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6 Healthcare Trends to Watch in 2018

6 Healthcare Trends to Watch in 2018 | Healthcare and Technology news | Scoop.it

It’s 2018, and the world looks much different than it did a year ago. Go back even further and the differences are even starker. No place is that more evident than in healthcare. As the largest industry in the world, healthcare has weathered the most significant political waves of the last fifteen years. As the costs of healthcare increased unchecked, politicians took notice.

In our pseudo free-market health system, where a considerable portion of costs are covered with public funds, and where the largest public payor initiates changes that are then emulated by commercial payors and, likewise, where government entities heavily regulate healthcare’s techniques and technologies, politicians have intervened to force changes. With healthcare being a major topic of the last several elections and a top priority for President Obama during one of his two terms (as it was for President Clinton, though his primary initiatives in healthcare didn’t pass), it’s no surprise that the current administration also would like to impart change. President Trump is now working to alter some of what the Obama administration put into place. This move creates more uncertainty and requires change. I think everyone agrees on a defined set of goals for the industry, known as the triple aim (better outcomes, lower costs, improved experience), but the path to achieving those goals is wildly variable depending on your political position.

 

Unfortunately, these required changes have placed the industry in turmoil. In an effort to modernize its technology, EHRs have been forced between providers and patients to ensure better, more consistent data collection. Ideally, this move should reduce medical errors and redundant tests, however, the government missed a massive opportunity here when it spent north of $40B on incentives to increase digitization of medical records — EHR software that wasn’t built to reduce medical errors, unnecessary tests or even improve clinician communication or data sharing across providers that would ensure continuity of care. At the same time, government financial incentives prompted a change to healthcare services to ensure quality. Yet, most of these quality initiatives didn’t go far enough and consequently increased data reporting burdens for clinicians. Meanwhile, payments for the majority of healthcare services have been reduced, squeezing provider margins and changing the rules for how providers are paid.

 

Healthcare hasn’t improved for consumers. During appointments, providers struggle to connect because they have screens, not patients, in front of them. Insurance coverage has gotten worse; choices have been reduced and the complexity of bills and payor communications to consumers more complex. How much worse have things become? I have an MD, MBA, and MS. I run a healthcare company with ~50 employees and have been writing and speaking on healthcare and healthcare technology for ten years. My wife and many of my friends are practicing physicians; some are my physicians. Yet, I woefully struggle to understand my medical bills, choices in providers, and generally how to navigate our broken system.

 

Where does that leave healthcare going into 2018? I’d argue that healthcare, if anything, is worse today than it was a year ago. The government, individuals, and private sector will certainly continue pushing for more changes in 2018. Given that, I predict we’ll see a few major healthcare trends as we move through the new year.

Subscription / direct pay / cash-based practices

Consumers, with minimal choice in healthcare, find it difficult to speak with their wallets or their feet. Similarly, providers have even fewer options. It’s no wonder that subscription medicine and cash-based medical practices are growing in popularity for both providers and patients (more on that below). These care models align incentives and are transparent. Geared towards those who have the ability to pay extra for better services, today, the majority of these care models bank on the pocketbooks of the middle to upper class. However, emerging data sets show the success of this model is also possible for underserved populations, as well. Learn more about what I think will happen with cash-pay practices in 2018.

Post-EHR healthcare

The gravy train of meaningful use (MU) is over. The effect of MU was a significant, artificial, driver of adoption for a few EHRs. Today, digital health records are the standard. As we move through 2018, keep an eye on EHRs and how they justify their ROI once massive capital expenditures are written down. Likewise, you’ll want to consider how clinicians adjust to this brave new world. Read more about my 2018 predictions for the post-EHR world.

Clinicians as developers

The EHR wave of health IT left out clinicians. EHR and IT vendors drove those early technology decisions. Now, with software eating the world, clinicians are acting like software developers and corporate innovators in helping to design and, in some cases, build new technology and technology-enabled services for their colleagues and their patients. Read more of my thoughts on clinicians as developers.

The real cloud

HIMSS 2018, the largest health technology conference on the planet, will for the first time see the behemoth booths of EHR vendors challenged by the equally massive booths of public cloud service providers like Amazon, Microsoft, and Google. This is the canary in the coal mine moment for healthcare, not just for the adoption of the real cloud over simple virtualization, but also in the fragmentation of infrastructure and services managed by third parties for healthcare delivery organizations. Learn more about the real cloud in healthcare.

Beyond digital health hype

Digital health has been hyped for a long time as a savior for healthcare. Unfortunately, healthcare is not that simple and no savior exists to untangle us from our current mess of a system. Technology, for technology’s sake, is not going to fix healthcare. While we’ve witnessed incredible enthusiasm around new technologies disrupting healthcare, we’re also now seeing some public failures, like the recent acquisition/fire sale of Practice Fusion, or the Castlight Health initial public offering hype and valuation assumptions compared to the market reality of today. Similar to EHRs, digital health now must prove it’s worth if it’s going to have sticking power. Find out more about getting beyond the digital hype.

Blockchain to the rescue

Speaking of hype, blockchain has made its way into healthcare. Smart contracts, immutability, and a clear audit trail — hallmarks of blockchain technology — hold much promise for healthcare data and exchange. The problem is that technology, especially when it comes to data sharing and interoperability in healthcare is not the dominant roadblock. Layering in new technology, like blockchain, leaves the fundamental organizational and political problems unsolved.

 

I’ll focus on each of these trends in subsequent posts, distilling all of these healthcare trends down into one larger narrative: post-EHR healthcare is finally ready and incented to start making the necessary changes that will align with the triple aim. Massive organizations will vie for their place in this new healthcare world; some will win and others won’t. The winners will be the providers AND the patients.

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ScientificAnimations's comment, May 22, 8:46 AM
Blockchain is a system that makes health information accessible to doctors from anywhere, anytime, and on any electronic medical system. http://sco.lt/5yVeuP
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What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration 

What Your Healthcare Organization Needs to Know About Measure Selection and EHR Configuration  | Healthcare and Technology news | Scoop.it

Participation in pay-for-performance plans like MACRA’s Quality Payment Program (QPP) poses new challenges for resource-strapped healthcare organizations. Many provider sites lack the time and technical expertise needed to retool their EHR implementation to document new metrics under value-based reimbursement models like the Merit-based Incentive Payment System (MIPS).

 

Nonetheless, that is precisely what clinicians must do to deliver on quality reporting requirements. When using EHR documentation tools, many factors must be considered for a provider to get credit on having met clinical quality measures (CQMs). How that information gets stored in the EHR directly affects reporting. Many healthcare organizations are finding that customizing an EHR to recognize when a measure has been met—preferably in a manner that poses as few interruptions to patient engagement as possible—is easier said than done.

Overcoming EHR Limitations

Many outpatient and inpatient settings still struggle with common EHR data management headaches. As clinicians bring new quality measures into the EHR, those underlying data management issues can foil even the best-laid reporting plans.

Discrete Data Capture

The push to better document clinical quality is causing a transition in EHRs to focus more on structured or discrete data that is easier to trend over time. Unfortunately, many healthcare providers still receive patient data from healthcare affiliates via fax. Those faxed documents show up as attachments in the patient chart and are not fully integrated into the patient data file. If that information was sent via HL7 interface instead, details on the care rendered by that hospital or other healthcare entity would flow into the EHR as discreet data variables. For many providers today, capturing that information in a manner that makes it usable in reporting and analytics still requires timely, manual data entry.

Documentation and Data Consistency

Provider sites with multiple clinicians may also encounter issues related to the slightly different way that each EHR user documents care. MIPS and other quality programs require consistency and a high degree of specificity in clinical documentation. If a clinician does not get diagnosis specifics into the patient chart, that patient may not be included in the CQM calculation they need to be included in. Many clinicians are having to modify their documentation process during patient encounters so they and the staff can capture all the necessary information in the EHR.

Clinical documentation will have even bigger repercussions under the Cost component of MIPS, which is slated to be factored into performance scores in coming years. Take, for example, a patient that is in for the flu. That patient has a certain anticipated cost impact (the average Medicare spending per beneficiary), calculated based on past medical history and services rendered. If a patient goes to a physician and has the flu but also has diabetes, heart failure, and asthma, that flu patient is probably going to cost more to care for. If the physician only submits the flu diagnosis and fails to document patient co-morbidities then the healthcare organization will not get the same allowance under the MIPS Cost category and could be labeled as “higher cost” than a comparable provider encounter for a patient that required fewer resources to care for.

Clinicians, coders, and staff need to make a mental transition away from “we’re submitting claims” to “we’re submitting data” to better serve clinical reporting initiatives and patient care analysis.

Making Informed CQM Selections

Beyond adapting to new data management processes, clinicians reporting under value-based programs also have a great deal to learn as they layer in additional quality measures under MACRA. One of the biggest challenges clinicians and administrators face is selecting the best measures for their specific healthcare organization. With limited spare time on their hands, many healthcare teams are leaning on outside expertise to help them evaluate the implications of various measure selections.

Measures Without Benchmarks

Many quality measures under MACRA are carry-overs or “relics” from other reporting programs. For these CQMs, providers can look to prior performance averages to evaluate the likelihood of success should the healthcare organization elect to report on those measures. That data does not exist for some CQMs, which are referred to as “measures without benchmarks.” On measures that have no benchmark data available, providers will be limited to a maximum of three reporting points instead of the ten points available on measures with benchmarks established.

To further complicate things, details on the availability of some benchmark data will not be calculated until after the March 2018 QPP reporting deadline. Providers may wish to further diversify or report on additional measures that could help offset low point earnings on measures without benchmarks.

Topped Out Measures

Another CQM caveat that providers should be aware of relates to “topped out” measures. These relic measures from other reporting programs are very engrained in many healthcare settings. Medication reconciliation, for example, was a requirement under Meaningful Use. Widespread adoption and universally high compliance rates on that measure makes it more difficult for clinicians to out-perform peers. Achieving maximum points on such measures requires a perfect or near-perfect score.

Keep average performance thresholds in mind when evaluating CQM selections, not just the healthcare entity’s individual performance track record. Look at a broader set of measures to maximize MIPS score potential. Clinicians could earn more points by scoring 70 percent on a non-topped out measure than they would earn scoring 95 percent on a topped out measure. Some topped out measures will likely be eliminated in future years to help diversify CQMs, as was the case under Meaningful Use.

