Archive for the ‘Electronic Health Records’ Category

Guest Post: EHRs, Artificial Intelligence and Empathy

March 9th, 2017 by Basil Hayek and Paul Penta, Sapient Health

social_business_strategyCan melding the best of electronic health records (EHRs) and artificial intelligence foster greater empathy among healthcare providers? Basil Hayek, Director of Business Consulting, Sapient Health, and Paul Penta, Manager of Business Consulting, Sapient Health, examine that possibility in this guest post.

EHRs, artificial intelligence, and empathy: If this were a Sesame Street segment, it would be easy to pick the one that is not like the others. But could combining the first two actually enable greater empathy?

First, let's set some context. Industry-wide, there is a high degree of dissatisfaction amongst physicians with EHRs. This can result from the increased clerical burden, poor user interfaces, and feeling of cookbook medicine. These challenges add to the burden already faced by physicians, and contribute to burnout, sub-optimal prescribing and referral behaviors, and erosion of clinician empathy.

As empathy diminishes, so do outcomes. Studies across multiple conditions, including diabetes, cancer, and the common cold, found evidence supporting this hypothesis. In addition, a broad evidence review saw a consistent positive association between patient experience, patient safety and clinical effectiveness. As clinician empathy can dramatically influence a patient’s experience, it can be surmised that empathy is a contributing factor.

There are various approaches to addressing EHR challenges. Healthcare organizations are deploying scribes, tablets and optimization programs. Legislative and policy changes are in the works. Although not enacted before the end of the congressional session, the Senate Committee on Health, Education, Labor, and Pensions Committee introduced a bill last year to help improve EHR usability. In addition, the Agency for Healthcare Research and Quality within the Department of Health & Human Services has called for certification requirements on EHR usability.

Ultimately, healthcare provider satisfaction with EHRs will improve through these tactics. That's not to say that EHRs cannot move from simply meeting a HCP’s expectations to exceeding them. This is where artificial intelligence (AI) will play a role.

When AI is mentioned, the first thing that comes to mind is probably IBM's Watson. Watson, which gained fame for winning Jeopardy against two former champions in 2011, has dramatically evolved its cognitive capability and reach to make an impact in various industries, including healthcare. Healthcare providers can use Watson to analyze medical records, assist in diagnosis, and help find evidence-based treatments, and its capabilities continue to grow. These developments are exciting, but only hint at what is achievable, which includes helping to achieve the Quadruple Aim of an improved patient experience, improved population health, reduced costs, and an improved clinician experience.

AI can contribute in realizing the Quadruple Aim due to its ability to efficiently analyze large volumes of data, discover patterns, and make logical inferences. The potential population health and cost implications resulting from AI are fairly self-evident. What is intriguing is how AI can play a role in helping improve the provider and patient experience. How this could come together is better told through two scenarios.

Scenario 1:

Consider 47-year-old Gary, recently diagnosed with type 2 diabetes. He is due for a follow-up with his doctor to review his treatment after completing blood work. In the first scenario, Gary is trying to navigate his diagnosis in the current state environment.

Because of a lab location that requires him to drive instead of taking public transit, Gary misses three scheduled lab appointments and is forced to reschedule his follow-up. When he finally completes his labs and meets with his doctor, she seems hurried and spends most of the time looking at her laptop as she updates Gary’s chart. Although she notes his A1Cs have risen, she opts to continue the same regimen until his next appointment. Gary leaves feeling uncertain about the effectiveness of his medication, and has doubts on whether the side effects of heartburn and indigestion are worth it.

Now, let’s look at a version of this same narrative where AI enables a better all-around experience.

Scenario 2:

After Gary misses his first lab appointment, the AI-enhanced EHR offers to reschedule at a location one stop away from his house. He attends that appointment and keeps his follow-up with his doctor. Prior to this appointment, his doctor reviews an AI-generated clinical summary, which highlights key factors to consider for Gary’s treatment and confirms that she has reviewed the latest research relevant to Gary’s condition and history.

She greets Gary when he arrives and asks how he’s doing with the medication. When he mentions heartburn and indigestion, she acknowledges they’re common side effects, and recommends that he be diligent about taking it with food and using an antacid until the side effects diminish.

