Transitioning to Telehealth

Telehealth opened the doors to remote care and cure at a time when visiting clinics for consultations became difficult. From just 11% in 2019 to 46% of consumers choosing telehealth in 2020, healthcare providers began seeing 50 to 175 times the number of patients than they did in pre-pandemic times. Up to $250 billion of current US healthcare spend attributed to telehealth as healthcare providers continue to scale their offerings.

According to Mckinsey, 74% of survey respondents expressed high satisfaction with their telehealth experience.

With technology at its helm, telehealth is now getting as good as in-person visits, if not better. Artificial Intelligence (AI) has facilitated quick diagnosis and treatments with deeper insights and ensures that routine care is streamlined for better health. Data aggregation also has been helping healthcare providers as well as individuals predict patient behavior and detect patterns.

Besides, seniors tend to require at least twice the number of healthcare services as compared to younger demographics. Telehealth addresses all their concerns effectively to provide continued care in these rather difficult times. As per research by Deloitte and ATA (American Telemedicine Association), a significant portion of care, prevention, and well-being settings are expected to go virtual by 2040.

We are fast moving towards technological advances, interoperable data, and virtual healthcare systems that ensure continuity, connectivity, coordination, and care continuum. As Laura Hoffman, a senior research fellow at Yale Law School’s Solomon Center for Health Law and Policy puts it, “It’s not just technology. How does this transform the patient-provider relationship? What does it mean to have that relationship in terms of doing it virtually instead of it being in person? We are at a very dynamic time.”

Clearly, there’s a lot that still needs to be done on the telehealth front to make it viable for patients as well as providers and tap into its full potential.

Measures to improve telehealth

As we move into the future, we need concerted efforts by healthcare stakeholders along with the adoption of advanced technologies, redesigning of care models, and proper infrastructure to leverage the full potential of telehealth. After all, it goes way beyond the scope of virtual care to include different aspects such as chronic disease management, doctor visits, surgical support, and remote patient monitoring.

Here’s what we can do to make it better and more dependable.

Define a clear roadmap

A data-driven approach is what is currently needed to enable care journeys digitally. Rich clinical data will empower not just clinicians but also patients so that everyone is on the same page. For instance, a patient with a complex medical condition will significantly benefit if all the relevant observations are updated into the clinical record by different providers and made available in readily sharable formats to decide further course of treatment.

You need to augment your reach and expand your capabilities to move the needle in essential areas. You need to ask questions – Would customized online education facilitate awareness and patient satisfaction? Would remote monitoring increase patient engagement? Would increasing capacity help increase e-visits too? What security measures need to be implemented to address privacy concerns?

Both providers and payers need to work on building flexible provider networks to shorten wait times. Virtual health needs to penetrate the ‘brick and mortar’ healthcare system and should be embedded in provider workflows. Hospitals are now using Artificial Intelligence (AI) to guide patients to the right care avenues.

Virtualize home care

This requires access to remote monitoring services so that specific clinical conditions can be monitored. For example, those with diabetes need continuous glucose monitoring, while those with cardiovascular conditions require regular monitoring of blood pressure and heartbeats.

An integrated approach and relevant patient engagement tools are required to include such devices into the care plans and encourage patients to play an active role in ensuring care. Besides, other monitoring systems and diagnostic kits such as home pulse oximeters, blood pressure machines, etc., also need to be factored in while ensuring a clear view for assessment.

Evaluate your IT infrastructure

User experience is paramount when it comes to the success of any telehealth initiative. Cloud-hosted platforms are now being increasingly used to support the virtual telehealth ecosystem. You need to also figure out which providers and healthcare partners need to be added to the delivery platform to ensure better collaboration among care providers.

Seamless data and communication flow among patients, cardiologists, therapists, etc., through video/ audio conferencing, messaging, and other forms of internet-based and mobile communications will then be possible.

You will also have to factor in what equipment you would require for communication as well as treatment. Laptops, speakers, Internet browsers, webcams are just a few of the many things you will need. Additionally, you will have to figure out the means to capture data from connected devices like blood glucose meters and blood pressure monitors too. Potential vulnerabilities in medical devices need to be addressed, along with risks associated with the deployment of third-party services.

