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Healthcare Technology trends to watch out 

Healthcare Technology trends to watch out  | Healthcare and Technology news | Scoop.it

The healthcare industry is on the cusp of a digital revolution. People are empowered with health information, thanks to technological innovations in digital health. It’s vitally important that healthcare professionals continue to stay up to date on advances in technology that will improve not only their internal systems but also patient treatment and care.

 

In this article, we’ll focus on top healthcare technology trends for 2018 in three main areas, namely Patient Engagement, Hospital Workflow, and Treatment.

 

Patient Engagement


2018 will witness more developments in the arena of patient-centric care. Mobile health is gaining prominence, pointing us to the fact that individuals are taking a more active role in their own health. Wearables and fitness trackers are gaining mass adoption by people of varying demographics. About 50% of healthcare consumers are expected to be active digital health tech adopters in 2018. Now, more than ever, patients will begin to have a say in their choice of treatment and expect transparency of information exchange from healthcare providers.

 

Telemedicine is another model of healthcare that is gaining traction in this hyper connected world. Get ready to see a rise in demand by consumers for health advice and information in the coming months. Adoption of telemedicine will connect patients and doctors like never before. The digital health empowered individual will pose a challenge to traditional healthcare services that are slow in adapting to the digital transformation happening around. The quality of service from healthcare providers will be measured by the ease of access to information by patients.

 

Hospital Workflow


Technology continues to advance as people become more and more accustomed and able to access information in seconds rather than hours or even days. Because of this, slow-paced administrative processes in hospitals are becoming increasingly frustrating to patients. This includes things as simple as difficulties of scheduling an appointment, to accessing medical reports, or even trouble in exchanging information between providers.

 

Hospitals are expected to make use of digital platforms and cloud computing services as part of their patient engagement measures. The motto of 2018 will be data access, anywhere, anytime.

 

Mobile health, telemedicine, and Electronic Health Records (EHR) will produce a plethora of data that healthcare providers can utilize to improve patient care. One of the challenges that many providers will face is the issue of storing and securely transmitting sensitive patient health information (PHI). Many organizations still depend on legacy fax equipment to securely transmit documents despite the criticism of relying on this ancient technology. Thankfully, 2018 will be the year hospitals decide to choose alternative technologies like online faxing that is secure, cost-effective, and environmentally friendly.

 

Other exciting news awaiting us as we talk about secure transmission of data is the blockchain. Utilization of the blockchain will disrupt the way data has been handled until now. IDC Health Insights predicts that 20% of healthcare organizations will actively develop systems utilizing the blockchain to keep data secure and enable easy exchange of information between trusted partners.

 

Treatment


Robots are coming - Not Terminators, but life savers.

 

Experts suggest that practitioners will make use of Artificial Intelligence (AI) for better diagnosis, surgeries, assistants, and more. Virtual Reality and Augmented Reality will become common tools at the hands of doctors for educating patients. AI bots will slice and dice data to help doctors make more accurate clinical decisions. The combined force of blockchain and AI will open a new realm in healthcare which will ultimately help provide better patient care. Use of AI will increase the efficiency and productivity of doctors as well. For those who fear a robotic conquer of the world, be assured that AI in healthcare is not going to replace doctors, but empower them.

 

These technological developments will help to fuel a positive change in the healthcare industry in 2018. It’s impossible to predict the pace of these implementations in hospitals, as these require not only capital and training but also an open-minded and forward thinking CIO that’s willing to adopt new and innovative technologies. The pertinent question is, are you ready to embrace the change?

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Digital Technologies can Address Cancer

Digital Technologies can Address Cancer | Healthcare and Technology news | Scoop.it

There have been remarkable strides in prevention and treatment of disease in the past 5 decades.  Few have rivaled targeted cancer therapies based on digital health, specifically genomics in scope and breadth.  I’d like to touch on a few ways in which digital technology is impacting cancer.

 

1. Targeted therapies. One only has to watch the avalanche of television commercials for cancer centers both local and national to appreciate the role genomics now plays in choosing therapies today for cancer. In simple terms, cancers have genetic fingerprints which are becoming specific targets of newer drugs. Different types of cancers may share similar genetic markers. Getting more layered in complexity, the same cancer may experience genetic changes during its course.  The National Cancer Institute offers a more in depth discussion of genomics and cancer.  An ambitious initiative with far-reaching implications is the National Cancer Institute’s NCI-MATCH (Molecular Analysis for Therapy Choice) trial. IBM Watson Health has recently partnered with Quest Diagnosticsto provide clinicians with recommended “… unbiased, evidence-based approaches based on a detailed view of the tumor’s mutations, scientific journals, and MSK’s OncoKB, a precision oncology knowledge base..” The possibilities are indeed many in this space and the use of digital tools like genomics and artificial intelligence are accelerating our knowledge and successes.

