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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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Adults use Online Health Resources instead of Primary Healthcare 

Adults use Online Health Resources instead of Primary Healthcare  | Healthcare and Technology news | Scoop.it

A recent survey of 2,201 US adults, conducted by University of Phoenix® College of Health Professions, found that almost 59 percent of the population is choosing to use online health information sites, such as WebMD, instead of primary care. The survey also found that though online health resources are being preferred by people, other health technologies are not getting adopted at the same rate.

 

Doris Savron, Executive Dean for the College of Health Professions, noted that “The healthcare industry is shifting to a patient-centered model that harnesses technology to both open communication channels and create a platform for patient engagement. Given this shift, it is crucial that patients not only have access to these technologies but also view them as important resources for improving their health and overall care experience.”

 

Merely a quarter of US residents who have access to technology utilize resources such as appointment booking, accessing health records and e-prescription filing.

 

In traditional care settings, Americans expect a certain level of quality from their healthcare professionals team. As per this survey, most of the respondents value the presence of interpersonal skills amongst their care teams, which includes listening, verbal communication and bedside care.

 

Savron further added, “The data shows that technology is just one piece of the puzzle when it comes to patient care. Although new technologies are resources that we should lean on to help improve communication, interpersonal skills are the foundation for ensuring patient trust and better care. Communication and empathy are vital skills for health professionals seeking to improve adherence and drive positive outcomes for patients.”

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Physicians warm to value-based pay models, but skepticism runs deep 

Physicians warm to value-based pay models, but skepticism runs deep  | Healthcare and Technology news | Scoop.it

Though significant barriers still stand in the way of the transition to value-based reimbursement, a new study offers encouraging signs that physicians are getting more comfortable with new payment models.

 

The study, a joint effort between the American Academy of Family Physicians and Humana, follows up on a similar study they conducted in 2015. Representatives from both organizations—plus Health Care Transformation Task Force Executive Director Jeff Micklos—participated in a briefing Wednesday on to discuss the findings.

 

Amy Mullins, M.D., medical director of quality improvement for AAFP, said one of the data points that stood out the most was that 37% of those surveyed said payments based on quality measures were distributed to physicians at their practice—a “huge jump” from 2015, when it was just 18%.

 

Micklos also highlighted that finding, noting it’s a good sign that shared savings are trickling down to frontline doctors.

“Without that financial incentive, it’s really hard to convince a medical professional that there’s a sustainable business model there,” he said.

 

Mullins said it’s also promising that significantly fewer physicians said they were “not at all familiar” with the concept of value-based payments—7% in 2017 versus 12% in 2015. In addition, the study found that more practices are also hiring care management, care coordinators and behavioral health support to prepare for value-based care.

 

A variety of barriers

It is not all positive news, however. In 2017, only 8% of family physicians agreed with the statement that “quality expectations are easy to meet in value-based payment models,” compared to 13% in 2015. Plus, 62% cited “lack of evidence that using performance measures results in better patient care” as a barrier to adoption.

 

Even the finding that little more than half of physicians said their practice participates in value-based care models shows there is still work to be done.

 

“If you didn’t already know, physicians are a skeptical bunch,” Mullins said, later adding, “we are slow adopters for lots of things.”

And while the share of family physicians who have contracts with 10 or more payers remained about the same, Mullins said it’s still noteworthy that it’s as high as 37%. That illustrates how “frustrating and exhausting” it can be for physicians to deal with the myriad quality measures and systems associated with each payer, she added.

 

One potential barrier not covered in the survey is the uncertainty over what will happen with the Center for Medicare and Medicaid Innovation, Micklos said, noting that Medicare has long been the driver of what happens with the rest of the industry. The Trump administration has asked industry stakeholders for input on an effort to take the innovation center in a “new direction.”

 

The panelists were less concerned, though, with the administration’s move to end mandatory bundled payment models. Regardless of what specific policy levers are pulled, the move to value is smart for the private sector, as fee-for-services has a “tremendous amount of demonstrable inefficiencies,” said Roy Beveridge, M.D., Humana’s chief medical officer and senior vice president.

 

Micklos agreed, adding that bringing people “screaming” into certain payment models isn’t the most sustainable concept anyway.

 

The IT factor

A little more than half of the physicians surveyed said their practices were updating or adding IT infrastructure to prepare to participate in value-based care models. The same share—54%—said as much in 2015.

 

As important as that is, though, physicians still must have better, easier-to-understand and more timely data to truly move forward on connecting payment to health outcomes, Mullins pointed out.

In that effort, insurers can be a crucial partner, Beveridge said. They have a tremendous amount of analytics and other supports to offer physicians, he said, and thus have the responsibility to share that with physicians so that they can act upon it.

 

One of the biggest issues that both payers and providers continue to face, however, is the lack of interoperability between electronic health records systems.

 

From Humana’s point of view, “some of the barriers for interoperability really should not exist,” Beveridge said. But Mullins added that “I don’t know if there is a light at tend end of the tunnel or not,” on fixing the issue.

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Formdox's comment, April 20, 5:33 AM
Nice post
Formdox's comment, April 20, 5:33 AM
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Lean Healthcare A Guide For Healthcare IT Directors

Lean Healthcare A Guide For Healthcare IT Directors | Healthcare and Technology news | Scoop.it

Healthcare IT directors face a set of challenges that are unique in the healthcare industry. You’re working to keep patient information secure, nail down IT processes and provide the best equipment and service to bolster patient care – all while reacting to daily IT issues that arise.

 

If you’re looking for a way to streamline your processes, improve operations and ultimately provide your patients with better care, it’s time to consider the advantages of Lean healthcare.

In this hospital IT director’s guide to Lean healthcare, we’ll discuss what Lean healthcare is and how it enables these benefits.

Improving Your Operations Through Lean Healthcare

Lean healthcare relies heavily on philosophy, methodology and process, with some improved or optimized tools. In other words, you don’t have to overhaul your entire IT infrastructure. You just have to start using the tools you already have in the most efficient way possible to maximize their effectiveness. This approach is not centered on you, your nurses, your doctors or your staff members working harder. It’s focused on how all of you can work smarter.

Every workplace has areas of wasted or duplicated effort and time. The key to running an efficient operation is eliminating that waste. For example, Lean healthcare organizations will use value-stream mapping to outline the daily tasks or projects from a hospital staff member or group. As all functions are mapped out within that task or project, waste is identified as a piece that doesn’t directly contribute to delivering patient value or provide the best experience possible. The goal then is to eliminate that waste in the process.

Benefits For Healthcare IT Directors

As your organization's IT director, you’re constantly seeking ways to improve processes, operations and patient care. Lean healthcare enables you to reach those goals. Some of the benefits of Lean healthcare for IT directors include:

  • IMPROVED PROCESSES – For IT directors, processes are everything. You need a streamlined, waste-free, solutions-based process for solving problems in your workplace. Lean healthcare helps you formulate that structure.
  • PROACTIVE SOLUTIONS – Not only does Lean healthcare enable you to ensure process-based solutions, but it also empowers you to identify proactive solutions for your staff needs. Stop putting out fires and start proactively anticipating what challenges you’re likely to face.
  • GREATER EFFICIENCY – When you’re working smarter instead of harder, you’ll find that you have more time on your hands to perform your job. Distancing yourself from reactive IT methods and proactively solving problems frees up more time to play a leadership role in your organization.

Implementing Lean Healthcare

Adopting a Lean approach is about more than just understanding the philosophy. As an IT director, you have to put the right implementation methods in place. Use the following tips to build a solid foundation for successfully integrating Lean healthcare at your organization.

  • ENSURE OPEN COMMUNICATION. One of the most powerful aspects of Lean organizations is open communication. Lead the implementation of Lean healthcare by bringing staff members together to find operational improvement. This roundtable discussion of how to reduce waste – waste of energy, time, money, etc. – comprises representatives of all hospital staff and interested parties, including hospital IT, nurses, pharmaceutical staff and more. It might be the first time a representative of the nurses has discussed these issues with someone from billing or the pharmaceutical staff. As the IT director, you must work to establish a foundation of open communication, allowing parties to address any challenges the hospital is facing. Then, use these different perspectives to find smart, efficient solutions.
  • ELICIT BUY-IN FROM THE TOP DOWN. If a change is implemented in a company but the head of the organization doesn’t buy into the new process, that change is unlikely to have lasting success. The same holds true for Lean hospitals and clinics. One of the keys to a successful implementation of Lean principles is gaining acceptance from the top down. Solicit help from your hospital’s most senior parties to communicate the importance of adopting Lean healthcare. They should consider running a small, internal public relations campaign of sorts, communicating to everyone that your organization is taking Lean healthcare seriously.
  • VIEW IT AS A WAY OF LIFE. Lean healthcare used to be viewed as a passing fad. Over the course of the last few years, however, it’s become more than the next “flavor of the month” for IT solutions. It’s a way of life for many hospitals – not just a temporary fix for some of the challenges your organization faces, but rather a long-term solution that should be part of your organization's DNA. Treat your shift to Lean healthcare as a cultural change in your hospital if you’re looking for the rest of your staff to follow suit.

You have a responsibility to ensure a streamlined, proactive approach to healthcare IT. Take the steps to properly implement Lean healthcare, and you’ll reap the long-term benefits of working in an efficient organization where patients come first.

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HIMSS18 – What, Where and How HealthIT can impact healthcare 

HIMSS18 – What, Where and How HealthIT can impact healthcare  | Healthcare and Technology news | Scoop.it

With the annual #HIMSS18 conference just a few weeks away, most of the industry’s attention is turning to matters relating to technology, cyber security and the regulations around HealthIT. We thought it would be fitting, therefore, to team up with the wonderful folks at @HIMSS for a tweetchat focused on technology and healthcare.

 

I am a fan of artificial intelligence, machine learning and virtual reality (even though I cannot physically use VR for more than 2 minutes at a time). However, the technology that I’m most intrigued by is 3D printing – specifically the 3D printing of organs and organic material.

 

First, there is the impact this technology could have on solving hunger and nutrition. Imagine if we could “print” healthy food in places where growing it is difficult or where shipping it is cost-prohibitive. Imagine also if we could print foods that are personalized to each person’s unique metabolism and dietary needs. The impact on public health would be significant and worldwide.

