The death of the disjointed office via technology

Jan 19, 2018

Most are familiar with the front, middle and back office. It's a business model that has existed for decades and one that has delivered tremendous value for organisations around the world.

It's also a model that, in the wake of new technologies and new digital ecosystems, is no longer an optimised approach for delivering business efficiency. [...]

While offshoring labor delivered significant financial benefits, organisations also experienced the negative impacts of disjointed business structure - namely disconnect amongst workers separated by borders, working cultures and time zones.At the same time, we saw the emergence of new automation solutions capable of managing tedious, data-intensive work. With this came an opportunity to rethink tired business models.

Ripple's Big Bet on Blockchain Technology

tion for forward-thinking businessesFor organisations looking to break down the barriers of their outdated business models and realise the benefits of a cohesive approach where people and automation work seamlessly together, they must focus less on categorising tasks into siloed areas and more about key qualifiers. While back office tasks are typically viewed as automatable work, it's not always that black and white.

Organisations should instead consider qualifiers that assess a task's suitability for automation. For robotic process automation (RPA), the qualifiers for automatable tasks are those that are rules-based, repetitive and have as few exceptions as possible.

With advances in technologies that can process complex data types (including images and voice), however, the range of possibilities can be expanded when those technologies are combined with RPA.

As business leaders looks ahead it's imperative for organisations to shift away from the front, middle and back office split, to a model that harnesses the inherent attributes of the resources available to them.

For many organisations, this might mean assigning rules-based, structured and repetitive processes, as well as work involving text and numbers, to virtual workforces, and allowing humans to focus on ad hoc, offline and image-based work. By taking this approach, organisations can:

• Optimise employees' potential.
• Enhance the client experience through more accurate and efficient processes.
• Ensure business agility and control through a more fluid, stable structure.

By taking advantage of the virtual and human resources available now, organisations will be able to best compete today. And by looking at their business structure comprehensively, they'll be able to assess, design and implement changes that keep pace with the evolving market and new client needs tomorrow.

Source: Information Age (View full article)

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Shaping the Future of Healthcare AI

Jan 19, 2018

[...] AI in healthcare is already poised for explosive growth in coming years as providers and researchers begin to explore the use of the technology in everything from radiology to senior care to public health. In fact, a recent report by Accenture predicts that by 2021 the AI market in healthcare will reach $6.6 billion, a growth rate of nearly 40 percent. Moreover, the technology can potentially create $150 million in annual savings for the healthcare economy by 2026 through efficiencies in cybersecurity, fraud detection, workflow assistance and more.

The market itself is bolstered by companies such as IBM, who's AI platform Watson is already at work in several hospitals to research and pilot ways the tech can be integrated into real healthcare delivery models and clinical decision-making.

The JASON report attributes the rise of AI to three things: Frustration with the existing -- or legacy -- medical systems, the ubiquity of connected devices and a rising comfort with virtual assistants, such as Amazon's Alexa.

Challenges and Next Steps for Healthcare AI

It's not all coming up roses for AI, however. As with any new technology, the ONC stresses that there are also risks and challenges ahead for AI, particularly regarding the integrity of the health data that it relies on to create and inform decision-making.

"What is clear from the report is that without access to high quality, reliable data, the promise of AI will not be realized: the increased availability of digital health data could allow for the use of AI in clinical practice, though issues regarding the quality of existing data must be addressed. Though many of us already use our smartphones and other smart devices in our daily lives, through the availability of open application programming interfaces (APIs), there are still concerns about how health data can be integrated into new tools, as well as equitable distribution of these potentially powerful tools," ONC officials write on the agency's HealthITBuzz blog.

So how will the ONC move forward to ensure this robust digital data is available to form solid foundations for the growth of AI in healthcare? The report lays out next steps:

• Capturing smartphone data: Wearables and apps are changing the way that people monitor their health, and making health indicators more avidly available in real-time via smartphones. Integrating the data generated by these devices can support AI applications and growth, the ONC points out in its blog post.
• Integrating social and environmental data: It's not just vitals that are indicators of health, and in fact, for a city dweller in the U.S., ZIP code is one of the best predictors of life span. "We need to foster capabilities to capture and integrate data on environmental exposures and social behaviors in AI health applications, as health outcomes are very affected by these factors," the ONC notes.
• Supporting AI competitions: Competitions are a great way to foster development of new applications or platforms for AI. "We should consider additional support for AI competitions, which have already shown promise, to further advance data generation and AI development," the ONC says.

