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How the Young Unity Health Score Company Handles The Dilemmas of Health IT Adoption

Posted on June 25, 2018 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.

I have been talking to a young company called Unity Health Score with big plans for improving the collection and sharing of data on patients. Their 55-page business plans covers the recruitment of individuals to share health data, the storage of that data, and services to researchers, clinicians, and insurers. Along the way, Unity Health Score tussles with many problems presented by patient data.
Unity Health Score logo
The goals articulated for this company by founder Austin Jones include getting better data to researchers and insurers so they can reduce costs and find cures, improving communications and thus care coordination among clinicians and patients, and putting patients in control of their health data so they can decide where it goes. The multi-faceted business plan covers:

  • Getting permission from patients to store data in a cloud service maintained by Unity Health Score
  • Running data by the patients’ doctors to ensure accuracy
  • Giving patients control over what researchers or other data users receive their data, in exchange for monetary rewards
  • Earning revenue for the company and the patients by selling data to researchers and insurers
  • Helping insurers adjust their plans based on analysis of incoming data

The data collected is not limited to payment data or even clinical data, but could include a grab-bag of personal data, such financial and lifestyle information. All this might yield health benefits to analytics–after all, the strategy of using powerful modern deep learning is being pursued by many other health care entities. At the same time, Jones plans to ensure might higher quality data than traditional data brokers such as Acxiom.

Now let’s see what Unity Health Score has to overcome to meet its goals. These challenges are by no means unique to these energetic entrepreneurs–they define the barriers faced by institutions throughout health care, from the smallest start-up to the Centers for Medicare & Medicaid Services.

Outreach to achieve a critical mass of patients
We can talk for weeks about quality of care and modernizing cures, but everybody who works in medicine agrees that the key problem we face is indifference. Most people don’t want to think too much about their health, are apathetic when presented with options, and stubbornly resist the simplist interventions–even taking their prescribed medication. So explaining the long-term benefits of uploading data and approving its use will be an uphill journey.

Many app developers seek adoption by major institutions, such as large insurers, hospital conglomerates, and HMOs like Kaiser. This is the smoothest path toward adoption by large numbers of consumers, and Unity Health Score includes a similar plan in its business model, According to Jones, they will require the insurance company to reduce premiums based on each patient’s health score. In return, they should be able to use the data collected to save money.

Protecting patient data
Health data is probably the most sensitive information most of us produce over our lifetimes. Financial information is important to keep safe, but you can change your bank account or credit card if your financial information is leaked–you can’t change your medical history. Security and privacy guarantees are therefore crucial for patient records. Indeed, the Unity Health Score business plan cites fears of privacy as a key risk.

Although some researchers have tried distributed patient records, stored in some repository chosen by each individual, Unith Health Score opts for central storage, like most current personal health records. This not only requires great care to secure, but places on them the burden of persuading patients that the data really will be used only for purposes chosen by the patients. Too many apps and institutions play three-card Monte with privacy policies, slipping in unauthorized uses (just think back to the recent Facebook/Cambridge Analytica scandal), so Internet users have become hypervigilant.

Unity Health Score also has to sign up physicians to check data for accuracy. This, of course, should be the priority for any data entered into any medical record. Because doctors’ time is going more and more toward the frustrating task of data entry, the company offers an enticing trade-off: the patients takes the time to enter their data, and the doctor merely verifies its accuracy. Furthermore, a consolidated medical record online can be used to speed check-in times on visits and to make data sharing on mobile devices easier.

Making the data useful
Once the patients and clinicians join Unity Health Score, the company has to follow through on its promise. This is a challenge with multiple stages.

First, much of the data will be in unstructured doctors’ notes. Jones plans to use OCR, like many other health data aggregators, to extract useful information from the notes. OCR and natural language processing may indeed be more accurate than relying on doctors to meticulously fill out dozens of structured fields in a database. But there is always room for missed diagnoses or allergies, and even for misinterpretations.

Next, data sources must be harmonized. They are likely to use different units and different lexicons. Although many parts of the medical industry are trying to standardize their codings, progress is incomplete.

