Monthly Archives: September 2016

Why Care About Chronic Care Management?

Almost half of the adult population in the US is affected by at least one chronic disease and more than half of Medicare reimbursements are spent on senior patients with more than one chronic conditions. These are not pretty statistics nor is this financially or socially sustainable.

As a response, albeit late response to this rise in cost and fall in population health statistics, CMS has devised a program to control the epidemic. The CMC Chronic Care Management program was designed to promote a ‘healthy’ and sustainable long-term care delivery model which will incentivize providers for providing care above and beyond traditional. The program will identify patients with more than one chronic condition as it is defined by CMS and will provide care as these patients have the most risk and thus the most expensive to treat.

It has been little more than a year and a half since this new program was introduced and yes, it is too early to evaluate. But as far as we can see the take away from the program is largely positive. Reports state that the program has been successful in increasing the patient’s participation in their health, improving patient-provider relationship and overall health outcome. Yet this might not be the right way of evaluating a program. The better way to look at this is to look at the overall picture of what the program promises not just for patients but for all stakeholders.

Chronic care management is proposed to set a new approach to healthcare and its expenditure, value-based model is taking over the fee-for-service model and is connected to provider reimbursement.

Some ‘‘other’’ benefits of CCM are as below

Reactionary care to proactive care
Beyond the four walls of a care facility
Reduce readmission chances
Promotes the use of telehealth technology
Holistic approach

1. Reactionary care to proactive care:

The use of medicine has always been more or less reactionary, healthcare did not actively participate in eliminating the chances of getting a disease or condition but always reacted to the symptoms resulting out of these diseases as it is explained by patients or observed by the healthcare professionals.
Those with multiple chronic conditions are at a greater risk of accumulating other health concerns as time progresses. Chronic care management aims to highlight this factor by looking at the overall health of the patients.

2. Beyond the four walls of care facility:

Chronic care management forces providers to look and reach beyond their office walls and provide care. It’s a conventional idea but in practice, this is rather a new concept.
For example, CCM program elements highlight that the provider or a qualified staff must contact the patient regularly for at least 20min of face-to-face care over a period of one calendar month. This is a new manner of engaging with patients for many physicians allowing them not only to look at the symptoms but sometimes be actively participating and engaging along the recovery period of the patients.

3. Reduce readmission chances:

Patients with more than one chronic conditions have a higher chance of getting admitted to a hospital than a healthy patient. For a chronic patient it is a never-ending journey to the hospital and from the hospital, not being able to put the constant shift, it gets hard to settle down post discharge. Continuous contact and monitoring of patient condition help in avoiding unnecessary readmission which not only affects the patient financially but also their morale.

4. Promotes the use of telehealth technology:

Telehealth means the use of various information technology tools to connect and contact with patients when they are geographically separated from the location of the provider or the facility. Chronic care management program promotes the use of such technologies, it has shown that such technology can improve the patient health outcomes. Such technologies need not be limited only to CCM program but can be successfully used for achieving better results with other patients in general.

5. Holistic approach

This is the whole point of the exercise, to have a holistic approach towards healthcare. CCM program aims to look at a patient as a whole rather than a list of conditions and complications. Our healthcare professionals have been doing a great job within the bounds of what they could do but with the introduction of CCM providers being incentivized to do the best they can for the health and welfare of their patients.

So, why should we care about CCM after the many acronyms that have come out before?
Acronyms proposed by many new laws and out of many agencies and they all came short of what was promised.

We should care about CCM because it is a new idea which came out of a new way of thinking, which if everything goes as well as it does on paper can positively impact the lives of many people who are forced to choose between health and financial well-being, having to watch their loved ones suffer helplessly; between pursuit of hospital bed and pursuit of happiness.

Role of Technology In Patient Engagement

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Patient engagement is the most demanding process in healthcare but its importance in improving healthcare outcome and care quality cannot be overemphasized. The value of patient engagement is now been realized by all stakeholders who would like to improve it though not easy.

