Tag Archives: healthcare

How COVID-19 is changing the Healthcare Industry

The COVID-19 Pandemic has greatly challenged the existing capabilities of the Healthcare Industry. The rapid spread of the virus has brought the world to a standstill and has health leaders scrambling to find new approaches to healthcare. Despite the obstacles that have been thrust upon the industry, the prospect of technological advancement gives the healthcare industry an opportunity for accelerated growth.

Short-Term Impacts of COVID-19

short term goal of healthcare during covid-19 pandemic

One of the main consequences of the Pandemic has been undermanned or under-equipped health staff. The intensity of the virus has left many clinics with less than the required resources to help COVID patients. Another related issue faced mainly by urban health clinics is Hospital Overcrowding. Non-COVID related patients will also see delays in their care journeys. The healthcare industry must also prepare for the following long-term impacts of the COVID-19 Pandemic.

Increasing Role of Virtual Health services

advancements of virtual healthcare services

The pandemic has revealed the importance of virtual health care services such as Telehealth and Remote Physiological Monitoring (RPM). The contagious nature of COVID-19 has forced many clinics to close their doors to non-COVID patients. Without virtual care technology, many patients with chronic or other severe conditions would lose access to essential healthcare. In addition, clinics would be losing a significant portion of their revenue. However, providers who utilize a virtual telemedicine platform are still able to connect with their patients. As of 2017, some form of Telemedicine platform is employed by over three-quarters of hospitals in the US. The pandemic will cause that number to increase while encouraging existing users of telehealth to make their platforms more extensive. 

Eliminating the Traditional Care Journey

Eliminating the Traditional Care Journey

The emergence of telemedicine has allowed for the virtual exchange of high-quality health services. By using virtual technology, physicians are able to provide check-ups, patient education, and care plans. Patients can access these services from the comfort of their homes. This new development due to the pandemic has brought into question the future of traditional clinical visits. Hassle-free telemedicine solutions have exposed the inefficiencies of conventional care journeys. Previously, patients might waste an entire day for a simple check-up due to long wait times and large clinical facilities. In the end, they may not even receive conclusive treatment if they are referred to another practice. These inefficiencies contribute to a high patient no-show rate, which costs the American healthcare industry over $150 billion/year. Convenient telemedicine platforms remind patients ahead of their appointments and provide them with effective and timely care. 

Altering the future of Value-Based Care

 future of Value-Based Health Care Services

While the “Value-Based Care” movement has been gaining momentum for a few decades, the COVID-19 pandemic might slow down the shift. The decrease in elective surgeries and non-COVID related care has been financially crippling for many practices. While RPM and Telehealth reimbursement codes cover for some of these losses, clinics are still seeing a decline in revenue due to the pandemic. The deal-breaker for most clinics involves the financial risk involved in a Value-Based model. Many Value-Based contracts involve a great deal of downside risk, or potential financial shortcomings due to missed targets. This financial risk may have over half of Accountable Care Organizations (ACO) consider abandoning this model. This may also encourage current fee-for-service providers to avoid adopting a Value-Based platform in the future. In order to mitigate a large-scale exodus from the Value-Based scheme, the CMS could subsidize providers by removing downside risk clauses for the near future.  

Accelerating the Adoption of Artificial Intelligence

 Adoption of Artificial Intelligence in healthcare

Artificial Intelligence (AI) is emerging as a new solution for the current healthcare-related issues. AI involves the use of machines to perform human activities such as learning, interpreting, and analyzing. While AI in healthcare has not yet reached its full potential, investment in this field is expected to grow tenfold between 2014 and 2024. While AI systems are still in an early developmental stage, they are already used by many providers in areas such as diagnosis, patient education, and predictive analysis. 

Robotic machines are an example of how AI could be put into action in a healthcare setting in the near future. These systems could carry out tasks like patient engagement, or even remote surgery. When dealing with infectious diseases like COVID-19, AI based robots could eliminate unnecessary human interactions, thus decreasing the risk of transmission. When used for diagnosis and treatment, these machines are significantly more accurate than existing technology. In the long run, AI could lead the way for virtual/augmented reality to make its way into mainstream healthcare. 

The COVID-19 pandemic has proven to be a watershed event in the history of medical care. While the industry continues to face immense challenges, greater opportunities for growth lay ahead.