Understanding the intricacies of CQM selection and EHR data management will be vital to success under value-based payment programs. Healthcare administrators and clinicians who proactively work to better understand the impact of various measures and streamline EHR processes will be best positioned to maximize program incentives.

 

Does your organization have the resources it needs to successfully navigate MIPS

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AI must overcome data challenges to reach healthcare potential 

AI must overcome data challenges to reach healthcare potential  | Healthcare and Technology news | Scoop.it

Dive Brief:

  • Rapid digitization of health information in EHRs and other repositories is creating new opportunities for AI in healthcare, but challenges in data accessibility, privacy and security persist, according to a new ONC report.
  • Frustration with legacy medical systems, the omnipresence of networked smart devices and consumer comfort with at-home services offered by Amazon and other tech vendors is driving interest in AI's potential.
  • Smartphone, social and environmental data can all be potential sources to fuel AI's use in healthcare. However, the report concludes such data must be high quality and reliable. Otherwise, AI's promise will not be realized in healthcare.

Dive Insight:

AI is a hot healthcare topic but still needs to be translated into reality, especially in an industry as complex as healthcare. 

During the second quarter of 2017, CB Insights counted 29 investment deals in the healthcare AI space — a record number — and predicted 2017 would set a six-year high.

 

Enthusiasm is expected to stay heated into 2018, with demand for tools that go beyond noting social determinants of health to using that data to inform patient care plans.

 

While investors will continue to fund wearables and biosensors, what grabs their attention are specific clinical use cases these technologies can support, Megan Zweig, director of research at Rock Health, told Healthcare Dive recently.

 

Tech giants including IBM Watson, Microsoft, Google and Apple are staking a claim in the space, too. Last month, Google launched Deep Variant, an open-source tool that uses AI to create a picture of a person’s genetic blueprint using sequencing data. The goal is to pinpoint specific genes or gene mutations that can help providers better manage disease states.

 

But challenges to widespread use of AI in health remain, as the ONC study shows. Among these are the acceptance of AI applications in clinical practice, difficulty leveraging divergent personal networked devices and AI solutions, access to quality training data on AI applications in health and gaps in data streams.

 

The report belies a large obstacle for rampant AI use. White noting the importance of high quality and reliable data, the industry has a data standards problem at the moment which needs to be ironed out. 

 

Currently, different vendors and clinicians send unstructured data in medical records back and forth across EHR systems through continuity-of-care documents, which are format flexible. If the promise of AI relies on reliable data, standards will have to be well-defined to ensure the data are high quality.

 

On the bright side, the industry seems aware that healthcare is close to a breaking point at interoperability. The growing Internet of Things and consumerism in healthcare naturally demands a more networked, connected industry approach. 

 

CMS Administrator Seema Verma in a town hall webcast on Wednesday with American Hospital Association CEO and President Rick Pollack said interoperability will be a topic of interest for the agency. She told listeners they will hear more from CMS in the future.

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Physician Reports Impact Of Electronic Health Record On Patient Safety

Physician Reports Impact Of Electronic Health Record On Patient Safety | Healthcare and Technology news | Scoop.it

Physicians who adopt electronic health record report EHR has improved the safety and quality of their office-based care

 

At the end of each day, every physician asks themselves two questions:

 

  • “Was there something I did today that I shouldn’t have?”

 

  • “Is there something I didn’t do that I should have?”

 

We can now see from the 2013 National Ambulatory Medical Care Physician Workflow Survey (NAMCS) that the answers to those questions weigh lighter on the minds of practicing physicians who have the help of electronic health records (EHR).

 

Through this annual survey of 11,000 physicians we get a snapshot of how EHR adoption has improved the safety and quality of their office-based care.  The details of the survey are published in an ONC data brief; and the larger contours of the perceived impact of electronic health records are clear: physicians feel that EHRs improve the quality and safety of the care they deliver.  From these data we can see that about 70 percent of physicians answering the survey felt that their EHR helped by alerting them of an important medication or a laboratory test result.

 

 

EHRs improve communications

 

As the practice of medicine becomes more complex, practice tools should help providers manage that complexity. The NAMCS survey finds that electronic health records are helping to improve communication between physicians and members of their care teams.  Nearly 60 percent of physicians using EHRs reported that their system facilitated communication among the care team and roughly one-half of them found that it improved the management of referrals.

 

Not unexpectedly, physicians in large practices (11 physicians or more) experienced slightly greater improvement in communication across the care team, compared to those in solo practices.

 

However, no practice tool is a panacea, and when looking at electronic records we also see that 40 percent of physicians felt the EHR led to a less effective communication with their patients during a visit, 15 percent felt the EHR led to an error in ordering a medication or test, and about 15 percent identified too many alerts as the reason they overlooked something important.

 

 

EHRs can improve patient safety

 

The net result of how physicians perceive the effects of electronic records on crucial processes of care within their practice is overwhelmingly positive.  This fact provides us with the support we need as we work toward the two goals of health IT safety articulated in the ONC Patient Safety Action and Surveillance Plan: to improve the safe use of health IT and to improve the overall safety and quality of care delivered through the use of health IT.

Those of us who have worked in any of the domains of safety — health care patient safety, nuclear safety, or aerospace safety — know safety is a journey and not a destination.

 

This NAMCS survey shows that electronic health records are tools that make the path toward patient safety easier for all of us who, after the day’s journey, soberly reflect on the answers to two very important questions: “Was there something I did today that I shouldn’t have?” and “Is there something I didn’t do that I should have?”

 

We all share a responsibility to try to answer these questions better today than we did yesterday.  And the good news is that we can meet that responsibility with confidence whether ordering medications and labs, communicating with our colleagues, or remembering important aspects of care, as the EHR is helping us to make that care better.

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How Physicians Must Practically Prepare for Retirement

How Physicians Must Practically Prepare for Retirement | Healthcare and Technology news | Scoop.it

In a broad survey of U.S. physicians by Merritt Hawkins in 2014, nearly 42 percent of those surveyed aged 46 and older said they plan to accelerate their retirement due to current changes in the healthcare industry. In the same survey, more than 55 percent of physicians reported their current morale as somewhat or very negative.


Numbers like those suggest some physicians could be rushing for the exits before their retirement ducks are in a row, which can lead to some regrettable outcomes, experts say. Among them: nest eggs that are too small or too heavily invested in risky assets, missed opportunities for disposing of practice assets, and depression resulting from a lack of purpose once work ends.


Ophthalmologist Arnold Pearlstone retired nearly five years ago at age 80, not because he failed to plan for retirement, but precisely because he planned so well for so long.


He and his practice partners started up a 401(k) plan decades ago when the concept was still new, and Pearlstone learned all he could about investments.


"We were all pretty conscientious about saving and we really had a pretty good amount put away, so we didn't have to worry," he says.

What did concern him was how he was going to spend his time in retirement. He loved practicing medicine and knew he wanted to do it as long as possible.


And so 23 years ago, about the time many people start retiring, Pearlstone and his wife, Marion (now deceased), established a foundation they called Eye Care for the Underprivileged. Through that foundation they received donations in addition to their own and established a clinic in Jamaica while Pearlstone was still actively practicing.


"I didn't limit the foundation's scope to Jamaica, because I thought I might one day need it for other clinics I wanted to open," he says. "I didn't know what I was going to be doing, so when I set up the fund I left it open-ended in case later on I wanted to volunteer and needed to purchase equipment."


Sure enough, as Pearlstone finally started winding down his practice, he contacted AmeriCares, a humanitarian aid organization. He began working at an AmeriCares free clinic in Bridgeport, Conn., two weeks after he retired in 2010, taking most of his office equipment with him and donating it to the clinic. Later, he used money from his foundation to add equipment to other AmeriCares clinic locations. He keeps his Connecticut medical license current with 50 hours of continuing medical education every two years.


"My advice is to not just quit when you retire," he says. "Find someplace to use those skills where they can make a difference. It's good for you to keep the brain going."


Practical Planning


As for the more practical aspects of retirement planning, getting going on those is equally important, experts say.


"Start early, because everything seems to take longer than you think it will," says Roy Bossen, a partner at Hinshaw & Culbertson LLP, with experience in medical office sales and acquisitions.


Increasingly, finding a junior partner willing to buy you out and continue the practice as it was is a rare find, Bossen says. Instead, you might have to consider a multi-year process where you join a hospital network for a few years at the end your career.


"If a hospital really wants a physician, it will often assume the lease or buy the building as part of the transaction," says Bossen. "They won't pay more than fair-market value," but having that obligation off your plate before you retire could be worth it if finding and keeping a tenant is difficult in your market, he says.


"These are issues you want to resolve going into a lease, not out, but if you're in a lease, for example, be aware that you may have to go to a condo board to get a tenant approved," he says, which can mean more delays and missed opportunities.


Near the end of his career, Pearlstone was the last of four partners in his office. He assumed the patient records of two colleagues who were retiring, closed down the office, and rented a new space from a friend who had another practice nearby for the last few years of practice. That doctor then paid Pearlstone a small fee for the patient records, which offset a portion of his rent, he says.


Preparing your nest egg to begin pumping out income at retirement is also a process that can take some time. A significant market correction in the first few years of retirement could doom an income system that relies on an initial withdrawal rate with automatic yearly increases — the oft-cited "4 percent" rule.


Be aware that because of stock market valuations and the low-yield bond market, projections for returns in coming years have market experts saying a more realistic safe withdrawal rate could be more like 2.5 percent to 3 percent.


If you're concerned you might not have saved enough to make it through retirement with just a systematic withdrawal plan, longevity insurance — or fixed deferred annuities — are beginning to be introduced for retirement accounts by insurers including The Principal and MetLife.


Recent federal regulations paved the way for these policies, called qualifying longevity annuity contracts (QLAC). Inside retirement accounts, the annuities allow owners to defer required minimum distributions on the amounts invested in the annuities.


Also, think strategically about how you want to receive Social Security income. You can now get an 8 percent bump-up in monthly benefits for every year you delay claiming benefits past full retirement age, up to 32 percent at age 70. Do this first before purchasing longevity annuities because it's the cheapest annuity available, many financial advisers say.


