Archive for the ‘Guest Posts’ Category

Guest Post: Analytics-Backed Wearables Provide Value Through Actionable Health Insights

July 18th, 2017 by John Valiton, CEO of Reemo Health

wearables for seniors

Analytics-enabled wearables offer opportunities for chronic disease management and delivery of value-based care.

The wearable market has experienced a growth rate of more than 20 percent and is estimated to reach over 213 million units shipped worldwide by 2020, according to IDC. These numbers likely don’t come as a surprise, as wearables have become an everyday tech accessory for nearly every generation — children, Millennials, Gen X, and even seniors. In fact, research by Accenture found that 17 percent of Americans over the age of 65 use wearables to track fitness — a percentage right on track with the 20 percent of those under the age of 65 that use wearables similarly.

But, while the value of utilizing wearables to track health has been tapped for the everyday consumer, it has yet to reach its full potential. Wearables can go far beyond heart rate monitoring and counting steps — especially for seniors. These devices, when connected with a data analytics platform, can provide the valuable insights needed to not only track health in real time, but predict potential threats and optimize care according to need. And the analytic insights, integrated with previous health records, not only benefit the senior, but give professional and family caregivers a deeper look into the behavior that can improve long-term health, streamlining delivery of care by mitigating the need for trial-and-error treatment planning.

With over 50 million seniors in the U.S., this offers a huge opportunity for care facilities to provide real value to the patients they serve, whether in a senior care facility where residents are monitored on an hourly basis, or still living independently where facilities provide data insights at scheduled check-ins. But, as more facilities adopt wearable and analytic solutions, they must acknowledge the importance of using the wearable-enabled analytics platform to keep users engaged by providing value through actionable insights, rather than simply mining data and pushing it out. If there are not real benefits for both the senior and care provider, that wearable device is likely to end up in a drawer in a matter of months.

As caregivers dive into these valuable insights, they can be applied to assist with everything from chronic disease management and health event recovery to reduce the chance of post-acute readmission, to predicting potential threats based on irregularities in activity levels and vitals — allowing providers to truly delivery value-based care. For example, through the analysis of activity data, caregivers can follow the pathway to a potential fall for a senior, and proactively take steps to avoid this often traumatic event. Additionally, urinary tract infections (UTIs) are a large risk for seniors, and often occur after a 72-hour period where light activity such as walking becomes increasingly painful and trips to the restroom increase. By tracking a senior’s activity levels through a wearable device, caregivers can strategically treat those with potential UTI issues.

Through these kind of applications, truly actionable wearable data can provide immense value for both seniors and the caregivers tasked with keeping them on the pathway to a positive aging experience. And for those still living independently, the integration of response systems — such as push-of-a-button 911 dialing — within the wearable devices can provide additional value in their daily life by providing peace of mind to the senior and their loved ones, and functionality in the case of an emergency.

The use of wearables in everyday life doesn’t have to be limited to tracking a morning walk or getting reminders to stand up when you’ve been sitting for too long. If used alongside a powerful analytics platform, these devices can truly improve seniors’ quality of life, while strengthening connections with caregivers through increased visibility into seniors’ daily activities and peace of mind for loved ones. And while the wearable revolution is sweeping the nation, it truly should be about more than wearables for seniors. Wearables, backed by powerful data analytics, can become invaluable for our aging generation while providing unmatched insights for both personal and professional caregivers.

John Valiton, CEO, Reemo Health

John Valiton, CEO, Reemo Health

About the Author: John Valiton is CEO of Reemo Health, a senior health technology solution designed to empower caregivers with actionable insights to improve the aging experience. As a 20-year business development veteran and entrepreneur, Valiton has developed partnerships with many national and international companies. He has been an avid technology enthusiast since an early age, and applied his interest in all things tech at the intersection of IoT, wearable technology, healthcare and data science through his position as a strategic advisor, chief revenue officer and now chief executive officer for Reemo.

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.

Guest Post: 5 Legal Considerations for Maximizing Telehealth Security

May 25th, 2017 by Ammon Fillmore and Mark Swearingen
Patient privacy and data security are key telehealth concerns providers must address.

Patient information privacy and security are key telehealth concerns for healthcare providers.

Telehealth is one of the fastest growing and developing areas of healthcare today. With this rapid growth come many questions and concerns that arise when legal and regulatory schemes are not able to keep up with the pace of development. One such concern is the legal and regulatory issues relating to the privacy and security of telehealth services. Telehealth services can be provided securely, but specific attention must be paid to information and application security in order to protect patient privacy and comply with laws such as the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).

Healthcare provider executives who currently offer, or are considering offering, telehealth services to their patients should give attention and appropriate resources to the following areas in order to maximize the organization’s security posture and operational efficiencies.

Arrangement Structure

One of the primary decisions for a healthcare provider organization to make with any telehealth arrangement is whether the organization will provide the telehealth services itself or in collaboration with a third party. Many considerations will be part of this decision, but information privacy and security should be one of them. An organization should only consider providing telehealth services on its own if it can dedicate sufficient resources and personnel to establishing and maintaining the secure transmission and storage of patient information. Only an organization with a competent and established information technology staff should consider providing telehealth services in this manner.

If an organization chooses instead to collaborate with a third party to provide telehealth services, there are several third parties with whom the organization can collaborate to provide those services securely. Those third parties can provide anything from equipment only to a full range of services, including digital infrastructure and professional physician services. When a third party is involved, the organization must also consider how to structure the arrangement for purposes of HIPAA, including determining whether the third party will be a business associate of the organization or whether the organization and the third party will function as a single Organized Health Care Arrangement (“OHCA”) under HIPAA. These decisions will impact how information flows between the parties and who is responsible for securing that information.

Contractual Protections

Responsibility for securing information where the provider organization collaborates with a third party will be governed by the operative agreements between the parties, including the Business Associate Agreement, where applicable. Provider organizations should be sure that the agreements detail the third party’s security-related obligations and establish the third party’s responsibility for failing to meet those obligations. The operative agreements also should contain sufficient representations and warranties of the third party’s security posture, including the technical specifications that the third party will implement in order to safeguard patient information. Equally important is making sure that the operative agreements include sufficient assurances that patient information will be accessible to the appropriate healthcare provider.