As it moves ahead with these and other initiatives that aim to shape the scope of AI in healthcare, the ONC says it will work closely with other HHS agencies, including the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) "to define and identify possible opportunities for the use of AI in their efforts to improve biomedical research, medical care and outcomes, including work related to the advent of precision medicine."

Source: HealthTech (View full article)

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Rural Connectivity Stands as One of Telehealth's Last Hurdles

Jan 18, 2018

Telehealth, also known as telemedicine, has a lot to offer rural regions, but connectivity issues are still getting in the way of the technology's ability to reach its full potential in the U.S.

Despite the hurdles, telehealth is expanding care and specialist options to those who live outside of major metropolitan areas. A new study by the University of Iowa, for example, found that the use of telehealth tech has helped reduce emergency room wait times for patients in rural hospitals by six minutes.

"Telemedicine decreases ED door-to-provider time, most commonly because the telemedicine provider was the first provider seeing a patient," concluded the authors of the report, which focused on 14 rural hospitals with emergency department telehealth programs. The report also found that length of stay for patients first seen by telehealth providers was an average of 22 minutes shorter.

Cheaper technology options mean that healthcare organizations, such as Mercy Clinic Family Medicine in St. Robert, Missouri, can reach out to patients -- who may not otherwise be able to make it to the facility -- via the patients' computers, tablets or smartphones.

"When we first started doing telemedicine, the local rural clinics had to have some very expensive videoconferencing equipment," Karen Edison, the medical director of the Missouri Telehealth Network, told the Columbia Missourian. "Today, we use our regular computers. You don't need to have anything special besides ... broadband access to make that secure and high quality."

But oftentimes, that broadband access does pose a problem for healthcare organizations looking to reach rural patients.

"We still have rural areas in Missouri that don't have high-quality broadband access, and this is a problem all over the country in rural areas but especially in the frontier areas of our country," said Edison.

Broadband Gaps, Buy-In Prevent Remote Telehealth Growth

Many rural healthcare organizations may not have the connectivity necessary to tackle their growing healthcare needs, Bryan Fiekers, senior director of research services at HIMSS Analytics, said during a webinar last month that outlined a HIMSS Analytics study on the impact of rural connectivity issues in telehealth.

"We are asking hospitals to do more and more and the data needs are changing all the time. And there's more and more frequency with which these needs are changing as we move forward," said Fiekers, who is also the primary author on the study. "This is especially challenging for rural hospitals who, in many ways, are more focused on keeping the doors open than on anything else."

What's causing this connectivity gap?

According to the study, a lack of competition to offer fiber to rural areas often means that the quality lags behind urban areas.

"If you need access and you can't get it for some reason, not only has [employing technology] not been helpful, it's been hurtful," said Fiekers. "What good is a digital record if you lose access to your [electronic health records] intermittently?"

This is exacerbated by the fact that clinicians and healthcare staff are already on a time crunch and often don't have the time to wait out slow or frustrating technology.

"They are running around trying to make sure their patients get the best care, and if they are impeded, they will quickly revert back to their old way of doing things," Fiekers said.

Telehealth Programs Can Drive Better Broadband

So, what can providers or industry do to ensure broadband will be able to carry rural healthcare organizations through the next phase of health IT?

There are lots of options on the table at the moment. Connect Americans Now, a consortium of businesses, including Microsoft, and advocacy organizations, are proposing to work with the Federal Communications Commission "to ensure that there is sufficient unlicensed low-band spectrum in every market in the country to enable broadband connectivity," via TV white spaces spectrum, or unused broadcasting frequencies in the wireless spectrum, mHealthIntelligence reports.

Microsoft has even included TV white spaces spectrum in its latest five-year plan, with the aim to connect 23.4 million rural Americans across the country.

"Greater broadband connection for larger rural healthcare providers would lessen the demand for more bandwidth, which in turn would lower costs, resulting in more resources to be reinvested in patient care. Currently, these rural healthcare providers pay up to three times as much for broadband as their urban counterparts, and many times these providers forgo broadband altogether," Microsoft announced in its white paper laying out the plan, released last year.

