Traditional RESTful APIs Will Not Solve Healthcare’s Biggest Interoperability Problems

Traditional RESTful APIs Will Not Solve Healthcare's Biggest Interoperability Problems
Brian Platz, Co-CEO and Co-Chairman of Fluree

Interoperability is a big discussion in health care, with
new regulations requiring interoperability for patient data. Most approaches
follow the typical RESTful API approach that has become the standard method for
data exchange. Yet Health Level Seven (HL7), with its new Fast Healthcare Interoperability
Resources (FHIR) standard for the electronic transfer of health data, is
leading to a rash of implementations that, to date, are not solving core interoperability
issues. 

Data is still insecure, users can’t govern their own health
records, and the need for multiple APIs for different participants with
different rights (human and machine) in the network is adding unneeded
expenditures to an already burdened healthcare system. The way out is not to
add more middleware, but to upgrade the basic tools of interoperability in a
way that finally brings healthcare
technology
into the 21st century.  

A Timely Policy 

Doctors, hospitals, pharmacists, insurance providers,
outpatient treatment centers, labs and billing companies are just a few of the
parties that comprise the overcomplicated U.S. healthcare system. 

In digitizing medical files, as required by the 2009 Health
Information Technology for Economic and Clinical Health (HITECH) Act, providers
have adopted whatever solution was most convenient. This has led to the mess of
interoperability
issues that HL7 seeks to remedy with FHIR. 

Existing Electronic Medical Records
(EMR)
systems do not easily share data. Best case, patients have to sign
off to share data with two incompatible systems. Worst case, information must
be turned into a physical CD or document to follow the patient between
providers. Data security is also notoriously poor. Hackers prioritized the healthcare sector as their main target in 2019; breach
costs exceeded $17.7 billion.

The New Infrastructure Rush

When common formats, by way of FHIR and HL7, provided
standards and solutions to empower global health data interoperability, the
industry erupted into a flurry of activity. Thousands of healthcare databases
are now being draped in virtual construction tarps and surrounded by digital
scaffolding. 

Building a new, interoperable data ontology for the entire
healthcare system is a massive undertaking. For one, 80% of hospital data is
managed using the cryptic, machine-language HL7 Version 2. Most of the rest
uses the inefficient, dated XML data format. HL7 FHIR promotes the use of more
modern data syntaxes, like JSON and RDF (Turtle). 

Secondly, databases have no notion of the new FHIR schema.
Armies of developers must build frameworks and middleware to facilitate interoperability.
This is why Big Tech incumbents including Google Cloud Healthcare, Amazon AWS
and Microsoft for Healthcare are jumping into the fray with their own
solutions. 

The outcome, once HL7’s 22 resources are fully normative, will
be seamless information sharing, electronic notifications, and collaboration
between every player in the giant web of patients, providers, labs, and
middlemen. But it will come at a steep cost in the current traditionally RESTful
API-based manner that is being broadly pursued. 

The Problem with APIs

The new scaffolding is expensive, takes data control away
from patients, and is not inherently secure. The number of unique APIs required
to support the access, rights and disparate user base in the healthcare network
are the reason. 

Interoperability requires a common syntax and “language” to
enable databases to talk to each other. The average traditional API costs up to
$30,000 to build, plus half that cost to manage annually. That is not to
mention the cost to integrate and secure each API. A small healthcare
organization with only 10 APIs faces costs of $450,000 annually for basic API
services. 

When you consider that most big healthcare organizations will
need to connect thousands of APIs, HL7’s interoperability schema really is the
best way forward. The traditional API tooling to manage the interoperability of
the well-framed data structures, however, is the problem. 

Moreover, the patient, the rightful owner of their own
health record, still doesn’t have the ability to govern their own data. Because
change only happens in the database itself, the manager of the database, not
the patient, controls the data within. 

In the best case, this puts an additional burden on patients
to give explicit permission every time health records move between providers.
In the worst case, a provider sees an entire medical history without a
patient’s consent–your podiatrist seeing your psychiatric records, for
example.

Finally, each API enables one data store to talk to the
next, opening opportunities for bad actors to make changes to databases from
the outside. The firewalls that protect databases and networks are penetrable,
and user profiles are sometimes created outside of the database itself, making
it possible to expose, steal and change data from outside the database. 

In that light, HL7 is paving the wrong road with good
intentions. But there is another way. 

Semantic Standards and Blockchain to the Rescue

If you eliminate data APIs, secure interoperability, with
data governance fully in the hands of the patient, becomes possible. Healthcare
data silos will be replaced with a dynamic, trusted and shared data network
with privacy and security directly baked in. The solution involves adding
semantic standards for full interoperability, blockchain for data governance
and data-centric security. 

Semantic standards, such as RDF formatting and SPARQL
queries, let users quickly and easily gain answers from multiple databases and
other data stores at once. Relational databases, the ones currently in use in healthcare,
are all formatted differently, and need API middleware to talk to one another.
Accurate answers are not guaranteed. Semantic standards, on the other hand,
create a common language between all databases. Instead of untangling the
mismatched definitions and formatting inevitable with relational databases,
doctors’ offices, for example, could easily pull in pertinent patient records,
insurance coverage, and the latest research on diseases.

Patients, for their part, would use blockchain to regain control
of their data. Patients would be able to turn on aspects of their data to
specific caregivers, instead of relinquishing control to database business
managers, as is currently the case. Your podiatrist, in other words, will not
be able to see your psychiatric records unless you choose to share them. 

The data ledger, which lives on the blockchain, will contain
instructions as to who can update (writer new records on) the ledger, who can
read it, and who can make changes. All changes are controlled by private-key
encryption that is in the hands of the patient; only those with authorization
can see select histories of health data (or, as in the case of an ER doctor,
entire histories, with permission). 

Data security is controlled in the data layer itself,
instead of through middleware such as a firewall. Data can be shared without
API, thanks to those semantic standards, and data are natively embedded with
security in the blockchain. Compliance, governance, security and data
management all become easier. Data cannot be stolen or manipulated by an
outside party, the way it commonly is by healthcare hackers today. 

The interoperability conundrum, in other words, is solved.
Fewer APIs means fewer security vulnerabilities; a common, semantic standard
eliminates confusion and minimizes mistakes. Blockchain puts patients in
control of who sees what parts of their health records. Eliminating the need
for API middleware also saves tens of thousands of dollars, at a minimum.


About Brian Platz 

Brian is the Co-CEO and Co-Chairman of Fluree, PBC, a decentralized app platform that aims to remodel how business applications are built. Before establishing Fluree, Brian was the co-founder of SilkRoad technology which expanded to over 2,000 customers and 500 employees in 12 international offices.


Meaningful Use of Genomics Requires Informatics Beyond EMRs

Why EHRs fall short w/ providing valuable genetic insights
Assaf Halevy, Founder and CEO of 2bPrecise

Electronic medical records (EMRs) are widely expected to serve as a cornerstone technology that drives the delivery of modern patient care. 

But can the EMR alone support all the informatics capabilities required by an ever-evolving healthcare industry? The rapid growth of precision medicine, particularly the use of genetic and genomic information during clinical decision making, is a compelling example that functionality beyond the EMR is required. Not only does genomic data represent a category of information used differently than traditional clinical knowledge, but the volume of data generated through molecular testing alone also requires informatics and management of a higher magnitude than previously required.

The EMR is designed to reflect a snapshot (or collection of snapshots) in time: clinical summaries, annotated lab and test results, operation notes, etc. These are mostly stored as isolated documents, loosely coupled with the rest of the patient chart. They need to remain available for reference over time, in some instances, so providers can chart and contextualize ongoing trends and chronic conditions. However, these views are anchored in time and represent limited actionable value during clinical decision-making months, years, and decades later.

Genomic information, on the other hand, represents a patient’s life signature. DNA rarely changes over the course of an individual’s lifetime. This means the results from germline testing – a patient’s molecular profile – conducted early in life are relevant, meaningful, and actionable during clinical decision making far into the future. They can also deliver insights exposing heritable proclivities that may be life-changing or life-saving for family members as well.

This recognition in and of itself alerts healthcare leaders that they need to adopt an advanced, more sophisticated strategy for data governance, management, and sharing than the approach traditionally applied to other clinical information systems, such as EMRs. 

To be successful, healthcare organizations need an accelerator external to the EMR that is built on a data model unique to the management of molecular knowledge so test results and genomic insights can be used and shared across clinical specialties and care settings, as well as overtime. In addition, the rise of precision medicine requires an agile informatics platform that enables the cross-pollination of genomic data with clinical insights and ever-advancing discoveries in genomic science.

Consider these examples of how EMRs fall short of expectations for optimal use of genomic intelligence:

1. Studies have found that, despite ubiquitous availability of molecular tests, providers consistently fail to identify patients most at risk for heritable diseases. The Journal of the American Medical Informatics Association (JAMIA) recently released research showing that half the women meeting national guidelines for genetic screening are not getting the tests they need to determine their breast and ovarian cancer risk. 

The reason? “The full story of a patient’s risk for heritable cancer within their record often does not exist in a single location,” says the JAMIA article. “It is fragmented across entries created by many authors, over many years, in many locations and formats, and commonly from many different institutions in which women have received care over their lifetimes.” In other words, no matter which EMRs they use, health systems routinely miss opportunities to improve care for patients they see. To achieve greater success, providers need tools that exceed EMR functionality and span multiple clinical systems.

2. Shortly after birth, Alexander develops a seizure disorder. The neonatologist orders a germline test to help her arrive at a precise diagnosis and begin targeted treatment. This approach is successful and Alexander thrives. In addition to genomic variants identifying the cause of his seizure disorder, the test results also contain information about other heritable risk factors, including cardiovascular disease.

Decades later, in the 70s, Alexander sees his primary care provider (PCP) with a rapid heartbeat and shortness of breath. After doing routine lab work, the PCP diagnoses congestive heart failure (CHF). If, however, the PCP had access to Alexander’s genomic test results – which remain as relevant and accurate as when he was an infant – the PCP would have noted a variation that indicated the CHF was due to dilated cardiomyopathy, requiring a different treatment regime.

It is vital that health leaders immediately begin to plan an informatics strategy that accommodates genetic and genomic data while empowering providers to leverage these insights at the point of care as they make routine, yet critical, clinical decisions. As they evaluate their approach, they would do well to ask the following questions:

– Which providers in my organization are already ordering genomic tests on their patients? How are test results being stored and managed – and can they be easily shared with and accessed by others in the health system?

– As the volume of genetic and genomic testing accelerates – and it will – how will we manage the volume of data generated? How will we apply consistent governance to the ordering process? How can we ensure results will be consumed as discrete data so our organization can optimize its value now and in the future?

– What steps do we need to take so our precision medicine strategy remains current with changing science? Which informatics tools deliver access to up-to-date knowledge bases and clinical guidelines to ensure optimal medical decisions are made?

The advent of precision medicine represents a new standard of care for healthcare providers from coast to coast. Genetic and genomic information supplies a new data set that can be used to arrive at more accurate diagnoses sooner and more effective treatment faster. This, in turn, supports better outcomes, higher patient (and provider) satisfaction, and competitive differentiation for the health system adopting precision medicine first in its market.

But to capture this value, healthcare leaders must look beyond their legacy EMRs, recognizing that they were not developed nor do they have the capacity to properly handle the upcoming data revolution. Instead, industry innovators are looking for platforms agnostic to individual EMRs and integrated with molecular labs to address the next-generation demands of precision medicine.


About Assaf Halevy

Assaf Halevy is the founder and CEO of 2bPrecise, LLC, leading an international team dedicated to bridging the final mile between the science of genomics and making that data useful at the point of care. He joined Allscripts as senior vice president of products and business development in 2013 when the company acquired Israel-based dbMotion. An initial inventor and co-founder of dbMotion, Halevy helped develop the leading clinical integration and population health management platforms in the industry today.

With 13 patents pending in the areas of actionable clinical integration, interoperability, and precision medicine, Halevy leverages his industry expertise by evaluating strategic alliances and partnerships for U.S. and international markets. Halevy was invited to participate in several U.S. government activities and contribute to an HHS privacy committee task force. In 2016, he was part of a small selective group of executives invited to the White House by Vice President Joe Biden to discuss the future of interoperability.


How to Capitalize on Digital Health Momentum in 2021

How to Capitalize on Digital Health Momentum in 2021
Adam Sabloff, Founder and CEO of VirtualHealth

As we re-examine the healthcare system in the wake of the pandemic, we are continually identifying opportunities to rebuild parts of the system to new and improved specifications. One critical facet is digital health, where we continue to struggle with what should really be table stakes: the ability to integrate data from disparate organizations and systems into a unified view of the whole person and take action.

During the height of the pandemic, telehealth made it possible to deliver care that was personal yet socially responsible. As a direct benefit, the use of digital health tools on both the clinical and consumer side picked up a tremendous and timely head of steam. But what will become of these innovations once we make our eventual return to normal?

Today, many healthcare consumers can talk to a therapist or a counselor through text, monitor glucose levels through a diabetes app and meet with their primary care provider over videoconference. The challenge is that a lot of this patient data is still landlocked in electronic medical record (EMR) systems that do not communicate or coordinate with one another or with payer systems or consumer apps.

The sustainability and applicability of digital health tools are still often questioned despite reports that investors had poured a staggering $5.4 billion into the digital health industry just by June of this year (Rock Health). The key to success is to seamlessly connect these tools with legacy systems and siloed access points to create a truly integrated healthcare continuum. Jumping between systems, each holding only its own limited slice of patient data, and then trying to take action on this data, is neither scalable nor sustainable.