The notion of a single number defining one’s health is appealing, but it might be too crude for many uses. Whether you’re making actuarial predictions (when will the individual die, or have to stop working?), estimating future health care costs, or guessing where to allocate public health resources, details about conditions may be more important than an all-encompassing number. However, many purchasers of the Unity Health Score information may still find the simplicity of a single integer useful.

Making the service attractive to data purchasers
The business plan points out that most rsearch depends on large data sets. During the company’s ramp-up phase–which could take years–they just won’t have enough patients suffering from a particular condition to interest many researchers, such as pharma companies looking for subjects. However, the company can start by selling data to academic researchers, who often can accomplish a lot with a relatively small sample. Biotech, pharma, and agencies can sign up later.

Clinicians may warm to the service much more quickly. They will appreciate having easy access to patient data for emergency room visits and care coordination in general. However, this is a very common use case for patient data, and one where many competing services are vying for a business niche.

Aligning goals of stakeholders
In some ways I have saved the hardest dilemma for last. Unity Health Care is trying to tie together many sets of stakeholders–patients, doctors, marketers, researchers, insurers–and between many of these stakeholders there are irreconcilable conflicts.

For instance, insurers will want the health score to adjust their clients’ payments, charging more for sick people. This will be feared and resented by people with pre-existing conditions, who will therefore withhold their information. In some cases, such insurer practices will worsen existing disparities for the poor and underpriviledged. The Unity Health Score business plan rejects redlining, but there may be subtler practices that many observers would consider unethical. Sometimes, incentives can also be counterproductive.

Also, as the business plan points out, many companies that currently purchase health data have goals that run counter to good health: they want to sell doctors or patients products that don’t actually help, and that run up health care costs. Some purchasers are even data thieves. Unity Health Score has a superior business model here to other data brokers, because it lets the patients approve each distribution of their data. But doing so greatly narrows the range of purchasers. Hopefully, there will be enough ethical health data users to support Unity Health Score!

This is an intriguing company with a sophisticated strategy–but one with obstacles to overcome. We can all learn from the challenges they face, because many others who want to succeed in the field of health care reform will come up against those challenges.

Wellness and Patient Centered Care – Fun Friday

Posted on June 22, 2018 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.

It’s time for the weekend, so let’s get your weekend started off right with some healthcare humor. This first cartoon explains a lot about our healthcare problems today. Although, in 2018 the device is even smaller.

This one is sad and funny. It definitely illustrates how many times we have to work on our definitions of patient centered care. I’ve found that the first step in that is talking with more patients.


MD Anderson Fined $4.3 Million For HIPAA Violations

Posted on June 21, 2018 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.

An administrative law judge has ruled that MD Anderson Cancer Center must pay $4.3 million to the HHS Office of Civil Rights due to multiple HIPAA violations. This is the fourth largest penalty ever awarded to OCR.

OCR kicked off an investigation of MD Anderson in the wake of three separate data breach reports in 2012 and 2013. One of the breaches sprung from the theft of an unencrypted laptop from the home of an MD Anderson employee. The other two involved the loss of unencrypted USB thumb drives which held protected health information on over 33,500 patients.

Maybe — just maybe — MD Anderson could’ve gotten away with this or paid a much smaller fine. But given the circumstances, it was not going to get away that easily.

OCR found that while the organization had written encryption policies going back to 2006, it wasn’t following them that closely. What’s more, MD Anderson’s own risk analyses had found that a lack of device-level encryption could threaten the security of ePHI.

Adding insult to injury, MD Anderson didn’t begin to adopt enterprise-wide security technology until 2011. Also, it didn’t take action to encrypt data on its devices containing ePHI during the period between March 2011 and January 2013.

In defending itself, the organization argued that it was not obligated to encrypt data on its devices. It also claimed that the ePHI which was breached was for research, which meant that it was not subject to HIPAA penalties. In addition, its attorneys argued that the penalties accrued to OCR were unreasonable.