It's important to reconsider your risk tolerance now that retirement is looming. A decade before he retired, Pearlstone says he began shifting his savings to more fixed-income investments and away from stocks.


"Today I'm about two-thirds in income investments and one-third in equities," he says, noting that he spent considerable time throughout his career learning about financial planning and investments.

If you haven't put in that much time and don't expect to, at least thoroughly check out the financial adviser you plan to use to help tap your nest egg. Online financial management services such as Personal Capital and Betterment are beginning to offer retirement spend-down strategies.  They do so for a fraction of what traditional advisers charge — and they won't approach you with obscure land deals only available to "accredited" investors.

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IBM Watson antes up $1B to buy Merge

IBM Watson antes up $1B to buy Merge | Healthcare and Technology news | Scoop.it

Continuing its shopping spree, IBM on Thursday announced that it will spend a cool $1 billion to acquire Merge Healthcare in a deal that will combine Merge's medical imaging technologies with IBM's Watson. 

Watson will gain the ability to "see" by bringing together Watson's advanced image analytics and cognitive capabilities with data and images obtained from Merge Healthcare's medical imaging management platform, IBM executives said in announcing the deal.


The intent, say IBM executives is to to unlock the value of medical images to help physicians make better patient care decisions.


Merge is a public company, traded on NASDAQ as MRGE.

Its technology platforms are used at more than 7,500 U.S. healthcare sites, as well as most of the world's leading clinicalresearch institutes and pharmaceutical firms to manage a growing body of medical images.


As IBM execs see it, these organizations could use the Watson Health Cloud to surface new insights from a consolidated, patient-centric view of current and historical images, electronic health records, data from wearable devices and other related medical data, in a HIPAA-enabled environment.


Under terms of the transaction, Merge shareholders would receive $7.13 per share in cash, for a total transaction value of $1 billion. The closing of the transaction is subject to regulatory review, Merge shareholder approval, and other customary closing conditions. It is expected to occur later this year.


It is IBM's third major health-related acquisition – and the largest – since launching its Watson Health unit in April, following Phytel, a population health company and Explorys, a cloud-based intelligence firm.

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Getting a checkup will be very different in the not-so-distant future

Getting a checkup will be very different in the not-so-distant future | Healthcare and Technology news | Scoop.it

Sometime in the not-so-distant future, getting a checkup will be very different.


When the doctor writes down your symptoms, it will be cross-checked with others in your area, making it easier to identify outbreaks and epidemics sooner. If you complain of shortness of breath, your phone’s heart rate monitor will instantly report how well your heart has functioned over the last month. Those readings then could be aggregated with others in your community, revealing hidden trends. As your doctor thinks about the best treatment for you, big-data analysis will help her assess how various options have worked for others with similar histories and body chemistry.


This is the promise of big data in healthcare. And, it’s not just while you’re at the doctor. Medical research and findings are now being combined into massive searchable databases, making it easier to assess and compare results. Databases can absorb terabytes worth of disparate data, including things like the weather. This will make it clearer whether it’s the drug — or something extraneous like humidity — that’s making people feel better.


But all this is in its infancy, with the sector moving slowly and cautiously. The Affordable Care Act now mandates that doctors switch to electronic health records when they treat Medicare patients. So far, they’re not especially sophisticated.

“Electronic health records right now are only collecting about 100 megabytes of data per patient, per year,” says Dale Sanders, senior vice president of strategy at Health Catalyst, an analytics firm. “Most patients, if they knew how poorly informed healthcare was from a data perspective, would be really disappointed.”


Health Catalyst is one of a number of companies — big and small — working to change that, seeing the immense potential to both improve care and save money. US healthcare industry expenditures are approaching $3 trillion annually. The McKinsey Global Institute estimated in 2013 that deploying big data could create $100 billion in value every year across the healthcare industry.


In Pittsburgh, a major hospital system teamed up in March with the city’s biggest universities to advance big-data analytics in healthcare. As part of a consortium, Carnegie Mellon University is working on artificial intelligence that draws on databases of studies and health records.


Andrew Moore, Dean of Carnegie Mellon’s School of Computer Science, imagines a day when his phone gives his doctor a more accurate report on his health than he can himself.

“If he or she asks me, ‘have you been getting out of breath much lately?’ and I say, ‘I don’t think so,’ at that point I would like my cell phone to chime in and say, ‘yes, you have, actually, Andrew,'” he says. “That would be awesome for me and the physician.


Moore expects the systems to be able to trace hospital-borne infections back to a specific piece of equipment or patient. Or, some might make it possible to diagnose a rash with a smartphone photo.

The Pittsburgh Health Alliance plans to spend $10-$20 million a year on its big-data collaboration. Carnegie Mellon joins with the University of Pittsburgh Medical Center and the University of Pittsburgh on the project, and UPMC already takes in info from 200 sources.


And big data has the potential to become big business. In 2013, investors put nearly $200 million into analytics and big-data startups, according to research firm Gartner. There have been similar size investments in digital medical devices and personalized medicine. The government is investing millions in analyzing medical databases, too. That’s not to mention health-tracking research and products from the likes of Apple, Google, and FitBit.


“Hospital systems realize that healthcare is becoming more and more an information technology business,” Moore says.


For all the excitement over big data’s potential for personalized medicine and better public health, it’s not without obstacles and risks. Moore worries about security, knowing that any breach of privacy will threaten public acceptance of the whole industry.


Sanders of Health Catalyst thinks the real promise of big data is improving the basics of healthcare. “We keep attaching big data to these moonshot kinds of expectations,” he says. To Sanders, big data isn’t a revolution. It’s a way to improve the fundamentals of care, like reducing hospital-borne infections.


“Reducing variability in care and reducing over treatment of patients is probably the most important place for any organization in healthcare to start,” he says.


And perhaps the biggest challenge for big data is culture. Doctors and hospitals tend to be understandably cautious and skeptical about adopting new technology, waiting for it to be sufficiently proven safe and effective. But as analytics improve, and the pressure to bring down the cost of healthcare builds, most agree big data will become a big deal in medicine.

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CVS to connect with health systems via Epic

CVS to connect with health systems via Epic | Healthcare and Technology news | Scoop.it

CVS Health has partnered with four health systems nationwide to provide them patient prescription and visit information, securely sharing data through its Epic electronic health record system.

CVS has entered into new clinical affiliations with Sutter Health in California, Millennium Physician Group in Florida, Bryan Health Connect in Nebraska and Mount Kisco Medical Group in New York.

Through the partnerships – which bring the number of clinical collaborations for CVS Health and MinuteClinic to nearly 60 major health systems – these organizations' patients will continue to have access to clinical support, medication counseling, chronic disease monitoring and wellness programs at CVS/pharmacy stores and MinuteClinic, the retail medical clinic of CVS Health, officials say.


These providers will receive data on interventions conducted by CVS pharmacists, with the aim of improving patients' medication adherence for their patients. The affiliation encourages collaboration between the health systems and MinuteClinic providers to improve coordination of care for patients seen at MinuteClinic locations.


Affiliate organizations and MinuteClinic practitioners will also work together on planning strategies around chronic care and wellness, officials say: If more comprehensive care is needed, patients can follow up with their primary care provider and have access to the services at the health care provider as appropriate.


"In this era of health care reform, we are pleased to work with these health care organizations to develop collaborative programs that enhance access to patient care, improve health outcomes and lower healthcare costs in the communities they serve," said CVS Health Chief Medical Officer Troyen A. Brennan, MD, in a press statement.

MinuteClinic, CVS/pharmacy and participating providers will work to streamline and enhance communication through their EHRs, such as the electronic sharing of messages and alerts from CVS/pharmacy to the health care organizations' physicians regarding medication non-adherence issues. MinuteClinic will electronically share patient visit summaries with patients' primary care physician when they are part of an affiliate organization and with the patient's consent.


"By allowing our electronic health records and information systems to communicate and share important information about the patients we collectively serve, we will have a more comprehensive view of our patients, which can aid in health care decision making and help ensure patients adhere to important medications for chronic diseases," said Brennan.

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Doctors, Not Patients, May Be Holding Back mHealth Adoption

Doctors, Not Patients, May Be Holding Back mHealth Adoption | Healthcare and Technology news | Scoop.it

Clearly, mHealth technology has achieved impressive momentum among a certain breed of health-conscious, self-monitoring consumer. Still, aside from wearable health bands, few mHealth technologies or apps have achieved a critical level of adoption.


The reason for this, according to a new survey, may lie in doctors’ attitudes toward these tools. According to the study, by market research firm MedPanel, only 15% of physicians are suggesting wearables or health apps as approaches for growing healthier.


It’s not that the tools themselves aren’t useful. According to a separate study by Research Now summarized by HealthData

Management, 86% of 500 medical professionals said mHealth apps gave them a better understanding of a patient’s medical condition, and 76% said that they felt that apps were helping patients manage chronic illnesses. Also, HDM reported that 46% believed that apps could make patient transitions from hospital to home care simpler.


While doctors could do more to promote the use of mHealth technology — and patients might benefit if they did — the onus is not completely on doctors. MedPanel president Jason LaBonte told HDM that vendors are positioning wearables and apps as “a fad” by seeing them as solely consumer-driven markets. (Not only does this turn doctors off, it also makes it less likely that consumers would think of asking their doctor about mHealth tool usage, I’d submit.)


But doctors aren’t just concerned about mHealth’s image. They also aren’t satisfied with current products, though that would change rapidly if there were a way to integrate mobile health data into EMR platforms directly. Sure, platforms like HealthKit exist, but it seems like doctors want something more immediate and simple.


Doctors also told MedPanel that mHealth devices need to be easier to use and generate data that has greater use in clinical practice.  Moreover, physicians wanted to see these products generate data that could help them meet practice manager and payer requirements, something that few if any of the current roster of mHealth tools can do (to my knowledge).


When it comes to physician awareness of specific products, only a few seem to have stood out from the crowd. MedPanel found that while 82% of doctors surveyed were aware of the Apple Watch, even more were familiar with Fitbit.


Meanwhile, the Microsoft Band scored highest of all wearables for satisfaction with ease of use and generating useful data. Given the fluid state of physicians’ loyalties in this area, Microsoft may not be able to maintain its lead, but it is interesting that it won out this time over usability champ Apple.

