Infographic: Health Security in the Internet of Things

March 27th, 2015 by Melanie Matthews

With the growing trend toward the Internet of Things (IoT) in healthcare, including wearables, embedded devices and other health and wellness monitoring devices, there is no doubt that networked healthcare offers numerous benefits, not only to the individuals involved, but to the healthcare industry as a whole, according to a new infographic by McAfee.

However, less than 60 percent of healthcare providers have implemented security controls or a basic risk assessment for their IoT devices.

The infographic outlines the benefits and risks of IoT deployment in healthcare.

E-Healthcare Systems and Wireless Communications: Current and Future ChallengesThe goal of E-Healthcare Systems and Wireless Communications: Current and Future Challenges is to explore the developments and current/future challenges in the successful deployment of future e-Healthcare Systems. The book combines the research efforts in different disciplines from pervasive wireless communications, wearable computing, context-awareness, sensor data fusion, artificial intelligence, neural networks, expert systems, databases, security and privacy.

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Are Multi-Specialty Physician Groups ‘Next Generation’ to Transition to ACOs?

March 26th, 2015 by Cheryl Miller

In another step towards advancing models of care that reward value over volume, HHS recently announced the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, a new initiative designed to move an increasing percentage of Medicare payments into models that support value-based care, and which supports a number of tools including telehealth and post-discharge home services.

With their built-in cadre of healthcare providers, multi-specialty physician groups (referred to here as physician groups), which comprised about a tenth of survey respondents to the Healthcare Intelligence Network's third annual Accountable Care Organization survey administered in 2013, would seem ideally placed to transition to accountable care organizations. Percentage-wise, this sector has the highest rate of existing ACOs (57 percent participating in ACOs versus 34 percent of overall respondents) and twice the rate of participants in the CMS Pioneer ACO program (25 percent versus 13 percent).

Other characteristics of this sector follow.

In other deviations from the norm, twice the number of physician group-reported ACOs favor the hybrid FFS + care coordination + shared savings payment model (75 percent of physician-group ACOs versus 37 percent of overall respondents).

More than half of ACOs in this sector are administered by independent physician associations (IPAs), and most are smaller than the hospital-sized ACOs reported above, with three-quarters reporting a physician staff of less than 100. These ACOs benefit from having specialists on board in greater numbers to help with care coordination of the chronically ill (100 percent include specialists, versus 71 percent overall).

They also unanimously include nurse practitioners (versus 90 percent of overall respondents) and with 50 percent including clinical psychologists in the ACO (versus 42 percent overall), are a little further along on the path of integrating behavioral health into the accountable care initiative.

Cognizant of the full care continuum, these IPA-led ACOs are almost twice as likely as overall respondents to include skilled nursing facilities (50 percent versus 29 percent overall) and hospice (75 percent versus 42 percent overall) in their ACOs.

Perhaps because their organizational structure lends itself to the ACO model, the majority of this sector—75 percent—needed less than year to launch its accountable care organization (versus 29 percent of overall respondents, whose comfort level was between 18 months and two years).

These ACOs seem to have all the clinical pieces in place, reporting near-unanimous usage of evidence-based care, case management, care transition management and population health management. They are also unanimous in the review of clinical outcomes as an ACO success measurement, and much more likely than their counterparts to consider provider satisfaction in program evaluation (50 percent of physician group-led ACOs, versus 32 percent of overall respondents).

Technology-wise, however, there’s some catch-up to be done here: only three-fourths of responding physician groups report the use of EHRs and patient portals, versus near-global usage levels reported in other sectors. This could explain why this sector was three times more likely to report technology as a barrier to ACO creation

Source: 2013 Healthcare Benchmarks: Accountable Care Organizations

http://hin.3dcartstores.com/2014-Healthcare-Benchmarks-Embedded-Case-Management-_p_4985.html

2013 Healthcare Benchmarks: Accountable Care Organizations documents the numerous ways in which accountable care is transforming healthcare delivery, particularly in the area of care coordination, where the ACO model has had the greatest impact for this year's respondents.

Infographic: HealthTech Trends

March 25th, 2015 by Melanie Matthews

Data, connectivity and innovation are changing the healthcare landscape, according to a new infographic by Philips.

