The field of neurology is at an inflection point. With a growing aging population, neurologists are facing an increasing number of patients needing care, and the pent-up demand for services due to COVID-19 only exacerbates this issue. The pressure on neurologists is enormous, with surveys indicating excessive stress caused by inefficient workflow and mounting paperwork 1,2. It is becoming increasingly clear that the traditional analog neurological exam and referral system is overwhelmed, and that long waiting times are becoming the norm, impeding prompt care delivery3,4.
For these patients, every moment counts when it comes to diagnosing and developing a treatment plan to address the often-irreversible effects of neurological disease. Neurologists need to be equipped with modern tools that provide the right data at the right time, and that helps them make confident diagnoses and effective treatment plans. This won’t happen overnight, though. By adopting clinically-driven solutions that allow for true data integration and by moving toward a holistic, personalized approach to care, neurology can overcome its historical burdens and advance the future of patient care.
The Digital Revolution and Neurology
The neurologist is the care orchestrator and the data integrator who refers patients out to other physicians and receives back clinical reports. In recent decades, the receiving physicians of the neurologist’s network have undergone a digital revolution. Take radiology for example, where radiologists increasingly rely on intelligent computer algorithms to extract meaningful information from scans, streamlining their workflows and boosting efficiency.
Similar advances are also starting to happen at the neuropsychologist’s office where antiquated paper-based cognitive tests and hand-written reports of results are slowly being replaced by more digital solutions with deeper insights. As the data sources flowing back to neurology become fully digital, the neurologist’s position will inevitably also change. Due to the data integrator role of the neurologist, digitization will enable advanced clinical decision support.
There is huge untapped potential in combining data streams with end-to-end analytics to enhance clinical decision-making and avoid both delayed treatment plans and siloed results. By following these three steps, neurologists will be better equipped to both keep pace with a growing volume of patients with complex needs as well as feel more empowered to make informed, data-driven decisions.
1. Embrace Clinically Driven Solutions
As neurology becomes digital, applying AI algorithms to the data flowing to the neurologist would support efficient neurodiagnostics and enable neurologists to spend more time in other areas of care delivery. Because medicine requires precise measures, AI-powered tools for all parts of the neurological exam need to be thoroughly validated to ensure the results they provide are the same as those interpreted by a clinician.
That being said, while AI and predictive analytics are well-intentioned and can improve workflows, they are only one component of achieving overarching clinically-focused goals. These tools are useful but are a means to the end goal of improving clinical outcomes, such as reducing waiting lists, providing a more precise diagnosis, or monitoring therapy. Whether the specific technology that will take us there is AI or rule-based is secondary.
2. Adopt Cloud-Based Systems for Enhanced Data Sharing
Interoperability will be a key step in advancing neurology. Both structured and unstructured data must be mapped and populated into one place to present neurologists with a complete view of the patient. Today’s workload burden in neurology arises largely from the fact that data points are stored in separate locations and inconsistent formats, and it is time-consuming and laborious to find and integrate them for decision-making.
An intelligent cloud-based solution could map data sources and identify all the relevant diagnostic and therapeutic data, from radiology reports to clinical notes to blood test results or cognitive deficits, to present the full patient picture to the neurologist. Organizing this data and highlighting the most relevant aspects for a neurologist can prompt specific, personalized care pathways.
For example, the multiple sclerosis pathway could present a timeline of lesion load changes and clinical attacks, and correlate it with drug therapy and cognitive changes. This provides the neurologist with a clear treatment plan, while also expediting the patient’s time to care.
Moreover, a robust, secure cloud that allows for easily accessible and shareable data will both facilitate the transmission of data over more sites, such as academic institutions and research centers, helping to further advance our understanding of neurological conditions. By working with hundreds of millions of data points that are acquired, stored, and analyzed in standardized formats, the solution can directly inform future developments of clinical practice based on real-life data. Biomarker research, pharmacological trials, or developing new diagnostic applications can all benefit from such a comprehensive and integrated system.
3. Move Toward Personalized Medicine by Leveraging Clinical Pathways
Shifting our mindset to a personalized medicine approach and moving away from the typical one-size-fits-all will help optimize clinical care quality. The clinical care pathway is a process created by a series of consecutive decisions, which are made by understanding the chain of events in a patient’s own journey, as well as the other patients like them. Capturing data on a continuous basis can paint typical pathways for a given disease, allowing the neurologist to spot deviations from the “norm” that can be tracked per patient.
We can also consider a patient’s lifestyle and use data from cognitive assessments to extend care into the home, leveraging digital therapies and monitoring solutions to assess which activities of daily living are viable. Neurological data can also be used to predict milestones, such as when a patient may need to move into a senior living facility or other supported-care environments.
The more structured data that is accumulated and the more clinical guidelines that are available, the more tailored the care pathway recommendations will become for individual patients, paving the way for personalized neurology.
Looking Ahead to a Promising Future for Neurology
The workload and inefficient processes facing neurologists today are unsustainable. Focusing on the clinically-driven solutions and operating in cloud-based, interoperable systems will help neurology streamline operations and achieve confident clinical decisions. Such solutions would have a positive impact not only on daily clinical practice but on the future of neurology too. While helping the practice of today it can create the practice of tomorrow.
Does the neighborhood I live in affect my health? How am I going to be able to see the specialist without a car? Can I share blood pressure and blood sugar readings I take at home with my doctor so she can monitor how I’m doing? These critical questions have helped to drive precision medicine research as well as improving care management and coordination.
While researchers and providers seek to capture and integrate insightful patient data from non-clinical settings and understand how social and environmental issues impact health,
– Onyx and AMA Innovations partner to rethink ways FHIR-based messaging technology can improve links between healthcare and community-based organizations.
– As part of the collaboration, both organizations will jointly
target grant opportunities through HHS’ Administration for Community Living’s
Social Care Referrals Challenge Program.
Onyx Technology LLC and AMA Innovations Inc., a technology development subsidiary of the American Medical Association, today announced a collaboration to build connections between healthcare providers and social services organizations. The intent is to support holistic health and social care by improving links between healthcare providers and social care networks. The companies will combine their technical expertise to deliver a powerful, HL7® FHIR®-based interoperability solution in response to the Department of Health and Human Services (HHS) Administration for Community Living’s (ACL) Innovative Technology Solutions for Social Care Referrals Challenge.
FIRE WIRE for FHIR-Based Secure Messaging
Onyx and AMA Innovations will develop FIRE Wire, an easy-to-use secure messaging solution that will support FHIR-based application programming interfaces (APIs) to link healthcare provider and social services directories. AMA Innovations will build a directory service, publish appropriate standards through HL7, and provide strategic oversight and guidance around the solution. Onyx will develop a secure messaging solution and end-user applications that leverage the directory. If the companies’ entry is accepted into the Challenge, they will present a demo version to ACL in the first half of 2021.
“AMA Innovations’ reach into medical community’s unique knowledge-base and its expertise in delivering clinically relevant solutions, combined with Onyx’s unique expertise with FHIR, will allow us to deliver on the next level of health data sharing while complying with applicable privacy law and best practices,” said AMA Innovations Vice President Tom Giannulli, MD, MS. “FIRE Wire is a lightweight, standards-based messaging and directory solution designed to facilitate secure, private, point-to-point patient information and referral exchange between individuals across organizations. With FIRE Wire, physicians and others will be able to easily establish trust and exchange messages and structured health information.”
Healthcare provider networks are experiencing enormous pressure to manage financial margins and invest in contactless patient experiences. With overall financial losses projected to exceed $323 billion as a result of COVID-19, a projected $200 billion in administrative waste due to revenue cycle inefficiencies, and increasing pressure to meet digital consumerism demands, it is essential for health systems to find ways to streamline processes, maximize their revenue cycles and cut costs. These industry trends are pushing organizations to invest heavily in automation solutions, such as artificial intelligence (AI) and robotic process automation (RPA) to alleviate operational and financial pressures.
In this rush to invest in automation and digital solutions, providers are often overlooking how a multi-layered technology approach can increase value realization. They need an intelligent automation (IA) platform that incorporates a mixture of powerful AI technology levers such as machine learning (ML), natural language processing (NLP), and optical character recognition (OCR), combined with RPA and workflow orchestration, which enables humans to work harmoniously with these digital assets. This article will examine how this IA platform can be utilized to strategically deliver financial value within the revenue cycle.
When deployed correctly, IA can help health systems realize new revenue streams by improving net revenue capture, deliver cost reductions through automating time-consuming rules-based revenue cycle tasks and produce more predictable reimbursements. However, in order to achieve these financial and operational results, organizations need to assess how and where to apply technology.
If working with unstructured data such as an image file or clinical chart, NLP and/or OCR technology needs to be deployed to pre-process or extract data; however, if you are working with large volumes of structured data, ML can be utilized straight away to assess trends and determine the best way to complete a transaction. When completing repetitive and routine revenue cycle transactions, such as adjustments, insurance verifications, and payment postings, RPA may be the right choice since it employs digital workers to perform these actions accurately and quickly.
While these technology levers deliver major enhancements individually, when utilized together they act as multipliers – expanding the number of revenue cycle challenges that can be solved through automation. With an IA platform, health systems can address several distinctive issues all while continually removing waste from revenue cycle processes and creating more capacity operationally.
With NLP and OCR technology, organizations can convert unstructured data from files that are frequently utilized in healthcare – medical records scanned documents, and audio recordings – into structured, normalized data. For example, OCR can convert explanations of benefits (EOB) PDFs into a data table that RPA bots can then auto-post into patient records. NLP can extract clinical terms from an EMR note and provide key data elements to a machine learning model that will then assess the likelihood of medical necessity denials prior to adjunction. In these scenarios, NLP and OCR are translating everyday documents into workable data for faster processing and applying the full IA platform to generate cost optimization and improve revenue capture across a health system’s enterprise.
An IA delivery platform also gives health systems access to better decision-making tools since the technology can consume large volumes of data and subsequently create learning algorithms that make consistent decisions on behalf of operators based on the task at hand. For example, ML can apply historical claim reimbursement trends when assessing data to predict potential write-offs and then using the integrated workflow platform to either escalate high priority items to operators or direct low-dollar write-offs to RPA to process. These learning algorithms can be applied to many situations within the revenue cycle to achieve greater cost optimization and streamline revenue cycle operations.
Finally, while most revenue cycle processes can be fully automated, there are still exceptions and use cases that require human intervention. Automation technology should be paired with an integrated workflow platform that can determine if a revenue cycle task should be automated or handled by humans to create a natural orchestration and seamless hand-off between digital workers and humans.
To illustrate how the IA platform truly works, let’s look at a common workflow: correspondence management. Paper document processing is still highly prevalent in healthcare, requiring significant resources from health systems. For example, issuing correct billing correspondence to patients requires receiving paper correspondence from banks, such as letters, checks, and EOBs, reviewing what is typically tens of thousands of files per day, and manually entering data from these files into subsequent workflow solutions.
With an IA delivery platform, this process can be automated by utilizing RPA to retrieve these documents, OCR and NLP technology to convert these documents into standard file formats, and then, once again, RPA to process and attach necessary documents into patients’ accounts in the accounting or indexing system. While these activities are taking place, the integrated workflow platform is tracking the activity and flagging any exceptions or high-risk materials that need to be pulled out and handled by humans.
This symbiotic platform creates standardized processes patients can rely on and that can ultimately be scaled. Patient experiences are improved by reducing frustrating administrative errors, such as misplaced information, incorrect bills or inefficient handoffs, that can prolong billing cycles. Health systems also typically see reduced revenue leakage and lower cycle times with automated processes since manual errors are significantly reduced and automation runs processes 24 hours a day.
Since an IA platform can take on numerous revenue cycle challenges across a health system’s enterprise and standardize them – removing many common administrative errors or interoperability issues – it gives leaders more visibility into daily operations allowing them to be more proactive in finding opportunities to boost revenue streams (e.g., ways to eliminate revenue leakage, increase ease of scheduling/payment for patients or maximize patient volume) and continually improve performance. Thoughtful application of these technologies in a platform-based strategy enables provider organizations to improve revenue and reduce costs so that they can prioritize their mission of keeping their patient population healthy.
Now is the time to move past a “one technology fits all” mentality and find solutions that can strengthen and improve multiple revenue cycle workflows and tasks. Given the high cost associated with developing these digital capabilities, health systems need a partner who not only offers the right model, but has made necessary investments toward cutting edge IA research, fully-staffed teams with subject matter expertise, and data-rich analytics needed to foster ongoing performance improvement. With an aligned partnership and IA platform, health systems can produce successful results that achieve intended benefits.
About Sean Barrett Sean Barrett is the Senior Vice President of Digital Transformation at R1 RCM. He joined R1 in 2018 and currently oversees R1’s core product management, automation, and machine learning functions. Prior to R1, Sean spent 14 years at Deloitte Consulting focusing on serving clients primarily in the healthcare provider segment-leading operational performance improvement and technology-driven transformation engagements at many of the largest health systems in the country.
The COVID-19 pandemic, which has taken 270,000 American lives to date, has shined a light on another crisis — the U.S. currently has no standardized system for reporting public health data. Health departments all over the country resort to using paper, fax, phone, and email to transmit and receive critical information, and essential healthcare workers are spending precious time retyping data into systems from printed reports and PDFs.
At the heart of this lack of a centralized infrastructure for reporting public health data is the 10th Amendment of the U.S. Constitution, which says, “The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Because of this amendment, the federal government — including the CDC — is not able to mandate that states, providers, or public health entities use a centralized reporting mechanism for managing all public health data. Further, the 10th Amendment also allows states to set up their own IT systems independently of other states and the federal government. The CDC then has to beg for data that sits in bespoke, disparate information systems in each state andterritory.
Congress has tried three times in the last fourteen years to fix the issue. In 2006, it passed the Pandemic and All Hazards Preparedness Act (PAHPA), which required the CDC to establish the near-real-time, electronic, nationwide, public health data-sharing capability. Four years later in 2010, the U.S. Government Accountability Office (GAO) reported that not even the most basic planning steps were taken to establish the network.
Then in 2013, Congress passed the Pandemic and All Hazards Preparedness Reauthorization Act (PAHPRA), which unsuccessfully called for a near real-time interoperable public health data exchange network. Finally, just months before the current pandemic, Congress passed the Pandemic and All-Hazards Preparedness and Advancing Innovation Act (PAHPAI), and our need for such a system is now greater than ever.
An Interoperable Public Health Data System
The U.S. Department of Health and Human Services (HHS) needs to lead the creation of a modern public health data approach on behalf of all public health agencies throughout the country, including the CDC. HHS was given $1 Billion for public health data infrastructure modernization in the recently passed CARES Act.
A modern approach to public health data would cost a fraction of that and must consist of three things: the creation of a gateway to link and securely move data between public health entities, the adoption of and adherence to widely accepted health data standards, and the creation of a cloud-based data hub for transparent analysis and reporting of data.
Creation of a Data Gateway
Data must be complete, timely, and accurate. A single federal data gateway would allow for the secure, two-way flow of data between all of the components of the public health ecosystem. The idea is not to create new, custom systems as we have done in the past, but to create a single gateway system at the federal level that stitches all existing data systems together using modern application programming interfaces (APIs). Such a system will allow data to timely flow between jurisdictions and up to the CDC so that we can collectively inform public health decision-making and public policy.
We should leverage recently adopted interoperability standards to connect data from existing Electronic Health Records (EHR) and insurance claims systems wherever possible to avoid duplicate entry of data by essential workers.
Adoption of a Standardized Data Model
We need to encourage state and local health organizations to use and promote a standardized approach to collecting data at the points of care, testing, and immunization.
Fortunately, the public health data interoperability challenge can be solved by supporting the private sector’s move to a standardized data model for healthcare data. Congress spent billions of taxpayer dollars over the past several years incentivizing healthcare providers to adopt electronic health record systems and data interoperability standards, most recently as part of the 21st Century Cures Act, which just saw its regulations go into effect this year. Healthcare providers are busy preparing to accommodate the Cures Act’s updated standards and requirements. The federal government should eat its own dog food by adhering to the same standards when creating the new gateway.
The two main standards to pay attention to are Fast Healthcare Interoperability Resources (FHIR) and the United States Core Data for Interoperability (USCDI). Major IT and EHR companies like Google, Amazon, Microsoft, IBM, Oracle, Salesforce, and Cerner have pledged to support these standards meaning they can immediately begin supporting a new gateway and helping America’s public health system quickly modernize.
A Cloud-Based Data Hub
Once the data is available, flowing, and standardized, we need a national, cloud-based data hub to begin gaining insights from COVID infection rates, vaccinations, and many other key indicators important to recovering from the pandemic.
Led by HHS with support from OMB and the White House, this new system could be set up within months. There are well-known tools and virtual computing environments that could be put to use right away. A modern data hub would benefit not only the federal government but also the research community and academia, as these organizations play very important roles in helping us further understand and respond to the pandemic.
Most importantly, such a hub would provide transparency and accountability, giving confidence in the data being reported by providing independent reproducibility of conclusions from data analysis.
About Ed Simcox
Ed Simcox is the chief strategy officer of LifeOmic, the creator of LIFE mobile apps, JupiterOne cloud compliance and security operations software, and the Precision Health Cloud platform in use at major medical and cancer centers. Prior to joining LifeOmic, Ed served as the Chief Technology Officer (CTO) at the U.S. Department of Health and Human Services (HHS), the largest civilian government agency in the world. He led efforts at HHS to effectively leverage data, technology, and innovation to improve the lives of the American people and the performance of the Department’s 29 agencies and offices. While CTO, he also served as Acting Chief Information Officer at HHS, where he oversaw the Department’s IT modernization efforts, IT operations, and cybersecurity
– Philips announces the acquisition of Capsule, a leading vendor-neutral Medical Device Integration Platform with a software-as-a-service business model
– The Capsule acquisition is a strong fit with Philips’
strategy to transform the delivery of healthcare along the health continuum
with integrated solutions.
Philips, today announced that it has signed an agreement to acquireCapsule Technologies, Inc., an Andover, MA-based provider of medical device integration and data technologies for hospitals and healthcare organizations. Capsule’s Medical Device Information Platform – comprised of device integration, vital signs monitoring, and clinical surveillance services – connects almost all existing medical devices and EMRs in hospitals through a vendor-neutral system. Capsule’s platform captures streaming clinical data and transforms it into actionable information for patient care management to enhance patient outcomes, improve collaboration between care teams, streamline clinical workflows and increase productivity.
Founded in 1997, Capsule is the leading global provider of medical device integration (MDI) and information solutions for healthcare providers. Capsule maximizes the value of live streaming medical device data by analyzing and synthesizing it across multiple sensors and devices attached to the patient to advance insight-driven, proactive care.
the company serves over 2,800 hospitals and healthcare organizations in 40
countries across the world. Capsule’s innovations are developed by strong
R&D teams in the U.S. and France. In 2020, the company achieved sales of
over USD 100 million with strong double-digit sales growth. The majority of
sales is related to recurring software-as-a-service and licensing revenues. The
acquisition will be accretive to Philips sales growth and Adjusted EBITA margin
Acquisition Underscores Philips Strategy to Scale Its
Patient Care Management Solutions
The acquisition of Capsule is a strong fit with Philips’
strategy to transform the delivery of care along the health continuum with integrated
solutions. Philips’ current portfolio already includes real-time patient
monitoring, therapeutic devices, telehealth, informatics and interoperability
solutions. The combination of Philips’ industry-leading portfolio with
Capsule’s leading Medical Device Information Platform, connected through
Philips’ secure vendor-neutral cloud-based HealthSuite digital platform, will
greatly enrich and scale Philips’ patient care management solutions for all
care settings in the hospital, as well as remote patient care. As part of the acquisition, Capsule and
its approximately 300 employees will become part of Philips’ Connected Care
“Integrated patient care management solutions supported by essential real-time patient data and AI are core to our strategy to improve patient outcomes and care provider productivity by seamlessly connecting care,” said Roy Jakobs, Chief Business Leader Connected Care at Royal Philips. “The acquisition of Capsule will further expand our patient care management offering. We look forward to integrating our strengths, adding a vendor-neutral medical device integration platform that further unlocks the power of medical device data to enhance patient monitoring and management, improve collaboration and streamline workflows in the ICU, as well as other care settings in the hospital and beyond its walls.”
will acquire Capsule for $635M (approximately EUR 530 million) in cash. The
transaction is subject to certain closing conditions, including regulatory
clearances in relevant jurisdictions outside of the U.S. The transaction is expected to be completed in the first quarter
The majority of industries have decreased or eliminated their use of the traditional fax machine over the past decade, including aviation, retail, and even finance. While the healthcare industry is at the forefront of disease research and treatment, however, it is still heavily reliant on this aging technology.
Traditional fax has become ubiquitous in healthcare. It worked for health systems for many years, but the overwhelming volume of patient data and paper documents the healthcare industry is now processing makes traditional faxing more challenging. In today’s environment, fax is no longer the most convenient, safe, or secure communications format but it is still an ingrained part of practice workflows. The good news is, there is no need to “axe the fax” in order to improve office communications and alleviate paper overload. By transitioning to electronic fax, healthcare providers can maintain their workflows and the benefits of fax, while incorporating it into their overall virtual communications strategy – further simplifying the business of healthcare.
The Traditional Fax Challenge
The challenge with traditional fax isn’t new. In fact, in 2008 the Obama administration allocated nearly $30 billion to incentivize American hospitals and doctor offices to switch from paper to electronic systems. Since then, the industry has made small steps towards a more digitized system via fax servers and virtual patient communications such as secure text and broadcast messaging. While this solved part of the problem by making documents electronic and streamlining communications, it did not address the issue of inefficiency at its core, as practices are still printing, signing, and scanning paper documents. This inefficiency is causing a bottleneck when it comes to getting information transferred quickly, creates unnecessary costs for practices, and causes a lack of integration between health technologies across our healthcare system.
This fragmented, outdated way of communication is not only inefficient and costly, it also impacts patient privacy and safety. At the onset of the COVID-19 pandemic, one Texas health department received so many test results via fax in one day that it simply couldn’t keep up with the amount of paper being spit out – resulting in hundreds of confidential results being dumped on the floor. In addition, the vast differences between old and new technology being blended together are making it difficult to keep track of patient records, share data between practices or report to the government, and more, including important racial, ethnic and geographic data that the Trump administration required for COVID tests. In addition to these challenges, traditional fax eats up staff time that could instead be spent on patient care.
Addressing Outdated Systems and Driving Transformation
While on the surface the solution seems simple, actually addressing this challenge at its core is not as easy as it seems. Many providers and large health systems face barriers when it comes to implementing this technology, such as:
Compatibility between systems
Fear of competition and/or losing patients to other health systems if e-fax enables patients to easily share data with other physicians
Regulatory issues around the transfer of data between providers/EHRs through electronic fax
Despite these challenges, the pandemic has highlighted the delayed, disjointed communications that exist within our healthcare system – and underscored the need for practices and health systems to adopt electronic fax technology. For example, a CNBC survey found that due to COVID-19 tests results coming in via fax in such large amounts, almost 40% of Americans had to wait more than three days for their results, which was too late to be clinically meaningful.
It’s time to address this challenge industry-wide. Last year’s MGMA 2020 virtual conference theme, Rise Above, focused on giving providers actionable tools to navigate through the challenges COVID-19 has presented. The importance of virtual care solutions, including communications tools like electronic fax and forms, are unprecedented. Electronic fax technology can help alleviate the bottlenecks and inefficiencies that currently exist in healthcare. These solutions can:
Reduce costs spent on traditional fax hardware, such as paper, ink, toner, etc.
Increase accessibility, allowing providers to view documents via mobile, etc. at their convenience
Improve practice workflow and efficiency, allowing practices to edit, organize, assign and complete patient forms online
Additionally, electronic fax should integrate seamlessly with other patient management solutions that practices are leveraging, such as video chat, SMS text, electronic forms, and a virtual waiting room, ultimately streamlining the entire patient experience.
Healthcare has transformed dramatically this year and will continue to do so — there’s a new expectation of patient care post-COVID. In order to improve patient communications, practice efficiency, system interoperability, and data sharing, practices must adopt an entire virtual care strategy, including electronic fax. Offering telehealth but still communicating via traditional fax will hold your practice back. It’s time for our healthcare system to ditch outdated systems and go completely paperless. This is how we will tap into the true power of the inbox, drive practice profitability and efficiency, and better serve patients.
About Michael Morgan, CEO of Updox With a successful track record in helping organizations use technology to transform the way healthcare is delivered, Mike has more than 25 years of healthcare leadership within software, behavioral health, and HIT organizations. Updox was named to the Inc. 5000 list of fastest-growing companies in America for the past six consecutive years.