The administrative law judge wasn’t buying it. In fact, the judge took an axe to its arguments, saying that MD Anderson’s “dilatory conduct is shocking given the high risk to its patients resulting from the unauthorized disclosure of ePHI,” noting that its leaders “not only recognized, but [also] restated many times.” That’s strong language, the like of which I’ve never seen in HIPAA cases before.

You won’t be surprised to learn that the administrative law judge agreed to OCR’s sanctions, which included penalties for each day of MD Anderson’s lack of HIPAA compliance and for each record of individuals breached.

All I can say is wow. Could the Cancer Center’s leaders possibly have more chutzpah? It’s bad enough to have patient data breached three times. Defending yourself by essentially saying it was no big deal is even worse. If I were the judge I would’ve thrown the book at them too.

Exec Tells Congress That New Health Data Threats Are Emerging

Posted on June 20, 2018 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 senior security executive with a major academic health system has told Congress that in addition to attacks by random attackers, healthcare organizations are facing new threats which are changing the health security landscape.

Erik Decker, chief security and privacy officer with the University of Chicago Medicine, testified on behalf of the Association for Executives in Healthcare Information Security in mid-June. He made his comments in support of the reauthorization of the Pandemic and All-Hazards Preparedness Act, whose purpose is to improve the U.S. public health and medical preparedness for emergencies.

In his testimony, Decker laid out how the nature of provider and public health preparedness has changed as digital health technology has become the backbone of the industry.

He described how healthcare information use has evolved, explaining to legislators how the digitization of healthcare has created a “hyper-connected” environment in which systems such as EHRs, revenue cycle platforms, imaging and ERP software are linked to specialty applications, the cloud and connected medical devices.

He also told them about the increasing need for healthcare organizations to share data smoothly, and the impact this has had on the healthcare data infrastructure. “There is increasing reliance on these data being available, and confidential, to support these nuanced clinical workflows,” he said. “With the adoption of this technology, the technical ecosystem has exploded in complexity.”

While the emergence of these complex digital health offers many advantages, it has led to a growth in the number and type of cybersecurity problems providers face, Decker noted. New threats he identified include:

* The development of underground markets and exchanges of sensitive information and services such as Hacking-as-a Service
* The emergence of sophisticated hacking groups deploying ransomware
* New cyberattacks by terrorist organizations
* Efforts by nation states to steal intellectual property to create national economic advantages

This led to the key point of his testimony: “We can no longer think of preparedness relative only to natural disasters or pandemics,” Decker said. “It’s imperative that we acknowledge the criticality of cybersecurity threats levied against the nation’s healthcare system.”

To address such problems, Decker suggests, healthcare organizations will need help from the federal government. For example, he pointed out, HHS efforts made a big difference when it jumped in quickly and worked closely with healthcare leaders responding to WannaCry attacks in mid-2017.

Meanwhile, to encourage the healthcare industry to adopt strong cybersecurity practices, it’s important to offer providers some incentives, including a financial subsidy or safe harbors from enforcement actions, he argued.

IT and Affordability, Care for the Poor, Population Health in Low-income Areas – #HITsm Chat Topic

Posted on June 19, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 6/22 at Noon ET (9 AM PT). This week’s chat will be hosted by Lenny Liebmann (@LennyLiebmann) on the topic of “IT and Affordability, Care for the Poor, Population Health in Low-income Areas.”

Technology can do a lot for healthcare delivery. But can technology—and technologists—specifically improve delivery for the economically disadvantaged and under-served? Or are the financial incentives in our industry too heavily stacked against such efforts?

Please join us this Friday, June 22 from noon to 1PM Eastern time for an interactive online discussion about the role technology can play in democratizing healthcare as costs rise and income disparity widens.

