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Fixing Medical Record Errors Should Be Easier In Age of EHRs

Posted on December 14, 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.

Wouldn’t it be nice if the advent of EHRs made it more likely that information in medical records was accurate? Sadly, that’s hardly the case.

In fact, patient matching issues actually seem to make it more likely that the wrong patient data makes it into a chart. Add problems with busy physicians making the occasional cut-and-paste error, and you can have a real mess on your hands.

I was thinking about this today when I read the story of Morgan Gleason, a woman who went through a struggle to get documentation of two non-existent pregnancies out of her medical records. Gleason, who suffers from a rare autoimmune disease, is a pro at managing her health, but had to fight hard to correct these errors, according to a CNBC story.

Gleason’s tale begins two years ago when she requested her medical records after a visit to a Florida women’s health clinic. With the help of her mother, who worked at health IT firm CareSync, Gleason stored all of her medical records in one place once she received them.

When she received the clinic records, she was surprised to find notes saying that she had two children, one living and the other having died shortly after being born. Gleason had never been pregnant.

Unfortunately, this wasn’t the first time she found a serious mistake in records. In the past, she told CNBC, a diagnosis of diabetes apparently popped up in her records, which was also erroneous data.

In this case, when she called the clinic to report the error an assistant on the other end of the line told her that she was wrong about her own medical history.

Gleason told CNBC that the assistant simply wouldn’t listen to her. “If you hadn’t told us this, there’s no way this could have been in your chart,” the assistant reportedly told her. The clinic didn’t change the record until Gleason made a formal request for it to be changed.

I can understand why the clinic might have wanted the changes to be requested in writing. Changing a patient’s record does have legal significance. At the same time, though, providers should have an easy-to-explain process in place for making appropriate changes.

In my view — particularly as someone with chronic illnesses — it’s inexcusable when an institution makes it hard for patients to correct mistakes. On the contrary, medical practices and facilities should be delighted if someone does the quality control for them, rather than leaving them open to liability when they make mistakes based on incorrect documentation.

Now more than ever, it seems to me to the culture of resisting patient interaction with their records has got to go. If you’re not sure how patients are treated when they make such requests, I encourage you to try and make such changes yourself and see how far you get.

 

The Common Thread Connecting Top-Performing Practices

Posted on November 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

A top-performing practice. Isn’t that what every organization in the healthcare industry is striving to become? But how do you get there? According to MGMA’s recent Winning Strategies From Top Medical Groups report, there are a few things that top performers have in common—from exceptional strategy, to smooth operations, and strong culture. But one interesting finding of the study was that top performing medical groups have a radically different approach to investment than the rest of the industry.

In an era of cutting costs and reducing overhead, many medical practices avoid spending money like the plague. However, top performers do the opposite. They are significantly more likely to spend additional money on their practice. They then maximize the returns on these investment, ultimately achieving lower overall operating costs. As MGMA President and CEO Halee Fisher-Wright, MD, recently said, “We have found that better performers are systematic about improvement and continually invest time and effort in new resources while maximizing the tools and information already available to them.”

Technology for the Future

If top-performers are investing more, where is that money going? One of the best investments—not only for today but the future as well—is technology. Emerging technologies are a critical aspect of the future of the healthcare industry. In fact, an SAP/Oxford Economics study recently found that 70 percent of healthcare executives say that investing in technology is essential to a practice’s growth, competitive advantage, and the quality of a patient’s experience. Thomas Laur, global president of SAP Health, explained, “Digital innovation will fuel the next wave of breakthroughs in healthcare and accelerate the broader shift toward data-driven care for healthcare organizations. Unlocking actionable data insights in real time is critical for the future success for value-based care.”

The technologies expected to create the highest return on investment include:

