Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

E-Patient Update:  I Was A Care Coordination Victim

Posted on June 12, 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.

Over the past few weeks, I’ve been recovering from a shoulder fracture. (For the record, I wasn’t injured engaging in some cool athletic activity like climbing a mountain; I simply lost my footing on the tile floor of a beauty salon and frightened a gaggle of hair stylists. At least I got a free haircut!)

During the course of my treatment for the injury, I’ve had a chance to sample both the strengths and weaknesses of coordinated treatment based around a single EMR. And unfortunately, the weaknesses have shown up more often than the strengths.

What I’ve learned, first hand, is that templates and shared information may streamline treatment, but also pose a risk of creating a “groupthink” environment that inhibits a doctor’s ability to make independent decisions about patient care.

At the same time, I’ve concluded that centralizing treatment across a single EMR may provide too little context to help providers frame care issues appropriately. My sense is that my treatment team had enough information to be confident they were doing the right thing, but not enough to really understand my issues.

Industrial-style processes

My insurance carrier is Kaiser Permanente, which both provides insurance and delivers all of my care. Kaiser, which reportedly spent $4 billion on the effort, rolled out Epic roughly a decade ago, and has made it the backbone of its clinical operations. As you can imagine, every clinician who touches a Kaiser patient has access to that patient’s full treatment history with Kaiser providers.

During the first few weeks with Kaiser, I found that physicians there made good use of the patient information they were accumulating, and used it to handle routine matters quite effectively. For example, my primary care physician had no difficulty getting an opinion on a questionable blood test from a hematologist colleague, probably because the hematologist had access not only to the test result but also my medical history.

However, the system didn’t serve me so well when I was being treated for the fracture, an injury which, given my other issues, may have responded better to a less standardized approach.  In this case, I believe that the industrial-style process of care facilitated by the EMR worked to my disadvantage.

Too much information, yet not enough

After the fracture, as I worked my way through my recovery process, I began to see that the EMR-based process used to make Kaiser efficient may have discouraged providers from inquiring more deeply into my particulalr circumstances.

And yes, this could have happened in a paper world, but I believe the EMR intensified the tendency to treat as “the fracture in room eight” rather than an individual with unique needs.

For example, at each step of the way I informed physicians that the sling they had provided was painful to use, and that I needed some alternative form of arm support. As far as I can tell, each physician who saw me looked at other providers’ notes, assumed that the predecessor had a good reason for insisting on the sling, and simply followed suit. Worse, none seemed to hear me when I insisted that it would not work.

While this may sound like a trivial concern, the lack of a sling alternative seemed to raise my level of pain significantly. (And let me tell you, a shoulder fracture is a very painful event already.)

At the same time, otherwise very competent physicians seemed to assume that I’d gotten information that I hadn’t, particularly education on my prognosis. At each stage, I asked questions about the process of recovery, and for whatever reason didn’t get the information I needed. Unfortunately, in my pain-addled state I didn’t have the fortitude to insist they tell me more.

My sense is that my care would’ve benefited from both a more flexible process and more information on my general situation, including the fact that I was missing work and really needed reassurance that I would get better soon. Instead, it was care by data point.

Dealing with exceptions

All that being said, I know that the EMR alone isn’t itself to blame for the problems I encountered. Kaiser physicians are no doubt constrained by treatment protocols which exist whether or not they’re relying on EMR-based information.

I also know that there are good reasons that organizations like Kaiser standardize care, such as improving outcomes and reducing care costs. And on the whole, my guess is that these protocols probably do improve outcomes in many cases.

But in situations like mine, I believe they fall short. If nothing else, Kaiser perhaps should have a protocol for dealing with exceptions to the protocols. I’m not talking about informal, seat-of-the-pants judgment call, but an actual process for dealing with exceptions to the usual care flow.

Three weeks into healing, my shoulder is doing much better, thank you very much. But though I can’t prove it, I strongly suspect that I might have hurt less if physicians were allowed to make exceptions and address my emerging needs. And while I can’t blame the EMR for this experience entirely, I believe it played a critical role in consolidating opinion and effectively limiting my options.

While I have as much optimism about the role of EMRs as anyone, I hope they don’t serve as a tool to stifle dissension and oversimplify care in the future. I, for one, don’t want to suffer because someone feels compelled to color inside of the lines.

Value-sizing The Patient Experience

Posted on June 8, 2017 I Written By

The following is a guest blog post by Sarah Bennight, Marketing Strategist for Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms

In health IT, we talk about the patient experience all the time. Many of us have dedicated our entire careers to improving the patient experience. It has become so central to improving healthcare that patient-reported experience results determine a significant portion of reimbursement.

But today’s patient experiences do beg the question: are they a pie in the sky dream or something tangible that can be addressed in our organizations?