Talk to us to understand how HealthViewX is transforming the Care Journey for both patients and providers!

Emerging Technologies that will shape the Future of the Healthcare Industry

The Healthcare Industry has witnessed a great deal of innovation over the past few centuries. Some pioneering breakthroughs include the discovery of vaccines, antibiotics, and insulin. Developments such as these have drastically increased the overall quality of life for billions of people across the planet. These substantial improvements over the past two centuries have led to the emergence of recent tech-based health innovations.  

How the move to Value-Based Care affects Innovation

The Healthcare industry has witnessed a shift towards “Value-Based Care” over the past few decades. This model focuses on the patient outcome more than any other factor. This has influenced technological innovations to be patient-centric rather than purely profit-focused. 

RPM Devices

how remote patient monitoring helps to achieve value based care

Remote Physiological Monitoring (RPM) is a form of real-time telehealth that employs the use of technology in the live collection of vital parameters such as heart rate, blood pressure, weight, or any other relevant measure. These compact gadgets track and send these parameters to qualified health professionals who can analyze the results. RPM devices give patients the opportunity to monitor their condition on a daily basis without constant clinical visits. These devices have allowed providers to remain updated with their patients when a physical visit is not possible. Effective use of these devices is proven to decrease the number of readmissions, which costs the industry over $41 billion a year. The RPM market is expected to grow to $2.7 billion by 2020, per a projection by Research and Markets. If RPM devices can prove their value in a competitive health tech market, they may become an integral part of human life. Their compact nature can allow them to become as ubiquitous as a wristwatch, especially for aging populations. 

Telehealth

what are new advancements in telehealth

Telehealth involves the transfer of healthcare services through a telecommunications platform. While it includes monitoring and education, it is most commonly used as a tool for virtual appointments between providers and patients. Commonly used Telehealth platforms involve the use of a video/audio system with the ability to send EHR/EMRs or other health records by message. Telehealth acts as an added revenue stream as the CMS reimburses providers who employ telehealth services. For patients, telehealth means they can access high-quality healthcare from the comfort of their homes. The use of telehealth has rapidly grown over the past decade as 75% of hospitals utilized a telehealth platform in 2017 as opposed to 35% in 2010. In the long run, telehealth can help eliminate nonessential patient visits which waste both time and resources. With technological advances, telehealth might soon adopt a “virtual reality” based format. This can increase patient-provider interaction while enhancing the quality of care.  

Artificial Intelligence

how Artificial Intelligence hep in healthcare industry

Artificial Intelligence (AI) involves the use of machines to perform human activities such as comprehension and analysis. In a healthcare setting, it can be used to make an advanced interpretation of health-based data. The amount of investment in health-based AI is projected to grow from $600 million to $6.6 billion between 2014 and 2021. AI can make patient-specific care plans by accounting for millions of variables involving the patient’s health condition and trajectory. AI could potentially open the door for “Precision Medicine,” which could be a landmark development in modern medicine. While this method is still highly experimental and embroiled in controversy, the prospects of an effective model remains promising.  

The Impact of COVID-19 on Health Tech Innovations

The COVID-19 Pandemic has placed a heightened focus on the current capabilities of the Healthcare industry. The pandemic has offered both challenges and opportunities for technological innovation. One of the primary flaws of the industry that COVID-19 has highlighted is the prevalence of unnecessary and inconvenient patient visits. As health centers across the country have been focused on tackling the pandemic, patients with other conditions have been encouraged to stay home and receive virtual care. Many patients are able to mitigate their existing conditions without time-consuming visits to a clinic. At the same time, this provides an opportunity for a widespread adoption of telehealth services. Many providers have experienced the efficiency of virtual health services and will continue to invest in these solutions. Clinics without such platforms will likely adopt telehealth to address their lack of virtual care services. The pandemic will no doubt leave an enduring mark on the healthcare industry. The lessons learned from the pandemic will surely shift the focus of innovations towards virtual health solutions. 

Talk to us to understand more about Value-Based Care and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

The Importance of Clinical Call Center Nurses in the RPM Care Journey

The emergence of Remote Physiological Monitoring (RPM) has greatly contributed to the rapid adoption of virtual health services. This practice would not be possible without the work of clinical call center nurses, who observe the condition of patients and accordingly make relevant health decisions.  

