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.

Consolidation and Mergers

Healthcare entities, both payers and providers, have been making an increased effort to capture market share and dominate their geography. Smaller players are being picked up by larger players, consolidating physician practices and health plans. These mergers have driven digital strategy projects and paperless environments, with an increased interest in advertising and public facing websites to try to attract market share.

• Changes in Hospital Finance Drives Flurry of Mergers
• Partners-South Shore merger review grows
• Cadence Health plans to merge with Rockford Health System
• Blue Cross of NEPA, Highmark exploring ‘stronger’ partnership
• Area hospitals promise transparent merger

Extending Your EMR

Healthcare professionals have been very vocal about the challenges that come along with electronic medical record systems. The workflow in many EMR systems was created by a programmer and works the way it was programmed, not the way healthcare professionals work. Several technology tools were made to extend or approve upon EMRs without ripping the code apart, often by putting it into a browser or allowing it to be mobile.

• EHRs can’t do everything
• 9 Reasons Doctors Hate Their EMR
• Docs blame EHRs for lost productivity
• So much data-gathering, so little doctoring
• How connected is EHR user satisfaction to vendor choice?

Security and Privacy of PHI

The further we develop our technology, the more security risks we’re introducing at the same time. BYOD and wireless networks increase the mobility and sharing of data, which is helpful for diagnosis and storage but risky for protecting PHI. There is a delicate balance between how much security is enough and when security will make it impossible for us to manage the system.

• Addressing BYOD security at a large medical research center
• Factoring healthcare BYOD policies into network security
• 3 tips for proactively protecting PHI
• Sloppy Handling Of Patient Data Always A Danger
• Data Security Added to Worries About Website

Fragmentation of Health Records

While interoperability is a key trend in healthcare, the cost of care is driving us away from this goal. In order to save money, patients are now going to several different pharmacies and stores to get discounted prescriptions where they can, fragmenting their health records. If the only time these medications are reconciled is when patients visit their primary physician, that’s not often enough to prevent adverse drug reactions.

• Why Healthcare Tech will save your life …and your wallet
• Interoperability: A critical mess
• Connecting a new world of care: why interoperability is vital for the NHS
• Health IT can improve care coordination for complex conditions
• Docs can prevent adverse drug reactions by looking up info on mobile phones

FDA Oversight

In September, the FDA revised its guidelines on what mobile medical applications need to be regulated and what are harmless to consumers. Now the FDA is wading into the issue of what else they need to regulate and what they don’t. This week they decided t to block 23andMe for providing medical advice without a physician involved. The FDA will battle where the concept of ensuring accurate medical information will start and stop.

• Congress delves deeper into FDA mHealth oversight
• U.S. approves drug tracking, compound pharmacy oversight law
• The HIT Group wants input into FDA regulation of health IT
• Here’s why the FDA is targeting 23andMe
• FDA to 23andME: Stop genetic tests

The FDA’s recent ruling on monitoring mobile medical applications tells us something: there are so many health apps on the market that the FDA has to focus on approving only those which are using mobile technology to make a specific diagnosis or that transform mobile devices into a regulated medical device. So with thousands of applications available, which ones should doctors focus on? Doctor Eric Topol recommends the top mobile apps for doctors to focus on:

EPOCRATES: One of the oldest and most established medical apps, Epocrates gives doctors basic information about drugs, the right dosing for adults and children, and warnings about harmful interactions.

UPTODATE: This app provides reference material doctors can consult when making treatment decisions.

ISABEL: Doctors enter symptoms, and the app lists possible diagnoses as well as medications that could cause the symptoms.

ALIVECOR: This portable heart monitor and app–one of the programs that opened Dr. Topol’s eyes–runs on a patient’s smartphone to produce electrocardiograms.

IHEALTH WIRELESS PULSE OXIMETER: People with trouble sleeping can use this app to record their blood-oxygen level during the night–data that can help a doctor diagnose whether they have sleep apnea.