 

A long time ago I read a science fiction novel that talked about the advent of this type of technology: Gateway by Fredrick Pohl. The novel made frequent mention of something called CHON-food. Pohl imagined a world where CHON machines were able to replicate food by combining four key elements: carbon, hydrogen, oxygen and nitrogen. The advent of these machines helped to solve world hunger and ended many of the wars for water and food that that plagued the Earth. I hope we are at the start of CHON revolution.

 

Second, there is the impact of 3D printing on surgery and transplants. Researchers are very close to being able to print human skin using organic printers that can be used in reconstructive surgeries. The impact this technology could have on burn patients would be incredible. So too could the impact on patients that need a transplant. According to UNOS, every ten minutes someone is added to the national transplant waiting list and on average 20 people die each day while waiting for a transplant. With organ-printing technology these premature deaths might be prevented. Using tissue samples, organs can be printed to exactly match the patient’s physiology. Bonus: no more worries about organ rejection.

 

I’ve got my eye on 3D printing and over the next few years I expect it to have an impact beyond technologies like AI, machine learning and analytics. However, it’s going to take time for this technology to mature. In the meantime, there are certain areas of healthcare that can use a little boost TODAY.

 

Patient engagement and behavior change is an area of healthcare I hope #HealthIT will be able to help. Patients are the most untapped resource available to healthcare. Despite all the trackers, portals and video tutorials, health literacy remains extremely low. Some would argue that the widespread adoption of EHRs had even contributed to patient dis-engagement as doctors and nurses spend more time staring at screens rather than speaking to patients about their health. I see a golden opportunity in healthcare for patient engagement technology.

 

In the early 90s, the field of behavioral economics took shape. Richard Thaler, the University of Chicago professor who recently won the Nobel Memorial Prize in Economic Sciences, began publishing a series of papers that combined psychology and economics. His work led many to begin studying the ways that human behavior influences financial decisions. We need to apply those same theories to healthcare and design #HealthIT systems that nudge patients (and clinicians) into healthier behaviors.

I am incredibly excited about the future of healthcare. I am certain we are making progress towards a brighter day for patients, doctors, nurses, family caregivers and administrators. As I walk the #HIMSS18 exhibit hall I will be on the hunt for companies that share this outlook and whose products show clear signs of patient/provider design input.

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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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What are the Top Healthcare Industry Challenges in 2017?

What are the Top Healthcare Industry Challenges in 2017? | Healthcare and Technology news | Scoop.it

Healthcare Industry challenges are always going to be evolving alongside the breakthroughs and innovations. In 2017, there are new healthcare industry challenges that go alongside the age-old difficulties.

For doctors, nurses and medical teams, here are 7 of the key healthcare industry challenges they are currently facing in the year ahead for 2017.

1) Retail Care offering increased access

Retail giants like CVS and Walgreens are pushing further into care delivery, continuing to put pressure on traditional providers to increase access to care.

According to Laura Jacobs, writing for Hospitals and Health Networks “The greatest challenge for most organizations will be finding the right pace for adapting to or embracing new [healthcare] payment models.”

Doctors will be required to step up their efforts to optimize the patient experience, beyond measuring patient satisfaction.

2) Behavioral healthcare

The healthcare industry is starting to recognize that Mental Health is important to the well-being of employees and consumers, according to a report from PWC.

The report notes that one out of five American adults experiences a mental illness every year. These conditions cost businesses more than $440 billion each year. Healthcare organizations and employers will look at behavioral care as ‘key to keeping costs down, productivity up and consumers healthy’ the report said.


3) Meaningful Use and Value Based Payments

Eligible providers and eligible hospitals are continuing to work on meaningful use of EHRs.

Value-based purchasing programs are solidly in place, and eligible physicians are starting to experience the penalty phase of CMS’s quality reporting and Meaningful Use initiatives. In fact, CMS revealed that more than 257,000 eligible professional providers who are not meaningful users of certified EHR technology would have their Medicare Fee Schedule cut by one percent.

Eligible physicians also need to comply with CMS’s new Value-Based Payment Modifier program, or face penalties. It’s part of Medicare’s efforts to improve healthcare, but the program adds yet more regulations physicians need to monitor.

All these changes and new reporting requirements can become overwhelming for already busy physicians, which is why the American Medical Association has repeatedly asked for relief.


4) Switching to ICD-10

The much anticipated and maligned change to ICD10 codes in 2015 led to a lot of discomfort for physicians. The increase in codes from 14,000 to 68,000 means a lot of diagnosis criteria must be re-learned.

There is a great deal of planning, re-training and new systems that go along with the upgrade in codes. For doctors, finding the time to do this proved to be a huge challenge, and still is.

5) Data Security

Patient privacy issues, including concerns about data breaches, continue to be a challenge for providers, payers, and consumers.

Providers and payers will need to be aware of the best practices for data security to avoid the type of Health Insurance Portability and Accountability Act (HIPAA) violations that can negatively impact an organization.


6) Managing Patient volume

While new payment models will are aiming to reduce acute hospital utilization, the continued expansion of Medicaid and the insured population through the public exchanges will seemingly keep demand up.

The rise of obesity and chronic disease and population aging are creating a demand for medical services like never before.

Emergency departments will continue to be overworked until efforts to decant volume through urgent care, better care management or redesigned primary care models begins to take effect..


7) Implementing Telemedicine

The idea of a doctor seeing you via a computer screen may no longer be new, but the adoption of the Telemedicine services by doctors with their own patients is still a struggle.

The Information Technology and Innovation Foundation shares a vision of how Telemedicine can reduce patient backlogs. “Imagine a world where patients in rural areas far from a nearby doctor can easily find a health care provider to consult with online from the comfort of their own homes; where doctors living in Pennsylvania can help reduce the backlog of patients waiting to see doctors in Mississippi; and where patients can connect to a doctor over the Internet for routine medical purposes with a few clicks of the mouse—like they do when ordering a book on Amazon.”

Finding a balance between in person visits and telemedicine will require doctors to adjust their approach to care. Learning to diagnose remotely also requires new skills and detailed reporting.

Of course, Healthcare Industry Challenges are nothing new. Technology and legislation will continue to change the landscape. Doctors and their medical teams must evolve their approach and focus to meet them.

 

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5 Ways Technology Is Transforming Health Care

5 Ways Technology Is Transforming Health Care | Healthcare and Technology news | Scoop.it

 

How are tech nerds getting involved in health care? Here are five ways:

 

 

1. Crunching data to offer a better diagnosis and treatment:

         

             Just call the computer “Dr. Watson.” Researchers at IBM have been developing the supercomputer known as Watson (which, in February 2011, beat out "Jeopardy" champs Ken Jennings and Brad Rutter to win $1 million, which was donated to charity) to help physicians make better diagnoses and recommend treatments. Doctors could potentially rely on Watson to keep track of patient history, stay up-to-date on medical research and analyse treatment options. Doctors at Memorial Sloan-Kettering Cancer Center in New York are expected to begin testing Dr. Watson later this year.

Recommended by BMO Harris Bank
 
 
 

2. Helping doctors communicate with patients:

 

                    Science Applications International Corporation (SAIC) has developed Omnifluent Health, a translation program for doctors and others in the medical field. The suite of products includes a mobile app that lets doctors speak into the app — asking, for example, if a patient is allergic to penicillin — and translate the message instantly into another language. Given that there are 47 million U.S. residents who don't speak English fluently, the program could be a boon for doctors who would otherwise need to rely on translators and medical assistants to communicate with their patients.

 

3. Linking doctors with other doctors:

 

                  Could social networking help doctors work better together to take care of their patients? That’s the premise behind Doximity, a social network exclusive to physicians. Through Doximity, doctors throughout the United States can collaborate online on difficult cases. It’s received $27 million in funding and counts among its board members Konstantin Guericke, a co-founder of LinkedIn.

 

4. Connecting doctors and patients:

         

                 New York City startup Sherpa offers patients medical consultations online and over the phone, potentially saving a trip to the ER. The medical advice doesn’t come from just anyone, but from some of the city’s top medical specialists. Employers such as Tumbler have signed onto the service.

 

 

5. Helping patients stay healthy:

 

           A growing number of mobile apps and gadgets aim to help people stay active, sleep well and eat healthy. Among them are Fit-bit, a pedometer that tracks daily sleep and activity and uses social networking and gaming to motivate its users. Lark is a silent alarm clock and sleep monitor that tracks and analyses a person’s quality of sleep over time, offering suggestions to help the person get better rest (it has since expanded to track daily activity, too). And there are dozens upon dozens of calorie-counting, food-monitoring and menu-tracking apps to aid the diet-conscious.

It's clear that technology is giving the health care industry a much-needed upgrade, from medical translation tools to mobile apps that help patients live healthier lives. Though much is still in the early and experimental stages, the advances in technology could help save money in health care costs and improve patient treatment.

Patients who can connect with their doctors more easily, for instance, won't need to make expensive and perhaps unnecessary trips to the ER or specialists. Doctors will be able to collaborate with other physicians and experts in new ways and use computers to analyse patient and medical data, allowing them to provide better and more efficient treatment for their patients. As technology continues to expand the horizons of medicine and medical interaction, it's becoming clear that we're entering a new era of health care — or as some people are beginning to call it, Health 2.0.

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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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Helping Patients Understand Insurance Benefits is Key

Helping Patients Understand Insurance Benefits is Key | Healthcare and Technology news | Scoop.it

Over the past several weeks, I've had the task of helping my own dad through some health issues. The biggest issue that we have run into multiple times is insurance challenges.


I know that I typically give you hints and tips to help lower your accounts receivable, get you paid on time, and manage your billing staff. But I'm going to take a different tack this week; focusing on the patient's viewpoint.


Before I get into the details of our struggle to help dad see the appropriate specialists, I feel it's most important to note that you and I are healthcare professionals. We do this job, everyday. We are immersed in professional jargon that sounds foreign to the typical patient. We understand (for the most part) that the laws are in place to protect the patient. We have to learn how to play nice with the insurance companies so that our practices get paid. Our patients don't really see this. From a patient's standpoint, they simply buy an insurance plan; they ask the practice to file a claim; and the insurance company pays what the practice is due. However, you and I know this is certainly not the case.