– The ONC released the first ONC Standards Bulletin, a new communication tool ONC will use to periodically update the healthcare industry about ONC health IT standards and policy initiatives.
– Based on a HITAC recommendation, the Bulletin is part of the
ONC’s ongoing efforts to communicate, coordinate, and promote the adoption and
use of health IT standards to facilitate the access, exchange, and use of
electronic health information.
– The inaugural ONC Standards Bulletin 2021-1 (SB21-1)
discusses the United States Core Data for
Interoperability (USCDI) and the Standards-Version Advancement Process (SVAP).
– The USCDI
Draft v2 is the result of wide-ranging public input into the elements that
should be included to enhance the interoperability of health data for patients,
providers, and other users. ONC encourages the public to review this draft
standard, including the list of data elements that didn’t make it into the
standard, and provide comments through the USCDI home page by April 15, 2021.
– ONC also released the Standards
Version Advancement Process (SVAP) Approved Standards for 2020. Under the
SVAP, health IT developers can incorporate newer versions of health IT
standards and implementation specifications used in certified health IT and
update systems for their customers without undergoing certification testing
– NeuroFlow raises $20M to expand its technology-enabled behavioral
health integration platform, led by Magellan Health.
– NeuroFlow’s suite of HIPAA-compliant, cloud-based tools
simplify remote patient monitoring, enable risk stratification, and facilitate
collaborative care. With NeuroFlow, health care organizations can finally
bridge the gap between mental and physical health in order to improve outcomes
and reduce the cost of care.
NeuroFlow, a Philadelphia-based digital health startup supporting technology-enabled behavioral health integration (tBHI), announces today the initial closing of a $20M Series B financing round led by Magellan Health, in addition to a syndicate including previous investors. Magellan is a leader in managing the fastest growing, most complex areas of health, including behavioral health, complete pharmacy benefits and other specialty areas of healthcare.
NeuroFlow for Digital Behavioral Health Integration
NeuroFlow works with leading health plans, provider systems,
as well as the U.S. military and government to enhance virtual health programs
by delivering a comprehensive approach to whole-person care through digital
behavioral health integration – an evidence-based model to identify and treat
consumers with depression, anxiety and other behavioral health conditions
across all care settings.
Key features of the behavioral health platform include:
– Interoperability: Seamless EHR and system integrations minimize administrative burden and optimize current IT investments.
– Measurement-based Care & Clinical Decision Support: NeuroFlow enables MBC at scale, keeps the patient in the center of care, and continuously monitors for a consistent connection to critical data and clinical decision support.
– Performance Management & Reporting: Recognize
the impact of your BHI program, monitoring the impact of clinical interventions
on quality and cost of care while recognizing outliers requiring program
– Consumer Engagement & Self-Care: personalized
experience that encourages, rewards and recognizes continuous engagement and
Maximize Efficiency, Revenue and Reimbursements
By integrating behavioral health into the primary care setting, increasing screening and self-care plans – NeuroFlow’s BHI solution can reduce ED utilization by 23% and inpatient visits by 10%. 80% of NeuroFlow users self-reported a reduction in depression or anxiety symptoms and 62% of users with severe depression score improve to moderate or better.
Telehealth Adoption Underscores Need for Behavioral
With record growth in telehealth adoption and historic spikes in depression and anxiety due to the ongoing pandemic, workflow augmentation solutions and the delivery of effective behavioral health care have been identified as top priorities in the industry. NeuroFlow’s technology increases access to personalized, collaborative care while empowering primary care providers, care managers, and other specialists to most effectively support patient populations by accounting for and addressing behavioral health.
“Behavioral health is not independent of our overall health — it affects our physical health and vice versa, yet most underlying behavioral health conditions go unidentified or are ineffectively treated. Most healthcare providers are overburdened, so introducing the concept to account for a person’s mental health in addition to their primary specialty can be overwhelming and lead to inconsistent and inadequate treatment,” said NeuroFlow CEO Chris Molaro. “Technology, when used strategically, can enhance and augment providers, making the concept of holistic and value-based care feasible at scale and easy to implement.”
Strategic Partnership with Magellan
Magellan Health’s network of more than 118,000 credentialed
providers and health professionals are now poised to join NeuroFlow customers
across the country by leveraging the best-in-class integrated data and
analytics platform to meet the rising demand for enhanced mental health
services and support. By partnering with and investing in NeuroFlow, Magellan
has the opportunity to drive further adoption of NeuroFlow’s behavioral health
integration tools and drive collaborative care initiatives with its customers
as well as its vast network of credentialed providers and health professionals
across the country.
NeuroFlow will use the Series B proceeds to scale its
operations and support its growth in data analytics, artificial intelligence,
and direct health record integrations. NeuroFlow’s contracted user base has
grown 10x to over 330,000 in support of almost 200 commercial health systems,
payers, accountable care organizations, independent medical groups, and federal
agencies to provide technology-enabled care solutions.
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
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
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
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
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
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.
Seema Verma is administrator of the Centers for Medicare and Medicaid Services.
This article was co-authored with Alexandra Mugge, deputy chief health informatics officer at CMS, and Shannon Sartin, chief technology officer at the Centers for Medicare & Medicaid Innovation.
The use of genetic testing is becoming increasingly routine in patient care. For example, tests are available to check newborns for genetic disorders, screen would-be parents for carrier status, inform cancer care, and evaluate potential pharmacogenetic associations. However, the laboratories that perform these tests face many challenges that keep them from being able to return clinical genomic results in a standardized way and fully leverage a patient’s electronic health record. This also affects healthcare professionals’ ability to deliver precision medicine and conduct precision medicine research.
– TigerConnect has announced an expansion in their suite
through the acquisition of Critical Alert, a leading provider of
enterprise-grade middleware for hospitals and health systems.
– For the hundreds of thousands of nurses that currently
use TigerConnect, these new capabilities will deliver real-time, contextual
information to their mobile device or desktop to allow them to work smarter,
prioritize responses, and efficiently coordinate care, all within the same
reliable TigerConnect platform they use every day for enterprise messaging.
a care team collaboration solution, today announced the acquisition
of Critical Alert, a Jacksonville,
FL-based leading provider of enterprise-grade middleware for hospitals and
health systems. Critical Alert’s product suite consists of a middleware suite
of products as well as traditional nurse call hardware servicing over 200
hospitals in North America. Financial details of the acquisition were not
Real-Time Care Team Collaboration for Hospitals
Founded in 1983, Cloud-native and mobile-first, Critical
Alert’s middleware solution enables any health system to combine nurse call,
alarm and event management, medical device interoperability, and clinical
workflow analytics. TigerConnect will integrate Critical
Alert’s middleware stack into its platform to power a wide range of alert types
and alarm management enhancements for TigerConnect’s customers. Critical
Alert’s Nurse Call hardware business will continue to operate under its
namesake as a standalone business unit.
When combined with Critical Alert’s middleware, TigerConnect dramatically
enhances the value proposition to nursing, IT leadership, and end-users. This ‘dream
suite’ of capabilities comes at a time when nurse burnout is at a record high
and chronic nurse shortages are severely challenging organizations’ ability to
deliver the best quality care.
“We see the Critical Alert acquisition as highly strategic and
a natural evolution of our already-robust collaboration
platform,” said Brad Brooks, CEO and co-founder of TigerConnect. “For the
hundreds of thousands of nurses that currently use TigerConnect, these new
capabilities will deliver real-time, contextual information to their mobile
device or desktop to allow them to work smarter, prioritize responses, and
efficiently coordinate care, all within the same reliable TigerConnect platform
they use every day for enterprise messaging.”
Joining TigerConnect is Critical Alert CEO John
Elms, who will assume the role as TigerConnect Chief Product Officer,
guiding the integration of the two companies’ technologies and leading the
development of all future product offerings. Wil Lukens, currently VP of Sales
for Critical Alert, will assume the role of General Manager of Critical Alert’s
traditional Nurse Call hardware unit.
“The timing of the deal and the fit of these two companies aligned perfectly,” said John Elms, CEO of Critical Alert. “Two best-in-class, highly complementary solutions coming together to solve some of the chronic challenges—alarm fatigue, response prioritization, resource optimization—that have driven nurse teams to the brink. Together, these unified technologies will make care professionals’ lives easier, not harder, and I couldn’t be more excited to lead the TigerConnect product organization into this next chapter.”
Critical Alert Integration with TigerConnect Plans
TigerConnect’s robust product suite, which includes care
team collaboration (TigerFlow®), on-call scheduling (TigerSchedule®), virtual
care/telemedicine (TigerTouch®), and now virtualized nurse call and
alerts/alarm management (Critical Alert middleware), will help transform
hospitals and healthcare organizations into the real-time health systems of the
Hardware-free Middleware Forms the Foundation
With a shared cloud-native approach, Critical Alert’s
advanced middleware seamlessly fuses TigerConnect’s care team
collaboration with alarm management and event notifications. Deep
enterprise-level integrations with hospital systems enable the centralization
of clinical workflow management and real-time analytics. Integrating these
systems will have a sizable impact on customer organizations’ productivity and
Next Generation Nurse Call
Critical Alert’s nurse call solution brings a modern, badly
needed upgrade to legacy systems, extending both their life and feature-set. A
single mobile- or desktop-enabled user-interface brings vital contextual
information about requests while allowing for centralized answering of nurse
call alerts and management of workflows and assignments. These streamlined
workflows reduce noise and clinical interruptions while improving
Physiological Monitoring – Less Noise, More Signal
The FDA-cleared offering intelligently routes context-rich
alarm notifications from clinical systems to TigerFlow+. An easy-to-use
workflow builder ensures alerts are prioritized accordingly and are routed to
the appropriate caregiver, suppressing unnecessary noise. The filtering,
mobilization, and escalation of alerts pairs with TigerConnect Teams,
allowing for prompt responses in critical situations.
Smart Bed Alarms for Enhanced Patient Safety
Integrations with popular smart bed systems provide remote
monitoring of bed status details, informing nurses whether they should walk or
run to a patient’s room. Staff can review and adjust bed compliance settings
from their mobile device and receive fall prevention notifications if safe-bed
configuration is compromised.
Real-time Location System (RTLS) Measures What Matters
The integration of RTLS with a deployed nurse call
application greatly enhances the data available to clinical leadership. The
combined TigerConnect/Critical Alert offering enables real-time tracking
of staff location (presence) and time spent on tasks, providing deeper insights
into resource planning, workflow effectiveness and ongoing process improvement
Advanced Analytics for Deeper Workflow Insights
A better understanding of patient behavior and workflows
helps reveal areas for optimization that can lead to improved patient care and
staff efficacy. The new combined platform capabilities centralize the
collection and tracking of patient event data and nurse task efficiency,
turning insights into action. Advanced analytics also allow for identifying,
documenting, and benchmarking responsiveness, compliance, resource allocation,
and patient throughput across the health system.
This new integrated functionality is expected to be
available to TigerConnect customers in Q1 of 2021.
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.
Prior to the pandemic, telehealth was a limited ad-hoc service with geographic and provider restrictions. However, with both the pandemic restrictions on face to face interactions and a relaxation of governmental regulations, telehealth utilization has significantly increased from thousands of visits in a week to well over a million in the Medicare population. What we’ve learned is that telehealth allows patients, especially high-risk populations like seniors, to connect with their doctors in a safe and efficient way. Telehealth is valuable for many types of visits, mostly clearly ones that involve mental health or physical health issues that do not require a physical exam or procedure. It’s an efficient modality for both the member and provider.
With the growing popularity of telehealth services, we may see permanent changes in regulatory standards. Flexible regulatory standards, such as being able to use platforms like FaceTime or Skype, would lower the barrier to entry for providers to offer telehealth and also encourage adoption, especially among seniors. Second, it’s likely we’ll see an emergence of providers with aligned incentives around value, such as in many Medicare Advantage plans, trying very hard to encourage utilization with their members so that they get the right care at the right time. In theory, the shift towards value-based care will allow better care and lower costs than the traditional fee for service model. If we are able to evolve regulatory and payment environments, providers have an opportunity to grow these types of services into 2021 to improve patient wellness and health outcomes.
Dr. Salvatore Viscomi, Chief Medical Officer, GoodCell
2021 will be the year of patient controlled-health
The COVID-19 pandemic brought the realities of a global-scale health event – and our general lack of preparedness to address it – to the forefront. People are now laser-focused on how they can protect themselves and their families against the next inevitable threat. On top of this, social distancing and isolation accelerated the development and use of digital health tools, from wellness trackers to telehealth and virtual care, most of which can be accessed from the comfort of our homes. The convergence of these two forces is poised to make 2021 the year for patient-controlled health, whereby health decisions are not dictated by – but rather made in consultation with – a healthcare provider, leveraging insights and data pulled from a variety of health technology tools at people’s fingertips.
Anish Sebastian, CEO of Babyscripts
Telemedicine was the finger in the dyke at the beginning of pandemic panic, with healthcare providers grabbing whatever came to hand — encouraged by relaxed HIPAA regulations — to keep the dam from breaking. But as the dust settles, telemedicine is emerging as the commodity that it is, and value-add services are going to be the differentiating factors in an increasingly competitive marketplace. Offerings like remote patient monitoring and asynchronous communication, initially considered as “nice-to-haves,” are becoming standard offerings as healthcare providers see their value for continuous care beyond Covid.
Daniel Kivatinos, COO and Co-Founder of DrChrono
Telehealth visits are going to supersede in-person visits as time goes on.
Because of COVID-19, the world changed and Medicare and Medicaid, as well as other insurers, started paying out for telehealth visits. Telemedicine will continue to grow at a very quick rate, and verticals like mental health (psychology and psychiatry) and primary care fit perfectly into the telemedicine model, for tasks like administering prescription refills (ePrescribing) and ordering labs. Hyperlocal medical care will also move towards more of a telemedicine care team experience. Patients that are homebound families with young children or people that just recently had surgery can now get instant care when they need it. Location is less relevant because patients can see a provider from anywhere.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Virtual Healthcare is Here to Stay (House Calls are Back)
This new normal however is going to put significant pressure on the data support and servicing requirements to do it effectively. As more services are offered to patients outside of established clinical locations, it also means there will be more opportunity to collect data and a higher degree of dependence on interoperability. Providers are going to have to up their game from just providing and recording facts to passing on critical insight back into these interactions to maximize the benefits to the patient.
Sarahjane Sacchetti, CEO at Cleo
Virtual care (of all types) will become a lasting form of care: The vastly accelerated and broadened use of virtual care spurred by the pandemic will become permanent. Although it started with one-off check-ins or virtual mental health coaching, 2021 will see the continued rise in the use and efficacy of virtual care services once thought to be in-person only such as maternity, postpartum, pediatric, and even tutoring. Employers are taking notice of this shift with 32% indicating that expanded virtual health services are a top priority, and this number will quickly rise as employers look to offer flexible and convenient benefits in support of employees and to drive productivity.
Omri Shor, CEO of Medisafe
Digital expansion: The pandemic has accelerated patient technology adoption, and innovation remains front-and-center for healthcare in 2021. Expect to see areas of telemedicine and digital health monitoring expand in new and novel ways, with increased uses in remote monitoring and behavioral health. CMS has approved telehealth for a number of new specialties and digital health tools continue to gain adoption among healthcare companies, drug makers, providers, and patients.
Digital health companions will continue to become an important tool to monitor patients, provide support, and track behaviors – while remaining socially distant due to the pandemic. Look for crossover between medical care, drug monitoring, and health and wellness – Apple
Watch has already previewed this potential with heart rate and blood oxygen monitoring. Data output from devices will enable support to become more personalized and triggered by user behavior.
Kelli Bravo, Vice President, Healthcare and Life Sciences, Pegasystems
The COVID-19 pandemic has not only changed and disrupted our lives, it has wreaked havoc on the entire healthcare industry at a scale we’ve never seen before. And it continues to alter almost every part of life across the globe. The way we access and receive healthcare has also changed as a result of social distancing requirements, patient concerns, provider availability, mobile capabilities, and newly implemented procedures at hospitals and healthcare facilities.
For example, hospitals and providers are postponing elective procedures again to help health systems prepare and reserve ICU beds amid the latest COVID-19 resurgence. While level of care is always important, in some areas, the inability to access a healthcare provider is equally concerning. And these challenges may become even more commonplace in the post-COVID-19 era. One significant transformation to help with the hurdle is telehealth, which went from a very small part of the care offering before the health crisis to one that is now a much more accepted way to access care. As the rise in virtual health continues to serve consumers and provide a personalized and responsive care experience, healthcare consumers expect support services and care that are also fast and personalized – with digital apps, instant claims settlements, transparency, and advocacy. And to better help serve healthcare consumers, the industry has an opportunity to align with digital transformation that offers a personalized and responsive experience.
Brooke LeVasseur, CEO of AristaMD
Issues pertaining to the COVID-19 pandemic will continue to be front-and-center in 2021. Every available digital tool in the box will have to be employed to ensure patients with non-COVID related issues are not forgotten as we try to free up in-person space and resources for those who cannot get care in any other setting. Virtual front doors, patient/physician video and eConsults, which connect providers to collaborate electronically, will be part of a broadening continuum of care – ultimately aimed at optimizing every valuable resource we have.
Bret Larsen, CEO and Co-Founder, eVisit
By the end of 2021, virtual care paths will be fairly ubiquitous across the continuum of care, from urgent care and EDs to specialty care, all to serve patients where they are – at home and on mobile devices. This will be made possible through virtualized end-to-end processes that integrate every step in patient care from scheduling, waiting rooms, intake and patient queuing, to interpretation services, referral management, e-prescribe, billing and analytics, and more.
Laura Kreofsky, Vice President for Advisory & Telehealth for Pivot Point Consulting
2020 has been the year of rapid telehealth adoption and advancement due to the COVID pandemic. According to CDC reports, telehealth utilization spiked as much as 154% in late March compared to the same period in 2019. While usage has moderated, it’s clear telehealth is now an instrumental part of healthcare delivery. As provider organizations plan for telehealth in 2021 and beyond, we are going to have to expect and deliver a secure, scalable infrastructure, a streamlined patient experience and an approach that maximizes provider efficiency, all while seeing much-needed vendor consolidation.
Jeff Lew, SVP of Product Management, Nextech
Earlier this year, CMS enacted new rules to provide practices with the flexibility they need to use telehealth solutions in response to COVID-19, during which patients also needed an alternative to simply visiting the office. This was the impetus to the accelerated acceptance of telehealth as a means to both give and receive care. Specialty practices, in particular, are seeing successful and positive patient experiences due to telehealth visits. Dermatology practices specifically standout and I expect the strong adoption will continue to grow and certainly be the “new normal.” In addition, innovative practices that have embraced this omni-channel approach to delivering care are also establishing this as a “new normal” by selectively using telehealth visits for certain types of encounters, such as post-op visits or triaging patients. This gives patients a choice and the added convenience that comes with it and, in some cases, increases patient volume for the practice.
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.
Health systems and EHR vendors have been working for months to comply with the ONC’s final rule on interoperability and information blocking that goes into effect in April and is expected to grant patients unprecedented access to their health information. Here is a look at some of the issues they contended with.
Healthcare data security has been a growing concern for CIOs for the last year or so, as hackers are increasingly targeting health information. Now, with a global pandemic forcing a shift to telemedicine and remote work, and new rules from the ONC and CMS introducing more regulatory burden, healthcare CIOs have more to manage than ever. Fortunately, it is possible to roll out new capabilities while simultaneously improving cybersecurity by following these three rules:
Rule 1: Think Like an Attacker
The coronavirus pandemic has forced healthcare providers everywhere to roll out new capabilities, processes, and workflows, such as telemedicine systems and new patient check-in procedures. These measures are being taken in addition to the necessary work being done to comply with the new mandates from ONC and CMS regarding patient data accessibility. Though these changes need to be implemented quickly, it’s important to follow cybersecurity best practices to avoid providing new openings for attackers.
When a hacker sees new systems and processes being implemented, they are thinking about:
– What software is being introduced? Are there known vulnerabilities or frequently unpatched exploits associated with it?
– How are new endpoints being added and are they secure?
– Since the new ONC and CMS rules require publicly exposed FHIR APIs, how can those be attacked? Are there social engineering exploits that can provide a way around security?
– Are there ways to perpetrate identity fraud if a patient does not need to be physically present to receive healthcare?
This approach should lead to a cybersecurity plan that puts measures in place for each identified risk. By thinking like the adversary, it is possible to identify and lock down the possible attack vectors.
Rule 2: Minimize the Attack Surface
Every way into an organization’s network needs to be secured, monitored, and maintained. The best way to make this process as efficient and fool-proof as possible is to minimize the number of ways into the network.
This is especially difficult in light of the ONC and CMS rules, which require that clinical systems must share data through publicly available FHIR APIs. At first, this seems like a mandate to radically expand the organization’s attack surface. Indeed, this is precisely what happens if the straightforward approach of exposing every clinical system through public APIs is followed.
A different approach, which provides the same capabilities and compliance with the rules, would be to route all API traffic through a central hub. Attaching all the clinical systems to a single point of API access provides a number of benefits:
– Most importantly, compliance is achieved while minimizing the new attack vectors.
– All traffic between clinical systems and the outside world can be monitored from a single place.
– The API hub can act as a façade that makes legacy systems compliant with the new rules, even if those systems lack native FHIR API capabilities.
The API hub need not be an expensive new component of the network architecture. Most healthcare organizations are already using a clinical integration engine to move HL7, XML, and DICOM traffic among their internal systems. The same technology can serve as an API hub. This is especially effective if a new instance of the integration engine is placed in an isolated part of the network without full access to other systems.
Rule 3: Have an Expert Review the Defenses
Even for healthcare organizations with cybersecurity experts on staff, it can be worthwhile to bring in a cybersecurity consultant to cross-check new implementations. Novel threats are constantly shifting and emerging, making it nearly impossible for internal IT staff to keep up with the looming threats of ransomware hacks, while also adequately carrying out the day-to-day responsibilities of their jobs. For that reason, it makes sense to bring in a professional who focuses exclusively on security. It is also often useful to have an independent review from someone who is looking at the implementation from an outsider’s perspective. Independent consultants can provide the necessary guidance, risk assessments, and other security support, to set healthcare organizations up for success and operate more securely.
Expanding an organization’s IT capabilities often means more exposure to risk, especially when implementations are subject to time constraints. However, given the value and importance of the data that’s being generated, transmitted, and stored, it is imperative not to let cybersecurity fall out of focus. By following best practices around design, implementation, and testing healthcare organizations can rise to meet the current challenges of the pandemic, address the mandates of the interoperability rules, and simultaneously improve data security measures.
About Scott Galbari, Chief Technology Officer
As Chief Technology Officer for Lyniate, Scott leads the development and delivery of all products and services. Scott has been in the healthcare IT domain for the past twenty years and has experience in developing and delivering imaging, workflow, nursing, interoperability, and patient flow solutions to customers in all geographies. He was most recently the General Manager for multiple businesses within McKesson and Change Healthcare and started his career as a software developer.
About Drew Ivan, Chief Product & Strategy Officer
Drew’s focus is on how to operationalize and productize integration technologies, patterns, and best practices. His experience includes over 20 years in health IT, working with a wide spectrum of customers, including public HIEs, IDNs, payers, life sciences companies, and software vendors, with the goal of improving outcomes and reducing costs by aggregating and analyzing clinical, claims, and cost data.
As we close out the year, we asked several healthcare executives to share their predictions and trends for 2021.
Kimberly Powell, Vice President & General Manager, NVIDIA Healthcare
Federated Learning: The clinical community will increase their use of federated learning approaches to build robust AI models across various institutions, geographies, patient demographics, and medical scanners. The sensitivity and selectivity of these models are outperforming AI models built at a single institution, even when there is copious data to train with. As an added bonus, researchers can collaborate on AI model creation without sharing confidential patient information. Federated learning is also beneficial for building AI models for areas where data is scarce, such as for pediatrics and rare diseases.
AI-Driven Drug Discovery: The COVID-19 pandemic has put a spotlight on drug discovery, which encompasses microscopic viewing of molecules and proteins, sorting through millions of chemical structures, in-silico methods for screening, protein-ligand interactions, genomic analysis, and assimilating data from structured and unstructured sources. Drug development typically takes over 10 years, however, in the wake of COVID, pharmaceutical companies, biotechs, and researchers realize that acceleration of traditional methods is paramount. Newly created AI-powered discovery labs with GPU-accelerated instruments and AI models will expedite time to insight — creating a computing time machine.
Smart Hospitals: The need for smart hospitals has never been more urgent. Similar to the experience at home, smart speakers and smart cameras help automate and inform activities. The technology, when used in hospitals, will help scale the work of nurses on the front lines, increase operational efficiency, and provide virtual patient monitoring to predict and prevent adverse patient events.