She turns Gary’s attention to a large wall-mounted screen showing a patient-optimized view of his health record. She uses a tablet as a second screen to direct the conversation via a physician view. Gary sees his blood glucose trends and notices that the side effects he just mentioned are in his record. As they discuss additional medication to help control Gary’s rising A1Cs, the doctor asks Gary to confirm the accuracy of the displayed list of medications and supplements. Gary mentions he has also started taking low dose aspirin.

Shortly after he says this, aspirin appears on the screen. The physician view on her tablet alerts her of new research indicating an interaction between aspirin and a candidate medication. With this information, she recommends an alternative combination drug, and Gary walks out with a new prescription and confidence in managing his diabetes.

Conclusion:

In the second scenario, AI enabled the following technologies and associated benefits to provide an alternate and improved experience:

  • Prescriptive analytics based on clinical and socio-demographic perspectives of EHR data: offloads intent from the patient and reduce barriers to care;
  • Context-aware clinical natural language processing: offloads data entry from the physician, and allows the patient to more naturally participate in the treatment conversation;
  • Cognitive computing to assess medical evidence: allows physicians to more easily review information relevant to a specific patient.

These enablers are neither new nor novel. However, combined they provide unobtrusive interventions that reduce the clerical and cognitive burden on physicians and provide improved opportunities for patient engagement. With time to think and a renewed focus on the person sitting in front of them, physicians can return to an empathy-driven encounter, and everyone wins.

About the Authors:

Basil Hayek, Director of Business Consulting, Sapient Health

Basil Hayek, Director of Business Consulting, Sapient Health

Basil Hayek is responsible for digital strategy and delivery for Sapient Health. He supports a broad portfolio of clients, with a focus on health plans, pharmacy, and retail health. He gets excited about bringing together his technology, data, and product background to drive engagement and deliver business results for companies and better health outcomes for individuals. Basil graduated from Cornell University with a BS in Computer Science.

Paul Penta, Manager of Business Consulting, Sapient Health

Paul Penta, Manager of Business Consulting, Sapient Health


As a Manager of Business Consulting at Sapient Health, Paul Penta draws on his experience building technology for patients in a clinical chronic care environment to enable digital change in healthcare organizations. With a focus on digital and technology strategy, Paul always keeps the patient at the center of the experience. Often taking on a cross-functional role, Paul excels in leading the strategic merger of process and product to achieve impactful metrics. Paul received an MBA from Boston University.


HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Infographic: Technology and the 21st-Century Medicine Bag

March 6th, 2017 by Melanie Matthews

The traditional clinician's medicine bag is now a thing of the past, but its replacement promises to be even more useful as a means of facilitating better patient care, according to a new infographic by Transcend Insight. Now, a doctor's visit is facilitated via laptop or with a smartphone -- technologies and products of healthcare innovation.

Healthcare innovation, in fact, is transforming everything from how physicians diagnose and treat their patients to how healthcare systems are reimbursed for their services. Here’s a quick look at how that transformation is unfolding, and how four key technologies in particular have become critical components of modern-day medicine.

Technology and the 21st-Century Medicine Bag

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.

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: EHR and Clinical Documentation Effectiveness

February 27th, 2017 by Melanie Matthews

EHR and Clinical Documentation EffectivenessInformation technology and healthcare leaders are looking at ways to improve electronic health record (EHR) and clinical documentation effectiveness, according to a new infographic by Nuance Communications, Inc.

The infographic examines the strategies healthcare organizations are implementing to improve clinician satisfaction with EHRs and how organizations are optimizing EHRs this year.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare's aggressive migration to value-based payment models and MACRA's 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS's 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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: Capturing the Value of Digital Healthcare Transformation

February 22nd, 2017 by Melanie Matthews

Healthcare providers across the globe are recognizing the need for digital technology in their hospitals and practices. But with ever-tightening budgets and numerous priorities, where exactly should they focus their investments? What will really drive the most value? The biggest impact comes from digitizing the ways clinicians, healthcare workers, and administrators do their jobs, according to a new report by Cisco.

A new infographic from Cisco highlights the report's findings and details potential digital health cost savings.

Capturing the Value of Digital Healthcare Transformation

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as 'connected health,' leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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: EHR + CRM = Superior Patient Engagement

February 13th, 2017 by Melanie Matthews

U.S. hospitals that provide superior patient experiences generate 50 percent higher financial performance than average providers…key in today's shift from volume- to value-based healthcare, according to a new infographic by Evariant. True patient engagement is about creating trust between the patient and health system, nurturing a relationship over the course of a patient's lifetime.

