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EMR Information Management Tops List Of Patient Threats

Posted on March 23, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A patient safety organization has reached a conclusion which should be sobering for healthcare IT shops across the US. The ECRI Institute , a respected healthcare research organization, cited three critical health IT concerns in its list of the top 10 patient safety concerns for 2017.

ECRI has been gathering data on healthcare events and concerns since 2009, when it launched a patient safety organization. Since that time, ECRI and its partner PSOs have collected more than 1.5 million event reports, which form the basis for the list. (In other words, the list isn’t based on speculation or broad value judgments.)

In a move that won’t surprise you much, ECRI cited information management in EMRs as the top patient safety concern on its list.

To address this issue, the group suggests that healthcare organizations create cross-functional teams bringing varied perspectives to the table. This means integrating HIM professionals, IT experts and clinical engineers into patient safety, quality and risk management programs. ECRI also recommends that these organizations see that users understand EMRs, report and investigate concerns and leverage EMRs for patient safety programs.

Implementation and use of clinical decision support tools came in at third on the list, in part because the potential for patient harm is high if CDS workflows are flawed, the report says.

If healthcare organizations want to avoid these problems, they need to give a multidisciplinary team oversight of the CDS, train end users in its use and give them access to support, the safety group says. ECRI also recommends that organizations monitor the appropriateness of CDS alerts, evaluating the impact on workflow and reviewing staff responses.

Test result reporting and follow-up was ranked fourth in the list of safety issues, driven by the fact that the complexity of the process can lead to distraction and problems with follow-up.

The report recommends that healthcare organizations respond by analyzing their test reporting systems and monitor their effectiveness in triggering appropriate follow-ups. It also suggests implementing policies and procedures that make it clear who is accountable for acting on test results, encouraging two-way conversations between healthcare professionals and those involved in diagnostic testing and teaching patients how to address test information.

Patient identification issues occupied the sixth position on the list, with the discussion noting that about 9 percent of misidentification problems lead to patient injury.

Healthcare leaders should prioritize this issue, engaging clinical and nonclinical staffers in identifying barriers to safe identification processes, the ECRI report concludes. It notes that if a provider has redundant patient identification processes in place, this can increase the probability that identification problems will occur. Also, it recommends that organizations standardize technologies like electronic displays and patient identification bands, and that providers consider bar-code systems and other patient identification helps.

In addition to health IT problems, ECRI identified several clinical and process issues, including unrecognized patient deterioration, problems with managing antimicrobial drugs, opioid administration and monitoring in acute care, behavioral health issues in non-behavioral-health settings, management of new oral anticoagulants and inadequate organization systems or processes to improve safety and quality.

But clearly, resolving nagging health IT issues will be central to improving patient care. Let’s make this the year that we push past all of them!

Study Offers Snapshot Of Provider App Preferences

Posted on March 20, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A recent study backed by HIT industry researchers and an ONC-backed health tech project offers an interesting window into how healthcare organizations see freestanding health apps. The research, by KLAS and the SMART Health IT Project, suggests that providers are developing an increasingly clear of what apps they’d like to see and how they’d use them.

Readers of this blog won’t be surprised to hear that it’s still early in the game for healthcare app use. In fact, the study notes, about half of healthcare organizations don’t formally use apps at the point of care. Also, most existing apps offer basic EMR data access, rather than advanced use cases.

The apps offering EMR data access are typically provided by vendors, and only allow users to view such data (as opposed to documenting care), according to the study report. But providers want to roll out apps which allow inputting of clinical data, as this function would streamline clinicians’ ability to make an initial patient assessment, the report notes.

But there are other important app categories which have gained an audience, including diagnostic apps used to support patient assessment, medical reference apps and patient engagement apps.  Other popular app types include clinical decision support tools, documentation tools and secure messaging apps, according to researchers.

It’s worth noting, though, that there seems to be a gap between what providers are willing to use and what they are willing to buy or develop on their own. For example, the report notes that nearly all respondents would be willing to buy or build a patient engagement app, as well as clinical decision support tools and documentation apps. The patient engagement apps researchers had in would manage chronic conditions like diabetes or heart disease, both very important population health challenges.

