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Cloud-Based EHRs With Analytics Options Popular With Larger Physician Groups

Posted on April 20, 2018 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.

Ever wonder what large medical practices want from the EHRs these days? According to one study, the answer is “cloud-based systems with all the bells and whistles.”

Black Book Research just completed a six-month client satisfaction poll questioning members of large practices about their EHR preferences. The survey collected data from roughly 19,000 EHR users.

According to the survey, 30% of practices with more than 11 clinicians expect to replace their current EHR by 2021, primarily because they want a more customizable system. It’s not clear whether they are sure yet which vendors offer the best customization options, though it’s likely we’ll hear more about this soon enough.

Among groups planning an EHR replacement, what appealed to them most (with 93% ranking it as their preferred option) was cloud-based mobile solutions offering an array of analytical options. They’re looking for on-demand data and actionable insights into financial performance, compliance tracking and tools to manage contractual quality goals. Other popular features included telehealth/virtual support (87%) and speech recognition solutions for hands-free data entry (82%).

Among those practices that weren’t prepared for an EHR replacement, it seems that some are waiting to see how internal changes within Practice Fusion and eClinicalWorks play out. That’s not surprising given that both vendors boasted an over 93% customer loyalty level for Q1 2018.

The picture for practices with less than six or fewer physicians is considerably different, which shouldn’t surprise anybody given their lack of capital and staff time.  In many cases, these smaller practices haven’t optimized the EHRs they have in place, with many failing to use secure messaging, decision support and electronic data sharing or leverage tools that increase patient engagement.

Large practices and smaller ones do have a few things in common. Ninety-three percent of all sized medical and surgical practices using an installed, functional EHR system are using three basic EHR tools either frequently or always, specifically data repositories, order entry and results review.

On the other hand, few small to midsize groups use advanced features such as electronic messaging, clinical decision support, data sharing, patient engagement tools or interoperability support. Again, this is a world apart from the higher-end IT options the larger practices crave.

For the time being, the smaller practices may be able to hold their own. That being said, other surveys by Black Book suggest that the less-digitalized practices won’t be able to stay that way for long, at least if they want to keep the practice thriving.

A related 2018 Black Book survey of healthcare consumers concluded that 91% of patients under 50 prefer to work with digitally-based practices, especially practices that offer conductivity with other providers and modern portals giving them easy access to the health data via both phones and other devices.

Pace of Technological Innovation

Posted on April 18, 2018 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.

Sometimes you come across a chart that blows your mind and causes you to step back and reconsider your perspective. That’s what happened to me when I saw this chart shared by Sandeep Plum MD. The chart shows every major technological innovation in the last 150 years and how they have changed the way we work. More specifically, I think it shows how technology has improved the output we’re able to create.

This chart is pretty astonishing to consider. I’d like to dig into the data some more, but no doubt the concept of technology allowing us to produce more is something we’ve all experienced. The amount of leisure time we have compared to farmers even 150 years ago is astonishing to consider.

The problem in healthcare is that many people will wonder why healthcare hasn’t seen the same increase in output. The reality is that we have seen an improvement. The challenge in healthcare is the care we provide has become much more complex and the regulations around that care have become more complex as well. So, the increased output doesn’t feel the same because of these added complexities.

When thinking about healthcare complexity I always like to think about the country doctor back in the day that had the famous black bag and would visit you in your home. What diagnostic tools did he have? Not very much. What treatment options were available to him? Not very many (and a lot of them were very questionable). Compare that to today’s healthcare which has extremely sophisticated diagnostic tools and treatment options. Much of our increased output goes into navigating these tools and options.

The same is true for the increased regulation and reimbursement requirements. How did the country doc handle documentation and reimbursement? He might have written a few notes on a sheet of paper. Underscore the might. The country doc didn’t have to worry about insurance requirements, prior authorizations, CPT codes, or other complexities that make medical billing so time-consuming. He just asked the patient if they could pay. Sometimes that meant he was taking a pig home with him as payment, but he didn’t have to worry about insurance claims denials or sending out patient bills.