Advanced technologies can help you tide over most challenges but having a clear perspective on things you need helps.

Regulatory barriers and their impact

The federal government did make temporary policy changes to make telehealth easily accessible during the pandemic. But we need to look beyond the pandemic, and efforts must be made to continue easing barriers to reimbursement.

Explains Dr. Diane Rittenhouse, a senior fellow at Mathematica, “People were seeing patients in the virtual space before they had the reforms to payment to get paid for it. They were doing it essentially for free. Now, payment reforms have caught up – but it’s unclear how long they’ll remain in place.”
She adds, “We’re asking for a lot of change in primary care over the last couple of decades. It’s good, and it comes from a good place, but these practices are being asked to add more team members, to work under different conditions, to adopt electronic health records, [and] to develop new population-based quality-measuring systems and reporting systems.”

The number of people availing virtual consultations has been significant primarily because they didn’t have to drive down to the facility physically. While The Centers for Medicare & Medicaid Services (CMS) has been highly supportive in facilitating telehealth, these rules should continue to relax to make remote care accessible to one and all irrespective of geographical barriers.

The Department of Health and Human Services(HHS) has even waived off penalties for HIPAA violations against healthcare providers that used conventional communications platforms such as Skype and Zoom to enable virtual care. But these breaches can have severe implications under normal circumstances, and care needs to be taken to ensure patient data remains private and secure at all times.

Broadband has to be accessible and affordable too, without which it would be impossible to leverage the full benefits of telehealth. Imagine you are deep into a call, and the connection goes off just like that, in a second. Also, when physicians are examining patients’ physical symptoms closely, it can be a futile exercise if the video call lacks the required clarity. Not everyone is tech-savvy, and connectivity issues can add to the frustration.

Last but not the least

Telehealth has immense potential and can improve outcomes significantly if efforts are made to expand access to care. Physicians are already reporting burnout as work stress continues. Telehealth programs, when implemented correctly, can bridge the gaps in healthcare now and forever for all. Not to forget the immense cost savings it can lead to.

Transition to telehealth with Trigent

Trigent can help your healthcare facility transform into an agile, robust network of digitally connected distributed entities to open doors to new and exciting opportunities in telehealth. Our domain knowledge and technology expertise help us work closely with stakeholders to meet the many challenges of care delivery in the telehealth sector.

We offer solutions and services to achieve EHR Interoperability and manage virtual consultations effectively. Call us today to book a business consultation.

Steps to Achieve EHR/EMR Interoperability to Put Patient at the Center of Healthcare

The US healthcare system has been battling quite a few challenges as they continue to track outbreaks, and stay abreast of the latest developments on vaccines and the spread of the disease. But what became glaringly evident during the pandemic was the lack of EHR/EMR interoperability that made sifting through patient information and providing seamless quality care pretty difficult. Although the federal government pumped in billions of dollars to accelerate the adoption of electronic health records, we are still far away from rising to the information challenges clinicians are facing on a day-to-day basis.

A classic case in point – California! It went through public health crises in 2020 as the state with the second-highest number of COVID-19 cases, pinning its hopes on a robust health data exchange. As Claudia Williams, CEO of Manifest MedEx (MX) points out, “Smaller practices don’t know what kind of hospital care the patient received, they don’t know what drugs the patient is on, and they don’t have the tools to conduct that level of risk stratification.”

The Department of Health and Humans Services (HHS) recently published its 2020-2025 Federal Health IT Strategic Plan based on recommendations from more than 25 federal organizations.

Quality of data, user interfaces, and usability concerns, along with the inability of data to adequately support discovery and interoperability among systems – all underline the need to have better EHR/EMR interoperability to put patients at the heart of healthcare.

It’s time we dive deeper into the challenges stakeholders are facing as they proceed towards achieving EHR/EMR interoperability and how we can work towards making it a reality.

EHR and EMR: The fundamental difference

An electronic health record (EHR) is an electronic version of a patient’s medical history that includes test results, present illness and its history, progress notes, immunization, medications, etc. Often confused with an electronic medical record (EMR), an EHR is much broader in scope and offers a comprehensive view of the patient’s health. An EMR also contains medical history along with a treatment plan but it’s often pertaining to one practice and the details will therefore stay with that particular physician or provider and is never really shared when the patient moves on to another physician or provider.

