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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.

 

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.

Easy Tips to Understand and Leverage Patient Survey Results

Posted on March 14, 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

Multiple studies have shown that surveys are critical to the economic health of medical practices. Experts say that using surveys to improve the patient experience can be a strategic differentiator for practices.

To read more about the increasing role of surveys in reimbursement, profitability, and quality care, check out this post from last month.

Once you’ve started sending out regular patient surveys and getting consistent responses, it’s time to take action. In order to get the most out of a survey, it is critical to analyze the responses and implement changes based on the results. Here are a few tips to get started.

Figure out how many survey responses are needed.

Any time a survey is sent, there must be enough responses received to have a “statistically significant” result. Obviously, if only one or two patients respond to a survey, those answers will not be a true picture of how patients view a practice. What is considered “statistically significant?” This will vary by practice size.

Start by finding out how many active patients visit your practice—for now, don’t count any inactive files. Of course, it would be amazing if every single patient responded to the survey, but that is pretty near impossible. Instead, each practice must decide what margin of error is acceptable to them personally. The greater margin of error found to be acceptable, the fewer responses needed to be statistically significant. For example, if a 10 percent margin of error is okay with you, only 100 out of 3,000 patients need to respond. If, however, a three percent margin of error makes you more comfortable, you would need 810 responses out of 3,000.

Use the following table as a basic rule of thumb when deciding how many responses are needed:

Leverage technology to calculate the hard numbers.

In order to easily understand survey results, responses need to be converted into percentages or averages (depending on question type) and formatted in a way that makes it easy to compare responses. For example, it doesn’t mean much that 281 respondents said that they had a poor experience. If, however, that number is converted into 40 percent that had a poor experience, it is much easier to recognize a problem. Survey answers should be imported into a system that analyzes the results and converts these into simple statistics. Fortunately, it is common for the platform used to originally send the survey to do this automatically. Many will also include trends over time, highlighting if problems are worse or better during certain times of the year. If the survey-sending platform does not include an analysis tool, there are a huge number of programs (including free tools) that can accomplish this task. Even programs like excel work perfectly fine for this.

Take action.

Great—you’re starting to get a feel for what patients think. But now what? Far too many practices collect incredibly valuable information only to sit on their hands and ignore it. But for a practice to really thrive, it is crucial to set goals and objectives based on survey results. After all, patients are communicating what they want. It’s up to you to see how you can accommodate their needs.

My favorite goal creation method can be remembered by the word SMART.

  • Specific– Select a specific goal, being as clear as possible.
  • Measurable– Decide how you will measure the success or failure of your goal.
  • Achievable – Do you have the time, money and resources to complete the goal?
  • Relevan– Not every goal will improve your business. Pick one that will make a real difference.
  • Timely  Set a realistic deadline for goal completion.

Let’s consider a real-life example. A common survey question for healthcare practices is, “How long did you wait to be seen?” If the score comes up as higher than ideal (typically more than 20 minutes), improvements are needed.

This is where SMART goal setting comes into play.

  • Specific—Set a specific goal. For instance, “Our goal is to lower wait times to 15 minutes.”
  • Measurable—Decide how to measure the result. Will you be timing the waits yourself? Will you send out a follow-up survey?
  • Achievable—Set goals that can realistically be accomplished. If your average wait time is over an hour, for example, trying to adjust that to just 15 minutes is probably not currently achievable. Try to set smaller improvements and over time you can reach your ultimate goal.
  • Relevant—Look at the goal you’ve created. Will lowering wait times improve your business? Don’t set goals that won’t really have an impact on your long-term success. In this case, reducing wait times will have a positive impact on your business so it is a relevant goal.
  • Timely— Set a realistic time frame. It probably won’t happen in a week, but you may not want it to take a year. Three months may be the right timeframe to make improvements. Check back at that point to see if you achieved your goal.

