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How telemedicine is transforming treatment in rural communities? 

How telemedicine is transforming treatment in rural communities?  | Healthcare and Technology news | Scoop.it

There's no denying it: rural hospitals are in trouble.

 

More than 48 rural hospitals have closed since 2010, according to the National Rural Health Association, and another 283 are in danger of closing.

 

The malaise effecting rural healthcare comes from several vectors. Reduced populations, higher percentage of uninsured and elderly patients, equipment underuse, and the absence of high-margin specialty services makes for a bleak economic outlook. A shortage of doctors willing to work in remote areas creates quality of care and a staffing issues. Then, there is the challenge of getting patients into rural hospitals in a timely manner because travel distances sometimes are too great.

 

Many believe that telemedicine and mHealth offer a way out for struggling rural hospitals, however.

 

A 2012 report by the Institute of Medicine for the National Academies, entitled The Role of Telehealth in an Evolving Health Care Environment, found that telehealth drives volume, increases quality of care, and reduces costs by reducing readmissions and unnecessary emergency department visits for rural communities. Through telemedicine, rural hospitals can serve rural patients at better costs and help cut down on the time it takes rural patients to receive care, particularly specialty care.

 

"When rural patients know their hospital is using telemedicine, they have higher regard for that hospital and are less likely to bypass it for treatment at an urban facility," noted James Marcin, director of the UC Davis Children's Hospital Pediatric Telemedicine Program, a pioneer in remote medicine.

 

The ways that rural hospitals can take advantage of telemedicine and mHealth technology advancements are many, and include remote consultations, in-home monitoring, outsourced diagnostic analysis, and remote specialist consultations.

 

Instead of waiting days or weeks for a healthcare professional to travel to a remote area, or traveling into a hospital and waiting for an appointment, telemedicine enables remote physician consultations that are faster, cheaper and more efficient than traditional healthcare appointments. For consultations on simple health concerns, or follow up on existing conditions, remote consultations can dramatically improve the patient experience while helping rural hospital economics at the same time.

 

The Georgia Partnership for Telehealth, for instance, assesses and treats students so that they do not need to travel to a clinic for healthcare, and currently has replaced more than 350 locations where a traditional doctor's visit was formerly required.

 

A second way that rural hospitals are leveraging telemedicine is through in-home monitoring. One example is decreased hospitalization rates for seniors enrolled in the FirstHealth Home Care Chronic Disease model in North Carolina. Patients previously diagnosed with heart failure, diabetes, or COPD and who experienced frequent hospitalizations are monitored by telehealth at home between periodic visits from nursing staff. Response and intervention times have improved substantially, according to the program.

 

Another benefit to struggling rural hospitals is outsourced diagnostic analysis and access to remote specialists. It is difficult for many rural communities to staff their own diagnosticians, but mobile imaging centers and lab specimen kiosks that can take X-rays and perform collections can work in conjunction with remote analysis labs in larger urban areas to bridge the gap.

 

One study that looked at 24 hospitals in four rural states in the Midwest including Kansas, Oklahoma, Arkansas, and Texas found that telemedicine brought an annual economic impact of at least $20,000 per year, with an impact of up to $1,300,000. The majority of these savings came from increased lab and pharmacy revenues due to additional work performed locally.

 

In addition to outsourced diagnostics, telemedicine also enables consultation with remote specialists at larger, urban hospitals instead of the need for having these specialists on staff. This can be particularly good for attracting doctors to rural hospital settings.

 

"Telemedicine fosters a collaboration that reduces the feelings of isolation that physicians may experience when they go to practice in a small town," noted Dr. Wilbur Hitt in a report, Telemedicine: Changing the Landscape of Rural Physician Practice. "With telemedicine, it's like having one foot in the city but being able to live and practice out in a rural area. It's also reassuring to know that you're on the right track with the treatment plan and are staying current."

 

Still, roughly 66 percent of rural hospitals had no telehealth services or were only in the process of implementing a telehealth application when the RUPRI Center for Rural Health Analysis reviewed 4,727 hospitals in the 2013 HIMSS Analytics database. Part of the reason comes from broadband access challenges.

 

Rural communities not only suffer from a population shortage and a lack of resources, they also typically have trouble with the necessary broadband infrastructure for telemedicine. The benefit of remote consultation by video conference for rural patients is clear, for instance, but these remote consultations amount to nothing if there isn't the broadband infrastructure to support it.

 

"The ability for physicians to connect with those in areas that don't have much of a wireless connection is the biggest problem when trying to treat these patients," noted Tony Zhao the CEO of Agora.io, a video SDK company that provides easy video conferencing with quality-of-service guarantees so telemedicine and e-learning initiatives work even in rural settings.

 

"With weak connections, video streams for telehealth are blurry, choppy or just won't work," he added. "Implementing technology that doesn't rely on the general internet but which relies on an infrastructure that strengthens signals in the most remote areas is crucial."

 

Another barrier for rural hospitals is the challenges that surround reimbursements. Medicare reimbursement is a major challenge for telemedicine, with states each having their own standards by which their Medicaid programs will reimburse for telemedicine expenses.

 

There is no single standard telemedicine reimbursement system for private payers, either. Some insurance companies value telemedicine and will reimburse for a wide variety of services while others do not.

 

These and other challenges put a drag on rural telemedicine at the same time as the need for it grows. Rural hospitals have a path toward recovery in the form of telemedicine, but obstacles still remain.

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How to Meet HIPAA Compliance Requirements

How to Meet HIPAA Compliance Requirements | Healthcare and Technology news | Scoop.it

A Revolutionary Approach to HIPAA Compliance

We all know that meeting the requirements set forth in the HIPAA compliance policy is mandatory for any healthcare, medical records, insurance, or other healthcare-related business. Securing individuals’ electronic protected health information (ePHI) is the most critical step to complying with HIPAA.

 

Yet this is often easier said than done, especially when you consider the high number of complex requirements that must be met in order to prove compliance.

The challenges of abiding by the “Security Rule”

For example, one of the most critical items on any HIPAA compliance checklist is meeting the Security Standards for the Protection of Electronic Health Information. Commonly referred to as the “Security Rule,” this requirement establishes a national set of security standards for protecting certain health information that is held or transferred in electronic form.

The Security Rule addresses the technical and non-technical safeguards that organizations referred to “covered entities” must put in place to secure individuals’ ePHI. All covered entities must assess their security risks, even those entities who utilize certified electronic health record (EHR) technology. Those entities must put in place administrative, physical and technical safeguards to maintain compliance with the Security Rule, and document every security compliance measure.

Related: Sorry for the Inconvenience – The Breaches Just Keep Coming (and so do the Ramifications)

CSPi’s HIPAA compliance solutions

If all of this sounds intimidating, we have some good news: CSPi’s security solutions are uniquely suited to address the requirements specified in the Security Rule (and in turn, to help you stay HIPAA compliant).

Our ARIA Software-Defined Security (SDS) solution and applications help healthcare organizations protect the security of individuals’ ePHI information with powerful tools and capabilities required to:

  • Know and prove what ePHI records were accessed (if any) through:

    • The automatic detection of intrusion or unauthorized access.
    • Continual and complete monitoring of ePHI data as it moves through the network (including east-west traffic), and is accessed throughout the environment.
    • The ability to stop or disrupt incidents that could lead to potential disclosure.
    • Block or redirect identified data conversations with ePHI repositories and provide the auditable documented detail of measures take to maintain HIPAA compliance.
    • Prevent unauthorized access of customer data through the use of encryption that can be applied on a per-customer basis.

Working in conjunction with ARIA, our nVoy Series provides additional proof of HIPAA compliance with:

  • Automated breach verification and notification, critical to giving healthcare organizations a better way to comply.
  • Detailed and complete HIPAA compliance reports, including recordings of all conversations involving ePHI.
  • Auditable proof of the exact impact of data breach, including:
    • What devices are involved and to what degree?
    • When did the breach start and when did it end?
    • What critical databases or files were accessed?
    • Who did the intruder talk to?

Visit CSPi at HIMSS19 in the Cybersecurity Command Center Booth 400, Kiosk 91.

Interested in learning more about CSPi, including how our innovative security tools are helping today’s healthcare leaders achieve compliance with HIPAA? Make your plans to visit with us at the upcoming HIMSS conference, or visit www.cspi.com, to learn more about our HIPAA compliance programs.

About CSPi

CSPi is a leading cybersecurity firm that has been solving security challenges since 1968. Our security solutions take a radically different approach to enterprise-wide data security by focusing on the data at its source, securing DevOps applications and leveraging network traffic for actionable insights. CSPI’s ARIA SDS platform uses a simple automated approach to protect any organization’s critical data, including PII/PHI, on-premise and in public clouds, no matter if is in use, in transit, or at rest. Our Myricom® nVoy Series appliances provide compliance assurance, automated breach verification and network monitoring enabled by the 10G dropless packet capture capabilities of our Myricom® ARC intelligent adapters. To learn more about how our cybersecurity products can help you with data privacy regulation compliance, check out our how-to guide, “Successfully Complying with Data Privacy Regulations.”

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Cybersecurity in the Spotlight 

Cybersecurity in the Spotlight  | Healthcare and Technology news | Scoop.it

Once again, cybersecurity issues will be in the spotlight at the Healthcare Information and Management Systems Society Conference, to be held Feb. 11-15 in Orlando, Florida.

 

This year's event at the Orange County Convention Center promises 1,300-plus exhibitors, including more than 70 vendors in the show's dedicated Cybersecurity Command Center.

 

The conference is expected to draw more than 45,000 attendees and offer more than 300 educational sessions spanning 24 topics - including cybersecurity and privacy as well as related regulatory updates.

Cybersecurity sessions will be weaved in throughout the week, with many taking place at the Cybersecurity Command Center. But the topic will also get special treatment on Monday, Feb. 11. A Cybersecurity Forum that day geared to CISOs and other health IT security leaders is among a handful of pre-show workshops before HIMSS19 officially opens on Tuesday.

Cybersecurity Forum

The Cybersecurity Forum has several key learning objectives for its attendees, HIMSS says, including:

  • Explain the types and details of recent cyberthreats;
  • Discuss what's new, what's different, what to look out for, and the impact on administrative, clinical operations and patient safety;
  • Describe how organizations can work better and smarter to enhance their cybersecurity program, despite resource and financial constraints.

Featured speakers at the forum include Ron Mehring, CISO at Texas Health Resources; Kevin McDonald, director of clinical information security at Mayo Clinic; Jason Hawley, director of information services and security at Yuma District Hospital & Clinics; Mitch Parker, executive director, information security and compliance at Indiana University Health; and James Brady, CIO of the Los Angeles County Department of Health Services.

Regulatory Updates

As usual, the HIMSS conference will provide opportunities to hear from government officialsabout the latest policy plans and other developments. Agencies to be featured include:

  • The National Institute of Standards and Technology, offering a session on Monday, Feb. 11, about its cybersecurity framework;
  • The Food and Drug Administration, which will describe its digital health software precertification program on Tuesday, Feb. 12;
  • The Office of the National Coordinator for Health IT, which will be featured in a number of sessions, including a standards and technology update slated for Thursday, Feb. 14.

I predict one of the best attended government sessions will be the HIPAA enforcement and compliance update on Tuesday, Feb. 12, featuring Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services.

Technology Spotlight

Among the emerging technologies to be spotlighted at the show is blockchain, which will be showcased at a four-hour forum on Wednesday, Feb 13, including a session about blockchain's privacy, security and compliance considerations in healthcare.

Machine learning and artificial intelligence are buzzwords that are guaranteed to be used by many of the exhibitors showcasing their health IT gear. But ML and AI will also be discussed at a variety of educational sessions, including a special all-day pre-show forum.

 

Many of the sessions at that forum appear to be heavily focused on the application of ML and AI for clinical applications. But the use of AI and ML for securing health data will also be showcased in a separate session, "AI in Healthcare: Ethical and Legal Considerations", at the Cybersecurity Command Center .

 

As usual, I'll be at the conference attending sessions as well as meeting with numerous healthcare CISOs, government leaders and other privacy and security experts. I'll share their insights in audio interviews, articles and blogs, so be on the lookout for daily updates on our HIMSS19 news site.

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Information Risk Management Still Needs Improvement

Information Risk Management Still Needs Improvement | Healthcare and Technology news | Scoop.it

Cybersecurity threats and attacks across various business sectors are on the rise pressuring for organizations to continuously assess the risks to any information. While the General Data Protection Regulation (GDPR) has garnered a lot of buzz in 2018, many standards and regulations in the United States also require cybersecurity.

 

But what are the technical details and operational steps needed to meet the high level guidance on cybersecurity risk? A recent Advisen survey revealed some interesting statistics:

 

  • 35% of respondents rated data integrity risks as “high risk” versus only 22% that of rated business continuity risks, or cyber related business interruption
  • Only 60% of the risk professionals surveyed said their executive management team viewed cyber risk as a significant threat to the organization, down 23% from the previous year.
  • Only 53% knew of any updates or changes even after the 2017 high profile attack

 

In short, these statistics paint a grim picture over the state of cybersecurity in the United States. While organizations are aware of the high risk of cyber attacks, management team involvement may be decreasing, and organizations may not be evolving their cybersecurity programs quickly enough.

 

Creating a Security First Risk Mitigation Posture
Many organizations have moved to a risk analysis security first compliance posture to enable stronger risk mitigation strategies and incorporate senior management oversight. However, identifying the potential risks to your environment only acts as the first step to understanding your overall risk. In order to identify all potential risks and engage in a full risk analysis that appropriately assesses the overall risk facing your data, you need to incorporate vendor risk as part of your risk management process.

 

That’s a lot of risk discussion, but you also have a lot of places in your overarching ecosystem that create vulnerabilities. Using a risk management process that establishes a security-first approach to your organization’s data environment and ecosystem means that you’re locking down potential weaknesses first and then backtracking to ensure you’ve aligned controls to standards and regulations. This approach, although it seems backward from a traditional compliance point-of-view, functions as a stronger risk mitigation program by continuously monitoring your data protection to stay ahead of hackers. Standards and regulations mean well, but as malicious attacks increasingly become sophisticated the best practices within these documents may be outdated in a single moment.

 

What is an Information Risk Management (IRM) Program?
An information risk management (IRM) program consists of aligning your information assets to a risk analysis, creating IRM policies that formalize the reasoning and decisions, and communicating these decisions with senior management and the Board of Directors. The National Institute of Standards and Technology (NIST) and the International Standards Organization (ISO) both provide guidance for establishing an IRM.

 

For example, the September 2017 NIST update to NIST 800-37 focuses on promoting information security by recognizing the need for organizational preparation as a key function in the risk mitigation process.

