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Everything Old is New Again at Lenovo #HIThinkTank Event

Posted on June 28, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

Last week in Durham NC, 35 healthcare innovators gathered at the Lenovo offices to discuss three trendy topics: Value-base care, connected health and virtual care. Dubbed the Health Innovation Think Tank #HIThinkTank, it was the first summit-style event hosted by Lenovo Health.

#HIThinkTank was designed to be an opportunity for audience members to learn about the latest innovations from leading academics, technology companies and healthcare organizations. I went into the event expecting to hear about the latest in artificial intelligence, big data, predictive analytics and genomic medicine. It did not turn out to be that kind of event…and it was all the better for it.

I would say that the overall theme of #HIThinkTank was innovation through the application of old ideas in new ways. In other words, everything old is new again in healthcare.

The day started with Rasu Shrestha MD, Chief Innovation Officer at UMPC Enterprises, emphatically stating that we are “in a time of tremendous opportunity in healthcare” and that it was “time for us to move from ‘doing digital’ to truly ‘being digital’”. Shrestha went on to explain that our challenge now was to reimagine clinical processes/workflows in light of modern technologies and methodologies. Like the re-engineering wave that swept through manufacturing in the 1980s, Shrestha believes it’s time to engage all stakeholders and collaborate on reworking healthcare.

Shrestha was followed by Juliet Silver of Perficient who gave us all a dose of reality by telling her personal healthcare story. The day Silver’s husband was diagnosed with cancer was the day she became an advocate – “Google searching and academic research quickly became my constant companions as we struggled to make sense of his disease.” Silver made specific mention of how she had to manually obtain paper copies of her husband’s medical records in order to share them with members of his care team and what a difference that made in his care. She hinted that patients may be the key to truly solving healthcare’s interoperability problem as they are the one stakeholder with the most to lose/gain.

After Silver, several speakers made their case for a return to a more community-based approach to healthcare – one that harkens back to the days of early pioneers when physicians, nurses and members of the community worked together to keep each other healthy.

Holly Miller MD of MedAllies presented the results of a local implementation of CMS’s Comprehensive Primary Care Plus (CPC+) program – a program that stressed simple post-discharge follow-up as a way to reduce readmissions and keep overall healthcare spending to a minimum. Miller specifically mentioned how community doctors do this all the time.

This was echoed by Marty Fattig, CEO of Nemaha County Hospital, a 16-bed facility 60 miles south of Omaha NE. Fattig spoke at length about the successful EHR, HIE data sharing and population health initiatives by his staff. Particularly noteworthy was his repeated statement: “We may not have the financial or technical resources of the large networks, but we get stuff done because we are all driven to improve the health of our community peers. It makes a big difference that we see our patients at church, at the grocery store and at the post office.” Ironically this old fashioned community approach to delivering healthcare is now the goal of many healthcare organizations.

In the afternoon Steve Aylward of Change Healthcare and Dr Sylvan Waller led the discussion on virtual care by first reminding the audience that over 90% of virtual visits still happen via the phone. Video consults is the fastest growing area of virtual care, but it has a long way to go to catch up to the telephone. Dr Waller said it best “In 30 years #telehealth will finally become the overnight success everyone expects it to be”. Both Aylward and Waller stressed that we cannot lose sight of these “older technologies” that work for patients when we think about innovation.

For me, what drove home this theme of old-is-new-again was the afternoon tour of the Lenovo model data center. This new highly efficient and “green” room prominently featured Lenovo’s latest innovation – direct water-cooled servers. The new NeXtScale WCT server series boasts high pressure water lines that physically run through the server and draw heat directly away from the quad CPUs. Back in the early 90’s I remember getting a tour of an IBM facility (not far from Lenovo’s facility in Durham) that still had a functioning 308X mainframe that featured…you guessed it…water cooling technology.