To tackle the patient experience, we have to audit all contact points to determine areas of weakness. A great way to start is by creating a healthcare consumer journey map. Identifying each point a patient could potentially interact with your organization is key to ensuring their experience will be great. Once you have identified each potential encounter, mystery shop that experience as if you were the patient to test your brand’s current performance. When determining whether or not your organization provides a great brand experience, you may find yourself comparing your performance to the top brands you work with on a daily basis.

For example, I recall a time when I studied abroad in the United Kingdom. Upon arriving in a foreign country after 22 hours of travel with little sleep, I needed to eat. I vaguely recalled passing a familiar restaurant sign on the way to my flat: McDonalds. And though I didn’t really love the golden arches at the time, I chose to eat there. Why? Because I knew what to expect. I knew how to order, what menu items would be available, and what it would taste like.

By focusing on consistent interactions and expectations for their customers, McDonalds has created a strong brand. In fact, when asked about introducing new products during a 2010 CNBC interview, former CEO James Skinner said “[McDonald’s doesn’t] put something on the menu until it can be produced at the speed of McDonalds.”

Can your healthcare consumers count on a consistent experience when contacting your organization? Your brand experience should encompass the entire health system to build confidence and loyalty in your brand. Creating consistency across each encounter begins with simple questions. Was their initial call met with a timely, sincere, and welcoming voice? Was parking convenient? Are average waiting times reasonable? Do Center A and Center B provide the same quality support? Is their bill easy to understand? If your answers are all yes, it’s more likely that patients will continue to choose your organization.

When patients feel confidence about provided services and perceive value in the care you provide, brand loyalty is achieved. What’s more, many studies show that patients who have great healthcare experiences and are confident in the level of care they receive will have better clinical outcomes. Value-based care demands consistent, evidence-based clinical interactions. But we can’t leave out the important patient experience outside the walls of the exam room.

After my exhaustive travels, I certainly had a better outcome by relying on my trust in McDonalds’ brand. I chose to value-size my meals frequently throughout my England journey – not because it was the best tasting food, but because I could always rely on consistently convenient and quality experiences. The healthcare industry can certainly learn a lot more from cutting edge commercial companies when it comes to creating loyalty. To learn more about the patient journey and loyalty, download our e-book.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

Staying Connected Beyond the Patient Visit

Posted on April 20, 2017 I Written By

The following is a guest blog post by Brittany Quemby, Marketing Strategist for Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle
I see it everywhere I go – heads down, thumbs flexing. We live in an era where our devices occupy our lives. When I’m sitting at the airport waiting for my flight, standing in line at the grocery store, waiting to be called at my doctor’s office, I see it – heads down, thumbs flexing. Although I wish we weren’t always heads down in our phones, it is inevitable, we rely on our smartphone to stay connected.  As it stands today, roughly two-thirds of Americans own a smart phone, meaning they have access to email, voice, and text at their fingertips.

The increase in connectivity that the smartphone gives its user provides physicians a whole new way to communicate beyond the patient visit. Below are some tips that can help healthcare professionals stay connected while improving engagement, behaviors, and revenue outcomes.

Consider the patient’s preferences
Quite often only one piece of contact information is gathered for a patient and it is typically a home phone number. Patients expect to be communicated with where it is convenient for them, and in a recent survey on preferred communication methods, 76 percent off respondents said that text messages were more convenient above emails and phone calls.  If you are looking to connect with patients in a meaningful way, consider asking them their preferred method of contact to help maximize your engagement.

Use a various methods of communication
Recently we surveyed over 400 healthcare professionals to learn about the ways they are communicating and engaging with their patients. Our findings revealed that 41 percent of physicians and healthcare professionals utilize various methods to connect and communicate with their patients.  Long gone are the days when you could reach someone by a simple phone call. Today, if I need to get in touch with someone this is how it goes down: I will email them, then I will call them to let them know I emailed them, and then I text them to tell them to go read my email.  A recent report shows that on average 91 percent of all United States consumers use email daily and that text messages have a 45 percent response rate and a 98 percent open rate. Connecting with patients through multiple channels of communication can show a significant change in patient responsiveness and behavior, including an increase in healthcare ownership, a decrease in no shows, and a substantial increase in revenue.

Automate your patient communication messages
Investing in an automated patient communication solution is a great way to connect with your patients beyond the doctor’s office. It will not only increase patient behaviors, efficiencies, satisfaction and convenience, but will also dramatically impact your bottom-line.

A comprehensive automated patient communication platform allows include regular and frequent communication from your organization to the patient in a simple and easy way.  Consider implementing some of the following automated communication tactics to help you increase your practice’s efficiencies while continuing to engage with patients outside of the office:

  • Send appointment reminders: Send automated appointment reminders to ensure patients show up to their appointment both on time and prepared.
  • Follow-up communication: Patients only retain 20 to 60 percent of information that is shared with them during the appointment. Send a text or email with pertinent follow-up information to increase patient satisfaction and decrease readmissions.
  • Program promotion: Connect with patients to encourage them to come in for important initiatives your practice is holding like your flu-shot clinic.
  • Message broadcast: Communicate important information like an office closure or rescheduling due to severe weather.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

Top 3 Tips for Taking on Digital Health

Posted on January 18, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Brittany Quemby, Marketing Strategist of Stericycle Communication Solutions as part of the Communication Solutions Series. Follow & engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle
The other day I deleted several apps from my mobile phone. One I had downloaded when I was traveling, one took up too many gigs on my phone, and the last was one I downloaded to track specific health activities last January probably hoping to achieve one of my many New Year’s resolutions.  This happens to me all the time – I download an app or tool, use it once or twice, realize I don’t have any use for it or haven’t used it in 3 months and end up deleting to free up space on my phone.

