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eHealth Initiative: New Payment Models Driving Population Health

eHealth Initiative: New Payment Models Driving Population Health | Healthcare and Technology news | Scoop.it

Value-based payment models aren't going away, making population health initiatives ever more critical, Tricia Nguyen, executive vice president for population health at Texas Health Resources, said during a webinar presenting results from the eHealth Initiative's latest population health survey. 

 

Nguyen, who also serves as president of the Texas Health Population Health, Education & Innovation Center, warned against the wait-and-see attitude some are taking.

 

Among 59 responses of individuals used from accountable care organizations, hospitals and health systems, physician practices, health insurance companies and elsewhere, 68.1 percent said they had created new roles or hired staff for population health.

 

Additionally, 68.1 percent said they had begun activities and 76.6 percent had purchased population health or analytics technology; 72.3 percent anticipate making such investments.

 

Nguyen said there's no single best technology for population health, but there are best-of-breed solutions from multiple vendors. Interoperability remains a huge problem, though, she added.

 

She also pointed to a study that found patients were contacted up to 15 times in the days following hospital discharge because various providers can't share data.

 

Population health management activities, according to the survey, are most often aimed at readmission risk (81 percent), multiple chronic conditions (79 percent), ER super users (77 percent) and specific diseases (70 percent).

 

Eighty-three percent of respondents said they measure success by intermediate outcomes and healthcare processes (72 percent), cost savings (70 percent) and patient satisfaction (70 percent). Thirty-seven percent said they're integrating patient-reported data.

 

These percentages far surpass the Centers for Medicare & Medicaid Services's goal of having 30 percent of providers in value-based payment models by the end of 2016, suggesting the results are skewed, said moderator Charles Kennedy, CEO of Accountable Care Solutions at Aetna.

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Apple's CareKit as an enabler for patient-generated healthcare data

Apple's CareKit as an enabler for patient-generated healthcare data | Healthcare and Technology news | Scoop.it

As we move from fee for service to alternative payment models/value-based purchasing we will increasingly measure our progress based on outcomes and total medical expense.

HealthKit was an enabler that led Beth Israel Deaconess to create BIDMC@Home, an iPhone and iPad app that uploads internet of things (blood pressure cuff, glucometer, scale, activity, sleep data etc.) to our electronic health record.

CareKit, announced by Apple this week, takes us one step further on our wellness-focused journey.

[Also: Apple unveils CareKit health tracking platform, first app is for Parkinsons]

Our vision is that objective data such as weight and blood pressure needs to be combined with subjective data such as activities of daily living, mood, and adherence to care plans in order to create a true measure of outcome.

If you take your beta blocker for blood pressure control but feel listless and unmotivated, that is not a good outcome.

Apple’s middleware (HealthKit, ResearchKit, CareKit) has enabled us to connect devices in BIDMC patient homes and this summer will enable us to collect answers to clinician generated questionnaires with dashboarding of the subjective and objective combined results.

We believe that mobile devices such as iPhones will become the predominant means by which patients interact with BIDMC. Your phone will be the repository of your medical record, the means by which you collaborate with your provider, and the vehicle for submission of data to your care team.

Today, 80 percent of all BIDMC publicly available resources (websites, portals) are accessed via mobile devices. The desktop is dead. The phone is the future.

Kudos to Apple for enabling simple integration of devices in the home, collection of patient provided questionnaires, and bidirectional exchange of care plans.

I know that the current FBI/Apple security issues are controversial, but if we’re going to use the phone as the means for patients to coordinate healthcare, we need to ensure data integrity. I support the idea of government entities obtaining cloud-based backups of devices when courts grant subpoenas.

I do not support the idea of compromising the integrity of phones when they are serving as the link between patient devices/patient sourced  healthcare data and providers.

