Archive for July, 2018

Guest Post: The Provider’s Responsibility for Building Patient Relationships

July 31st, 2018 by Dr. Delanor Doyle

A foundational element of healthcare is the relationship between a patient and their PCP.

One of the foundational elements of healthcare is, or at least should be, the relationship between a patient and their primary care physician (PCP). And yet, it seems many Americans are not fully utilizing their PCP and instead are turning to emergency rooms or urgent care clinics for non-urgent conditions and illnesses. In fact, only 9 percent of emergency department visits result in a hospital admission. This means it is likely that many of these cases could have been avoided by seeking the care of a PCP.

Emergency department visits not only result in hefty costs to the patient and their employer, but also create wastes of time and resources in the healthcare system. The impact in terms of costs, for the patients can have many down-stream consequences. In fact, a recent report by the U.S. Federal Reserve found that four out of 10 adults in the United States could not cover an unexpected $400 expense. In some cases, this amount can easily be reached for a single emergency room visit between out-of-pocket costs for the visit, medications and laboratory services —especially when dealing with out-of-network issues. Providers should work to keep patients out of emergency rooms and urgent care facilities and to emphasize the importance and purpose of the PCP in the patient’s healthcare journey.

Until the 1940s, about 40 percent of all physician visits were house calls and while today patients don’t have this same expectation, providers should treat patients with that same level of personalized, individual care that builds a strong relationship. Providers can consider implementing the following best practices with their patients:

Every Discharge Deserves a Follow-Up

In many cases the PCP is not the provider who admitted or cared for the patient while in the hospital. However, it is imperative that the PCP insist on receiving information about the patient’s admission, so that he or she can be a part of the discharge plan. The patient should be seen back in the practice within three to five days after discharge —even if they were seen just prior to going into the hospital. In fact, this should be scheduled for the patient prior to hospital discharge. Timely follow-up appointments have been associated with a decreased risk of readmission. A converse association also exists. A study published in Clinical Interventions of Aging found only half of patients discharged following heart failure had a follow-up appointment scheduled and the readmission rate was significantly higher in those that had no follow-up scheduled.

Follow-up appointments allow for the provider to engage or re-engage the patient and ensures the patient is aware of any care transition recommendations. Concerns regarding disease process, expectations and convalescence should be addressed at this time. Working to schedule all patients for timely follow-up post discharge eliminates the risk of the patient forgetting to schedule the appointments themselves. Many patients report a higher sense of satisfaction with the communication between themselves and their provider and with their overall care.

Encourage Virtual Care Options

For after-hours needs, do your patients know there are virtual care options they can use in lieu of going to the emergency room or urgent care clinics for non-urgent concerns? Many patients are simply unaware of these services or aren’t sure how to use them so they don’t consider it as an option. According to the National Business Group on Health, only 8 percent of employees utilize telemedicine services, yet the cost of healthcare benefits is expected to increase an average of 5 percent due in part to pharmaceutical costs but also to site of service issues as well. Spend a few minutes during the visit to educate patients on the services available as well as when to use them.

Promote Health Plan Resources

Unfortunately, many patients are also not familiar with the services or programs offered by their health plans. These materials are good resources for preventative care measures and offer proactive suggestions for patients. For example, their insurance provider might offer diabetes educational materials and resources. Most health plans have programs for diabetes and other chronic conditions. If members are encouraged to access the materials available online, telephonically and in print they might be more likely to seek out that information and if contacted by the health plan they will be much more likely to engage. It is important that patients begin to get a sense that the health plan and the providers are collaborating for the patient’s benefit.

We are still in a fee-for-service world but moving toward fee-for-value. This is being driven by the Centers for Medicare and Medicaid Services (CMS) and all the major health plans. To be successful in this new world, improved patient outcomes should be a major focus for providers. Strategies that engage the patient and simplify the healthcare experience when and where it is needed most are going to be produce the winners in this new era. The literature is replete with strategies that can produce population health success, but few are shown to be consistently correlated to economic success combined with improved patient satisfaction and outcomes. The exceptions have been those that employ heavy care coordination in a face-to-face venue and that address the social determinants of disease.