There is a huge gap between reality and what the patient thinks happens with their insurance plan. They do not understand that not only is it a plan they purchased, but they must also understand the nuances of that plan. Is outpatient physical therapy a covered benefit? Does the plan have a deductible? Is there a copay or coinsurance associated with some visits and not others? Is the doctor in network? The typical patient is truly not aware that this type of information is their responsibility to know.


So, that said, let me share my story. My dad has a Medicare replacement plan. He still thinks he has Medicare primary and UnitedHealthcare as a secondary insurance. So, lesson one when explaining patients' benefits prior to being seen is that they understand if they have a replacement plan, and not Medicare with a secondary.

Next, his primary physician referred him to a specialist. The specialist was 50 miles away. I'm not kidding. Dad gets to the appointment, and the office manager took him aside and said they do not accept his insurance; but he could pay the $3,000 out-of-network rate if he wanted to. No phone call, no warning about the physician's out-of-network status, nothing. Dad walked out and drove back 50 miles to his house and called me a few hours later. The next morning, Dad and I did a conference call with his medical group. I asked them why there wasn't a specialist in their group that he could see? I also said that if there isn't a physician that fits the requirements of Dad's care, they would have to provide the authorization to see an out-of-network physician, as that was not Dad's problem they didn't fill up their network. A few hours later poof! They found a doctor only 10 minutes from his house that was just credentialed that day. Shocking, I know.


So, the medical group contacted the doctor's office and set up an appointment. They called us back on another conference call and let us know everything was taken care of. I asked, "Okay, I have my pen and paper, can you please provide the authorization number for this visit?" There was silence on the other end of the line. There were four people telling us seconds ago that everything was set up and ready to go and no one could provide the authorization number. They asked for a few minutes to call us back. The phone rang, an authorization for three visits was provided, I took names, phone numbers, etc.


My dad was so frustrated and completely confused about why things are so complicated, and wondered how was he supposed to know all of this?! Technically, he is supposed to know these things, but honestly, there is no way he would ever have been able to get this figured out without my help.


I suppose my point is when you have a patient that needs an authorization, or does not understand the difference between in-network and out-of-network status, please take the time to work with them. Be patient. Be kind. They are in pain or sick, and the last thing they want to worry about is their insurance plan.


It would be ideal if the insurance company took the time to explain plan details and teach patients how best to utilize their plan benefits. We know this will never happen, as it would be very costly for the insurance company.


Take it easy on your patients and find it in your heart to spend the necessary time with your patient; remember this likely someone's dad, mom, sister, or brother.

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Could On Demand Medical Services Be Good for Doctors?

Could On Demand Medical Services Be Good for Doctors? | Healthcare and Technology news | Scoop.it

I’ve been seeing a lot of discussion lately about the peer sharing economy and how it applies to healthcare. Some people like to call it the Uber of healthcare, but that phrase has been applied so many ways that it’s hard to know what people mean by it anymore. For example, is it Uber bringing your doctor to your home/work or is it an Uber like system of requesting healthcare? There are many more iterations.


I’ll to consider doing a whole series of posts on the Peer Sharing Economy and how it applies to healthcare. There’s a lot to chew on. However, most recently I’ve been chewing on the idea of on demand medical services. In most cases this is basically the Skype or Facetime telemedicine visit on a mobile device. These models are starting to develop and it won’t be long until all of us can easily hop on our mobile device and be in touch with a doctor directly through our phone. In some cases it will be a telemedicine visit. In other cases it might be the doctor coming to visit you. I’m sure we’ll have a wide variety of modalities that are available to patients.


Every patient loves this idea. Every insurance company is trying to figure out the right financial model to make this work. Most doctors are scared at what this means for their business. Certainly there are reasons for them to be concerned, but I believe that this new on demand medical service could be very good for doctors.


In our current system practices do amazing scheduling acrobatics to ensure that the doctor is seeing a full schedule of patients every day. They do this mostly because of all the patient no shows that occur. This makes life stressful for everyone involved. Imagine if instead of double booking appointments which leads to all sorts of issues, a doctor replaced no show appointments with an on demand visit with a patient waiting to be seen on a telemedicine platform. Basically the doctor could fill their “free time” with on demand appointments instead of double booking appointments which then causes them to get behind when both appointments do show up.


I can already hear doctors complaining about them being “mercenaries” and shouldn’t they be allowed free time to grab a coffee. I’d argue that in the current system they are mercenaries that are trying to fill their schedule as full as possible. The current double booking scheduling approach that so many take means that some days the doctor has a full schedule of appointments and some days they have more than a full schedule of appointments. If doctors chose to back fill no-shows with on demand appointments, then their schedule would be more free than it is today. Plus, if they didn’t want to back fill a no show, they could always make that choice too. That’s not an option in the double book approach they use today.


In fact, if there was an on demand platform where doctors could go and see patients anytime they wanted to see patients, it would open up a lot more flexibility for doctors much like Uber has done for drivers. Some doctors may want to work early in the morning while others want to work late at night. Some doctors might want to take off part of the day to see their kid’s school performance, but they can work later to make up for the time they took off (if they want of course).


Think about retired doctors. I’m reminded of my pharmacist friend who was still working at the age of 83. I asked him why he was still working at such an advanced age. He told me, “John, if I stop, I die.” I imagine that many retired doctors would love to still see some patients if they could do it in a less demanding environment that worked with their new retirement schedule. If there was an on demand platform where retired doctors could sign in and see patients at their whim, this would be possible. No doubt this is just one of many examples.


Currently there isn’t an on demand platform that doctors could sign into and see a patient who’s waiting to be seen. No doubt there are many legal, financial and logistical challenges associated with creating a platform of this nature. Not the least of which is that doctors are only licensed to practice in specific states. This is a problem which needs to be solved for a lot of reasons, but I think it will. In fact, I think that legal issues, reimbursement changes, and other logistical challenges will all be solved and one day we’ll have this type of on demand platform for healthcare. Patients will benefit from such a platform, but I believe it will open up a lot more options for doctors as well.

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Google Glass Shown Beneficial for Bedside Toxicology Consults

Google Glass Shown Beneficial for Bedside Toxicology Consults | Healthcare and Technology news | Scoop.it

Although Google Glass may have been pulled as a product for the masses, Alphabet plans on continuing to develop the device for professional applications. And it’s certainly proving itself useful in medicine, as a new study in Journal of Medical Toxicology has shown that it’s useful and effective for tele-toxicology consults. The project involved emergency medicine residents who wore Glass during evaluations of poisoned patients while toxicology fellows and attendings in a remote location participated in the consults via a video connection. They essentially set back and reviewed the findings of the emergency docs, offering advice as necessary.


The study looked at how everyone involved accepted the use of the communication medium, as well as how it affected the care provided. Interestingly, the toxicologists changed their opinions of how to treat the patients in 56% of cases after using Glass. In six cases the antidote that was prescribed was accurately selected only after using Glass. In 11 of cases the connection was too poor for usability, but that can probably be attributed to the network used.

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Hospitals work on allowing patients to actually sleep

Hospitals work on allowing patients to actually sleep | Healthcare and Technology news | Scoop.it

It's a common complaint — if you spend a night in the hospital, you probably won't get much sleep. There's the noise. There's the bright fluorescent hallway light. And there's the unending barrage of nighttime interruptions: vitals checks, medication administration, blood draws and the rest.

Peter Ubel, a physician and a professor at Duke University's business school, has studied the rational and irrational forces that affect health. But he was surprised when hospitalized at Duke -- in 2013 to get a small tumor removed -- at how difficult it was to sleep. "There was no coordination," he said. "One person would be in charge of measuring my blood pressure. Another would come in when the alarm went off, and they never thought, 'Gee if the alarm goes off, I should also do blood pressure.'"

"From a patient perspective," he added, "you're sitting there going, 'What the heck?'"

As hospitals chase better patient ratings and health outcomes, an increasing number are rethinking how they function at night — in some cases reducing nighttime check-ins or trying to better coordinate medicines — so that more patients can sleep relatively uninterrupted.

The American Hospital Association doesn't formally track how many hospitals are reviewing their patient-sleep policies, though it's aware a number are trying to do better, said Jennifer Schleman, an AHA spokeswoman.

And, though few studies specifically link quality of shut-eye and patient outcomes, doctors interviewed said the connection is obvious: patients need sleep. If they get more of it, they're likely to recover faster.

    Traditionally, hospitals have scheduled a number of nighttime activities around health professionals' needs — aligning them with shift changes, or updating patient's vital signs so the information is available when doctors make early morning rounds. Both the sickest patients and those in less serious condition might get the same number of check-ins. In some cases, that can mean patients are being disturbed almost every hour, whether medically necessary or not.

    "The reality for many, many patients is they're woken up multiple times for things that are not strictly medically necessary, or...multiple times for the convenience of staff," said Susan Frampton, president of Planetree, a nonprofit organization that encourages health systems to consider patient needs when designing care.

    Changing that "seems like kind of easy, low-hanging fruit," said Margaret Pisani, an associate professor at Yale School of Medicine. She is working with other staff at the Yale hospital to reduce unnecessary wake-ups, using strategies like letting nurses re-time when they give medicines to better match patient sleep schedules, changing when floors are washed or giving nurses checklists of things that can and should be taken care of before 11 p.m.

    Not only is the push for better patient sleep part of a larger drive to improve how hospitals take care of their patients, but it is fueled in part by measures in the 2010 health law tying some Medicare payments to patient approval scores. As more hospitals try to improve those numbers, experts said, more will likely home in on improving chances for a good night's sleep.

    "There's a movement toward patient-centered care, and this is definitely a part of it," said Melissa Bartick, an assistant professor at Harvard Medical School.

    That focus makes sense, since federal patient approval surveys specifically ask about nighttime noise levels. A number of hospitals initially struggled to get good scores on that, said Richard Evans, chief experience officer at Boston-based Massachusetts General Hospital.

    His hospital instituted quiet hours -- a couple of hours in the afternoon and between six and eight hours at night, depending on the hospital unit, in which lights are turned low and staff encouraged to reduce their noise levels. It also encourages staff members to consider whether patients really need particular care at night before waking them. "We're trying to [increase awareness] that patients need to rest, and we need to structure our care as much as possible to allow that to happen."