This understanding is possible by integrating healthcare CRM software and EHR systems. Combined, these two systems weave together patient data from a variety of sources, including demographic, social, behavioral, and clinical data.

The infographic examines how a combined EHR and CRM can bridge the patient engagement gap and extend the EHR investment.

Infographic: EHR + CRM = Superior Patient Engagement

Patient-centric interventions like population health management, health coaching, home visits and telephonic outreach are designed to engage individuals in health self-management—contributing to healthier clinical and financial results in healthcare's value-based reimbursement climate.

But when organizations consistently rank patient engagement as their most critical care challenge, as hundreds have in response to HIN benchmark surveys, which strategies will help to bring about the desired health behavior change in high-risk populations?

9 Protocols to Promote Patient Engagement in High-Risk, High-Cost Populations presents a collection of tactics that are successfully activating the most resistant, hard-to-engage patients and health plan members in chronic condition management. Whether an organization refers to this population segment as high-risk, high-cost, clinically complex, high-utilizer or simply top-of-the-pyramid 'VIPs,' the touch points and technologies in this resource will recharge their care coordination approach.

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: Is Your Healthcare Organization Data Rich But Insight Poor?

December 16th, 2016 by Melanie Matthews

Is Your Healthcare Organization Data Rich But Insight Poor?Healthcare organizations with access to electronic healthcare record, claims, socio-demographic and administrative data, have to apply that data through all available lenses to act properly on the data to improve health, according to new infographic by Optum.

The infographic details three possible lenses through which healthcare data should be examined, as well as finding opportunities for intervention and measuring intervention success.

The move from fee-for-service to value-based healthcare is driving the need for increased capabilities in population health management, including addressing all of the areas that may impact a person's health. There is growing recognition that a broad range of social, economic and environmental factors shape an individual's health, according to the New England Journal of Medicine. In fact, 60 percent of premature deaths are due to either individual behaviors or social and environmental factors. Healthcare providers who adopt value-based reimbursement models have an economic interest in all of the factors that impact a person's health and providers must develop new skills and data gathering capabilities and forge community partnerships to understand and impact these factors.

During Social Determinants and Population Health: Moving Beyond Clinical Data in a Value-Based Healthcare System, a December 8th webinar, now available for replay, Dr. Randall Williams, chief executive officer, Pharos Innovations, shares his insight on the opportunity available to providers to impact population health beyond traditional clinical factors.

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.

Providers and ACO Data Analytics: Too Much Information Is Not Helpful

November 22nd, 2016 by Patricia Donovan
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Collaborative Health Systems believes the health data it distributes to its physicians should speak to the challenges providers see in the market.

As the largest sponsor of Medicare Shared Savings Program (MSSP) accountable care organizations (ACOs), Collaborative Health Systems (CHS) has learned a number of lessons about the integration of data analytics and technology. Here, Elena Tkachev, CHS director of ACO analytics, outlines three challenges her organization has faced in the rollout of health analytics to its provider base, and some CHS approaches to these hurdles.

What are some of the challenges we have identified, and some solutions? Number one is the availability and access to timely and accurate data. This has been a challenge for us. As an insurance company, we have a very strong expertise and access to the claims information Medicare provides to us, but we did face the challenge of incorporating electronic medical records (EMRs) into our data. We have been taking a phased approach, where we continue only adding and enhancing our data. If you are not at a point where you’re ready to consume everything, it doesn’t mean you should not do it until you have all the pieces together. It’s better to start with something and then you can grow from that point and improve it.

The second is related to the technology and capability—the ability to aggregate all this different data from different resources and have it be meaningful. For us, it’s really an investment in having strong technology data architect subject matter experts as well as the tools that can help us with that.

The third is display of meaningful results. This has been a challenge and we’ve reiterated it. Since I first started at CHS, the reports have drastically changed, because we learned from our providers that too much information is not helpful; just giving someone a spreadsheet with a lot of columns is not very useful.

Providers would rather see information summarized, and less is more. It’s really important to have information be very clear. The data needs to speak to the challenges the providers see in the market.