As practices consistently strive to make changes based on survey results, the patient experience will improve dramatically. Because setting specific improvement goals is so important to practice success, over the next few months I’ll be addressing some of the most common patient frustrations uncovered on surveys. I will include SMART goals to improve these frustrations and boost patient satisfaction.

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.

The Increasing Role of Surveys in Reimbursement, Profitability, and Quality Care

Posted on February 14, 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

Delivery of high-quality, patient-centered care has become the hallmark of the medical industry. The most commonly used indicators for measuring the quality of care are patient satisfaction and the patient experience. How patients feel about their experience is critical to overall practice success because it has been proven to impact health outcomes, patient retention, and medical malpractice claims.

The emerging standard for measuring patient satisfaction is the use of patient surveys. Patient satisfaction surveys are not only important when required for reimbursement, but also for practices focused on improving their patient-centered care (that should be everyone). A well written survey can be a very powerful and reliable tool. It can provide more information about what is going on in your practice. It demonstrates that your practice is working to improve. It shows patients that quality is your focus.

What are the key reasons that every practice should start implementing patient surveys?

Patient Surveys Increasingly Drive Reimbursement

Because both practice and hospital reimbursement are increasingly tied to health outcomes and patient satisfaction, patient surveys have become the go-to guide for improving the patient experience.

Currently, CMS (the Centers for Medicare and Medicaid Services) uses the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey to measure how patients feel about their hospital experience. They then take those results and compare them to hospitals locally, regionally and nationally and assign them a score. Those scores have been a big part of the Hospital Value-Based Purchasing program for nearly six years.

This past year, we have seen the implementation of MACRA. Under MACRA, physician and hospitals patient satisfaction scores are calculated. By 2019, these scores will impact Medicare reimbursements.

It is highly likely that this trend towards survey-based reimbursement will continue to grow. Even if your practice is not currently required to use patient satisfaction surveys for reimbursement, it is probable that you will at some point in the future. By sending out surveys now, you can get a better handle on changes that need to be made to secure high scores for future reimbursement.

Patient Surveys Increase Profitability

High patient satisfaction levels impact a practice’s profitability for reasons beyond just reimbursement. Studies have found a significant correlation between high patient satisfaction and the overall profitability of a practice. Consider this:

  • A good patient experience significantly lowers your risk of a malpractice suit. In fact, for each drop in satisfaction score, a provider is nearly 22 percent more likely to be hit by a lawsuit.
  • One surprising effect of an improved patient experience is reduced staff turnover. Because a better patient experience often involves implementing more efficient and effective processes, staff are able to work in a more pleasant environment. One provider saw their turnover rate drop 5 percent after efforts to improve the patient experience.
  • A good patient experience leads to lower patient turnover. This one is more obvious. Today’s consumer-minded patients are looking for a great experience. One study found that practices with poor patient-physician relationships are three times more likely to move to a new practice than those with good patient-physician relationships.

It’s easy to see why the use of a patient survey to track and improve the patient experience is quickly becoming best practice. As Joe Greskoviak, president and COO of Press Ganey explained, “We are seeing a shift in the way organizations look at the engagement of their patient populations. The ability to use patient experience as a competitive and strategic differentiator to gain market share is a valuable tool,” Mr. Greskoviak said.

Patient Surveys Lead to Quality Improvement

As dozens of studies have found, there is quantifiable evidence that tracking the patient experience leads to quality improvement in multiple ways. These studies have found that:

  • A good patient experience improves both prevention and disease management. In one study, diabetic patients increased their ability to self-manage their disease and, subsequently, improved their quality of life simply due to a good experience with their provider.
  • Positive patient experiences lead to a higher likelihood of care adherence for the patient. This is especially true for those with chronic conditions who meet regularly with their provider.
  • Patients who have a good patient experience and a positive view of their provider have better health outcomes compared to patients that have poor patient experiences. Heart attack patients who were highly satisfied with their practice saw significant improvements over their less satisfied peers one year post-attack.