Technical Specifications

Telehealth arrangements will differ in the precise technical specifications that the parties implement to safeguard patient information. However, certain technical specifications are broadly applicable and can significantly reduce security risks. One example of such a specification is the use of encryption technology. Encrypting patient information, both while stored on computer systems and during transmission between systems, is an effective means of safeguarding the information from unauthorized third parties and preventing breaches from occurring. Another such specification is authentication of the participants in a telehealth encounter, the clinicians and patients themselves. It is important that technological measures are implemented to ensure the identity of both the clinicians and patients so that all parties can have confidence that the individuals involved in the encounter are actually who they appear to be. Provider organizations should strongly consider implementing such technologies in any telehealth services arrangement.

Security Awareness

Even the best technical safeguards can be compromised by human error, so it is imperative that effective security awareness training be provided both to workforce members as well as patients. Workforce members who participate in telehealth services arrangements must be made aware of their obligations to protect the privacy and security of patient information under their organization’s policies and procedures and be sanctioned when a violation occurs. Likewise, patients should be provided with information about the security risks present in telehealth arrangements and advised of the steps they can take to mitigate those risks.

Security Risk Analysis

Provider organizations are required under HIPAA to periodically perform an enterprise-wide security risk analysis and to take steps to remediate any risks that are identified. The failure to do so can result in substantial fines and penalties to a provider organization. An enterprise-wide risk analysis considers not only the electronic health record but also any system or equipment that contains electronic patient information, which would include equipment and systems utilized in providing telehealth services. Accordingly, provider organizations should be sure to include telehealth systems in their risk analysis, including those utilized by a third party service and to address any identified risks and vulnerabilities in a timely fashion.

This article is educational in nature and is not intended as legal advice. Always consult your legal counsel with specific legal matters. If you have any questions or would like additional information about this topic, please contact Ammon Fillmore at (317) 977-1492 or afillmore@hallrender.com or Mark Swearingen at (317) 977-1458 or mswearingen@hallrender.com.

About the Authors: Ammon Fillmore and Mark Swearingen are attorneys with Hall, Render, Killian, Heath & Lyman, P.C., the largest healthcare-focused law firm in the country. Please visit the Hall Render Blog for more information on topics related to healthcare law.

Mark Swearingen

Mark Swearingen

Ammon Fillmore

Ammon Fillmore















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.

Guest Post: Care Transitions Are Susceptible To Breakdowns; Technology-Enabled Patient Outreach Offers Clarity and Improved Outcomes

November 15th, 2016 by Chuck Hayes, vice president of product management for TeleVox Solutions, West Corporation

Technology-Enabled Patient Touchpoints Post-Discharge

A surprisingly simple way to improve care transitions is to reach out to patients within a few days of hopsital discharge automatically with the help of technology.

Transitional care’s inherently complex nature makes it susceptible to breakdowns. During care transitions there are many moving parts to coordinate, patients are vulnerable, and healthcare failures are more likely to occur. For these reasons, transitional care is a growing area of concern for hospital administrators and other healthcare leaders.

Errors that happen at pivotal points in care, like during a hospital discharge or transfer from one facility to another, can have serious consequences. Fortunately, strengthening communication and engaging patients can effectively solve many of the problems that transpire during care transitions.

When patients’ needs go unmet after being discharged from the hospital, the risk of those individuals being readmitted is high. Around 20 percent of Medicare patients discharged from the hospital return within a month. CMS has taken several steps to try to improve transition care and minimize breakdowns that lead to hospital readmissions. Under the government’s Hospital Readmissions Reduction Plan (HRRP), hospitals can be assigned penalties for unintentional and avoidable readmissions related to conditions like heart attacks, heart failure, pneumonia, COPD, and elective hip or knee replacement surgeries.

Between October 2016 and September 2017, Medicare will withhold more than $500 million in payments from hospitals that incurred penalties based on readmission rates. These penalties affect about half of the hospitals in the United States.

Not only are payment penalties problematic, but because readmissions rates are published on Medicare’s Hospital Compare website, public opinion is also worrisome for hospitals with a high number of readmissions.

A surprisingly simple way to prevent patients from returning to the hospital is to reach out to them within a few days of discharge. Outreach can be done automatically with the help of technology. For example, with little effort, hospitals can send automated messages prompting patients to complete a touchtone survey. A survey that asks patients whether they are experiencing pain–and whether or not they have been taking prescribed medications–provides good insight about the likelihood of them returning to the hospital. It also allows hospitals to respond to issues sooner rather than later.

Medical teams know that patients are particularly vulnerable during the 30 days following a hospital discharge. Leveraging technology-enabled engagement communications multiple times, in multiple ways throughout that month-long window is a good strategy for improving post-discharge transitions. Whether that involves reminding a patient about a follow-up appointment, asking them to submit a reading from a home monitoring device, verifying that they are tolerating their medication, or communicating about something else, it is important to have plans in place to initiate an intervention if necessary.

For example, if a patient indicates that they are experiencing side effects or symptoms that warrant examination by a doctor, a hospital team member should escalate the situation and help coordinate an appointment for the patient. Recognizing problems is one component of improving care transitions, responding to them is another.

Imagine a patient has recently been released from the hospital after having a heart attack. The patient was given three new prescriptions for medications to take. He may have questions about when and how to take the medications or whether they can be taken in combination with a previous prescription. Hospital staff can use technology-enabled communications to coordinate with the patient’s primary care doctor and pharmacy to ensure the patient has all the information they need to safely and correctly follow medication instructions. The hospital can also survey the patient to find out if he is having difficulty with medication or other discharge instructions, and learn what services or interventions might be beneficial. Following that, a care manager can provide phone support to answer questions.

Fewer than half of patients say they’re confident that they understand the instructions of how to care for themselves after discharge. Without some sort of additional support, what will happen to those patients? In the past, hospitals may have felt that patient experiences outside the walls of their facility were not their concern. But that has changed.

