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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

AMIA Shares Recommendations On Health IT-Friendly Policymaking

Posted on April 17, 2017 I Written By

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

The American Medical Informatics Association has released the findings from a new paper addressing health IT policy, including recommendation on how policymakers can support patient access to health data, interoperability for clinicians and patient care-related research and innovation.

As the group accurately notes, the US healthcare system has transformed itself into a digital industry at astonishing speed, largely during the past five years. Nonetheless, many healthcare organizations haven’t unlocked the value of these new tools, in part because their technical infrastructure is largely a collection of disparate systems which don’t work together well.

The paper, which is published in the Journal of the American Medical Informatics Association, offers several policy recommendations intended to help health IT better support value-based health, care and research. The paper argues that governments should implement specific policy to:

  • Enable patients to have better access to clinical data by standardizing data flow
  • Improve access to patient-generated data compiled by mHealth apps and related technologies
  • Engage patients in research by improving ways to alert clinicians and patients about research opportunities, while seeing to it that researchers manage consent effectively
  • Enable patient participation in and contribution to care delivery and health management by harmonizing standards for various classes of patient-generated data
  • Improve interoperability using APIs, which may demand that policymakers require adherence to chosen data standards
  • Develop and implement a documentation-simplification framework to fuel an overhaul of quality measurement, ensure availability of coded EHRs clinical data and support reimbursement requirements redesign
  • Develop and implement an app-vetting process emphasizing safety and effectiveness, to include creating a knowledgebase of trusted sources, possibly as part of clinical practice improvement under MIPS
  • Create a policy framework for research and innovation, to include policies to aid data access for research conducted by HIPAA-covered entities and increase needed data standardization
  • Foster an ecosystem connecting safe, effective and secure health applications

To meet these goals, AMIA issued a set of “Policy Action Items” which address immediate, near-term and future policy initiatives. They include:

  • Clarifying a patient’s HIPAA “right to access” to include a right to all data maintained by a covered entity’s designated record set;
  • Encourage continued adoption of 2015 Edition Certified Health IT, which will allow standards-based APIs published in the public domain to be composed of standard features which can continue to be deployed by providers; and
  • Make effective Common Rule revisions as finalized in the January 19, 2017 issue of the Federal Register

In looking at this material, I noted with interest AMIA’s thinking on the appropriate premises for current health IT policy. The group offered some worthwhile suggestions on how health IT leaders can leverage health data effectively, such as giving patients easy access to their mHealth data and engaging them in the research process.

Given that they overlap with suggestions I’ve seen elsewhere, we may be getting somewhere as an industry. In fact, it seems to me that we’re approaching industry consensus on some issues which, despite seeming relatively straightforward have been the subject of professional disputes.

As I see it, AMIA stands as good a chance as any other healthcare entity at getting these policies implemented. I look forward to seeing how much progress it makes in drawing attention to these issues.

Study Offers Snapshot Of Provider App Preferences

Posted on March 20, 2017 I Written By

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

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

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

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

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

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

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

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

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

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

E-Patient Update: Naughty, Naughty Telehealth Users

Posted on March 17, 2017 I Written By

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

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

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

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

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

First, the facts

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

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

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

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

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

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

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

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

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

Consumer indictment

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

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

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

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

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

Please. I can’t even.

E-Patient Update: Patients Need Better Care Management Workflows

Posted on March 10, 2017 I Written By

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

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

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

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

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

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

Building a patient workflow

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

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

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

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

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

Just get started

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

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

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

Health IT Leaders Struggle With Mobile Device Management, Security

Posted on January 30, 2017 I Written By

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

A new survey on healthcare mobility has concluded that IT leaders aren’t thrilled with their security arrangements, and that a significant minority don’t trust their mobile device management solution either. The study, sponsored by Apple device management vendor Jamf, reached out to 550 healthcare IT leaders in the US, UK, France, Germany and Australia working in organizations of all sizes.

Researchers found that 83% or organizations offer smartphones or tablets to their providers, and that 32% of survey respondents hope to offer mobile devices to consumers getting outpatient care over the next two years.  That being said, they also had significant concerns about their ability to manage these devices, including questions about security (83%), data privacy (77%) and inappropriate employee use (49%).

The survey also dug up some tensions between their goals and their capacity to support those goals. Forty percent of respondents said staff access to confidential medical records while on the move was their key reason for their mobile device strategy. On the other hand, while 84% said that their organization was HIPAA-compliant, almost half of respondents said that they didn’t feel confident in their ability to adapt quickly to changing regulations.

