How Blockchains Will Impact the Modern Economy

Dec 12, 2017

A new system for healthcare

One of the most talked about implementations of blockchain is the opportunity to apply it to the broken healthcare system that is currently fragmented across a number of different tools and services. With a blockchain ledger, we could store and encode citizens' private health care records, creating permissioning such that the information is only accessible via selective permissioning.

In other words, we could securely and efficiently decide who can see the information, when they see it, and for how long. All of the transaction information between patients and doctors will be automatically stored and logged on this ledger, preventing the all-too-common threat of misinformation.

We can use this same framework in a variety of other places in the healthcare space, such as regulation compliance, testing results, and managing healthcare supplies. For perhaps the first time in history, we can begin optimizing the way we think about the healthcare space broadly, automating past inefficiencies and providing a better end user experience.

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Source: Huffington Post (View full article)

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Automating hiring and credentialing with Predictive Analytics

Dec 11, 2017

The Greeley Company, Newport Credentialing and SkillSurvey are helping healthcare providers to start automating hiring and credentialing to streamline and ultimately accelerate the processes.

SkillSurvey CEO Ray Bixler, for instance, said that once his company built its first peer referencing application, it reduced clients' peer referencing processes from several weeks to just three days.

If a doctor is filling out a potential employer's application, they need to fork over some personal information, work history, degrees, where they graduated, what they'd like to accomplish once hired. They need to divulge their licenses, their certifications. It's a lot of information, and the credentialing team needs to sift through all of it.

"Once that's done, the person's still not credentialed," said Bixler. "Hospitals have these department chairs and committees that meet, and they generally don't meet more than once a month. So if the credentialing process isn't complete, it could be another 30 days. That is how the market has been served, and how it's been doing this job for decades."

With a more automated approach, the process becomes akin to using TurboTax in that software guides the credentialing team along.

"A doctor that can't get credentialed isn't going to service anybody," said Bixler. "Patients aren't getting serviced when positions aren't getting filled. And of course the hospital feels the impact because now they're not generating revenue."

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Source: Healthcare IT News (View full article)

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Predictive analytics improve scheduling

Dec 11, 2017

Automation can make lives easier for managers, some of whom can spend up to 60 or 70 percent of their time trying to fill vacant shifts as opposed to rounding with patients or mentoring new staff.

Avantas, AMN Healthcare and Shiftboard are among the players trying to change the rules to that particular game. Avantas touts its use of predictive analytics, using embedded forecasting to create a shift in how managers are thinking about staff.

In a manual process, they rely largely on intuition to know what the volumes are and how to craft the staff schedules. But two hours before the start of a shift they're often scrambling because something's changed, or someone has been called off the unit.

An automated approach using predictive analytics can often project 120 days in advance of a shift what the demands are going to be, what the availability of the staff will be and how that aligns with workforce demands.

Avantas President Jackie Larson said the team collects historical data that managers can tap into to predict 96 percent of the time what the staff targets will be 60 days out.

"They're creating anywhere from 1,000 to 2,000 different models based on time series modeling. They're creating exploratory models validated before and after," Larson said.

Avantas then refines those models based on what actually happened to adjust projections going forward, which Larons described as the continual refinement of the algorithms.

"The model is able to essentially digest the new information and assess whether that's a legitimate trend," she said. "Or the model can also say, 'This looks like it's an anomaly, but we're going to continue to watch it in case there's enough validation on it that will warrant a change.'"

With clinician shortages in the workforce these days, the number of time hospitals are spending on administrative details can be wasteful. It's time that would be better spent taking care of patients, and and that's what automation does: free up time so clinicians can focus on what's going to drive patient care and quality, and improve both patient and staff satisfaction.

Larson estimated that automating scheduling can result in an organization saving 4 to 7 percent annually on their labor spend. Managers at University of Kansas Hospital, one of Avantas' clients, used to spend 13 hours creating a schedule; that's now down to 6.