 

2. Registries.The traditional collection of information on cancer has been with the collection of limited data derived from patient demographics, health history and episodic office encounters. There are now digital technologies now which incorporate raw data from pathology, genomics, imaging studies, patient reported symptoms and follow-up and more. In a previous post I describe ways in which a well-designed registry can address multiple stakeholder needs. The value of an excellent tech-based registry is best appreciated in oncology and rare diseases. As someone who has a family member with a very rare cancer, I have seen first-hand the potential benefits of and resistance (primarily ‘political’) to such registries which would expedite decision-making via pooled experiences.

 

3. Connected care: apps: Connected care today includes such technologies as wearables and mobile health apps. Benefits of connected care include triangulating the transmission of information (among clinicians, patients and caregivers), convenience, and timeliness. Three impressive mobile apps in the oncology space are:

 

a. Pocket Cancer Care Guide. Helps patients and caregiver obtain information about specific cancers, understand medical terminology, builds lists of questions to ask physicians, and provides the ability to record and save clinicians’ answers to questions.

 

b. Cancer Side-Effects Helper by pearlpoint. “…offers trusted nutrition guidance and practical tips to help survivors feel better, maintain strength, and speed recovery from common cancer side effects…”

 

c. My Cancer Genome. Managed by the Vanderbilt-Ingram Cancer Center, this award-winning app has both clinician and patient-facing information on cancer genomes, targeted therapies, and provides updated appropriate available clinical trials.

 

4. Connected clinical trials. The rising cost of clinical trials, the increasingly recognized importance of patient reported outcomes, and the transformation of trials with electronic data capture all suggest the value proposition of digital tech in clinical trials. Obtaining real-time vital sign trends, patient-reported adverse events (drug side effects/toxicities, unplanned ER or office visits), and outcomes data will make clinical trials more relevant (by recruiting a larger and more diverse patient population via digital tools), less costly and safer.

 

5. Social media support. The convergence of social media and healthcare was both inevitable and beneficial for patients. The advantages of online support groups over traditional in real life organizations are many. Access to information, governmental agencies, empathy, and convenience are some of them. Twitter has contributed greatly in this regard. TweetChat groups focusing  on specific diseases abound.

 

Critics of digital technology in healthcare raise valid issues regarding accuracy and reliability of information, privacy and security, and patient safety. There are existing regulatory guidelines addressing these, arguably not comprehensively enough.  Accurate and reliable information about cancer is available via many digital avenues. Digital technologies are an integral part of cancer diagnosis and treatment today.  We are living in an age where they might be among the most important tools we have as clinicians, patients, and caregivers. Hats off to those dreamers who make it possible!

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How blockchain can address the two biggest challenges in healthcare IT

How blockchain can address the two biggest challenges in healthcare IT | Healthcare and Technology news | Scoop.it

A recent study on blockchain adoption in health care by Blackbook Market Research indicated that a large percentage of payers surveyed, and a small but growing percentage of providers, were either considering deploying or were in the process of implementing, some blockchain solution sets. Blockchain appears to have moved from the awareness and education phase to actual deployment of solutions.

 

“Blockchain can solve two of the biggest problems in health care today," says Lidia Fonseca, CIO of Quest Diagnostics, a leader in lab testing services. She is referring to the gnarly issues of interoperability and data quality. While data quality has long been an issue in health care, the interoperability challenge is a legacy of the massive digitization of patient medical records over the past eight years which have left us with proprietary electronic health record (EHR) systems that don't "talk" to one another. The result is inefficiency and waste, as stand-alone information systems slow down processes and create redundant work. 

Taking a look at the healthcare blockchain pioneers

Some technology solution providers, including IBM and Change health care, along with a number of other companies listed in the Blackbook Research study, have made initial moves in establishing blockchain capabilities and launching solutions. Federal agencies such as FDA and CDC have expressed interest in applying blockchain to find solutions for public health issues.

 

Amazon, with its long-awaited entry into health care, recently announced the launch of blockchain templates for health care, aimed at making it easier for developers to create blockchain-based projects and deploy blockchain networks via open source frameworks. In a sense, Amazon has started the democratization of the blockchain-enabled application development, something we saw before with machine learning algorithms in the wake of the big data and analytics hype a few years ago.

 

A group of large healthcare enterprises, including large payers such as Humana and United Health Group (UHG), along with Quest Diagnostics, UHG subsidiary Optum, and Multiplan Health recently came together to launch a blockchain pilot program to solve for one of the most significant data challenges in health care today – provider data management. Provider data, a fundamental enabler for all manner of healthcare transactions, is a key building block for processing claims and maintaining up-to-date provider directories. Today, most provider data is stored in siloed and independent databases. Provider data quality is estimated to be a $2.1 billion problem today, according to a report by CAHQ, a non-profit alliance focused on creating shared initiatives to streamline the business of health care. By streamlining the inefficiencies in provider data maintenance, participants can have a "single source of truth." It is estimated that up to 75 percent of provider data management costs can be eliminated using blockchain solutions.

