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!!

Can Providers Survive If They Don’t Get Population Health Management Right?

Posted on August 27, 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.

Most providers know that they won’t succeed with population health management unless they get some traction in a few important areas — and that if not, they could face disaster as their volume of value-based payment share grows. The thing is, getting PHM right is proving to be a mindboggling problem for many.

Let’s start with some numbers which give us at least one perspective on the situation.

According to a survey by Health Leaders Media, 87% of respondents said that improving their population health management chops was very important. Though the article summarizing the study doesn’t say this explicitly, we all know that they have to get smart about PHM if they want to have a prayer of prospering under value-based reimbursement.

However, it seems that the respondents aren’t making nearly as much PHM progress as they’d like. For example, just 38% of respondents told Health Leaders that they attributed 25% or more of their organization’s net revenue to risk-based pop health management activities, a share which has fallen two percent from last year’s results.

More than half (51%) said that their top barrier to successfully deploying or expanding pop health programs was up-front funding for care management, IT and infrastructure. They also said that engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%) weren’t proving to be easy tasks.

At this point it’s time for some discussion.

Obviously, providers grapple with competing priorities every time they try something new, but the internal conflicts are especially clear in this case.

On the one hand, it takes smart care management to make value-based contracts feasible. That could call for a time-consuming and expensive redesign of workflow and processes, patient education and outreach, hiring case managers and more.

Meanwhile, no PHM effort will blossom without the right IT support, and that could mean making some substantial investments, including custom-developed or third-party PHM software, integrating systems into a central data repository, sophisticated data analytics and a whole lot more.

Putting all of this in place is a huge challenge. Usually, providers lay the groundwork for a next-gen strategy in advance, then put infrastructure, people and processes into place over time. But that’s a little tough in this case. We’re talking about a huge problem here!

I get it that vendors began offering off-the-shelf PHM systems or add-on modules years ago, that one can hire consultants to change up workflow and that new staff should be on-board and trained by now. And obviously, no one can say that the advent of value-based care snuck up on them completely unannounced. (In fact, it’s gotten more attention than virtually any other healthcare issue I’ve tracked.) Shouldn’t that have done the trick?

Well, yes and no. Yes, in that in many cases, any decently-run organization will adapt if they see a trend coming at them years in advance. No, in that the shift to value-based payment is such a big shift that it could be decades before everyone can play effectively.

When you think about it, there are few things more disruptive to an organization than changing not just how much it’s paid but when and how along with what they have to do in return. Yes, I too am sick of hearing tech startups beat that term to death, but I think it applies in a fairly material sense this time around.

As readers will probably agree, health IT can certainly do something to ease the transition to value-based care. But HIT leaders won’t get the chance if their organization underestimates the scope of the overall problem.

Healthcare CIOs Focused On Patient Experience And Innovation

Posted on August 2, 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.

Not long ago, 22 healthcare CIOs had a sit-down to discuss their CEOs’ top IT-related priorities. At the meeting, which took place during the 2018 Scottsdale Institute Annual Conference, the participants found that they were largely on the same page, according to researchers that followed the conversation.

Impact Advisors, which co-sponsored the research, found that improving patient experiences was priority number one. More than 80% of CIOs said patient engagement and better patient experiences were critical, and that deploying digital health strategies could get the job done.

The technologies they cited included patient-facing options like wearables, mobile apps and self-service tools. They also said they were looking at a number of provider-facing solutions which could streamline transitions of care and improve patient flow, including care coordination apps and tools and next-generation decision support technologies such as predictive analytics.

Another issue near the top of the list was controlling IT costs and/or increasing IT value, which was cited by more than 60% of CIOs at the meeting. They noted that in the past, their organizations had invested large amounts of money to purchase, implement and upgrade enterprise EHRs, in an effort to capture Meaningful Use incentive payments, but that things were different now.

Specifically, as their organizations are still recovering from such investments, CIOs said they now need to stretch their IT budgets, They also said that they were being asked to prove that their organization’s existing infrastructure investments, especially their enterprise EHR, continue to demonstrate value. Many said that they are under pressure to prove that IT spending keeps offering a defined return on investment.