Patient engagement is the process of involving patients in their own care regime. An individual patient’s outcome holds the efforts of the patient, physician, care coordinator, provider and patient’s family members. The logic is to improve one’s wellness he/she need to show some interest.

Healthcare IT can help in designing technology which will boost user experiences and aims to better the engagement activity by strengthening the communication between doctors and patients. But not every providers’ needs are the same, so the healthcare professionals should analyze their needs and implement a solution which will best suit their requirements and that of their patients (for example a visually impaired patient will not be able to use a visual app).

Technology has a huge impact on engagement rate and this could lead to positive improvement of overall health outcome.

Role of Technology in Patient Engagement

Medical providers understand that only when people care there will be an engagement. The way people are connected to the internet is an example, patients today can be reached and engaged just like how they are engaged with social media.

1 out of 20 searches in Google is for health-related searches and 80 percent of users seek online health information. So people want to have the similar experience with hospitals. Since the introduction of the patient portal, the use of health data have seen significant growth and many stay connected.

Recent trends in technology focus mainly on managing health data, secure communication, educating patients and self-care. An innovative way to access personal health records from wearable tech to patient portals is an attempt to improve health outcome.

A few weeks before, the National Coordinator for Health IT launched two new online tools

1. A consumer-facing video to educate patients and tell them their rights to access health record, and
2. A provider-facing “Patient Engagement Playbook” which illustrates the steps to engage patients.

Benefits of Technology

1. Appointment Scheduling/ Reminder/Notification

No more waiting in a queue for making an appointment. With the use of patient portal and apps, patients can book the appointment online. Any changes in the appointment can also be made easily.

Patients get reminders for scheduled appointments and notification for prescription refills either via text, email or voice. Meaningful Use 2(MU2) mandates more than 5% of patients to communicate through secure electronic messages with their providers.

2. Enabling E-consultation/E-visits through Telehealth Feature

Telehealth service helps physicians to communicate with patients any time to know about their health condition. Readmission rate can be curbed with the use of such technology.

While meeting a doctor, patients may not communicate their problems effectively and some tend to forget what they want to convey. With Telehealth feature doctor-patient communication becomes easier.

3. Access to Family Members

Portals allow family members to stay engaged with relatives health. Patients and their families can now access EHRs and can send messages especially to patients with chronic illness.

4. Visible Medical Charge Details

Providers encourage consumers to have control over their payments. The details of bills, including lab charges along with clinical data, will be available in the patient portal.
Giving patients clear insight into their medical charges may have the potential to engage them.

5. A Good Workplace

Clinicians also play an important role in engaging patients. A positive workplace makes caregivers happy which results in good care delivery. Only when employees are engaged they make patients engage. So hospitals should provide a good atmosphere for the better outcome.

If you take a moment to reflect on the other side of the coin, the disadvantages new tech might cause are a few. Right from generating junk information to the security concern of adding more patient information into the internet, from overworked doctors to unforeseen technological changes. These are all real concerns but healthcare IT like any other is a tool and the usage depends on the users, the providers, and the patients.

But with all the increased cost of healthcare and the poor performance of population health parameters, the unceasing demand for modernization of healthcare sector from all sides, we can be optimistic that an industry which is yearning for such a technology will make best of it.

Technology & Chronic Pain

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Pain – Excruciating, unbearable, constantly disturbing work and life, regularly raids quiet mornings and good night’s rest. Chronic pain is the boulder standing in the way of millions of Americans.

Healthcare system wasn’t quite prompt in understanding the cause and effect of chronic pain but with more focus being given to the quality of care, pain management is getting the attention and the resources it requires. New technologies and tools are being experimented to ease pain and to measure and study, in order to provide individual intervention and attention rather than a blanket approach to the problem.

One such development in this field is the pain recording app, which enables detailed recording of pain, its intensity, duration, causes etc. There are many such apps available now to track and report pain to your physician, which helps them to make a more informed decision. These apps have only scratched the surface on what information technology can do to aid pain management, but has been successful in demonstrating what such technology can do in this field. Any Pain Management tool to be successful needs to communicate with healthcare providers and must form a part of the larger system of care delivery rather than a small disconnected device.