"Healthcare is fairly conservative," said Larson. "Sometimes it's really hard to think about a different way of doing things. We need to have a good support network -- knowing what to do, how to do it, and when it gets hard, knowing they have a network of individuals they can reach out to so they don't revert to old practices. It gets hectic. That's what clinical life is."

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Source: Healthcare IT News (View full article)

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How Soon Will Healthcare Connect Machine Learning with Consumers?

Dec 11, 2017

Machine learning and artificial intelligence have taken the healthcare industry by storm as innovators offer tempting visions of sophisticated clinical decision support, smoother EHR workflows, and more intuitive consumer-provider relationships to beleaguered clinical staff.

The development of AI, or at least its beginnings, has been a constant theme among health IT vendors and healthcare provider organizations who believe they are on the leading edge of a revolution.

They might well be correct: early research into imaging analytics, natural language processing, and decision support tools has been largely promising, with some algorithms even claiming to outperform trained human professionals in certain tasks.

Imaging analytics, natural language processing, and the analysis of huge datasets involved in the Internet of Things (IoT) are prime use cases for machine learning, but the methodology is shaping up to be more than just the engine that drives decision-making processes under the hood.

Machine-to-human interactions through ambient computing, virtual personal assistants, and augmented reality are on the agenda for many forward-thinking health IT vendors, who see direct machine-to-human interactions as a way to revolutionize workflows and customer service.

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Healthcare consumers are different than retail, financial, or manufacturing customers. Their concerns are more complicated, their privacy is protected by stringent regulations, and their data could be scattered across a dozen disconnected providers in both analog and digital forms.

Automation is indeed coming to healthcare, as it is to every industry, and machines will no doubt soon take over some of the simpler, time-consuming tasks that humans hate to handle.

But the incredible complexity of healthcare and its big data may mean that healthcare will have to wait until other industries work out all the kinks and create an AI-driven ecosystem that can be smoothly implemented without using patients in life-or-death situations as guinea pigs.

While healthcare consumers may not always have the same experiences in hospitals and clinics as they do at their banks, in their shops, and on their phones, taking the time to get the basics of big data right might be the best move that healthcare providers can make.

Many providers may still feel that the risks of racing to implement machine-driven automation in healthcare may not yet be worth the rewards, but organizations should be prepared to start accelerating their investments if they wish to eventually see success in the inevitably data-driven environment of the near future.

Source: Health IT Analytics (View full article)

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2018 is primed for blockchain, big data and cloud computing advancements, all with a better security plan

Dec 8, 2017

Photo by NASA on Unsplash

1. Blockchain-based EHR systems emerge

Although significant efforts have been made to make health records interoperable, there often have been security-related risks associated with these efforts. Recent ransomware attacks and cybersecurity breaches have further added to the concerns over the security of health data.

The use of blockchain technologies for documenting and transferring patient data is being considered as one of the solutions for achieving interoperability and overcoming data exchange issues.

"This will necessarily require disruptive design changes in EHR architecture, and some vendors are already exploring blockchain to be the new model for ensuring the interoperability of patient information among different institutions," Dhawal Thakur, healthcare research lead at research firm MarketsandMarkets said. "In 2018, several more vendors will be putting forth blockchain-based EHR solutions as one of the major areas of innovation or technological transition."

2. Security gains a seat in the boardroom

"CISOs need to help executives and board members understand the ROI, cost-benefit analysis and security program tradeoffs by articulating the business risk versus business value," said Brendan O'Connor, security chief technology officer at Service Now, an IT and security consulting firm.

In the coming year, the healthcare industry will see infosec leaders doing more to present their security concepts and programs in business terms, O'Connor said. Talking about securing data is one thing, but demonstrating the value that security offers the organization is something else.

"This will eventually apply to every aspect of the business, but most immediately applies to regulatory compliance, potential lost revenue, customer relationships, legal liability, competition, intellectual property, stockholder loyalty and brand protection," he said. "The boardroom needs to take a step toward security, and security operations need to take two steps toward the boardroom."

3. Healthcare continues its move to the cloud

Provider organizations are quickly discovering that cloud-based systems can be more secure and more sophisticated than on-premises technologies. Put another way: Healthcare organizations are discovering that cloud-based systems may very well be the future.