RESOLUTIONMD: Doctors can look at X-rays and other images on a smartphone or tablet when they use this app

CELLSCOPE OTO: A smartphone becomes an otoscope, the instrument doctors use to look into the ear, thanks to this app and optical device.

ISCRUB: This infection-control app collects and rapidly displays data on whether hospital staff are being scrupulous about washing their hands.

BREAST CANCER DIAGNOSIS GUIDE: Using this app, breast-cancer patients enter and track details of their disease and treatment, from the size of the tumor to the presence or absence of estrogen receptors.

CLINICAM: Increasingly, doctors are using their phones to take photos of a patient’s condition–such as a rash or wound–and to upload the images to the patient’s electronic medical record.

This morning, I read an article called “Stop playing games with healthcare” about gamification being “a buzzy word, not a real fix” for healthcare. The author, Ryan Bradley, sat in on a case competition earlier this year where teams pitched ideas that would leverage IT to transform and improve healthcare.

Immediately, a theme emerged, and the theme was games. “How do we gamify healthcare?” a presenter on one team asked, rhetorically, after listing off the growing toll chronic diseases take in both developed and developing nations… One of the many difficulties in treating chronic diseases is that one must adhere to a strict medical regimen and see it through to the end of its prescription. Chronic disease demands chronic medication. Taking medication is no fun, but the idea that it might be made a game is, at least, as old as Mary Poppins.

Team after team presented ideas centered on using gamification to make adhering to medical regimens more fun, or at the very least less of a chore.

As the day wore on, one of the Merck representatives finally asked, in exasperation, “Why would you make a game out of taking a pill? This will never be fun,” which is true. When the goal is good health, the “upshot should simply be getting well,” she added… Teams argued that the data gleaned from users playing games, competing for arbitrary points to improve their diets or take their drugs, would help pharmaceutical companies design better drugs. “I don’t see that happening,” another Merck rep said, flatly.

The author made some good points about gamification – it’s not ever going to be “fun” to take a pill. It’s difficult to make patients write in food diaries, keep a log of their medication times, or track activities. However, there is a growing group of people who track their own health data already – members of the quantified self.

Gamification may not be the answer for every diet, disease, or drug in healthcare. But for those who are already motivated to improve their health, it may be just the push they need to get on track.

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.

Mobile Medical Applications

Last month, the FDA released its final guidance for developers of mobile medical applications. The FDA will focus 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 transform mobile devices into a regulated medical device.

• Final medical app guidance issued by FDA
• New House bill aims to slash FDA’s mHealth oversight
• Risky business: FDA mobile medical apps final guidance focuses on risk to patient safety
• Bill provides guidance on FDA mobile medical apps regulation
• Health IT Regulators Face Challenges as Medical Apps Proliferate

Patient Engagement and Connected Health

With the progression of patient engagement, consumers are looking to become involved in their own care and health. The quantified-self movement helps patients track their health, physical activity, food consumption, heart rate, and more. From mobile apps to worn digital sensors like the FitBit to implanted devices, patients keep track of their own health data – which eventually may be used to create a more personalized experience.

• Partners tackles ‘huge void’ in wellness
• Digging Deeper on Patient Engagement
• Patient Engagement: How To Do It Right
• Need motivation? There’s an app for that
• Tracking your path to better health: The future of personal health monitoring

Sluggish Adoption of Healthcare IT

The healthcare industry is experiencing an ongoing reluctance or sluggish adoption of healthcare IT by providers. This industry is chronically slow to move to new technologies, as is evident in the struggle to move from paper records to EMRs. Meaningful Use, ICD-10, Accountable Care Organizations, and HIEs have all experienced a pushback from providers and vendors.

• Providers still sluggish with health IT
• Providers grappling with the ‘other’ ROI
• Providers Still Hesitant With Portals, Study Finds
• What’s Holding Back The Mobile Health Revolution?
• Most Doctors Using Traditional Communication Tools, Survey Say

Meaningful Use Stage 2 Struggle

In order to be eligible for federal subsidies, providers must meet meaningful use regulations. Hospitals and physicians have less than one year to meet the MU Stage 2 requirements, which many are contesting due to the aggressive schedule. Additionally, many vendors are encountering problems getting their EHRs certified for Meaningful Use.