This got me thinking about digital technology in the healthcare industry. Unfortunately, every day there is a slew of digital health tools developed that take a lot of time, money and effort and then go unused by the user for a variety of reasons. I picture something like a digital health tool graveyard that exists somewhere in the cloud.

After I got the mental image of a technology version of the Lion King’s Elephant Graveyard out of my head, I began to ask myself why so many digital heath technologies went stale. What needed to change? The time, money, and beautiful design that is put into development won’t draw patients by the masses.  The thing about digital health is that there has to be something in it to evoke a user’s actions.  Below are 3 important strategies I believe we need to all keep in mind when taking on digital health:

1. What does the patient EXPECT?

It’s no surprise that patients want technology incorporated into their healthcare.  However, it’s essential to couple the right technology with appropriate expectation of the user.  What you THINK a patient expects, might not always turn out to be the case.  According to a recent study by business and technology consulting firm West Monroe Partners, 91 percent of healthcare customers say they would take advantage of mobile apps when offered.  However, according to an Accenture report, 66% of the largest 100 US hospitals have consumer-facing mobile apps, 38% of which have been developed for their patients, and only 2% of patients are actively using these apps. When users are met with digital health technology that lacks the expected user experience, they are left feeling disappointed, unfulfilled, and begin looking elsewhere for services.

2. What does the patient WANT?

Patients are longing for a consumer experience when it comes to their healthcare.  New research shows that “patients today are choosing their providers, in part, based on how well they use technology to communicate with them and manage their health,” says Joshua Newman, M.D., chief medical officer, Salesforce Healthcare and Life Sciences.  Patients crave technology, customization and convenience.  There is no doubt that digital health tools satisfy the convenience factor.  However, they are nothing without a customized experience. Limiting your interactions with patients to an out-of-the-box, one-way digital communication strategy can be disadvantageous and could mean you aren’t reaching patients at all.  Digital health that is personalized, optimized, and sent through multi modalities allows you to be sure that you are engaging your patient in a way they want.

3. Where does the patient GO?

It’s no surprise that patients expect a consumer experience when it comes to interacting with their healthcare provider. But mastering digital health must include more than just mobile apps and the doctor’s office.  A digital health strategy that connects with patients across the entire continuum of care will optimize their experience and satisfaction.  In a recent study by West Monroe Partners called No More Waiting Room: The Future of the Healthcare Customer Experience, Will Hinde, Senior Director says “we’re starting to see more providers incorporate the digital experience with their office visit, by shifting to more online scheduling of appointments, paperless office interactions, following up via email, portals, and mobile apps and taking steps towards greater cost and quality transparency.”  Connecting with patients outside of the doctor’s office and in places where they frequent most allows for better changes of engagement, leading to greater experiences.

Tackling digital health can be daunting and unsuccessful if it’s looked at solely from the angle that technology is king. Looking at it from the lens of the patient becomes less intimidating and more likely that your digital health efforts don’t end up in the Elephant Graveyard.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality call center & telephone answering servicespatient access services and automated communication technology. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media: @StericycleComms

CVS Launches Analytics-Based Diabetes Mgmt Program For PBMs

Posted on December 29, 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.

CVS Health has launched a new diabetes management program for its pharmacy benefit management customers designed to improve diabetes outcomes through advanced analytics.  The new program will be available in early 2017.

The CVS program, Transform Diabetes Care, is designed to cut pharmacy and medical costs by improving diabetics’ medication adherence, A1C levels and health behaviors.

CVS is so confident that it can improve diabetics’ self-management that it’s guaranteeing that percentage increases in spending for antidiabetic meds will remain in the single digits – and apparently that’s pretty good. Or looked another way, CVS contends that its PBM clients could save anywhere from $3,000 to $5,000 per year for each member that improves their diabetes control.

To achieve these results, CVS is using analytics tools to find specific ways enrolled members can better care for themselves. The pharmacy giant is also using its Health Engagement Engine to find opportunities for personalized counseling with diabetics. The counseling sessions, driven by this technology, will be delivered at no charge to enrolled members, either in person at a CVS pharmacy location or via telephone.

Interestingly, members will also have access to diabetes visit at CVS’s Minute Clinics – at no out-of-pocket cost. I’ve seen few occasions where CVS seems to have really milked the existence of Minute Clinics for a broader purpose, and often wondered where the long-term value was in the commodity care they deliver. But this kind of approach makes sense.