Yet another important item on their to-do list was to foster innovation, which was cited by almost 60% of CIOs present. To address this need, some CIOs are launching pilots focused on machine learning and AI, while others are forming partnerships with large employers and influential tech firms. Others are looking into establishing dedicated innovation centers within their organization. Regardless of their approach, the CIOs said, innovation efforts will only work if innovation efforts are structured and governed in a way that helps them meet their organization’s broad strategic goals.

In addition, almost 60% said that they were expected to support their organization’s growth. The CIOs noted that given the constant changes in the industry, they needed to support initiatives such as expansion of service lines or building out new ones, as well as strategic partnerships and acquisitions.

Last, but by no means least, more than half of the CIOs said cybersecurity was important. On the one hand, the participants at the roundtable said, it’s important to be proactive in defending their organization. At the same time, they emphasized that defending their organization involves having the right policies, processes, governance structure and culture.

Some Of The Questions I Plan To Ask At #HIMSS18

Posted on February 23, 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.

As always, this year’s HIMSS event will feature enough noise, sound and color to overwhelm your senses for months afterward. And talk about a big space to tread — I’ve come away with blisters more than once after attending.

Nonetheless, in my book it’s always worth attending the show. While no one vendor or session might blow you away, finding out directly what trends and products generated the most buzz is always good. The key is not only to attend the right educational sessions or meet the right people but to figure out how companies are making decisions.

Below, here are some of the questions that I hope to ask (and hopefully find answers) at the show. If you have other questions to suggest I’d love to bring them with me to the show —  the way I see it, the more the merrier!

-Anne

Blockchain

Vendors:  What functions does blockchain perform in your solution and what are the benefits of these additions? What made that blockchain the best technology choice for getting the job done? What challenges have you faced in developing a platform that integrates blockchain technology, and how are you addressing them? Is blockchain the most cost-efficient way of accomplishing the task you have in mind? What problems is blockchain best suited to address?

Providers: Have you rolled out any blockchain-based systems? If you haven’t currently deployed blockchain technology, do you expect to do so the future? When do you think that will happen? How will you know when it’s time to do so? What benefits do you think it will offer to your organization, and why? Do you think blockchain implementations could generate a significant level of additional server infrastructure overhead?

AI

Vendors: What makes your approach to healthcare AI unique and/or beneficial?  What is involved in integrating your AI product or service with existing provider technology, and how long does it usually take? Do providers have to do this themselves or do you help? Did you develop your own algorithms, license your AI engine or partner with someone else deliver it? Can you share any examples of how your customers have benefited by using AI?

Providers: What potential do you think AI has to change the way you deliver care? What specific benefits can AI offer your organization? Do you think healthcare AI applications are maturing, and if not how will you know when they have? What types of AI applications potentially interest you, and are you pilot-testing any of them?

Interoperability

Vendors:  How does your solution overcome barriers still remaining to full health data sharing between all healthcare industry participants? What do you think are the biggest interoperability challenges the industry faces? Does your solution require providers to make any significant changes to their infrastructure or call for advanced integration with existing systems? How long does it typically take for customers to go live with your interoperability solution, and how much does it cost on average? In an ideal world, what would interoperability between health data partners look like?

Providers: Do you consider yourself to have achieved full, partial or little/no health data interoperability between you and your partners? Are you happy with the results you’ve gotten from your interoperability efforts to date? What are the biggest benefits you’ve seen from achieving full or partial interoperability with other providers? Have you experienced any major failures in rolling out interoperability? If so, what damage did they do if any? Do you think interoperability is a prerequisite to delivering value-based care and/or population health management?

What topics are you looking forward to hearing about at #HIMSS18? What questions would you like asked? Share them in the comments and I’ll see what I can do to find answers.

Is A Cerner Installation A “Downgrade” From Epic? Ask This Guy

Posted on January 8, 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.

I don’t know if I’ve ever quoted a letter to the editor in a column for this publication, but I have to this time. I thought it had an interesting story to tell.

The letter, written by a patient at the Banner University of Arizona Medical Center in Tucson, offers a scathing critique what he sees “degradation of services” taking place after the institution switched from an Epic to a Cerner EHR, a change he refers to as a downgrade throughout the letter.

Since the “downgrade,” said the patient, John Kimbell, appointments take much longer. “Three weeks after the downgrade, my 30-minute appointment took three hours and 40 minutes,” he complains.