All in all, I walked away from #HIThinkTank feeling encouraged about the future of healthcare. It was refreshing to be at an innovation event and hear about actual successful implementations rather than pie-in-the-sky promises. The event reaffirmed my belief that technology alone is insufficient to fix healthcare. Those of us in HealthIT need to do more than just create cool products, we need to help clients re-engineer their internal processes to better utilize those products to improve community health.

As Dr Shrestha said – It’s time for us to stop doing digital and truly be digital.

Retail Clinics Are Not the Enemy, Inconvenience Is!

Posted on June 16, 2017 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.

Check out this incredible insight that Gabriel Perna shared on Twitter:

What a great insight and something that most of the entrenched healthcare people don’t understand. Retail clinics are not the enemy, inconvenience is.

In many ways, it reminds me of the approach that taxi cabs took to Uber and Lyft. Taxis described them as evil as opposed to understanding why consumers wanted to use Uber and Lyft instead of a taxi cab. If the taxi cab industry would have understood the conveniences that Uber and Lyft provided customers, they could have replicated it and made Uber and Lyft disappear (or at least they could have battled them more effective than they’ve done to date).

Gabriel Perna further describes the issues of retail clinics and AMA’s approach to retail clinics in his article and this excerpt:

There are many reasons for this phenomenon [growth of retail clinics], but more than anything though, retail clinics are convenient and many physician offices are not. Because of this, the AMA shouldn’t be trying to treat the retail clinics as some kind of foreign invader, but rather use their rise to prominence as a way to guide physician practices forward. For instance, getting in to see a doctor shouldn’t be a three-week endeavor, especially when the patient is sick and needs attention immediately. However, that’s what has happened. Personally, I’ve been told “the doctor doesn’t have anything open for at least a month” more times than I can count.

It’s simple supply and demand. If you or your child needs to see someone immediately because of an illness and your doctor’s office can’t take in you for a week, and there happens to be a retail clinic down the street, guess where you’re going? Any hesitations you may have over your care being fragmented, the limited ability of your retail clinic physician, or anything else will go out the window pretty quickly.

I agree completely with the idea that convenience is key. However, what Gabriel doesn’t point out is that the fact that doctors have a 3 week waiting list for patients is why they don’t care about offering convenience to their patients. They have enough patients and so they don’t see why they should change.

You can imagine the taxi cab industry was in a similar position. They had plenty of people using their taxi service. They didn’t see how this new entrant could cause them trouble because they were unsafe and whatever other reasons they rationalized why the new entrant wouldn’t be accepted by the masses. Are we seeing the same thing with retail clinics vs traditional healthcare? I think so. Will it eventually catch up to them? I think so.

What’s even more interesting in healthcare is that retail clinics are just one thing that’s attacking the status quo. Telemedicine is as well. Home health apps and sensors are. AI is. etc etc etc. All of these have the potential to really disrupt the way we consume healthcare.

The question remains: Will traditional healthcare system be disrupted or will they embrace these changes and make them new tools in how they offer care? It took the taxi cab industry years to adapt and build an app that worked like Uber and Lyft. However, it was too late for them. I don’t think it’s too late for healthcare, but it’s getting close.

Women Executives in Telehealth American Telemedicine Association ATA2017

Posted on May 18, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor. Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare. twitter: @coherencemed

Susan Dentzer, Charlotte Yeh, Janet McIntyre, and Janae Sharp at the American Telemed Women Executives in Telehealth Panel

One of the highlights of the American Telemedicine conference in Orlando Florida was excellent coverage of women in telemedicine and leadership.  They had a panel of women in leadership which focused on promoting women in telemedicine and had the best moderation of a panel I’ve seen at a conference.  Highlights of great advice for women in HealthIT were from that panel, and from speaking with women that were tasked with going to the conference as buyers in the telemedicine space.

Charlotte Yeh acted as moderator of the panel. She framed what the panel would cover and what they were not concerned with. She mentioned that we would not cover work life balance since that also applies to men and has been covered on many platforms.  Framing a conversation within the conference and healthcare setting made a huge impact.  Promoting women in telemedicine and HealthIT needs to have a specific framework.

