Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

E-Patient Update: Video Visits Need EMR Support

Posted on July 11, 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.

From what I’ve read, many providers would like to deliver telemedicine consults through their EMR platform. This makes sense, as doing so would probably include the ability to document such visits in the same way as face-to-face encounters. It would also make it far easier to merge notes from telehealth visits into existing records of traditional care.

Unfortunately, there’s little reason to believe that this will be possible anytime soon. If nothing else, vendors won’t face too much pressure from providers until the health insurers routinely pay for such care. Or one could argue that until providers are living on value-based care models, they have little incentive to aggressively push care to lower-cost channels like telemedicine. Either way, EMR vendors aren’t likely to focus on this issue in the near term.

But I’d argue that providers have strong reasons to add EMR support to their telemedicine efforts. If they don’t take the bull by the horns now, and train patients to see video visits as legitimate and worthwhile, they are unlikely to leverage telehealth fully when it becomes central to the delivery of care. And that means, in part, that providers must document video consults and integrate that data into their EMR anyway they can. After all, patients are already beginning to understand that it data doesn’t appear in their electronic record, it probably isn’t important to their health.

It seems to me that the lagging EMR support for telemedicine visits springs in part from how they grew up. Just the other day, I had a video visit with a primary care doc working for one of the major direct-to-consumer telehealth services. And his comments gave me some insight into how this issue has evolved.

As sometimes happens, I ended up straying from discussion of my health needs to comment on HIT issues with the visit, notably to complain about the fact that I had to reenter my long list of daily meds every time I sought help from that service. He agreed that it was a problem, but also pointed out that the service’s founders have assumed that their users would almost exclusively be seeking one-off urgent care. In fact, he noted, none of the data collected during the visit is formatted in a way that can be digested easily by an EMR, another result of the assumption that clients would not need a longitudinal record of their telemedical care.

Admittedly, this service is in a different business than hospital or ambulatory care providers with a substantial brick-and-mortar presence. But my guess is that the assumptions upon which the direct-to-consumer businesses were founded are still shared by some traditional providers.

As a patient, I urge providers to give serious thought to better documenting telehealth today, rather than waiting for the vendors to get their act together on that front. If your clinicians are managing relationships by a video visits today, they will be soon. And when that happens I want a coherent record of my digital care to be available. Letting all that data fall through the cracks just doesn’t make sense.

Providers: Today’s Telehealth Tech Won’t Work For Future

Posted on July 5, 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 has concluded that while healthcare leaders see major opportunities for growing their use of telehealth technologies, they don’t think existing technologies will meet the demands of the future.

For the study, which was sponsored by Modern Healthcare and Avizia, researchers surveyed more than 280 healthcare executives to see how they saw the future of telehealth programs and delivery models. For the purposes of the study, they defined telehealth as encompassing a broad mix of healthcare approaches, including consumer-focused wireless applications, remote monitoring of vital signs, patient consultations via videoconferencing, transmission of still images, use of patient portals and continuing medical education.

The survey found that 63% of those surveyed used telehealth in some way. Most respondents were with hospitals (72%), followed by physician groups and clinics (52%) and a grab bag of other provider organizations ambulatory centers in nursing homes (36%).

The most common service lines in use by the surveyed providers included stroke (44%), behavioral health (39%), staff education and training (28%) and primary care (22%). Other practice areas mentioned, such as neurology, pediatrics and cardiology, came in at less than 20%. Meanwhile, when it comes to telehealth applications they wish they had, patient education and training was at the top list at 34%, followed by remote patient home monitoring (30%) and primary care (27%). Other areas on providers’ wish lists include cardiology (25%), behavioral health (24%), urgent care (20%) and wound care (also 20%).

Not only did surveyed providers hope to see telemedicine extended into other service lines, they’d like to see the technologies used for telehealth delivery change as well. Currently, much telehealth is delivered via a computer workstation on wheels or ‘tablet on a stick.’  But providers would like to see technology platforms advance.

For example, 38% would like to see video visits with clinicians supported by their EMR, 25% would like to offer telemedical appointments through a secure messaging app used by providers and 23% would like to deliver telemedical services through personal mobile devices such as tablets and smartphones.

But what’s driving providers’ interest in telehealth? For most (almost 75%) consumer demand is a key reason for pursuing such programs. Large numbers of respondents also cited the ability to improve clinical outcomes (66%) and value-based care (62%).

That being said, to roll out telehealth in force, many respondents (50%) said they’d have to make investments in telehealth technology and infrastructure. And nearly the same number (48%) said they’d have to address reimbursement issues as well. (It’s worth mentioning, however, that at the time the study was being written, the number of states requiring reimbursement parity between telehealth and traditional care had already risen to 29.)