    It's hard to delineate the degree to which such efforts have affected patient approval scores, Evans said. Anecdotally, though, patients have expressed appreciation, he added.

    The Department of Veterans Affairs New Jersey Health Care System is taking this concern even further. In addition to quiet-time restrictions, in which they try to reduce the use of noisy equipment, staff chatter and things like phone volume, patients can opt to have lavender oil sprayed in their rooms or an evening cup of herbal tea to facilitate sleep.

    All of these kinds of changes can help, said Planetree's Frampton. But they don't get at the real problem for most patients.

    "Low scores on quiet-at-night [questions on patient suarveys] are not because it's overly noisy...but because patients are woken up repeatedly," she said. "Their sleep is disturbed so they're lying awake."

    To address that, hospitals may need to look at less obvious questions. At New York's Mount Sinai Hospital, doctors are rethinking when they prescribe medicines as well as what kind, said Rosanne Leipzig, a professor of geriatrics and palliative medicine and who practices at the hospital. For instance, some antibiotics can be given at six-hour intervals rather than four-hour intervals, reducing the need for nighttime interruptions. And some drugs usually given every six hours can instead be given four times a day during the hours patients are usually awake.

    The hospital is also working to develop a system to classify patients who need repeated checks from the medical staff, such as those who might face imminent health threats or are at risk for serious infections such as sepsis. For those patients, frequently checking vitals is important, even if patients sleep less, Leipzig said. But not every patient's condition requires that they be roused every four hours, she added.

    About half of all patients woken up for vitals checks probably don't need to be, according to a 2013 study published in JAMA Internal Medicine. The study suggests waking those patients may contribute to bad patient results and dissatisfaction, and could increase the odds of patients having to come back to the hospital.

    Another study, published in 2010 in the Journal of Hospital Medicine, looked at efforts to encourage patient sleep — particularly by rescheduling activities, nighttime checks and overnight medication doses so as not to wake patients. That paper, co-written by Bartick, the Harvard professor, found a 49% drop in the number of patients who were given sedatives. That can have the added benefit of improving patient outcomes, since sedatives are associated with dangerous side effects such as falling or hospital delirium or confusion.

    "Sleep disruptions are actually not benign as far as patients are concerned," said Dana Edelson, an assistant professor of medicine at the University of Chicago and an author on the 2013 study. "We're putting them at unnecessary risk when we're waking them up in the middle of the night when they don't need to be." And possibly making the recovery a bit more difficult.

    "Patients will tell you, 'I was so exhausted, I couldn't wait to get home and go sleep,'" said Yale's Pisani.

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    Major Challenges remain for Health IT Interoperability 

    Major Challenges remain for Health IT Interoperability  | Healthcare and Technology news | Scoop.it

    The road to the seamless sharing of patient data across the digital health care spectrum is not measured in miles or meters, but in the continued collaborative efforts of the public and private sectors to build and regulate networks for the free flow of information.

     

    But for all of its efforts, the Office of the National Coordinator for Health IT concedes that path to interoperability remains winding. That’s why it hosted two panel discussions Tuesday for National Health IT Week to talk about the challenges and successes of the adoption and sharing of electronic health records.

     

    “We certainly still have a long way to go with health IT, whether it be usability or interoperability, but we wanted to talk a bit about where we’ve come so far,” said Principal Deputy National Coordinator for Health IT Genevieve Morris.

     

    The panels focused on both the interoperability of the digital devices storing EHRs and their usability in an effort to map out where the health sector is and where it still has to go.

    Among the takeaways were:

     

    It’s not a tech problem — it’s leadership 

    Ed Cantwell, president and CEO of the Center for Medical Interoperability—a nonprofit research lab advancing data sharing in medical technology—said that while innovation is being spurred through the health care sector, the gap in information sharing is coming from a lack of collaboration.

     

    “I have a hypothesis that you could put 20 executives in a room representing comprehensive interoperability, there would be vendors, hospital CEOs and physicians, but it’s not a technology problem,” he said. “It’s a lack of coordinated leadership. I think the call to action is let’s put those people in a room. Every other industry has done it, they’ve come together and put their differences aside.”

     

    Cantwell also said during the panel that while ONC does have the leverage to guide the policy direction of health IT, the private sector will have to lead the move toward greater interoperability.

    “I think this is the time where the private market needs to step up,” he said. “Whether it’s for-profit or nonprofit or public or military or [the Department of Veterans Affairs], if we are to start the slurry of digital and set a goal to be on parallel with every other data liquid industry, then I think we need to stop this fantasy of think that ONC can, from the sidelines, impact a $3 trillion market.”

     

    There’s no one-size-fits-all

    John Kansky, president and CEO of the Indiana Health Information Exchange, said that part of the challenge of interoperability is that it has to serve a diverse range of needs across a wide network, from physicians to hospitals to insurance providers.

     

    “I don’t think moving health care data around the country is any less complicated than moving people and stuff around the country,” he said. “Interoperability isn’t one thing. Every organization has complex interoperability needs.”

     

    Kansky said that both government and the market have distinct roles in guiding and adapting interoperability and have to collaborate to ensure that they can make it more efficient.

     

    Hard-to-build software to meet every need

    Andrey Ostrovsky, chief medical officer at the Centers for Medicare & Medicaid Services and the Children’s Health Insurance Program, said it’s very difficult to design a product centered on its ease of use while also delivering functionality that serves the layers of users in health care.

     

    “It’s very hard to build software well,” Ostrovsky, the former CEO of predictive insights platform Care at Hand, said. “It’s even harder to build software well when you have multiple end users. When we talk about the federal government’s role in somehow influencing how software gets developed or evolves, we not only have the design constraints of what does the patient need but also what does the physician need, what does the practicing admin need, what does the potential payer need in terms of reporting, and then we’ve got what does the federal government need?”

    To try to bridge those gaps, at least when it comes to physician adoption, ONC Chief Medical Information Officer Andrew Gettinger said the office is working with MedStar to develop a usability package to help smooth the rocky process physicians face in implementing an EHR system.

     

    “Putting in an EHR is very different than buying an automobile,” he said. “If you are buying an automobile, you have a couple different choices for color and drive off the lot pretty quickly. When you do an EHR, there are hundreds and perhaps thousands of small decisions that the implementation team makes along the way.”

    Gettinger said ONC expects the usability package to be out by March 2018, which will hopefully provide doctors with a streamlined process for EHR adoption.

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    Interactive text messages improve Medicare members prescription refills by 14 percentage points 

    Interactive text messages improve Medicare members prescription refills by 14 percentage points  | Healthcare and Technology news | Scoop.it

    new large-scale study shows that interactive, tailored text messages can improve medication adherence by 14 percent.

    “The program results far exceed our expectations with 44 percent refill rate in the text message group as compared to 30 percent in the non-text group,” Rena Brar Prayaga, the paper’s corresponding author and a behavioral data scientist at mPulse Mobile, said in a statement. “In addition to the difference in refill rates, the 37 percent response rate by this older Medicare population was higher than expected and patient feedback was very positive with 96 percent of the patients indicating that the solution was easy to use.”

     

    The study — conducted at Kaiser Permanente Southern California and using technology from mPulse Mobile — included 88,340 Medicare patients (all over age 65) with multiple chronic conditions. Specifically, patients were taking ora diabetes medications, blood pressure medicines, statins, or some combination of the three. The cohorts were not randomized. All patients were given the option to sign up for text messages, but only 12,272 opted in, leaving 76,068. Both groups received traditional adherence aids like automated and non-automated phone calls reminding them to refill prescriptions.

    The mPulse Mobile platform instigated an automated dialogue through which patients could get prescriptions refilled, ask questions, or explain why they had not refilled their prescription. Eighteen percent of text message dialogues resulted in refill requests.

     

    Researchers also used natural language processing to parse the tone of patient responses to the automated message. About half were neutral, 41 percent were positive or very positive, and just 9 percent were negative or very negative. When asked directly whether the service was easy to use, 95 percent of those who responded said yes and 5 percent said no.

    “It is worth noting that patients in the texting group engaged at a much higher rate than predicted,” researchers wrote in the study. “We had estimated that the patient response rate would be between 10 percent and 20 percent. … Our target refill request rate was 5 percent to 7 percent since we were messaging an older patient population. At the same time, we hoped that the ease of use of the refill dialogue might draw in more patients and nudge them toward completing their refill requests. The program results far exceeded our expectations. Throughout the three-month program, the response rate was around 37 percent, and the three-month average refill request rate was 18 percent.”

    Based on the success of the program, Kaiser Permanente intends to deploy it at additional locations.

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    How to Grow Your Practice with Personalized Healthcare Marketing 

    How to Grow Your Practice with Personalized Healthcare Marketing  | Healthcare and Technology news | Scoop.it

    With every New Year, there are new plans and strategies for self and practice’s growth. This year also, you are ought to see new healthcare and marketing developments combined with a higher competition. This makes digital marketing imperative for your practice. But, how to win the race of online marketing? According to Hubspot, “Nearly three-fourths (74%) of online consumers get frustrated by the content they receive that has nothing to cater to their interest. Since one-size-fits-all has become an outdated concept today, you need to go for personalized marketing strategy.

    Benefits of personalized marketing

    Let’s start with understanding the benefits of personalization. In addition to a quality experience for your patients, your practice also enjoys following advantages

    Loyal patients: A personalized care motivates your patient to revisit your practice. Patients, value your treatment and care that meet their needs and go for additional services as well. Subsequently, loyal patients promote your practice among their friends and family.

    Strong online reputation: With happy patients, you are likely to get numerous positive reviews for your practice. Personalization helps you request individuals for positive feedback and they won’t mind sparing a few minutes to write well about you and your practice online. But, the story does not end here, instead, you need to respond them.

    Check for reviews on all reviews platforms and social media channels and whether positive or negative, respond to reviews. This will make your patients feel valued and inspired to revisit your practice.

    How to personalize your marketing message?

    1. Email marketing

    One aspect of personalized emailing is launching email campaigns segmented on the basis of gender, age, family, etc. That is

    – Gender-specific: Uncheck the male email IDs when launching a health program for women.