How does RPM work?

RPM uses technology to track a patient’s vital parameters such as heart rate, blood pressure, weight, etc. This data is recorded by the device and sent to health professionals involved with the patient’s care. The care provider can then make informed decisions on the patient’s health. RPM devices notify the care provider if any abnormal vitals are detected. They also allow patients to receive quality health care from a virtual setting. Effective RPM systems result in higher patient satisfaction while increasing the revenue of care providers.

how does call centers help remote patient monitoring

The role of Call Centers in RPM

Clinical Call Centers play a crucial role in the RPM care journey. RPM devices track a large number of complex metrics relating to the patient’s health. Any data recorded by an RPM device is useless until a qualified health professional is able to analyze it. This is where call center nurses factor into the Care Journey. The RPM device emits data through the provider’s RPM software to the clinical center. Here the data can be received and analyzed by the nurses in charge of the virtual patient care. They can record a patient’s progress and better understand how a patient responds to treatment. If there are any slight deviations from the care plan, nurses can video conference with the patient to identify and address the source of the irregularity. If there are any concerning metrics, the nurses can immediately connect the patient with the necessary professional. 

How RPM help Call Center Nurses

Call Center Nurses may be in charge of monitoring hundreds of patients in a virtual manner. Without a Remote Monitoring option, nurses need to manually contact individual patients. RPM devices can connect with these patients on a daily basis, without constant human interaction. These devices can collect the data of hundreds of patients and send these results to the call center in just a few minutes. RPM also allows patients to track their health from the comfort of their homes-meaning providers are able to turn their attention to their most at-need patients. 

RPM and the COVID-19 Pandemic

The COVID-19 pandemic has heightened the importance of virtual care services like RPM. The pandemic has greatly decreased the healthcare industry’s focus on combating non-COVID related ailments. However, providers with existing RPM mechanisms are benefiting from the ability to monitor health through a virtual platform. In addition, patients who suffer from chronic conditions are still able to receive daily updates on their health. 

Characteristics of a functional RPM platform

The following characteristics can be found among all effective RPM systems:

  1. Reduce Emergency Situations: RPM devices can track any abnormal patterns and immediately report them to a health center. Emergency situations are of increased danger to the health of chronic care patients. RPM devices can provide a timely intervention and allow the patient to receive care before an emergency situation unfolds. 
  2. Reduce Readmissions: An efficient RPM platform can prevent patients from being readmitted for their existing conditions. By tracking the trajectory of the patient’s health, nurses can notify patients when they deviate from their care plan. This helps patients stay on top of their treatment while decreasing the probability that they are readmitted. 
  3. Increased Patient Involvement: The interactive nature of RPM gives patients the opportunity to be more involved in their care. This means patients are more informed on their condition and the treatment plan referred to them. Ultimately a more involved patient increases the likelihood of recovery. 

The increased importance of virtual care has allowed RPM to emerge as a powerful tool in care delivery. The proper use of these technologies greatly enhances the convenience and effectiveness of health care.

Schedule a demo and learn how HealthViewX is transforming the Care Journey for both patients and providers!

Technology’s Role in the Shift Towards Value-Based Care

Value-Based Care is an increasingly popular healthcare model in which providers receive reimbursement that reflects the outcome of the patient. This concept emphasizes the importance of improved patient health and accordingly benefits providers who are able to deliver to their patients. The traditional “Fee-For-Service” model which involves flat rate payments irrespective of patient outcomes or care quality has grown out of favor. 

The move away from a purely profit-focused model and towards a patient-centric model highlights the trend of developments in the US healthcare industry. This seismic shift towards Value-Based Care is not possible without some of the modern health tech innovations which are at the forefront of the movement. 

The move towards Value-Based Care

For quite some time, the healthcare industry was known as a purely profit-based industry. In order to shift the care focus towards the patient outcome, the Centers for Medicare & Medicaid Services (CMS) has laid the groundwork for various Federal Acts that incentivize providers who adopt a value-based model. The most notable of these was the 2010 Affordable Care Act (ACA). This aligns with the “Triple Aim” framework promoted by the CMS:

Triple Aim framework promoted by the CMS

The increase in concrete support from the Federal Government influenced many providers in shifting to a Value-Based model. 