Understanding how your patients feel through patient satisfaction surveys is an invaluable tool. These surveys can be as important to the success as your healthcare credentials. If implemented and used properly, a patient survey can help you increase profitability, healthcare outcomes, and reimbursement.

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. Learn more about the Patient-Provider relationship survey here.

5 Ways to Keep Patients from Feeling like a Number

Posted on January 17, 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

Think about the last time you felt upset at work. What was the root cause? Did you feel ignored? Overlooked? Unappreciated? If so, you are not alone. Studies have found that two out of three workers feel unappreciated at work and 65 percent would prefer a better boss over a pay raise. Everyone wants to feel that they matter. It’s simply part of our nature as social beings. This need to feel valued is not restricted to the work environment. In fact, studies find that it extends far beyond the office walls to retail, service, and—yes—healthcare experiences.

The Patient-Provider Relationship Study confirmed this—noting that practices can no longer rely on their excellent clinical care to keep patients coming back. Patient dissatisfaction is at an all-time high, prompting patients across the generations to switch physicians.

Between 43 and 44 percent of millennials and Gen Xers will switch providers in the next few years. It’s not just the younger generations, even baby boomers are restless—20 percent are likely to find a new physician in the next three years. While patient dissatisfaction is a complex issue with multiple solutions, one of the easiest and most effective treatments also has the lowest cost to practices—making patients feel valued.

Here are five simple tools a provider can use to help patients feel they are important:

  1. Acknowledge. Nothing makes patients feel like they are on the conveyor belt of medical care more than being ignored. There is a reason the grocery king, Walmart, pays to have people simply greet you as you enter and leave the store. Humans like to be acknowledged. Consider having different front desk staff assigned as the office “greeter” along with their regular duties. A quick, “Welcome John! I’ll be right with you” along with a genuine smile can go a surprisingly long way towards patient satisfaction.
  2. Remember. Try to remember small things about each patient. One way is through use of their name. Another great time to show a patient you remember them is on their birthday. Eighty five percent of Americans say that they feel special when others celebrate their birthday. It is easy to automate a personalized birthday email or text message that keeps you connected outside of the office.
  3. Respond. Medical offices are busy. There’s no way around it. But when a patient reaches out, it is important to respond as quickly as possible. The ability to two-way text with patients is handy here because it allows you to acknowledge (see #1) a message from an out-of-office patient while still being present with patients in the office.
  4. Listen. It can be easy to brush past comments or questions from patients. In fact, research shows that the average patient is interrupted within 18 seconds of their visit. Instead of assuming that you know what a patient is going to say, wait patiently until they finish speaking. Devote your energy to looking at them and focusing on them while they talk.
  5. Thank. Patients are the reason you are in business. Every position in a medical office is made possible because of patients. During the hectic everyday rush, it can be easy to forget this simple fact. Try shooting off a personal “thank you” email or text (or even a handwritten note). The good news is that research shows that showing gratitude not only improves the well-being of those you thank, but your own well-being as well.

It is often the small things that can make the biggest difference to patient satisfaction. In the era of consumer-centric patients, it is important to help patients feel like more than just another number. Following these five simple steps will bring practices closer to that goal.

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. Learn more about the Patient-Provider relationship survey here.

Moving to Health Care from Sick Care

Posted on December 29, 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.

One of the biggest themes I’ve heard in 2017 was the need for health care to shift from our current sick care system to really focused on the whole person. This has largely been driven by the move to value based reimbursement, but health data has also illustrated this problem.

The good news is that technology can help with this challenge as well. Technology can sift through all the data and provide insights that can help a healthcare provider personalize the wellness care a patient really needs. That’s a powerful idea that I think we’ll see starting to bloom in 2018.

I found this powerful image that describes at least part of our health problems in the US:

There’s certainly a link between happiness and health, but beyond that I think you could replace happier with healthier. It’s fascinating to consider how much healthier we’d all be if we could just slow down and simplify our lives. As someone who does far too much, this idea resonates with me. However, it also is very apparent how hard it is to change this culture.

