Guest post by Mark Ott, vice president of product, RoundingWell.
As 2016 unfolds, the move from fee-for-service to value-based care is entering a more advanced stage. As the process evolves, priorities for healthcare providers of resources, teams and tools becomes more convoluted. To keep on track, both for healthcare organizations and CMS changes, providers should keep in mind the following:
The care management/coordination record rises in importance, especially as team-based care models expand
Some call it a care management medical record and others call it a care coordination record. Regardless of the term, the concept is essentially the same. EHRs are basically encounter management systems, but as care expands beyond the in-person encounter, capturing and tracking what happens between patient visits will be of utmost importance. In addition, enabling care teams to stay on the same page about a patient’s care plan, track action steps, and reduce the friction of working together will be crucial to succeeding in a value-based world. Expect to see the Care Management Record concept start catching fire in 2016.
Demand will increase for consumer-grade user experiences in healthcare enterprise software
For so long, clinicians on the frontlines of care delivery have had to struggle with software that’s hard to use, difficult and downright frustrating. The biggest culprit for poor user experiences in healthcare software has to do with the enterprise purchasing process. Vendors build for buyers, like the C-suite, who aren’t also the end users. If the end user and the buyer were the same, you’d see healthcare software vendors value user experience like what we see in other B2B industries, not to mention B2C industries. Regardless, in 2016 we will see more buyers value products with consumer-grade user experiences. Much of this has to do with end users’ reluctance and sometimes outright resistance to adopting technology in their worklife. Clinicians often get a bad wrap for being technology averse. But in reality, it’s not that they’re averse to technology; it’s that they’re averse to bad technology.
Integrating wearables and their data into care delivery processes will remain a niche activity
The enthusiasm around wearables, trackers and remote monitoring is exciting and there is enormous potential for device data to impact the delivery of care in ways that benefit both patient and provider. But the technology hasn’t caught up with the promise of what they can be, and that won’t change in 2016. Not only is the technology not yet able to deliver, but the incentives and processes to support wide-scale deployment are not in place yet. Though all signs point to wearables becoming an integral part of delivery of care, this won’t happen next year.
Guest post by Cathy Reisenwitz, content specialist, Capterra.
Every year at Capterra we predict the top trends in business technology. Last year we predicted gamification, wearables, telemedicine, mobile medicine, and 3D printing would be the top 5 medical technology trends for 2015.
This year, we expect wearables, telemedicine, and mobile medicine to continue to advance. They’ll be joined by cloud computing, patient portals, and big data.
Telemedicine has come a long way, from remote villagers using bicycle pedal-powered, two-way radios to communicate with the Royal Flying Doctor Service of Australia to helping recovering stroke patients in rural Minnesota avoid hours-long (and often snowy) drives for follow-up care.
As the technology has improved, the investment has increased. Transparency Market Research valued the global video telemedicine market at $559 million in 2013. Today, they predict it will grow to $1.6 billion by the end of 2020. Walgreens, the largest U.S. drugstore chain, and telehealth provider MDLive recently expanded their virtual care collaboration to 20 more states in November, bringing the total to 25.
Telemedicine offers tons of value to a large, growing segment of the population: seniors. Telemedicine improves care by getting it to remote patients who live far from hospitals. It also enables homebound patients to get high-quality care. It makes care cheaper, and allows seniors to stay at home longer. It benefits providers by making their jobs more flexible. And it also eliminates picking up new illnesses in a clinical care setting.
In rural Minnesota, nurses check motor skills by asking patients to push, pull and squeeze with their hands and feet. A doctor, located further away from patients, can advise on care onscreen.
Going back to wearables, their mass adoption has made store-and-forward telemedicine much easier. Devices like Fitbits automatically collect valuable health data. Store-and-forward telemedicine just means that data goes to a doctor or medical specialist so they can assess it when they have time. Watch for more EHRs learning to connect with wearables in 2016.
More EHRs will provide patient portals
Patient portals grew in popularity in 2014 and 2015. Twenty-six percent more patients received lab tests via an EHR patient portal between 2013 and 2014. Patients also received 50% more health and disease education through their portals in that time. “Patient engagement through health technology such as patient portals is rapidly increasing,” Craig Kemp, leader of innovative partnerships for Merck Vaccines, told mmm-online.com.