Omri Shor, CEO of Medisafe
Healthcare policy: Expect to see more moves on prescription drug prices, either through a collaborative effort among pharma groups or through importation efforts. Pre-existing conditions will still be covered for the 135 million Americans with pre-existing conditions.
The Biden administration has made this a central element of this platform, so coverage will remain for those covered under ACA. Look for expansion or revisions of the current ACA to be proposed, but stalled in Congress, so existing law will remain largely unchanged. Early feedback indicates the Supreme Court is unlikely to strike down the law entirely, providing relief to many during a pandemic.
Brent D. Lang, Chairman & Chief Executive Officer, Vocera Communications
The safety and well-being of healthcare workers will be a top priority in 2021. While there are promising headlines about coronavirus vaccines, we can be sure that nurses, doctors, and other care team members will still be on the frontlines fighting COVID-19 for many more months. We must focus on protecting and connecting these essential workers now and beyond the pandemic.
Modernized PPE Standards Clinicians should not risk contamination to communicate with colleagues. Yet, this simple act can be risky without the right tools. To minimize exposure to infectious diseases, more hospitals will rethink personal protective equipment (PPE) and modernize standards to include hands-free communication technology. In addition to protecting people, hands-free communication can save valuable time and resources. Every time a nurse must leave an isolation room to answer a call, ask a question, or get supplies, he or she must remove PPE and don a fresh set to re-enter. With voice-controlled devices worn under PPE, the nurse can communicate without disrupting care or leaving the patient’s bedside.
Voice-controlled solutions can also help new or reassigned care team members who are unfamiliar with personnel, processes, or the location of supplies. Instead of worrying about knowing names or numbers, they can use simple voice commands to connect to the right person, group, or information quickly and safely. In addition to simplifying clinical workflows, an intelligent communication system can streamline operational efficiencies, improve triage and throughput, and increase capacity, which is all essential to hospitals seeking ways to recover from 2020 losses and accelerate growth.
Michael Byczkowski, Global Vice President, Head of Healthcare Industry at SAP,
New, targeted healthcare networks will collaborate and innovate to improve patient outcomes.
We will see many more touchpoints between different entities ranging from healthcare providers and life sciences companies to technology providers and other suppliers, fostering a sense of community within the healthcare industry. More organizations will collaborate based on existing data assets, perform analysis jointly, and begin adding innovative, data-driven software enhancements. With these networks positively influencing the efficacy of treatments while automatically managing adherence to local laws and regulations regarding data use and privacy, they are paving the way for software-defined healthcare.
Smart hospitals will create actionable insights for the entire organization out of existing data and information.
Medical records as well as operational data within a hospital will continue to be digitized and will be combined with experience data, third-party information, and data from non-traditional sources such as wearables and other Internet of Things devices. Hospitals that have embraced digital are leveraging their data to automate tasks and processes as well as enable decision support for their medical and administrative staff. In the near future, hospitals could add intelligence into their enterprise environments so they can use data to improve internal operations and reduce overhead.
Curt Medeiros, President and Chief Operating Officer of Ontrak
As health care costs continue to rise dramatically given the pandemic and its projected aftermath, I see a growing and critical sophistication in healthcare analytics taking root more broadly than ever before. Effective value-based care and network management depend on the ability of health plans and providers to understand what works, why, and where best to allocate resources to improve outcomes and lower costs. Tied to the need for better analytics, I see a tipping point approaching for finally achieving better data security and interoperability. Without the ability to securely share data, our industry is trying to solve the world’s health challenges with one hand tied behind our backs.
G. Cameron Deemer, President, DrFirst
Like many business issues, the question of whether to use single-vendor solutions or a best-of-breed approach swings back and forth in the healthcare space over time. Looking forward, the pace of technology change is likely to swing the pendulum to a new model: systems that are supplemental to the existing core platform. As healthcare IT matures, it’s often not a question of ‘can my vendor provide this?’ but ‘can my vendor provide this in the way I need it to maximize my business processes and revenues?
This will be more clear with an example: An EHR may provide a medication history function, for instance, but does it include every source of medication history available? Does it provide a medication history that is easily understood and acted upon by the provider? Does it provide a medication history that works properly with all downstream functions in the EHR? When a provider first experiences medication history during a patient encounter, it seems like magic.
After a short time, the magic fades to irritation as the incompleteness of the solution becomes more obvious. Much of the newer healthcare technologies suffer this same incompleteness. Supplementing the underlying system’s capabilities with a strongly integrated third-party system is increasingly going to be the strategy of choice for providers.
Angie Franks, CEO of Central Logic
In 2021, we will see more health systems moving towards the goal of truly operating as one system of care. The pandemic has demonstrated in the starkest terms how crucial it is for health systems to have real-time visibility into available beds, providers, transport, and scarce resources such as ventilators and drugs, so patients with COVID-19 can receive the critical care they need without delay. The importance of fully aligning as a single integrated system that seamlessly shares data and resources with a centralized, real-time view of operations is a lesson that will resonate with many health systems.
Expect in 2021 for health systems to enhance their ability to orchestrate and navigate patient transitions across their facilities and through the continuum of care, including post-acute care. Ultimately, this efficient care access across all phases of care will help healthcare organizations regain revenue lost during the historic drop in elective care in 2020 due to COVID-19.
In addition to elevating revenue capture, improving system-wide orchestration and navigation will increase health systems’ bed availability and access for incoming patients, create more time for clinicians to operate at the top of their license, and reduce system leakage. This focus on creating an ‘operating as one’ mindset will not only help health systems recover from 2020 losses, it will foster sustainable and long-term growth in 2021 and well into the future.
John Danaher, MD, President, Global Clinical Solutions, Elsevier
COVID-19 has brought renewed attention to healthcare inequities in the U.S., with the disproportionate impact on people of color and minority populations. It’s no secret that there are indicative factors, such as socioeconomic level, education and literacy levels, and physical environments, that influence a patient’s health status. Understanding these social determinants of health (SDOH) better and unlocking this data on a wider scale is critical to the future of medicine as it allows us to connect vulnerable populations with interventions and services that can help improve treatment decisions and health outcomes. In 2021, I expect the health informatics industry to take a larger interest in developing technologies that provide these kinds of in-depth population health insights.
Jay Desai, CEO and co-founder of PatientPing
2021 will see an acceleration of care coordination across the continuum fueled by the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access rule’s e-notifications Condition of Participation (CoP), which goes into effect on May 1, 2021. The CoP requires all hospitals, psych hospitals, and critical access hospitals that have a certified electronic medical record system to provide notification of admit, discharge, and transfer, at both the emergency room and the inpatient setting, to the patient’s care team. Due to silos, both inside and outside of a provider’s organization, providers miss opportunities to best treat their patients simply due to lack of information on patients and their care events.
This especially impacts the most vulnerable patients, those that suffer from chronic conditions, comorbidities or mental illness, or patients with health disparities due to economic disadvantage or racial inequity. COVID-19 exacerbated the impact on these vulnerable populations. To solve for this, healthcare providers and organizations will continue to assess their care coordination strategies and expand their patient data interoperability initiatives in 2021, including becoming compliant with the e-notifications Condition of Participation.
Kuldeep Singh Rajput, CEO and founder of Biofourmis
Driven by CMS’ Acute Hospital at Home program announced in November 2020, we will begin to see more health systems delivering hospital-level care in the comfort of the patient’s home–supported by technologies such as clinical-grade wearables, remote patient monitoring, and artificial intelligence-based predictive analytics and machine learning.
A randomized controlled trial by Brigham Health published in Annals of Internal Medicine earlier this year demonstrated that when compared with usual hospital care, Home Hospital programs can reduce rehospitalizations by 70% while decreasing costs by nearly 40%. Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 and other viruses such as influenza for patients and healthcare professionals, and improved patient and family member experience.
Jake Pyles, CEO, CipherHealth
The disappearance of the hospital monopoly will give rise to a new loyalty push
Healthcare consumerism was on the rise ahead of the pandemic, but the explosion of telehealth in 2020 has effectively eliminated the geographical constraints that moored patient populations to their local hospitals and providers. The fallout has come in the form of widespread network leakage and lost revenue. By October, in fact, revenue for hospitals in the U.S. was down 9.2% year-over-year. Able to select providers from the comfort of home and with an ever-increasing amount of personal health data at their convenience through the growing use of consumer-grade wearable devices, patients are more incentivized in 2021 to choose the provider that works for them.
After the pandemic fades, we’ll see some retrenchment from telehealth, but it will remain a mainstream care delivery model for large swaths of the population. In fact, post-pandemic, we believe telehealth will standardize and constitute a full 30% to 40% of interactions.
That means that to compete, as well as to begin to recover lost revenue, hospitals need to go beyond offering the same virtual health convenience as their competitors – Livango and Teladoc should have been a shot across the bow for every health system in 2020. Moreover, hospitals need to become marketing organizations. Like any for-profit brand, hospitals need to devote significant resources to building loyalty but have traditionally eschewed many of the cutting-edge marketing techniques used in other industries. Engagement and personalization at every step of the patient journey will be core to those efforts.
Marc Probst, former Intermountain Health System CIO, Advisor for SR Health by Solutionreach
Healthcare will fix what it’s lacking most–communication.
Because every patient and their health is unique, when it comes to patient care, decisions need to be customized to their specific situation and environment, yet done in a timely fashion. In my two decades at one of the most innovative health systems in the U.S., communication, both across teams and with patients continuously has been less than optimal. I believe we will finally address both the interpersonal and interface communication issues that organizations have faced since the digitization of healthcare.”
Rich Miller, Chief Strategy Officer, Qgenda
2021 – The year of reforming healthcare: We’ve been looking at ways to ease healthcare burdens for patients for so long that we haven’t realized the onus we’ve put on providers in doing so. Adding to that burden, in 2020 we had to throw out all of our playbooks and become masters of being reactive. Now, it’s time to think through the lessons learned and think through how to be proactive. I believe provider-based data will allow us to reformulate our priorities and processes. By analyzing providers’ biggest pain points in real-time, we can evaporate the workflow and financial troubles that have been bothering organizations while also relieving providers of their biggest problems.”
Robert Hanscom, JD, Vice President of Risk Management and Analytics at Coverys
Data Becomes the Fix, Not the Headache for Healthcare
The past 10 years have been challenging for an already overextended healthcare workforce. Rising litigation costs, higher severity claims, and more stringent reimbursement mandates put pressure on the bottom line. Continued crises in combination with less-than-optimal interoperability and design of health information systems, physician burnout, and loss of patient trust, have put front-line clinicians and staff under tremendous pressure.
Looking to the future, it is critical to engage beyond the day to day to rise above the persistent risks that challenge safe, high-quality care on the frontline. The good news is healthcare leaders can take advantage of tools that are available to generate, package, and learn from data – and use them to motivate action.
Steve Betts, Chief of Operations and Products at Gray Matter Analytics
Analytics Divide Intensifies: Just like the digital divide is widening in society, the analytics divide will continue to intensify in healthcare. The role of data in healthcare has shifted rapidly, as the industry has wrestled with an unsustainable rate of increasing healthcare costs. The transition to value-based care means that it is now table stakes to effectively manage clinical quality measures, patient/member experience measures, provider performance measures, and much more. In 2021, as the volume of data increases and the intelligence of the models improves, the gap between the haves and have nots will significantly widen at an ever-increasing rate.
Substantial Investment in Predictive Solutions: The large health systems and payors will continue to invest tens of millions of dollars in 2021. This will go toward building predictive models to infuse intelligent “next best actions” into their workflows that will help them grow and manage the health of their patient/member populations more effectively than the small and mid-market players.
Jennifer Price, Executive Director of Data & Analytics at THREAD
The Rise of Home-based and Decentralized Clinical Trial Participation
In 2020, we saw a significant rise in home-based activities such as online shopping, virtual school classes and working from home. Out of necessity to continue important clinical research, home health services and decentralized technologies also moved into the home. In 2021, we expect to see this trend continue to accelerate, with participants receiving clinical trial treatments at home, home health care providers administering procedures and tests from the participant’s home, and telehealth virtual visits as a key approach for sites and participants to communicate. Hybrid decentralized studies that include a mix of on-site visits, home health appointments and telehealth virtual visits will become a standard option for a range of clinical trials across therapeutic areas. Technological advances and increased regulatory support will continue to enable the industry to move out of the clinic and into the home.
Doug Duskin, President of the Technology Division at Equality Health
Value-based care has been a watchword of the healthcare industry for many years now, but advancement into more sophisticated VBC models has been slower than anticipated. As we enter 2021, providers – particularly those in fee-for-service models who have struggled financially due to COVID-19 – and payers will accelerate this shift away from fee-for-service medicine and turn to technology that can facilitate and ease the transition to more risk-bearing contracts. Value-based care, which has proven to be a more stable and sustainable model throughout the pandemic, will seem much more appealing to providers that were once reluctant to enter into risk-bearing contracts. They will no longer be wondering if they should consider value-based contracting, but how best to engage.
Brian Robertson, CEO of VisiQuate
Continued digitization and integration of information assets: In 2021, this will lead to better performance outcomes and clearer, more measurable examples of “return on data, analytics, and automation.
Digitizing healthcare’s complex clinical, financial, and operational information assets: I believe that providers who are further in the digital transformation journey will make better use of their interconnected assets, and put the healthcare consumer in the center of that highly integrated universe. Healthcare consumer data will be studied, better analyzed, and better predicted to drive improved performance outcomes that benefit the patient both clinically and financially.
Some providers will have leapfrog moments: These transformations will be so significant that consumers will easily recognize that they are receiving higher value. Lower acuity telemedicine and other virtual care settings are great examples that lead to improved patient engagement, experience and satisfaction. Device connectedness and IoT will continue to mature, and better enable chronic disease management, wellness, and other healthy lifestyle habits for consumers.
Kermit S. Randa, CEO of Syntellis Performance Solutions
Healthcare CEOs and CFOs will partner closely with their CIOs on data governance and data distribution planning. With the massive impact of COVID-19 still very much in play in 2021, healthcare executives will need to make frequent data-driven – and often ad-hoc — decisions from more enterprise data streams than ever before. Syntellis research shows that healthcare executives are already laser-focused on cost reduction and optimization, with decreased attention to capital planning and strategic growth. In 2021, there will be a strong trend in healthcare organizations toward new initiatives, including clinical and quality analytics, operational budgeting, and reporting and analysis for decision support.
Dr. Calum Yacoubian, Associate Director of Healthcare Product & Strategy at Linguamatics
As payers and providers look to recover from the damage done by the pandemic, the ability to deliver value from data assets they already own will be key. The pandemic has displayed the siloed nature of healthcare data, and the difficulty in extracting vital information, particularly from unstructured data, that exists. Therefore, technologies and solutions that can normalize these data to deliver deeper and faster insights will be key to driving economic recovery. Adopting technologies such as natural language processing (NLP) will not only offer better population health management, ensuring the patients most in need are identified and triaged but will open new avenues to advance innovations in treatments and improve operational efficiencies.
Prior to the pandemic, there was already an increasing level of focus on the use of real-world data (RWD) to advance the discovery and development of new therapies and understand the efficacy of existing therapies. The disruption caused by COVID-19 has sharpened the focus on RWD as pharma looks to mitigate the effect of the virus on conventional trial recruitment and data collection. One such example of this is the use of secondary data collection from providers to build real-world cohorts which can serve as external comparator arms.
This convergence on seeking value from existing RWD potentially affords healthcare providers a powerful opportunity to engage in more clinical research and accelerate the work to develop life-saving therapies. By mobilizing the vast amount of data, they will offer pharmaceutical companies a mechanism to positively address some of the disruption caused by COVID-19. This movement is one strategy that is key to driving provider recovery in 2021.
Rose Higgins, Chief Executive Officer of HealthMyne
Precision imaging analytics technology, called radiomics, will increasingly be adopted and incorporated into drug development strategies and clinical trials management. These AI-powered analytics will enable drug developers to gain deeper insights from medical images than previously capable, driving accelerated therapy development, greater personalization of treatment, and the discovery of new biomarkers that will enhance clinical decision-making and treatment.
Dharmesh Godha, President and CTO of Advaiya
Greater adoption and creative implementation of remote healthcare will be the biggest trend for the year 2021, along with the continuous adoption of cloud-enabled digital technologies for increased workloads. Remote healthcare is a very open field. The possibilities to innovate in this area are huge. This is the time where we can see the beginning of the convergence of personal health aware IoT devices (smartwatches/ temp sensors/ BP monitors/etc.) with the advanced capabilities of the healthcare technologies available with the monitoring and intervention capabilities for the providers.
Simon Wu, Investment Director, Cathay Innovation
Healthcare Data Proves its Weight in Gold in 2021
Real-world evidence or routinely stored data from hospitals and claims, being leveraged by healthcare providers and biopharma companies along with those that can improve access to data will grow exponentially in the coming year. There are many trying to build in-house, but similar to autonomous technology, there will be a separate set of companies emerge in 2021 to provide regulated infrastructure and have their “AWS” moment.
Kyle Raffaniello, CEO of Sapphire Digital
2021 is a clear year for healthcare price transparency
Over the past year, healthcare price transparency has been a key topic for the Trump administration in an effort to lower healthcare costs for Americans. In recent months, COVID-19 has made the topic more important to patients than ever before. Starting in January, we can expect the incoming Biden administration to not only support the existing federal transparency regulations but also continue to push for more transparency and innovation within Medicare. I anticipate that healthcare price transparency will continue its momentum in 2021 as one of two Price Transparency rules takes effect and the Biden administration supports this movement.
Dennis McLaughlin VP of Omni Operations + Product at ibi
Social Determinants of Health Goes Mainstream: Understanding more about the patient and their personal environment has a hot topic the past two years. Providers and payers’ ability to inject this knowledge and insight into the clinical process has been limited. 2021 is the year it gets real. It’s not just about calling an uber anymore. The organizations that broadly factor SDOH into the servicing model especially with virtualized medicine expanding broadly will be able to more effectively reach vulnerable patients and maximize the effectiveness of care.
Joe Partlow, CTO at ReliaQuest
The biggest threat to personal privacy will be healthcare information: Researchers are rushing to pool resources and data sets to tackle the pandemic, but this new era of openness comes with concerns around privacy, ownership, and ethics. Now, you will be asked to share your medical status and contact information, not just with your doctors, but everywhere you go, from workplaces to gyms to restaurants. Your personal health information is being put in the hands of businesses that may not know how to safeguard it. In 2021, cybercriminals will capitalize on rapid U.S. telehealth adoption. Sharing this information will have major privacy implications that span beyond keeping medical data safe from cybercriminals to wider ethics issues and insurance implications.
Jimmy Nguyen, Founding President at Bitcoin Association
Blockchain solutions in the healthcare space will bring about massive improvements in two primary ways in 2021.
Firstly, blockchain applications will for the first time facilitate patients owning, managing, and even monetizing their personal health data. Today’s healthcare information systems are incredibly fragmented, with patient data from different sources – be they physicians, pharmacies, labs, or otherwise – kept in different silos, eliminating the ability to generate a holistic view of patient information and restricting healthcare providers from producing the best health outcomes.
Healthcare organizations are growing increasingly aware of the ways in which blockchain technology can be used to eliminate data silos, enable real-time access to patient information, and return control to patients for the use of their personal data – all in a highly-secure digital environment. 2021 will be the year that patient data goes blockchain.
Secondly, blockchain solutions can ensure more honesty and transparency in the development of pharmaceutical products. Clinical research data is often subject to questions of integrity or ‘hygiene’ if data is not properly recorded, or worse, is deliberately fabricated. Blockchain technology enables easy, auditable tracking of datasets generated by clinical researchers, benefitting government agencies tasked with approving drugs while producing better health outcomes for healthcare providers and patients. In 2021, I expect to see a rise in the use and uptake of applications that use public blockchain systems to incentivize greater honesty in clinical research.
Alex Lazarow, Investment Director, Cathay Innovation
The Future of US Healthcare is Transparent, Fair, Open and Consumer-Driven
In the last year, the pandemic put a spotlight on the major gaps in healthcare in the US, highlighting a broken system that is one of the most expensive and least distributed in the world. While we’ve already seen many boutique healthcare companies emerge to address issues around personalization, quality and convenience, the next few years will be focused on giving the power back to consumers, specifically with the rise of insurtechs, in fixing the transparency, affordability, and incentive issues that have plagued the private-based US healthcare system until now.
Lisa Romano, RN, Chief Nursing Officer, CipherHealth
Hospitals will need to counter the staff wellness fallout
The pandemic has placed unthinkable stress on frontline healthcare workers. Since it began, they’ve been working under conditions that are fundamentally more dangerous, with fewer resources, and in many cases under the heavy emotional burden of seeing several patients lose their battle with COVID-19. The fallout from that is already beginning – doctors and nurses are leaving the profession, or getting sick, or battling mental health struggles. Nursing programs are struggling to fill classes. As a new wave of the pandemic rolls across the country, that fallout will only increase. If they haven’t already, hospitals in 2021 will place new premiums upon staff wellness and staff health, tapping into the same type of outreach and purposeful rounding solutions they use to round on patients.
Kris Fitzgerald, CTO, NTT DATA Services
Quality metrics for health plans – like data that measures performance – was turned on its head in 2020 due to delayed procedures. In the coming year, we will see a lot of plans interpret these delayed procedures flexibly so they honor their plans without impacting providers. However, for so long, the payer’s use of data and the provider’s use of data has been disconnected. Moving forward the need for providers to have a more specific understanding of what drives the value and if the cost is reasonable for care from the payer perspective is paramount. Data will ensure that this collaboration will be enhanced and the concept of bundle payments and aligning incentives will be improved. As the data captured becomes even richer, it will help people plan and manage their care better. The addition of artificial intelligence (AI) to this data will also play a huge role in both dialog and negotiation when it comes to cost structure. This movement will lead to a spike in value-based care adoption
– Healthcare technology company Forcura names the five
most significant trends for the post-acute care industry in 2021.
The post-acute care (PAC) sector saw some of its most
profound challenges this year, from deadly COVID-19
outbreaks in skilled nursing facilities (SNFs) to a suddenly accelerated need
for the services provided by home health and hospice. The biggest question now
is that what does the post-acute care future hold for all of us?
Forcura, a healthcare technology company that enables safer patient care transitions along the care continuum recently released their report, What Happened and What’s Next in Post-Acute Care,” which synthesizes the top takeaways for the post-acute care industry in 2020, and explores the five themes it projects will be the leading business influencers on the sector in 2021 and for years to come.
The report names these as the five most significant drivers
for the post-acute care industry in 2021:
1. Interoperability: The Industry Inches Closer to a
In its guide to “Interoperability in Healthcare,” HIMSS
as “the ability of different information systems, devices and applications
(systems) to access, exchange, integrate and cooperatively use data in a
coordinated manner, within and across organizational, regional and national
boundaries, to provide timely and seamless portability of information and
optimize the health of individuals and populations globally.”
Individuals and organizations have worked tirelessly for
years to create a technological foundation that will make care transitions
safer and more holistic. They’ve made incredible progress…with patients and PAC
providers beginning to reap the benefits of increased data sharing.
2. Healthcare will be Increasingly Built Around the
Service providers talk about the “user experience” and now
users are finally seeking better care experiences. People are becoming savvier
and more demanding about their healthcare in the same ways they have done so in
consuming other services. While technology is certainly a component of the move
towards patient centricity, it is a tool that enables or enhances care
delivery. Post-acute care is poised for the shift to patient centricity.
3. Payment Models and Reimbursement Plans Remain in Play
The post-acute care industry will continue to be shaped by
regulatory and financial forces. By being proactive, fully understanding the
impacts of payment models (like unified payments), learning from the lessons of
acute care payment reform, and choosing the right partners, PAC providers
should be able to more confidently control their bottom lines in the coming
4. New Business Models are Not Your Parents’ PAC
PAC companies themselves also are beginning to explore new
options for their business operations. Post-acute care is being asked to
deliver better patient outcomes and greater value – and it’s time to respond.
Driven in part by the explosion of home-based health care services from legacy
players and new entrants, PAC organizations will be scrambling to retain as
much patient share as possible. By diversifying, providers can reduce the
vulnerability experienced by single service line agencies.
5. Healthcare for All Remains Elusive
COVID-19 has revealed some harsh realities about the ongoing
effects of structural inequity…to no one’s surprise. Some steps towards equity
are occurring. Research led by Oregon Health & Science University shows
that a new national care program for hip and knee joint replacements seems to
reduce health outcome disparities for Black patients. The CMS Comprehensive
Care for Joint Replacement model is a bundled payment model designed to reduce
spending and improve outcomes for all joint replacement patients. “Although
Black patients were discharged to institutional post-acute care more than white
patients, the gap narrowed under the new bundled payment model. Readmission
risk decreased about 3 percentage points for Black patients under the new
model, and stayed roughly the same for Hispanic and white patients.”