Hospital leaders, meanwhile, expressed interest in using sophisticated patient portal apps which go beyond simply allowing patients to view their data. “What I would like a patient app to do for us is to keep patients informed all throughout their two- to four-hours ED stay,” one CMO told researchers. “For instance, the app could inform them that their CBC has come back okay and that their physician is waiting on the read. That way patients would stay updated.”

When it came to selecting apps, respondents placed a top priority on usability, followed by the app’s cost, clinical impact, capacity for integration, functionality, app credibility, peer recommendations and security. (This is interesting, given many providers seem to give usability short shrift when evaluating other health IT platforms, most notably EMRs.)

To determine whether an app will work, respondents placed the most faith in conducting a pilot or other trial. Other popular approaches included vendor demos and peer recommendations. Few favored vendor websites or videos as a means of learning about apps, and even fewer placed working with app endorsement organizations or discovering them at conferences.

But providers still have a few persistent worries about third-party apps, including privacy and security, app credibility, the level of ongoing maintenance needed, the extent of integration and data aggregation required to support apps and issues regarding data ownership. Given that worrisome privacy and security concerns are probably justified, it seems likely that they’ll be a significant drag on app adoption going forward.

E-Patient Update: Naughty, Naughty Telehealth Users

Posted on March 17, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Wow. I mean, wow. I can’t believe the article I just read, in otherwise-savvy Wired magazine yet, arguing that patients who access telemedicine services are self-indulgent and, well, sorta stupid.

Calling it the “Uber-ization” of healthcare, writer Megan Molteni (@MeganMolteni on Twitter) argues that telemedicine will only survive if people use it “responsibly” – apparently because people are currently accessing care via direct-to-consumer services because their favorite online gambling site was offline for system maintenance.

In making this claim, Molteni cites new research from RAND, published in the journal Health Affairs, which looked at the impact direct-to-consumer telemedicine services had on overall healthcare costs. But the piece goes from acknowledging that this model might not reduce costs in all cases to attacking e-patients like myself – and that’s where I got a bit steamed.

In structuring the piece, the writer seems to suggest that if consumer behavior doesn’t save the health insurance industry money, we need to stop being so gosh-darned assertive about getting help with our health. Then it goes further, arguing that we should just for-Pete’s-sake control ourselves (apparently we’re either hypochondriacs, attention-seekers or terminally bored) and just step away from the computer.  Why can’t we just say no?

First, the facts

Before we take this on, let’s take a look at the journal article which the writer drew upon as a primary source and see what assertions it makes. Facts first.

In the abstract, the authors note that demand for direct-to-consumer telehealth services is growing rapidly, and has the potential to save money by replacing physician office and emergency department trips with virtual visits.

To see whether this might be the case, the authors gathered commercial claims data over 300,000 patients covered by CalPERS Blue Shield, which began covering telehealth services in April 2012. During the next 18 months, 2,943 of those 300,000 enrollees came down with a respiratory infection, one third of which sought services from direct-to-consumer telehealth company Teladoc.

Once they had their data in hand, the research looked at patterns of care utilization and spending levels for treatment of acute respiratory illnesses.

After completing the analysis, the authors found that 12% of direct-to-consumer telehealth visits replaced visits to other providers, while the remaining 88% represented new care utilization. Net annual spending on acute respiratory illness grew $45 per telehealth users, researchers found.

The researchers concluded that because it offers more convenient access, direct-to-consumer telehealth may increase utilization and healthcare spending.

It should be noted that Molteri’s article doesn’t look at whether increased utilization was excessive or ineffective. It doesn’t ask whether patients who accessed telemedical care had different outcomes than those who didn’t and if those new patients saved the health system money because of the interventions that wouldn’t have happened without telehealth. It doesn’t address whether patients who used telehealth in addition to face-to-face care were actually sicker than those who didn’t, or had other co-existing conditions which affected overall costs. It just notes a pattern for a single group of patients diagnosed with a single condition.