Susan Dentzer, President and CEO of the Network for Excellence in Healthcare innovation suggested making an award for advancing women in leadership in Telehealth.  I’m a huge fan of medals for participation. Every day I get up and when I work out I suspect that I deserve a medal.  The medals for best contribution for advancing women next year should be an amazing ceremony at ATA.

Susan quoted Madeline Albright that “there’s a special place in hell for women who don’t support other women.” Think deliberately about creating something you want to be a part of. This year I’ve personally seen Max Stroud of Doyenne Connections simply create something she wanted to be a part of.

Julie Hall-Barrow invited leaders to find a young woman and become their mentor. Some of the women in leadership in healthcare are happy to promote other women but the promotion seems more strategic than like actual concern. Leaders should purposefully craft their ideal mentor relationship. ATA discussed creating a group dedicated to what women and companies in the telemedicine space would like to do with collaboration.

Paula Guy, when asked what she would tell a younger self, said “first of all I would tell myself not to get married so many times.” Her advice was hilarious and focused on not letting people tell you no. There is a power in knowing what you are capable of and surrounding yourself with other women who are also in that space. Paula’s advice was also to be part of a group that promotes mentors and other women working together.

Kristi Henderson spoke about not being afraid to push boundaries. Never settle until you get where you want to go. The advice and positive belief that women are capable of breaking through boundaries and leveraging their social connecting makes women poised for success despite being underrepresented.

Janet McIntyre, The Vice President of Professional services of the Colorado Hospital association, decided to approach Patrick Kennedy about coming to Colorado to help with the opioid epidemic there. He shared his family story and personal conviction about making a difference and Janet decided to invite him to help with her state.  Women need to be fearless in their ask and expect that people will want to help them succeed.

Rachel Dixon, director of Telehealth for AccessCare services, pointed out that women should have a safe space to discuss gender issues in their work. We can create a place to discuss which companies are working well with women in the telemedicine space and which ask about an older man partner or lack professionalism. I shared a story with her about a potential employer asking if he should consider my job only a work proposition.  Gender issues for a younger woman in leadership can be complex in navigating personal relationship. A soft intelligence network about how a company treats women is valuable for investors and employees.

I was impressed with the positive planning of women in healthcare leadership in telehealth. The thought leadership at this conference was one of the best organized in terms of giving organizations and individuals actionable plans for increasing female technology talent in leadership positions.

Various Medical Practice Model Types

Posted on May 3, 2017 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 EHR vendor (and many other services), Kareo, has put out a practice model guide which they call “Practice Models: The ABCs from ACOs to Concierge and Everything in Between.” With this guide they shared this picture that includes various practice models:

When I see an image like this I’m torn on if this is an extremely exciting time for physicians or if it’s a miserable time to be a physician. One thing is clear, times are a changing. The medical practice models of the past are going to be blown up by new models.

Take for example Telemedicine. Can you imagine any healthcare future where telemedicine is not part of that future? I can’t.

I’m still personally torn on concierge practices. I can see why they’re appealing to so many. I love the idea of unlimited primary care and getting insurance out of primary care. However, it’s not clear to me that this idea can scale across the entire healthcare system. Certainly the rich can do it no problem. Can the concierge model work for the middle and lower class? Many fans of concierge tell me it can. I’m still not so sure.

I know a lot of doctors that are part of ACOs. I don’t know very many that are excited by the work ACOs are doing. Most of them just feel like they need to be part of it to understand the future of medicine. They’re not joining ACOs because they think it’s something that shows a lot of promise for their patients.

I’m probably coming off a little more cynical than I am about these shifts. A number of these changes are really exciting to see happening. However, I’m also not blind to the challenges that many of these medical practice models face.