Healthcare consumers have long looked at the seamless nature of apps in other areas of life and asked for a similar level of accessibility and on-demand, high-quality information from the healthcare system. Accenture found in its 2020 Digital Health Consumer Survey that although consumers are interested in virtual services, a cumbersome digital experience turns them off. Additionally, the survey found that concerns over privacy, security, and trust remain, along with difficulty integrating new tools and services into day-to-day clinical workflows.

The good news is that the Office of the National Coordinator (ONC) has made several major data exchange rulings this year that will push providers and payer organizations to update legacy systems to make consumer health data more assessable and sharable across all parties, all for the benefit of the patient.

The Stage is Set: Healthcare Leaders Must Act, Now

The incredible investments in the industry, increasing consumer demand, and data sharing regulation show that healthcare connectivity and interoperability have never been more essential. To ensure that the digital health transformation and remote healthcare delivery models progress optimally beyond the current environment, we must support healthcare organizations in evolving their infrastructure and software capabilities to support this kind of strategy. This is where health tech has a critical role to play in building flexible pipes to connect the full spectrum of repositories and players, including doctors, specialists, nurses, care managers, health coaches, caregivers, and, of course, the healthcare consumer.

What does this look like in practice? Imagine if an unusually high heart rate warning was triggered by a patient’s smartwatch, which then alerted the patient’s care manager to check-in. With a comprehensive view of that patient, the care manager calls the patient to assess if they are okay and learns the patient ran out of their prescription which helps lower the heart rate. Knowing that patient does not have access to a car and is afraid to take public transportation due to COVID-19, the care manager then sets up a prescription delivery straight to that patient’s doorstep.

Through this process, digital health tools, patient data, and social determinants of health all came together to equip that care manager to deliver personalized care to the patient. Sound like sci-fi? This innovative approach can actually be a reality for organizations that manage large populations. The key is educating more healthcare leaders about the benefits of a comprehensive healthcare platform that improves health outcomes, lowers costs and increases member satisfaction. 

This all starts with a platform that coordinates and aggregates the siloes of data and tools (clinical and digital) into a central hub. that allows providers to oversee the access points, plans, and processes in a patient’s healthcare journey without the task of building or maintaining the system themselves. This can be a game-changer in the way we assess and treat patients and help the industry to fully realize the dream of truly comprehensive, coordinated care.


About Adam Sabloff

Adam Sabloff is the founder and CEO of VirtualHealth, provider of HELIOS, the leading SaaS care management platform, serving more than 9 million members across the U.S. Prior to VirtualHealth, Sabloff served as VP of Development and Chief Marketing Officer for Midtown Equities, a $7 billion real estate, media and aviation conglomerate, where he also oversaw its technology subsidiary, Midtown Technologies.


Despite COVID-19: Providers Should Not Lose Sight of MIPS Compliance

Despite COVID-19: Providers Should Not Lose Sight of MIPS Compliance
Courtney Tesvich, VP of Regulatory at Nextech

When 2020 began, no one anticipated that complying with the Merit-based Incentive Payment System (MIPS)—the flagship payment model of the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP)—would look so different halfway through the year. Like many other things, the COVID-19 crisis has delayed, diverted, or derailed many organizations’ reporting efforts and capabilities. Lower procedure volumes, new remote work scenarios, and shifting priorities have taken attention away from MIPS work. 

Despite the disruptions and uncertainties associated with the pandemic, healthcare organizations should not lose track of MIPS compliance and the program’s intent to improve care quality, reduce costs, and facilitate interoperability. Here are a few strategies for keeping a MIPS program top of mind. 

Understand the immediate effects of the pandemic on MIPS reporting 

Due to COVID-19, CMS granted several 2019 data reporting exceptions and extensions to clinicians and providers participating in Medicare quality reporting programs. These concessions were enacted to let providers focus 100% of their resources on caring for and ensuring the health and safety of patients and staff during the early weeks of the crisis. For the 2020 MIPS performance period, CMS has also chosen to use the Extreme and Uncontrollable Circumstances policy to allow requests to reweight any or all of the MIPS performance categories to 0%.

Clinicians and groups can complete the application any time before the end of this performance year. If practices are granted reweighting one or more categories but submit data during the attestation period, the reweighting will be void and the practice will receive the score earned in the categories for which they submit data

Seize the opportunity to improve interoperability 

Interoperability is a key area that organizations were focused on before the crisis, and this work still warrants attention. If an organization is not on the front lines of the COVID-19 response, it should use this time to shore up communications with other entities so, once things return to “normal,” it will be well prepared to seamlessly exchange information with peer organizations. 

Establishing processes for sending and receiving care summaries via direct messaging is important for practices to earn a high score in the Promoting Interoperability category. Direct messaging is a HIPAA-compliant method for securely exchanging health information between providers, which functions as an email but is much more secure due to encryption. A regular pain point organizations face is being unable to obtain direct messaging addresses from peer organizations, including referral partners.

To assist providers in this area, the Office of the National Coordinator for Health Information Technology (ONC) and CMS has created a mandatory centralized directory of provider electronic data exchange addresses published by the National Plan & Provider Enumeration System (NPPES). The NPPES directory is searchable through a public API and allows providers to look up the direct messaging addresses for other providers. To meet current interoperability requirements, providers must have entered their direct messaging address into the system by June 30, 2020. If they haven’t done so, the provider could be publicly reported for failure to comply with the requirement, which could constitute information blocking. 

Take time now to ensure direct messaging addresses have been entered correctly for all members of your practice. This is also a good time to begin reaching out to top referral sources to make sure they are also prepared to send and receive information.

Look for ways to streamline quality reporting 

Over the next few months, the focus will return to quality measure reporting. As such, it’s wise to take advantage of this time to ensure solid documentation and reporting methods. Electronic medical records (EMRs) can be helpful in streamlining these efforts.

For example, dropdown menus with frequently used descriptions and automated coding can enable greater accuracy and specificity while easing the documentation process for providers. Customizable screens that can be configured to include specialty-specific choices based on patient history and problem list can also smooth documentation and coding, especially if screen layouts mirror favored workflow.

Regarding MIPS compliance in particular, it can be helpful to use tools that offer predictive charting. This feature determines whether a patient qualifies for preselected MIPS measures in real-time and presents the provider with data fields related to those items during the patient encounter—allowing the physician to collect the appropriate information without adding additional charting time later on. 

With respect to reporting, providers may benefit from using their certified EMR in addition to reporting through a registry. At the beginning of the MIPS program, providers could report through both a registry and EMR directly and would be scored separately for their quality category through each method. They would then be awarded the higher score of the two. This method had the potential to leave some high-scoring measures on the table.

Beginning in 2019, providers reporting through both registry and EMR direct are scored across the two methods. CMS uses the six highest scoring measures between the two reporting sets to calculate the provider’s or group’s quality score, potentially resulting in a higher score than the provider would earn by reporting through either method alone. 

A knowledgeable partner can pave the way to better performance

COVID-19 has impacted healthcare like no other event in recent history, and it’s not surprising that MIPS compliance has taken a back seat to more pressing concerns. However, providers still have the opportunity to make meaningful progress in this area. By working with a technology partner that keeps up with the current requirements and offers strategies and solutions for optimizing data collection and reporting, a provider can realize solid MIPS performance during and beyond this unprecedented time.


About Courtney Tesvich, VP of Regulatory at Nextech

Courtney is a Registered Nurse with more than 20 years in the healthcare field, 15 of which have been focused on quality improvements and regulatory compliance. As VP of Regulatory at Nextech, Courtney is responsible for ensuring that Nextech’s products meet government certification requirements and client needs related to the regulatory environment.  


M&A: Imprivata Acquires Patient Privacy Intelligence Company FairWarning

M&A: Imprivata Acquires Patient Privacy Intelligence Company FairWarning

What You Should Know:

– Imprivata acquires FairWarning Technologies, a provider
of patient privacy intelligence.

– The combined solutions will offer healthcare a single Digital Identity platform that integrates role-based access controls, identity governance, and data privacy compliance.


Imprivata®, the digital identity company for healthcare, today announced the acquisition
of FairWarning
Technologies, LLC
, a Clearwater, FL-based provider of patient privacy intelligence. The
combination of Imprivata and FairWarning
solutions provide customers with a single Digital Identity platform that
integrates role-based access controls, robust identity
governance, and critical data privacy compliance.

Patient Privacy
Intelligence Platform

FairWarning is an analytics and insider threat detection platform. The platform ingests hundreds of data sources, such as EMR, CRM, HR, and others, and applies data logic and machine learning to identify potential breaches of protected information. Primarily serving the healthcare market, FairWarning is the leader of Patient Data Privacy Intelligence and Drug Diversion analytics that serves compliance officers in the protection of Protected Health Information (PHI). FairWarning also provides similar data privacy solutions specifically designed for mission-critical business applications for enterprise and financial services.

“Like Imprivata, FairWarning is focused on delivering a world-class experience that ensures customers benefit from the full value of the investment in their solutions,” said Gus Malezis, CEO of Imprivata. “I’m thrilled about the similarities we share in culture and in our commitment to our customers. We’re excited to make FairWarning a key component of our go-forward analytics and Digital Identity strategy, and to be able to offer our customers a broader set of solutions from a single vendor that is committed to delivering innovative products and a signature customer experience.”


KLAS: Epic, NextGen, Cerner Best at Making Outside Patient Data Usable

Epic, NextGen, Cerner Best at Making Outside Patient Data Usable, KLAS Finds

What You Should Know:

– New KLAS report finds acute and ambulatory care EMR
vendors Cerner, Epic and NextGen are best at making outside patient data usable
for clinicians (data from outside the clinician’s health system).

– KLAS report examines adoption and usability among advanced
users of the main acute and ambulatory care EMR vendors.


The national interoperability networks of Carequality and CommonWell Health Alliance have become some of the primary means by which patient records are shared between healthcare organizations in the US. Despite progress in delivering interoperability, the number of providers connected to these plug-and-play networks, and the usability of the shared data varies significantly depending on the EMR in use. The KLAS report, Interoperability 2020 (Acute/Ambulatory) examines adoption and usability among advanced users of the main acute and ambulatory care EMR vendors.

Epic, NextGen, Cerner Best at Making Outside Patient Data
Usable

The report reveals Cerner, Epic and NextGen are the best
acute/ambulatory EMR vendors at making outside patient data
usable for clinicians (data from outside the clinician’s health system). Epic
continued to enhance the end-user experience with its Happy Together solution delivering
the most natural integration of outside data into the clinician workflow,
including the recent addition of basic lab trending.

KLAS named NextGen as the only ambulatory specific EMR vendor
to provide a strong usability experience for all interoperability workflows,
while Cerner customers validated its strong capabilities for accessing and
incorporating a wide variety of outside data into the patient record.

Duplicate PAMI Data a Growing Problem

Customers of both Cerner and Epic say the next step is for
the vendors to reduce the duplication of problems, allergies, medications, and
immunizations (PAMI).

NextGen Healthcare is the only vendor whose customers report
significant improvement in this area. The NextGen EMR is able to filter out duplicate
medications, even for inexact matches (e.g., Tylenol vs. acetaminophen). While
other solutions may be capable of flagging duplicate information and removing
some of it, customers say the process is often still very manual.

Other key findings of the report include:

– athenahealth and Epic continue to lead in overall
adoption, with nearly all customers connected to CommonWell Health Alliance
network.

– Cerner has been encouraging customers to adopt the
CommonWell connection for some time, and over the past 18 months, the number of
customers live has doubled, meaning a majority of clients are now connected.

– NextGen Healthcare has also continued to advocate for the adoption of Carequality among its customer base.

– eClinicalWorks customers have been actively connecting;
their usability experience remains similar to what it was in the past.

– Since early 2019, many organizations have implemented Expanse, but the adoption of CommonWell among MEDITECH customers has increased only slightly (from two customers to eleven).

– Allscripts was a founding member of CommonWell in 2013 but
never connected. After multiple delays and a shift to Carequality, they
connected their first customer (via dbMotion) in the second half of 2020.

Epic Pharmacy Progress Made But Gaps Remain, KLAS Report Finds

What You Should Know:

– Despite pressure to take an Epic-first approach to
software decisions, many pharmacies at Epic organizations have held on to
third-party products due to the relative immaturity of some of Epic’s more
recently developed pharmacy solutions.

– Latest KLAS report explores medication inventory
management (MIM) and IV workflow management—the two areas where Epic has
focused much of their development efforts—to validate what capabilities these
modules deliver and where gaps still exist.


Despite pressure to take an Epic-first approach to software decisions, many pharmacies at Epic organizations have held on to third-party products due to the relative immaturity of some of Epic’s more recently developed pharmacy solutions, according to the latest KLAS report. Recently, Epic has put a significant focus on broad pharmacy development (the only enterprise EMR vendor to have done so), and customers want to know—is it time to switch?

To answer this question, the latest KLAS report, Epic
Pharmacy Solutions 2020
explores medication inventory management (MIM) and
IV workflow management—the two areas where Epic has focused much of their
development efforts—to validate what capabilities these modules deliver and
where gaps still exist.

What Progress Has Epic Made with Medication Inventory and
IV Workflow Management

Customers agree that Epic does well at helping with initial
implementations and continuing to develop needed interfaces. Once live,
customers are highly reliant on their own internal Willow analyst teams to
customize workflows and deliver reporting to drive optimization. As a result,
pharmacy managers and directors can feel they lack a direct Epic connection and
the ongoing vendor guidance and expertise that many third-party pharmacy
vendors typically provide.

