Healthcare and Technology news
45.0K views | +2 today
Follow
Healthcare and Technology news
Your new post is loading...
Your new post is loading...
Scoop.it!

The Latest Trends in Nursing Technology

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

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

 

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

 

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

 

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

 

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

 

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

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
No comment yet.
Scoop.it!

Digital Technologies can Address Cancer

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

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

 

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

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
No comment yet.
Scoop.it!

Digital health’s last mile problem

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

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

 

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

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

 

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

 

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

The Last Mile problem

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

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

Addressing the bottleneck

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

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

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

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
No comment yet.
Scoop.it!

How nine out of ten healthcare pages leak private data

A study by a Timothy Libert, a doctoral student at the University of Pennsylvania, has found that nine out of ten visitsto health-related web pages result in data being leaked to third parties like Google, Facebook and Experian:

There is a significant risk to your privacy whenever you visit a health-related web page. An analysis of over 80,000 such web pages shows that nine out of ten visits result in personal health information being leaked to third parties, including online advertisers and data brokers.

What Libert discovered is a widespread repetition of the flaw that the US government's flagship Healthcare.gov website was dragged over the coals for in January.

The sites in question use code from third parties to provide things like advertising, web analytics and social media sharing widgets on their pages. Because of the way those kinds of widgets work, their third party owners can see what pages you're visiting.

The companies supplying the code aren't necessarily seeking information about what you're looking at but they're getting it whether they want it or not.

So if you browse the pages about genital herpes on the highly respected CDC (Centres for Disease Control and Prevention) site you'll also be telling marketing mega-companies Twitter, Facebook and AddThis that you've an interest in genital herpes too.

It happens like this: when your browser fetches a web page, it also fetches any third party code embedded in it directly from the third parties' websites. The requests sent by your browser contain an HTTP header (the annoyingly misspelled 'referer' header) that includes the URL of the page you're looking at.

Since URLs tend to contain useful, human-readable information about what you're reading, those requests can be quite informative.

For example, looking at a CDC page about genital herpes triggers a request to addthis.com like this:

GET /js/300/addthis_widget.js HTTP/1.1
Host: s7.addthis.com

Referer: http://www.cdc.gov/std/Herpes/default.htm

The fact that embedded code gets URL data like this isn't new - it's part of how the web is designed and, like it or not, some third parties actually rely on it - Twitter uses it to power its Tailored Suggestions feature for example.

What's new, or perhaps what's changed, is that we're becoming more sensitive to the amount of data we all leak about ourselves and, of course, health data is among the most sensitive.

While a single data point such as one visit to one web page on the CDC site doesn't amount to much, the fact is we're parting with a lot of data and sharing it with the same handful of marketing companies.

We do an awful lot of healthcare research online and we tend to concentrate those visits around popular sites.

A 2012 survey by the Pew Research Center found that 72% of internet users say they looked online for health information within the past year. A fact that explains why one of the sites mentioned in the study, WebMD.com, is the 106th most popular website in the USA and ranked 325th in the world.

The study describes the data we share as follows:

...91 percent of health-related web pages initiate HTTP requests to third-parties.  Seventy percent of these requests include information about specific symptoms, treatment, or diseases (AIDS, Cancer, etc.). The vast majority of these requests go to a handful of online advertisers: Google collects user information from 78 percent of pages, comScore 38 percent, and Facebook 31 percent.  Two data brokers, Experian and Acxiom, were also found on thousands of pages.

If we assume that it's possible to imply an individual's recent medical history from the healthcare pages they've browsed over a number of years then, taken together, those innocuous individual page views add up to something very sensitive.

As the study's author puts it:

Personal health information ... has suddenly become the property of private corporations who may sell it to the highest bidder or accidentally misuse it to discriminate against the ill.

There is no indication or suggestion that the companies Limbert named are using the health data we're sharing but they are at least being made unwitting custodians of it and that carries some serious responsibilities.

Although there is nothing in the leaked data that identifies our names or identities, it's quite possible that the companies we're leaking our health data to have them already.

Even if they don't though, we're not in the clear.

Even if Google, Facebook, AddThis, Experian and all the others are at pains to anonymise our data, I wouldn't bet against individuals being identified in stolen or leaked data.

It's surprisingly easy to identify named individuals within data sets that have been deliberately anonymised.

For example, somebody with access to my browsing history could see that I regularly visit Naked Security for long periods of time and that those long periods tend to happen immediately prior to the appearance of articles written by Mark Stockley.

For a longer and more detailed look at this phenomenon, take a look at Paul Ducklin's excellent article 'Just how anonymous are "anonymous" records?'

It's possible to stop this kind of data leak by setting up your browser so it doesn't send referer headers but I wouldn't rely on that because there are other ways to leak data to third parties.

Instead I suggest you use browser plugins like NoScript, Ghostery or the EFF's own Privacy Badger to control which third party sites you have any interaction with at all.

What the study hints at is bigger than that though - what it highlights is that we live in the era of Big Data and we're only just beginning to understand some of the very big implications of small problems that have been under our noses for years.


more...
Lava Kafle's curator insight, March 3, 2015 5:40 AM

#DidYouKnowThis #HealthCare #Cyber #Security #threats #leaks #vulnerabilities #Mitigation #strategy @deerwalkinc #bigdata #thirdparty

Lava Prasad Kafle's curator insight, March 23, 2015 1:15 AM

@deerwalkinc

Instead I suggest you use browser plugins like NoScript, Ghostery or the EFF's own Privacy Badger to control which third party sites you have any interaction with at all.

What the study hints at is bigger than that though - what it highlights is that we live in the era of Big Data and we're only just beginning to understand some of the very big implications of small problems that have been under our noses for years.

Scoop.it!

U.S. needs to raise investment, shift medical research priorities

U.S. needs to raise investment, shift medical research priorities | Healthcare and Technology news | Scoop.it

The U.S. is losing its lead in global medical research, and many of the projects that do get funded overlook common diseases that afflict millions of people, according to a new analysis.