    – Age-specific: If your email campaign is focused on millennials diet or lifestyle, keep the baby boomers and the elderly out of it. Else, they might consider your email irrelevant and end up unsubscribing it.

    – Family-focused: Email campaigns with general health tips, awareness programs, etc. should target the family of the reader. Next time, the reader is likely to bring his/ her family members to your practice for treatment.

    – Try sending emails from your name instead of your practice’s name. This adds a value to the reader on being addressed by a human and not a brand.

    – The mail should start with the recipient’s name such as “Dear (Patient name)”, “Hi (Patient name), and so on. This will motivate the receiver to read the email and won’t appear as a machine generated message.

    1. Social media marketing

    You are very well aware of the popularity of social media sites and the growing number of people joining them. These platforms have become information forums where people discuss anything and everything with a large crowd. So, manage your social media profiles actively. Respond to your patients in a personalized manner. Monitor their activities regularly and design content that matches the needs of your target audience.

    1. Multichannel Marketing

    Personalization needs to be accessed via all marketing channels to attract patients of all age groups. From mobile phones to newspapers, you need to get the attention of all your target audience. Where millennials are internet savvy, elderly people can be reached through TV ads and newspapers. Select the channel judiciously according to the age group of your patient.

    In addition to the age, patient’s location is also an important consideration. Check your analytics and accordingly plan your activities. You can launch TV ads on local channels or get your articles published in the local newspaper to acquire local patients.

    You can also make use of pay-per-click ads and remarket to capture more patients focusing their needs. This way an individual will find your service ads informative for himself and his acquaintance and will approach you immediately.

    1. Greetings

    Wish your existing patients and new ones on occasions or life events such as birthdays or anniversaries for a delightful surprise. This will forge a personal connection with them. See you so considerate, you are likely to build a long-term relationship with many of your patients. These messages can be posted on social media accounts or sent in form of emails and text messages to people.

    The story does not end here. Organize surveys, informal discussions, and seminars to gather feedback of your existing patients after their treatment. In addition to taking the feedback, you can enhance their knowledge of a treatment or ailment.

    Lastly, what matters the most is an amazing user experience a patient gets on visiting your practice. To make your practice grow really big this year, personalize your services and get your patients revisit you in times of any health emergencies.

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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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    10 Trends You Can Expect from Healthcare in 2018 

    10 Trends You Can Expect from Healthcare in 2018  | Healthcare and Technology news | Scoop.it

    With 2017 almost in the rear-view mirror, it is time to look forward to 2018 and how healthcare will evolve in this year. The last year has been an eventful one for healthcare, from the uproar in healthcare regulations to potential mega-mergers. Needless to say, it’s a time of transition, and healthcare is in a very fluid state- evolving and expanding. There are certainly going to be new ways to keep healthcare providers and health IT pros stay engaged and excited, and here are our top 10 picks:

     

    1. The future of the GOP Healthcare bill

    The Republican healthcare reform bill gained immense traction this year. In their third attempt at putting a healthcare bill forward, the senators and the White House officials have been working round the clock to gather up votes, but somehow, the reservations persist. The lawmakers have insisted that Americans would not lose their vital insurance protections under their bill, including the guarantee that the plan would protect those with preexisting conditions. However, as it so happens, even these plans have been put to rest. Perhaps sometime in 2018, the GOP may pass a budget setting up reconciliation for tax reform, and then pass tax reform. Then, they would pass a budget setting up reconciliation for Obamacare repeal, and then pass that- it all remains to be seen.

    2. The ongoing shift to value from volume

    Despite speculations, healthcare providers, as well as CMS have pushed for more value-based care and payments tied to quality, but it’s been going slow. Although providers have been slightly resistant to take on risk, they do recognize the potential to contain costs and improve quality of care over value-based contracts. And perhaps as data assumes a central role in healthcare, the increasing availability of data and smarter integration of disconnected data systems will make the transition easier and scalable. Notably, with a $3.3 trillion healthcare expenditure this year, there has been slow down the cost growth. 2018 is expected to be much more impactful as it builds on the strong foundation.

    3. Big data and analytics translating data into real health outcomes

    Big data and analytics have always brought significant advancements in making healthcare technology-driven. With the help of big data and smart analytics, we are at a point in healthcare we can make a near-certain prediction about possible complications a patient can face, their possible readmission, and the outcomes of a care plan devised for them. Not only it could translate to better health outcomes for the patients, it could also make a difference in improving reimbursements and regulatory compliance.

    4. Blockchain-based systems

    Blockchain could arguably be one of the most disruptive technologies in healthcare. It is already being considered as a solution to healthcare’s longstanding challenge of interoperability and data exchange. Bringing blockchain-based systems will definitely require some changes from the ground up, but 2018 will have a glimpse of by innovation centered around blockchain and how it can enhance healthcare data exchange and ensure security. 

    5. AI and IoT taking on a central role

    2018 can witness a good amount of investment from healthcare leaders in the fields of Artificial Intelligence and Internet of Things. There is going to be a considerable advancement in technology, making the use of technology crucial in healthcare and assist an already unbalanced workforce. AI and IoT will not only prove instrumental in enhancing accuracy in clinical insights, and security, but could also be fruitful in reducing manual redundancy and ensuring fewer errors as we transition to a world of quality in care.

    6. Digital health interventions and virtual care to improve access and treatment

    In December 2016, many were suggesting that wearables were dead. Today, wearables are becoming one of the most sought-after innovation when it comes to digital health. And, the market is quickly diversifying as clinical wearables gain importance and as several renowned organizations integrate with each other. Not only wearables- there are several apps and biosensors that can assist providers with remotely tracking patient health, engage patients, interact with them, and streamline care operations. As technology becomes central to healthcare, 2018 will be the year when these apps and wearables boost the patient-physician interaction. 

    7. The increasing importance of security

    We deal with a tremendous amount of confidential and critical information in healthcare. It’s not just patient health information- it goes from credit card information to digital footprints. As the plethora of devices and systems storing information grows in size, a focus on ensuring becomes extremely vital as a breach could range from something as slight as information being stolen to as dangerous as a person being physically harmed. 2018 may be high time we took a good, hard look at the security of our infrastructure.

    8. Payer-provider collaborations

    Over the years, healthcare insurers have been stepping into primary care delivery model, encouraging prevention and wellness. At the same time, we have also witnessed the trend of hospitals and healthcare systems getting into the insurance part to take control of the complete patient care process. 2017 saw a lot of merger activity and 2018 will continue to see this synergy focused on value-based care, direct primary care, chronic care management, and patient engagement.

    9. Possibly stable healthcare costs

    Analysts predict that the healthcare industry will observe a growth of 6.5% in 2018, only half a percentage point higher than in 2017. And, after the changes like copays and network sizes are made to benefit plan design, this growth rate could be as low as 5.5%. Healthcare has long waited for an inflection point, where the spending will take off. But as it so happens, healthcare seems to be settling into a ‘new normal,’ where the fluctuations are more attuned and the growth rate remains in a single digit, with providers seeking strategies that would improve care management, optimize resource utilization and bring the costs down.

    10. The future of ACA

    There have been several debates and speculations regarding the future of the Affordable Care Act. With a new GOP healthcare bill on the cards, some things will stay the same, but with differences- people can still sign up on healthcare.gov, but the sign-up period would be shorter. They can still get subsidies to help lower their premiums or reduce their deductibles and copays, but some plans will be much more expensive. The future of ACA is still cloudy, and the attempts to repeal and replace ACA have been laid to rest, for now, but one thing is certain- a lot fewer people will enroll for ACA in 2018, fearing a repeal. 

    This is definitely an amazing time in the digital health world. There may be complexities and uncertainty, but for any healthcare system deeply passionate about realizing data-driven outcomes, looking for technology that can drive their core processes and help them win with value-based care- 2018 will be the year!

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    10 Biggest Technological Advancements for Healthcare in the Last Decade

    10 Biggest Technological Advancements for Healthcare in the Last Decade | Healthcare and Technology news | Scoop.it

    The reach of technological innovation continues to grow, changing all industries as it evolves. In healthcare, technology is increasingly playing a role in almost all processes, from patient registration to data monitoring, from lab tests to self-care tools.

    Devices like smartphones and tablets are starting to replace conventional monitoring and recording systems, and people are now given the option of undergoing a full consultation in the privacy of their own homes. Technological advancements in healthcare have contributed to services being taken out of the confines of hospital walls and integrating them with user-friendly, accessible devices.

    The following are ten technological advancements in healthcare that have emerged over the last ten years.

     

    1. The electronic health record. In 2009, only 16 percent of U.S. hospitals were using an EHR. By 2013, about 80 percent of hospitals eligible for CMS' meaningful use incentives program had incorporated an EHR into their organizations. "For such a long time we had such disparate systems, meaning you had one system that did pharmacy, one did orders, one that did documentation," says Jeff Sturman, partner at Franklin, Tenn.-based Cumberland Consulting Group. "Integrating these systems into a single platform, or at least a more structured platform, has allowed more integrated and efficient care for patients," he says.

    While the EHR has already created big strides in the centralization and efficiency of patient information, it can also be used as a data and population health tool for the future. "There's going to be a big cultural shift over the next several years of data-driven medicine," says Waco Hoover, CEO of the Institute for Health Technology Transformation in New York. "Historically, that hasn't been a big part of how medicine is practiced. Physicians go to medical school and residencies, but each organization has its own unique ways they do things. That's one of the reasons we see varied care all over the country. When data is what we're making decisions off of, that's going to change and improve outcomes of the consistency of medicine delivered."

     

    2. mHealth. Mobile health is freeing healthcare devices of wires and cords and enabling physicians and patients alike to check on healthcare processes on-the-go. An R&R Market Research report estimates the global mHealth market will reach $20.7 billion by 2019, indicating it is only becoming bigger and more prevalent. Smartphones and tablets allow healthcare providers to more freely access and send information. Physicians and service providers can use mHealth tools for orders, documentation and simply to reach more information when with patients, Mr. Sturman says.

