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The Healthcare AI Future, From Google’s DeepMind

Posted on February 22, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

While much of its promise is still emerging, it’s hard to argue that AI has arrived in the health IT world. As I’ve written in a previous article, AI can already be used to mine EMR data in a sophisticated way, at least if you understand its limitations. It also seems poised to help providers predict the incidence and progress of diseases like congestive heart failure. And of course, there are scores of companies working on other AI-based healthcare projects. It’s all heady stuff.

Given AI’s potential, I was excited – though not surprised – to see that world-spanning Google has a dog in this fight. Google, which acquired British AI firm DeepMind Technologies a few years ago, is working on its own AI-based healthcare solutions. And while there’s no assurance that DeepMind knows things that its competitors don’t, its status as part of the world’s biggest data collector certainly comes with some advantages.

According to the New Scientist, DeepMind has begun working with the Royal Free London NHS Foundation Trust, which oversees three hospitals. DeepMind has announced a five-year agreement with the trust, in which it will give it access to patient data. The Google-owned tech firm is using that data to develop and roll out its healthcare app, which is called Streams.

Streams is designed to help providers kick out alerts about a patient’s condition to the cellphone used by the doctor or nurse working with them, in the form of a news notification. At the outset, Streams will be used to find patients at risk of kidney problems, but over the term of the five-year agreement, the developers are likely to add other functions to the app, such as patient care coordination and detection of blood poisoning.

Streams will deliver its news to iPhones via push notifications, reminders or alerts. At present, given its focus on acute kidney injury, it will focus on processing information from key metrics like blood tests, patient observations and histories, then shoot a notice about any anomalies it finds to a clinician.

This is all part of an ongoing success story for DeepMind, which made quite a splash in 2016. For example, last year its AlphaGo program actually beat the world champion at Go, a 2,500-year-old strategy game invented in China which is still played today. DeepMind also achieved what it terms “the world’s most life-like speech synthesis” by creating raw waveforms. And that’s just a couple of examples of its prowess.

Oh, and did I mention – in an achievement that puts it in the “super-smart kid you love to hate” category – that DeepMind has seen three papers appear in prestigious journal Nature in less than two years? It’s nothing you wouldn’t expect from the brilliant minds at Google, which can afford the world’s biggest talents. But it’s still a bit intimidating.

In any event, if you haven’t heard of the company yet (and I admit I hadn’t) I’m confident you will soon. While the DeepMind team isn’t the only group of geniuses working on AI in healthcare, it can’t help but benefit immensely from being part of Google, which has not only unimaginable data sources but world-beating computing power at hand. If it can be done, they’re going to do it.

E-Patient Update: Hey Government, Train Patients Too!

Posted on February 10, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Recently I got a most interesting email from the ONC and A-list healthcare educator Columbia University. In the message, it offered me a free online course taught by Columbia’s Department of Biomedical Informatics, apparently paid for by ONC funding. (Unfortunately, they aren’t giving away free toasters to students, or I definitely would have signed up. No wait, I’m sorry, I did register, but I would have done it faster for the toaster.)

The course, which is named Health Informatics For Innovation, Value and Enrichment) or HI-FIVE, is designed to serve just about anyone in healthcare, including administrators, managers, physicians, nurses, social workers an care coordinators. Subjects covered by the course include all of the usual favorites, including healthcare data analytics, population health, care coordination and interoperability, value-based care and patient-centered care.

If I seem somewhat flippant, it’s just because the marketing material seemed a little…uh…breathlessly cheery and cute given the subject. I can certainly see the benefits of offering such a course at no cost, especially for those professionals (such as social workers) unlikely to be offered a broader look at health IT issues.

On the other hand, I’d argue that there’s another group which needs this kind of training more – and that’s consumers like myself. While I might be well-informed on these subjects, due to my geeky HIT obsession, my friends and family aren’t. And while most of the professionals served by the course will get at least some exposure to these topics on the job, my mother, my sister and my best girlfriend have essentially zero chance of finding consumer-friendly information on using health IT.

Go where the need is

As those who follow this column know, I’ve previously argued hard for hospitals and medical groups to offer patients training on health IT basics, particularly on how to take advantage of their portal. But given that my advice seems to be falling on deaf ears – imagine that! – it occurs to me that a government agency like ONC should step in and help. If closing important knowledge gaps is important to our industry, why not this particular gap. Hey, go where the need is greatest.