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Euris's curator insight, February 20, 4:55 AM
Clearly, mHealth technology has achieved impressive momentum among a certain breed of health-conscious, self-monitoring consumer. Still, aside from wearable health bands, few mHealth technologies or apps have achieved a critical level of adoption.

The reason for this, according to a new survey, may lie in doctors’ attitudes toward these tools. According to the study, by market research firm MedPanel, only 15% of physicians are suggesting wearables or health apps as approaches for growing healthier.
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How hard is it to 'Get My Health Data'?

How hard is it to 'Get My Health Data'? | Healthcare and Technology news | Scoop.it

"We the people want easy, electronic access to our health information."

That's the seemingly simple objective for supporters of Get My Health Data, a new initiative organized by former National Coordinator for Health IT Farzad Mostashari, MD.

Folks like ePatientDave, Regina Holliday, and other patient advocates have spent years fighting for better patient access to health data, but support for the movement has reached new heights, thanks to recently proposed changes to themeaningful use program.

In April, CMS stirred up the patient data access hornets' nest by proposing a modification to the Stage 2 meaningful use requirement that 5 percent of a provider's patient population views, downloads, or transmits their online health information.

Many providers thought the bar was too high because few patients were interested in accessing their health information online. CMS responded to provider concerns by reducing the threshold from 5 percent to one single patient.

The proposal caused a bit of an uproar as patient advocates decried that one patient was not enough. Mostashari quickly called for a "day of action" to show opposition to the proposed changes.

Earlier this month Mostashari expanded on the plans for the renamed "Data Independence Day," scheduled for the fourth of July. Organizers are hoping that the one day event will actually spur a larger movement with consumers demanding access to their health data. The intent is to demonstrate to lawmakers, providers, and other decision makers that people do care about electronic access to their health information.

The Get My Health Data movement is asking consumers to sign a petition demanding convenient, secure online access to their health data. In addition, the organization is looking for patients to serve as "tracers" by requesting access to their records and reporting on the response.

I was curious how my family's doctors would comply with such a request, so I reached out to four of them. Here's how it went:

  • Primary care physician. My family practice is part of a large group that utilizes Epic's MyChart patient portal. I accessed the portal and was able to easily view and download my health summary in a format that was very user-friendly. This is how it the process should work.
  • Specialist #1. My gastroenterologist uses gMed EHR and its gPortal. I accessed the portal and easily pulled up my health summary. While it included basic details on my health history, it lacked a few critical elements, such as diagnostic test results. I had the option to email a copy of my medical summary to anyone I chose, as long as they used a secure email with a Direct protocol address. I was also able to download the summary but it came over as a .XML file that was nearly impossible to decipher. I messaged the practice about getting a more user-friendly version of my records and received a quick reply that they could either mail me a hard copy or I could pick up a copy in person. Unfortunately there was no option for a more complete electronic version. All and all this practice came close to delivering what I needed and they get bonus points for being so responsive.
  • Specialist #2. My daughter's endocrinologist uses the Medfusion portal. Actually, it's probably more accurate to say they have the portal installed but it's obviously underutilized. There is no option for accessing medical histories, though you could request lab results or medication refills, as well as pay bills online. You can send a message, so I sent a note asking for an electronic copy of my daughter's records. I wasn't optimistic I would get a response since I have sent them five messages over the last year, none of which appear to have been opened, much less replied to (I ended up calling.) It's been four days since I requested the records and so far no response. I'm calling this a failure.
  • Specialist #3.  Basically ditto to Specialist #2. Nothing is available online and no one responds to my messages.
     

My takeaways:

  • The technology exists to provide patients with easy online access to their medical data.
  • Some providers are a little behind on the technology curve but making good progress.
  • Shame on providers that implement technology to engage patients and then abandon the project. Patients like me use the online messaging option either because the office is not opened at an hour convenient to me, or because I am avoiding a confusing phone system – which never connects me to a live person.

  • Everyone should take 30 seconds and sign the Get My Health Data petition. We all deserve easier and less frustrating access to our health information.
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Preventing Physician Burnout

Preventing Physician Burnout | Healthcare and Technology news | Scoop.it

In a cross-sectional survey ("Predictors of physician career satisfaction, work-life balance, and burnout," Obstetrics & Gynecology) of randomly selected physicians from across the country just under half of all respondents indicated that they were satisfied with their work-life balance, and half of respondents indicated that they felt some level of emotional "resilience." It turns out that the lack of these two factors plays a significant role in the development of physician burnout; a syndrome that occurs when a person is under constant pressure, and is marked by emotional exhaustion, cynicism, feeling ineffective in one's work, and experiencing interpersonal difficulties. Burnout in physicians, which has been on the rise, has been linked to impaired job performance, poor health, marital difficulties, and alcohol or substance abuse.

The good news is that there are strategies that can be taken to significantly reduce the incidence and negative effects of burnout. Factors that are critical to combating burnout are having control over one's schedulethe number of hours worked, and emotional resilience. Unfortunately, in this current era of healthcare reform, controlling the first two factors can be quite challenging, but not impossible, if one takes a conscious and deliberate approach to managing priorities and time. Many physicians find that they spend a significant amount of time on activities that do not provide enough value — one way to think about this is to determine your "time ROI" (return on investment).


Follow these five steps to significantly improve your work-life imbalance:


1. Identify the five to eight most important aspects of your life (what you value most).

2. Now determine how much time you devote to those areas (and how much time is spent in areas not on your list).

3. If there is a disconnect between what you value and how you spend your time, this is a signal to you to make changes in your life.

4. Plan your time so that you are focused on what you value most.

5. Determine what can be delegated to others.


Preventing burnout also involves developing emotional resilience — the ability to manage stressful situations effectively and prevent stress from building up. For this we turn to some interesting research from the field of neuroscience that explores the link between stress, sleep, and positivity. These three factors have an interdependent relationship with one another — cause a change in one, and the other two are impacted.


So for example, the more stress in your life, the worse your sleep and mood. If you get too little sleep, then you will experience more stress and a lowered mood. In general, it can be difficult to derive meaningful change in the first two factors, sleep and stress, but much easier to have an impact on the latter one — positivity. If you are able to increase positivity, you will experience a significant improvement in sleep and a significant reduction in stress (negative emotional state).


Follow these simple brain-training steps to increase your positivity:


1. Practice positive "self-talk" by cultivating self-encouragement optimism, recognizing accomplishments, and appreciating good fortune.

2. Challenge your negative (typically distorted) thinking, the most common of which are:


• Catastrophic thinking. Identify a more realistic assessment of the situation. Usually, things are not as bad as we think they are. And often, our greatest learning comes from adversity.

• Black and white thinking. Challenge all-or-nothing thinking. Usually there is some gray area to work with. It is very seldom absolute.

• Jumping to conclusions. Avoid leaping to a foregone conclusion, such as thinking you know what others must be thinking. Learn to get curious, ask questions, and look for alternative explanations.

• Over generalizing. Look for a more accurate appraisal of the situation. When we look more closely at situations, we often find that negative or stressful outcomes are limited to that event, not generalizable across all situations.

• Excessive criticism. Whenever you hear yourself thinking, "should," substitute "it would be nice." This allows you to avoid excessive self-criticism or the belief that there is only one solution.

Changing thinking leads to changes in behaviors which leads to changes in results. So the easiest and most efficient method to change the results you are getting is to engage in positive and constructive thought patterns. As you transform your thoughts, you actually create an alteration in the neural connections in your brain. This in turn, leads to the development of new habits, ensuring that the changes you create are lasting ones.

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Dan Diamond, MD's curator insight, June 12, 2015 2:16 PM

I also suggest that people have a team of at least 10 people that will encourage and challenge them. If you team is too small, it is easy to burn them out. Write the name of your ten on paper and post it on the back of your medicine cabinet. Reconnect, stay connected. 

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Health IT Certification Policies Affect Healthcare Reforms

Health IT Certification Policies Affect Healthcare Reforms | Healthcare and Technology news | Scoop.it

Over the last five years, healthcare providers have had to pay greater attention to policy changes,meaningful use requirements, and ongoing ICD-1o transition delays as the nation worked toward reforming the medical sector to greater benefit patients and everyday citizens. Specifically, EHR implementation has been a great focus of the healthcare industry. Health IT vendors as well as federal agencies have focused on developing certified EHR technology through the Health IT Certification Program.


The Department of Health and Human Services (HHS) has recently issued a document detailing the submittal of test procedures and data under the Health IT Certification Program established by the Office of the National Coordinator for Health IT (ONC).


In early 2011, HHS established a certification program for health IT systems and EHR technology. In September of 2012, the program was renamed the “ONC HIT Certification Program.” At this point in time, HHS proposes to change the name of the program once again to the “ONC Health IT Certification Program.”


Over the last several years as the program operated, health IT designers have proposed that “testing efficiencies” could be garnered if the ONC Health IT Certification Program took advantage of operational testing including e-prescribing network testing.


“The National Coordinator is open to approving test procedures, test tools, and test data that meet the outlined approval requirements above for an applicable adopted certification criterion or criteria,” the HHS document proposal stated. “By way of this document, we strongly encourage persons or entities to submit such test procedures, test tools, and test data to ONC if they believe such procedures, tools, and data could be used to meet ONC’s certification criteria and testing approval requirements. We also note that there is no programmatic prohibition on the approval of multiple test procedures, test tools, and test data for a certification criterion or criteria.”


Along with the health IT certification program, some other new proposed guidelines on healthcare reform include the modified Stage 2 Meaningful Use requirements. As providers began moving toward attesting to Stage 2 Meaningful Use regulations, federal agencies began to see certain missteps with the requirements, which led them to modify the rulings.


Currently, the Centers for Medicare & Medicaid Services (CMS) has announced that public comments to the proposed Stage 2 Meaningful Use modifications are due by June 15, 2015. The proposed ruling changes certain requirements between the years 2015 to 2017 for those eligible professionals attesting to meaningful use under the Medicare and Medicaid EHR Incentive Programs.


Public comments can be submitted to CMS electronically, by courier, and by regular or express mail. Anyone interested in more information about the proposed ruling are encouraged to read themodifications to Stage 2 Meaningful Use requirements and view a factsheet on the CMS website.


As the healthcare industry continues toward a path of reform, federal agencies will likely continue developing new regulations and policies that will aim toward improving the quality of patient care, boosting health outcomes, and reducing medical spending.

