Archive for the ‘Guest Posts’ Category

3 Crucial Factors to Consider before Designing an mHealth App

May 19th, 2021 by Rahul Varshneya

Mobile health (often referred to as mHealth) is all the rave in healthcare right now. According to one recent statistical data piece compiled by Health IT Outcomes, close to 93 percent of physicians believe that mobile health apps can improve patients’ health.

Therefore, healthcare organizations looking to formulate an mHealth strategy are likely to consider mobile apps the right place to start delivering improved patient experience and services. Rightly so, the adoption of these apps can be highly beneficial for both the provider as well as consumers.

However, with the amount of options available in the marketplace today, designing and developing an mHealth app that can attract customers for its uniqueness has become a huge challenge for healthcare providers. Having a carefully designed and well-functioning app simply isn’t enough. It also needs to sustain amid the rising competition.

There are a few crucial factors that providers should keep in mind before getting an mHealth app developed.

  1. Know the Pain Points and Needs of your Target Audience

    The key to successful mhealth app design lies in knowing how and why users will want to use the app, knowing customer pain points and then designing in a way that you can solve their problems.

    Therefore, before healthcare organizations develop an mHealth app should identify their customers’ pain points and how their problems can be solved, and then figure out why an mHealth app would be the best way to solve it.

    Once an assessment of the requirements are completed and an mHealth app would fulfill those requirements, the next step is to determine the target group (for example, General Health and Fitness Apps, Chronic Care Management, Diabetes Management Apps, Medication Management Apps, Personal Health Record (PHR) Apps, Professional Medical Applications, etc.) and then include features that truly meet the needs of that particular group.

    Dr Vinati Kamani, dentist turned healthcare author, in one of her recent articles explains how keeping end users in mind is the ultimate goal when it comes to developing mHealth apps: “It is extremely critical to collect all necessary data concerning usage, understand what all the stakeholders interested in the app might be looking for, and use the acquired information throughout the development lifecycle. One best practice is to involve practicing healthcare providers, specialized in the area your app will be servicing in, to assess the key issues the app will resolve for the users and to develop the functionality that will be most usable for your audience.”

    Healthcare providers can also develop a custom application rather than an off the shelf solution. In this way, features that aren’t absolutely required or don’t add value to the app can be left out; you get a solution that does both – meets the needs of your target audience and is cost-effective for you.

  2. Designing for Scalability, Simplicity and Sustainability

    The next crucial consideration deals with optimizing the app to be as simple, scalable, and easy to use as possible.

    To begin with, the registration/sign-in process should be hassle-free and shouldn’t demand much of the user’s time or effort. One best practice would be to avoid employing too many clicks and screens for performing these actions. You can provide the option of additional verifications when the app hasn’t been actively used for quite some time.

    Then again, it would be a useful add-on to make information on your app easily retrievable in the event of an emergency. For instance, quick access to useful information such as placing the doctor’s phone number and information about nearby clinics on the homepage of the app itself can help the patient retrieve such crucial data without having to log in during an emergency.

    Try balancing options out in a way that depicts that all scenarios have been taken into consideration.

    Another best practice would be to integrate the platform with a dedicated cloud server to make the platform more interoperable for both end users and care providers. Cloud platforms also provide the option to encrypt the confidential information within the mHealth app to ensure it isn’t accessed during data breaches or misused by a hacker.

    Ensure that the content on the various pages of the mHealth app is uniform, identical and easy to read, and the layout of these pages is equally appealing for the users. Also, try to keep the alignment and spacing uniform throughout. Users usually favor pages that have soothing themes and colors. Don’t go overboard with design.

    mHealth apps should keep in mind the app’s target audience at all times, especially when designing it for the end user. For instance, older people might need bigger icons and larger text, and people with certain health conditions might need an app that does not attract gawkers.

    Trying to make the app as scalable and sustainable as possible may seem like a lot of work in the beginning, but it will pay off by retaining users and keeping them coming back for more in the long run.

  3. Taking a Second Opinion from Compliance Experts

    When getting an mHealth app developed, it’s crucial to understand the different types of data and information that fall under the Health Insurance Portability and Accountability Act (HIPAA). The first thing is to discern whether the mHealth app is going to collect, store, or transmit protected health information (PHI) at any given point in time. PHI comprises sensitive patient information regulated by HIPAA.

    An mHealth app that handles PHI needs to remain HIPAA compliant at all times. In addition, mHealth apps that exchange information with covered entities for medical reasons, also need to be HIPAA compliant.

    To make sure the mHealth app remains HIPAA compliant, adhere to these 4 rules:

    • Privacy Rule
    • Security Rule
    • Enforcement Rule
    • Breach notification Rule

    To create a secure app that’s fully HIPAA compliant, using reliable providers, a set of technical tools like libraries and third-party services isn’t enough. Not only does the data have to be encrypted in the mHealth app, but the data also can’t be accessed if the server or device is physically compromised.