The following are the questions we’ll discuss during the hour chat:

T1: What particular interest and/or experience do you have in the topic of better healthcare for lower-income families. #HITsm

T2: Should health technologists purposefully prioritize initiatives that improve care for the poor—or is improved care an innate result of the improved efficiencies and efficacies generally enabled by IT? #HITsm

T3: Can you share any specific examples you’ve seen of technology specifically helping lower-income patients achieve better health outcomes? #HITsm

T4: Any ideas about how healthcare providers can leverage tech to improve population health in low-income neighborhoods—above and beyond better serving low-income individuals and families? #HITsm

T5: Do the economics of healthcare appropriately incentivize the use of technology to benefit the poor? Or do those economics actually disincentivize such efforts? #HITsm

Bonus: Any other thoughts about the relationship between technology innovation in healthcare and the needs of low-income citizens? #HITsm

Upcoming #HITsm Chat Schedule
6/29 – How Nursing Informatics is Changing the Healthcare Landscape
Hosted by Cathy Turner (@MEDITECH_Nurses) and Ashley Dauwer (@amariedauwer) from @MEDITECH

7/6 – What’s the Future of Patient Communication?
Hosted by Lea Chatham (@LeaChatham)

7/13 – TBD
Hosted by TBD

7/20 – TBD
Hosted by Jared Jeffery (@Jk_Jeffery)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

5 Steps to Ensure Revenue Integrity After Implementing a New EHR

Posted on June 18, 2018 I Written By

The following is a guest blog post by Lisa Eramo, a regular contributor to Kareo’s Go Practice Blog.

In the rush to implement EHRs for Meaningful Use incentives, many practices lost sight of what matters most for continued success—revenue integrity, says Joette Derricks, healthcare compliance and revenue integrity consultant in Baltimore, MD. Revenue integrity—the idea that practices must take proactive steps to capture and retain revenue—isn’t a novel concept. However, it’s becoming increasingly important for physician practices operating in a regulatory-driven environment, she adds.

Revenue integrity is also an important part of ensuring smooth cashflow during and after the transition to a new EHR, says Derricks. This is a time when revenue opportunities are easily overlooked as practices adjust to new navigation, templates, and more, she adds.

Revenue integrity is all about compliance, says Derricks. “It’s about taking a holistic approach to operational efficiency, regulatory compliance, and maximizing reimbursement,” she adds. “It’s about doing things the right way.”

Maximizing reimbursement isn’t about ‘gaming’ the system to upcode. Rather, it’s about implementing processes and procedures to ensure that practices are paid for all of the services they perform without leaving money on the table or generating revenue that payers will later recoup, she explains.

Derricks provides five simple steps practices can take to ensure revenue integrity following an EHR implementation:

1. Review EHR templates. Do templates include the most specific CPT and ICD-10-CM codes? And do physicians understand the importance of avoiding unspecified codes, when possible?

2. Examine the interface between the EHR and practice management system. Do the codes that physicians assign in the EHR feed correctly into the practice management system? For example, when a physician performs an E/M service in addition to a procedure, does the EHR map both codes to the practice management system for billing purposes? Does the practice management system correctly bundle and unbundle services, when appropriate?

3. Run your numbers frequently. Ideally, practices will perform a monthly data analysis to help gauge performance and identify potential missed revenue opportunities, says Derricks. For example, she suggests running a report of the practice’s top 20 billing codes in a particular month. Then, compare those codes with the top 20 codes the practice billed that same month in the previous year. What has changed, and why? And have these changes benefited or hurt the practice? For example, practices may see new codes in that list because they added chronic care or transitional care management, both of which provide additional revenue. Or practices may discover a system glitch that incorrectly bundled services that are separately payable, thus causing a revenue loss.

“Everybody can play the ‘I’m too busy’ game, but this is too important to fall into that trap,” says Derricks. “I applaud the office manager or practice administrator who recognizes the value of constantly being on the lookout for system-wide improvements and analyzing their own numbers.”

Some practice management systems provide robust billing analytics that can help practices identify the root cause of billing errors and omissions. Working with a consultant is another option, says Derricks. Consultants provide unbiased input regarding inefficiencies and vulnerabilities and can provide a ‘fresh set of eyes’ necessary to effect change. They also often have access to benchmarking tools and other resources that can help practices identify revenue gaps and delays, she adds.

For example, Derricks suggests performing an assessment for revenue gaps and roadblocks to reduce the workflow process errors that delay revenue. Download the assessment.