This is why I think so many doctors are frustrated by technology. The technology has improved their output, but in many ways that improved output has just been pushed to satisfy bureaucratic requirements as opposed to improving care and making the doctor more efficient.

The good news is that the pace of technological change will continue. It’s not too hard to see the day when a doctor goes into an exam room and the documentation that’s required for reimbursement and continuity of care just happens automatically. We’re not there yet, but the technology to make that a reality is. The only question is whether we can stem the increase in regulations that are eating away all that increased output that technology provides.

Value Based Care: We Need a Better Health IT System to Measure It

Posted on April 16, 2018 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

At HIMSS this year in Las Vegas I looked at the nature of the EHR and if we have the current computing and data infrastructure to enable better value based care.  Our data capabilities are failing to allow providers to align reimbursement with great care delivery.

Under the premise of “what gets watched gets done”, we understand that improving care delivery will require us to align incentives with desired outcomes. The challenge is that, among the many ills plaguing our version of the truth mined from data found in electronic health records systems, reimbursement data presents the core issue for informatics departments across the country. To resolve this issue, we need documentation to reflect the care we are delivering, and we need care delivery to center around patient care. Health information management should be heavily involved in data capture. To truly improve care, we need better tools to measure it, and healthcare data is expanding to answer difficult questions about care delivery and cost.

Our first challenge is stemming the proliferation of extraneous documentation, and healthcare is still addressing this issue. What used to be written on a 3-by-5 index card (and sometimes via illegible doctor’s notes) is now a single point in a huge electronic record that is, surprisingly, not portable. Central to our issues around the cost of care, we have also seen that quantity is valued more than quality in care delivery.

Duplicated testing or unnecessary procedures are grimly accepted as standard practice within the business of medicine. Meaningless and siloed care delivery only helps this issue proliferate across the health of a population. To resolve these issues, our workflow and records need to capture the outcomes we are trying to obtain and must be customized for the incentives of every party.

Incentives for providers and hospital administrators should center around value: delivering the best outcomes, rather than doing more tests. Carefully mapping the processes of healthcare delivery and looking at the resource costs at the medical condition level, from the personnel costs of everyone involved to perform a medical procedure to the cost of the medical device itself, moves organizations closer to understanding total actual costs of care.  Maximizing value in healthcare–higher quality care at lower costs–involves a closer look and better understanding of costs at the medical condition level. Value and incentives alignment should provide the framework for health records infrastructure.

When you walk into Starbucks, your app will tell you what song is playing and offer options to get extra points based on what you usually order. Starbucks understands their value to the customer and the cost of their products to serve them. From the type of bean, to the seasonal paper cup, to the amount of time it takes to make the perfect pumpkin spice latte, Starbucks develops products with their audience in mind–and they know both how much this production costs and how much the user is willing to pay. The cost of each experience starts well before the purchase of the beverage. For Starbucks, they know their role is more than how many lattes they sell; it is to deliver a holistic experience; delight the customer each time.  

Healthcare has much to learn about careful cost analysis from the food and beverage retail industry, including how to use personalized medicine to deliver the best care. Value-Based Healthcare reporting will help the healthcare industry as a whole move beyond the catch-up game we currently play and be proactive in promoting health with a precise knowledge of individual needs and cost of care. The investment into quantifying healthcare delivery very precisely and defining personal treatment will have massive investments in the coming years and deliver better care at a lowered cost. Do current healthcare information systems and analytics have the capacity to record this type of cost analysis?

“Doctors want to deliver the best outcomes for their patients. They’re highly trained professionals. Value Based Healthcare allows you to implement a framework so every member of the care team operates at the top of his or her license.”

-Mahek Shah, MD of Harvard Business School.

