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Vendor Study Says Wearables Can Promote Healthy Behavior Change

Posted on November 28, 2016 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 backed by a company that makes an enterprise health benefits platform has concluded that wearables can encourage healthy behavior change, and also, serve as an effective tool to engage employees in their health.

The data from the study, which was sponsored by Mountain View, CA-based Jiff, comes from a two-year research project on employer-sponsored wearables. Rajiv Leventhal, who wrote about the study for Healthcare Informatics, argues that these findings challenge common employer beliefs about these type of programs, including that participation is typically limited to young and healthy employees, and that engagement with these rules can’t be sustained over time.

The data, which was drawn from 14 large employers with 240,000 employees, apparently suggests that wearable adoption and long-term engagement is possible for employees of all ages. The company reported that among the employers offered the wearables program via its enterprise health platform, 53% of employees under 40 years old participated, and 36% of employees over 50 years participated as well.

Jiff researchers also found that employee engagement had not measurably fallen for more than nine months following the program rollout, and that for one employer, levels of engagement have been progressively increasing for more than 18 months, the company reported.

According to Jiff, they have helped sustain employee engagement by employing three tactics:  Using “challenges,” time-bound immersive and social games that encourage healthy actions, “device credits,” subsidies that offset the cost of purchasing wearables and “behavioral incentives,” rewards for taking healthy actions such as walking a minimum number of steps per day.

The thing is, as interesting as these numbers might be — and they do, if nothing else, underscore the role of engaging consumers rather than waiting for them to engage with healthier behaviors on their own — the story doesn’t address one absolutely crucial issue, to wit, what concrete health impact are companies seeing from employee use of these devices.

I don’t think I’m asking for too much here when I demand some quantitative data suggesting that the setup can actually achieve measurable health results. Everything I’ve read about employee wellness initiatives to date suggests that they’ve been a giant bust, with few if any accomplishing anything measurable.

And here we have Jiff, a venture-backed hotshot company, which I’m guessing had the resources to report on results if it found any. After all, if I understand the study right, with their researchers had access to 540,000 employees for significant amount of time.  So where are the health conclusions that can be drawn from this population?

And by the way, no, I don’t accept that patient engagement (no matter how genuine) can be used as a proxy or predictive factor for health improvement. It’s a promising step in the right direction but it isn’t the real thing yet.

So, I shared the study with you because I thought you might find it interesting. I did. But I wouldn’t take it too seriously when it comes to signs of real change — either for wearables used for employee wellness initiatives. At this point both are more smoke than substance.

Are Healthcare Data Streams Rich Enough To Support AI?

Posted on November 21, 2016 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 I’ve noted previously, artificial intelligence and machine learning applications are playing an increasingly important role in healthcare. The two technologies are central to some intriguing new data analytics approaches, many of which are designed to predict which patients will suffer from a particular ailment (or progress in that illness), allowing doctors to intervene.

For example, at New York-based Mount Sinai Hospital, executives are kicking off a predictive analytics project designed to predict which patients might develop congestive heart failure, as well as to care for those who’ve are done so more effectively. The hospital is working with AI vendor CloudMedx to make the predictions, which will generate predictions by mining the organization’s EMR for clinical clues, as well as analyzing data from implantable medical devices, health tracking bands and smartwatches to predict the patient’s future status.

However, I recently read an article questioning whether all health IT infrastructures are capable of handling the influx of data that are part and parcel with using AI and machine learning — and it gave me pause.

Artificial intelligence, the article notes, functions on collected data, and the more data AI solution has access to, the more successful the implementation will be, contends Elizabeth O’Dowd in HIT Infrastructure. And there are some questions as to whether healthcare IT departments can integrate this data, especially Internet of Things datapoints such as wearables and other personal devices.

After all, O’Dowd notes, for the AI solution to crawl data from IoT wearables, mobile apps and other connected devices, the data must be integrated into the patient’s medical record in a format which is compatible with the organization’s EMR technology. Otherwise, the organization’s data analytics solution won’t be able to process the data, and in turn, the AI solution won’t be able to evaluate it, she writes.

