As we launch into 2018, questions remain about the healthcare policy environment and how it can impact many healthcare initiatives. As Yogi Berra said, “It’s difficult to make predictions – especially about the future.” I feel confident, however, about some fundamental trends in the healthcare landscape. These include a steady shift toward value-based care, an increased focus on data and analytics as a core enabler for digital transformation, and the all-consuming focus on the patient experience.
Here are my four key predictions for the healthcare IT trends that will transform the industry in 2018:
Patient Satisfaction Takes Center Stage
The era of healthcare consumerism is here. Patients are bearing increasing financial responsibility for healthcare costs, and seek improved experiences as a part of the value-for-money equation. In response, providers are taking a 360-degree view of patients, employing better analytics to leverage patient data such as demographic information, lifestyles and individual preferences, to personalize interactions and treatment.
Artificial Intelligence (AI) Becomes Entrenched in Clinical Settings
Despite the overuse of the term AI to describe many types of technology-enabled solutions, the adoption of AI has been steadily gaining ground in a wide range of settings. Deep learning algorithms will increasingly be used in clinical settings to support medical diagnosis and treatment decisions, predict the likelihood of patient re-admissions and help providers better leverage the data that has been accumulating in electronic health records. According to the 2017 Internet Trends Report by venture capital firm Kleiner Perkins, medical knowledge is doubling every three years, and the average hospital is generating more than 40 petabytes of data every year.
While all this accumulated information empowers more informed physicians, the growing range of data and knowledge sources creates a challenge as well, since physicians and clinicians must manage and stay on top of this information on specific conditions, especially in fields such as oncology. AI technologies are enabling time-constrained and overworked physicians to make sense of the vast amounts of data, helping them uncover hidden insights and supporting their medical diagnoses and decisions with timely and relevant input at the point of care.
Open Source Finally Takes Hold
Healthcare organizations have been conservative when it comes to open source technologies, largely due to concerns about data security and privacy. With the growing adoption of cloud-enabled solutions and a gradual shift of enterprise IT workloads to the cloud, they no longer have to worry about risks to the IT environment and can rely on mature cloud service providers, such as Amazon Web Services (AWS) or Microsoft Azure. And, open source architecture can now incorporate robust technology components with rich functionality. Our current collaboration with Partners Healthcare to build a digital platform for clinical care is based on an open source architecture. As the industry shifts rapidly to value-based care, cost pressures will force healthcare enterprises to transform their technology strategies, turning to open source solutions to rapidly build new solutions cost-effectively.
The need of Telemedicine AHA Report shows that 20 percent of US citizens are located in the rural areas and do not have access to the healthcare professionals and their services. The industry, though, has found a way out in form of telemedicine.
Telemedicineis defined by American Telemedicine Association as the process of medical data exchange from one site to another via electronic devices in order to improve patient clinical health status, electronic devices meaning emali, applications, video, wireless gadgets, smartphones, etc.
Telemedicine notion includes three main modalities: real-time, store-and-forward, and remote patient monitoring. The first modality means doctor-patient interaction with the help of audiovisual technology. The second — transmission of patient data and her history via secured electronic channels to a healthcare specialist. The third — collection of the patient data with the help of special devices (like wearables) and its transmission to a healthcare provider.
Telemedicine Perspectives
Foley predicts that by 2020, telemedicine will grow to 36.2 billion US dollars at CAGR (compound annual growth rate) of 14.3 percent. In 2014, it was 14.3 billion US dollars. Currently, there are around 200 healthcare academic centers in the US that provide video consultations worldwide, according to American Telemedicine Association.
Foley has also reported that 90 percent of healthcare top minders have already begun telemedicine integration. Nearly 70 percent of employers are going to offer telemedicine services as perks for their employees. 42 states in the US have already created more than 200 legislative acts about telemedicine.
US patients are not opposed to the idea of telemedicine, too. According to American Well, 64 percent of them would attend a meeting with their doctor via telecommunication means; forecasts that there will be 7 billion telemedicine users worldwide.