Other key findings of the report include:

– Willow tracks in-Scope medications well, but gaps remain
with reporting.

– Completeness of data from solutions outside the Epic ecosystem
varies, requiring significant IT investment from customers, who would like both
Epic and the hardware vendors to partner better around interfaces.

– IV dispense prep meets core needs for customers, but
additional gaps include Epic’s lack of deep expertise in clean-room safety and
lack of hardware (which precludes customers from being able to completely
consolidate vendors).

– Epic pharmacy functionality delivers breadth but not
depth.

For more information about the report, visit https://klasresearch.com/report/epic-pharmacy-solutions-2020/1703

HP Launches EMR-Integrated Print Solutions to Digitize Point of Care Workflows

HP Launches EMR-Integrated Print Solutions to Digitize Point of Care Workflows

What You Should Know:

– HP launches patient-first print technologies to help healthcare
workers stay safe and spend more time caring for patients.

– Innovations co-developed with healthcare professionals
include industry’s first sterilizable printers, exclusive EMR-compliant
workflow solutions, and services to improve patient safety and privacy.


Today, HP Inc.
officially launched new print solutions for the healthcare industry. Based on
deep customer insights and co-developed with healthcare providers, associations
and partners, HP Healthcare Print Solutions address the most pressing issues
facing the healthcare industry today including patient wellness and safety,
care coordination, mobility, privacy and security. 

Reducing the Risk of Virus Transmission and Healthcare-Associated Infections 

HP’s new Healthcare Edition MFP keyboards and touch-enabled
control panels are designed to be disinfected regularly, withstanding up to
10,000X industry-standard germicidal wipes, helping to reduce the risk of
health-care associated infections (HAIs) and viral pathogen transmission. 
HP has further enhanced the disinfection capabilities of high-touch areas of
the printer with removable covers/drapes that can be sterilized daily in an
autoclave up to 134 ºC. HP is also collaborating with Clorox Healthcare to
offer a guide detailing infection prevention best practices and other
educational tools.

In order to enhance support of infection prevention
policies, HP has also broadened disinfection capabilities of HP Personal System
devices to include HP Engage Go3 and HP Elite products such as HP EliteDesks,
HP EliteOne (display panel only), ZBook Mobile Workstations and Z Series
Desktop Workstations, HP Elite and Z Displays (Z, S, E and P series, Display
Panel Only) and HP Education Notebooks (keyboards only) .

The U.S. Centers for
Disease Control (CDC) estimate
s that healthcare-associated infections
(HAIs) are responsible for 1.7
million infections and 99,000 associated deaths
each year. Infections and
viruses add further strains to healthcare organizations’ ability to provide
safe, quality care to patients. Influenza alone accounts for an US$11B economic
annual burden. Studies show commonly used technologies, like printers and
mobile devices, are often highly contaminated with pathogenic bacteria and
viral pathogens. Most IT and IoT devices were not designed to be regularly
cleaned by hospital-grade disinfectant wipes. Repeated use has shown to damage
the integrity of the plastic and, ultimately, the device itself.  

Minimizing Contact with Common Points of Transmission

HP’s unique global Managed Print Services (MPS) program with
Zebra Technologies provides the HP Advance mobile app on Zebra’s TC52-HC
handheld touch computer to enable care providers to minimize contact with
common points of infection transmission at the point of care. Providers can
walk up to any HP Healthcare Edition MFP, authenticate with the TC52-HC mobile
computer and release critical patient documents without having to touch the
device.    

Reducing the Risk of Electromagnetic Interference (EMI)

Patient and clinical worker mobile and IoT devices add to a
very congested radio spectrum that can interfere via electromagnetic
interference (EMI) with life-saving medical devices. The new HP Health
Solutions portfolio of IoT hand-held devices and IoT print devices are EN/IEC
60601-1-2 certified for EMI safety. The EN/IEC 60601-1-2 certification
ensures these devices can be used within the patient sphere and shared patient
areas without risk of EMI to sensitive patients and surrounding medical
equipment. 

Helping Ensure Positive Patient ID 

Patient identification errors are common and can lead to
serious reportable events that harm not only the patient’s health, but also the
clinical standing of the healthcare facility where such an error occurred. Together,
HP and Zebra solutions empower clinicians to better manage positive patient
identification through integrated color patient ID wristbands, trackable
specimen labels printed on-demand with Radio Frequency Identification (RFID)
location services and point of care identification solutions for patients.

Digitizing Processes for Faster, More Efficient Care
Coordination 

HP Healthcare Edition MFPs include the HP Workpath Biscom for Healthcare app fully integrated
with EPIC and Cerner. This
enables the entire clinical team to digitally transmit and receive patient
information and high-resolution color imaging like MRIs or directly input data
into the electronic
medical record (EMR)
system right from an app on the printer.  As a
result, care providers can make timely critical decisions to improve the
experience of patients and the entire care team and give back face time with
their patients. 

68% of physician respondents reported feeling burned out at
the moment, largely because of paperwork, regulatory demands and electronic
health record (EHR) documentation. Important pieces of healthcare data can fall
through the cracks, frustrating patients who don’t understand why a specialist
can’t see last week’s diagnostic test result or why they were not offered a
diabetic-friendly hospital menu while staying as an inpatient, for
example. 

Protecting Patient Privacy and Security

As the implementation of technology advances, so too are the
security threats against healthcare systems.  To help healthcare
organizations defend against emerging threats, HP provides the world’s most
secure PCs16 and printing solutions to protect patient privacy and sensitive
information. The new Healthcare portfolio also offers Basic Print Cloud
Services delivered through a service, HP Print Security Advisory Services and
HP Security Manager that provides patient data protection to all HP devices,
with the added protection of PrintSecure on Zebra wristband printers.

Availability

HP Healthcare Print Solutions are now available for direct
MPS customers in North America with plans to roll out across Europe and Asia in
2021.

WellSky Acquires CarePort Health from Allscripts for $1.35B

WellSky Acquires CarePort Health from Allscripts for $1.35B

What You Should Know:

– Health technology leader WellSky has agreed to acquire
CarePort Health to power coordinated care transitions for acute and post-acute
care patients for $1.35B.

– By providing end-to-end visibility across the
continuum, WellSky and CarePort can improve outcomes, lower costs, and increase
patient satisfaction.


WellSky, a global health, and community care technology company, announced today that it has entered into a definitive agreement with Allscripts to acquire CarePort Health (“CarePort”), a Boston, MA-based care coordination software company that connects acute and post-acute providers and payers.


Financial Details

The agreed sale price of $1.35 billion represents a multiple
of greater than 13 times CarePort’s revenue over the trailing 12 months, and
approximately 21 times CarePort’s non-GAAP Adjusted EBITDA over the trailing 12
months. CarePort is included in Allscripts Data, Analytics and Care Coordination
reporting segment and represents approximately 6% of Allscripts consolidated
revenues. Reference should be made to the Allscripts quarterly earnings reports
and supplemental financial data for a reconciliation of non-GAAP Adjusted
EBITDA. William Blair and J.P. Morgan Securities, LLC acted as financial
advisors to Allscripts in connection with the sale of CarePort.


Acquisition Enhances Care Coordination Across Acute,
Post-Acute Continuum

As part of the acquisition, WellSky and CarePort will facilitate effective patient care transitions across the continuum — driving better outcomes for patients, providers, and payers. With the addition of CarePort, WellSky is uniquely positioned to manage the acute care discharge process, track patients across post-acute care settings, apply patient and population-level analytics, and support EMR-based care protocols.

CarePort’s EHR-agnostic suite of solutions connects the
discharge process with post-discharge care coordination — allowing providers
and payers to track and manage patients throughout their care journey. By
providing end-to-end visibility across the continuum, WellSky and CarePort can
improve outcomes, lower costs, and increase patient satisfaction.


“As part of the WellSky team, we will be able to accelerate our mission to connect providers across the continuum. Both of our organizations are aligned in our dedication to proactively bridging gaps in care. Together, we have the technology, analytics, and network to ensure that patients receive seamless care,” said Dr. Lissy Hu, CEO of CarePort. “Joining WellSky means that we can increase vital connections between acute, post-acute, and community care providers to make a meaningful difference in the lives of more patients in more places.”


With WellSky’s deep experience in post-acute care and
CarePort’s suite of care coordination solutions, this combination is a natural
fit. CarePort clients will gain access to a broader network of post-acute
providers and can leverage WellSky’s powerful predictive analytics suite, and
leading value-based care technologies. This combination of capabilities will
enable health systems, payers, and post-acute providers to more effectively
collaborate in a data-driven way and enhance patient outcomes.


“Together with CarePort, WellSky will establish new, meaningful connections between historically disparate settings of care. We have the exciting opportunity to bring care coordination to more providers in service of delivering more informed, personalized care,” said Bill Miller, CEO of WellSky. “Through this agreement, we’re ensuring our clients have the intelligent technology they need to do right by their patients, collaborate with payers, and succeed in value-based care models. It’s WellSky’s mission to realize care’s potential, and this moves us that much closer to achieving it.”


NVIDIA Develops AI Model to Accurately Predict Oxygen Needs for COVID-19 Patients

NVIDIA Develops AI Model to Accurately Predict Oxygen Needs for COVID-19 Patients

What You Should Know:

– NVIDIA and Massachusetts General Brigham Hospital
researchers develop an AI model that determines whether a person showing up in
the emergency room with COVID-19 symptoms will need supplemental oxygen hours
or even days after an initial exam.

– The ultimate goal of this model is to predict the
likelihood that a person showing up in the emergency room will need
supplemental oxygen, which can aid physicians in determining the appropriate
level of care for patients, including ICU placement.


Researchers at NVIDIA
and Massachusetts General Brigham
Hospital
have developed an artificial
intelligence (AI)
model that determines whether a person showing up in the
emergency room with COVID-19
symptoms will need supplemental oxygen hours or even days after an initial
exam.

The original AI model, named CORISK, was developed by scientist Dr. Quanzheng Li at Mass General Brigham. It combines medical imaging and health records to help clinicians more effectively manage hospitalizations at a time when many countries may start seeing the second wave of COVID-19 patients.

EXAM (EMR CXR AI Model) & Results

To develop an AI model that doctors trust and that
generalizes to as many hospitals as possible, NVIDIA and Mass General Brigham
embarked on an initiative called EXAM (EMR CXR AI Model) the largest,
most diverse federated
learning
 initiative with 20 hospitals from around the world.

In just two weeks, the global collaboration achieved a model
with .94 area under the curve (with an AUC goal of 1.0), resulting in excellent
prediction for the level of oxygen required by incoming patients. The federated
learning model will be released as part of NVIDIA
Clara on NGC
 in the coming weeks.

Leveraging NVIDIA’s Clara Federated Learning Framework

Using NVIDIA Clara
Federated Learning Framework
, researchers at individual hospitals were able
to use a chest X-ray, patient vitals and lab values to train a local model and
share only a subset of model weights back with the global model in a
privacy-preserving technique called federated learning.

The ultimate goal of this model is to predict the likelihood
that a person showing up in the emergency room will need supplemental oxygen,
which can aid physicians in determining the appropriate level of care for
patients, including ICU placement.

Dr. Ittai Dayan, who leads the development and deployment of AI at Mass General Brigham, co-led the EXAM initiative with NVIDIA and facilitated the use of CORISK as the starting point for the federated learning training. The improvements were achieved by training the model on distributed data from a multinational, diverse dataset of patients across North and South America, Canada, Europe, and Asia.

Participating Hospitals in EXAM Initiative

In addition to Mass Gen Brigham and its affiliated
hospitals, other participants included: Children’s National Hospital in Washington,
D.C.; NIHR Cambridge Biomedical Research Centre; The Self-Defense Forces
Central Hospital in Tokyo; National Taiwan University MeDA Lab and MAHC and
Taiwan National Health Insurance Administration; Kyungpook National
University Hospital in South Korea; Faculty of Medicine, Chulalongkorn
University in Thailand; Diagnosticos da America SA in Brazil; University of
California, San Francisco; VA San Diego; University of Toronto; National
Institutes of Health in Bethesda, Maryland; University of Wisconsin-Madison
School of Medicine and Public Health; Memorial Sloan Kettering Cancer Center in
New York; and Mount Sinai Health System in New York.

Each of these hospitals used NVIDIA Clara to
train its local models and participate in EXAM. Rather than needing to pool
patient chest X-rays and other confidential information into a single location,
each institution uses a secure, in-house server for its data. A separate
server, hosted on AWS, holds the global deep neural network, and each
participating hospital gets a copy of the model to train on its own dataset.

NVIDIA Announces Partnership with GSK’s AI-Powered Lab
for Discovery of Medicines and Vaccines

In addition, the new AI model, NVIDIA today announced a
partnership with global healthcare company GSK and its AI group, which is
applying computation to the drug and vaccine discovery process. GSK has
recently established a new London-based AI hub, one of the first of its kind,
which will leverage GSK’s significant genetic and genomic data to improve the
process of designing and developing transformational medicines and vaccines.

Located in London’s rapidly growing Knowledge Quarter, GSK’s hub will utilize biomedical data, AI methods, and advanced computing platforms to unlock genetic and clinical data with increased precision and scale. The GSK AI hub, once fully operational, will be home to its U.K.-based AI team, including GSK AI Fellows, a new professional training program, and now scientists from NVIDIA.