Without a doubt, O’Dowd has raised some important issues here. But the real question, as I see it, is whether such data integration is really the biggest bottleneck AI and machine learning must pass through before becoming accessible to a wide range of users. For example, healthcare AI-based Lumiata offers a FHIR-compliant API to help organizations integrate such data, which is certainly relevant to this discussion.

It seems to me that giving the AI every possible scrap of data to feed on isn’t the be all and end all, and may even actually less important than the clinical rationale developers uses to back up its work. In other words, in the case of Lumiata and its competitors, it appears that creating a firm foundation for the predictions is still as much the work of clinicians as much is AI.

I guess what I’m getting to here is that while AI is doubtless more effective at predicting events as it has access to more data, using what data we have with and letting skilled clinicians manage it is still quite valuable. So let’s not back off on harvesting the promise of AI just because we don’t have all the data in hand yet.

What Would A Community Care Plan Look Like?

Posted on November 16, 2016 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.

Recently, I wrote an article about the benefits of a longitudinal patient record and community care plan to patient care. I picked up the idea from a piece by an Orion Health exec touting the benefits of these models. Interestingly, I couldn’t find a specific definition for a community care plan in the article — nor could I dig anything up after doing a Google search — but I think the idea is worth exploring nonetheless.

Presumably, if we had a community care plan in place for each patient, it would have interlocking patient-specific and population health-level elements to it. (To my knowledge, current population health models don’t do this.) Rather than simply handing patients off from one provider to another, in the hope that the rare patient-centered medical home could manage their care effectively on its own, it might set care goals for each patient as part of the larger community strategy.

With such a community care strategy, groups of providers would have a better idea where to allocate resources. It would simultaneously meet the goals of traditional medical referral patterns, in which clinicians consult with one another on strategy, and help them decide who to hire (such as a nurse-practitioner to serve patient clusters with higher levels of need).

As I envision it, a community care plan would raise the stakes for everyone involved in the care process. Right now, for example, if a primary care doctor refers a patient to a podiatrist, on a practical level the issue of whether the patient can walk pain-free is not the PCP’s problem. But in a community-based care plan, which help all of the individual actors be accountable, that podiatrist couldn’t just examine the patient, do whatever they did and punt. They might even be held to quantitative goals, if the they were appropriate to the situation.

I also envision a community care plan as involving a higher level of direct collaboration between providers. Sure, providers and specialists coordinate care across the community, minimally, but they rarely talk to each other, and unless they work for the same practice or health system virtually never collaborate beyond sharing care documentation. And to be fair, why should they? As the system exists today, they have little practical or even clinical incentive to get in the weeds with complex individual patients and look at their future. But if they had the right kind of community care plan in place for the population, this would become more necessary.

Of course, I’ve left the trickiest part of this for last. This system I’ve outlined, basically a slight twist on existing population health models, won’t work unless we develop new methods for sharing data collaboratively — and for reasons I be glad to go into elsewhere, I’m not bullish about anything I’ve seen. But as our understanding of what we need to get done evolves, perhaps the technology will follow. A girl can hope.

Health Plans Need Big Data Smarts To Prove Their Value

Posted on November 2, 2016 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.

Recently, Aetna cut a deal which suggests a new role for health insurers in big data analytics and population health management. In partnership with Merck, the health insurer is launching a new program using predictive analytics to identify target populations and provide them with health and wellness services. AetnaCare will start by targeting patients with diabetes and hypertension in the mid-Atlantic U.S., but it seems likely to go national soon.

In its press release on the matter, Aetna says the goal of the program is to “proactively curate various health and wellness services… to support treatment adherence, ensure that critical social support needs are met, and reinforce healthy lifestyle behaviors.” That in and of itself isn’t a big deal. We all know that these are goals shared by providers, employers and health plans, and that most of the efforts health plans make on this front are pie in the sky, half-baked initiatives featuring cutesy graphics and little substance.

But then, Aetna’s chief medical officer gives away the real goal here — to power this effort by analyzing patient data being spun out by patients in varied care settings.  In the release, Dr. Harold Paz notes that patients are getting care in a wide variety of settings, including retail clinics, healthcare devices, pharmaceutical services, behavioral health, and social services, and that these services are seldom coordinated well, and implies that this is the real problem Aetna must solve.

