer to text immediately with a professional rather than wait to meet in-person.
For many consumers, a chat-based solution may be less intimidating as a first step than going in-person to see a licensed professional. Coaching is emerging as a way for individuals to access support in overcoming day-to-day challenges, reach goals, and learn skills to reduce stress. While not licensed like a traditional provider, coaches do have credentials like coaching certifications or master’s- and doctoral-level backgrounds in mental and behavioral health. And just this year, the American Medical Association approved new codes for health and well-being coaching. Individuals can work with coaches alongside a therapist and psychiatrist to receive support between appointments and sustain the progress they’re making toward personal growth. Coaching is also effective as a preventative layer of mental healthcare. At Ginger, 68 percent of our members are non-severe and don’t require intensive therapy or medication management.
Text-based Chat is the New Normal
The younger generations that are digital natives have grown up with texting and chatting online as a regular, highly expressive form of communication. It comes as no surprise that they would be comfortable expressing themselves in this way to mental healthcare providers. For them, text-based chat with a coach can help them find meaning and healing. Additionally, both therapy and psychiatry are episodic in nature—with clinicians meeting clients bi-weekly or monthly. But as I’ve found in my work as a psychiatrist, life does not operate on that schedule.
While clients might demonstrate an overall trajectory of improvement, unexpected mini-crises in between appointments can slow down improvement. Immediate coaching intervention at the exact time of need helps to address these natural setbacks that occur between therapy or psychiatry visits. In addition to handling acute issues, coaching can offer a helpful longitudinal approach to goal setting. For example, coaches can check in with clients between clinical visits and remind them of healthy sleep hygiene techniques or provide light motivational interviewing to help an individual reduce alcohol consumption.
Scaling Care to Meet Demand
As mental health stigma decreases, more people are actively seeking services. Earlier this year, in partnership with Dimensional Research, Ginger surveyed more than 1,200 U.S. workers and found that a growing number of workers are proactively seeking out mental healthcare. Fifty percent of workers said they are more likely to seek help now than they were five years ago and 85 percent reported that behavioral health benefits are important when evaluating a new job.
Patient care in the U.S. continues to modernize through rapid digitization, increasing connectivity among the internet of things (“IOT”). Supporting a robust infrastructure that allows for large scale flow of information through interconnected systems requires modernization of network technologies. One such technology advance is 5G.
5G is similar to its predecessor wireless technologies, such as 3G, 4G and LTE, but promises to have the capability to transmit 10 to 100 times more data than 4G in the same amount of time. 5G will also overcome issues related to latency, capacity, and customization that currently plague predecessor technologies. As the roll out of 5G progresses, the health industry is considering its potential impact of 5G on the healthcare ecosystem. Many believe that 5G will revolutionize healthcare delivery, and ultimately contribute to improved patient care. 5G appears poised to impact healthcare by facilitating faster and more seamless transmission of patient information at much larger volume than possible today. As such, 5G can improve patient care by facilitating Artificial Intelligence (“AI”), enabling remote care paradigms, and improving access to care.
One sector that will benefit from 5G’s ability to allow for fast and voluminous data transmission is AI. AI technologies are powered by algorithms that process complex and large data sets at exceptional speeds. With the arrival of 5G, health organizations may be better positioned to implement AI solutions directly into their delivery of care models. Advances in AI coupled with the power of 5G would foster care delivery that is data-rich and data-driven to improve quality of care and outcomes.
Additionally, adoption of 5G will likely increase access to high-quality care, by supporting remote care paradigms in the health industry. For example, remote radiological imaging and remote robotic surgery will likely thrive in the 5G world. The secure transport of extremely large, high-resolution image data is required for successful use of these technologies. The capacity of 5G to transmit these types of data at scale in a real-time or near-real time fashion will likely be transformative. Patients will be able to gain access to care from specialists they otherwise could not have had access to previously. For the same reasons, 5G will further untether providers from historical brick and mortar facilities such as hospitals and clinics.
Data analytics is the next step in the evolution of healthcare as it uses data-driven findings to predict and address health issues. Healthcare data analytics can also help to keep track of inventory and access methods and treatments faster than conventional systems. Data analytics is often paired with health information exchanges (HIEs) to provide safer and more personalized care based on patients’ medical history, chronic conditions and medications. Healthcare data analytics software extracts, translates and synthesizes vast amounts of data to reduce costs, involve patients more in their own health and wellness and improve patient outcomes.
Opportunities and practical applications of data analytics in healthcare
Data analytics in healthcare relies on big data (vast quantities of digitized information) that gets consolidated and analyzed. The application of data analytics in healthcare has life-saving outcomes as it uses data of a subset or a particular individual to prevent potential epidemics, cure diseases and cut down on healthcare costs. Here are a few of the opportunities and practical applications of data analytics in healthcare.