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Healthcare data security is like a box of chocolates

Healthcare data security is like a box of chocolates | Healthcare and Technology news | Scoop.it

The Fifth Annual Benchmark Study on Privacy & Security of Healthcare Data by Ponemon Institute had more surprises than Forrest Gump’s box of chocolates – surprises that were far from palatable. One key finding was that criminal attacks are up 125 percent and are now the leading cause of healthcare data breaches. Other results of the study were just as unsettling:


Surprise 1: Sixty-five percent of healthcare organizations do not offer any protection services for patients whose information has been lost or stolen. With cyber threats on healthcare data mounting, this is unacceptable. Ironically, the Ponemon study also found that 65 percent of healthcare organizations—the same percentage that don’t offer protection services—believe patients whose records have been lost or stolen are more likely to become victims of medical identity theft.


According to the Ponemon Medical Identity Fraud Alliance study, 2014 Fifth Annual Study on Medical Identity Theft, medical identity theft nearly doubled in five years, from 1.4 million adult victims to over 2.3 million in 2014. Many medical identity theft victims report they have spent an average of almost $13,500 to restore their credit, reimburse their healthcare provider for fraudulent claims and correct inaccuracies in their health records. Healthcare organizations and business associates must make available medical identity monitoring and identity restoration services to patients whose healthcare records have been exposed.


On the other hand, the majority of people still don’t understand the serious risk of medical identity theft. They pay more attention to their credit score and financial information than they do their insurance EOBs or medical records. They don’t understand that while a credit card can be quickly and easily replaced, their medical identity can take years to be restored. When their records become polluted, patients can be misdiagnosed, mistreated, denied much needed medical services, or billed for services not rendered. Medical identity theft can literally kill you, as ID Experts CEO Bob Gregg has said.


Surprise 2: The average cost of a healthcare data breach has stayed fairly consistent over the past five years – $2.1 million. This is in contrast to the average total cost of data breach in general, which has risen 23 percent over the past two years to $3.79 million, according to another recent Ponemon report, 2015 Cost of Data Breach Study: Global Analysis. Cyber liability insurance to cover notification costs, better options for identity monitoring, and more privacy attorneys offering help should reduce the cost of healthcare data breaches over time.


Healthcare organizations can take proactive steps to reduce the likelihood and impact of a data breach. This means addressing the tactical issues of protecting patient data. According to Dr. Larry Ponemon, founder and chairman of Ponemon Institute, healthcare organizations face “the dual challenge of reducing both the insider risk and the malicious outsider. Both require different approaches that can tax even the most robust IT security budget.” 


According to the Ponemon report, 96 percent of healthcare organizations had a security incident involving lost or stolen devices, and employee negligence is the greatest concern among these organizations. Dr. Ponemon says healthcare providers should create “a more aggressive training and education awareness program, as well as invest in technologies that can safeguard patient data on mobile devices and prevent the exfiltration of sensitive information.”

These training and awareness programs should center around protecting PHI, especially education on how to avoid phishing emails and what to do to ensure data is not disclosed. Healthcare organizations must also collaborate with their business associates to also ensure they have similar programs in place. 


For external risks such as the growing number of criminal attacks, Dr. Ponemon says that healthcare providers must “assess what sensitive data needs to be monitored and protected, and the location of this data.” I would add that board and executive management must recognize that professional hackers are targeting health data and records and, as mentioned earlier, that such attacks are now the leading cause of data breaches in healthcare. This awareness should spur enterprise-wide alignment in addressing cyber threats.


Surprise 3: Too many healthcare organizations take an ad-hoc approach to incident risk assessment. Only 50 percent of healthcare organizations in the study performed the four-factor risk assessment following each security incident, as required by the HIPAA Final RuleOf that 50 percent, 34 percent used an ad hoc risk assessment process, and 27 percent used a manual process or tool that was developed internally.


This practice is not acceptable. Healthcare organizations now have software tools available to help automate and streamline processes such as risk assessment and data breach response. By supporting consistent and objective analysis of security incidents, providing a central repository for all incident information, and streamlining the documentation and reporting process, these tools can improve outcomes and free an organization’s privacy and security staff to spend more time on prevention.


So far, 2015 has been a bad year for protecting patients and their data. Increasing cyber attacks mean that even more patients and their data will be put in harm’s way. While nobody can escape the inevitable security incidents, it is my hope that we can all learn lessons from the Ponemon study and each other, and work more collectively so that next year will bring fewer unpleasant surprises and many more happy ones.

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Better Choices Needed to Manage US Healthcare Cost Growth 

Better Choices Needed to Manage US Healthcare Cost Growth  | Healthcare and Technology news | Scoop.it

LAS VEGAS – In a fireside chat at the HX360 conference, Nobel Prize-winning economist Paul Krugman said there are reasons for optimism even as the U.S. healthcare system faces serious financial challenges. 

 

In a fireside chat with HIMSS CEO Hal Wolf, Krugman said the demographic challenge is serious, “but not as serious as one would think.”

 

He said that healthcare has been absorbing about 18 percent of GDP since 2010 but that there has been a flattening of the cost curve. He believes that healthcare’s share of GDP should remain constant for at least a few years.

 

Wolf said that he has concerns that as baby boomers live longer and the financial burden of treating disease kicks up, the population takes on more costs.

 

Though the U.S. still has the highest healthcare costs in the world, there are a few options that could be used to dig out of that -- any of which would be better than the current state, said Krugman, which he described with a quote from Homer Simpson: “The U.S. government is an insurance company with an army.” 

 

To Krugman, “Medicaid looks more like the systems in other countries and is a well-established system. But if the goal was the cheapest care, we’d do something like the NHS -- but I don’t see that happening in my lifetime.”

 

While a single-payer system is expensive, costs can be mitigated by a system that would more carefully scrutinize unnecessary elective treatments.

 

The Veterans Health Administration, which has been working to improve its system since the 1980s, presents a good model for how to overhaul healthcare, said Krugman. They were pioneers, the first to implement EHRs and shifted a lot of their care from hospitals to health centers. It was a precursor to the private sector.

“We have the capacity, but it would require that you have capable leadership,” said Krugman.

 

Krugman also explained that healthcare costs aren’t necessarily in a crisis, “but it still needs improvement.” And that means everyone is going to have to find a solution to limit costs.

“It’s not that the whole structure of healthcare is unsustainable. But it has the historical pattern of ever-rising costs that cannot continue,” he said.

 

Reflecting on the Dot-com bust and the real estate crisis, Krugman said we were able to dig out of those situations, “but right now, we’re still reeling from what feels like a permanent hangover from the last crisis. And it’s not at all clear that we resolved the issues that brought us there in the first place.”

 

Though the country has low interest rates, the private sector debt is still high, said Krugman. But he’s less worried about that,than the fact that “when these crises hit, no one sees it coming.” We’re all set up to do it again one of these days.”

 

Adding to the worry is America’s deficit. “When the next crisis comes along, it’s going to increase debt,” he said.

Krugman called the latest tax cuts passed by Congress a really bad policy that could make things much worse if a trade war breaks out. What’s worse is that the tax cuts were “not designed for anything really. There were a bunch of people that wanted a tax cut, and they were obliged to that.”

 

That might make our current situation worse when combined with the trade wars. Calling it a “really bad policy,” he did specify that it doesn’t necessarily mean “tremendous risk.” It does mean, however, Krugman said he checks Twitter “every 40 minutes to see if the trade war has broken out.”

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4 Healthcare Software Trends to Watch in 2018 

4 Healthcare Software Trends to Watch in 2018  | Healthcare and Technology news | Scoop.it

Healthcare has always been an industry where innovative technologies transform the way services are delivered and received. It’s also one of those sectors that can be affected by slow movement in innovation, due to the complication of its formalities, tasks, processes and regulations.

 

The good news is that the industry’s innovative side has finally taken off in the last few years, and software is playing a major role in reshaping the healthcare sector.

 

What does that mean for you, the medical professional: dentist, doctor, ER practitioner, risk manager, nurse, etc? It means that both your practice and your patients’ experiences will improve over the course of the next decade with the help of some amazing new technology.

 
In terms of software, the following four healthcare software trends are most likely to impact the healthcare industry in the next few years:

1. Multi-Speciality & Niche Specialty EHR Software

A multi-specialty EHR for software has several benefits for specialty practices spanning to multiple domains. It ensures improved compatibility and prevents a patchwork approach to integrating a separate EHR system for every specialty. This can help bring down the added time and expense of interconnecting different groups of specialists. Healthcare organizations can find the investment costs, financial health and reputation of differentEHR software on software evaluation sites, and make a sound IT software decision based on their needs.

2. Patient Portals & Self-Service Software

With patients rapidly becoming active players in their own healthcare treatment, portal software is on its way to becoming mainstream. It enables patients and physicians to interact online and access their medical records. In addition, portal software can be an extraordinary ally for the patients who use it, helping them catch errors and becoming an active participant in ongoing treatments.

Patient Kiosk software is another interesting development. It can help patients with checking identification, registering with clinics, paying copays and signing official paperwork. However, institutions have to be careful when using it to ensure that human-to-human communication isn’t entirely eliminated.

3. Blockchain Solutions

Healthcare professionals and technologists across the globe see blockchain tech as a means to streamline and secure the sharing of medical records, giving patients greater control over their information and protecting sensitive details from hackers. In order to achieve these goals, custom-built healthcare blockchains are needed. Startups like Patientory, Burst IQ, Hashed Health, doc.ai and others are gearing up to introduce blockchain tech to the EHR software industry, providing a way to store health records. When required, professionals can request to see their patients’ data from the blockchain.

4. Consumer-Grade UX in Enterprise Software

For almost a decade, physicians at the front line of enterprise healthcare delivery struggled with software that’s difficult to use, confusing and downright frustrating. The biggest culprit of poor UX is linked to the purchasing process of the enterprise.

 

Oftentimes, vendors create software for buyers who aren’t end users. If the buyers and end users have the same personas, healthcare software vendors can deliver the same user experience as seen in other B2B industries.

 

Regardless, in 2018, expect more consumer-grade user experiences and buyer-value products. Additionally, enterprise healthcare management will bank on analytics and machine learning to improve visibility into healthcare efficiency for personnel and employers. This will reveal usage patterns and reduce inappropriate and unnecessary care.