 

 

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10 Ways Document Viewing and Conversion Technologies Improve Healthcare IT Efficiency

10 Ways Document Viewing and Conversion Technologies Improve Healthcare IT Efficiency | Healthcare and Technology news | Scoop.it

It’s rare to find an organization where document management doesn’t play a major role in day-to-day operations, and healthcare is no exception. Advancements in patient record technology have revolutionized how healthcare systems operate and have greatly improved patient information sharing between different physicians, departments and even disparate organizations.

 

 

With recent HIPAA regulations and the impending Health Information Technology for Economic and Clinical Health (HITECH) mandates, which require electronic health records (EHR) adoption by 2015, the focus on technology in the healthcare space will only get stronger in the coming months, as more and more organizations put measures in place to achieve compliance.

 

 

Currently, typical phases of the document lifecycle (capturing, viewing, processing and archiving) carry significant costs in terms of both time and software investment. Integrating powerful document viewing and conversion technologies can help healthcare organizations avoid these costs and streamline every phase of the document lifecycle.

 

 

And because these technologies can be easily integrated into existing electronic content management systems, companies can enjoy these workflow improvements without investing in additional infrastructure. Below are just 10 of the ways that viewing and conversion solutions can improve workflow efficiency for healthcare IT.

 

 

From the E.R. to the pharmacy, view any document you need:

 

Successfully viewing the myriad different file types generated in the healthcare setting can be challenging to say the least. Sophisticated document viewing solutions address this challenge by supporting and providing access to virtually any document or image format (Word, Excel, DICOM, PDF, AFP, TIFF, JPEG, PNG and many more) and can be utilized on a variety of platforms (HTML5 web viewer, Windows .NET, and Java). 

 

 

Eliminate deliverability issues because of platform restrictions:

 

Organizations can reduce installation issues and support costs by avoiding the need to download and install cumbersome clients with a browser-based, HTML5 document viewer. Making documents and images viewable via any web browser regardless of operating system allows for seamless cross-platform support and trouble-free processing.

 

 

Get only what you Need:

 

Scrolling through large documents downloaded from a remote server can slow down workflow and impede efficiency. Page on Demand document viewing technology eliminates these issues, equipping web viewers with the ability to download only the relevant portions of a document within seconds. A doctor can download notes from a visit when you had the flu in 2001, instead of your entire medical chart from 2000-2013. 

 

 

Update and add forms:

 

Page manipulation support makes it easier for users to create and modify server-based documents from the client. Users across an enterprise can add, delete, and move pages—all while preserving the original files and saving newly created documents back to a repository or forwarding them along as part of the workflow process.

 

 

Leave your two cents:

 

The typical collaboration process of authoring, sharing, reviewing, editing and approving documents can be time-consuming and tedious. With annotation capabilities, users can expedite this process by adding or removing notes and mark-ups as the document moves across the enterprise. A variety of annotation types (rubber stamps, sticky notes, etc.) make this communication and collaboration easy.

 

 

Redact content securely:

 

It’s important for an organization to share information while also protecting sensitive content based on security standards and user permissions. Redaction technologies enable users to redact confidential data, like credit card information and social security numbers, to ensure sensitive document data is removed before it changes hands throughout the organization. 

 

 

Search documents quickly:

 

The ability to search text is essential for quickly accessing critical information and speeding up the workflow process. A server-based search provides enterprises with powerful capabilities, allowing users to efficiently navigate through text-based documents (Microsoft Office, PDF, AFP, and PCL) displaying only pages with matching results. For example, users can easily scan for any instance when a certain drug was used or be able to check if a patient has ever received a certain type of vaccine. This cuts down on time wasted sorting through multiple files, or worse, missing an important document entirely.

 

 

Save to a wide variety of formats:

 

From dentists to primary care to physical therapy, total healthcare incorporates a variety of disparate offices, all of which store documents in a diverse range of file formats. It’s important for users to not only be able to view numerous file types, but also be able to convert and save files to a variety of mission-critical output formats like JPEG, TIFF, PDF, PNG, and AFP.