Care transitions are exactly that–transitions. They are changes, but not end points. Hospitals should foster a culture that recognizes and supports the idea that care does not end at discharge. It continues, just in a different way. When patients physically leave a hospital, the manner in which care is delivered needs to progress. Rather than delivering care in person, healthcare organizations can support patients via outreach communications. The degree to which that happens impacts how well (or poorly) transitions go for patients.

Improving care transitions is not as daunting as it might seem, particularly for medical teams that use technology-enabled communications to support and engage patients. To ensure patients have the knowledge and resources they need, and that they are acting in ways that will keep them out of the hospital, medical teams must focus on optimizing communications beyond the clinical setting.

About the Author: Chuck Hayes is an advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting. He leads product and solution strategy for West Corporation’s TeleVox Solutions, focusing on working with healthcare organizations of all sizes to better understand how they can leverage technology to solve organizational challenges and goals, improve patient experience, increase engagement and reduce the cost of care. Hayes currently serves as Vice President of Product Management for TeleVox Solutions at West Corporation (www.west.com), where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

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.

Guest Post: 6 Ways Predictive Analytics Will Move Healthcare Forward in 2016

June 28th, 2016 by Anand Shroff, co-founder and chief technology and product officer, Health Fidelity

change this text

Identifying at-risk patient populations is one way to use predictive analytics to generate rapid returns.

In non-healthcare sectors like retail and manufacturing, ‘predictive analytics’ was arguably the top buzz phrase of 2015. Respected industry analyst Gartner even included predictive analytics in its ‘Top 10 Strategic Technology Trends’ roundup. Predictive analytics have become increasingly important in the healthcare industry, too, as the volume of electronic data grows.

But healthcare organizations have grappled with how to access, analyze and apply their data. Many lack the advanced automated capabilities needed to extract meaning from complex, unstructured data sets from multiple sources. However, it’s crucial to find a way, since the stakes are incredibly high: A McKinsey & Company study estimated that the industry could extract $300 billion in value annually from big data and drive overall healthcare expenditures down by 8 percent.

The key to extracting maximum value from healthcare data sets is to use predictive analytics and cloud-based technologies. By analyzing current and historical data and using the findings to predict future events and trends, healthcare enterprises such as accountable care organizations (ACOs) and others can address the cost-quality equation that is so essential to successful operations in an outcomes-based environment.

The pay-for-performance ecosystem ACOs and other healthcare organizations operate in today demands new strategies to handle bundled payments and population health management challenges, and predictive analytics are tailor-made to produce the insights they need. Using predictive analytics to assess current data sheds new light on the following key metrics:

  • The relationships between cost, quality and patient outcomes;
  • Clinical best practices that drive optimal patient outcomes; and
  • Individual and population-level health risks.
  • By submitting current metrics to predictive analytics, healthcare organizations will gain incredibly valuable insights into how various factors intersect to affect outcomes and which issues they need to address first to drive improvements and value. As they respond to changes in payment models in 2016 and beyond, healthcare organizations will also use predictive analytics to refine their strategies by:

    • Gaining insights into risk factors and how to optimize risk management;
    • Identifying the practices, performers and results that affect organizational performance; and
    • Assessing the impact of ACO reimbursement and bundled payment strategies.
    • Taken together, these are the six ways predictive analytics will move healthcare forward in 2016. By leveraging the power of predictive analytics, healthcare organizations will be able to clearly identify the factors that drive clinical quality and operational expenses. And by applying this information, they can predict and manage clinical and financial performance with greater accuracy. Moreover, they’ll have the opportunity to drive continuous improvement in practices and processes, which will minimize costs while maximizing care quality going forward.

      Healthcare organizations that want to put predictive analytics to work for their operations should consider a two-part strategy that focuses on simple, high-value initiatives first. They’ll need to create an infrastructure that allows them to secure quick wins and then address more complex projects—for example, focusing on revenue improvement by using predictive analytics to proactively manage risk can pay tangible, substantial dividends in the short term.

      Identifying at-risk patient populations in terms of the 30-day readmission window is another way to use predictive analytics to generate rapid returns. Once healthcare organizations have the right processes and practices in place, they can branch out into more complex initiatives like analyzing value-based payment models such as the ACO, episode-based care and patient-centered medical homes. The ability to use discrete and unstructured clinical, financial and operational data to improve performance is the key to success.

      Organizations that embrace predictive analytics in 2016 and beyond will have a key competitive advantage: They will have finally unlocked the value of their data. Predictive analytics have transformed many business sectors in 2015, and 2016 is shaping up to be the breakthrough year for predictive analytics in healthcare, driving better value and outcomes. That’s good news for healthcare organizations and patients alike.

      Anand Shroff

      Anand Shroff, co-founder and chief technology and product officer of Health Fidelity.


      About the Author: Anand Shroff is a co-founder and chief technology and product officer of Health Fidelity. He is responsible for the company’s product strategy and execution and marketing initiatives. He has championed the cause of enterprise performance improvement by promoting electronic capture, exchange and analysis of healthcare data. Prior to founding Health Fidelity, Anand was vice president of EHR and HIE products at Optum. Anand has an MBA from the Haas School of Business at the University of California, Berkeley and an MS in Computer Science from the University of California, Santa Barbara. Anand has an undergraduate degree in Computer Engineering from the University of Mumbai. Connect with Anand on LinkedIn and on Twitter.

      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.

Guest Post: 5 ACO Competencies to Create Value-Based Change

May 3rd, 2016 by Bob Wadsworth, Client Executive, Freed Associates

Only when an accountable care organization (ACO) succeeds in both delivering high-quality care and spending healthcare dollars wisely will it share in savings it achieves from its efforts. In this guest post, Bob Wadsworth, Client Executive with Freed Associates, suggests five steps for organizations to consider as they think critically about ACO development.