Anyway, not surprisingly the program also includes a connected health component. Diabetics who participate in the program will be offered a connected glucometer, and when they use it, the device will share their blood glucose levels with a pharmacist-led team via a “health cloud.” (It might be good if CVS shared details on this — after all, calling it a health cloud is more than a little vague – but it appears that the idea is to make decentralized patient data sharing easy.) And of course, members have access to tools like medication refill reminders, plus the ability to refill a prescription via two-way texting, via the CVS Pharmacy.

Expect to see a lot more of this approach, which makes too much sense to ignore. In fact, CVS itself plans to launch a suite of “Transform Care” programs focused on managing expensive chronic conditions. I can only assume that its competitors will follow suit.

Meanwhile, I should note that while I expect to see providers launch similar efforts, so far I haven’t seen many attempts. That may be because patient engagement technology is relatively new, and probably pretty expensive too. Still, as value-based care becomes the dominant payment model, providers will need to get better at managing chronic diseases systematically. Perhaps, as the CVS effort unfolds, it can provide useful ideas to consider.

Improving Clinical Workflow Can Boost Health IT Quality

Posted on August 18, 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.

At this point, the great majority of providers have made very substantial investments in EMRs and ancillary systems. Now, many are struggling to squeeze the most value out of those investments, and they’re not sure how to attack the problem.

However, according to at least one piece of research, there’s a couple of approaches that are likely to pan out. According to a new survey by the American Society for Quality, most healthcare quality experts believe that improving clinical workflow and supporting patients online can make a big diference.

As ASQ noted, providers are spending massive amounts of case on IT, with the North American healthcare IT market forecast to hit $31.3 by 2017, up from $21.9 billion in 2012. But healthcare organizations are struggling to realize a return on their spending. The study data, however, suggests that providers may be able to make progress by looking at internal issues.

Researchers who conducted the survey, an online poll of about 170 ASQ members, said that 78% of respondents said improving workflow efficiency is the top way for healthcare organizations to improve the quality of their technology implementations. Meanwhile, 71% said that providers can strengthen their health IT use by nurturing strong leaders who champion new HIT initiatives.

Meanwhile, survey participants listed a handful of evolving health IT options which could have the most impact on patient experience and care coordination, including:

  • Incorporation of wearables, remote patient monitoring and caregiver collaboration tools (71%)
  • Leveraging smartphones, tablets and apps (69%)
  • Putting online tools in place that touch every step of patient processes like registration and payment (69%)

Despite their promise, there are a number of hurdles healthcare organizations must get over to implement new processes (such as better workflows) or new technologies. According to ASQ, these include:

  • Physician and staff resistance to change due to concerns about the impact on time and workflow, or unwillingness to learn new skills (70%)
  • High cost of rolling out IT infrastructure and services, and unproven ROI (64%)
  • Concerns that integrating complex new devices could lead to poor interfaces between multiple technologies, or that haphazard rollouts of new devices could cause patient errors (61%)

But if providers can get past these issues, there are several types of health IT that can boost ROI or cut cost, the ASQ respondents said. According to these participants, the following HIT tools can have the biggest impact:

  • Remote patient monitoring can cut down on the need for office visits, while improving patient outcomes (69%)
  • Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)
  • EMRs/EHRs that eliminate the need to perform some time-consuming tasks (68%)

Perhaps the most interesting part of the survey report outlined specific strategies to strengthen health IT use recommended by respondents, such as:

  • Embedding a quality expert in every department to learn use needs before deciding what IT tools to implement. This gives users a sense of investment in any changes made.
  • Improving available software with easier navigation, better organization of medical record types, more use of FTP servers for convenience, the ability to upload records to requesting facilities and a universal notification system offering updates on medical record status
  • Creating healthcare apps for professional use, such as medication calculators, med reconciliation tools and easy-to-use mobile apps which offer access to clinical pathways

Of course, most readers of this blog already know about these options, and if they’re not currently taking this advice they’re probably thinking about it. Heck, some of this should already be old hat – FTP servers? But it’s still good to be reminded that progress in boosting the value of health IT investments may be with reach. (To get some here-and-now advice on redesigning EMR workflow, check out this excellent piece by Chuck Webster – he gets it!)

Modern Day Healthcare Tools and Solutions Can Enhance Your Brand Integrity and Patient Experience

Posted on August 11, 2016 I Written By

The following is a guest blog post by Chelsea Kimbrough, a copywriter for Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Chelsea Kimbrough
Digitally speaking, the healthcare market is more crowded than ever – and finding the perfect provider, practice, or physician online can quickly become an arduous task for even the most tech-savvy patient. But healthcare organizations that dedicate the time, effort, and resources to create a unique digital presence, enhance their search engine optimization (SEO), and reinforce their brand integrity can cut through oversaturated search results to acquire and retain more patients.