    However, mHealth is not only about wireless connectivity. It has also become a tool that allows patients to become active players in their treatment by connecting communication with biometrics, says Gopal Chopra, MD, CEO of PINGMD, and associate professor at Duke University Fuqua School of Business in Durham, N.C. "Now I can make my bathroom scale wireless. I can make my blood pressure mount wireless. I can take an EKG and put it to my smartphone and transfer that wirelessly," he says. "mHealth has the opportunity to take healthcare monitoring out of the office, out of the lab and basically as a part of your life."

     

    3. Telemedicine/telehealth. Studies consistently show the benefit of telehealth, especially in rural settings that do not have access to the same resources metropolitan areas may have. A large-scale study published in CHEST Journal shows patients in an intensive care unit equipped with telehealth services were discharged from the ICU 20 percent more quickly and saw a 26 percent lower mortality rate than patients in a regular ICU. Adam Higman, vice president of Soyring Consulting in St. Petersburg, Fla., says while telemedicine is not necessarily a new development, it is a growing field, and its scope of possibility is expanding.

    The cost benefits of telehealth can't be ignored either, Mr. Hoover says. For example, Indianapolis-based health insurer WellPoint rolled out a video consultation program in February 2013 where patients can receive a full assessment through a video chat with a physician. Claims are automatically generated, but the fees are reduced to factor out traditional office costs. Setting the actual healthcare cost aside, Mr. Hoover says these telemedicine clinics will also reduce time out of office costs for employees and employers by eliminating the need to leave work to go to a primary care office.

     

    4. Portal technology. Patients are increasingly becoming active players in their own healthcare, and portal technology is one tool helping them to do so. Portal technology allows physicians and patients to access medical records and interact online. Mr. Sturman says this type of technology allows patients to become more closely involved and better educated about their care. In addition to increasing access and availability of medical information, Mr. Hoover adds that portal technology can be a source of empowerment and responsibility for patients. "It's powerful because a patient can be an extraordinary ally in their care. They catch errors," he says. "It empowers the patient and adds a degree of power in care where they can become an active participant."

     

    5. Self-service kiosks. Similar to portal technology, self-service kiosks can help expedite processes like hospital registration. "Patients can increasingly do everything related to registration without having to talk to anyone," Mr. Higman says. "This can help with staffing savings, and some patients are more comfortable with it." Automated kiosks can assist patients with paying co-pays, checking identification, signing paperwork and other registration requirements. Mr. Higman says there are also tablet variations that allow the same technology to be used in outpatient and bedside settings. However, hospitals need to be cautious when integrating it to ensure human to human communication is not entirely eliminated. "If a person wants to speak to a person, they should be able to speak with a person," he says.

     

    6. Remote monitoring tools. At the end of 2012, 2.8 million patients worldwide were using a home monitoring system, according to a Research and Markets report. Monitoring patients' health at home can reduce costs and unnecessary visits to a physician's office. Mr. Higman offers the example of a cardiac cast with a pacemaker automatically transmitting data to a remote center. "If there's something wrong for a patient, they can be contacted," he says. "It's basically allowing other people to monitor your health for you. It may sound invasive but is great for patients with serious and chronic illnesses."

    An article by Kaiser Health News, National Public Radio and Minnesota Public Radio discussed the effects a home monitoring system had on readmission rates for heart disease patients at Duluth, Minn.-based Essentia Health. The national average rate of readmissions for patients with heart disease is 25 percent, but after Essentia Health implemented a home monitoring system, the rates of readmission for their heart disease patients fell to a mere two percent. And now that hospitals are being financially penalized for readmissions, home monitoring systems may offer a solution to avoid those penalties.

     

    7. Sensors and wearable technology. The wearable medical device market is growing at a compound annual growth rate of 16.4 percent a year, according to a Transparency Market Research report. Wearable medical devices and sensors are simply another way to collect data, which Dr. Chopra says is one of the aims and purposes of healthcare. He says sensors and wearable technology could be as simple as an alert sent to a care provider when a patient falls down or a bandage that can detect skin pH levels to tell if a cut is getting infected. "Anything we are currently using where a smart sensor could be is part of that solution," Dr. Chopra says. "We're able to take a lot of these data points to see if something abnormal is happening."

     

    8. Wireless communication. While instant messaging and walkie-talkies aren't new technologies themselves, they have only recently been introduced into the hospital setting, replacing devices like beepers and overhead pagers. "Hospitals are catching up to the 21st century with staff communicating to one another," Mr. Higman says, adding that internal communication advancements in hospitals followed a slower development timeline since they had to account for security and HIPAA concerns.

    Systems like Vocera Messaging offer platforms for users to send secure messages like lab tests and alerts to one another using smartphones, web-based consoles or third-party clinical systems. These messaging systems can expedite the communication process while still tracking and logging sent and received information in a secure manner.

     

    9. Real-time locating services. Another growing data monitoring tool, real-time locating services, are helping hospitals focus on efficiency and instantly identify problem areas. Hospitals can implement tracking systems for instruments, devices and even clinical staff. Mr. Higman says these services gather data on areas and departments that previously were difficult to track. "Retrospective analysis can only go so far, particularly in places constantly changing like emergency departments," he says, but tracking movement with a real-time locating service can highlight potential issues in efficiency and utilization.

    These tools also allow flexibility for last minute changes. "If [a physician has] an add-on case today, do they have instruments on hand, and where are [the instruments]?" he asks. At the most basic level, these services can ensure equipment and supplies aren't leaving the building, and for high-cost equipment and supplies of which hospitals may only have one or a few, being able to track their location can help verify its utilization, he says.

     

    10. Pharmacogenomics/genome sequencing. Personalized medicine continues to edge closer to the forefront of the healthcare industry. Tailoring treatment plans to individuals and anticipating the onset of certain diseases offers promising benefits for healthcare efficiency and diagnostic accuracy. Pharmacogenomics in particular could help reduce the billions of dollars in excess healthcare spending due to adverse drug events, misdiagnoses, readmissions and other unnecessary costs.

    Before a full-fledged system of pharmacogenomics comes to fruition, the healthcare industry needs a tool that can aggregate and analyze all the big data and digital health information, Mr. Hoover says. "When we really start to have the ability to study a lot of that data, it's going to transfer how we match up that information at the population, individual and macro levels," he says. "The ability to actually compare that information is going to be valuable as we move forward, making sure medications we are taking are going to work for us."

     

    Tools for big data analysis for pharmacogenomics are still being developed, but data analytics and data aggregation for the purpose of population health may be the next big advancement on the horizon. "Understanding and connecting all these variables is going to be profound as it relates to moving forward in healthcare and designing interventions and analyzing patient populations and ultimately improving the lives and health of the American population," Mr. Hoover says.

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    New Efficient Techniques for Health Monitoring Using Multiple Wearables 

    New Efficient Techniques for Health Monitoring Using Multiple Wearables  | Healthcare and Technology news | Scoop.it

    As body-worn sensors are becoming cheaper and easier to use, there arises the possibility of complex continuous health tracking using numerous devices all at once. Because they can use quite a bit of power as well as computing resources, to really make them practical one has to limit their energy and resource expenditure. Researchers at North Carolina State University have been working on making sure that such sensors only transmit important readings and organise these readings within data structures that will provide the most utility to clinicians.

    Their approach is to continuously classify different states that the wearer is in, whether it be walking, running, or sitting, and to then transmit only data that doesn’t seem to fit what the person seems to be doing. So an increase in one’s heartbeat while sitting may be a sign of arrhythmic tachycardia, but if the same thing happens as a person starts running then the same heart readings can be ignored.

    The researchers had grad students wear suits full of sensors and tested different data capture schemes to minimize power and data consumption while gathering interesting readings. For example, they identified that six seconds is enough time to classify what the person is doing at any one time. This means that every six seconds the system should update its readings and focus on spotting changes relevant to the new state.

    The team will be presenting their research titled “Hierarchical Activity Clustering Analysis for Robust Graphical Structure Recovery,” at the 2016 IEEE Global Conference on Signal and Information Processing, Dec. 7-9 in Washington, D.C.

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    HealthIT Can Benefit From Internet of Things

    HealthIT Can Benefit From Internet of Things | Healthcare and Technology news | Scoop.it

    Healthcare technology is growing leaps and bounds and with the inclusion of Internet of things in the equation, both patients and providers will benefit from it.  In a report by Forbes, by 2020, 40% of IoT-related technology will be health-related, more than any other category, making up a $117 billion market.  Internet of things can make a huge impact on the healthcare industry by increasing efficiency, focusing on patient care and also reducing costs. Internet of things in healthcare can help create an intelligent system that can capture real time, life critical data.

     

    How internet of things has benefited Healthcare

     

    The potential of internet of things in healthcare is wide; there is already a huge market for fitness tracking and soon the patients will be able to take more responsibility of their health. With the use of IOT devices, there will be a focus on taking hold of preventive measures thereby disrupting current care delivery and also help shape the future of healthcare.

     

    Below are the three most important uses of IoT in Healthcare

     

    • Chronic care management: Internet of things in healthcare has made a major impact especially in the chronic care management sector.  Healthcare technology has helped increase longevity with the tracking of health and chronic care conditions. Any change in vital or any questionable change in the health can quickly be reported to eth provider. Newer applications are now easily connected to wearables that can help transmit information to the a mobile application and thereby help stay connected to the provider. There are many new applications in the market like Healthkey that help in the management of chronic conditions.  Health Key monitors & tracks blood pressure, heart rate, blood glucose, BMI, body fat and a host of other measures using home health devices from FitBit, Withings and iHealth. Providers get real-time alerts and allow timely intervention.
    • Assisted living and remote monitoring: Assisted living and costs in nursing homes are rising and therefore pushing the providers to help encourage elderly to live independently while being monitored . This can be done in the comfort of the home and also helping in reducing the risk of staying alone. With the advent of sensors attached to the skin, clothing and other wearables. As per BCC Research  , in 2010 the healthcare global market for biosensors was $15.4 Billion and is expected to grow due to a rise is demand for point-of-care diagnostics and monitoring, aging of the population with its concomitant increase in the prevalence of chronic disease, increasing healthcare costs and unmet healthcare needs. It is predicted that this number is bound to increase, and the demand for biosensors in the United States alone will grow by 7.7% annually. 
    • Preventive care: The preventive healthcare is another benefit of Internet of things in healthcare . A lot of diseases and ailments can be managed with the touch of button, diseases like chickenpox; measles etc. can be easily managed with software applications setting reminders about the same. Also since the vitals are being constantly monitored, a lot many chronic diseases can also be prevented.
    • The only issue and problem at hand is the security of data that is being captured from devices connected to the patient monitoring system. The security of IoT is serious enough that a contractor for the Department of Homeland Security spoke about it at HIMSS 2015.