Step 1: Set Holistic Quality Goals

In care management, simpler is often better, especially if the same program can be used across numerous payor-specific ACOs. Some program capabilities are needed to address unique and specific line-of-business needs; others work across multiple insurance lines. If several ACO contracts delegate medical management, healthcare delivery organizations have the opportunity to set up across-the-board quality and cost/utilization management programs to achieve steadily improving quality, resource efficiency, and patient satisfaction improvements.

To prevent assumptions about the burden of illness in attributed populations, get smart on their risk profiles. Find the target populations for risk/care management, and match them to specific programs. Better-performing ACOs have high-cost stratification in place for common episode treatment groups (ETGs) with high incidence rates and uncommon ETGs with lower incidence rates, allowing them to proactively address care coordination needs for an all-encompassing set of expensive chronic episodes.

Integrated care management efforts require clinical staff to re-think and remodel their care approach, from a physician-only care delivery model to one involving team-based care across the medical, behavioral health, and social services continuum. It requires empowerment of care team members, and ensuring all roles are operating at the “top of their license” with clear delineation of who’s coordinating what across a range of medical and non-medical services.

Step 2: Emphasize Financial and Organizational Goals

Your board and physician leadership need to be aligned with your long-term plan for reimbursement mix changes. Establish how you plan to grow at-risk lives over your planning time horizon, specify percentage shifts in fee-for-service (FFS) and at-risk revenues. Given the increasing exposure to downside insurance risk in shared risk and capitation contracts, this is a difficult, yet essential, dialogue. This value-based transformation should be led by your CEO, CFO, and clinical leadership in visible ways.

Be clear about the financial impact of the value-based ACO model and the individual contributions required of clinicians and administrative staff to reach sustained financial viability under new reimbursement models. Align financial incentives, such as individual physician bonus programs, with the new ACO financial contract structure.

As second-generation ACOs gain steam, they get smarter on their end-to-end risk/care management models. Many ACOs build up internal HIT knowledge and secure objective, third-party input on enterprise-wide HIT strategies. These strategies will address overall enterprise needs and narrow the unique line of business needs. The objective of this effort should be to align senior staff on a multi-year, holistic vision of the organization and its operations. It can pay for itself by identifying technology rationalization opportunities (latent or un-identified by staff who could be wedded to a particular solution/vendor because of convenience or other subjective criteria).

Step 3: Involve People and Roles

Aligning the roles of patient care delivery staff to support an ACO model is a cultural and operational shift. First, educate clinical and administrative staff on management expectations for their departments and how individual roles might change. The dual focus on both quality and cost efficiency can be a difficult transition. Provide real examples and proof points, such as showing how reduced utilization through use of evidenced-based medicine guidelines (and joint physician/patient decision-making) can benefit the patient, curb medical cost inflation, and increase patient satisfaction.

As you examine roles in a new ACO world, there may be duplicative roles across your organization and others, particularly payor medical management and inpatient case management. Remind staff that moving along the ACO ‘change curve’ will require a series of steps, with changes happening incrementally inside and outside the organization. Management’s goal is to orchestrate these changes in ways that incremental quality, cost, and patient satisfaction improvements can be readily seen as “waypoints” toward the desired future state of the enterprise.

Step 4: Create and Maintain Sustainable Processes

Process orientation and management is becoming a valuable competency in most ACOs. First, develop a process to identify the right group of patients for care coordination. If you don’t have the patient “risk score” data needed in-house, collaborate with your payors; they’re likely rich with the information needed to make informed decisions about areas of focus. Staff the care coordination of higher risk patients accordingly, using conservative case load benchmarks in the beginning, so case managers/care coordinators are not initially overwhelmed by productivity expectations. Work intelligently to determine the location of care coordination roles and their work activity —those that should be situated centrally or at physician offices. Measure results and continuously modify and improve processes.

Being process-oriented means being “performance tracking”-oriented. Develop measurement capability so leaders can be informed by dashboards that tell them the health of the processes along with results. Inform and engage physicians continuously during the change process, so they can effectively champion the improvements.

Step 5: Connect with the Right Technology

One area of potential long-term financial gain is making better use of existing technologies, or replacing them with simpler, cheaper, and more effective technologies. Your organization may have purchased a veritable hodgepodge of niche technologies. But are they all working together to your utmost advantage? Might a narrower set of existing and new solutions be far better than, say, six disparate systems? As your ACO begins accepting more financial risk, the need to enhance IT systems increases, so people and processes supporting ‘risk management’ can be sufficiently supported.

In an ACO world, it’s essential that technology be placed within the natural workflow of clinical staff. If they’re taking a lot of extra time training and re-training themselves to use a particular technology, they’ll be relieved when provided with a less time-consuming, superior solution in one or a few, easy-to-use software applications.

Be sure your technologies meet multi-payor needs, so that a simpler technological footprint can be realized, which has speed and cost-to-market benefits when trying to improve overall operations. A simpler and easy-to-use technology portfolio will likely yield improved patient service and quality, and provide the benefit of higher staff satisfaction with their work environment.

Bob Wadsworth joined Freed Associates in 2015 as a Client Executive. He has significant experience in deploying technology for cost, quality, and service improvement in both payor and provider operational settings. Prior to this position, Bob was a senior vice president of healthcare delivery networks with an integrated care management software company. He also has held executive positions at a large health plan and leadership positions in other health care technology companies, in addition to his management consulting experience.

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.

Guest Post: 5 Ways to Protect Against Cyber Attacks

February 23rd, 2016 by Salim Hafid, product marketing manager, Bitglass

Cyber attacks like the recent hack of Hollywood Presbyterian Medical Center are on the rise.

Editor’s Note: Could the Hollywood hack happen to your organization?

The event had all the hallmarks of a Hollywood blockbuster, but this month’s assault by a hacker on Hollywood Presbyterian Medical Center (HPMC) was frighteningly real. The malware attack locked access to certain computer systems and prevented the medical center from sharing communications electronically, according to a statement by Allen Stefanek, President & CEO. The medical center paid the requested ransom—40 Bitcoins, equal to approximately $17,000—and restored its electronic medical record (EMR) system. There is no evidence at this time that any patient or employee information was subject to unauthorized access, Stefanek said in his statement.