His other concerns include:

  • Data exchange problems: “My local doctor has TWICE sent results of a scan to my oncologist, and they never arrived.”
  • Privacy issues: With the automated paging system gone, “nurses call out names in the waiting areas in each clinic,” Kimbell notes.
  • Useless information: After Kimbell’s most recent appointment, he says, he was “handed out a 13-page printout that gave 12 pages information I didn’t need.” Before the Epic to Cerner switch, he reports, he was able to access this information online.
  • Communication issues: Kimbell says he never gets telephone call reminders of appointments anymore.

As Kimbell sees it, the quality of care has slipped significantly since Epic was switched out for a Cerner system. “All the cancer patients I have known while a patient there are in need of better care than Banner now provides,” he writes.

It’s important to note here that the Epic-to-Cerner switch-off took place in October last year, which means that the tech and administrative staff haven’t had much time to work out problems with the new installation. It may be the case that the concerns Kimbell had in late December won’t be an issue in a couple of months.

On the other hand, I do think it’s possible that as the letter implies, UMC owner Banner Health may have had reasons to push the Cerner install into the facility, most particularly if all of its other properties already operate using Cerner.

Regardless, if everything is as Kimbell describes, let’s hope it all gets back in order soon.  From the looks of things, UMC seems to offer a renowned cancer treatment program. Let’s hope that a quality program isn’t undermined by IT concerns.

Health IT Leaders Spending On Security, Not AI And Wearables

Posted on December 18, 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.

While breakout technologies like wearables and AI are hot, health system leaders don’t seem to be that excited about adopting them, according to a new study which reached out to more than 20 US health systems.

Nine out of 10 health systems said they increased their spending on cybersecurity technology, according to research by the Center for Connected Medicine (CCM) in partnership with the Health Management Academy.

However, many other emerging technologies don’t seem to be making the cut. For example, despite the publicity it’s received, two-thirds of health IT leaders said using AI was a low or very low priority. It seems that they don’t see a business model for using it.

The same goes for many other technologies that fascinate analysts and editors. For example, while many observers which expect otherwise, less than a quarter of respondents (17%) were paying much attention to wearables or making any bets on mobile health apps (21%).

When it comes to telemedicine, hospitals and health systems noted that they were in a bind. Less than half said they receive reimbursement for virtual consults (39%) or remote monitoring (46%}. Things may resolve next year, however. Seventy-one percent of those not getting paid right now expect to be reimbursed for such care in 2018.

Despite all of this pessimism about the latest emerging technologies, health IT leaders were somewhat optimistic about the benefits of predictive analytics, with more than half of respondents using or planning to begin using genomic testing for personalized medicine. The study reported that many of these episodes will be focused on oncology, anesthesia and pharmacogenetics.

What should we make of these results? After all, many seem to fly in the face of predictions industry watchers have offered.

Well, for one thing, it’s good to see that hospitals and health systems are engaging in long-overdue beefing up of their security infrastructure. As we’ve noted here in the past, hospital spending on cybersecurity has been meager at best.

Another thing is that while a few innovative hospitals are taking patient-generated health data seriously, many others are taking a rather conservative position here. While nobody seems to disagree that such data will change the business, it seems many hospitals are waiting for somebody else to take the risks inherent in investing in any new data scheme.

Finally, it seems that we are seeing a critical mass of influential hospitals that expect good things from telemedicine going forward. We are already seeing some large, influential academic medical centers treat virtual care as a routine part of their service offerings and a way to minimize gaps in care.

All told, it seems that at the moment, study respondents are less interested in sexy new innovations than the VCs showering them with money. That being said, it looks like many of these emerging strategies might pay off in 2018. It should be an interesting year.

AMA Connects Doctors With Health IT Ventures

Posted on November 22, 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.

Maybe I’m wrong, but the following strikes me as coming straight from the Redundancy Department of Redundancy…but let’s see. Maybe I’m just being mean. Or maybe it’s because I just couldn’t taste The Rainbow in my last package of Skittles.

Anyway, recently AMA announced the launch of an online platform, the Physician Innovation Network (PIN), designed to connect physicians together with health tech firms.