To manage pain, pain apps and other healthcare information technology can provide the following services

1. Recording pain
2. Telemedicine
3. Timely Medication
4. Cause and Effect Relation
5. Access to Pain Management

1. Recording Pain :

The most straightforward way that we can employ the services of an app or other such mediums is to record pain. Pain is inconsistent and the doctors may be able to observe the phenomenon when it occurs or when it triggered. Recording pain helps in tracking its nature, location, trigger, and effect. This information can then be used by the provider in easing the pain.

2. Telemedicine:

Telemedicine is the use of various technologies to connect with patients and providers such as video chat, secure texting etc. Telemedicine eliminates the need for a patient to visit a pain specialist but instead gets help from them as and when needed. For primary care physicians who are pressed for time and resources telemedicine provides an alternative (and in many cases a more effective way) to prescription drugs which can have unintended side effects.

3. Timely Medication:

Healthcare IT can prove very useful in managing medication, it can help in determining a more appropriate and effective use of drugs. Apps can also set reminders when it is time to take medicines and help in tracking medication compliance.

4. Cause and Effect Relation:

To understand pain, its cause should be recorded first. Just as the effect of pain and medication, the cause and effect relationship between pain triggers will help in managing pain. If the pain is caused by an external stimulator, then this will help in identifying it. Understanding the reason for pain can help make patients active participants in managing pain rather than just delegating pain meds exploration to doctors.

5. Access to Pain Management:

Apps and telemedicine can improve patients’ access to pain management programs and necessary treatments. As of now, many people suffering from chronic pain do not have access to medication and treatment, the unavailability of specialists and the busy schedule of PCPs, and increasing cost of treatment just adds to this problem. Health IT can improve access, relatively reduce costs associated and give care.

Medicines and treatments are to help society be healthy. A healthy society is more productive and so, will add more value to everything. Healthcare information technology allows viewing an individual’s health and treatment need from a holistic perspective of both physiological and psychological health. Pain management solutions can help achieve the better outcome for patients suffering from chronic pain. Learn more about Chronic Care Management!

Data Analytics Next “Big Thing” in the Healthcare Industry!

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Digital technology is instrumental in reforming businesses all over the world. Going digital is a bonanza for the industry. Though digitization makes the process quick, there are some security concerns coming along with it, Health Data Management is a challenge considering the frequency of data breach in the recent past.

Present healthcare system stores patient records in a digital form as EMR (Electronic Medical Record) which gathers all information at one place. A patient health record includes both financial and clinical data.

Clinical data includes physician feedback, prescriptions, medical imaging, laboratory, pharmacy, insurance, and other administrative data. Patients who have leverage wearable devices can sync those data to their respective patient’s record.

Data analytics means finding different patterns with respect to patient health conditions and available medical data. It allows physicians to have a deep-rooted understanding of the problem, and be able to take medically informed decisions while lowering costs.

Analytics helps providers to

Improve process
Boost outcomes
Reduces time, and
Tackles problems

Ideally developing this pattern will help gain insight in choosing better treatment options resulting in high-quality care.
All healthcare systems generate the large volume of data and this data has to be processed in an effective manner to make a huge difference in the outcome.

Engaging practice with new technology hasn’t been effective so far. Though it may look expensive, implementing a new technology and leveraging big data can be advantageous and prove to be cost-effective over a period of time.
Big data is nothing but a large volume of complex and variable data that require advanced techniques to capture, store and distribute to analyze the information.

Advantages of leveraging big data in healthcare,

Data has always been the basis of healthcare, every healthcare procedure, processes, studies, and diagnosis is recorded for better understanding. But the problem arises when understanding this data collected and generating information out of it. Big data can help in this area by turning data into information. Following are some of the advantages big data present

1. Clinical research and operations

A large volume of data can help clinical researchers to discover cost-effective ways, and diagnose and treat patients. Big data can help physicians to perform better, be more insightful during the process of decision making. Study of diseases and conditions and as a result the search for a cure lies in recognizing the underlying patterns which lead to health or diseases. Some of these patterns are more obvious than others and in some cases, the database is not sufficient to arrive at a conclusion. Big data will help in identifying such patterns faster and more accurately and can reduce the need for trial and error treatment.