“Everyone realizes that 2020 is historic for the unprecedented disruption and lives lost to the COVID-19 public health crisis” says Forcura founder and CEO, Craig Mandeville, “and operating in-the-moment has been a necessity. It has also possibly reduced the time the industry has to plan for what else is around the corner.” Craig continues, “Our original research and conversations from our CONNECT Summit clearly point to five market drivers that everyone should factor into their strategic initiatives. We’re proud to offer this report and believe it will guide health industry companies to focus more on patients and better secure their bottom lines.”
Healthcare leaders can continue to wait for the government to enact and enforce IT changes that may or may not serve the needs of clinicians. Or, they can embrace proven solutions today that make their EHRs a bit more like a good butler – and serve the needs of clinicians.
– Regence and MultiCare ink first-in-the-nation value-based
care partnership to deliver improved health outcomes at lower costs.
Health insurance provider Regence
and MultiCare Health System,
an independent accountable
care organization (ACO) have partnered to deploy a first-in-the-nation value-based model
that delivers better health outcomes to members at lower costs while
simplifying administration for health care providers. Regence serves
approximately 3.1 million members through Regence BlueShield of Idaho, Regence
BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and
Regence BlueShield (select counties in Washington). The new approach between
Regence and MultiCare Connected Care—the Accountable Care Organization that is
a wholly owned subsidiary of MultiCare Health System—marks a milestone in the
evolution of value-based partnerships between insurance payers and providers.
Da Vinci Member Attribution List Standard for Value-Based
The partnership will leverage utilized a soon to be
published HL7® FHIR® (Fast Healthcare Interoperability Resources) Standard
“Da Vinci Member Attribution List” which was developed by the HL7® Da Vinci Project for
value-based arrangements. This national standard provides an
interoperable method to share member attribution data assisting in reducing the
burden on provider organizations managing patient data and allowing providers
to spend more time with patients. The Regence and MultiCare partnership establish
a foundation for the development of future population data interoperability
applications, such as the exchange of data for measuring care quality and
Why It Matters
Value-based arrangements result in improved outcomes, lower
costs and fewer care gaps for health plan members, and higher patient and
provider satisfaction. Providers are eligible to earn financial incentives by
meeting established targets for patient outcomes, costs and satisfaction
By creating efficiencies and security in delivering patient data to providers more frequently, it allows provider organizations to spend less time acquiring the data and more time with the patient.” said Melanie Matthews, president of MultiCare Connected Care. “It frees up providers to do the work of population health and helps us embrace our mission of partnering for a healing and healthy future.”
A recent Advisory Board briefing examined the annual Centers for Medicare & Medicaid Services (CMS) Readmission penalties. Of the 3,080 hospitals CMS evaluated, 83% received a penalty for payments to be made in 2021, based on expected outcomes for a wide variety of treated conditions. While CMS indicated that some of these penalties might be waived or delayed due to the impacts of the Covid pandemic on hospital procedure volumes and revenue, they are indicative of a much larger issue.
For too long, patients discharged from the hospital have been handed a stack of papers to fill prescriptions, seek follow-up care, or take other steps in their journey from treatment to recovery. More recently, the patient is given access to an Electronic Health Record (EHR) portal to view their records, and a care coordinator may call in a few days to check-in. These are positive steps, but is it enough? Although some readmissions cannot be avoided due to unforeseen complications, many are due to missed follow-up visits, poor medication adherence, or inadequate post-discharge care.
Probably because communication with outside providers has never worked reliably, almost all hospitals have interpreted ‘care coordination’ to mean staffing a local team to help patients with a call center-style approach. Wouldn’t it be much better if the hospital could directly engage and enable the Primary Care Physician (PCP) to know the current issues and follow-up directly with their patient?
We believe there is still a real opportunity to hold the patient’s hand and do far more to guide them through to recovery while reducing the friction for the entire patient care team.
Strengthening Care Coordination for a Better Tomorrow
Coordinating and collaborating with primary care, outpatient clinics, mental health professionals, public health, or social services plays a crucial role in mitigating readmissions and other bumps along the road to recovery. Real care coordination requires three related communication capabilities:
1. Notification of the PCP or other physicians and caregivers when events such as ED visits or Hospitalization occur.
2. Easy, searchable, medical record sharing allows the PCP to learn important issues without wading through hundreds of administrative paperwork.
3. Secure Messaging allows both clinicians and office staff to ask the other providers questions, clarify issues, and simplify working together.
There are some significant hurdles to improve the flow of patient data, and industry efforts have long been underway to plug the gaps. EHR vendors, Health Information Exchanges (HIEs), and a myriad of vendors and collaboratives have attempted to tackle these issues. In the past few decades, government compliance efforts have helped drive medical record sharing through the Direct Messaging protocol and CCDAs through Meaningful Use/Promoting Interoperability requirements for “electronic referral loops.” Kudos to the CMS for recognizing that notifications need to improve from hospitals to primary care—this is the key driver behind the latest CMS Final Rule (CMS-9115-F) mandating Admission, Discharge, and Transfer (ADT) Event Notifications. (By March 2021, CMS Conditions of Participation (CoPs) will require most hospitals to make a “reasonable effort” to send electronic event notifications to “all” Primary Care Providers (PCPs) or their practice.)
However, to date, the real world falls far short of these ideals: for a host of technical and implementation reasons, the majority of PCPs still don’t receive digital medical records sent by hospitals, and the required notifications are either far too simple, provide no context or relevant encounter data, rarely include patient demographic and contact information, and almost never include a method for bi-directional communications or messaging.
Delivering What the Recipient Needs
PCPs want what doctors call the “bullet” about their patient’s recent hospitalization. They don’t want pages of minutia, much of it repetitively cut and pasted. They don’t want to scan through dozens or hundreds of pages looking for the important things. They don’t want “CYA” legalistic nonsense. Not to mention, they learn very little from information focused on patient education.
An outside practitioner typically doesn’t have access to the hospital EHR, and when they do, it can be too cumbersome or time-consuming to chase down the important details of a recent visit. But for many patients—especially those with serious health issues—the doctor needs the bullet: key items such as the current medication list, what changed, and why.
Let’s look at an example of a patient with Congestive Heart Failure (CHF), which is a condition assessed in the above-mentioned CMS Readmission penalties. For CHF, the “bullet” might include timely and relevant details such as:
– What triggered the decompensation? Was it a simple thing, such as a salty meal? Or missed medication?
– What was the cardiac Ejection Fraction?
– What were the last few BUN and Creatinine levels and the most recent weight?
– Was this left- or right-sided heart failure?
– What medications and doses were prescribed for the patient?
– Is she tending toward too dry or too wet?
– Has she been postural, dizzy, hypotensive?
Ideally, the PCP would receive a quick, readable page that includes the name of the treating physician at the hospital, as well as 3-4 sentences about key concerns and findings. Having the whole hospital record is not important for 90 percent of patients, but receiving the “bullet” and being able to quickly search or request the records for more details, would be ideal.
Similar issues hold true for administrative staff and care coordinators. No one should play “telephone tag” to get chart information, clarify which patients should be seen quickly, or find demographic information about a discharged patient so they can proactively contact them to schedule follow-up.
Building a Sustainable, Long-Term Solution
Having struggled mightily to build effective communications in the past is no excuse for the often simplistic and manual processes we consider care coordination today.
Let’s use innovative capabilities to get high-quality notifications and transitions of care to all PCPs, not continue with multi-step processes that yield empty, cryptic data. The clinician needs clinically dense, salient summaries of hospital care, with the ability to quickly get answers—as easy as a Google search—for the two or three most important questions, without waiting for a scheduled phone call with the hospitalist. X-Rays, Lab results, EKGs, and other tests should also be available for easy review, not just the report. After all, if the PCP needs to order a new chest x-ray or EKG how can they compare it with the last one if they don’t have access to it?
Clerical staff needs demographic information at their fingertips to “take the baton” and ensure quick and appropriate appointment scheduling. They need to be able to retrieve more information from the sender, ask questions, and never use a telephone. Additionally, both the doctor and the office staff should be able to fire off a short note and get an answer to anyone in the extended care team.
That is proper care coordination. And that is where we hope the industry is collectively headed in 2021.
About Peter Tippett MD, PhD: Founder and CEO, careMESH
Dr. Peter S. Tippett is a physician, scientist, business leader and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
About Catherine Thomas: Co-Founder and VP, Customer Engagement, careMESH
Catherine Thomas is Co-Founder & VP of Customer Engagement for careMESH, and a seasoned marketing executive with extensive experience in healthcare, telecommunications and the Federal Government sectors. As co-founder of careMESH, she brings 20+ years in Strategic Marketing and Planning; Communications & Change Management; Analyst & Media Relations; Channel Strategy & Development; and Staff & Project Leadership.
– Highmark Health signs six-year strategic partnership agreement
with Google Cloud to transform the health experience for patients and
caregivers through the development of Highmark Health’s new Living Health
– The Living Health model is designed to eliminate
the fragmentation in health care by re-engineering the healthcare delivery
model with a more coordinated, personalized, technology-enabled experience.
Highmark’s Living Health model is designed to eliminate the fragmentation in health care by re-engineering the healthcare delivery model with a more coordinated, personalized, technology-enabled experience. In addition to offering seamless, simpler, and smarter interactions with patients, the Living Health model is designed to free clinicians from time-consuming administrative tasks while providing them with timely data and actionable information about each patient. Living Health is not just focused on improving the patient-clinician relationship, it is about changing the way health care delivery operates.
“The Living Health model is about improving each person’s health and quality of life, every day,” commented Dr. Tony Farah, executive vice president and chief medical and clinical transformation officer of Highmark Health. “The traditional health care system is too fragmented and for the most part reactive. The Living Health model takes the information and preferences that a person provides us, applies the analytics developed with Google Cloud, and creates a proactive, dynamic, and readily accessible health plan and support team that fits an individual’s unique needs.”
Living Health Model
Powered by Google Cloud
Highmark Health will lead the collaboration to build its
Living Health Dynamic Platform on Google Cloud. Key elements of the agreement
– The construction of a highly secure and scalable platform
built on Google Cloud
– The application of Google Cloud’s advanced analytic and
artificial intelligence capabilities to supercharge Highmark Health’s existing
clinical and technology capabilities
– The engagement of a highly skilled professional services
team that will collaborate to drive rapid innovation
– The use of Google Cloud’s healthcare-specific solutions, including the Google Cloud Healthcare API, to enable rapid innovation, interoperability, and a seamless Living Health experience.
Highmark Health will control access and use of its patient
data using rigorous long-standing organizational privacy controls and
governance, which will be enhanced through the creation of a joint Highmark
Health-Google Cloud Data Ethics and Privacy Review Board to ensure that uses of
data are consistent with prescribed ethical principles, guidance, and customer
expectations of privacy.
Why It Matters
The strategic partnership reflects Highmark Health’s vision for a remarkable health experience by moving care and disease management of clinical conditions beyond traditional care settings through an engaging digital experience. By providing the insights needed to enable timely interventions, people will be empowered to proactively manage their health. For example, specific outcomes could include proactive intervention based on timely and individual patient data; digital disease management; easily accessible, personalized health plans; and centralized scheduling and management of care teams.
Economic Impact of Partnership
Approximately 125 new jobs are being created at Highmark Health to support the development of the Living Health Dynamic Platform, specifically in the areas of application development, cloud-based computing architectures, analytics, and user experience design.
– Mayo Clinic researchers are collaborating with TripleBlind on next generation algorithm sharing and training on encrypted data.
– TripleBlind’s solution functions as the innovative data
encryption conduit that keeps the data and intellectual property in the algorithm
today it is collaborating with Mayo Clinic researchers
who will use TripleBlind tools to validate interoperability
of encrypted algorithms
on encrypted data and the training of new algorithms on encrypted data. TripleBlind
has created a rapid, efficient and cost effective data privacy focused solution
based on breakthroughs in advanced mathematics, which will be used and
validated by the Mayo team. No Mayo data will be accessed by TripleBlind.
Why It Matters
Today, healthcare systems have to either transfer data or
algorithms outside their institution for experts to train or conduct research.
The encryption conduit being evaluated will eliminate the need for data
transfer or for sharing the algorithm, thus protecting intellectual property.
TripleBlind’s solution functions as the innovative data encryption conduit that
keeps the data and intellectual property in the algorithm secure.
The aim of this collaboration is also to demonstrate that
TripleBlind’s toolset can be applied to train entirely new algorithms from
independent entities anywhere in the world without the need to share raw data,
thus preserving privacy and security while meeting regulatory standards.
“Training novel algorithms on encrypted data sets and
facilitating trust between independent parties is critical to the future of AI
in medicine. By using advanced mathematical encryption technologies, we will
greatly enhance scientific collaboration between groups and allow for more
rapid development and scalable implementation of AI-driven tools to advance
healthcare,” said Suraj Kapa, M.D., a practicing cardiologist and director of
AI for knowledge management and delivery at Mayo Clinic.
Mayo Clinic and Dr. Kapa have financial interest in the
technology referenced in this release. Mayo Clinic will use any revenue it
receives to support its not-for-profit mission in patient care, education and
– Microsoft launches a COVID-19 vaccine management platform with partners Accenture and Avanade, EY, and Mazik Global to help government and healthcare customers provide fair and equitable vaccine distribution, administration, and monitoring of vaccine delivery.
– Microsoft Consulting Services (MCS) has deployed
over 230 emergency COVID-19 response missions globally since the pandemic began
in March, including recent engagements to ensure the equitable, secure and
efficient distribution of the COVID-19 vaccine.
With COVID-19 vaccines soon to be available, Microsoft
announced it has launched a COVID-19 vaccine management platform together with
industry partners Accenture, Avandae, EY, and Mazik Global. The COVID-19
vaccine management solutions will enable registration capabilities for patients
and providers, phased scheduling for vaccinations, streamlined reporting, and
management dashboarding with analytics and forecasting.
These offerings are helping public health agencies and
healthcare providers to deliver the COVID-19 vaccine to individuals in an
efficient, equitable and safe manner. The underlying technologies and approach
have been tested and deployed with prior COVID-19 use cases, including contact
tracing, COVID-19 testing, and return to work and return to school programs.
To date, Microsoft
Consulting Services (MCS) has deployed over 230 emergency COVID-19
response missions globally since the pandemic began in March, including recent
engagements to ensure the equitable, secure and efficient distribution of the
COVID-19 vaccine. MCS has developed an offering, the Vaccination Registration
and Administration Solution (VRAS), which advances the capabilities of their
COVID-19 solution portfolio and enables compliant administration of resident
assessment, registration and phased scheduling for vaccine distribution.
Key features of the solutions include:
– tracking and reporting of immunization progress through
secure data exchange that utilizes industry standards, such as Health Level
Seven (HL7), Fast Healthcare Interoperability Resources (FHIR) and open APIs.
– health providers and pharmacies can monitor and report on
the effectiveness of specific vaccine batches, and health administrators can
easily summarize the achievement of vaccine deployment goals in large
Microsoft partners have leveraged the Microsoft cloud to
provide customers with additional offerings to support vaccine management.
These offerings also apply APIs, HL7 and FHIR to enable interoperability and
integration with existing systems of record, artificial intelligence to
generate accurate and geo-specific predictive analytics, and secure
communications using Microsoft Teams.
–EY has partnered with Microsoft for the EY Vaccine
Management Solution to enable patient-provider engagement, supply chain
visibility, and Internet of Things (IoT) real-time monitoring of the vaccines.
Additionally, the EY Vaccine Analytics Solution is an integrated COVID-19 data
and analytics tool supporting stakeholders in understanding population and
geography-specific vaccine uptake.
Mazik Global has created the MazikCare Vaccine Flow that is built on Power Apps and utilizes
pre-built templates to implement scalable solutions to accelerate the mass
distribution of the COVID-19 vaccine. Providers will be able to seek out
specific populations based on at-risk criteria to prioritize distribution.
Patients can self-monitor and have peace of mind to head-off adverse reactions.
Our recent virtual event, Accelerating APIs in Healthcare: A Year in Review and Momentum for 2021, featured more than 1,000 viewers and 40 speakers with one clear, consistent message: big things will come in 2021. The full recording is now available on our website.
We got a front-row seat not just to presentations, but to the passion from our partners across industry for improving health IT (and individuals’ health). The event showcased and set the stage for how application programming interfaces (APIs) in healthcare will connect clinicians to better data,
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.
– Elation Health, which provides an easy-to-use and
affordable clinical technology platform for more than 7 million independent primary
care clinicians serving 14M+ patients – including an EHR raises $40M in Series
C funding from Al Gore’s sustainable investment firm, Generation Investment
– Elation’s API-enabled platform also allows
organizations to transform the patient and provider experience and implement
their own models of data-driven, value-based care.
– Company will surpass a milestone this year of
delivering more than 20 million in-office and virtual visits through their
Health, a clinical-first technology company powering the future of
independent primary care, today announced a Series C financing round of $40
million led by Al Gore’s Generation Investment
Management, a firm that invests in sustainable businesses accelerating the
transition to a more healthy, fair, safe, and low-carbon society. The round
also included participation from existing investors, including Threshold Ventures and Kapor Capital.
Clinical-First Commitment to Independent Primary Care
Independent primary care is one of the few areas in healthcare where upfront investment leads to significant savings in the long term. For every dollar spent on primary care, studies suggest that as much as $13 in downstream healthcare costs are avoided. Increased spending on primary care is also associated with fewer emergency department visits and reduced total hospitalizations and specialty interventions for chronic conditions such as diabetes, high blood pressure, and congestive heart failure
Elation Health was founded in 2010 after siblings Kyna and
Conan Fong struggled to help their father transition his solo primary care
practice from paper charts to a digital system. Born from that experience,
today Elation Health powers the largest network for independent primary care,
with 14,000 independent clinicians caring for seven million patients. The
company offers an EHR
solution, enterprise APIs, revenue cycle services, patient engagement app, and
access to interoperability partners.
The company surpassed a milestone this year of delivering more than 20 million in-office and virtual visits through its provider network. In addition to serving small practices, Elation has partnered with primary care innovators such as Crossover Health and Cityblock Health to provide the underlying clinical platform for technology-enabled, team-based care.
Helping Intendent Practices Shift to Virtual Care Amid The
In 2020, Elation Health’s customer base of independent
practices has faced significant business challenges as primary care shifts to
virtual settings and the pace of insurance and government policy change has
accelerated. The company has responded by expanding its role as a critical
technology partner — including adding HIPAA-compliant telehealth to its core
offering, deepening support for Medicare and Medicaid quality programs, and
delivering new patient engagement capabilities for patients to schedule
appointments and interact with practices. Elation’s API-enabled platform also
allows organizations to transform the patient and provider experience and
implement their own models of data-driven, value-based care.
In the year ahead, Elation Health will continue to invest in
its core platform, while adding new capabilities to support business operations
for independent primary care. The company has plans to develop solutions in
billing and payment collection, patient population management, interoperability,
and quality reporting — ensuring practices have the tools to drive high-quality
patient outcomes and business success.
The second day of INVEST Precision Medicine includes presentations by healthcare companies in the Health IT track of the Pitch Perfect startup pitch contest, a panel discussion on interoperability and a panel discussion on building a bioinnovation hub. Register today!
– Amazon today announced the launch of Amazon HealthLake,
a new HIPAA-eligible service enables healthcare organizations to store, tag,
index, standardize, query, and apply machine learning to analyze data at
petabyte scale in the cloud.
– Cerner, Ciox Health, Konica Minolta Precision Medicine,
and Orion Health among customers using Amazon HealthLake.
Today at AWS re:Invent, Amazon
Web Services, Inc. (AWS), an Amazon.com company today announced Amazon HealthLake, a
HIPAA-eligible service for healthcare and life sciences organizations. Current
Amazon HealthLake customers include Cerner, Ciox Health, Konica Minolta
Precision Medicine, and Orion Health.
Health data is frequently incomplete and inconsistent, and is often unstructured, with the information contained in clinical notes, laboratory reports, insurance claims, medical images, recorded conversations, and time-series data (for example, heart ECG or brain EEG traces) across disparate formats and systems. Every healthcare provider, payer, and life sciences company is trying to solve the problem of structuring the data because if they do, they can make better patient support decisions, design better clinical trials, and operate more efficiently.
Store, transform, query, and analyze health data in
Amazon HealthLake aggregates an organization’s complete data across various silos and disparate formats into a centralized AWS data lake and automatically normalizes this information using machine learning. The service identifies each piece of clinical information, tags, and indexes events in a timeline view with standardized labels so it can be easily searched, and structures all of the data into the Fast Healthcare Interoperability Resources (FHIR) industry-standard format for a complete view of the health of individual patients and entire populations.
Benefits for Healthcare Organizations
As a result, Amazon HealthLake makes it easier for customers to query, perform analytics, and run machine learning to derive meaningful value from the newly normalized data. Organizations such as healthcare systems, pharmaceutical companies, clinical researchers, health insurers, and more can use Amazon HealthLake to help spot trends and anomalies in health data so they can make much more precise predictions about the progression of the disease, the efficacy of clinical trials, the accuracy of insurance premiums, and many other applications.
How It Works
Amazon HealthLake offers medical providers, health insurers,
and pharmaceutical companies a service that brings together and makes sense of
all their patient data, so healthcare organizations can make more precise
predictions about the health of patients and populations. The new
HIPAA-eligible service enables organizations to store, tag, index, standardize,
query, and apply machine learning to analyze data at petabyte scale in the
Amazon HealthLake allows organizations to easily copy health
data from on-premises systems to a secure data lake in the cloud and normalize
every patient record across disparate formats automatically. Upon ingestion,
Amazon HealthLake uses machine learning trained to understand medical
terminology to identify and tag each piece of clinical information, index
events into a timeline view, and enrich the data with standardized labels
(e.g., medications, conditions, diagnoses, procedures, etc.) so all this
information can be easily searched.
For example, organizations can quickly and accurately find
answers to their questions like, “How has the use of cholesterol-lowering
medications helped our patients with high blood pressure last year?” To do this,
customers can create a list of patients by selecting “High Cholesterol” from a
standard list of medical conditions, “Oral Drugs” from a menu of treatments,
and blood pressure values from the “Blood Pressure” structured field – and then
they can further refine the list by choosing attributes like time frame,
gender, and age. Because Amazon HealthLake also automatically structures all of
a healthcare organization’s data into the FHIR industry format, the information
can be easily and securely shared between health systems and with third-party
applications, enabling providers to collaborate more effectively and allowing
patients unfettered access to their medical information.
“There has been an explosion of digitized health data in recent years with the advent of electronic medical records, but organizations are telling us that unlocking the value from this information using technology like machine learning is still challenging and riddled with barriers,” said Swami Sivasubramanian, Vice President of Amazon Machine Learning for AWS. “With Amazon HealthLake, healthcare organizations can reduce the time it takes to transform health data in the cloud from weeks to minutes so that it can be analyzed securely, even at petabyte scale. This completely reinvents what’s possible with healthcare and brings us that much closer to everyone’s goal of providing patients with more personalized and predictive treatment for individuals and across entire populations.”
As if 2020 couldn’t be
any more challenging for healthcare providers, new federal rules on
interoperability and patient access, granting patients direct access to their healthcare
data, begin taking effect this November and continue into 2022. These rules,
while ultimately beneficial to patients, bring an additional level of
operational complexity to many revenue-stressed healthcare organizations.
If anything, the 2020 pandemic has illustrated the vast potential of interoperability. For example, consider the huge increase in 2020 in virtual care visits, projected to be more than 1 billion by year’s end, and with an estimated 90% related to Covid-19. Many of these new virtual health patients will move through different care networks, using different health plans, and seeking remote access to their health records. These are precisely the type of patients’ interoperability is meant to help.
What should healthcare providers be doing now to ensure they’re not only compliant with new interoperability rules, but also applying them as optimally as possible to benefit their patients and organizations? In this article, we review the upcoming rules and suggest five key steps providers can take to ensure their interoperability implementations proceed as smoothly as possible.
What’s Ahead with
After several years of discussion on interoperability standards, the Office of the National Coordinator (ONC) for Healthcare IT and the Centers for Medicare & Medicaid Services (CMS) issued their final rules on interoperability in the spring of 2020. The new rules, covering both health systems and health plans, are intended to ensure that patients can electronically access their healthcare information regardless of health system or type of electronic health records (EHR) and covering all CMS-regulated plan types, including Medicare Advantage, CHIP, and the Federally Facilitated Exchanges.