Experts point to falling public and private spending on the kind of basic research that leads to new discoveries, and a lack of innovation in delivering healthcare, in a paper in the Journal of the American Medical Association that’s part of a series on the future of medicine,

"With respect to U.S. public financing there has not been the political will to make biomedical research a priority in the same way that it was in the 1970s with the war on cancer or in the 1980s with the war on AIDS," said lead study author Dr. Hamilton Moses, of the Alerion Institute and Alerion Advisors LLC in North Garden, Virginia.

At the same time, private U.S. companies have concentrated investment in advanced clinical trials rather than on the basic research that’s needed to tackle some of the chronic conditions like diabetes that afflict the greatest number of people, Moses told Reuters Health in an interview.

Overall U.S. investment in biomedical and health services research grew just 0.8 percent a year from 2004 to 2012, down from a 6-percent annual growth rate between 1994 and 2004, Moses and his colleagues found.

Government funding in the U.S. fell to 49 percent of the world's public research investment by 2011, down from 57 percent in 2004.

U.S. industry, which accounted for nearly half of corporate investment worldwide in 2004, slipped to 41 percent of private funding in 2011.

Asia, aided largely by China, tripled investment to $9.7 billion in 2012 from $2.6 billion in 2004.

In the U.S., public funding concentrated on cancer and rare diseases, with less than half of government investment targeting 27 common diseases – including chronic obstructive lung disease, injuries, stroke, dementia and pneumonia - that account for 84 percent of deaths in the U.S. and significant disability.

Cancer alone accounted for 16 percent of total funding from the National Institutes of Health and was the target of one in four medicines in clinical trials, the study found.

"With cardiovascular disease, the number one killer, some of the large pharmaceutical companies have really pulled back in this area," said Dr. Kenneth Kaitin, director of the Tufts Center for the Study of Drug Development in Boston, Massachusetts.

"The industry has changed over the last few years and there has been tremendous pressure to reduce research and development costs that has resulted in a tremendous shift away from high-volume, low-cost medicines toward seeking a billion- dollar drug that treats a very, very small population," said Kaitin, who wasn't involved in the study.

Health services research, which looks at issues around access to care as well as quality and costs, has accounted for less than 0.33 percent of national health expenditures between 2003 and 2011, the study found.

Private insurers ranked last (0.04 percent of revenue) and health systems 19th (0.1 percent of revenue) among 22 industries in their investment in innovation in this area, the authors note.

"This is concerning in terms of trying to tackle improved quality of care and improved access to care, and in terms of bending the cost curve," said Glen Giovannetti, a global life sciences expert at Ernst & Young in Boston.

"There's lots and lots of research done on drug development and much less done on whether one course of treatment is better than another," said Giovannetti, who wasn't involved in the study.

With respect to both biotech and health services research, there is an acute need to increase research investment and to create more reliable funding mechanisms, said Dr. Victor Dzau, president of the Institute of Medicine, a division of the U.S. National Academies of Science.

Dzau, who co-wrote an editorial accompanying the study in JAMA, said the danger of disparate, unreliable funding streams is that it forces scientists to work in fits and starts, often abandoning promising basic research.

"If you think about all of the major advances in health care services, biomedical research, and diagnostics, there is no question that it's based on innovation and relied at the start on basic research," Dzau told Reuters Health.

"When we decided to put a man on the moon that was an aspirational goal, and we as a nation should be able to recognize that this is now an important moment in medical research," Dzau said. "We aren't saying give money for money's sake. We are saying set priorities, and give researchers at least five years of stable funding to pursue specific goals."



more...
No comment yet.
Scoop.it!

As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care

As Medicaid Rolls Swell, Cuts in Payments to Doctors Threaten Access to Care | Healthcare and Technology news | Scoop.it

Just as millions of people are gaining insurance through Medicaid, the program is poised to make deep cuts in payments to many doctors, prompting some physicians and consumer advocates to warn that the reductions could make it more difficult for Medicaid patients to obtain care.

The Affordable Care Act provided a big increase in Medicaid payments for primary care in 2013 and 2014. But the increase expires on Thursday — just weeks after the Obama administration told the Supreme Court that doctors and other providers had no legal right to challenge the adequacy of payments they received from Medicaid.

The impact will vary by state, but a study by the Urban Institute, a nonpartisan research organization, estimates that doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average.

Stephen Zuckerman, a health economist at the Urban Institute and co-author of the report, said Medicaid payments for primary care services could drop by 50 percent or more in California, Florida, New York and Pennsylvania, among other states.

In his budget request in March, President Obama proposed a one-year extension of the higher Medicaid payments. Several Democratic members of Congress backed the idea, but the proposals languished, and such legislation would appear to face long odds in the new Congress, with Republicans controlling both houses.

Dr. David A. Fleming, the president of the American College of Physicians, which represents specialists in internal medicine, said some patients would have less access to care after the cuts. It would make no sense to reduce Medicaid payments “at a time when the population enrolled in Medicaid is surging,” he said.

Dr. George J. Petruncio, a family physician in Turnersville, N.J., described the cuts as a “bait and switch” move. “The government attempted to entice physicians into Medicaid with higher rates, then lowers reimbursement once the doctors are involved,” he said.

But Nicole Brossoie, a spokeswoman for the New Jersey Department of Human Services, which runs the state’s Medicaid program, said the increase was not meant to be permanent. “The enhanced rates will not be extended in New Jersey,” Ms. Brossoie said. “It was always understood to be temporary.”

The White House says Medicaid is contributing to the “largest coverage gains in four decades,” with 9.7 million people added to the Medicaid rolls since October 2013, bringing the total to 68.5 million. More than one-fifth of Americans are now covered by Medicaid.

But federal officials have not set forth a strategy to expand access to care with enrollment, and in many states Medicaid payment rates for primary care services, like routine office visits and the management of chronic illnesses, will plunge back to 2012 levels, widely seen as inadequate.