    Remember to assess how much information the app actually needs to operate and bring value to the user. HIPAA compliant apps don’t collect any information that isn’t necessary; if yours does, you’ll be spending resources on protecting information you don’t actually need.

When the consumer is kept at the apex of every decision while developing an app, the app will truly contribute toward increasing the bottom line of healthcare organizations and fortify customer relationships.

About the Author:
Rahul Varshneya is the co-founder and president of Arkenea, a digital health consulting firm. Mr. Varshneya has been featured as a technology thought leader across Bloomberg TV, Forbes, HuffPost, Inc, among others.

Guest Post: Winning the War for Talent in the Healthcare Industry

August 6th, 2019 by Melanie Matthews

How can healthcare facilities recruit and retain top candidates?

It’s no secret that a “war for talent” exists in the healthcare industry, with doctors, nurses and other medical professionals being recruited to large organizations, the impact of which could have serious trickle-down ramifications to patients.

So, how can a smaller practice compete with “deep pocket” healthcare facilities to recruit and retain top candidates?

It all starts with the tried and true—competitive pay and benefits. This is not to say that offers must be at the top of the market, however they should be within market range. And with an increasing number of states and cities enacting pay equity legislation, compensation must not only be reviewed in terms of the market, but also against gender-specific compliance rules.

In terms of benefits, the “must haves” to be competitive include solid medical and retirement plans and generous paid time off. Dental, vision, life insurance and commuter benefits can help sweeten the deal for a prospective candidate. As a means of attracting top talent directly out of medical school, some healthcare practices are offering to help pay off student loans.

To many candidates —particularly millennials—providing opportunities is just as or even more important that receiving top dollar. But let’s not confuse development opportunities with providing a career path. Employers do not need to guarantee promotions; rather, top talent is typically more interested in continual learning and exposure to new experiences. By creating a culture of learning, with solid reimbursement policies for job-related training and programs, a workplace becomes that much more attractive.

The healthcare industry continues to innovate at a rapid pace, so making certain that your practice embraces up-to-date technology and best practices in the field can go a long way toward securing top talent.

Today’s applicants also takes corporate citizenship into consideration when job interviewing. The desire to work for an organization that makes a difference by giving back to the community has become a priority for many. While some larger healthcare facilities practice good citizenship with financial support only, smaller practices can up the ante with volunteer programs. This is an element of corporate culture that can genuinely resonate with a candidate.

Speaking of interviews, when dealing with a war for talent, a disciplined and strategic approach is essential. In times past, the candidate was often on the hot seat, sometimes made to feel they should be grateful for being considered for the job. Not today – while the tables have not completely turned, they have definitely moved in a different direction! Hiring managers and HR professionals within healthcare organizations should concentrate on three primary areas during the interview process:

Selling: In this hyper-competitive market, it’s crucial to sell your organization and clearly state the reasons why the candidate should come on board. The mere “this is a great place to work” spiel won’t do the trick. You need to articulate why it’s so great.

Seeing is believing: Give prospective hires a tour of your facility; show them where they would work and let them speak with potential colleagues. By doing so, there should be no doubt with the candidate as to the nature and expectations of the job.

Ask the right questions: Use open-ended behavioral questions to see if the candidate has the proper skills for the job. Questions that can be answered with a “yes” or “no” only provide a blurry snapshot of someone’s abilities. Instead consider asking “tell me about a time when you worked on a team, why were you or weren’t you successful and what was the outcome?” These behavioral questions allow candidates to paint a true picture of their behaviors in certain circumstances. And the answers are more interesting to listen to! Finally, they provide the candidate with a better experience as you are really listening to their responses.

Once the right candidate has been identified, stop shopping! A great applicant can be lost to another organization with unnecessarily drawn out and over-extensive comparison shopping. No single person is perfect for any job, but when you find an excellent candidate, hire them—if you don’t, someone else will. The healthcare field is particularly competitive and not acting quickly can cost dearly. This is not about settling; it is about recognizing and moving forward with a good fit.

Some of the best candidates come from internal referrals but avoid that outdated policy of paying out a referral bonus after a 90-day “trial period.” This type of policy was intended to prevent employees from referring subpar performing candidates, but let’s face it —no employee wants to jeopardize their own job by referring someone who is underqualified. Use referral bonuses only for specific difficult-to-fill positions; pay out the bonus as soon as the hire starts; and make the bonus substantial enough to grab employees’ attention and motivate them to take action. The paid-out bonus is certain to be less than the cost to retain a recruiting agency.

