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Wearables Data May Prevent Health Plan Denials

Posted on August 27, 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.

This story begins, as many do, with a real-world experience. Our health plan just refused to pay for a sleep study for my husband, who suffers from severe sleep apnea, despite his being quite symptomatic. We’re following up with the Virginia Department of Insurance and fully expect to win the day, though we remain baffled as to how they could make such a decision. While beginning the complaint process, a thought occurred to me.

What if wearables were able to detect wakefulness and sleepiness, and my husband was being tracked 24 hours a day?  If so, assuming he was wearing one, wouldn’t it be harder for a health plan to deny him the test he needed? After all, it wouldn’t be the word of one doctor versus the word of another, it would be a raft of data plus his sleep doctor’s opinion going up against the health plan’s physician reviewer.

Now, I realize this is a big leap in several ways.

For one thing, today doctors are very skeptical about the value generated by patient-controlled smartphone apps and wearables. According to a recent survey by market research firm MedPanel, in fact, only 15% of doctors surveyed see wearables of health apps as tools patients can use to get better. Until more physicians get on board, it seems unlikely that device makers will take this market seriously and nudge it into full clinical respectability.

Also, data generated by apps and wearables is seldom organized in a form that can be accessed easily by clinicians, much less uploaded to EMRs or shared with health insurers. Tools like Apple HealthKit, which can move such data into EMRs, should address this issue over time, but at present a lack of wearable/app data interoperability is a major stumbling block to leveraging that data.

And then there’s the tech issues. In the world I’m envisioning, wearables and health apps would merge with remote monitoring technologies, with the data they generate becoming as important to doctors as it is to patients. But neither smartphone apps nor wearables are equipped for this task as things stand.

And finally, even if you have what passes for proof, sometimes health plans don’t care how right you are. (That, of course, is a story for another day!)

Ultimately, though, new data generates new ways of doing business. I believe that when doctors fully adapt to using wearable and app data in clinical practice, it will change the dynamics of their relationship with health plans. While sleep tracking may not be available in the near future, other types of sophisticated sensor-based monitoring are just about to emerge, and their impact could be explosive.

True, there’s no guarantee that health insurers will change their ways. But my guess is that if doctors have more data to back up their requests, health plans won’t be able to tune it out completely, even if their tactics issuing denials aren’t transformed. Moreover, as wearables and apps get FDA approval, they’ll have an even harder time ignoring the data they generate.

With any luck, a greater use of up-to-the-minute patient monitoring data will benefit every stakeholder in the healthcare system, including insurers. After all, not to be cliched about it, but knowledge is power. I choose to believe that if wearables and apps data are put into play, that power will be put to good use.

ONC Plans Mobile Device Security Guidance For Smaller Practices

Posted on August 22, 2012 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.

In an effort to help them avoid joining the long list of mobile device-based security failures, ONC has set plans to release guidance for small- and mid-sized providers on securing mobile devices. The agency, which has projects underway studying how mobile devices are used by smaller providers, expects to release its conclusions in the spring, reports HealtcareInfoSecurity.com.

If you read medical business trades, it’s hard to miss that slip-ups with mobile devices and mobile data sources (such as flash drives) have been a major source of security breaches.  In fact, it seems that 54 percent of the 464 HIPAA breaches affecting 500 or more individuals reported to HHS between September 2009 and July 2012 involved the loss or theft of unencryped mobile devices.

To see how smaller medical practices are doing in this area, ONC is conducting an effort dubbed the Endpoint Security Project, for which it has built a health IT implementation typical of mid-sized and small doctor practices, including tablets, laptops, smartphones, storage devices and desktops. When the project is done, ONC plans to release configuration settings which should help these smaller practices protect their mobile device data.

This is all well and good. After all, smallish practices seldom have an IT staffer to advise them on such things, and a simple set of best practices can go a long way.

Still, what strikes me is that time and again, it’s the larger providers whose data breaches are making the news.  That’s no surprise — big providers and hospitals simply have more data endpoints to control — but given this, ONC might make slapping larger organizations into shape more of a priority.

Of course, it’s also true that we don’t want small providers being the “weakest link” in HIEs, or compromising even a comparatively small amount of patient data in their practices. But if ONC’s assuming that big practices and hospitals can take care of themselves, they’re ignoring a truckload of evidence that it ain’t so.

Will Carts Delay Adoption of Hospital Mobile Devices? Could Be…

Posted on June 24, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I just caught an interesting piece in on the use of plain old, unsexy carts in hospitals — one whose conclusions which may surprise you a bit.  The piece argues that since hospitals are comfortable using carts to haul around full-sized equipment, they may be slower than expected to adopt hot portable devices in care delivery.

The article notes that while mobile devices remain on hospital IT execs’ radar, carts laden with standard technologies like barcode scanners and laptops continue to be popular.

IT administrators interviewed by Health Data Management magazine said that hauling IT equipment with carts may be a better option than mobile deployment.  And research suggests that they’re not alone. According to a HIMSS study quoted in the article, carts are being used by 45 percent of hospitals in 2011, up from 26 percent in a related 2008 study. That’s a pretty dramatic leap.

It certainly makes sense. The fact is, carts make it possible to haul around a full-size keyboard (along with barcode scanners and medication), which allows nurses to work comfortably with EMRs at the bedside.

On the other hand, the small screens and awkward typing mechanisms used by mobile gear can actually slow down the care process.  Not only that, the small text used by mobile devices can be hard for an aging nursing workforce to read, according to Joan Harvey, RN, clinical nurse specialist at Ocean Medical Center, who was interviewed by HDM.

That being said, hospital IT leaders aren’t ignoring the mobile device explosion. At least one hospital interviewed by the reporter, Good Samaritan of Vincennes, Ind., is testing mobile devices for future use. But execs there are frustrated by problems with compatibility between the different operating systems used by the devices, and differences between devices using the same operating environment. When you consider how much easier it may be to just have nurses drag along a standard PC and keyboard, why would they consider buying an Android tablet or iPhone?

Unless this author’s got his facts completely wrong, he’s made a really important point — that mobile device makers had better get their act together if they want to really step into the healthcare market. No matter how fascinating their potential use cases may be, the reality is that mobile vendors won’t make major headway in hospitals unless they get smart about barriers like the ones mention here.  The cool factor just won’t cut it.

EMRs Are A Transitional Technology

Posted on May 2, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

OK, I’m probably going to raise some people’s blood pressure, but here it is:  Is it possible that EMRs are a transitional technology which the industry will outgrow within the next several years?

I contend that with telemedicine  expanding rapidly, connected/remote health changing the focus of care and smart phones evolving along their own path — just to name a few factors — that which we call an EMR might not be up to managing care of the future.  Given the need for corporate and medical security, EMRs are also ill-equipped to give the emerging class of e-patients the data access they demand.

Yes, you can connect telehealth sites with a health system or clinic network.  You can burn through developer time making sure  your EMR supports the latest developments in mobile health applications.  You can find ways to integrate the data generated by remote patient monitoring and make it usable. But will the final result, the application which governs all of this, be the EMR we know today?

Today’s EMR, let’s face it, is not great at connecting beyond the institution where it lives. Sure, we’re building HIEs, but there’s a reason why so many are still at an embryonic stage;  forming such networks is a damnably hard job.

So what will happen when medical interactions and care shift decisively to environments and platforms outside of a hospital or clinic?  I don’t know, but I think it will take a different type of system — focused on coordination rather than just data storage and analytics.  It will need to be wherever patients are, collect data in whatever form it’s generated and support care delivery in ways that are in their infancy today.

So, that’s my opinion and I’m sticking to it.  What about you?