 

In fact, the core standards organization, ISO, updated its ISO 27005 in July 2018 to focus more on the information risk management process.

 

Specific to the United States, the Committee of Sponsoring Organizations of the Treadway Commission (COSO) updated it enterprise risk management framework to minimize data threats while requiring organizations to detail potential risks and manage risks more proactively.

 

As risk analysis increasingly drives information security practices, you need to focus on a risk treatment program that begins with risk identification, establishes an acceptable level of risk, defines your risk treatment protocols, and create risk mitigation processes.

 

Create an Information Risk Management (IRM) Team
In order to appropriately manage risk, you need to create an IRM Team consisting of stakeholders across the organization. Relying solely on your IT department may leave gaps in the process. To determine the stakeholders, you should explore the departments integral to risk identification. For example, you might want to ask yourself:

 

  • What departments hire vendors?
  • What departments can help with the overall risk process?
  • What stakeholders are legally required (in the United States) to be informed of the risk process?
  • Who brings unique insights into the risks that affect my data environment and ecosystem?

 

For example, while your IT department sets the controls that protect your information, your human resources department handles a lot of sensitive data. You need to incorporate stakeholders who understand the data risks unique to their role in your organization so that they can work with your Chief Information Officer and Chief Information Security Officer. Additionally, many United States regulations, such as the Sarbanes-Oxley Act of 2002 (SOX) require senior management and Board of Director oversight so they should also be included as part of your IRM team.

 

Begin with Business Processes and Objective
Many organizations forget that businesses processes and organizational business objectives should be the baseline for their risk analysis. Senior management needs to not only review the current business objectives but think about the future as part of the risk identification process. Some questions to ask might include:

 

  • What businesses processes are most important to our current business objectives?
  • Do we want to scale in the next 3-5 years?
  • What business processes do we need to meet those goals?

 

Understanding the current business objectives and future goals allows organizations to create stronger risk mitigation strategies. Many organizational goals rely on adding new vendors whose software-as-a-service products enable scalability. Therefore, you need to determine where you are as well as where you want to be so that you can protect the data that grows your organization and choose vendors who align with your acceptable level of risk.

 

Catalogue Your IT Assets
The next step in the risk analysis process requires you to look at all the places you transmit, store, or access data. This step often becomes overwhelming as you add more cloud storage locations that streamline employee workflows. Some questions to ask here might include:

 

  • What information is most critical to my business processes?
  • What servers do I store information on?
  • What networks does information travel over?
  • What devices are connected to my servers and networks?
  • What information, servers, networks, and devices are most essential to my targeted business processes?
  • What vendors do I use to management my data?

 

Review Your Potential Risks from User Access
Once you know what information you need to protect and where it resides, you need to review the users accessing it. Using multi-factor authentication and maintaining a “need to know” access protocol protects your information.

 

  • Who accesses critical information?
  • What vendors access your systems and networks?
  • Does each user have a unique ID?
    Can each user be traced to a specific device?
  • Are users granted the least authority necessary to do their jobs?
  • Do you have multi-factor authentication processes in place?
  • Do users have strong passwords?
  • Do you have access termination procedures in place?

 

These questions can help you manage risks to critical information because employees lack password hygiene or decide to use the information maliciously upon employment termination.

 

Establish An Acceptable Level of Risk
Once you’ve completed the risk identification process, You need to review what risks you want to accept, transfer, refuse, or mitigate. To determine the acceptable level of risk, you may want to ask some questions such as:

 

  • What is an acceptable level of external risk to my data environment?
  • What is an acceptable level of risk arising out of vendor access?
  • How do I communicate the acceptable level of risk to senior management?
  • How can I incorporate my acceptable level of risk in service level agreements (SLAs) with my vendors?
  • Can I quantify the acceptable level of risk I have assumed as part of my risk analysis?

 

Your information risk management (IRM) process needs to incorporate the full level of tolerances and strategies that protect your environment. In some cases, you may decide that a risk is unacceptable. For example, you may want to limit consultants from accessing your corporate networks and servers. In other instances, you may need to find ways to mitigate risks with controls such as password management or a Bring-Your-Own-Device policy.

 

Define the Controls That Manage Risk
Once you’ve set the risk tolerance, you need to define controls that manage that risk. This process is also called risk treatment. Your data ecosystem can leave you at risk for a variety of data breach scenarios, so you need to create information risk management (IRM) policies that outline your risk treatment decisions. In doing this, you need to question:

 

  • What firewall settings do I need??
  • What controls protect my networks and servers?
  • What data encryption protects information in transit across my networks and servers?
  • What encryption protects the devices that connect to my systems and networks?
  • What do I need to make sure that all vendor supplied passwords are change?
  • What protects my web applications from attacks?
  • What do I need from my vendors as part of my SLAs to ensure they maintain an acceptable level of security?

 

Defining your controls includes everything from establishing passwords to requiring anti-malware protection on devices that connect to your systems and networks. Creating a clearly defined risk treatment program enables a stronger security-first position since your IRM policies focus on protecting data proactively rather than reactively changing your security controls after a data event occurs.

 

Tracking the Risks With IRM Policies
Creating a holistic security-first approach to risk treatment and management means using IRM policies to help create a risk register. A risk register creates a tracking list that establishes a mechanism for responding to security threats. Your IRM policies, which should outline the entire risk management process, help establish the risk register by providing the list of risks monitored and a threat’s impact.

 

Although this process seems intuitive, the larger your environment and ecosystem, the more information you need to track. As you add vendors and business partners, you increase the risk register’s length making threat monitoring cumbersome.

 

How SecurityScorecard Enables the Information Risk Management Process
SecurityScorecard continuously monitors threats to your environment across ten factors: application security, DNS health, network security, patching cadence, endpoint security, IP reputation, web application security, cubit score, hacker chatter, leaked credentials, and social engineering.

 

Using these ten factors, organizations can streamline the risk management process. A primary hassle for those engaging in the risk management process lies in defining risks and establishing definitions for controls that mitigate overall risk. The ten factors remove the burden of identifying both risks to the environment and ecosystem as well as controls that mitigate risk. Moreover, you can use these same ten factors to quantify your risk monitoring and reaction, as well as the security of your vendors.

 

SecurityScorecard’s continuous monitoring tool can help alleviate bandwidth problems and help facilitate a cybersecurity program more in line with the sophisticated cyberthreat landscape.

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Empower Patients With StrongBox Payment Portal & Patient Financing Alternatives

Empower Patients With StrongBox Payment Portal & Patient Financing Alternatives | Healthcare and Technology news | Scoop.it

Customer churn. The phrase refers to the periodic loss of patients and the gaining of new clients. One way to ensure that churn works in your office’s favor is to empower your customers through our online financing portal. StrongBox, a leading platform as a service (PaaS) provider based in Boca Raton, FL, understands that when patients have the freedom to finance their procedures at a time and place of their choosing they are more likely to follow through with timely payments.

 

Why Customer Empowerment Matters
We all live busy lives, and patients are no different. No matter how welcoming and friendly your clinic is, patients are always mindful of their next appointments. One way StrongBox allows your clinic to empower patients is through our online financing portal. Instead of requiring your customers to fill out lengthy forms in the office, they simply need to sign on through our online portal to apply for financing from top lenders. By allowing your patients to choose when they apply, you are showing that you respect their valuable time. Plus, the online platform reduces wait time in your office.

 

A 2016 article in the Journal of Dental Hygiene found that long wait times in office have a measurable “negative effect” on patients’ satisfaction with their dentist and lowers patient return rates.

 

How StrongBox Empowers Your Patients
In addition to our revenue recognition cloud-based platform and our Payment Portal, StrongBox also offers two financing options, Select and Pro, that are accessible at the office or to be completed by the patient when they have the time to complete the less than 5 minute application process. The application process is paperless and offers instant access to an easy to use online financing application form. By partnering with StongBox, your patients will benefit from: 

  • Fixed-rate loans
  • No hidden markups
  • No interest hikes for late payments
  • No impact on credit score
  • Access to top-tier lenders (Discover, OneMain, Ascend)
  • Fast response from lenders
  • Easy application process
  • Hassle-free payments
  • Set monthly payments

 

Small- to medium-sized providers will benefit from our Select financing option. This service gives patients access to 30 lenders simultaneously. Select financing applications are approved at twice the rate as medical credit card applications. Both forms of application take less than five minutes for patients to complete.

 

Larger groups and networks may be best served with our Pro patient financing option. Our cloud-based platform can analyze your patients’ credit characteristics and rank them accordingly. Once approved, your clinic will receive funds within 24 hours.

 

More options for patients means a greater likelihood of compliance with billing, accelerating revenue recognition and reducing collection risk for the provider.  Many patients already experience anxiety over medical bills and non-payment is a healthcare system issue. In fact, a recent survey found that 79 million Americans have trouble paying medical bills and medical debt. Why not turn those worried patients into informed allies. The StrongBox model has a proven track record. Hospitals and clinics that use Pro and Select plans can see their collection rate increase from 15 to 70 percent to best practices 95 percent over the near term.


Learn How Our Online Platform Can Grow Your Business
Once your office begins using our online financing platform and payment portal, you can enjoy the benefits of our prompt customer support and proven return on investment. The freedom delivered by our revenue recognition platform and financing options means that your patients will feel empowered to handle payments on their terms while your team of oral health professionals can spend more time focusing on what you do best — serving patients.

 

If you have questions about StrongBox’s financing services, contact our team online or call our Boca
Raton, FL office at (855) 468-7876.

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4 Things to Know About Telehealth

4 Things to Know About Telehealth | Healthcare and Technology news | Scoop.it

Telehealth has emerged as a critical tool in providing health care services. [1] The practice covers a broad range of medical technology and services that collectively define the discipline. Telehealth is especially beneficial for patients who live in rural communities and other remote areas where medical professionals use the Internet to gather and share information as well as monitor the health conditions of patients by using peripheral equipment and software such as video conferencing devices, store-and-forward imaging, and streaming media. The following information details important factors that are shaping this burgeoning field.

 

The Changing Face of Telehealth Law
Today’s competitive health care marketplace has created an environment where patients demand lower costs, higher service quality, and convenient access to services. [2] Telehealth is an innovative and valuable mechanism that provides patients with efficient access to quality services. Lowering costs and removing barriers to service access, are critical components in promoting patient wellness and population health. Convenience and cost-effectiveness are important commodities in the modern health care marketplace, as patients tend to avoid treatment that is difficult to access or too expensive. As a result, telehealth technology is emerging as a preferred choice among patients and providers. Telehealth has also attracted the attention of US legislators. They utilize this tool for improving the competitiveness of American health care services. This is especially important, seeing as health care represents 17 percent of the nation’s gross domestic product (GDP). In fact, the resource has helped to define the role that lawmakers play in ensuring that patients benefit in a competitive health care market.

 

Reimbursement for Services Delivered by Telehealth
The laws regarding reimbursements change regularly as more service providers incorporate telehealth technology into their practices. Reimbursement procedures can vary by state, practice, insurer, and service. [3] Care providers need to understand several facts, regulations, and laws to navigate Medicare telehealth reimbursements. They must first scrutinize whether the distance between the facility (the originating site) and the patient is far enough to qualify as a distant site. The location must also qualify as a Health Professional Shortage Area (HPSA) per Medicare guidelines. Additionally, the originating site must fall under Medicare’s classification as a legally authorized private practice, hospital, or critical access hospital (CAH). For instance, the Centers for Medicare and Medicaid Services ranks the Harvard Street Neighborhood Health Center as a top facility in need of physician services based on these criteria. Care providers must also use proper insurance coding to be reimbursed for hosting services that use telehealth technologies. For now, collecting reimbursements for telehealth services remains simpler for practitioners who limit the scope to which they apply the technology.

 

Telehealth or Telemedicine?
The term ‘telehealth’ is gaining popularity among medical professionals, compared to the original term, ‘telemedicine.’ [4] Some medical professionals use the names interchangeably. However, telemedicine is a term that may apply to the application of any technology in the clinical setting, while telehealth more distinctly describes the delivery of services to patients. Telemedicine is a familiar term, but telehealth more appropriately describes the latest trends in using technology to deliver treatments to patients. Depending on the organization, service providers may use a different definitions of telehealth. Although the basic premise remains similar, the context may change according to factors such as organizational objectives, and the needs of the patient population being served. Medical experts do agree on one point; telehealth is an innovative way of engaging patients, and it is highly beneficial for both providers and patients.

 

The Road Ahead
There are several areas where telehealth medicine could make a significant impact. It could be used as a tool to remotely monitor patients who have recently been discharged. It may also help treat individuals with behavioral health issues who might normally avoid treatment due to its high cost, or to avoid any perceived public stigma. [5] The largest area where technology could advance medicine is in treating the chronically ill. These patients usually require many visits with several specialists who may practice at different and distant originating sites. To move telehealth forward, organizational leaders must present evidence to peers and patients that the technology offers value. In addition, care providers must work to transition patients from using telehealth services only for minor conditions (for headaches, colds, etc.), to accepting the technology as a viable replacement for costly physician office visits. Advocates for telehealth medicine must also develop quality controls, so that this potentially transformational tool can maximize its problem solving capabilities and its service effectiveness. To harness the benefits of telehealth technology, America’s brightest medical professionals (both experienced and up-and-coming) must make a concerted effort to incorporate the tool into their practices and make it a regular service offering. Today’s medical students — as they enter a world where telehealth is becoming more pervasive — can take part in what might be a monumental change in the way health professionals think about medical treatment.

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Health System began exploring telemedicine as a way to connect its physicians and specialists with patients 

Health System began exploring telemedicine as a way to connect its physicians and specialists with patients  | Healthcare and Technology news | Scoop.it

In 2005, Tift Regional Health System began exploring telemedicine as a way to connect its physicians and specialists with patients in the rural area surrounding its Tifton, Georgia, home base.

At that time, telehealth technology largely consisted of a hub-and-spoke network, based out of large tertiary care centers or academic medical centers.

 

"We understood [telehealth] was the future and we needed to be a part of this technology that could get our patients to the specialists that they needed to see 200 or more miles away," said Jeff Robbins, MD, director of telehealth and neurodiagnostics at Tift Regional Medical Center.

 

The virtual visits idea was starting to be discussed in rural parts of the country. The Internet was slow, but the tech was getting close to making distant encounters possible.

 

"In the early days, every encounter was basically a telehealth network within itself," Robbins said. "The technology only allowed us to connect to one endpoint at a time. The technology didn't allow us to network to a new endpoint or customer without a lot of IT involvement. Internet was slow and the devices used to conduct a patient-to-provider encounter were primitive compared to what we have today."