And finally, there’s nothing like a good swag bag! Every candidate should come away from the interview with a couple company-branded items. It doesn’t have to be expensive —a water bottle or mouse pad —something that makes them feel a part of the team even at this early stage. And when the job offer is extended, send a plant or gift basket (or something hobby-related you may have gleaned in the interview process) to the new hire’s home. Organizations that go this extra personal mile increase their chance of getting the desired candidate.

Amy Allen

Amy Allen

About the Author: Amy Allen, SPHR, is a partner with blumshapiro, the largest regional business advisory firm based in New England, with offices in Connecticut, Massachusetts, and Rhode Island. The firm, with a team of nearly 450, offers a diversity of services, which include auditing, accounting, tax, and business advisory services. blum serves a wide range of privately held companies, government, education, and nonprofit organizations, as well as provides non-audit services for publicly traded companies. To learn more, visit the firm at

Guest Post: Artificial Intelligence’s Impact on the Future of Patient Care

June 11th, 2019 by Steve Bradshaw

Healthcare organizations that adopt AI will become more efficient; their professional judgments will become more accurate and their health predictions better informed.

In the near future, applications of artificial intelligence (AI) will play an increasingly important role in healthcare services. AI’s ability to assist in managing electronic health records, as well as in diagnosing and treating patients, will prove too valuable for healthcare providers and administrators to ignore. By adopting AI, their operations will become more efficient, their professional judgments more accurate, and their health predictions better informed.

Making Electronic Health Records Management More Flexible

Electronic health record (EHR) systems are expensive to maintain and cumbersome to use. AI is already being applied to make EHR systems more efficient. AI can extract and index information from provider notes and help personalize treatment plans. In the near future, AI could make it easier for providers to continually customize their EHR systems to better meet the changing needs of their practices to save time and improve patient outcomes.

Improving Diagnoses and Treatment

Computers can analyze massive amounts of data. They also excel at recognizing patterns. Put these two abilities together, and you get AI’s extraordinary power to successfully perform tasks that previously required human intelligence—in some cases, even surpassing humans in accuracy.

In a process called “deep learning,” scientists train AI systems using large amounts of labeled data. The AI is then able to identify patterns by itself when given data to which it hasn’t yet been exposed. In healthcare, deep learning will train AI systems to help clinicians provide more accurate diagnoses, identify patients at risk of various diseases and conditions, and create individualized treatment plans.

A recent study found that AI outperformed radiologists at finding cancer on CT scans used to screen smokers for lung cancer. When prior scans were not available, the AI did better than all six radiologists in the study, coming up with both fewer false positives and fewer false negatives. When there were prior images, the AI and the radiologists were equally accurate. Although this was a preliminary study, it shows how near-future applications of AI can provide clinicians with more accurate diagnostic and predictive information than is available to them now. The results of this study also may enable radiologists to make more frequent life-saving identifications of early-stage cancer and other diseases.

In addition to reading images, AI will be able to extract useful information from patients’ medical records. By finding patterns in the medical histories, AI could provide warnings when patients are at risk of developing conditions such as sepsis, diabetes or heart disease. An area of intense interest now is using AI to identify which patients are most at risk of being re-admitted to a hospital after being discharged.

AI may also reduce the amount of trial and error involved in prescribing medications and other treatments. It can help identify the treatments most likely to succeed based on each patient’s unique combination of genes, medical history and environmental influences.

The Time Is Right

In the past, there was more resistance to using AI in healthcare. Now, providers and the public are increasingly ready to accept the use of this cutting-edge technology to make healthcare administration more efficient and providers’ decisions more accurate.

Healthcare professionals are seeing what AI can bring to their practices. At the same time, the public has gotten used to the idea of self-monitoring their health using smartphones and smart watches. More work still needs to be done to implement industrywide standards and to safeguard patient privacy, but the benefits of AI in healthcare now appear overwhelming. It is inevitable that healthcare providers and organizations will soon come to increasingly rely on AI applications.

This could be just the beginning. How well AI can “think” depends in large part on how much computing power is available — and that power is increasing exponentially.

Healthcare in the more distant future may include AI applications that we can’t even imagine now. In the meantime, healthcare providers and administrators may soon enjoy greater efficiency and cost containments, while patients could benefit from more accurate diagnoses and effective treatments.


About the Author: Steve Bradshaw began working in the medical gas and environmental industry in 1991, starting Evergreen Medical Services, Inc. in the Carolinas in 1997.

Guest Post: Americans Say Healthcare Isn’t the Consumer Experience Leader It Needs to Be

March 14th, 2019 by Nate Brogan

Healthcare consumer experiences are falling short of patients’ expectations, according to a West survey. West surveyed 1,036 adults and 317 healthcare providers in the United States to learn how Americans feel their healthcare experiences stack up against other consumer experiences. The survey revealed that, although patients want healthcare experiences to outshine other consumer experiences, 72 percent of patients feel healthcare is falling behind other industries in terms of delivering exceptional experiences. The solution? Patients suggest better communication is needed for healthcare to live up to consumer experience expectations.