NVIDIA Building UK’s Most Powerful Supercomputer,
Dedicated to AI Research in Healthcare

NVIDIA Building UK’s Most Powerful Supercomputer, Dedicated to AI Research in Healthcare

NVIDIA today announced that it is building the United
Kingdom’s most powerful supercomputer, which it will make available to U.K.
healthcare researchers using AI to solve pressing medical challenges, including
those presented by COVID-19.

Expected to come online by year end, the “Cambridge-1”
supercomputer will be an NVIDIA DGX SuperPOD™ system capable of delivering more
than 400 petaflops of AI performance and 8 petaflops of Linpack performance,
which would rank it No. 29 on the latest TOP500 list of the world’s most powerful
supercomputers. It will also rank among the world’s top 3 most energy-efficient
supercomputers on the current Green500 list.

Value-Based Reimbursement Contracts Now Account for 26% of Hospital Revenue, KLAS Finds

What You Should Know:

– Value-based reimbursement (VBR) contracts now account
for 26% of hospital revenue, according to a new report from KLAS research and
CHIME.

– Report reveals providers are looking first to their
electronic health record (EHR) systems to drive PHM, and are most interested in
investing in new healthcare information technology (HIT) when they know there
is a clear ROI. 


With value-based reimbursement (VBR) adoption slowing, healthcare providers are searching for ways to manage risk and achieve ROI on population health management (PHM) solutions adoption, according to a new report from KLAS Research and CHIME – the College of Healthcare Information Management Executives. The new report, issued, reveals that providers are looking first to their electronic health record (EHR) systems to drive population health management (PHM), and are most interested in investing in new healthcare information technology (HIT) when they know there is a clear ROI.  The findings were based on findings from KLAS Decision Insights, the KLAS 2019 Population Health Management Cornerstone Summit, and CHIME’s 2019 HealthCare’s Most Wired data.

Value-Based Reimbursement in 2020: How Far Have We Come?

VBR contracts now account for 26% of hospital revenue. Fee-for-service still outpaces VBR, and over time, the lack of significant progress toward VBR has eroded healthcare organizations’ confidence that the change will happen in the near future. The biggest factors limiting the adoption of VBR are uncertainty that an ROI will be achieved and a lack of needed infrastructure.

How Is Technology Being Used to Support VBR?

Once organizations decide to invest in technology to help
with VBR, they generally turn first to their EMR. Though provider organizations
may not ultimately choose their EMR for certain population health management
(PHM) needs, EMRs are almost always considered, due to (1) assumed integration
with EMR data; (2) anticipated cost savings; and (3) increased ease of access
to PHM data in the EMR.

EMRs are slightly less likely to be used for administrative
and financial reporting—EMRs have historically struggled to provide the nuanced
views needed in these areas, so organizations often opt for third-party
solutions that provide additional analysis, visualization, and ad hoc reporting.
Third-party solutions may be used on their own or in conjunction with EMR
functionality.

Organizations invest in HIT when there is a concrete ROI

Solutions that help organizations identify and act on care
gaps see some of the broadest adoption as they can be helpful with just about
any VBR contract. Once a gap is identified, organizations need to reach out to
the patient and close it, so patient engagement tools are also highly sought
after.

Functionality is a significant driver in PHM purchase
decisions

Healthcare organizations are looking for enterprise EMRs and
broad BI platforms capable of tackling a large swath of their PHM and
VBR-related functionality needs (e.g., root cause analysis, A/B testing, etc.).
In this quest for consolidation, organizations are seeking to eliminate ad hoc
interfaces and replace vendors who haven’t delivered on functionality or
quality.

“Providers are trying to find positive ROI on their population health management investments,” said Adam Gale, president of KLAS Research. “This report offers a useful roadmap for how they can meet that challenge.”

For more information about the report, visit https://klasresearch.com/report/value-based-reimbursement-2020/1705

Why International Expansion Must Remain a Priority for Cerner, Epic, Allscripts, MEDITECH

What You Should Know:

Why International Expansion Must Remain a Priority for Cerner, Epic, Allscripts, MEDITECH

– How the top US acute EHR vendors, namely Cerner, Epic, Allscripts, and MEDITECH (+85% share of US acute market in terms of revenues), have progressed on international expansion.


As highlighted below, there is a significant variance amongst the big four in terms of revenue and share of business outside the US. Cerner has by far the highest revenue at more than $650M in 2019, representing 12% of its business. Whilst MEDITECH has considerably lower revenue than Cerner, its international revenue is broadly similar to a share of its total revenue.

By contrast, Allscripts and MEDITECH each has international business that is comparable in terms of revenues, but as a share of overall revenues, international is much less important for Allscripts.

Allscripts’ international revenue was lower than Epic, Cerner, and Meditech in 2018, however, its growth in 2019 enabled it to overtake MEDITECH and become the third largest of the four vendors in 2019.

Main Chart

Cerner

cerner

Cerner’s international revenues fell marginally as a proportion of its total business in 2019 (11.5%, down from 11.9% in 2018), although revenues grew in absolute terms by 3%. This growth was aided by success in Europe, particularly in the UK and Nordics where it won new contracts. Cerner’s overall revenue suffered a 3% decline in 1H 2020 (versus 1H 2019). Despite the impact of COVID-19, its international business witnessed marginal revenue growth (+1%) and rose as a share of its overall business (11.9%) during this period.

Cerner received a significant boost to its international business in 2015 when it acquired Siemens’ EHR business. This provided it with a broad footprint of deployments in DACH (Germany, Austria, Switzerland), Benelux, France, Norway, and Spain. Since this acquisition, the challenge for Cerner had been to migrate the customer base to Millennium. However, this has not happened to date, particularly in Germany and Spain.

Tough market conditions, especially in Germany which already had a highly competitive acute EHR market, was another factor impacting the market growth. The above challenges faced by Cerner were key drivers behind the deal to sell parts of Cerner’s Healthcare IT portfolio in Germany and Spain to CompuGroup Medical (CGM). Cerner will continue to maintain a presence in Spain and German acute markets via its i.s.h.med solution (originally contracted to SAP/Siemens), which was not included in the CGM agreement. i.s.h.med has also provided Cerner a footprint in several other European, African, and Asian countries such as Russia and South Africa.

In other European countries where Cerner has a Millennium footprint it has had more success, and the additional product support and development costs have been less.

Cerner has a substantial UK presence, in part owing to its legacy relationship with BT and the subsequent contracts given out under the largely failed NPfIT program. These customers do use Millennium and the company has grown this business in recent years. To date, Cerner has an installed base of 26 trusts in the UK, up from 22 in 2019, and has had success upscaling these contracts to include products such as HealtheIntent. It has also grown the number of acute trusts served. For example, in 2018 it won contracts with The Countess of Chester Hospital National Health Service Foundation Trust, previously using MEDITECH, and Sandwell and West Birmingham Hospitals. In 1Q 2020, Cerner was selected by two NHS Foundations Trusts (Ashford and St Peter’s Hospital and Royal Surrey) to implement a shared Millennium EHR system, which should support a more coordinated care approach between the two organizations.

Elsewhere in Europe, Cerner expanded its Nordic business recently with large contracts in Region Skäne and Västra Götalandsregionen (both in Sweden) during 2018 and 2019. Cerner was chosen as the preferred EMR supplier for Central Finland (four of 19 sote-areas) and will have the opportunity to expand the contract to other surrounding regions in the mid-long term. However, it lost its Norwegian footprint to Epic when it chose not to bid when the Helse Midt-Norge (Central region) contract was renewed in 2019.

The company has also seen success in the Middle East, particularly in the UAE, Qatar, and Saudi Arabia. However, growth has been more subdued over recent years. In the UAE, it has large contracts with the Ministry of Health and Prevention (MOHAP) and Abu Dhabi department of health (HAAD). Whilst Cerner already has a significant footprint in Saudi, e.g. King Faisal Hospital, the country is still relatively untapped in terms of deployment of digital solutions and offers Cerner a good future growth opportunity.

In Asia Cerner has been successful in Australia, winning state/territory-wide EHR contracts in both Queensland and New South Wales (the only vendor to win two state/territory-wide contracts), and also had success in other states/territories where procurement is decentralized.  Cerner was aiming to add a third centralized Australian contract to its customer base, namely ACT Health (Capital Territory), but was unsuccessful in a head-to-head with Epic, which was selected as the chosen partner in July 2020. Cerner aims to push its PHM solution (HealtheIntent) through its existing state-level contracts where it already has a presence with Millennium.

Most of Cerner’s non-US business in the Americas is in Canada where approximately 100 hospitals are estimated to be using its solution. Here it faces competition from the other leading US vendors such as MEDITECH, Epic, Allscripts, and also local vendor Telus.

In summary, Cerner has broadly made a success of its international business. It tops the market share table in several of its international geographies and it has done this while broadly maintaining the margins achieved with its US business. However, Cerner’s divestiture of the legacy Siemens business in Germany/Spain, and withdrawal from Norway (Central region), will reduce the size of its European business. Cerner also faces an increasing threat from EMEA competitor Dedalus, whose recent acquisitions of Agfa Health’s EHR and integrated care business, and DXC’s healthcare provider business (deal to close in March 2021), could impact Cerner’s position as acute EHR market leader in EMEA moving forwards.

Allscripts

Allscripts

Allscripts’ international revenues witnessed a substantial rise in real terms (up by 34% versus 2018) and as a share of overall business in 2019. This was partly due to a strong performance in the UK with existing customer sales, and new contract wins in New Zealand, Qatar, Philippines, and Saudi Arabia. The impact of COVID-19 on Allscripts’ total revenues was comparatively significant (versus Cerner and MEDITECH), with declines of 9% and 6% respectively in 2Q 2020 and 1H 2020. It is estimated that these declines predominantly impacted North American revenues, whereas international revenues suffered to a lesser extent.

Canada had historically been its largest market outside the US accounting for just under a third of its non-US business, however, its share fell by six percentage points from 2018 to 23% in 2019, largely owing to the growth of its business in the UK and Australia, which are estimated to now be broadly similar in size to Canada.

In Canada, it is a top-five player, but lagging someway behind MEDITECH, Cerner, and Epic in terms of hospital installations. Allscripts continues to steadily grow its Canadian business with a focus on selling added functionality/upgrades to long-standing customers in three provinces (Manitoba, Saskatchewan, and New Brunswick). It aims to expand its Canadian coverage by securing the contract with Nova Scotia province in 2H 2020.

Success in EMEA was mainly driven by wins in the UK, which included two Sunrise clinical wrap contracts along with several added-value solutions for existing client systems. In May 2019, Gloucestershire Hospitals NHS Foundation Trust selected Allscripts to provide a clinical wrap around InterSystems’ PAS. This was rolled out to the entire Trusts’ inpatient wards in March 2020 and represented the fifth clinical wrap around another vendor’s PAS in the UK. In the UK it serves 18 acute trusts (only Cerner, DXC, and SystemC are estimated to serve more).

Much of the company’s UK footprint was built from its acquisition of Oasis Medical Solutions six years ago. However, it has slowly built on this foundation adding new acute trust customers and upgrading many from the legacy Oasis PAS solution to Sunrise and other Allscripts’ solutions such as dbMotion – although perhaps at a slower rate than hoped. Besides the UK and Italy (where it has one Sunrise contract) Allscripts does not have immediate plans for Sunrise expansion in mainland Europe. However, countries that are attempting to implement integrated data-sharing programs (e.g. France, Germany, and Italy), offer Allscripts potential markets for its dbMotion solution.

Allscripts also achieved growth in the Middle East, fuelled by a contract win in March 2020 with Qatar’s Alfardan Medical / Northwestern Medicine for Sunrise. Allscripts has been working on opportunities across Saudi Arabia, UAE, Oman, Qatar, and Kuwait, with different strategies for each country. For example, Oman has a relatively low level of digital healthcare maturity and is being targeted with EMR solutions, whereas relatively mature health markets (e.g. UAE and Qatar) are being targeted with PHM/dbMotion.

Its entry into the Oceania market was also largely via acquisition (Core Medical Solutions in 2016). Core Medical Solutions was a leading player in the smaller hospital and private hospital markets in Australia. Allscripts has added to this legacy with a state-wide Sunrise EHR contract in South Australia (although deployment has not been without its challenges). Sunrise has been implemented in Royal Adelaide Hospital, South Australia Health and Medical Research Center, University of Adelaide, and the University of South Australia.

In 4Q 2019 Allscripts added South Australia’s largest regional hospital network, Mt Gambier, to its coverage. It also had success selling its Sunrise solution outside of this state-wide contract (e.g. Gippsland Health Alliance in Victoria in 2018) and in 2019 its footprint expanded into New Zealand.

In terms of its broader Asian strategy, the company recently split its Asian business into two sub-businesses, ASEAN and ANZ, indicating it sees opportunities beyond its existing Singapore footprint in South East Asia. This has been supported by 2019 wins in the Philippines. In less digitally mature countries, the BOSSNet EHR solution it obtained via the Core Medical Solutions acquisition offers a potential route to offering a more entry-level EHR solution compared to Sunrise.

At just 4.0% of revenues in 2019, international remains a relatively niche business for Allscripts. To some extent the company needs to decide where it wants to take this business. Relying on organic growth in the regions it currently serves is unlikely to move the dial far from this 4.0% figure over the next five years. A significant change is likely only via acquisition, something the company has not shied from in the past. However, should it focus on cementing its position in existing markets or expansion into new? Given it is not a top-two vendor in any of its current geographies outside the US, acquisition to cement its position in existing markets would make more sense than further expansion into new geographies.