 

These issues prevented Tift Regional from achieving the outcomes it knew were possible but staff understood, given its track record at other hospitals, that telehealth could play a very important part in delivering healthcare in the near future.

 

Tift at that point partnered with the Global Partnership for Telehealth, a nonprofit with a 12-year track record in developing and implementing sustainable, cost-effective telehealth programs.

 

The Global Partnership for Telehealth markets telehealth systems to hospitals and other medical facilities in 11 states. There are a variety of telemedicine technology vendors with varied offerings on the market. These include American Well, Avizia, Cisco Systems, HealthTap, InTouch Health, MDLive, SnapMD, TeleHealth Services and Tellus -- many of those are in the Healthcare IT News Buyers Guide: Comparing 11 top telehealth platforms.

 

GPT's network of caregivers and its technology gave Tift Regional the ability to connect to nursing homes, school clinics, emergency rooms, stroke teams, specialized wound care teams and advanced critical care teams hundreds of miles away from its rural location in South Georgia.

 

"I like to say the miracle of telehealth is that it gives us the ability to erase time and distance," Robbins said. "Our patients benefit with virtually no travel time or expenses, decreased time waiting for an appointment, reduced medical costs, and extra value to the patient encounter and extended access to consultations with specialists not offered in their area and usually hundreds of miles away."

 

The partnership with GPT also allows Tift Regional's employed physicians to increase revenue because they can see patients outside their area, reducing missed appointments, and giving them the tools to treat more patients over time and have better patient follow-ups that improve outcomes, which also cuts down on readmissions, he added.

 

Telehealth carts generally include a monitor, camera, keyboard and remote control. Peripherals give physicians the ability to monitor vital signs, use a digital stethoscope, and use high-definition cameras for specific types of care such as dermatology or wound care.

 

Telehealth has become a critical component in Tift Regional's ability to deliver quality healthcare, and the healthcare organization has seen success in using the technology.

 

"Telehealth has increased access to healthcare within our organization by making it easier for our patients to obtain clinical services," Robbins said. "It also allows our hospital to provide emergency services that we cannot always provide like advanced/emergency stroke care. We have also seen an increase in improved health outcomes."

 

Telehealth allows Tift Regional to get its patients seen, diagnosed and treated earlier. This leads to improved outcomes and less costly treatments, Robbins explained.

 

"Telehealth has allowed us to have advanced ICU support and that has reduced mortality rates, reduced complications and subsequent hospital stays," he added. "We are seeing a reduction in healthcare costs through home monitoring, which is lowering costly hospital visits. Our stroke program is reducing the high cost of transferring stroke and other emergencies."

 

And Tift Regional has used telehealth to address the shortage in healthcare providers by allowing its patient population to see specialists outside Tift's area, also enabling Tift's own specialists to serve more patients, he said.

 

Before telemedicine, a virtual encounter meant both the presenter and the provider had to switch between many different programs. This presented issues when programs failed and data didn't link up correctly.

 

"The provider can now see who is waiting to be seen in the virtual waiting room, and data entry has been streamlined to allow patient data and notes to be uploaded into our existing EHR," Robbins said. "And maybe the best improvement is the ability to switch programs, going from Pathways to the stethoscope then the cameras within the same encounter."

 

 

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Why is Telehealth so Important in Our Healthcare System? 

Why is Telehealth so Important in Our Healthcare System?  | Healthcare and Technology news | Scoop.it

Telehealth is emerging as a critical component of the healthcare crisis solution. Telehealth holds the promise to significantly impact some of the most challenging problems of our current healthcare system: access to care, cost-effective delivery, and distribution of limited providers. Telehealth can change the current paradigm of care and allow for improved access and improved health outcomes in cost-effective ways.

 

Telehealth increases access to healthcare:

  • Remote patients can more easily obtain clinical services.
  • Remote hospitals can provide emergency and intensive care services.

Telehealth improves health outcomes:

  • Patients diagnosed and treated earlier often have improved outcomes and less costly treatments.
  • Patients with Telehealth supported ICU’s have substantially reduced mortality rates, reduced complications, and reduced hospital stays.

 

Telehealth reduces healthcare costs:

  • Home monitoring programs can reduce high cost hospital visits.
  • High cost patient transfers for stroke and other emergencies are reduced.

 

Telehealth assists in addressing shortages and misdistribution of healthcare providers:

  • Specialists can serve more patients using Telehealth technologies.
  • Nursing shortages can be addressed using Telehealth technologies.

 

Telehealth supports clinical education programs:

  • Rural clinicians can more easily obtain continuing education.
  • Rural clinicians can more easily consult with specialists.

 

Telehealth improves support for patients and families:

  • Patients can stay in their local communities and, when hospitalized away from home, can keep in contact with family and friends.
  • Many telehealth applications empower patients to play an active role in their healthcare.

 

Telehealth helps the environment:

  • Reducing extended travel to obtain necessary care reduces the related carbon footprint.

 

Telehealth improves organizational productivity:

  • Employees can avoid absences from work when telehealth services are available on site or when employees can remotely participate in consultations about family members.
  • These examples illustrate the some improved outcomes and cost savings being achieved by Telehealth and telehealth programs:
  • Home monitoring of chronic diseases is reducing hospital visits by as much as 50% by keeping patients stable through daily monitoring.
  • The national average for re-admission to hospitals within 30 days following a heart failure episode is 20%. Telehealth monitoring programs have reduced that level to less than 4%.
  • Timely provision of treatments that effectively reverse the consequences of a stroke have risen from 15% to 85% due to the availability of telestroke programs.

 

Telehealth support to Intensive Care Units (often called eICUs) is reducing mortality rates by 15 – 30% and substantially reducing complications and length of stay.

 

Telehealth retinopathy screening programs support early identification of serious eye disease and reduce the incidence of blindness in diabetic patients.

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Using telemedicine to treat chronic disease 

Using telemedicine to treat chronic disease  | Healthcare and Technology news | Scoop.it

Flash back to the brink of the Patient Protection and Affordable Care Act. On the cusp of the passage of the ACA, more than 41 million Americans were uninsured or underinsured, driving one of the largest health care overhauls in history. While controlling costs was an important consideration, the main focus of the ACA was expanding coverage. To increase accessibility to affordable health insurance options, the law employs a mixture of mandates, subsidies, tax credits, and penalties to increase coverage of the uninsured, spur health care innovation, and provide for new payment models to reward quality of care and improved health care outcomes.

 

More than five years into the ACA era, the White House touts that the number of people without health insurance continues to decline and has dropped by 15.8 million since 2013. Of the roughly 11 million people who enrolled in state or federal Marketplaces in 2015, about 4.2 million were auto-renewals or renewals, indicating that roughly half of all 2015 enrollees kept their 2014 Marketplace insurance plan.

 

The rurally ignored

 

Despite the widely publicized successes of the ACA, many rural Americans were forgotten by health care reform. Although the ACA proclaimed a renewed focus on rural America, little was accomplished for rural populations outside of Medicaid expansion. A policy brief published by the National Advisory Committee on Rural Health and Human Services stressed the importance of coverage in rural areas, where the population is disproportionately older, more chronically ill, lower in income, and less insured compared to urban areas.

 

Where are the rural communities? "Rural" encompasses all populations, housing, and territories not included in an urban area; essentially, it is defined by what it is not. In 2010, the U.S. Census estimated that 59.5 million people – 19.3 percent of the population – lived in rural areas.

 

Rural residents tend to be poorer, earning a per capita average income of $19,000, which is nearly $7,000 less than what their urban counterparts earn. Although rural Americans account for only 22 percent of the population, rural residents account for 31 percent of the nation's food stamp beneficiaries. Only 64 percent of rural residents are covered by private insurance, and the rural poor are less likely to be covered by Medicaid benefits than their urban counterparts (45 percent versus 49 percent, respectively). Compounding the issue of obtaining affordable coverage, rural areas rarely have access to the same types of coverage. According to the National Rural Health Association, only about 10 percent of physicians practice in rural America, even though nearly 25 percent of the population lives in rural areas. There are only 401 specialists per 100,000 people, compared to 910 in urban areas.

 

"Rural Americans face a unique combination of factors that create disparities in health care not found in urban areas. Economic factors, cultural and social differences, educational shortcomings, lack of recognition by legislators, and the sheer isolation of living in remote rural areas all conspire to impede rural Americans in their struggle to lead a normal, healthy life."

 

Perpetuated by the inability to find and afford care, rural populations face higher incidences of chronic disease. Obesity, diabetes, heart disease, and alcohol and substance abuse are all chronic conditions that disproportionately affect rural populations.

 

Turns out, chronic disease is costly

 

In the U.S., chronic diseases and the health risk behaviors that cause them account for highest health care costs. In fact, 86 percent of all health care spending in 2010 was for people with one or more chronic medical conditions. The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical costs for people who are obese were $1,429 higher than those for people of normal weight in 2006. Of the top 10 states with the highest rural populations, half fell on the list of the states with the highest rates of adult obesity and diagnosed diabetes

 

So what is the government doing? Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services recently awarded $2.7 million to improve rural health, however, those grants will support 3-year pilot programs designed to train health professionals and expand health insurance coverage in rural areas, rather than impact rural health directly. Essentially, the 20 recipients of the grants (ranging from $75,000 to $200,000) are community colleges, hospitals, health education centers, individual counties, and other various providers, which are to use the money for formal training programs for health professional students. To put it in perspective, HRSA responded to the outcry by millions of rural Americans by awarding grants equal to the price of 17-year-old Kylie Jenner's first home, after spending hundreds of millions of dollars implementing the ACA and federal and state Marketplaces.

 

Is telemedicine the perfect solution? Maybe

 

Although the ACA does not specifically link telemedicine to rural populations, "telehealth" or "telemedicine," which is using telecommunication and information technologies to provide clinical health care at a distance, is a critical component of transitioning to value-based treatments, and to better serving rural communities and chronic conditions.

 

For rural populations, telemedicine has the potential to increase accessibility to providers and specialists who can remotely monitor and treat chronic disease, without the hassle or costs associated with traveling. In many states, telemedicine services are covered by insurance to the same extent as in-person services. It helps eliminate distance barriers to medical services that would often not be consistently available in distant rural communities.

 

Although it seems like a catch-all, it is important to note that telemedicine is not a replacement for an annual, in-person physical; it is used most effectively to manage chronic condition and preventive health care costs. Even the best physicians in the world cannot take the blood pressure of a patient or press on the abdomen of a sick patient remotely. While certainly this represents a drawback, it also presents an opportunity. The rules governing the practice of medicine do not need to be the same rules that govern the practice of telemedicine. By linking patients with doctors either via telephone or video chat, barriers of distance can be eliminated, which proves crucial for rural areas.

 

Telemedicine snapshot: Mississippi

 

To address the prevalence of chronic conditions, Mississippi became the 16th state to pass advanced telemedicine provisions. In 2014, the American Telemedicine Association (ATA) graded existing state telemedicine programs based on reimbursement and physician practice standards, rating Mississippi with the highest possible composite score. Evidence of a collaborative landscape accommodating telemedicine, Mississippi requires telemedicine services to be a 'real-time' consultation, which does not include the use of audio-only telephone, email, or fax. Additionally, the Mississippi legislature also required that telemedicine services are covered to the same extent as in-person services, although a health plan may limit the number of telemedicine providers to a local network.

 

With the highest prevalence of adult obesity and diabetes in the country, Mississippi prioritized remote patient monitoring services to coordinate primary, acute, behavioral, and long-term social service needs for high-need, high-cost patients. For telemedicine services to be reimbursed, patients must be eligible for remote patient monitoring and specific patient criteria must be met. For example, qualifying patients for remote patient monitoring must be recommended by their physician, be diagnosed in the last 18 months with a chronic condition like diabetes or heart disease, and have a history of costly services because of that condition.

 

Initial barriers to telemedicine implementation

 

Although Mississippi has faced relatively little resistance incorporating these laws, many states still need to consider a number of issues or barriers when developing telemedicine programs and policy.

 

1. Requiring coverage for telemedicine under private insurance, state employee health plans, and public assistance


Reimbursement continues to be a barrier to telemedicine adoption in some states. Medicare, which typically sets reimbursement standards, reimburses for telehealth services with relatively stringent requirements. Medicare pays for telemedicine services only when patients live in Health Professional Shortage Areas (HPSAs) and those who engage in "face-to-face" interactive video consultation services and some store-and-forward applications (e.g., teleradiology, remote electrocardiogram applications). As stated in a report by the American Hospital Association, "Without adequate reimbursement and revenue streams, providers may face obstacles in investing in these technologies."

 

Plan administrators and providers need to work together to discuss telemedicine benefits and determine coverage options and reimbursement policies, similar to the Mississippi State Legislature passing a bill requiring private insurance to pay for telemedicine services at the same rate as it does for in-person care. States considering telemedicine will have to wrestle with similar decisions about what to cover (e.g., video consultations, asynchronous store-and-forward platforms, patient monitoring) and review technology guidelines that determine reimbursement eligibility to ensure maximum reimbursement. To put it simply, if providers are not getting paid, they cannot provide.

 

2. Patient consent and education

 

Consent is a vital component of health care and is more complicated with a telemedicine platform. States must consider requirements for how to approach and obtain patient consent. The risk of consent-based claims for providers is a concern, and malpractice laws are currently geared toward face-to-face interactions; if consent-based claims become rampant, the willingness of providers to administer health care via telemedicine will likely decrease. Nebraska, for example, requires written informed consent, while California and Arizona law permit verbal consent to satisfy the statutory informed consent requirement. Since telehealth is a new and emerging field, patient education is critical to patients' health and providers' ability to practice.

 

Ideally, patients need to understand details about the expected risks and benefits of telemedicine, available alternatives, and how telemedicine fits into their personal wellness plan.

 

3. Geographical restrictions on telemedicine services


Although many states are ironing out provisions for health professional licensure requirements, including implementing special telemedicine licenses, border state and consultation exceptions, and interstate reciprocity and endorsements, little research has been done regarding restrictions on limitations for patient location while receiving telehealth services. For instance, can a patient on vacation in another state or country meet with his or her physician for an appointment? If the physician prescribes medication, can the patient fill his or her prescription outside of state lines?

 

Consideration needs to be placed on not just where the provider is operating from but also where the patient is located at the time of treatment and how treatment is administered.

 

4. Establishing the provider-patient relationship


Trust is an essential factor in a provider-patient relationship. It has been historically built during face-to-face interactions. States need to consider whether an in-person examination component is necessary or telemedicine can be used instead of an initial in-person patient evaluation.

 

The face of health care is changing, but prioritizing relationships is at the core of what creates value and better outcomes in health care. When implementing telemedicine programs, it is essential to consider the health of the patient first and design an interaction model that will create the most effective patient-provider relationship.

