Updox, a telehealth platform, experienced a significant spike in demand throughout March, onboarding more than 10,000 new customer users to its HIPAA-compliant telehealth solution in just two weeks. Today, the company facilitates more than 45,000 telehealth visits per day between patients and their doctors, with that number increasing rapidly.
More than 300 million Americans are currently under orders to shelter-in-place as public health officials and providers work to contain and mitigate the coronavirus. Updox experienced a sharp increase in the demand for telehealth from mid-March, when more states began issuing stay-at-home orders and physicians needed a safe and secure way to connect with their patients.
Unlike some first-generation telehealth solutions, Updox allows patients to connect with their own physicians instead of someone unfamiliar to them. Likewise, rather than competing with physicians, the Updox platform supports practices to maintain revenue, protect staff and deliver care safely to their patients. Studies show that patients prefer receiving treatment from their own physicians, with whom they’ve developed strong, trusted relationships. In fact, according to a recent survey by Sharecare, 60% of Americans noted they would want to “access care with their primary physician if they experienced COVID-19 symptoms.”
Very few businesses today use fax machines, yet more than 9 billion faxes are still sent every year in healthcare, according to DirectTrust. Eighty percent of all serious medical mistakes result from poor communication, which includes fax. Simply put, every industry decreased or eliminated its reliance on the fax machine over the past decade – except healthcare. Beyond fax, healthcare’s dependence on manual communications is costly, inefficient and brings serious security risks.
According to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, there is no place left for the antiquated fax machine. In 2018, she issued a bold vision to transform patient care by improving communication and data exchange. She challenged the industry to make doctors’ offices “a fax-free zone” by 2020.
Why not push healthcare to go beyond that? Let’s look at all the ways inefficiencies and “doing things the way they’ve always been done” are holding healthcare back with manual processes, repetitive tasks and increasing frustration.
To replace fax, we must look at why it’s still being used. Fax is easy. Fax numbers are already programmed and shared. Faxes (usually) go directly to the recipient. But, the costs associated with faxing keep growing. The process isn’t efficient and it’s not at all secure in today’s HIPAA-compliant environment.
Yet, reports say nearly 90% of hospitals still rely on fax. Change is a challenge. Fax machines must become a thing of the past in order to bring healthcare fully into the 21st century. As those machines are eliminated, healthcare providers still need a way to exchange information and transfer documents. The need to exchange documents isn’t going to change but the way that is done – to ensure efficiency and security – has to change.
Are providers of all sizes ready for the end of an era? Understanding the true value and efficiency of eliminating fax is critical, but it has to be replaced with a solution that actually makes it easier.
Benefits Beyond Cost Savings
While physicians and staff are familiar and comfortable with using traditional faxing, this old school approach is an inefficient and costly part of both independent practices and health systems alike. Redundant work processes, like inputting information from faxes into electronic health record (EHR) systems, severely hampers productivity and profitability.
On average, providers spend upwards of 55 hours per month manually faxing based on a customer engagement survey by Updox. And for every 5,000 fax pages sent or received, a practice spends about $155 in supplies, including paper, toner, phone lines and shredding costs.
Plus, there are patient privacy and security concerns when using faxes. In recent years, researchers have discovered security flaws that can leave entire networks vulnerable from malicious faxes. Manual errors, too, result in protected patient information getting sent to the wrong number, which could lead to HIPAA violations and fines costing hundreds of thousands of dollars.
Whether it’s using FaceTime to catch up with friends across the country or web conferencing in the workplace to save the time and cost associated with business travel, video has become pervasive in almost every aspect of our everyday life. But there is one major exception: healthcare. While there is great promise in telehealth, the healthcare industry has been slow to adopt video solutions – even when the demand clearly exists.
Three-quarters of consumers say they want the same experience in healthcare that they get from other businesses, according to “The Consumerization of Healthcare” survey by Econsultancy. About 60 percent of individuals under age 55 say they would consider it “life changing” or “very useful” to use video chat instead of going for a routine in-person visit with their provider. And an equal number indicate they would be very likely to switch to a provider that offered video appointments and online booking, among other consumer-friendly options.
So what’s holding healthcare providers back from integrating video into their practices? Much of the hesitancy revolves around reimbursement and perceived complexity.