If you listen to this with the ears of a health IT chick like myself, you hear Aetna (and Merck, actually) admitting that they must engage in predictive analytics across all of these encounters – and eventually, use these insights to help patients make good healthcare choices. In other words, they have to think like providers and even offer provider-like services fulfill their mission. And that means competing with or even beating providers at the big data game.

The truth is, health plans are in the same boat as providers, in that they’re at the center of a hailstorm of data and struggling with how to make use of it. Also, like providers they’re facing pressure from health purchasers to slow healthcare cost growth and boost patient wellness. But I’d argue that they’re even less prepared, technically and culturally, to improve health or coordinate care. So jumping in now is critically important.

In fact, I’d argue that health insurers are under greater pressure to improve population health than even sophisticated health systems or ACOs. Why? Because while health systems and ACOs can point to what they do – they make people better, for heaven’s sake — insurance companies are the eternal middleman who must continue to prove that they add value to the healthcare equation.

It remains to be seen whether programs like AetnaCare succeed at helping patients find the resources they need to improve and maintain their health. But even if this concept doesn’t work out, others will follow. Health plans need to leverage their unique data set to boost quality and reduce costs. Otherwise, as providers learn to work under value-based payments and accept risk, employers will have increasingly good reasons to contract directly — and leave the insurance industry out of the game entirely.

Locking Down Clinician Wi-Fi Use

Posted on November 1, 2016 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 that Wi-Fi-based Internet connections are available in most public spaces where clinician might spend time, they have many additional opportunities to address emerging care issues on the road, be they with their family in a mall or a grabbing a burger at McDonald’s.

However, notes one author, there are many situations in which clinicians who share private patient data via Wi-Fi may be violating HIPAA rules, though they may not be aware of the risks they are taking. Not only can a doctor or nurse end up exposing private health information to the public, they can open a window to their EMR, which can violate countless additional patients’ privacy. Like traditional texting, standard Wi-Fi offers hackers an unencrypted data stream, and that puts their connected mobile device at risk if they’re not careful to take other precautions like a VPN.

According to Paul Cerrato, who writes on cybersecurity for iMedicalApps, Wi-Fi networks are by their design open. If the physician can connect to the network, hostile actors could connect to the network and in turn their device, which would allow them to open files, view the files and even download information to their own device.

It’s not surprising that physicians are tempted to use open public networks to do clinical work. After all, it’s convenient for them to dash off an email message regarding, say, a patient medication issue while having a quick lunch at a coffee shop. Doing so is easy and feels natural, but if the email is unsecured, that physician risks exposing his practice to a large HIPAA-related fine, as well as having its network invaded by intruders. Not only that, any HIPAA problem that arises can blacken the reputation of a practice or hospital.

What’s more, if clinicians use an unsecured public wireless networks, their device could also acquire a malware infection which could cause harm to both the clinician and those who communicate with their device.

Ideally, it’s probably best that physicians never use public Wi-Fi networks, given their security vulnerabilities. But if using Wi-Fi makes sense, one solution proposed by Cerrato is for physicians is to access their organization’s EMR via a Citrix app which creates a secure tunnel for information sharing.

As Cerrato points out, however, smaller practices with scant IT resources may not be able to afford deploying a secure Citrix solution. In that case, HHS recommends that such practices use a VPN to encrypt sensitive information being sent or received across the Wi-Fi network.

But establishing a VPN isn’t the whole story. In addition, clinicians will want to have the data on their mobile devices encrypted, to make sure it’s not readable if their device does get hacked. This is particularly important given that some data on their mobile devices comes from mobile apps whose security may not have been vetted adequately.

Ideally, managing security for clinician devices will be integrated with a larger mobile device management strategy that also addresses BYOD, identity and access management issues. But for smaller organizations (notably small medical groups with no full-time IT manager on staff) beginning by making sure that the exchange of patient information by clinicians on Wi-Fi networks is secured is a good start.

Time To Treat Telemedicine as Just “Medicine”

Posted on October 25, 2016 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.

Over the last year or two, hospitals and clinics have shown a steadily growing interest in offering telemedicine services. Certainly, this is in part due to the fact that health plans are beginning to pay for telehealth consults, offering a new revenue stream that providers want to capture, but there’s more to consider here.