What it will take for blockchain initiatives to succeed

While blockchain is coming of age in health care, we’re still in the early stages of the hype cycle for blockchain. The initial mania around bitcoin, the very first use case for blockchain, is now giving way to more carefully considered use cases for business with tangible benefits. Healthcare, a sector that generally lags in the adoption of technologies, is currently in a wait-and-watch mode; notwithstanding the high levels of interest among payer organizations, the Blackbook survey also points to low levels of interest among health systems, citing the undetermined cost of blockchain solutions as the major issue that stops health system executives from committing to a timeframe for deploying the technology. Our best hope is that the early pilots will bring tangible proof points and provide more confidence to the industry in the technology.

 

Health care is a team sport and so is blockchain. The more participants there are in a blockchain network, the better it is for the network and the industry. Pilot programs such as the provider data management initiative by Quest Diagnostics and others will need a much higher level of participation across the industry to reap the benefits of the network effects.

 

As with most transformative technologies, the big challenge is usually not the technology; it’s managing culture and workflow changes, driving collaboration, and an execution focus. In blockchain, there is an added dimension of a commitment and willingness to work across company boundaries, which is an entirely new paradigm for most health care enterprises.

In a unique development, a group of health care industry executives has come together to launch a peer-reviewed blockchain journal to share both the positive and the negative experiences with blockchain in health care.

 

The potential for blockchain to improve health care operating efficiencies is significant. High-value use cases include revenue cycle management, supply chain, clinical trials, and provider data management. The initial pilots will need to demonstrate the real benefits of the technology and lead to higher adoption of blockchain in the coming year.  

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Reimbursements red herring, trust, and key infrastructure needs for Telemedicine success  

Reimbursements red herring, trust, and key infrastructure needs for Telemedicine success   | Healthcare and Technology news | Scoop.it

Telemedicine is a growing part of modern healthcare and could play a pivotal role in the U.S.’s efforts to streamline and expand preventative services. Virtual, video-based doctor’s appointments can help alleviate the general practitioner shortage and encourage preventative care. They also offer a cheaper, more convenient alternative to in-person appointments for many patients. Unfortunately, there’s a lot of hype and misinformation being reported so I was pleased to see that TechnologyAdvice (TA) surveyed 504 U.S. adults about telemedicine and their willingness to use such services. I think the results shed important light on where healthcare providers and telemedicine vendors still need to gain acceptance with patients so I reached out to Cameron Graham, Managing Editor at TA to see if he can give us the facts on the ground. Cameron heads market research for healthcare IT, business intelligence, and other emerging technologies and is uniquely qualified to help shed some light on the subject. Here’s what Cameron said:

 

1. It’s not just about reimbursements

Despite the promise of telemedicine, the vast majority of Americans still aren’t using such services. One oft-cited reason for this is the lack of insurance reimbursement for many telemedicine procedures. While some private insurers will cover telemedicine, many only cover select types of visits or specific applications. Medicare, for instance, covers face-to-face interactions, but only when the originating site (point of care, not the patient’s home) is in a Health Professional Shortage Area (HPSA). Although coverage is slowly improving in many states, the American Telemedicine Association gives just five states (plus DC) an A grade in coverage and reimbursement.

 

However, the current hodgepodge of reimbursement rules is not the only thing holding back telemedicine from widespread use. An equally important factor is likely Americans general comfort with video-based platforms and their trust in remote appointments. According to our study, less than half of adults (44.9%) said they would be comfortable conducting a doctor’s appointment over video. Only 35.3% of respondents said they would choose a video appointment over an in-person one. Until patients are more comfortable with the notion of remote care, it is unlikely that telemedicine will gain significant traction.

 

In order to facilitate acceptance of telemedicine among Americans, providers and vendors need to work on educating patients about the benefits of such systems. Telemedicine vendors, in particular, should help patients navigate the complex reimbursement rules currently in place, and promote the cost-savings of remote appointments. By doing so they will not only gain brand awareness among patients but will be able to recruit patients as advocates for more comprehensive insurance reimbursement policies.

 

2. Trust is a key component of effective telemedicine

Americans are not only hesitant about scheduling telemedicine appointment, they are also sceptical about diagnoses made through video platforms. Forty-five per cent of respondents said they would trust a virtual diagnosis less than one made in person. An additional 29.3% said they simply would not trust a virtual diagnosis. This suggests there is a distinct lack of trust among Americans in the quality of medical services that telemedicine platforms can provide.