Where do you see the move from sick care to health care happening? Are there initiatives, organizations, companies, etc that are doing a good job in this regard? What are you doing in your personal life to slow down and improve your health? We look forward to hearing your thoughts in the comments.

Should We Continue Wearing Fitness Trackers?

Posted on December 28, 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.

Wired recently published an article that says “Science Says Fitness Trackers Don’t Work. Wear One Anyway.” No doubt they chose the headline to cue off of the word science in our political world. However, their article lacked substance as to why people should wear a fitness tracker even though we’ve already said with our actions that we’re not interested.

In fact Wired leads off with this in their article:

Our devices, apps, and platforms, experts increasingly warn, have been engineered to capture our attention and ingrain habits that are (it seems self evident) less than healthy.

Unless, that is, you’re talking about fitness trackers. For years, the problem with Fitbits, Garmins, Apple Watches, and their ilk has been that they aren’t addictive enough. About one third of people who buy fitness trackers stop using them within six months, and more than half eventually abandon them altogether.

The follow this up with 2 studies that show that fitness trackers are ineffective but go on to argue that fitness trackers are getting better and so we should keep wearing them.

Needless to say, I’m not convinced and I don’t believe the majority of the population will be convinced either. I’ve long argued that what we really need mobile health sensors to accomplish is for them to become clinically relevant. Once these sensors are clinically relevant, then we’ll all wear them much more. Until then, these fitness trackers and other health sensors will just be novelty items which we discard after a short period (except for the crazy few quantified selfers out there).

It’s really a simple math. As soon as the value of wearing a health sensor outweighs the cost of wearing one, we’ll all do it. I believe that the key to showing that value is to make the data the health sensor collects clinically relevant.

Lately, I’ve seen some patient advocates suggesting that EHR patient portals should really embrace patients uploading their sensor data to the portal. While I think the posture of empowering patients outside of the office is important, there’s very little value for doctors or patients to have them upload their current sensor data. What will change this? That’s right…once the data becomes clinically relevant, then every doctor will want that data to be uploaded. This demand will drive every EHR vendor to implement it. Problem solved. Until then, don’t hold your breath.

What do you think of fitness trackers? Should we keep wearing them? When will health sensors finally become clinically relevant?

4 Reasons Patient Texting Is Taking Center Stage

Posted on December 14, 2017 I Written By

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

Communication is one of the most time consuming tasks for medical practices. Hundreds of patients need to be contacted on a regular basis. Keeping up can be a challenge. Failing to do so can be damaging to the practice. Modern patients have adopted a consumer-based mentality and are quick to switch practices when it does not live up to their expectations. Communication methods that used to be regarded as personal and engaging are now felt to be invasive and outdated. The stats back it up:

  • Nineteen percent of people never check their voicemail.
  • Ninety percent of cell phone users ignore incoming phone calls.
  • Seventy eight percent of emails are never opened.

What do patients want instead? Texting.

The “Why” Behind the Success of Texting

Today’s patients are already savvy texters in their everyday lives and expect to be able to do the same with their medical practices. The Patient-Provider Relationship Study found that 79 percent of patients would like to receive text messages from their doctor and 73 percent want to send a text to their doctor’s office. In response, more and more offices are turning to texting. Why is texting so critical to practice success?