Meanwhile, the FCC recently proposed raising its broadband spending limits in order to promote rural telemedicine. In the meantime, by adopting telemedicine programs, providers are actually driving better connectivity in these regions.

"Telemedicine is having a pretty significant impact on the organization's strategy to improve connectivity," said Fiekers. "With the goal of improving patient and physician satisfaction, allowing faster access to specialists [through telemedicine] is key to help keep those patients healthy and reduce costs."

Source: Health Tech (View full article)

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How to Build a Foundation for Telehealth Success

Jan 18, 2018

Digital health, and telehealth in particular, is a complex yet rapidly evolving landscape. Provider adoption of telehealth, for instance, continues to grow at a steady pace, from 54 percent in 2014 to 71 percent today, according to HIMSS Analytics.

Organizations looking to start their own telemedicine program must approach the effort thoughtfully. Leading organizations are constantly adopting and responding to today's fast-moving marketplace, mindful of five fundamental building blocks: accountability, strategy, workflow integration, support and education.

Massachusetts General Hospital considered these principles in 2011 as the organization began enterprise investment in telehealth, ranging from video-enabled visits with patients in their homes to remote second opinions.

Establish Accountability and Strategy for Telehealth Programs

Organizations that were pioneers in resourcing telemedicine before it was a buzzword initially placed telehealth responsibilities with the IT department, and ultimate accountability with the CIO. As telehealth services and underlying strategies have matured, many organizations have successfully realigned -- or co-aligned -- reporting and function to executives accountable for strategy and operations, such as a COO or a chief innovation officer.

Strategic ownership of telehealth tells stakeholders that telehealth is not just another technology, but rather a fundamentally different way of delivering care. Leadership buy-in and vocal support are essential for prioritization of resources and focus.

Meanwhile, the extent to which telehealth may provide enterprise support of an organization's strategies is tied to both resourcing and maturity of the program.

In today's constrained environment, it is tempting to spread resources in a broad and shallow manner, rather than deeply and narrowly. Health systems variably use telehealth to increase access, attract new patients, improve patient outcomes and reduce the total cost of care. However, if there are too many priorities, on-the-ground teams might be able to demonstrate value beyond increased patient volume.

The telemedicine programs gaining the most momentum, though, are those rooted in a singular underlying strategy, such as improved value, patient engagement or new business development. Tenacious alignment of organizational strategy with a narrow focus will lead to a more effective program.

Remote Options Make Way for Workflow and Support

One of the biggest barriers to moving telehealth programs into mainstream healthcare operations is provider adoption. This challenge, however, is an opportunity to move the needle on improved workflow.

At Massachusetts General, providers across 15 clinical departments use two-way videoconferencing tools to enhance workflow in a variety of ways. Such technology allows doctors to simply click in and out of encounters with different patients at the same workstation, rather than having to constantly log on and off of the electronic health record to physically walk patients to and from clinic rooms. This helps doctors to mentally stay in the flow of visits.

Additionally, videoconferencing technology allows providers to conduct visits from an administrative office, or even from home, opening valuable in-person space for other patient appointments. It also gives doctors a window into a patient's home environment.

Investigating the potential workflow impacts of such tools prior to deployment is critical.

In addition to ensuring that telehealth is easy to use and creates a safe patient experience, it is essential to provide timely and user-friendly support as needed. Patients, providers and staff will not have a high tolerance for failure.

Consider short-term centralization of activities that are not routine in the early stages of implementation, such as in-person training for new providers, round-the-clock virtual or in-person technical support for providers and community hospital clients, or test calls to ensure patients are ready for an upcoming visit with their provider.

As programs mature, adoption increases and telehealth workflows are built into day-to-day clinical operations, support can naturally evolve to a more decentralized model that mirrors the organization's support approach for other enterprise tools such as phones and computers. Decentralized approaches could take advantage of online webinar training, or a train-the-trainer model designed to educate departmental liaisons on how to address most technical problems, with escalation to centralized resources for more complex issues.

Prioritize Telemedicine Education

At the root of the issue, tomorrow's providers must be educated today to ultimately achieve adoption and sustainability. The reticent provider's rebuff that "my patients aren't ready for telehealth" will be self-perpetuating; if the provider isn't ready, the patient won't be ready either. In healthcare, patients generally are deferential to a provider's recommendations, including the appropriateness of telehealth. Patients are ready for their care to catch up to their digital experiences with transportation, finance, commerce and entertainment.