 

Much of this scepticism is likely due to a lack of familiarity with the services. It also reinforces the fact that telemedicine providers must earn patients trust before they can effectively increase adoption rates. Once that trust is established, it appears people are far more likely to consider using remote appointments. While initially, only 35.3% of respondents said they would choose a virtual appointment over an in-person visit, 65% of respondents said they would be more likely to conduct a virtual appointment if they have first seen the doctor in-person.

 

It’s unlikely that providers or vendors will be able to dramatically change such preferences given the personal nature of many medical visits. However, increased awareness about the qualifications of physicians could make potential patients more comfortable about conducting preventative care via video. Incorporating a rating system, or minimum quality threshold for participating physicians is one potential solution.

 

3. Personal and professional infrastructure is key

The personal infrastructure for telemedicine is already in place across much of the United States, in the form of video-enabled smartphones. According to the latest PEW research, 64% of Americans own a smartphone. In theory, this provides them with the basic means to access remote, video-based health care. Smartphones will likely serve as first means of exposure to such services for many people.

 

More advanced, capable systems (such as dedicated telemedicine kiosks) however are far from established. Aside from a few test programs in select areas, there is no nationwide, professional infrastructure or technology for telemedicine. This hinders adoption and limits the use of telemedicine to basic, preventative care that can be conducted entirely remotely. Dedicated kiosks can greatly expand the use-case for telemedicine, by incorporating sensors, multiple cameras, and other advanced technology. Further investment from telemedicine vendors and insurance companies could help to boost the nationwide profile of telemedical services and expand access for many Americans.

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Can technology break the silos in the healthcare sector?

Can technology break the silos in the healthcare sector? | Healthcare and Technology news | Scoop.it

Digital health or the use of information and communication technology (ICT) to provide health services, has the potential to advance the goal of universal health coverage and improve the quality and efficiency of health services, according to a new report published by the Broadband Commission for Sustainable Development’s Working Group on Digital Health.

 

But can technology also break silos between the technology and healthcare sectors? 

 

The study group, co-chaired by the Novartis Foundation and Nokia, noted that key challenges remain in making digital health a reality, including fragmentation in digital health solutions, risks to funding continuity and capital expenditure, workforce capacity constraints, and collaboration problems across the health and ICT sectors. 

“Despite the promise and potential of global connectivity, we cannot lose sight of the fact that nearly four billion people have no access to the Internet. We need to look at innovative cross-sectoral strategies that can leverage the power of high-speed networks to improve education, healthcare and the delivery of basic social services to everyone, especially the poorest people, who need healthcare most urgently,” said ITU Secretary-General Houlin Zhao.

 

The report, “Digital Health: A call for Government Leadership and Cooperation between ICT and Health,” recommends that the industry look into at least three things: the importance of senior government leadership with committed financing, effective governance mechanisms with defined roles, and a national ICT framework to facilitate alignment between the ICT and healthcare sectors.

 

“We need continuous committed leadership from government with sustained financial resources to ensure a strong national digital health strategy,” Ann Aerts, Head of the Novartis Foundation, and Chair of the Broadband Commission Working Group on Digital Health.

 

She said many technology-based health initiatives have been introduced in the past but they never reached scale or achieved long-term sustainability because more government support and intergovernmental collaboration are needed to take these initiatives past the pilot stage.

 

“To help solve these challenges and to uncover how we can truly harness the power of information and communications technology (ICT) for health, we need a better understanding of the key elements involved,” she explained in the report.

Rajeev Suri, CEO of Nokia and Chair, Broadband Commission Working Group on Digital Health, added that many technology companies are pushing the frontiers of healthcare to reach the remotest of locations, harnessing the power of mobile devices to help health professionals bring the most efficient medical techniques.

 

“The next step is to share the technology with every corner of the globe. To do that we need the leadership of national governments. Health and telecommunication should be united, working closely with regulators—to avoid potential roadblocks, change old practices and spread new knowledge on how to leverage technology for healthcare,” he said.

 

Case Study: Malaysia

With a population of 30 million, Malaysia is currently implementing the Health Information System Strategic Plan (11th MP). This plan builds on the first Health Information System Strategic Plan (10th MP) rolled out between 2010-2015. 

According to the report, the government is currently scaling of a hospital information system deployed in 25 percent of hospitals, in the process of integrating primary care and oral health clinical information system, rolling out a pharmacy information system and building the Malaysia Health Data Warehouse.

Because Malaysia began using digital health in the late 1990s when the Malaysian Ministry of Health (MoH) unveiled the first
telemedicine blueprint and created the first paperless hospital in the world, it has adopted a progressive approach.