• Stage 2 proves challenging for vendors
• EHR Vendors Face Difficulties Under Stage 2 of Meaningful Use
• Electronic Health Records: The Next Chapter
• EHR makers surprised by Stage 2 complexity
• EHR market in flux as Stage 2 of Meaningful Use approaches

HIPAA and Privacy Challenges

Over 15 years ago, in response to an increase in the abuse of personal health information (PHI), HIPAA was established to protect the privacy of patients and prevent improper disclosure and use of information. HIPAA rules set limits and conditions on uses of PHI, establish national standards to protect electronic PHI, put in place standards for notification of breaches, and improve patient safety. Violation of these rules or a breach can result in a fine or lawsuit.

• HIPAA and its Impact on Your Organization
• CHIME, AHA skeptical of disclosures rule
• HIPAA breach is bad news for 729,000
• Trickle-down effects of new HIPAA omnibus BA definition
• ONC demystifies 10 HIPAA myths: Risk analysis best practices

The patient centered medical home (PCMH) emphasizes care coordination and communication between various healthcare delivery systems. This coordinated care system can lead to better quality healthcare delivery as well as a better patient experience – but in order to achieve these benefits, providers must be able to see and interpret data from across the many entities the patient interacts with.

Leveraging clinical data from EMRs, HIEs and patient devices allows organizations to:

• Enhance access and continuity
• Identify and manage patient populations
• Plan and manage care
• Provide self-care support and resources
• Track and coordinate care
• Measure and improve performance

Join us October 29th for the webinar “Make the Most of Your ACO with Healthcare Analytics.” You will learn how Oracle Enterprise Health Analytics (EHA), coupled with Oracle Business Intelligence and Oracle WebCenter, fulfills the ACO mandate for a patient centered medical home.

Click here to register for the webinar.

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.

Obamacare Defunding

Under the Affordable Care Act, or Obamacare, over 48 million uninsured Americans will be eligible for enrollment in subsidized plans through state-run health insurance exchanges, with annually increasing fines for those who go uncovered. Currently, the US government is reviewing calls to defund Obamacare while Health Insurance Exchanges are set to open on October 1st.

• Guide to the Capitol Hill stand-off over defunding ObamaCare
• Most oppose Obamacare defund if it means government shuts down: Poll
• Most Americans against defunding Obamacare: CNBC survey
• A Friendly Reminder That Defunding Obamacare Won’t Stop the Law
• Efforts To Defund Health Care as Georgia Exchanges Set to Open

Google Calico

Last week, Google announced it would be reentering the e-health game with its new product, Calico. The goal of Calico is to positively impact aging and associated diseases, while focusing on health and well-being. Initially, Calico will fun aging and preventable disease research projects.

• Google Calico: Has Digital Health Just Become Redefined Around Immortality?
• Google, Apple Chairman Team Up to Extend Your Life
• Google Decides to Take on Oil of Olay
• Calico: How Google’s stab at the fountain of youth could transform health care
• How Google’s Calico Can Win Us Over, One Genome at a Time

FDA Final Rule on Mobile Apps

This week, the FDA released its final guidance for developers of mobile medical applications. The FDA will focus 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 transform mobile devices into a regulated medical device.

• Making Mobile Medical Apps Just Got Easier
• FDA issues final guidance on mobile medical apps
• F.D.A. to Regulate Some Health Apps
• FDA gets thumbs up on mobile apps regs
• U.S. FDA issues final rules on mobile medical apps

Personalization of Medicine through Big Data

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.

