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Are Patients Becoming Price and Quality Sensitive?

Posted on October 20, 2015 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.

Yesterday I was watching the live stream of Jonathan Bush, CEO of athenahealth speaking and then on a panel at US News’ Hospital of Tomorrow event. Jonathan Bush was as good as ever and offered some really amazing insights into the changing culture of health care as we know it. He also introduced the LetDoctorsBeDoctors.com website along with the ZDoggMD Jay Z parody video called EHR State of Mind.

At one point in the panel discussion he made a point that really stuck with me. He suggested that a few years ago you could cut the price of your services in half and you’d still get the same number of patients in your office. Then he said that you could double the price of your services and you’d still get the same number of patients. He went on to say that you could provide better care to your patients and you’d still get the same number of patients.

Certainly that’s not a direct quote, but you get the gist of what he’s saying. Essentially, a few years back patients weren’t price or quality of care sensitive. Sure, maybe on a really macro scale some really doctors would be found out, but for the most part patients didn’t care what the price of healthcare was since they just paid the co-pay and they had no way of knowing the quality of care the doctor provided.

Jonathan suggested that over the past couple years this has started to change. Patients were becoming more price and quality of care sensitive. He didn’t explain why this is the case, but I’d suggest that it’s due to more availability of information and high deductible plans.

I think this shift in how patients select their healthcare is going to have wide ranging impacts on the health care system. Michael Robinson, Vice President, U.S. Health and Life Sciences, Microsoft, was on the panel with Jonathan Bush and suggested that technology was the enabler for a lot of these changes. That’s not true for all of the changes, but no doubt it plays a role in a lot of them.

By Supporting Digital Health, EMRs To Create Collective Savings of $78B Over Next Five Years

Posted on December 1, 2014 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.

Here’s the news EMR proponents have been insisting would emerge someday, justifying their long-suffering faith in the value of such systems.  A new study from Juniper Research has concluded that EMRs will save $78 billion cumulatively across the globe over the next five years, largely by connecting digital health technologies together.

While I’m tempted to get cynical about this — my poor heart has been broken by so many unsupportable or conflicting claims regarding EMR savings over the years — I think the study definitely bears examination. If digital health technologies like smart watches, fitness trackers, sensor-laden clothing, smart mobile health apps, remote monitoring and telemedicine share a common backbone that serves clinicians, the study’s conclusions look reasonable on first glance.

According to Juniper, the growth of ACOs is pushing providers to think on a population health level and that, in turn, is propelling them to adopt digital health tech.  And it’s not just top healthcare leaders that are getting excited about digital health. Juniper found that over the last 18 months, healthcare workers have become significantly more engaged in digital healthcare.

But how will providers come to grips with the floods of data generated by these emerging technologies? Why, EMRs will do the job. “Advanced EHRs will provide the ‘glue’ to bring together the devices, stakeholders and medical records in the future connected healthcare environment,” according to Juniper report author Anthony Cox.

But it’s important to note that at present, EMRs aren’t likely to have the capacity sort out the growing flood of connected health data on their own. Instead, it appears that healthcare providers will have to rely on data intermediary platforms like Apple’s HealthKit, Samsung’s SAMI (Samsung Architecture for Multimodal Interactions) and Microsoft Health. In reality, it’s platforms like these, not EMRs, that are truly serving as the glue for far-flung digital health data.

I guess what I’m trying to say is that on reflection, my cynical take on the study is somewhat justified. While they’ll play a very important role, I believe that it’s disingenuous to suggest that EMRs themselves will create huge healthcare savings.

Sure, EMRs are ultimately where the buck stops, and unless digital health data can be consumed by doctors at an EMR console, they’re unlikely to use it. But even though using EMRs as the backbone for digital health collection and population health management sounds peachy, the truth is that EMR vendors are nowhere near ready to offer robust support for these efforts.

Yes, I believe that the combination of EMRs and digital health data will prove to be very powerful over time. And I also believe that platforms like HealthKit will help us get there. I even believe that the huge savings projected by Juniper is possible. I just think getting there will be a lot more awkward than the study makes it sound.

Microsoft Joins Battle for Wearables Market

Posted on November 4, 2014 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.

Following the lead of several other companies big and small, Microsoft has jumped into the wearables healthcare market with a watch, a fitness tracker and a cloud-based platform that condenses and shares data.