This study underscores some important reasons why providers are embracing telehealth strategies. Another one pointed out by my colleague John Lynn is that telehealth can encourage early interventions which might otherwise be delayed because patients don’t want to bother with an in-person visit to the doctor’s office. Over time, I suspect additional benefits will emerge as well. This is such an exciting use of technology!

Sometimes Health Is About A Simple Connection to the Right People

Posted on June 24, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post is sponsored by Samsung Business. All thoughts and opinions are my own.

One of our biggest health care costs comes from our aging population. No doubt they’re a challenging group that often has multiple chronic conditions and is generally seen as anti-technology. While their medical conditions can be a challenge, it’s unfair to say that technology can’t have a great impact for good on even senior citizens.

In fact, one of the biggest health challenges senior citizens face is loneliness. It’s amazing the health impact being lonely can have on a person. The great thing is that technology as simple as a tablet can have a dramatic impact for good on senior citizens. Here’s a great video from Samsung and Breezie that illustrates this point:

I’ve seen a number of solutions like the Breezie tablets that have made the internet extremely accessible for senior citizens. It’s extraordinary to watch the impact for good that connecting to their friends and family on a tablet can have on a person. Plus, once their emotional state is in a better place, it’s often much easier for them to deal with their physical health challenges as well.

The amazing part is that these tablets don’t need some sort of complex health apps. They don’t need an AI generated dog to be their friend (Although, people are working on this). They don’t need dozens of healthcare sensors that are constantly monitoring their every health stat (Although, people are working on this too). All these seniors need is simple apps like Facebook where they can see pictures of their grandkids and email where they can communicate with their family and friends.

I’m sure that as things progress we’ll see more and more advanced health apps on these tablets. Many seniors have a challenge traveling to see their doctor, so you can easily see how a telemedicine app would be very convenient for both patient and doctor. Plus, sometimes you don’t even need video, but just a personal message from your trusted caregiver to help a patient feel better. All of this will come to the tablets, but we can start with something much simpler. A basic connection to the right people for that person.

I heard of one project where the patient improvement came as much from the daily call these lonely, elderly patients received as it was the actual study that was being conducted. While we could throw more people at the problem, that only scales so far. If we really want to scale this type of care to seniors, we’re going to need to utilize technology. These tablets designed for seniors are a great place to start. Then, we can build from there.

I don’t think it will be long before we see doctors prescribing tablets to patients. It’s not currently in doctors normal line of thinking, but maybe it should be.

For more content like this, follow Samsung on Insights, Twitter, LinkedIn , YouTube and SlideShare.

Telemedicine Coverage and Payment Parity

Posted on June 14, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently heard Nathaniel Lacktman from Foley & Lardner LLP give the best presentation on telehealth I’d ever seen. I’d never heard someone so familiar with the challenges and laws associated with telehealth. In fact, with that in mind, I’m hoping to get him on a Healthcare Scene interview in the future.

One of the key things he said about telehealth is the need for: Coverage and Payment Parity.

I thought it was the perfect synopsis of what’s holding telehealth back. If we had telehealth insurance coverage and payment parity, then telehealth services would go through the roof! Although, it’s worth pointing out that you need both of these things.

One problem I’ve seen with many telehealth initiatives is that a telehealth visit is treated like a second class citizen. Why would a doctor want to do a telehealth visit if they aren’t getting paid the same? This is why payment parity is so important and hasn’t been addressed nearly enough in the telehealth laws that have been passed.

The real question is why shouldn’t a telehealth visit be paid the same? If you’re able to document and code the telehealth visit to the same level as you would an in-person visit, why would we pay a doctor less for doing the same type of visit, just virtually?

There are a few states where they’re making progress with coverage and payment parity. It’s too bad we don’t have a national effort to get this in place. Telehealth is not the end all be all. It won’t replace all in-person visits to your PCP, but it could replace a lot of them. Plus, it will encourage a lot of early interventions that would have been delayed because a patient didn’t want to go to the hassle of an in-person visit to the doctor’s office.

Insights from #WEDI25

Posted on May 25, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This week I’ve been spending time at the WEDI annual conference in Salt Lake City. I’ve never been to a conference with a more diverse set of attendees. I’ve really enjoyed the diversity of attendees and perspectives that were at the conference. I was a little disappointed (but not really surprised) that clinicians weren’t part of the event. I understand why it’s hard to get them to attend an event like this, but it’s unfortunate that the physician voice isn’t part of the discussion.