4. Provide physician training. Physicians need thorough training on how to use the EHR properly so as to avoid data omissions, says Derricks. They also need annual training on new CPT and ICD-10-CM codes as well as new documentation requirements, she adds.

5. Create an environment that promotes compliance. This requires a top-down approach from physicians and practice managers, says Derricks. “Everyone should have their eyes open and feel comfortable being able to address concerns,” she says. “It should be an open-door policy in terms of looking at processes versus putting your head down.”

About Lisa Eramo
Lisa Eramo is a regular contributor to Kareo’s Go Practice Blog, as well as other healthcare publications, websites and blogs, including the AHIMA Journal. Her focus areas are medical coding, clinical documentation improvement and healthcare quality/efficiency.  Kareo is a proud sponsor of Healthcare Scene.

Doctors at the Nurses Station – Fun Friday

Posted on June 15, 2018 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.

Time for a little Fun Friday as we head into the weekend. This week’s Fun Friday is a video from ZDoggMD as his alter ego, Doc Vader. In this video Doc Vader spends time at the nurses station. There’s some funny truth to the idea of doctors trying to do the work that nurses do. Always important to remember how important every person in a healthcare organization is to the success of the healthcare organization. Enjoy the video and the weekend!

Creating Provider Loyalty – And Why Communication Matters

Posted on June 14, 2018 I Written By

The following is a guest blog post by Chelsea Kimbrough from Stericycle Communication Solutions, as part of the Communication Solutions Series of blog posts. Follow and engage with them on Twitter: @StericycleComms

Chelsea Kimbrough

A few months ago, I was on the hunt for the perfect healthcare provider – and my list of expectations was high. Thankfully, my extensive search paid off. I am happy to report I found an amazing physician who I fully plan on remaining loyal to for years to come! The main reason for this loyalty boils down to one common characteristic: communication. Across every step of my patient journey, I was engaged in a clear, convenient way.

Scheduling my appointment was easy. Like many patients, I enjoy the convenience of online scheduling. But as a first time patient, I opted to pick up the phone to make my appointment. The person who answered my call was friendly, focused, and efficient. I was not asked to repeat information and ended the call more quickly than I anticipated – and with more confidence that I’d made the right choice.

Before my appointment, I received a number of reminders. The first was sent via email a few days before my appointment. When I failed (read: forgot) to reply to it, I received another friendly reminder via text message. This time, I promptly confirmed my appointment. A few days before the appointment, I was invited to pre-check in online. I did this from the comfort of my home computer in just a few minutes. As a digital-minded patient, I was stoked that this was an available perk of my new doctor’s office.

When I arrived, I was thanked for already checking in. Unlike other locations where I needed to fill out additional paperwork upon arrival, I didn’t need to do this often repetitive task. This pleasant surprise allowed me to simply wait to be called back.

During my appointment, the doctor looked me in the eye, asked me genuine questions, and clearly explained anything I wanted to know more about. This level of dedicated attention made me feel genuinely cared for. What’s more, she ensured I understood what to expect after my appointment.

After my appointment, I received the communications I was advised to expect in a timely and unobtrusive manner. What’s more, I was invited to provide candid, anonymous feedback about my appointment. The survey was quick and unobtrusive, and left me feeling as if my opinion was valid and valued.

Each point of my patient journey was met with timely, convenient, and reliable engagement. As a patient, I felt confident and at ease. And as someone who works closely with healthcare communication services and solutions – both human and technology based – I was impressed. Few healthcare organizations provide patient experiences that meet patients’ traditional and digital expectations and reliably deliver on the expectations they set. Those that do, however, are sure to acquire patients like me who will stay loyal for the foreseeable future.

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

The Widening Gap in Dementia Care and One Woman’s Crusade to Address it

Posted on June 13, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

According to Alzheimer’s Disease International (ADI), someone in the world develops dementia every 3 seconds. An estimated 50 million people had dementia in 2017. That number is expected to grow to 75 million people by 2030.

