During the pandemic, nearly every healthcare provider in the country had to execute a rapid, unplanned switch to telemedicine for the majority of their consults and activities. According to one study from the RAND Corporation, there was a 20-fold increase in the rate of telemedicine utilization after March 2020. For the most part, this transition was executed well and successfully, but only due to heroic levels of creativity and dedication by clinicians in every field.
With few established practices to rely on, it fell to each hospital, each department, each clinician to more or less invent ways to conduct virtual consultations in dermatology, cardiology, oncology, and more. There was much trial and error, but a commitment to rapid learning meant that the community as a whole was able to achieve a reasonable level of healthcare delivery quality to patients via the web.
Now, however, it is clear that telemedicine will be a permanent and sizeable segment of healthcare delivery; some estimate that more than 20% of healthcare from 2021 onward will be virtual. As a result, every aspect of the healthcare ecosystem must move out of an “emergency” mindset when it comes to telehealth and focus on establishing scalable, sustainable processes that ensure that a steady shift to telehealth drives equity, access, and quality. Healthcare providers themselves are actively engaged in this effort, and medical schools also now need to evolve to reflect this new normal.
Medical schools have incorporated some telehealth training into their programs in recent years, but it has tended to be ancillary. Now, it will be critical for telemedicine training to be incorporated more structurally into core curricula. What is being called “webside manner,” for instance, is significantly different to “bedside manner” and needs to be taught explicitly ?— in both a classroom setting and during clerkship rotations, as well as residencies.
Clinicians need to be taught how to establish rapport with patients whom they don’t see face to face, how to assess possible domestic abuse threats when the patient may not be able to speak freely, and how to gather emergency contact information in case there is a critical event during the consult for which the clinician needs to call emergency services. They also must learn how to take advantage of the unique opportunity that telehealth presents to closely observe and document social determinants of health by, for instance, asking patients to show the contents of their refrigerator. And they must be taught how to navigate the “digital divide” and ensure that patients without access to broadband or smartphones aren’t consigned to a lower quality of telehealth care.
The blockchain is a ledger, a database that keeps everything in one place and cannot be changed without leaving a mark in the ledger in the event of information changing. According to Jacob Kostecki of Blockhead Factor, blockchain makes it perfect for the recording of both research and treatment information, as well as medical histories. “Right now information is siloed and because people know that a lot of the information contained in medical records is false, there is a lack of trust that causes delays in diagnosing and treating patients,” Kostecki said. “In a blockchain-enabled world, patients will hold their whole medical histories in a wallet — from birth to where they are now in life. These EHRs will include medical records, procedures and everything else.”
When a patient visits a doctor he or she will have access to the patient’s full records instantaneously, making diagnosing cancer, for example, much easier. But blockchains mean more to healthcare than providing assistance at the point of care. Blockchain securely shares health data, standardizes formatting and improves healthcare transactions overall. Its impact can affect every major participant in the care cycle, from patient and provider to payer, pharma and even researchers and federal regulators.
It’s not a stretch to say that blockchain is everywhere in healthcare. Its application to healthcare has not reached its full potential, but the results may be profound as it comes of age, according to industry insiders. To better understand blockchain, we asked some insiders – technology experts, investors, professors, vendor reps and physicians – about what the technology may mean to the future of healthcare.
HIMSS organizers, in preparation of its annual conference and trade show and as a way to rally attendees around several trending topics for the coming show, asked the healthcare community how it feels about several key issues. I’ve reached out to readers of this site so they can respond to what they see as the future of healthcare innovation, data security, patient engagement and big data.
Their responses follow.
Do you agree with the following thoughts? If not, why; what’s missing?
Sean Benson, vice president of innovation, clinical solutions, Wolters Kluwer Health Future innovations in health IT, big data in particular, will focus on the aggregation and transformation of patient data into actionable knowledge that can improve patient and financial outcomes. The ever-growing volume of patient data contained within disparate clinical systems continues to expand. This siloed data often forces physicians to act on fragmented and incomplete information, making it difficult to apply the latest evidence. Comprehensive solutions will normalize, codify and aggregate patient data in a cloud system and run it against clinical scenarios to create evidence-based advice that is then delivered directly to the point of care via a variety of mobile devices. This will empower physicians with patient-specific knowledge based on the latest medical evidence delivered to the point of care in a timely, appropriate manner, ultimately resulting in higher quality treatment and more complete care.
Susan Reese, MBA, RN, CPHIMS, chief nurse executive, Kronos Incorporated
Gamification — the trend of creating computer-based employee games and contests for the purpose of aligning employee productivity with the organization’s goals — is currently a popular topic with business leaders and IT. For proof, consider that Gartner recently projected that by 2015, 50 percent of all organizations will be using gamification of some kind, and that by 2016, businesses will spend a total of $2.6 billion on this technology.
With numbers like these, it is clear that that gaming is serious business and that it is here to stay. But at this point, you may be asking yourself, “Could gamification work in my healthcare environment? What potential benefits could it have?””