The PIN will give HIT companies will have a straightforward channel for collecting physician input on the products and services they’re developing. The health IT ventures will also be able to search for physicians who have the expertise they need and are willing to exchange information with them. Meanwhile, the platform will help physicians to find paid and volunteer opportunities to work with health tech companies to work with the health take ventures that suit them.

In recent years, the AMA has taken several steps to bring the world of health IT and physicians closer together. Most recently, the trade group announced that it had created a data standardization organization known as the Integrated Health Model Initiative. The physician group and its partners say the new data model will include clinically-validated data elements designed to speed up the development of improved data organization, management, and analytics.

Its other HIT initiatives include:

  • Co-founding Health2047, a company designed (like PIN) to bring together physicians with established healthcare companies and help them launch useful services and products
  • Serving as one of four founding organizations behind Xcertia, an organization intended to foster knowledge about clinical content, usability, privacy, security and evidence of efficacy for mHealth apps
  • Managing a student-run biotechnology incubator in collaboration with Sling Health,

But what is there to say about PIN that distinguishes it from all of these efforts? It resembles Health2047, mais non? And what benefit does it add over LinkedIn? Specialty interest groups within the MGMA and HIMSS? AngelList? A giant digital corkboard and some virtual Post-It notes?

Don’t get me wrong, I know I’ve come down hard on the AMA’s product launch announcements rather often, perhaps too often. Depending on how it actually works, PIN may actually offer some incremental value over all of these other options. And hey, if the trade group wants to throw its money around, whom am I to say that they shouldn’t have at it.

The thing is, though, the AMA doesn’t work in a vacuum.

Look, as we all know, we’re absolutely drowning in initiatives and proposals and great new ideas for interoperability and the collection of consumer-generated health data. And don’t forget scoping out the best architecture for deploying two tin cans with a piece of string between them, getting budget approval from a Magic 8 Ball (signs point to no), and repurposing some BASIC code from a  Commodore 64 to develop your next mobile health app. (Yes, it tired me out to write that sentence but it was worth it.)

Silliness aside, when you have the kind of resources the AMA does, you want to the profession to say something meaningful when you open your mouth, professionally speaking. Other than that, you’re just sucking air out of the room that could be used for people with a differentiated idea in real value to deliver.  Hey, but other than that, the PIN announcement is just fine.

Searching EMR For Risk-Related Words Can Improve Care Coordination

Posted on September 18, 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.

Though healthcare organizations are working on the problem, they’re still not as good at care coordination as they should be. It’s already an issue and will only get worse under value-based care schemes, in which the ability to coordinate care effectively could be a critical issue for providers.

Admittedly, there’s no easy way to solve care coordination problems, but new research suggests that basic health IT tools might be able to help. The researchers found that digging out important words from EMRs can help providers target patients needing extra care management and coordination.

The article, which appears in JMIR Medical Informatics, notes that most care coordination programs have a blind spot when it comes to identifying cases demanding extra coordination. “Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data,” the authors wrote. “However, not all clinically relevant data reside in claims and formatted data.”

For example, they say, relying on formatted records may cause providers to miss psychosocial risk factors such as social determinants of health, mental health disorder, and substance abuse disorders. “[This data is] less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data,” the authors note.

To address this issue, the researchers set out to identify psychosocial risk factors buried within a patient’s EHR using word recognition software. They used a tool known as the Queriable Patient Inference Dossier (QPID) to scan EHRs for terms describing high-risk conditions in patients already in care coordination programs.

After going through the review process, the researchers found 22 EHR-available search terms related to psychosocial high-risk status. When they were able to find nine or more of these terms in the patient’s EHR, it predicted that a patient would meet criteria for participation in a care coordination program. Presumably, this approach allowed care managers and clinicians to find patients who hadn’t been identified by existing care coordination outreach efforts.

I think this article is valuable, as it outlines a way to improve care coordination programs without leaping over tall buildings. Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence, and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Still, it’s good to know that you can get meaningful information from EHRs using a comparatively simple tool. In this case, parsing patient medical records for a couple dozen keywords helped the authors find patients that might have otherwise been missed. This can only be good news.

Yes, there’s no doubt we’ll keep on pushing the limits of predictive analytics, healthcare AI, machine learning and other techniques for taming wild databases. In the meantime, it’s good to know that we can make incremental progress in improving care using simpler tools.