In the infographic, Philips examines the potential of wearable technologies, connected devices, electronic health records, telehealth, predictive analytics, population health management, mobile health apps, data security, partnerships and cloud-based technology in healthcare.

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care ManagementReal-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation's (NYCHHC) House Calls Telehealth Program that significantly lowered patients' A1C blood glucose levels.

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Countering 5 Remote Monitoring Cautions in Face of mHealth Uncertainty

March 24th, 2015 by Cheryl Miller

remote_patient_monitoring

Physician champions and legislative advocates can spur remote patient monitoring success.

Physician skepticism about mHealth is a frequently cited barrier to implementing remote monitoring. But once physicians understand they can allot in-person visits for those who truly need them, then use their other time remotely monitoring other patients to wellness, they might be more willing to buy in to mHealth.

It's all about educating the physician, advises Dr. Luke Webster, vice president, chief medical information officer, CHRISTUS Health, who shared how CHRISTUS responded to these challenges during its remote patient monitoring pilot.

  • Unclear ROI: There are always questions around ROI. We look at pre-implementation costs and pre-enrollment costs versus post-costs, including all project costs. What does that ROI mean for your organization?
  • Limited Resources: With care transitions, we took remote patient monitoring and put it on top of the care transitions program. That added additional responsibilities to the already busy workflow process. Whether you’re looking at an E-Hub model or expanding these programs into other areas of your organization, it’s important to review that budget up front. What’s expected of your outcome goals? How will you do that from a day-to-day process and biweekly performance outcomes and measures so you meet that targeted overall outcome, whether it’s reducing length of stay, cost of care, or 30-day readmissions?

    You want all of that to match. Your resources have to be identified upfront. We have been very fortunate to have our providers as champions. They buy into it; they understand it. They didn’t buy into it initially because the nurse coach thought it necessary to make that patient home visit. Sometimes it is. But she has found, with these tools, that she can better do that from her office and manage more patients.

  • Physician Skepticism: It is important to understand your champions, your available resources, backup, etc., when issues come up and you need those resources. We’re finding — and statistics state this — that physicians are still more comfortable doing face-to-face visits. Keeping those patients healthier and at home means we’re keeping them out of the facilities. The physicians and primary care providers may have some skepticism regarding that as well. They have less hands-on training with the equipment so perhaps don’t fully understand the opportunity for them to fill clinic days with patients that are truly in need of an appointment that day versus monitoring others who can be coached to wellness at home.

    It’s about educating physicians, finding those champions and engaging them in the overall process and direction of our health system.

  • Reimbursement Regulations: You need an advocate who can speak for you, represent what you’re doing, and prove the value both at a state and federal level. That should be an ongoing process and on your calendar monthly: identifying and calling your state or federal representative.
  • Rising Technology Costs: This is a booming area; vendors can’t get their products out fast enough. When you set up a budget for a program like this and look to initiate a pilot or expansion, you must look at all technology costs—not only for hardware but for software, upgrades and required support. Do you go through a third party vendor, and do you lease or purchase your equipment? When do you purchase the equipment? Just from our original pilot in late 2012 to today, we’ve seen some changes in technology. If your kits are organized to fit that original technology, how will that change 18 months later, and what will be the cost of adjusting the kits (for example, Styrofoam, boxes, etc.)?

    All of that will change. Look at those technology costs and related issues as you move forward and have a plan to how best recycle that kit.

    Remote Monitoring
    Luke Webster, MD, is vice president and chief medical information officer of CHRISTUS Health. Dr. Webster has over 20 years of clinical and health informatics experience. He specializes in health informatics and physician leadership, clinician adoption and change leadership, clinical transformation, evidence-based medicine, clinical analytics and process improvement.

    Source: Remote Patient Monitoring for Chronic Condition Management

Infographic: The Adverse Impact of High-Deductible Health Plans on Providers

March 23rd, 2015 by Melanie Matthews

The increase in high-deductible health plans (HDHP) is having a negative impact on healthcare providers, according to a new infographic by Nobility.