Needless to say, it’s an exciting and challenging time to be in medicine. The structure of how we pay for healthcare is being questioned and new models are being explored. This can be really exciting if you find yourself tracking the right wave. However, if you miss the wave, then you can be stuck out in the middle of the ocean wondering how you missed out.

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.

 E-Patient Update:  The Impact Of Telehealth Confusion

Posted on January 27, 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 am a huge fan of telemedicine consults. As far as I can tell, all of the chronic conditions I currently cope with can be addressed effectively by a virtual visit unless I’m in a medical crisis.

My reasons are not unusual. Like most people, I hate having to drive to a doctor’s office if I’m already feeling yucky, particularly if it’s not necessary. And since time is money – particularly when you work for yourself like me – there’s some material benefits to telehealth too. Not only that, since I’m a tech fan who lives online, these contacts “feel” as real as face-to-face visits, so I don’t have lingering doubts that I’m not getting much for my money.

Getting a quick visit in regarding an acute medical issue (like, say, a sinus infection) has been pretty easy and relatively affordable as well. But reaching out to a new specialist – or even connecting with my existing providers — is another story. Over the last several months, I’ve encountered a number of barriers which seem to be fairly entrenched in the system.

Garbage contact info

Over the last year, I’ve been with two major health insurers (CIGNA and United Healthcare) whose databases included a list of specialists which were allegedly willing to do telehealth consults. But as it turns out, actually moving ahead with such visits has been impossible.

At one point, I decided to go all out and see if I could actually schedule a telehealth visit with one type of specialist I need. Armed with a list of providers who were supposedly up for it, I called perhaps 15 or 20 offices to see how I could schedule my first virtual visit. But I got nowhere. Most of the physicians simply never returned my calls, and in the rare cases where I got a live person, they had no idea what I was talking about.

I’m assuming that this happened because the doctors had the option to check a “telemedicine” box if they were generally interested in implementing it, and that few if any had actually gone ahead with their plans. But I’m still very annoyed with the whole thing. Sure, insurers don’t have perfect information on hand at any given moment, but isn’t in their interests to steer patients to less-expensive telehealth services if they’re available?

Coverage confusion

Another thing that astonishes me is that while I allegedly have telemedicine coverage via my current insurer (CIGNA) I can’t find anyone who has the slightest idea of how I should use it!  I have called CIGNA’s call center four or five times in an attempt to straighten this out, but none of the reps I spoke with had a clue as to which providers were covered by my policy, if any, and under what circumstances.

At some point, telemedicine coverage will be known as “coverage,” of course. There’s really no reason to segment it out into a separate category if you’re going to pay for it anyway. But at present, if CIGNA is any indication, there’s still some confusion around how and when coverage is even applicable. I can’t understand it, but I can attest to you that such foolishness is a Real Thing.

Launch fears

The other problem I’ve encountered is that while medical practices may have the technical capability to deploy telemedicine, they seem afraid to do so. I’ve asked many of my doctors (and their staff) what it will take for them to begin offering virtual visits, and I’ve gotten a mix of confusion and concern. None, even for example the fairly large and seemingly well-funded PCP office I visit, appears to be anywhere close to rolling out such services.

I can’t prove it, but my sense is that two things are going on here. First, I sense that practice leaders don’t feel ready to take on the technical challenges involved in supporting virtual visits. Though my guess is that security is the only real issue — which can be addressed by using the right vendor — they seem quite timid about even experimenting with this approach. Second, I am pretty sure they’re not sure how to handle billing, or alternatively, what to charge if they don’t bill insurance.

I admit their concerns are reality-based. But I’d argue that the benefits of offering telehealth far outweigh these concerns. Apparently, my doctors don’t agree just yet.

Ultimately, I think we’d all agree that telemedicine uptake will grow by leaps and bounds over the next several years. But it seems we’ll have to deal with a lot of administrivia before that can happen.

E-Patient Update: All I Want For 2017

Posted on January 6, 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.