 

Overwhelmed? Here's what we know, and where we're going. We know that there are a significant number of rural Americans in the U.S. who have a difficult time accessing and affording health care. We know that many of these Americans are the ones who really need it, given their higher incidence of chronic disease. We know that chronic disease costs a lot and that most rural Americans cannot afford to treat it conventionally. We know that on its face, telemedicine may be one solution to solving the problem of rural health care.

 

A continued focus on this population of Americans and a renewed sense of urgency will allow for thoughtful state legislation and progressive development. Using Mississippi as a model of telemedicine implementation that is more thorough than many of its counterparts, other states can review their successes and challenges, with specific focus on the issues identified in this piece. For instance, considering where a patient must be located to receive care from providers, as well where they are legally able to fill a prescription from that provider are critical considerations for every state developing and amending telemedicine laws. There are a number of stakeholders involved in the telemedicine field. To ensure comprehensive, thoughtful laws and reforms, state legislature should reach out to local health care providers, nonprofit research centers, state insurance and Medicare/Medicaid departments, private insurance companies, state legislators, and patients to evaluate needs and requirements, and implement suitable legislation.

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CMS is making telehealth a cornerstone in its first Rural Health Strategy.

CMS is making telehealth a cornerstone in its first Rural Health Strategy. | Healthcare and Technology news | Scoop.it

CMS has unveiled its first-ever Rural Health Strategy in an effort to improve access to healthcare for the estimated 60 million Americans living in rural areas. The plan includes an emphasis on modernizing and advancing telehealth and telemedicine.

 

The Centers for Medicare & Medicaid Services unveiled the first-ever program this past week, releasing a five-point, eight-page initiative to improve access to care for the estimated 60 million Americans living in rural and underserved communities.

 

“For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” CMS Administrator Seema Verma said in a press release. “The Rural Health Strategy supports CMS’s goal of putting patients first. Through its implementation and our continued stakeholder engagement, this strategy will enhance the positive impacts CMS policies have on beneficiaries who live in rural areas.”

 

One part of the strategy focuses on using connected care technologies to bring healthcare to those residents.

 

“Telehealth has been identified as a promising solution to meet some of the needs of rural and underserved areas that lack sufficient health care services, including specialty care, and has been shown to improve access to needed care, increase the quality of care, and reduce costs by reducing readmissions and unnecessary emergency department visits,” the plan states. “To promote the use of telehealth, CMS will seek to reduce some of the barriers to telehealth use that stakeholders identified in the listening sessions, such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine.”

 

In its strategy, CMS says it will look to modernize and expand telehealth and telemedicine programs, particularly through the Next Generation Accountable Care Organization Model, Frontier Community Health Integration Project Demonstration and Bundled Payments for Care Initiative advanced model.

 

CMS has long come under criticism for its guidelines on reimbursing healthcare providers for telehealth delivered in rural areas, including restrictions on what services can be reimbursed under Medicare, where those services can be delivered, and even how rural areas are defined.

 

The agency has been the focus of several lobbying efforts to improve telehealth and telemedicine reimbursement, as well as several bills introduced in Congress. But few of those bills have become law, and healthcare providers still see Medicare reimbursement as one of the biggest barriers to pushing sustainable virtual care into rural America.

 

Last year, The Healthcare Information and Management Systems Society (HIMSS), American Medical Association (AMA), American Medical Informatics Association (AMIA), Center for Connected Health Policy (CCHP) and Personal Connected Health Alliance (PCHA) all called on CMS to go beyond current proposals to amend the Medicare 2018 physician fee schedule and open the doors to more connected care services.

 

“HIMSS encourages CMS to embrace a reimbursement system that recognizes the unique characteristics of connected health that enhances the care experience for the patient, providers and caregivers,” former HIMSS President and CEO H. Stephen Lieber and Denise W. Hines, chair of the HIMSS North America Board of Directors and CEO of the eHealth Services Group, wrote.

 

In that letter, HIMSS called on CMS to support:

 

Collaborative decision-making involving diverse care-teams. “Decisions are no longer just between a doctor and patient,” the organization wrote. “Connected technologies allow for the incorporation of a patient’s family and trusted advisors, as well as other allied health professionals, in the decision-making process.”
Expanded care locations and always-on monitoring. “When patients are always connected, care (the interpretation of data and decision support) can occur at any time and in any place,” HIMSS said.


A reliance on technology, connectivity and devices. “Connected health involves communication systems using a variety of components; these may be managed by the provider, the patient, or other parties in the care team,” HIMSS said.
And “empowerment tools and trackers that enable patients to become active members of the care continuum outside of the hospital setting and promote long-term engagement which, in turn, leads to a healthier population.”


Recognizing the challenges faced by healthcare providers in sustaining and scaling telehealth, the National Quality Forum (NQF) issued its own report last year, in which it proposed to set a national framework for measuring and supporting success in telehealth and telemedicine.

 

“Telehealth is a vital resource, especially for people in rural areas seeking help from specialists, such as mental health providers,” Marcia Ward, PhD, director of the Rural Telehealth Research Center at the University of Iowa and co-chair of NQF’s Telehealth Committee, said in a release accompanying the 81-page report. “Telehealth is healthcare. It is critically important that we measure the quality of telehealth and identify areas for improvement just as we do for in-person care.”

 

CMS’ Rural Health Strategy, developed by the CMS Rural Health Council, formed in 2016, and culled from input gained at 14 public hearings, features five objectives:

 

  • Apply a rural lens to CMS programs and policies;
  • Improve access to care through provider engagement and support;
  • Advance telehealth and telemedicine;
  • Empower patients in rural communities to make decisions about their healthcare; and
  • Leverage partnerships to achieve the goals of the strategy.
    The effort was met with words of support from several organizations.

 

“(The) AHA is pleased CMS put forward thoughtful recommendations to address the unique challenges of providing care to patients in rural communities,” Joanna Hiatt Kim, the American Hospital Association’s vice president of payment and policy, said in a release. “We look forward to working with CMS and Congress to take meaningful action to stabilize access in rural communities, such as creating new alternative payment models, expanding coverage of telemedicine and access to broadband and reducing regulatory burden.”

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Virtual Healthcare Gets Real, As Telehealth Turns to AI

Virtual Healthcare Gets Real, As Telehealth Turns to AI | Healthcare and Technology news | Scoop.it

One day you wake up with a pain in your side that persists. You want to be seen by a medical professional, but you don't want to go through the hassle of making an appointment and schlepping to your doctor. Most large healthcare organizations now allow you to make an appointment with a physician and get observed from the comfort and privacy of your own home — via video conferencing software on your smartphone, tablet or PC.

 

Such "telehealth" capabilities, as they're known, have been around for several years, but they're gaining traction as the sector swivels from fee-for-service to outcomes-based care. Intermountain Healthcare, a healthcare system that operates 23 hospitals and 170 clinics in Utah and Idaho, earlier this year took the concept of telehealth to another level by launching a virtual hospital.

 

The digital service, Intermountain Connect Care Pro, provides people anything from basic care to advanced services such as stroke evaluation, mental health counseling and critical care for newborns, says CIO Marc Probst.

 

Virtual care on the rise
Connect Care Pro marks the acceleration of a trend. Seventy-four percent of healthcare customers have already received or are interested in some form of virtual care, according to Forrester Research. The researcher also says that 55 percent of healthcare organizations are making a new investment or increasing investment in virtual care technologies, which they view as crucial to patient acquisition and retention.

 

"Patients seek personalized and convenient care," Forrester analyst Arielle Trzcinski wrote in a recent blog post. "They will not tolerate an aggravating, time-consuming experience when options that fit their needs are just a click away."

 

For Connect Care Pro, Intermountain Healthcare wove together 35 telehealth programs and allocated more than 500 caregivers. Probst says the virtual hospital saves patients and doctors the time and trouble of meeting in person for routine ailments, such as a headache or a pulled muscle. "They do 100 percent of their work virtually," Probst says of the physicians working for the virtual hospital. Probst estimates that as much as 75 percent of healthcare appointments can be performed virtually.

 

That presents great opportunities for Intermountain, which can now more efficiently treat patients who require emergency medical attention, Probst says. Probst helped implement the software and systems for the virtual hospital, including integrating them with the provider's Cerner electronic medical record (EMR) system.

 

The virtual hospital is one of the cornerstones of Intermountain's multi-year digital transformation, supporting more than 2,300 physicians and clinicians. It builds off of a decade-old telehealth initiative that Probst helped expand to more than 12 non-Intermountain healthcare facilities in Utah, Wyoming in Idaho.

 

However, he acknowledges that the technology doesn't work for all scenarios. "I don't want my prostate exam over my computer," says Probst, when asked for an example of a necessary in-person treatment. Indeed, while telehealth will never completely supplant on-site caregivers, Intermountain believes it can ease the burden on existing staff, particularly with the population of Baby Boomers set to exceed children in the U.S. by 2030, according to the U.S. Census Bureau.

 

A virtual assistant for your healthcare needs
For Intermountain, virtual care is just one piece of a larger emerging healthcare puzzle that Probst says will also include virtual assistants driven by artificial intelligence (AI) — think Iron Man's "Jarvis" for healthcare. Take the virtual hospital or telehealth scenarios, for example.

 

If someone has a medical issue they want attended to, they can cue up Amazon.com's Alexa or Google Assistant from their home-based smart appliance and describe the condition. The virtual assistant could walk the patient through questions about the location and severity of the pain, while in the background accessing the patient's EMR (with the patient's prior permission, of course). Ideally, the assistant could then "get close to a diagnosis" and recommend the person see a doctor either in-person or via virtual care, Probst says. The assistant can then make that appointment.

 

Probst says these capabilities, which he expects could one day be integrated into Connect Care Pro, will likely happen within his career. "It's very much using AI and tapping into the EMR for digital triage," Probst says. He says the AI will also, with a patient's permission, assist with ordering prescriptions, such as an antibiotic to a CVS or Walgreens.

 

Eventually, AI could be extended to the exam room, assisting a doctor while he or she is examining a patient. Most doctors today spend an inordinate amount of time entering notes into a patient’s EMR on a computer.

 

Probst envisions a future where computer vision and voice recognition technologies can “listen” and “understand” what a doctor is telling a patient during an exam and accurately enter the data into the EMR.

 

"It may seem a little farfetched, but a lot of what we can do for healthcare can be completely digitized with little to no human interaction once we've proven out the AI,” Probst says.

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How telemedicine is transforming treatment in rural communities? 

How telemedicine is transforming treatment in rural communities?  | Healthcare and Technology news | Scoop.it

There's no denying it: rural hospitals are in trouble.

 

More than 48 rural hospitals have closed since 2010, according to the National Rural Health Association, and another 283 are in danger of closing.

 

The malaise effecting rural healthcare comes from several vectors. Reduced populations, higher percentage of uninsured and elderly patients, equipment underuse, and the absence of high-margin specialty services makes for a bleak economic outlook. A shortage of doctors willing to work in remote areas creates quality of care and a staffing issues. Then, there is the challenge of getting patients into rural hospitals in a timely manner because travel distances sometimes are too great.

 

Many believe that telemedicine and mHealth offer a way out for struggling rural hospitals, however.

 

A 2012 report by the Institute of Medicine for the National Academies, entitled The Role of Telehealth in an Evolving Health Care Environment, found that telehealth drives volume, increases quality of care, and reduces costs by reducing readmissions and unnecessary emergency department visits for rural communities. Through telemedicine, rural hospitals can serve rural patients at better costs and help cut down on the time it takes rural patients to receive care, particularly specialty care.

 

"When rural patients know their hospital is using telemedicine, they have higher regard for that hospital and are less likely to bypass it for treatment at an urban facility," noted James Marcin, director of the UC Davis Children's Hospital Pediatric Telemedicine Program, a pioneer in remote medicine.

 

The ways that rural hospitals can take advantage of telemedicine and mHealth technology advancements are many, and include remote consultations, in-home monitoring, outsourced diagnostic analysis, and remote specialist consultations.

 

Instead of waiting days or weeks for a healthcare professional to travel to a remote area, or traveling into a hospital and waiting for an appointment, telemedicine enables remote physician consultations that are faster, cheaper and more efficient than traditional healthcare appointments. For consultations on simple health concerns, or follow up on existing conditions, remote consultations can dramatically improve the patient experience while helping rural hospital economics at the same time.

 

The Georgia Partnership for Telehealth, for instance, assesses and treats students so that they do not need to travel to a clinic for healthcare, and currently has replaced more than 350 locations where a traditional doctor's visit was formerly required.

 

A second way that rural hospitals are leveraging telemedicine is through in-home monitoring. One example is decreased hospitalization rates for seniors enrolled in the FirstHealth Home Care Chronic Disease model in North Carolina. Patients previously diagnosed with heart failure, diabetes, or COPD and who experienced frequent hospitalizations are monitored by telehealth at home between periodic visits from nursing staff. Response and intervention times have improved substantially, according to the program.

 

Another benefit to struggling rural hospitals is outsourced diagnostic analysis and access to remote specialists. It is difficult for many rural communities to staff their own diagnosticians, but mobile imaging centers and lab specimen kiosks that can take X-rays and perform collections can work in conjunction with remote analysis labs in larger urban areas to bridge the gap.

 

One study that looked at 24 hospitals in four rural states in the Midwest including Kansas, Oklahoma, Arkansas, and Texas found that telemedicine brought an annual economic impact of at least $20,000 per year, with an impact of up to $1,300,000. The majority of these savings came from increased lab and pharmacy revenues due to additional work performed locally.

 

In addition to outsourced diagnostics, telemedicine also enables consultation with remote specialists at larger, urban hospitals instead of the need for having these specialists on staff. This can be particularly good for attracting doctors to rural hospital settings.

 

"Telemedicine fosters a collaboration that reduces the feelings of isolation that physicians may experience when they go to practice in a small town," noted Dr. Wilbur Hitt in a report, Telemedicine: Changing the Landscape of Rural Physician Practice. "With telemedicine, it's like having one foot in the city but being able to live and practice out in a rural area. It's also reassuring to know that you're on the right track with the treatment plan and are staying current."

 

Still, roughly 66 percent of rural hospitals had no telehealth services or were only in the process of implementing a telehealth application when the RUPRI Center for Rural Health Analysis reviewed 4,727 hospitals in the 2013 HIMSS Analytics database. Part of the reason comes from broadband access challenges.

 

Rural communities not only suffer from a population shortage and a lack of resources, they also typically have trouble with the necessary broadband infrastructure for telemedicine. The benefit of remote consultation by video conference for rural patients is clear, for instance, but these remote consultations amount to nothing if there isn't the broadband infrastructure to support it.