These outcomes should be based on the population a given hospital serves, the group of people being treated, or at the medical condition level. Measures of good outcomes are dynamic and personalized to a population. One of the difficulties in healthcare is that while providers are working hard for the patient, healthcare systems are also working to make a profit.

It is possible to do well while doing good, but these two goals are seemingly in conflict within the billion dollar healthcare field. Providing as many services as possible in a fee-for-service-based system can obfuscate the goal of providing great healthcare. Many patients have seen multiple tests and unnecessary procedures that seem to be aligned with the incentive of getting more codes recorded for billing as opposed to better health outcomes for the patients.  

The work of Value Based Time Data Activity Based Costing can improve personalized delivery for delivery in underserved populations as well as for affluent populations. The World Health Organization (WHO) published the work of improving care delivery in Haiti. This picture of the care delivery team is population-specific. A young person after an accident will have different standards for what constitutes “right care right time right place” than a veteran with PTSD. Veterans might need different coverage than members of the general public, so value based care for a specific group of veterans might incorporate more mental health and behavioral health treatment than value based care serving the frail elderly, which could incorporate more palliative care and social (SDoH) care. Measuring costs with TDABC for that specific population would include not just the cost of specialists specific to each segment of the population, but of the entire team (social worker, nursing, nutritionist, psychologists) that is needed to deliver the right care, achieve the best outcomes, and meet the needs of the patient segment.

Healthcare systems are bombing providers and decision makers with information and trying to ferret out what that information really means. Where is it meaningful? Actionable? Process improvement teams for healthcare should look carefully at data with a solid strategy. This can start with cost analysis specific to given target populations. Frequently, the total cost of care delivery is not well understood, from the time spent at the clinic to prescribe a hip replacement to the time in the OR, to recovery time; capturing a better view includes accounting for every stage of care. Surgeons with better outcomes also have a lower total long-term cost of care, which impacts long-term expenses involved when viewing it through the lens of an entire care cycle. If you are a great surgeon–meaning your outcomes are better than others–you should get paid for it. The best care should be facilitated and compensated, rather than the greatest number of billing codes recorded. Capturing information about outcomes and care across multiple delivery areas means data must be more usable and more fluid than before.

Healthcare informatics systems should streamline the processes that are necessary to patient care and provider compensation. The beginning of this streamlined delivery involves capturing a picture of best care and mapping the cost of processes of care. The initial investment of TDABC in researching these care costs at the patient level can be a huge barrier for healthcare systems with small margins and limited resources. This alignment is an investment in your long-term viability and success.

Once you understand your underlying costs to deliver care, health systems will be better prepared to negotiate value-based payment contracts with payers and direct-to-employers. Pair your measurement of costs with your outcomes. Integrating care delivery with outcomes standards has improved in recent times through ICHOM. Medical systems need to incentivize health if healthy patients are a priority.  The analysis of specific costs to a system needs a better reporting system than a charge master or traditional EHR which is strongly designed toward recording fee for service work. We must align or incentives and our health IT with our desired outcomes in healthcare. The more billing codes I can create in an electronic health record, the more I am reimbursed. Reimbursement alignment should match desired outcomes and physicians operating at top of their license.

Under value-based care, health and well-being become a priority whereby often in the fee-for-service model, sickness can be the priority because you get paid by doing more interventions, which may not lead to the best outcomes. The careful measurement of care (i.e. TDABC) paired with standards of best care will improve care delivery and reduce the cost of that care delivery. Insights about improved models and standards of care for outcomes and healthcare delivery allow patients, providers, and administrators to align with the shared goal of healthier patient populations. I am looking forward to the data infrastructure to catch up with these goals of better care delivery and a great patient experience.

 

Almost 20 Percent of CDS Alert Dismissals May Be Inappropriate

Posted on April 13, 2018 I Written By

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

The number of alerts generated by clinical decision support systems can be overwhelming for clinicians. It’s little wonder that the Joint Commission has long identified alert fatigue as a critical safety issue for providers, particularly given how many turn out to be unimportant or even irrelevant.