Starting Nov. 2, 2020, healthcare systems must begin complying with interoperability rules preventing information blocking, which means not interfering with patients’ access to or use of their electronic health information. Providers must also attest they are acting “in good faith” regarding preventing information blocking, with any non-compliance flagged on the National Plan and Provider Enumeration System. By May 1, 2021, hospitals, psychiatric hospitals, and critical access hospitals with an EHR must send notification of their patients’ admission, discharge, and transfer (ADT) events to providers.
Interoperability will replace the current fragmented and error-prone ways of exchanging vital healthcare information. Near-term benefits of interoperability include improved care coordination and patient experience, greater patient safety, and stronger patient privacy and security. Longer-term benefits include higher provider productivity, reduced healthcare costs, and more accurate public health data.
For providers, the good
news about interoperability is that they’ve had years to think about and
implement many of its fundamental tenets, based on their work meeting
meaningful use requirements. That’s borne out in a 2019 HIMSS survey of
healthcare organizations which found nearly 75% of respondents past the
“foundational” level of interoperability – “foundational” defined as allowing
data exchange from one IT
system to another, but without data interpretation.
Five Steps for
While healthcare systems
will achieve significant interoperability gains through technology investments,
they should not consider technology as the ultimate sole key to
interoperability success. If anything, financial and political considerations
may be far more important to your organization’s interoperability success. Here
are five critical non-technology factors to consider:
1. Determine your “master”
All pertinent stakeholders in your organization should be on the same page about your interoperability strategy, resources, and timing. Know up-front that those implementing interoperability may not have previously worked with patient-centric analytics, partners, or departments in your organization. Plan your resources and timing accordingly. Your strategy should focus on the value-add of interoperability internally, such as access to additional data points on your patients, and externally, such as how you describe the upcoming benefits of interoperability to your patients.
2. Convey your vision, expectations
and expected return
An interoperability implementation is
a massive change management initiative, which requires continuous, top-down
leadership and championship, and proper expectation-setting. Communicate where
your organization currently stands regarding its interoperability capabilities,
and where you wish to have it go. Convey how the organization plans to get to
its future desired state. And perhaps most importantly, share the likely return
on investment in this effort. Be as specific as possible. For example, if you
believe interoperability gains will ultimately enable a 5% decrease in your
hospital readmissions, state that.
3. Examine workflows and identify
specific use cases
Every type of ADT event in your
organization, and its corresponding workflows and system interactions, should
be under review. Consider all types of clinical use cases, the types of data to
be exchanged, and those involved in providing patient care. This will help
determine your optimal approach to data-sharing and how your organization can
strategically use the additional data you receive from other health
4. Rigorously prep your data
Standardized data collection and reporting
which produces quality data is the heart and soul of successful
interoperability. Be sure your organization’s data is clean and meaningful, and
will ultimately be understandable and useful to your patients.
5. Think big-picture differentiation
There’s nothing in the ONC and CMS
interoperability rules that says you need to stop at mere rules compliance.
Consider your pursuit of interoperability as a singular opportunity to be a
patient-centric leader in your market. Let everyone relevant know of the
success you’ve achieved.
offers a chance for healthcare systems to achieve multiple operational gains,
when handled well, it is ultimately a patient-centric endeavor. Always keep the
needs and interests of your patients at the core when facilitating access to
their personal health data. It’s the ultimate smart long-term interoperability
– CommonHealth has connected to 230
health systems in the United States, allowing patients to gather, manage and
share their health and test data, including COVID test and vaccination status. By
the end of this month, CommonHealth will connect to more than 340 health
– CommonHealth extends the health data
portability and interoperability model pioneered by Apple Health to the 55
percent of Americans with Android devices (85 percent globally)
The Commons Project, a nonprofit public trust established to build digital platforms and services for the public good, today announced that the CommonHealth app has now connected to 230 health systems in the United States, allowing patients using those health systems to gather, manage and share personal health information – including COVID test and vaccine status – on Android devices for free. CommonHealth enables broader and more equitable participation in remote consultations with doctors, telemedicine, innovative care models, next-generation health services, and research.
CommonHealth App Development Background
Developed in collaboration with UCSF, Cornell Tech, and Sage Bionetworks with a team of clinicians, public health experts, technologists, scientists and privacy advocates, CommonHealth is operated by The Commons Project. CommonHealth was first deployed at UCSF Health and underwent substantial testing and user experience research in multiple diverse populations in San Francisco. CommonHealth is the first and only platform designed to allow users of the Android operating system to collect and manage their health data on their mobile devices in a similar way that Apple Health Record operates on iOS.
Already integrated with LabCorp, which
operates one of the largest clinical laboratory networks in the world,
CommonHealth allows individuals to store their COVID test results and vaccination
status, in addition to any health record. CommonHealth plans to integrate with
an additional 110 health systems in December, connecting to more than 340
health systems before the year ends.
Earlier this year, the Center for Medicare and Medicaid (CMS) rolled out new patient health record sharing rules that will require hospitals and physician offices to send standardized medical information, such as lab test results, vaccination records, and imaging tests, directly to third-party apps, like CommonHealth, by July 2021.
Why It Matters
“The COVID pandemic has accelerated the need for the safe sharing of health data as medical consultations go online and individuals are required to demonstrate COVID test and vaccination status in order to travel, work, study and undertake other social activities,” said JP Pollak, co-founder and chief architect at The Commons Project. “CommonHealth extends the privacy-centered data portability and interoperability model pioneered by Apple Health to the 55 percent of Americans who have Android devices.”
– Google Cloud launches Healthcare Interoperability
Readiness Program to help healthcare organizations achieve healthcare data interoperability.
Google Cloud launched the Google Cloud Healthcare Interoperability Readiness
Program, helping organizations achieve data interoperability in advance of
upcoming HHS deadlines and to enable future innovation. Alongside partners like Bain, BCG, Deloitte, HCL,
KPMG, SADA, and more, the Healthcare Interoperability
Readiness Program will help healthcare organizations understand the current status
of their data and where it resides, map out a path to standardization and
integration, and make use of data in a secure, reliable, compliant manner.
Google Cloud Interoperability Readiness Program
This program provides a comprehensive set of
services for interoperability, including:
– HealthAPIx Accelerator provides
the jumpstart for the interoperability implementation efforts. With best
practices, pre-built templates and lessons learned from our customer and
partner implementations, it offers a blueprint for healthcare stakeholders and
app developers to build FHIR API-based digital experiences.
– Apigee API Management provides the underpinning and enables a security and governance layer to deliver, manage, secure and scale APIs; consume and publish FHIR-ready APIs for partners and developers; build robust API analytics, and accelerate the rollout of digital solutions.
– Google Cloud Healthcare API enables
secure methods (including de-identification) for ingesting, transforming,
harmonizing, and storing your data in the latest FHIR formats, as well as HL7v2
and DICOM, and serves as a secondary longitudinal data store to streamline data
sharing, application development, and analytics with BigQuery.
– Interoperability toolkit that includes solution architectures, implementation guides, sandboxes, and other resources to help accelerate interoperability adoption and streamline compliance with standards such as FHIR R4.
COVID-19 Pandemic Underscores Drive to Accelerate
“With COVID-19 underscoring the importance of even more data sharing and flexibility, the next few years promise to accelerate data interoperability and the adoption of open standards even further—ideally ushering in new and meaningful partnerships across the care continuum, new avenues for business growth, and new pathways for patient-centered innovation,” stated in the announcement blog post.
Healthcare can achieve optimum efficiency when patients are at the center of care. When patients have the necessary information to navigate their care journey, they will choose the path to high-quality care at the lowest costs. Cost-sharing and insurance premiums are rising consistently since the last decade for employer plans, which covers nearly half of the country’s population. Plan members are shouldering a part of the healthcare cost burden, so they want to keep it as low as possible. At the same time, they want maximum value for their money with access to quality care.
CMS identified this as an opportunity and issued the Final Interoperability and Patient Access rule. The rule allows patients to access electronic health data through any third-party application of their choice. The rule intends to allow patients to take control of their data and determine who can see which data. It will also make transferring data from provider to provider easier. So that patients can be ensured that their provider is fully aware of their medical history.
The Challenge of Providing Members Access to Healthcare Data
The biggest challenge that health plans will face is to extract data from multiple sources in-house, clean and scrub it, and ensure it is in the appropriate format as required by the Centers for Medicare and Medicaid Services (CMS). Some health plans have been in business for a really long time. Patient data has been accumulating through these years in legacy systems. Providing access to that data through certified third-party applications will require a lot of effort on the part of health plans. The health plans also have to ensure tight authentication standards so that only the people requested by the members have access to their healthcare data.
In addition, there are multiple problems associated with provider data. Incorrect data in the provider database costs close to $3 billion annually. CMS has also issued warnings for inaccurate provider directories, high claim-reprocessing volumes, and substantial encounter-data rejection rates. Payers have been addressing the data issues with short term solutions. But now they have to resolve the provider data problems for good and make health data readily available to the members.
The COVID Crisis Upended The Payer Compliance Initiatives
Payers are in solidarity with providers and patients in this time of crisis. While providers work tirelessly to help an increased number of patients access the required care, payers are providing support through fast track reimbursements and reduced utilization management.
Many health plans are focused on ensuring that their members have access to resources to fight COVID, which is why CMS extended the deadline for the Final Interoperability rule. Utilization patterns are witnessing a significant change. Many members are not receiving scheduled care as some elective surgeries are rescheduled and some provider offices are shut down. There has been a drop in certain kinds of utilization. Conversely, there has been a dramatic surge in telehealth office visits and behavioral health services.
The Road Ahead for Health Plans
Healthcare payers have endured significant claims-based, economic, and operational challenges during the pandemic. While they battle those bottlenecks, they also have to ascertain and prepare for the future and devise ways to ensure that their members have access to quality care.
Health plans will have to try to anticipate what utilization patterns will look like in the future, especially in the next year. Telehealth utilization will not be the same as it was pre-COVID. They will also have to ensure that members have access to care. They will have to reach out to members, especially those who are the most vulnerable. They will have to make sure members are not suffering from social isolation, they are taking their medication and they have access to transportation to get to the doctor.
Provider Alliance for CMS Compliance
CMS is handing over the reins of the care journey to the patients to improve care delivery through the Interoperability rule. Providers will play a key role in enabling access to healthcare data to patients by streamlining data and closing coding gaps. Payers must assist providers with their data needs to ensure compliance with the CMS rules.
As the pandemic ends and CMS comes out with more definitive long term rules and coverages, it is going to be important to ensure that providers are on the same page with payers. Health plans can partner with providers to educate them about the acceptable telehealth codes and what type of services are to be performed using those codes. Providers want to take care of their patients and they want to do it well. They want to leverage technology to ensure patient access to care and ensure their safety, especially for patients who suffer from multiple comorbidities.
About Elizabeth Bierbower
Elizabeth Bierbower is a strategic leader with more than thirty years of executive experience in the health insurance industry. She has experience scaling cost-effective and profitable growth strategies through internal innovation, and a reputation as being one of the industry’s most fiscally responsible and progressive leaders. Bierbower currently serves on the Boards of Iora Health, the American Telemedicine Association, and is on Innovaccer’s Strategic Advisory.
Previously Beth was a member of Humana’s Executive Management Team and held various roles including Segment President, Group and Specialty Benefits, and was an Enterprise Vice President leading Humana’s Product Development and Innovation teams.
– 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
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
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
– 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.
Interoperability in healthcare is a national disgrace. After more than three decades of effort, billions of dollars in incentives and investments, State and Federal regulations, and tens of thousands of articles and studies on making all of this work — we are only slightly better off than we were in 2000.
Decades of failed promises and dozens of technical, organizational, behavioral, financial, regulatory, privacy, and business barriers have prevented significant progress and the costs are enormous. The Institute of Medicine and other groups put the national financial impact somewhere between tens and hundreds of billions of dollars annually. Without pervasive and interoperable secure communications, healthcare is missing the productivity gains that every other industry achieved during their internet, mobile, and cloud revolutions.
The Human Toll — On Both Patients and Clinicians
Too many families have a story to tell about the dismay or disaster wrought by missing or incomplete paper medical records, or frustration by the lack of communications between their healthcare providers. In an era where we carry around more computing power in our pockets than what sent Americans to the moon, it is mystifying that we can’t get our doctors digitally communicating.
I am one of the many doctors who are outraged that the promised benefits of Electronic Medical Records (EHRs) and Health Information Exchanges (HIEs) don’t help me understand what the previous doctor did for our mutual patient. These costly systems still often require that I get the ‘bullet’ from another doctor the same way as my mentors did in the 1970s.
This digital friction also has a profoundly negative impact on medical research, clinical trials, analytics, AI, precision medicine, and the rest of health science. The scanned PDF of a fax of a patient’s EKG and a phone call may be enough for me to get the pre-op done, but faxes and phone calls can’t drive computers, predictive engines, multivariate analysis, public health surveillance programs, or real-time alerting needed to truly enable care.
Solving the Surround
Many companies and government initiatives have attempted to solve specific components of interoperability, but this has only led to a piecemeal approach that has thus far been overwhelmed by market forces. Healthcare interoperability needs an innovation strategy that I call “Solving the Surround.” It is one of the least understood and most potent strategies to succeed at disruptive innovation at scale in complex markets.
“Solving the Surround” is about understanding and addressing multiple market barriers in unison. To explain the concept, let’s consider the most recent disruption of the music industry — the success of Apple’s iPod.
The iPod itself did not win the market and drive industry disruption because it was from Apple or due to its great design. Other behemoths like Microsoft and Philips, with huge budgets and marketing machines, built powerful MP3 players without market impact. Apple succeeded because they also ‘solved the surround’ — they identified and addressed numerous other barriers to overcome mass adoption.
Among other contributions, they:
– Made software available for both the PC and Mac
– Delivered an easy (and legal) way for users to “rip” their old CD collection and use the possession of music on a fixed medium that proved legal “ownership”
– Built an online store with a massive library of music
– Allowed users to purchase individual tracks
– Created new artist packaging, distribution, licensing, and payment models
– Addressed legalities and multiple licensing issues
– Designed a way to synchronize and backup music across devices
In other words, Apple broke down most of these barriers all at once to enable the broad adoption of both their device and platform. By “Solving the Surround,” Apple was the one to successfully disrupt the music industry (and make way for their iPhone).
The Revolution that Missed Healthcare
Disruption doesn’t happen in a vacuum. The market needs to be “ready” to replace the old way of doing things or accept a much better model. In the iPod case, the market first required the internet, online payment systems, pervasive home computers, and much more. What Apple did to make the iPod successful wasn’t to build all of the things required for the market to be ready, but they identified and conquered the “surround problems” within their control to accelerate and disrupt the otherwise-ready market.
Together, the PC, internet, and mobile revolutions led to the most significant workforce productivity expansion since WWII. Productivity in nearly all industries soared. The biggest exception was in the healthcare sector, which did not participate in that productivity revolution or did not realize the same rapid improvements. The cost of healthcare continued its inexorable rise, while prices (in constant dollars) leveled off or declined in most other sectors. Healthcare mostly followed IT-centric, local, customized models.
Solving the Surround for Healthcare Interoperability
‘Solving the Surround’ in healthcare means tackling many convoluted and complex challenges.
Here are the nine things that we need to conquer:
1. Simplicity — All of the basics of every other successful technology disruptor are needed for Health communications and Interoperability. Nothing succeeds at a disruption unless it is perceived by the users to be simple, natural, intuitive, and comfortable; very few behavioral or process changes should be required for user adoption.
Simplicity must not be limited to the doctor, nurse, or clerical users. It must extend to the technical implementation of the disruptive system. Ideally, the new would seamlessly complement current systems without a heavy lift. By implication, this means that the disruptive system would embrace technologies, workflows, protocols, and practices that are already in place.
2. Ubiquity — For anything to work at scale, it must also be ubiquitous — meaning it works for all potential players across the US (or global) marketplace. Interoperability means communicating with ease with other systems. Healthcare’s next interoperability disruptor must work for all healthcare staff, organizations, and practices, regardless of their level of technological sophistication. It must tie together systems and vendors who naturally avoid collaboration today, or we are setting ourselves up for failure.
3. Privacy & Security — Healthcare demands best-in-class privacy and security. Compliance with government regulations or industry standards is not enough. Any new disruptive, interoperable communications system should address the needs of different use cases, markets, and users. It must dynamically provide the right user permissions and access and adapt as new needs arise. This rigor protects both patients from unnecessary or illegal sharing of their health records and healthcare organizations in meeting privacy requirements and complying with state and federal laws.
4. Directory — It’s impossible to imagine ubiquitous national communications without a directory. It is a crucial component for a new disruptive system to connect existing technologies and disparate people, organizations, workflows, and use cases. This directory should maintain current locations, personnel, process knowledge, workflows, technologies, keys, addresses, protocols, and individual and organizational preferences. It must be comprehensive at a national level and learn and improve with each communication and incorporate each new user’s preferences at both ends of any communication. Above all, it must be complete and reliable — nothing less than a sub-1% failure rate.
5. Delivery — Via the directory, we know to whom (or to what location) we want to send a notification, message, fetch request or record, but how will it get there? With literally hundreds of different EHR products in use and as many interoperability challenges, it is clear that a disruptive national solution must accommodate multiple technologies depending on sender and recipient capabilities. Until now, the only delivery “technology” that has ensured reliable delivery rates is the mighty fax machine.
With the potential of a large hospital at one end and a remote single-doctor practice at the other, it would be unreasonable to take a one size fits all approach. The system should also serve as a useful “middleman” to help different parties move to the model (in much the same way that ripping CDs or iTunes gave a helping hand to new MP3 owners). Such a delivery “middleman” should automatically adapt communications to each end of the communication’s technology capabilities, needs, and preferences..
6. Embracing Push — To be honest, I think we got complacent in healthcare about how we designed our technologies. Most interoperability attempts are “fetch” oriented, relying on someone pulling data from a big repository such as an EHR portal or an HIE. Then we set up triggers (such as ADTs) to tell someone to get it. These have not worked at scale in 30+ years of trying. Among other reasons, it has been common for even hospitals to be reluctant to participate fully, fearing a competitive disadvantage if they make data available for all of their patients.
My vision for a disruptive and innovative interoperability system reduces the current reliance on fetch. Why not enable reliable, proactive pushing of the right information in a timely fashion on a patient-by-patient basis? The ideal system would be driven by push, but include fetch when needed. Leverage the excellent deployment of the Direct Trust protocol already in place, supplement it with a directory and delivery service, add a new digital “middleman,” and complement it with an excellent fetch capability to fill in any gaps and enable bi-directional flows.
7. Patient Records and Messages — We need both data sharing and messaging in the same system, so we can embrace and effortlessly enable both clinical summaries and notes. There must be no practical limits on the size or types of files that can easily be shared. We need to help people solve problems together and drive everyday workflows. These are all variations of the same problem, and the disruptor needs to solve it all.
8. Compliance — The disruptor must also be compliant with a range of security, privacy, identity, interoperability, data type, API, and many other standards and work within several national data sharing frameworks. Compliance is often showcased through government and vendor certification programs. These programs are designed to ensure that users will be able to meet requirements under incentive programs such as those from CMS/ONC (e.g., Promoting Interoperability) or the forthcoming CMS “Final Rule” Condition of Participation (CoP/PEN), and others. We also must enable incentive programs based on the transition to value-based and quality-based care and other risk-based models.
9. On-Ramp — The iPod has become the mobile phone. We may use one device initially for phone or email, but soon come to love navigation, music, or collaboration tools. As we adopt more features, we see how it adds value we never envisioned before — perhaps because we never dreamed it was possible. The healthcare communications disruptor will deliver an “On-Ramp” that works at both a personal and organizational scale. Organizations need to start with a simple, driving use case, get early and definitive success, then use the same platform to expand to more and more use cases and values — and delight in each of them.
So here we are, decades past the PC revolution, with a combination of industry standards, regulations, clinician and consumer demand, and even tens of billions in EHR incentives. Still, we have neither a ‘killer app’ nor ubiquitous medical communications. As a result, we don’t have the efficiency nor ease-of-use benefits from our EHRs, nor do we have repeatable examples of improved quality or lower errors — and definitively, no evidence for lower costs.
I am confident that we don’t have a market readiness problem. We have more than ample electricity, distributed computing platforms, ubiquitous broadband communications, and consumer and clinician demand. We have robust security, legal, privacy, compliance, data format, interoperability, and related standards to move forward. So, I contend that our biggest innovation inhibitor is our collective misunderstanding about “Solving the Surround.”
Once we do that, we will unleash market disruption and transform healthcare for the next generation of patient care.
About Peter S. Tippett
Dr. Peter Tippett is a physician, scientist, business leader, and technology entrepreneur with extensive risk management and health information technology expertise. One of his early startups created the first commercial antivirus product, Certus (which sold to Symantec and became Norton Antivirus). As a leader in the global information security industry (ICSA Labs, TruSecure, CyberTrust, Information Security Magazine), Tippett developed a range of foundational and widely accepted risk equations and models.
He was a member of the President’s Information Technology Advisory Committee (PITAC) under G.W. Bush, and served with both the Clinton Health Matters and NIH Precision Medicine initiatives. Throughout his career, Tippett has been recognized with numerous awards and recognitions — including E&Y Entrepreneur of the Year, the U.S. Chamber of Commerce “Leadership in Health Care Award”, and was named one of the 25 most influential CTOs by InfoWorld.
Tippett is board certified in internal medicine and has decades of experience in the ER. As a scientist, he created the first synthetic immunoglobulin in the lab of Nobel Laureate Bruce Merrifield at Rockefeller University.
launches member engagement solution for healthcare payers to drive improvement
in healthcare cost and quality boosts member satisfaction and enhances member
enrollment and retention.
– Innovaccer’s solution create member-oriented care
plans, enhance connectivity with care managers, and drive interventions for
social determinants of health risks through the solution.
Innovaccer, Inc., a
technology company, has launched its member engagement
solution for healthcare payers. The solution will enable payers to use a
more consumer-oriented approach and allow the network members to take charge of
their own healthcare journeys. The solution will empower them with the right
information, resources, and the network’s best-performing providers.
Creating a Patient-Centered Care Paradigm
U.S. healthcare is making strides toward a more
patient-centered care paradigm. The latest Interoperability and Patient Access
final rule is one of the initiatives that put patients at the center of care.
The rule made it mandatory for payers to share electronic health data with
patients, which will enable them to participate more in their healthcare
In addition to meeting the regulatory requirements, the
member engagement solution enables payers to provide on-demand, mobile-based
educational materials, lab and test results, clinical visit notes, personalized
health assessments, and digitized services to health plan members.
Enabling Payers to Become More Patient-Centered
Innovaccer’s solution enables payers to become more
patient-centered. Payers can create member-oriented care plans, enhance
connectivity with care managers, and drive interventions for social
determinants of health risks through the solution.
“By building strong payer-beneficiary collaboration, we will be able to establish a more active, responsible, and value-driven care journey. Engaged members will know and understand exactly what is being done for the successful management of their medical conditions. A more informed and savvy member can potentially contribute to improving the quality of care, reduce excessive resource utilization, and decrease their costs,” says Abhinav Shashank, CEO at Innovaccer.
Human API, a startup making it easier for consumers to share their health data, raised $20 million in funding. The company plans to use the funds to build out new features for clinical trial recruitment, insurance and digital health
In addition to the Mann-Grandstaff VA Medical Center, the EHR was implemented at its four community-based outpatient clinics across Washington, Montana, and Idaho, as well as the West Consolidated Patient Account Center, a VA business operations facility in Las Vegas.
The Department of Veterans Affairs (VA) now joins the
Department of Defense (DOD) and the Department of Homeland Security, via the
U.S. Coast Guard (USCG), in the successful deployment of Cerner-powered
technology that will create a single health record for 18 million Service
members, Veterans plus their family members. The technology is designed to
provide Service members a smoother transition when they leave active duty, as
well as provide VA clinicians the information they need to help Veterans
get quality individualized care.
“This new system is much more than an EHR,” said Travis Dalton, president, Cerner Government Services. “It is a platform to help drive interoperability across the continuum of care and ensure data flows between federal agencies and to commercial partners. This can help improve health outcomes, create public health infrastructure, enable more effective predictive clinical models and create better informed research critical to solving some of the nation’s most pressing health challenges, such as suicide and the opioid epidemic. Though there is still much work to be done, this go-live, along with the deployment of Cerner’s Centralized Scheduling Solution at Columbus and joint health information exchange are key proof points that EHRM is and will continue to be a success. We congratulate VA on this historic achievement and are proud to support this momentous initiative.”
– Cohere Health partners with health insurer Humana to modernize
the prior authorization process for musculoskeletal treatment across 12 states.
– In addition, the company has closed an additional $10M
in funding led by Flare Capital Partners and Define Venture, bringing the
company’s total funding to $20M.