While about half of physicians offer patient portals right now, almost another fifth of them plan to offer one in the next 12 months. In a 2015 survey of more than 11,000 patients, 237 physicians, and nine payer organizations representing 47 million lives, almost a third of patients said they were interested in using a patient portal to engage with their physician, track their medical history, and receive educational materials and patient support. However, almost 40 percent said they’d never heard of a patient portal.
Educating patients on how and why to use portals will be key to getting them to use them in 2016.
This article is part of the “Think Further” series sponsored by Fred Alger Management. For more “Think Further” content, please visit www.thinkfurtheralger.com.
There is almost nothing I’m certain of except that life is an uncertain thing and that it seems to change a lot. Even in the most predictable of settings, even the minutest changes in detail can have a lasting and overwhelming effect on nearly everything in its atmosphere. In healthcare, a space seemingly immune to the status quo, things seem to get a whole lot more complicated. The same can be said of life and death, health and well-being. On their own, they are not so difficult to understand and often, in most cases, predictable and redundant; until the final days, of course, then things begin to get a little more complicated. When we’re fine, we’re fine. Life is good and most of our concerns seem trivial.
Then health gets involved and the minutest change in detail can send our lives in a spiral so much so that we barely recognize our place in it let alone who we are and where we belong. When such an occurrence arises, we begin to rely on beeps and buttons, software and technology in ways never before imagined for the intersection of our lives.
Clearly, the health IT landscape will be completely different five years from now. From where we stand today to where we’re headed, we’ll likely look back on this moment and wonder how we survived such archaic times. Just a couple years removed from the age of the electronic health records, technology that already seems dated and antiquated, is no longer monolithic and domineering to the space as it likely seemed in 2010.
Our future selves might stand on the threshold of 2020 and say that we were being single minded. The technology — EHRs were supposed to save healthcare and are now nothing but foundational. The technology was supposed to simply aggregate information collection, provide for the ability to quickly share information system wide and around the world; and give us the capability accessing all of a patient’s information at the tips of the proverbial finger.
When the promise of those solutions faded (yes, their stars have faded) and as our attention forced us into new technologies (primarily because of consumers’ desire) we are now seeing developments in technology creating touch points that impact patients “where they live” and has become the new force behind healthcare technology.
Consumers will drive healthcare’s future. Probably not a secret at this point, but a point that is hard for the old guard. They’ve had enough of being left out of the ownership process regarding their own health. They’re tired of being locked out of their own records, and kept access to their own information. Such data would not exist without those helping produce it. New consumer technologies have and will further level the field. Consumer tech will continue to spur innovation, at light speeds. Data will flow between healthcare parties and its consumers; HIPAA protections will be waived and open access for the social good will become the norm. Standard and traditional approaches when dealing with patients, in a generation or so, will be completely different and far less segmented, as they are now.
Guest post by Will Hayles, technical writer and blogger, Outscale.
Last year, 2014, was the year the wearables market really took off. No end of wearable technologies were released, each promising to hook users into the personal analytics and quantified self trends. Of course, many of those releases went nowhere, and even some of the big companies saw their wearable devices fizzle rather than pop — the obvious example being Google Glass, which received an unprecedented amount of attention, much of which was negative. But there were many successes, and later this year Apple will be entering the fray with the Apple Watch and its bundle of sensors.
Last year the wearables industry was worth around $2.8 billion. Over the next five years it’s expected be to worth more than $8.3 billion. But there is a market with the potential to dwarf the consumer fitness monitoring market, and that’s chronic illness management, which has, unfortunately, if understandably, seen far less attention from startups. As J.C. Herz notes in a Wired article on the subject, the entire market for fitness trackers is vastly outstripped by the size of the market for blood glucose test strips, which are an essential tool in the monitoring of diabetes.