Over the past year, I’ve done a lot of kvetching about the ways in which I think my e-relationships with doctors and hospitals have fallen short. I don’t regret doing so, but I think it’s just as important to focus on the future. So without further ado, here’s a list of ways in which providers could improve their digital interactions with me and my fellow patients during the coming year:

  • Have consistent policies and operations: Over time, I’ve found that many providers don’t seem to keep track of what they say about e-services such as portals and telemedicine visits. Others do little to let you know whether, say, doctors respond to email and how long it may take for them to do so. All of this creates patient confusion. This year, please be consistent in what you do and how you do it.
  • Create channels for patient feedback: As you may recall, I recently trashed a practice that didn’t respond to patient complaints about a broken appointment-making function on its site, and noted that all could have been avoided if patient objections had gotten routed to practice administrators sooner. Let’s make sure this doesn’t happen anymore. This year, make sure your patients don’t face this kind of frustration; create formal channels for patient technical feedback and have a process for escalating their concerns quickly.
  • Give us more access: While patients do have access to some data from their medical records, most of the time we still have to jump through onerous hoops if we need a complete record. Given that it’s all digital these days, this is very hard for us to understand, so fix this process. (And by the way, don’t pile on $2.50 per page charges when you produce a digitally-produced patient record; not only is it insulting and predatory, if that fee doesn’t reflect the costs of sharing the record it may be illegal in many states.)
  • Give us more control: Particularly when, like me, you have more than one chronic condition to manage, it gets very tiring to deal with the policies of multiple institutions when you want the big picture. We want more control of our records!  We’ll be much happier (and possibly healthier) if we have ways to compile complete record sets of our own.
  • Take us seriously: The following is not just an e-patient concern, but it still applies. Too often, when I raised a concern (“Why do you say I don’t have an appointment when I made one online?”) I’ve gotten a blank stare or defensive posturing. This year, providers, please take our digital problems as seriously as other any problems we face in interacting with you. We do!

As I look at this list, I think it’s interesting that I have no temptation to suggest one technology or another (though as your faithful scribe I’ve seen many intriguing options). The truth is, I’d submit, that most providers should get their social and operational ducks in a row before they roll out sophisticated patient engagement platforms or roll out major telehealth initiatives. Just make sure everything works, and everybody cares, and you’ll be off to a better start.

Patients Frustrated By Lack Of Health Data Access

Posted on January 3, 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.

A new survey by Surescripts has concluded that patients are unhappy with their access to their healthcare data, and that they’d like to see the way in which their data is stored and shared change substantially.  Due to Surescripts’ focus on medication information management, many of the questions focus on meds, but the responses clearly reflect broader trends in health data sharing.

According to the 2016 Connected Care and the Patient Experience report, which drew on a survey of 1,000 Americans, most patients believe that their medical information should be stored electronically and shared in one central location. This, of course, flies in the face of current industry interoperability models, which largely focus on uniting countless distributed information sources.

Ninety-eight percent of respondents said that they felt that someone should have complete access to their medical records, though they don’t seem to have specified whom they’d prefer to play this role. They’re so concerned about having a complete medical record that 58% have attempted to compile their own medical history, Surescripts found.

Part of the reason they’re eager to see someone have full access to their health records is that it would make their care more efficient. For example, 93% said they felt doctors would save time if their patients’ medication history was in one location.

They’re also sick of retelling stories that could be found easily in a complete medical record, which is not too surprising given that they spend an average of 8 minutes on paperwork plus 8 minutes verbally sharing their medical history per doctor’s visit. To put this in perspective, 54% said that that renewing a driver’s license takes less work, 37% said opening a bank account was easier, and 32% said applying for a marriage license was simpler.

The respondents seemed very aware that improved data access would protect them, as well. Nine out of ten patients felt that their doctor would be less likely to prescribe the wrong medication if they had a more complete set of information. In fact, 90% of respondents said that they felt their lives could be endangered if their doctors don’t have access to their complete medication history.