Epic

Historically, there have been two major points of entry into new geography for EHR vendors; either through a partnership to gain expertise and ‘localize’ a solution or through the acquisition of a local vendor (as with Cerner and Allscripts earlier). Both have their challenges, with partnerships often being slow to progress and acquisition resulting in the long-term support, and in some instances a significant burden of a legacy solution (e.g. Cerner is still supporting several legacy Siemens EHR solutions nearly six years after announcing its acquisition plans and most of Allscripts’ UK customers are not using Sunrise).

Examples where vendors have taken on large regional projects without sufficient ‘localization’, have often resulted in projects not meeting expectations and negatively affecting both vendors and providers alike. To some extent, Epic has suffered from this with several of its non-US deployments, in particular in the UK (e.g. Cambridge University Hospitals in 2015) and more recently in Denmark (regional contracts in the Zealand region and Capital Region) and Finland (regional contract in the Apotti Region). 

Epic has not made acquisitions to enter its international markets and in all these examples EHR implementations have not met expectations and have either had to be scaled back, delayed, or required a significant amount of remedial action. The main criticism is often not enough ‘localization’ before deployment. That said Epic has had success elsewhere internationally, with less controversy surrounding its deployments in DACH, Netherlands, Middle East, and Singapore. In Canada, it is estimated to be the market leader in terms of revenues and second only to MEDITECH in terms of hospital deployments.

Epic has increased its focus on international expansion in recent years with incremental increases in revenue. However, it needs to improve on implementation/execution or future opportunities may be limited.  The fact it was the only vendor to hit the preselection criteria in Norway for the Helse Midt-Norge contract which it won in 1Q 2019 (replacing Cerner) suggests that progress has perhaps been made on this front.

Historically Epic has struggled to win any Australian state/territory-wide deployments where Cerner, Allscripts, and InterSystems have been successful. However, Epic strengthened its position by winning its first state contract in July 2020 – a $151m deal for the Australian Capital Territory (ACT Health). This was also significant due to it being the first time the Capital Territory had centralized contracting.

MEDITECH

Meditech

At 12% of 2019 revenue, MEDITECH had the highest proportion of non-US sales of all the vendors analyzed in this insight. However, the overwhelming majority of this was from Canada, where it is estimated to be the market leader in terms of the number of hospital installations (although in terms of revenues it is smaller than Epic, Cerner, and Allscripts). Of approximately $60M in non-US sales in 2019, nearly $50M is estimated to have been from Canada. Non-US revenue share was down marginally from 13% in 2018 and in absolute revenues (-7%) due to a fall in Canadian revenues (-8%), whereas revenue from other international markets was marginally up (+1%).

In early 2018 MEDITECH announced the release of its cloud-based EHR, Expanse. MEDITECH has since been rolling out its cloud-based EHR to new customers and replacing its legacy hosted Magic solution for existing customers. This will ease some of the costs and time associated with implementing the solution, which should make it more competitive. In addition, the data hosted on the cloud will make it easier to drive interoperability through a Health Information Exchange, further increasing its attractiveness for provider networks.

Implementation delays caused by COVID-19 contributed toward MEDITECH’s total revenue declining by 3% in 2Q 2020 (versus 2Q 2019). However, a strong international performance in 1Q 2020 (estimated revenue up by c.25%) was driven by new Expanse installations in Canada (including Ontario Mental Health Hospital), leading to 1H 2020 revenues rising by almost 10% (versus 1H 2019).

Approximately 2% of MEDITECH’s business comes from outside North America, a trend that has remained relatively unchanged for several years. As with Epic, Cerner and Allscripts, a significant proportion of its non-American business is in other English-speaking countries, such as the UK/Ireland (22 customers in the UK and 3 in Ireland – mainly public/private sector hospitals), South Africa (24 hospitals) and Australia (72 private hospitals). In the UK it is a second-tier vendor providing EHR solutions to a small number of NHS trusts (low double-digit). Despite a concerted push into the UK, with the acquisition of Centennial (its UK distributor and system integrator) and the official formation of MEDITECH UK in 2018, the number of trusts served decreased with Cerner taking Chester NHS Trust from MEDITECH in 2018.

The company has had considerable success in Africa, selling solutions in 12 countries including Botswana, Namibia, South Africa, Kenya, Nigeria, and Uganda. In September 2019, it partnered with Aga Khan University for a new 2020 deployment of Expanse in South African and Kenya, and subsequent deployment in Pakistan. Contracts in Kuwait and the UAE result in the whole MEA region accounting for a sizable share of its non-North American business.

MEDITECH’s international business mirrors its US business to some extent. It has one of the largest installed bases of hospitals worldwide, but predominantly small hospitals, and often in countries where spend per bed is low; it is also typically not upselling beyond core EHR, meaning that its international revenues, particularly when Canada is excluded, remain small.

Key Takeaways

In Signify Research’s latest global EHR analysis, it was estimated that the US accounted for nearly two-thirds of global EHR sales in 2019, so for these four vendors it must remain the key priority. However, the US is forecast to be one of the slowest growing EHR markets over the next five years as it approaches saturation, particularly for core-EHR products in the acute market. Further, the acute market in the US has now broadly consolidated around these four vendors meaning opportunities for gains in share through replacement is increasingly rare – the long tail has gone.

The geographic expansion offers a potential avenue to drive growth. However, it is not easy and there are plenty of pitfalls. Localizing solutions, acquiring local vendors, displacing local incumbents, aligning products to match government requirements and projects, and putting in place local implementation, project management, and support teams all require significant time and investment. Because of this, the global market remains highly fragmented and market share change is slow. However, for the big four discussed in this insight, ignoring the international opportunity will significantly limit long-term growth; so despite slow and sometimes painful progress, we expect it to remain a priority.


About Arun Gill, Senior Analyst at Signify View

Arun Gil is a Senior Market Analyst at Signify Research, a UK-based market research firm focusing on health IT, digital health, and medical imaging. Arun joined Signify Research in 2019 as part of the Digital Health team focusing on EHR/EMR, integrated care technology, and telehealth. He brings with him 10 years’ experience as a Senior Market Analyst covering the consumer tech and imaging industry with Futuresource Consulting and NetGrowth Consultants.

Memorial Health Deploys Chatbots to Virtualize Waiting Room Experience

Memorial Health System Deploys Mobile Chatbots to Virtualize Waiting Room Experience

What You Should Know:

– Memorial Health System selects LifeLink Conversational
AI technology to virtualize the waiting room experience for patients

– Mobile chatbots to automate intake for telehealth and
in-person visits, while maintaining COVID-19 social distancing and safety
protocols.


Memorial Health System
, a community-based, not-for-profit corporation serving the people and
communities of central Illinois through five hospitals has selected LifeLink to deploy advanced conversational
technology that virtualizes the waiting room experience for every
patient who has an appointment with their physicians. LifeLink-powered AI chatbots
communicate through natural language-based messaging to help patients confirm
appointments, screen for COVID symptoms,
complete their intake forms, provide timing updates, and check in for their
visits. The mobile solution supports both in-person and telehealth visits.

Virtualize the Waiting Room Experience for
Patients

The virtual waiting room chatbot solution
digitizes processes that were previously handled through manual, one-off phone
calls, paper forms, and in-person interactions. Now patients simply converse
with a digital agent on any smartphone or personal device. Key capabilities
include:

–  Reminder and
confirmation messages are sent ahead of appointments

–  Intake and consent
forms are digitized into conversational workflows and completed before arrival

–  Chatbots educate
patients about COVID-19 protocols and conduct a risk assessment

 – On the day of
appointment, the bot provides timing updates and alerts patients when it is
time to enter the office and go directly to the exam room

 – Integration into
EMR and scheduling systems for full process automation

Why It Matters

As patients get back to seeing their physicians for care, we
must find ways to virtualize that experience to keep everyone safe, but there’s
a bigger opportunity at hand,” said Jay Roszhart, president of MHS’ ambulatory
group.  “We’re always looking for ways to improve our patient experience.
LifeLink chatbots virtualize the entire intake process on mobile devices, which
will ultimately do away with the need for waiting rooms and will
make the patient’s visit more efficient.”

“We were among the first providers to successfully launch conversational chatbot screeners from LifeLink as the COVID-19 pandemic began to spread,” Roszhart added. “Now it’s time to take patient engagement innovation to the next level. The waiting room presents a significant opportunity to reduce costs and streamline operations, all in the context of delivering a better, safe patient experience.”

M&A Analysis: 3 Benefits of Siemens Healthineers’ $16.4B Acquisition of Varian Medical

M&A Analysis: 3 Benefits of Siemens Healthineers $16.4B Acquisition of Varian Medical

What You Should Know:

– Siemens Healthineers and Varian Medical announce a $16.4B deal in an all-cash transaction on 2nd August 2020.

– Deal expected to close in 1H 2021.

– Varian Medical will maintain its brand name and operate “independently”

– Siemens AG will drop holding in Siemens Healthineers from 85% to 72% as part of the transaction.


News of the deal between Siemens Healthineers and Varian Medical will have caught many industry onlookers off guard on Sunday evening. Flotation of the Healthineers business segment on the German stock market raised a few eyebrows back in 2017, but with Siemens AG retaining 85% of the stock, many observers postulated little change to the fortunes of the well-known business; an unwieldy technical hardware leader facing an uphill battle in an increasingly digital market.

However, the Varian deal has just made it very clear that Siemens Healthineers has emerged from the IPO with big ambitions and firepower to match. So, what does this mean for the future?

Win-win?

Three benefits of the deal are clear at first glance. Firstly, Siemens Healthineers will be adding an additional mature product set to its already strong modality hardware line-up. Radiation Therapy hardware (linear accelerators, or linac), is the lion’s share of Varian’s business, for which it is market leader holding over 55% of the global installed base in 2019. Combining this with Siemens’ extensive business in diagnostic imaging and diagnostics will create a product line-up that no major peer can today match. It also opens up opportunities for providing “end-to-end” oncology solutions (imaging, diagnostics, and therapy) under one vendor, a strong play in a market where health providers are increasingly looking to limit supply chain complexity and explore long-term managed service deals with fewer vendors.

Secondly, Varian is operating in a relatively exclusive market, with its only main competition coming from market peers Elekta and Accuray Inc. Demand for linacs has been consistently improving in recent years, with Varian suggesting only two-thirds of the Total Addressable Market (TAM) for Radiation Therapy has been catered for so far. The acquisition, therefore, opens a new growth market for Siemens Healthineers to offset the gradual slowing demand for its advanced imaging modality (MRI, CT) business, a more competitive and mature segment. The adoption of Radiation Therapy in emerging markets such as China and India is also well behind advanced imaging modalities, offering new greenfield opportunities near term, a rarity in most of Siemens Healthineers’ core markets.

Thirdly, Varian has grown to a size where progressing to the next level of growth will require substantial investment in operations and new market channels. Revenue growth over the last five years has been patchy, though gross margin remains strong for this sector. If Siemens can leverage its far larger operational and sales network and apply it to Varian’s product segments, none of Varian’s current main competitors will have the resources to compete, unless acquired by another major healthcare technology vendor.

The Digital Gem 

While the Radiation Therapy hardware business has gained the most attention for its potential impact on Siemens Healthineers’ business, Varian’s software business is arguably its most valuable jewel, hitting almost $600m and 18% YoY growth in FY19.

Many healthcare providers have become increasingly beleaguered by the challenges of digitalization today, especially in terms of complex integration of diagnostic and clinical applications across the healthcare system. This frustration is especially common in Oncology, which sits at the convergence of major departmental and enterprise IT systems, including the EMR, laboratory, radiology, and surgical segments.

Changing models of care provision towards multidisciplinary collaboration for diagnosis and care have only intensified focus on fixing this issue, with some preferring single-vendor offerings for major clinical or diagnostic departments. The Varian software suite is one of the few premium full-featured oncology IT portfolios available today, competing mostly against main rival Elekta, generalist oncology information system modules from EMR vendors (few of which have the same capability) and a host of smaller standalone specialist IT vendors.

For Siemens Healthineers, the Varian software asset is a great fit. Siemens has for some time been gradually changing direction in its digital strategy, away from large enterprise data management segments towards more targeted diagnostic and operational products. This process began with the sale of its EMR business to Cerner for $1.3B back in 2015, with notably reduced marketing focus and bidding or deal activity on big imaging management deals (PACS, VNA etc.) in North America in recent years.

Instead, Siemens Healthineers has channeled its digital efforts on three main areas where it has specialist capabilities: advanced visualization and access to artificial intelligence for image analysis; digitalization of advanced imaging hardware modalities, including driving efficiency for fleet management and radiology operations; and lab diagnostics automation. While still early in this transformation, this approach is tapping into the main challenges facing most healthcare providers today; improving clinical outcomes at a net neutral or reduced cost, better managing and reducing Total Cost of Ownership (TCO), and implementing autonomous technology to augment clinical and diagnostic practice.

Assuming integration with Siemens’ broader portfolio is not too bumpy, it is already clear how the different software assets of the Varian business sit well with Siemens’ digital strategy. The Aria Oncology Information System platform will provide an entry point for Siemens to build on clinical outcome improvement in Oncology (along with Noona/360 Oncology) while also integrating diagnostic content from the Siemens syngo imaging and AI-radiology applications. Further, with growing attention on operational software to support modality fleet services and radiology operations, Siemens could translate this business into RT linac fleet management, an area currently underserved.

With no competing vendor today able to match this capability in Oncology IT, the potential long-term benefits for Siemens’ digital strategy with Varian far outweigh the risks of integration.