 

From detecting fraud to slashing healthcare spending, advanced healthcare software could very well be the silver bullet that eliminates all kinds of healthcare inefficiencies.

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Barbara Lond's curator insight, January 28, 10:37 AM
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The digital hospital: Streamlining workflow to improve care

The digital hospital: Streamlining workflow to improve care | Healthcare and Technology news | Scoop.it

Hospitals are complex ecosystems with hundreds of clinical and business processes. In this guest post, Brendan Ziolo, head of large enterprise strategy at an IP networking, ultra-broadband access and cloud technology company, gives hospital executives a glimpse at how digitization and automation of processes are key to streamlining workflows to enable providers to spend less time on non-care related tasks and more time on patients.

 

Patient care teams handle multiple patients and care management tasks. The result is a multifaceted web of workflows that can be prone to decision bottlenecks or missed/delayed tasks that can impact patient safety and care quality.

If properly integrated and automated, these processes have the potential to seamlessly unite patients, doctors, staff, assets and information throughout the hospital.

Digital strategy

But, it’s not just about adopting new technology; hospitals must have a clear digital strategy across their entire organization and IT infrastructure. To become a digital hospital, processes must be streamlined and reengineered to create paperless automated digital workflows.

Many functions within hospitals are already on their way to becoming digital. For example, electronic health records (EHRs) are being widely implemented to help track patient health data and support medical decisions. Digital medical imaging systems are quickening the process of reviewing medical images by physicians and other healthcare professionals.

Hospitals are extending workflow through mobile health (mHealth) initiatives, which enable physicians and patients to use mobile devices such as smartphones and tablets to record and find the right information and resources anytime from any location. In fact, according to the 2014 HIMSS Analytics Mobile Devices Study, more than half of U.S. hospitals are using smartphones and/or tablets and 69% of clinicians are using both a desktop/laptop and a smartphone/tablet to access information.

In addition, hospitals are eliminating distance barriers with telemedicine through the use of network and communication technologies to provide broader access to standard or specialized care, regardless of location. Other functions and processes that are being digitized and automated include delivery robots that can handle a number of fetch-and-deliver tasks, and real-time location systems (RTLS) are used to locate equipment, patients and staff.

Duplication of processes

Progress is being made, yet most digital information and processes in hospitals reside in disparate systems or devices that must be interconnected and integrated to truly improve workflow and quality care. Duplication of information and processes must be avoided to eliminate unintended consequences.

Often you can find staff doing double data entry or pulling information from different systems, and jumping through hoops to pull together the knowledge required for the best patient care. There are many tasks throughout the hospital that staff spend time on every day just to get their jobs done. The goal in a digital hospital is to automate as many of these tasks as possible to improve staff efficiency, information accuracy and overall cost savings.

By standardizing procedures and breaking down processes into their component parts, digitizing, connecting and analyzing them, hospitals can realize unprecedented efficiency. Once processes are well understood, technology solutions can be leveraged to streamline these processes and integrate disparate elements. Essential to this integration is the information and communications technology (ICT) infrastructure that interconnects all aspects of care delivery and hospital administration.

The big picture

The use of mobile, cloud and new communication technologies can create a platform that can capture data from disparate sources, such as EHRs, wearables, clinical information systems, mobile devices and more.

Pull it all together and a caregiver is given a holistic and real-time view of a patient’s health on any device that is accessible to the patient, or other specialists as needed, for the best ongoing care.

This is just one view of how a digital workflow could look and the impact it might have on both the patient and provider. But it’s clear that the only way healthcare providers can meet the growing expectations of the healthcare consumer is with a streamlined, digital workflow that not only improves care but still meets critical compliance and security regulations.

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Barbara Lond's curator insight, December 22, 2017 3:42 PM
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CMS Finalizes 2016 Medicare Payment Rules for Physicians, Hospitals & Other Providers

CMS Finalizes 2016 Medicare Payment Rules for Physicians, Hospitals & Other Providers | Healthcare and Technology news | Scoop.it

The Centers for Medicare & Medicaid Services (CMS) issued final rules this week detailing how the agency will pay for services provided to beneficiaries in Medicare by physicians and other health care professionals in 2016 that reflects the administration’s commitment to quality, value, and patient-centered care. Payment rules for the 2016 calendar year for End-Stage Renal Disease Prospective Payment System, the Hospital Outpatient Prospective Payment System, Home Health Prospective Payment System, and the Physician Fee Schedule were all finalized this week.


“CMS is pleased to implement the first fee schedule since Congress acted to improve patient access by protecting physician payments from annual cuts. These rules continue to advance value-based purchasing and promote program integrity, making Medicare better for consumers, providers, and taxpayers,” said CMS Acting Administrator Andy Slavitt. “We received a large number of comments supporting our proposal to allow physicians to bill for advanced care planning conversations and we are finalizing this rule accordingly.”

Key policies finalized in the 2016 payment rules include:

  • Finalizing the Home Health Value-Based Purchasing model. This model, authorized under the Affordable Care Act, is designed to improve health outcomes and value by tying home health payments to quality performance. All Medicare-certified home health agencies that provide services in Massachusetts, Maryland, North Carolina, Florida, Washington, Arizona, Iowa, Nebraska, and Tennessee will participate in this model starting January 1, 2016. Compared to the proposed rule, the maximum payment adjustment in the first year of the model was reduced from 5 percent to 3 percent. This was part of the Home Health Prospective Payment System final rule.


  • Finalizing updates to the “Two-Midnight” rule. The rule clarifies when inpatient admissions are appropriate for payment under Medicare Part A. This continues CMS’ long-standing emphasis on the importance of a physician’s medical judgment in meeting the needs of Medicare beneficiaries by providing clearer guidelines and a more collaborative approach to education and enforcement. This was part of the Hospital Outpatient Prospective Payment System final rule.
  • Finalizing the End-Stage Renal Disease Quality Incentive Program. The End-Stage Renal Disease final rule will apply payment incentives to dialysis facilities to improve the quality of dialysis care. Facilities that do not achieve a minimum total performance score with respect to quality measures, such as anemia management, patient experience, infections, and safety, will receive a reduction in their payment rates. 
  • Beginning the new physician payment system post the Sustainable Growth Rate (SGR) formula and supporting patient- and family-centered care. This is the first final Physician Fee Schedule final rule since the repeal of the SGR formula by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Through the final rule, CMS is beginning implementation of the new payment system for physicians and other practitioners, the Merit-Based Incentive Payment System, required by the legislation.
  • Finalizing provision to empower patients and their families regarding advance care planning. Consistent with recommendations from a wide range of stakeholders and bipartisan members of Congress, CMS is finalizing its proposal that supports patient- and family-centered care for seniors and other Medicare beneficiaries by enabling them to discuss advance care planning with their providers.
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Hospitals press HHS on meaningful use

Hospitals press HHS on meaningful use | Healthcare and Technology news | Scoop.it

Their patience wearing thin, a group of leading hospital organizations have implored Health and Human Services Secretary Sylvia Mathews Burwell to publish pending meaningful use modifications sooner rather than later.

In a letter this past week that CC'd Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt, eight hospital groups urged CMS "to release, in the immediate future," final rule modifications to meaningful use for fiscal years 2015 to 2017.

"The rule is past due, given that it will affect the current program year for meaningful use," according to the letter, co-signed by America's Essential Hospitals, American Hospital Association, Association of American Medical Colleges, Catholic Health Association of the United States, Children's Hospital Association, Federation of American Hospitals,Premier healthcare alliance and VHA Inc.

"Indeed, under current rules, meaningful use applies to fiscal year performance for hospitals. FY 2015 ends on Sept. 30 – fewer than 60 days from now," they write.


CMS recently floated a proposal to shift meaningful use reporting to the calendar year. Even then, however, "the last possible reporting period would begin on Oct. 3," according to the letter.


"Even if reporting is moved to a calendar year, hospitals need the certainty of a final rule now to determine the best reporting period to choose and begin the process of reviewing performance and ensuring they have met all of the revised requirements."


While recent proposed changes to MU, such as a 90-day reporting period for FY 2015 and simplified patient electronic access requirements are appreciated, the hospitals want CMS to quickly "finalize those changes as proposed."


They object to other proposals, however – mandating the e-prescribing of discharge medications, requiring new public health reporting measures – that "would make meeting Stage 2 more difficult."


Not to mention the fact that "given the delay in the release of a final rule, they would be virtually impossible for hospitals to accommodate."

Without quick action from the feds, hospitals "simply will not have sufficient time to understand the new requirements, work with their vendors to purchase and implement new or revised technology that would accommodate them, and invest in the training and work flow changes necessary to meet the new requirements," according to the letter.

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Epic at work on new tech to avert falls

Epic at work on new tech to avert falls | Healthcare and Technology news | Scoop.it

Healthcare IT giant Epic is working on a clinical decision tool aimed at helping healthcare providers reduce the risk of falls in unsteady patients. The technology is expected to be ready and available to Epic's EHRclients by year's end.


Longtime Epic customer Kaiser Permanente will roll out the tool at its facilities across the country and will also make its evidence-based falls prevention program widely available to other health systems and health plans.

The technology is called STEADI, an acronym for Stopping Elderly Accidents, Deaths & Injuries. The tool is being designed based on CDC's guidelines for falls assessment. The goal is to make it easier for healthcare providers to screen for falls, intervene to reduce risk and provide follow-up care.


The announcement came at the end of a White House Fact Sheet released this morning regarding The White House Conference on Aging, which President Barack Obama is hosting today.


The sweeping conference agenda focuses on issues facing Americans as they plan for retirement. Many of the measures proposed build on the Affordable Care Act and on efforts to improve Medicare and Medicaid.


"In a year that marks the 50th anniversary of Medicare, Medicaid and the Older Americans Act, as well as the 80th anniversary of Social Security, the White House Conference on Aging is an opportunity to recognize the importance of these programs, highlight new actions to support Americans as we age and focus on the powerful role that technology can play in the lives of older Americans in the decade ahead," the White House announced.

Federal data to be released

The Administration announced that by September 2015, federal data sets relevant to aging and to elderly Americans would be made easily available on Data.gov, the repository for the U.S. government's open data. This resource will continuously be updated with datasets on aging, much like it is for other important Administration priorities such as climate, public safety and education. 