Why Value-Based Care?

The attractiveness of the Value-Based structure can be attributed to its numerous benefits for both patients and providers. This model is highly popular amongst patients as it highlights provider accountability for the outcome of their care. Patients can achieve peace of mind knowing that the improvement of their health is the primary goal. 

For providers, this model offers a larger patient outreach while handing out incentives for better performance. The increased use of technology has helped practices use reliable data to make informed business decisions. While this structure is inherently appealing for all parties involved, the advancement of technology has fueled its widespread acceptance. 

Achieving Value-Based Care through Enhanced Care Journey Mapping

Enhanced Care Journey Mapping involves the tracking of patient activities throughout their care process. It is used to conceptualize the process and eliminate any tedious or redundant tasks. Journey Mapping is a prime example of Value-Based care as it seeks to improve patient outcomes. Providers can identify areas where patients face inconvenience and take measures to address them. By analyzing the overall care journey, providers can optimize the patient experience.

What technology solutions are involved?

The large-scale move to a Value-Based Care model has been made possible by the following solutions:

    • Telehealth: Telehealth involves the exchange of virtual health services (such as video conferencing) using an electronic platform. The emergence of telehealth software has given patients high accessibility to quality care. Providers can open a new revenue stream while staying up-to-date with their patients, even when a physical meeting is not possible. 
    • Remote Patient Monitoring: Remote Patient Monitoring (RPM) is a healthcare practice that uses technology to monitor patients in a virtual manner. RPM allows patients to monitor their health daily and encourages them to be more involved with their care. The adoption of RPM services can be directly attributed to a decrease in readmission rates. RPM gives providers valuable insights into the patient’s current condition.
    • Chronic Care Management: Chronic Care Management (CCM) involves the facilitation of patients suffering from two or more chronic conditions. Virtual health software services have greatly improved the quality of CCM. Providers save time and money by using these services to connect with their chronic care patients. Patients with chronic conditions can eliminate unnecessary clinic visits and receive timely health feedback from the convenience of their homes.  
    • Referral Management: Providers have increasingly adopted software systems that streamline their patient referrals. Patients can expect increased efficiency while not having to worry about documentation and processing issues. This has greatly decreased referral leakage which can cost individual practices millions of dollars each year. 

Challenges in shifting to a Value-Based Model

While providers across the nation have welcomed the value-based model, some significant obstacles remain before it becomes the industry standard. 

  • Technological Disparities: Many practices do not have the necessary tech infrastructure to operate a value-based model. Many practices lack programs like RPM and EHR Integration, which are integral to the operability of the model.
  • Government Support: While the CMS has supported many value-based initiatives, it remains to be seen how the Federal Government will include all patients and providers under the triple aim
  • Financial Risk: This shift, like any large financial investment, comes with a moderate level of risk. Many smaller practices cannot afford to gamble on a move that may not pan out.  

Nonetheless, the Value-Based model has shown great promise in bringing change to provider-patient relationships. The response to these issues will determine the success of the model in the long run. 

Talk to us to understand more about Value-Based Care and we will guide you to achieve our common goal “Quality Care for All” seamlessly. 

How Can Price Transparency Impact The Healthcare Industry?

Patient financial responsibility is the greatest challenge of healthcare industry. For a long time, healthcare experts have argued that price transparency will help patients in making informed healthcare decisions thereby decreasing healthcare costs.

In August 2018, CMS stated in its updates to the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH PPS) final rules that price transparency will become a nationwide industry standard.

With effect from January 1, 2019, hospitals across the country are responsible for full price transparency. As per the IPPS and LTCH PPS rules, hospitals must list their prices online in a “machine-readable format.”

CMS approach to enforcing price transparency

Previously, hospitals were required to make their prices publicly available, but not necessarily in a digital format. In the new rule, CMS has mandated that these new price transparency resources be in a machine-readable format. CMS analyzed public comments on the most efficient way to achieve this. Finally, CMS called on all hospitals to list their chargemaster prices on a publicly-available Excel spreadsheet. The searchable spreadsheet will make it easier for patients to use.

Hiccups in the existing approach by CMS

Many questions have been raised about this approach.