Fully leveraging these strategies is going to require the development of trust between the patient and provider so that patients know we are not just treating a disease but caring for the whole person. When that level of trust is reached it becomes easier to influence utilization of the PCP practice and other more appropriate levels of care instead of the ED. Similarly, it becomes easier to impact the readmission rate in one’s own panel of patients.

About the Author:

Dr. Delanor Doyle

Dr. Delanor Doyle

Dr. Delanor Doyle is the chief medical officer of Texas Health Aetna. Leveraging the strengths of two leading organizations, Texas Health Aetna is blurring the lines of traditional health care plans and health systems to create a truly integrated solution that’s simple to navigate and puts the member’s experience first. The local health plan is committed to providing affordable, high-quality health care services and delivering customized care to members throughout the Dallas-Fort Worth metroplex. For more information about Texas Health Aetna, visit www.texashealthaetna.com.

Infographic: HIPAA Compliance Checklist & Healthcare Cybersecurity Awareness

July 30th, 2018 by Melanie Matthews

While Health Insurance Portability and Accountability Act audits by the Department of Health and Human Services (HHS) continue to ramp up, healthcare organizations have seen penalties and settlement agreements between healthcare organizations and HHS in the millions of dollars, according to a new infographic by eFax Corporate.

The infographic provides a checklist of important information to help healthcare organizations with HIPAA compliance.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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Infographic: Challenges and Success Factors for Telehealth

July 27th, 2018 by Melanie Matthews

As telehealth continues to expand each year, current and prospective adopters face an array of challenges, according to a new infographic by URAC.

The infographic examines these challenges, as well as success factors.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System Encouraged by early success in coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients. At that scaling-up juncture, the challenge for CHRISTUS shifted to balancing its mission of keeping patients healthy and in their homes with maintaining revenue streams sufficient to keep its doors open in a largely fee-for-service environment.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge.

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Guest Post: A Report on Healthcare Data Security & Privacy Compliance

July 26th, 2018 by Gary Palgon

Privacy and security regulations for enterprise data in healthcare organizations are complex and current efforts to bolster enterprise data compliance among all organizations, including those in healthcare, are immature and ineffective, according to a recent study conducted by Aberdeen, an industry analyst firm.

In fact, 86 percent of 112 hospitals and hospital groups in the study are dealing with multiple types of data and data-related processes that are subject to compliance requirements. This is not surprising because healthcare organizations generate, collect, store and manage financial transactions, personally identifiable information, protected health information, employee records and confidential or intellectual property records such as partnership agreements and contracts.

When asked if their organizations were compliant with 11 common regulations and frameworks for data privacy and security, only 65 percent reported achievement. PHI has the highest percentage of compliance reported—85 percent. The lowest compliance rates were reported for ISO 27001 and the General Data Protection Regulation at 63 percent and 48 percent respectively.

To measure the maturity of healthcare organizations’ efforts to comply with privacy and security requirements for data, Aberdeen developed a Net Maturity Index across six key elements of an enterprise data lifecycle. An index score above 50 percent indicates strong maturity in compliance activities and below 50 percent indicates immaturity.

Managing data, which includes normalizing, cleansing, validating and correlating data, earned a 66.6 percent score for healthcare respondents, the only element that indicated maturity. Scores for other key elements were:

  • 49 percent for storing data—persistent, on-demand, self-service access to data;
  • 41.2 percent for protecting data—encryption, tokenization;
  • 33.4 percent for syndicating data between any two applications—including mobile, connected devices, on-premises or cloud;
  • 25.4 percent for ingesting data into a common repository—cloud-based, data lakes; and
  • 3.9 percent for integrating data from multiple sources—disparate sources, formats and protocols

The immaturity of the data lifecycle and associated enterprise data compliance efforts has real-world consequences for healthcare entities. Four out of five (81 percent) study participants reported at least one data privacy and non-compliance issue in the past year, and two out of three (66 percent) reported at least one data breach in the past year.