After all, as I’ve noted time and again, we do want patients to understand consumer health IT and how to reap its benefits, as this may help them improve their health. But if you want engagement, folks, people have to understand what you’re talking about and why it matters. As things stand, my sense is that few people outside the #healthit bubble have the faintest idea of what we’re talking about (and wouldn’t really want to know either).

What would a consumer-oriented ONC course cover? Well, I’m sure the authorities can figure that out, but I’m sure education on portal use, reading medical data, telemedicine, remote monitoring, mobile apps and wearables wouldn’t come amiss. Honestly, it almost doesn’t matter how much the course would cover – the key here would be to get people interested and comfortable.

The biggest problem I can see here is getting consumers to actually show up for these courses, which will probably seem threatening to some. It may not be easy to provoke their interest, particularly if they’re technophobic generally. But there’s plenty of consumer marketing techniques that course creators could use to get the job done, particularly if you’re giving your product away. (If all else fails, the toaster giveaway might work.)

If providers don’t feel equipped to educate patients, I hope that someone does, sometime soon, preferably a neutral body like ONC rather than a self-interested vendor. It’s more than time.

Switching Out EMRs For Broad-Based HIT Platforms

Posted on February 8, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I’ve always enjoyed reading HISTalk, and today was no exception. This time, I came across a piece by a vendor-affiliated physician arguing that it’s time for providers to shift from isolated EMRs to broader, componentized health IT platforms. The piece, by Excelicare chief medical officer Toby Samo, MD, clearly serves his employer’s interests, but I still found the points he made to be worth discussing.

In his column, he notes that broad technical platforms, like those managed by Uber and Airbnb, have played a unique role in the industries they serve. And he contends that healthcare players would benefit from this approach. He envisions a kind of exchange allowing the use of multiple components by varied healthcare organizations, which could bring new relationships and possibilities.

“A platform is not just a technology,” he writes, “but also ‘a new business model that uses technology to connect people, organizations and resources in an interactive ecosystem.’”

He offers a long list of characteristics such a platform might have, including that it:

* Relies on apps and modules which can be reused to support varied projects and workflows
* Allows users to access workflows on smartphones and tablets as well as traditional PCs
* Presents the results of big data analytics processes in an accessible manner
* Includes an engine which allows clients to change workflows easily
* Lets users with proper security authorization to change templates and workflows on the fly
* Helps users identify, prioritize and address tasks
* Offers access to high-end clinical decision support tools, including artificial intelligence
* Provides a clean, easy-to-use interface validated by user experience experts

Now, the idea of shared, component-friendly platforms is not new. One example comes from the Healthcare Services Platform Consortium, which as of last August was working on a services-oriented architecture platform which will support a marketplace for interoperable healthcare applications. The HSPC offering will allow multiple providers to deliver different parts of a solution set rather than each having to develop their own complete solution. This is just one of what seem like scores of similar initiatives.

Excelicare, for its part, offers a cloud-based platform housing a clinical data repository. The company says its platform lets providers construct a patient-specific longitudinal health record on the fly by mining existing EHRs claims repositories and other data. This certainly seems like an interesting idea.

In all candor, my instinct is that these platforms need to be created by a neutral third party – such as travel information network SABRE – rather than connecting providers via a proprietary platform created by companies like Excelicare. Admittedly, I don’t have a deep understanding of Excelicare’s technology works, or how open its platform is, but I doubt it would be viable financially if it didn’t attempt to lock providers into its proprietary technology.

On the other hand, with no one interoperability approach having gained an unbeatable lead, one never knows what’s possible. Kudos to Samo and his colleagues for making an effort to advance the conversation around data sharing and collaboration.

Healthcare Trade Groups Join To Evaluate mHealth Apps

Posted on December 29, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A group of leading healthcare organizations, including HIMSS, the American Medical Association, the American Heart Association and DHX Group, have come together to evaluate mHealth apps. The new organization, which calls itself Xcertia, says members came together to foster knowledge about clinical content, usability, privacy, security and evidence of efficacy for such apps.

It’s hardly surprising that that healthcare groups would want to take a stand on the issue of health app quality. According to a study published late last year by the IMS Institute for Healthcare Informatics, there are at least 165,000 mHealth apps available on the iTunes and Android stores.