Source: Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results

http://hin.3dcartstores.com/Health-Analytics-in-Accountable-Care-Leveraging-Data-to-Transform-ACO-Performance-and-Results-_p_5185.html

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results documents the accomplishments of CHS's 24 ACOs under the MSSP program, the crucial role of data analytics in CHS operations, and the many lessons learned as an early trailblazer in value-based care delivery.

Infographic: Hidden Encrypted Threats Impact Healthcare

November 11th, 2016 by Melanie Matthews

Healthcare organizations are increasingly targeted by cyber criminals seeking to steal electronic protected health information, electronic health records, personally identifiable information and other confidential patient data, according to a new infographic by A10.

The infographic examines the healthcare cyber threat, the need for SSL, why healthcare organizations have been slow to adopt SSL and the top SSL decryption tools.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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.

MACRAeconomics: Chronic Care Management Is the Future of Medicare Reimbursement

November 3rd, 2016 by Patricia Donovan

The newly finalized 2017 Physician Fee Schedule expands Chronic Care Management codes to complex patients with multiple chronic illnesses.

Managing a Medicare population, particularly when the majority has two or more chronic illnesses, can be daunting. But in the current realm of healthcare reimbursement, the care of these beneficiaries is rife with opportunity.

"Depending on the manner in which you're managing your Medicare Part B demographic, you have an opportunity to generate from 100 to 120 percent of the Medicare fee schedule under MACRA," noted Barry Allison, chief information officer, the Center for Primary Care, during Physician Chronic Care Management Reimbursement: Setting MACRA's MIPS Path for 2017.

During this October 2016 webinar now available for replay, Allison described how early adoption of Medicare's Chronic Care Management (CCM) Reimbursement program enhanced the Center's MACRA-readiness under the Merit-based Incentive Payment System (MIPS) path. By identifying the more than three-quarters of its 24,000 active Medicare beneficiaries that met CMS's CCM requirements, the Center had a ready pool of patients on which to overlay CMS's care coordination best practices and begin earning crucial CCM revenue.

"CMS recognizes that care management is a critical component of primary care. It contributes to better health and care for individuals, as well as reduced spending," said Allison, who estimates his 40-provider organization is the largest chronic care management initiative in the Southeast.

Using the value-based modifier data available within CMS's Quality Use and Resource Report (QRUR), The Center for Primary Care further identified its percentage of high-risk Medicare patients for more focused care management.

Accessing and reviewing QRUR reports, available from the CMS Enterprise Identity Management (EIDM) desk, is an essential prerequisite to MACRA participation, advised Allison, who also detailed the type of reports and data available from the QRUR. "Procure that data as soon as possible, because you can learn a lot about what CMS will be looking for in the future, and how the value-based modifier will actually become a part of that MACRA multi-pronged approach."

While his organization's CCM program utilized ENLI software to identify 'hot-spotter' data elements such as unfilled prescriptions or ER visits for specific conditions, physician practices that lack this technology still have many tools at their disposal—even appointment scheduling software—to identify high-risk patients.

"Open up consistent lines of dialogue and engage your providers. Sit down with them and say, 'You know your patients better than anyone else. Tell us who to reach out to.'" With or without CCM software, practices should "document, document, document" the amount of time devoted to CCM, as well as how that time benefited patients.

Long-term planning rather than a reactive view will better position physician practices for success under MACRA's Quality Payment Program, Allison concluded. The Center is already estimating how it will fare under Medicare's newly finalized 2017 Physician Fee Schedule (PFS). Next year's PFS significantly updates CCM, offering new codes for complex chronic care management and for extra care management furnished by a physician or practitioner following the initiating visit for patients with multiple chronic conditions.

"For us, CCM is not really focused on the near term revenue as much as it is about the long term action-reaction we can have in the patient's life, and how our physicians are paid over the next three years."

Click here for an interview with Barry Allison on the MACRA Prerequisite of Procuring QRUR Performance Data to Maximize MIPS Success.

Infographic: The Healthcare Security Challenge

October 21st, 2016 by Melanie Matthews

The role of IT in healthcare delivery has expanded dramatically in just the last few years—and so has the threat from data thieves. A single, stolen healthcare record is worth hundreds of dollars on the black market—creating an estimated $6 billion cybersecurity problem for the industry as a whole, according to a new infographic by NaviSite.

The infographic examines the latest data on the healthcare security problem and a seven-step plan for protection.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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.