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Posts Tagged ‘telehealth’

7 Features the Market Wants in Your Patient Portal: Blog Series

In case you missed it, we recently concluded our blog series on What the Market Says You Need in Your Patient Portal. Two of our healthcare experts, Melody Smith Jones, Manager of Connected Health (@melsmithjones) and Nick Lecker, Director of Architecture and Interoperability teamed up to take a deeper look into the 7 features that the market wants in your patient portal:7 Features the Market Wants in Your Patient Portal Blog Series

Healthcare consumers are at the center of the industry’s evolution and patient portals are going to continue to be a vital tool for connecting, engaging and empowering them.


Market-Driven Patient Portal: Telehealth Beyond the Virtual Visit

Last month I published a post entitled “What the market says you need in your patient portal” that garnered a lot of interest. In that post I addressed the balancing act that healthcare executives face when market based initiatives are sidelined in order to drive focus to regulatory requirements such as Meaningful Use. Sometimes the market and regulatory requirements are in sync. However, when those regulatory initiatives get delayed things get complicated. My advice is that, beyond Meaningful Use, ultimately the market will determine what true patient engagement means, and I highlighted seven features that a market driven portal should have. I will spend time during this series going into detail on those features. They include:google-smart-contact-lens-glucose-sensor-640x353

  • Telehealth that moves beyond the virtual visit
  • Dynamic scheduling
  • Social collaboration
  • Gamification and serious games
  • Avatars for personalized health coaching
  • Health information exchange across diverse care settings
  • Integration of clinical and financial data

Today we will begin with telehealth. The topic has been in the news quite a bit recently – mostly in terms of telehealth reimbursement. The world of telehealth is not only in a state of transition currently, telehealth is also one of the major net deltas that we will see between healthcare of today and the healthcare of ten years from now. So, what does telehealth look like beyond the virtual visit? We are pushing towards a world where technological innovations will make the brick and mortar less and less relevant even in the world of healthcare. One of the more interesting developments in this area is a push by X Prize, by way of multiple multimillion-dollar prizes, to innovate technologies in such a way to diagnose common medical conditions with no intervention from a health care professional. With this drive in the marketplace in mind, telehealth in a market-driven patient portal you would find:

  • Socially Enabled Patient Portals: In a socially enabled patient portal, physicians and patients can work together toward their combined goals of better health using tactics like dynamic messaging, activity feeds, blogging, and open question forums.  These technologies are particularly effective in rural and low-income areas and are being used to enhance the quality of care for diabetic populations in low-income areas, for example.  These technologies show great promise for providers and health plans interested in managing chronic disease in a cost-effective fashion, especially for the uninsured.
  • Robotics:  Children’s hospitals have been the early adopters of telehealth technologies. Some innovations of interest are in the realm of robotics. Boston Children’s Hospital has an impressive telehealth program with a video-monitoring robot. These 4-foot-6, 17-pound, two wheel robots help with post-operative consultations and care primarily as a means of videoconferencing, giving the families of hospital patients a way to keep in touch with doctors and nurses in between post-surgical appointments. Equipped with cameras, audio gear and a video screen for a “face,” the robots are operated remotely by Children’s Hospital staff. In addition to facilitating communication, they can take video and close-up photos of surgical scars or other key areas of interest to help medical staff monitor recovery.
  • The Smart House: When it comes to uncovering issues early, the tracking of vitals, combined with analytics that readily alert clinicians when those vitals show potential for problem, have been crucial to telehealth outside the virtual visit. We are seeing innovations that embedded fiberoptics into carpeting that can track the activity of patients in and out of their bed while at at home. There is also an innovation called the Health-e-Chair that incorporates a vast array of biosensors to measure vital signs including weight, blood pressure, temperature, ECG, auscultation of heart and lung sounds, blood oxygen saturation, motion analysis and reflex response time. The chair incorporates a communication unit with a remotely controlled camera.
  • Nanosensors: Taking the tracking of remote patient monitoring microscopic is no longer just something we will get to eventually. There are innovations on the market now that can make a big difference in population health. Diabetes is a serious issue in the world of healthcare (understatement of the year award nomination). One of the leading causes of blindness in the world, diabetes patients have a risk of developing retinopathy, which could ultimately lead to blindness. Nanotatoos have already proven out in diagnostic efforts to track blood glucose levels, for example. Google and friends are also innovating around embedded camera functionality into contact lenses to find early signs of diabetic retinopathy.