Predictive analytics for personalized treatments
Predictive data analytics is the process of using historical data in order to make predictions that are personalized to each individual. Typically, analytics tools use information from millions of patients to help doctors make data-driven decisions and improve the delivery of care. Predictive data analytics helps to identify individuals who are at an elevated risk of developing chronic conditions based on lab tests, biometric data and patient-generated health data. Physicians can provide insight on lifestyle changes, wellness activities and enhanced services that can help patients avoid long-term health problems. This is particularly useful for patients with complex medical histories and suffering from multiple conditions,
Data analytics to advance telemedicine
Data analytics and telemedicine go hand in hand as it helps to empower physicians and patients and offers opportunities for remote patient monitoring and remote clinical services. Smart devices are the future of telehealth monitoring as they monitor a patient’s vitals in real-time and communicate with other devices and cloud health information systems based on data analytics to alert physicians about potential problems and provide analysis on possible interventions. Data analytics in telemedicine can help to predict acute medical events – this doctors to alter medication dosages to avert negative outcomes and prevent deterioration of patients’ conditions. Telemedicine also cuts down on costs, reduces the need for hospital visits and allows patients to live healthier and more comfortable lives.
Data analytics for real-time alerting
Hospitals have started employing clinical decision support (CDS) software that analyzes medical data on the spot and provides health care experts with suggestions as they make prescriptive decisions. However, in cases where patients are unable to make frequent hospital visits, doctors recommend wearables that collect patients’ data and send it to the cloud continuously. This data is analyzed continuously so that the system can identify potential problems and send real-time alerts to physicians. Doctors can then contact patients immediately to administer medications to prevent problem escalation.
By Dr. Michael Blackman, medical director, population health and analytics, Allscripts.
As healthcare delivery continues to evolve, healthcare technology needs to be there to support it. But, how will technology facilitate healthcare as we move forward?
Healthcare accessibility, especially for certain populations, continues to be problematic. The expansion of telemedicine has the potential to improve access, especially for populations that have difficulty accessing care, such as those with mobility or transportation issues.
Additionally, looking from a primary care standpoint alone, a fair percentage of patient visits can be conducted remotely while continuing to insure care quality. Telemedicine can extend a clinician’s reach by freeing up office time for those who gain extra benefit from being seen in person. However, the technology must support both the clinician and patient interaction, while not creating new barriers.
Potential barriers can come not just from factors implicit in the technology, but from the way it is implemented as well. For example, simple things such as a clinician needing to turn his or her back to a patient to access the system disrupts the clinician/patient relationship. Workflow considerations need to be front and center for all technology-related changes.
Leverage what you have – especially the data
There’s continually a desire to pursue the next shiny object, the next buzzword, the next big technology. But it comes down to why? What are you trying to accomplish with new technology that you can’t already do today? If it serves a strategic goal, then the new technology may be highly beneficial, but have you optimized what you are using now?
Electronic health records (EHRs) and other healthcare technology have brought us a plethora of data, but how many of us are using this data effectively?
The original goal of capturing data in EHRs was to improve care. We need to use that data to understand and improve care delivery. Sometimes that requires new technology, but whether one is using new technology or not, improving care requires a change in the way business is conducted.
Are AI and machine learning the future of healthcare?
Both AI and machine learning are likely to be integral components of healthcare’s future, but the underlying culture and business framework supporting these technologies will determine if we are able to get the most from them. Differences in organizational culture and business processes often explain why some succeed and others fail using the same technology.
Telehealth has been in practice now for over 40 years, yet in the last 5 years it is seeing considerable growth in all sectors. There are a number of reasons for this, primarily, as the use of the internet and various new technologies are becoming more and more advanced and widespread, this has meant that the cost of using this technology for such purposes has decreased significantly.
a greater understanding of how best to make use of and implement telehealth has
improved overtime, with new uses for it continually being developed. The
increase of reliance on telehealth has sparked debate between physicians
regarding the pros and cons of its usage, with particular consideration of the
role it plays in medical malpractice.