Types of Telemedicine
Telemedicine deals with many spheres of healthcare: telestroke (remote data transferred to the emergency specialists on site), teleradiology (images and media transfer), tele-ICU (systems and networks connected to the critical medical specialists), telemental health (distant mental health treatment), cybersurgery (operations held by surgeons remotely with the help of telecommunication and robotic instruments), and telepharmacy.
Importance of Telepharmacy
As stated by Centers for Disease Control and Prevention, 74.2 percent of physician visits involve drug therapy. During hospital outpatient department visits, there were 329.2 million drugs ordered or provided. These numbers demonstrate the potential hidden in the telepharmacy. Moreover, the number of independent pharmacies is steadily decreasing from 2011.
Telepharmacy was originally introduced for the rural areas that lack the resources to supply existing demands in the pharmacy. However, it’s now being actively used by healthcare systems, regardless of the location, due to its ability to meet medication needs 24/7.
A vivid example of telepharmacy success, Comprehensive Pharmacy Services, has launched telepharmacy project, CPS Telepharmacy, that works 24/7 the whole year round. It has been reported to detect and improve 1,300 medical errors per year and to have reduced around 45 percent of costs, with improved quality.
Telepharmacy Cases
CPS Telepharmacy can process nearly 3 million medication events a year and involves with 200 medication orders a day (73,000 cases a year). Averagely, errors occur 3.6 times per day. Those can be wrong patient, wrong dose, or wrong medication.
CPS Telepharmacy has brought substantial improvements in form of reduced costs, lowered adverse drug events, and improved clinical outcomes.
PiplineRX, another leader in the industry, has recently announced its round funding at $9.1 million U.S. dollars by McKesson Ventures, Mitsui & Co Inc., and AMN Healthcare. Currently, the system is available in around 200 hospitals.
Telepharmacy Perspectives
Many reports have been issued emphasizing the importance of the control of antibiotics prescription, namely ASP (antimicrobial stewardship program) to prevent emerging antibiotic resistance. Advanced technologies are to help reduce costs on drug by finding cheaper alternatives or preventing over prescribing of medications.
To sum up, telemedicine, as well as telepharmacy, have great perspectives. The number of their supporters in the healthcare industry is increasing from day to day and is not going to stop.
Guest post by Kate Jester-Brod, vice president of client success, EoScene.
Kate Jester-Brod
Since Hurricane Katrina, the healthcare industry has been pushing towards maintaining comprehensive EHRs. The concept of an EHR combined with the concepts of the health information exchange (HIE) creates a means for patients and providers to always have a 30,000-foot view of the patient’s health. Which then begs the question, ‘what about the actual healthcare facilities?’ What does their 30,000-foot view look like? Are facility and staff doing their part to support exceptional and safe patient care?
In the most basic of explanations, enterprise risk covers the overall opinion of others towards your organization. It can affect revenue, staff retention, grant funding, and much more. In the healthcare industry, the enterprise is at risk at many levels. Drug safety, staff and patient safety, clinical outcomes, facilities maintenance, public relations, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores are some but not all of the components of enterprise risk.
Moreover, reducing enterprise risk in any industry includes reducing not only overhead and operational costs but also consumer costs. In healthcare reducing costs for consumers can increase patient satisfaction, which is an obvious connection. More interesting, however, are recent news stories reporting on suits against major hospital systems for frauds and schemes—or applauding them for lowering healthcare costs.
While telemedicine and home health are increasingly major components of healthcare, much of healthcare operates in a facility like a hospital or clinic. Facilities, along with structural integrities and heating, ventilation, and air (HVA) systems, also include patient equipment and a state of cleanliness. All of these components comprise the environment of patient care and healing, and the enterprise. By taking control of these areas a hospital or healthcare facility becomes one step closer to protecting the enterprise.
The best way to protect it is to predict and manage risk before problems happen. This is even more critical as the healthcare industry works towards the Institute for Healthcare Improvement’s Triple Aim as a means to optimize care. The three components of the Triple Aim complement and overlap the need to reduce enterprise risk.
Fundamentally, the Triple Aim works towards creating system-level metrics to measure success. Enterprise risk is at the center of these metrics that ultimately drive decision making. Understanding the policies and procedures that make up facilities management, patient safety, accreditation, and the overall health of the system can significantly reduce enterprise risk while supporting more effective decision making.