To address their concerns about mobile deployments, many providers are leveraging mobile device management platforms.  Of those organizations that either have or plan to put an MDM solution in place, 80% said time savings was the key reason and 79% said enhanced employee productivity were the main benefits they hoped to realize.

Those who had rolled out an MDM solution said the benefits have included easier access to patient data (63%), faster patient turnaround (51%) and enhanced medical record security (48%). At the same time, 27% of respondents whose organizations had an MDM strategy in place said they didn’t feel especially confident about the capabilities of their solution.

In any event, it’s likely that MDM can’t solve some of the toughest mobile deployment problems faced by healthcare organizations anyway.

Health organizations that hope to leverage independently-developed apps will need to vet them carefully, as roughly one-quarter of these developers didn’t have privacy policies in place as of late last year. And the job of selecting the right apps is a gargantuan one. With the volume of health apps hitting almost 260,000 across the Google and Apple app marketplaces, it’s hard to imagine how any provider could keep up.

So yes, the more capabilities MDM systems can offer, the better. But choosing the right apps with the right pedigree strikes me as posing an even bigger challenge.

E-Patient Update:  You Need Our Help

Posted on January 20, 2017 I Written By

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

I just read the results of a survey by Black Book Research suggesting that many typical consumers don’t trust, like or understand health IT.

The survey, which reached out to 12,090 adult consumers in September 2016, found that 57% of those interacting with health IT at hospitals or medical practices were skeptical of its benefit. Worse, 87% said they weren’t willing to share all of their information.

Up to 70% of consumers reported that they distrusted patient portals, medical apps and EMRs. Meanwhile, while many respondents said they were interested in using health trackers, 94% said that their physicians weren’t willing or able to synch wearables data with their EMR.

On the surface, these stats are discouraging. At a minimum, they suggest that getting patients and doctors on the same page about health IT continues to be an uphill battle. But there’s a powerful tactic providers can use which – to my knowledge – hasn’t been tried with consumers.

Introducing the consumer health IT champion

As you probably know, many providers have recruited physician or nurse “champions” to help their peers understand and adjust to EMRs. I’m sure this tactic hasn’t worked perfectly for everyone who’s tried it, but it seems to have an impact. And why not? Most people are far more comfortable learning something new from someone who understands their work and shares their concerns.

The thing is, few if any providers are taking the same approach in rolling out consumer health IT. But they certainly could. I’d bet that there’s at least a few patients in every population who like, use and understand consumer health technologies, as well as having at least a sense of why providers are adopting back-end technology like EMRs. And we know how to get Great-Aunt Mildred to consider wearing a FitBit or entering data into a portal.

So why not make us your health IT champions? After all, if you asked me to, say, hold a patient workshop explaining how I use these tools in my life, and why they matter, I’d jump at the chance. E-patients like myself are by our nature evangelists, and we’re happy to share our excitement if you give us a chance. Maybe you’d need to offer some HIT power users a stipend or a gift card, but I doubt it would take much to get one of us to share our interests.

It’s worth the effort

Of course, most people who read this will probably flinch a bit, as taking this on might seem like a big hassle. But consider the following:

  • Finding such people shouldn’t be too tough. For example, I talk about wearables, mobile health options and connected health often with my PCP, and my enthusiasm for them is a little hard to miss. I doubt I’m alone in this respect.
  • All it would take to get started is to get a few of us on board. Yes, providers may have to market such events to patients, offer them coffee and snacks when they attend, and perhaps spend time evaluating the results on the back end. But we’re not talking major investments here.
  • You can’t afford to have patients fear or reject IT categorically. As value-based care becomes the standard, you’ll need their cooperation to meet your goals, and that will almost certainly include access to patient-generated data from mobile apps and wearables. People like me can address their fears and demonstrate the benefits of these technologies without making them defensive.

I hope hospitals and medical practices take advantage of people like me soon. We’re waiting in the wings, and we truly want to see the public support health IT. Let’s work together!

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

IBM Watson Partners With FDA On Blockchain-Driven Health Sharing

Posted on January 16, 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.

IBM Watson Health has partnered with the FDA in an effort to create scalable exchange of health data using blockchain technology. The two will research the exchange of owner-mediated data from a variety of clinical data sources, including EMRs, clinical trial data and genomic health data. The researchers will also incorporate data from mobiles, wearables and the Internet of Things.