“The MoH provides digital health leadership, strategy and program implementation in the form of three divisions: ICT, Planning and Telehealth,” the report noted. “MoH’s ICT strategic plan and ensures alignment with the national ICT strategic plan.”

However, even after years of digital health implementation, some challenges still remain. “Our biggest challenges are still the user, change management and training. And clinical leadership is so important! If you don’t get buy-in from the clinicians, the system won’t work. We learned from experience,” said Dr. Fazilah Shaik Allaudin, Director of Telehealth Division at MoH.  

 

Other challenges include monitoring, evaluation, and private sector engagement. “ “We’re still struggling with M&E and how to do it effectively. We haven’t really come up with a mechanism for this yet. We’ve seen hospitals give up on digital systems and go back to paper or situations where the core team involved in implementation leaves and the project dies or loses momentum. How do you keep this when the leader leaves? How to keep the fire burning?” he explained.

 

Case Study: Philippines

The Philippines launched the National eHealth Strategy in 2010. This was followed in 2014 with the release of the eHealth Strategic Framework and Plan for 2004-2020. The overall goal of the plans is to achieve universal health coverage, which means access to affordable health services for all citizens.

Some of the key performance indicators (KPIs) the 2014 eHealth framework set out to do include the increasing use of the DoH/PhilHealth eClaims, deployment of telehealth devices, the establishment of a government data warehouse and implementation of health data standards.

According to the report, a joint memorandum between the Department of Health (DoH) and the Department of Science and Technology (DoST) created the basis for a shared understanding of roles and responsibilities. Each agency has its own IT teams which make it hard to know which team is responsible for what. 

“In our country, the DoST was keen to start working on eHealth but realized that it needed to be led by the health sector as per the WHO-ITU Toolkit. Fortunately, our DoH also shared the same view. From this common ground, the seeds for the multisectoral approach emerged. The key is to get those two persons engaged, one from the DoH and one from the DoST, and involved in the development of the national eHealth strategy” Dr. Alvin Marcelo, Executive Director of AeHIN and former CIO of PhilHealth.

Meanwhile, the creation of advisory groups allowed universities and private-sector representatives to share their expertise and views. 

 

“Cross-sectoral collaboration is not easy. Players come from different backgrounds, with different approaches and priorities, and may understand different things on the basis of the same words or phrases,” affirmed Zhao in the report’s foreword. “Nowhere is this truer than in digital health, where the needs are great, the investments are significant and lives are at risk.”

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The Latest Trends in Nursing Technology

The Latest Trends in Nursing Technology | Healthcare and Technology news | Scoop.it

If trying to make sense of the stock market is enough to have you ready for a straitjacket. It is much easier to let your 401(k) do its thing and not think about it too often. The same can’t be said for those of us in the healthcare industry even though it feels like things are changing as rapidly as they do on Wall Street. Between the legislative changes, corporate mergers, innovative technologies, and everything else that is happening in our industry, it is enough to make your head spin. Let’s look at trends and technologies that will become more commonplace in 2018 and beyond.

 

Patient Engagement. As with most industry trends, nurses are on the front lines of patient engagement efforts. If you haven’t already been exposed to the concept, patient engagement is the practice of a patient taking more responsibility for their own health and well-being. When providers and patients work together, health outcomes are improved. New technologies are being developed to support patient engagement, and nurses are finding themselves more involved in helping evolve engagement efforts for their patients.

 

Precision Medicine. Another newer concept that will ultimately involve nurses providing direct care to patients, Precision Medicine, refers to the advancement of medical research that targets how certain diseases impact people differently based on their genetic makeup. It may include different treatments for certain types of cancers based on the genetics of the tumor. Precision medicine is an acknowledgment that healthcare is never one-size-fits-all and treatments are being adapted to the individual rather than the disease.

 

Centralized Command Centers. Inspired by NASA, many hospitals are implementing command centers that serve as a “mission control” for all of the services and functions related to patient care. Today’s nurses are finding themselves able to interact with the second set of eyes and also have help in managing daily bottlenecks. These command centers are also being utilized for central monitoring of patients to overcome alarm fatigue from the 90% of hospital alarms that aren’t actionable. The centers utilize complex algorithms and analytics to assist nurses in making real-time decisions to improve quality of care and reduce costs.

 

Smarter Smartphones? All of us are already using our smartphones for just about everything we track, post, and read lately, so nurses using them for their work is not surprising. One example of ways that nurses are able to use their smartphone is called Steth IO, which turns your phone into a modernized stethoscope. A special case is attached to your iPhone (not yet available for Android) and channels the sounds of a patient’s heart and breathing into the microphone. The Steth IO app then digitizes the heartbeat into a graph on the phone screen to record and enable easier detection of abnormal heart sounds.