One in five Medicare patients are readmitted to a hospital within 30 days of discharge, and one in three are readmitted within 90 days. It’s estimated that 75% of all hospital readmissions are preventable. Telehealth provides many benefits as a virtual visit. However, it is taking telehealth beyond the virtual visit that the market will push towards as we work to bring down the cost of care and reduce readmissions. Stay tuned for a future post on how the integration of all of this data takes this effort a giant leap forward.

Anything you think I’m missing? I’d love to hear your thoughts in the comments below.

The “Yellow Brick Road” to Value-Based Care

“The Wizard of Oz” is a wonderful movie, full of metaphors that can be applied to real life. As I look at the current state of Healthcare, I can’t help but wonder if there is a true “yellow brick road” from volume based care to value based care. If there is, which stops will we make along the way and what roadblocks will we face?The “Yellow Brick Road” to Value Based Care

Physician engagement is a crucial component on the road to value-based care. As Michael Porter and Thomas Lee mentioned in their article in the Harvard Business Review, “care fragmentation is reinforced by the fee-for-service model in which each doctor, specialist or otherwise, is paid separately, while the hospital receives its own payment.” They go on to mention that crucial services, like care coordination, are often not reimbursed, thus further fragmenting healthcare.

As our population ages, these crucial components will need to be addressed as practices, hospitals and payers will be flooded with patients needing coordinated services. So how do we engage our physicians in this battle? Like the Scarecrow, listening and learning needs to take place. We can allow clinicians to work to the level of their licenses to unburden the physicians by coordinating patient care and documentation which becomes available for the treating physician.   This will then allow the physician to spend quality time diagnosing and treating the patient, patient and physician satisfaction will rise and overall medical costs will decrease. Payers, Accountable Care organizations (ACO’s), Patient Centered Medical Homes (PCMH) and governmental regulators will see the health care value being generated. With value-based care, these services should be included in reimbursement and quality care should be rewarded. Sounds simple, right?! Read the rest of this post »

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Posted in News

Imagine all the people…without healthcare insurance?

This morning a colleague forwarded a Fast Company article entitled “The Mayo Clinic’s New Doctor is an iPhone.”  The article describes a new Mayo Clinic concierge medicine via mobile device that is subscription based.  For $50 per month (per household) the Mayo Clinic basically offers unlimited access to their nurse’s line powered by iPhone virtual visits.  The service includes:

  • 06FOB-MEDIUM-SPAN-articleLargeReal-time video chats with Mayo Clinic nurses
  • Personally-tailored health information culled from Mayo Clinic databases
  • A “symptom checker” that incorporate’s individual user’s health histories
  • Access to a personal medical concierge who can provide more information or schedule patients’ doctor appointments

Programs like this are becoming increasingly popular.  As I mentioned in the Connected Health trends seriesTime Warner Business Class announced it was venturing into the world of virtual medicine through a partnership with the Cleveland Clinic.  The program is part of Time Warner Cable’s Home Health Monitoring network that was designed to connect healthcare providers to patients in their homes.  It will provide secure, encrypted, two-way video conferencing between patients and Cleveland Clinic providers on a subscription basis. Read the rest of this post »

Trends to Watch in the Healthcare World in 2014

What’s transforming the ways in which healthcare is provided?