Also, it’s worth pointing out that we don’t know whether Teladoc’s performance is better or worse than that of rivals like HealthTap, MDLive and Doctor on Demand. And if there are meaningful differences, that would be important.  But the piece doesn’t take this on either.

So in summary, all we know is that using one provider for one condition, a health plan paid a little bit more for some patients’ care when they had a telemedicine consult.

Consumer indictment

But in Molteri’s analysis, the study offers nothing less than an indictment of consumers who use these services. “For telehealth to fully deliver on its promise, people have to start treating their health care less like an Uber you summon in a thunderstorm,” she asserts, while citing no evidence that people do in fact access such services too casually.

All told, the piece suggests that the people are accessing telehealth for trivial reasons such as, I don’t know, kicks, or as an easy way to find an online buddy. Really? Give me a break. Even when it’s delivered online, people seek care out because they need it, not because they’re lazy or, as I noted above, stupid.

To be as fair as I can be, the article does note that direct-to-consumer healthcare models have unique flaws, particularly a lack of integration with patients’ ongoing care. It also concedes that some providers (such as the VA, which has slashed costs with its telehealth program) are using the technology effectively.

It also notes that telemedicine can do more to meet its potential if it’s used to manage chronic disease and engage people in preventive care. “Telehealth has to be integrated fully into a total care system,” said Mario Gutierrez, executive director of the Center for Connected Health Policy, who spoke with Molteri. As a patient with multiple chronic conditions, I couldn’t agree more. Anything that makes care access easier on one of my bad days is a winner in my book.

Ultimately, though, the author unfortunately bases her article on the assumption that the real problem here is patients accessing care. Not the gaps in the system that prompt such usage. Not the unavailability of primary care in some settings. Not the 15-minute fly-by medical visits that perforce leave issues unaddressed. Not even the larger issues in controlling healthcare costs. No, it’s e-patients like me who use telehealth to meet unmet needs.

Please. I can’t even.

E-Patient Update: Patients Need Better Care Management Workflows

Posted on March 10, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Now and then, I get a little discouraged by the state of my health data. Like providers, I’m frustrated as heck by the number of independent data sources I must access to get a full picture of my medications, care and health status. These include:

* The medication tracker on my retail pharmacy’s site
* My primary care group’s portal
* My hospital’s Epic MyChart portal
* A medication management app to track my compliance with my regimen
* A health tracker app in which I track my blood pressure
* My Google calendar, to keep up with my health appointments
* Email clients to exchange messages with some providers

That’s not all – I’m sure I could think of other tools, interfaces and apps – but it offers a good idea of what I face. And I’m pretty sure I’m not unusual in this regard, so we’re talking about a big issue here.

By the way, bear in mind I’m not just talking about hyperportalotus – a fun term for the state of having too many portals to manage – but rather, a larger problem of data coordination. Even if all of my providers came together and worked through a shared single portal, I’d still have to juggle many tools for tracking and documenting my care.

The bottom line is that given the obstacles I face, my self-care process is very inefficient. And while we spend a lot of time talking about clinician workflow (which, of course, is quite important) we seldom talk about patient/consumer health workflow. But it’s time that we did.

Building a patient workflow

A good initial step in addressing this problem might be to create a patient self-care workflow builder and make it accessible website. Using such a tool, I could list all of the steps I need to take to manage my conditions, and the tool would help me develop a process for doing so effectively.

For example, I could “tell” the software that I need to check the status of my prescriptions once a week, visit certain doctors once a month, check in about future clinical visits on specific days and enter my data in my medication management app twice a day. As I did this, I would enter links to related sites, which would display in turn as needed.

This tool could also display critical web data, such as the site compiling the blood sugar readings from my husband’s connected blood glucose monitor, giving patients like me the ability to review trends at a glance.

I haven’t invented the wheel here, of course. We’re just talking about an alternate approach to a patient portal. Still, even this relatively crude approach – displaying various web-based sources under one “roof” along with an integrated process – could be quite helpful.

Eventually, health IT wizards could build much more sophisticated tools, complete with APIs to major data sources, which would integrate pretty much everything patients need first-hand. This next-gen data wrangler would be able to create charts and graphs and even issue recommendations if the engine behind it was sophisticated enough.