"They are often more secure than traditional on-premises solutions - Amazon Web Services can create a more secure environment than a healthcare organization with limited IT staff and security experience," said Mark LaRow, CEO of Verato, a patient matching technology vendor. "And they can offer a dramatically lower total cost of ownership than traditional on-premises solutions by eliminating maintenance fees and upgrade costs, and by requiring much less effort to install and operate."

4. Digital health and Big Data translate into real health outcomes

"Big Data analytics is set to bring about significant advancements in terms of creating a more technology-enabled approach to develop preventive medicine and personalized treatment pathways," said Thakur of MarketsandMarkets. "The availability of a significant volume of information from digital health devices used by patients or individuals on a daily basis is further strengthening this approach."

With the help of analytics, technologies are reaching a point where it will be possible to predict when and why patients will be rehospitalized, and what will be the expected therapy response and recovery time, Thakur said. From a provider point of view, this will translate into improved reimbursements, regulatory compliance, better health outcomes and operational optimization.

"2018 is set to bring exciting outcomes for digital health and Big Data analytics," Thakur said. "With the transition toward a more passive way of monitoring patient health, physicians will increasingly start prescribing IoT-enabled devices for real-time access to vital signs. Technological enhancements will keep pushing specialized devices for monitoring specific patient biometrics into the market, and IoT devices, coupled with Big Data analytics, will form the basis of virtual care or telehealth services."

5. A security breach affects someone's physical well-being

There is a difference between information security and physical security. The breaches that plague organizations today are primarily information security violations. While painful, having credit card information, a social security number or personal digital information stolen does not result in physical harm to the victim.

"In 2018, we will see a breach impact our physical, personal lives," said O'Connor of Service Now. "It might be a medical device or wearable that is hacked and remotely controlled. Perhaps it will be an industrial IoT device or self-driving car that gets compromised. Or something closer to home, like smart garage doors. The impact of such an attack will force government, business and individuals to take a closer look at the security of our infrastructure."

6. AI and the IoT will begin to improve workforce shortages

Healthcare faces complex workforce surpluses and shortages leading up to 2030, particularly with clinicians who will be crucial in navigating the shift from volume to value, Forrester Research said. But healthcare is uniquely positioned to work side by side with computers to optimize an already unbalanced workforce.

Healthcare digital business strategy professionals will invest in AI technologies, business processes and the Internet of Things to help close skills and labor gaps for specific use-cases, according to the Forrester Research report, "Predictions 2018: Digital Will Disrupt Siloed Healthcare Ecosystems."

Source: Healthcare IT News (View full article)

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How Online Tools Increase Patient Retention

Dec 8, 2017

Photo by William Iven on Unsplash

The shift to value-based healthcare means practices are feeling the pressure to improve their patient engagement and retention. With competition from other practices, "minute" clinics, urgent care centers, and health systems, patients have more choice than ever. If patients aren't satisfied with their provider all it takes is a quick online search to find another one. In fact, 54 percent of Millennials have done just that in the past two years, and 42 percent are likely to switch in the coming two years. How can providers work to proactively combat these high attrition rates? Not surprisingly, the top items on patients' wish lists for the ideal doctor are greater connectivity and convenience through online tools -- both things that are easy for a practice to implement using patient relationship management (PRM) solutions.

Online Scheduling

The option to schedule or change an appointment online removes many of the barriers that patients traditionally face when scheduling an appointment. They aren't forced to make a phone call when the practice is open, instead they can visit the practice website at their convenience, or schedule right from the practice's Facebook page as they scroll through their feed. Patients can see the entire listing of times available for the specific type of appointment they need, and choose the one that fits best into their schedule. If something comes up down the road and rescheduling is needed, they can change or cancel the appointment with the same amount of ease. Even if the patient doesn't realize they need to reschedule an appointment until they receive the reminder text or email, they can follow the link in the message and change the appointment without dealing with the arduous process of a phone call.