  • legislation
  • new competition
  • innovative incentives
  • a call to refocus on priorities
  • a more empowered and digitally engaged consumer, who has more and greater expectations for quality of care and convenience of care.
  • a renewed attention on healthcare by the consumer market thanks to ongoing press about and the Affordable Care Act
  • new services and business models in healthcare that we’d never seen before recent reform

Susan DeVore, Premier healthcare alliance…and much more.

Susan DeVore, CEO of our partner and client Premier healthcare alliance, wrote a post yesterday fro titled, “The Changing Health Care World: Trends To Watch In 2014.” In the article, she introduces the new trends she expects to see in healthcare this year. We are also seeing each of these trends impact conversations about investments our clients need to make this year and next year.

I have summarized the trends below.

1. Investments in Chronic Care

  • Chronic conditions increase costs by 3X, so, “The biggest health care consumers are those with multiple chronic conditions.”
  • We should see more investments in Ambulatory ICUs and patient-centered medical homes as providers work to improve their shared savings payments and better manage chronic conditions within primary care facilities.

2. New Job Roles in Healthcare

  • DeVore has seen an increase in the popularity of hiring “health coaches” who are there to listen, inspire and motivate and spend time getting to know the patient’s family and life situation as it affects their ability to both access care and to care for themselves.

3. Home Health Care

  • Back to the days of the house call.
  • “Marketing firm BCC Research predicts that the market for remote monitoring and telemedicine applications will double from $11.6 billion in 2011 to about $27.3 billion in 2016.”
  • Technology is increasing access and convenience of healthcare from outside the traditional care setting, especially for rural, hard-to-access locations.

Read the rest of this post »

Connected Health Trend Countdown: #7 Care Knows No Bounds

Top TenToday’s entry in the 2014 Connected trend Health countdown takes us far away from home:

Trend #7: Care That Knows No Bounds

It wasn’t so long ago when the general consensus amongst healthcare leaders was ripe with uncertainty regarding the returns to be had from telehealth and remote patient monitoring investments.  It’s only a year or so later and these same telehealth programs are now becoming well established at health systems across the country (and around the world).  It seems that the very concerns holding telehealth back in the not so distant past are the same concepts that are driving it forward today.  As mentioned by Gienna Shaw of Fierce Healthcare, telehealth is saving money and extending the mission of better health.

Life Saving Decisions Made from a Distance

Children’s hospitals across the country have been the fastest adopters of mobile health technology.  Children’s of Philadelphia and Boston Children’s Hospital are considered thought leaders in this area.  However, it was a west coast provider that recently got my attention.  In mid-November, I happened upon an article in the Business Journal about how the telemedicine program at Oregon Health & Science University (OHSU) saved a baby’s life.  7 month old MaLea Fox had a very high fever.  Blood work revealed that she had a virus, but after returning home MaLea’s mother was unable to wake her after four hours.  The on duty physician at Columbia Memorial Hospital in Astoria was able to call for a telemedicine consultation with OHSU’s Dr. Jennifer Needle, a pediatric intensivist.  She exambined the child using a two-way communication system with a “robot-like” device.  Dr. Needle was able to see MaLea’s symptoms, which made her look like a burn victim. MaLea was diagnosed with Memingococcemia, which is a life threatening bacterial infection.  Needle advised having a breathing tube inserted before sending her to Portland by helicopter.  Weather made the transport a challenge, which made intubation a lifesaver in this case.  MaLea spent 111 days in Portland and had her leg amputated above the knee.  She is now doing much better and has no memory of the trauma.

Online Medicine Means Big Business

One area of strong growth in telehealth is the area of online medicine, which is more popularly dubbed “virtual visits”.   According to the Pew Internet and American Life Project, 88% of US adults with Internet access research health information online and 60% say the Internet info influenced a decision about how to manage a health condition. Going online is no longer a one-way stream of information from computer to patient.  We are now in the era of web 2.0, which is empowered by social networking. Patients go online to find meaningful engagement with other epatients and, becoming more and more common, with their providers via secured access patient portals.