Under Medicare rules, telehealth services are typically reimbursable only if they are provided for beneficiaries who live in certain rural or underserved areas. And for non-Medicare patients, reimbursement is not uniform; the amounts depend on the local jurisdictions and what individual insurers will pay. While providers truly want to provide more remote services, the inconsistencies and varying rules for how they can be reimbursed have resulted in providers taking a cautious approach to implementing these offerings.
But worrying only about what can be billed is also short-sighted. The value in telehealth goes far beyond that. Instead of focusing only on reimbursement, consider the big picture. Factor in the ease and convenience for both the patient and the provider. Think about how telehealth can improve health outcomes by increasing patient engagement, not just access to care. Start using telehealth now and take advantage of reimbursements that are available today, depending on local payers and their rules. This positions practices — and patients — to be familiar with the technology and to capture additional reimbursements that will inevitably become available in the future.
A Focus on Simplicity
Early adopters of telehealth solutions have tended to overbuy for what they need, focusing on point solutions, and likely aren’t considering if, or how, they integrate with other productivity solutions used within the practice. Other providers are scared off by the high price tag of dedicated telehealth platforms, as well as the complexity for both patients and practitioners of using them for remote service offerings.
The cornucopia that is the annual HIMSS conference and tradeshow – healthcare technology’s biggest event – is behind us, but what’s left in the wake is wonderful, inspiring even, if not a bit overwhelming. The reactions to this year’s event have been overwhelmingly positive. Interoperability in the form of data sharing and a ban on patient health information blocking by CMS (through proposed rules released the first day of HIMSS) set the tone.
This was followed by CMS administrator Seema Verma taking a strong tone in all of her presentations at HIMSS, with the media and during her keynote speech. The federal body made it clear that data generated from patient care is, unequivocally, their data. While these themes heavily influenced the show, there were other takeaways.
There are many other diverse opinions about what came out at HIMSS19 and the themes that will affect healthcare in the year ahead. For some additional perspective, I turned to healthcare’s thought leaders; people who are a lot smarter than I. Their responses follow. That said, did we miss anything in the following?
Dr. Geeta Nayyar, Femwell Group Health and TopLine MD
After spending a week surrounded by some of the most intellectual and innovative minds globally in healthcare at HIMSS19, I’m even more confident that the shift toward patient engagement mass adoption is well underway and ON FHIR. The new CMS/ONC proposed law around interoperability and penalties for “information blocking,” are both touchdowns for the quarterback, which remains to be patient engagement. The robust discussions during the pre-conference HIMSS patient engagement program, reflected a move to a consumer-centric approach evidenced by the presence of Amazon, Google and Microsoft at the show. The keynote by Premier’s CEO Susan Devore shared a consumer-centered, provider led vision, “with data flowing seamlessly and being analyzed and effectively leveraged to guide decision making at the point of care.” Collaboration in healthcare is the key to everyone’s success. I was inspired to see her and so many women coming together to support each other in HIT, as Dr. Mom remains the healthcare decision maker in the households, we are all ultimately trying to reach.
Andrew Schall, Modernizing Medicine
Physician burnout continues to be a hot topic coming out of HIMSS19 and many feel that EHR platforms may be a part of the burnout epidemic. There were several sessions that focused on user-centered design at HIMSS this year including one that focused on the iterative approach to software development and user experience. First, I think that the industry is recognizing that one-size-fits doesn’t work for EHRs. Additionally, I believe that improvements will come in large part from the greater involvement of practicing physicians in designing specialty-specific EHR workflows and interfaces. A combination of powerful technology like AI and augmented intelligence, as well as well-designed EHR solutions with an intuitive user interface and user experience, will help ease the physician burden and automate time-consuming and administrative tasks like coding and billing – ultimately reducing burnout.
Shane Whitlatch, FairWarning
HIMSS 2019 showcased the ongoing digital transformation to make healthcare responsive to patients across a continuum of care. Enabling patients to be able to access, use and own their personal health data, while ensuring privacy and security was the central takeaway of this year’s HIMSS. Notable, critical moves to support this goal included: the Department of Health and Human Services announced proposed rules to enhance interoperability and data access with payor data; ongoing security and privacy efforts to ensure appropriate patient access to their data while mitigating emerging risks from items including medical devices to nation-state attackers; and artificial intelligence and machine learning initiatives to effectively manage the tsunami of data in healthcare while promoting optimal healthcare.