  1. Efficiency-fueling technologies. Most healthcare organizations are riddled with inefficiencies throughout their patient care processes. One of the biggest inefficiencies lies with unwieldy administrative processes. In the healthcare industry, 31 percent of employees deal solely with administrative challenges. As a comparison, across other industries, just 13 percent of workers perform administrative work. That’s a whole lot of wasted time! Technologies that standardize and streamline administrative processes will reduce this burden, improving efficiency levels and overall patient care. This includes automation of appointment reminders, recall messaging, billing, scheduling, and more.
  2. Technology that personalizes care. For years and years, uniform medicine has been the norm in healthcare. The large majority of patients with the same disease will end up receiving the exact same treatment as one another. This is not the most effective nor efficient way of treating patients. It is estimated that a staggering $700 billion each year is spent in the U.S. on health care efforts that do not improve health outcomes. This is where the technology of personalized medicine comes in to play. A variety of tools are emerging that target patient’s health at an individual level. From technology that predicts a patient’s likelihood of contracting any given disease to technologies that can take into account an individual patient’s makeup before prescribing medications, more and more options are available for personalized care. And these technologies are very popular with patients. According to one study, more than three-quarters of consumers say they would like to undergo diagnostic tests that develop personalized prevention or treatment plans. Implementing these options differentiates you from the competition.
  3. Patient engagement technologies. Todays’ digital patients want access to tools that give them greater understanding and control over their own care. Since patient engagement is a major goal of the healthcare industry as well, implementing technology that engages patients is a no-brainer. From patient portals to text messaging to targeting patient education, the options to get patients involved and excited about their care have never been more diverse.
  4. Security-based technology. Data breaches and security concerns have become a hot-button issue in the industry. While it is impossible to completely eliminate all security threats, there are more and more options to safeguard your data. Some of the most exciting trends include next-generation firewalls (NGFWs), block chain technology, cloud-based securities, secure messaging and health information exchange, and biometric security applications. You can read more about each of these emerging technologies here.
  5. Remote-health monitoring. Remote wearables and apps are not only fun and popular with patients, but can also provide healthcare providers access to extended monitoring, greater disease prevention, and improved fact-based care decisions. Practices should look for ways to maximize the use of remote monitoring tools.

In order to obtain long-term success, healthcare organizations need to find ways to invest in the future. Looking at some of these most popular technologies is a great way to get started. Choose just one or two that you would like to focus on and then expand from there. This will put you in a great position for the future.

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.

How to Text PHI with Patients and Stay Compliant

Posted on September 19, 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

Did you know that 73 percent of Americans say it is difficult to reach them by phone? In fact, Americans ignore 337 calls each year and that number is rising. Even if you leave a message, chances are high no one will ever hear it—80 percent of people report that they don’t even bother leaving a voicemail anymore because they don’t believe it will get listened to. More and more, phone calls are seen as invasive, outdated, or ineffective. Instead, people prefer to communicate via modern methods such as text message.

Texting Reigns as Favorite Communication Tool

We all know that pretty much everyone with a cell phone texts friends and family regularly. What is less well-known is that people would like to extend their texting habits to their healthcare provider. According to the 2017 Patient-Provider Relationship Study, 60 percent of patients want text reminders. Seven out of ten patients say they would like text communication beyond just reminders as well. It’s not just millennials. Around half of baby boomers also prefer text messages.

Unfortunately, many practices have shied away from texting or emailing patients through unsecured channels, wary of running into compliance issues. This is especially true when it comes to texting patients when those messages may include protected health information (PHI).

In fact, I suspect that if you were to poll a group of healthcare workers concerning the legality of sending PHI through unsecured text message, you would probably get answers all along the spectrum. Yes, no, maybe so? Many just don’t know.

Last March, at the HIMSS health IT conference Roger Severino, Director of the US Department of Health and Human Services Office for Civil Rights (OCR), the HIPAA enforcement agency, clarified the confusion.  According to Severino, providers may share PHI with patients through unsecure text messages as long as they have informed their patient that texting is not secure, asked for permission, and documented that consent.

“I think it’s empowering the patient, making sure that their data is as accessible as possible in the way they want to receive it, and that’s what we want to do.” Severino said.

Implementing Texting in a Compliant Way

This announcement was a big deal. Patients want to text you…and they want you to text them back. You significantly increase the value you offer to patients simply by giving them this option. So how does the implementation of Severino’s suggestions look in practice? Let’s say that you receive a text message from a patient named Mary asking you for some health-related information. In response, you can send something like this: “Hi Mary. I would love to chat with you more about your health. Text message is not a secure way to do that. Would you still like to continue this conversation?” If you are the one to initiate the conversation, you can send a similar message requesting permission before continuing.

Once Mary agrees and you document that permission, you are then allowed to continue the conversation without concern of violation. A key piece to remember here is that it is important that you make sure your patients are aware that texting is not secure. Then, if the patient feels uncomfortable communicating via that channel, you should move the conversation to a secure method such as a phone call, secure patient portal, or in-office visit. Remember—you are required to make patients aware of unsecured communication and receive authorization before discussing PHI on an unsecured channel.