For the last two years, the federal government has required state Medicaid agencies to pay at least as much as Medicare pays for primary care services. Family doctors, internists and pediatricians have thus received Medicare-level payments for primary care, with the federal government making up the difference in costs.


The impending cuts are larger in states like California that have the widest gaps between Medicaid and Medicare rates.

A survey by the Ohio State Medical Association found that some Ohio doctors began accepting Medicaid patients because of the rate increase in 2013. Ohio doctors who were already participating in the program said they had accepted more Medicaid patients after the rate increase. And almost 40 percent of Ohio doctors indicated that they planned to accept fewer Medicaid patients when the extra payments lapsed.

Under federal law, Medicaid rates must be “sufficient to enlist enough providers” so that beneficiaries have at least as much access to care as the general population in their geographic area. In practice, doctors say, this standard is murky.

The Obama administration told the Supreme Court last month that health care providers had no legal right to enforce the “equal access” requirement in court. This section of the Medicaid law provides guidance to federal and state officials in setting Medicaid rates, but does not allow health care providers to sue state officials to enforce it, said Donald B. Verrilli Jr., the solicitor general of the United States.

The case, Armstrong v. Exceptional Child Center, was filed against Richard Armstrong, director of the Idaho Department of Health and Welfare, by five providers of residential habilitation services to children with disabilities. They argued that Idaho’s payment rates fell below federal standards, and they sued to enforce federal law, invoking the supremacy clause of the Constitution, which makes federal law “the supreme law of the land.”

The court sidestepped the issue in a similar case from California in 2012. Chief Justice John G. Roberts Jr. said then, in a dissenting opinion, that “nothing in the Medicaid Act allows providers or beneficiaries (or anyone else, for that matter) to sue to enforce” the equal-access provision.

Matt D. Salo, the executive director of the National Association of Medicaid Directors, which represents state officials, said his group had not lobbied for an extension of the Medicaid fee increase. “It has rewarded providers who were already doing the right thing, but did not bring in a flood of new providers,” Mr. Salo said.

The higher payments for primary care have been available in the traditional fee-for-service Medicaid program as well as in managed-care plans, which typically pay doctors a fixed amount per patient per month.

Joseph A. Reblando, a spokesman for Medicaid Health Plans of America, a trade group, said, “The fee increase was a good idea in concept, but it was built on an antiquated system in which doctors were paid a separate fee for each service.”



more...
No comment yet.
Scoop.it!

Mentoring, Telemedicine Offer Paths to Better Rural Health Care Access -- AAFP News

Mentoring, Telemedicine Offer Paths to Better Rural Health Care Access -- AAFP News | Healthcare and Technology news | Scoop.it

One doesn't have to look too hard to find long-standing obstacles to providing rural health care: too few primary care physicians in sparsely resourced areas and limited support for specialty care referrals. And even as new technologies are enabling greater access for patients and enhanced training to improve care coordination, old education and payment standards persist..

Long-distance Mentoring

In 2003 in New Mexico, gastroenterologist Sanjeev Arora, M.D., was treating patients with hepatitis C virus infection -- many of whom faced an eight-month waiting period to see him. Moreover, some had to drive as much as 250 miles each way for their appointments. Patients were dying of liver cancer and other ailments because they could not obtain timely care.

"I knew if we had treated them earlier, we could have cured them," he said.

Ultimately, Arora realized that the best way to manage patients with complex chronic conditions was not simply for the subspecialty physician to see patients around the clock. Rather, an entire network of health care professionals could be trained to provide needed care. The idea of spreading that knowledge gave birth to Project ECHO (Extension for Community Healthcare Outcomes), where Arora serves as executive director.

ECHO is a mentoring network that seeks to teach primary care physicians and other health care professionals how to care for specific chronic conditions. To make this "telementoring" system work, subspecialty physicians provide guided instruction to primary care physicians, nurse practitioners and physician assistants.

"We know that chronic disease management is a team sport," Arora said. "You become a mentor as opposed to a doer."

Such interactive training sessions are a necessity in a changing medical environment, according to Arora, who said he thinks the traditional graduate medical education (GME) curriculum is no longer effective.

"The system of GME where we educate residents and fellows and just send them out there isn't going to work in a knowledge-based workforce," Arora said. "Academic medicine needs to take responsibility for training the entire health care workforce for their entire career."

Arora said funding for such career training efforts should be considered an infrastructure investment similar to the U.S. National Library of Medicine, a publicly funded institution.

Perinatal Care Via Telemedicine

In rural states such as Arkansas, some residents must drive for hours to meet with a physician. Forty-four percent of the state's population resides in rural areas, and the number of obstetricians, in particular, is inadequate to meet population needs. Curtis Lowery Jr., M.D., medical director of the University of Arkansas for Medical Sciences ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) program, outlined how telemedicine has helped to close the gap in regions without enough physicians to provide care for women with high-risk pregnancies.

"It's very difficult to get physicians to go to the (Mississippi) Delta," said Lowery, who is also chair of the university's department of obstetrics and gynecology. "They feel alone, like they are on an island with no support. So we use technology to support them."

When the ANGELS program started in 2003, there were only three maternal/fetal specialists in a state that saw 45,000 deliveries each year. Initially, a few telemedicine hubs were set up around the state with local government support. Thanks to an infusion of $102 million in federal funding, however, the program soon expanded to cover the entire state.

Instead of expecting rural patients to meet physicians in urban areas, telemedicine enables physicians to connect with those patients by teleconference. A 24-hour call center is available for patients and physicians to coordinate care. And telemedicine efforts that originally focused on management of high-risk pregnancies have expanded to include care protocols for patients with stroke or sickle cell anemia, as well as those in need of surgical consultations.

Much as the influx of patients newly insured under the Patient Protection and Affordable Care Act has initially added to overall health care system expenditures, wider adoption of telemedicine will also likely lead to increased costs in the short term as more patients are seen via this method. But, Lowery predicted, the system will ultimately save costs on travel and the long-term care that becomes necessary when appropriate preventive and management services are unavailable.