The growth in HDHPs, up from one million in 2005 to 17.4 million in 2014, has led to some patients skipping or delaying procedures and an increase in medical debt for patients who cannot afford their deductible. The infographic examines the impact of HDHPs and how physician practices can respond to this growing trend.

Healthcare Trends & Forecasts in 2015: Performance Expectations for the Healthcare IndustryFrom collaboration and consolidation to the inevitable acceptance of a value-based system, the state of healthcare continues to stimulate health plans, providers and employers.

Healthcare Trends & Forecasts in 2015: Performance Expectations for the Healthcare Industry, HIN's eleventh annual industry forecast, examines the factors challenging healthcare players and suggests strategies for organizations to distinguish themselves in the steadily evolving marketplace.

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Infographic: How Many Doctors Are Using EHRs?

March 20th, 2015 by Melanie Matthews

More than half of U.S. physicians had adopted electronic health records (EHRs) by 2013, according to a new survey by The Commonwealth Fund.

An infographic on the study results breaks down the percentage of physicians who were early adopters, new adopters, partial implementers, planners (adopting in the next two years) and persistent non-adopters, as well as some demographic insight into these groups.

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable CareWhile widespread adoption of electronic health records has generated new streams of actionable patient data, John C. Lincoln has taken data mining to new levels to enhance performance of its accountable care organization (ACO).

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care reviews the concentrated data dig undertaken by John C. Lincoln to prepare for participation in the CMS Medicare Shared Savings Program (MSSP).

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8 Effective PCMH Tools to Protect the Medical Home Investment

March 19th, 2015 by Cheryl Miller

The patient-centered medical home (PCMH) model is one of the top five investments in 2015, according to Accenture's recent analysis of government-sponsored State Health Innovation Plans. Researchers from Accenture found that states are investing in PCMHs in order to strengthen primary care integration with specialists and community health workers. Most will also integrate physical and behavioral care.

Embedding care coordinators in physician offices so they can work with case managers is one way to achieve this integration, according to respondents to the seventh comprehensive Patient-Centered Medical Home (PCMH) survey by the Healthcare Intelligence Network (HIN). We asked survey respondents what other tools they felt were most effective in implementing the medical home. Following are their responses:

  • Electronic communications that include actionable data and access to patients to initiate the change, and a focus on minimal hassle to physician office.
  • The NCQA PCMH tool.
  • Pre-visit planning and ‘huddles.’
  • Patient registries.
  • Monitoring. We fundamentally changed how we operate daily and monitor change. We incorporated our goal measures into the very fabric of what we do.
  • Using templates in electronic medical records (EMRs) for pre-visit planning and coordination of relevant visits.
  • Home care nurse management system.
  • Patient-centered scheduling.

Source: 2014 Healthcare Benchmarks: The Patient-Centered Medical Home

http://hin.3dcartstores.com/Remote-Monitoring-of-High-Risk-Patients-Telehealth-Protocols-for-Chronic-Care-Management_p_5008.html

2014 Healthcare Benchmarks: The Patient-Centered Medical Home is the Healthcare Intelligence Network's in-depth analysis of medical home adoption, tools, technologies, challenges, benefits and outcomes. Based on HIN's PCMH survey administered in February 2014, this resource takes the industry's pulse on patient-centered activity. Now in its seventh year, it is designed to meet business and planning needs of physician practices, clinics, health plans, managed care organizations, hospitals and others by providing critical benchmarks in medical home implementation and results.

Communication During Care Transitions: Technology, Templates Clarify Handoff Message

March 19th, 2015 by Patricia Donovan

With communication between care sites a top barrier to efficient transitions for one quarter of respondents, HIN's fourth comprehensive Care Transitions Management survey pinpointed information tools getting the message across during patient discharge and handoff.

Technology offers a leg up by way of telehealth and remote monitoring, respondents said; 75 percent of respondents transmit patient discharge or transition information via electronic medical records (EMR).