As one final best practice, always include an opt-out message. Even if a patient has given consent in the past, you must always offer the option to discontinue the communication. This means that it is best to include a message such as “Reply STOP to opt-out” in your text messages.

In summary, if a healthcare provider would like to share PHI with a patient through regular, unsecured text messages, they must first:

  • Inform the patient that texting is not secure
  • Receive permission from the patient to continue
  • Document the patients’ consent
  • Offer an opt-out option

If you are not yet texting with patients (or only sending basic text reminders), this is a critical time to make a change. There is no other form of communication that has such a high level of adoption and engagement. Texting improves the health outcomes for patients as well as the financial outcomes for practices. With this recent clarification of policy by compliance officials, we can expect that the use of text will continue to grow dramatically as we move into the future.

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.

Don’t Be The Last Practice To “Get” Digital Health

Posted on September 14, 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.

Physicians, are you savvy about the digital health technologies your patients use? Do you make it easy for them to interact with you digitally and share the health data they generate? If not, you need to move ahead and get there already. While you may be satisfied with sidestepping the whole subject, patients aren’t, a recent report suggests.

As you probably know already a growing number of patients, most notably millennials, are integrating digital health tools into their everyday lives.

Research from Rock Health, which surveyed about 4,000 consumers, found that the share of respondents using at least one digital tool (such as telemedicine, digital health tracking apps or wearables) hit 87% last year. To get a sense of how impressive this is, bear in mind that just five years ago, only a tiny handful of consumers had given any of these tools a try.

What’s also of note is that some of these consumers were willing to skip insurance and pay out of pocket for digital care. One particularly clear example of this involves live video telemedicine; Sixty-nine percent of consumers who paid out of pocket for such consults said they were “extremely satisfied” with the experience.

Patients who reported having a chronic health condition seemed less likely to use digital tools to track their health metrics. Case in point: When it came to blood pressure tracking, just 11% captured this data with a digital app or journal. However, this may reflect the higher-than-average of those diagnosed with elevated pressures, a senior population with a lower level of tech sophistication.

Lest all of this sound intimidating, there’s at least some good news here. Apparently, a full 86% of respondents said that they’d be willing to share data with their physician, a much larger share than those who would exchange data with a health plan (58%) or pharmacy (52%). In other words, they trust you, which is a big asset under these circumstances.

If you want to dive into digital health more deeply, here’s a few obvious places to start:

  • Link in-person and telemedicine visits: Rock Health found that a whopping 92% pf respondents who had an in-person visit first were satisfied with their video visit.
  • Be vigilant about data security: Almost 9 out of 10 consumers participating in the survey said that they would be willing to share data with you. Don’t lose that trust to a health data breach; it will be hard if not impossible to get it back.
  • Bring chronically-ill seniors on board: While this group may not be terribly inclined to digitize their healthcare, doing so can help you treat them more effectively, so you’ll probably want to make that point up front.

Like it or not, wearables, fitness bands, mobile health apps, and other digital health tools have arrived. It’s no longer a matter of if you take advantage of them, but when and how. Don’t be the last practice in your neighborhood that just doesn’t get it.

Walgreen’s Perspectives on Patient Engagement at #DHIS18

Posted on August 15, 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.

The past 2 days I’ve been attending the Digital Health Investor Summit that’s hosted by KLAS. It was a classy event and the people they had in attendance were phenomenal. I’ll be offering up a number of insights I got from the event across the Healthcare Scene network of blogs, but a couple slides from Chet Robson really stood out for me today. Chet is the Medical Director, Clinical Programs & Quality at Walgreens.

The slides that Chet Robson shared were around some views on patient engagement. Or as he framed it: patient engagement, patient activation, patient involvement, patient participation, patient adherence, patient compliance, patient empowerment, or patient experience. I love that we have so many terms for the same concept.

Here’s the first chart he shared for patient engagement:

The 3 dimensions in the chart listed above seemed like a good framework for patient engagement. So, I was glad when Chet then shared this slide:

I think that more things could be added to the above expectations. However, it’s a really good start. Imagine if all of healthcare implemented these principles.