 

"The ability for physicians to connect with those in areas that don't have much of a wireless connection is the biggest problem when trying to treat these patients," noted Tony Zhao the CEO of Agora.io, a video SDK company that provides easy video conferencing with quality-of-service guarantees so telemedicine and e-learning initiatives work even in rural settings.

 

"With weak connections, video streams for telehealth are blurry, choppy or just won't work," he added. "Implementing technology that doesn't rely on the general internet but which relies on an infrastructure that strengthens signals in the most remote areas is crucial."

 

Another barrier for rural hospitals is the challenges that surround reimbursements. Medicare reimbursement is a major challenge for telemedicine, with states each having their own standards by which their Medicaid programs will reimburse for telemedicine expenses.

 

There is no single standard telemedicine reimbursement system for private payers, either. Some insurance companies value telemedicine and will reimburse for a wide variety of services while others do not.

 

These and other challenges put a drag on rural telemedicine at the same time as the need for it grows. Rural hospitals have a path toward recovery in the form of telemedicine, but obstacles still remain.

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Time to End ‘Wild West’ of Health Data Usage in HIPAA-Free Zones 

Time to End ‘Wild West’ of Health Data Usage in HIPAA-Free Zones  | Healthcare and Technology news | Scoop.it

In a recent conversation, a CMIO described the era of Meaningful Use and ICD-10 to me as the “doldrums of regulatory reform” that “sucked up all the oxygen” in the industry, leaving little room for innovation. So I can see why there would be little appetite for more regulation related to health data, and obviously the current administration prefers market-based solutions to regulatory ones.

 

Yet the Oct. 22 meeting, “Data Min(d)ing: Privacy and Our Digital Identities,” put on by the U.S. Department of Health & Human Services, made it clear to me that as more health data is gathered (and sold) outside the clinical setting, there is a “Wild West” atmosphere in which pretty much anything goes in terms of what companies not covered by HIPAA can do with our health data.

 

As an example, an April 2018 CNBC article noted that Facebook “has asked several major U.S. hospitals to share anonymized data about their patients, such as illnesses and prescription information, for a proposed research project. Facebook was intending to match it up with user data it had collected in order to help the hospitals figure out which patients might need special care or treatment.” (That project is currently on hiatus, Facebook said.)

 

The HHS meeting brought together industry leaders and researchers for some thought-provoking presentations about the many ways genetic, wearable and EHR health data is being used. For instance, James Hazel, Ph.D, J.D., a research fellow at the Center for Biomedical Ethics and Society at the Vanderbilt University Medical Center, presented his research that involved a survey of the privacy policies proffered by U.S. direct-to-consumer genetic testing companies. Hazel noted that there has been huge growth in direct-to-consumer genetic testing, with an estimated 12 million people tested in the United States. Beyond offering consumers the services, these companies doing the testing wish to monetize that data through partnerships with pharmaceutical companies and academic researchers. There is also value to government and law enforcement officials – to solve cold cases, for instance.

 

There is a patchwork of federal and state laws governing disclosure of secondary data usage to consumers, but the industry is largely left to self-regulate, he said. In his survey of 90 companies offering these genetic data services, “10 percent had no policies whatsoever,” he said. About 55 companies had genetic data policies, but there was tremendous variability in policies about collection and use. Less than half had information on the fate of the sample. In terms of secondary use, the majority of policies refer to internal uses of genetic data. However, very few addressed ownership or commercialization. And although almost all made claims to being good stewards of the data, 95 percent did not provide for notification in case of a data breach. The provisions for sharing de-identified data are even less restrictive. Hazel noted that 75 percent share it without additional consent from the consumer.

 

Hazel’s take-home message: “We saw variability across the industry. Also, we had a group of law students and law professors read the policies and there was widespread disagreement about what they meant,” he said. “Also, nearly every company reserves the right to change the policy at any time, and hardly any company provided for individual notice in event of a change.” He finished his presentation with a question. “What is the path forward? Additional oversight by the Federal Trade Commission? Or allowing industry efforts to take the lead before stepping in?”

 

In a separate presentation, Efthimios Parasidis, J.D., a professor of Law and Public Health at the Ohio State University, spoke about the need for an ethical framework for health data.

 

Parasidis began by noting that beyond data security and privacy, consent and notice are inadequate ethical markers. “If one looks at regulations, whether it is HIPAA, the European Union’s GDPR, or California’s recently enacted consumer privacy law, the regulatory trend has been to emphasize consent, deletion rights and data use notifications,” he said. While these are important regulatory levers, missing is a forum for assessing what is fair use of data.

 

“Interestingly, few areas of data collection require ethics review,” he stressed. HIPAA does not speak to when data use is ethical but rather establishes guidelines for maintaining and sharing certain identifiable health information. Even those protections are limited. HIPAA only applies to covered entities, he noted. It does not apply to identifiable health information held by a wide variety of stakeholders, including social media, health and wellness apps, wearables, life insurers, workers’ compensation insurers, retail stores, credit card companies, Internet searches, and dating companies.

 

“While the volume of identifiable health information held in HIPAA-free zones engulfs that which is protected by HIPAA and may support more accurate predictions about health than a person’s identifiable medical records,” Parasidis said, “the limits of HIPAA’s protections go beyond scope. For data on either side of the HIPAA divide, an evaluation of ethical implications is only required for human subject research that falls under the Common Rule. Much of data analytics falls outside the Common Rule or any external oversight.”

 

Citing the Facebook example mentioned above, Parasidis noted that tech giant Amazon, Apple, Google, Microsoft and Uber are entering the digital health space. “The large swathes of identifiable information that these entities hold raise a host of ethical questions,” he added, “including widespread re-identification of de-identified health information, health profiling of individuals or groups and discrimination based on health conditions.”

 

Policies and guidelines can supplement the small subset of data covered under legally mandated ethics review, he explained. For instance, federal agencies sometimes use internal disclosure review boards to examine ethical implications of data disclosure. But it is not clear this type of review is happening in the private sector.

 

Parasidis described work he has done with Elizabeth Pike, director of Privacy Policy in the Office of the Chief Information Officer at HHS, and Deven McGraw, who served as deputy director of health information privacy at HHS, on a framework for ethical review of how health data is used.

 

One way to think about more robust ethics review is the use of data ethics review boards, he said. Their structure can be modeled on institutional review boards or disclosure review boards. “This new administrative entity is necessary because much of contemporary data analytics falls outside existing frameworks,” he said. “We argue that these boards should focus on choice, responsiveness, accountability, fairness and transparency — a CRAFT framework. For instance, choice goes beyond consent. Individuals have an ongoing interest in their health data and should be able to specify how it is collected, analyzed and used.”

 

Reasonable minds can disagree on the relative weight of ethical principles or how they should be enacted into the context of data use deliberations, he said. “We nevertheless believe there remains an urgent need to craft an ethical framework for health data.”

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Advancing healthcare through technology

Advancing healthcare through technology | Healthcare and Technology news | Scoop.it

Healthcare is personal. Each of us knows stories of friends and family dealing with difficult medical issues. We hear how hard it can be to navigate the health system. It seems that one fills out the same information over and over and wonders why the physicians and hospitals don’t have it already. We hear how people must research their own conditions to make tough decisions about treatment options. We know there are access and affordability issues for many people.

 

As National Health IT week comes to an end, we must renew our commitment to make a positive impact on health care through technology.

 

I am fortunate to have worked with many passionate, committed people in healthcare over the past 30+ years. And I’m grateful to have a team of advisors working with us at StarBridge Advisors. Each has made an amazing and lasting impact on healthcare.

 

In our most recent StarBridge Advisors blog, “NHIT Week: 6 Leaders on the Value of HIT”, we discussed the value of health IT with six of our advisors. Their perspectives provide a lens into how technology is transforming healthcare though there is much more to do.

 

I encourage you to check out the perspectives shared by these CIOs and clinical leaders here. And if you like what you see, read more of our “View from the Bridge” posts and subscribe to receive notifications of new posts from our team of industry leaders.

 

Together, we all make a difference!

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How Telemedicine Can Help Stroke Victims Faster 

How Telemedicine Can Help Stroke Victims Faster  | Healthcare and Technology news | Scoop.it

In developed countries like the United States, stroke is still the third leading cause of death. In fact, each year stroke occurs in more than 700,000 patients, leaving many with disabilities and unable to resume a normal life.

 

When a stroke occurs, every second counts. The sooner a stroke victim is treated with medication that breaks up blood clots and restores blood flow to the brain, the less chance the patient will suffer permanent damage such as the loss of muscle control, mobility, or the ability to speak.

 

According to the American Stroke Association, ‘time lost is brain lost.’ That’s because every minute that passes before a stroke patient is treated, means the death of millions of brain cells.

 

Unfortunately, less than 30% of stroke victims receive clot-dissolving medication inside a recommended window of an hour or less for maximum effectiveness, according to information from Healthcare delivery network Kaiser Permanente.

 

But the same study reveals how telemedicine – or a telestroke system to be precise – can be a vital tool in getting stroke victims faster treatment – and thereby limiting the debilitating effects of the attack.

 

A Race Against Time

Basically, a telestroke system requires a neurologist and attending nurse to have a high-speed Internet connection and videoconferencing capabilities on a laptop, tablet or desktop computer.  The purpose is for the consulting neurologist to be able to talk to the patient or an emergency response team about what symptoms the patient is experiencing, evaluating the patient’s motor skills, viewing a computed tomography (CT) scan, making a diagnosis and prescribing treatment.

 

Data gathered from 300 stroke patients being treated in 21 Kaiser emergency rooms in Northern California shows that those who were diagnosed as having a stroke via a telehealth consultation received clot-busting medication intravenously much faster than the 60-minute guidelines from the American Heart Association and American Stroke Association.

 

The Kaiser emergency rooms were equipped with telestroke carts, which included a video camera and access to patients’ electronic scans and test results. When emergency room staff contacted a staff neurologist and a radiologist via a telestroke cart, patients received anti-blood clot medicine in an average of 34 minutes. Eighty-seven percent of stroke patients received the intravenous medication in 60 minutes or less, 73% in 45 minutes or sooner and 41% in 30 minutes or less.

 

A Clear Priority

According to the American Stroke Association, American Heart Association, and the American Telemedicine Association, telestroke services could save thousands of lives each year and cut costs by $1.2 billion over the next decade.

 

The reason is because processes that used to happen sequentially during a stroke alert are now happening at the same time. That allows medical staff to provide evaluation and treatment to stroke patients more quickly, safely, and confidently, to avoid further brain damage.

 

The addition of specialized stroke services helps hospitals improve patient outcomes, decrease patient disability related to stroke, and reduce costs, while keeping patients in the community. Providing expert stroke consults remotely via telemedicine allows prompt care close to home for these patients, making a priority for health care providers nationwide.

 

If you are interested in bridging the gap of care for patients in need, whether they be in remote areas or unable to leave home, telemedicine can help provide quality care to more people in need. Contact TeleMed2U today, at (855) 446-TM2U (8628).

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Popular Small Business Phone Systems

Popular Small Business Phone Systems | Healthcare and Technology news | Scoop.it

Before you sign with a phone service provider, you’ll want to have a strong foundation of understanding about phone systems for small businesses. Go beyond simply knowing what features you want the small business phone system to have. Know the various types of systems out there. From phone systems that rely on traditional phone lines to make calls, to those that use broadband or fiber internet connections.

 

As far as features go, if you’re putting budget into a serious business phone system, you should be expecting to receive multiple lines, voicemail, conference calling capabilities and an auto attendant at the very least in return.

 

Among the choices you’ll be facing for your small business phone system is whether to get a multi-line system, a Private Branch Exchange (PBX) system, a Voice over Internet Protocol (VoIP) system, or a cloud-based phone system. Let’s take a look at the most popular small business phone systems options and how to determine what will work best for your small business:

Multi-line Phone Systems

These more old-school phone systems are also known as key service units (KSU). These systems use an electro-mechanical switching device that controls the routing and operation of a traditional analog telephone system. These systems are time-tested ways for you to keep the phones ringing for anywhere between five and 40 employees.

 

When considering how many lines your business needs wired into the office, it’s important to find a balance between not having more lines than you really need while also giving your business room to grow. If you have a business with less than 10 people, it’s also possible to take advantage of a KSU-less system in which the phone contains all the technology. This means the system doesn’t have to be permanently wired into the office space.

 

Private Branch Exchange Systems

Private Branch Exchange Systems (PBX) are essentially private phone networks for your office that give you more advanced features and options. At Fastmetrics, the system is actually cloud-based. PBX features can include call holding, routing to extensions, and conference calling.

 

These phone systems are different from KSU systems in that the call routing does not occur through the phone unit or building’s wiring but is centralized. These systems, designed for companies needing to cater to more than 40 employees, used to be run on monstrous devices that took up an entire closet. Now, they can comfortably fit on a shelf.

Voice Over Internet Protocol Phone Systems

If you go with a VoIP phone system, it will run on your broadband internet connection rather than through your phone lines. When this technology first came out, it was very rough and reliability was an issue, especially as your phone system’s effectiveness was tied to your high-speed internet connection.

Nowadays, a VoIP system offers a vast number of advantages: from the ease of installation and scalability to pricing and advanced features. Among these features is a VoIP system’s ability to integrate with your customer relationship management software (CRM), which can then automatically log interactions.

 

VoIP systems also boast the ability to host a virtual receptionist or auto attendant to handle calls, as well as all the other bells and whistles that come with a full phone system, such as conference calls, call waiting, and voicemail. These same VoIP features are also offered by Fastmetrics’ cloud PBX solution. VoIP adoption by businesses is growing rapidly. Between 2011 and 2015, there was a projected 50 percent growth due to increased demand by small offices and home offices.

Cloud Phone Systems

The key to a cloud-based phone system is that it removes the telephone infrastructure from your office. This system will be run by a third-party company and can be hosted through either a PBX or by a VoIP system. This setup is perfect for your business if you’re on a tight or fixed budget and don’t have the IT staff necessary to operate and maintain PBX hardware or troubleshoot your VoIP system.

 

FREE with a new cloud-based phone system plan, Fastmetrics customers receive their choice of new Yealink or Polycom phones with business voice services. Get in touch with Fastmetrics touch to learn more.

 

Of course, by having a third-party company managing the system, you are dependent on its reliability as a company and you do lose a certain amount of control. At Fastmetrics, users have a much higher level of control over the standard cloud phone system, in terms of setup and customization. Nonetheless, a cloud phone system is often the most cost-effective solution for a small business and the easiest to deal with regarding scalability.

7 Small Business Phone System Feature Considerations

A lot of features that come with small business phone systems are designed to make your life as a business owner easier and help your employees to be more effective and efficient.