One Hospital Faces Rebuild After Brutal Cyberattack

Posted on July 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.

Countless businesses were hit hard by the recent Petya ransomware attack, but few as hard as Princeton, West Virginia-based Princeton Community Hospital. After struggling with the aftermath of the Petya attack, the hospital had to rebuild its entire network and reinstall its core systems.

The Petya assault, which hit in late June, pounded large firms across the globe, including Nuance, Merck, advertiser WPP, Danish shipping and transport firm Maersk and legal firm DLA Piper.  The list of Petya victims also includes PCH, a 267-bed facility based in the southern part of the state.

After the attack, IT staffers first concluded that the hospital had emerged from the attack relatively unscathed. Hospital leaders noted that they are continuing to provide all inpatient care and services, as well as all other patient care services such as surgeries, therapeutics, diagnostics, lab and radiology, but was experiencing some delays in processing radiology information for non-emergent patients. Also, for a while the hospital diverted all non-emergency ambulance visits away from its emergency department.

However, within a few days executives found that its IT troubles weren’t over. “Our data appears secure, intact, and not hacked into; yet we are unable to access the data from the old devices in the network,” said the hospital in a post on Facebook.

To recover from the Petya attack, PCH decided that it had to install 53 new computers throughout the hospital offering clean access to its Meditech EMR system, as well as installing new hard drives on all devices throughout the system and building out an entirely new network.

When you consider how much time its IT staff must’ve logged bringing basic systems online, rebuilding computers and network infrastructure, it seems clear that the hospital took a major financial blow when Petya hit.

Not only that, I have little doubt that PCH faces doubts in the community about its security.  Few patients understand much, if anything, about cyberattacks, but they do want to feel that their hospital has things under control. Having to admit that your network has been compromised isn’t good for business, even if much bigger companies in and outside the healthcare business were brought to the knees by the same attack. It may not be fair, but that’s the way it is.

That being said, PCH seems to have done a good job keeping the community it serves aware what was going on after the Petya dust settled. It also made the almost certainly painful decision to rebuild key IT assets relatively quickly, which might not have been feasible for a bigger organization.

All told, it seems that PCH survived Petya successfully as any other business might have, and better than some. Let’s hope the pace of global cyberattacks doesn’t speed up further. While PCH might have rebounded successfully after Petya, there’s only so much any hospital can take.

The Fight For Patient Health Data Access Is Just Beginning

Posted on July 11, 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.

When some of us fight to give patients more access to their health records, we pitch everyone on the benefits it can offer — and act as though everyone feels the same way.  But as most of us know, in their heart of hearts, many healthcare industry groups aren’t exactly thrilled about sharing their clinical data.

I’ve seen this first hand, far too many times. As I noted in a previous column, some providers all but refuse to provide me with my health data, and others act like they’re doing me a big favor by deigning to share it. Yet others have put daunting processes in place for collecting your records or make you wait weeks or months for your data. Unfortunately, the truth, however inconvenient it may be, is that they have reasons to act this way.

Sure, in public, hospital execs argue for sharing data with both patients and other institutions. They all know that this can increase patient engagement and boost population health. But in private, they worry that sharing such data will encourage patients to go to other hospitals at will, and possibly arm their competitors in their battle for market share.

Medical groups have their own concerns. Physicians understand that putting data in patient’s hands can lead to better patient self-management, which can tangibly improve outcomes. That’s pretty important in an era when government and commercial payers are demanding measurably improved outcomes.

Still, though they might not admit it, doctors don’t want to deluge patients with a flood of data which could cause them to worry about inconsequential issues, or feel that data-equipped patients will challenge their judgment. And can we please admit that some simply don’t like ceding power over their domain?

Given all of this, I wasn’t surprised to read that several groups are working to improve patients’ access to their health data. Nor was it news to me that such groups are struggling (though it was interesting to hear what they’re doing to help).

MedCity News spoke to the cofounder of one such group, Share for Cures, which works to encourage patients to share their health data for medical research. The group also hopes to foster other forms of patient health data sharing.

Cofounder Jennifer King told MCN that patients face a technology barrier to accessing such records. For example, she notes, existing digital health tools may offer limited interoperability with other data sets, and patients may not be sure how to use portals. Her group is working to remove these obstacles, but “it’s still not easy,” King told a reporter.