The results have shown promising enough to elicit private investment.  Time Warner Business Class recently announced it was venturing into the world of virtual medicine through a partnership with the Cleveland Clinic.  The program is part of Time Warner Cable’s Home Health Monitoring network that was designed to connect healthcare providers to patients in their homes.  It will provide  for secure, encrypted, two-way video conferencing between patients and Cleveland Clinic providers.  

We now live in a world where the local hospital is competing with national leaders.  However, the wonder that is social technology has historically favored David over Goliath.  I’m very interested in seeing where this trend leads us throughout the coming year.


Making Mobile Medical Apps Just Got Easier

Earlier today, the FDA released its final guidance for developers of mobile medical applications. The FDA is focusing on regulating potentially harmful apps instead of policing applications that pose minimal risk to consumers. These more harmful apps include those which are using mobile technology to make a specific diagnosis and those which medicaltransform mobile devices into a regulated medical device – for example, an app that can turn your phone into a ECG to track heart risks. There are currently thousands of mobile applications currently on the market, with only about 100 that have been approved by the FDA.

With the FDA focusing on mobile applications that work as or with regulated medical devices, telehealth services are likely to be affected. Gaining approval by the FDA will likely be a difficult, stringent process. However, it also will increase the safety and security of telehealth and can lead to better care.

With this relaxed oversight on health apps that are not related to regulated medical devices, do you think we will see an increase in the number of apps available?

Top 5 Technology Trends in Healthcare – August 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

Personalization of Medicine

Personalized analytics have the power to improve care outcomes for patients by drawing data from a complete view into their care coordination. Healthcare analytics and big data hold the key to being able to provide personalized care and prevention. By integrating personal health records with EMR data, providers have a 360 view into the history of the patient and the care they require.


Interoperability plays a key role in ensuring systems can communicate with each other to share information. It helps to reduce redundant data entry, speed access to information and create a real-time flow of information through an enterprise IT system. The key benefit of creating interoperability is to improve the visibility, sharing and re-use of data collection between disparate healthcare applications and devices.

Read the rest of this post »

Innovative Medical Education…Can it Save Healthcare?

Is there such a thing as “disruptive medical education”?  Can traditional medical education be infused with technology, techniques and individualized learning such that it creates the next generation of enlightened and empowered physicians?  I think so.  Years ago, when I was enrolling in medical school at Case Western Reserve University, I felt like I was a part of just that…exciting, cutting edge education which was “disrupting” the traditional training by allowing students to start interacting with patients immediately.  So I was intrigued when I read about a new program starting at Brown University’s Alpert Medical School in 2015. This program focuses on combining Ausmedschoolpopulation health management and primary care to create physicians who are focused on the principles of the Triple Aim: improved outcomes, better quality healthcare delivery, and decreased cost of care.  But will it work?

As everyone knows, the cost of healthcare is astronomical.  Federal mandates and regulations abound.  To survive in this landscape, physicians need to understand these increasing pressures and begin to embrace the tools which will allow them to provide improved outcomes, better quality of care and do it with less cost.  It seems to me that educating our next generation physicians and arming them with these tools to succeed only makes sense.  Social media, mobile health, telehealth, population wellness, and more are all here to stay.  Patient engagement in healthcare is rapidly evolving and will be an integral part of any health system of the future.  Medical education needs to change and not stagnate.

So my answer is this:  I am hopeful that we choose the right path and decide to disrupt medical education.  I encourage all of the cutting edge, forward thinking, connected educators to lead the charge, just like those at Brown are currently doing.  Just like Case Western Reserve University’s Medical School did several decades ago.  Do you think it will happen?