 

Here are a few small business phone systems essentials:

 

  • Voicemail transcriptions: This feature, which sometimes is called voicemail-to-email or voicemail-to-text, transcribes a message left in the phone system, making it easier to respond to.
  • Voicemail: Though voicemail isn’t used much in social calls anymore, people still expect to be able to leave a message inquiring about a product with a company. Though more cumbersome than other forms of communication, voicemail remains an essential feature for small business phone systems.
  • Call forwarding: This allows your employees to transfer a customer to the right department or person.
  • Call queuing: If your company faces heavy phone traffic and you have limited employees available to answer the phone, this is an essential feature to ensure that you don’t miss clients’ calls.
  • Call recording: This is a particularly important feature for businesses that review customer service employee interactions on a regular basis, as it gives you an opportunity to see how your employees are interfacing with clients.
  • Interactive voice response: This allows you to create a series of menus for your business that a caller can navigate to help them reach the representative best prepared to help them.
  • Conference calling: With more people working on the road or from their home, bringing everyone together in one place can sometimes feel impossible. However, with conference calling, you’re able to pull in everyone around the table (so to speak) and hash out ideas.

 

These are just a few of the most essential features you’ll want to consider having for your small business’s phone system. Other options include ring groups, directory assistance, internet faxing, call reports, call monitoring, and missed call notifications. Most phone service providers charge extra for extended phone system features but at Fastmetrics, many of these features are included for no additional cost.

Final Thoughts: Choosing Between the Most Popular Small Business Phone Systems

By having a firm grasp on all the options for small business phone systems from those hardwired into your building, to those cloud systems hosted by a third party, you’ll be able to confidently approach a phone service provider and not be overwhelmed by the options, features, and details of what they’re trying to sell you. This is important because you’ll want to settle on a phone system for your small business where you aren’t paying for a lot of lines and features you don’t need, but are still giving your company room to grow.

 

Have more questions about phone systems for small businesses? Get in touch with the Fastmetrics team.

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Top 3 Third Party Risk Management Challenges

Top 3 Third Party Risk Management Challenges | Healthcare and Technology news | Scoop.it

Since the massive Target data security breach in December 2013, third party cyber security stopped being an afterthought and started becoming one of the top security priorities for CISOs and Risk Departments. As a response, Third Party Risk Management (TPRM) underwent a transformation in early 2014, and continues to reverberate today.

 

With attackers finding new ways to break into third parties in hopes of infecting a larger organization, the third party ecosystem is more susceptible than ever before. Meanwhile third party usage is growing fast in large organizations and enterprises. Many critical business services such as HR functions, data storage, and modes of communication are the responsibility of cloud-based third parties.

 

Without a modern TPRM program, many of these third parties are left behind in security risk management, putting organizations in a vulnerable position.

 

Over 60% of data breaches can be linked either directly or indirectly to a third party (per Soha Systems, 2016) but TPRM programs don’t often take a risk-first perspective when it comes to risk management. Security and Vendor Risk departments are often solely focused on compliance. That’s important, but doesn’t get at the heart of the risk posed by your third parties. To shift the approach of your TPRM program to measure true risk, you’ll need to make some adjustments in how you manage third parties.

 

Here are the three top TPRM challenges and the actions you and your organization can take in order to bolster your TPRM program.

 

1. Automate Your TPRM Process to Reduce Unmanaged Risk
With the rise in SaaS, businesses are now using cloud-based third parties more than ever. Gartner predicted that SaaS sales will nearly double by 2019, and that SaaS applications will make up 20% of the growth rate in all public cloud services, a $204B market. Last year, Forrester had already predicted that enterprise spend on software would reach $620B by the end of 2015.

 

As businesses engage in IT and infrastructure digital transformation, the need to manage vendors is more pronounced. Over 60% of respondents from a Ponemon Institute’s survey on Third Party Risk Management believe that the Internet of Things increases third party risk significantly. 68% believe the same is true for cloud migration.

 

However, as more third parties are brought in, they’re often not managed to match the level of cyber security risk they carry. Worse, they may not be managed at all due to a lack of resources. This creates unmanaged security risk. If these third parties have access to your network, your employees’ PII, or your customers’ sensitive data, shouldn’t they be subject to rigorous risk management assessments?

 

Unfortunately, as the number of third parties swell to the hundreds, it’s often not feasible for every vendor to be assessed in the same critical fashion. That’s why having an automated risk assessment tool for assessing vendors is a way to ensure you’re minimizing unmanaged risk from both new and existing vendors.

 

Automating your TPRM process is one of the major steps towards having a mature TPRM department capable. Its benefits include:

 

  • Improved third party management flexibility
  • Standardized processes and thirdparty management
  • Metrics and reporting consistency
  • Improved data-driven decision making
  • Further structuring the TPRM organization
  • Increased third party responsibility
  • Increased overall risk assessment and mitigation

 

By automating the TPRM process, you’re creating a standardized structure that can be applied to all third parties, whether existing or onboarded.

 

You can automate your TPRM process by finding new technologies or tools that will automate the assessment and information gathering process for your third party vendors. This helps to ensure that you’re optimizing your resources and spending company time on what is most impactful.

 

2. Augment and Validate Self-Reported Questionnaires Through Independent Risk-Based Assessments
Third parties are often assessed through questionnaires, onsite assessments, or via penetration tests. Each has its own advantages and disadvantages. Onsite risk assessments and penetration tests are resource-intensive, requiring time, money, and staff in order to carry out the assessments. Because of the costs, these kinds of assessments cannot be used for all third parties, and should be reserved for the most risk-critical third parties.

 

That leaves questionnaires to fill the void for most of the other third parties. However, questionnaires are self-reported, which makes using a ‘trust, but verify’ approach to risk management difficult to accomplish.

 

In a 2016 Deloitte Study on Third Party Risk Management, 93.5% of respondents expressed moderate to low levels of confidence in their risk management and monitoring mechanisms. With numbers like that, it’s easy to see why TPRM programs need increased attention. Without a way to independently verify the security posture of your third parties, you can only rely on the word of your third parties who are, for obvious reasons, incentivized to report positively.

 

Organizations should find independent third parties that can provide risk-based assessments of their third parties to validate that the findings from questionnaires are a realistic portrait of the state of third party security.

 

There are a number of cyber security solutions that provide risk-first third party assessments. To find the right solution, you should research whether or not those solutions:

 

  • are accurately assessing third parties
  • can facilitate communication between you and third parties
  • are focusing on key cyber security areas that are indicative of a potential breach


3. Utilize Continuous Monitoring to Assess Third Parties Beyond Point-In-Time Assessments
The assessment methods mentioned in the previous section all have one glaring flaw in common – they assess third parties at a single point in time. Many times, the information gathered by security risk assessments is outdated by the time it falls into your hands. The speed at which hackers are developing new attacks and exploiting vulnerabilities is too fast for point-in-time assessments or annual reviews to provide any insight into the real security posture of a vendor.

 

A PWC Third Party Risk Management report on the finance industry noted that 58% of companies using ad hoc monitoring experienced a third party service disruption or data breach, compared to only 37% of those that regularly monitor their providers and partners. Without having a way to know the security posture of your third parties on-demand, you’re managing risk with a blindfold on for most of the year. By only having point-in-time information that is quickly outdated, your ability to react to new vulnerabilities, or worse, a potential third party cyber security incident, is negligible.

 

Through continuous monitoring, you’re bolstering the security of your third party by keeping them consistently accountable, which in turn, minimizes your overall risk to a potential security incident.

 

How to Get Started Revamping Your VRM
We covered how to implement continuous monitoring in your TPRM program in part 2 of our How to Revamp Your VRM Program article series. Start by establishing a central TPRM office if you don’t already have one, prioritize and identify your most risk-critical and business-critical vendors, and then define your third parties’ security controls and processes that you’ll monitor on an ongoing basis. If you have the resources, look for automated risk healthassessment tools and solutions that offer continuous monitoring for your third parties.

 

Conclusion
Updating your TPRM program doesn’t have to be a complete overhaul of your department. Instead, you should use a risk-first perspective to define the aspects that are the most criticalto update. The three we highlighted here will yield the most dramatic changes in a TPRM program, reducing your unmanaged risk, and reducing your reaction time should a security incident occur.

 

By automating aspects of your TPRM program, using independent third party assessments, and adopting continuous monitoring, you’re not far from having a mature TPRM program that can easily assess any new third party as it comes, keeping your organization safe.

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Top 6 Benefits of Adopting a Phone System 

Top 6 Benefits of Adopting a Phone System  | Healthcare and Technology news | Scoop.it

In the modern medical era of robot surgeries, drones, and telemedicine, it’s easy to overlook basic communication platforms like your phone system. But your phone system is still a critical method patients and providers rely on for communication. If your organization is using a legacy phone system, it’s time to discover the benefits of voice over Internet protocol (VoIP).

 

VoIP is the transmission of phone calls over the Internet instead of traditional telephone lines, and this technology is rapidly transforming how healthcare organizations across the country communicate with their providers, patients, and counterparts.

 

No matter if your organization is a large medical system, behavioral health group, small doctor’s office, public health department, or rural clinic, VoIP systems can provide numerous benefits that legacy phone services just can’t deliver. Here are the top six benefits of adopting a VoIP phone system.

 

Enhanced Productivity and Efficiency

It’s no secret healthcare organizations are slammed in our current fast-paced climate. Healthcare administrators and providers alike are watching their responsibilities increase while the amount of time to meet them stays the same. According to IT Toolbox, switching gears throughout the day to tackle tasks like managing contacts and voicemail leads to a 40% reduction in staff productivity.

 

With a VoIP phone system, you can get your day back with productivity-enhancing features that legacy phone systems can’t support, and the integration of those features creates seamless, time-saving communications among your staff members. Simple-to-configure call routing and self-routing auto attendant features are easy for staff to navigate, improves staff availability to callers who need them, and decreases time spent on routing calls. And, if your goal is to reduce the time physicians and medical staff spend on voicemails, VoIP systems offer voicemail transcribing features that will automatically transcribe messages and deliver them to your email inbox.

 

Additionally, advanced reporting data gives your team an inside look into the traffic loads of your system. This data is extremely valuable and can be used to make intelligent routing and configuration decisions to balance call loads across your organization.

 

Cost Savings

With costs escalating and reimbursement rates shrinking, it’s more important than ever for healthcare providers to find innovative ways to save money without sacrificing efficiency.

 

VoIP is a cost-effective solution because calls are made and received over your organization’s Internet rather than traditional phone lines. This means your organization isn’t being charged for local and long distance calls on a minute-by-minute basis, cutting down your costs by a huge margin.

 

VoIP systems are also affordable to install. Because VoIP is cloud-based, most of the equipment a healthcare organization needs is already in place, making installation fast and seamless. Typically, the only capital expenditure needed is the cost for the phones themselves. VoIP allows your organization to save time and effort that otherwise would have been spent on additional infrastructure, project management, and staffing. These critical savings can be reallocated to other needed services that directly save lives.

 

Delivers a Better Patient Experience

At any healthcare establishment, the quality of care provided and patient experience delivered is paramount to success. Adopting a VoIP phone system can help elevate the communication experience your patients have with your facility.

 

With a VoIP phone system, you enjoy enhanced audio quality and clarity, making it easier to decipher and respond to a patient’s questions and concerns. Additionally, several features can be implemented to ensure your patients and callers are routed to the correct point of contact. Some of these features include:

 

  • Prioritized calling for medical emergencies
  • Call forwarding
  • Click-to-call
  • Routing calls based on caller ID
  • Routing calls with option sets for billing, scheduling, care, etc.
  • Custom messages based on day and time
  • Custom hold music or announcements
  • Integration with patient account information systems

 

These advanced features work together to ensure your callers are able to reach their destination and gather or relay information quickly and painlessly.

 

Online Portals Put You in Control

With legacy phone systems, changing system settings can be a difficult task and can even require multiple calls to the vendor. That’s time your providers and staff simply can’t afford to waste.

 

Cloud-based VoIP platforms deliver complete organization and control to your staff through easy-to-use online portals. These portals give your staff advanced features that allow easy day-to-day management of your voice services without ever having to call the service provider. Authorized administrators can change call-forwarding settings, manage call groups, update contacts, reset passwords, configure phones, listen to transcribed voicemails, and more, all through their online portal. Your staff can easily and quickly update and configure settings instantaneously anytime from any web browser.

 

Flexibility Allows You to Scale

Another advantage cloud-based VoIP services offer is simple scalability, allowing you to transition as slowly or as quickly as needed. Healthcare organizations vary in size and complexity and your phone system should be able to scale to your needs. With traditional phone systems, this is incredibly difficult and can cost you more money in the long run. Flexible designs enable healthcare organizations to deploy VoIP at one site or multiple sites if you’re looking to consolidate multiple voice platforms. Additionally, VoIP systems allow you to scale your system to only include features your organization truly utilizes.

 

Streamlined Communications on the Go

With a mobile VoIP capability, such as an app on your smartphone, your staff and providers are always reachable on their mobile phones. Missing important calls or information can create a lot of added work and decrease efficiency. Thanks to the mobility provided by many VoIP applications, staff members can stay connected by using their mobile devices to receive and make calls to and from their work extensions, as well as access voicemail, call logs, and contact lists.

 

 

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Compromised logs can hamper IT security investigations 

Compromised logs can hamper IT security investigations  | Healthcare and Technology news | Scoop.it

At the heart of most devices that provide protection for IT networks is an ability to log events and take actions based on those events. This application and system monitoring provides details both on what has happened to the device and what is happening. It provides security against lapses in perimeter and application defences by alerting you to problems so defensive measures can be taken before any real damage is done. Without monitoring, you have little chance of discovering whether a live application is being attacked or has been compromised.

 

Critical applications, processes handling valuable or sensitive information, previously compromised or abused systems, and systems connected to third parties or the Internet all require active monitoring. Any seriously suspicious behaviour or critical events must generate an alert that is assessed and acted on. Although you will need to carry out a risk assessment for each application or system to determine what level of audit, log review and monitoring is necessary, you will need to log at least the following:

  • User IDs
  • Date and time of log on and log off, and other key events
  • Terminal identity
  • Successful and failed attempts to access systems, data or applications
  • Files and networks accessed
  • Changes to system configurations
  • Use of system utilities
  • Exceptions and other security-related events, such as alarms triggered
  • Activation of protection systems, such as intrusion detection systems and antimalware

Collecting this data will assist in access control monitoring and can provide audit trails when investigating an incident. While most logs are covered by some form of regulation these days and should be kept as long as the requirements call for, any that are not should be kept for a minimum period of one year, in case they are needed for an investigation.  However, monitoring must be carried out in line with relevant legislation, which in the UK is the Regulation of Investigatory Powers and Human Rights Acts. Employees should be made aware of your monitoring activities in the network acceptable use policy.

