Text messaging in healthcare can be more than an administrative function and serve a greater purpose than being a new way to deliver appointment reminders to patients. Texting can nudge people to get on their feet and be more active, according to a study in the Journal of the American Heart Association.
The study was divided into multiple sections and groups. Its most notable conclusion was that study participants that received inspirational and informative text messages walked approximately 2,500 more steps — or one-quarter of their expected daily total — than non-recipients.
During the first week of the five-week study of cardiology patients, researchers measured the baseline for participants’ daily activity. Patients were then split into separate groups for the following two weeks of the study: those that had complete access to their activity levels and progress through their smartphones and patients that didn’t. In weeks four and five — the final stage of the study — researchers took the group with access to their data and split it down the middle. One half of those patients received three daily text messages updating them on their progress and encouraging them to meet their daily 10,000-step target, while the others went without any texts.
In the last two weeks of the study, 44% of the groups with limited or no access to their activity levels met or exceeded the daily step mark. By comparison, that percentage was nearly doubled by the third group, as 81% of those that obtained texts walked 10,000 or more steps.
The cardiology study may add more evidence to the list of reasons why providers should use text messaging in healthcare. Texting is already established as a way to alert patients of new appointments and keep them in touch with their physicians about their conditions and treatment plans. There are still situations in which healthcare providers won’t risk texting, and most of them involve protected health information (PHI). It’s hazardous to text PHI because the devices usually making those transmissions are challenging to protect, both from physical theft and device hacks.
The healthcare world has been wary of the cloud for a while now, citing possible HIPAA violation as the main concern and reason for not adopting the cloud. But according to a recent report by Bitglass, Inc. a cloud access security broker based in Campbell, Calif., that may be changing.
The report sampled over 100,000 businesses, with 8,148 of those businesses in the healthcare industry. The results showed that in regulated industries, such as financial services and healthcare, cloud adoption has nearly tripled jumping from 15% in 2014 to 39% this year.
In healthcare alone, cloud adoption has grown to 37% of the market, up from 8% in 2014, the report said.
In fact, SearchHealthIT recently spoke with Shawn Wiora, CIO and chief information security officer at Creative Solutions, based in Fort Worth, Texas, about how his healthcare organization is 100% in the cloud.
Despite this jump in healthcare’s adoption of the cloud, the report said the industry “remains a laggard due in part to HIPAA compliance concerns. Finding security solutions continues to be a challenge for the healthcare industry due to privacy concerns and limited applicability of Mobile Device Management solutions, where doctors have multiple hospital affiliations but only one device.”
But to those who believe cloud computing in healthcare is not and will never be HIPAA compliant, Judy Hanover, research director of provider IT transformation at IDC Health Insights, a research firm in Framingham, Mass., says: “That’s absolutely incorrect.”
Hanover told SearchHealthIT that cloud services enable healthcare organizations to not only access “best of breed” technology but also get back to focusing on the patient.
“The blinding pace at which these organizations are adopting cloud apps suggests that many of the unique needs of regulated industries are being solved by solutions,” the report said.
Health information exchange (HIE) has accelerated, particularly in hospitals, according to a new report from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ).
However, the report also shows that HIE use is still low overall, with ambulatory healthcare providers and nursing homes showing little adoption, and that HIE’s effects on medical outcomes still need more research.
Three investigators and a research librarian based at the Pacific Northwest Evidence-based Practice Center in Oregon produced the report under contract with AHRQ after reviewing and analyzing about 200 full-text studies and articles focusing on various aspects of HIE.
The materials included 34 pieces on effectiveness; 26 on intermediate clinical, economic, or patient outcomes; eight that reported on clinical perceptions of HIE; 58 studies on HIE use; 22 on usability; 45 on facilitators or barriers to HIE implementation; and 17 on factors related to sustainability of HIE.
Studies of HIE use found that adoption of HIE has risen sharply in recent years, with 76% of U.S. hospitals exchanging information electronically in 2014, an 85% increase over 2008 and a 23% increase since 2013.