The HPMC hack is only the latest cyber attack to plague the industry. In this guest blog post, Salim Hafid, product marketing manager for Bitglass, suggests ways organizations can safeguard themselves against these damaging events.

Data breaches in 2015 resulted in a massive 113 million leaked records nationwide, up from 12 million in 2014, according to Bitglass’ Healthcare Breach Report. This means that one in three Americans’ personal information was leaked as a result of cyber attacks. The increase suggests that hackers are increasingly targeting medical records, which contain a trove of valuable information including addresses, Social Security numbers, and patients’ medical history. As hackers become more sophisticated, IT must take steps to secure data both in the cloud and across all employee devices.

Given the rising threat of cyber attacks, healthcare organizations must be proactive when it comes to securing corporate data. Here are five ways IT can both protect healthcare data in the cloud and limit the risk of a large-scale breach:

1. Control access.

Cloud applications have made file-sharing and access to data easier than ever, but for all the flexibility these apps offer, there are risks to sharing files with unsecured, unmanaged devices outside the corporate network. Granular access controls are a critical piece of the security puzzle in that organizations need the ability to limit access in certain risky contexts. In the case of the Anthem breach for example—in which phished credentials were used in China, resulting in 78.8 million leaked records—access controls would have limited the damage.

2. Encrypt, track, protect.

The most sensitive data in an organization is often the most valuable to hackers. Files with customer Social Security numbers, addresses, and medical claims information are the targets of large-scale breaches. To secure data, IT needs a means to identify the files that contain sensitive content and apply Data Loss Prevention (DLP) to those files. Contextual DLP solutions enable IT administrators to distinguish between devices and set policies to encrypt, apply watermarks to track data, or even wrap files with digital rights management (DRM).

3. Secure BYOD.

As demand for bring-your-own-device (BYOD) in healthcare rises, organizations need to protect data on unmanaged devices without impeding user privacy. What is critical here is control over data as it travels to the end-user’s device and data that resides on the device itself. With features like selective wipe and native mail access, organizations can encourage adoption of BYOD while still protecting data and maintaining HIPAA compliance on these unmanaged devices.

4. Quickly identify potential breaches.

As healthcare organizations are now more likely to be targeted by hackers than ever before, IT needs the ability to quickly identify suspicious traffic and be alerted to potential risks. Administrators can leverage tools like cloud access security brokers to act on that information and limit sharing using the aforementioned access control capabilities.

5. Improve authentication.

Major breaches like Anthem and Premera, coupled with the low rate of single sign-on adoption across the healthcare industry, highlight the need for a more secure means of authenticating users. With an integrated identity solution, organizations can maintain control over the key access points to their data and can easily manage user account credentials with tools like Active Directory. Industry standards like single sign-on, multi-factor authentication, and single-use passwords can also help minimize risk of breaches due to stolen credentials.

These are just a few of the many ways healthcare organizations can better secure corporate data in public cloud applications like Google Apps, Box, and Office 365. In light of the massive year-on-year increase in breaches, securing healthcare data has never been more critical. Healthcare organizations need a HIPAA-compliant, comprehensive, data-centric solution that provides complete control and visibility over protected health information (PHI), a means of securely authenticating users, and BYOD security.

Download the Bitglass Healthcare Breach Report for more on the key capabilities necessary to protect healthcare data in the cloud and achieve compliance.

About Bitglass: In a world of cloud applications and mobile devices, IT must secure corporate data that resides on third-party servers and travels over third-party networks to employee-owned mobile devices. Existing security technologies are simply not suited to solving this task, since they were developed to secure the corporate network perimeter. The Bitglass Cloud Access Security Broker solution transcends the network perimeter to deliver total data protection for the enterprise—in the cloud, on mobile devices and anywhere on the Internet. For more information, visit bitglass.com

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.

Guest Post: Delivering Value-Based Healthcare Starts at the Top

January 7th, 2016 by Nicholas Christiano, National Managing Partner, Healthcare, Tatum

The healthcare industry has long been characterized by change and evolution. Yet, new requirements introduced by the Affordable Care Act (ACA), as well as changing demands and expectations among patients, have created new pressures for today’s healthcare organizations. Healthcare providers that fail to address this new reality and meet the call for more value-based healthcare that focuses on the patient will struggle to remain sustainable in this changing world.

So, what can healthcare management do to prepare their organizations to deliver more customer-centric care? Although a recent study found that the vast majority of healthcare CEOs plan to improve their ability to innovate, change technology investments and better manage data, very few have made significant headway in these areas. As with any large-scale change, the move to customer-centric healthcare needs to start at the top. To ensure an effective transition, C-level executives, whether the CEO or chief medical officer (CMO), must take the lead to get their teams on board and ensure they can create a sustainable model for the future.

A New Approach to Patient Care

Today’s patients have greater choice in the care they receive, meaning that organizations that don’t provide a positive experience for their patients will struggle to compete. The onus to improve falls on the CEO and CMO, who must revamp the typical patient experience of waiting a long time, only to spend five to seven minutes with the physician. Healthcare leaders can improve the process by making the operation more like a concierge service—scheduling appointments at literal points in time to minimize waiting, enabling patients to enter their information only once and treating patients as valued customers. They should also strive to offer more flexibility by way of extended hours, home visits and telehealth programs that enable patients to have a remote, video-based conversation with their physician.

In addition to optimizing the patient experience, healthcare leaders must also change their cost structures. Rather than the typical process of determining prices behind closed doors and putting a margin on it, costs need to come down, be determined by performance and quality of service and be delivered with greater transparency. More and more, the industry is shifting to a value-based operating model. One such example is the accountable care organization (ACO) model, whereby healthcare providers join together to deliver a payment and care delivery approach that ties provider reimbursements to quality metrics, while driving down costs for an assigned patient population.

The ACO approach links payment to quality improvements that can reduce costs for patients; data from the U.S. Centers for Medicare & Medicaid Services found that the ACO model has led to savings of $417 million since the program began in 2012. As the model continues to evolve, healthcare organizations will be managing a particular portion of the population whom they see regularly. When patients are part of a healthcare organization and receive frequent care, fewer patients will need emergency room service, resulting in lower costs. The industry is increasingly moving towards value-based operating models, but as with any change, implementing the associated customer-centric practices may be easier said than done.