But what percentage of those apps are worth using? Nobody really knows. It’s hard to tell after casual use which apps are useful and which don’t live up to their hype, which protect patient privacy and which leave data open to prying eyes, and particularly, which offer some form of clinical benefit and which just waste people’s time. And without a set of formal standards by which to judge, it’s very hard to compare one with the other in a meaningful way.

This uncertainty is holding back mHealth adoption by doctors. According to a recent survey by the AMA, physicians are interested in using apps and related tools – in fact, 85% told researches that digital health solutions can have a positive impact on patient care – they’re also reluctant to “prescribe” apps until they understand them better. (There’s also a group of doctors I’ve encountered who say that until mobile apps are FDA-approved, they won’t take them seriously, but that may be another story.)

In late November, attendees at a recent AMA meeting moved the mHealth puck up the ice a little bit, adopting a set of proposed set best principles for mobile health design. The criteria they adopted for mobile apps and devices included that they should follow evidence-based practice guidelines, support data portability and interoperability, and have a clinical evidence base to support their use. But these guidelines are hardly specific enough to help doctors decide which apps to adopt.

So far, all Xcertia is willing to say about its plans is that it plans to develop a framework of principles that will “positively impact the trajectory of the mobile health app industry.” The guidelines should help both consumers and clinicians choose mHealth apps, the group reports.

Let’s hope those guidelines are less ho-hum than those coming out of the AMA meeting – after all, it certainly would be good if developers and providers had concrete standards upon which they could base their app efforts.

American Well Deal Adds Remote Physical Exams To Its Offerings

Posted on December 9, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Telehealth provider American Well has partnered with a vendor allowing patients to conduct and transfer data from their own basic physical exam during telemedical consults.

The partner, TytoCare, offers an “examination platform” allowing patients to do their own medical examination of the heart, lungs, abdomen, ears, throat, skin and temperature at home, then share the information with the clinician before or during their virtual visit.

Tyto’s consumer platform TytoHome, which is priced at $299, combines a digital stethoscope, otoscope, thermometer and examination camera. The company also offers a model, TytoPro, designed for professional use, which offers extended battery life, a headset for listening to heart and lung sounds, initial set of disposables for the otoscope and tongue depressor, and software designed specifically for clinician use. The company doesn’t say what the Pro technology costs.

Tyto’s software platform, meanwhile, offers cloud-based secure digital exchange of clinical data and a clinical repository. The company says it can integrate with most EHR systems as part of its TytoLink integration services. It doesn’t say what those integration services will cost, but it seems likely that they don’t come free.

At least at the outset, the partners plan to deliver services to health systems and employers, but without a doubt plans to scale beyond this. And they’re likely to have the resources to do so. American Well has established a foothold in telemedicine, while Tyto Care has received over $19 million in funding to date from investors that include Walgreens.

It’s worth noting at this point that TytoCare is far from the only player in the market offering remote examination tools. For example, I’m familiar with at least one vendor, MedWand Digital Health, offering a similar bundle of remote examination technologies. The MedWand platform lets consumers measure their heart rate or pulse or pulse ox level, listen to their heart, lungs or abdomen, look into their mouth, throat and ears, examine their skin and take the temperature. It can also integrate with other remote monitoring tools, such as connected glucometers of blood pressure monitors. It sells for $249.

And MedWand, like TytoCare, has venture backing, in this case from a technical partner. The company recently received a “major” investment from the venture arm for Maxim Integrated Products, which designs, manufactures and sells semiconductor products.

In my opinion, however, American Well may have a meaningful advantage over other competitors, as it appears to have fairly strong connections with health plans and health systems. The telehealth vendor has partnerships with more than 170 health plans and systems, and has created an enterprise telehealth platform designed to connect with providers’ clinical information systems.

While a company like MedWand may be better position to scale up a consumer technology offering — given backing by a semiconductor maker — over the near term I’d argue that better to be on good terms with those delivering and financing care. Right now, my guess is that very few consumers are willing to sink almost $300 into a home telehealth platform, even if they occasionally use telemedicine services, but this seems little doubt that health systems and health plans see the value of offering such services in a sophisticated way.