Hang on; I’m getting a notification from my body on my phone

Today I heard an airplane defined as a number of parts flying in formation.  That is an accurate description of an airplane if your work is to maintain or repair airplanes.  But that definition isn’t right for marketing air travel to people who fly as often as I do.  I would prefer to know that the whole airplane, including the human crew, is going to get me to my destination safely and on time.  The idea that wireless sensors implanted in your body that feed information to a smart phone can help maintain your body like a number of parts, walking, running, driving or flying in formation is very exciting.  It is sensational to think that we could collect minute by minute information to manage our body and take actions to prevent or control chronic illness. The idea that a diabetic could wear or have an implanted device to monitor blood glucose levels and then have that device wireless talk to an insulin pump could be a real game changing event for all types of diabetics.  Close control of blood glucose levels really helps prevent implantdevicedamage, sometimes irreversible damage to the body, for example.  How about a real time wireless notification when blood sugar levels are too low, like when you are sleeping, for example?  Better yet, an alarm that notifies you and someone else to check on you.

There is an excellent article about the research on wireless sensors implanted in the body to provide medical information at “The internet of you: How wireless medical implants will change medicine”.  The article captures the challenges faced by implanting silicon based chips and how quickly the body will attack and try to repel them out of the body. However, having personally seen the success of implanted devices to monitor and manage epilepsy in children, this type of research deserves more attention and funding to make breakthroughs.  Instead of a large belt-worn device wired with electrodes into the brain, how about miniaturization into a small waterproof hearing aid sized device?  The potential is definitely there for real breakthroughs.  A great example is using tiny nerve signals to control prosthetic devices to allow more sophisticated fine motor skills.  The ability to tap into the auditory nerve to address hearing loss is another example where the device may one day be implanted and then wireless stream signals to an external device. Read the rest of this post »

e-Patients Enhancing Health Through Social Media

Each day millions of pieces of information are shared over social platforms. There are over 400 million Tweets and 2.5 billion items shared on Facebook each day – and these are just two of many social networks. Healthcare has not ignored this shift to social and is working towards integrating these various networking channels with health information to lead to a healthier population. Our new Perficient Perspective, “The Driving Force of Social Media in Healthcare,” gives insight on the increasingly social world of healthcare from practicing physician and Perficient director Dr. Marcie Stoshak-Chavez.

Marcie answers several timely questions on how social media can be a boon to providers, how it has had an effect on communication between physicians and patients, and how doctors can use social networking to their advantage. There are many different aspects of healthcare that can be tied to social media and patient engagement, including telehealth, remote monitoring, and the quantified self. Marcie’s unique role as both a practicing physician and a business consultant allows her to see these variations on traditional care from both sides of the fence.

A video series with Perficient’s Martin Sizemore gives additional thoughts on driving patient engagement through social media and networking. Knowing your audience and tailoring the delivery is key, and knowing which technologies healthcare organizations should be focusing on to communicate with patients will be critical. Meaningful use requirements  are spurring patient engagement by using patient portals, mobile phones, and remote monitoring to engage patients and lower costs. Mobile phones are also making self-tracking quicker, easier, and more interactive, which can be leveraged for preventative health measures. These preventative health measures can be used towards population health management, along with online communities for chronic condition support.

View the Perficient Perspective with Marcie and Martin here.

Top Technology Trends in Healthcare – June 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

ACOs and Patient Centered Medical Homes

An ACO is a group of healthcare providers that partner under a payment and delivery reform model that become collectively accountable for the full continuum of care for a population of patients. This reform model ultimately ties reimbursement to quality metrics and reductions in the total cost of care for the patient population. Patient Centered Medical Homes (PCMH) focus on improving the quality of care delivered by creating a health care environment that facilitates communication between the patient and their physician, allowing patients to receive and understand the care they need when they need it.

Telehealth and Remote Patient Monitoring

The healthcare industry is experiencing revolutionary changes stemming from the rapidly shifting role of the patient within the continuum of care. This is resulting in high demand for easier access to healthcare professionals, access to online medical information, and alternatives to traditional care. Telehealth allows for the transmission of medical images, video, audio and information related to diagnosis and treatment can be stored and sent from the provider’s computer or mobile device via secure data exchanges. Remote Patient Monitoring allows patient’s health data to be sent electronically to a provider who then can analyze it and respond with appropriate recommendations.

Read the rest of this post »