 

 

Log files are a great source of information only if you review them. Simply purchasing and deploying a log management product won’t provide any additional security. You have to use the information collected and analyse it on a regular basis; for a high-risk application, this could mean automated reviews on an hourly basis. ISO/IEC 27001 control A.10.10.2 not only requires procedures for monitoring the use of information processing facilities, but demands the results are reviewed regularly to identify possible security threats and incidents.

 

However, even small networks can generate too much information to be analysed manually. This is where log analysers come in, as they automate the auditing and analysis of logs, telling you what has happened or is happening, and revealing unauthorised activity or abnormal behaviour. This feedback can be used to improve IDS signatures or firewall rule sets. Such improvements are an iterative process, as regularly tuning your devices to maximise their accuracy in recognising true threats will help reduce the number of false positives. Completely eliminating false positives, while still maintaining strict controls, is next to impossible, particularly as new threats and changes in the network structure will affect the effectiveness of existing rule sets. Log analysis can also provide a basis for focused security awareness training, reduced network misuse and stronger policy enforcement.

 

ISO/IEC 27001 controls A.10.10.4 and A.10.10.5 cover two specific areas of logging whose importance is often not fully appreciated: administrator activity and fault logging. Administrators have powerful rights, and their actions need to be carefully recorded and checked. As events, such as system restarts to correct serious errors, may not get recorded electronically, administrators should maintain a written log of their activities, recording event start and finish times, who was involved and what actions were taken. The name of the person making the log entry should also be recorded, along with the date and time. The internal audit team should keep these logs.

 

There are two types of faults to be logged: faults generated by the system and the applications running on it, and faults or errors reported by the system's users. Fault logging and analysis is often the only way of finding out what is wrong with a system or application. The analysis of fault logs can be used to identify trends that may indicate more deep-rooted problems, such as faulty equipment or a lack of competence or training in either users or system administrators.

 

All operating systems and many applications, such as database server software, provide basic logging and alerting faculties. This logging functionality should be configured to log all faults and send an alert if the error is above an acceptable threshold, such as a write failure or connection time-out. The logs should be reviewed on a regular basis, and any error-related entries should be investigated and resolved. While analysing all logs daily is likely an unrealistic goal, high-volume and high-risk applications, such as an e-commerce Web server, will need almost daily checking to prevent high-profile break-ins, while for most others a weekly check will suffice.

 

There should be a documented work instruction covering how faults are recorded or reported, who can investigate them, and an expected resolution time, similar to a service contract if you use an outside contractor to support your systems. Help desk software can log details of all user reports, and track actions taken to deal with them and close them out.

 

No matter how extensive your logging, log files are worthless if you cannot trust their integrity. The first thing most hackers will do is try to alter log files to hide their presence. To protect against this, you should record logs both locally and to a remote log server. This provides redundancy and an extra layer of security as you can compare the two sets of logs against one another -- any differences will indicate suspicious activity.

 

If you can’t stretch to a dedicated log server, logs should be written to a write-once medium, such as a CD-R or DVD-R, or to rewritable media such as magnetic tape data storage or hard disk drives that automatically make the newly written portion read-only to prevent an attacker from overwriting them. It's important also to prevent administrators from having physical and network access to logs of their own activities. Those tasked with reviewing logs should obviously be independent of the people, activities and logs being reviewed.

 

The protection of log information is critical. Compromised logs can hamper IT security investigations into suspicious events, invalidate disciplinary action and undermine court actions.

 

Another point to bear in mind is system clocks need to be synchronised so log entries have accurate timestamps. Check computer clocks and correct any significant time variations on a weekly basis, or more often, depending on the error margin for time accuracy.

 

Clocks can drift on mobile devices and should be updated whenever they attach to the network or desktop. Always record the time of an event in a consistent format, such as Universal Coordinated Time (UTC) across all files. For additional security, add a checksum to each log entry so you can detect if any entries have been tampered with. Controls also need to be in place to ensure there is ample log storage. If your logs can be trusted, they can help you reconstruct the events of security incidents and provide legally admissible evidence.

 

Logging and auditing work together to ensure users are only performing the activities they are authorised to perform, and they play a key role in preventing, as well as in spotting, tracking and stopping unwanted or inappropriate activities.

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Serve More Patients and Increase Your Revenue

Serve More Patients and Increase Your Revenue | Healthcare and Technology news | Scoop.it

Healthcare costs are rising. So are insurance deductibles and prescription fees. As more and more patients struggle to pay for their medical needs, healthcare providers suffer as well. Healthcare financing is evolving, and practice owners must change with it if they want to stay afloat. Our team at StrongBox offers healthcare/medical/dental patient financing that integrates seamlessly with our revenue cycle management software. Read on to find out how we can help you reduce bad debt expense and increase your return on investment (ROI).

 

Patients’ Confidence in Healthcare Affordability is Declining

In a study conducted this year, only 62.4% of adults in the United States said they were somewhat or very confident in their ability to pay for healthcare costs. [1]  This is a significant decline from 2015, when almost 70 percent of individuals said they were confident they could pay for medical care.

 

In this same study, about 55% of adults with employer-provided insurance plans said they felt certain they would be able to afford medical care when if necessary. But what about those with individual coverage? One-third of all American adults stated that healthcare has become significantly more difficult
to afford over the past year. Additionally, only half of the population said they would have the money necessary to cover the costs of an unexpected medical bill.

 

What Needs to Change?
The statistics mentioned above are staggering. Clearly, we need a better way to help patients afford the
care they need. However, if healthcare providers keep performing treatment on patients who cannot
pay, their business suffers. What is the solution? At StrongBox, we offer healthcare/medical/dental
patient financing that benefits both the doctor and the patient.

 

Lending Partners and Patient Financing
What if you could give your patients the option to search fixed-rate healthcare loans from top-tier lenders? This is precisely what StrongBox offers. When your patient fills out an application, rates are provided without markup. Better yet, compared to medical credit cards, over twice as many applicants are approved. This option is not only ideal for elective procedures, such as cosmetic surgery and fertility treatments, it’s also extremely beneficial for individuals who do not have the money to pay for health-related procedures upfront.

 

StrongBox Healthcare/Medical/Dental Patient Financing
When it comes to patient financing, StrongBox offers two primary solutions: Select and Pro. Select is ideal for small to mid-sized providers. This cloud-based software works in conjunction with StrongBox revenue cycle management. Patients can complete their application in less than five minutes, after which it is submitted to a pool of up to 15 lenders. With terms up to 60 months and reasonable interest rates, this option is non-recourse to healthcare providers.

 

Pro is designed for large group practices and hospitals. This proprietary software identifies each patient’s credit profile and predicts their ability to pay. After approval, the healthcare facility receives funds directly within 24 hours. This increases average collections from 15% to 70%. As a result, practice owners can enjoy improved revenue and reduced bad debt expense.

 

Learn More about Healthcare/Medical/Dental Patient Financing with StrongBox

Are rising healthcare costs having a negative impact on the financial state of your practice? We can help.
If you would like to learn more about StrongBox solutions, request a virtual demo. We can assess your
unique practice needs and design customized software to address those concerns. Contact our Boca
Raton, FL office by calling (855) 468-7876.

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Phone Systems that keep the Practice and Patient Connected 

Phone Systems that keep the Practice and Patient Connected  | Healthcare and Technology news | Scoop.it

Today’s medical practice office is increasingly concerned with patient satisfaction. Of course, the health and well-being of patients has always been a concern; but as revenue and billing cycles quickly shift to a larger percent of patient responsibility, it’s becoming important to focus on ways to keep the conversation between practice and patient open and customer-centric at all times.

 

Healthcare providers have begun looking to technology solutions to up their patient satisfaction game. One likely solution? Automated phone systems that keep the practice and patient connected. Here’s a look at some of the key pros and cons of using automated phone systems in healthcare.

 

Everyone can relate to being annoyed by automated phone systems that keep directing callers around in circles, never to reach a human voice. That experience doesn’t translate to high patient appreciation. But it’s important to note that a good automated phone system can be far easier to use and more personalized for your practice needs.

 

Pros of Automated Phone Systems

 

Save Money. Automated phone systems have the potential to cover all of the work of your standard receptionist. Calls can be directed to the right party fairly quickly and the practice is still saving on the man hours it takes to answer and direct those calls manually.


Easy Installation and Upkeep. Most phone systems can be installed and up and running in a short amount of time and they can be hosted by the provider, meaning that the office will not need to worry about troubleshooting problems.


Routing Calls. New systems are exceptionally advanced and calls can easily be routed to the right destination, as well as voicemail boxes.


Setting Up Call Options. If the office manager takes a good look at what patients generally call about, they can narrow down specific options so that callers are quickly directed to the right location. For instance, if the largest number of calls come in to schedule appointments, “Scheduling” should be the first item on the automated list.


Cons of Automated Phone Systems

 

Patient Approval. No matter how well designed the phone system is, there will always be patients who are opposed simply because they’ve had bad experiences with automated systems–potentially not even in healthcare, but in another industry altogether. Most patients will get used to a new system, though practices should definitely listen to feedback and adjust to better serve the patients.

 

Voice Recognition Mistakes. Voice recognition is exceptionally useful so that patients can speak their choices and be directed immediately, without punching in any keys. Many people prefer this method, but voice recognition does still have occasional issues in deciphering speech, especially with differing accents.

 

Managers should take some time researching the company and product before deciding on any system. Taking the patients’ needs into consideration can go a long way in making the decision, as well as breeding satisfaction with patients as they become better acquainted with the phone system. Looking to the future of healthcar, technology plays the biggest role in facilitating patient satsifaction.

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StrongBox: Your Medical/Dental Billing Software Solution

StrongBox: Your Medical/Dental Billing Software Solution | Healthcare and Technology news | Scoop.it

In today’s modern world, revenue cycle management and intuitive billing software are essential aspects
of any successful healthcare practice. Together, these tools can help reduce bad debt expense, increase
collections, and reduce overall costs. Here, our team at StrongBox explores how our medical/dental
billing software can be an invaluable asset to your practice. Once our software is in place, our clients
enjoy a number of benefits, all while making more money and working less.


#1: Increase Practice Efficiency
Administrative and billing tasks often take up a shocking amount of time. In fact, according to The
Commonwealth Fund, 20.6 hours are spent every week on health plan-related tasks. [1]  With better
organization, StrongBox can help your practice increase its workflow efficiency. Our proprietary
software integrates seamlessly with your practice management software, not only enabling faster note-
taking, but also helping your entire team stay organized throughout the work day.


#2: Decrease Practice Overhead
Many practice owners assume their billing headaches will go away if they hire more employees. On the
contrary, fewer staff members can actually streamline the process and keep costs down. The best way
to achieve this is to employ a reliable medical/dental billing software. At StrongBox, we design our
software to be user-friendly and intuitive. As a result, your staff spends less time on billing and more
time getting new patients through the door.


#3: Billing Transparency
Part of workflow efficiency is complete billing transparency. You need to know which claims have been
processed and if any have been denied. You also need to keep track of every charge and every
transaction. StrongBox’s medical/dental billing software can help you quickly assess the financial status
of every patient and catch any billing errors in the process.


#4: Increase Your Return on Investment (ROI)
If you’ve been in healthcare for a while, you know how quickly billing costs have risen, and continue to
do so. A positive return on investment is absolutely essential for a successful practice. By keeping
revenue up and keeping costs down, StrongBox medical/dental billing software can help you run your
practice efficiently and reap the rewards for your hard work.


#5: Best Practice Training
When choosing a medical/dental billing software, you want a company that can help train your team
and address any technical issues. At StrongBox, we not only have a team of IT experts, we also partner
with several experts in the dental and medical fields. This gives us a full understanding of your unique
needs as a practice, so we can build a software solution that will enhance your productivity.


Seamless Integration

 

We understand that shopping for new software solutions can seem daunting, especially since you likely
have a number of programs installed already. StrongBox’s billing software seamlessly integrates with
your practice management software of choice, making the transition as simple and as smooth as
possible. Furthermore, StrongBox also offers revenue cycle management as well as a patient payment
portal, making administrative tasks that much easier.

 

Learn More about StrongBox Medical/Dental Billing Software
If you are currently in the market for healthcare billing software, request a free demo from StrongBox.
We can help you assess your needs so we can deliver a fully customized software solution for your
practice. To learn more, contact our Boca Raton, FL office by calling (855) 468-7876.

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Adoption of Telehealth Can Generate Cost Savings for Hospitals 

Adoption of Telehealth Can Generate Cost Savings for Hospitals  | Healthcare and Technology news | Scoop.it

The adoption of telehealth technologies in rural areas can result in significant cost savings for hospitals and their communities due to transportation cost savings, lost wages savings, hospital cost savings and increased revenues for local labs and pharmacies, according to a white paper by the NTCA-The Rural Broadband Association.

 

In the white paper, titled “Anticipating Economic Returns on Rural Telehealth,” Rick Schadelbauer, manager, economic research and analysis at the organization, outlines the case to be made for increasing adoption of telehealth in rural areas, and throughout the country, by keeping patients using local health care services rather than traveling to bigger, nearby cities for health care services. Schadelbauer noted that within the United States, there is a distinct health disparity between rural and non-rural Americans, primarily as a result of demographics and limited access to health care.

 

Telehealth and telemedicine, or the remote delivery of health care services and clinical information using telecommunications technology, holds potential to improve the quality, cost and availability of health care in rural areas. However, telemedicine is not viable without access to robust, reliable broadband service, Schadelbauer wrote. “Rural areas currently lag in broadband deployment, but continue to make impressive gains due in large part to the efforts of small telecommunications providers. Wireless applications require wireline infrastructure in order to be viable options,” he wrote.

 

The white paper examines the rural health care challenges, telehealth adoption and the potential benefit of telehealth technologies, both non-quantifiable and quantifiable. And the white paper drills down into challenges for rural health, such as reimbursement, cost, patient privacy and licensing.

 

According to the paper, the non-quantifiable benefits of telehealth are numerous: improved access to specialists, speedier treatment, the comfort of remaining close to home, eliminating the need for long-distance transportation, the ability for health care providers to sharpen their skills, and improved patient outcomes.

 

The white paper also quantifies several categories of quantifiable benefits of telehealth: transportation cost savings (median cost savings: $5,718 per medical facility, annually); lost wages savings ($3,431 per medical facility, annually); hospital cost savings ($20,841 per medical facility, annually); and increased revenues for local labs ($145,109 per medical facility, annually) and pharmacies ($8,558 per medical facility, annually.)