More than half (56 percent) of providers agree that healthcare may be trailing other industries when it comes to delivering meaningful consumer experiences, the West survey revealed. Also, around one in three Americans believe healthcare organizations are not as focused on customer experiences as grocery stores (30 percent), travel companies (30 percent) and financial services companies (29 percent).

Lagging Healthcare Experiences

Patients who feel healthcare organizations need to raise the bar when it comes to delivering customer experiences point to billing and wait times as two of the areas where improved communication could make healthcare experiences better. Around one in three patients say healthcare bills are more confusing than other bills (30 percent) and doctors run late for appointments more frequently than service providers from other industries (35 percent). Both of those, patients say, detract from the overall healthcare consumer experience.

Transforming healthcare experiences—at least in regard to billing and wait times—may be as easy as making some simple communication adjustments. It doesn’t take much in terms of time or resources to send patients a text or email that notifies them when a doctor is running behind schedule. Most healthcare organizations already use patient engagement technology that enables teams to send patients automated messages to remind them about upcoming appointments. That same technology can be used to send other types of messages to patients—like a message to clarify a bill, for example.

Here is a closer look at two communication upgrades healthcare teams can make to deliver better experiences for patients:

Actively and clearly communicate about financial responsibilities.

Most patients agree that interpreting and paying medical bills is confusing. The financial stress of having to pay medical bills can be heavy enough. But add to it the confusion of trying to determine what amount is actually owed, what is covered by insurance, what services are included in billed costs, and the process of paying medical bills can become overwhelming. A majority of healthcare providers (61 percent) admit that they believe healthcare bills are more confusing than other bills. Unfortunately, healthcare’s lack of cost transparency and complicated billing can cause patients to feel negatively about their healthcare experiences. But some of that frustration can easily be avoided.

Sending messages to communicate about costs and payments can eliminate stress caused by medical bills and improve overall healthcare experiences for patients. Healthcare teams that use patient engagement technology to send appointment reminders can adapt their messages and use their existing technology to communicate about a variety of financial topics. This might mean sending patients messages following appointments to let them know when to expect a bill, what services will be included on their bill and what payment options are available to them. It could also mean following up with a message after a bill has been sent, to explain and clarify what costs are covered by insurance. According to West’s survey findings, only 15 percent of providers routinely send these types of messages. Making this type of increased communication a standard part of the billing process allows patients to better budget for healthcare expenses, and it lessens confusion and frustration—in other words, a big patient experience improvement.

Notify patients when there are delays or changes to scheduled appointments.

Another time when patients want increased communication is when doctors are running late. More than eight in ten patients (83 percent) think healthcare organizations are more likely than other companies to run behind schedule or keep them waiting. Because patients typically don’t find out about delays until after they arrive for an appointment, this causes a lot of waiting. Many providers don’t recognize quite how much of a problem waiting is, or that delays are a major frustration for patients. Less than half of providers (42 percent) think healthcare professionals actually run late more frequently than service providers in other industries. This explains why less than half (49 percent) of healthcare providers say that their patients receive notifications (text messages, voice calls or emails) when there are delays that impact their healthcare appointments.

It is unlikely that delays could be completely eliminated or that providers could maintain an on-time schedule 100 percent of the time. However, healthcare teams can certainly reduce waiting by leveraging their appointment reminder technology to communicate with patients when there are delays. Other industries send similar messages to alert consumers of delays. For example, airlines send messages to notify fliers of delayed and cancelled flights. By doing this, it allows consumers to adjust their arrival time and it helps minimize frustration. When healthcare teams send these types of communications to patients, they can show patients their time is valued and help them feel better about their healthcare experiences.

Patients hold healthcare to high standards; they want healthcare experiences to outshine other consumer experiences. Taking advantage of opportunities to use technology-enabled communications to better communicate with patients is an effective way to deliver better patient experiences. And doing so can help healthcare become the consumer experience leader patients expect it to be.

Nate Brogan

Nate Brogan

About the Author: Nate Brogan is an advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting, promoting the idea that engaging with patients between healthcare appointments in meaningful ways will encourage and inspire them to follow and embrace treatment plans—and that activating these positive behaviors ultimately leads to better outcomes for both healthcare organizations and patients. Brogan currently serves as President of Notification Services at West (, where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

Guest Post: Medicare Advantage Environment Sparks Effective Risk, Quality and Care Strategies to Battle New Challenges

January 17th, 2019 by Jay Baker

Commercial insurers remain interested in competing for MA beneficiaries.