Unfortunately, however, there’s a flipside to this issue. Sometimes, CDS alerts can actually prevent care problems, clearly suggesting that clinicians shouldn’t dismiss them out of hand either. In fact, recently-published research found that at least in an ICU setting, overriding alerts might be associated with patient harm.

The study, which appeared in BMJ Quality & Safety, focused on the nature and impact of medication-related CDS overrides in the ICU. To conduct the analysis, the authors gathered data on adults admitted to any of six ICUs between July 2016 and April 2017.

The research team looked at a total of 2,448 overridden alerts from 712 unique patient encounters. The studies looked at patients with provider-overridden CDS alerts for dose, drug allergies, drug-drug interaction, geriatric and renal alerts. They also looked at how frequently patients suffered adverse drug events following alert overrides and the risk of adverse drug events given the appropriateness of the overrides.

A team of two independent reviewers concluded that while 81.6% of the overrides were appropriate, the roughly 19% remaining were inappropriate.

Researchers found that inappropriate overrides were associated with a greater risk of adverse drug events. In addition, they concluded that they could find more potential and definite adverse drug events following inappropriate overrides than appropriate overrides. They also found that inappropriate overrides were associated with an increased risk of adverse drug events.

Overall, inappropriate overrides were six times as likely to be associated with potential and definite adverse drug events.  That’s too big a correlation to ignore.

One thing the study doesn’t comment on is how the alerts were presented. Given that they may have been presented through multiple interfaces, the question arises of how big a difference those interfaces make in how clinicians respond to alerts. It could be that these interfaces have more impact than the clinical content of the alerts.

Bottom line, this problem may very well fall under the larger umbrella of usability problems. Just one more reason why the industry needs to keep a laser focus on improving usability in HIT across the board.

Addressing Common Patient Frustrations: Wait Times

Posted on April 11, 2018 I Written By

The following is a guest blog post by Jim Higgins, Founder & CEO at Solutionreach. You can follow him on twitter: @higgs77

Experts agree that it is critically important that practices keep their finger on the pulse of patient satisfaction—and one of the best ways to do this is through patient surveys. However, the question remains: what should a practice do if a survey reveals there is a problem?

It is of utmost importance that any issue found in a survey be studied and addressed. Interestingly, the vast majority of patient irritants do not relate to the quality of care at all. In fact, a study in the Journal of Medical Practice Management found that 96 percent of all patient complaints are related to customer service rather than poor care. Some of the biggest complaints include:

  • Excessive waiting times
  • Inadequate communication
  • Disorganized operations

Over the next few months, we will be digging in to each of these topics in depth. Today we will start with the top frustration of patients: excessive wait times. These long wait times, often associated with poor time management, are also some of the major criticisms reported by respondents of the Patient Provider Relationship study. Check out some of these numbers:

  • Sixty-eight percent of patients say that the wait times in their medical office are not reasonable.
  • Sixty-six percent say that they have to wait too long to schedule an appointment.
  • Sixty-eight percent say they feel like messages are not returned in a timely manner.

The problem is only getting worse. Average practice wait times have risen by 30 percent since 2014. Unfortunately, the common patient response to long wait times is simply to change practices. Around one in three patients say they are likely to find a new medical practice in the next couple of years. So how do you reduce long wait times?