Just get started

All that being said, I may be overstating how easy it would be to make such a solution work. In particular, I’m aware that integrating a tool with such disparate data sources is far, far easier said than done. But why not get started?

After all, it’s hard to overestimate how much such an approach would help patients, at least those who are comfortable working with digital health solutions. Having a coordinated, integrated tool in place to help me manage my care needs would certainly save me a great deal of time, and probably improve my health as well.

I urge providers to consider this approach, which seems like a crying need to me. The truth is, most of the development money is going towards enabling the professionals to coordinate and manage care. And while that’s not a bad thing, don’t forget us!

Could Patents Freeze Blockchain’s Progress?

Posted on March 6, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Everywhere you look, somebody’s talking about blockchain technology and its amazing future. In fact, the healthcare industry is engaging in perhaps the most aggressive blockchain deployments of any industry, according to Deloitte.

Originally, blockchain was an open-source platform, freely available to anyone who wanted to use it. But that could soon change, if a new item from Reuters is any indication.

According to the news service, Aussie computer scientist Craig Wright – who claims to be the pseudonymous “Satoshi Nakamoto” responsible for the technology – is working with Canadian online gambling entrepreneur Calvin Ayre to patent aspects of bitcoin/blockchain tech.

To date Wright, who’s being funded by the wealthy Canadian, has filed more than 70 patent applications in Britain in cooperation with associates. This may not sound like a big deal, but it is, considering that only 63 blockchain-related patents were filed globally last year, according Reuters.

Not only that, Wright plans to file many more, Reuters research has concluded. The patent applications include approaches specific to healthcare, including storage of medical documents. Ultimately, Wright and his partners plan to file as many as 400 patent applications, the news service reports.

Ayre is investing in blockchain largely because he sees it as a good fit with the gambling business. And that serves Wright’s interests, which have included online gambling for decades. In fact, Reuters notes that the bitcoin code base contains unimplemented functions related to poker. So it makes sense that he wants to lock it down and own it.

That being said, it seems unlikely that well-funded corporate interests – including healthcare organizations – are going to just sit back and ignore these developments. After all, companies spent more than $1.5 billion on blockchain technology during 2016, and they’re likely to scale up further this year. In other words, they’re not going to let go of blockchain technology without a fight.

Also, it’s worth noting that none of the 70 existing patent applications have been granted to date, and according to Reuters it’s not clear if they’ll even be enforceable if they are.

Finally, Ayer’s history in the U.S. raises questions as to whether he’s completely above-board. In the past, most of his online gambling revenue came from the U.S., a highly-lucrative business which made him extremely rich. But offering such a platform was and is illegal in many states, and as a result one of the states (Maryland) indicted his online gambling network Bodog, Ayer himself and four other people. The case is still pending.

All told, it doesn’t seem likely that health IT organizations need to drop their blockchain plans anytime soon. But it’s worth bearing in mind that blockchain development may be more complicated – and more expensive – in the future.

Costs Of Compromised Credentials Rising

Posted on March 3, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Healthcare organizations face unique network access challenges. While some industries only need to control access by professional employees and partners, healthcare organizations are increasingly opening up data to consumers, and the number of consumer access points are multiplying. While other industries face similar problems – banking seems particularly relevant – I don’t know of any other industry that depends on such a sophisticated data exchange with consumers to achieve critical results.

Given the industry’s security issues, I found the following article to be quite interesting. While it doesn’t address healthcare concerns directly, I think it’s relevant nonetheless.

The article, written by InfoArmor CTO Christian Lees, contends that next-generation credentials are “edging toward a precarious place.” He argues that because IT workers are under great pressure to produce, they’re rushing the credentialing process. And that has led to a lack of attention to detail, he says:

“Employees, contractors and even vendors are rapidly credentialed with little attention given to security rules such as limiting access per job roles, enforcing secure passwords, and immediately revoking credentials after an employee moves on…[and as a result], criminals get to choose from a smorgasbord of credentialed identities with which to phish employees and even top executives.”