  1. It’s faster for everyone. The average text message takes just four seconds to send. Compare that to a phone call, in which people talk for at least two minutes. Those two minutes don’t include the time spent dialing, waiting for an answer, leaving a message, or following up. Experts estimate that a phone call to schedule an appointment—from start to finish—takes 8.1 minutes. Those minutes add up. For example, if your practice receives 50 incoming phone calls each day, even at just two minutes per call, that’s almost two hours spent on the phone. Add to that outbound calls and the hours build even more. Text messages, on the other hand, take only seconds to type and send.
  2. It improves health outcomes.research study by JAMA Internal Medicine reviewed data from 16 randomized clinical trials and found that texting can double the odds of chronic illness patients sticking to medication adherence. When using text messages as ways to remind patients of appointments and medication needs, they resoundingly respond.
  3. It keeps the schedule full. A text message system can be completely automated—meaning it can send notifications as often as desired. This ensures lower rates of patient no-shows. In addition, when a last-minute cancellation happens, texting is a great way to fill those spots. Patients who want to be seen soon can be put on a waiting list. When someone cancels their appointment, an automated text can be sent to each patient on the waiting list letting them know an appointment has become available. This text takes far less time than calling each person on the waiting list and hoping to reach an available patient in time to rebook the appointment. Your schedule stays full and your revenue increases.
  4. It increases in-office engagement. Freeing up so much time allows front office staff to spend more time where they are needed most—engaging in compassionate care with the patient right in front of them. Extensive research has found that patient-based, compassionate care leads to lower stress levels and burnout for healthcare providers and better health outcomes and satisfaction for patients. This type of care is only made possible, however, when staff members are not talking on the phone all day. Texting frees up this time.

Texting is the norm in almost every aspect of our society, and it is quickly becoming the expectation in the healthcare industry as well. It offers patients an easy way to communicate with your practice and still provide great service to the patients you are serving in your office. Your patients are happy with the way your practice communicates, you reduce the amount of time spent on phone calls, and—most importantly—your practice continues to grow.

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. Learn more about the Patient-Provider relationship survey here.

Alexa and Medical Practices

Posted on December 12, 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.

Today I was asked to do a webinar for Solutionreach on the topic of “What You Need to Know for 2018: From Government Regulations to New Technology.” It was a fun webinar to put together and I believe you can still register and get access to the recorded version of the webinar.

In my presentation, I covered a lot of ground including talking about the consumerization of healthcare and how our retail experiences are so different than our healthcare experiences. In 2018, I see the wave of technology that’s available to make a medical practice’s patient experience be much closer to a patient’s retail experience. That’s exciting.

One of the areas I mentioned is the move to voice-powered devices like Amazon Echo, Google Home, Siri, etc. Someone asked a question about how quickly these devices were going to hit healthcare. No doubt they have experienced how amazing these devices are in their home (I have 2 at home and love them), but the idea of connecting with your doctor through Alexa is a little mind bending. It goes against our normal rational thoughts. However, it will absolutely happen.

Just to be clear, Alexa is not currently HIPAA compliant. However, many things we want to do in healthcare don’t require PHI. Plus, if the patient agrees to do it, then HIPAA is not an issue. It’s not very hard to see how patients could ask “Alexa, when is my next appointment?” or even “Alexa, please schedule an appointment with my OB/GYN on Friday in the afternoon.” The technology is almost there to do this. Especially if you tie this in to one of the patient self scheduling tools. Pretty amazing to consider, no?

I also highlighted how the latest Amazon Echo Show includes a video screen as well. It’s easy to see how one could say, “Alexa, please connect me with my doctor.” Then, Alexa could connect you with a doctor for a telemedicine visit all through the Alexa Show. Ideally, this would be your primary care doctor, but most patients will be ok with a doctor of any sort in order to make the experience easy and convenient for them.

Of course, we see a lot of other healthcare applications of Alexa. It can help with loneliness. It can help with Alzheimers patients who are asking the same question over and over again and driving their caregiver crazy. It could remind you of medications and track how well you’re doing at taking them or other care plan tracking. And we’re just getting started.

It’s an exciting time to be in healthcare and it won’t be long until voice activated devices like Alexa are connecting us to our healthcare and improving our health.

What do you think of Alexa and other related solutions? Where do you see it having success in healthcare? How long will it take for us to get there?

Note: Solutionreach is a Healthcare Scene sponsor.

Telehealth and Its Contribution to Healthcare

Posted on December 6, 2017 I Written By

The following is a guest blog post by Juan Pablo Segura, Co-founder & President of Babyscripts.