Investment in data compliance efforts is not lacking. A median of 37 percent of the overall IT budget of healthcare survey respondents is allocated to data compliance activities. This is a significant amount of funding to still experience data breaches, data compliance issues and low percentage of achievement of compliance with multiple enterprise data security and privacy regulations. When compared to respondents from life science and other industries, healthcare respondents reported the highest percentage of the IT budget devoted to data compliance.

The survey also indicated that healthcare organizations are more likely than organizations in other industries to have instituted compliance-specific governance processes and appointed specialized leadership such as data protection officers, compliance officers or chief risk officers, to oversee enterprise data compliance initiatives. While these are often considered to be best practices for achieving data compliance, still less than half of all healthcare organizations have instituted these approaches. Having specialized leadership is one of the most likely ways to effectively address enterprise data security and privacy compliance issues but it may also present further complications. Although the role may be assigned to an individual, the task of ensuring compliance with multiple regulations that evolve and change along with new technology and the addition of new data sources, requires an expertise that is difficult to achieve and oversee by one person who probably wears multiple hats in the organization.

One solution to the complex, challenging task of achieving data security and privacy compliance is the use of third-party providers who can address the healthcare organization’s need to enhance integration, management and storage of data. Providers who are experts at data management and integration but also provide the added value of the expertise needed to ensure compliance with regulatory requirements affecting data will offset some of the burden on hospital staff. The solution is not a simple application or a one-off project. Achieving and sustaining compliance with data privacy and security rules as they evolve is an ongoing effort.

The study also points to the need to better manage financial investment in compliance strategies. One option for healthcare organizations is managed services agreements with data management and integration providers. Switching to a predictable, monthly fee versus periodic capital investment or ongoing efforts that are ineffective frees IT funds to be used to advance other hospital goals.

Although many healthcare organizations do not consider outsourcing some of their data management, integration and compliance challenges, but choosing a partner wisely—one with expertise in healthcare as well as other data-centric industries with multiple privacy and security requirements—can reduce the compliance burden on an already overworked hospital IT staff and make funds available to continue digital transformation or other strategic initiatives.

Read the overall survey report here: Enterprise Data in 2018: The State of Privacy and Security Compliance

Read the brief on results for healthcare organizations here: Enterprise Data in 2018: The State of Privacy and Security Compliance in Healthcare

About the Author:

Gary Palgon

Gary Palgon

Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences. His unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce.

Infographic: 3 Key Steps To Healthcare Success

July 25th, 2018 by Melanie Matthews

Healthcare leaders have sought to improve healthcare quality, delivery, efficiency, and customer service by using organizational change as a mechanism for success, according to a new infographic by Optimum Healthcare IT.

The infographic examines the three key steps that can lead to change success for healthcare organizations.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: 5 Ways Artificial Intelligence Will Transform Healthcare

July 23rd, 2018 by Melanie Matthews

From personalized medicine to CRISPR gene editing, artificial intelligence (AI) has a revolutionary part to play in tackling healthcare industry challenges, according to a new infographic by AI Business.

The infographic examines the potential for AI to improve healthcare services and reduce costs.

2018 Healthcare Benchmarks: Telehealth & Remote Patient MonitoringArtificial intelligence. Automation. Blockchain. Robotics.

Once the domain of science fiction, these telehealth technologies have begun to transform the fabric of healthcare delivery systems. As further proof of telehealth’s explosive growth, the use of wearable health-tracking devices and remote patient monitoring has proliferated, and the Centers for Medicare and Medicaid Services (CMS) has added several new provider telehealth billing codes for calendar year 2018.