If I were either of these companies — or one of their competitors — I’d try to employers, health plans and health systems to buy and place the devices in the homes of chronically ill or high risk patients. But I don’t know if that’s in their plans. Let’s see how the next 12 months go.

Advice On Winning Attention For Digital Health Solutions

Posted on December 7, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Some of you reading this are probably involved with a digital health startup to one degree or another. If so, you’ve probably seen firsthand how difficult it can be to get attention for your solution, no matter how sophisticated it is or how qualified its creators are. In fact, given the fevered pace of digital health’s evolution, you may be facing worse than typical Silicon Valley odds.

That being said, there are strategies for standing out even in this exploding market, according to participants at a recent event dedicated to getting beyond health tech hype. The event, which was written up by health tech startup incubator Rock Health, featured experts from Dignity Health, Humana, Kaiser Permanente and Evidation Health.

Generally speaking, the panelists from these organizations spelled out how health tech startups can make more convincing pitches, largely by providing more robust forms of evidence:

  • They said that standard metrics demonstrating the effectiveness of your solutions — such as randomized trials and evidence-based reviews — probably weren’t enough, as they sometimes don’t translate to real-world results. Instead, what they’d like to see is the product “used under some stress or duress and how it’s received by caregivers, members, patients and their families,” said Dr. Scott Young, who serves as executive director and senior medical director of Kaiser Permanente’s Care Management Institute.
  • They want you to produce “softer feedback” such as stories and testimonials directly from customers and users. “So many solutions claim to do the same thing,” said Karen Lee, innovation and strategic partnerships leader at Humana. “This softer feedback allows us to really get a feel for that experience and whether or not it’s effective.”
  • They expect you to be able to nail down how your product meets their strategic objectives, and can help them achieve the specific outcomes they have in mind. If you can’t do that, though just reach out to someone who can.
  • They want to bear in mind that even if they’re quite interested in what you’re doing, there’s typically a lot of politics to navigate before they can the pilot with your technology, much less implement fully. “Beyond the evidence, a successful pilot, and research, there are some complexities that you have to be patient and working through,” says Lee.
  • Perhaps most importantly, they need to know that you’ve kept the patient in mind. “The patient needs to know how to use [your technology], and should be using it,” said Dr. Manoja Lecamwasam, executive director of intellectual property and strategic innovations at Dignity Health. “You have to first build that foundation – look at it there, and a lot of people want to talk to you.”

At this point, readers, I realize some of you are probably feeling frustrated, as it may seem that many potential digital health adopters have set the bar for adoption very high, even once you’ve proven that your solution works by most conventional methods. Still, it doesn’t hurt to get an idea of how the “other side” thinks.

AMA Approves List Of Best Principles For Mobile Health App Design

Posted on November 29, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

The American Medical Association has effectively thrown her weight behind the use of mobile health applications, at least if those apps meet the criteria members agreed on at a recent AMA meeting. That being said, the group also argues that the industry needs to expand the evidence base demonstrating that apps are accurate, effective, safe and secure. The principles, which were approved at its recent Interim Meeting, are intended to guide coverage and payment policies supporting the use of mHealth apps.

The AMA attendees agreed on the following principles, which are intended to guide the use of not only mobile health apps but also associated devices, trackers and sensors by patients, physicians and others. They require that mobile apps and devices meet the following somewhat predictable criteria:

  • Supporting the establishment or continuation of a valid patient-physician relationship
  • Having a clinical evidence base to support their use in order to ensure mHealth apps safety and effectiveness
  • Following evidence-based practice guidelines, to the degree they are available, to ensure patient safety, quality of care and positive health outcomes
  • Supporting data portability and interoperability in order to promote care coordination through medical home and accountable care models
  • Abiding by state licensure laws and state medical practice laws and requirements in the state in which the patient receives services facilitated by the app
  • Requiring that physicians and other health practitioners delivering services through the app be licensed in the state where the patient receives services, or will be providing these services is otherwise authorized by that state’s medical board
  • Ensuring that the delivery of any service via the app is consistent with the state scope of practice laws

In addition to laying out these principles, the AMA also looked at legal issues physicians might face in using mHealth apps. And that’s where things got interesting.

For one thing, the AMA argues that it’s at least partially on a physician’s head to school patients on how secure and private a given app may be (or fail to be). That implies that your average physician will probably have to become more aware of how well a range of apps handle such issues, something I doubt most have studied to date.

