Internet of Things (IoT) is not a new term. Nearly 20 years ago an MIT professor described a world where “things” are connected and able to share data. In healthcare, IoT is not a technology trend on the horizon, it is here today, and having an enormous impact on the healthcare industry.
Ninety percent of all of the world’s data has been generated the last two years and that statistic will be blown away in 2015 and the years to come as the IoT continues to grow. In fact, Gartner, Inc. forecasts that 4.9 billion connected things will be in use in 2015, up 30% from 2014, and will reach 25 billion by 2020. Leveraging the invaluable insights enabled by the connection of these devices is what the Internet of Things is all about.
IoT is a powerful force transforming the way healthcare organizations do business by allowing them to leverage the cloud to reduce operational costs and generate valuable data-driven insights. IoT starts with the data, devices and services within a healthcare organization including EHRs, claims and financial systems. The data from these various sources is combined with new sources of data like wearable devices and in-home monitors, providing a complete patient view across the entire continuum of care. Healthcare organizations are using the cloud to leverage the IoT to reduce operational costs with predictive maintenance and real-time monitoring of medical devices and to lower readmission rates with predictive insights that identify patients who need additional clinical intervention.
Healthcare organizations that implement a strategy to leverage the Internet of Things will improve efficiencies by spending less time managing processes and systems and more time delivering high-quality and cost-effective patient care. Check out 10 Trends Impacting Healthcare in 2015
There has always been value in being able to reach healthcare consumers remotely, however, the fee-for-service model and health plans have not supported it. Rising expenses, increasing number of Accountable Care Organizations, elevated interest in consumer engagement, focus on population health management and a shortage of healthcare providers are all driving telehealth. Andrew Watson, MD predicts that 85% of healthcare delivery will occur in the home in the next five to six years.1 Telehealth provides convenience to an increasingly busy healthcare consumer and expands access to care while reducing costs. Healthcare Providers need to be including telehealth in their plans or they will miss out on a big opportunity to attract and retain healthcare consumers. Here are four reasons telehealth will transform healthcare:
An Increasing Need for On Demand Care - In years past on-demand care meant dropping into a retail or walk-in clinic to get checked out or to get a prescription. Today, on-demand care means online, from the comfort of your home, even in your pajamas if you wish. More and more people are preferring to email their provider questions or video chat rather than stopping into a near by clinic.
Healthcare reform has provided insurance to more than 40,000 individuals who do not have a formal source of care, making them prime candidates to use telehealth. Additionally, there continues to be a growing need for primary care physicians, in fact it is estimated by 2020 there will be a shortage of 20,400 primary care physicians.1 Telehealth provides a great opportunity to expand primary care capacity, tackle the physician shortage and provide convenient and affordable care.
Healthcare Consumers Driving Their Care - Healthcare consumers are becoming more savvy with their healthcare in terms of leveraging their resources and directing their own care based on personal judgement. They are more accountable for their care and taking responsibility for their preventative care plans. Telehealth may just be the solution to meet the needs of the new healthcare consumer who is seeking convenience and ease as they juggle their busy lives.
Regulatory Barriers Being Addressed - The regulatory environment continues to change to help knock down barriers that have stood in the way of telehealth in the past. Reimbursement eligibility for telehealth services is expanding geographically and new laws are ensuring that certain virtual visits are reimbursed the same way in-person visits are. In addition to government mandates, professional groups are focusing on setting guidelines for evidence-based telemedicine and insurers are partnering directly with telehealth vendors to provide virtual care.
An Emphasis on Customer Experience & Continuum of Care - Healthcare consumers are frustrated with the increased time they spend in the waiting room and the lack of time spent with the healthcare provider. With an emphasis being placed on customer experience healthcare providers are expanding their hours to accommodate for the demand, however, this is not sustainable. Telehealth also provides a channel for delivering healthcare that can bridge the gap and provide care across the entire continuum leading to better outcomes and an overall improved customer experience.