The benefits of telehealth
of the most obvious benefits of telehealth is the newfound ability to provide
healthcare to patients in remote areas who otherwise may struggle to get
access, while also being advantageous for elderly or disabled patients with
mobility or logistical issues.
has the potential also to improve patient coverage given a shortage of
physicians in relation to the number of patients in some cases. It also
provides the opportunity for patients with rare conditions to get much needed
medical advice from long distance specialists.
a healthcare systems perspective, telehealth has the potential to both decrease costs and improve outcomes, however
this needs to be weighed up against the potential risks involved.
represents a paradigm shift in medical care, changing the way that doctors operate
and deal with their patients, it could be harder for more experienced doctors
to adapt to these new ways of working as they were not trained that way, and
many want to and are used to seeing the patient in their office.
technology removes the physician’s ability to see and interact with the patient
face to face. It is natural that physicians will fear their ability to do their
job will be reduced at such a distance plus any technological change also
changes medical malpractice thresholds. It will be down to malpractice expects
such as JJS
Justice, and law courts to determine how telehealth and other new
technologies relate to the acceptable healthcare provision threshold for
patients. Doctors will need to adapt and learn to implement these technologies
within these limits.
issues involve the quality of service that is being provided using this
technology, can patients trust in this? Will they receive a quality of care equivalent
to that of a face to face consultation? It also remains to be determined how
exactly physicians will be reimbursed for their work done through this method.
The potential for medical malpractice
is still work to be done to ensure that telemedicine is controlled and
regulated effectively, to maximise its efficacy and minimise the risk of
medical malpractice. The main concerns around the potential for medical
malpractice in telehealth include issues around online prescribing, informed
consent and state licensure.
regard to online prescribing, in some cases it may be insufficient to prescribe
medication on the basis of an over the phone consultation or upon review
of a patient questionnaire submitted online. It Is therefore important that
there are crystal clear guidelines and expectations set around when a physical
examination is required.
around informed consent are different between states, physicians should
therefore be au fait with the requirements on this front for the states where
they are licensed to prescribe medication to patients.
physicians should not operate beyond their jurisdiction, a doctor needs to be
licensed in the patient’s home state in order to prescribe them medication. In
fact, most malpractice issues in relation to telemedicine involve unlicensed
malpractice litigations, it is essential that physicians are licenced, have
full knowledge of their duties and responsibilities, receive adequate
training and that they have taken a full and extensive medical history of all
the patients that they prescribe for.
Whether you work in a hospital, dentist, doctor or dermatologist’s office, providing your patients with a positive experience should be a priority. The increased costs of healthcare premiums and deductibles that are often passed down to subscribers, has caused a lot of people to become more aware of the type of treatment they receive from medical professionals. Like with other industries, consumers are starting to shop around to ensure they’re getting the best experience possible.
Patients are more inclined to visit a medical professional who can not only treat the problem but someone who gives them a supportive and positive experience every time they visit. Healthcare providers are urged to understand that this experience is not only tied to the success of treatment. They must work diligently to ensure their patients’ needs are accommodated from the time they schedule the appointment to the time they’re treated.
One powerful and innovative resource that medical professionals like a dermatologist in Mckinney TX or a dentist in Miami FL are technology. Medical practices would be wise to leverage the use of technology to their advantage. Such tools can help to enhance the patient experience which leads to better doctor-patient relationships and overall patient outcomes. Though there are lots of technological resources out there to consider, below are a few features one might consider implementing in their practice:
Online appointment setting and reminders
With a hectic schedule, how in the world does a person find the time during traditional business hours to set an appointment with their doctor? The answer is, they don’t. It simply gets put off for days. Then, when they finally set an appointment, it’s often missed simply because they forgot.
Medical practices can help patients with this problem and reduce their no call, no show visits by implementing online appointment setting features with reminders. Allowing patients to go online whenever it’s most convenient for them and pick a date and time for an appointment provides a convenience they can get behind. With a reminder being texted or emailed to them a few days before, you also help them to stay on track with their health.
Electronic patient forms
When someone makes an appointment to see the doctor, chances are they’re on a schedule themselves. Meaning, they don’t necessarily have the time to spend the next ten or fifteen minutes filling out paperwork. This increases wait times and inconvenience the patient. Healthcare providers can remedy this problem by allowing patients to complete their forms online. This way the patient can complete the forms prior to showing up and get seen faster.
There are patients that simply have a hard time making it in to visit the doctor. Some face mobility challenges while others lead busy lifestyles that don’t allow them to slow down. Healthcare providers can assist their patients in making their health a priority by offering telemedicine features. This is a technological tool in which medical professionals to consult, diagnose, and prescribe medication for their patients remotely. This helps to shorten wait times for patients who are in office, it increases patient interest in caring for their health, reduces healthcare costs, and strengthens the doctor-patient relationship.
If it isn’t already clear, the headlines are signaling that the era of healthcare innovation is upon us and moving swiftly. Managed Medicaid plans could be losing out on millions of contracted lives (and money) by lagging in the adoption of digital telehealth resources to improve access to care and patient outcomes. Leveraging an eConsult solution is a proven way to increase access to high-quality care while lowering system cost, ensuring innovation scoring opportunities are not missed.