Here’s a quick list of some insights I tweeted during the conference which could be useful to you:

3 Benefits of Virtual Care Infographic

Posted on May 20, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The people at Carena have put out an infographic that looks at 3 ways virtual clinics are improving care quality. I’d like to see better sources since most of the sources for the data in this infographic come from virtual care providers. However, it’s also interesting to look at the case virtual care providers are making so we can test if they’re living up to those ideals.

What do you think of these 3 benefits? Are they achievable through virtual care?

3 Ways Virtual Clinicals are Improving Care Quality

Telemedicine Rollouts Are Becoming More Mature

Posted on May 19, 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.

For a long time, telemedicine was a big idea whose time had not come. Initially, the biggest obstacles providing video consults was consumer bandwidth. Once we got to the point that most consumers had high-speed Internet connections, proponents struggled to get commercial insurers and federal payers to reimburse providers for telemedicine. We also had to deal with medical licensure which most companies are dealing with by licensing their providers across multiple states (Crazy, but workable). Now, with both categories of payers increasingly paying for such services and patients increasingly willing to pay out of pocket, providers need to figure out which telemedicine business models work.

If I had to guess, I would’ve told you that very few providers have reached the stage where they had developed a fairly mature telemedicine service line. But data gathered by researchers increasingly suggests that I am wrong.

In fact, a new study by KPMG found that about 25% of healthcare providers have implemented telehealth and telemedicine programs which have achieved financial stability and improved efficiency. It should be noted that the study only involved 120 participants who reported they work for providers. Still, I think the results are worth a look.

Despite the success enjoyed by some providers with telemedicine programs, a fair number of providers are at a more tentative stage. Thirty-five percent of respondents said they didn’t have a virtual care program in place, and 40% had said they had just implemented a program. But what stands out to me is that the majority of respondents had telehealth initiatives underway.

Twenty-nine percent of survey respondents said that one of the key reasons they were in favor of telehealth programs is that they felt it would increase patient volumes and loyalty. Other providers have different priorities. Seventeen percent felt that implement the telehealth with help of care coordination for high-risk patients, another 17% said they wanted to reduce costs for access to medical specialists, and 13% said they were interested in telemedicine due to consumer demand.

When asked what challenges they faced in implementing telehealth, 19% said they had other tech priorities, 18% were unsure they had a sustainable business model, and 18% said their organization wasn’t ready to roll out a new technology.

As I see it, telemedicine is set up to get out of neutral and pull out of the gate. We’re probably past the early adopter stage, and as soon as influential players perfect their strategy for telemedicine rollouts, their industry peers are sure to follow.

What remains to be seen is whether providers see telemedicine as integral to the care they deliver, or primarily as a gateway to their brick-and-mortar services. I’d argue that telemedicine services should be positioned as a supplement to live care, a step towards greater continuity of care and the logical next step in going digital. Those who see it as a sideline, or a loyalty builder with no inherent clinical value, are unlikely to benefit as much from a telemedicine rollout.

Admittedly, integrating virtual care poses a host of new technical and administrative problems. But like it or not, telemedicine is important to the future of healthcare. Hold it is at arms’ length to your peril.

Telemedicine Cartoon

Posted on January 29, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Thanks to @WTBunting for this week’s Fun Friday cartoon.

Healthcare Telemedicine Humor

Telemedicine and remote monitoring does raise a lot of interesting questions and situations. However, I’m starting to see a lot more people tackle those challenges. I look forward to that future.

My Optimism for Healthcare IT in 2016

Posted on January 1, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In yesterday’s post about physician EHR dissatisfaction in 2015 that there are many reasons to be optimistic about where healthcare is heading. I really am optimistic about healthcare IT in 2016. Here’s a look at some of the reasons I’m optimistic about 2016 improving healthcare and improving life for doctors.

Medical Knowledge Sharing – Platforms like Figure 1 are changing how medical knowledge is learned and shared. It’s impossible for any 1 person to keep up with the body of medical knowledge that’s available. That’s why crowdsourced platforms like Figure 1 are so exciting. Add in the AI developments like Watson and there’s a lot of cause for excitement about how patients will benefit from doctors getting the right information they need to provide the best care. I’m also excited by efforts to share best practices and clinical decision support findings between institutions. I’m hopeful that 2016 will mark a banner year for this type of sharing between medical professionals.