Meanwhile, if auto-generated passwords are short and ineffective, or so long that users must write them down to remember them, credentials tend to get compromised quickly. What’s more, password sharing and security shortcuts used for sign-in (such as storing a password in a browser) pose further risk, he notes.

Though he doesn’t state this in exactly these words, the problem is obviously multiplied when you’re a healthcare provider. After all, if you’re managing not only thousands of employee and partner credentials, but potentially, millions of consumer credentials for use in accessing portal data, you’re fighting a battle on many fronts.

And unfortunately, the cost of losing control of these credentials is very high. In fact, according to a Verizon study, 63% of confirmed data breaches happening last year involved weak, default or stolen passwords.

To tackle this problem, Lees suggests, organizations should create a work process which handles different types of credentials in different ways.

If you’re providing access to public-facing information, which doesn’t include transaction, identifying or sensitive information, using a standard password may be good enough. The passwords should still be encrypted and protected, but they should still be easy to use, he says.

Meanwhile, if you need to offer users access to highly sensitive information, your IT organization should implement a separate process which assigns stronger, more complex passwords as well as security layers like biometrics, cryptographic keys or out-of-band confirmation codes, Lees recommends.

Another way to improve your credentialing strategy is to associate known behaviors with those credentials. “If you know that Bill comes to the office on Tuesdays and Thursdays but works remotely the rest of the week and that he routinely accesses certain types of files, it becomes much harder for a criminal to use Bill’s compromised credentials undetected,” he writes.

Of course, readers of this blog will have their own strategies in placefor protecting credentials, but Lee’s suggestions are worth considering as well. When you’re dealing with valuable health data, it never hurts to go that extra mile. If you don’t, you might get a visit by the HIPAA police (proverbial, not actual).

HIMSS17: Health IT Staff, Budgets Growing

Posted on March 1, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study announced last week at the HIMSS17 event concludes that demand for health IT staff continues to grow as employers expand their budgets. Not surprisingly, given this growth, the healthcare employers are having trouble recruiting enough IT staffers to meet their growing needs.

Results from the HIMSS Leadership and Workforce Survey reflect responses from 368 U.S. health IT leaders made between November 2016 and early January 2017. Fifty-six of respondents from vendors and consulting firms were in executive management, as compared with 41% of providers.

The survey concluded that the majority of health IT respondents have positions they’d like to fill, including 61% of health IT vendors/consultants and 43% of providers who responded. Only 32% of vendor/consultant organizations and 38% or providers said they were fully staffed, HIMSS said. We’ve seen this challenge from many of the healthcare IT companies which post their jobs on Healthcare IT Central.

Demand for IT recruits grew last year, as well. Researchers found that 61% of vendors/consultants responding and 42% of providers responding saw IT staffing increases over the past year, and that the majority of respondents in both groups expect to increase their IT staffing levels or at least hold them steady next year.

Of course, someone has to pay for these new team members. HIMSS researchers found that IT budgets were continuing to rise over time. Roughly nine out of ten vendors/consultants and 56% of providers said they expected to see increases in their IT budgets this year.

As often happens, however, vendors and consultants and providers seem to have different HIT priorities. While vendors seem to be addressing new technology issues, providers are still focused on how to manage their existing EMR infrastructure investments, HIMSS said.

That being said, the survey found, health IT stakeholders have many overlapping concerns, including privacy and security, population health, care coordination and improving the culture of care.

One of the key insights from this study – that vendors/consultants and providers have different views on the importance of enhancing existing EMRs – is borne out by another study released at the HIMSS event.

The study, which was backed by voice recognition software vendor Nuance Communications, found that providers are broadly interested in implementing new technologies that enhance their EMR, especially computer-assisted physician documentation, mobility and speech recognition tools.

However, when asked to be specific about which tools interested them, they were less enthusiastic, with 44% showing an interest in mobility tools, 38% computer-assisted physician documentation and 25% speech recognition. Documentation tools that enhanced existing functions were especially popular, with 54% of respondents expecting to see them support a reduction in denied claims, 52% improved performance under bundled payments, 38% reduced readmissions and 38% better physician time management which improves patient flow.