2018 Healthcare Benchmarks: Telehealth & Remote Patient Monitoring delivers the latest actionable telehealth and remote patient monitoring metrics on tools, applications, challenges, successes and ROI from healthcare organizations across the care spectrum. This 60-page report, now in its fifth edition, documents benchmarks on current and planned telehealth and remote patient monitoring initiatives as well as the use of emerging technologies in the healthcare space.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: 6 Forces Transforming the Future of Healthcare

July 20th, 2018 by Melanie Matthews

Disruptive technologies are advancing healthcare at an extraordinary pace, according to a new infographic by Publicis Health.

The infographic examines the future of healthcare and how companies will have to adapt to stay relevant.

2018 Healthcare Benchmarks: Telehealth & Remote Patient MonitoringArtificial intelligence. Automation. Blockchain. Robotics. Once the domain of science fiction, these telehealth technologies have begun to transform the fabric of healthcare delivery systems. As further proof of telehealth’s explosive growth, the use of wearable health-tracking devices and remote patient monitoring has proliferated, and the Centers for Medicare and Medicaid Services (CMS) has added several new provider telehealth billing codes for calendar year 2018.

2018 Healthcare Benchmarks: Telehealth & Remote Patient Monitoring delivers the latest actionable telehealth and remote patient monitoring metrics on tools, applications, challenges, successes and ROI from healthcare organizations across the care spectrum. This 60-page report, now in its fifth edition, documents benchmarks on current and planned telehealth and remote patient monitoring initiatives as well as the use of emerging technologies in the healthcare space.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: Tackling Hospital Staffing Problems

July 18th, 2018 by Melanie Matthews

Healthcare staffing remains a problem for hospitals. Thirty-one percent of hospitals cannot find enough candidates to fill open positions. Only slightly more than 25 percent of leadership positions are being filled within three months. Medium and large hospitals spend between $10,000 and $30,000 to hire leadership positions, according to a new infographic by TargetRecruit.

The infographic examines healthcare staffing trends and how healthcare organizations can tackle these problems.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.

Infographic: Reducing the Use of Low-Value Healthcare Services

July 16th, 2018 by Melanie Matthews

The United States spends more, both per capita and as a percent of GDP, on healthcare than any other country, yet fails to achieve commensurate health outcomes. One reason for this discrepancy between health spending and outcomes is the significant amount—upwards of $200 billion per year—that the United States spends on low-value care, according to the University of Michigan Value-Based Insurance Design (V-BID) Center.

A new infographic by the V-BID Center provides a list of the top five low-value clinical services for purchasers to target for reduction. The selected services were chosen based on their association with harm, their cost, their prevalence, and the availability of concrete methods to reduce their use.

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS SuccessA laser focus on population health interventions and processes can generate immediate revenue streams for fledgling accountable care organizations that support the hard work of creating a sustainable ACO business model. This population health priority has proven a lucrative strategy for Caravan Health, whose 23 ACO clients saved more than $26 million across approximately 250,000 covered lives in 2016 under the Medicare Shared Savings Program (MSSP).

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

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Infographic: Skilled Nursing Facilities Focus on Quality and Partnerships

July 13th, 2018 by Melanie Matthews

Focus on performing well in the CMS Five-Star Quality program has become a business imperative for skilled nursing facilities—it’s essential to keeping occupancy rates up, according to a new infographic by the Health Industry Distributors Association.

The infographic examines how skilled nursing facilities are working with the hospitals in their communities to reduce readmission rates and gain referral volume.

2018 Healthcare Benchmarks: Post-Acute CareValue-based healthcare payment models, such as clinical integration, shared savings, bundled payments, shared risk and full capitation, as well as the need to coordinate care across the acute and post-acute care (PAC) continuum, are reshaping the PAC landscape. And, with the start of Medicare readmission penalties for skilled nursing facilities starting in October of this year, PAC providers will continue to examine strategies for improving care quality and reducing costs.

2018 Healthcare Benchmarks: Post-Acute Care is the second comprehensive analysis of the PAC market by the Healthcare Intelligence Network, capturing such key metrics as PAC initiatives, strategies, challenges, tools used to manage PAC, results and ROI.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you’d like featured on our site? Click here for submission guidelines.