As timing would have it, I’ve actually done 3 appointments at Walgreens in the last month. Without going into all the details of why, I’m happy to say that Walgreens delivered on these expectations. The visits were easy to schedule, quick and painless, and the experience was great. My only complaint was that the appointment process wasn’t clear. I wasn’t sure if you could only schedule certain appointments or if you could also do walk-ins. The answer is that it’s best to have an appointment. Otherwise, when you walk in, the computer will have you schedule an appointment and unless you’re lucky, you’ll likely be waiting for a bit. However, this is a minor learned thing that can easily be fixed.

What do you think of looking at patient experience from a behavioral, cognitive, and emotional dimension?

There Are No Simple Answers When You Try to Personalize Healthcare Communication

Posted on July 27, 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.

Earlier this month, Brian Norris (@Geek_Nurse), a registered nurse and informaticist who also has an MBA (when has this mix ever occurred?) asked the question on Twitter “Which would you rather receive post having labs drawn as a patient?” His options were: A call, email, text, or Leave Me Alone. While not scientific in anyway, the poll did have a good response and the results below were quite interesting:

The results of this poll highlighted that everyone has different preferences. In fact, if you look over the comments in reply to the poll, you’ll realize that many hated the poll because they would want different modalities based on the specific situation. Personalizing healthcare communication gets really complex really quickly.

The good news is there are healthcare companies that are working towards this kind of personalization. My friends at CareCognitics (I’m an advisor to the company) are doing detailed tracking of each patient’s communication preferences so they can customize which communication platform is used, but also what time is best to communicate and much more.

Another great example of this is the ways Stericycle Communication Solutions allows patients to communicate across a wide variety of platforms from text to humans. That’s right, they have actual humans who talk to you. Eventually, our systems might get good enough that a human discussion isn’t needed, but as the poll above shows, there’s still a desire for phone discussions with patients. Depends on the situation of course since many would argue that a phone call is the worst experience when a text could have accomplished the same thing. Many long-time readers will remember a post by Jim Higgins from Solutionreach that highlights the gap between the communication patients want and what practices offer. A call when a text is sufficient is a bad patient experience. A text when a call is needed is a bad patient experience.

Of course, we also see outside of healthcare where we can experience communication overload. When I do a payment on Paypal, I get an email notification, a Paypal app notification, and a notification from my bank. Another example that might be more familiar to you is an Amazon shipment. They send me an email and a text and an app notice. That’s a bit of overkill no?

Over communication is generally better, but not always. When I’m receiving a package from Amazon, then a few extra messages might just get me more excited for the package to arrive. Even the extra notifications from Paypal are good since I’m afraid of some sort of identity theft. However, if it’s a bad lab result, do I want to be reminded of it 3 times? Definitely not.

What does all of this mean? Healthcare communication is hard work and it’s almost impossible to get perfect. However, we can do better than we do today. The key is to provide the patient multiple avenues of communication. Until the systems start learning about patient’s preferences, ask the patient and let them adjust their preferences over time as they learn what works for them and what doesn’t. Learn from communication mistakes that happen, but make sure you keep the mistakes in perspective. One bad communication doesn’t mean you should necessarily stop the thousands of good communications.

Stericycle Communication Solutions and Solutionreach are both Healthcare Scene sponsors.

DrChrono App Store Illustrates Important Point

Posted on July 16, 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.

In a recent post, my colleague John Lynn argued that EHRs won’t survive if they stick to a centralized model.  He contends — I think correctly — that ambulatory practices will need to plug best-of-class apps into their EHR system rather than accepting whatever their vendor has available. If they don’t create a flexible infrastructure, they’ll be forced to switch systems when they hit the wall with their current EHR, he writes.

Demonstrating that John, as usual, has read the writing on the wall correctly, I present you with the following. I think it illustrates John’s point exactly. I’m pointing to EHR vendor DrChrono, which just announced that billing and collections company Collectly would be available for use.

Like its peers, Collectly built on the DrChrono API, and will be available in the DrChrono App Directory on a subscription basis. (The billing company also offers custom pricing for large organizations.)

Other apps featured in the app directory include Calibrater Health, which offers text-based patient surveys; Staple Health, a machine learning platform that providers can use to manage at-risk patients and Genius Video, which sends personalized video via text message to educate patients. Payment services vendor Square is also a featured partner.

Collectly, for its part, digitizes paper bills and sends billing statements and collection notices to patients via text or email. The patient messages include a link to the patient portal which offers a billing FAQ, benefits and insurance info and a live chat feature where experts offer info on patient insurance features and payment policy. The live chat staffers can also help patients create an approved payment schedule on behalf of a practice.