Meanwhile, she notes, almost every hospital has implemented a customized medical record, which can often block data sharing even if the hospitals buy EMRs from the same vendor. Meanwhile, if patients have multiple doctors, at least a few will have EMRs that don’t play well with others, so sharing records between them may not be possible, King said.

To address such data sharing issues, King’s nonprofit has created a platform called SHARE, an acronym for System for Health and Research Data Exchange. SHARE lets users collect and aggregate health and wellness data from multiple sources, including physician EMRs, drug stores, mobile health apps and almost half the hospitals in the U.S.

Not only does SHARE make it easy for patients to access their own data, it’s also simple to share that data with medical research teams. This approach offers researchers an important set of benefits, notably the ability to be sure patients have consented to having their data used, King notes. “One of the ways around [HIPAA] is that patient are the true owners,” she said. “With direct patient authorization…it’s not a HIPAA issue because it’s not the doctor sharing it with someone else. It’s the patient sharing it.”

Unfortunately (and this is me talking again) the platform faces the same challenges as any other data sharing initiative.

In this case, the problem is that like other interoperability solutions, SHARE can only amass data that providers are actually able to share, and that leaves a lot of them out of the picture. In other words, it can’t do much to solve the underlying problem. Another major issue is that if patients are reluctant to use even something as simplified as a portal, they’re not to likely to use SHARE either.

I’m all in favor of pushing for greater patient data access, for personal as well as professional reasons. And I’m glad to hear that there are groups springing up to address the problem, which is obviously pretty substantial. I suspect, though, that this is just the beginning of the fight for patient data access.

Until someone comes up with a solution that makes it easy and comfortable for providers to share data, while diffusing their competitive concerns, it’s just going to be more of the same old, same old. I’m not going to hold my breath waiting for that to happen.

Tips on Implementing Text Analytics in Healthcare

Posted on July 6, 2017 I Written By

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

Most of us would agree that extracting clinical data from unstructured physician notes would be great. At present, few organizations have deployed such tools, nor have EMR vendors come to the rescue en masse, and the conventional wisdom holds that text analytics would be crazy expensive. I’ve always suspected that digging out and analyzing this data may be worth the trouble, however.

That’s why I really dug a recent article from HealthCatalyst’s Eric Just, which seemed to offer some worthwhile ideas on how to use text analytics effectively. Just, who is senior vice president of product development, made a good case for giving this approach a try. (Note: HealthCatalyst and partner Regenstrief Institute offer solutions in this area.)

The article includes an interesting case study explaining how healthcare text analytics performed head-to-head against traditional research methods.

It tells the story of a team of analysts in Indiana that set out to identify peripheral artery disease (PAD) patients across two health systems. At first gasp, things weren’t going well. When researchers looked at EMR and claims data, they found that failed to identify over 75% of patients with this condition, but text analytics improved their results dramatically.

Using ICD and CPT codes for PAD, and standard EMR data searches, team members had identified less than 10,000 patients with the disorder. However, once they developed a natural language processing tool designed to sift through text-based data, they discovered that there were at least 41,000 PAD patients in the population they were studying.

To get this kind of results, Just says, there are three key features a medical text analytics tool should have:

  • The medical text analytics software should tailor results to a given user’s needs. For example, he notes that if the user doesn’t have permission to view PHI, the analytics tool should display only nonprivate data.
  • Medical text analytics tools should integrate medical terminology to improve the scope of searches. For example, when a user does a search on the term “diabetes” the search tool should automatically be capable of displaying results for “NIDDM,” as this broadens the search to include more relevant content.
  • Text analytics algorithms should do more than just find relevant terms — they should provide context as well as content. For example, a search for patients with “pneumonia,” done with considering context, would also bring up phrases like “no history of pneumonia.” A better tool would be able to rule out phrases like “no history of pneumonia,” or “family history of pneumonia” from a search for patients who have been treated for this illness.

The piece goes into far more detail than I can summarize here, so I recommend you read it in full if you’re interested in leveraging text analytics for your organization.

But for what it’s worth, I came away from the piece with the sense that analyzing your clinical textual information is well worth the trouble — particularly if EMR vendors being to add such tools to their systems. After all, when it comes to improving outcomes, we need all the help we can get.