Still, for telemedicine to achieve its full potential, Lowery said changes that permit payment for telemedicine consultations are needed.

"The biggest problem with the adoption of telemedicine is the payment," he said. "We need to change the way we pay and need to be able to pay for new systems. In my career, I've done thousands of telephone consultations, but I've never been paid for one."

Effecting this change is particularly difficult, Arora chimed in, when one considers the fact that elderly patients -- those in their 80s and 90s -- consume 10 times more health care than an individual in his 60s. And it's certainly conceivable that these older people would be using telemedicine services frequently.

"The payers are terrified," Lowery said. "When a lot more care is given, a lot more money is spent in fee-for-service. That's where we are in telemedicine."



more...
No comment yet.
Scoop.it!

Top 5 Technology Trends for Healthcare

Top 5 Technology Trends for Healthcare | Healthcare and Technology news | Scoop.it

It's been a challenging year for the healthcare industry - new payment models and regulatory changes combined with big data and tech innovations have forced healthcare providers to rapidly adapt their practices at all levels of healthcare management and delivery. With big changes on the horizon and uncertainty everywhere, one thing providers can count on is that technology will continue to play a bigger and bigger role in health care services and delivery in the coming year.

 

In a shaky regulatory environment, the healthcare providers that survive and thrive will be the ones that quickly adapt to the needs of the patient by adopting the latest innovations. With healthcare premiums set to rise across the country and growing transparency regarding service costs, patients will be raising their expectations for quality of care in 2018, giving the upper hand to facilities that invest in infrastructure that meets patient engagement requirements and improves business processes.

 

In this article, we've highlighted our picks for the top 5 healthcare technology trends of the year. In our view, these should be major areas of concern for healthcare IT departments. How will your healthcare facility address these trends over the next 12 months?

 

Telemedicine an Expanding Service Area for Healthcare Providers


Telemedicine will play a bigger role in our healthcare systems than ever before. With increasing life expectancy, treatment for the elderly and those who may face issues with mobility or feasibility of transportation is heavily supported by telemedicine solutions that allow physicians and specialists to interact with their patients remotely, using video conferencing technology.

 

Although telemedicine saw significant adoption throughout 2017, growth drivers for the future include a rise in leaner and more expensive health care plans and the growing prevalence of value-based compensation for healthcare providers. Telemedicine helps to minimize external and incidental costs associated with obtaining health care, enhancing patient engagement at a time where growing premiums for health care insurance are threatening access to health care services for at-risk groups.

 

Cloud Computing Grows in Importance for Healthcare Facilities


A study conducted by Black Book, a leading research firm in healthcare information technology, found that 55% of hospital Corporate Information Officers (CIOs) expressed confidence in their cloud application strategies, but that many had not yet invested in cloud storage for disaster recovery.

 

Other studies have estimated that 65% of interactions between patients and healthcare facilities will take place via mobile devices in 2018. 80% of doctors are already using smartphones and medical applications, while 72% use smartphones to access drug data on a regular basis.

 

It's clear that mobile data and communications will play a big role in the modern hospital, and those who invest in cloud infrastructure that adequately supports the volume of interactions that take place in a healthcare setting will benefit from improved performance and patient satisfaction.

 

Big Data Solutions for Population Health Management


New technology continues to unveil new possibilities in the world of medicine, and healthcare facilities are starting to understand how a robust cloud infrastructure and real-time EHR tracking can be used to facilitate population health management. Nearly all hospitals with 200 beds or fewer say they're not adequately capturing all the information needed for actionable population health analytics, according to Black Book.

 

How will hospitals solve this problem? Electronic data warehouses that capture data from thousands of EHR updates per day and use risk modeling to assess population health are the way of the future, and it's likely that they will be adopted on a large scale by the largest hospitals. Still, those with large-scale data monitoring solutions still face difficulties in effectively storing and managing EHR data along with financials, labor, and supply chain information.

 

Improvements Coming for EHR and Interoperability


The EHR mandate has seen widespread adoption throughout our healthcare system, especially in hospitals and larger healthcare facilities, but it's crucial that EHR vendors continue to adapt to new requirements.

 

For example, the new Medicare Access and CHIP Reauthorization Act 2015 (MACRA) may not be supported by all EHR vendors, and many EHRs do not support the level of record keeping that would be required for meaningful application of pay-for-performance reimbursement structures. These structures require features that most EHRs just don't have today, like the ability to track contractual payment agreements or assess the contribution to care.

 

Facing pressure from many sides, interoperability is becoming a concern for facilities that want to upgrade their infrastructure and data analytics, but require support from EHR vendors and other service providers, and regulatory relief while making the required upgrades. The successful healthcare facility of the future will effectively integrate EHR records, big data analytics, population health management, and a robust cloud infrastructure that supports it all, and this will require extensive cooperation and collaboration between healthcare providers, EHR vendors, insurance firms, and other stakeholders.

 

The Internet of Things (IoT) Could Change Everything


Are big innovations in the Internet of Things on the horizon for healthcare facilities? We definitely think so, and it's the facilities that upgrade their computing capabilities that will be set to take advantage as medical device companies roll out an increasing number of products that can plug into the hospital's internal networks for tracking and operation.

 

Wearable devices that allow physicians to receive real-time emergency updates on patient welfare and respond accordingly will impact patient expectations for standards of care in the coming years, and hospitals with monitoring systems that leverage the IoT will find business systems improvements at every turn.

 

Patients could be empowered to test their own vitals, using wearable devices to measure their heart rate and pulse, or even to conduct an ECG whose results can be transmitted automatically to healthcare providers through the hospital's cloud storage system. This could improve healthcare outcomes and positively impact labor costs, but only for those who invest in the infrastructure and interoperability measures to support it.