From Morph Suits to Moon-shots

As alluded to in our introduction, perhaps most intriguing is the bullish signal Siemens Healthineers has made to its customers and the wider market about its future.

The Healthineers 2025 strategy identified three clear stages of transformation, with “reinforcing the core portfolio” the key aspect of the 2017-2019 post IPO. In the second phase “upgrading” the business focused on pushing up growth targets and earnings per share across all segments while adding capabilities in allied markets.

Picture9

Judged against the criteria for the “upgrading” phase, the Varian deal has ticked all the boxes, perhaps clarifying why Siemens was willing to pay a premium:

The scale of the deal has also reinforced that the gradual untethering of Siemens Healthineers from its corporate parent Siemens AG is bearing fruit, both in terms of flexibility to deal-make and the ability to use the financial firepower of its majority shareholder for competitive gain.

The deal, once completed in 1H 2021, also now puts Siemens Healthineers in an exclusive club of medical technology companies with annual revenues above $20B, with a potential position as the third-largest public firm globally (based on 2019 revenues, behind Medtronic and Johnson and Johnson).

It is therefore hard to argue that the Varian acquisition can be viewed as anything but positive for Siemens Healthineers. Given the current impact of the COVID-19 pandemic and expected challenging economic legacy, the growth potential of Varian will help to smooth the expected mid-term dip in some core business over the next few years.

Yet it is the intention and message that Siemens Healthineers is sending with the Varian acquisition that has is perhaps most impressive; despite the turmoil and challenges facing markets today, it fundamentally believes in its strategy to reinvent its healthcare business and target precision medicine long term.

Its major competitors should sit up and take note; Siemens Healthineers is fast re-establishing itself as a leading force within healthcare technology. The morph suits of the “Healthineers” brand launch was just one small step on this journey; the Varian acquisition is going to be one great leap.


About Steve Holloway 

Signify Research_Steve Holloway

Steve Holloway is the Director at Signify Research, an independent supplier of market intelligence and consultancy to the global healthcare technology industry. Steve has 9 years of experience in healthcare technology market intelligence, having served as Senior Analyst at InMedica (part of IMS Research) and Associate Director for IHS Inc.’s Healthcare Technology practice. Steve’s areas of expertise include healthcare IT and medical Imaging.

Why Now Is The Time to Reimagine Healthcare Through Technology

The Tech Isn’t New – It’s Time to Embrace It (How Patient Comforts Improve All of Healthcare)
Jeff Fallon, CEO, eVideon

It wasn’t that long ago that people went to the bank on a Friday to cash their paper paychecks. Maybe they’d put some in checking and take some out in cash. They’d go to the grocery store over the weekend and maybe write one of those checks. Everyone always had to have a pen with them.

It wasn’t that long ago that people would call the ticket agent and discuss flight options for vacation. They’d send a paper ticket in the mail. When it was time to go, people would carry that ticket with them through the airport and onto the plane. (Of course, people could also keep their shoes on and could bring as much shampoo as their heart desired).

It wasn’t that long ago that if someone needed surgery, they’d have to call to schedule it. The hospital would call again the day before to tell them what time to come. People would travel there, fill out a bunch of paperwork, and be wheeled around to several different areas and talk to several different people. Eventually, they’d wake up post-surgery in a hallway with a bunch of other people and hopefully a family member. They’d wheel the person to their room where they’d have a small TV for entertainment, a dry erase board with some names on it and maybe the room number, and a stack of papers on the bedside table – cafeteria menus, instructions, important phone numbers and the like.

Oh wait – that time is now.

Better, more convenient systems are a no brainer for industries like banking and travel, but the hospital experience is still rife with paper handouts, basic cable packages, and manual dry erase boards with markers that don’t work half the time. Patients shouldn’t settle for that, and in this era when COVID-19 has led healthcare to embrace lots of other conveniences (like telehealth for remote doctors’ appointments), they won’t settle for it anymore.

Imagine a new kind of hospital room. While nobody should take a patient’s TV away, there’s so much more that can be done with patient TV. Most people have smart TVs in their homes that serve as a complete hub for their entertainment. Add a smartphone to the mix, and people can do nearly anything from their couch. A hospital bed should be no different.

Since EMRs became mandatory years ago, hospitals have relied on them as the source of truth for patient records and information. But EMRs paired with additional technology can do so much more. Now, hospitals can pull information from the EMR to personalize the patient experience. Imagine a hospital room TV greeting you by name with soothing music and welcoming imagery. Imagine the pillow speaker handset transforming into a smart TV remote where you can peruse movies on demand, live TV, or Netflix. Take it a step further – imagine that TV can talk to your EMR, so you can watch educational content just for you based on your condition, so you can learn about your care, treatment, and how to recover when you go home. 

Imagine adding more systems. Integrate dietary systems (in concert with the EMR) to let patients order their meals without sifting through paper and dialing phone numbers – as they do at home when they’re using DoorDash. Imagine letting patients dim the lights, request a blanket, or turn the thermostat up if they’re cold, without climbing out of bed and risking a fall. Imagine letting patients use their phones to input important information for the care team to know, or to video chat with a “visitor,” even during a pandemic when in-person visits aren’t allowed – even if the person on the other end doesn’t have a Zoom account or an iPhone for FaceTime.

Imagine never seeing a dry erase board in a patient room again. Instead, a digital display automatically updates with all the patient’s latest information, based on what’s in the EMR. 

Imagine up-to-the-minute precautions displayed instantly and digitally outside each patient’s room so care teams know what PPE they need before they go in.

Technology exists to do all these things. The early adopters are already seeing increased patient satisfaction scores that seem to consistently climb. Beyond that, especially now when nurse retention and preventing care team burnout are paramount, these technologies alleviate the burden on them. Streamlining, digitizing, and virtualizing all aspects of care and a patient’s time in the hospital benefits staff, too. When nurses don’t have to search all over to find markers that work or run back and forth to the printer to get pages of hand-outs for patients, they can spend more quality face time with patients and operate at top of license. 

When patient education is delivered in the right way, at the right time to the bedside, you’re not just saving printer paper – you’re giving patients the tools to succeed at home and avoid costly readmissions. It’s time to reimagine healthcare, and there’s no better time than now when the window to adopt new technology is wide open.


About Jeff Fallon

Jeff Fallon brings over 30 years of experience in healthcare technology, medical devices, pharmaceuticals, and diagnostics to eVideon as their Chief Executive Officer. Prior to joining eVideon, he helped distinguished organizations such as Johnson & Johnson and patient experience technology companies forge innovative strategic relationships and strategies.

5 Critical Considerations for Patient Privacy in Telehealth

5 Critical Considerations for Patient Privacy in Telehealth
Sachin Nayyar, CEO at Securonix

The COVID-19 pandemic has had a tremendous ripple effect across all industries, with one of the most impacted being healthcare. Providers have had to quickly adapt to supporting patients ‘virtually’ in a secure manner, while simultaneously developing procedures to support accurate reporting to government organizations. These changes have placed added pressure on security and privacy professionals, as they struggle to keep up with urgent demand.

Mature healthcare organizations already have stringent policies and procedures in place to remain compliant with government regulatory requirements (i.e., HIPAA, HITECH Act, etc.) and protect patients’ privacy. However, with the new focus on telehealth, unprecedented patient growth, and strict regulations on reporting, the key threats healthcare security and privacy teams need to be able to detect are also evolving: 

  • Unauthorized access to patient data by employees
  • Patient data snooping (by employees, family members, co-workers, etc.)
  • Compromised records (unusual access patters – new locations, multi-location access, etc.)
  • Failed logins and download spikes 
  • Terminated or dormant user accounts being used to gain access
  • Accessing discharged patient records or deceased patient records

Identifying these threats and uncovering suspicious patterns or activities, however, is no easy feat. Most security monitoring solutions cannot integrate with and consume electronic medical records (EMR) in a usable format. As a result, these solutions have limited out of the box content, leaving a majority of threat detection engineering to the security operations teams, which are already overwhelmed. Legacy security tools are no longer cutting it, as they use rule-based security event monitoring methods that do not account for the need to protect patient data privacy required by regulations such as HIPAA, HITRUST, and GDPR. They also lack the ability to protect patient data from insider threats, advanced persistent threats, or targeted cyberattacks.

Successfully monitoring patient data privacy must focus on two key entities: the employees accessing records and the patients whose records are being accessed. Organizations need to be able to visualize and correlate events across these entities and throughout the IT infrastructure and EMR applications to detect suspicious patterns while adhering to reporting and compliance mandates.

Monitoring EMR applications is crucial to detect and prevent suspicious activity that may lead to data compromise. However, this can be a cumbersome process. Given that nearly all EMR records contain patient data information, organizations must maintain the confidentiality of this data while enabling security monitoring. Unfortunately, most traditional SIEMs do not provide solutions to this problem. As a result, organizations are forced to intermix sensitive patient data with other IT data, risking compliance violations.

To achieve these goals in the near term, there are five crucial areas where healthcare security and privacy teams need to focus attention:

1. Remote Access Protocol: Like all other industries, healthcare organizations must now grant remote access to a large percentage of their workforce. As they migrate workers to remote access these organizations must address logistical challenges such as ensuring IT support can keep up with requests and implementing multi-factor authentication. 

2. Security Training: Organizations must make sure that their employees are abreast of the unique challenges that accompany working remotely and associated security best practices (i.e., security hygiene, secure internet connections, strong vs. weak passwords, signs of phishing attacks, etc.)

3. Critical App Exposure: Typically, critical applications containing electronic health records are not exposed to the internet without very rigid security controls. However, with the need to share and access more information via apps, strict security is more critical than ever before. 

4. Use of Personal Devices: Many organizations do not issue corporate devices to all their employees. Therefore, there is a greater security risk as workers are being permitted to use their personal devices to access critical systems.

5. User Monitoring and Detection: Identity activity patterns are vastly different as employees adapt to the new normal. As a result, prospective attack vectors have changed drastically. Monitoring and detecting new patterns of human and non-human identities must happen quickly in order to adapt to the new reality and detect attacks.

With the entire world experiencing unprecedented changes, we must learn to adapt quickly and strategically. New threat patterns will emerge, but it is crucial to remain vigilant about all activity and access occurring across IT infrastructure. Stringent regulations and ethical codes of conduct also mean that organizations need to be more vigilant about protecting patient data privacy than ever before. 

The constantly evolving data landscape makes it hard to differentiate new and normal, from malicious and threatening. Healthcare organizations need to assess their security posture, ensuring that they have proper tools in place to accurately analyze and correlate events across the IT infrastructure and electronic records. Only with access to this full picture will they be able to detect any suspicious patterns and ultimately protect patient data.


About Sachin:

Sachin Nayyar is the CEO of Securonix, a company redefining Next-Gen SIEM using the power of big data and machine learning. drives the vision and overall business strategy for Securonix. Built on an open Hadoop platform, Securonix Next-Gen SIEM provides unlimited scalability and log management, behavior analytics-based advanced threat detection, and automated incident response on a single platform.

Prior to Securonix, Nayyar served as the founder & CEO of VAAU where he led the company from conception to acquisition by Sun Microsystems. Following the acquisition by Sun, Sachin served as the Chief Identity Strategist for Sun Microsystems where he led the vision and strategy for the Sun security portfolio. Sachin is a renowned thought leader in areas of risk, regulations, compliance, identity/access, and governance and speaks frequently at professional conferences and seminars.

Allscripts & eClinicalWorks EMRs Not A Good Fit for Ambulatory Pediatric Practices, KLAS Report Finds

KLAS: PCC, athenahealth, and Office Practicum Named Top Pediatric Ambulatory EMRs

What You Should Know:

– According to a recent KLAS report, Allscripts and
eClinicalWorks EMRs are not a good fit for pediatric practices, while Greenway
Intergy is improving.

– PCC, athenahealth, and Office Practicum EMRs named best suited for pediatric offices.


Despite their unique needs, many ambulatory pediatric
offices are expected to “make do” with generalized EMR templates and charting.
From growth charts, to well-child visits, to immunization tracking, to registry
integration, pediatric offices often find their EMR doesn’t meet their
needs. KLAS’ latest report, “Pediatric
Ambulatory EMR 2020: Best EMR Performers in Pediatric Settings

examines which EMR vendors best ensure pediatric provider success by providing
an outstanding EMR and tailored service. Note that this report is focused on
ambulatory-focused vendors, including pediatric-specific EMR vendors.

Allscripts and eClinicalWorks EMRs Not a Good Fit for
Pediatric Practices; Greenway Intergy Making Improvements

While Allscripts’ EMR is highly customizable and can be
tailored for use in pediatric settings, customers report that in order to make
the solution work for their needs, KLAS reports customers have to dedicate
large investments of time and resources (e.g., hire an IT team to run and
customize the EMR) for customization/optimizations. These investments are not
always communicated to pediatric practices during the sales process, leading to
mixed results and expectations around Allscripts’ pediatric functionality. In addition,
customers cited issues with Allscripts’ support is often subpar or nonexistent.

Although KLAS conducted a limited number of interviews with eClinicalWorks
customers, they cited a negative view of the EMR’s quality, saying it does not
meet the needs of pediatric practices and does not come with necessary
pediatric-specific content or workflows. Multiple respondents also complain
about bugs, crashes, and problematic upgrades that introduce new problems
without bringing substantive fixes. Historically, Greenway Health customers
have felt the solution falls short in aspects like ease of use and needed
functionality; however, a number of interviewed customers feel the vendor is
making more of an effort to listen to customers’ problems and deliver requested
pediatric-specific functionalities.