• The Coming “Big Data” Storm
• How Big Data Can Personalize Healthcare
• Exponential Health Technology Bringing Personal ‘Check Engine Lights’
• Solving America’s Big Health Care Challenges With Big Data
• 4 ways groups are harnessing big data to improve cancer treatment

Wearable Devices and the Quantified Self

With the progression of patient engagement, consumers are looking to become involved in their own care and health. The quantified-self movement helps patients track their health, physical activity, food consumption, heart rate, and more. From mobile apps to worn digital sensors like the FitBit to implanted devices, patients keep track of their own health data – which eventually may be used to create a more personalized experience.

• Quantitative Self Movement: Not Just for Healthcare Professionals
• Wearable Technology and Wellness Apps: The Future?
• A Pill That Tracks Your Health? The Reality Of The ‘Quantified Self’ Movement
• Technology Puts You in Charge of Your Health
• The future of biometric data tracking isn’t about devices, it’s about experiences

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 transform 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?

Congratulations to Perficient client Marshfield Clinic on their 2013 Healthcare Provider Standard of Excellence WebAward in Web Development. The Web Marketing Association‘s annual WebAward competition has been setting the standard of excellence for website development since 1997. Independent expert judges from around the world review sites in 96 industries. The best are recognized with a WebAward. The WebAward Competition is the premier award recognition program for Web developers and marketers worldwide.

Earlier this week two of my colleagues, Michael Porter and Ryan Duclos, each wrote blogs about the potential uses beyond gaming for the upcoming Xbox One. Micheal explored some of the possible uses in healthcare specifically, from gamification to surgical tool:

Better Healthcare because of Kinect

The HIT Consultant has a blog post on how XBox is transforming gamification in healthcare. His focus is on the fact that Kinect allows you to move and that moving is healthy. He also has a great quote on what the next version of Kinect will do.

During a presentation for the new Kinect, Microsoft showed off this feature and allowed the media to talk about it, as in these observations by Matt Hickey, shared by fellow Forbes contributor Dan Munro:

“10:23: It’s more sensitive, can read more data points of articulation [referring to the new Kinect camera]

10:23: The sensor can read your heartbeat

10:23: IT CAN READ YOUR HEARTBEAT”

Enough said about the obvious possibilities of sensors capturing key and ongoing data about your health. The consumerization of this is nice. My Dad pays a hefty price for a phone hooked up via bluetooth to a sensor that tracks his hear rate. Kinect in one or more rooms my do the same but for much less $$.

Kinect as a Surgical Device

Almost two years ago I walked into a hospital IT director’s office and saw the Xbox and Kinect just sitting there. He explained that it was a beta app for remote surgery. Well, one hospital in Canada has a video on what they did with Kinect.

So yes, there is a lot of potential for Xbox in Healthcare and Xbox One is bringing up to a new level.

The Xbox One, coupled with the Kinect, has the potential to get users moving and gamify their health. With the ability to read heart rate it could also translate into a quantified-self tracking tool. What other potential uses could the Xbox One provide to healthcare consumers and providers?

Being in a position where I work in both healthcare and marketing, I love seeing these two worlds come together. Last week I read the article, “Why Marketers Should Care About The Quantified Self,” which touches on a topic that is of personal and professional interest to me. As the article explains, the quantified self movement involves tracking personal health metrics through online calorie counting, activity monitoring devices such as the FitBit, logging of heart rate and other physical data, and more. Not only is this of interest to marketing folks, who can use the data to better position products and ads, it’s especially useful to healthcare providers.

Smartphones have become commonplace in many of our lives and have paved the way for mobile health. Consumers want to not only communicate with their care providers more quickly and easily, many want to share information about themselves that their doctor would not normally have access to. Quantitative self-reporters have a slew of data about themselves – how many hours they sleep each night, the number of miles they walked last week, blood pressure readings over the last month. With access to this data, doctors can be better informed of a patient’s history and current health standing. All of their health information can give providers a more complete view and can be a powerful tool to improve their care. This is in addition to the self-motivating factor involved in consumers seeing their data and improving upon their stats.

To read more on the quantified self movement, view our recent white paper, “Beyond Gamification: Revolutionizing Healthcare with the Quantified Self.”

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.

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.