Meaningful Use Shackles are Broken – We’ll see if the government shuts down the meaningful use program or if doctors will essentially shut down the meaningful use program by not participating. Either way, I predict that 2016 will put meaningful use in our rear view mirror. The shackles of meaningful use will be broken and we’ll be able to start focusing EHR on things that matter to doctors and patients: improved care, improved productivity, and lower costs.

Data Sharing Starts Providing Value – Value based reimbursement and associated trends are pushing data sharing and I believe healthcare organizations are finally on board. No, 2016 won’t bring one central repository of all your healthcare data that any health care provider can access anytime. No, 2016 won’t bring ubiquitous sharing of all your healthcare data in exact the right place it’s needed at the right time. Those will both take more time. However, we’re going to see targeted sharing that makes patients lives better and lowers costs.

Patient Activism – The waves of sensors and high deductible plans is changing patients from passive viewers of their healthcare into active patients. Many won’t have a choice but to be involved in their healthcare since they can’t afford to not be involved. This will require some doctors some angst, but will ultimately be embraced and appreciated by most. This change in patient behavior is going to inspire a whole new breed of technology that enables patients and changes our view of healthcare.

New Care Models – A wide variety of new models have started in healthcare. Direct primary care and concierge medicine are two that have gotten a lot of attention. However, I’m not sure those will scale across all of healthcare. However, combine those with trends in telemedicine (which I believe is inevitable) and platforms like HealthTap which open up health care services in new, creative ways.

Healthcare Communication – It still shocks me how poorly health care has implemented the communication that’s available every where else in society today. I realize that privacy concerns has been used as the excuse for why healthcare is further behind, but that’s a poor excuse. I’m not trying to discount the need for applying appropriate privacy and security principles in these applications. I am suggesting that it’s possible to implement the latest communication technologies in healthcare in a HIPAA private and secure manner. There’s so much opportunity for health care to benefit from better communication that’s facilitated by technology that it’s impossible for this not to improve in 2016.

Those are a few of the things which have me optimistic for healthcare in 2016. I’d love to hear your thoughts in the comments. What will 2016 bring us?

Time For A Health Tracking Car?

Posted on December 30, 2015 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.

Several years ago, I attended a conference on advanced health technologies in DC. One of the speakers was Dr. Jay Sanders, president and CEO of The Global Telemedicine Group. And he had some intriguing things to say — especially given that no one had heard of a healthcare app yet and connected health was barely a vision.

One of Dr. Sanders’ recommendations was that automobile seat belts should integrate sensors that tracked your heart rhythm. After all, he noted, many of us spend hours a day behind the wheel, often under stressful conditions — so why not see how your heart is doing along the way? After all, some dangerous arrhythmias don’t show up at the moment you’re getting a checkup.

Flash forward to late 2015, and it seems Dr. Sanders’ ideas are finally being taken seriously. In fact, Ford Motor Co. and the Henry Ford Health System are co-sponsoring a contest offering $10,000 in prize money to employees creating smartphone apps linking healthcare with vehicles. While this doesn’t (necessarily) call for sensors to be embedded in seat belts, who knows what employees will propose?

To inspire potential entrants, the Connected Health Challenge sponsors have suggested a few ideas for possible designs, including in-vehicle monitoring and warnings and records access from the road. Other suggestions included appointment check-ins and technology allowing health data to be transmitted to providers. The contest kicks off on January 20th.

In some ways, this isn’t a huge surprise. After all, connected vehicles are already a very hot sector in the automotive business. According to research firm Parks Associates, there will be 41 million active Internet connections in U.S. vehicles by the end of this year.

At present, according to Parks, the connect car applications consumers are most interested in include mapping/navigation, information about vehicle performance, Bluetooth technology and remote control of vehicles using mobile phones. But that could change quickly if someone finds a way to interest the well-off users of wearables in car-based health tracking. (A possible direction for Fitbit, perhaps?)

Ordinarily, I’d have some doubts about Henry Ford Health System employees’ ability to grasp this market. But as I’ve reported elsewhere on Healthcare Scene, Henry Ford takes employee innovation very seriously.

For example, last year HFHS awarded a total of $10,000 in prizes to employees who submitted the best ideas for clinical applications of wearable technology. Not only that, the health system offers employees a 50% share of future revenues generated by their product ideas which reach the marketplace.

Now, it’s probably worth bearing in mind that the wearables industry is far more mature than the market for connected health apps in automobiles. (In fact, as far as I can tell, it’s still effectively zero.) Employees who participate in the challenge will be swinging at a far less-defined target, with less chance of seeing their ideas be adopted by the automotive industry.

Still, it’s interesting to see Ford Motor Co. and HFHS team up on this effort. I think something intriguing will come of it.