In today’s consumer-driven world, shopping for the ideal healthcare organization is quickly becoming the norm. More and more frequently, patients are turning toward the internet during their hunt. In fact, 50 percent of millennials and Gen-Xers used online reviews while last shopping for a healthcare provider. And with 85 percent of adults using the internet and 67 percent using smartphones, accessing this sort of information is easier than ever before.

This ease of access has led patients to adopt more consumer-like behaviors and expectations, such as valuing quality and convenience. Healthcare organizations that proactively ensure their brand image, digital presence, and patient experience cater to these new expectations could be best positioned to thrive. By providing convenient, patient-centric healthcare tools and services, organizations can help facilitate this effort throughout every step of the patient journey.

One such tool is real-time, online appointment self-scheduling, which 77 percent of patients think is important. In addition to adding a degree of convenience for digitally-inclined patients, online self-scheduling tools can support your healthcare organizations’ key initiatives – including driving new, commercially insured patient growth. By using an intuitive way to quickly schedule an appointment, potential patients’ shopping process can be halted in its tracks, ensuring more patients choose your organization over a competitor’s. And with the right tool, your search rankings and discoverability, or SEO, could be significantly enhanced.

Reaching patients where they are most likely to be reached is another way to improve your brand experience. Like consumers, patients are often connected to their phones – so much so that text messages have a 98 percent open rate. Organizations that leverage automated text, email, and voice reminders can successfully communicate important messages, boost patients’ overall satisfaction and health, and improve appointment and follow-up adherence – ultimately setting themselves apart from competitors.

Other digital tools, technologies, and communication strategies can help fortify your brand’s digital standing and patients’ satisfaction, including social media outreach, useful email campaigns, and more. Whatever method – or methods – best serve your organization, it’s important they help improve your SEO, enhance patients’ overall accessibility and experience, and support your brand values and initiatives.

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

Has Technology Changed The Way We Interact With Each Other, Our Healthcare Providers And Healthcare Organizations?

Posted on July 19, 2016 I Written By

The following is a guest blog post by Brittany Quemby,  Marketing Manager of Stericycle Communication Solutions as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms
Brittany Quemby - Stericycle

In this blog series, we have talked a lot about healthcare consumerism, the importance of communication in the patient/provider relationship and how embracing technology can lead to an increased patient experience. Today I want to talk about how technology is changing the way we interact with each other in the healthcare industry.

The other day I tried to book a doctor’s appointment with my family physician.  I looked up my family physician’s phone number online and called in. After about 25 rings, 20 minutes on hold and a cranky voice on the other end, I hung up the phone feeling extremely frustrated and couldn’t event remember the time of my appointment.

This left me thinking. Everyday we rely and crave the use of technology to help us be more efficient and to simplify our lives.  I would argue, even more so, when it comes to our health. Approximately 58% of patients believe that technology leads to better care.  Technology has truly transformed the way patients want to interact with providers.  And to be fair, a lot of healthcare organizations and clinicians have been quick to adopt as they see the efficiency and patient experience benefits – so what was the hold up with my family physician?  I think perhaps they just weren’t aware of the facts.

So let’s take a look at them:

Fact 1 – Mobile Health

The truth hurts.  Many of us are addicted to our phone and are guilty of driving home when we were almost at work to retrieve it. When it comes to mobile health, the addiction is just as strong. Over 50% of smartphone owners, have used their phone to look up health or medical information.  A staggering 80% of patients want the option of using their smartphone to interact with healthcare providers.  Traditional methods of inquiring about our health and interacting with healthcare providers are long gone. Today’s technology makes it much more convenient for both physicians and patients to connect, research and communicate right from their smartphone.

Fact 2 – Online Health

Face it! Most of us have gone down the rabbit hole of searching a particular ailment online.  At least 35% of U.S. adults say they have gone online to try to figure out what medical condition they or someone else might have. Research indicates that 77% of online health seekers began their last session at a search engine such as Google, Bing, or Yahoo.  The presence of the internet has given patients easy access to information and has empowered them to make more informed choices about their health. It has also allowed physicians to easily update new information and build interactive treatment plans that can increase patient adherence and retention.

Fact 3 – Online Scheduling

Truth be told, I did scream when I got off the phone with doctor’s office.  Why was calling in to book my doctor’s appointment the most painful thing I had done all week? I am not alone, 77% of consumers think that the ability to book, change or cancel healthcare appointments online is important. Technology has us conditioned to want the quickest and easiest way of getting things done.  It is much quicker and convenient to go online to book the next available appointment than the 8.1 minutes it takes for a patient to complete a scheduling call.  Online scheduling helps to satisfy a patient’s need for quick gratification and alleviates the significant amount of time staff spend scheduling appointments.