  1. Understand how long is too long. Studies have found that about 20 minutes is the maximum amount of time a patient is willing to wait before becoming frustrated. Unfortunately, it is estimated that 53 percent of physicians say patients at their practice typically wait for more than 20 minutes. If you are not sure where you stand in terms of wait time, carefully track your wait times, both in the waiting room and the exam room. There are a variety of programs and apps that can do this for you. Or if you’d prefer to go old-school, you could acquire a supply of timers. When a patient checks in or is taken to the exam room, simply press the START button. Keep an eye on the timers and recognize when a patient has waited longer than is optimal.
  2. Provide clear communication. One of the easiest fixes for long wait times is often overlooked—communication. Eighty-six percent of patients say that if they were told in advance about a long wait time that they would feel less frustrated. So make sure to let patients know if the doctor is running behind schedule. You can also consider shooting off a quick text message to incoming patients if your office is running very late. If you are tracking wait times, make sure to acknowledge the inconvenience and apologize when the wait goes longer than 20 minutes. This would minimize frustration for nearly 70 percent of patients.
  3. Improve front desk workflow. Melanie Michael, lead author of a study that looked at interventions for lowering patient wait times found that one of the critical factors in reducing wait times was the front desk management. She noted, “[At one practice], we found that these people were trying to answer phones, field questions from patients in the waiting room, check patients in, secure insurance info, and many other tasks.” Automation of these tasks enables practices to get patients seen by the physician faster and more efficiently. Appointment reminders, scheduling, and check-in are all processes that can (and should) be automated.

Wait times are directly correlated to the satisfaction of patients. If your patient survey finds that people are feeling annoyed about the wait at your office, make changes now. If you wait too long, you may find you have no patients left.

Solutionreach is a proud sponsor of Healthcare Scene. As the leading provider of patient relationship management solutions, Solutionreach is dedicated to helping practices improve the patient experience while saving time for providers and staff.

EHR Usability Problems Linked To Potential Patient Harm

Posted on April 9, 2018 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.

If you’re a clinician, you’ve probably always felt that EHR usability problems were a factor in some patient care glitches. Now, there’s some research backing up this hunch. While the numbers of EHR-specific events represented in the study are relatively low, its lead researcher said that it probably underestimated the problem by several orders of magnitude.

The study, which was profiled in the American Journal of Managed Care concluded, that at least some patient safety events were attributable to usability issues. The study, which was just published in JAMA, involved the analysis of nearly 2 million reported safety events taking place from 2013 to 2016 in 571 healthcare facilities in Pennsylvania. The data also included records from a large mid-Atlantic multi-hospital academic medical system.

Of the 1.735 million reports, 1,956 (0.11%) directly mentioned an EHR vendor or product. Also, 557 (0.03%) include language explicitly suggesting that usability concerns played a role in possible patient harm, AJMC reported.

Meanwhile, of the 557 events, 84% involved a situation where patients needed to be monitored to preclude harm, 14% of events potentially caused temporary harm, 1% potentially caused permanent harm and under 1% (2 cases), resulted in death.

The lead researcher on the study, Raj Ratwani, PhD, MA, told the AJMC that these issues are unlikely to resolve unless EHR vendors better understand how providers manage the rollout of their products.

Even if the vendor has done a good job with usability, he suggests, healthcare organizations adopting the platform sometimes make changes to the final configuration during their implementation of the product, something which could be undoing some of the smart usability choices and safety choices made by the vendor. “We really need to focus on the variability that’s occurring during the implementation and ensuring that vendors and providers are working together,” Ratwani said.

Along the way, it’s worth pointing out that the researchers themselves feel that the actual number of usability-related patient safety events could be far higher than the study would suggest.

Ratwani cautioned that he and his team took a “very, very conservative approach” to how they analyzed the patient safety reports. In fact, he suspects that since patient safety events are substantially underreported, the number of events related to poor usability is probably also very understated as well.

He also noted that while the study only included reports that explicitly mentioned the name of the vendor or product, clinicians usually don’t include such names when their writing up a safety report.

AAFP Opposes Direction Of Federal Patient Data Access Efforts

Posted on April 4, 2018 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.

Not long ago, a group of federal agencies announced the kickoff of the MyHealthEData initiative, an effort designed to give patients control of their data and the ability to take it with them from provider to provider. Participants in the initiative include virtually every agency with skin in the game, including HHS, ONC, NIH and the VA. CMS has also announced that it will be launching Medicare’s Blue Button 2.0, which will allow Medicare beneficiaries to access and share their health information.