Innovation is the new constant
Although the pace of innovation in healthcare has traditionally been slow, organizations are increasingly seeking new ways to innovate in order to support value-based care models. Recent partnerships formed between Amazon, Berkshire Hathaway and JPMorgan Chase, CVS and Aetna, Cigna and Express Scripts, and so on strongly indicate that innovations rooted in providing better care for lower costs are paramount to the success and growth of healthcare.
Payers whose ongoing strategies are not placing precedence upon innovation will be left in the dust. Not only will this be costly for access and quality, it can jeopardize managed Medicaid payers’ chance of re-procuring and expanding contracts.
Managed Medicaid Plans must innovate to reach objectives
Managed Medicaid plans need innovations to improve the value and efficiency of healthcare provided. To ensure they’re getting the best value, state Medicaid programs re-procure contracts with managed care payer groups on a perpetual basis — sometimes as frequently as every three years. States use these periods as an opportunity to seek updated solutions to long-standing or emerging challenges, often assigning points to questions that speak to innovations in care delivery for Medicaid recipients.
Key Medicaid challenges
Barriers to care and access within Medicaid programs are often among the most important issues states and managed care plans are attempting to address. The Kaiser Family Foundation 2017 survey of Medicaid managed care plans reported high rates of difficulty in recruitment for some specialties and listed provider supply as a leading challenge.
Timely access to care is key to healthcare goals, as delays in accessing necessary care exacerbate health conditions, in turn leading to more costly treatment and poor outcomes. This lack of care access worsens a health crisis that could have been easily avoided with more proactive (and less expensive) care.
A key takeaway from 2018’s 11th annual Medicaid Managed Care Summit was that, “Reforming healthcare in the U.S. is not about spending more money, but about moving around the dollars that we’re already spending.” Adoption of eConsult platforms allows health plans to solidify their value-based initiatives and Medicaid payers to expand access to needed specialist services, bring new physician access points to urban and rural areas and leverage the latest in technology and sophisticated referral protocols to help meet members’ care needs.
Patient is not a word typically used to describe the current generation of tech savvy, time saving, health conscious millennials – and it shows in their healthcare decisions, too. Fewer individuals choose to see their primary care physician, and more are turning to quick clinics or urgent care offices for care. According to a survey by NPR, one in five respondents reported going to an urgent care facility at least once in the last two years for common ailments because of the lack of available appointments at their primary care provider. And typically, urgent care offices can guarantee same day appointments, with short wait times of 30 minutes or less.
Although patients are commonly turning to these solutions to meet their needs, most still prefer being treated by their own doctor who knows them and their medical history. Ask patients why they opted to go to the urgent care center, or even more cumbersome, the emergency room for a non-emergent issue and the answer generally boils down to convenience. Primary care physicians are finding a solution through telemedicine that not only provides their patients with additional options for care but can increase practice revenue.
Telemedicine provides patients with the opportunity to meet with their doctor regarding common yet non-life-threatening conditions. Some of the conditions that are most commonly treated through telemedicine in a primary care setting are a cough, runny nose, sore throat, musculoskeletal pain, pink eye or urinary symptoms that do not warrant a physical exam to diagnose. Additionally, lab reviews, medication refills, and managing widespread chronic conditions including diabetes and hypertension can be effectively handled through virtual visits.
By seeing these patients virtually in addition to in-office visits, these physicians can maximize their time by increasing the number of patients they see in a day while still maintaining a quality level of care. Happier patients, and increased revenue? Who could ask for better.
Here are some of the most common conditions that Dr. Kaufmann of the Kaufmann Clinic, one of the primary care practices that uses ExamMed’s technology, treats virtually through telemedicine:
Cough/Sore Throat: Many patients see the provider for a sore throat unknowing if it’s strep throat, allergies or a cold. A virtual appointment can determine if in-person testing and/or antibiotic treatment is needed.
Urinary Symptoms: Urinary infections are extremely common. Although a less common condition for men, according to the National Institute of Health, 50 percent to 60 percent of women will experience a UTI in their lifetime. Urinary infections can easily be managed virtually, including diagnoses and treatment.
Follow-up Appointments: Many follow-up appointments do not require a physical examination. Rather than taking the time to travel to a doctor’s appointment to discuss a new medication, patients can talk with their doctor virtually.
Pink Eye: A highly contagious infection, pink eye is diagnosed in more than three million people each year. Rather than potentially exposing others to the germs, pink eye can be easily diagnosed, treated and reevaluated through virtual appointments.
While telemedicine is not the solution for all appointments, it is a great addition to couple traditional, in-person visits. Virtual care enhances a practice’s capabilities, improves patient outcomes and offers a convenient option. Blending telemedicine services into a medical practice is a strategic move that will benefit both patients and providers long-term.