Telehealth engages healthcare consumers, provides valuable insights for population health management and offers an option that addresses rising healthcare costs and healthcare provider shortages. The time for telehealth is now and providers must leverage it to transform their business models, improve care management and tackle rising healthcare costs.
Look for telehealth to have an enormous impact on healthcare in 2015. Both healthcare providers and health plans need to start embracing telehealth. Check out 10 Trends Impacting Healthcare in 2015
Regulations continue to drive changes through the $2.9 trillion dollar healthcare industry, with the goal of transforming the traditional system to improve quality of care and reduce costs. Healthcare customers are seeking price transparency now that they are responsible for a larger portion of the cost of medical services. Health plans must shift their business models to align with an industry that is becoming increasingly competitive and being driven by a more empowered and demanding customer.
Since its inception, the health insurance industry business model has been a B2B operation based on premiums and reimbursements. Today, health insurance organizations are in varying stages of a journey that is transforming them from platforms for purchasing insurance into health management bodies striving to engage their members and provide resources to help them change their health and wellness behaviors. In order to attract new members and retain existing ones, health plan organizations must think like B2C organizations and transform their business models to improve the overall customer experience. They must shift their focus from providing customer service to finding ways to engage their customers.
Health plans must strategically address these technology imperatives, at an enterprise level to enhance the customer experience and succeed in the new world of healthcare:
Digital Strategy - Develop a strong enterprise vision with a road map that utilizes a multichannel enrollment approach (web, mobile, social).
Data Management Strategy – Develop a data management strategy and infrastructure that integrates ALL data, including clinical, and transforms it into actionable, secure and useful insights.
Mobile Strategy – Develop a mobile (mHealth) strategy that embraces mobile applications and leverages them to engage and empower customers.
These technology imperatives must be considered from a strategic perspective in order to meet the true needs of the business.
The transformation of the healthcare industry from a fee for service model to a value-based care model will only succeed if healthcare providers are able to generate a complete, 360 degree view of the patient. In a recent blog Stephanie Banks, Senior Marketing Manager at Perficient, talks about how the importance of leveraging technology to uncover value in healthcare data:
Healthcare companies in the digital age are now responsible for vast amounts of data. This data is created and acquired on a daily basis, and the volumes are increasing substantially with each patient visit or interaction. Some information is stored in pre-determined, structured fields within Electronic Medical Records (EMR), claims or financial systems and is readily accessible with traditional analytics. Other information, such as doctor’s notes, patient surveys, call center recordings and diagnosis reports is saved in a free-form, textual format and is rarely used for analytics due to the limitations of traditional business intelligence solutions.
Experts suggest that up to 80% of enterprise data exists in an unstructured format, which means a large majority of critical data isn’t being considered or analyzed. Without accounting for this significant percentage of available information, healthcare organizations will find it challenging to make accurate and well-informed decisions that impact patient care and organizational operations.
Mark Polly, Director at Perficient recently posted a blog titled Lessons Learned from 2014: Healthcare and Patient Portals. In his blog post Mark takes a look at the challenges with healthcare patient portals, including whether or not patients know they exist and what elements of a patient portal are most essential.
Read Mark’s entire post here and I would also encourage you to read What the Market Says You Need in Your Patient Portal, a great post by Melody Smith Jones, Manager of Perficient’s Connected Health Practice.
Patient portals shouldn’t just be implemented to meet a regulatory requirement, they should be used as an engagement and empowerment tool for patients.
I loved an article I read in a recent issue of HFMA Magazine in the Healthcare Value section. The title is “The Secret to Building Effective Quality Programs” written by John Byrnes, MD. The finance playbook, described by John, includes these cornerstones:
Rule #1: Don’t allow clinicians to calculate cost savings. Finance and clinical counterparts should partner together using transparent calculations and data.
Rule #2: Ensure quality reporting is comprehensive. If a hospital can report financial data for every department, they should be able to report quality data. Make the data available across clinics and define system wide measures.
Rule #3: Ensure quality-control resources are adequate. By demonstrating the business value of quality improvements, the quality department should be able to secure the resources needed to build quality control processes.