The fact that EHR travels with the patient wherever they go, it gets shared with other physicians and providers helping them make informed decisions. EHR helps maintain continuity of medical care even when patients are moved to a different facility.

But in a complex healthcare environment, EHR integrations are not so easy. EHR solutions used by different medical facilities can differ in features, capabilities, workflows, and infrastructure requirements. Seamless sharing of information will therefore be possible only when we introduce interoperability into the system. This would require stakeholders to tide over the many challenges in attaining healthcare data interoperability.

The top ones include:

  • Absence of a unique patient identifier – Absolutely no or minimum standardization for identifying patients makes data exchange between EMR and EHR extremely tedious.
  • Lack of standardized data – With different standard formats for collating data, the information exchanged varies in format. This poses a barrier to analyzing, storing, and exchanging data seamlessly.
  • Slow FHIR adoption – The use of Fast Healthcare Interoperability Resources (FHIR) is recommended since it describes data formats and APIs for health record exchange and integrates the best of HL7, v2, HL7v3, and CDA while leveraging the best of web service technologies. It provides agility, efficiency, and security to data exchange with perfect standardization of data. The adoption of FHIR application programming interfaces (APIs) has a long way to go before it touches the finish line. While FHIR apps do extract data, they lack the ability to write data back.
  • Data privacy and security issues – Healthcare compliances such as HIPAA can impose limitations on how stakeholders share and exchange data amongst each other and third-party vendors.
  • The relatively high cost of integration – Traditional models can be a tad out of reach of small and mid-sized organizations from a cost perspective.

Interoperability for patient-centric care

Interoperability allows patients to be informed all the time irrespective of which vendor they choose. It ensures:

  • Better patient health outcomes
  • Better quality of care
  • Lower healthcare costs
  • Tailored treatments based on individual history and preferences
  • Greater patient engagement
  • Reduced ambiguity
  • Data devoid of redundancies

Interoperability initiatives should be patient-centric and revolve around improving patient care. The chief objective should be to safely and securely exchange patient information across the healthcare ecosystem where interoperability serves as the linchpin.

As Dr. Farzad Mostashari, the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services iterates, “(the agency wants to ensure that) information follows the patient regardless of geographic, organizational, or vendor boundaries.”
A CHIME KLAS report suggests 67% (up from 28% in 2017) of providers admitted they often or nearly always had access to the needed patient records in 2020 while only 15% (up from 6% in 2017) believe data exchange has impacted patient care. The Cures Act and many other federal initiatives are now focused on improving patient care through data sharing. Significant progress has been noticed in data sharing across disparate EMRs.

The way to interoperability

There are certain milestones to touch on the road to attaining interoperability. Just like the banking sector where current systems are modified instead of being recreated, the EHR too will benefit from suitably modified systems wrapped in applications and added capabilities.

Here’s what we need to do:

  • Use a population health management system – This will make providers accountable for caring for populations with common health conditions. The system will use data from various sources including EHRs, EMRs, claims, monitoring devices, etc. to give a 360-degree view to providers while helping patients with regular alerts and messages.
  • Leverage the services of Health Information Exchange (HIE) – HIE connects healthcare organizations across the state to allow them to exchange patient data. So if a patient gets admitted into an emergency room, the HIE will access data from other care centers too so as to give an accurate clinical picture of the patient to providers and alert them when a patient checks in to some other facility.
  • Deploy health management apps designed for patients – These are typically expected to help patients aggregate their health data, get health status, track appointments, manage healthcare plans, etc.
  • Employ big data analytics systems – These systems are expected to review large amounts of data to compare the effectiveness of treatments, aid medical discovery, analyze shifts in patterns of diseases and response to diseases, safety issues pertaining to healthcare equipment, etc. They rely on artificial intelligence for automatic correction of data inconsistencies and other chores such as extracting data from images, free text, etc.
  • Integrate APIs in healthcare – APIs allow developers to build applications quickly and protect patient data from malware and other malicious threats. They save storage space and allow users to pinpoint the exact source of data and get precise data. APIs are thus playing a pivotal role in alleviating clinical burden helping third-party apps and programs analyze data and enhance clinical decisions. As an integral part of healthcare, they now lead the way for successful interoperability.