 

Overcoming Language Barriers. As our nation’s population becomes more diverse, nurses are finding themselves in more frequent situations where patients speak a language other than English. This often leads to another nurse who speaks the language being brought in to translate. By September of this year, a hand-held, two-way voice translator, The Pocketalk, will be available to translate up to 63 languages in real time. Working via Wi-Fi, mobile data, or a personal hotspot, the translator transfers speech to text on the screen and relays responses verbally. Nurses will also be able to save up to 20 exchanges to assist with post-visit notes and charting.

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Who ‘owns’ the healthcare consumer of the future?

Who ‘owns’ the healthcare consumer of the future? | Healthcare and Technology news | Scoop.it

CVS and Aetna are merging. Amazon, JPMorgan Chase, and Berkshire Hathaway are forming a joint venture aimed at reducing health care costs and improving outcomes. Cigna is acquiring Express Scripts. The proposed mergers promise a revolution that could fundamentally alter the current healthcare landscape and the relationships between providers and patients. With these giant corporations betting big on healthcare, a logical question to ask is: What’s behind it all?

 

The answer is simple: ownership of the healthcare consumer experience, and by extension, the consumer.

Digitalization and healthcare consumerism

In the past few years, Amazon has reshaped the relationship between consumers and marketers. It has forged itself into being the preferred destination for consumers seeking convenience. Now, imagine Amazon applying this power to the healthcare sector. The company already offers a wide range of the over-the-counter drugs in their health and wellness section. Going from there to selling prescription drugs is not a big step. However, that step could become a big leap in terms of the shift in consumer loyalties if consumers are provided the option to order their 90-day medication refill and have it delivered to their doorstep (maybe even by a drone).

 

Recognizing the threat, many health systems are taking measures to digitalize their relationships with consumers by focusing on something they have long neglected: convenience. Virtual visits and e-visits are now becoming commonplace. A young mother of three no longer has to bundle her kids into the car and drive an hour each way to her hospital for a routine follow-up that takes all of fifteen minutes in the physician's office. A senior citizen in a wheelchair on multiple chronic-care medications no longer needs to "check in" by getting physically to a physician's office. They can both do their visits through secure messaging, or if required, through a virtual real-time consultation.

 

The above is just one example of how digitalization could reshape relationships between consumers and providers.

Data, analytics, digital

Here is another scenario that is already starting to play out. Consider a patient with high blood pressure. Technology is enabling patient-generated health data (PGHD) from wearables and sensors that include blood pressure, heart rate, glucose levels, and medication adherence to be transmitted seamlessly into the patient’s electronic health record (EHR). The combined data is being analyzed for trends and insights and made available to everyone involved in that patient’s care, enabling care teams to manage the patient more effectively. The patient can still control who can see the information by following an e-consent process through an app right on the mobile device. If a patient opts to participate in clinical studies, that person can be matched automatically with relevant opportunities. Both the individual patient and the population improve their health outcomes as a result.

 

Data-driven advancements are arriving in the form of both precision medicine and healthcare consumerism. Advancements in precision medicine are expected as the relationship between data from wearables, sensors, social determinants and other emerging sources is better interpreted through advanced artificial intelligence (AI), and yielding better outcomes. We are in the early stages of a new push toward patient-centered, consumer-directed care that is demonstrating strong growth potential.

 

What we are also starting to see is some redistribution of the in-person visits between traditional providers and emerging ones. As an example, CVS and Aetna are betting that consumers may prefer to visit one of their many walk-in clinics for minor conditions instead of waiting to schedule an appointment with their primary care physician in the hospital down the road. Urgent care is already shifting out of hospitals, and in many cases, going virtual altogether. The rise of companies such as Teladoc and Doctor-on-demand is clear evidence of this.

Bricks and mortar is not going away

None of this suggests that the traditional healthcare setting is fading into obscurity. Health systems, especially those with strong brands in their local and regional markets, have an unassailable lead today as trusted healthcare partners in their communities. Many of them are already making big investments in digitalization programs that will enable consumers to get the best of both worlds, namely a virtual experience for routine healthcare and urgent care needs, and an in-patient experience for acute care needs. For a high-quality patient journey, these two worlds must be tightly integrated. Only traditional hospitals can provide that truly integrated experience today.

The future of healthcare consumerism is not an either/or

If Big Data’s relationship to precision medicine has been on a more or less predictable trajectory, the explosive growth of healthcare consumerism has opened up options for healthcare consumers seeking convenience in addition to the quality of care. The healthcare leaders of tomorrow will ideally sit at the intersection of these two critical aspects of healthcare delivery. A reputation built on high-quality care alone will no longer be enough; neither will a reputation for slick user interfaces and transactional convenience.