PCC, athenahealth, and Office Practicum EMRs Best Suited
for Pediatrics

KLAS reports PCC (one of two pediatric-specific vendors in
this report) stands out with the highest overall score and the most consistent
customer satisfaction. They have a proven history of and reputation for
supporting customers and delivering the pediatric-specific technology needed to
successfully run an ambulatory pediatric practice.

KLAS reported athenahealth’s EMR also performs well in
pediatric settings; more than 90% of pediatric customers are satisfied with the
solution and its pediatric specific functionality. Additionally, customers of
Office Practicum (the other pediatric-specific EMR vendor) are generally
satisfied with the functionality they receive and feel it helps make their
practices successful. Recent issues with nickel-and-diming and buggy updates
have caused some frustration for a number of interviewed customers.

For more information about the KLAS report, visit https://klasresearch.com/report/pediatric-ambulatory-emr-2020/1378

4 Ways Healthcare Organizations Can Establish Partnerships to Drive Innovation

Nebraska Medicine’s experience points to four ways healthcare organizations can establish partnerships with vendors that drive innovation and performance excellence.

With public and private healthcare spending significantly outpacing that of other countries, U.S. hospitals face intense pressure to find new ways to capture greater value. More and more, organizations are finding that partnerships with existing vendors can help unlock next-level performance gains in a transformative environment.

Take Nebraska Medicine, for example. In the early 2000s, the health system created multidisciplinary committees to boost revenue integrity and adopted new revenue cycle management processes that strengthened performance—with strong results. But best practices alone are no longer enough to fuel revenue cycle gains at a time of decreased reimbursement, rising out-of-pocket costs, and staffing issues. “You’ve got to be able to get to the data,” says Jana Danielson, Executive Director, Revenue Cycle for Nebraska Medicine—a $1.8 billion academic medical center with two hospitals, ~450 revenue cycle staff, 913,000 hospital billing claims, and 1.6 million physician billing claims per year. 

“Without real-time access to data and data analytics, revenue cycle teams risk making decisions based on emotions, not facts,” Danielson says. “Our partnership with a vendor enables our revenue cycle team to more effectively use data to identify our pain points and empower team members to take the right steps for improvement.”  

Nebraska Medicine’s experience points to four ways healthcare organizations can establish partnerships with vendors that drive innovation and performance excellence.

1. Look for a partner that will challenge your assumptions around performance

The right partner will dig deeper, not only tracking key performance indicators (KPIs) but also taking a hard look at how these KPIs were calculated. 

For example, in revenue cycle management, there are many ways to track clean claim rates, a measure that reflects the quality of claim data that is collected and reported. Some organizations consider a clean claim rate to be the percentage of claims accepted by the payer on the first pass. Others calculate it as the percentage of claims that pass through the organization’s billing department without manual intervention before being submitted to the payer. Depending on how this metric is calculated, sometimes a percentage that seems to indicate above-average performance in comparison with peers may not reflect breakdowns in processes that have occurred before a claim is submitted.

At first glance, Nebraska Medicine’s clean claim rate in 2017 was strong: 

95.87 percent for a physician billing and 87.59 percent for hospital billing. However, using claims analytics, the health system uncovered a hidden challenge. Some billers were bypassing the claim edits. In those instances, claims were being submitted before corrections were made. The result: a lower-than-expected clean claim rate. 

Nebraska Medicine’s revenue cycle leaders worked with the organization’s vendor to tackle this challenge. The revenue cycle department developed scorecards by individual employees that showed their performance against key metrics, including their rate of bypassed edits, and reiterated expectations for revenue cycle processes. Within three months, the number of bypassed edits significantly decreased. Today, Nebraska Medicine’s clean claims rate averages 93.78 percent—well above the industry standard—for more than 900,000 hospital claims per year.

EXHIBIT ONE:

At Nebraska Medicine, Reduction in Bypassed Claim Edits Drives High Clean Claims Rate 

2. Make sure the vendor has both product knowledge and operational expertise

Many vendors make the business case for partnership based on the quality of their product or system, such as a 99 percent clean claim rate or a 3 percent denial rate. Some back up their product expertise by regularly working with clients to optimize their use of a technology or service—and it’s a solid step toward a true partnership.

But the best vendors also commit to understanding the context in which their products or services are used in your organization. They examine your team’s work processes and draw upon their operational expertise to make suggestions for improvement, even when the modifications they propose fall outside their paid relationship with your organization.

Consider that 90 percent of patients expect out-of-pocket estimates before care is delivered—not surprising, given the rise in high deductibles and patients’ expected contribution toward their healthcare costs. Providing a patient financial “concierge” at the point of contact not only helps patients better understand their out-of-pocket obligation but also bolsters an organization’s ability to:

– Collect copays upfront

– Explore barriers to payment and patient-tailored solutions

– Increase point-of-service collections and revenue

The right vendor will offer both tried-and-true and out-of-the-box suggestions to drive increased efficiency and revenue, regardless of whether this boosts the vendor’s bottom line.

3. Ask bold questions—and expect thoughtful responses

We’re at the tip of the iceberg when it comes to using artificial intelligence (AI) in healthcare. AI offers a massive set of capabilities for innovation and improvement in healthcare, including in revenue cycle. For example, the use of machine learning has the potential to elevate revenue cycle performance by predicting:

– When a claim will be paid—and how much—down to the hour of remittance

– The probability that a claim will be denied payment—and why

– Whether a patient encounter will require prior authorization before the date of service

– Whether new edits need to be incorporated into existing workflows based on payer responses and denials

But is now the right time for your organization to invest in AI for revenue cycle, or are there other, more foundational competencies your team should hone first? The best vendors keep a pulse on the industry’s newest innovations and partner with you in determining the right approach for your organization. They also help make the business case for innovation to senior leaders, when appropriate.

As Nebraska Medicine examines opportunities to leverage AI in revenue cycle, it has worked with a claims analytics vendor to assess how payer behavior affects revenue, both in the short term and long term. At a time when the nation’s biggest health plans vary greatly in their time to payment, instant access to payment trends by individual payers empowers Nebraska Medicine to have more candid conversations with payers around performance. It also strengthens Nebraska Medicine’s contract negotiating power.

“We want to make sure we’re not at the bottom of the pile when it comes to our relationships with payers,” Danielson says. “If we are, we need to be able to dive into the specific issues that need to be fixed to improve performance.”

4. View your vendor as a strategic ally

Sometimes, you don’t know what you need until you see it. Other times, the pain points you’re sure to require dedicated focus turn out to be pebble-sized problems, not boulders. The key to finding a true partner in innovation is to actively seek a vendor that demonstrates not just a superior level of service, but also a strong willingness to listen to clients and share candid feedback.  

For example, senior leaders at Nebraska Medicine once asked revenue cycle leaders to uncover what they viewed as “skyrocketing denials rate.” Danielson partnered with the health system’s claims analytics vendor to drill down, by payer, into first-pass denial rates, partial denial rates, and more to provide a complete picture of denials status. These efforts showed one payer’s clean claim rate was 10 points lower than that of its peers.

However, the payer did not account for significant patient volume, translating to a small impact on revenue cycle performance. Nebraska Medicine determined it could make a bigger difference in lowering denial rates by focusing on the organization’s largest payer—avoiding a complete overhaul to the revenue cycle team’s payer relations approach.

Creating an Innovation Mindset

The bar for revenue cycle performance is rising, especially with continued dips in reimbursement rates, an uptick in challenges to claim payment, and an environment where consumers are the new payer. Moving past the traditional mindset of what a vendor relationship should look like toward an innovation mindset enables leaders to more fully benefit from a vendor’s subject matter expertise and accelerates gains in performance.


About Eric NilssonEric Nilsson joined The SSI Group, LLC (SSI) as the Chief Technology Officer to lead SSI’s long-term technology vision. He brings nearly 30 years of experience in the software industry with the last 10 in healthcare technology. Prior to joining SSI, he served as the chief technology officer at Nextech and Surgical Information Systems (SIS), where he focused on SaaS, on-premise EMR and practice management solutions as well as inpatient and ambulatory surgery providers from large hospital networks to surgery centers.

Enhancing Patient Care With a Touchscreen EMR Interface

Enhancing Patient Care With a Touchscreen EMR Interface
 Jeff Fountaine, Director, Healthcare Vertical Market, Elo

A clinician’s mission is to deliver the best possible care to his or her patients. However, when technology gets in the way of the workflow, clinicians are obligated to spend valuable time making sure data inputs are accurate and complete across disparate systems. Nowhere is this more prevalent than with electronic medical records (EMRs).

Dr. Peter Greene, MD, CMIO, with Johns Hopkins, said, “Efficiency is really at the heart of what troubles us most. Clinicians really want the EMR to make their work easier. Current EMRs take up too much of their time and pull them away from face-to-face time with patients and care teams.”

Dr. Greene’s reflections embody the concerns that the design of the EMR system in critical workflows does not put the patient first. To address this, EMR developers are devoting significant effort into making the EMR design work on behalf of the clinician and patient. Many are finding the greatest room for improvement is in implementing touchscreen technology into the workstation on wheels (WoW) or on in-room wall mounts. Such technology allows clinicians to quickly access key sections of the EMR and input important data like physical exam findings and medication type and dosage. 

Transform Healthcare With Touch Technology 

EMR developers are recognizing that touchscreens significantly enhance the clinician’s experience and patient interaction. From the chief medical officer to the clinicians and medical staff, everyone is familiar with touchscreen technology in their daily lives via their mobile devices. Bringing this technology to clinicians’ and nurses’ workflows frees them from needing to use a keyboard and mouse in favor of a more intuitive and dynamic display. This allows them to more quickly and easily access medical records, view medical images, prescribe medication and document care, and improve their efficiency by up to 20%

It’s faster and easier to clean touchscreen displays too, especially when comparing them to a traditional keyboard and mouse. With a solid piece of glass and a seamless surface, the touchscreen is easily cleaned with wipes commonly available is patient settings. Whether it’s COVID-19, common influenza, or another infectious disease, implementing a streamlined touchscreen solution can help protect patients.  

Build a Unified Architecture for Clinicians

Many modern touchscreen-based workflows are built on a mobile architecture like Android. As healthcare organizations invest in streamlined solutions for clinicians, there’s often a gap that occurs when the mobile operating system doesn’t link seamlessly with the desktop architecture. Without a unified platform connecting every touchpoint, organizations lose precious time continually replacing outdated platforms and hardware. Making the decision to invest in a unified architecture will streamline the entire ecosystem, shorten future deployment time, and enable flexibility across the organization. 

The first step for CIOs, CMIOs, CNIOs, and health systems to achieve this is to create a proof of concept that brings together key leaders within the clinical staff to showcase inclusion of touch technology at the desktop level, coupled with mobile devices for a variety of clinical applications. Next, they can deploy a trial built on a flexible, scalable architecture to help the organization better envision the investment they are making before committing more money. 

In this trial, they can demonstrate how the EMR improves key workflows as clinicians more easily enter data and health information while taking care of their patients. From this demonstration, CIOs and health systems can receive feedback from clinicians to share with the EMR engineering team to help them better understand how they can improve the design of their UI/UX to get the most out of the unified desktop and mobile experience. 

From trial and iteration to solution deployment, the objective remains the same – to create an infrastructure that scales to the demands of the environment while leaving the user satisfied. The outcome of patient care is always first and foremost in the minds of clinicians, so the technology should enable them to focus on care and deliver on that ultimate goal.


About Jeff Fountaine

As director of the healthcare vertical market for Elo, Jeff Fountaine develops and delivers solutions that enhance provider experiences and patient engagement in the healthcare and medical market. With 15 years of experience, he addresses critical workflow challenges for clinicians while ensuring positive patient outcomes through the use of technology.

Health Catalyst Acquires Clinical Workflow Optimization Solution healthfinch

healthfinch Nabs $6M for Charlie Practice Automation Platform

What You Should Know:

– Health Catalyst announces an agreement to acquire
clinical workflow optimization solution healthfinch using a mix of stock and
cash.

– As part of the acquisition, healthfinch will be a new
application suite category called EMR Embedded Insights and its refills, care
gaps closure, and visit planning applications will continue to be available in
their original configuration.


 Health
Catalyst, Inc.,
a provider of data and analytics technology and services to
healthcare organizations, today announced that it has entered into a definitive
agreement to acquire healthfinch, Inc., a Madison,
Wisconsin-based company that provides a workflow integration engine delivering
insights and analytics into EMR workflows to
automate physicians’ ability to close patient care gaps in real-time. Health
Catalyst expects to fund the transaction using a mix of stock and cash.

Clinical Workflow Optimization

Founded in 2011, healthfinch has developed the healthcare
industry’s most trusted, most used clinical workflow optimization solution,
Charlie. Charlie’s unique combination of EMR-integrated technology and protocol
content streamlines key workflows such as prescription renewal processing,
visit planning, and care gap closure. With Charlie, health systems are able to
deliver a better, safer patient experience, while also achieving lower rates of
provider and staff burnout, increased care gap closure, improved quality
metrics, and significant time and cost savings for providers and clinical
staff.

Integration with Health
Catalyst Analytics Application Portfolio

The healthfinch acquisition, which will allow Health
Catalyst’s customers to enhance clinical workflows in the EMR, further
strengthens the Health Catalyst Population Health portfolio, which was
bolstered by the Able Health acquisition in February 2020 and Care
Management Suite launch earlier this month.