Best Practices to Deliver Customer-Centric Care

To ensure their organizations remain competitive and sustainable in the face of unprecedented change across the healthcare industry, the CEO and CMO must implement the strategies that can lead to positive transformation. Though large-scale changes don’t happen overnight and inevitably will be met with some resistance, healthcare leaders should consider the following best practices to deliver a customer-centric approach:

  1. Meet patients where they are: Today’s healthcare consumers increasingly expect the same level of service from their healthcare providers that they receive in other areas of life and business. Healthcare leaders must spearhead the process changes that meet this demand, by providing greater flexibility, extended hours, home visits and telehealth.
  2. Set the tone for employees: To implement effective change management and overcome employee resistance, CEOs and CMOs must provide strong guidance throughout. Working with other C-suite executives to identify transformation needs, communicate these changes, introduce tools that can facilitate the transition and explain how each employee can contribute to delivering customer-centric care is essential.
  3. Revamp cost structures: To be successful, CEOs and CMOs must deliver on two key priorities: keeping patients healthy and providing service at reasonable costs. This entails designing a fundamentally different operating model and driving down costs for activities that do not provide value – all while offering higher-quality care to their target population.
  4. Seek outside help when needed: Healthcare leaders might not always have the internal senior-level capacity and capability needed to accelerate change. Leveraging the help of an executive talent provider to ensure the organizations have the support and expertise to deliver a more customer-centric patient experience can make all the difference.

Meeting Demand for a New Level of Care

As the ACA has given more people greater access to healthcare—and more options in how they receive that care—healthcare leaders must rethink their current processes to deliver high quality care. If patients are unhappy, they can always switch to another provider. In this age of empowered patients and increased competition between providers, the CEO and CMO must communicate a transformative vision throughout their organizations. This starts with having qualified leadership at the top to guide these changes, the right technology to facilitate the processes and the best team to deliver on this goal. With these factors in place, healthcare organizations can deliver the customer-centric care necessary for success in today’s healthcare climate.


Nick Christiano

About the Author: Nick Christiano is responsible for the overall execution of the National Healthcare Practice for Tatum, a Randstad company. The Healthcare Practice provides executive leadership solutions to healthcare provider organizations, heath plans, private-equity backed bio-tech firms and affiliated organizations where subject matter expertise is critical to a successful client engagement. Christiano is recognized as a leader in the pursuit of optimum patient care, productivity, efficiencies, cost management and navigating new challenges in the healthcare field. He has an M.B.A. in MIS/Finance from the John Hagan School of Business – Iona College and a B.S. with a dual major in Computer Science/Electrical Engineering from N.Y.I.T.

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.

The Value of Unlocking Unstructured Patient Data

October 27th, 2015 by John Smithwick, CEO, RoundingWell

In this guest post, RoundingWell CEO John Smithwick explains why all healthcare data should be structured and ready for interpretation and analysis, no matter how it is initially collected.


Getting patients diagnosed correctly and treated appropriately depends on providers gathering both quantitative data, which is typically structured, and qualitative data, which is typically unstructured. When comparing both types of data, it’s more challenging to manage and derive value from unstructured data.

Structured data is that which is quantifiable and measureable, such as signs like lab results, blood sugar levels and cholesterol. This type of data is objective and can be entered discretely into EMRs via predefined fields. Since the data is structured, software systems are able to understand the meaning of the data, interpret the data and report on it. Structured data can be put to use by clinicians at the point of care to aid their decision-making.

On the other hand qualitative data, such as symptoms like pain, discomfort and fatigue, is considered unstructured data. This type of data is subjective to the patient and is often gathered through conversations based on what the clinician asks and what the patient discloses. While it might seem like a simple exchange of niceties between clinician and patient, these communications provide a lot of information to the clinician, such as whether a patient is experiencing depression, or notices shortness of breath upon standing.

Correct diagnoses and appropriate treatments are dependent on managing both structured and unstructured data. Managing each type of data appropriately also greatly influences the outcomes a healthcare organization is able to deliver. As the amount of reimbursements tied to outcomes increases, delivering quality outcomes becomes all the more important.

Problems with Unstructured Data

Managing structured data is usually handled well. It’s in the management of unstructured data where problems arise. There are two primary problems with unstructured data:

  • The first problem is technical. Unstructured data is most often recorded in EMRs in free text fields or note fields. Data stored this way makes it very difficult for software systems to interpret, understand and analyze.
  • The second problem is process-related. Unstructured data is not gathered consistently or systematically. A clinician only knows about symptoms if he or she asks the patient, which doesn’t always happen, or if the patient discloses the information, which, again, doesn’t always happen. When symptoms are overlooked or patients withhold information, clinicians can’t make the right diagnosis or give the best treatment.

The ballooning amount of data available is its own issue. In 2012, worldwide digital healthcare data was estimated to be equal to 500 petabytes, and that number is only growing: the data is expected to reach 25,000 petabytes in 2020. It can be a daunting challenge for healthcare organizations to gain value from this mountain of data. To add to this, industry consensus is that approximately 80 percent of all healthcare data is unstructured data.

What the Future Holds for Unstructured Data

So, what if technology could not only ensure patients were being diagnosed correctly, but also automate the process? Cloud-based care management and patient engagement software are providing new ways for healthcare organizations to unlock the value of unstructured data. In essence, by creating “structured symptoms”—gathering patient-reported symptoms and discretely capturing them in a way the data could be analyzed.

These platforms systematically assess patients for symptoms (and signs) that they might not get asked about directly by a provider, and that they might not self-disclose because they don’t think it’s important (or because they simply forget). Care management software then stores patient symptom information in a structured way, allowing this previously unstructured data to be analyzed and made actionable.