 

A friend, who is also the CIO of a large health system, recently suffered a heart attack during a race. As he felt it coming on, he wisely checked himself into the medical tent from where he was rushed to a nearby hospital. A stent was put into his chest that saved his life. Imagine a scenario where with the help of real-time, advanced analytics and AI technologies, his imminent heart attack could have been predicted. Imagine, too, if he had not had access to one of the most experienced and qualified cardiologists in the country to attend to him during the emergency. Digitalization can ensure that the cardiologist's knowledge, wisdom, and experience are still accessible no matter the current physical location of the patient.

 

Ownership of the healthcare consumer experience requires a mixture of convenience and quality enabled by a robust data and analytics capability. No one sits precisely at that happy intersection today. However, the race is already underway to get there.

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Digital health’s last mile problem

Digital health’s last mile problem | Healthcare and Technology news | Scoop.it

In my book, The Big Unlock, I describe the four major categories of technology providers as Custodians, Enablers, Arbitrageurs, and Innovators. Each of these categories of providers has staked a claim to reimagining the digital future of healthcare.

 

First, the Custodians: These are the big electronic health record (EHR) vendors like Epic and Cerner who have the data and the workflow. As systems of record, they enjoy the long-term strategic commitment of the health systems they serve and are the first port-of-call whenever a health system decides to enable new functionality for enhancing the patient and caregiver experience. 

Systems of record have certain limitations and are arguably weak in several areas, such as advanced analytics, which is critical for a digitally reimagined healthcare experience. Along came the Enablers to address this problem. Big technology firms such as Google, GE Healthcare, Microsoft, Salesforce and IBM’s Watson Health business have built technology stacks that integrate multiple emerging and traditional data sources, including EHR systems, and have incorporated some proprietary data sources as well, such as images in the case of GE Healthcare.

 

These big technology stacks include inbuilt advanced analytics capabilities that can deliver insights to power digital health experiences. Google’s Deep Mind, for instance, recently analyzed eye scans from over 125,000 patients to build an algorithm that could detect diabetic retinopathy, the number one cause of blindness in some parts of the world, with over 90 percent accuracy. The company claimed the accuracy of the analysis was on par with board-certified ophthalmologists.

 

The Arbitrageurs are mostly technology agnostic consulting firms such as Accenture and Deloitte, as well as India-heritage firms such as Wipro and Infosys, that rely on information and labor-arbitrage models to build digital experiences from scratch using the preferred technology tools that exist in health systems.

The Last Mile problem

All three categories of technology providers described above have stopped short of building ready-to-deploy digital health experiences, which leads us to the Last Mile problem in healthcare. Despite the powerful computing and data analytics infrastructure that big technology firms have invested in, there is a shortage of viable, proven digital health experiences for health systems and their key stakeholders in healthcare delivery i.e. patients and caregivers. The challenge – and the opportunity – has fallen to the fourth category of technology providers, namely the Innovators.

By definition, the Innovators are typically startups that have come up with a whole new way of addressing an existing problem with technology-enabled healthcare experiences, or for filling a gap in the current healthcare experience with technology. Digital health startups raised an estimated 11.5 billion in 2017, and money continues to pour into the sector, despite the slow pace of exits. Despite the promise, a report by IQVIA indicates that while over 318,000 health apps and 340 consumer wearable devices are now available worldwide, 85 percent of the apps had fewer than 5000 installs. The few apps that did reach critical mass demonstrated strong clinical evidence, robust integration with the established workflow integration, and high user ratings – prerequisites for any digital health solution looking to break into the health systems marketplace.

Addressing the bottleneck

The need for last mile applications is enormous, and yet the innovation ecosystem has not built and implemented viable applications fast enough and at scale to meet the demand. Common challenges include:

  • Extended cycles to hit prime time usage: most health systems follow a traditional approach that takes promising new solutions through the phases of a free pilot, paid pilot, and enterprise adoption. The process could take years, and many solutions remain in "pilot purgatory" for an extended period, often failing to break through to enterprise adoption. Health systems need a newer, more agile model, to assess and deploy promising solutions more quickly and efficiently
  • Too many standalone solutions: the digital health landscape is littered with thousands of point solutions that stand in isolation, with no established connectivity to systems of record which is the price of entry for any new solution. Health systems are loath to sign up dozens of point solutions and take on the burden of integrating and managing these solutions. They prefer to default to the many solutions that EHR vendors have built or are actively building (or claim to be building) that effectively make stand-alone solutions redundant, despite the superior experience architectures that startups are known for. A potential approach for startups is to align with one of the big Enabler companies who, through established relationships with health systems, can create a pathway to adoption and growth.
  • An absence of scale: No single platform addresses all the needs of a digital health enterprise today, unlike the mature enterprise resource planning (ERP) systems of the manufacturing and financial sectors. There is a significant opportunity for Enables companies to build ready-to-deploy innovation ecosystems through partnerships with digital health startups. However, Enabler platforms too have increased and are at risk of becoming too fragmented to present a real alternative to health systems looking for scale and velocity in the digital transformation journeys.