Generally speaking, these programs sound okay, but the devil is always in the details. And according to the American Academy of Family Physicians, some of the assumptions behind these initiatives put too much responsibility on medical practices, according to a letter the group sent recently to CMS administrator Seema Verma.

The AAFP’s primary objection to these efforts is that they place responsibility for the adoption of interoperable health IT systems on physicians. The letter argues that instead, CMS should pressure EHR vendors to meet interoperability standards.

Not only that, it’s critical to prevent the vendors from charging high prices for relevant software upgrades and maintenance, the AAFP argues. “To realize meaningful patient access to their data, we strongly urge CMS to require EHR vendors to provide any new government-required updates such systems without additional cost to the medical practice,” the group writes.

Other requests from the AAFP include that CMS:

  • Drop all HIT utilization measures now that MIPS has offered more effective measures of quality, cost and practice improvement
  • Implement the core measure sets developed by the Core Quality Measures Collaborative
  • Penalize healthcare organizations that don’t share health information appropriately
  • Focus on improving HIT usability first, and then shift its attention to interoperability
  • Work to make sure that admission, discharge and transfer data are interoperable

Though the letter calls CMS to task to some degree, my sense is that the AAFP shares many of the agency’s goals. The physician group and CMS certainly have reason to agree that if patients share data, everybody wins.  The AAFP also suggests measures which foster administrative simplification, such as reducing duplicative lab tests, which CMS must appreciate.

Still, if the group of federal organizations thinks that doctors can be forced to make interoperability work, they’ve got another thing coming. It’s hard to argue the matter how willing they are to do so, most practices have nowhere near the resources needed to take a leading role in fostering health data interoperability.

Yes, CMS, ONC and other agencies involved with HIT must be very frustrated with vendors. There don’t seem to be enough sanctions available to prevent them from slow-walking through every step of the interoperability process. But that doesn’t mean you can simply throw up your hands and say “Let’s have the doctors do it!”

Self-Learning Analytics and Making Analytics Useful

Posted on April 2, 2018 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.

One of the shocks to me at HIMSS 2018 was that there wasn’t nearly as much discussion around healthcare analytics as I thought there would be. I thought for sure we’d see an explosion of proven analytics that healthcare organizations could start to take advantage of. Maybe I just missed it, but I certainly didn’t see anything all that new.

It’s too bad because that’s one of the huge opportunities I see for healthcare. I was looking through some old notes from conferences and saw a note where I wrote: “What you do with the data is the competitive differentiator, not the data.

Certainly, you need access to the data to be successful, but there are a lot of organizations out there which have access to health data and they’re not making any sort of dent. Many of the now defunct HIEs had access to the data, but they didn’t know what to do with all that data. I’m still on the search for more analytics which are useful.

One other idea I found in my notes was the concept of a self-learning analytic. Related to this was the discussion we had about black box analytics in a recent #HITsm Twitter chat. I don’t think they have to be the same, but I do think that the key to successful healthcare analytics is going to require some component of self-learning.

The concept is simple. The analytic should look at its past recommendations and then based on the results of past recommendations, the analytic should adjust future recommendations. Notice that I still call it recommendations which I think is still the right approach for most analytics. This approach to constantly learning and evolving analytics is why it’s so hard to regulate healthcare analytics. It’s hard to regulate moving targets and a self-learning analytic needs to be moving to be most effective.

This is possibly why we haven’t seen an explosion of healthcare analytics. It’s hard to get them right and to prove their effectiveness. Plus, they need to continually evolve and improve. That’s the opposite of what researchers want to hear.

This is why the future of healthcare analytics is going to require deep collaboration between healthcare analytics vendors and provider organizations. It’s not a black box that you can buy and implement. At least not yet.

What’s been your experience with healthcare analytics? Where are you seeing success? We’d love to hear your thoughts in the comments.