Extending Online Services

Offering a patient portal or patient app where these online services are available adds yet another level of convenience for patients. Not only can these offer the ability to schedule and manage appointments and bills, but they also provide a tools for secure messaging when needed. While most patients would prefer to simply text with their providers, there are times when a secure communication tool is needed. For example, if a patient doesn't want to discuss protected health information on an unsecure channel, a practice can move the conversation to secure messaging. Offering patients options to meet all their needs is key to building patient loyalty.

Greater Connectivity

Social media is also a platform for patients to easily share their positive experience. In this way, cultivating patient relationships and improving retention by using technology can help practices grow. Happy patients are more likely to share their experience in online reviews when asked, and this is becoming an important part of being discovered by new patients. Positive reviews play a large part in which provider a potential patient chooses -- 88 percent trust online reviews as much as a personal recommendation.

But if a practice is going to engage in social media and encourage patients to leave reviews, it is important to be active. Patient and prospective patients feel it is important for a provider to respond to reviews, so a process to monitor and respond to online comments shouldn't be overlooked. Not responding could hurt more than help.

Using online tools to engage with patients and simplify processes can make a significant difference in the patient experience. It can also improve a practice's reputation, and help engage new patients. The end the result is not only better retention but also practice growth.

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Source: Health IT Outcomes (View full article)

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Using Business Intelligence to Fine-Tune Operating Room Utilization

Dec 8, 2017

Photo by Piron Guillaume on Unsplash

[...] Balancing adaptability with predictability was a difficult task for Huang, who doesn't have a large in-house analytics team to help him take on the challenge.

"When I started at BMC, there was very little data available about OR scheduling and what we were doing," he recalled. "We had just transitioned to Epic Systems, and we were trying to set up some of the analytics and reporting to understand whether our surgical teams were effectively using the time that was allotted to them."

"Epic has a lot of strengths, but we couldn't get exactly what we needed in this case. I was actually taking the PDF reports we got from Epic, copying and pasting the data into Excel, and re-working the data so we could use it for what we needed."

Using Excel as a fallback wasn't sufficient for this use case, Huang said, even though the ubiquitous data management tool can provide healthcare organizations with some analytics capabilities.

"Hospitals have so much data available these days, but we're still cutting that data with stone tools," he stated. "You can have a great data warehouse, but if you don't have the right applications on top of that to perform meaningful analytics, you're probably going to rely heavily on Excel."

"That's a classic stone tool. You can get the job done with some effort, but it's not very pretty, and you can't really get as deep into the data as you might want to."

Healthcare organizations are in desperate need of better business intelligence, he continued. Without a firm grip on utilization metrics, patient challenges, and available resources, providers will be unable to meet the high-pressure challenges of value-based care.

"Every hospital or health system has to learn to use their data better and understand their patients better so they can intervene to improve outcomes quicker and more effectively, especially if they want to compete in the value-based care market," he stressed.

Small tweaks to a population health management approach, for example, could produce significant returns in patient health as well as spending.

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Source: Health IT Analytics (View full article)

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OPM eyes blockchain for employee records

Dec 7, 2017

Photo by Jason Leung on Unsplash

The Office of Personnel Management faces challenges in securely transferring employee records between agencies that have redundant, siloed human resources IT systems.

The lack of integration, interoperability and data standards across agencies and service providers leads to inefficient and inaccurate reporting that makes it difficult to make strategic decisions and take advantage of a shared services model.

One solution is the creation of the federal employee digital record that would enable a secure exchange of information on the lifecycle of employees. An EDR based on data standards and a data exchange strategy will make it easier for agencies to access records throughout an employee's career.

Marcel Jemio, chief data architect and acting chief of OPM's Data Management Federal Data Solutions, sees blockchain as a way to facilitate the sharing of personnel data.

"There are all of these processes, regulations and rules that keep us from having speed of delivery and getting data in front of decision-makers faster and sooner without a collapse in quality," Jemio said a Dec. 6 FCW event on shared services and emerging technologies. "Personnel data is [personally identifiable information], but there may be a way that we can share this data more securely."