On the other hand, as of 2012, only 38% of office-based physicians used HIE systems and less than 1% of long-term care providers are using electronic health information exchange, according to the report.
Among organizations with HIE capabilities, few employees actually used HIE often, the AHRQ study revealed.
The report’s authors concluded that barriers to wider use of HIE include:
- Lack of critical mass participating in the exchange
- Inefficient workflow
- Poorly designed interface and update features.
They also said the HIE field needs more studies. However, the study’s basic premise is that HIE is a good thing.
“The idea that records should follow patients wherever they receive care has been promoted as a cornerstone of efforts to improve the coordination, efficiency and effectiveness of health services,” according to the executive summary. “The underlying belief is that ultimately patients would benefit if all relevant information were available to the various healthcare providers involved in treating them and working to maintain their health.”
Many of this year’s most-discussed health IT topics will figure prominently in next year’s healthcare technology landscape, though some of those conversations will take on a new tone.
The third stage of the meaningful use program may be stalled or cancelled in 2016, according to predictions released by DirectTrust, a nonprofit group that promotes interoperability. The meaningful use program achieved its chief goal of encouraging widespread implementation of EHRs, but some healthcare organizations, such as CHIME, stated that many providers are still attesting to the second stage of meaningful use and that it would be premature to deem stage 2 a success.
If meaningful use is sliding down the health IT industry’s priority list, then security might ascend and take its place. Security is the primary source of worry for many healthcare providers, partially due to the reputational and financial expenses of sustaining a data breach. That attention to data breach prevention will pay off in 2016, as DirectTrust believes the growth of electronic health data exchange will cause a similar spike in security measures devised to protect those transactions.
Major data breaches beset health insurance company Anthem, Inc. and provider UCLA Health this year, accounting for an estimated 80 million and 4.5 million people affected, respectively. The Anthem breach didn’t expose the health or financial information of patients and employees, but it revealed other personal data, such as phone and Social Security numbers. UCLA Health wasn’t alone in potentially failing to insulate the health data of millions of patients; Premera Blue Cross experienced an attack that involved the data of 11 million people. With all these breaches occurring when data is in the hands of security professionals, it’s fair to wonder whether patients should be provided greater access to their data.
The first item on DirectTrust’s list of 2016 trends is the inclusion of patients in the health data exchange process. DirectTrust stated more patients will soon have access to their health information and will be free to move their data wherever they please. Patients that want paper copies of their health records may be discouraged from doing so because of the high costs attached to that process. Some states charge more than $90 for printing 75 pages of health records.
If you’re a health IT professional and you’re not looking into 3D printers, you might want to start now. Some hospitals have already got a jump on this not-so-new technology that is helping some physicians improve patient care.
Recently, SearchHealthIT spoke with Adnan Siddiqui from the Jacob’s Institute in Buffalo, N.Y. Siddiqui is using a 3D printer to create 3D models of brain aneurysms that require a complex and risky surgery. Having a 3D model of the aneurysm he will operate on enables him to better plan the surgery by trying out various methods and seeing which one will yield the best outcome.
And it’s clear that many other hospitals are finding value in 3D printing — and not just when it comes to brain aneurysms. According to an article by the Huffington Post, quite a few hospitals across the United States are using 3D printing to solve various problems, including:
- Shriners Hospital for Children in Houston, Texas, is using 3D printing to create prosthetic hands for kids. 3D printers produce lightweight, customizable and inexpensive artificial hands which are ideal for children. They can even choose their own colors and don’t have to worry about damaging the prosthetic because replacing it is easy and cheap.
- Brigham and Women’s Hospital in Boston is using 3D printers to help with face transplants. With the help of CT imaging, Brigham and Women’s is using 3D printing to create life-sized models of patients’ heads, which help the surgeon understand the facial anatomy and allows them to do plan in advance, operate with more confidence and spend a shorter amount of time in the operating room.