The bottom line? Whether gathered via care management software, EHR or patient-specific physician insights, all data should be structured and be ready for interpretation and analysis. This is especially critical in value-based models: for any risk-bearing entity, getting this complete picture is absolutely critical in order to give patients the right treatment at the right time, to improve outcomes and prevent adverse health events.

John Smithwick

About the Author: John Smithwick is the CEO of RoundingWell. He co-founded RoundingWell in 2011 following four years at Nashville’s Healthways, where he led the design effort for its Web-based disease and lifestyle management product offerings. Prior to his work at Healthways, he worked in product management at Microsoft in Redmond, Wash. and in technology strategy consulting with Accenture in Boston, Mass. A graduate of the University of Richmond, he holds a master’s of business administration from the University of Pennsylvania’s Wharton School of Business.

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.

Guest Post: 7 Ideas to Improve Communication and Coordination between Care Sites

September 22nd, 2015 by Richard A. Royer, CEO, Primaris

With access to some of the most highly educated and trained medical professionals in the world, providing Americans with the best patient care possible should be simple. Unfortunately, that’s not often the case. Poor communication between specialists, duplicate tests and unnecessary procedures are frequently the norm rather than the exception, leading to costly, dangerous and sometimes deadly consequences. With so many specialists and resources readily on hand, how is this happening?

The problem is a lack of care coordination. Simply put, care coordination is the idea that all specialists treating a patient should communicate and share information to ensure that everyone acts as a team to meet patient needs. This includes reporting all results back to a primary care practice or to someone coordinating patient care, and ensuring that labs, specialists, hospitals, and long-term care facilities work together to communicate information quickly and appropriately. It’s about primary care physicians, nurses, technicians, specialists, and caregivers collaborating on patient care rather than working as separate entities.

The average Medicare beneficiary interacts with seven physicians in four different practices during a single year, according to the New England Journal of Medicine. For those with chronic conditions, the numbers can be even higher. And, nearly one-fifth of Medicare patients who are hospitalized are readmitted within 30 days of discharge, and 75 percent of these readmissions could have been prevented by improved care coordination.

Too often, patients discharged from hospitals don’t get the support and encouragement they need to take their medicine, follow their diets, and adhere to the regimens doctors have prescribed during their stay. Many of these problems can be solved by improving care coordination, and that starts with communication between care sites.

Here are seven suggestions for improving communication between care sites—as well as across the care continuum:

  • Start the dialog: As a rule of thumb, improving communication between care sites begins with healthcare providers asking themselves what they know that others need to know, and sharing that information with the patient’s care team. What do patients need to know when they’re referred to a specialist? What do the specialists that patients are being referred to need to be aware of, e.g. what tests have already been completed? Has the primary care physician been informed?
  • Create a team and make it accountable: Organizations should start by assigning a team of people to be accountable for managing patient care. Define the extent of their responsibilities for key activities such as following up on test results and communicating information to other physicians. Establish when specific responsibilities should be transferred to other care providers—whether that means specialty physicians, long-term care facilities, or home care providers.
  • Designate care coordinators: Designate staff that will act specifically as care coordinators can help to reduce hospital readmissions. Before patients leave the hospital, care coordinators should meet with them to make sure they understand the treatment plans they need to follow at home as well as any changes to their medication regimens. The hospital care coordinators also must follow up on any pending labs and imaging studies and contact primary care physicians to communicate updated medications, treatment plans, and test results for their patients. The likelihood of readmission drops significantly when patients leave with a clear understanding of their treatment plans and when their primary care physicians know what is necessary during follow-up care.

    This same communication protocol should also apply to patients who leave the hospital for long-term care facilities. In this instance, the hospital care coordinator should communicate discharge instructions to the long-term care staff. As soon as residents return to the long-term care facility, staff there should meet with residents to review their discharge instructions, answer their questions, and communicate with the hospital if any further clarification is needed. Long-term care staff should also follow up regularly with these residents to ensure they continue to comply with instructions the doctor has recommended and intervene if any problems arise.

  • Standardize communication processes: Create a protocol for filling out patient charts in a standard way so they are easy to interpret and key elements aren’t overlooked. You also should standardize communication by using structured forms to ensure primary care providers, specialists, and long-term care providers all have the same and necessary information.
  • Develop a referral tracking system: Creating a system to internally track and manage referrals and transitions— including consultations with specialists, hospitalizations and ER visits, and referrals to community agencies—can go a long way towards improving communication between care sites. It will help to ensure patients are well prepared for their referral visit and know what to expect afterwards. And, it simplifies follow-up with referral providers about findings, next steps and treatment plans.
  • Follow up on referrals: When a primary care physician refers a patient to a specialist, for example, office staff should follow up to make sure the appointment was made and completed. In addition, office staff needs to ensure the specialist shares his findings with the primary care physician so he can be well versed on the patient’s progress and any additional steps to be taken.
  • Notify providers in the patient’s medical neighborhood: Similarly, when patients visit the emergency room or are admitted to the hospital, communication should be a priority. In this instance, hospital staff should notify the primary care practice so the primary care doctor can follow the patient’s progress through discharge and institute a care plan to prevent future admissions. In addition, the practice can reach out to patients when they leave the hospital to make sure they understand discharge instructions and schedule follow-up appointments. When the patient comes in for follow-up care, the primary care physician should have a complete history of specialists seen during the hospital admission, their recommendations, and tests performed, along with the results.

The healthcare industry can no longer simply “discharge” patients. Providers must now work collaboratively with all others across the continuum of care to transition and coordinate the ongoing care of every patient. That’s what care coordination is all about.


Richard Royer

About the Author: Richard A. Royer has served as the chief executive officer of Primaris since 2001. He has extensive administrative healthcare experience and is actively involved in several statewide healthcare initiatives. In 2006 he was appointed by the Missouri governor to the Missouri Healthcare Information Technology Task Force and chaired the resources workgroup. He also serves on the board of directors as treasurer for the Excellence in Missouri Foundation. In his over 35 years of medical business experience he has held positions as chief executive officer at Cuyahoga Falls, Ohio, General Hospital; executive director of Columbia Regional Hospital in Missouri; and founder and president of Avalon Enterprises, a medical financial consulting firm.