Insightful feedback from providers that "this isn't how I was trained," gets to the heart of the issue. Providers were trained for in-person care, often over the course of many years of medical education across multiple healthcare provider systems.

Providers must be exposed early and often to virtual options for diagnosis, treatment and prevention. In addition, training moving forward must make the next generation of healthcare providers comfortable with the ongoing transformation of clinical care that today's rapidly evolving digital landscape will require.

Expose clinician trainees to telemedicine and stay tuned for a profound and cascading impact on provider acceptance, patient engagement and the sustainability of healthcare systems.

Digital solutions like telehealth are the future of care, yet like the industry itself, there is no black-and-white formula for success. By taking a methodical approach to implementation, organizations can set themselves up for success, even amid looming hurdles.

Source: HealthTech (View full article)

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Doctors must stop blaming EHRs for clinical documentation shortcut failures

Jan 17, 2018

Overuse of copy and paste in electronic health records is a problem. Sure, it's convenient. And it's entirely understandable why it's a common shortcut used by scores of physicians. But it often results in note bloat - unwieldy patient records overflowing with repetitive documentation - that can potentially lead to serious safety risks.

"Copying or importing text increases the risk of including outdated, inaccurate, or unnecessary information, which can undermine the utility of notes and lead to a clinical error," wrote researchers in a 2017 study in Journal of the American Medical Association.

The practice of copy and paste has to be reigned in, and one chief medical information officer, writing for the Agency for Healthcare Research and Quality, says that has to start with the physicians themselves.

Shannon Dean, MD, CMIO at University of Wisconsin School of Medicine and Public Health, penned a column this month for AHRQ's Perspectives on Patient Safety. She began with an example of what can happen when notation gets lazy.

She cites the case of a 78-year-old man who, "with an alleged history of 'PE' (interpreted by the clinicians as pulmonary embolism) received an unnecessary CT scan to rule out a suspected 'recurrence' of pulmonary embolus.

"As it happens, years earlier, the abbreviation 'PE' had been used in the electronic note to indicate that the patient had had a physical examination, not a pulmonary embolism!" said Dean. "In a vivid example of copy and paste, once the diagnosis of pulmonary embolism was mistakenly given to the patient, it lived on in the EHR."

Beyond the risks to patient safety, that also points to the unnecessary costs that can pile up when unwitting clinicians order tests that are based on erroneous and repetitive data.

Nonetheless, said Dean, too many clinicians still copy and paste as a habit: "Perhaps we are complacent about copy and paste because we remain unconvinced that there is a correlation between its use and patient safety."

In her article, she surveys more than a dozen studies on the subject, and finds that published research into adverse outcomes isn't as voluminous as one might expect, even if it's understood, intuitively, that the practice isn't ideal.

So "it is clear that much work remains to be done," said Dean. She points to toolkits like the one put together by AHIMA, and the fact that Epic has rolled out functionality that can "identify the source of every character within a note, whether it is newly typed, imported from another source, or copied and pasted."

Still, "I am aware of very few organizations that are actively using these tools to educate and mentor clinicians in a systematic way to improve documentation quality," she said.

While more academic research would be welcome on the correlation between copy and paste and patient safety, she said, it's fairly widely accepted that it's a shortcut that should only be used sparingly and in specific instances.

Healthcare organizations need to start making use of resources such as AHIMA's toolkits, Epic's auditing features and innovations like natural language processing technology to help physicians do better with their EHR documentation.

She also points to the OpenNotes initiative, which continues to gain momentum, as another big opportunity: Giving patients the ability to read their own doctor's clinical notes allows them to "hold us accountable for quality documentation."

But at the end of the day, "physicians need to reestablish ownership of the accuracy of clinical documentation," said Dean. "We must stop blaming the EHR for our carelessness and start educating ourselves about how to use documentation efficiency tools, including copy and paste, more responsibly."