- Seattle Children’s Hospital and the University of Washington Medical Center are using 3D printers to help surgeons practice before they perform heart surgery, a challenging procedure to say the least. Also, using CT scans and MRIs, surgeons are able to create an exact replica of the patient’s heart that feels real to the touch.
All of these examples show the potential demand and value in healthcare that will come with 3D printers, and point to the importance of the underlying healthcare technology that will be involved.
Health insurance payers are accelerating their move to value-based payments at a remarkable rate, according to a new survey by HealthEdge, a vendor of financial-administrative-clinical software systems for health insurers.
For its fifth annual “State of the Payor” survey, HealthEdge polled 100 senior executives at payer organizations and found that 80% of health plans following Medicare are shifting to value-based payments, a dramatic jump from the 50% that were adopting value payments when the survey first launched in 2011.
The survey also revealed a robust tilt toward technology and IT in the industry, with 73% of the insurance execs reporting they are planning “major, technology-driven transformation at their organizations,” Ray Desrochers, HealthEdge executive vice president, said in a release.
“The transition to a digital business is now required to provide members with the consumer-friendly, retail-like experiences they expect, effectively participate in new healthcare business models and drive new levels of operational efficiency,” Desrochers said.
Other key findings:
- Payers’ support for accountable care organizations (ACOs) is decreasing, from a high of 69% a few years ago to 55% this year
- Mobile technology (69%) and social media (59%) figure prominently in payers’ plans, while wearable health technology devices still are of only modest interest (20%)
- A majority of payer organizations still manually process 20% to 40% of claims, showing that while automation is the rule, paper claims still are abundant
- For managing patients, payers are prioritizing innovative care coordination strategies, such a social media engagement and mobile capabilities
Over the next three years, payer organizations are planning to support or participate in:
- Value-based benefits (rewarding members for what insurers consider) healthier choices), 48%
- Value-based payments, 80%
- ACOs, 55%
- Next-generation consumer-directed health plans, which actively encourage patients to manage their own health and healthcare spending, 36%
- Medicare and Medicaid expansion, 77%
- Insurance exchanges, 68%
- Enhanced care management, disease management and utilization management programs, 51%
It’s difficult to predict how adopting health IT will change an organization’s productivity or quantify how well a technology measured up to its expectations. The Healthcare Information and Management Systems Society (HIMSS) hopes to demystify that process and assign a value to the quality of health IT services.
HIMSS will assess health IT through its newly-developed HIMSS Value Score system. The system will attempt to define and measure how health IT products and initiatives affect organizations’ clinical, financial and operational performances. HIMSS will also monitor the outcomes produced by health IT to see if certain scenarios — such as implementing new technology — can be repeated in other healthcare facilities and produce more positive outcomes across the industry.
A group of small critical access hospitals and HIMSS’ Davies Award winners — given to healthcare organizations that excel at using health IT to improve patient care and outcomes — are among the providers that currently piloting the Value Score system. The Value Score system expands upon HIMSS Analytics’ Electronic Medical Record Adoption Model (EMRAM), which ranks hospitals’ EHR integrations on an eight-level scale. Many providers installed and became comfortable with operating EHRs since the passage of the HITECH Act in 2009. The HITECH Act gave life to the meaningful use program, which offered financial incentives to providers that proficiently used EHR systems. EMRAM, introduced in 2005, tracked the progression of EHRs in the U.S.
“With the move towards value-based care, the international healthcare community can now look toward a broader, all-encompassing way to measure the clinical and financial value of health IT,” Stephen Lieber, president and CEO of HIMSS, said in a release.
Recent news from Massachusetts supports Lieber’s words about the industry transitioning to more value-based care. Providers affected by a value-based care agreement between four state healthcare organizations and Massachusetts Blue Cross and Blue Shield will be rewarded for keeping their patients in good health and decreasing the quantity of hospital visits. The deal involves thousands of state Blue Cross preferred provider organization members and is a clear move away from the fee-for-service care model, which pays physicians based on the frequency of patient visits and procedures.