Health IT efforts

Like Epic's several of the planned initiatives surrounding the aging initiative have healthcare IT underpinnings. These are put forward by the private sector:


  • As part of its annual HackFest, LeadingAge, an association of 6,000 not-for-profit organizations and businesses representing a broad field of aging services, will partner with Hewlett-Packard using HP's 3D immersive computing platform and Federal open data to challenge innovators to create technology-driven tools to improve the lives of older adults and their families.
  • The employer coalition ReACT (Respect a Caregiver's Time), Care.com and the Massachusetts Institute of Technology are joining forces to generate the tools employers need to effectively support employees who are caregivers. MIT and Care.com will jointly conduct a case study based on MIT's approach to employer-supported elder care. 
  • Uber is announcing pilot programs in Florida, Texas, Ohio, Arizona and California that will partner with senior community centers and other advocates to provide free technology tutorials and free or discounted rides to older Americans to increase access to transportation options and support mobility and independence.
  • Airbnb has conducted research to support and understand the experience of older Americans in their travels and in their use of technology and is partnering with communities to enhance accessibility and the user experience for older populations. 
  • Walgreens has made advancements in its digital technologies to connect individuals with its telehealth services provider, which offers 24/7 access to U.S. board-certified doctors.  Seniors also can track their health behavior with personal wellness smartphone technologies from Walgreens and WebMD.
  • Peapod has adopted "best in class" Web accessibility standards to ensure that all individuals, including those with disabilities and those who are unable to shop at traditional stores, can use its website and mobile applications. 
  • Honor, a tech-enabled company that matches seniors with care professionals, will offer $1 million in free home care across 10 cities in the country and work with established care providing organizations in those communities to ensure this care goes to helping older Americans. 
  • The University of Washington's School of Nursing and the HEALTH-E (Home-based Environmental Assisted Living Technologies for Healthy Elders) initiative are introducing an Aging and Technology Laboratory, which includes hardware and software tools to support participatory design of technology for older adults.  The laboratory will allow scientists, engineers, and others to engage older adults and their families to accelerate the generation of new solutions to support aging.
  • The Stanford Center on Longevity will develop a State of Longevity Index to be released in early 2016 that will measure how well the U.S. is doing to improve the prospects for long-term well-being in financial security, physical health, social connectedness, educational attainment, and age-friendly communities. 
  • IDEO is announcing the launch of "The Powerful Now," a project to build a cross-sector collaboration around positive aging for all.


Among the planned government initiatives are.


  • Facilitating state efforts to provide workplace-based retirement saving opportunities: About a third of the workforce lacks access to a workplace retirement plan, the White House notes. That's why, in every budget since taking office, the President has put forth proposals to provide access for 30 million Americans to workplace-based retirement savings by requiring employers not currently offering a retirement plan to automatically enroll their workers in an IRA.  But in the absence of Congressional action, the states are leading the charge.
  • Launching Aging.gov – today: The intent is to provide older Americans, their families, friends and other caregivers, a one-stop resource for government-wide information on helping older adults live independent and fulfilling lives.
  • Modernizing federal rules that affect long-term care, healthy aging and elder justice: Steps announced today include: a new Centers for Medicare and Medicaid Services proposed rule to update, for the first time in nearly 25 years, the quality and safety requirements for more than 15,000 nursing homes and skilled nursing facilities to improve quality of life, enhance person-centered care and services for residents in nursing homes, improve resident safety, and bring these regulatory requirements into closer alignment with current professional standards.
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How New Prices and Payments are Changing the Way We'll Receive Healthcare under the Affordable Care Act

How New Prices and Payments are Changing the Way We'll Receive Healthcare under the Affordable Care Act | Healthcare and Technology news | Scoop.it

In the wake of the recent King v. Burwell Supreme Court decision to uphold subsidies for the 34 state health insurance exchanges under the Affordable Care Act, it's worth understanding why losing them would've made insurance for nearly 6.4 million Americans unaffordable. It boils down to two numbers: the cost of delivering care and the rate that hospitals are paid to do so.


Most physicians are currently paid under a 'fee-for-service' model, a flat sum for each individual test or procedure provided to a patient. It's no surprise then that the number of prescribed tests has skyrocketed over the past two decades as hospitals attempt to increase revenue. For any given condition, the United States both orders and spends more on unnecessary screens and treatments than any other country on Earth, often with no better outcome for the patient. An MRI in the United States costs five times as much as the same MRI in France.

Most countries negotiate with healthcare providers to set rates at acceptance levels. Prices are either directly set by the government or are negotiated upon by providers and insurers prior to delivering care. In both instances, the price of healthcare is generally much lower than that of the United States, where, outside of public programs like Medicaid and Medicare, providers can usually charge whatever they can get away with to make up for the high costs of pharmaceuticals and medical devices. Furthermore, the amount paid for a given service is identical regardless of whether the outcome is good or bad. Imagine going to a restaurant and paying the same amount for a meal that left you satisfied and another--that you likely didn't order but were given anyways--that gave you food poisoning. That's how fee-for-service works.


The lack of accountability on the quality of care compounded with a healthcare financing model that rewards hospitals for increasing volume, not value, was a recipe for disaster, causing healthcare spending to jump to nearly 20% of GDP, but left the rate of increase in life expectancy in the dust compared to Europe and Japan.


The U.S. first tried to address rising healthcare costs in the 1990s through a model known as 'global capitation'. Providers were paid a single pre-defined sum to cover all treatment for each patient. If a physician or healthcare organization delivered care to a patient at a cost less than the sum it received, it turned a profit. If it overshot the sum, it lost money. While this model rewarded physicians for spending less, it did nothing to reward physicians for improving outcomes. As a result, physicians had a financial incentive to avoid expensive treatment plans and costly patients, resulting in poor quality care.


In 2012, as an extension of the Affordable Care Act, the Obama Administration launched the Pioneer Accountable Care Organization (ACO), a 'global payments' model that rewards hospitals that deliver quality care at costs lower than a pre-defined benchmark and punishes hospitals that overspend. If hospitals in the program spend below expected costs, they keep 70% of the savings; the other 30% goes to the federal government. If they spend more than expected, they pay the federal government the difference.


Some policymakers and physicians worry that the Affordable Care Act's global, or bundled, payments model is simply disguised capitation. Although bundled payments have a cost control structure similar to global capitation, they have been flexibly designed to avoid its pitfalls by rewarding value-based patient care. Physicians are paid for each patient based on how much treatment would cost for a given clinically defined episode of care. This risk adjustment allows for variability in global payments based on the illness burden of a provider's patient population. Additionally, unlike capitation, providers are directly rewarded for improving patient outcomes, incentivizing consistently-measured, high-quality care. Some global payment models do not involve any punishments for overspending, as opposed to the Pioneer ACO, but continue to reward strong physician performance.


Over the last two years, the Pioneer ACO program has saved $384 million in healthcare costs. In combination with the Medicare Shared Savings Program (MSSP), another global payments initiative, it has contracted with 154 organizations in forty states. All hospitals involved showed improved performance quality measures, readmission rates, and cholesterol level monitoring. Furthermore, patients gave similar rates of satisfaction compared to previous models of care and even reported better access to physicians. The end result is higher quality care at a lower cost for patients.


While Pioneer is illustrative of a step towards progress in managing healthcare costs, it hasn't been perfect. Most 2012 Pioneer participants were large, sophisticated hospital networks with the capability to rapidly change their method of delivering care, very different from the public hospitals that serve the populations that need health reform the most. Of the 32 hospitals that registered for Pioneer in 2012, 13 dropped out and 14 failed to produce any substantial savings. However, most dropout hospital networks still plan to pursue less-aggressive value-based payment models, such as MSSP, and found their experience with Pioneer to be an effective transition for both patients and providers to the global payments model. Additionally, the practice of measuring and collecting data on physician performance and patient outcomes will give both the federal government and providers a more transparent understanding of what treatments work, providing evidence-based information to set prices based on the value of individual treatments. If there's any one change that will reduce U.S. healthcare costs in the long term, it's lowering prices.

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CVS Health Announces New Clinical Affiliations with Four Leading Health Care Organizations

CVS Health Announces New Clinical Affiliations with Four Leading Health Care Organizations | Healthcare and Technology news | Scoop.it

CVS Health (NYSE: CVS) announced today it has entered into new clinical affiliations with Sutter Health in California, Millennium Physician Group in Florida, Bryan Health Connect in Nebraska and Mount Kisco Medical Group, PC in New York. These affiliations will help enhance access to high-quality, affordable health care services for patients.

Through these clinical affiliations, CVS Health will provide prescription and visit information to the participating health care organizations by enabling communication between our secured electronic health record (EHR) systems, which will help enhance clinical care for patients served by the partnering organizations. In addition, patients will continue to have access to clinical support, medication counseling, chronic disease monitoring and wellness programs at CVS/pharmacy stores and MinuteClinic, the retail medical clinic of CVS Health.

"In this era of health care reform, we are pleased to work with these health care organizations to develop collaborative programs that enhance access to patient care, improve health outcomes and lower health care costs in the communities they serve," said Troyen A. Brennan, MD, Chief Medical Officer, CVS Health. "By allowing our electronic health records and information systems to communicate and share important information about the patients we collectively serve, we will have a more comprehensive view of our patients, which can aid in health care decision making and help ensure patients adhere to important medications for chronic diseases."

CVS/pharmacy currently has more than 7,800 retail pharmacy locations across the U.S. where CVS pharmacists provide counseling to patients to help them be adherent to their chronic disease medications. In addition, MinuteClinic also plays an important role by providing patients with timely, affordable and high-quality walk-in health care. There are nearly 1,000 MinuteClinic walk-in medical clinics available at CVS/pharmacy retail stores. MinuteClinic locations are open seven days a week, offering evening hours with no appointment necessary and most health insurance is accepted. The clinics are staffed by nurse practitioners and physician assistants who provide treatment for common family illnesses and administer wellness and prevention services, including health-condition monitoring for patients with chronic diseases. 

Affiliates' health care providers will receive data on interventions conducted by CVS pharmacists to improve medication adherence for their patients. The affiliation also encourages collaboration between the health care providers and MinuteClinic providers to improve coordination of care for patients seen at MinuteClinic locations.