Until recently, much of the discussion around telehealth centered on how to get health insurance companies to pay for it. But now, as value-based purchasing becomes more the norm, providers will need to look at telemedicine as a key tool for managing patient health more effectively.

Evidence increasingly suggests that making providers available via telemedicine channels can help better manage chronic conditions and avert needless hospitalizations, both of which, under value-based payments, are more important than getting a few extra dollars for a consult.

Looked at another way, the days of telehealth being a boutique service for more-sophisticated consumers are ending. “It’s time to treat telemedicine as just ‘medicine,’” one physician consultant told me. “It’s no different than any other form of medicine.”

As reasons for treating telehealth as a core clinical service increase, barriers to sharing video and other telemedical records are falling, the consultant says. Telemedicine providers can already push the content of a video visit or other telehealth consult into an EMR using HL7, and soon information sharing should go both ways, he notes.

What’s more, breaking down another wall, major EMR vendors are offering providers the ability to conduct a telehealth visit using their platform. For example, Epic is offering telemedicine services to providers via its MyChart portal and Hyperspace platform, in collaboration with telehealth video provider Vidyo. Cerner, which operates some tele-ICUs, has gone even further, with senior exec John Glaser recently arguing that telehealth needs to be a central part of its population health strategy.

Admittedly, even if providers develop a high level of comfort delivering care through telehealth platforms, it’s probably too soon to rely on this medium as an agent of change. If nothing else, the industry must face up to the fact that telemedicine demand isn’t huge among their patients at present, though consumer plays like AmWell and DoctoronDemand are building awareness.

Also, while scheduling and conducting telemedicine consults need not be profoundly different than holding a face-to-face visit — other than offering both patient and doctor more flexibility — working in time to manage and document these cases can still pose a workflow challenge. Practical issues such as how, physically, a doctor documents a telehealth visit while staring at the screen must be resolved, issues of scheduling addressed and even questions of how to store and retrieve such visit records must be thought through.

However, I think it’s fair to say that we’re past wondering whether telemedicine should be part of the healthcare process, and whether it makes financial sense for hospitals and clinics to offer it. Now we just have to figure out where and when.

E-Patient Update: The Patient Data Engagement Leader

Posted on October 20, 2016 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 healthcare delivery models shift responsibility for patient health to the patients themselves, it’s becoming more important to give them tools to help them get and stay healthy. Increasingly, digital health tools are filling the bill.

For example, portals are moving from largely billing and scheduling apps to exchanging of patient data, holding two-way conversations between patient and doctor and even tracking key indicators like blood glucose levels. Wearables are slowly becoming capable of helping doctors improve diagnoses, and patterns revealed by big data should soon be used to create personalized treatment plants.

The ultimate goal of all this, of course, is to push as much data power as possible into the hands of consumers. After all, for patients to be engaged with their health, it helps to make them feel in control, and the more sophisticated information they get, the better choices they can make. Or at least that’s how the traditional script reads.

Now, as an e-patient, the above is certainly true for me. Every incremental improvement in the data I get me brings me closer to taking on otherwise overwhelming health challenges. That’s true, in part, because I’m comfortable reading charts, extrapolating conclusions from data points and visualizing ways to make use of the information. But if you want less tech-friendly patients to get on board, they’re going to need help.

The patient engagement leader

And where will that help come from? I’d argue that hospitals and clinics need to create a new position dedicated to helping engage patients, including though not limited to helping them make their health data their own. This position would cut across several disciplines, ranging from patient health education clinical medicine to data analytics.

The person owning this position would need to be current in patient engagement goals across the population and by disease/condition type, understand the preferred usage patterns established by the hospital, ACO, delivery network or clinic and understand trends in health behavior well enough to help steer patients in the right direction.

It also wouldn’t hurt if such a person had a healthy dose of marketing skills under their belt, as part of the patient engagement process is simply selling consumers on the idea that they can and should take more responsibility for their health outcomes. Speaking from personal experience, a good marketer can wheedle, nudge and empower people by turns, and this will be very necessary to boost your engagement.

While this could be a middle management position, it would at least need to have the full support of the C-suite. After all, you can’t promote population-wide improvements in health by nibbling around the edges of the problem. Such measures need to be comprehensive and strategic to the mission of the healthcare organization as a whole, and the person behind the needs to have the authority to see them through.