Projections show that national health expenditure growth is expected to average 5.5 percent annually to reach $5.7 trillion by 2026—higher than the projected increase in Gross Domestic Product (GDP). Fortunately, trends of insurers entering and exiting the program show that the Medicare Advantage (MA) market is stable yet dynamic—roughly the same numbers of plans enter/exit the program each year. Data shows that commercial insurers remain interested in competing for MA beneficiaries.

Given the benefits and challenges of value-based healthcare, stakeholders should gain a full understanding of Medicare Advantage (MA) plans, as well as strategies for optimizing this approach. What’s more, research indicates that the successes of MA are already having a positive impact on the broader healthcare delivery and payment landscape. In fact, fee-for-service Medicare spending has trended down in markets with high MA plan participation, indicating that doctors and other medical professionals operating in markets with high MA penetration adapt their practice patterns in alignment with MA plans’ strategies that control spending and use. This, in turn, helps to reduce use and costs for all their patients—including those enrolled in traditional Medicare and commercial/employer-sponsored plans.

MA plan coverage offered by private companies approved by Medicare provide all Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) coverage.

Optimizing the MA Plan Opportunity

An effective MA plan that significantly improves outcomes takes a whole patient approach and applies an end-to-end solution designed to enhance care coordination using analytics, in-home care, retrospective solutions and care management.

Value-based contracting generates cost efficiencies and improves clinical outcomes in MA. The challenge is to design MA plans and risk-bearing entities to remain sustainable. This requires innovative quality and risk adjustment programs to meet the growing demand for effective care strategies. For instance, MA plans can gain clinical insight into risk-adjusting conditions to enhance their traditional analytical platforms.

Understanding a Risk Adjustment Model

Risk adjustment is an actuarial tool used to calibrate payments to health plans based on the relative health of the at-risk populations. If insurers are limited in the extent to which premiums can vary by health status or other factors that are associated with health spending, risk adjustment ensures that health plans are appropriately compensated for the risks they enroll.

Keep in mind that most claims in fee-for-service Medicare are paid using procedure codes, which offer little incentive for providers to record more diagnosis codes than necessary to justify ordering a procedure. In contrast, MA plans have a built-in financial incentive since the current risk adjustment model was introduced that prompts providers to record all possible diagnoses. This is important because higher enrollee risk scores result in higher payments to the plan.

Consider MA plans that rely upon Physician Record Review (PRR), a two-stage retrospective chart review process from a 1) certified coder and 2) board-certified physician. These same plans also use Prospective Health Assessments (PHA) to gain a robust view of members and their care needs. Providers also rely on PHAs to lay the groundwork for developing more accurate reporting documentation, improving patient engagement and compliance, enhancing disease management, and reducing utilization.

This kind of full-spectrum, end-to-end approach to care helps providers identify gaps in care and manage plan members more productively. It also helps health plans that are serving as intermediaries, executing solutions and assuming risk. Fortunately, plan members gain the most form this approach because they are guided toward more preventive care and self-management early in the care process.

Risk-Based Contracting on the Rise

Medicare beneficiaries in fee-for-service Medicare are normally required to pay multiple premiums and deductibles and face a confusing array of cost-sharing arrangements for benefits and services from physicians, pharmacies, and hospitals.

In contrast, when a Medicare beneficiary enrolls in a MA plan it is usually a comprehensive, integrated health plan that includes richer benefits and solid catastrophic coverage. Unburdened of siloed benefits and payments, MA beneficiaries’ plan structure is simpler, and they are able to receive more coordinated care.

The value-based world is enlarging to the benefit of MA patients. In a recent move, CMS expanded its definition of “primarily health-related” benefits that private insurers are allowed to include in their MA policies. These extras include, for instance, air conditioners for people with asthma, healthy food, rides to medical appointments and home-delivered meals. This means MA beneficiaries will have more supplemental benefits and be better able to lead healthier, more independent lives.

Jay Baker

Jay Baker is the senior vice president of quality and risk adjustment solutions at Advantmed, LLC. He was most recently responsible for the ACA risk adjustment strategy and execution for UnitedHealth Group’s Optum division. His accomplishments included standing up an end-to-end service offering and exceeding revenue goals for the first two years of the program. As one of the founders of Dynamic Healthcare Systems, he was responsible for the original design for each of their 10 Medicare Advantage software modules. He is an ACA and Medicare Advantage industry leader and expert in policy, compliance, systems and plans operations.