Herz takes a harsh tone with an industry that has failed to focus research and development on solutions for people who stand to benefit the most, but I’m more optimistic. Healthcare outside of the fitness sphere is a difficult market, with a heavy — and necessary — regulatory burden and entrenched ideas about treatment and patient monitoring. Unity Stoakes, co-founder of StartUp Health, recognizes both the challenges and the potential for innovation that can significantly improve people’s lives:
“Unlike other industries, healthcare is plagued by regulation and longer product development timelines. Bringing successful products to market is challenging for both large industry players and digital health entrepreneurs. Startups need access to advisors, peers and dollars, while large companies need ‘batteries included’ entrepreneurs fueling innovation. The unprecedented level of change gripping the healthcare industry today presents both challenges and opportunities for both.”
There is recognition both within the healthcare industry and among technology companies that monitoring tools and other applications of wearable and mobile technology offer an opportunity to substantially change healthcare and the lives of people who suffer with chronic illnesses.
According to a recent study from the Health Research Industry, 42 percent of healthcare providers are comfortable relying on at-home test results for prescriptions. Sixty-six percent thought mobile solutions have the potential to help with the management of chronic diseases. And as we’ve discussed on this blog several times before, mobile technology and wearables are helping caregivers better collaborate and coordinate care.
With consumer use of wearables, smart pill bottles, health apps and other forms of personalized health technology rapidly increasing, concerns around data privacy, proper interpretation of health information and data stewardship are also on the rise. In response, the Vitality Institute, along with Microsoft Corporation, the University of California, San Diego, and other stakeholders, are developing a set of industry guidelines to address the legal, social and ethical concerns associated with the development and use of the technology and the data it generates. The guidelines build on existing best practices to create a standardized approach. A draft of the guidelines is being released online today, opening a three month public comment period before the guidelines are finalized.
“I urge anyone with an interest in the future of health technology to review the guidelines and comment. This includes consumers who use wearables, smartwatches and health apps, along with leaders of the companies that develop, market and distribute these products,” said Derek Yach, executive director of the Vitality Institute and senior vice president of the Vitality Group. “Personalized health technology has great potential to benefit the health of countless individuals and it is critical that we proactively address these legal, social and ethical challenges so that potential benefit is not hindered.”
The draft responsibility guidelines make six recommendations that call on personalized health technology to:
Protect the privacy of a user’s health data
Clearly define who owns a user’s health data
Make it easy for users to accurately interpret their data
Integrate validated scientific evidence into product design
Incorporate evidence-based approaches to health behavior improvement
Guest post by Chris Boone, CEO, Health Data Consortium.
Consumers are receiving more health data than ever, as evidenced by the myriad mobile apps (WeightWatchers, Mindshift, Nike+ Training Club, etc.) and wearables (FitBit, iWatch, Jawbone, etc.) now available. With health data so pervasive, health literacy has become a commonly discussed issue as it pertains to consumers’ ability to obtain and process healthcare information to make better healthcare decisions. But, with the advent of so much data, there must be a national emphasis on the importance of health data literacy, as well, to empower patients to leverage available data in a meaningful way that can improve their and their loved ones’ health outcomes.
The Health Data Literacy Landscape
There remain challenges to the health data movement – such as privacy concerns – and as a result, questions around how to improve health data literacy remain largely unexplored. The road to health data literacy starts with digital access to health information, and new technologies that seamlessly augment consumers’ daily health practices to enable better health decision-making. Interestingly enough, however, the rate at which health data entrepreneurs and innovators are producing incredible technologies may be exceeding the rate at which consumers are able to digest and use the information.
So, how do we leverage the opportunities provided by greater access to health data without overwhelming the consumer?
Data Visualization and the User Experience
Once data becomes accessible to consumers, data visualization is a key component to ensuring it is understandable and actionable. Consumers must be able to comprehend and digest data to put it to work.
In addition – and like in any other industry – the user experience must be a top priority when building new technologies. We need developers to build mobile apps, wearables, websites, etc. that are simple in design with an emphasis on providing useful and easily actionable data for consumers.
Girish Navani is CEO and co-founder of eClinicalWorks, an electronic health record company exceeding in the B2B field since 1999. Under the leadership and foresight of Navani, the company is expanding its services to B2C with the launch of healow – an app for patients to easily find new doctors, schedule appointments online and access their personal health records.
Here, Navani speaks about his path to eClinicalWorks, he offers his expert insight on EHRs and their benefits to healthcare, and he speak of likely trends that will continue to change the healthcare landscape.