Fact 4 – Digital Communication Platforms

The fact that I couldn’t remember the time of my appointment the moment I got off the phone was a bit embarrassing. But let’s face it, we’ve become so reliant on technology telling us where we need to be and what time we need to be there that our brains begin to ignore certain timelines. The truth is, the sticky note no longer holds the top spot in patient’s minds. A whopping 85% of consumers say that they would welcome digital appointment reminders, medication reminders and general health tips.   This type of technology is a win-win for both patients and clinicians.  Patients receive a simple reminder that can be added into their calendar allowing them to show up and be better prepared and clinicians receive appointment confirmations allowing them to increase their operational efficiencies, revenue and better manage their daily schedule.

Fact 5 – Tracking Health

Tracking health is not a new concept, but the exchanges and the method patients are tracking their health has revolutionized with newer technology. When recommended by a doctor, 3 in 4 consumers followed advice to wear technology to track their health. Over 20% of patients track their health indicators with the use of technology.  Technologies that assist in tracking one’s health have allowed for higher patient engagement which can lead to better monitoring and increased outcomes.  Both US consumers (77%) and doctors (85%) agree that using wearables helps a patient engage in their own health.

As technology evolves, so will our interactions as patients, providers and healthcare organizations.   It’s imperative to capitalize on the many benefits healthcare technology has given us to ensure we expand our connectivity, grow our data, increase our health outcomes and continuously improve our communication and collaboration. However, and unfortunately, in the meantime while we wait for everyone to catch up some of us will suffer from the frustration of expecting technology and not getting it. #Siricantyoujustrunmylife

The Communication Solutions Series of blog posts is sponsored by Stericycle Communication Solutions, a leading provider of high quality telephone answering, appointment scheduling, and automated communication services. Stericycle Communication Solutions combines a human touch with innovative technology to deliver best-in-class communication services.  Connect with Stericycle Communication Solutions on social media:  @StericycleComms

Most Popular Healthcare IT Articles of 2015

Posted on December 31, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As we come to the end of 2015, I thought I’d take a minute and look back at our top 16 most read Healthcare IT articles in 2015.

6 Healthcare Incubators Growing the Future of HealthTech – Great article. No doubt there are more great healthcare incubators starting all the time. Looks like maybe we should go back and do an update.

Healthcare IT and EHR Conferences and Events – If you’re looking for healthcare IT related conferences and events, this page is a great resource. Along with showing our schedule of conferences and events, we also highlight some of the most popular healthcare IT conferences.

Crazy and Funny ICD-10 Codes – People love a good laugh. Amazing that this post in 2011 was still making people laugh in 2015. It would be interesting to see how many times these funny codes have been used since ICD-10 started on Oct 1, 2015.

Benefits of EMR or EHR Over Paper Charts – I love when people just complain about their EHR software. It’s amazing how quick we forget the benefits of EHR and start to take them for granted.

The 2015 #HIT99 Results Are In – I love this list of people. If you’re looking for an amazing group of healthcare IT people to follow, start with this list.

2014 EHR Mandate – I’m really glad that so many years later this post is still getting traffic. I’m still annoyed by people that say that EHR was mandated. This post outlines why it’s not mandated, but why you should consider EHR anyway (Note: Government money isn’t one of the main reasons)

Mark Cuban’s Suggestion to Do Regular Blood Tests – I was amazed at the brouhaha that Mark’s comments created. This post was my take on it. I side with Mark, but most people I read did not. This topic is going to become more and more important as more tests and sensors enter the market.

Best Scanners for High Volume Scanning in a Doctor’s Office – I need to update this post with the latest version of the various scanners out there. I’ll have to reach out to Fujistu, Ambir, and Canon to get updates on the latest scanners.

HIPAA Security and Compliance Thoughts from the Healthcare Cyber Security Summit – This is a great guest post by Anna Drachenberg. I always love when smart people take time to share their insights on this blog.

Practice Fusion Violates Some Physicians’ Trust in Sending Millions of Emails to Their Patients – This is still the article that took me the longest to write. In fact, it probably took me 10 times as long as any other article I’ve written. I’m glad that people are still reading it. It’s a story that every EHR vendor should learn about so they can avoid the same thing happening to them.

Digital Signatures in EMR – Signatures are still the biggest source of blame for paper in health care. Well, that doesn’t count printing from EHR software. I’m glad that we now have a number of great digital signature options. Much has changed since this post back in 2007.

EMR Companies Holding Practice Data for “Ransom” – I wish I could say that this isn’t a problem anymore. Unfortunately, I’m sure we’re going to see even more of it as organizations choose to switch EHR.

HIPAA Compliance and Windows Server 2003 – I wonder how many healthcare organizations still have Windows Server 2003 in production. I’m guessing far too much.

Examples of HIPAA Privacy Violations – More HIPAA Lawsuits Coming? In 2006 we knew that more HIPAA violations were coming, but I don’t think then we even dreamed of the size of the breaches that would occur. I think more HIPAA Lawsuits are still coming.

Firewall & Windows XP HIPAA Penalties – Same story with Windows XP as Windows Server 2003. You’re a brave soul to still run Windows XP in a healthcare organization.