Advantmed recently developed a white paper that discusses federal policy and the economics of Medicare. Advantmed, LLC is a healthcare solutions company dedicated to partnering with health plans, provider groups and risk-bearing entities to optimize risk adjustment and quality improvement programs. Our integrated and technology-enabled solutions improve health plan financial results and offer insights on health plan members. For more information on Advantmed’s solutions visit

Guest Post: Clinicians and Developers Take Healthcare to New Heights Through Virtual Reality Technology

October 25th, 2018 by Laura Reagen

Hospitals and medical centers are using virtual reality and augmented reality technologies to assist in a variety of clinical applications.

What does a theme park game complete with roller coasters and thrill rides have to do with identifying cardiovascular birth defects in the womb? Both are the latest in virtual reality (VR), and among the many innovative experiences designed by some of today’s leading tech companies. What started out as fun and games has turned into a serious business for many VR developers, as well as the healthcare organizations they serve. In fact, all of healthcare is going virtual in a big way, as hospitals and medical centers use VR and augmented reality (AR) technologies to assist in a variety of clinical applications.

Using VR To Distract Patients From Pain

Prominent names in healthcare like St. Jude Children’s Research Hospital are among these organizations. St. Jude is exploring the use of VR as a way to distract children and teens from the intense pain that accompanies sickle cell disease. People with sickle cell disease have abnormally-shaped blood cells, which makes it difficult for these cells to navigate through tiny blood vessels throughout the body in order to deliver oxygen. When this blood flow is disrupted, it can be incredibly painful. Unfortunately, the IV medications used to manage this pain may not immediately ease the suffering of many patients.

To address that issue, the hospital is hoping to bring relief to these young people through an innovative study that will use virtual reality as a distraction technique while this IV medication is administered. Patients will be able to dive into the ocean, experience marine wildlife and navigate through sunken ruins through an innovative VR app, which clinicians hope will divert their attention away from their intense discomfort.

This particular application may not come as a surprise for anyone who has tried the real deal in VR—not just cardboard phone-enabled headsets but instead the sophisticated gaming systems like the Oculus Rift or HTC Hive. The idea of managing pain through this immersive experience isn’t far-fetched once you’re strapped inside a headset that controls your entire visual field and allows you to “virtually” walk inside of spectacular landscapes. It can distract you from all kinds of stimuli, both within your body and outside of it. This concept of distraction from pain and discomfort is one that is just beginning to find its way into the halls of many hospitals and prominent healthcare institutions.

Reducing the Reliance on Pain Meds During Labor and Delivery

At the forefront of this shift is Phoenix-based Banner Health. Physicians and researchers there are exploring the use of VR in the delivery room, in an effort to understand whether this intervention could help patients deal with labor pain and reduce the need for narcotic medications. Banner had already tried out virtual reality as a mechanism for training healthcare professionals. Then Dr. Mike Foley heard from other clinicians about the value of VR following surgery. Some felt using this technology in the recovery room could reduce the need for post-surgery pain medication and even drive earlier discharge from same-day surgery. Given the current opioid epidemic, Dr. Foley wanted to use this idea to help women deal with labor pain while receiving less opioids. This, in turn, could lead to safer deliveries and easier transitions home for both moms and babies. Dr. Foley and his team at Banner just completed a small randomized study of 20, which showed promising results in this area.

Pioneering the Use of VR in Managing Phobias and Pain

The origins of using VR in the area of pain management date back to some of the earliest days of this technology. Dr. Hunter Hoffman first heard about the potential for VR through a prominent researcher who was using it to help patients overcome a fear of heights. He decided to try a similar technique to assist a psychologist treating individuals with arachnophobia. Out of this very specific need, “Spider World” was born. The application was a means of exposure therapy, allowing individuals to gradually increase their interactions with fear-inducing scenarios.

This effort took place in the 1990s—when VR hardware and software were just emerging but were still cumbersome and costly. In fact, the hardware Dr. Hoffman used in these early efforts included a 75-lb supercomputer and helmets that weighed nearly eight pounds. But from this early iteration, Dr. Hoffman expanded his use of VR, ultimately developing a “Snow World” designed to help burn victims manage the pain associated with their injuries. Dr. Hoffman collaborated closely with Dr. Dave Patterson of the Harborview Burn Center on the effort, and is still using this same technique (albeit with much more affordable and lighter systems in place!) 20 years later. He is also at the forefront of using VR to help treat patients with post-traumatic stress disorder many of whom are veterans.

Pairing Clinical Best Practices With VR Expertise

For developers that specialize in creating virtual experiences, the future looks especially bright. As healthcare embraces this new technology as a natural extension of the clinical setting, VR could become more synonymous with treating patients than entertaining gamers. Those at the forefront of this trend, like St. Jude and Banner Health, will continue to publish their results and may inspire others to enter this “new world” of care delivery.