Source: Healthcare IT News (View full article)

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Developing The Blockchain in Healthcare

Jan 17, 2018

In terms of cost, healthcare is one of the most heavily debated industries in the United States; fortunately, blockchain has the potential to make a tremendous impact on the healthcare industry, dramatically cutting costs even as it increases security and efficiency. Because blockchains are both secure and transparent, the technology is predicted to transform the way in which patient data is transferred between providers, cutting costs and better protecting sensitive health information. As much as 86 percent of mistakes in healthcare are administrative, according to GetReferral MD, but blockchain holds the potential to prevent those kinds of errors from happening at all.

Companies like Nano Vision want to make our healthcare and medical research more efficient and effective. "Globally, we spend $5-10 trillion on healthcare each year, which includes administrative costs that have very little real impact," the Nano Vision team explains. But the power of blockchain technology and artificial intelligence can do far more than increase efficiency; the platform's Nano Sense™ chip is being designed to actually analyze molecular data and identify health threats in real-time, and in the real world where it impacts all of us.

The implications of this technology are mind-blowing; the system is decentralized and uses a cryptocurrency to share or contribute data, meaning that major institutions, corporations, foundations, and insurers can't control the information collected and stored. It will also be possible for anyone to simply purchase some of Nano Vision's cryptocurrency to direct research funding to a particular disease area. Because it will be able to access critical data in real time (at the molecular level, mind you), it will identify and assess health problems faster and more accurately than ever before.

"Nano Vision is pioneering a life-saving economic system that incentivizes the collection and use of molecular data at a global scale using blockchain and a new crypto asset to share data and resources to fundamentally change the way we address world health," said the Nano Vision team. "This is the trillion dollar challenge of our day."

Despite promising, potentially groundbreaking applications like these, the healthcare industry presents some unique challenges for blockchain technology. For blockchain to be truly successful in healthcare, it's going to have create an infrastructure large enough to support the tech's use in every hospital and care facility across the country. To do that, you'll have to install systems and teach new operations all hospitals and staff, making the potential roadblocks against widespread blockchain implementation steep. Despite these limitations, there is ever more consumer demand for solutions in healthcare, and it's really only a matter of time before blockchain becomes the mammoth healthcare disruptor many are predicting it will be.

Source: TechBullion (View full article)

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Applying The Concept Of Preventative Care To Your Virtualized Application Services

Jan 17, 2018

Healthcare invented the concept of preventative care - the regular analysis of patient health indicators and diagnostics to stay ahead of issues. Practitioners aim to discover health related anomalies in their earliest stages of development in order to treat them quickly before they become life threatening and catastrophic. If we were to extend this principle to the digital services doctors and clinical staff need and use in treating patients, wouldn't it also make sense to monitor and analyse the application services and underlying networks to stay ahead of slowdowns that could wreak havoc throughout the patient care delivery network?

Virtualized Application Services In Healthcare

Most healthcare organizations in recent surveys report wide-spread deployment of virtualized network services and high adoption rates of "as-a-service" models. Micro-services applications, electronic medical records (EMR) and radiology services are just a few of the essential healthcare applications being virtualized or deployed as a service. So when slowdowns and outages occur, doctors, nurses, clinicians, and especially patients may feel the pain.

Pinpointing root cause of degradations has become more challenging given the complexity of the modern environments. Resolution may be delayed and time lost as the ever increasing numbers of equipment and service vendors claim innocence as to the originating source of the problem. In many cases, healthcare IT organizations have proactively implemented visibility and monitoring tools to address such problems. In fact, leveraging wire data has become a popular approach to successfully minimizing risk and even getting ahead of slowdowns and outages in healthcare networks. However, of late, with the explosion in virtualized application server technology, the gaps in monitoring and service assurance visibility for have become more apparent and threatening.

Where Once We Were Blind, Now We Can See

Addressing deployment issues and cost concerns have, to date, been barriers to achieving the necessary visibility into virtualized healthcare applications, regardless of whether they are hosted in private data centers or public cloud environments. Innovations that expand the reach of proactive monitoring and analysis of the east-west traffic of virtualized applications are needed to overcome these visibility challenges.

Consider a multi-specialty, central U.S. healthcare organization that was experiencing slowdowns with its radiology information system (RIS) that leverages the DICOM protocol (Digital Imaging and Communications in Medicine) to communicate. Doctors, nurses, and clinicians require swift availability to RIS for file transfers and accurate retrieval of stored documents and images for the particular patient in question. In this particular case, the healthcare professionals were suffering significant wait times of up to 20 minutes delay in pulling up patients' cardiology images. These cardiology images were critical to have available during patients' exams for evaluation and diagnosis. Given the nature of the cardiology practice, minutes can mean the difference between life and death.