The digital transformation of healthcare is in its early stages, and the gold rush is underway. Wanted: creative approaches to solving the Last Mile problem and unifying the fragmented ecosystem of point solutions and stand-alone technology enablement platforms.

Technical Dr. Inc.'s insight:
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Health IoT creates huge opportunities for public health and software companies 

Health IoT creates huge opportunities for public health and software companies  | Healthcare and Technology news | Scoop.it

Connecting smart biological sensors to the internet is not a new idea. There are already dozens of products in the market that continuously monitor blood glucose and heart function, for example, and enable secure remote management for clinicians and caretakers. The safety of life implications are enormous, and the commercial opportunities untold. Some analysts predict a $100 billion-plus market for the healthcare segment of the “internet of things” (IoT).

 

What is new and emerging is the physical scale of the devices on the one hand, and the need to aggregate, reconcile, and consolidate those data streams for downstream clinical care services. Advances in semiconductor device manufacturing will relentlessly drive down the price and the size of these electrophysiological sensors, literally to the nanometer scale, which will ultimately be able to do more than detect, they will be able to intervene. At the same time, our ability to make sense of the torrents of information is catching up to our ability to create them.

We believe that these are tremendous opportunities for public health and software companies like ours. It is why we are investing so much of our own resources to promote the open design, secure exchange, and value-added analysis of health data systems. Perhaps the largest inhibitor to a promising future of longer, healthier, less expensive life are the software merchants and device manufacturers who still and astonishingly insist on keeping data closed, isolated, and trapped in proprietary systems. We believe this is about to change too.

 

The interoperability troubles with electronic medical records are legion, and we won’t waste our page space or your attention lamenting the deeply ignorant and the nearly criminal. The immortal words of Forest Gump’s assessment about doing dumb things find purchase here.

 

What we can do, however, is find clever ways leverage of IoT as yet-another, and maybe decisive, the fulcrum of connected care. For what is today true in isolation – progressive plans, concerned parents, engaged patients – will soon-enough be more the ubiquitous standard of coordinated care; that coordination will reach deeply into pocketbooks as well as bodies.

We know that there are legitimate concerns about individual privacy and device safety and that some people would literally rather die than compromise on either. We respect that, even as we actively promote more automation and digital services in health care.

 

Some of us believe that the existential benefits of independence and longevity outweigh the potential risks of intrusion and malfunction, some of us don’t. The point is that everyone should have the choice and that no one should be coerced or manipulated into choosing one side of the argument. Fear mongering (about privacy) and fabrication (about intrusion) are forms of manipulation. In the case of health care, they cost lives and money.

 

Let’s, instead, imagine a world of seamless, secure, and reliable health data interoperability. Let’s find a better way to safely liberate data at its source – labs, pharmacies, hospital and clinics, insurance claims, as well as implantable and wearable devices – pass it through hygienically sealed pipes, and receive it in places where it does the most good. That may be during a clinical care or remote telemedical encounter (to give you the best possible advice based on evidence and your personal health history), it may be when you pick up your medicines (to check for interactions with other medicines), or it may be to help your insurance company help you (because they have always had a bird’s eye view of your services, and they can’t kick you out for pre-existing conditions anymore).

 

Because of changes in the law, it may be with a loved one or trusted caretaker. It may be you.

The data could be as simple as a reminder message about an upcoming appointment, a warning message that a clinical value seems out of range, or an answer to a securely-texted question to your doctor. We have imagined that future and it is, as Ray Kurzweil likes to say, near.

 

There are two challenges, and they are slowly receding.

The first is that the data holders are still reluctant to share, even though it isn’t “their” data.  This will become less of a problem, as forward-looking providers like VA and DoD have shown, as well as payers like CMS, Aetna, and HCSC among many others have demonstrated.  All are outspoken supporters of the Blue Button program, now in its fifth year, and still growing.

 

The second falls squarely on our shoulders:  we need to make the user experience attractive, convenient, and useful.  The health IT community has made terrific strides recently – we-two have worked on the InCircleand a soon-to-be-announced medication management app, for example –  and there are many companies that target data-driven patient-provider interactions, including AmericanWell and covers health.

 

The beautiful thing is that IoT fits so neatly into this conversation. The goal, of course, is to help us achieve our best-possible health. The best way to do this is with data. And the best data is coming at us in ever more granular packages, from patient-hosted sensors that monitor, detect, interact, and intervene. Weaving those into the tapestry of your personal health history is the next vanguard of coordinated and managed care.

Technical Dr. Inc.'s insight:
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inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

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