Patients in control

If things go right, establishing this position would lead to the creation of a better-educated, more-confident patient population with a greater sense of self efficacy regarding their health. While specific goals would vary from one healthcare organization to the other, such an initiative would ideally lead to improvements in key metrics such as A1c levels population-wide, drops in hospital admission and readmission rates and simultaneously, lower spending on more intense modes of care.

Not only that, you could very well see patient satisfaction increase as well. After all, patients may not feel capable of making important health changes on their own, and if you help them do that it stands to reason that they’ll appreciate it.

Ultimately, engaging patients with their health calls for participation by everyone who touches the patient, from techs to the physician, nurses to the billing department. But if you put a patient engagement officer in place, it’s more likely that these efforts will have a focus.

Supply Of mHealth Apps Far Exceeds Demand

Posted on October 19, 2016 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.

With demand relatively high and barriers to entry low, the supply of mHealth apps available on the two main marketplaces has exploded in recent years. And according to a new report from analyst firm Research 2 Guidance, the number of apps continues to mushroom despite lagging demand.

The report notes that nearly 100,000 mHealth apps have been added to the Google and Apple app marketplaces since the beginning of last year, bringing the total apps available to about 259,000. Also, 13,000 mHealth publishers entered the market since the start of 2015, bringing the total to 58,000, according to the study, which looked at global health app development.

To get a sense of trends, the group’s mHealth App Developer Economics 2016 report compared the number of available apps and publishers with the number of mHealth downloads.

During the past year, researchers found, the total number of mHealth apps climbed a whopping 57%, boosted by the expanding number of health app publishers, the increased importance of publishing across both key app marketplaces in the increase in app portfolios by publishers, R2G found.

Multi-platform publishing seems to be particularly important. Currently, 75% of mHealth publishers are developing apps on both iOS and Android platforms. (An even higher percentage of HTML 5 and Windows Phone developers publish across each other’s platforms, but their numbers are small so they don’t contribute much to the overall market stats, the firm found.)

Meanwhile, the number of health app publishers on major app stores climbed 28% since the beginning of 2015, a torrent of entries that doesn’t seem to be slowing down, the analyst firm concluded. This includes not only veteran publishers but also ongoing entrances by new mHealth publishers.

The problem is, demand is nowhere near keeping up with supply, at least when measuring by the number of downloads. Statistics by the research firm indicate that while demand continued to grow by a solid 35% in 2015, health app downloads are estimated to be only 7% in 2016.

Though such downloads are expected to reach a total of 3.2 billion in 2016, further massive growth seems unlikely, as the growth in use of capable devices that can use and download apps has slowed down in most Western countries, R2G notes.

Given the amount of noise in the mHealth app market, few publishers are likely to have the resources to stand out and grab significant download market share. As the analyst firm notes, only 14% of mHealth app publishers generated more than 100,000 downloads across their portfolio in one year, a number which is climbed only 3% since 2014.

KPMG: Most Business Associates Not Ready For Security Standards

Posted on October 17, 2016 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 by consulting firm KPMG has concluded that two-thirds of business associates aren’t completely ready to step up to industry demands for protecting patient health information. Specifically, the majority of business associates don’t seem to be ready to meet HITRUST standards for securing protected health information. Plus, it’s worth noting that HITRUST certification doesn’t mean your organization is HIPAA compliant or protected from a breach. It’s just the first steps and many aren’t doing it.

HITRUST has established a Common Security Framework which is used by healthcare organizations (as well as others that create, access, store or exchange sensitive and/or regulated data). The CSF includes a set of controls designed to harmonize the requirements of multiple regulations and standards.

According to KPMG’s Emily Frolick, third-party risk and assurance leader for KPMG’s healthcare practice, a growing number of healthcare organizations are asking their business associates to obtain a HITRUST CSF Certification or pass an SOC 2 + HITRUST CSF examination to demonstrate that they are making a good-faith effort to protect patient information. The CSF assessment is an internal control-based approach allowing organizations such as business associates to assess and demonstrate the measures they are taken to protect healthcare data.

To see if vendors targeting the healthcare industry seemed capable of meeting these standards, KPMG surveyed 600 professionals in this category to determine their organization’s security status. The survey found that half of those responding weren’t ready for HITRUST examination or certification, while 17.4% were planning for the CSF assessment.