Tell me your story. About how you got here, how you developed your technology and the reasoning for a private company set up?
We wanted to use technology as a way to completely transform the healthcare delivery model to streamline processes, prevent errors and provide easily accessible information to both providers and patients. Not only was our primary goal to make doctors’ jobs easier by providing them with a way to operate more efficiently, but we also wanted to improve the patient experience.
I’m a strong believer in keeping my company private and concentrating on building a solid product. Selling shares and depending on investors means that they will always have a say in how we conduct our business. We use our profits to continue building our company and our products.
What about the leadership inside the company? Is it true the no employees have titles? What’s the reasoning?
I have an open-door policy, which allows the opportunity for anybody to approach me to ask questions and brainstorm ideas. Over time, I’ve learned to listen more. I’m okay with second guessing my own decisions and receiving feedback from my colleagues, even if what they say is “no.”
Yes, our employees do not have titles, but instead, the whole company is team-based with team leaders being the only leadership position. Employees’ careers grow with bigger projects. I think titles are self-fulfilling and short-term objectives that people quickly get tired of. With a team-based structure, employees can work together to achieve successful results instead of individuals striving for the next title.
What drew you to healthcare? Why does it stand out for you?
I have always worked in technology, and in 1999, I heard a lecture in Geneva about using wireless computing in healthcare and the idea of “connected healthcare” really stuck with me. I loved the idea of a doctor and patient sitting in the doctor’s office reviewing charts on a tablet instead of pieces of paper, so I wanted to build a technology that connects all parties involved in healthcare, including the doctor, patient and insurance company.
Prior to launching Webbed Marketing (the previous name of Fathom Columbus), founder Bill Balderaz worked with some of the largest publishers in the world to plan, execute and measure Internet marketing programs. He began working on search engine optimization, pay-per-click advertising and link-building in 1998, prior to the launch of Google. He has spoken on Internet marketing topics at events sponsored by the Public Relations Society of America, the American Marketing Association and the National Fuel Funds Network. Bill holds a bachelor’s degree in public relations journalism from Bowling Green State University and an MBA from Franklin University.
Here, he discusses health IT trends, the future of wearables as he sees them and the consumerization of healthcare.
What are the biggest changes we will see in 2015 in terms of healthcare technology?
Hospitals and health systems across the country will be adopting or upgrading EHRs, telehealth capabilities, and mobile tools. Look for increased reliance on and more sophisticated use of data analytics, as well as individualized medicine, ‘doctor-less’ patient models, and quantification of population health via social media. Patients will take more control of their health.
Also look for integration. Patients have so many inputs: lab results, wearable data, fitness plans. Then they have outputs, newsletters, emails, patient portals. The smart money is on the technology to connect and simplify.
What is driving these changes?
At the consumer level, where patients are more informed and involved than ever, what some call the ‘democratized future’ of healthcare is bringing more accountability and transparency to both the methods and costs of care. The parallel needs to cut skyrocketing costs, increase access to care, improve quality of service, and encourage patient engagement are all factors contributing to the growing potential of health IT to transform the delivery and experience of healthcare at fundamental levels.
You work with healthcare systems across the country in a variety of markets. What trends are common to all hospitals and healthcare systems? What differences do you see?
Guest post by Nilesh Chandra and Nick Mathisen, healthcare experts at PA Consulting.
Healthcare as an industry is undergoing rapid, fundamental changes brought about by reform. The Affordable Care Act of 2010 turned the incentive system upside down for healthcare providers, moving them from fee-for-service payments to Accountable Care Models. Providers who previously made money by separately charging for each procedure and bore little financial risk for patient health, now get paid a single bundled amount for providing care for a group of people, with incentives to reduce the total cost of care and share in those savings. Taking a cue from Medicare and Medicaid, private health insurers are increasingly adopting similar payment models.
The challenges today
Doctors and nurses who had the responsibility to help sick people get better, are now expected to keep people healthy. Hospital administrators who were measured on financial metrics like bed utilization are now expected to keep people out of hospitals. Traditional healthcare involved dealing with sick people who came in to hospitals and clinics. Tomorrow, healthcare will be about proactively engaging with healthy people and encouraging them to adopt behaviors that keep them healthy. This will involve outreach and engagement in entirely new ways that the modern healthcare industry has not done before.