2. Prevents diseases and treatments

To reduce the spending and readmission rate insurance companies have started to gather patient data to foretell, and to avoid repeated hospitalization by discovering illness pattern using analytics, also helps to restrict patients from being vulnerable to diseases.

3. Precision treatment

By identifying the disease pattern with available genetic predisposition and family history or disorder it is easy to start appropriate treatment. This treatment steps will be stored for future medication and references.

4. Population Health

Many healthcare communities follow present technology for data collection and data mining. Record tracking facility and pattern analyzing technique allows to uncover the disease outbreak and helps to deliver timely care.
With large population data, we can identify patient needs, offer required services, predict diseases and prevent the future crisis to benefit the population.

Data analytics can also contribute to

1. Evidence-based medicine

Various organized and unorganized patterns are discovered from patient’s clinical, operational and genomic data which helps physicians to tackle treatment-related problems and helps to figure out how effectively the treatment can be done to bring the desired results.
And this is done by finding patients who are at risk and providing instant treatment to better the outcome.

2. Genomic analytics

Helps to identify gene pattern more efficiently and cost-effectively. Genomic analysis is a part of the regular medical care decision process.

3. Fraud Analysis

Data analytics helps to cut down fraud requests by analyzing more number of claim requests.

4. Real-Time Monitoring

Real-time capturing of data and analyzing fast-moving data from hospitals and wearable devices for safety monitoring. It prevents adverse effects from medical errors when data monitoring is continuous and real-time.

Hence adopting data analytics technique will improve the care outcome and will also bring in most needed massive changes in healthcare delivery. Schedule a demo with us for free!

Data Reliability and Medical Errors

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Medical errors are the scariest thing for anyone who is involved in Healthcare. Patients who are the eventual victims are usually frightened each time they undergo a treatment.

The US Senate disclosed that after heart disease and cancer, medical errors are the third most noted cause of death in the United States. A report says, every year medical errors cost $1 trillion, 400,000 lives, and affects 12 million people because of the unknown mistakes made while treating the patient.

Though physicians and staff are putting their maximum effort to increase patient safety by avoiding faults, it has still been challenging to curb medical errors in the past few years. Various researchers and surveys are done each year to minimize these mishaps; still, there is no system to code these deaths.

People visit hospitals when they get sick. Although hospitals try to give their one hundred percent efforts to cure them there still occur some unknown mistakes. According to a survey report of 9.5%, people are dying due to the complications caused by medical errors.

Hospitals need to concentrate more on their care quality and safety measures to reduce the percentage of errors.

Problems in ambulatory settings

Many treatment mistakes happen because of improper record maintenance and manual inaccuracies. The utilization of medical records is considerably low due to lack of reliable systems to record test reports which result causes a delay in diagnosis.

Also, staffs are not fully equipped with devices for updating patient data which sources to an imprecise data record.

Some common Medical errors

1. Physician Error 2. Diagnosis Error 3. Nurse Error 4. Surgical Error 5. Communication Error 6. Medication Error 7. System Error 8. Right and Left side body mix Error etc.

Some of the medical errors are very easy to find. Treatment-related errors are more noticeable compared to diagnostic and prevention errors. The reason why it is easily detected is that of its adverse outcomes.

Adverse events are visibly seen after few days of errors made. Until these adverse events take place we will not know about the occurrence of errors. These kinds of difficulties can be avoided with near to real-time record maintenance.

Will Technology help Hospitals to Reduce Medical Errors?

Present healthcare system relies on technology to avoid errors and it involves spending thousands on it to ensure patient safety. However, there are some issues with interoperability and limitations due to inconsistencies of the system.

In a Survey conducted it was figured out that system inconsistency issue between system and devices were the primary reason for most of the medical errors.

Errors not only costs human life but also costs the providers. Hospitals are moving to cloud environment to solve compatibility issues and reduce security threats. Cloud-based interoperability will ensure efficient & quick transfer of data and also data can be viewed in multiple systems simultaneously without any intervention.