 

More specifically, hospitals in rural communities could potentially save more than $81,000 a year on employing doctors, and the white paper presented as one example a hospital that reduced its use of a full-time radiologist from five days a week to one. And, at the same time, hospitals could potentially generate revenue from lab work and pharmacy services that would remain local as a result of telemedicine, according to the white paper. For example, the authors estimated that tens of thousands of dollars could generated by local MRIs, CTs and other lab and pharmacy billings.

 

“The decision to implement telemedicine is unique to each medical facility, and should take into account not only costs but also non-quantifiable benefits and quantifiable benefits accruing to parties other than the medical facility, such as the patient and local labs and pharmacies located in the communities where telemedicine takes place,” the authors wrote.

 

As potentially significant as the potential benefits to telehealth—both non-quantifiable and quantifiable—may be, , Schadelbauer wrote that “it is critically important to remember that rural telehealth’s role in addressing the significant health problems inherent to rural areas will depends upon the availability of an underlying, future-proof, fiber-based broadband infrastructure. Further investment in, and expansion of, broadband infrastructure is a critical need not only for rural Americans but also our country as a whole.” Further, he noted, “Absent access to such an infrastructure, the benefits of telemedicine will remain merely theoretical.”

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5 Ways Telemedicine Is Helping Hospitals & Their Communities 

5 Ways Telemedicine Is Helping Hospitals & Their Communities  | Healthcare and Technology news | Scoop.it

Change has been hard on rural hospitals and their communities. Since 2010, more than 48 rural hospitals have closed and much more are on the brink of the same fate. Patients are seeking higher levels of specialized care from urban hospitals while rural communities are struggling to find top-notch providers willing to reside in remote areas. Lack of resources, provider shortages, and all-time low patient censuses are causing more and more hospitals to consider closing their doors.

But according to a Becker’s Hospital Review article, many believe that virtual health could be the answer to much of the woes rural hospitals are experiencing.

 

1- Patients are looking for more specialized services
When patients within rural communities contract long-term illnesses that require more extensive testing and monitoring, they’re often forced to spend additional time and resources on traveling to larger hospitals and health systems that are more equipped to provide the care they need. This could include regular check-up appointments with specialty physicians or more in-depth tests that require equipment their rural hospital doesn’t have access to. This can cause a snowball effect by taking away the same patient for general care needs that they can certainly receive from their community hospital.

 

Rural hospitals have quite a number of options when it comes to providing telemedicine to their patients and all are helpful in their own ways to combat the potential churn of a patient.

 

Remote specialist consultations can allow a rural hospital to connect with the nearest urban hospital and their physicians for specialized services while still retaining the patient and making their care more convenient and low-cost.

 

Outsourced diagnostic analysis allows patients to receive diagnostic tests followed by top-notch care depending on the outcome. Patients no longer need to travel for hours just to have an x-ray or specialty lab work performed.

 

Remote consultations allow doctors to perform routine check-in appointments with patients from home. Not only do they get to skip the long drive to their nearest urban hospital, they can even avoid the short commute to their rural hospital while still seeing their same physician.

 

Direct-to-consumer telemedicine allows rural hospitals to expand their services to new patients. Patients who don’t typically take the time to see a doctor can now have virtual consultations for urgent care needs without making an appointment, driving to an urgent care, or spending time waiting in the emergency department.

Telemedicine consultations of any kind save time for both the patient and the doctor, leaving room in the physician’s schedule for more appointments with other patients who do require in-person care. Patients in rural areas benefit by removing the barrier of transportation, long drive times and the costs associated with both.

 

2- Rural hospitals are experiencing provider shortages
There is expected to be an overall shortage of 46,000 to 90,000 physicians by the year 2025 and rural hospitals will feel it. Rural communities are having a hard time attracting physicians who are willing to live in remote areas. Rural communities have about 68 primary care doctors per 100,000 people compared with 84 in urban areas.

 

Rural hospitals who are experiencing provider shortages can utilize telemedicine platforms that come completely staffed with physicians who are fully trained in providing virtual care, and at a much less expensive rate. Telemedicine platforms who come staffed with 24/7 physician coverage are the perfect solution for small rural hospitals whose emergency departments get overwhelmed with patients not experiencing a true emergency. Patients can access a doctor from home and leave the resident physicians available for truly urgent conditions. Most physicians who staff a telemedicine platform are not primary care physicians, so there is no risk of losing patients to outside providers. In most cases, the physicians can help refer patients back to the hospital for other medical needs.

 

For hospitals who need an extra benefit to attract physicians from urban areas, according to Dr. Wilbur Hitt in an NEJM career resources article, “telemedicine fosters a collaboration that reduces the feelings of isolation that physicians may experience when they go to practice in a small town,” he said. “With telemedicine, it’s like having one foot in the city but being able to live and practice out in a rural area. It’s also reassuring to know that you’re on the right track with the treatment plan and are staying current.” In addition, it gives rural physicians the opportunity to specialize in something high-tech and innovative that will surely be the way of the future.

 

3- A high percentage of a rural hospital’s patients receive Medicare
Medicare and the subject of reimbursement often hinder the way a rural hospital can deploy telemedicine to their patients, especially in North Carolina where telemedicine parity doesn’t exist.

 

Currently, patients in rural areas who are covered by Medicare Part B can be reimbursed for telemedicine services, like office visits and consultations, as long as they are located at one of these places during the telemedicine consultation:

  • A doctor’s office
  • A hospital
  • A critical access hospital
  • A rural health clinic
  • A federally qualified health center
  • A hospital-based or critical access hospital-based dialysis facility
  • A skilled nursing facility
  • A community mental health center


An additional advantage of telemedicine for any patient, including those on Medicare, is that the cost of a visit is much less expensive compared to an urgent care facility or an emergency department visit which often tend to be the first choice for unscheduled care. With most virtual consultations costing less than $50 per visit, patients are able to save on both routine and urgent medical care costs. The savings also applies where insurance isn’t concerned. Non-existant commutes save on the cost of transportation and allow those without means of reliable transit to see a doctor from the comfort of their home.

 

4- Helping rural hospitals reduce readmissions
Telemedicine is already a proven tool for helping rural hospitals lessen the penalties they receive from value-based reimbursement policies. Rural hospitals who are using telemedicine in addition to implementing care coordination and patient experience improvement strategies are receiving fewer penalties than their urban counterparts.

 

While rural hospitals are already excelling, there is always room for improvement. According to RevCycle Intelligence, rural hospitals still have ways to go under the Hospital Readmissions Reduction Program. 79% of participating rural hospitals faced value-based penalties in 2015 under the program. This year, hospitals will see a 3% maximum rate of penalty and CMS estimates that will total $528 million dollars in penalties across the US.

 

A big factor in reducing readmissions is providing better preventive care, this is where telemedicine excels. Remote monitoring allows patients to check in more frequently with their physicians or nurses and also increases the chance that they’ll seek advice when experiencing an unscheduled medical care need before it advances to a more serious condition. By catching a sudden change in status, a patient can be seen by a primary care physician rather than being readmitted to the hospital, thus impacting a hospital’s penalties.

 

For some patients managing at-home care can be the challenge, especially when dealing with lengthy discharge instructions. When patients aren’t following their discharge instructions correctly, disease symptoms can flare, causing a trip back to the hospital. With remote monitoring via a HIPAA secure video connection, physicians and nurses have the ability to check in on a patient to see if they’re following their discharge instructions correctly and can also administer help remotely for patients who need a little extra hand-holding, this is especially useful for those who do not have at-home care or someone to assist with the fine details.

 

Prescriptions can also cause problems. Elderly patients may have trouble remembering to fill a prescription, especially when it involves scheduling an additional doctor appointment. By communicating via telemedicine, prescriptions can be refilled during a regular, virtual consultation and can be ready for pick-up at their preferred pharmacy in just a few short hours.

 

5- Increase patient census & reach the remote and underserved
As mentioned under section #1, direct-to-consumer telemedicine increases a hospital’s reach by attracting patients who otherwise wouldn’t seek care from a rural hospital’s network. Those who live and work in the corners of rural areas have the longest drive time and those who are underserved and do not have reliable transportation usually go without medical care. Even established patients will find value in seeing a doctor from home, greatly increasing their satisfaction of care received.

 

Telemedicine providers today are able to provide a white-labeled app, meaning they can design both the desktop and mobile interface where patients receive care to use a specific hospital’s brand standards- allowing a patient to seek care from a known and trusted healthcare provider. But, the branding isn’t the most important part. You should also consider how a patient is recognized when using telemedicine provided by your hospital and how their PHI is delivered back to your EHR. While most telemedicine providers can white-label the app, some cannot connect the patient back to your hospital, this creates a fragmented patient record contributing to disparate care coordination.

 

In addition to being able to tell where a patient is coming from, it also allows the physician providing the virtual care to help the patient determine where they should receive follow-on, in-person care, if necessary. Patients who are linked to one rural hospital can be referred back to that hospital’s network if it makes the most sense.

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8 Signs of a strong security culture

8 Signs of a strong security culture | Healthcare and Technology news | Scoop.it

Cybersecurity incidents in healthcare are on the rise. Organizations are continuing to strengthen their security programs.

 

I am currently working with two clients who are focusing on security. One is a large regional organization that is hiring their first Chief Information Security Officer (CISO). They asked StarBridge Advisors to provide an interim CISO to help build the security program while they recruit. The other is a university health system that is consolidating their security program under the university CISO and hiring an associate CISO to focus on the health system. Both organizations recognize the importance of the CISO role and the need to continually strengthen their security profile.

 

While it may be surprising to see organizations hiring their first CISO in 2018, what matters is that they recognize the need and are making the investment.

 

When I served as CIO at Michigan Medicine for the hospitals and health centers, we crossed that bridge in 2015. The IT leader responsible for infrastructure had been responsible for security as well – not uncommon in healthcare organizations. I recognized that the security function needed a dedicated focus, so we hired a full-time CISO.

 

I engaged a third-party security expert to conduct an assessment using the NIST framework. As a CIO, I learned a great deal through that process. With the help of our consultant, I was able to educate the executive team as well. One component of the final assessment report was about creating a security culture.

Security cannot just be the job of the CISO. It is everyone’s job. These are the signs that an organization has developed a security culture:

 

  • Security is discussed at the senior executive level, with critical decisions about organizational security activities made by the CEO and other senior leaders;
  • Senior executives receive regular reports on the security posture of the organization, and incorporate them into overall organizational risk management;
  • The organization has a CISO, positioned to influence organizational activities, and who operates independent of conflicts of interest;
  • Security staffing levels are adequate to address the existing and future security issues;
  • Security is a defined budgetary item, with security spending sufficient to address identified risks;
  • Security is incorporated into overall organizational activities, including system acquisition, and data sharing with business partners;
  • The organization’s research arm views security as critical to research activities, even if the research involves information considered public; and
  • Workforce members are aware of their roles and responsibilities with respect to IT security and are held accountable to meeting them.

 

Can your organization check off all the boxes on this list? If not, you’ve got work to do.

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Continuous Learning in Healthcare and Technology

Continuous Learning in Healthcare and Technology | Healthcare and Technology news | Scoop.it

What was the last webinar you participated in? What was the last podcast you listened to? What was the last book or in-depth article you read to learn something new? The bigger question is do you have a continuous learning plan?

 

One of the things I love about working in healthcare and technology is the pace of change and that there is always something new to learn. But that is also one of the challenges. So how do we keep up?

 

Don’t doubt that having a continuous learning plan is important for your career. The most recent This Week in Health IT podcast was interviews with six CIOs. Bill Russell asked them each the same five questions. The last question was what did they wish they knew or had done before they started their current role. A theme in the answers was around staff development – needing their staff to develop new skills and developing their leadership teams.

 

There are many different options and formats for ongoing training and learning to consider. You may prefer reading or webinars or podcasts or classroom training. Most likely you need a combination of all.

 

A few observations and tips from my own experience:

 

Reading: What used to be a stack of publications piled up in my office to read has now become a lot of bookmarked articles to read online. I read a lot of articles each week and add more to my list, even though I may not get to them. Having a few good “go to” resources and knowing your key areas of interest help manage and filter out the noise.

 

Webinars: You could spend several hours a week just doing webinars. Focus on a few “go to” resources and register for the ones that are most relevant to what you need to know. Or register for something new that you want to learn about. Once you put it on your calendar, consider it like any meeting. Too often we register with good intentions and then decide we don’t have the time when that day comes. But, if you really can’t make the time, many webinars are archived and available later.

 

Podcasts: I find several times a week when I can be listening and learning – driving a long distance, gym workout, or walking the dog. Find the podcast series that are most useful to you and subscribe. Then go to your Podcast library and pick one next time you have 30 minutes to listen.

 

Conferences: IT budgets have gotten tighter over the years and far fewer people are able to attend conferences. As a CIO, I encouraged the “divide and conquer” strategy. Plan in advance, coordinate attendance at sessions and hold staff accountable for sharing their learning when they return.

 

Online courses: This is a new one for me. I’ve thought of going back to school to get more current in healthcare and technology emerging topics, but I really would just like to take some specific courses. I am hearing about edX, an online learning destination offering a huge collection of online education courses, Also, there are MicroMasters programs, a series of graduate level courses from top universities.

 

Degrees and certificate programs: If you are considering going back to school for an advanced degree, more power to you. I got my MBA over a four-year period taking one course a quarter when my children were young, and I was already in management. It was hard to balance it all. But I had the long view on the value of getting my master’s degree and never allowed myself to say I was too busy to do it. I saw too many colleagues putting off starting a program and others skipping quarters – all because they thought they were too busy. A certificate program in a focused area is another option to consider. Most likely your company offers some form of tuition reimbursement. Make sure you understand the benefits and take advantage of whatever is offered.

 

I’m guessing that for those six CIOs who were interviewed and every CIO I know, one of their ongoing challenges when they review their IT budget is training and development. They want to invest in their staff and that takes time and money.

 

But far too often, the various institutional memberships we were paying for were way underutilized. I found the solution was to educate and promote the resources to my entire staff. If possible, try to work with the company to customize and target content that is most relevant to you. Organizational level subscriptions and memberships in HIMSS, Scottsdale Institute, Advisory Board, or Gartner to name a few should be leveraged to their fullest. If not, they will be the first line item to cut at budget time.

 

Some of the smartest and most successful people follow the “5 hours a week rule” – spending 5 hours a week learning. Busy people like former President Obama, Bill Gates, Warren Buffett, Oprah Winfrey follow it. So why can’t you?

 

Think about continuous learning like you do your gym workout schedule. Develop a plan that’s right for you. Make the time. And remember, it’s an investment in you.

Technical Dr. Inc.'s insight:
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