Rule #4: Equate Chief Quality Officers to Chief Financial Officers. If it takes the CFO level position to ensure the financial health of the hospital, why wouldn’t we want an equal position to ensure that effective quality control procedures are established?
The common thread here is data and leadership isn’t it? On the data side, enterprise data warehouse solutions are important to source data for common measures for the hospital. This intersection of quality and finance also will be affected by the upcoming conversion from ICD-9 to ICD-10 coding methods. By permitting more-specific coding of patient conditions, it may be possible for care management organizations to identify which members require disease management and to tailor programs more precisely to their conditions, thereby raising the efficacy of disease management and saving both lives and money.
This article initially attracted my interest because of my background in finance and operational analytics, but I also had an unfortunate encounter with a mid-size hospital system recently with a family member that shook me to the core. There was no Quality Officer and no incident reporting process in place and no one to turn to after a life threatening situation unfolded with a close family member. My heart sank not only for my loved one, but for those who would encounter this in the future. I did report this to the Joint Commission and I hope that the culture has changed for this organization.
Where did 2014 go? It flew by…then again after I turned 30, I feel like every year is flying by. As this year comes to a close and planning begins for the upcoming year, like most organizations in the United States, my organization is going through an “open enrollment” period for healthcare benefits, allowing employees to make adjustments to their current healthcare benefits for next year. I rarely change my healthcare benefits. I usually just skim through the HR documents in the slim chance something major changed from the year prior. Ninety-nine percent of the time, nothing changes. However, to my surprise, this year, something maj or, and impressive, did change. For the first time, our healthcare benefits were going to include telemedicine. Amazing!
What is Telemedicine…or is it Telehealth?
Oftentimes we see “telehealth” interchangeably used with “telemedicine,” but there is a slight nuance between the two. According to Dr. Stephen Perkins, Vice president of Medical Affairs UMPC Health Plan, “Telehealth is a general term describing the delivery of health-related services and information by the use of telecommunication technology. It can include phone calls between physicians, videoconferencing or even robotic technology.” Telemedicine has a narrower definition: The specific use of medical information that is exchanged from one site to another via electronic communications for the health and education of a patient or a health care provider for the purpose of improving patient care. It includes consultative, diagnostic and treatment services1.”
The Impact of Telehealth
As the healthcare industry continues to go through major transformation, it is no surprise that healthcare providers are trying to find innovative ways, such as telemedicine, to deliver efficient and effective patient care. Through telehealth, providers can impact access, cost and quality to help achieve this.
Providers2: Accessibility for providers in both remote and central sites relates to convenience, opportunity cost, and work load. Providers located in remote and isolated areas and institutions will have ready access to consultants and referral sources. With telemedicine, they may encounter less “red tape” in arranging for both consultations and referrals. Remote providers may be able to alleviate their work load and coverage during off-hours because of their link to medical centers and the use of non-physician providers. Providers located at tertiary care centers will be able to offer their expertise to a much larger and diverse provider and client population compared to those only seen at their medical centers.
Patients2: The target populations and the major beneficiaries of telemedicine are the geographically remote, the institutionally confined, and those otherwise medically underserved, including inner city residents and the elderly. The substitution of telemedicine for person to-person encounters reduces the need for travel and the related opportunity costs and other inconveniences encountered in the process of obtaining care. Instead of having to travel to distant tertiary care centers for specialized, and sometimes even routine, services, residents of rural areas, correctional institutions, and nursing homes could receive an array of services via telemedicine. Only when it is determined appropriate through consultation with specialists would it be necessary for clients to be referred or transferred to be served at the medical centers.
Patients don’t have to live in rural or remote areas to reap the benefits of access to care through telehealth. Access can also be related to sheer convenience. Many of us truly just don’t have time to get to the doctor. Penciling in a lunch-hour visit with our physician can prove challenging, especially when a can’t-miss conference call absorbs the bulk of our afternoon3. According to Jessica Harper, telemedicine eases this problem -through video, Web chat, or phone, workers can follow-up on a prescription or diagnosis with a physician and reduce the time you spend in the waiting room, flipping through yet another mind numbing magazine3.