2015 Care Transition Survey Highlights

  • Discharge summary templates are used by 45 percent of respondents.
  • Beyond the EHR, information about discharged or transitioning patients is most often transmitted via phone or fax, say 38 percent of respondents.
  • Twenty-seven percent of respondents record patient discharge instructions for patients' future access.
  • After communication, inconsistent follow-up is the most frequently reported barrier to care transition management, say 21 percent of respondents.
  • The hospital-to-home transition is the most critical transition to manage, say 50 percent of respondents.
  • Home visits for recently discharged patients are offered by 49 percent of respondents.
  • Heart failure is the top targeted health condition of care transition efforts for 81 percent of respondents.
  • A history of recent hospitalizations is the most glaring indicator of a need for care transitions management, say 81 percent of respondents.
  • Beyond the self-developed approach, the most-modeled program is CMS’ Community-Based Care Transitions Program, say 13 percent of respondents.
  • Eighty percent of respondents engage patients post-discharge via telephonic follow-up.
  • A majority of respondents—72 percent—assign responsibility for care transition management to a healthcare case manager.
  • Download an executive summary of the February 2015 Care Transitions Management survey.

Infographic: Variations in Surgical Procedure Survival Rates

March 18th, 2015 by Melanie Matthews

Across U.S. hospitals, the survival rates for four high-risk procedures vary significantly, according to a new report by The Leapfrog Group. Moreover, most hospitals surveyed do not meet Leapfrog's standard for each procedure.

The infographic looks at survival rates of four high-risk surgeries, including: removing all or part of the pancreas (pancreatectomy); removing all or part of the esophagus (esophagectomy); repair of the major vessel supplying blood to the body (abdominal aortic aneurysm or AAA); and replacement of the aortic valve in the heart (AVR). The infographic goes on to calculate the number of lives lost between the top and worst performing hospitals.

Quality Assurance in Healthcare Service Delivery, Nursing and Personalized Medicine: Technologies and ProcessesQuality Assurance in Healthcare Service Delivery, Nursing and Personalized Medicine: Technologies and Processes offers a framework for measuring quality of service in the healthcare industry as it pertains to nursing, with insight into how new technologies and the design of personalized medicine have improved quality of care and quality of life. Assessment and feedback are a vital part of developing and designing personalized medicine, and this book details case studies and the latest research in the field of healthcare service delivery assessment. In addition to describing assessment methodology, the book is also a compendium of the latest research into new medical technologies.

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5 Trends in Chronic Care Management by Physician Practices

March 17th, 2015 by Cheryl Miller

One hundred percent of physician practices rely on face-to-face and telephonic visits to administer chronic care management (CCM) services, according to respondents to the Healthcare Intelligence Network's 10 Questions On Chronic Care Management survey administered in January 2015.

A total of 119 healthcare organizations described tactics employed, 17 percent of which were identified as physician practices. A sampling of this sector's results follows.

  • Less than half of physician practices (46 percent) admitted to having a chronic care management program in place. But they overwhelmingly agree (100 percent) that CMS’s CCM initiative will drive similar reimbursement initiatives by private payors.
  • This sector’s criteria for admission to existing chronic care management programs is on par with other sectors except for asthma; just 17 percent of physician practices use this as an admitting factor versus 49 percent of all respondents.
  • Not surprisingly, this sector assigns major responsibility for CCM to the primary care physician, versus 29 of all respondents. This sector also relies on healthcare case managers (40 percent versus 29 of all respondents) and advanced practice nurses (APNs) (20 percent versus 8 percent overall) to assist with CCM.
  • This sector relies most heavily on face-to-face visits for CCM services (100 percent versus 71 percent for all respondents) and telephonically (100 percent versus 87 percent of all respondents).
  • Among the biggest challenges for this sector is reimbursement (33 percent versus 20 percent overall) and documentation (17 percent versus 2 percent overall). Unlike other sectors, patient engagement is not a major challenge (17 percent versus 33 percent overall).

Source: 2015 Healthcare Benchmarks: Chronic Care Management

http://hin.3dcartstores.com/2015-Healthcare-Benchmarks-Chronic-Care-Management_p_5003.html

2015 Healthcare Benchmarks: Chronic Care Management captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease. This 40-page report, based on responses from 119 healthcare companies to HIN's industry survey on chronic care management, assembles a wealth of metrics on eligibility requirements, reimbursement trends, promising protocols, challenges and ROI.