While some of the DrChrono apps offer help with well-understood back-office issues – such as Health eFilings, which help practices submit accurate MIPS data –  those functions may be duplicated or at least partially available elsewhere. However, apps like Collectly offer options that EHRs and practice management platforms seldom do. The number of best of breed apps that an EHR won’t be able to replicate natively is going to continue to increase.

Integrating consumer-facing apps like this acknowledges that neither medical practice technology nor its staff is terribly well-equipped to bring in the cash from patients. It may take outside apps like Collectly, which functions like an RCM tool but talks like a patient, to bring in more patient payments in for DrChrono’s customers. In other words, it took a decentralized model to get this done. John called it.

The Role of Technology in Patient Satisfaction

Posted on July 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

Over the past six months, we have been discussing the importance of understanding patient needs in order to improve their satisfaction levels. But why does it really matter if patients are happy? Happy patients are the ones who refer their friends and family. They’re are the ones leaving you stellar reviews online. Happy patients stick with you.

One of the most effective (and easiest) ways to improve the patient experience is through the use of technology. According to one study, using technology to communicate with patients increases patient satisfaction scores by around 10 percent. Not only that, but technology saves practices a huge amount of time and hassle. Here are just a few of the ways you can use technology to personalize patient experience and simplify workflow for staff.

  1. Streamline (and personalize) scheduling and check-in

The Patient-Provider Relationship Study found that two of the biggest frustrations patient have around experience are feeling like a number and difficulty with scheduling and wait times. One great way to address these issues is to offer convenient 24/7 online scheduling and electronic forms.

Two-thirds of patients think it is important to be able to schedule appointments online. And practices can make that experience even easier with the right technology. When online scheduling in integrated with your practice management system, it can identify existing versus new patients and adapt the forms so existing patients don’t have to provide information that you already have.

Consider having patient forms on the scheduling page or somewhere on your website, or send them out in an email before the appointment. Then, instead of spending 15 minutes filling out forms, patients can relax. This also allows you to spend more time speaking with each patient individually and addressing any concerns they may have.

If you have patients who don’t fill out their forms online or bring them before arriving, consider using a tablet to expedite the process. Tablets make filling out those forms faster, easier, and more accurate. Waiting to see the doctor shouldn’t feel like homework time. Do whatever you can to make this a time, instead, where you connect with your patients.

  1. Implement two-way texting

Texting is the most popular method of communication today (even 80 percent of senior citizens own a cell phone). Just like people want to text their friends and families, they also want to text you. As the Patient-Provider Relationship study found, 73 percent of patients want to text back and forth with you. With two-way texting, you can:

  • Confirm appointments
  • Coordinate care
  • Discuss appointment follow-up instructions
  • Reschedule appointments

Of course, you want to make sure you stay HIPAA compliant whenever you may be sending PHI information via text message. Make sure to use technology that offers the tools to stay compliant.

  1. Upgrade your patient appointment reminders

If you want to stay competitive in today’s healthcare world, automated appointment reminders are a must. Not only does automating your patient reminders make life a lot easier for your staff, but it ensures that no patients fall through the cracks. Make sure to ask patients which way they prefer to be contacted and use that.

Using mobile messages like text message and email for reminders is especially important in this era when people just don’t like talking on the phone. Now your patients can be stuck in a boring work meeting and still get that text message appointment reminder. It saves you a lot of time, improves productivity, and gives you the time you need to focus on what is most important—the patients in your office.

Automated messages also provide another opportunity to personalize and customize communications to each patient. Just like a postcard or phone call, they have the patient’s name, appointment time, and provider listed, but they can also contain other appointment details. Based on the appointment type, they can have instructions like remember to fast or bring your medications. The patient will feel the personalization and your practice will be able to make sure patients show up prepared.

  1. Automate patient satisfaction surveys

As we’ve discussed at length in prior blog posts, surveys can tell you a whole lot about how you and your practice are measuring up to patient expectations. The more you focus on patient happiness, the more likely you are to make it a priority. So always send out patient surveys following patient visits.

In the past, you may have asked patients to fill out paper surveys in the office. That method of collecting surveys is difficult to track, less likely to be completed, and may have answers that are skewed. Using technology to email or text your patients a survey after their appointment increases the likelihood that they will give more honest responses. It also makes it a whole lot more likely that they will be filled out.