  • Critics claim that charge master prices are not ideal for patients. Between insurance, subsidies, and other payment design, patients usually pay less than chargemaster price.
  • The feasibility of an Excel spreadsheet having all prices is a big question.
  • As more organizations publish their price transparency lists, more difficulties may come to light.

How can price transparency help patients?

  • Digital price transparency will enable patients to more easily access this information.
  • Price transparency will enable patients to make more informed decisions about care access that minimize their out-of-pocket costs and total expenditures borne by Medicare and Medicaid.
  • Increased price transparency will improve the patient experience of care.
  • Although price transparency itself cannot lower healthcare costs, but it may create market pressure that in turn lowers patient costs.
  • Additionally, price transparency will allow patients to choose the best care option for their needs.

The healthcare industry is still debating about the efficacy of price transparency. Healthcare price transparency tools have already made their mark in the healthcare industry. Do such tools improve patient experiences with healthcare or cut costs? How can organizations reconfigure these tools to increase its effectiveness?

Can price transparency reduce healthcare costs?

According to a 2016 study published in Health Affairs, it was found that price transparency tool actually increased out-of-pocket outpatient spending by about $59 per patient. The researchers suggested that it must must have been due to low patient awareness or perceived need of the tool.

Moreover, cost compare tools did not show many meaningful areas for cost savings.

Other studies have also shown similar results. A 2017 report by the American Journal of Managed Care found that though patients liked the idea of a cost comparison tool, they saw little use of the tool. They either forgot to use the tool before seeking care or did not see any use because they were already beyond their deductible or saw consistent copayments at their doctor’s office.It also touched on the idea of patient loyalty. Although patients could use price transparency tools to find a less expensive care option of equal quality, a sense of loyalty kept them going to their current clinicians.

Payers who offer price transparency tools have also had little luck with the tools. A 2017 report published by Health Affairs found that although scanning a cost compare website could result in 14% cost cuts for imaging services, only 1% of patients actually use the tool, making it of little use.

What do industry professionals say?

Although price transparency tools are not currently impacting the rising healthcare costs, these tools still have the potential to reduce spending and improve patient experience.

If properly utilized, cost compare technology should help patients cut their own healthcare spending because they know the lower-cost providers to visit. Patients with access to a price transparency tool have the opportunity to compare cost and quality and make their preferred treatment selection based on that data. Ideally, this will lead patients to a lower-cost option.

Clinics have little incentive to lower their costs when patients do not know how much they’ll pay before they receive the service. But if all clinics knew patients were visiting a high-quality facility with substantially lower costs, area competitors could be forced to change their prices, as well.

How can organizations make price transparency work?

Making price transparency tools that are attractive and usable for patients will be critical for delivering on the promise of cost compare. Simply offering a price transparency tool will not lower costs. Patients must actually use these systems to select lower-cost care.

As the healthcare industry continues to place more financial burden on patients, it will need to adopt strategies that help patients. High copay and high-deductible health plans have put patients in the role of the healthcare consumer. Price transparency tools are a key retail-style engagement strategy that will help consumers make better decisions about where to access care.

But in order to make those price transparency tools effective, industry leaders must keep the patient at the center of their design. Making a usable cost compare tool that uses simple language and factors in metrics that are important to patients will be integral going forward.

 

Reference

https://patientengagementhit.com/news/myhealthedata-patients-over-paperwork-key-in-cms-final-rules

https://jamanetwork.com/journals/jama/fullarticle/2518264

https://patientengagementhit.com/news/price-transparency-tools-receive-tepid-patient-reactions

https://patientengagementhit.com/news/4-patient-engagement-strategies-to-improve-patient-retention

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1636

Why do Federally Qualified Health Centers need a Referral Management Software In Addition To An EMR?

Patient Referral Management is crucial for Federally Qualified Health Centers (FQHCs). With the advent of the Patient Protection and Affordable Healthcare Act, Electronic Health Records have been widely adopted across many FQHCs. There are many benefits to EHRs like improved,

  • Accessibility to patient data
  • Charge capture
  • Preventative health

Let us look into each of them in detail to understand an EMR/EHR implementation better.