This survey also found that the most popular strategy for enhancing physician satisfaction with health IT tools was providing clinician training and education (chosen by 82%). Since their EMR is probably their biggest IT investment, my guess is that the training will focus there. And that suggests that EMRs are still the center of their universe, doesn’t it?

Patient Misidentification Remains Common

Posted on February 27, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The following information was released several weeks ago, but I just found it and thought readers would still find it relevant. The research, from security researcher Ponemon Institute, concludes that patient misidentification is relatively common and continues to impact patient safety and experience.

Late last year, Ponemon surveyed 503 healthcare professionals from across the US, including nurses, physicians, IT practitioners and leaders in financial operations, on the frequency and root causes of patient misidentification, as well as the consequences.

According to the researchers, 86% of respondents said they’d witnessed or know of medical errors resulting from patient misidentification. And 67% said that when searching for patient information, they find duplicate medical records for that patient almost all of the time. Along the way, about three-quarters of respondents agreed that use of biometrics could reduce patient misidentification and by extension, cut down on medical errors.

The most common root cause of patient misidentification was incorrect identification at registration (chosen by 63%), followed by time pressure when treating patients (60%), insufficient employee/clinician training and awareness (35%), too many duplicate medical records in system (34%), registrar errors (32%), turf wars between departments (29%), inadequate safety procedures (20%), over-reliance on homegrown or obsolete identification systems (15%) and misinformation provided by patient (9%). (The remaining 3% was reported as “other”.)

The key causes of misidentification named in the survey included the inability to find a patient’s chart or medical record (68% of respondents), a search or query which brings up multiple or duplicate medical records for a patient (67%), patient associated with incorrect records due to same names and/or dates of birth (56%), or having the wrong record pulled up for a patient because another record in the registration system or EMR has the same name and/or date of birth (61%).

Not surprisingly, the survey also suggests that widespread patient misidentification can have a serious financial impact. On average, Ponemon says, respondents said that more than one-third of all denied claims resulted directly from an inaccurate patient identification or inaccurate/incomplete information. This costs the average healthcare facility $1.2 million per year, they reported.

Meanwhile, patient identification problems have a negative impact on patient experience, the survey concluded. Sixty-nine percent of respondents told researchers that staff spent up to or more than 30 minutes per shift contacting medical records or HIM departments to get critical patient information.

Not only that, misidentifying patients can have a ripple effect, with missing or incomplete information leading to patient care delays. Thirty-seven percent of respondents said that they spent an hour or more contacting medical records or HIM departments to get critical patient information.

E-Patient Update:  Can Telemedicine Fill Gap For Uninsured Patients?

Posted on February 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As someone who will soon will need to buy insurance through an ACA exchange – but doesn’t know whether that will still be possible – I’ve been thinking about my healthcare needs a lot, and how to meet them effectively if I’m ever uninsured.

Being an e-patient, the first thing that crossed my mind was to explore what Internet connectivity could do for me. And it occurred to me that if I had access to a wider range of comparatively-affordable telemedical services, I just might be able to access enough doctors and advanced practice clinicians to survive. (Of course, hospital and prescription drug costs won’t be tamed that easily, but that’s a subject for a different column.)

I admit that video visits aren’t an ideal solution for me and my husband, as we both have complex, chronic health conditions to address. But if I end up without insurance, I hold out hope that cheaper telemedicine options will get me through until we find a better solution.

Right now, unfortunately, telemedical services largely seem to be delivered on a hit-or-miss basis – with some specialties being easy to find and others almost inaccessible via digital connectivity – but if enough people like me are forced to rely on these channels perhaps this will change.

What’s available and what isn’t

This week, I did some unscientific research online to see what kind of care consumers can currently access online without too much fuss. What I found was a decidedly mixed bag. According to one telehealth research site, a long list of specialties offer e-visits, but some of them are much harder to access than others.

As you might have guessed, primary care – or more accurately, urgent care — is readily available. In fact one such provider, HealthTap, offers consumers unlimited access to its doctors for $99 a month. Such unfettered access could be a big help to patients without insurance.