"I see blockchain as an accelerator, with the alignment of different technologies coming together," Jemio said. "We are willing to look into blockchain to see if it will succeed ... but we need to create the right data standards to help it succeed."

Source: GCN (View full article)

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Healthcare Interoperability: A Must To Revolutionize Value-Based Care

Dec 7, 2017

The numerous health IT solutions we have around us today were meant to improve not just the delivery of care, but also enhance patient outcomes as the care continues across multiple practices. At the most basic level, I suppose we can define interoperability as two or more systems communicating with each other- how and when you want something to interoperate and talk. We may have EHRs all over the nation, but that has not led to an easy flow of health data across different care settings. Even today, there are essential pieces of information that are either missing or hard to access.

What Does An Interoperable Value-Based System Look Like?

So far, developing a national patient identifier, improving standardization across the industry and terminating information blocking are the hurdles remaining in the way of 100 percent interoperability. Still, what can we achieve with a connected healthcare?

Consider a patient, George. George is 67 years old with slightly high blood pressure and lives alone. After he felt his blood pressure rise and ran off to the nearest ER a couple of times, his children insisted he started using an app that takes just one tap to notify his doctor and his children of his condition. Although his episodes weren't severe, George decided he might as well use the app just in case something serious did happen, and he needed assistance.

Last month, George was diagnosed with sleep apnea and started using some medications. The suggestions for most of these medications popped up on his phone's screen. And, just a few days ago, George decided to get a fitness tracker- he uses the tracker to count the number of steps, his resting heart rate, his blood pressure and whatnot.

Each of these devices and apps provides value to George, helping him manage his health and keep a stroke at bay. However, if these devices were to share information, it might be possible for George's doctor to figure out symptoms of a stroke from the quality of his sleep and share better-suited care plans. Indeed, the data would be much more valuable, helping George's caregivers be aware and notified, identify patterns in his health and monitor his health on the go.

There lies the promise of data sharing and interoperability in a true value-based care world.

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Source: Health IT Outcomes (View full article)

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Why we need to fix the broken technology pipeline for digital medicine now

Dec 7, 2017

When it comes to health information technology, innovative ideas and companies abound. Downstream improvements in outcomes or costs of care resulting from these innovations, however, have to date been underwhelming.

To illustrate this observation, there is no better example than the limited results yielded by the massive investment in electronic health records (EHRs). Another can be found in the $28.7 billion consumer wearable technology market. A recent randomized controlled clinical trial found that individuals using wearables lost less weight over 24 months than those making lifestyle changes alone.

This finding is disappointing, but unfortunately not unusual -- despite generating such excitement and investments in these innovations, less-than-optimal or even negative outcomes make it clear that we have yet to fully ascertain HIT's potential.

Some may attribute this underperformance to the general complexities and attributes of the healthcare sector, but we, as members of the Network of Digital Evidence (NODE), disagree. One need only to look to the drug and device industries to see examples of far more mature and effective, albeit imperfect, processes that have served as guides for countless innovations from development through to scaling and implementation.

An unwieldy HIT ecosystem (or innovation pipeline), especially related to digital medicine, has developed, one in which innovators create products and then scramble to navigate the complex and opaque needs and buying processes of health systems.

The end consumers may not be familiar with a particular innovation, but they can be assured that the drug or device in question has passed a rigorous FDA-led evaluation. There are no such guidelines or evaluations to serve/for the HIT innovation community.

Medical institutions, meanwhile, struggle to sort through the vaporware and correctly identify the legitimate and promising innovations in digital medicine.

Despite major investments in HIT, drug and device development appear to dramatically outpace that of HIT innovation -- why? This may ultimately be due to the maturity of the innovation pipeline across those three segments of the healthcare system. The drug and device pipeline is far more standardized, academic, and regulated than that for HIT, and it is this level of sophistication that enables a consistent production of novel drugs and devices.

It is clear that HIT must develop a comparably evolved pipeline; only then will this sector stand a chance of enjoying a steady, reliable stream of implementable innovation.

Source: Healthcare IT News (View full article)

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