Health insurer Humana has signed an agreement with healthcare collaboration company Cohere Health to improve the prior authorization process for musculoskeletal treatment across 12 states, starting Jan. 1, 2021. Cohere aligns physicians, patients, and health plans on a patient’s optimal healthcare experience—enabling access to higher quality care while at the same time minimizing administrative burden and siloed decision-making.
The partnership leverages CohereNext Platform’s prior authorization capability which grants authorizations across an entire episode of care, in effect pre-authorizing a complete treatment regimen from the initial diagnosis to treatment plan selection, and, ultimately, to the patient’s return to good health. Cohere’s approach aims to expedite evidence-based treatment plans to improve the healthcare experience for doctors and patients alike.
Humana to Leverage CohereNext Platform to Streamline
As part of the partnership, Humana will employ the CohereNext Platform to streamline prior authorizations in musculoskeletal treatment in Alabama, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia. The platform will initially serve approximately 2 million members and more than 3,500 physician practices.
This partnership supports Humana’s vision to reimagine and modernize processes for prior authorization by reducing approval times and improving the delivery of care, all while preserving important benefits such as safety, predictability, and cost containment.
Cohere’s solution will initially focus on prior
authorization; the company is developing additional use cases such as
value-based contract performance, improving physician and patient engagement,
and optimizing health plan clinical programs. By facilitating physician and
health plan collaboration, Cohere’s technology will help accelerate the
evolution to value-based care models.
“Through this strategic initiative and collaboration with Cohere Health, Humana is building on its commitment to reduce the complexity and friction of prior authorization for our physicians and members,” said William Shrank, MD, MSHS, Chief Medical Officer, Humana and Board Member, Cohere Health. “Cohere’s solution was co-designed with physicians and represents a major leap forward in improved physician experience and the adoption of evidence-based medicine.”
Cohere Health Closes Additional $10 Million in Funding to
Accelerate Delivery of Patient Journey Platform
In addition, the company announced it closed an additional
$10 million in funding led by Flare
Capital Partners and Define Ventures,
bringing the company’s total funding to $20 million. The funding will be used
to enhance the company’s scalable CohereNext® platform that is built on
next-generation cloud and data technologies and provides interoperability to
existing healthcare infrastructure as well as the emerging digital health
Series A extension comes just two months after Cohere Health’s initial $10 million Series
A funding, which was also led by Flare
Capital Partners with Define Ventures contributing as an investor and partner,
as well as participation from a leading national strategic partner.
The CohereNext Platform improves the physician experience
and quality by:
– Authorizations that begin with diagnoses and not billing
– Facilitating and auto-approving evidence-based treatment plans
– Delivering a peer review process with a true peer
specialist or sub-specialist
– Sharing quality performance relative to peers for specific
care paths and patient cohorts
– Providing tools, data and technology that optimizes
“The tragedy of COVID-19 has reinforced that the basic infrastructure supporting healthcare innovation is fundamentally broken. The shift from fee-for-service to value-based-care requires enabling interoperable capabilities to facilitate care around the interests of patients, and as a result, Cohere Health continues to rapidly grow and attract additional investments,” said Siva Namasivayam, CEO and founder of Cohere Health. “The additional funding will enable us to expand the CohereNext platform to impact more failure points across patient journeys so that physicians can deliver better outcomes and we can continue building our team, which has grown by more than 95 people this year.”
The COVID-19 pandemic has forever changed patient expectations for healthcare delivery, including offered services and health office operations. Although health systems have remained dynamic in adopting telehealth capabilities, their long-term capital, like real estate and supply chain management (SCM) protocols, have not adapted to match these expectations. Health systems must be aware of current trends in both areas to inform their future decisions.
Divesting in healthcare real estate is also key to reducing unnecessary costs to a health system, especially if optimal use of these spaces is already lacking. The overwhelming costs of ownership and management lock money away in underutilized and obsolete real estate spaces. Divesting provides more capital liquidity, and frees capital to go towards investment in telehealth, diagnostic technology, and emerging specialties, assets that go towards increasing patient and workforce engagement and satisfaction. In addition, eliminating unused real estate assets allows freedom from liabilities and human capital investments, like facility maintenance and upkeep, not to mention the increased frequency of deep cleaning necessary in the post-COVID-19 bi-lateral operations era.
Further, years of mergers and acquisitions in the healthcare industry have left many health systems with the unwanted result of increases in real estate assets. This has led to increased consolidation of these assets, a trend that has been exacerbated by the pandemic pressure on health system funds. Future consolidation and reevaluation of assets should be informed by trends in patient expectations as well as trends in the market.
Here are five emerging trends driving the future of healthcare real estate and assets. Each encourages divestment out of health system real estate ventures or restructuring of existing spaces in order to better cater to forever changed patient expectations.
1. Rise of Telehealth
According to the Department of Health & Human Services, telehealth use is up around 50% in primary care settings since the beginning of the public health emergency and is projected to remain high in the time following. Most recently, in-person visits have increased and as a result, telehealth visits have declined due to the state’s reopening, and thereby some critics posit that this trend may not continue. However, that could not be further from the truth.
Moving forward, despite health system fear regarding long-term reimbursement may be lacking from federal, state, and commercial health plan payers for virtual care delivery, leveraging telehealth to augment traditional healthcare delivery will become a necessity because consumers will demand it and physicians in some studies have shown satisfaction with their video visit platforms. This will no doubt have an impact on office layout and services.
2. Convenience of Outpatient Services
Motivated in part by telehealth utilization, patients seek convenience and accessibility in their healthcare now more than ever. Health system expansion may therefore mean satellite offices in high traffic areas to cater to the patient’s need for accessibility, marking a movement away from the traditional, centralized hospital campuses.
3. Value-Based Care Transitions
As legislation and CMS regulation moves more towards a value-based care system, trends show a natural move towards lower-cost facilities that provide preventive care. These could also contribute to continued trends to more off-campus real estate and planning for alternative care delivery options, for example, mobile vans reaching more vulnerable, at-risk populations for care such as life-saving vaccinations.
4. Pandemic Precautions
Bilateral operations are likely to be maintained for some time even after more normal operations return, and healthcare real estate, especially with consolidation, will need to accommodate this precaution, and others like it in all locations.
New diagnostic and testing tools are constantly being released, forcing health systems to reevaluate their current assets and make room for new ones which contributes to wasted space. Furthermore, remote monitoring apps will continue to proliferate in the market and become more affordable and accessible to consumers while advancing interoperability standards and federal information blocking requirements will allow information to flow more freely.
Strategies to Optimize Healthcare Real Estate & Strategy
In order to unlock money trapped in assets, health systems should look to make their assets work better in response to current trends and patient expectations. To accommodate patient demands and changes to health industry regulation and reimbursement, it makes sense to ensure efficient use of all facilities and optimize real estate and assets using the following strategies:
– Divest underutilized assets of any kind: Begin with real estate and move smaller to reduce unneeded capital investment.
– Remove or reduce administrative spaces: Transition non-clinical workforces to partial or complete work from home status, including finance, legal, marketing, revenue cycle, and other back-office functions. Shared space or “hotel” workspaces are popular.
– Reconfigure medical office or temporary care buildings: As these are often empty several days a week, they must be consolidated.
– Get out of expensive leases for care that can be given remotely or in lower-cost options or by strategic partners: Take full advantage of telehealth capabilities and eliminate offices that have become obsolete.
– Integrate telehealth into real estate only where it makes sense: Telehealth is more applicable to some services and care modalities than others. Offices should reconfigure to meet these novel needs where necessary, even if it means forgoing leases for the near term.
– Assess other expensive assets: Appraise assets like storage and diagnostic tools. Those not supportive of the new post-COVID-19 care model or prioritized service lines and are otherwise not producing revenues should be sold or outsourced to strategic partners.
– Diversify with off-campus offices: Provide convenient access to outpatient care and new outpatient procedures by investing in outpatient medical offices in high foot traffic locations.
– Create space for services in high demand: Services like preventive care and behavioral health should be given physical or virtual space in the system to cater to patient needs.
About Moha Desai
Moha Desai is a Principal of Healthcare Strategy and Transformation where she focuses on driving forward strategic, planning, financial, revenue cycle, operational improvement, and patient engagement healthcare projects for providers, federal government health agencies, and various firms requiring growth, business development, and project implementation and management. She has previously served in leadership roles at Partners HealthCare, Deloitte Consulting, Bearing Point, etc. Moha received her B.A. in Economics and her M.B.A. at Yale University.
– CommonWell Health Alliance enables payer access with the addition of a new service provider, DataFile Exchange to support the operational services specific to the Payment and Health Care Operations use case.
Health Alliance today announced it is extending its interoperability
services to enable additional use cases beyond treatment and patient access,
starting with Payment and Health Care Operations data requests.
Data File Exchange Background
To support this effort, CommonWell has added a new service
provider, DataFile Exchange, to support the operational services specific to
the Payment and Health Care Operations use case. Together, DataFile Exchange
and Change Healthcare, the technology service provider for CommonWell, will
facilitate the automated exchange of data requests from a broader set of users,
including payers, record locator vendors and other qualified entities.
Why It Matters
Despite strides made in electronic clinical data exchange, existing payments and operations processes providing access to protected health information (PHI) remain archaic, predominantly manual, expensive, error-prone, and time consuming. The additional functionality provided by the new use case aims to end these outmoded processes, improve the quality of care, and drive efficiency across the health care continuum.
DataFile Exchange was founded by Janine Akers, an industry leader in the exchange of PHI. DataFile Exchange will work closely with CommonWell, its members, and Change Healthcare, which continues to act as the CommonWell technology service provider and data broker for the CommonWell network––in addition to building the functionality needed to support Payment and Health Care Operations data requests.
“Improving data exchange of Payment and Health Care Operations is critical, particularly as we look at ways to help our health care system do more with less time and resources,” said Janine Akers, founder and CEO of DataFile Exchange. “DataFile Exchange has broad industry experience with handling PHI, so it’s only natural for us to shift our focus to automating the exchange of PHI. We’re well-positioned to partner with CommonWell in its effort to help patients, providers and payers benefit from these next-level interoperability services.”
Four CommonWell Service Adopters who provide record
Healthcare, Ciox, Inovalon and Moxe Health––currently are participating in
a pilot to refine the use case, with the goal of making CommonWell services for
Payment and Health Care Operations purposes generally available for these underserved
areas in the coming few months.
Today, the CommonWell network enables the federated exchange
of patient information across more than 17,000 provider sites representing 100
million individuals on its nationwide network alone. Combined with its CommonWell
ConnectorTM and collaboration connections like the Carequality Framework,
connected provider sites can exchange data with more than 50,000 clinics,
hospitals, specialty centers and more. To date, more than 790 million health
documents have been exchanged across the CommonWell network.
Today, Apple announced
the Health Records feature within the Health app is now available for users in
the UK and Canada to securely view and store their medical records right on
their iPhone, with their privacy protected at all times. Oxford University
Hospitals and Women’s College Hospital has been selected the first healthcare
institutions in the UK and Canada to make this feature available to their
How Health Records Works
Health Records creates a direct connection between medical
institutions and a patient’s iPhone, allowing users to see a central view of
their allergies, conditions, immunizations, lab results, medications,
procedures, and vitals across multiple institutions, and to be notified when
their data is updated. Apple utilizes a direct, encrypted connection between
the user’s iPhone and the healthcare organization to protect patient’s privacy.
All Health Records data is encrypted on device and protected
with the user’s iPhone passcode, Touch ID, or Face ID. Apple worked closely
with Cerner, Epic, Allscripts, and InterSystems to enable the FHIR (Fast
Healthcare Interoperability Resources) standards-based integration with the
Health app for their UK and Canadian customers.
To date, over 500 institutions currently support Health
Records on iPhone, listing more than 11,000 care locations. Previously,
patients’ medical records were held in multiple locations, requiring patients
to log in to each healthcare provider’s website to piece together their health
The Health Records feature in the Health app is available to
patients of the medical institutions listed below.
– Oxford University Hospitals NHS Foundation Trust – Oxford,
– Milton Keynes University Hospital NHS Foundation Trust –
Milton Keynes, UK
– Women’s College Hospital – Toronto, Ontario
– St. Joseph’s Healthcare Hamilton – Hamilton, Ontario
Whichever way you look at it, many countries across the globe are experiencing a rise in COVID-19 cases coinciding with the start of the Autumn/Winter seasons, says Dr Saif Abed, founding partner at The AbedGraham Group.
Since COVID-19 emerged as a major health threat, virtual care has taken off. As many as 46% of patients reported in late April that they had used telehealth to replace a canceled healthcare visit in 2020, while 48% of physicians said they had started using telehealth to treat patients.
While a shift in care models was necessary to address business continuity amid the pandemic, these trends also represent positive movements as a growing body of evidence supports the real-life benefits of telehealth. Remote models of care are connected to safe and effective consultations across many use cases, low exposure to viruses, and much-needed access to care.
Yet the fact that physician adoption isn’t higher suggests two things:
1) Physicians may be taking a ‘wait and see’ approach in the hopes that patients will want to return to in-person care as economies reopen; or
2) Some physicians haven’t yet figured out their long-term telehealth strategy. In truth, many providers are treating telehealth as a “stop-gap” — or temporary — solution until life returns to normal.
But given the increasingly positive data around telehealth as a safe alternative to in-person care, as well as its track record in successfully treating patients, it’s time for providers to reframe their thinking. In the future, practices will need a healthcare strategy that balances virtual with in-person care.
As recently as ten years ago, telehealth reimbursement was largely limited to patients in rural areas, as payers didn’t yet see the value of compensating doctors for virtual encounters.
Today, most payers and providers recognize the value of telehealth on some level amid rising demand for services and severe professional shortages. In particular, remote care models have proven their worth during the pandemic as an effective means of preventing the spread of disease. Greater acceptance of telehealth is further demonstrated by the recent decision to relax HIPAA requirements by HHS’ Office of Civil Rights (OCR), allowing more providers and patients to virtually connect through FaceTime, Zoom, or other two-way communications systems during the current pandemic.
This is an important first step, although many providers remain resistant to change for a variety of valid reasons. Some of these include discomfort with remote care models, reimbursement concerns, and the cost of deploying telehealth.
Performing medicine in a way that doesn’t align with one’s training feels unnatural, and some providers have said that virtual encounters feel less personal. The fact is that most clinicians weren’t trained to diagnose patients remotely or engage over a screen and are simply hesitant to embrace this approach to care.
Also, providers may have trepidation about not getting paid. While CMS and private payers have expanded coverage, multiple healthcare providers have reported that bills are being delayed or only partially paid by health plans.
With limited insight into the potential return on that investment, concerns over the cost of implementing telehealth are also reasonable. A physician who is consulting with patients remotely through FaceTime, for example, might wonder if the investment in a more secure, robust telehealth platform will make sense in 12 months, should a COVID-19 vaccine materialize.
Yet by not adopting a more permanent telehealth solution, providers may be hurting themselves down the road. Patients increasingly believe virtual care is highly effective, and some even prefer it. According to a SYKES consumer survey administered in March, 60% of 1,441 respondents said the COVID pandemic has increased their willingness to try telehealth.
Also, while HHS has relaxed HIPAA enforcement at the moment, there’s no indication this will continue. Healthcare organizations will need to ensure that the platform or program they’re using is designed to keep protected health information (PHI) safe.
Investing in the Future
Given the upward trajectory of telehealth, it benefits providers to thoughtfully invest in the right strategies and solutions now to extract the greatest value and return on investment down the road. Here are four steps to take, when shifting to a long-term telehealth strategy:
– Identify needs. Many primary-care practices may have seen a bump in interest in telehealth due to COVID-19, while specialty practices may see increases stay steady, even when fears of the coronavirus fade. When planning long-term, put patient needs first: In what ways can telehealth improve care delivery, going forward? Look at data, such as virtual-visit utilization patterns, to see where there are opportunities to grow telemedicine (e.g., expanding chronic care management) based on needs.
– Consider workflows. The ideal telehealth program doesn’t interrupt clinical workflows – it enhances them. If you’re using a ‘stop-gap’ video conferencing solution to provide telemedicine, is it easy to integrate practice notes with your EHR? Or, do you have to take extra steps to document patient encounters for clinical and billing departments?
–Seek supportive partners. You can use any number of technology platforms to conduct telemedicine encounters, but not all platforms are created equal. When looking at implementing a telehealth platform, consider not only ease of use, and interoperability, but also what a particular vendor is offering: How well the telehealth platform in question can accommodate the needs of a particular specialty? What are existing clients are saying about things like training, vendor support, and the patient experience?
– Proactively engage. Your patients have most likely heard of telehealth, but they may not realize that telehealth is multifaceted and can be used to diagnose conditions such as skin disorders or allergies and can be just as effective as in-person visits. Educating patients about telehealth’s benefits, and making it easy for them to try telehealth, is essential to success.
Expanding telehealth’s role in the medical practice benefits everyone, from physicians to patients to payers. Moving past the “stop-gap” mentality now will reap greater benefits in the future, regardless of whether we’re in the midst of a pandemic, or simply trying to provide excellent care on a day-to-day basis.
About Roland Therriault
is the President and Executive Vice President of Sales at InSync Healthcare Solutions, a provider
of integrated EHR and practice management software, revenue cycle management
services and medical transcription to thousands of healthcare professionals
throughout the United States. Roland Therriault manages all operations of the
company, driving its go-to-market strategy and overseeing all sales activities.
His experience in healthcare and technology includes more than 20 years of
direct and channel sales, strategic planning and business development. Prior to
joining InSync, Roland served as Vice President of Sales for MD On-Line, a
provider of acute and ambulatory clinical and practice management solutions.
– Fresenius Kidney Care, the dialysis services
division of Fresenius Medical Care North America, rolled out CommonWell health
data exchange services to its dialysis facilities nationwide.
– This initiative is a significant stride towards better-coordinated care for patients requiring life-sustaining dialysis for kidney failure and will enable the real-time exchange of critical patient health information–allowing healthcare providers to access the most up-to-date records when treating these patients with complex health needs.
Fresenius Kidney Care, the dialysis services division of Fresenius Medical Care North America and the nation’s leading network of dialysis facilities, is deploying CommonWell health data exchange services to all of its dialysis facilities, enabling near-real-time exchange of critical patient health information. With the connection to the CommonWell Health Alliance interoperability network and its bridge to the Carequality interoperability framework, care team members can locate, exchange, and view patient health documents from more than 600,000 providers and 2,800 hospitals across the country.
National Data Exchange Network
The exchange enables the provider network to access dialysis
treatment records for any patient treated at Fresenius Kidney Care and better
coordinate care with patients’ other participating providers. Because people
living with kidney failure often have multiple comorbidities, many are
routinely treated in other facilities and hospitals outside the dialysis center
making access to health information critical.
The document exchange is made possible within the company’s
existing Cerner technology for managing patient health records. Examples of
health information accessible on the exchange network include discharge
summaries and emergency room visits.
“Ensuring all healthcare providers have the most up-to-date records when our dialysis patients receive care is vital to providing the best treatment and outcomes possible,” said Mike Asselta, President of Fresenius Kidney Care. “By implementing this leading national exchange, we are taking another important step toward better coordinated care for all patients living with kidney failure.”
Fresenius Kidney Care recently began implementing these data
exchange services in select states and dialysis centers and will continue to
expand these services in the coming months. Several studies have shown that use
of health information exchange (HIE) systems can decrease the number of
hospital emergency room visits and reduce readmission rates.
Twenty years ago, technology consultants started advising CIOs to build less. That’s when the movement towards Commercial Off the Shelf (COTS) began.
Today, there are many shops, especially those in small and medium-sized organizations, with few programmers who build new applications from scratch.
Yes, they have programmers who configure, script, and integrate various applications but very little is built. For the provider community, we have a habit of either sourcing our needs from our Electronic Health Records (EHR) application vendor or buying a “best of breed” application from a niche vendor.
Moving to Software as a Service (SaaS) has even reduced the dread of upgrades. No doubt buying commercial software has enabled all of us to have access to better solutions and in some cases, may have reduced the ongoing run rate. Still, it means technology costs have gone up and a lot of our technology goals have not been achieved.
For example, interoperability remains a point to point problem. ONC and CMS are still pushing to remove barriers to interoperability and have mandated data exchange with penalties.
CIOs are struggling with the realities of constraint budgets where new programs are starving while dollars go to pay maintenance, integration costs associated with prior purchases (e.g. tech debt).
Then, in a year of the normal pull-and-tug between maintaining current and delivering new systems, COVID-19 arrived and our planning fell short. Technology teams were challenged as never before. They suddenly needed to:
– Enable teams to work from home – even teams who have never worked remotely.
– Stand up telehealth solutions in days – not months.
– Find a good external data source with statistics to integrate and then discover a newer, better source days later.
– Provide real-time updates on the availability of hospital rooms to leadership.
– Provide rapidly evolving guidance to patients on admissions changes, new requirements for entrance to facilities reduced access to admitted patients.
– Be a trusted, consistent source of guidance to reduce the spread of the disease.
This was all new, unplanned work. Work that took resources from other budget areas and other teams. Work that didn’t always meet our aim for better patient care or patient experience.
For example, we saw some providers advertising the availability of telehealth services but requiring a patient to call their primary care doctor to schedule instead of requesting an appointment online. Then due to staff shortages, the patient would land in voice mail, further delaying access to care.
Patients needing tests have been told to get an order from their physician. The truth is telehealth isn’t integrated and isn’t part of our daily processes.
The story here is the emergence of an unsung hero you can’t find on the nightly news: our IT Teams. We need to arm this group of heroes with better tools. Tools where delivery of new programs, updates to existing processes and integrating new data from external sources can be done in days, not months.
Did your clients link to external data sources such as John Hopkins? Did they need to enable test sources from new partners? Did they need to build new mobile applications to integrate workstations in parking lots and third-party locations?
New approach – Low-Code
Today’s challenges require a new approach that is “low-code.” Low-code is shorthand for an application development environment that is primarily visual and uses simple declarative statements to create applications. The primary goal of low-code is to accelerate program delivery.
This is surely a goal for every healthcare technology team. As enterprise clients embrace low-code, they can ensure readiness by putting these building blocks in place so clients can realize the promised value:
– Authentication Management through APIs (OAuth)
– Standardized access through APIs
– Management and Monitoring
In preparation for the adoption of a low-code application platform (LCAP), it is essential to assess the adoption of authentication best practices.
The technology landscape now spans on-prem, private cloud, and public cloud solutions requiring a standardized, tokenized approach to authentication. Without this, security processes will inevitably fall short of the CISO’s goals or will require additional manpower to monitor and maintain.
OAuth is the building block
Given the number of vendors, environments, and the velocity of human interactions (non-employee clinicians, temporary resources of all types, patients, etc.), OAuth is the building block for scalable secure authentication. OAuth is a delegated authentication framework that replaces the need to send credentials in program calls (APIs).
It has been required by CMS for the interoperability rule as a foundation for data sharing. If you haven’t, invest in a centralized identity management system and move to use OAuth to authenticate service and access requests. Standardizing authentication is foundational. Do it before selecting a low-code vendor.
LCAP platforms deliver a variety of methods to access data from other applications. Typical integration patterns include files, database calls (ODBC, JDBC, etc.), and scripting.
Now is the time to adopt API-First and design thinking. Stop building point-to-point integrations – the velocity of LCAP will result in a proliferation of connection methods if interfaces are not standardized.
Using APIs – fast delivery
Using APIs will enable faster delivery and better performance. Providing a set of standardized interfaces that meet the needs of consumers (a fundamental goal of API-First) will reduce test time, production breakage, and upgrade complexity. Don’t wait.
Doing APIs right requires a culture shift – slapping an API on an enterprise application is not the goal. Delivering APIs that drive consumption and adoption by citizen developers and go-to-market programs will power user experiences that truly do more with less.
Management and monitoring
Last but not least is the management and monitoring of your new agile applications, especially the application interactions with your core enterprise applications and external integrations. We have all seen it, a new program or upgrade is delivered, and performance slows to a crawl.
Monitoring and metering access (limited access to X number of calls per time period) is essential to proactively prevent coding errors and shield your client from bad actors. Knowing who is accessing what, and how the load varies, is necessary to achieve the goals of delivery velocity and efficient use of resources.
API Management vendor leaders include policy engines, management, and embedded analytics in their gateways to protect and scale service integrations.
Better, faster, cheaper is our mantra (once again, some of us mutter under our breaths). Adopting low-code will accelerate delivery and help us meet the demands of the new normal.
LCAP demands standardized authentication, application program interfaces (APIs), and secure, monitoring gateways to accelerate adoption while protecting and securing enterprise resources.
About Ruby Raley
Ruby Raley is VP of Healthcare and Life Sciences at Axway. Axway empowers customers to compete and thrive in dynamic marketplaces using hybrid integration solutions to better connect their people, systems, businesses, and digital ecosystems. More than 11,000 organizations in 100 countries rely on Axway to solve their data integration challenges.