In 2017, Dr. Anitha Rao, a board certified geriatric neurologist and CEO of Neurocern, published a paper that highlighted the uneven distribution of trained dementia specialists in the United States. Her paper pointed to 20 States that were “Dementia Deserts” where there was insufficient access to specialists given the number of Dementia patients. Without intervention, this gap in Dementia care will only get wider.

While practicing at UCSF’s renowned Memory & Aging Center, Rao noticed two alarming trends:

  1. The time between booking an appointment and the actual appointment continued to grow
  2. More and more undiagnosed patients were coming in to the Center

ADI estimates that only 20-50% of dementia cases are recognized and documented in primary care. With little training and few resources available to patients, primary care doctors are reticent to tell patients they may have Dementia. Read this excellent, and frightening, article by Alice Park in Time on this topic.

An unfortunate consequence of this delay in diagnosis, was that Rao often had the unenviable job of telling patients and their families that the disease had progressed beyond the early-stage interventions that might have made a difference. Worse, she found that many patients were taking medications that were ineffective or harmful given their particular type of Dementia (there are many types of Dementia including Alzheimer’s, Lewy Bodies, Vascular, Frontotemporal, etc).

It was around this time that Rao came across two siloed data sets. One was the distribution of neurologists by state. The other was a data set of Dementia patients by state by year (including future years). She mashed the data together and what resulted was an eye-opening map of Dementia Deserts. The state of Wyoming, for example, was particularly ill-prepared to handle the expected number of Dementia patients. With very few Dementia specialists practicing in the state, patients residing there would likely have poorer outcomes due to lack of access. Rao’s paper has since been used by state agencies to lobby for more training and funding for neurological resources.

Rao, however, didn’t stop at simply identifying the problem. She wanted to do something about it and Neurocern was the result. After analyzing the problem she zeroed in on two specific issues: access to care and the lack of expert Dementia advice for patients. Here’s how the system works:

  • Patients and/or family build a brain profile in the application by answering questions (think a Myers-Briggs assessment but for your brain)
  • Based on the brain profile, the system comes up with recommendations for what can be done at home to keep seniors safe
  • Recommendations include:
    • How to gently convince someone to wash themselves (patients suffering from Dementia usually refuse to bathe)
    • How to help patients not to slip in the bathroom
    • The signs to look for if the patient needs insulin. Some Dementia patients pace the room which means they burn their sugar faster than normal and if they also have Diabetes they will need insulin sooner

“Neurocern is a cross between a neurologist and a social worker,” explains Rao. “It mirrors how my sessions with patients would go. For the first hour I would sit and listen to the family’s story. I’d use that information to build a profile. In the second hour I would review a care plan with the patient and their family. I would make sure they had things they could do at home to help reduce the impact of the Dementia. For example, if a patient suffers from, hallucinations, one of the care recommendations would be to cover mirrors in the home as they are triggers for hallucinations.”

Neurocern currently is capable of generating 5,000,000 care plans based on individual attributes discerned from the brain profile. Plans can be customized by the end-user.

The application has been piloted by a provider organization and Rao is currently in pilot discussions with a number of payers. “There is definitely a financial incentive to help patients better manage Dementia,” says Rao. “Dementia patients are 20% more likely to be readmitted and they have longer than average length of stays (ALOS). Dementia patients who have suffered a stroke have, on average, 38% higher costs. It’s the same story with Dementia + diabetes or other chronic conditions. On top of this is the fact that many healthcare organizations do not have the Dementia-trained staff to care for these patients. Neurocern can help to bridge that gap.”

Dementia is quickly becoming the leading cause of death around the world. It is already #1 in England and Wales and is the top cause of death for Australian women. In many other countries Dementia trails only heart disease. Without adequate training, resources and funding, our healthcare system runs the risk of being overwhelmed. We will need products like Neurocern and people like Rao to ensure the problem gets attention and that patients as well as providers have tools at their fingertips to help mitigate Dementia’s impact.

Rao will be presenting on a panel at next week’s AHIP conference – Innovate with Purpose: Technology Tools of Change alongside 3 other healthcare entrepreneurs.