• Mayo Clinic benefactor: Personalized medicine ‘a good business to invest in’
• New tool harnesses big data for personalized health recommendations
• Only 27% of US Consumers Have Heard of “Personalized Medicine”
• Personalized models for preventive health care services
• Healthcare Industry Sees Big Data As More Than a Bandage

Interoperability

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.

• It is time for Interoperability to catch fire! (FHIR(R) that is)
• Healthcare’s interoperability problem isn’t about technology
• FDA recognizes device interoperability standards
• Stakeholders to CMS: We need interoperability standards
• Feds dropped the ball on interoperability acceleration

Predictive Analytics

Predictive analytics are able to help healthcare organizations manage clinical issues in a timely manner and analyze statistical data to identify potentially preventable conditions. Doing so can not only help organizations meet accountable care objectives, it is also able to reduce costs, waste and fraud. Providers are able to proactively provide better care and reduce readmission rates.

• Real-Time Predictive Analytics Help Cardiac Surgeons Improve Patient Outcomes, Cut Medical Costs
• Healthcare Analytics & Medical Analytics Market Worth $10.8 Billion by 2017
• What can predictive analytics do for healthcare reform?
• How can predictive analytics improve medication adherence?
• Can EHR data calculate a useful risk score for readmissions?

Telehealth and Remote Patient Monitoring

The high demand for easier access to healthcare professionals, access to online medical information and alternatives to traditional care are driving telehealth expectations. Telehealth allows for the transmission of medical images, video, audio and information related to diagnosis and treatment to be shared with the provider via secure data exchanges. Remote Patient Monitoring allows patient’s health data to be sent electronically to a provider who then can analyze and respond with recommendations.

• Remote Patient Monitoring Adoption Is Driving Global Telehealth Market
• Telemedicine Improves Patient Outcomes: Study
• Break down barriers to telehealth
• Getting patients comfortable with telehealth
• Technology allows for long-distance doctoring

Meeting Meaningful Use Stage 2

In order to be eligible for federal subsidies, providers must meet meaningful use regulations. MU Stage 2 is set to begin on October 1, 2013, for eligible hospitals, and on January 1, 2014, for eligible professionals. Hospitals and physicians have one year from these dates to meet the MU Stage 2 requirements, which many are contesting due to the aggressive schedule.

• HIMSS: Extend MU Stage 2 Deadline
• MGMA Requests Delay of Meaningful Use Stage 2 Penalties
• AAFP asks for MU Stage 2 delay
• Is it time to press the MU pause button?
• Citing ‘System Failure,’ AHA Urges Delay of MU Stage 2

It is a much talked about fact that the healthcare industry lags behind other industries in IT adoption. With constantly changing regulations, security concerns, and the pressure to deliver better care at a lower cost, healthcare providers have not implemented the latest technologies to leverage their data. One solution to these issues is cloud computing.

Cloud computing in healthcare holds many advantages, including:

• Mobility: Data is stored in the cloud infrastructure, allowing provider staff to access it from anywhere, anytime.
• Decreased costs: There is a reduced capital expenditure on hardware and maintenance. Also, hospitals will only pay for the services they use, and challenges can be addressed remotely by IT personnel.
• Better care: The cloud provides a central platform for EMR data, prescriptions, reports, and patient history. When all of this data is available, the risk for misdiagnosis or conflicting treatments is reduced.
• Scalability: As the amount of data healthcare provider house grows, cloud server storage can easily be increased, unlike IT infrastructure.
• Security: Cloud service providers are liable for HIPAA compliance, requiring them to encrypt and securely house data.
• Speed: Working in the cloud allows for collaborating and sharing data in real time. Data is synchronized as it is processed or updated, allowing staff to work together without being in the same place.

Leveraging the cloud would allow providers to meet regulatory compliance standards at a lower cost than implementing traditional technology. Various forms of data are interoperable, allowing for analysis and reporting. While security concerns remain, cloud computing is becoming a viable answer for healthcare challenges. Read more about cloud capabilities in the article, “Perficient’s cloud prescription for healthcare companies.”