Within the Health Catalyst analytics application portfolio,
healthfinch will be a new application suite category called EMR Embedded
Insights and its refills, care gaps closure, and visit planning applications will
continue to be available in their original configuration. Additionally, the
healthfinch technology will augment workflows across Health Catalyst’s product
portfolio, with data and insights powered by Health Catalyst’s cloud-based Data
Operating System (DOS™), a healthcare-specific, open, flexible, and scalable
data platform that provides customers with a single comprehensive environment
to integrate and organize data.

healthfinch’s industry-leading capabilities are already in demand from Health Catalyst customers and prospects across multiple product areas including quality measures, care management, population health, patient safety, and others. Providing these capabilities will bring even greater value to Health Catalyst customers by making the critical insights and analytics from the DOS platform actionable within clinical workflows – providing more effective care for patients and saving time for both doctors and staff through automation so they can work at the top of their license. 

“We are thrilled to benefit from healthfinch’s decades of collective experience gained from working with customers across the United States that are using a variety of different EMRs.  And we also find deeply compelling the strong mission and cultural alignment with our respected healthfinch teammates. We are excited to have the healthfinch leadership team and their talented colleagues join Health Catalyst, and we are grateful for the tremendous insights, knowledge and perspectives they bring, which will accelerate the achievement of our mission to be the catalyst for massive, measurable, data-informed healthcare improvement,” said Health Catalyst CEO Dan Burton.

Burton added, “This acquisition highlights Health Catalyst’s ability to integrate and scale software applications on top of our DOS platform. The healthfinch technology will easily serve up actionable insights, derived from DOS and other Health Catalyst analytics applications into the EMR, at the point of care.”

Post COVID-19: 3 Things I Hope Healthcare Won’t Recover From

Post COVID-19: 3 Things I Hope Healthcare Won’t Recover From
Randy Carpenter, SVP of the Executive Advisory Board at HCTec

The loss of lives and livelihoods from COVID-19 is almost too much to comprehend. And yet, slowly, conversations are emerging about the positives percolating from the pandemic. 

It’s human nature to want to look for the positives in even the worst of situations, and I’ve noticed that in both my personal and my professional circles of late, people are talking about the things they hope we don’t lose when things go back to “normal.”  

Chief among them, especially in my healthcare technology circles, is a level of humanity that our previously faster-paced lives, ways, and organizations had perhaps too often and too easily dismissed. Humans on the frontline of care delivery, for example. The effects of social isolation on healthy people, much less those who are sick. The struggle and juggle of modern work-life balance. Inequalities in healthcare access and delivery. 

We’ve long talked about technology’s ability to make some of these things easier, to close some of these gaps, but now we know just how possible they are when people, politics, and policy unite in the face of a pandemic. We now know just how quickly even the largest and slowest-moving of health systems can change course and even course-correct. 

Until now, it’s been far easier to talk about the promise of technology, telemedicine, and remote workforce scenarios than it was to actually deploy them. Because before, to deploy such solutions also meant loss; loss of control, loss of normalcy, loss of humanity. Until now.

Now, the very things that once seemed to threaten us are bringing us and our organizations closer together. They’re also shining a light on the hard facts about the real value (indeed, the necessity) of such soft skills as empathy, communication, and human insight; skills that have never been more important nor more obvious in the deployment of technology, applications, and people to deliver care. 

Amid the COVID-19 recovery that we all hope is near, here are three things from which I hope we never recover: 

 1. Virtual Care Support and Delivery 

Whether telemedicine, telehealth, or the remote workforce, we’ve not merely crossed the chasm but bridged it, and I predict we’re here to stay.

Prior to COVID-19, less than 10% of healthcare visits were conducted with telehealth and/or telemedicine. That number is now estimated at 40% to 50%, and it’s unlikely that the cat gets put back in the bag, nor should it. 

Key enablers of this long-overdue trend have been changing reimbursement policies, the relaxing of regulations governing patient data, and the ability of doctors to treat patients across state lines and platforms thanks to various state and federal licensure waivers

Necessity, too, has relaxed the barriers to working remotely, which until now was relatively unheard of for large health systems with equally large corporate and back-office staff and campuses. 

Back in my CIO days, I too was a believer in the importance of physical office presence. I wanted to see the 50-plus people on my service desk. It provided a comfort level that people were doing their jobs and doing them at the levels that I and our patients expected. 

Being on the consulting side, though, I’ve completely changed my mind. The flexibility of being able to work remotely is a phenomenal perk, and I dare say that the thousands now working from home would agree with me that you actually find yourself working more hours, not fewer, than in an office environment. 

Countless IT Service and Support Desks, one of which I serve on the advisory board, has been working remotely throughout the pandemic, and they’re doing yeoman’s work in the face of huge increases in IT support for health systems across the country deploying more and new solutions for patients, physicians and staff alike. 

For context, telehealth-related calls for one organization at which I serve on the advisory board have jumped 29% during COVID, accounting for more than 30% of calls compared to just 1% pre-COVID. EMR-related calls jumped 54% for one health system client, mostly due to telehealth appointments being conducted through patient portals such as MyChart. We also saw monthly call volume for that same client nearly triple during COVID, with more than 11,500 calls in April alone. 

Overall, we saw a jump in average call duration of more than 60% for telehealth-related calls.

This is likely another trend that continues along with more and more teams working remotely, especially with tech giants like Facebook and Google once again setting precedent. Both recently announced they would let employees continue to work from home for the rest of the year. If that kind of flexibility holds, we’ll likely see unprecedented movement among the tech workforce who may now be freer to pick their employer without the prospect of having to pick up their lives and move. 

This means pay, flexibility, and, yes, communication, become increasingly important in recruiting and retaining the best tech development and support teams. 

2. Communication with Feeling and Facts

To be fair, communications were probably pretty good in most health systems prior to COVID-19, but it was likely more periodic and in the form of an email from HR rather than the constant communications with teams like we’re seeing now.

Every employer in the healthcare arena should continue to focus on employee and stakeholder communication as we see this pandemic through, and indeed well beyond it. According to research from McKinsey & Company, “The overwhelming effects of a crisis strip leadership back to its most fundamental element: making a positive difference in people’s lives. By turning inward to cultivate awareness, vulnerability, empathy, and compassion, and then turning outward to comfort and address the concerns of stakeholders, leaders can exhibit individual care, build resilience, and position their organizations to positively reimagine a postcrisis future.”

Most people are hungry for solid, factual information, and the more that can be disseminated to the organization the better. In fact, the latest Edelman Trust Barometer found that people have increasingly lost faith in traditional authority figures and institutions and have shifted their trust to the relationships within their control, most notably their employers. 

The more we can learn from some of the best practices coming from these times of crisis and upheaval and continue to keep connected with our teams, the better. 

When we demonstrate to our people and our patients that we understand their struggles and needs and that we trust them enough to share real, factual, meaningful information… as well as to work remotely and get the job done and done well… that’s when everyone wins. 

3. Empathic HIT

There has been a dramatic shift in mentality about how and where people do their jobs as well as how and where they receive care. I’ve been heartened by the increased show of heart as we all navigate these uncharted waters. 

I believe this uptick in empathy may, in fact, be COVID-19’s most meaningful consequence, and I believe empathic HIT has newfound intrinsic value. Here’s why. 

Remember that dramatic increase in call volume and call duration that I mentioned earlier? Yeah, well guess why these calls are lasting longer. The Continuous Improvement Manager who supervises IT Support Desk teams at one organization I’m involved with tells me it’s because their people are focusing as much on the humans on the other end of the line and their holistic needs as they are on the reason they called in the first place. 

Recently, one of the supervisor’s agents received a call from an elderly patient in her 80s whose husband had just passed away. To access his life insurance policy and cover funeral expenses, she needed to gather all sorts of health information, but she couldn’t access his medical records. Adding to her stress, she wasn’t particularly tech-savvy. The agent helping her knew the patient was already traumatized to have lost her husband, and she knew it had to be heightened by the pandemic, so she was determined to help ease some of her stress. Instead of transferring her to another department – billing, medical records, insurance – the Support Desk agent stayed on the line with her for two and a half hours, helping her through every phone conversation with all of the right people to ensure she received everything she needed.

While a lengthy phone call may sound like a relatively simple task for some, it meant the world to the human on the other end. These are the kinds of soft skills that make technology work for us. Empathic HIT Support understands that it’s not just a numbers game or getting to the next call. Rather, it’s about being a voice of comfort and reason and being curious enough to ask the questions that lead to the right answers, connecting people with technology in ways that lead to access to care and healing. 

I’ve been both proud and impressed with how our healthcare providers have responded to the challenges we’ve been presented these past few weeks and months. We’ve probably grossly over-engineered as many solutions as we’ve simplified, but that’s ok. Healthcare people, in general, don’t wait for solutions, they usually create them. They’re creative people who want to do good for their patients and their people.

About Randy Carpenter

Randy Carpenter is currently the Senior Vice President of the Executive Advisory Board at HCTec. He has over 30 years of experience in all aspects of Healthcare Information Technology (HIT) and has held various leadership roles for healthcare and pharmaceutical services organizations throughout his career.

Hospital Wayfinding: The Next Frontier in Healthcare Design

Wayfinding: The Next Frontier in Healthcare Design
Christopher Thompson, RN, Director of Patient Experience, CenTrak

Healthcare facilities and their sprawling campuses can be overwhelming and challenging to navigate. In fact, facilities lose close to $800 million a year due to missed hospital appointments, and many physicians blame a significant portion of this lost revenue on the problems patients have navigating these facilities.

Figuring out where to park and finding the correct office can be stressful and negatively impact the patient’s experience. Making matters worse, most hospital staff members work in the same unit day in and day out. If a patient approaches them with a question regarding directions, they may not be able to provide an answer or will spend valuable time searching for one. When patients get lost, they tend to arrive late for their appointment, which can back up schedules and create costly inefficiencies for facilities. 

Digital wayfinding can help ease this burden on busy staff while improving the patient experience. Visitors also benefit from feeling at ease, knowing they can quickly locate their loved ones. Implementing a wayfinding solution enables healthcare organizations to automate turn-by-turn directions and highlighted routes, making it easy for patients and visitors to find their desired location. 

Hospital Wayfinding Mechanics

Wayfinding: The Next Frontier in Healthcare Design

Most hospital wayfinding systems utilize Bluetooth Low Energy (BLE) technology found in smartphones, which allows for seamless connectivity and lets patients and visitors view the hospital map on their device and navigate in real-time. To deploy this application successfully, all buildings and outdoor areas of the facility must first be mapped. 

Once a facility’s maps are finalized, they are uploaded to a Content Management System (CMS) with correlating data such as pathways, routes, and points of interest (POIs). If desired, facility administrators can easily access the cloud-based CMS to create, update and manage maps, points of interest, and pathway routing. Advanced analytics such as real-time occupancy, the volume of visits, historical routing and heatmaps, dwell times, space utilization rates, and web usage data are available for in-depth reporting. This information can help your facility better prepare for the future and ensure your patients receive the care they need. 

Locating infrastructure, including BLE beacons, are easily installed to provide indoor location data to the application layer. For more precise coverage and use case expansion, facilities can leverage other Real-Time Location System components using a combination of technologies such as Wi-Fi, Second Generation Infrared, Low Frequency, and BLE. Combining a wayfinding solution with other location services investments reduces IT burden, enhances patient and staff satisfaction, and improves ROI. A future-proof solution can continue to add immense value to healthcare facilities for years to come. 

Hospital Wayfinding and Patient Experience

The most advanced indoor wayfinding applications offer many features, including interactive hospital directories, pathway management, informative POIs, navigation from home, geofencing, and location sharing. They can trigger appointment reminders, GPS driving directions to the facility, and turn-by-turn directions once a patient has arrived. Various routes are provided to patients, visitors, and staff who can select filters such as ADA compliance or minimized outdoor travel time in poor weather conditions. These routes are customizable and can also be modified for construction routes, new additions, staff-only and visitor access, and even pathways that avoid specific areas, like COVID-19 units, to support infection control. 

The mobile application can contain keyword smart search and can also share helpful details such as contact information, hours of operation, images, videos, descriptions, and URLs. While at the facility, patients and visitors can share their indoor location via text and email. When it is time to leave, they can use the save my parking feature to locate their parked car. In the case of an emergency, the application can direct patients where to go to receive urgent assistance to avoid wasting precious minutes. 

Other technologies such as Electronic Medical Records (EMR)/Electronic Health Records (EHR) and Real-Time Location Systems are easily integrated with the wayfinding solution to improve patient experience and make healthcare workers’ shifts easier. Patients can access personalized appointment information such as care plans, questionnaires, and check-in capabilities through the app. In-app access to leading EMR/EHR systems allow users to launch navigation directly from appointment reminder texts or notifications as well as search for a physician.

Staff members can utilize the solution to quickly search for and locate available equipment, such as wheelchairs. Additional integrations include visibility to ER and urgent care wait times, transportation services, scheduling systems, and more. Multiple delivery options, including mobile applications, touchscreen digital kiosk displays, and web browsers, are also available. 

One day soon, healthcare facilities will be entirely revolutionized by IoT technologies including wayfinding applications. Digital wayfinding solutions are the first application to provide seamless connectivity of indoor and outdoor environments with navigation and routing from home, across campuses, between buildings, and to parking areas. By investing in wayfinding, healthcare facilities can design a better patient experience, improve operational efficiency, and save valuable resources.


About Christoper Thompson

Christopher Thompson is the Director of Patient Experience at CenTrak, a leading provider of location and sensing technology for the healthcare industry. Thompson has a master’s degree in nursing and more than 20 years of experience improving hospital workflow and operations.