Data Security is still a question!

There are few security and privacy concerns we need to look at. In August 2016 alone there were 44 reports of data breaches and in total 8,804,608 of patient records that have been breached.
To reduce the hacking, rate providers and device vendors are now focusing on cybersecurity.

Medical errors can be reduced only when providers and physicians truly come together in terms of care delivery, efficiency and show interest in the implementation of new technologies.

Rising Cost of Healthcare

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The United States government spends more on healthcare compared to other countries in the world. According to World Health Organization, US spent 17.9% of its GDP in 2011, which is considered to be the highest in the world. Experts say this will increase to 19.5% of GDP by 2017.

From a report, of each dollar spent on healthcare goes 30% to a hospital, 20% to physicians, 10% to prescription drugs, 6% for nursing and continued care, 4% to administrative cost etc.

Even after spending much more on healthcare per capita, US healthcare system has not seen better outcome while other countries spend less, but their outcome is more. The following are some of the reasons why US healthcare cost is rising.

1. Growing Aging Population

.Life Expectancy of an American has significantly increased to 79.1 years in 2015 from 77.9 years in 2007, means the United States population ages 65 and older will nearly double in future.
The aging of the population also has important implications for future Medicare spending. Because an increase in population age has a significant impact on government’s Medicare Expenditure.

Yet population aging is one factor which is not directly related to increases in health care cost.

2. Technology Advancement

Technology is one of the major contributors to increasing overall healthcare cost. Medical devices or instruments help doctors to give effective treatment.
Technology opens up to the wide range of treatment options by replacing older less cost treatment and gives the highest order possible in terms of care delivery.
Understandably the US has a big market for medical technology.

3. Drugs

Another massive reason for increasing Healthcare cost is because of increase in drug price. Production of new drug incurs the most cost, as it involves years of research & development than producing an existing product. It is a competitive market, drug manufacturers fix their own pricing depending on the market needs and supply to demand ration, which has an impact on the patient’s medical bill.

4. Physician Fees

Physicians in the US are highly paid compared to physicians in other countries. However, availability of primary care physicians are less in number, hence patients are mostly treated by the specialist whose remuneration is relatively higher than primary care physicians.

5. Administrative Cost

Approximately, the US healthcare spends 20-30% on administration. Hospitals have many departments, bills to manage and to deal with payers. Other countries have single payer so they do not have work burden and cost is comparatively less. But US hospital deals with multiple payers and contractors which makes process complex and expenditure directly proportional to complexity.

6. Treatment Process

Physicians in the US are very cautious by nature, considering patient’s health conditions they take multiple tests to diagnose and ascertain any disease to avoid any negligible chances of wrong medication. This process increases the number of people involved, and dependence on technology which automatically increases the cost.

7. Lifestyle

Living for long years does not mean living a healthy life. Due to poor eating habits and lifestyle, many people are prone to diseases.

There may be many factors like this which may be directly or indirectly linked to increase in healthcare cost but the only goal of healthcare providers is to deliver a better care to their patients. The predominant cause for why cost inflicts high in healthcare is because of its less organized system, complex regulation, and poor management.

This problem can be solved by measuring the actual cost of the treatment and comparing it with the outcome. This process involves only a patient and his disease, it will help us realize measurable change by calculating accurate cost and value delivered into healthcare practices. But in current system finding the actual cost is challenging, and the value of care is not proportionate either.

Appropriate treatment has to be carried out immaterial of the cost. The health of an individual in a population should be given utmost importance without any monetary constraints.

If the US government takes charge then there will be a possible reduction in cost. Government starting to negotiate costs based on health outcomes might as well help in optimizing their spending on the annual bill while achieving desired results.

Promoting transparency in healthcare and providing affordable drugs will help people to get better health at less cost.

“We need more transparency in our healthcare system; we need to drive improvements in health IT; we need to make it easier to get data on how much treatments actually cost and how effective they are so providers, payers and consumers all can make better decisions.”- Clinton said at HIMSS14