Contain Cost – The Center for Information Technology Leadership estimates that widespread use of telehealth systems to promote preventive care, early intervention and effective information sharing could save the United States $3.61 billion annually4. Telemedicine reduces travel expenses, especially for those living in rural communities, where they would need to normally travel hours out of their way to access key health services3. In addition, the number of days of work people take for routine visits can add up in lost wages. According to a recent study, with telemedicine, 92% of patients saved $32 in fuel costs; 84% saved $100 in wages; and 74% saved $75-$150 in family expenses5. Even more astonishing, $1.2 billion could be saved by video consultations between doctors and patients in cases where office visits are not practical5. In addition, many providers actual charge less for a telemedicine consultation than they do for a face-to-face visit.
Increase in Revenue- If time and distance barriers to care are removed, use of service is likely to increase, which in turn increases the volume without declining the cost and resulting in an increase in revenue generation2. Improved operations can also prove to be a revenue generator. According to a recent study in Telemedicine and e-Health, hospitals that utilized telemedicine technology and referred patients to other hospital facilities, specifically children’s facilities, saw their revenue significantly increase6. The research looked at 16 hospitals’ billings before and after they implemented telemedicine tools. Before the implementation of telemedicine, the 16 hospitals recorded 143 transfer patients. After deployment the number jumped to 285, resulting in a revenue jump, going from $2.4 million beforehand to $4 million6.
Timeliness to Care – The National Healthcare Disparities Report (2009), states that, timely delivery of appropriate care has been shown to improve health care outcomes and delaying health care can lead to a diagnosis at a more advanced disease stage and reduce opportunities for optimal treatment5. The window to receive treatment for many disorders is typically small and early detection and diagnosis can be vital. Ongoing remote monitoring and the ability for patients to check in with providers via telemedicine, before something worse happens, makes a positive difference in patient outcomes and satisfaction7.
Care Coordination – According to Kevin J. Boyle, “Transition care typically includes both patient education and medication management components to help ease the transition from hospital to residential facilities and reduce readmissions. While face-to-face communication is ideal, it is often impractical. Telemedicine provides a quick, convenient and more affordable forum for assessing patient recovery, assisting with medication management and keeping patients on track with discharge instructions. Advanced high-definition video capabilities can also help clinicians’ document key indicators of recovery and conduct demonstrations for self-care or physical therapy techniques8”, especially those with chronic conditions.
Patient Engagement – Providers can involve their patients in their own healthcare, thus improving compliance and, over time, clinical outcomes. Randall S. Moore, MD, MBA, states that, “One of the most interesting and promising outcomes of telehealth programs has been the increase in patient participation and self-care. Because patients have an active role in their care plan and are in more frequent contact with their healthcare provider, they gain a better understanding of their condition and become more compliant in their care.9” Patients want to take a more active role in their healthcare and see technology, such as telehealth, as a mean to helping them achieve this important goal.
Telehealth has continued to grow as a unique way of delivering care to patients, while greatly improving access, reducing cost and positively impacting quality. The number of patients using telehealth services is expected to jump from the 350,000 in 2013 to about seven million by 201810. Despite this staggering increase in users, there are still some barriers preventing its wide-spread use, such as resistance on the part of providers, limited insurance coverage and reimbursement, and privacy and security issues. However, over the past few years these challenges seem to be lessening as the healthcare industry, as a whole, is understanding the benefits of telehealth and from the looks of it, it seems like telehealth is here to stay as a recognized part of healthcare delivery.
What do you think? Do you think telehealth and telemedicine can change the healthcare industry?
Resources for this blog post:
Technology is a major player in the evolving healthcare environment, and organizations are increasing their health IT budgets to adapt to the “new” industry. Having the right technology in place can enhance patient experience, help meet regulatory requirements and provide key insights that reduce costs and improve outcomes. In our recently released HIT SNAPSHOT we have identified ten trends impacting the healthcare industry that can help determine which technology investments should be made to achieve the greatest return on investment.