Tread on the road to interoperability with Trigent

It’s easy to get lost in the shuffle, but with Trigent by your side, you can surely adopt best practices to shift your focus and achieve EHR/EMR interoperability. No matter how far you are on the road to interoperability, we will take you there with the necessary solutions. A few workflow changes and technologies should get us started.

Allow us to tell you how the new interoperability standards can help your practice. Call us today.

Extract 40%+ efficiencies in Healthcare with Robotic Process Automation

The healthcare industry is facing the biggest challenges (and opportunities) in the prevailing situation. Traditional modes of delivery of care have been disrupted, coordinating patient care is driving the demand for sharing data across silos and technology is playing a vital role in enabling remote diagnostics, tracking treatment effectiveness, and monitoring patients while they recover at home. Conventional norms are being challenged. The changes however are accompanied by a different set of considerations that need to be addressed – Data privacy and Cybersecurity for instance. So how can all these be overcome?

Healthcare providers have to manage the massive amounts of patient data, triage the cases, optimize appointment scheduling and treatments and expedite billing & claims management. Apart from being HIPAA compliant, they also have to ensure error-free streamlining and execution of the tasks, which usually prove to be a gargantuan effort. However, these pain points can be overcome by automating the entire process.

Robotic Process Automation (RPA) in the Healthcare Industry

The convergence of robotic process automation (RPA) with the healthcare industry has helped providers accelerate their digital transformation journey. AI-powered RPA has helped the industry deliver efficient services across the value chain – from patient experience to claims management and revenue cycle management to analytics.

CAQH in its eighth annual report stated that automating healthcare administrative transactions has reduced annual costs by $122 billion, $16.3 billion more can be saved through further automation. Gaining traction in the healthcare industry, RPA has enabled automation of routine and repetitive tasks, thereby freeing healthcare professionals to focus more on the much-needed human element — patient care.

How RPA enhances healthcare service

Implementing robotic process automation can channel more resources and optimize healthcare tasks that are of prime importance.

Improved patient support

One of the most important tasks rendered by healthcare organizations is providing ideal care according to each patient’s unique needs. With RPA implementation, healthcare providers have witnessed significant improvement in triage and the resulting patient-facing operations.

Robotic process automation simplifies and streamlines the entire procedure, right from patient data collection to insurance claims. Bots can manage patient appointments as per location, test results, and doctor availability. They can also assist patients with upcoming appointment notifications, medical tests, prescription pick-ups, and discharge guidelines.

Error-free and reduced repetitive work

In RPA, bots replace human involvement in repetitive tasks like patient onboarding, data extraction/migration, appointment/treatment scheduling, and claim management among others. This means work is done in a considerably less amount of time with no errors.

Automating healthcare processes can help the providers reduce critical errors and achieve 100% accuracy rates while providing patient care. Data collected from the patient can be processed as per diagnosis and location, matched with the relevant doctor. In case of the doctor’s unavailability, a bot will automatically reschedule and inform the patient of the change, avoiding confusion and hassle.

Reduced operational costs

By embracing RPA, healthcare organizations can reduce operating costs significantly, while leveraging a cost-effective workforce. Increased automation enhances process efficiency, allowing staff to spend less time on tedious manual tasks.

Traditional methods involved manual data entry, scheduling, record maintenance, and claims management, each of which involved a considerable number of people. Since every task was done manually, there could be errors and rework could come with a cost. RPA implementation standardizes the entire lifecycle, eliminates rework and corrections.

Reduced Data Breaches

Ensuring privacy and security of sensitive patient data is one of the top concerns for healthcare organizations. Using RPA ensures that private information can only be accessed by the appropriate staff. This role-based access minimizes data breach or improper use of data.

RPA allows healthcare providers to control data access and ensure that only the relevant staff can access private information when required. This control is critical since doctors, IT staff, and the claims departments need varying levels of access to classified patient data.

HIPAA and other regulatory compliances

Robotic process automation helps maintain compliance by securing medical data and ensuring all processes are in line with HIPAA and other regulatory bodies. Custom reports and detailed audit logs can also be maintained.