Through this collaboration, the affiliate organizations and MinuteClinic practitioners will also work together on planning strategies around chronic care and wellness. If more comprehensive care is needed, patients can follow up with their primary care provider and have access to the services at the health care provider as appropriate. For those patients who do not have regular access to health care, MinuteClinic provides information to help patients in finding a primary care physician and a greater opportunity for continuity of health care services.

MinuteClinic, CVS/pharmacy and the participating health care organizations will begin to work toward streamlining and enhancing communication through their EHR systems. This will include the electronic sharing of messages and alerts from CVS/pharmacy to the health care organizations' physicians regarding medication non-adherence issues. In addition, MinuteClinic will electronically share patient visit summaries with the patient's primary care physician when they are part of an affiliate organization and with the patient's consent. MinuteClinic will continue its standard practice of sending patient visit summaries to primary care providers who are not affiliated with one of these participating health care organizations via fax or mail, with patient consent.

The new affiliations announced here bring the total number of clinical collaborations for CVS Health and MinuteClinic to nearly 60 major health systems and health care providers across the country.

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Nebraska Medicine and Epic ahead of their time with a new patient engagement app for the Apple Watch

Nebraska Medicine and Epic ahead of their time with a new patient engagement app for the Apple Watch | Healthcare and Technology news | Scoop.it

Apple has always been about innovation. The same can be said for Epic, the Verona, Wisconsin-based healthcare software company whose customers manage medical records for more than half the U.S. population, including patients at Nebraska Medicine. Now, Epic and Nebraska Medicine announce one of the first efforts to improve the patient experience using Apple’s first wearable device.


“We’re always looking for ways to improve the satisfaction of our patients,” said Michael Ash, M.D., chief transformation officer at Nebraska Medicine. “We recognize that as more of our patients use devices like the Apple Watch, we not only have to be able to use that technology to initially provide convenience for them, but we also have to envision how we can also improve patient outcomes via use of the device in the future.”


Epic’s MyChart app for Apple Watch, available now on the App Store, lets patients view messages from their care providers, upcoming appointment details, and information on their active medications. They can also see notices when new test results, billing statements and health maintenance reminders are accessible on their iPhones.


“It’s great to see Nebraska Medicine help lead the way on patient engagement with the Apple Watch,” says Sumit Rana, Epic’s senior vice president for research and development. “Wearables such as the Apple Watch have great potential to empower patients as active participants in their own healthcare and wellness while improving the overall care experience.”


Epic has development in the works based on the Apple Watch’s ability to “tap” wearers on the wrist to get their attention. Diabetic patients will be able to get reminders to test their blood sugar regularly, for example. Care organizations will also be able to use the watch to help patients get quicker access to high-demand specialty visits and services. Epic’s Fast Pass On the Go feature would allow a patient with an appointment three weeks out to get an Apple Watch alert if an earlier slot opens up – when another patient cancels an appointment, for example – and accept the new appointment time from the watch.


An Apple Watch app is also available for physicians who use Epic’s Haiku mobile application for the iPhone. Doctors can view their schedule, hospitalized patients and clinical summaries. They can also use Siri’s speech-to-text functionality to record a clinical note or a MyChart message to send to a patient.

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Health IT Certification Policies Affect Healthcare Reforms

Health IT Certification Policies Affect Healthcare Reforms | Healthcare and Technology news | Scoop.it

Over the last five years, healthcare providers have had to pay greater attention to policy changes, meaningful use requirements, and ongoing ICD-1o transition delays as the nation worked toward reforming the medical sector to greater benefit patients and everyday citizens. Specifically, EHR implementation has been a great focus of the healthcare industry. Health IT vendors as well as federal agencies have focused on developing certified EHR technology through the Health IT Certification Program.


The Department of Health and Human Services (HHS) has recently issued a document detailing the submittal of test procedures and data under the Health IT Certification Program established by the Office of the National Coordinator for Health IT (ONC).


In early 2011, HHS established a certification program for health IT systems and EHR technology. In September of 2012, the program was renamed the “ONC HIT Certification Program.” At this point in time, HHS proposes to change the name of the program once again to the “ONC Health IT Certification Program.”


Over the last several years as the program operated, health IT designers have proposed that “testing efficiencies” could be garnered if the ONC Health IT Certification Program took advantage of operational testing including e-prescribing network testing.


“The National Coordinator is open to approving test procedures, test tools, and test data that meet the outlined approval requirements above for an applicable adopted certification criterion or criteria,” the HHS document proposal stated. “By way of this document, we strongly encourage persons or entities to submit such test procedures, test tools, and test data to ONC if they believe such procedures, tools, and data could be used to meet ONC’s certification criteria and testing approval requirements. We also note that there is no programmatic prohibition on the approval of multiple test procedures, test tools, and test data for a certification criterion or criteria.”


Along with the health IT certification program, some other new proposed guidelines on healthcare reform include the modified Stage 2 Meaningful Use requirements. As providers began moving toward attesting to Stage 2 Meaningful Use regulations, federal agencies began to see certain missteps with the requirements, which led them to modify the rulings.


Currently, the Centers for Medicare & Medicaid Services (CMS) has announced that public comments to the proposed Stage 2 Meaningful Use modifications are due by June 15, 2015. The proposed ruling changes certain requirements between the years 2015 to 2017 for those eligible professionals attesting to meaningful use under the Medicare and Medicaid EHR Incentive Programs.


Public comments can be submitted to CMS electronically, by courier, and by regular or express mail. Anyone interested in more information about the proposed ruling are encouraged to read themodifications to Stage 2 Meaningful Use requirements and view a factsheet on the CMS website.


As the healthcare industry continues toward a path of reform, federal agencies will likely continue developing new regulations and policies that will aim toward improving the quality of patient care, boosting health outcomes, and reducing medical spending.

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Even Without Meaningful Use Dollars, EMRs Still Selling

Even Without Meaningful Use Dollars, EMRs Still Selling | Healthcare and Technology news | Scoop.it

I don’t know about you, readers, but I found the following data to be rather surprising. According to a couple of new market research reports summarized by Healthcare IT News, U.S. providers continue to be eager EMR buyers, despite the decreasing flow of Meaningful Use incentive dollars.


On the surface, it looks like the U.S. EMR market is pretty saturated. In fact, a recent CMS survey found that more than 80% of U.S. doctors have used EMRs, spurred almost entirely by the carrot of incentive payments and coming penalties. CMS had made $30 billion in MU incentive payments as of March 2015. (Whether they truly got what they paid for is another story.)


But according to Kalorama Information, there’s still enough business to support more than 400 vendors. Though the research house expects to see vendor M&A shrink the list, analysts contend that there’s still room for new entrants in the EMR space. (Though they rightfully note that smaller vendors may not have the capital to clear the hurdles to certification, which could be a growth-killer.)


Kalorama found that EMR sales grew 10% between 2012 and 2014, driven by medical groups doing system upgrades and hospitals and physician groups buying new systems, and predicts that the U.S. EMR market will climb to $35.2 billion by 2019. Hospital EMR upgrades should move more quickly than physician practice EMR upgrades, Kalorama suggests.


Another research report suggests that the reason providers are still buying EMRs may be a preference for a different technical model. Eighty-three percent of 5,700 small and solo-practitioner medical practices reported that they are fond of cloud-based EMRs, according to Black Book Rankings.


In fact, practices seem to have fallen in love with Web-based EMRs, with 81% of practices telling Black Book that they were happy with implementation, updates, usability and ability to customize their system, according to the Q2 2015 survey. Only 13% of doctor felt their EMRs met or exceeded expectations in 2012, when cloud-based EMRs were less common.


Now, neither research firm seems to have spelled out how practices and hospitals are going to pay for all of this next-generation EMR hotness, so we might look back at the current wave of investment as the time providers got in over their head again. Even a well-capitalized, profitable health system can be brought to its knees by the cost of a major EMR upgrade, after all.


But particularly if you’re a hospital EMR vendor, it looks like news from the demand front is better than you might have expected.

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IT could save $100B for US healthcare

IT could save $100B for US healthcare | Healthcare and Technology news | Scoop.it

New research from Accenture projects that digital health tools will save the U.S. healthcare industry more than $100 billion over the next four years.


In 2014 alone, it calculates, technology such as Web-enabled devices, digital diagnostic tools and other FDA-approved IT help achieve some $6 billion in reduced costs – mostly thanks to things such as improved medication adherence, behavior modifications and fewer emergency room visits.


Accenture expects that number to approach $10 billion this year and $18 billion next year – increasing to $30 billion in 2017 and $50 billion in 2018 as these technologies take hold, proliferate and evolve.


It also predicts that FDA approval of digital health tools will triple by the end of 2018, to 100 (up from from just 33 this past year).

"A digital disruption is playing out in healthcare, as witnessed by the emergence of new business models and technology that will change the nature of patient interactions, alter consumer expectations and ultimately improve health outcomes," said Rick Ratliff, Accenture's managing director of digital health solutions in a press statement.

Factors, such as government health IT mandates, payment reform and other regulatory changes are accelerate the growth of FDA-approved digital solutions, the report shows.


Increasing ubiquity of health IT among physicians and patients will enable more and more devices to integrate withpatient portals and digital health records, according to Accenture, which finds that one in four U.S. physicians routinely use telemonitoring devices for some aspect of chronic disease management.


Meanwhile, as more and more patients take charge of their own care, the number of U.S. consumers who own a wearable fitness device will double in the next five years, according to Accenture, from 22 percent this year to 43 percent by 2020. More than half (57 percent) of consumers track their health online, such as medical history (37 percent), physical activity (34 percent) and symptoms (33 percent), according its poll.


Recent FDA guidelines for low-risk health products – setting a regulatory line between wellness tools and medical devices – will enable more clarity, expedite regulatory pathways and could drive 30 percent annual growth of digital tools through 2018.


The evolution toward value-based care is also creating fertile ground for clinical and business strategies that incorporate these technologies, with Accenture projecting digital health funding to reach $6.5 billion by 2018.


"The proliferation of Internet-connected solutions and evolving regulatory guidelines are blurring the lines between clinical and consumer health solutions," said Ratliff. "As consumer health platforms support more 'medical' devices, rather than just today's wellness trackers, they'll create a viable self-care model in a segment that today is occupied by chronic-disease monitoring companies."

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