As we wrap up 2014, let’s take a look at the top 10 blog posts from our thought leaders. These blogs were published on Perficient’s Healthcare Industry Trends Blog.
If you missed these you may want to take a look.
#1. What the Market Says You Need in Your Patient Portal
by Melody Smith Jones | June 19, 2914
#2. Connected Health Trend Countdown: #1 Health Plans Go B2C
by Melody Smith Jones | February 5, 2014
#3. Changing Delivery and Spending of Medicaid Through DSRIP
by Priyal Patel | May 22, 2014
#4. Healthcare Gamification: Avoiding Chocolate Covered Broccoli
by Melody Smith Jones | February 4, 2014
#5. How Enterprise Mobility Management can Improve Patient Care
by Kate Tuttle | May 7, 2014
#6. Perficient Ranked One of the Largest Healthcare Consulting Firms
by Kate Tuttle | August 25, 2014
#7. Connected Health Trend Countdown in Review
by Melody Smith Jones | February 6, 2014
#8. Apple: The New Digital Hub for Healthcare Data
by Kate Tuttle | September 9, 2014
#9. Healthcare Benchmarking
by Priyal Patel | July 9, 2014
#10. The Problem with Health IT is in the Definition
by Kate Tuttle | October 13, 2014
As we wrap up 2014, I wanted to share with you Perficient’s top 10 healthcare thought leadership assets from 2014. Visit the Thought Leadership section of our website to discover additional complimentary resources and to register for upcoming webinars on trends and topics within healthcare IT.
#1. Gearing Up for 2015 – 10 Trends Impacting Healthcare
Guide: Multiple Contributors
#2. Top 10 Connected Health Trends, What You Need to Know
White Paper: Written by: Melody Smith Jones
#3. Implementing a SOA Strategy to Improve Healthcare Interoperability
Perspective: An Interview with Terie McClintock
#4. Improve Quality of Care and Business Outcomes through Enterprise Information Management
Perspective: An Interview with Juliet Silver
#5. The Connected Healthcare Enterprise
White Paper: Written by: Jaclyn Layton and Melody Smith Jones
#6. How Cloud Computing Delivers Scale, Security, Compliance and Social in Healthcare
Perspective by: Joan Rothman
#7. Healthcare Enterprise Data Model: The Buy vs Build Debate
Webinar: Presented by: David Meintel
#8. Learn How ProHealth Care is Innovating Population Health Management with Clinically Integrated Insights
Webinar: Presented by: Juliet Silver and Christine Bessler
#9. Align Patient Outcomes with Financial Data – A Formula for Correlating Cost and Quality
White Paper: Written by: Lesli Adams and Terie McClintock
#10. The Health Plan Transformation: Improving Customer Experience with CRM Solutions
Perspective: An Interview with Andrew O’Driscoll
For more than 15 years, Perficient has delivered a variety of high-quality and cost-effective solutions and services to help healthcare organizations adapt to the ever-changing healthcare market. Our deep domain expertise, strategic partnerships with the world’s leading technology vendors, dedicated healthcare industry expertise, and a broad portfolio differentiates us from the competition.
At Perficient, building long-lasting relationships with our clients is a priority. In each of the past four years, approximately 85% of our revenue was derived from repeat business. This reflects our commitment to quality consulting and speaks to the long-term partnerships we build with our clients.
I grew up in a small town in Iowa and lived in and around my hometown for 30 years. It wasn’t unusual for my commute to work to be interrupted by a John Deere tractor driving down the highway. When I hit 30 I traded in my rural roots and headed off to the booming metropolis of St. Louis for a change of scenery. I, like many others, struggle to schedule routine and regular doctors appointments so when I moved, finding a new doctor was not a priority. I have been blessed with a relatively healthy life thus far and tend to view healthcare as sick care. (When I’m sick I will go to the doctor.) Needless to say, it took me a while to take the time to find a new doctor after moving to St. Louis. In fact, it didn’t happen until I had found a veterinarian and a groomer for my dogs, a hair stylist I liked and a car repair shop that was reliable and trustworthy. To be honest, I still may not have a doctor if it weren’t for the fact that I needed to get a refill on my prescription.