The Next Major Healthcare Product – Care Management System – I still reference this article a lot when talking with people about trends in healthcare IT. I got my first PR pitch about a Care Management System. We’ll see if the term catches on. Regardless of whether the term catches on or not, the concept of a patient centered care management system is the next stage of what we need to provide care to patients.

Not a bad list. Looks like a few of the posts need updating. Something to look forward to in 2016. Happy New Year!

CMS Redefines Telemedicine by Bringing Better Care to 15 Million Patients and Huge Profitability to Medical Facilities

Posted on September 17, 2015 I Written By

The following is a guest blog post by Donald Voltz, MD.
Donald Voltz - Zoeticx
Telemedicine is about reaching out to patients in remote locations, but limited to videoconferencing between patients and health providers. It is similar to a face-to-face service with the exception that the patient and primary care provider are not physically together. Such efficiency is limited in term of scope and only addresses the geographical challenge and scarcity of physician availability, a far cry from what CMS wanted for its Chronic Care Management Services (CCM) which would fundamentally change telemedicine as it is practiced.

CCM services bring the telemedicine definition to the next level – a quiet continuous monitoring and collaboration from all care services to the patient, given the ability to anticipate and engage in care issues. Such ability not only curbs care costs, it would also increase care provider bandwidth, giving them the ability to cover more patients with better efficiency. The challenge is not on the requirements part of CCM services, but the lack of an IT solution to really address all CMS guidelines, including its intent to enforce the concepts through the healthcare industry.

The New England Journal of Medicine has covered the major challenges from the new CCM guidelines, touching on all the major shortcomings in today healthcare IT offerings.  Healthcare providers recognized that the fee-for-service system, which restricts payments for primary care to office-based visits, is poorly designed to support the core activities of primary care, which involve substantial time outside office visits for tasks such as care coordination, patient communication, medication refills, and care provided electronically or by telephone.

The time has come for a paradigm shift to reengineer how we deliver care and manage our patients. To arrive at a new plateau requires rethinking the needs of our patients and how to meet these needs in an already resource constrained system. Unless we develop solutions that both integrate with and enhance the technologies currently available and those yet to be realized, we will not realize a return on health IT investment.  This needs to be an area of focus for hospital CEOs, CIOs and CMOs.

Huge Market Opportunity

According to the 2010 Census, the number of people older than 65 years was 40 million with increasing trends to 56 million in 2020 and not reaching a plateau until 2050 at 83.7 million.  With two-thirds of Medicare beneficiaries having two or more chronic conditions while one-third has more than three chronic conditions according to CMS data, putting the number of patients who qualify for CCM services at 15 million. This number is predicted to continue on an upward trend until 2050.

The World Health Organization (WHO) recognized the growing burden this trend in chronic disease places on the healthcare system and addressed the need for innovative solutions in their 2002 report. While the potential market is huge, in the billions of dollars yearly, healthcare organizations have been struggling to address the CMS guidelines with key requirements from CMS. We can no longer afford not to address the needs of patient with chronic medical conditions along with engaging them in their healthcare decisions.

CMS’ CCM guidelines are as follows:

  • 24×7 access to clinical staff
  • Patient care continuum
  • Collaboration, coordination between primary care providers and other care services
  • Electronic management of care transition among care providers
  • Coordination between home and community care services
  • Patient engagement

Here is how these guidelines are now being addressed:

The Patient-Centric Model

While each patient has a primary care provider who is responsible for CCM service, they are not confined to receiving care in a single practice or institution. The primary care provider assumes the role of care coordinator, but care is likely to be distributed between multiple care providers, often across different care locations. In a patient-centric care model, care services can come from any care providers – geographically and organizationally diverse, necessitating an accountable provider to coordinate and orchestrate high-quality care across multiple chronic conditions.

Secure Electronic Care Transition

CMS clearly states these CCM care plans must be electronically available at all times to all care providers who will be delivering care to these patients, not available by faxing, or scanning as patient data is currently shared. The chronic care management plan must be available to all healthcare providers who might take care of these patients 24×7. In addition, the primary care provider who assumes the care coordinator responsibility for a patient is expected to follow-up on the care delivered, additional needs of the patient and changes in chronic condition that may have been addressed by a healthcare professional remote to the patients’ primary practice.

CMS neither authorizes how such a CCM system is designed nor enforces how efficient the implemented care service is. The monthly reimbursement limits the time and additional resources physicians are able to allocate for the development, implementation and daily operations of a CCM program in their practice. The manual implementation of a system that meets all of the requirements defined by the CMS will far exceed the reimbursement recovered. It is also likely to be inferior to one with some degree of automation coupled with messaging when a patient’s condition changes or their chronic care management plan is accessed by other providers. Efficiency along with automated logging of time spent on care coordination are critical requirements for a service to be effective.