CMS Wants Interoperability. Should Patient Data Access Champions Cheer – or Not? – #HITsm Chat Topic

Posted on June 12, 2018 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.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 6/15 at Noon ET (9 AM PT). This week’s chat will be hosted by Janice McCallum (@janicemccallum) on the topic of “CMS Wants Interoperability. Should Patient Data Access Champions Cheer – or Not?.”

Earlier this year at HIMSS18 and HealthDataPalooza, Seema Verma, CMS Administrator, announced the MyHealthEData initiative that places a priority on interoperability of EHRs, a long desired objective of health data enthusiasts.

The MyHealthEData initiative proposes open APIs with common data standards that will facilitate access to EHR data for software developers, although the business terms for accessing the data aren’t yet clear. In today’s #HITsm chat, I’d like to focus on how the MyHealthEData initiative will—or will not– benefit patients directly. I have more questions than answers and look forward to input from a range of healthIT and data management experts, patient data access advocates, innovation enthusiasts, and more.

First, some background materials:

This is the official announcement of MyHealthEData: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2018-Press-releases-items/2018-03-06.html.  Note, the initiative is not intended to give consumers direct access to their data from their healthcare providers; rather, it gives them the ability to choose a “provider that best meets their needs and then give that provider secure access to their data, leading to greater competition and reducing costs. ” In this case, “provider” means a technology provider that will likely charge an initial fee and an ongoing fee for data management.

From ONC director, Don Rucker on interoperability, transparency and an API ecosystem: https://www.healthit.gov/buzz-blog/interoperability/apis-path-putting-patients-center/

Adrian Gropper, MD, in a comment on Rucker’s post on the Health Care Blog, questions whether patient-friendly and cost-effective developers will have full access to APIs:

The issue is fairly simple and was well documented by the API Task Force: Can a small, independent startup serving patients or physicians have access to the FHIR API if the patient says it should – period? http://thehealthcareblog.com/blog/2018/04/24/apis-a-path-to-putting-patients-at-the-center/

Finally, some insights from the current state of the Apple Health app that may give us reason to question how quickly something close to full data access and ongoing data liquidity will occur: https://corepointhealth.com/apple-health-fhir

Join me for this week’s #HITsm chat. Let’s start the conversation.

T1 : Does anyone see any downside to the latest data and API standards? Is anything missing from CMS announcements and fact sheets? Or, should we all be cheering? #HITsm

T2: Health IT vendors that focus on patient engagement and patient data management should be happy about MyHealthEData. Who among the existing patient data app developers do you think will benefit most from an API ecosystem? Who might be hurt? #HITsm

T3: Do you think patient access to full health records will be more affordable due to MyHealthEData? #HITsm

T4: How long do you think it will take to make the apps useful to patients with complex conditions, given the current state of data availability via Apple Health app and early patient portals? #HITsm

T5: What’s the likely business model for the app developers? #HITsm
Here are some possibilities to discuss:
(1) app developers charge low price to patients; revenue will come from businesses that want to buy access to aggregate data.
2) Full fee paid by patients.
3) An advertising model?
4) Access to app is given as a benefit to existing customers, e.g., Google can afford to offer app for free/low cost to existing customers, because it sells other services; health insurers can subsidize costs to incentivize patients to better manage their health status via health data apps.
5) Other revenue/business models?

Bonus: How do you think healthcare providers will react to the requirement that they “ensure data sharing”? How will it affect small physician practices v. hospitals? #HITsm

Upcoming #HITsm Chat Schedule
6/22 – IT and Affordability, Care for the Poor, Population Health in Low-income Areas
Hosted by Lenny Liebmann (@LennyLiebmann)

6/29 – How Nursing Informatics is Changing the Healthcare Landscape
Hosted by Cathy Turner (@MEDITECH_Nurses) and Ashley Dauwer (@amariedauwer) from @MEDITECH

7/6 – What’s the Future of Patient Communication?
Hosted by Lea Chatham (@LeaChatham)

7/13 – TBD
Hosted by TBD

7/20 – TBD
Hosted by Jared Jeffery (@Jk_Jeffery)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.