Patients Expect Retail-Style Digital Health Experiences

Posted on March 30, 2018 I Written By

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

The retail industry has been pretty successful in integrating digital tools into their business. All major retailers have customized apps of their own, many if not all retail sites offer chatbots to answer questions and virtually all have spent countless millions on their e-commerce websites.

Healthcare organizations, on the other hand, are far behind when judged by these standards. That’s particularly true in the case of medical practices, few of which offer much in the way of digital sophistication. In fact, in most cases the most patients can hope for is a basic portal offering data, scheduling and bill payment options. (Ok, at times, bigger offices may toss in a kiosk or two, but that’s not a huge service upgrade.)

According to one study, however, consumers are losing patience with this gap. New research by NTT DATA Services has concluded that 59% of US consumers expect their healthcare digital experience to be comparable to their retail digital experience. This is part of a larger trend in which patients are looking for seamless care bringing together diagnosis, treatment, rehab and health promotion, according to Alan Hughes of NTT in a prepared statement.

Some of consumers’ frustrations around mobile options include not being able to accomplish what they wanted to do (62%), feeling that the options offered are not relevant to them (42%) and that entering data into forms took too long to complete (40%). This is not exactly a good report card.

Meanwhile, patients have a long list of services they feel could be improved, including searching for a doctor or specialist (81%), accessing their family health records (80%), making or changing an appointment (79%), accessing test results (76%), paying their bills (75%) and filling a prescription (74%). In other words, consumers see most of the digital services provided by medical practices as subpar. Again, this is not encouraging news.

What’s more, within the general population of consumers, there is one subsection of patients who are particularly demanding, a group NTT has dubbed “explorers.” ITT research found that 78% of explorers say that the digital healthcare experience must improve. Perhaps even more importantly, 50% of these explorers would leave their current doctor if another offered a better digital experience.

If healthcare providers can barely meet the needs of the general population, they’re likely to lose these explorers pretty quickly if they don’t get their act together. Medical practices, in particular, need to step up their digital health game.

Doctors Aren’t Tuned In To Blockchain News

Posted on March 28, 2018 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.

Sure, there are doctors who are knee-deep in clinical informatics work. Others may not work in IT full-time, but they keep an eye on IT developments and feel comfortable using new technology.

Then, of course, there are physicians who only interact with technology when they must (and yes this is probably the biggest group). They skim or even ignore technology articles in their favorite magazines and journals, and you’re not likely to see them comparing notes on the advantage of one EHR vs. another. In other words, when it comes to health IT, they’re definitely not trendy.

Even so, I was surprised to see how many physicians were out of the loop when it came to blockchain technology. According to a poll by physician-oriented site SERMO, which asked whether blockchain was ready to enter the healthcare world 25% said yes and 28% said no, but a far larger number (47%) responded that they weren’t aware of this technology.

I have a few theories as to why this is the case:

  • Though many vendors are experimenting with integrating blockchain into EHRs, working models are far from common at this point
  • Most physicians are overwhelmed by using EHRs as they currently exist, and aren’t too likely to contemplate adding even more complexity to their platform
  • Too few of their actual peers — practicing doctors working in traditional settings — have attempted to explain the basics of blockchain tech
  • Even high-level health IT experts are still grappling with the problem of how, exactly, healthcare tools can benefit from incorporating blockchain

The truth is, it’s not too surprising to see that many doctors have tuned out blockchain discussions, and probably other bleeding edge technologies like AI as well.  Until these technologies are more mature, and vendors can demonstrate a day-to-day use for them, why would your average physician take time out of their crazy day to ponder what the health IT whiz kids are talking about this week?

And honestly, until someone can demonstrate that blockchain offers real benefits to practicing physicians, I think they’re actually wise to step back from it for the time being. Unless they are natural techies who really want to experiment with blockchain options, there’s little for them to gain from pursuing a topic. Right now, it doesn’t affect them much.

Yes, the time will come when blockchain features are incorporated into EHRs, and vendors can demonstrate why this matters. In the meantime, physicians’ indifference seems very logical.