When asked how they were progressing toward meeting HITRUST CSF requirements, just 7% said they were completely ready. Meanwhile, 8% said their organization was well along in its implementation process, and 17.4% said they were in the early stages of CSF implementation.

One the biggest barriers to CSF readiness seems to be having adequate staff in place, ranking ahead of cultural, technological and financial concerns, KPMG found. When asked whether they had the staff in place to meet the standard, 53% said they did, but 47% said they did not have “the right staff the right level skills to execute against the HITRUST CSF.” That being said, 27% said all four factors were at issue. (Interestingly, 23% said” none of the above” posed barriers to CSF readiness.)

Readers won’t be surprised to learn that KPMG has reason to encourage vendors to seek the HITRUST cert and examination – specifically, that it works as a HITRUST Qualified CSF Assessor for healthcare organizations. Also, KPMG works with very large organizations which need to establish high levels of structure in how they evaluate their health data security measures. Hopefully this means they go well beyond what HITRUST requires.

Nonetheless, even if you work with a relatively small healthcare organization that doesn’t have the resources to engage in obtaining formal healthcare security certifications, this discussion serves as a good reminder. Particularly given that many breaches take place due to slips by business associates, it doesn’t hurt to take a close look at their security practices now and then. Even asking them some commonsense questions about how they and their contractors handle data is a good idea. After all, even if business associates cause a breach to your data, you still have to explain the breach to your patients.

A Look At Nursing Home Readiness For HIE Participation

Posted on October 12, 2016 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 newly released study suggests that nursing homes have several steps to go through before they are ready to participate in health information exchanges. The study, which appeared in the AHIMA-backed Perspectives in Health Information Management, was designed to help researchers understand the challenges nursing homes faced in health information sharing, as well as what successes they had achieved to date.

As the study write up notes, the U.S. nursing home population is large — nearly 1.7 million residents spread across 15,600 nursing homes as of 2014. But unlike other settings that care for a high volume of patients, nursing homes haven’t been eligible for EMR incentive programs that might have helped them participate in HIEs.

Not surprisingly, this has left the homes at something of a disadvantage, with very few participating in networked health data sharing. And this is a problem in caring for residents adequately, as their care is complex, involving nurses, physicians, physicians’ offices, pharmacists and diagnostic testing services. So understanding what potential these homes have to connect is a worthwhile topic of study. That’s particularly the case given that little is known about HIE implementation and the value of shared patient records across multiple community-based settings, the study notes.

To conduct the study, researchers conducted interviews with 15 nursing home leaders representing 14 homes in the midwestern United States that participated in the Missouri Quality Improvement Initiative (MOQI) national demonstration project.  Studying MOQI participants helped researchers to achieve their goals, as one of the key technology goals of the CMS-backed project is to develop knowledge of HIE implementations across nursing homes and hospital boundaries and determine the value of such systems to users.

The researchers concluded that incorporating HIE technology into existing work processes would boost use and overall adoption. They also found that participation inside and outside of the facility, and providing employees with appropriate training and retraining, as well as getting others to use the HIE, would have a positive effect on health data sharing projects. Meanwhile, getting the HIE operational and putting policies for technology use were challenges on the table for these institutions.

Ultimately, the study concluded that nursing homes considering HIE adoption should look at three areas of concern before getting started.

  • One area was the home’s readiness to adopt technology. Without the right level of readiness to get started, any HIE project is likely to fail, and nursing home-based data exchanges are no exception. This would be particularly important to a project in a niche like this one, which never enjoyed the outside boost to the emergence of the technology culture which hospitals and doctors enjoyed under Meaningful Use.
  • Another area identified by researchers was the availability of technology resources. While the researchers didn’t specify whether they meant access to technology itself or the internal staff or consultants to execute the project, but both seem like important considerations in light of this study.
  • The final area researchers identified as critical for making a success of HIE adoption in nursing homes was the ability to match new clinical workflows to the work already getting done in the homes. This, of course, is important in any setting where leaders are considering major new technology initiatives.

Too often, discussions of health data sharing leave out major sectors of the healthcare economy like this one. It’s good to take a look at what full participation in health data sharing with nursing homes could mean for healthcare.