Healthcare providers may use different applications to store and access patient data. Securing such a vast amount of information can be complicated and prove to be challenging. With RPA, HIPAA compliance becomes easier to manage. Audit controls can also be easily implemented using process automation. Detailed audit histories can be set up automatically and any time there’s an internal or external audit, auditors can easily access the data.

Automation is here to stay. RPA is flexible to automate any procedure and is basically to help clear the clutter, thereby streamlining the entire process. With RPA around, even searching for a needle in a haystack will seem effortless.

The Trigent Advantage

With change happening at a rapid pace, the healthcare industry is transitioning to automation to offer better outcomes to patients. Be it migrating from a legacy system, updating a current workflow, or even on advisory, Trigent is your go-to partner for all your technology requirements. Our RPA experts will take care of the entire cycle from adaption to managing, while your healthcare providers do what they do best-providing optimal patient care.

The Importance of Small data vs Big Data for Healthcare

Clinicians favor small data over big data for healthcare assessments and predictions. Here’s why

The healthcare sector is fragmented, complex, and hyper-local. There are over 100 healthcare systems in the US, 280 health information exchanges, and over 5500 hospitals. One million physicians are addressing the healthcare requirements of 320M Americans. While all these channels spit out data, leading to what is popularly known as big data for healthcare, there is another quiet and continuous flow of data from individuals or in this case patients, called `small data’.

Deborah Estrin, Computer Science at Cornell Tech and Healthcare Policy and Research at Weill Cornell Medicine puts it succinctly when she says, “Small data is being generated continuously on our mobile phones and through our online activities: walking and location patterns, as well as shopping, communicating, and web surfing. It is the various data traces we each generate every day, just by living our day-to-day routine: checking email, taking the bus to work, going grocery shopping, walking home, and more.”

Why clinicians prefer Small Data to Big Data for healthcare prediction models 

The big difference between big and small data is in big data large volumes of data are analyzed for patterns while small data looks at an individual’s historical data to develop models for predictions and futuristic treatment.

 

While big data has been at the forefront in healthcare technology for some time now, clinicians are often turning to small data to efficiently manage patient care. Small data helps them by providing quick input on allergies, times for blood cultures, missed appointments, and so forth, which are tactical in nature but extremely important inefficient patient care. Big data for example can say, X number of patients were admitted in the ER during a certain period of time. Can big data quickly identify how often or why Mr. or Mrs. John was admitted to the ER last month?

Small data is providing big insights for the individual. An app for managing pain for example quietly collects data about the individual, such as a fitness tracker, and can be presented to the individual and his clinician. In similar ways, smartphones can track heartbeats, eating habits, fitness quotient and you name it, to empower the clinician with insights into a person’s physical well-being.

The rising importance of Small Data in healthcare technology

Technology companies see the potential of smartphones in healthcare and innovative solutions are being unleashed. For healthcare ISVs, the challenge is to connect small data to big data, to improve individual healthcare, even as solutions are uncovered which can have a far greater impact on a larger target group. Not stopping there, the hidden challenge is to ensure privacy even as data that is collected is assessed and answers are uncovered.

Healthcare systems that have implemented electronic health records (EHR) can extend this to patients. If the systems can integrate individual health information, then both physicians and patients are maximizing digital health technologies.

Big Data Model  Small Data Model
What can be the effect of immunization programs? Is my child’s immunity to diseases taken care of?
Where do some of the healthiest people in the world live Is my diabetes medication working as expected
Are there any generic factors to identify a disease  Am I susceptible to X disease?

Some suggested systems include:

  • Health information exchange
  • Point-of-care decision support systems
  • Workflow tools to track and report on patient health
  • Smartphone and online appointment setting and registration.

Trigent Software understands the healthcare space having served a large number of clients over the last 20 years. Our commitment to patient healthcare has resulted in our focus on small data to improve the quality of patient care, reduce healthcare costs, and enhance patient loyalty. Call us today to know how we can enhance your patient-clinician relationships.

Reference:

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jep.12350

https://research.cornell.edu/news-features/small-data-and-big-health-benefits