Laura Reagen

Laura Reagen

About the Author: Laura Reagen is the Creative Director of Activate Health, a Phoenix and Nashville-based marketing firm. Activate Health specializes in providing marketing, advertising and public relations support to entities across the healthcare industry including health technology firms, hospitals, health plans and health systems. Laura is a graduate of the Walter Cronkite School of Journalism and Arizona State University.

Guest Post: Rethinking Healthcare Cybersecurity by Focusing on the Attacker, not the Attack

October 4th, 2018 by Ofer Israeli

Why are healthcare systems so challenging to secure? What is driving this complexity. How might we rethink our approach?

Healthcare systems, like all digital networks today are increasingly inter-connected and consumer-driven. The digital transformation necessary to make them agile, also renders them easy targets for data and identity theft, insurance fraud, and other forms of cybercrime. As the recent spate of ransomware has shown, cyberattacks on healthcare institutions also disrupt vital services and risk patient safety.

Beyond the health organization’s core staff, a wide variety of guests, students, visitors, patients, maintenance workers and others have direct physical access to healthcare systems and devices. Temporary workers and contractors require access to sensitive systems while employed. External interconnection of these systems with universities, research partners, and other remote services further mitigates the effectiveness of perimeter and access security controls. Higher and thicker security walls will not support the organization’s need to break down barriers, share information, and increase patient access.

Clearly, a new approach is required. If we cannot stop attacks, then we must stop the attackers. This is not a semantic nuance. The key to protecting healthcare systems in the future will be to transform our thinking—from a focus on defending ourselves from an infinitely expanding phalanx of attacks and attack vectors, to instead focus on disrupting the attack process itself regardless of attack style or source. We must stop the attackers.

As difficult as that might sound at first blush, there is, in fact, a silver bullet that will disrupt the vast majority of attacks. Malicious actors targeting healthcare systems all share a common trait that makes them vulnerable to disruption and detection. Regardless of how they enter a healthcare network, or what their intent, attackers must move laterally across the healthcare network to access their target applications, devices, systems, and data. To move undetected, they must gather intelligence about the environment and make careful decisions regarding their attack path.

The key then, quite simply, is to disrupt the attacker’s decision-making process—to blind and befuddle them so that they cannot progress their attack. Done well, cyber deception technology disrupts the attacker’s intelligence gathering process, and destroys their ability to make accurate decisions, by flooding the attack plane with false and misleading data. Similar in effect to evasive maneuvers used in aerial combat such as disgorging flak, disrupting radar, and disorienting GPS signals, these new technologies destroy the attacker’s ability to navigate, and ensure they are detected by any movement they do decide to make.

The challenges of securing healthcare systems will continue to grow as attackers, and their tools, methods, and infrastructure, become more sophisticated and diverse. Just as digital transformation is improving efficiency and patient outcomes, the traditional security mindset must be transformed to a modern security mindset. To protect these new system architectures, we must refocus our efforts from defending against attacks to disrupting the attack process itself. Deception offers a promising path forward in this direction.

Ofer Israeli

Ofer Israeli

About the Author: Ofer Israeli, founder and CEO of Illusive Networks, pioneered deception-based cybersecurity. He leads the company at the forefront of the next evolution of cyber defense. Prior to establishing Illusive Networks, Mr. Israeli managed development teams based around the globe at Israel’s seminal cybersecurity company Check Point Software Technologies and was a research assistant in the Atom Chip Lab focusing on theoretical Quantum Mechanics.

Guest Post: 3 Strategies for Combating Physician Burnout

September 20th, 2018 by James Korman

Physicians now find themselves under more stress and pressure from a variety of sources beyond their control.

Physicians call it “Pajama Time.” But it has nothing to do with curling up with a good book before heading off to bed. In medical parlance, Pajama Time refers to the several hours at night that many physicians must set aside to catch up on completing notes, tasks and orders that they simply don’t have a time to manage during the workday.

Pajama Time is symptomatic of a larger and growing problem throughout the medical profession: physician burnout. Dealing with a flood of medical data is a major cause of physician burnout. But it’s not the only one.

Physicians now find themselves under more stress and pressure from a variety of sources beyond their control. For example, stress is sparked by increased patient volume, wrestling with complex and time-consuming electronic health records (EHRs), merging practices that result in a loss of autonomy and peer-to-peer interactions, and a sharper emphasis on outcome metrics and benchmarks.

Although many of these changes are necessary as medicine moves away from fee-for-service and toward fee-for-value, the triple aim that is meant to fix the U.S. healthcare system only magnifies and perpetuates the stress experienced among the nation’s physicians.

Often difficult to detect, physician burnout takes on many forms. Chief among them is emotional exhaustion, detachment and insensitivity toward patients and a lack of feeling successful and accomplished in their work.

The severity of physician burnout often depends on the type of medical specialty being practiced.