 

Conclusion


Healthcare is undergoing a period of significant change in many ways. While it's unclear how healthcare insurance and accessibility will look in the coming years, pressures like increasing cost transparency and pay-for-performance will force hospitals to continue finding cost-savings and efficiency through adopting the latest technologies and working with vendors to continue meeting the needs of an aging, and increasingly more demanding, patient population.

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
onlinepharmacy's curator insight, October 5, 6:51 AM

https://goldenskyonlinepharmacy.online/product/adhd-buy-adderall-online/
https://goldenskyonlinepharmacy.online/product/buy-generic-accutane-online/
https://goldenskyonlinepharmacy.online/product/buy-adipex-online/
https://goldenskyonlinepharmacy.online/product/buy-ambien-online/
https://goldenskyonlinepharmacy.online/product/buy-arimidex-online/
https://goldenskyonlinepharmacy.online/product/buy-ativan-online/
https://goldenskyonlinepharmacy.online/product/buy-bimatoprost-generic-online/
https://goldenskyonlinepharmacy.online/product/buy-clenbuterol-online/
https://goldenskyonlinepharmacy.online/product/buy-concerta-online/
https://goldenskyonlinepharmacy.online/product/buy-darvocet-online/
https://goldenskyonlinepharmacy.online/product/buy-demerol-online/
https://goldenskyonlinepharmacy.online/product/buy-dexedrine-online/
https://goldenskyonlinepharmacy.online/product/buy-dilaudid-online/
https://goldenskyonlinepharmacy.online/product/buy-generic-premarin-cream-online/
https://goldenskyonlinepharmacy.online/product/buy-generic-sporanox-online/
https://goldenskyonlinepharmacy.online/product/buy-ecstasy-online/
https://goldenskyonlinepharmacy.online/product/buy-hydrocodone-online/
https://goldenskyonlinepharmacy.online/product/buy-janumet-online/
https://goldenskyonlinepharmacy.online/product/buy-klonopin-online/
https://goldenskyonlinepharmacy.online/product/buy-lortab-online/
https://goldenskyonlinepharmacy.online/product/buy-lyrica-online/
https://goldenskyonlinepharmacy.online/product/buy-methadone-online/
https://goldenskyonlinepharmacy.online/product/buy-morphine-online/
https://goldenskyonlinepharmacy.online/product/buy-nexavar-online/
https://goldenskyonlinepharmacy.online/product/buy-oxycontin-online/
https://goldenskyonlinepharmacy.online/product/buy-phentermine-online/

Scoop.it!

The Biggest Areas of Opportunity for Digital Health

The Biggest Areas of Opportunity for Digital Health | Healthcare and Technology news | Scoop.it

Digital health is unquestionably becoming part of healthcare lexicon and fabric. Electronic health records (EHRs) and personal fitness trackers have helped create awareness through use.  The entrepreneurial enthusiasm for the healthcare space is evident by the volume of digital health incubators, medical school innovation centers,  and angel investors.  Though there has been significant sector investment, the road to success of adoption in the healthcare enterprise has been challenging.  I’d like to discuss what I believe are five areas of significant opportunity for quality technologies.

 

  • EHRs. According to most recent statistics from the Office of the National Coordinator,use of EHRs has increased from 20% in 2004 to 87% in 2015. EHRs were designed as documentation centers for billing and regulatory purposes. Relevant clinical patient management data workflow was not a priority and remains a major pain point for clinicians today. According to a study in the American Journal of Emergency MedicineER physicians spend only 28% of their time in direct face to face patient contact and can go through 4000 computer mouse clicks in one shift.  From a provider standpoint. the regulatory and billing data entry should be performed by someone else and relegated to an (almost) invisible part of the EHR.  We need EHRs which are clinically oriented with good user interfaces. Interoperability [defined by the federal Office of the National Coordinator for health information technology (HIT) as the ability of information systems to exchange patients’ electronic health information and use information from other EHR systems without any special effort from the user] is another major pain point that needs to be addressed. .Six years into Meaningful Use we have yet to achieve any significant interoperability of EHRs. There are hospitals within the same healthcare system in many places with disparate EHRs which do not talk to each other or exchange information.  Increasing healthcare consolidation of hospitals has exacerbated the problem of lack of interoperability. Health Information Exchanges (HIEs) have been woefully underfunded and have fallen short of their vision. There remain many opportunities for technologies to assist in achieving true interoperability.

 

  • Clinical trials. CIOs are constantly inundated with requests to purchase new technologies which will “save money, improve patient satisfaction and outcomes and decrease readmissions.” What is in fact lacking in most cases is evidence for these claims.  The hesitation of many entrepreneurs to embrace the intuitive adoption requirement of proof of claim (which needs to be said should not differ from the adoption of product in any field of endeavor making claims) is the misconception that time-consuming large costly randomized clinical trials are what I am referring to. This should not however translate to “take my word for it” is all you need. I agree that traditional trials are neither practical nor necessary for most tools. Even the FDA has now recognized with thoughtful and cautious restraint a role for ‘real world evidence’(defined by the legislation as “data regarding the usage, or the potential benefits or risks, of a drug derived from sources other than randomized clinical trials,” including sources such as “ongoing safety surveillance, observational studies, registries, claims, and patient-centered outcomes research activities.” in the approval process of drugs. Thus, the opportunity for trials utilizing digital registries, mobile clinical trial platforms, quality communications and analytics tools is significant.

 

  • Artificial Intelligence (AI). One early definition of Artificial Intelligence (AI) in medicine (1984) was “…the construction of AI programs that perform diagnosis and make therapy recommendations. Unlike medical applications based on other programming methods, such as purely statistical and probabilistic methods, medical AI programs are based on symbolic models of disease entities and their relationship to patient factors and clinical manifestations.” Today a broader definition may be applied: “the simulation of human intelligence processes by machines, especially computer systems. These processes include learning (the acquisition of information and rules for using the information), reasoning (using the rules to reach approximate or definite conclusions), and self-correction.” The use of artificial intelligence in medicine has been the subject of intense and rapidly growing interest in medical, computer science, and business arenas.  The market growth of AI is based on its projected impact on both technology and non-technology sectors. There have been arguments for and against the inevitability of replacement of physicians by AI technologies for a while now. The debate continues. BASF declared “We don’t make the household product, we make the product better.” An analogy can surely be made with AI. It runs in the background of technologies already in use but will make them run faster and more importantly will add a dimension of relevance of incoming data.