Taking control of facilities management can directly impact the reduction of enterprise risk. Facilities Management holds many different responsibilities in a healthcare system, including emergency management, fire safety, patient and staff safety, infection prevention, environmental services, utilities and equipment, accreditation, and many others.
Improving patient-centered care with consideration for facility compliance results in tangible ways to improve the Triple Aim. The electronics health record is assumed to document all the components of the Triple Aim, but this clinically based monitoring system focuses on provider-patient experience and overlooks other components of the healthcare environment.
Utilizing facilities information technology plays a critical role in establishing the foundation necessary to achieve positive results in achieving the Triple Aim. Recent innovation in health facilities IT has resulted in quality improvement and measurement from the ground up and has the potential to address an often overlooked component of that we all strive for in Triple Aim.
We put a lot of faith in health technology: to make us better, to save our systems, to revolutionize healthcare. We may be looking at it from the wrong side entirely.
The social determinants of health matter more than our ability to deploy doctors or provide insurance; physical and mental, health is always more social than clinical.
But most of our health tech that is supposed to be revolutionary is aimed at clinical factors, rather than the social determinants of health. Yes, telehealth can increase reach, but it is still just a matter of touchpoints, not a fundamental change to the lifestyles and cultures that determine health.
Same with all our EHR systems creating more ways to record information, more ways to quantify patients, to put more emphasis on engagement and quality-based reimbursement. Even genomics and personalized medicine are taking a backseat to soliciting reviews and trying to turn the patient experience into a number. It all puts greater focus on the clinical encounters, on how patients “feel” broadly about each minute aspect of their time in the medical facility.
A Digital Disease
As politicians trade blows on minimum wages and the ACA, the likelihood grows that insurance benefits and livable incomes (and lifestyles) will get pushed further out of reach for more people.
Modern work is tech-centric, which means lots of sitting, and manages to facilitate increased snacking without being particularly physical, a double-whammy that prevents employment or higher incomes from leading to healthier choices. For the less-skilled, normally accessible jobs are in the sights of automation and disruption. While tech is taking over medicine and opening up new possibilities, it is also transforming the labor market and closing countless doors to workers.
By extension, technology is changing the social framework that determines public health. Income inequality is growing, wage growth is stagnant, and no amount of awareness can change these front-of-mind concerns for people who may well want to eat better and exercise more, or even commit to seeing the doctor more often and following his or her advice to the letter.
Poor people can’t necessarily eat better as a simple matter of choice or doctor’s orders. Planning meals and purchasing healthful foods is a tax on limited resources–time as well as money. Working three jobs to pay the bills, many lower income individuals also don’t necessarily have time to exercise. And more likely than not, those working even high-paying jobs are sitting all day, sapping their bodies of energy and resilience, undoing the good of their intentions and smart devices alike through attrition.
In the current era, it is important to understand the role technology plays in different industrial sectors. The different verticals of the medical industry have adopted technology and identified the benefits associated to it. Healthcare and other medical services can be easily accessed with the help of a smart phone. It has become more convenient to track, regulate, and monitor several medical cycles such as medicine intake, therapy, and treatment. The communication gap between the patients and doctors has reduced over the years owing to advancements in technology. Progressive Markets recently added a market report that offers useful insights related to the global telemedicine market such as market share, size, and growth. The digitalization in medical field is set to facilitate enhanced healthcare and medical services in the coming years.
Technology has revolutionized several industries worldwide over the last two decades. The onset of innovative and modern technological advancements have made a notable difference in the medical field and has made telemedicine a game-changing way to serve people throughout the world. The adoption of telemedicine has increased significantly in the last decade although there are a few concerns regarding its reliability and precision. Approximately more than 70 percent urgent illness conditions can be taken care of with the help of telemedicine according to the American Telemedicine Association. A simple physician training enables providers to diagnose and treat minor problems such as pharyngitis, sinusitis and upper respiratory illnesses with the help of video chat.