Tait Shanafelt, MD, a nationally recognized expert in physician wellness, in 2014 administered the Maslach Burnout Inventory to a large national physician sample showing that approximately 50 percent of U.S. physicians were experiencing at least one symptom of burnout. In 2013, the first year of the “Medscape Lifestyle Report,” showed that emergency medicine had the highest rates of burnout, just above 50 percent. That jumped to close to 60 percent in 2017. It also showed that physicians working in primary care tended to struggle most with burnout.

The consequences of physician burnout run far and wide.

Picture a Venn diagram, with burnout overlapping the personal and the professional effects. Personal consequences include anxiety, depression, alcohol and substance abuse, family conflict and an increased risk of suicide, according to the Mayo Clinic. Professional consequences range from decreased quality of care to increased medical errors to decreased patient satisfaction.

The rising level of physician burnout is simply unsustainable, with repercussions negatively affecting nearly every facet of the healthcare system.

Summit Medical Group, the nation’s largest independent multispecialty physician group, recognized the concerning trend of burnout among doctors even before it was talked about openly, and is at the forefront of this issue. The group is combating physician burnout on multiple fronts:

  1. Improve communications. One way to help physician burnout is to give physicians an avenue to express what they see as causing their stress and have someone take it seriously. Summit Medical Group (SMG) has made this a top priority by having its board of directors, who are practicing physicians, meet with the group’s physicians to obtain their feedback, thoughts and suggestions. By having regular small group meetings with physicians these leaders gain a keener sense of the possible remedies that SMG can adopt to reduce burnout. Also, most of the interventions that the group has adopted to address burnout has come from these meetings. To further help with communication, SMG assigned lead physicians to geographic regions to ensure that accurate and timely information gets down to the individual physician and their feedback gets up to leadership. Another way SMG has strengthened overall communication is through various electronic newsletters that keep its physicians informed and engaged about the medical group and their colleagues. They have also created a dedicated email address and voicemail allowing their physicians to leave confidential feedback at any time.

  2. Bolster physician support services. It is well-known that physicians are excellent at helping others, but not very good at asking for help themselves. It’s not in their DNA. That’s why it’s incumbent upon medical groups to proactively offer support services to their physicians with minimal barriers. For example, SMG has trained 14 volunteer physicians from different specialties to speak with their colleagues during times of acute stress, unexpected outcomes or when dealing with a medical malpractice lawsuit. These volunteer physicians often have been though similar situations, making it easier for them to offer support and advice. SMG also does not wait for their physicians to ask for help but will reach out to them to offer support whenever one has had a stressful event or appears in need. SMG further understands that at times medical providers need more than a peer to speak to and does have professional psychological services available to them. There are also other support services that SMG has implemented, including ways to help physicians unplug when they are on vacation. Because many physicians receive hundreds of patient orders and tasks per week it is no wonder that many feel compelled to log on to the EHR when they’re supposed to be recharging their batteries. And if they choose not to log-on many experience anxiety on vacation knowing what they are going to return to when they head back to the office. To help, SMG has hired Advanced Practicing Nurses and Physician Assistants to manage their doctors’ EMR inboxes when they are on vacation. This not only helps the vacationing physician but also reduces the burden on the office staff who are often managing their own work along with that of the vacationing doctor.

  3. Foster a sense of community. The ‘Physician Lounge,’ a physical space where doctors could unwind and exchange professional information and give each other support, used to be a staple of the medical profession. No longer. Physicians simply do not have the time to go to the lounge during busy work hours and many medical systems have eliminated them in favor of more clinical space. However, medical groups do need to find alternative means for their physicians to interact with each other to avoid having them feel isolated and siloed. For example, this summer SMG adopted a social media platform called Yammer. Yammer has been described as an on-line “Physician Lounge” where doctors can exchange medical information, consult on general medical cases, share social pleasantries and provide each other support. Similar to Facebook, Yammer is set up for each medical department throughout SMG as well as for the larger physician group. Perhaps most important, Yammer offers physicians a sense of community—a place where they can share ideas, frustrations and solutions to the stresses they face. In addition, SMG holds regular networking events, which give providers who may feel isolated in their work the opportunity to interact with colleagues both professionally and socially.

James Korman

James Korman

About the Author: James Korman, PSYD, FACT, is the director of behavioral health and provider engagement at Summit Medical Group.

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

July 31st, 2018 by Dr. Delanor Doyle

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

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

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

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

Every Discharge Deserves a Follow-Up

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

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

Encourage Virtual Care Options

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

Promote Health Plan Resources

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

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

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

About the Author:

Dr. Delanor Doyle

Dr. Delanor Doyle

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

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

July 26th, 2018 by Gary Palgon

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

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

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

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

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

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

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

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

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

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

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

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

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

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

About the Author:

Gary Palgon

Gary Palgon

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