 

 

High-speed image and document conversion:

 

While a powerful viewing solution can often satisfy document management requirements, sometimes batch conversion of files is needed when an organization moves to a new document storage system. For companies with large repositories, this can often be an expensive and tricky process. A reliable, high-speed image and document conversion solution allows an organization to safely convert and archive millions of files to a specified output like TIFF or PDF. 

 

 

Easily retrieve archival documents and images:

 

Many organizations have large archives of legacy documents (like AFP, PCL, or proprietary TIFF) from old content systems that they have since jettisoned. The files still contain critical information, but unfortunately often cannot be read with standard office document software. With the right viewing or conversion technology, an organization can easily view the legacy format or convert it to a more modern format like PDF. This allows users to easily keep X-Rays and medical notes all in one easy to access place.

 

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Nurses are the superheroes of health care

Nurses are the superheroes of health care | Healthcare and Technology news | Scoop.it

Being a nurse is one of the most important jobs in any society. It is also one of the most respected. Public opinion polls consistently rank nurses as the most trusted profession — usually ranking well above physicians. And it’s for good reason. Patients in hospital may forget who their doctor is, but they will rarely forget their nurse. The doctor may be in and out of the room in ten minutes or so, but the nurse is the one who will be right there by their patient’s side throughout their recovery.


Nurses work tirelessly for their patients and are their biggest advocates. They run around all day in and out of patient rooms, multitask to an unbelievable agree, constantly talk to patients and relatives, administer all the medications on time, and invariably pick up on any problems that the doctor hasn’t. Every doctor will have a story to tell about how a nurse has saved their patient, even if they don’t acknowledge it as much as they should.

Unfortunately, however, the sad reality is that for such a heroic profession, nursing seems to constantly be facing more than its fair share of administrative battles. It’s a very sad situation if hospital administration is ever perceived to not value their nurses. It’s also unacceptable for doctors to ever disrespect nurses, which frequently happens on a daily basis up and down the country.

Nurses are the foot soldiers of all patient care. Before the foundations of modern nursing were laid by Florence Nightingale in the 19th century, nursing care was often provided by people who practiced organized religious activities, including nurses and monks — which is a profound thing to reflect on (the fact that nursing was equated with religion and good work). That changed after Nightingale’s pioneering work helped established nursing as a more organized profession. The expansion of modern medicine over the last several decades has also allowed nurses to increasingly diversify and specialize. Today there are an estimated 3 million nurses in the United States and 500,000 in the United Kingdom, representing about 1 in every 100 people in each country.


The challenges faced by today’s nurses are surprisingly similar across the Western world. Here are 3 of the biggest:


1. Workload. It goes without saying that in no other profession does the workload need to be controlled and restricted more than with nurses and their patients (much more so than with doctors). Nurses cannot be expected to be competently taking care of excessive numbers of patients. These safe patient care ratios need to be agreed between nurse unions and administrators, and then strictly implemented.


2. Job duties. Nurses must be supported by the other professions around them and not be expected to do anything beyond the scope of their job. Examples include restraining, transporting, and even walking or feeding patients when there’s lots of other clinical work that needs to be done. Care assistants, transporters, sitters, physical therapists and hospital security—they must be present in adequate numbers to do what they need to do and free up nurses.


3. Pay. How much nurses should be compensated has been an issue for a long time, and is frequently debated in the media when nurse unions may threaten to strike. It’s a terrific shame that nurses should ever feel the need to strike, but at the same time they should be valued appropriately for the difficult job they do. Paying an hourly rate which is lower than other jobs which require only a high school education, or offering pay rises of only a few cents an hour — when nurses have debt to pay off and a family to support — is not an acceptable situation.

With the ever-changing health care landscape, the job of nurses is set to continue to evolve and expand. We need to attract the best and brightest students into the profession while keeping compassion at its core. The above three issues are widespread, and while there is no magic pill, there should be constant recognition of the vital work that nurses do. The medical world needs to support our nurses and treat them as what they are: the absolute heroes of frontline health care.


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