In 2016, Americans spent roughly 18% of GDP on healthcare. Abetted by an aging population and continuously rising costs of care, CMS projects that this number will only grow over the next decade, increasing at an average of 5.6% annually. A crisis seems unavoidable: yet a huge fraction of this sum is lost to inefficient spending, which, when compared to other factors like an aging population, socio-economic challenges, or expensive new treatments, seems completely within the industry’s control to control and eliminate. A new OECD report calculates that approximately 20 cents out of every dollar spent on healthcare are considered unnecessary.

Could a simple reallocation of time and resources be enough to check the seemingly inevitable? The potential cost-savings of such a reallocation has policymakers and health professionals poised to revolutionize healthcare, as an industry that has long been resistant to innovation rejects antiquated models of care for more efficient methods that prioritize patient and provider alike.

A simple resolution that is already allowing more patients to receive necessary and important primary care is the extension of care teams through mid-level providers that cost a fraction of the salary of a full time physician. Physician’s Assistants and nurse practitioners are being granted more autonomy, as State governments remove restrictions while enacting legislation that grants PAs and other personnel full prescriptive authority. Allowing these lower cost health professionals to perform routine, primary care instead of more expensive, specialized physicians, immediately eliminates inefficiencies in the system and increases access to care to patients in the midst of a physician shortage.

These changes in personnel are necessary, but not enough to respond to the changing face of care. The answer to more affordable care is in leveraging existing technologies.

The rapid adoption of synchronous, video visits between patients and providers across the country is an exciting example of how technology can eliminate waste and help the system reallocate its resources. Recognizing its potential to decrease the administrative demands on providers and facilitate access to patients in remote areas, the industry has placed great emphasis on this aspect of telemedicine, even to the extent of providing incentives to providers for facilitating care through video.

But far from being the solution, video visits just scratch the surface of technology’s potential contributions to affordable healthcare, and in fact are the least beneficial of the efficiencies that technology is poised to provide. Some studies have indicated that when video visits are included in a medical plan, patients tend to treat them as an add-on, rather than a replacement for traditional in-person care. Furthermore, without integrated systems, video visits function much as if a patient were receiving all medical care at the ER, producing a fractured and incomplete medical record.

The dialogue must be centered on those innovations that revolutionize the way we approach healthcare, not simply attempt to translate an outdated system into a world that has evolved past it.

The conversation needs to focus on the most relevant, effective and impactful technology tools to affect the ultimate cost of care. Already, forward thinking providers like Greenville Health are creating end to end “virtual strategies” that rely heavily on remote monitoring apps and asynchronous visits that have the capacity to identify the problems before they begin. Beyond the immediate benefit of proper allocation of time and resources, the ultimate goal of technological innovation in healthcare has always been the opportunity to identify potential problems and create the necessary infrastructure to allow our healthcare system to focus on preventative health.

Of the healthcare apps currently in the digital marketplace, some have been shown not only to decrease costs but to be as successful as medication in preventing complications, anticipating a future of decreased prescription costs. Remote monitoring programs that use IOT devices like blood pressure cuffs and weight scales have reduced the cost of prenatal care by 40% while detecting problems like preeclampsia and other high-risk illnesses. Yet there is very little coding or direct payer incentive for deploying preventative technologies like that provided for video visits.

And why not? Video visits are a move in the right direction, but the decrease to cost of care does not have to come at the expense of the client/physician relationship or integrated care. Instead, effective technology should cut costs while assuring patient and provider of the continuity and efficacy of care.

The conversation amongst policymakers needs to expand to include these more revolutionary aspects of digital health, rewarding those who are effectively reducing costs without compromising care. Digital health will not be confined to a narrow vision, but it is up to the government and the industry to expedite the future of healthcare.

About Juan Pablo Segura
Juan Pablo Segura is Co-founder & President of Babyscripts, a Washington, DC-based technology company that builds mobile and digital tools to empower women to have better pregnancies. Juan Pablo was named a Wireless Life Saver by CTIA and a health care Transformer by the Startup Health Academy in New York City.