The COVID-19 pandemic is not just a medical crisis. Since the highly contagious disease hit American shores in early 2020, the virus has dramatically changed all sectors of society, negatively impacting everything from food supply chains and sporting events to the nation’s mental and behavioral health.
For some people, work-from-home plans and limited access to entertainment are manageable obstacles. For others, the shuttered schools, lost wages, and social isolation spell disaster – especially for individuals already living with socioeconomic challenges.
The social determinants of health have always been important for understanding why some populations are more susceptible to increased rates of chronic conditions, reduced healthcare access, and shorter lifespans. COVID-19 is throwing the issue into high relief.
Now more than ever, healthcare providers need to gain full visibility into their populations and the non-clinical challenges they face in order to help individuals maintain their health and keep their communities as safe as possible during the ongoing pandemic.
Exploring correlations between socioeconomic circumstances and COVID-19 vulnerability
Clinicians and researchers have worked quickly to identify patterns in the spread of COVID-19. Early results have emphasized the danger posed by advanced age and preexisting chronic conditions such as obesity, diabetes, and heart disease.
Further, data from the Johns Hopkins University and American Community Survey indicates that the infection rate in predominantly black counties is three times higher than in mostly white counties. The death rate is six-fold higher.
Data from the Centers for Medicare and Medicaid Services (CMS) confirms the trend: black Medicare beneficiaries are hospitalized at a rate of 465 per 100,000 compared to just 123 per 100,000 white beneficiaries. Hispanic Medicare beneficiaries had 258 hospitalizations per 100,000, more than double the white population’s hospitalization rate.
Researchers suggest that the social determinants of health may be largely responsible for these disconnects in infection and mortality rates. Racial, ethnic, and economic factors are strongly correlated with increased health concerns, including longstanding disparities in access to care, higher rates of underlying chronic conditions, and differences in health literacy and patient education.
Leveraging data-driven tools to identify vulnerable patients
Healthcare providers will need to take a proactive role in identifying which of their patients may be at enhanced risk of contracting the virus and experiencing worse outcomes from the disease.
They will also need to ensure that person gets adequate treatment and participate in contact tracing efforts after a positive test. Lastly, providers will have to ensure their public health reporting data is accurate to inform local and regional efforts to contain the disease.
The process begins by developing confidence in the identity of each individual under the provider’s care. Healthcare organizations often struggle with unifying multiple electronic health record (EHR) systems and other health IT infrastructure, resulting in medical records that are incomplete, inaccurately duplicated, or incorrectly merged.
Access to current and complete medical histories is key for highlighting at-risk patients. An enterprise master patient index (EMPI) can provide the underlying technical foundation for initiating this type of population health management.
EMPIs help organizations create and manage reliable unique patient identifiers to ensure that records are always associated with the correct individual as they move throughout the healthcare system.
When paired with claims data feeds, health information exchange (HIE) results, and interoperability connections with other healthcare partners, EMPIs can bring a patient’s complete healthcare status into focus.
This approach ensures that providers stay informed about past and present clinical issues and service utilization rates. It can also support a deeper dive into the social determinants of health.
Combining EHR data with standardized data about socioeconomic needs can help providers develop more comprehensive and detailed portraits about their patients’ holistic health status.
By including this information in EHRs and population health management tools, providers can develop condition-specific registries to guide outreach activities. Providers can deploy improved care management strategies, close gaps in care, and connect individuals with the resources they need to stay healthy.
Healthcare organizations can acquire socio-economic data about their communities in a variety of ways, including integrating public data sources into their population health management tools and collecting individualized data using standardized questionnaires.
Once providers start to understand their patients’ non-clinical challenges, including the ability to avoid situations that may expose them to COVID-19, they can begin to prioritize patients for outreach and develop personalized care plans.
Conducting effective outreach and interventions for high-needs patients
COVID-19 has taken a staggering economic toll on many families, including those who may have been financially secure before the pandemic. Routine healthcare, prescription medications, and even some urgent healthcare needs are often the first to fall by the wayside when finances get tight.
Healthcare providers have gotten creative about staying connected to patients through telehealth, drive-in consults, and other contactless strategies. But they must also ensure that their vulnerable patients are aware of these options – and that they are taking advantage of them.
Contacting a large number of patients can be challenging since phone numbers, emails, and home addresses change frequently and are prone to data entry errors during intake. Organizations with EMPIs can leverage their tools to ensure contact information is up to date, accurate, and associated with the correct individual.
Care managers should prioritize outreach to patients with complex medical histories and known clinical risks for vulnerability to COVID-19. These conversations are a prime opportunity to collect social determinants of health information or refresh existing data profiles.
Looking to the future of healthcare in a COVID-19 world
Combining technology-driven strategies with targeted outreach will be essential for healthcare organizations aiming to provide holistic support for their populations during – and after – the COVID-19 pandemic.
By developing certainty about patient identities and synthesizing that information with data about the social determinants of health, providers can efficiently and effectively connect with their patients to offer much-needed resources.
Taking a proactive approach to addressing the social determinants of health during the outbreak will help providers maintain relationships with high-needs patients while building new connections with those facing unanticipated challenges.
With a combination of population health management strategies and innovative technology tools, healthcare providers and public health officials can begin to view the social determinants of health as a fundamental component of the fight against COVID-19.
Andy Aroditis, is CEO of NextGate, the global leader in healthcare enterprise identification.
The clinical manifestations of COVID-19 are varied, and patients are known to have rapidly changing signs and symptoms that must be tracked with laboratory testing. A patient may start his treatment journey with his primary care physician and will include lab centers, diagnostic centers, inpatient, and home quarantine centers.
– Dignity Health Management Services (DHMSO), the largest
health system in the state of California to transform their network health data
into actionable insights.
– With this partnership, the organization will leverage
Innovaccer’s FHIR-enabled Data Activation Platform to better manage healthcare
services for its attributed patients.
Dignity Health Management Services
(DHMSO), a healthcare management company part of CommonSpirit Health, that helps providers
and payers deliver better clinical outcomes through innovative tools and
partnering with Innovaccer. As part of
the partnership, DHMSO will leverage Innovaccer’s FHIR-enabled Data Activation
Platform and built-in solutions to enhance its care management approach while
engaging their network providers and payers in real-time.
Transform Network Health Data Into
DHMSO will integrate its clinical
and financial data from multiple sources on Innovaccer’s FHIR-enabled Data
Activation Platform. Once the data is integrated on the platform, the
organization will power multiple care processes. This platform supports
critical FHIR API resources and solves numerous data-exchange challenges for
providers and payers. DHMSO will have the advantage of real-time data sharing
and true interoperability with the platform.
To achieve a comprehensive overview
of its network, Dignity Health Management Services will also use InGraph,
Innovaccer’s population health management solution built on top of the
FHIR-enabled Data Activation Platform. DHMSO’s leaders will view drilled-down
analysis of their under-performing parameters through InGraph’s 60+ patient
stratification features and advanced analytics offered by customizable
dashboards. They will be able to identify, have a complete overview of, and
gain insight into their cohort of at-risk patients to track utilization and
trends. The organization will be empowered to implement care management
improvements and follow results within different management spheres, adjusting
as needed to drive optimum healthcare delivery and patient outcomes.
Additionally, billing processes for patient visits will be simplified and
automated through the platform’s automated reporting feature.
InNote, Innovaccer’s point-of-care technology, the organization will furnish
its providers with a full view of their patient’s healthcare journey right at
the moment of care. This will enable DHMSO and its healthcare teams to focus on
closing the care and coding gaps in real-time to deliver quality outcomes with
Health Management Services, we believe in keeping our patients happy, healthy,
and whole every day. It is our goal to meet the physical, mental, and spiritual
needs of every patient. This partnership with Innovaccer will strengthen our
approach towards achieving this goal. Innovaccer’s FHIR-enabled Data Activation
Platform will assist us as we work toward improvements in our care delivery,
and will be a great addition to our strategy,” says Dr. Soham Shah, Medical
Director of Clinical Informatics & Quality Management, Dignity Health
One of the more remarkable features of the NHS’s response to the coronavirus pandemic has been its rapid uptake of technology in the UK says director of international relations at NHS Confederation, Dr Layla McCay.
– 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.
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’ 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.
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.
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.
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.
– Bridge Connector raises $25.5 million in Series B funding to advance interoperability layer for healthcare organizations as demand for integrated health data intensifies during COVID-19 pandemic.
– The investment will support the growth of Destinations,
the company’s new integration-platform-as-a-service (iPaaS) that connects
health data systems using use-case-based interoperability blueprints to speed
integrations with major vendors.
a Nashville, TN-based interoperability company changing the way health care
communicates, today announced it has raised $25.5 million in Series B funding led
by Axioma Ventures. The round was also joined by all existing investors,
including veteran investor Jeff Vinick, and brings Bridge Connector’s total
funding to over $45 million.
COVID-19 Underscores Growing Demand for Integrated Health
The last decade has seen an explosion of digital health platforms and the U.S. health care system has taken incremental steps toward achieving interoperability between them. In March, the Department of Health and Human Services (HHS) issued new rules that force formerly closed vendor solutions to become interoperable.
However, the COVID-19 pandemic has exposed the urgent need for data liquidity as healthcare providers across the country have struggled to share essential patient information and provide comprehensive care via remote delivery methods such as telehealth. In the face of the pandemic’s disproportionate effect on minority communities, the industry has also recognized the critically important role that social determinants of health — the environments in which we are born, live and work — play in our overall well-being and the need to make this information available to health care providers.
A True Interoperability Layer for Healthcare
Founded in 2017, Bridge Connector provides a suite of vendor-agnostic integration solutions and a full-service delivery model, helping health care vendors, providers, and payers more easily share data between disparate systems, such as electronic health records (EHRs) or patient engagement solutions. The company’s technology is designed to democratize health care by allowing organizations of any size to equitably connect data systems and empower care teams with the most accurate patient data in real-time. Unlike other health care interoperability vendors, Bridge Connector’s unique approach does not lock customers into a forced data model or proprietary APIs, instead of employing a vendor-agnostic integration layer that works across data models without the need for standardization.
The investment will further support the company’s increasing
market share in healthcare interoperability and growth of Destinations, a new
integration-platform-as-a-service (iPaaS) that connects health data systems
using use-case-based interoperability blueprints to speed integrations with
Recent Integrations with Key HIT Stakeholders
The new funding comes shortly after Bridge Connector finalized various collaborations with some of the most influential stakeholders in health IT, including Epic, Allscripts, and Salesforce, as well as other system integrators such as MuleSoft. Those collaborations represent calculated steps toward creating a centralized hub of integration solutions for all data platforms that any health care provider or payer can access. The average hospital today uses approximately 16 disparate electronic health records platforms that limit data sharing within the walls of a single hospital, let alone between separate hospitals.
HHS’ Office of the National Coordinator will allocate $2.5 million in CARES Act funding to health information exchanges to support public health uses of information from health information exchanges (HIEs). Five recipients will each get $500,000.
– Lumeon, the leader in care pathway orchestration
announced it has raised $30M in Series D funding to extend the reach of its
Care Pathway Management (CPM) platform.
– The platform empowers providers to improve care
quality, deliver better outcomes, reduce costs, and ultimately develop and
scale new models of care delivery – particularly important right now as
COVID-19 accelerates the technology-driven transformation of healthcare.
Lumeon, a Boston, MA-based provider of care pathway orchestration, today
announced that it has closed $30M in Series D funding led by new investors
Optum Ventures and Endeavour Vision, with participation from current investors
LSP, MTIP, IPF Partners, Gilde and Amadeus Capital Partners. The investment
will enable the company to extend the reach of its Care Pathway Management
(CPM) platform, which helps healthcare providers automate their patient care coordination
to improve care quality, deliver better outcomes and reduce costs.
Why Care Pathways?
With proven ability to reduce unwarranted
variation and lower the overall cost of care delivery, care pathways are
an increasingly attractive proposition for healthcare providers.
The challenge, however, has always been to take paper-based pathways off the
page and into operational reality. This means being able to direct tasks and
coordinate care across clinicians, ward managers, nurses, patient educators –
the entire team responsible for successful care delivery – even the patient
Deliver Engaging Virtual Care Journeys
Founded in 2005, Lumeon’s platform connects
the care journey across the care continuum, operationalizing care plans beyond
the four walls of your hospital. Lumeon’s CPM platform
uses real-time data to dynamically guide patients and care teams along their
care journeys. By automating, orchestrating and virtualizing care delivery
across care settings, Lumeon’s solutions allow health systems to operate with
predictability and efficiency, delivering optimal care to each patient while
substantially lowering costs for healthcare providers.
Lumeon’s CPM platform
integrates with all electronic health record (EHR) systems in addition to
incorporating required clinical and administrative data from point solutions
and devices, addressing the fragmented nature of healthcare technology and the
challenge of interoperability. By extending beyond the confines of a healthcare
provider’s EHR, Lumeon’s configurable solutions maximize current investments as
organizations evolve their care delivery models.
“While the markets for data analytics, clinical decision support and patient engagement are well established, what is missing today is the ability to effectively connect them to solve the problem of personalizing care delivery in a scalable way,” said Lumeon Founder and CEO Robbie Hughes. “The ‘last mile’ that turns the insight into action is the hardest part for health systems, and is the core of the Lumeon proposition.”
Whether it’s solving a gap in care problem, or a payer/doctor connectivity problem there will always be individual use cases where multisided platforms (or health information exchanges) can and should connect to solve for information exchange at scale.
Michael Seres was an entrepreneur, patient advocate, husband and father of three. He died on 30 May 2020, in California, US, of a sepsis infection. This news not only shook the patient community, but also the global healthcare IT space.
– Redox adds data on demand and single sign-on access
features to its cloud interoperability platform to help to simplify the process
of developing software for healthcare.
– Both new features are now available to all customers on
the Redox platform.
Inc., a Madison, WI-based interoperability platform for healthcare data
exchange, unveiled Data on Demand, which enables software developers to query
any electronic health
record (EHR) or healthcare data source via the Redox API. Powered by a
FHIR-conformant data storage architecture, Data on Demand is pre-built
integration infrastructure designed to simplify and normalize the integration
experience and reduce the technical burden of consuming hundreds or thousands
of messages per day. In addition, the company has added Single Sign-on that allows applications using Redox to make
it easier for providers to launch their products from within their EHR in an
efficient manner. Both features are available to all customers on the Redox
Data on Demand and Single Sign-on Simplify the Process of
Redox continues to expand the integration capabilities
healthcare software developers can access through a single API with these new
Data on Demand converts traditional HL7 feeds into a
data store that application developers can query on demand. This provides a
consistent integration experience that works with both the push- and API-based
integrations provided by EHR companies. Regardless of how data is provided by
the EHR, Redox customers can more easily manage the volume of messages and
logic needed to update information, allowing them to focus on getting the data
that they want, when they want it. No other integration vendor can turn HL7
feeds into reusable queries.
Single Sign-On (SSO) allows customers to improve the
provider’s experience with their products by sharing login credentials and
pertinent patient or visit context along with patient data that they’ve
collected. This allows applications on the Redox network to securely connect to
other applications and share the login context for a user. Customers trust Redox
to verify that the SSO request is valid, and Redox normalizes and pulls the
information to launch the application.
“Redox continues to develop the robust integration
capabilities software developers need to navigate the fragmented world of data
exchange and interoperability in healthcare,” said Niko Skievaski, co-founder
and president, Redox. “The Redox API is transforming the way healthcare
organizations access and share data. Our company’s ultimate goal is to enable
the frictionless adoption of technology in healthcare, and we’re making great
strides as the interoperability standard and one-stop-shop for our customers.”
As the COVID-19 pandemic continues to change healthcare operations in the world, foundational systems are being adapted to meet these new demands. Sometimes it takes extreme circumstances to see the cracks in a system. COVID-19 has exposed areas with more room for improvement in the healthcare system, such as optimizing operational efficiency. Organizations and individuals have changed their interactions, processes, ways of working, treatment plans, and even foundational technology. As the United States is beginning to reopen, many questions arise – namely, are these changes temporary fixes during the pandemic, or are they here to stay?
Physicians have been inundated during this time of crisis, and their ongoing main priorities amplified: saving as many lives as possible and providing the best patient care. Recent estimates from the beginning of July say, worldwide there have been more than 10.7 million COVID-19 cases and at least 516,000 deaths from the disease, according to Johns Hopkins University (JHU). JHU also revealed that in the United States, there have been 128,000 deaths out of a total of over 2.6 million cases. To say this has been a time of great stress and pressure for physicians who are on the frontlines is an understatement.
This pandemic has increased providers’ already heavy workload, amplifying where physicians need support. Patients need to remain the top priority, even in the first generations of the digital age where the list of backend administrative tasks and paperwork can feel endless, thus reducing the number of patients physicians can see each day. Finding a way to streamline administrative tasks with advanced technology can bring physicians back to why they went to medical school in the first place: to help patients.
One example of an important, and time-sensitive task is communicating with payers around treatment plans and reimbursement. Using technology to streamline this process to get the patient the optimal treatment and maximize use of their insurance coverage is essential, especially in this time of crisis where there is an increased number of patients in need and a depressed economy. Whether processing prior authorizations or checking eligibility, hospitals and health systems need technology to keep operations efficient, including smooth payer-provider communication to ease physicians’ workload, help to ensure providers will be reimbursed for care, and optimize business operations, ultimately providing an improved patient experience.
Three foundational ways in which payer-provider information exchange technology provides immense value to healthcare organizations are:
– Creating Administrative Efficiency: To help physicians stay focused on patients, administrative efficiency is key. Solutions can come in many shapes and sizes – technology can help to automate workflows and avoid care delays. Modernizing the prior authorization workflow can shorten average time to care, reduce the risk of treatment abandonment, and improve the quality of care. With changing legislation, updated laws encourage the use of technology to increase efficiency while keeping data secure in near real-time exchanges.
– Streamlining Exchange of Information: Interoperability and the technology standards needed to achieve it is an ongoing discussion in healthcare. Technologies that provide efficient, secure, and near real-time and even automated exchange of information are in high demand and will bring about the next era of healthcare. For example, technology has the power to align providers and payers efficiently and consistently, create an open exchange of information, centralize information, provide rapid and organized data transfer, ensure appropriate reimbursement by treatment plan, show pre-authorized treatment plans for the most successful and affordable care and aid health plans’ adaptability in health crises, like COVID-19.
– Increasing Value-Based Care: Optimizing the quality and cost of patient care is a leading principle of healthcare. The COVID-19 pandemic has exposed areas of healthcare where improvements in patient experience and provider reimbursement desperately need to be accelerated. Using technology with built-in normative databases of accepted treatment paths allows for evidence-based treatment decisions, which in conjunction with efficient payer-provider communication to ensure reimbursement, allows for optimal patient outcomes – creating value for all stakeholders.
Adopting technology to provide administrative efficiency, streamline information exchange and increase the value of all aspects of care will continue to be a fundamental pillar of healthcare; the pandemic has ignited a critical need for even faster change. COVID-19 has brought with it increased stress and uncertainty across the healthcare industry, amplifying the burden on physicians and their staff. Organizations have moved quickly to adopt technologies, such as those that provide a more efficient way to organize and analyze massive amounts of treatment plan decision inputs and aid communication between stakeholders, in order to better support physicians, and ultimately patients.
Tools and technology that automate processes, streamline communications and provide dynamic solutions have proven their value and are now “need to have” rather than “nice to have” for providers. These technologies are foundational to the healthcare system, providing the base from which all stakeholders operate. The pandemic has helped to realize the true value of efficiency technologies, galvanizing the adoption of these tools. Ultimately, more operational efficiency can bring the focus of care back to the patient.
About Christina Perkins
Christina Perkins is VP of Product Management and Strategy for NaviNet at NantHealth. She joined NaviNet in 2003 and has spent the last 17 years expanding the company’s products and services. Prior to joining NaviNet Christina spent seven years designing and building web-based solutions for Partners Healthcare and other hospitals in the Northeast U.S. and Ontario, Canada. Christina on LinkedIn.
Telehealth has quickly transformed the healthcare industry. Rather than scheduling an appointment, waiting up to a few weeks, and going to a doctor’s office or another healthcare facility, we can now access many types of care from the convenience of our smartphones.
However, telehealth has also brought in its own set of new challenges that must be overcome for it to be successful in the long term. Below, we explore five of the biggest issues telemedicine faces and offer insights on how they can be solved.
Clearing Legislative Hurdles
The Centers for Medicare and Medicaid Services greatly lowered the bar for provisioning telehealth in the wake of COVID-19. Since then, providers have been allowed to deliver care through a larger range of platforms as long as they are not public-facing.
However, this doesn’t address the widely varying state requirements for licensing and credentialing. In general, telehealth providers must be licensed in the state where patients receive care. Only nine states currently offer special telehealth licenses that allow providers to deliver telemedicine outside their state limiting their potential scope.
Although we can expect deregulation to occur over the next few years, the timeline and the path it will take is very much up in the air. This means providers must develop platforms that are flexible enough to adapt to changing legal environments.
Overcoming reimbursement issues
Prior to COVID-19, reimbursement had been a key barrier to the widespread implementation of telehealth. Even now, reimbursement for conditions not related to the coronavirus can still be difficult.
Each state has different regulations guiding the type of services and providers eligible for Medicaid reimbursement. For example, reimbursement policies often only applied to rural areas or those within certain geographic restrictions.
Once the public health crisis has ended, many of the current flexibilities will end, putting a particular strain on smaller facilities. Overall, there must be comprehensive and holistic reform that ensures all providers get reimbursed, whether providing care in person or via telehealth.
Addressing inequality in access to care
One of the greatest benefits of telehealth is that it can facilitate care well beyond the walls of physical healthcare facilities. No longer limited by geography, mobility, or other factors, patients can receive care as long as they have an internet connection.
However, many individuals around the country do not have access to high-speed internet and/or smartphones. For example, only 69.3% of rural areas and 64.6% of tribal areas have adequate access to high-speed broadband. This directly affects patients’ ability to participate in telehealth modalities, including consultation and remote monitoring.
Likewise, many telehealth services are based on smartphone apps. Rural populations are also less likely to own smartphones compared to urban and suburban residents—71% of rural residents compared to 83%.
While 71% may sound like a good number, we’re talking about tens of millions of people, and disproportionately elderly individuals with greater needs, who can’t use telehealth for these reasons.
Providers must develop platforms that can support audio-only, offline, and alternative channels to compensate for these connectivity and device-access obstacles.
Interoperability is fundamental for the long term success of telehealth services. While the large scale adoption of electronic health records (EHR) has been one of the greatest achievements of the past decade, even that has not been with its hurdles—particularly in rural settings.
Taking this electronic health data and ensuring interoperability among disparate apps will require secure data exchange without special user effort. Second, interoperability needs complete access, modification, and use of all patient electronic health information. Finally, it must restrict information blocking or any “knowingly and unreasonably” interfering with the exchange of EHR data.
To do all of this requires the development of core standards and practices, cross-training, and significant investment in data security for all telehealth platforms across the industry.
Since the foundation of medicine, healthcare has relied on in-person interactions. COVID-19 taught everyone just how important remote care is, especially during times of infectious disease transmission.
However, even with its clear advantages, some patients remain unconvinced. How do you still deliver effective and safe care to these individuals?
As telehealth continues to expand and patients grow more familiar with it, some of this will disappear on its own. But, telehealth providers must take steps to educate patients about the specific benefits of telemedicine, explain to them how to use platforms and services, and ensure their PHI is secure.
Of all the challenges to telehealth, this is both the most difficult, yet attainable. It’s entirely in the hands of telehealth providers how well and how quickly they’ll be able to overcome this barrier.
Telehealth: Driving the Future of Healthcare
Now is the watershed moment for telehealth. As the world slowly returns to normal and some of the regulatory and reimbursements policy restrictions come to an end, whether the healthcare industry can maintain the gains that have been made the last few months remains to be seen. There is no guarantee that healthcare won’t return the way it was before the pandemic.
Now’s the time for telehealth providers and those interested in joining the market to create solutions for the issues described above that will capitalize on all of telehealth’s benefits and ensure the long term viability of this effective and absolutely vital care modality.
You can dive further into the world of telehealth in our Shine podcast. In our latest episode, four industry experts discuss the world of telehealth, the tests it’s facing, and where it’s headed in the near future.
About Ed Adamson
Ed Adamson is a Director of Strategy & Insight at Star, a global consultancy that connects insights, strategy, design, engineering, and marketing services into a seamless workflow. Adamson has 19 years of experience of brand-led innovation for some of the world’s greatest CPG brands from companies including P&G, Kimberly-Clark, Coty, GSK, Bayer, Danone, Mondelez and McCormick Foods.