Attempting to rectify this problem had covered a few weeks, several war room calls involving upwards of 20 people from the healthcare organization's IT staff and third-party vendors (including the application provider) without resolving the issue. A great deal of time was lost as each vendor tried to prove it wasn't their part of the environment creating the slowdown.

The IT staff had been proactive in implementing a monitoring solution that relied on wire traffic to provide visibility and service assurance capabilities that helped refine the troubleshooting in the war room. The visibility gap became apparent as the IT staff and application vendor tried to understand how the traffic flowed through the virtualized application server farms. With the aid of their service assurance partner, the healthcare organization implemented virtual agents for monitoring within the RIS application servers to gain the full scope of information necessary to pinpoint the cause of the slowdown.

Preventative Medicine For Virtualized Application Service Assurance

With healthcare IT teams embracing the benefits and value of virtualized server environments, the visibility chasm is only going to become that much more threatening to safe and speedy treatment of patients. In the case of our healthcare with 20 minute delay in cardiology images, their expanded use of the solution they already had in place in their data center for proactive service assurance with the addition of virtual agents for the RIS application servers was the answer. It helped them bridge the gap in visibility to east-west traffic analysis and ultimately revealed that the radiology application was operating incorrectly. The application was archiving new images in third-tier public cloud storage, which was causing significant delays in retrieval and playback.

It would be easy to focus on the tactical value the IT staff reaped in gained with proactive service assurance visibility in the application server farms. That is, they have a significantly reduced mean time to resolve (MTTR) problems across their environment now - down from weeks, and 20 individuals dedicating hours in war rooms to under an hour of analysis time. Or even the impact on the doctors and hospital staff now that cardiac image retrieval has been reduced from 20 minutes to seconds with the corrections implemented by the application developers.

However, in looking at the bigger picture, the Executive Director of the healthcare organization expressed the true strategic value the new visibility provided when she exclaimed, "This almost certainly saved a life!"

Source: Health IT Outcomes (View full article)

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Leveraging Health IT to Achieve Patient, Physician and Cost Benefits

Jan 16, 2018

By implementing the latest technologies to reduce transcription costs, systematize evidence-based guidelines for blood product utilization and prevent outdated test ordering, the system has realized measurable improvements in patient outcomes, contributing to Advocate's reputation as a leader in providing the highest quality of care across the continuum of clinical need.

"Advocate Health Care is committed to delivering the safest and most effective care regardless of setting," said Dr. Bobbie Byrne, chief information officer. "To achieve that mission, we must embrace the most up-to-date technologies to help our health care team members perform their work in both routine and unique circumstances. We are honored to be recognized by HIMSS for our work in using technology to make Advocate a better place for our providers and, most importantly, our patients."

Introducing voice-to-text technology at Advocate

Recognizing that doctors' time is better spent taking care of patients than typing on a keyboard, Advocate leveraged advancements in voice-to-text technology to identify an electronic health record (EHR) solution that allows clinical users to document their findings in the medical record without relying on keyboard entry or telephone transcription. The technology permits physicians to speak at length about different diagnostic or treatment options for a specific patient with the information recorded in the EHR within seconds instead of hours. The clinical users embraced the new process and decreased transcription costs 50 percent in the first year and further decreases in subsequent years.

Additional Advocate information technology initiatives include developing workflows within the EHR that direct clinical users to reduce overuse and improve the patient experience.

Monitoring blood product orders

In 2011, Advocate identified a high level of variability among patients who received blood products. Clinical leaders were challenged to develop guidelines to direct blood product use with real-time EHR decision support. Clinical users were presented with the system guidelines and the patient's specific test results before blood products could be ordered. No user was stopped from ordering blood, but they had to enter a reason why they were ordering blood outside the guidelines. The blood product leadership team circulated utilization reports generated by the EHR team each quarter to help identify outliers and encourage behavior change. The initiative reduced blood product utilization by nearly 50 percent over the first year with sustained reductions five years later. Advocate's clinical leaders attribute the project's success to a combination of effective project management, targeted EHR decision support and reporting to monitor and impact guideline adherence.