General awareness related to telemedicine technology is growing
Telemedicine technology has not flourished largely yet as it is still in the nascent stage. However, as awareness related to the telemedicine is growing, the adoption rates are set to grow. The benefits associated to telemedicine are gradually making a mark in the medical industry. Telemedicine has largely helped to save time. With the help of telemedicine, a patient does not have to travel to the provider and save time.
Further, telemedicine eliminates any chances of transmitting infectious diseases from a patient to the health care professional. Telemedicine saves time and offers time-efficient solutions. However, there are additional benefits associated to it. It reduces costs significantly. The most important aspect of telemedicine is its ability to cater to the needs of the patients from any place at any given time. This is highly beneficial for occupational medicine. Telemedicine helps to formulate an efficient and reliable healthcare plan.
Benefits of telemedicine
Telemedicine is making its mark worldwide and it is important to realize that the technological advancement does not eliminate visits to traditional doctors. There are a few medical conditions that cannot be diagnosed without the presence of the patient. However, with data such as medical history of the patient, visual exam and an interview with the patient along with the providers training of pattern recognition, it is convenient to treat patients without them being physically present in the room.
Guest post by John Squire, president and COO, Amazing Charts.
John Squire
As developers of electronic health record (EHR) software, my company gets into a lot of conversations with providers about their expectations for the future. This information helps us make decisions about what to build next. Here are three trends we’re hearing from our customers right now:
Low-tech beats high-tech in telemedicine
Unlike the way it was imagined decades ago by science fiction writers, telemedicine does not necessarily mean holographic images or live video conferencing with a physician half a continent away. Patients would rather receive “low tech” remote care from their primary care physician who has a full picture of their health status.
This form of telemedicine happens whenever an EHR system adds to a patient’s clinical chart the messages, pictures, or videos sent securely via smartphone. It happens whenever a smartphone connects to a remote health monitoring device for collection of real-time data such as blood pressure, oxygen levels, and heart rate.
The new rules allowing reimbursement of telemedicine and other non-face-to-face services will encourage physicians to bill for these remote care activities. Medicare’s recently expanded set of billing codes for Chronic Care Management (CCM) is a good example of how the future of value-based care goes beyond the office visit to keep patients out of hospitals and emergency rooms. The ability to securely and rapidly receive and answer a patient’s questions via text, and then capture those activities in the patient’s permanent clinical record is a critical step in that direction.
Primary care providers are trying new types of practices
Primary care physicians are frustrated with the hassle and expense of dealing with insurance companies. The new Medicare fee-for-value quality payment program is creating uncertainty about future reimbursement levels and requires additional reporting. Also, there is an acute level of burnout with “corporate medicine,” which has providers booked for dozens of daily appointments, only to spend less than 15 minutes with each patient.
In order to remain independent, a small but growing group of primary care practitioners are becoming more financially creative and experimenting with new models of practice. One example is direct care, in which a financial relationship is established directly between patient and provider, cutting out insurance altogether. This model includes concierge and direct primary care (DPC), where patients become “members” of a practice and pay a fixed monthly fee for unlimited primary care – similar to a gym membership, but for healthcare. Another example of direct care is the cash-only practice that sees walk-in patients for urgent care.
EHR interoperability will catch FHIR
Physicians and their patients are frustrated with the lack of interoperability in health IT. The concept of having a patient’s medical records accessible to any authorized provider at any time is still a rare occurrence. When a patient switches primary care physicians, the first office typically prints out and faxes their medical records to the second office, which introduces the possibility of errors, HIPAA violations, and others.
Guest post by Gaby Loria, analyst for mental health software, Software Advice.
Gaby Loria
There are certain factors clinicians are constantly working to improve at their practices, such as:
While these three P’s apply to every health care provider, regardless of practice size or specialty, they are especially important for independent physicians.
Solo and small practice doctors face more challenges than their counterparts in group-owned or hospital-affiliated organizations. They shoulder all the responsibility for:
Ensuring care quality
Retaining and attracting patients
Paying the office’s overhead costs
Keeping up with shifting regulatory requirements, which some say favor larger providers
For all of these reasons, it’s wise for small practices to invest in health IT tools that can give them an edge in a competitive and increasingly data-driven industry. The three tech trends we describe below can help improve performance, increase profitability and impact productivity without breaking tight budgets.