Today, many healthcare organizations are looking to the future and considering gamification as a way to increase employee engagement, collaboration, and productivity as well as to align their behavior with larger business goals – but they don’t know how to do it quite yet. Also, gamification can be a delicate decision, complete with advantages and risks. After all, employees’ day-to-day work responsibilities and careers are not games and can’t be trivialized. Healthcare organizations must be careful to avoid sending the wrong message to their workforce, or the whole program could backfire, or even lead to more negative consequences.
Mike Lanciloti, vice president of product management and marketing, Spectralink
In today’s digital age, healthcare IT needs to come a long way to get up to speed in innovation and connectivity. However, as we begin to see mobile play a larger role in the industry, healthcare is moving the needle on innovation as well.
The mobile revolution has picked up in healthcare for both health IT professionals and in patient care. Primary as healthcare providers find ways to utilize smartphones, mobile devices and Wi-Fi networks to improve the communication and efficiency of their workforce.
Through mobile devices, clinicians have the ability to access what they need, when they need it. Mobile devices ensure nurses and mobile staff are equipped with the right technology to promote timely, efficient and reliable communication. This not only allows healthcare professionals to perform their jobs more effectively but also helps deliver a higher quality of patient care.
The growing mobile trend does present several questions for the industry. Hospital managers are quickly learning that an influx of smartphones into the hospital setting can become a larger problem than anticipated. Not only do personal devices lack the security required for enterprise-owned devices, they pose other risks, calling into question issues surrounding encryption, authorized access and mobile security. Personal phones aren’t designed to be equipped with the same encryption capabilities as enterprise-owned mobile devices.
Guest post by Allison Errickson, CPC-H, director of coding compliance, ProVation Medical, with Wolters Kluwer Health.
Never before have effective revenue cycle management strategies been so critical to future positioning in hospitals and health networks. In today’s lean environment of declining and unpredictable reimbursement, effective oversight of timely billing practices can simply be a make or break element to success.
Because the revenue cycle is dependent on the time-to-bill for procedures and diagnostic care, healthcare organizations must enact processes to support the most efficient coding practices to speed receipt of payment. Success in this area remains an obstacle for many organizations struggling with how to allocate limited resources to ensure the most accurate coding and efficient turn-around.
Denials plague the industry in terms of maintaining consistent cash flow. Inaccurate or incomplete documentation can impact as much as 5 percent of revenues if a healthcare organization is experiencing denial rates of 25 percent or more. Revenue is also negatively impacted when documentation does not support the highest level of acuity, minimizing reimbursement potential.
While accurate documentation remains an ongoing issue, resource allocation to effectively address the issue will likely be further impacted with the introduction of ICD-10. The industry has been granted a reprieve with the recent deadline extension of Oct. 1, 2015, but the reality of the transition will be coming into focus very soon. Coding challenges will be exacerbated as coders will now have 72,000 unique procedure codes to choose from, increasing the complexities associated with specificity and accurately coding to the highest level of reimbursement.
For the ninth year, national health IT week is in full swing, from Sept. 15 – 19, 2014. Those in healthcare, policy makers and stakeholders have come together to “collaborative forum for public and private healthcare constituents to discuss the value of health information technology (IT) for the U.S. healthcare system.”
HIMSS is again hosting a lineup of events and activities centered in the DC. According to the organization, the event is designed as health IT continues its advancement to “improve the quality of healthcare delivery, increase patient safety, decrease medical errors, and strengthen the interaction between patients and healthcare providers.”
For those of us in health IT, NHIT Week is a forum, a conversation starter and an awareness builder that assembles healthcare constituents dedicated to working together to elevate the necessity of advancing health through the best use of information technology. As a brand awareness campaign, the effort is paying off and bringing about deeper conversations with health IT game changers, leaders and those who wish to learn more about the ramifications of the technology on the overall landscape.
That said, and because of the importance of the event, I asked a few folks for their reaction to NHIT Week. Their responses follow:
Arvind Subramanian, president and CEO, Wolters Kluwer Health, Clinical Solutions
Vision, innovation, hard work and perseverance are foundational to any significant change for the better. These are fundamental components of the health IT movement—an ever-evolving landscape that has experienced tremendous successes, along with its share of challenges.
National Health IT Week offers a platform for celebrating progress and expanding awareness of the tremendous potential of health IT to advance healthcare’s broader goals of improved outcomes and lower costs. It’s an opportunity for those deeply involved in the movement and those watching it unfold from a distance to come together and remember what forms the core of its agenda: improving the human experience and saving lives.
Here at Wolters Kluwer Health, we have the advantage of seeing the outcomes associated with advances in clinical content integration, clinical knowledge management and data analytics every day. Whether it’s a highly effective response to a public health crisis or the ability to mitigate adverse outcomes through real-time patient surveillance, our clients are experiencing a transformation to more highly-effective care delivery.