 

  • Personalized medicine. The National Cancer Institute’s definition of personalized medicine is “a form of medicine that uses information about a person’s genes, proteins, and environment to prevent, diagnose, and treat disease…” Personalized medicine is medical care directed in whole or part from information specific to an individual.  Discoveries in the area of the genetics of cancer have resulted in the development of drugs no longer targeted towards an anatomical location but a specific genetic marker. A landmark clinical trial in which drugs are given solely on the basis of genetic markers identified in the cancer tissue itself is the NCI-MATCH Trial (Molecular Analysis for Therapy Choice). “Patients with advanced solid tumors, lymphomas, or myeloma may be eligible for MATCH, once they have progressed on standard treatment for their cancer or if they have a rare cancer for which there is no standard treatment.” The role of personally derived connected data (from sensors external or internal to the body) will also facilitate personalized medical care. Opportunities thus exist for life sciences and technology companies to develop products for this new therapeutic approach.

 

  • Social Media. An early observational study of synergistic impacts of healthcare and social media demonstrated that personal experiences and not data drive social media healthcare discussions. One early survey of physicians on their use of social mediafound that “85% of oncologists and primary care physicians use social media at least once a week or once a day to scan or explore health information. Sixty percent said social media improves the care they deliver.” The potential for social media to disseminate information from published clinical trials, the exchange of professional education among peers, and discussions surrounding disease states is invaluable.  To be sure there exist professional and regulatory guidelines for the use of social media for providers, vendors and other healthcare stakeholders.  Social media open platforms in healthcare have proven successful for patients, caregivers and others.  Examples areTreatment Diaries, patientslikeme, and WEGOHEALTH.  Potential opportunities here involve recruitment of patients for clinical trials, gleaning real world evidence data from discussions.

 

By no means is this a complete discussion of opportunities for digital health. These are what I consider the ‘biggest bang for the buck’ ones doable today. I look forward to comments and the sharing of experiences from others. As a consultant I am amazed on a daily basis at the high quality clinical, financial and personal experience energies devoted to the development and advocacy for digital health tools. Bring it!

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
No comment yet.
Scoop.it!

No dilemma for innovators in healthcare

No dilemma for innovators in healthcare | Healthcare and Technology news | Scoop.it

The big trends in healthcare today are rising consumerism, a shift to value-based care, emerging data sources, and the use of advanced technologies for improving care delivery and reducing costs. There is unprecedented innovation opportunity in the digital transformation of healthcare.

 

At a recent industry event, I moderated a panel discussion on innovations in health care with a group of technology innovators and healthcare veterans. We all agreed that technology-led innovation was accelerating rapidly, but the innovation landscape had a set of unique challenges as well. In this post, I share some of the key thoughts from the discussion.

The market landscape for healthcare innovation

In the past few years, we have seen several significant changes in the market for technology-led innovation in health care. Here are some important trends.

 

  • A shift towards the virtualization of health care. Many routine health care services are now available on your smartphone – a perfect example would be urgent care visits or routine consultations. According to one report, there are over 300,000 health apps in the Apple and Android stores. However, only a small number have reached critical mass, indicating that consumer preferences for virtual care are changing slowly.
  • Huge amounts of venture capital pouring into digital health: $11.5 billion in 2017, according to one report. The first quarter of 2018 has seen continued investments in digital health, serving as a validation of the promise of digital health innovation and the opportunities in the digital transformation in health care. At the same time, many of these startups are struggling, exits are not keeping pace with expectations, and a few that have raised very large amounts of money, such as Outcome Health, have gotten into trouble for trying to find short-cuts to growth and profitability.
  • Innovations from big technology firms are also struggling to gain traction. Recent troubles at IBM’s Watson Health business which has reportedly laid off significant numbers of employees in the face of market and organizational challenges indicate a deeper problem for the business model itself.
  • New data sources such as genomics, wearables and social determinants are driving a whole new way of managing patient populations. Unstructured data, such as clinical notes, is now the new goldmine that people are digging into, with the help of emerging technologies such as AI. Other emerging technologies, like blockchain, are still in early stages but with great potential. However, data interoperability, especially with the big electronic health record (HER) systems like Epic and Cerner, remains a challenge.
  • We are in the early stages of breakthroughs such as gene-editing with CRISPR (powered by massive data analytics capabilities) that are likely to transform healthcare, along with an explosion in smart sensors and wearables. Other technologies, such as augmented reality (AR) and virtual reality (VR) are in very early stages but show enormous potential in transforming the way healthcare is delivered in the future.

Health care’s innovation focus and the players

A recent survey by Modern Healthcare indicates that health care consumerism is the no. 1 area for innovations, followed by clinical practice, or care delivery, and payment reform or alternate payment models. Most respondents in the survey felt that innovation was accelerating.

 

Data from Rock Health, a venture capital (VC) firm, lines up with the survey responses. While disease diagnosis and treatment remain significant focus areas, consumer empowerment is emerging as a strong funding category, confirming the rise of consumerism in health care. As healthcare shifts progressively away to virtual care delivery models, interest in telemedicine, remote monitoring, and alternate care delivery models continue to drive innovation.

 

It’s not just VC firms that are funding and driving technology-led innovation in health care. We are seeing health systems getting into the innovation game themselves by setting up funds.

 

Examples include Partners Healthcare, UPMC, Intermountain and Mayo Clinic, to name a few. While these funds are relatively small, the opportunity for promising startups with innovative solutions to accelerate the path to product validation and market acceptance improves with the support of the sponsoring health system.