The future of healthcare
The future of healthcare is outside the boundaries of what our modern healthcare industry knows how to do.
Think about it. Many industries are facing disruptive innovation where the future of the industry is completely different from what has been the norm. For example, the PC industry with the rapid shift to tablets, or retail with the increasing move to online channels. However, both of those industries have always been subject to rapid innovation and players have learned to evolve rapidly. The transformation in healthcare is more profound because it is larger in scale and it has a much greater impact on people’s lives.
So what does the future of healthcare involve and how can technology help? There are three key elements that the healthcare industry has to learn to be more efficient and proactive:
Caring for the chronically sick more efficiently with wearables
The rate of diabetes, heart conditions, obesity and other chronic conditions are projected to continually rise. The chronically ill consume a large proportion of healthcare, therefore any efficiency gained in providing care for them translates into significant savings in the overall health system. A recent study from Robert Wood Johnson University hospital found that 80 percent of all heart-attacks could have been prevented by simple changes in lifestyle. Changes in lifestyle will have a similar positive impact on other chronic conditions as well.
Dr. Cliff Bleustein, chief medical officer and head of Dell’s global healthcare consulting services, leads an integrated team of clinical, business, and technical professionals who provide expertise to health systems, hospitals, physician practices, health plans and life sciences organizations. Here he discusses Dell’s healthcare vision; improving patient engagement and how he defines the term; data security; and trends that he thinks will be worth tracking in the near term — here’s a hint: smartphones, yes; wearables, no.
In your new role as chief medical officer and global head of healthcare consulting at Dell Services, what are your responsibilities?
As chief medical officer, I play a key role in Dell Services’ healthcare division supporting our aggressive strategic initiative to revolutionize the way healthcare is managed. I spend a lot time listening to customers and helping them to better manage patient-specific data that spans the entire continuum of care. Ultimately, better information and technology will drive improvements in quality, patient safety, efficiency and outcomes. I help shape our strategy and ensure that it meets the needs of our customers, both now and in the future.
Tell me about your background in healthcare and how you came to be passionate about the space.
Ever since I was a child, I knew that I wanted to be a physician. Originally I was fascinated with the ability of body builders to be able to grow muscle to such huge proportions and lift weights several times greater than their mass. As my career developed, I focused on how treatments and diagnostics could move from the lab to the bedside. During training and private practice, I became more involved in understanding how systems work and function and what drives them. I was fortunate enough in my career to work internationally, as well. This gives a much broader view about how healthcare can be improved on a larger scale. I am driven by a desire to continue to disrupt the market with new technologies and solutions that can have a meaningful impact on improving health at scale.
What is Dell’s background in healthcare IT and why does the company put an emphasis on this sector (other than for obvious financial reasons)?
People are often surprised to learn that Dell has more than 20 years of experience in serving healthcare customers. That, combined with our deep bench of clinical and technical experts, is why Gartner has ranked Dell number one among healthcare IT service providers for four years running. But it goes beyond that; it’s also personal. Michael Dell is keenly interested in exploring how technology can improve healthcare systems around the globe. And we have thousands of employees who get up every day and focus solely on the needs of our healthcare customers. With an aging population and the impact of chronic diseases, such as heart disease and diabetes, we must find ways to reduce cost, improve productivity and improve health outcomes. Technology has a huge role to play. We also know we can’t do it alone, and for that reason we work with and partner with some of the leading companies in the industry.
What solutions does Dell offer and how do they set the company apart from competing vendors?
What sets Dell apart is our holistic approach. It’s not enough to just add technology. It’s also about connecting people to the right technology and integrating that technology into their workflows. Processes need to be re-examined and, in many cases, re-engineered. So, in addition to the traditional IT products and services Dell is known for, we also offer a robust suite of solutions and services that are specially designed for healthcare. These include secure cloud solutions such as our Unified Clinical Archive, EHR implementation, mobile clinical computing, sophisticated analytics tools, social media integration, HIX and HIE services and support, and clinical transformation. We also have a strong focus on the life sciences, with a genomics analysis platform that supports clinical trials investigating personalized treatments for cancer.