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    Health risk assessments may benefit elderly

    Health risk assessments may benefit elderly | Healthcare and Technology news | Scoop.it

    When healthy elderly people fill out health risk questionnaires and get personalized counseling, they have better health behaviors and use more preventive care, according to a new study.


    Eighteen percent of firms ask working-age employees to complete health risk assessments, but the use of these tools in older persons is relatively new, said lead author Andreas E. Stuck of University Hospital Bern in Switzerland.


    The personal health risk assessments covered multiple potential risk factors relevant in old age, and participants received individualized feedback and health counseling, lasting two years, Stuck said.


    “Thus, prevention in old age is likely effective, but only if risk assessment is combined with individualized counseling over an extended period of time,” Stuck told Reuters Health by email.


    In his team’s study, conducted in Switzerland between 2000 and 2002, 874 healthy adults over age 65 filled out questionnaires and received individualized computer-generated feedback reports, which were also sent to their doctors.


    Additionally, for two years, nurse counselors visited patients at home and called them every three to six months to reinforce what health behaviors they should be pursuing or preventive care they should be obtaining based on their individualized reports.


    About 85 percent of those assigned to the health risk assessment group returned their questionnaires, the researchers reported in PLoS Medicine.


    Counselors identified the most important risk factors for each person, and the interaction between risk factors was taken into account. For example, for a person with low physical activity who was having pain, the first step was to intervene on management of pain, then on physical activity, Stuck said.


    At the end of two years, the researchers compared the risk assessment group to another 1,000 similar adults who did not get the questionnaires or counseling.


    Seventy percent of those who completed the health-risk assessments were physically active and 66 percent had received a seasonal flu vaccine, compared to 62 percent and 59 percent of the comparison group, respectively.


    Long-term outcomes like nursing home admission or functional status were not available, but the researchers estimated that almost 78 percent of the adults in the health risk assessment group were still alive after eight years, compared to almost 73 percent in the comparison group.


    The health assessment, data entry and individualized feedback report takes patients about one hour to do and costs about $30, Stuck said, not including the cost of individualized counseling by the nurse counselor or a primary care physician.


    Health risk assessment should be offered to all older people starting between age 60 and 65, he said.


    “The authors report promising evidence that a complex intervention might improve longevity and functioning in older adults,” said Evan Mayo-Wilson of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, who was not part of the new study.


    “The team provided many services in addition to standard care, and we cannot tell if all of those services were important or if only certain activities would be necessary to achieve good outcomes,” Mayo-Wilson told Reuters Health by email.


    But only half of the people assessed for the trial were enrolled, while many weren’t eligible or refused, and some who were assigned to the health risk assessments didn’t return their questionnaires or otherwise didn’t engage with the program, he noted.


    “We should be cautious in interpreting the results of this study because previous studies found inconsistent effects of mortality and other health outcomes,” Mayo-Wilson said.

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    How one health system tightened security

    How one health system tightened security | Healthcare and Technology news | Scoop.it

    St. Elizabeth Healthcare in Northern Kentucky has added security muscle targeted at its network-connected medical devices by rolling out technology that monitors the devices for cyber vulnerabilities.

    The health system tapped Tenable Network Security for nonstop network monitoring via the company's SecurityCenter Continuous View, which makes it possible to keep watch over the devices without taking them offline.


    Through this deployment, hospital executives say, St. Elizabeth's IT security team has tackled one of the biggest security challenges in the healthcare industry – securing "smart" medical devices that cannot be interrupted for active vulnerability assessments.


    "Everything we do at St. Elizabeth, including our security program, is based on the principle of putting patients first," Harold Eder, director of IT infrastructure and security at the hospital, said in a news release. "CT scanners, MRIs, smart IV pumps – any of these endpoint devices may be running on outdated systems that leave the entire network vulnerable to attack, but you can't perform traditional vulnerability assessments because taking the systems offline is risky and could diminish patient care."


    St. Elizabeth's security team uses Tenable's SecurityCenter CV to gain complete visibility into medical device security and overall network status through a combination of active and passive scanning as well as advanced analytics. With the technology, Eder and his team assess 9,600 IP addresses and more than 300 medical device endpoints across five main campuses and more than 60 remote facilities.


    Continuous network monitoring gives Eder a better understanding of cyber risk for the entire St. Elizabeth enterprise,  and it gives him the opportunity to focus his security team on the tasks that will have the most impact, he added.


    With guidance from HealthGuard Security, a cyber risk management provider and a partner that St. Elizabeth has worked with for more than 10 years, Eder said he chose the platform for St. Elizabeth because it delivered the right combination of advanced analytics, real-time reporting and increased visibility into the health system's hard-to-see medical devices.


    "When I looked at the challenges St. Elizabeth faced, I knew they needed a comprehensive solution that would help with HIPAA compliance, improve visibility into critical systems and deliver high-level analytics and reporting capabilities," said Apolonio Garcia, founder and president, HealthGuard Security, in a statement. "After seeing the success of Tenable's products with many customers over the years, SecurityCenter CV was clearly the right fit and the best product for St. Elizabeth."


    The platform, as Eder continued, "gives me a much more holistic view into what my priorities should be, so I spend less time figuring out the problems and more time fixing them," he said. "The best part is that as our network evolves and our security program matures, we will continue to get additional value out of (the platform) along with the continued assurance that our infrastructure and patients are well protected."


    St. Elizabeth Healthcare operates six major facilities throughout Northern Kentucky and more than 110 primary care and specialty office locations in Kentucky, Indiana and Ohio. 

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    Readmissions Penalties Get Very, Very Real

    Readmissions Penalties Get Very, Very Real | Healthcare and Technology news | Scoop.it

    It was quite bracing to read the August 3 Kaiser Health News report entitled “Half of Nation’s Hospitals Fail Again to Escape Medicare’s Readmission Penalties.” As Jordan Rau wrote in the article, “Once again, the majority of the nation’s hospitals are being penalized by Medicare for having patients frequently return within a month of discharge—this time losing a combined $420 million, government records show. In the fourth year of federal readmission penalties,” Rau reported, “2,592 hospitals will receive lower payments for every Medicare patient that stays in the hospital—readmitted or not –starting in October. The Hospital Readmissions Reduction Program, created by the Affordable Care Act, was designed to make hospitals pay closer attention to what happens to their patients after they get discharged. Since the fines began,” he added, “national readmission rates have dropped, but roughly one of every five Medicare patients sent to the hospital ends up returning within a month.”


    What’s more, Rau noted, “Some hospitals view the punishments as unfair because they can lose money even if they had fewer readmissions than they did in previous years. All but 209 of the hospitals penalized in this round were also punished last year, a Kaiser Health News analysis of the records found.”


    As hospital executives already know, the fines for failure to meet the criteria of the Centers for Medicare & Medicaid Services (CMS) focus on five conditions: heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), as well as elective hip and knee replacements, and are based on readmissions between July 2011 and June 2014.


    And these reimbursement cuts are everywhere—indeed, the penalties will be assessed on hospitals in every state except for Maryland, as that state has a special payment arrangement with Medicare. And the cuts will affect three-quarters or more of hospitals in the following states: Alabama, Connecticut, Florida, Massachusetts, New Jersey, New York, Rhode Island, South Carolina, Virginia, and the District of Columbia.


    What’s more, the readmissions-driven reimbursement cuts are hitting hospitals on top of cuts coming out of the mandatory value-based purchasing program and the mandatory healthcare-acquired conditions (mostly hospital-acquired infections) program.


     Meanwhile, the average penalties by state are being found to vary tremendously. Nationwide, 54 percent of hospitals (2,592 organizations) are being penalized, with an average Medicare pay cut of 0.61 percent. But those nationwide averages encompass huge variations. On one end of the spectrum, in North Dakota, where only three hospitals, or seven percent of the state’s hospital organizations, are being penalized this year, the average penalty is just 0.14 percent of Medicare payments. But in Kentucky, where 62 organizations, representing 65 percent of the state’s hospitals, are being penalized, the average penalty amounts to a full 1.19 percent of Medicare revenues—that’s an 850-percent spread.


    And as everyone knows, many not-for-profit community hospitals in the U.S. are surviving on operating margins of between 1 and 3 percent; and for those with a majority of their revenues coming from Medicare reimbursement, a penalty of more than 1 percent could potentially be devastating.


    Five years ago when the U.S. Congress passed he Affordable Care Act, and President Obama signed it, I predicted that the mandatory readmissions program would be one of the healthcare system reform provisions in the ACA that would be one of its most impactful; and it already has been. As we all know, ten years ago, if you were talk walk into the office of the average CFO in the average inpatient hospital in the U.S. and were to ask that CFO what her/his hospital’s average 30-day readmissions rates were for patients with documented congestive heart failure, diabetes, or COPD (chronic obstructive pulmonary disease), s/he could likely not have told you. Now, that CFO needs to know that number—and needs to be working with all levels and disciplines of leadership in her/his hospital to reduce that number.


    What’s more, private health insurers are absolutely moving forward to implement similar programs in their hospital contracts, since, as is nearly always the case with such things, once the Medicare program, the U.S. healthcare system’s proverbial 800-pound gorilla, moves forward in an area, all the major private health insurers quickly follow Medicare’s lead and design their own versions of the same initiative.


    Industry experts have long noted that many, if not most, readmissions that occur within 30 days are relatively easily predicted. Research, and the experiences of pioneering hospital organizations, have found that the key gaps in this area have to do with care management on multiple levels—ensuring effective discharge planning, including really robust patient and family member education; and then, very importantly, case manager/care manager nurse follow-up with the discharged patient in a day or two at most following discharge, via phone communication, which must involve the scheduling of a follow-up primary care physician appointment; and then of course, that follow-up PCP visit, along with further coaching, education, and care management.