Pros of EHR/EMR

1. Improved data accessibility

Before EHRs, access to medical charts required a fair amount of physical labor. For example, every time a patient visits the physician’s clinic or hospital, physician physically pulls their file from a storage space. As a result of this back and forth exchange, there was a greater chance of human error and charts would sometimes be missing information or be chronologically out-of-order.

EHRs, on the other hand, have eliminated the physical transporting, sifting and filing charts, making data available at all times. Additionally, for systems that allow remote access to charts, clinicians can even be offsite and still securely access patient files.

2. Computerized physician order entry

CPOE allows physicians to place lab and imaging orders, prescriptions and other notes electronically. This reduces the error of handwritten orders and allows the patient’s other physicians within the same network access to the order.

3.Preventative health

EHRs allow prompts for preventative health screenings. During routine doctor or urgent care visits, the physician has access to preventive health records conveniently in one place. If the patient is due for a cancer screening (such as mammogram or colonoscopy), or blood pressure testing, the referral coordinator can easily look this up via the EHR system and schedule an appointment for the patient.

4. Ease sign off for PAs and NPs

While this varies from state-to-state by law, physician assistants and nurse practitioners are typically required to have their notes approved and signed off on by their supervising physician. EHRs allow the revision and cosigning of notes to happen electronically as opposed to physically moving and signing the paper.

5. e-messaging between providers

As any referral coordinator can attest referral information, telephone tag between providers can be common and is a big time-waster. With EHR software, physicians can e-message across practices. One situation that benefits in particular from e-messaging is referrals. Rather than playing telephone tag to get an appointment scheduled, the physician electronically sends a message to schedule the appointment.

How can a Patient Referral Management Referral Management work in cohesion with an EMR/EHR system?

FQHCs prefer working with EMR/EHR systems because they are comfortable with it. So they do not wish to move out their EHR/EMR system. 

How great it would be if a Patient Referral Management software could integrate seamlessly with an EMR/EHR system? It can help in ensuring end-to-end Patient Referral Management without disturbing the existing system.

An EHR/EMR system has many advantages but when it is complemented with a Referral Management software practices can experience many more benefits.

HealthViewX Patient Referral Management solution provides easy steps to integrate with a practice’s EMR/EHR system. The patient demographics, diagnostic reports, test results or any sensitive information can be transferred safely. The solution is HIPAA-compliant with complete data security. It has the following features,

  1. Outbound Referrals – HealthViewX Referral Management Solution can integrate with both the receiving and referring end. For inbound referrals, it helps in channelizing various sources into one single queue. In case of outbound referrals, it facilitates integration with the existing system to read the patient data and send out referrals.
  2. Referral Timeline – In HealthViewX Referral Management System, any referral has a timeline, to capture and notify the progress of the referral to all the stakeholders. A referral will be mapped to a status which helps in tracking it better. For e.g. – If a patient does not show up for the appointment, the status of the referral can be changed to no-show and an appropriate reason can also be given. With the help of a referral timeline, the providers can always be aware of what is going on with the referral.
  3. Workflow and Task Management – A workflow can be defined on how the referral flow must be(business rules). Providers can create tasks to manage referrals by assigning it to the respective person.
  4. Improved communication – HealthViewX Referral Management Solution supports messaging and calling features for the referring and the receiving providers to stay connected.
  5. Data Management – The solution is HIPAA compliant and enables secure data exchange of all patient-related documents.
  6. Seamless Integration – The solution can seamlessly integrate with any EMR/EHR/RIS or Third Party application thus providing minimal disruption in the existing referral flow.
  7. Referral History Consolidation – The consolidated data regarding the referrals and the referral history of any patient can be printed as a hard copy at any time in pdf/excel.
  8. Smart Search – HealthViewX Referral Management solution has a smart search facility that helps in finding the right provider for the treatment required.
  9. Referral Data Analytics – Referral data-centric dashboard gives complete data regarding the number of referrals flowing out, the number of referrals in various status, patient follow-ups, etc.

HealthViewX Referral Management solution helps in building a secure referral network in no time. Our expert team will guide you in changing to a Patient Referral Management Software with minimal effort. Schedule a demo with us to know more about our solution.

 

 

Reference

University of California—Davis. “UC Davis study finds e-medical records have varying effects on productivity.” Dec. 2010. http://www.news.ucdavis.edu/search/news_detail.lasso?id=966