The AMA also charges physicians to become aware of whether mHealth apps and associated devices, trackers and sensors are abiding by all applicable privacy and security laws. In fact, according to the new policy, doctors are supposed to consult with an attorney if they don’t know whether mobile health apps meet federal or state privacy and security laws. That warning, while doubtless prudent, must not be helping members sleep at night.

Finally, the AMA notes that there are still questions remaining as to what risks physicians face who use, recommend or prescribe mobile apps. I have little doubt that they are right about this.

Just think of the malpractice lawsuit possibilities. Is the doctor liable because they relied on inaccurate app results collected by the patient? If the app they recommended presented inaccurate results? How about if the app was created by the practice or health system for which they work? What about if the physician relied on inaccurate data generated by a sensor or wearable — is a physician liable or the device manufacturer? If I can come up with these questions, you know a plaintiff’s attorney can do a lot better.

E-Patient Update: Time To Share EMR Data With Apps

Posted on November 18, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Like most Americans, I’ve used many a health-related app, in categories including vitals tracking, weight control, sleep management, medication management and exercise tracking. While I’ve continued to use a few, I’ve dropped most after a few uses because they didn’t contribute anything to my life.

Now, those of you who are reading this might assume that I lost interest in the apps because they were poorly designed. I admit that this was true in some cases. But in others, I’ve ceased to use the apps because the data they collect and display hasn’t been terribly useful, as most of it lives in a vacuum. Sure, I might be able to create line graph of my heart rate or pulse ox level, but that’s mildly interesting at best. (I doubt physicians would find it terribly interesting either.)

That being said, I believe there is a way healthcare organizations can make the app experience more useful. I’d argue that hospitals and clinics, as well as other organizations caring for patients, need to connect with major app developers and synch their data with those platforms. If done right, the addition of outside data would enrich the patient experience dramatically, and hopefully, provide more targeted feedback that would help shape their health behaviors.

How it would work

How would this work? Here’s an example from my own life, as an e-patient who digitally manages a handful of chronic, sometimes-complex conditions.

I have tested a handful of medication management apps, whose interfaces were quite different but whose goals seem to be quite similar — the primary one being to track the date and time each medicine on my regimen was taken. In each case, I could access my med compliance history rather easily, but had no information on what results my level of compliance might have accomplished.

However, if I could have overlaid those compliance results with changes in my med regimen, changes in my vital signs and changes in my lab values, I have a better picture of how all of my health efforts fit together. Such a picture would be far more likely to prompt changes in my health behavior than uncontextualized data points based on my self-report alone.

I should mention that I know of at least one medication management app developer (the inspiration for this essay) which hopes to accomplish just this result already, and is hard at work enriching its platform to make such integration possible. In other words, developers may not need much convincing to come on board.

The benefits of added data

“Yes,” I hear you saying, “but why should I share my proprietary data?” The answer is fairly simple; in the world of value-based reimbursement, you need patients to get and stay well, and helping them better manage their health fits this goal.

Admittedly, achieving this level of synchronization between apps and provider data won’t be simple. However, my guess is that it would be easier for app developers to import, say, pharmacy or EMR data than the other way around. After all, app platforms aren’t at the center of nearly as many overlapping data systems as a health organization or even a clinic. While they might not be starting from zero, they have less bridges to build.

And once providers have synchronized key data with app developers, they might be able to forge long-term partnerships in which each side learned from the exchange. After all, I’d submit that few app developers would turn up the chance to make their data more valuable — at least if they have bigger goals than displaying a few dots on a smartphone screen.

I realize that for many providers, doing this might be a tall order, as they can’t lose their focus on cultivating their own data. But as a patient, I’d welcome working with any provider that wanted to give this a try. I think it would be a real win-win.

Portals May Not Reduce Calls To Medical Practices

Posted on November 16, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Initially, patient portals were rolled out to give patients access to their core medical information, with the hope that a more educated patient would be more likely to take care of their health. Over time, features like appointment setting and the ability to direct-email providers were added, with some backers predicting that they would make practices more efficient. And since providers began rolling out nifty new interactive portals, anecdotes have piled up suggesting that they are delivering the goods.