A healthcare system in which stakeholders share, adopt and apply medical knowledge in real time enables improved care, accelerated workflows, streamlined business processes and a better balance of resources with demand.
The wait is finally over! The ONC Cures Act Final Rule went into effect on June 30, 2020, and since its release one of the most common questions ONC has received is when and how can we submit proposals for new data elements in USCDI? The answer is, now!
The United States Core for Data Interoperability (USCDI) ONC New Data Element and Class (ONDEC) submission system is now open. The ONDEC system gives you the opportunity to submit new data elements and data classes through this ongoing,
As COVID-19 continues to impact the country, providers across the continuum face new challenges delivering care and ensuring safety for their patients and themselves. During this period, sharing real-time information about patients’ care encounters across provider types and care settings matter more than ever. In particular, hospitals sharing admission, discharge, and transfer (ADT) events with COVID-19 patients’ community-based providers is critical to ensure the best treatment course and safer more seamless care transitions for infected and recovering patients.
Real-time ADT-based notifications include information about a patient’s current care encounter, demographic details, information about the provider or institution sending the notification, and, as permissible, clinical information. This data enables providers across the continuum to make informed and coordinated decisions about their patients’ treatment and care transition plans. Even before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recognized the importance of such ADT notifications in supporting patient care and finalized a new Condition of Participation (CoP) as part of the recently published Interoperability and Patient Access Final Rule (85 FR 25510). The CoP requires hospitals to share electronic patient event notifications, or e-notifications, with other community providers, such as primary care physicians (PCPs) and post-acute care providers, to facilitate better care coordination and improve patient outcomes.
The necessity and benefit of these e-notifications has come into stark relief as providers and the healthcare system more broadly fight COVID-19. ADT-based e-notifications are an accessible and easy way to help enable better safety for COVID-19 patients and their providers while also ensuring efficient use and appropriate allocation of scarce resources. For example, ADT-based e-notifications can:
Enhance Safety for PatientsProtecting patient safety and providing appropriate treatment is especially urgent during a crisis like COVID-19 when resources are limited and staff is stretched. E-notifications allow hospitals that treat COVID-19 patients to more rapidly get in touch with a patient’s other providers and obtain important medical histories to help guide treatment and clinical decision-making. Traditional exchange of data facilitated by phone calls, faxes, or labor-intensive data searches can introduce treatment delays, unnecessary or harmful interventions, and frustrations for providers. The faster information can be exchanged and a patient’s history is known by the hospital care team, the easier it is to effectively and safely treat the patient with the most appropriate interventions.
Enhance Safety for Providers: Hospital e-notifications are especially important for post-acute and other community-based providers that will continue treatment for COVID-19 patients discharged from the hospital. Because e-notifications provide context about the patient’s most recent encounter, including diagnoses where permissible, they help guide the continuation of care. Receiving e-notifications from hospitals allows such providers to appropriately prepare staff and put safety measures in place prior to treating COVID-19 patients. In particular, Skilled Nursing Facilities need time to properly and safely intake infected patients while Home Health Agencies need to prepare and equip their nurses for visits to homes of infected patients.
Open Hospital Beds for the Sickest Patients: Through real-time e-notifications, hospitals are able to more easily and quickly communicate and share information with COVID-19 patients’ other community-based providers who will care for recovering patients after they are discharged from the hospital. This exchange of information allows hospital care teams to more seamlessly and quickly transition recovering COVID-19 patients to the next level of care, which opens scarce hospital beds for the sickest patients.
Improve Care for COVID-19 Patients:Real-time e-notifications from hospitals allow PCPs and care coordinators to know when their patients have inpatient or ED events. In particular, discharge notifications can trigger critical follow-up services, including telehealth-based visits, to ensure COVID-19 patients recover safely and fully after they leave the hospital. Engaging COVID-19 patients after a hospitalization can help prevent readmissions and keep patients healthy in their homes. At the same time, PCPs are able to support the financial viability of their practices by being able to provide and bill for Transitional Care Management Services and ensure patient engagement in ongoing preventive and other clinical care.
Bolster Public Health Response:Aggregated and de-identified ADT-based notifications offer wide-ranging and powerful real-time data for local, state, and federal public health officials to detect emerging COVID-19 hotspots and intense ED, hospital, ICU strain. Real-time data about the hospital and ED utilization can help public health officials direct and allocate scarce resources to the highest need areas quickly.
These are just some examples of how ADT-based e-notifications can play an important part in helping healthcare organizations effectively, efficiently, and safely deliver care for their patients during the ongoing pandemic – and beyond.
About Jay Desai, CEO & Co-Founder, PatientPing
Jay started PatientPing in 2013 with one goal in mind: to connect providers everywhere to seamlessly coordinate patient care. Prior to founding PatientPing, Jay worked at the CMS Innovation Center (CMMI) where he helped develop ACOs, bundled payments, and other payment initiatives. Jay’s passion lies at the intersection of technology, policy, and community building. He has an MBA in healthcare management from Wharton and a BA from the University of Michigan.
– A new Accenture report called “Breakthrough Behavioral
Health Access: Think Virtual” finds that the use of virtual behavioral health could
expand care for more than 53 million Americans facing these conditions.
– Demand for behavioral health specialists significantly outweighs current availability; in addition to severe wait times of 25 days for first clinical appointments, we are projected to have a shortage of 250,000 behavioral health and mental health professionals by 2025.
– Just a 1% increase in treatment for these disorders would save $2.4 billion annually and could yield as much as $2.4 billion in medical cost savings annually.
The use of virtual delivery channels could expand treatment
to 53 million Americans suffering from behavioral health issues, according
to a new report from Accenture. The
report, “Breakthrough Behavioral Health Access: Think Virtual,” is
based on a survey of more than 3,400 people in the U.S. diagnosed with or
having symptoms related to specific behavioral health conditions such as
anxiety, depression, post-traumatic stress syndrome, attention deficit disorder
or reported themselves as having addiction or substance abuse issues.
Access to Behavioral Healthcare Barriers
Access to behavioral healthcare is especially challenging.
Beyond the burden on individuals, the challenges of accessing and delivering
behavioral health services have a ripple effect across healthcare. Payers,
providers, employers, government and life sciences companies are all impacted
“The behavioral health crisis in the U.S. isn’t new, but the pandemic is clearly exacerbating it,” said Rich Birhanzel, a senior managing director at Accenture who leads the company’s Health practice globally. “The rapid expansion of virtual care models during lockdown in the current pandemic created new expectations for effective and reliable healthcare at a distance. While our research found that only 38% of respondents hadn’t been widely using a virtual channel for such treatment in the prior three years, they’re now overwhelmingly willing to do so.”
Virtual Health Can Shatters Barriers
Current data indicates that nearly 58 million adults and
8 million youth between the ages of six and 17 in the U.S. have mental
health and/or substance use disorders, yet only 43% of affected adults are receiving
treatment for them. Four in five respondents (81%) of the Accenture survey said
they would either definitely or probably engage in a virtual channel to manage
their behavioral health condition. Applying this finding to the 66 million
adults and youths impacted by these disorders suggests that virtual channels
could expand care to approximately 53 million people. Furthermore, the number
of people with such conditions is likely to rise due to the current environment
of COVID-19, record unemployment, and widespread social unrest.
Among the channels respondents said they’d be willing to use include on-demand
videos (cited by 55%), webchat (63%), individual therapy via voice (59%) and
individual therapy via voice plus video (56%).
The research shows younger patients are much more likely
than older ones to engage in virtual behavioral health services. The report
notes that this is critical insight for employers as they develop their
workforce and talent strategies, particularly since millennials comprise the
largest percentage of the U.S. labor force, followed by Gen Zers.
In addition to improving people’s lives, better access to
care and treatment is a potential breakthrough in terms of overall outcomes and
medical spending as behavioral health patients typically have co-occurring
medical conditions and as a result, can have two to three times the amount of
associated health expenditures. Related Accenture analysis shows that even a 1%
increase in treatment for behavioral health disorders in the U.S. could yield
as much as $2.4 billion in medical cost savings annually, due largely to the
fact that individuals with behavioral health conditions often have other
From Tipping Point to Transformation
The report notes three fundamental factors that healthcare
providers should consider to remain relevant and responsive to consumers’
· Control the personal cost. Four in 10 respondents
(44%) said they would only use such channels if the services are provided at
low or no cost to them. Public and private organizations sponsoring these
solutions will need to think through how to lower costs to
consumers—particularly those in need.
· Orbit around experience. Beyond cost, consumers want convenience and positive user experience. While consumers are hungry for behavioral health services through virtual channels, the design of the programs and consumers’ experiences will make or break adoption no matter the demand.
· Make all the connections. Coordination and integration of care with a whole-person approach is critical. Services should be offered in the context of individuals’ physical health, and data-sharing and interoperability among different healthcare stakeholders are critical to providing the most effective care.
For the Accenture 2020 Behavioral Health Consumer Survey,
Accenture surveyed 3,448 US consumers ages 13 and over to better understand
attitudes and behaviors related to virtual health options for treating mental
health conditions and substance abuse issues. All survey respondents were
either diagnosed with and/or had symptoms related to specific mental health
conditions such as anxiety, depression, PTSD, ADD/ADHD, or reported themselves
as having addiction issues. Survey respondents received anonymity and
represented a cross-section of the population based on age, location,
ethnicity, insurance coverage, gender and income. The survey was conducted by
Dynata in May and June 2020.
Without cross-border co-operation the potential of personalised health cannot be realised, acccording to Bogi Eliasen, director at the Health Copenhagen Institute for Futures Studies and HIMSS Future50 leader, who will be speaking at HIMSS & Health 2.0 European Digital Event taking place 7-11 September.
– Microsoft released the public preview of Azure IoT
Connector for FHIR (Fast Healthcare Interoperability Resources), the latest
update to the Microsoft Cloud for Healthcare.
– The Azure IoT Connector for FHIR makes it easy for
health developers to set up a pipeline to manage protected health information
(PHI) from IoT devices and enable care teams to view patient data in context
with clinical records in FHIR.
This week, Microsoft released the preview of Azure
IoT Connector for FHIR—a fully managed feature of the Azure API for FHIR.
The connector empowers health teams with the technology for a scalable
end-to-end pipeline to ingest, transform, and manage Protected Health
Information (PHI) data from devices using the security of FHIR APIs.
and remote monitoring. It’s long been talked about in the delivery of
healthcare, and while some areas of health have created targeted use cases in
the last few years, the availability of scalable telehealth platforms that can
span multiple devices and schemas has been a barrier. Yet in a matter of
months, COVID-19 has accelerated the discussion. There is an urgent need for
care teams to find secure and scalable ways to deliver remote monitoring
platforms and to extend their services to patients in the home environment.
Unlike other services that can use generic video services
and data transfer in virtual settings, telehealth visits and remote monitoring
in healthcare require data pipelines that can securely manage Protected Health
Information (PHI). To be truly effective, they must also be designed for
interoperability with existing health software like electronic medical record
platforms. When it comes to remote monitoring scenarios, privacy, security, and
trusted data exchanges are must-haves. Microsoft is actively investing in
FHIR-based health technology like the Azure IoT Connector for FHIR to ensure
health customers have an ecosystem they trust.
Azure IoT Connector for FHIR Key Features
With the Azure IoT Connector for FHIR available as a feature
on Microsoft’s cloud-based FHIR service, it’s now quick and easy for health
developers to set up an ingestion pipeline, designed for security to manage PHI
from IoT devices. The Azure IoT Connector for FHIR focuses on biometric data at
the ingestion layer, which means it can connect at the device-to-cloud or cloud-to-cloud
workstreams. Health data can be sent to Event Hub, Azure IoT Hub, or Azure IoT
Central, and is converted to FHIR resources, which enables care teams to view
patient data captured from IoT devices in context with clinical records in
Key features of the Azure IoT Connector for FHIR include:
– Conversion of biometric data (such as blood glucose, heart
rate, or pulse ox) from connected devices into FHIR resources.
– Scalability and real-time data processing.
– Seamless integration with Azure IoT solutions and Azure
– Role-based Access Control (RBAC) allows for managing
access to device data at scale in Azure API for FHIR.
– Audit log tracking for data flow.
– Helps with compliance in the cloud: ISO 27001:2013 certified supports HIPAA and GDPR, and built on the HITRUST certified Azure platform.
Microsoft customers are already ushering in the next generation of healthcare
Some of the healthcare organizations who are embracing the technology include:
– Humana will accelerate remote monitoring programs for
patients living with chronic conditions at its senior-focused primary care
subsidiary, Conviva Care Centers.
– Sensoria is enabling secure data exchange from its Motus
Smart remote patient monitoring device, allowing clinicians to see real-time
data and proactively reach out to patients to manage care.
– Centene is managing personal biometric data and will
explore near-real-time monitoring and alerting as part of its overall priority
on improving the health of its members.
– In the age of COVID-19, healthcare CIOs cite interoperability,
cybersecurity, and operationalizing SDOH data priorities as top three priority
areas, according to the third annual LexisNexis focus group of CHIME
– The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare.
The Health Care business of LexisNexis® Risk Solutions announced
the results of its annual
focus group, comprised of over 20 healthcare IT executives that are members
of the College of Healthcare Information
Management Executives (CHIME). The focus group participants accepted more
accountability than in previous years to provide the safe and
reliable technology tools necessary to deliver high-quality, connected,
and cost-effective care. The survey results also highlighted the importance of
a team approach with support across the organization in helping CIOs
achieve the vision of connected healthcare.
In light of the COVID-19
pandemic, data sharing and security to using data analytics to help vulnerable
populations – have become more urgent in light of the pandemic challenges. For
example, recent months have illustrated the need for data access to inform
decisions about population health, wellness and care capacity.
The surveyed healthcare CIOs identified three main priority
1. Managing interoperability: Members acknowledged
challenges amid the surge of digital touchpoints, such as mobile phones, smart
devices and remote services. Goals include a common patient identifier to combine
and verify disparate patient records for a true health information exchange.
2. Bolstering cybersecurity: Members are confronting
new cybersecurity risks, confusion over who bears the ultimate responsibility
for patient data, and the competing goals of seamless user experience and data
safety. To address that final challenge and strike an appropriate balance,
executives are moving to multifactor authentication strategies for optimal user
workflow and security.
3. Integrating Social Determinants of Health (SDOH):
As the pandemic has highlighted, incorporating SDOH
data is a vital, immediate requirement for improving the delivery of patient
support and value-based care, and ultimately, outcomes. Executives shared SDOH
implementation challenges, including data aggregation and operationalization
within IT and EHR systems, especially when not utilizing third-party data to
support their efforts. While CIOs previously had not perceived specific
accountability for SDOH data, that changed as its value was demonstrated.
“CHIME’s executive health IT members are approaching evolving patient and industry needs with careful consideration, ingenuity and focus,” said Josh Schoeller, chief executive officer of LexisNexis Risk Solutions Health Care. “Our annual focus group presents valuable insights about how healthcare decision-makers are strategically using technology solutions to overcome hurdles regarding cybersecurity, data governance, and interoperability, all of which have become more urgent during the COVID-19 pandemic. It’s a big challenge but with the right data integration and analytics they continue to make great progress even in the face of the COVID-19 pandemic.”
To access the group insights, download the report here.
– GYANT raises $13.6M in Series A funding for AI-enabled digital front door solutions to drive meaningful patient-doctor engagement.
– The investment will enable GYANT to scale up its product development to meet rapidly increasing market demand and support its exponential customer growth.
– Current customers include Intermountain Healthcare, OSF
Healthcare, Adventist Health, Health First, Integris, etc.
GYANT, a San Francisco, CA-based care navigation company, today announced the close of a $13.6 million Series A financing round led by Wing Venture Capital. Wing VC is joined by Intermountain Ventures and existing investors Grazia Equity, Alpana Ventures, Techstars Ventures and Plug and Play Ventures. The financing will enable GYANT to continue providing best in class support and services for its fast-growing and high-profile customer base. In addition, GYANT will advance technology and interoperability to deliver the most user-friendly and personalized digital care navigation assistant on the market.
Connecting Patients & Managing Relationships
Patient expectations for a convenient and seamless healthcare experience continue to grow. As a result, health systems face an increasing need for digital health tools that improve patient experiences while optimizing workflow and reducing costs. Founded in 2016, GYANT has built the virtual front door to help health systems improve care utilization, cut costs through automation, and improve the patient experience. GYANT’s Front Door appears on a hospital system’s website or mobile app to chat with patients and guide them to the care and digital health tools they need, 24-7. GYANT is customizable to any organization’s branding, EHR, digital tools, and clinical endpoints.
GYANT ties together all of the digital tools a health system needs in a single interface, creating a seamless patient experience — increasing engagement, trust, and loyalty at each stage of the healthcare journey. GYANT’s unique combination of deep intelligence, physician oversight, and a human-driven, empathetic approach allows health systems to solve for traditional complex care issues, ensuring that patients receive the right care, anytime and anywhere.
GYANT’S AI-Driven Platform Increased Hospital’s Patient
Contact Rate by 39%
Cleveland Clinic first started working with GYANT to
virtualize patient outreach in 2018 to complement their existing post-discharge
call program. The combination of Cleveland Clinic’s care management processes
and GYANT’s AI-driven patient engagement platform has since fueled a 39 percent
increase in the hospital’s patient contact rate.
GYANT’s platform combined with live clinical engagement
helps patients stay in touch with their providers, while also offering a more
efficient patient and caregiver experience. This process allows more patients
to receive the support and resources they need following their hospital stay
and are escalated to a Cleveland Clinic caregiver should they require
Demand for GYANT’s AI-enabled Front Door solution
skyrocketed this year, and was further accelerated
by COVID-19. The pandemic forced rapid,
widespread adoption of digital access. The digital health market is valued
at over $106 billion and expected
to grow significantly as providers innovate to meet the demands of
healthcare consumerization. Delivering on this need, GYANT’s financing follows
a period of remarkable growth, having expanded from 3 customers in July 2019 to
24 customers in July 2020 including Intermountain Healthcare, Geisinger, OSF
Healthcare, Adventist Health, Health First, Integris, etc.
“We are thrilled by the support of ambitious, successful investors who see the disruptive potential of AI in healthcare,” said Stefan Behrens, co-founder and chief executive officer, GYANT. “The need for digital access and care navigation has never been greater, especially with healthcare inequities and disparities in the spotlight today. This is the time for GYANT to continue growing and realize our vision of personalized patient experiences with digital navigation to the right, best possible care.”
Health has been selected as the pilot site to participate in the Advancing
Standards for Precision Medicine (ASPM) project.
– The ASPM project
is focused on how healthcare providers can systematically identify the
socio-economic factors that may impact the health of patients in order to
provide more individualized care that reflects patients’ needs.
Fenway Health, a
Boston, MA-based Federally Qualified Community Health Center (FQCHC) dedicated
to making enhancing the wellbeing of the LGBTQIA+ community, people living with
HIV/AIDS and the broader population has been selected as the pilot site to participate
in the Advancing
Standards for Precision Medicine (ASPM) project. Conducted by the U.S. Department of Health and
Human Service’s Office of the National Coordinator for Health Information
Technology (ONC), in partnership with Audacious
Inquiry, the University of Washington’s Clinical Informatics Research Group
and athenahealth, the project aims to develop standards for the
collection of social determinants of health data (unmet needs in areas such as income, educational attainment, employment
status, food security, housing, and more).
Advancing Standards for Precision Medicine Background
Data sharing is critical to realizing the future of
precision medicine. Launched in 2018, the Advancing Standards for Precision
Medicine (ASPM) project works to further the development and testing of
standards for new and diverse types of health data. The ultimate goal is to
make health data easier to share, curate, aggregate, and synthesize.
The project will leverage digital tools and questionnaires
to advance the standardized collection of data. Social determinants of health
play a major role in individual health outcomes. “athenahealth’s
partnerships with Fenway health and others ground us to the realities and
challenges of healthcare today to improve health outcomes” said Kedar
Ganta, athenahealth’s Product Leader for Interoperability Strategy.
“Transforming Patient Care by prioritizing the collection and sharing of
interoperable SDOH data will better identify patient needs and create impact
across the communities”
In fact, patients’ unmet social needs have been found to
account for up to 40 percent of individual health outcomes. Increasingly,
health care organizations are focused on addressing these needs to help improve
treatment and care in a way that addresses the whole patient.
EHR Data Collection Approach
Fenway Health will employ their current web-based assessment
tool, ePRO, which was developed by the University of Washington’s Clinical
Informatics Research Group (CIRG), as a prototype for testing and transmitting
the systematic capture of SDOH data, as well as ASPM’s proposed standards and
implementation guides as part of their effort. That data will then be sent to
athenahealth, Fenway Health’s electronic health record (EHR) vendor, and be
incorporated into the patient’s health record in a standardized format.
“Standardizing SDOH data and incorporating that information into the EHR along with other patient-reported outcomes, allows health care providers to better understand the context in which their patients live and what they experience, and helps providers offer more personalized and relevant care”, said Dr. Bill Lober, Professor at the University of Washington, and director of CIRG.
Pilot Project Timeline
The ASPM project is set to last through the Fall of 2020 and
will culminate in an evaluation report to be shared with ONC and the National
Institute of Health (NIH). The evaluation will be used to identify challenges
in data collection and sharing between health care providers and to develop
solutions that will lead to better implementation of collection initiatives and
protocols in the future.
The project hopes to expand the types of data that can be
integrated into EHRs
to create a more complete picture of the patient that would reflect the
patient’s practical reality and the issues that may impact their health in the
future. Ultimately, the project’s goal is to give health care providers the
data and tools needed to provide patients with individualized treatment and to
help them achieve better outcomes.
– Allscripts and Microsoft sign a five-year partnership extension to support Allscripts’ cloud-based Sunrise electronic health record and drive co-innovation.
– The alliance will enable Allscripts to harness the power of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams, and Power BI, creating a more seamless and highly productive user experience.
Today Allscripts and Microsoft Corp. announced the
extension of their long-standing strategic alliance to enable the expanded
development and delivery of cloud-based health IT solutions.
The five-year extension will support Allscripts’ cloud-based Sunrise electronic health record
(EHR), making Microsoft the cloud provider for the solution and opening up
co-innovation opportunities to help transform healthcare with smarter, more
scalable technology. The alliance will enable Allscripts to harness the power
of Microsoft’s platform and tools, including Microsoft Azure, Microsoft Teams
and Power BI, creating a more seamless and highly productive user experience.
Partnership Impact for Cloud-based Sunrise EHR
Sunrise is an integrated EHR that connects all aspects of
care, including acute, ambulatory, surgical, pharmacy, radiology and laboratory
services including an integrated revenue cycle and patient administration
system. Cloud-based Sunrise will offer many added benefits beyond the
on-premise version that will improve organizational effectiveness, solution
interoperability, clinician ease of use and an improved patient experience.
Client benefits include a subscription model delivering faster implementations
and lower annual upgrade costs, helping organizations leverage the software
without increasing burdens on their internal IT resources.
The cloud-based Sunrise solution will provide enhanced
security, scalability and flexibility, as well as the opportunity to add new
capabilities quickly as business needs and the cloud evolve. The cloud-based
solution will also include expanded analytics and insights functionality that
can quickly engage with the Internet of Things. Finally, the cloud-based
Sunrise solution will include a marketplace that enables healthcare apps and
third parties to easily integrate with a hospital EHR. Allscripts clients will
begin to see these updates by the end of 2020.
Why It Matters
“The COVID-19 pandemic will forever change how healthcare is
delivered, and provider organizations around the world must ensure they are
powered by innovative, interoperable, comprehensive and lower-cost IT solutions
that meet the demands of our new normal,” said Allscripts chief executive
officer Paul Black. “Healthcare delivery is no longer defined by location —
providers need to have the capability to reach patients where they are to truly
deliver the care they require. Cloud solutions, mobile options, telehealth
functionality — these are the foundational tools for not just the future of
healthcare, but the present. Collaborating with Microsoft, the leader in the
public cloud sector, we will efficiently deliver the tools caregivers need to
improve the clinical outcomes of their patients and operational performance of
ONC is excited to announce the Consolidated Clinical Document Architecture (C-CDA) Scorecard 2.0. The updated Scorecard includes Health Level Seven International (HL7) approved best practices, quantitative scoring, a new user interface, updated issue checking, and performance is improved by 20 percent.
The C-CDA Scorecard promotes best practices in C-CDA implementation by assessing key aspects of the structured data found in individual documents. It is designed to allow implementers to gain insight and information into industry best practices and usage overall.
Let’s invest in an interoperable health data system that connects all providers, hospitals, nursing homes, insurance companies, state and local governments, public health and patients who need access to medical records.