Improve Performance with Population Health Tools
The goal of managing population health is to achieve measurable improvements in the health outcomes of a group of people. In other words, taking steps to help groups of patients get healthier instead of solely focusing on one individual’s treatment plan at a time.
That may sound like a lot of work, but it’s not—if you have the right IT. Nowadays, there are a number of population health-enabled capabilities that are built into electronic health records (EHR) software systems commonly used by small practices. The breadth and depth of these capabilities vary depending on the system, but here are some examples:
Leveraging an EHR’s reporting module to pinpoint the percentage of prediabetic patients at a practice, then specifically sending those patients information about diet and exercise changes to lower their risk of developing Type 2 diabetes.
Setting targeted, automated appointment reminders to women who have not had a breast cancer screening in more than a year, making them more likely to come in for preventive care.
Using software to generate risk assessments grouping patients by the severity of their chronic conditions. These assessments are based on patients’ digitized clinical records, so it’s easier to identify at-risk patients.
This technology makes it feasible for busy physicians to provide extra attention and care to patient populations that need it most, so they can prevent a worsening condition from developing. Such clinical interventions on a group scale can therefore make it possible to improve the overall health of a practice’s patient base.
Increase Profitability via Telemedicine
Telemedicine is the use of technology to support remote medical services. One of the most lucrative ways small practices can adopt telemedicine is by offering video consultations, which are virtual patient-physician interactions enabled by videoconferencing software. This allows doctors to see more patients per day without adding overhead costs (e.g., office space or staffing).
Interested physicians have two main options to capitalize on this trend:
The first is to get an EHR with integrated videoconferencing capabilities. This is ideal for practices that want to offer telemedicine services to existing patients. Depending on their state laws, they may be able to get reimbursed for these virtual consultations.
Alternatively, doctors can sign up to be a provider for a stand-alone platform (e.g., Teladoc, eVisit and American Well). This is better suited for practices looking to attract new patients. Some platforms charge doctors a monthly subscription fee, while others treat practitioners as independent contractors who get a percentage of whatever the patient pays per visit.
Like retail and education before it, a major shift is underway in the healthcare industry that is putting power back in consumers’ hands. Similar to how retail outlets are delivering custom experiences based on consumer preferences, or how there is more attention to individual needs in the classroom, patients are able to play a more active role in their healthcare administration and decision-making than ever before. This means participating in a shared decision-making model with physicians, seeing their needs and preferences reflected in the course of their treatment, and easier access to their medical data, made readily available to both the patient and his or her medical team.
This article will explore the phenomenon that is PCC, a paradigm shift changing the healthcare industry at its core. So much so, PCC is driving adoption of three technology related trends that are in line with its principles. They include: telemedicine, cloud computing and mHealth.
Patient Centered Care and 2016 Healthcare IT Trends
Telehealth
While many assumed in-facility care would remain the norm after house calls faded from popularity decades ago, that may not be the case. Increasingly, telemedicine — or remote consultations, diagnoses, and treatment performed by medical professionals — is becoming a standard practice in the healthcare industry.
For example, the below ad from Anthem BlueCross and LiveHealth Online was released by one of the nation’s largest insurance agencies promoting remote consultations states the “doctor is always in” and sessions are “quick and easy with no appointments and no driving.”
In line with the principles of PCC, telehealth promises greater access to care for patients who don’t live in close proximity to a healthcare facility. For the greater population, telehealth offers convenience and the comfort of care delivered in a patient’s natural environment. Administering care in a patient’s environment instead of a traditional healthcare setting can also facilitate better care in some cases. Fierce Healthcare provides the example of blood pressure screening – taking a patient’s blood pressure in a natural setting, like their home or workplace, may more accurately reflect their blood pressure on a daily basis.
Telehealth and the benefits this practice offers to patients are perfectly in line with the patient-centric approach favored today. In light of this, it wouldn’t be surprising if telemedicine adoption continues to rise in the coming years, along with the demand for technology that can facilitate remote care.