And some specialties seem to be well-represented online. For example, if you want to get a dermatology consult, you can see a dermatologist online at DermatologistOnCall, which is partnered with megapharmacy Walgreens.

Telepsychiatry seems to be reasonably established, though it doesn’t seem to be backed yet by a major consumer branding effort. On the other hand, video visits with talk therapists seem to be fairly commonplace these days, including an option provided by HealthTap.

I had no trouble finding opportunities to connect with neurologists via the Web, either via email or live video. This included both multispecialty sites and at least one (Virtual Neurology) dedicated to offering teleneurology consults.

On the other hand, at least in searching Google, I didn’t find any well-developed options for tele-endocrinology consults (a bummer considering that hubby’s a Type 2 diabetic). It was the same for tele-pulmonology services.

In both of the former cases, I imagine that such consults wouldn’t work over time unless you had connected testing devices that, for example allow you to do a peak flow test, spirometry, blood or urine test at home. But while such devices are emerging, I’m not aware of any that are fully mature.

Time to standardize

All told, I’m not surprised that it’s hit or miss out there if you want to consult your specialists via an e-visit. There are already trends in place, which have evolved over the last few years, which favor some specialties and fail to address others.

Nonetheless, particularly given my perilous situation, I’m hoping that providers and trade groups will develop some standardized approaches to telemedicine. My feeling is that if a specialty-specific organization makes well-developed clinical, technical, operational and legal guidelines available, we’ll see a secondary explosion of new tele-specialties emerge.

In fact, even if I retain my health insurance benefits, I still hope that telemedical services become more prevalent. They’re generally more cost-efficient than traditional care and certainly more convenient. And I’m pretty confident that I’m not the only one champing at the bit here. Let’s roll ‘em out, people!

Consumers Fear Theft Of Personal Health Information

Posted on February 15, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Probably fueled by constant news about breaches – duh! – consumers continue to worry that their personal health information isn’t safe, according to a new survey.

As the press release for the 2017 Xerox eHealth Survey notes, last year more than one data breach was reported each day. So it’s little wonder that the survey – which was conducted online by Harris poll in January 2017 among more than 3,000 U.S. adults – found that 44% of Americans are worried about having their PHI stolen.

According to the survey, 76% of respondents believe that it’s more secure to share PHI between providers through a secure electronic channel than to fax paper documents. This belief is certainly a plus for providers. After all, they’re already committed to sharing information as effectively as possible, and it doesn’t hurt to have consumers behind them.

Another positive finding from the study is that Americans also believe better information sharing across providers can help improve patient care. Xerox/Harris found that 87% of respondents believe that wait times to get test results and diagnoses would drop if providers securely shared and accessed patient information from varied providers. Not only that, 87% of consumers also said that they felt that quality of service would improve if information sharing and coordination among different providers was more common.

Looked at one way, these stats offer providers an opportunity. If you’re already spending tens or hundreds of millions of dollars on interoperability, it doesn’t hurt to let consumers know that you’re doing it. For example, hospitals and medical practices can put signs in their lobby spelling out what they’re doing by way of sharing data and coordinating care, have their doctors discuss what information they’re sharing and hand out sheets telling consumers how they can leverage interoperable data. (Some organizations have already taken some of these steps, but I’d argue that virtually any of them could do more.)

On the other hand, if nearly half of consumers afraid that their PHI is insecure, providers have to do more to reassure them. Though few would understand how your security program works, letting them know how seriously you take the matter is a step forward. Also, it’s good to educate them on what they can do to keep their health information secure, as people tend to be less fearful when they focus on what they can control.

That being said, the truth is that healthcare data security is a mixed bag. According to a study conducted last year by HIMSS, most organizations conduct IT security risk assessments, many IT execs have only occasional interactions with top-level leaders. Also, many are still planning out their medical device security strategy. Worse, provider security spending is often minimal. HIMSS notes that few organizations spend more than 6% of their IT budgets on data security, and 72% have five or fewer employees allocated to security.

Ultimately, it’s great to see that consumers are getting behind the idea of health data interoperability, and see how it will benefit them. But until health organizations do more to protect PHI, they’re at risk of losing that support overnight.