Tripp Peake, LRVHealth
The best part of HIMSS this year was we seemed to get away from a single buzzword. Healthcare is hard, there’s no silver bullet. The Precision Medicine Summit got into the weeds about how to really roll out a program in a provider system. The AI companies stopped talking about AI for AI sake and were more focused on ROI. Everyone seemed more balanced about VBC: yes, inevitable, but also gradual. Consumerism was probably as close to a central theme as existed. And I continue to be excited about the energy, creativity, and commitment of the entrepreneurs in this market.
Don Woodlock, InterSystems
Anytime you bring 43,000 healthcare professionals together in one location, you will never have a shortage of opinions on the future of the industry. We are at the cusp of a revolution in healthcare, driven by technological advancements. Some key trends we saw at HIMSS19 were, no surprise, around artificial intelligence, where people are trying to enhance predictive risk scoring and improve patient engagement. Additionally, there were profound announcements around mandating application programming interface (APIs) to improve the flow of healthcare data across the ecosystem. As interoperability becomes liquid, it will become the critical component of every healthcare system, driving the industry to new heights.
Paddy Padmanabhan, Damo Consulting
On day one of the conference, the HHS sucked the oxygen out of the room by dropping a proposed 800-page rule on data and interoperability. The rule aims to aggressively expand interoperability by making it mandatory for providers and health plans participating in government programs such as Medicare Advantage, CHIP and others to make patient data available to patients as a condition for business. CMS head Seema Verma and ONC Chief Don Rucker drove the message home repeatedly during the conference. Indeed, Seema Verma declared it an epic misunderstanding that patient data can belong to anyone other than the patient. A somewhat sobering counterpoint was voiced by Epic Systems CEO Judy Faulkner in a media interview where she suggested that interoperability challenges go well beyond data sharing by EHR vendors. Regardless of where it may fall, interoperability will continue to dominate healthcare IT agenda for some time to come. Related issues around new and emerging data sources, especially social determinants of health, will gain prominence in the coming months.
Erin Benson, LexisNexis Health Care
The proposed rule on interoperability of health information influenced most conversations at HIMSS. In the context of cybersecurity, the rule served as a reminder that it’s just as important to let “good guys” in quickly and seamlessly as it is to prevent unauthorized access. We want to enable value-based care and give patients the ability to manage their own health by having access to their records. We also want to keep costs low and efficiency high by enabling interoperability and giving partners, vendors and employees necessary access to systems. Therefore, a cybersecurity strategy needs to strike a balance between user engagement and data security.
Mike Morgan, Updox
The power of consumerism is really impacting healthcare and the need for patient engagement is alive and well. Providers across the board must look at new technologies and ways to redefine patient engagement to better communicate with patients and partners but do it via channels that are easy for staff and customers to use. New applications, such as telehealth and secure text messaging, have changed how healthcare communicates and consumers are demanding that immediate, convenient engagement.
Vince Vickers, KPMG
HIMSS19 seemed to have the most decision makers at the conference in five-plus years when a lot of healthcare organizations were still looking at implementing electronic health records. We might be ready for another wave of healthcare IT investment after healthcare organizations digested those investments made in electronic health records. The key is now around optimizing EHRs – interoperability, improving ease of use, enhancing analytics — or dedicating resources to enterprise resource planning (ERP) systems to make themselves more efficient in the back office. We’re also seeing healthcare organizations position themselves to be more consumer-oriented, partly to address new entries from some of the tech companies, such as Google, Amazon, Microsoft, and a multitude of others, that wanted to make a big splash at HIMSS.
“Consumer pressure is driving a disruptive technology-enabled shift in healthcare today,” said Hal Wolf, HIMSS president and CEO, in a statement about the report. “Digital health technologies are beginning to deliver on their promise to help providers understand individual consumer preferences and provide personalized care that effectively coordinates care throughout the broader health ecosystem. By fully realizing the potential of information and technology, we can create an ever-increasingly informed and empowered global community of innovators, care providers, and patients.”
Specifically, the HIMSS report addresses four key trends: digital health implications and applications, consumer impact, financial and demographic challenges, and issues of data governance and policy. “Digital health tools have been riding the peak of the hype cycle for several years now,” the report points out, “but 2019 will be the year that digital health will need to answer for the way technology will increase access to care and narrow gaps in care and coverage.”
Given these areas of focus, it’s a good bet that the upcoming HIMSS19 conference and trade show will heavily promote these ideals. Even with that, there are likely going to be many other takeaways from healthcare technology’s biggest annual event so we asked some industry insiders, experts and thought leaders what they hope become the main takeaways from the event once it has wrapped. Here’s what they said.