The initial project planned for IBM Watson and the FDA will focus on oncology-related data. This makes sense, given that cancer treatment involves complex communication between multispecialty care teams, transitions between treatment phases, and potentially, the need to access research and genomic data for personalized drug therapy. In other words, managing the communication of oncology data is a task fit for Watson’s big brain, which can read 200 million pages of text in 3 seconds.

Under the partnership, IBM and the FDA plan to explore how the blockchain framework can benefit public health by supporting information exchange use cases across varied data types, including both clinical trials and real-world data. They also plan to look at new ways to leverage the massive volumes of diverse data generated by biomedical and healthcare organizations. IBM and the FDA have signed a two-year agreement, but they expect to share initial findings this year.

The partnership comes as IBM works to expand its commercial blockchain efforts, including initiatives not only in healthcare, but also in financial services, supply chains, IoT, risk management and digital rights management. Big Blue argues that blockchain networks will spur “dramatic change” for all of these industries, but clearly has a special interest in healthcare.  According to IBM, Watson Health’s technology can access the 80% of unstructured health data invisible to most systems, which is clearly a revolution in the making if the tech giant can follow through on its potential.

According to Scott Lundstrom, group vice president and general manager of IDC Government and Health Insights, blockchain may solve some of the healthcare industry’s biggest data management challenges, including a distributed, immutable patient record which can be secured and shared, s. In fact, this idea – building a distributed, blockchain-based EMR — seems to be gaining traction among most health IT thinkers.

As readers may know, I’m neither an engineer nor a software developer, so I’m not qualified to judge how mature blockchain technologies are today, but I have to say I’m a bit concerned about the rush to adopt it nonetheless.  Even companies with a lot at stake  — like this one, which sells a cloud platform backed by blockchain tech — suggest that the race to adopt it may be a bit premature.

I’ve been watching tech fashions come and go for 25 years, and they follow a predictable pattern. Or rather, they usually follow two paths. Go down one, and the players who are hot for a technology put so much time and money into it that they force-bake it into success. (Think, for example, the ERP revolution.) Go down the other road, however, and the new technology crumbles in a haze of bad results and lost investments. Let’s hope we go down the former, for everyone’s sake.

An Intelligent Interface for Patient Diagnosis by HealthTap

Posted on January 9, 2017 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

HealthTap, an organization that’s hard to categorize, really should appear in more studies of modern health care. Analysts are agog over the size of the Veterans Administration’s clientele, and over a couple other major institutions such as Kaiser Permanente–but who is looking at the 104,000 physicians and the hundreds of millions of patients from 174 countries in HealthTap’s database?

HealthTap allows patients to connect with doctors online, and additionally hosts an enormous repository of doctors’ answers to health questions. In addition to its sheer size and its unique combination of services, HealthTap is ahead of most other health care institutions in its use of data.

I talked with founder and CEO Ron Gutman about a new service, Dr. AI, that triages the patient and guides her toward a treatment plan: online resources for small problems, doctors for major problems, and even a recommendation to head off to the emergency room when that is warranted. The service builds on the patient/doctor interactions HealthTap has offered over its six years of operation, but is fully automated.

Somewhat reminiscent of IBM’s Watson, Dr. AI evaluates the patient’s symptoms and searches a database for possible diagnoses. But the Dr. AI service differs from Watson in several key aspects:

  • Whereas Watson searches a huge collection of clinical research journals, HealthTap searches its own repository of doctor/patient interactions and advice given by its participating doctors. Thus, Dr. AI is more in line with modern “big data” analytics, such as PatientsLikeMe does.

  • More importantly, HealthTap potentially knows more about the patient than Watson does, because the patient can build up a history with HealthTap.

  • And most important, Dr. AI is interactive. Instead of doing a one-time search, it employs artificial intelligence techniques to generate questions. For instance, it may ask, “Did you take an airplane flight recently?” Each question arises from the totality of what HealthTap knows about the patient and the patterns found in HealthTap’s data.

The following video shows Dr. AI in action:

A well-stocked larder of artificial intelligence techniques feed Dr. AI’s interactive triage service: machine learning, natural language processing (because the doctor advice is stored in plain text), Bayesian learning, and pattern recognition. These allow a dialog tailored to each patient that is, to my knowledge, unique in the health care field.

HealthTap continues to grow as a platform for remote diagnosis and treatment. In a world with too few clinicians, it may become standard for people outside the traditional health care system.