Ordering lab tests

Advocate also leveraged the EHR to reduce the likelihood its users would order tests deemed "low utility" by its lab utilization committee by hiding tests within the ordering window. The intervention has curbed improper utilization by two-thirds with a corresponding decrease in costs and a better patient experience.

[...]

Source: HIMSS (View full article)

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Virtual care success lies in EHR, telehealth integrated workflow

Jan 16, 2018

Since it launched its virtual care telemedicine program in October 2016, Mission Health in Asheville, North Carolina, has completed 1,200 patient visits. In November 2017, the provider organization saw its highest overall use with 178 total visits; 155 of those were treated via its Mission Virtual Clinic program and 23 were triaged out for additional evaluation and treatment.

"Since July 2017, we have seen steady growth in the use of Mission Virtual Clinic," said Steve North, MD, clinical director, Mission Virtual Clinic, and a family physician at Mission Health.

The provider organization uses Cerner for its EHR and Zipnosis for telemedicine.

"I believe this growth is due to a combination of increased marketing to the community, increased community acceptance of the care delivery, and increased provider acceptance resulting in fewer referrals out," said North.

Mission Health now is recommending Mission Virtual Clinic in combination with its primary care practices, North added.

Beginning this month, patients who are on insurance plans offered by Mission Health Partners will be able to log into their insurance account and access the Mission Virtual Clinic platform. The organization believes this will help patients see Mission Virtual Clinic as an integrated part of the comprehensive care offered through its health system and ACO.

"The Mission Virtual Clinic is online convenient care for common illnesses from the comfort of the patient's home for only $25, no matter the type of insurance," North explained.

Because of more and more success stories like Mission Health, telemedicine is on the rise. This month has brought several new developments on the telehealth front, as vendors look to capitalize on the recent momentum of virtual care. Among them: InTouch Health, which has expanded its telemedicine offerings with an eye toward both direct-to-consumer delivery and in-house providers, and Teladoc, which debuted an integrated mobile app with a single, patient-centered point of access to answer a wide array of medical needs.

[...]

North believes, based on Mission Health's experience, that the technology-based way of caring for patients will expand in the future and become more important.

"The integration of virtual care into all aspects of medical care will continue to grow as patients and providers become more comfortable with the modalities used to deliver this care," he said.

"Successful integration of Mission Virtual Clinic into our health system will be seen when our primary care triage nurses and on-call providers recommend Mission Virtual Clinic as a treatment option for patients and we see a decrease in the office visits for the acute conditions treated through Mission Virtual Clinic," said North.

Source: Healthcare IT News (View full article)

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Blockchain, Blue Button and interoperability at CES 2018

Jan 15, 2018

The tech world descended upon Las Vegas this week for the annual Consumer Electronics Show, and plenty of health IT's biggest players were in attendance. While much of the discussion was on consumer-friendly health tools and novel digital interventions, there were still a handful of products and discussions between executives and entrepreneurs focused on healthcare's largest roadblocks -- namely, data management and analytics.

"Everyone loves playing in their own sandbox. How does it get to the point of sharing that data? How do we have EMRs being shared across systems today?" Pat Keran, VP of innovation and R&D at Optum Technologies, said during a roundtable discussion at CES' Digital Health Summit. "I think data sharing is first and foremost, but even for the data that we have, how do we effectively analyze that today? How do we use artificial intelligence, deep learning, those types of things that are starting to evolve right now into being a lot more effective for where we're at today?"

With more continuous sensors entering care, a rising challenge is separating the useful data from noise and extracting actionable insights. While most speakers focused on how to address these issues in the consumer space, others highlighted the gaps that health systems and insurers still have to address.

"We really need to start thinking about the caregiver. Until we get all the data integrated and all the interoperability and everything, there are people in the lives of every patient you serve, already there," Stefani Benefield, VP of health innovation at Humana, said during the same session. "Make sure that the data can somehow get to them ... you may not be able to get it into one beautiful care plan yet, and I think we would all love that, but I think we have to be able to trust and put data with people and make sure that you do it in a way that is scalable and gives them just enough information. I actually think [the insight is] there, we just need to get it to the right people." [...]

Source: Healthcare IT News (View full article)

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