Who Uses FAX Machines? Doctors Do…
I took some time looking online to find doctor reviews and patient referrals and, of course, listened to word of mouth from my new friends in St. Louis. Once I settled on a doctor I made a call to schedule an appointment and then contacted my previous doctor back in Iowa to have my records FAXED to my new doctor. The fact that fax machines are still being used, not only as the primary technology but the only one, both humored and frightened me at the same time. But I thought whatever works to get my information to the new doctor, works for me. Having my previous medical history in the hands of my new doctor would save me time. I wouldn’t have to fill out the medical history paper work because I took the time prior to my appointment to have my records faxed to them…Right? Wrong, this didn’t save me any time at all.
A NEW Patient Again and Again…
I was advised to arrive 20 minutes early to fill out paperwork and when I arrived I checked in and was handed a blank stack of medical history forms to fill out. I began by filling in the easy stuff, name, social security number, birth date, address but when I got to the medical history part I felt like writing “check the records that were faxed to you.” I stumbled my way through the paperwork and turned it in, thinking to myself, if that were a test I would be happy with a C. I sat back down and waited for the nurse to call my name, and when she did, I followed her back as she proceeded to ask me questions about my medical history. The same questions that I had just struggled to answer on paper. And again, I felt like telling her to “look at the paper work I just wasted 20 minutes of my time filling out.”
At this point I was ready to see the doctor, get my prescription and be on my way. The doctor entered and I had a similar experience with her, a lot of repeated questions and answers, but I survived, got my prescription and set up another appointment for the following year. I was pretty proud of myself for scheduling a routine appointment! As painful as this visit was, I was glad that it is only a process that new patients have to endure, so I wouldn’t have to do it again…Right? Wrong, I received a letter in the mail that my doctor is closing shop, leaving me once again with the rigorous task of finding a new doctor and worse yet, becoming a NEW patient again.
Those Are MY Medical Records, Aren’t They…
As I began my search for a new doctor, I was able to seek additional referrals from friends now that I had lived in the area for a couple of years. I picked up the phone and called to make an appointment and the receptionist asked that I have my medical records faxed to them. After making the appointment I called my previous doctor and asked that my medical records be sent to my new doctor. I was told that they could fax the records from my single visit but that they could not fax my older records and that I would have to contact my doctor back in Iowa to have those faxed. Wait, aren’t those my medical records? I’m giving you permission to fax them, why do I have to contact the doctor in Iowa to fax them? The receptionist reiterated that she would be happy to fax my one record but I would need to fill out a release form in order for her to do that. She asked if I had a fax machine….seriously, why do all these doctors insist on the fax machine? I asked if she could email it, but email wasn’t an option. So I am now waiting for snail mail to deliver a release form that I have to fill out and drop back in snail mail in order for my request to be processed.Upon hanging up with her I called my doctor in Iowa and asked to have my medical records faxed to the new doctor. Again I was told that I would have to fill out a release form and that I could get that at my new doctor’s office. So, I now have to fill out 2 different release forms in order to get MY medical records faxed to my new doctor. And I am sure when I go to my new doctor I will have to fill out the same paperwork that I have jumped through so many hoops to get to them prior to my appointment.
I can’t wait for the day when all my medical records are stored in one place and I won’t have to get permission to have MY records sent to a new doctor. A secure and private location that is easily accessible by ALL of my doctors – both current and future!
Accountable Care Organizations (ACOs) as a model to deliver high-quality, cost-effective care across the continuum and improve population health management (PHM) has significantly increased. In an ACO, healthcare providers take responsibility for the health of a defined population, coordinate care across the continuum, and are held to benchmark levels of quality and cost. In 2015 ACOs will continue to be on the rise! Read the rest of this post »