Meanwhile, patients also seem more willing than ever to share their medical history. Researchers found that 77% will share physical information, 69% will share insurance information and 51% mental health information. I don’t have a comparable set of numbers to back this up, but my guess is that these are much higher levels than we’ve seen in the past.

On a separate note, the study noted that 52% of patients expect doctors to offer remote visits, and 36% believe that most doctor’s appointments will be remote in the next 10 years. Clearly, patients are demanding not just data access, but convenience.

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.

How IRIS Puts the Real Triple Aim of Healthcare In Action

Posted on November 22, 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.

As I’ve been doing my Fall Healthcare IT Conference tour, I’ve had the chance to meet with hundreds of companies and thousands of people working to improve healthcare. While all this travel takes its toll, I also come away from all of these meetings invigorated by the quality of people and their desire to make healthcare better. That’s true almost across the board.

While most of the solutions I see are an evolution of something I’ve seen before, every once in a while I meet with a company that’s really impacting healthcare in a unique and interesting way. I found just such a case when I met with Patrick Cresson from IRIS – Intelligent Retinal Imaging Systems.

On face value, many might look at IRIS as just another diabetic retinopathy exam that’s been done by ophthalmologists forever. While this is true, what makes IRIS unique is that they have an FDA cleared exam that can be done in the primary care setting as opposed to being referred to an ophthalmologist. As Patrick pointed out to me, of all the diabetic screenings that need to be done for diabetic patients can be done in the primary care setting except for the retinal exam. At least that was the case before IRIS brought those exams to the primary care setting.

A look at the numbers is quite telling. There are 116 million patients with diabetes or pre-diabetes and that number is increasing every day. It’s estimated that 30 million diabetes patients get referred for an eye exam every year and 19 million diabetes patients do not get the annual retinal exam. There are plenty of reasons why this is the case, but it’s not hard to see why this happens. The same thing happens with referrals across healthcare. Diabetic patients that can’t tell any difference in their eyesight are unlikely to keep going back for an annual retinal exam. Who really wants to go to the pain of scheduling an appointment for what doesn’t seem to be an issue? So, they don’t.

The problem with this thinking is that diabetic retinopathy is asymptomatic. The only way to know if you’re heading for trouble is to have a retinal exam. The good news is that early detection can solve the problem and literally save diabetic patients’ eyesight. I know this first hand since it saved my grandfather’s eyesight.

This is the compelling story that IRIS tells as it pushes the retinal exam into the primary care setting where they can ensure patients are getting the early screenings they’ve so often missed in the past. This plays out in the numbers. Over the past 3 years, IRIS has performed 120,000 diabetic retinopathy exams which resulted in 56,000 patients identified with a pathology and 11,600 patients saved from potential blindness.

While this type of early detection can help healthcare organizations HEDIS compliance, I’m intrigued by the way IRIS straddles the fee for service and value based care worlds. I’ve seen very few models that get a primary care provider paid in the fee for service world, but also work to significantly lower the costs of healthcare in a value based care world. However, that’s exactly what you get from IRIS’s early screening exams.

What’s also fascinating to consider about IRIS is ophthalmologists’ response. It’s easy to see how many ophthalmologists could be afraid of diabetic retinal exams being done in the primary care setting and not in the ophthalmologists’ offices. That’s taking business away from them. While this is true, it’s also easy to see how an increase in retinal exams will drive more previously undiagnosed higher acuity exams, surgeries and interventions to ophthalmologists. Every ophthalmologist I know would much rather do a higher acuity surgery than a basic diabetic retinopathy exam. That’s the reality that IRIS creates since it’s an FDA cleared exam for diabetic retinopathy, but it’s only a screening tool for other eye diseases that require a full exam by an ophthalmologist.

Stories like IRIS are why I love blogging about healthcare IT. IRIS is changing healthcare as we know it by reducing healthcare costs, improving the patient experience, and getting doctors paid. That’s the real triple aim of healthcare in action.