    And all of those processes must be strategically directed, excellently executed, and very strongly facilitated by robust information systems run by hospital and health system leaders with commitment to strategic goals and to success over long periods of time and across large groups of patients. Now, clearly, the leaders of many patient care organizations are moving forward with alacrity to develop accountable care organizations (ACOs), either under the aegis of one of Medicare’s ACO programs, or in collaboration with private health plans; as well as implementing population health management programs, and developing patient-centered medical homes.


    But here’s the thing about the Medicare readmissions reduction program: because it’s mandatory, it is forcing action on the part of every hospital that receives regular Medicare payment, regardless of whether or not that hospital is also pursuing ACO, population health, or PCMH strategies, or not.


    So the same “blessed cycle” of performance improvement is called for on the part of all regular U.S. hospitals receiving Medicare reimbursement, at this point. And that means creating really good data collection and reporting mechanisms, reporting the data, developing continuous clinical performance improvement processes to reduce predictable 30-day readmissions, making those improvements, and continuously sharing with clinicians, clinician leaders, and administrative executives and managers the ongoing results of those efforts, for further improvement work.


    In other words, we’re talking about a continuous learning system in U.S. healthcare. And guess what? It’s no longer optional.

    The reality is that healthcare IT leaders are playing and will continue to play, an extremely important role in all of this work; indeed, their contributions will be vital to success, at the data and information level, the process improvement level, and the strategic level, organization-wide. The one thing that neither healthcare IT leaders nor any other leaders can do is to sit any longer in denial about what is happening. Because, along with the mandatory value-based purchasing program under Medicare, and to a lesser extent as well, the mandatory healthcare-acquired conditions reduction program under Medicare, continuous clinical performance improvement is in effect now a core component of federal policy.


    In other words, folks, this is happening.


    The good news is that leaders at the most pioneering hospitals and health systems are lighting the way for others to follow. The bad news is that anyone waiting for further “clarity” on all this is going to be waiting so long as to potentially endanger the future of their hospital organization. So as the readmissions reduction program under Medicare—and inevitably under many, if not most, private health insurers as well—expands and ramps up, it will be incumbent on healthcare IT leaders and on all healthcare leaders to get ahead of the curve, because the penalties are only going to get more and more real—and won’t ever be reversing.

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    7 ways physicians can improve health care quality

    7 ways physicians can improve health care quality | Healthcare and Technology news | Scoop.it

    Patients want to receive health care that is of the highest quality. Physicians want to provide it. But what is “high-quality health care?” On that, few agree.


    Ask most Americans and they’re unsure where to find it. They know they want to be kept healthy, have rapid access to personalized care whenever they need it and be charged only what they can afford.

    Ask the leaders of the national medical and surgical societies, and they are likely to define quality as having access to the latest — and often the most richly reimbursed — procedures, diagnostic imaging, and genetic testing.

    Ask physicians themselves and, well, they’re already overwhelmed by the exponential growth in clinical measures of quality developed for public and private pay-for-performance formulas.


    Even so, medicine is coming closer to a definition of high-quality health care — and also to a system for evaluating how physicians and medical groups perform. The Institute of Medicine (IOM), a highly regarded independent organization established by Congress to advise on health care issues — the gold standard on improving our nation’s health – recently released a report: “Vital Signs: Core Metrics for Health and Health Care Progress.”


    The IOM panel of experts identified 15 measures, narrowed down from hundreds, with the best potential for improving health, including reducing the overall rate of preventable deaths.The consensus: If the U.S. systematically raises its performance in each of these 15 domains, the quality of life for millions would improve dramatically.


    This IOM report is important, even though it received surprisingly scant media attention. It should serve as a starting point and a road map about how clinical practice can most effectively lift the quality of care delivered to patients.

    But let me come back to the report itself in a minute.


    The quality conundrum


    A little context about the issue of quality might help here. At last count, the number of health care quality measures in place was in the thousands. The Joint Commission has 57 just for inpatient care at hospitals. The Healthcare Effectiveness Data and Information Set has about 81. The National Quality Forum currently endorses more than 630. The Centers for Medicare & Medicaid Services has no fewer than about 1,700.


    That may explain why keeping track is such a challenge for all parties involved.


    Perceptions of quality are of course subjective. According to the Merriam-Webster Dictionary, quality is “how good or bad something is; a characteristic or feature that someone or something has; a high level of value or excellence.” The Oxford Dictionary says quality is “the standard of something as measured against other things of a similar kind; the degree of excellence of something” It cites this example: “The hospital ranks in the top tier in quality of care.”


    The upshot here is a paradox: a definition that is itself ill-defined – and as such, leaves plenty of uncertainty and doubt.


    7 actions physicians can take


    That’s why the IOM report is so valuable and welcome. It cites 15 “vital signs,” but let’s focus on the seven that relate to direct health care delivery and better care for patients.


    1. Overweight and obesity. Physicians should help their patients exercise regularly, eat a healthy diet and maintain their weight within a normal range. More than two-thirds of Americans are overweight or obese. Specifically, physicians can make diet and weight management a vital sign and counsel every patient on the options available.


    2. Addictive behaviors. Eliminating smoking and alcohol abuse, along with reducing the percentage of people who are overweight, would dramatically lower the incidence of diabetes, lung cancer, and cardiovascular disease. Physicians should engage and educate patients about approaches to take to quit smoking and alcohol abuse, and provide advice and resources toward that end. Today, addiction to nicotine, alcohol, opiates and other psychoactive drugs continues at unacceptably high rates.


    3. Preventive services. Physicians should urge patients to take the recommended screening tests and stay current on their vaccinations. Preventive screenings alone could dramatically lower the risk of dying from cancer, heart disease, and strokes.


    Combining this with smoking cessation and exercise could help avoid 200,000 heart attacks and strokes in the U.S. each year, and reduce the mortality from cancer by tens of thousands yearly, based on an internal analysis done by The Permanente Medical Group’s Division of Research.


    Screen for colon cancer in fewer than 50 percent of patients, rather than in 80 percent to 90 percent, and you double the chances of dying from an invasive adenocarcinoma. Smoke at the national average of 18 percent, rather than at under 10 percent, and you dramatically increase lung cancer, emphysema, and heart attacks.


    Preventive services present a valuable opportunity for both improving health and reducing health expenditures.


    4. Patient safety. Physicians and nurses can, through rigorous practice, help patients avoid hospital-acquired infections, pressure ulcers, medication errors and wrong-site surgery. Even a decade after the 1999 IOM report, “To Err is Human” — with its estimate that 100,000 patients die each year from medical errors, the equivalent of a jetliner crashing each day — these so called “never events” still occur too frequently.


    And when patients develop infections like sepsis, or suffer an adverse drug reaction, they face a higher chance of dying in the hospital, and experiencing problems long after hospital discharge. Avoiding harm has been a core value of the medical profession from the time of Hippocrates, and is “first among equals” when it comes to the principal responsibilities of the health care system. Yet medical errors with adverse outcomes are still far too common.


    5. Unintended pregnancy. Physicians should take the opportunity to focus on ensuring the health of an expectant mother in order to increase the chances for a healthy baby and safe delivery, whether a pregnancy is unintended or the result of careful planning.


    An estimated 50 percent of pregnancies in the US are unplanned, and occur in women across the spectrum of child-bearing years, and among women in every socioeconomic demographic. Unintended pregnancy results from social, behavioral, cultural, and health factors, including — and perhaps most especially — women’s lack of knowledge about and access to tools for family planning.


    Research has demonstrated that medical care soon after conception is critical, and identified ways to reduce the risks of a maternal or fetal complication. Good nutrition, along with avoidance of drugs, alcohol and cigarette smoke, are essential. After birth, comprehensive medical care and early diagnosis of problems can prevent longer-term health problems and future complications.


    6. Access to care. Access to health care is one of the most powerful determinants of clinical outcomes. The ability to access care when needed is a vital precondition for a high-quality health system.

    Physicians in integrated, multi-specialty practices have advantages in ensuring patients get all the care needed thanks to comprehensive electronic health records. But in today’s fragmented health care system, with close to 15 percent of the population still uninsured, health care still remains beyond the reach of all too many Americans. Policy makers are relentlessly pursuing affordable access.


    7. Evidence-based care. Physicians should see to it that patients receive medical care based on the most current scientific evidence for what is appropriate and effective, rather than on an anecdote or an “in my experience” approach. Physicians working in hospitals with electronic health records can do so, deciding about care according to scientifically validated protocols for complex problems like heart attacks, strokes, and hip fractures.


    In the not-too-distant past, when physicians lacked many of the current diagnostic tools and access to sophisticated information technology, medical practice was far more art than science.


    Even today, variation in how physicians treat patients with the same problem is unwarranted, and leads to system-wide under performance and less-than-optimal clinical outcomes.


    Fortunately, medical practice today is far more science than art.


    What patients should do


    The best quality, then, according to the IOM, is not based on using a robot, providing transplantation or completing genetic sequencing. The reality is that, contrary to what some might assume, these often advertised technologies have minimal impact on mortality.


    And quality is not a result of individual technical excellence in performing procedures such as heart surgery, neurosurgery or hip replacement surgery. The variation from surgeon to surgeon is far less than people assume. In fact, many health care experts now perceive overuse of these high-intensity surgical interventions to be a problem that sometimes results in associated complications and minimal improvements in clinical outcomes.


    The list, in short, is more practical than exotic or “sexy,” offering the interventions which have the greatest impact on human life.

    The IOM committee concluded that leadership “at nearly every level of the health care system” will be required to adopt, implement, refine and maintain these core measures. And among the many stakeholders, physician leadership will be key.


    Patients should make health choices based on these 15 vital signs from the IOM. They enable people to distinguish the most important quality measures from all the “noise” about what are the newest and most exotic tools and approaches available. More specifically, patients would be wise to select a personal physician or medical group whose practice philosophy incorporates these approaches — and whose clinical results in each area are superior.


    We physicians are obligated to heed the IOM recommendations on behalf of our patients, the better to fulfill health care’s promise of easing suffering and extending lives. This is where American health care should invest its efforts. The IOM is a gift to both physicians and patients. Taking our eyes off what will most impact the health of all would be a mistake our nation can ill afford.

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