When it comes to making patient satisfaction a priority, it’s critical to gauge if your current technology is up to the challenge. Technology can greatly improve how your patients view you and your entire practice. It can also improve the productivity and efficiency of you and your staff.

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.

Payers Say Value-Based Care Is Lowering Medical Costs, But Tech Isn’t Contributing Much

Posted on June 22, 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.

A new survey of health insurers has concluded that while value-based care seems to be lowering healthcare costs significantly, they aren’t satisfied with the tools they have to analyze value-based performance.

The report, which draws on a survey sponsored by Change Healthcare, including answers from 120 payers across several types of insurance, including managed Medicare, managed Medicaid and commercial plans.

The topline finding from the report was that value-based care (VBC) has lowered healthcare costs by 5.6% on average, with one-quarter of respondents reporting savings of more than 7.5%.

Meanwhile, the volume of fee-for-service payments has dropped dramatically as a percent of overall payments, now accounting for just 37.2% of all reimbursement among respondents. That number is expected to fall below 26% by 2021.

Not only that, 64% of payers said that provider relationships improved, and 73% said patient engagement improved. This suggests that providers have made some strides in delivering value-based care, as many had a hard time restructuring their business in the past.

That said, some payers haven’t met their own VBC goals. In particular, 66% of payers are investing administrative staffers to support episode-of-care programs given what the study terms “exceptional” medical cost savings. Also, one third to one-half said that episode-of-care models were either very or extremely effective at improving care quality.

However, payers haven’t made much progress as they’d like in rolling out episode-of-care programs. While 21% of payers said they were capable of rolling out a new episode-of-care program in 3 to 6 months, more than a third said the needed a year to launch such a program, 21% said it would take 18 months, and 13% said it would take up to 24 months or more. In other words, many payers are so far behind the curve that the programs they’re designing might be obsolete by the time they roll them out.

What’s more, they’ve had a tough time getting providers interested in episode-of-care programs. Forty-three to 58% reported that it is either very or extremely difficult to get providers to participate in these efforts. Not only that, even when they find interested providers, payers are having a hard time finding common ground with them on episode definitions, budgets, the details of risk and reward sharing and performance metrics. These disagreements could prove a major hurdle to overcome.

In addition, more than half of payers said they were not very satisfied with the current value-based analytics, automation and reporting tools, even though most of the tools were developed in-house by the payers themselves. It could be that given provider resistance, the payers aren’t quite sure about what to look for. Regardless, it seems that payers have a longer-than-expected road to travel here.

AMA Says Med Students Don’t Get Enough EHR Training

Posted on June 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.

Whether or not doctors like it, the U.S. healthcare industry has embraced EHR technology, and in most cases, medical groups depend on it for a number of reasons. Now, the industry may be taking the next step in this direction, with the AMA deciding that it’s time to enshrine EHR use as part of medical education.

At its recent annual meeting, the AMA released a new policy embracing two somewhat contradictory notions. On the one hand, it encouraged med schools to train students on using EHR technology, while on the other, underscored the need for future doctors to get their faces out of the computer screen and engage with patients.

According to the trade group, some medical schools actually limit student access to EHRs. The AMA contends that this is a bad idea. “Medical students and residents need to learn how to ensure quality clinical documentation within an electronic health record,” said AMA board member and medical student Karthik Sarma in a prepared statement. “There is a clear need for medical students to have access to – and learn how to properly use – EHRs well before they enter practice.”

That being said, the group’s report on this subject concedes that there’s a long way to go in making this happen. For example, it notes that many med school faculty members aren’t offering students and residents much of a role model for the appropriate use of and practices in working with EHRs.

To address this problem, the new policy urges medical schools and residency programs to design clinical documentation and EHR training. It also recommends that the training be evaluated to be sure that it’s useful for future medical practice.

The AMA also suggests that med schools and residency programs provide faculty members with EHR professional development options. These lessons will help faculty serve as better role models on EHR use during interactions between physicians and patients.

That being said, there is an inherent tension between these goals and the realities of EHR use. Yes, training students to create good clinical documentation makes sense. At the same time, there are good reasons to worry about the effects of EHRs on student and resident relationships with patients. Unfortunately, this problem seems to be unavoidable as things stand today. Either you train budding physicians to be clinical documentation experts or you encourage them to use EHRs as little as possible during patient encounters.

In short, we’ve already learned that we can’t have both at the same time. So what’s the point of telling medical students that they should try to do the impossible?