 

We are also seeing some non-traditional partnerships emerging. The big announcement earlier this year by Amazon and Berkshire Hathaway, and the more recent announcement by a consortium of healthcare companies to invest in blockchain technology are examples.

 

Despite health care's reputation as a slow follower of technology, the innovation ecosystem is buzzing. In my book, the Big Unlock, I refer to four categories of technology solution providers: The Custodians such as the EHR vendors, who have the data and the workflow; the Enablers, which are big companies like Google, Microsoft, and Salesforce who have invested in health cloud infrastructures that can be rented for building digital health experiences; the Arbitrageurs, which include global consulting and technology services firms who rely on information and labor arbitrage for developing and delivering technology solutions; and finally the Innovators, which include the hundreds of startups and VC-funded companies who are developing entirely new ways to deliver health care. Every one of these categories is innovating in their own way.

 

At the heart of the innovation ecosystem is a final category of innovators, namely the healthcare enterprises. Leading health systems are innovating with health care delivery models and pricing/contracting models and are using technology to enable their digital transformation.

Into the great wide open

Despite all the activity and the fierce competition, there is good news for innovators; the market is wide open, and there is no single dominant entity in the digital health innovation landscape. Each of the categories of technology providers I refer to have their unique strengths and many would like to become that one dominant solution provider of choice.

 

While it does not seem likely that we will see a dominant digital health innovator in the near term, the window of opportunity for innovators is narrowing. As the high value “white spaces” get filled up and the risks of failure increase, VCs are committing larger and larger amounts of funding to more mature companies in the hope of a successful exit. New entrants in the innovation landscape will either need to find new white spaces or build “better mousetraps” to challenge well-capitalized incumbents on their turf. At the same time, as the pace of exits picks up, VC firms will look for new investment opportunities for their liquidation gains. For now, it’s best for digital health innovators to operate with an abundance mindset. It’s an “all you can eat” world out there. 

Technical Dr. Inc.'s insight:
Contact Details :

inquiry@technicaldr.com or 877-910-0004
www.technicaldr.com

more...
No comment yet.
Scoop.it!

Should Google Be Allowed to Mine Your Health Care Data?

Should Google Be Allowed to Mine Your Health Care Data? | Healthcare and Technology news | Scoop.it

On the heels of the I/O keynote on Thursday, Google cofounder Larry Page spilled his guts to Farhad Manjoo from The New York Times. "Right now we don't data-mine health care data," Page said. "If we did we'd probably save 100,000 lives next year." But is that actually a good idea?

Mining health care is a very slippery slope, whether it's done by Google or some government agency or anyone really. The privacy concerns alone have always kept prying eyes out of your health records. But now that technology has advanced to the point where we could anonymize the data and use the information to cure diseases, it's worth revisiting that topic.

The data store is only going to get bigger, too, as gadgets like fitness and health trackers become more ubiquitous. (Google, of course, is leading the charge on this front as well.) While Page's 100,000 figure is probably completely made up—and not even that many lives in the grander scheme of things—it seems pretty clear that a better understanding of health care data is a good thing.

So what do you think? Is it time to chill out about privacy so that Google algorithms can start saving some lives? Or would you rather keep your personal health care data personal?

more...
No comment yet.
Scoop.it!

How Medicaid for Children Recoups Much of Its Cost in the Long Run

How Medicaid for Children Recoups Much of Its Cost in the Long Run | Healthcare and Technology news | Scoop.it

When advocates talk about the advantages of government health care, they often talk about a moral obligation to ensure equal access. Or they describe the immediate health and economic rewards of giving people a way to pay for their care.

Now a novel study presents another argument for the medical safety net, at least for children: Giving them health coverage may boost their future earnings for decades. And the taxes they pay on those higher incomes may help pay the government back for some of its investment.

The study used newly available tax records measured over decades to examine the effects of providing Medicaid insurance to children. Instead of looking at the program’s immediate impact on those children and their families, it followed them once they became adults and began paying federal taxes.

People who had been eligible for Medicaid as children, as a group, earned higher wages and paid higher federal taxes than their peers who were not eligible for the federal-state health insurance program. And the more years they were eligible for the program, the larger the difference in earnings.

“If we examine kids that were eligible for different amounts of Medicaid over the course of their childhood, we see that the ones that were eligible for more Medicaid ended up paying more taxes through income and payroll taxes later in life,” said Amanda Kowalski, an assistant professor of economics at Yale and one of the study’s authors.

The results mean that the government’s investment in the children’s health care may not have cost as much as budget analysts expected. The study, by a team that included economists from the Treasury Department, was able to calculate a return on investment in the form of tax revenue.

The return wasn’t high enough to pay the government back for its investment in health insurance by the time the children reached age 28, when the researchers stopped tracking the subjects. By that age, the Treasury had earned back about 14 cents for every dollar that the federal and state governments had spent on insurance. But it did suggest that, if the subjects’ wages continued to follow typical trajectories as they aged, the federal government would earn back about what it spent on its half of the program by the time the children reached 60 — about 56 cents on the dollar, calculated using a formula that took into account the time value of money.

The split in spending between the federal and state governments for Medicaid varies by state, but, on average, federal taxpayers pay 57 cents of each dollar. There may also be some return on investment for states that collect income taxes, but the researchers didn’t measure that.

Here’s what that means in real numbers: The average person in the study with no Medicaid earned a total of $149,000 by age 28. For each year a person was eligible for Medicaid, that income went up by $250, and the taxes the person paid went up accordingly.

“What’s exciting about this is how good the outcome variables that they can look at,” said Janet Currie, a professor of economics and public affairs at Princeton. A few studies have tracked the health outcomes of children who were eligible for Medicaid over time, including one Ms. Currie wrote, but the study’s measures of economic outcomes are new.