It’s little wonder. After a few years of uncertainty, it seems pretty clear that the wearables market is taking off like a rocket. In fact, 21% of US consumers own such a device, according to research by PricewaterhouseCoopers. That’s slightly higher that the number of consumers who bought tablets during the first two years after they launched, PwC reports. Not only Microsoft, but Apple and Samsung, as well as smaller players with a high profile — such as Fitbit — are poised to take the sector by storm.

Microsoft’s new entry is called Microsoft Health, a platform letting users store health and fitness data. The date in question is collected by a Microsoft Health app, available on Android, iOS and Windows Phone. The platform also gathers data generated from the Microsoft Band, a smart and designed to work with Microsoft’s new platform.

The idea behind pulling all of this data into a single platform is to integrate data from different devices and services in a smart way that allows consumers to generate insights into their health. The next step for Microsoft Health, execs say, is to connect all of that data in the platform to the tech giant’s HealthVault, a Web-based PHR, making it easier for people to share data with their healthcare providers.

Other tech giants are making their own wearables plays, of course. Google, for example, has released Google Fit, a fitness-based app designed to help users track physical activity. Google’s approach is  Android smart phones, relying on sensors built into the smart phones to detect if the user is walking, running or biking. Users can also connect to devices and apps like Noom Coach and Withings.

Apple, for its part, has launched HealthKit, its competing platform for collecting data from various health and fitness apps.  The data can then be accessed easily by Apple users through the company’s Health app (which comes installed on the iPhone 6.) HealthKit is designed to send data directly to hospital and doctor charts as well. It also plans to launch a smart watch early next year.

While there’s little doubt consumers are interested in the wearables themselves, it’s still not clear how enthusiastic they are about pulling all of their activity onto a single platform. Providers might be more excited about taming this gusher of data, which has proved pretty intimidating to doctors already overwhelmed with standard EMR information, but it remains to be seen whether they’ll find fitness information to be helpful.

All told, it looks like there will be a rollicking battle for the hearts and minds of wearables consumers, as well as the loyalty of providers.  As for me, I think it will be a year or two, at minimum, before we get a real sense of what consumers and providers really want from these devices.

EHRs Don’t Make Errors, People Do

Posted on July 31, 2014 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.

An intriguing blog title, I know. I saw it on Bill Crounse, MD’s blog post and couldn’t resist extending the discussion. This is a really challenging topic and so it’s definitely worth of discussion.

On the one hand it’s clear to me that EHR software isn’t perfect. However, paper charts weren’t perfect either. On the other hand, people aren’t perfect either. Unfortunately, we don’t want to admit our imperfection and our society has gotten to the point that imperfections are unacceptable.

In the blog post mentioned above, Dr. Crounse offers the following suggestions and I’ll add my own commentary for each:

Involve the Patient Right from the Start – I’m hopeful that some of the companies working on this problem will get widespread adoption. The patient could definitely be more involved in entering their patient data before the visit even happens and thus relieve the burden on the clinician. This is a challenging problem to solve though when you consider the vast array of physician preferences.

Ease the Documentation Burden on Clinicians – This is mostly a knock on our current billing system. If we make the switch to value based reimbursement can we ease the documentation burden on clinicians? That’s worthy of its own post and some deeper thought. Sadly, I think in the short term it likely means more documentation burden for clinicians. I don’t see this happening soon, but it’s a noble goal.

Prohibit Templates, Cut and Paste – I generally disagree with this one. Ironically, the title of the post illustrates my issue with it, “Electronic Health Record solutions don’t make errors, people do.” It’s not templates and cut and paste that’s the problem as much as it is rushed physicians who don’t use it appropriately. I think one word describes most of the issues: laziness. I know. When I use a template for my blog posts or email blasts, I get lazy on them sometimes too. Fortunately, my blog posts or emails don’t have people’s lives hanging on them. So, maybe Dr. Crounse has a point. It’s just too easy to screw up templates and copy/paste.

Share Information with Patients – I’ve long been a proponent of the patient being aware of the information in the paper chart. I know that many doctors fear this. Usually they reference the fear that patients won’t understand the information that’s in the chart. I’ve just not seen this to be the case in practice and the benefits of the patient being able to be involved in their chart is so much more valuable than any perceived risk. The harder part is that I haven’t seen any system which creates a simple way for the patient to update/correct/verify information in a chart. Access is a great step forward, but the next steps is to empower the patient to assist in the patient chart quality control process.

As long as we have imperfect humans using imperfect EHR software, errors are going to happen. However, we can do better than we’re doing today. I like the ideas that Dr. Crounse suggested. I’d love to hear any ideas you have as well.