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.

Guest Post: Winning the Healthcare Revolution with Technology for Care Coordination, Collaboration & Communication

September 8th, 2015 by Richard Purcell, intelliSanté president & CEO

Healthcare is in the middle of a revolution. Health systems continue to integrate and expand, acquiring private practices and hospitals. Insurance carriers still navigate the Affordable Care Act, and merge to build actuarial risk pools. Providers deal with changing payment models, transitioning from traditional fee-for-service to merit-based incentive payments, though the exact definition of pay-for-performance is not yet codified. And in the midst of these radical changes, doctors, hospitals, and health systems are implementing an array of electronic medical records (EMRs) to finally replace paper records.

Two things are clear with all of this upheaval in the medical world: providers are frustrated, and the patient is nowhere to be found.

Doctors, nurses, and healthcare administrators are all under financial and workload pressures; they are trying to comply with healthcare IT requirements for meaningful use, and everyone is uncertain about the future. Patients are exasperated with figuring out insurance plans and in-network versus out-of-network provider coverage; obtaining medical records from their doctors is a challenge; and they are left to their own devices to navigate the complexities of the healthcare system.

Technology is the answer for healthcare transformation, but the entire healthcare ecosystem is a decade behind the information technology boom that has transformed every other industry.

6 Barriers to Health IT Integration

Why has it been difficult to bring technology to healthcare? Based on two years of interviewing dozens of stakeholders across the healthcare continuum, we can point to several reasons:

  • HIPAA, short for the Health Insurance Portability and Accountability Act passed in 1996 that legislates data privacy and security provisions designed to safeguard medical information.;
  • Reimbursement: Only this year and last has CMS provided CPT codes for care coordination, Chronic Care Management 99490 and Transitional Care Management 99495 and 99496. Shared savings models provide inconsistent results and are still largely undefined;
  • Limited investment: Providers already have invested heavily in EMRs, spending money and time on workflow management, and are therefore reluctant to add new workflows and software unless integrated with their current EMR systems, which are not built for patient-centric care coordination;
  • Technology proficiency: Medical personnel, especially physicians, are not broadly trained in technology and software other than the specific EMR in the practice or hospital, and that training is lagging. Patients, especially senior citizens, have widely varying and often negligible technology access and knowledge;
  • Data overload: There is so much unintegrated data from internal EMR and billing systems, claims forms, labs, and metabolic measures from myriad devices that no person can comprehend. Doctors and patients need clinically meaningful reports, not just data.
  • Transformation: The medical system has been trained and operated as a treatment-focused, fee-for-service business; that is how healthcare professionals earn their living. Population health management and the primary care medical home (PCMH) models of healthcare require a realignment of the provider-patient relationship, transformation of business focus from in-office visits to out-of-the-office management, new staff and resource allocation—all without a defined financial model for future practice.

What’s Needed for a Patient-Centric Collaboration?

So, how in the current tumultuous environment can we ever achieve the Triple Aim of better health and improved care delivery at lower costs? The answer is patient-centric collaboration—working together to achieve a common outcome. But in order to make collaborative care work, we need patients, nurses, and doctors to embrace technology for collaboration. To this end, a new role in healthcare, the care coordinator, is the lynchpin to connecting patients to the healthcare system. Plus, an array of new and emerging software platforms like GetRealHealth and C3HealthLink for population health management can foster the personal communication necessary to engage patients outside the office environment, with the system-driven performance to drive efficiency.

Fortunately, the care coordinator position is currently being championed in several areas. For example, in New Jersey, Horizon Blue Cross Blue Shield has promoted care coordination for many years by funding practices for on-site care coordinators. The PCMH movement embraces the care coordinator role and collaborative care, and The Patient Centered Primary Care Collaborative (PCPCC), a not-for-profit trade group, is dedicated to healthcare transformation through primary care.

Plus there is hope on the patient technology front. According to the Pew Research Center, 64 percent of Americans own a smartphone, and for those seniors who do own smartphones, 82 percent describe the phone as “freeing.” Plus, broadband access is expanding through initiatives like the recently announced ConnectHome Pilot Program that will bring Internet access to underserved areas.

4 Ways Technology Will Optimize Healthcare Delivery

Through technology, we can optimize care delivery if we can provide care coordinators and patients with the tools they need to engage in health, and systems that provide interconnected data exchange through the patient’s health record, enabling the following:

  • Patients to engage in health practices that promote adherence to medication schedules, self-monitoring, and care planning, together with HIPAA-compliant communications tools that foster responsibility and collaboration with a care team;
  • Medical practices to manage patient populations inside and outside of the healthcare system to optimize care coordination (treatment, transition, communication, monitoring), while establishing workflows for the impending reimbursement changes to pay for performance;
  • Health systems to establish new care coordination and data sharing models using cloud-based, HIPAA-compliant data exchange and communications channels that integrate clinically relevant data;
  • Payors to evaluate and measure patient engagement in health and provider practices for care coordination and collaborative care in order to reimburse providers for performance.

The challenges in healthcare are many, but we can emerge from this healthcare revolution with a stronger healthcare system through collaboration: with patients taking responsibility, providers communicating and sharing data, health systems funding new delivery models, and payors enabling a sustainable financial model that provides benefits to all stakeholders.


Richard Purcell

About the Author: Richard Purcell is president and chief executive officer of intelliSanté. He has played a lead role in founding the company, molding the corporate vision, and leading the commercial launch of C3HealthLink. Purcell has extensive experience in drug development, clinical data management, and business operations in a regulated environment. Previously, he was president of ClinPro, Inc., a mid-sized clinical research organization. In addition, he participated in the start-up of the medical Web site Medscape through sales and business development initiatives. Rich holds a B.S. in Biochemical Sciences from Princeton University, and attended Rutgers Graduate School of Management majoring in marketing and finance. He is an executive member of the Patient Centered Primary Care Collaborative (PCPCC), a member of the Licensing Executives Society, and an active member of the New Jersey Technology Council and HIMSS. (rich@intelliSanté.com)

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.