However, a new study suggests that this might not be the case — or at least not always. The researchers behind the study, published in the Journal of the American Board of Family Medicine, had predicted that when patients got access to a full-featured portal, clinic staffers’ workload would be cut. But they did not achieve the results they had expected.

The researchers, who were from the Oregon Health & Science University in Portland, compared portal adoption rates and the number of telephone calls received at four clinics affiliated with a university hospital between February and June 2014.

They found that despite growing adoption rates of the portal at all four clinics, call volumes actually increased at two of the clinics, which included a commercial, community-based health center and a university-based health center. Meanwhile, call volume stayed level at the two other clinics, a rural health center and a federally-qualified health center. In other words, in no case did the volume of phone calls fall.

The researchers attempted to explain the results by noting that it might take a longer time than the study embraced for the clinics to see portals reduce their workload. Also, they suggested that while the portal didn’t seem to reduce calls, it might be offering less-concrete benefits such as increased patient satisfaction.

What’s more, they said, the study results might have been impacted by the fact that all four clinics were implementing a patient centered medical home model. They seemed to think that PCMH requirements for care coordination and quality improvement initiatives for chronic illness, routine screenings and vaccinations might have increased the complexity of the patients’ needs and encouraged them to phone in for help.

As I have noted previously, patients seldom see your portal the way you do. In that previous article, I described my largely positive — but still somewhat vexing – experience using the Epic MyChart portal as a patient. In that case, while I could access all of the data held within the health system behind the EMR pretty easily, getting the health system employees to integrate outside data was a hassle and a half.

In the case described in the study, it sounds like the portal may not have been designed with patient workflow in mind. With the practices rolling out a patient-centered medical home model, the portal would have to support patients in activities that went well beyond standard appointment setting and even email exchanges with clinicians. And presumably, it didn’t.

Bottom line, I think it’s good that this research has led to questions about whether portals actually make make medical practices more efficient. While there is plenty of anecdotal evidence suggesting that they do — so much that investing in portals still makes sense — it’s good to see questions about their benefits looked at with some rigor.

Healthcare Orgs Must Do Better With Mobile Data Security Education

Posted on November 15, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new study finds that while most healthcare professionals use mobile messaging at work, many aren’t sure what their organization’s mobile messaging policies are, and a large number have transmitted Protected Health Information via insecure channels. In other words, it seems that health IT leaders still have a lot of work to do in locking down these channels.

According to a report by Scrypt, 65% of health professionals who use a mobile device at work also use the same device for personal use, the standard BYOD compromise which still gives healthcare CIOs the willies. Underscoring the security risks, 52% of respondents said that they had free reign over which applications they downloaded and used at work.

To be fair, virtually all respondents (96%) use at least one security method to protect the security of their mobile device. However, their one-factor efforts — usually passcode or PIN-based — may not be secure enough to protect such sensitive data.

The research also blows the whistle on the frequency with which health professionals share PHI using a mobile messaging clients (not surprisingly given that the vendor sells a secure mobile messaging solution). It notes that just a quarter of those who reported using mobile messages use a secure client, and that one in five have sent or received PHI via mobile message with names (24%), telephone numbers (19%) and email addresses (13%) included in the content.

Researchers found that 78% of healthcare professionals use mobile messaging at work. However, few understand how their organizations expect them to use these services. Fifty-two percent of respondents who use mobile messaging said they didn’t know or weren’t sure of what their organization’s policies were on the subject.

Showing some awareness of data security vulnerabilities, 56% of the survey respondents said they believe the organization could do more to educate employees on the rules around sharing PHI and HIPAA compliance. On the other hand, it seems like most consider this to be everybody else’s problem, as 80% of respondents reported that their own knowledge of HIPAA compliance was either good or very good.

Clearly, as self-serving as the vendor’s conclusion is, they’re onto something important. Not only are CIOs facing huge challenges in establishing a smart BYOD policy, they’re confronted with a major educational problem when it comes to sharing of PHI. While the professionals on their team may have been handed a mobile policy, they may not have absorbed it. And if they haven’t been given a policy, you have to be conservative and assume they’re not doing a great job protecting data on their own.

If nothing else, healthcare organizations can remind their staff members to be careful when texting at work – heck, why not text them the reminder so it’s in context? Bottom line, even highly intelligent and educated team members can succumb to habit and transmit PHI. So a nudge never hurts!