A CCM service solution must meet the requirements defined by CMS while integrating into the current operational structure of primary care practice and integrate with current health IT systems and manage the secure documentation flow.  It must also offer a built-in notification system to alert physicians to changes in patient status and/or access to the care plan while maintaining an efficient operation in clinics with a lower overhead and no need for additional infrastructure.

While CMS does not enforce the efficiency of a CCM care service, the monthly payment must represent an increase of revenue to care providers. Care providers cannot implement a new potential code while increasing its cost due to manual labor increase. So, efficiency must be part of the solution requirements.

The answer to CCM service would be a new healthcare application offering secure documentation flow, built-in notification and collaboration services to support a low cost, efficient operation for clinics.

The CCM application must address the following requirements:

  • No disruption of existing services. The application must operate and integrate seamlessly with any existing EHR so to not change provider workflow or disrupt current processes; defining a very stringent requirement to keep the existing EHR systems untouched and unchanged while allowing for this new service to co-exist.
  • Secure electronic care transition with CCM care plan sharing. Patients can engage with this new care service even when the service may not be contained within the same network as the primary care provider. Patients ultimately maintain control of what information and with whom this information is shared. The primary care provider is responsible for maintaining the CCM care plan, as well as the patient, and should expect any information shared will be used for a single care session and not beyond it. Although the CCM care plan is expected to contain the most up-to-date medication information, primary care providers are not interested in opening up their entire system to others, but instead need to maintain control and secure access while allowing for access to these protected documents.
  • Automation, automation and automation. Efficiency of the whole CCM service must be at the core so that primary care providers can enhance patient care without adding expense and resources to implement it. Consider a patient with Congestive Heart Failure (CHF) where continuous monitoring of weight is critical for early intervention and the avoidance of hospitalizations. To engage patient’s in their care, they must be given a mechanism to report daily weight to their primary care provider. The primary care provider must have a solution where attention is given if the patient’s condition so it not has exceeded a certain threshold. Automation is required so that primary care providers can be efficient and only given attention when attention is required. Automation must be in place so that no activities such as follow-up would be omitted.
  • An EHR-agnostics solution. Implementation of a CCM service must address the constraints of a non-homogeneous environment. Healthcare organizations and physician practices are not able to control the EHR environments when patients receive care outside of their primary practice. The requirement for electronic document exchange along with the expectation of the latest patient health data being contained in the CCM care plan goes beyond a static solution offered by a data duplicated HIE (Health Information Exchange) infrastructure.
  • Visible value to a patient. A critical requirement for CMS reimbursement is a patient’s opting into a CCM management program that includes out-of-pocket monthly co-pay for the service of 8 dollars per month. A patient must see the value for CCM services which can be demonstrated through enhanced engagement, access to providers and the assurance that their condition is being overseen each month by their chronic care coordinator. Anticipation of an early intervention for potential problems along with the ability to inquire and receive feedback on their condition(s) brings added value to patients and their loved ones. This value can only be delivered if such a service can be developed in an efficient manner with a low cost of operating and a limited expansion of personal to bring it about.
  • Documentation of discontinuous time spent on care coordination. CMS requires at least 20 minutes are spent on care coordination activities each month in order to bill for this for patients enrolled in the program. Without a seamless component to log such activity, the efficiency of the overall process comes into question. A comprehensive CCM application must address the practice management side to account for and generate monthly reports of the CCM activities completed.

Future of Healthcare Impacted by Integration, Patient Data and New Modes of Delivery

The future of healthcare will be impacted by the integration of technology, patient collected data, and enhancement of healthcare professionals’ ability to deliver care in modes not yet imaged. With respect to management of chronic medical conditions, leveraging technology to coordinate the care delivered so these patients can lead productive lives at a reduced cost with less time in the hospital for exacerbations of their disease is a goal that is now possible.

Development of tools to coordinate care without additional health IT expense, in either time spent learning a new workflow or cost of such an application, is now available. Finding such an innovate model that works for patients, healthcare professionals and health systems for chronic care management will likely spread into other areas of healthcare. CCM services and care coordination allow remote, discontinuous, non-face-to-face management of patients with complex health conditions when it meets stringent requirements – a quiet, continuous monitor of health status and interventions, collaboration of all care delivered to the patient, an ability to anticipate, engage and alert patients and care professionals of impending issues, along with the administrative side of billing and logging such activity.

This ability not only changes the direction of the chronic care cost curve, it also increases care provider bandwidth, giving them the ability to successfully manage more patient, with better efficiency while delivering high quality, valuable care.

About Donald Voltz, MD
Donald Voltz, MD, Aultman Hospital, Department of Anesthesiology, Medical Director of the Main Operating Room, Assistant Professor of Anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.

Board-certified in anesthesiology and clinical informatics, Dr. Voltz is a researcher, medical educator, and entrepreneur. With more than 15 years of experience in healthcare, Dr. Voltz has been involved with many facets of medicine. He has performed basic science and clinical research and has experience in the translation of ideas into viable medical systems and devices.

Thanh Tran, CEO of Zoeticx, also contributed.