The new paper was made possible by a series of policy changes throughout the 1980s and 1990s that slowly expanded Medicaid to cover more and more American children. The changes essentially happened in two phases: First, the federal government allowed the program to include older children, and then individual states approved expansion to those groups. The slow, state-by-state spread of the policy enabled the researchers to compare children who were eligible for Medicaid with a control group of similar children of the same age and family income level who were not eligible for the program. The study looked at children who were eligible for Medicaid, even though not every eligible child actually signed up.




Expanded eligibility had two other important effects closely related to the earnings statistics: Children who were eligible for coverage were less likely to die before reaching 28, and they were more likely to attend college. Those are outcomes that, Ms. Kowalski points out, the government may value even if the program doesn’t return any money to the Treasury.

The study can’t entirely explain how access to childhood health insurance helped low-income children earn more later in life. But Ms. Kowalski has a few theories. One is that it may have helped the girls, in particular, by offering them a way to get contraception (which Medicaid covers to varying degrees in all states) and avoid unplanned pregnancies. The earnings effect was much more pronounced for girls than it was for boys.

The difference may also come from the way that public health insurance changed the budgets of the children’s families, she said. By taking care of health care bills, Medicaid may have freed the parents to make other investments in their children’s development that paid off.

Ms. Currie said that earlier studies of children’s health outcomes also suggest that children with serious illnesses often go on to be sick as adults as well — meaning they are more likely to miss work or have limited career options. Medicaid supports and funds a lot of important preventive health care for very young children. She said the lesson could be that “an ounce of prevention is worth a pound of cure.”

Now that the earlier expansions have had a chance to spread, nearly every low-income child in the country is eligible for Medicaid, and more than a third of all American children are currently enrolled in either Medicaid or a closely related federal-state program, called the Children’s Health Insurance Program.

“If this is right, then we’re going to be seeing a lot more impact for the kids that are born now and in the future,” said Judy Solomon, a vice president for health policy at the left-leaning Center on Budget and Policy Priorities.


more...
No comment yet.
Scoop.it!

A Turning Point? Wearables Could Save 1.3M Lives by 2020 | Hospital EMR and EHR

A Turning Point? Wearables Could Save 1.3M Lives by 2020 | Hospital EMR and EHR | Healthcare and Technology news | Scoop.it

For years, wearable health bands have been expensive toys useful almost exclusively to fit people who wanted to get fitter. On their own, wearables may be chic, sophisticated and even produce medically relevant information for the user, but they haven’t been integrated into practical care strategies for other populations.

And with good reason. For one thing, doctors don’t need to know whether an otherwise-healthy patient took 10,000 steps during a run, what their heart rate was on Thursdays in June or even what their pulse ox reading was if they’re not wheezy asthmatics. Just as importantly, today’s EMRs don’t allow for importing and analyzing this data even if it is important for that particular patient.

But as the banners at last week’s mHealth Summit pointed out, we’re headed for the era of the mHealth ecosystem, a world were all the various pieces needed to make patient generated data relevant are in place. That means good things for the future health of all patients, not just fitness nuts.  In fact, a Swiss analyst firm is predicting that smart wearable devices will save 1.3 million lives by 2020, largely through reductions in mortality to in-hospital use of such devices, according to mobihealthnews.

New research from Switzerland-based Soreon Research argues that smart wearables, connected directly with smart devices, projects that using wearables for in-hospital monitoring will probably save about 700,000 lives of the 1.3 million it expects to see preserved by 2020. Even better, wearables can then take the modern outside the hospital. “New wearable technology can easily extend monitoring functions beyond the intensive care unit and alert medical professionals to any follow on medical problems a patient may develop,” according to Soreon Research Director Pascal Koenig.

Not surprisingly, given their focus on monitoring aerobic activities, Soreon projects that wearables can be particularly helpful in avoiding cardiovascular disease and obesity. The firm believes that monitoring patients with wearables could prevent 230,000 deaths due to cardiovascular diseases, and reduce obesity related deaths by 150,000.

And that’s just a taste of how omnipresent wearables use may be within a few years. In fact, Soreon believes that patients with chronic conditions will help push up the smart wearables market from $2 billion today to $41 billion, or more than 1000% growth. That’s a pretty staggering growth rate regardless of how you look at it, but particularly given that at the moment, clinical use of smart wearables is largely in the pilot stage.

What few if any pundits are discussing — notably, as I see it — is what software tools hospitals will use to crunch this flood of data that will wash it on top of the astonishing volume of data EMRs are already producing.

True, at the mHealth Summit there were vendors pitching dashboards for just this purpose, who argued that their tools would allow healthcare organizations to manage populations via wearable. And of course tools like Apple HealthKit and Microsoft Health hope to serve as middlemen who can get the job done.

These solutions will definitely offer some value to providers. Still, I’d argue that wearables will not make a huge impact on clinical outcomes until the day what they produce can be managed efficiently within the EMR environment a provider uses, and I don’t see players like Epic and Cerner making big moves in this direction. When the mHealth ecosystem comes together it’s likely to produce everything analysts predict and more, but bringing things together may take much longer than they expect.



more...
No comment yet.
Scoop.it!

Healthcare data: a virtual tsunami | HIMSS Future Care

Healthcare data: a virtual tsunami | HIMSS Future Care | Healthcare and Technology news | Scoop.it

Get ready, 'cause it’s coming! Heck, it’s already here – the healthcare data tsunami, that is – and CIOs are just one key group trying to figure out how to swim without going under. 

A recent report from research firm IDC  “pegs the volume of healthcare data at 153 exabytes in 2013. At projected growth rates, that figure will swell to 2,314 exabytes by 2020. To paint a picture, the authors of the report suggest storing all of that data on a stack of tablet computers. By the 2013 tally, that stack would reach nearly 5,500 miles high. Seven years later, that tower would grow to more than 82,000 miles high, bringing you more than a third of the way to the moon.”

One IDC executive says the key to staying afloat is to "Identify who owns the data and build consensus on data definitions . . . Understanding what the data means is key to making data governance and interoperability work, and is essential for analytics, big data initiatives and quality reporting initiatives, among other things."


more...
No comment yet.