After all the anticipation – and after some experts predicted that ICD-10 would be a disaster with little value — it seems ICD-10 has turned out to be a Y2K-type of event so far, in which expected widespread mishaps proved unfounded. A recent KPMG survey supports that stance.
KMPG – an audit, tax and advisory firm — is not alone in its findings. Directors at the Medical Group Management Association and American Health Information Management Association both told SearchHealthIT that many of their clients have also reported a smooth transition to ICD-10 so far.
“ICD-10 is the healthcare industry’s equivalent to the Y2K changeover in scope and has a profound influence on not only the billing and reimbursement, but the ability to track quality of the delivery of healthcare,” Todd Ellis, managing director at KPMG, said in a press release. “This is an ongoing process, however, and this transition affects not just technology, but finance, employee training, clinical information and other functions in healthcare.”
Of the 298 respondents in the KPMG survey, only 11% declared their transition to ICD-10 a failure while 51.4% said they had a few technical issues but overall their transition was a success. In addition, 28.3% said the transition was smooth so far.
“While there seems to be a fairly smooth transition to ICD-10, the 11% of organizations that are struggling need to be helped,” Ellis said. “The communities these organizations serve depend upon their healthcare providers to meet their medical needs, and we need to help them through these challenges. ICD-10’s implementation was a lengthy process, and unfortunately they will address these issues or face greater competitive disadvantages in measuring quality and reduced cash flow.”
In fact, 41.9% of the respondents said they foresaw all of the following as huge challenges in dealing with ICD-10 in the future:
- Clinical documentation improvement and continuous physician education
- Increase in denials and rejected claims
- Reduced revenue due to coding delays or coding errors
- System testing and information technology fixes
Although it seems the transition to ICD-10 was largely a success, it is clear that more work needs to be done in order to maintain that success.
A stolen laptop can be worth more than $800,000. At least that was the case with a laptop taken from Lahey Clinic Hospital, Inc. in 2011. The HHS Office for Civil Rights (OCR) recently ruled that Lahey — based in Burlington, Mass. — must pay an $850,000 fine for violations of the HIPAA Privacy and Security Rules, stemming from the loss of that laptop.
The stolen laptop was used in association with a computerized tomography (CT) scanner and held the electronic protected health information (ePHI) of nearly 600 patients. Lahey reported the breach to OCR, prompting an inspection of Lahey’s security practices. The OCR probe returned six primary infractions, including the improper disclosure of ePHI, failure to assign procedures to the movement of devices containing ePHI in and out of the facility and a deficiency in “physical safeguards for a workstation that accesses ePHI to restrict access to authorized users.”
On top of paying the fine, Lahey entered into an agreement with HHS to prove it has taken steps to avoid future breaches. The corrective plan mandates that Lahey execute a risk analysis of its entire organization and document any security and ePHI vulnerabilities. Lahey must give the resulting risk analysis report and a separate risk management proposal to HHS for review.
While OCR watches over hospitals, the Office of the Inspector General (OIG) is monitoring OCR. The OIG — another HHS office that handles ePHI matters — has the topic in its plans for the 2016 fiscal year. The OIG said it will assess OCR’s enforcement of ePHI security next year and determine if it is sufficient. Specifically, OIG will check that OCR is conducting regular audits of HIPAA covered entities and business associates to confirm those entities are compliant with HIPAA and the HITECH Act. The Food and Drug Administration (FDA) will also be in the OIG’s crosshairs in 2016, when OIG promises to evaluate how well the FDA is overseeing medical devices and the security of their interactions with ePHI.
Mother Jones recently published a highly critical article on Epic Systems, claiming that the EHR vendor’s product lacked interoperability and therefore was hurting patients.
Well, Epic has responded.
In a letter to the editors of Mother Jones, Peter DeVault, Epic’s vice president of interoperability, defended the company. The letter was published online in the comments section of the original article, joining more than 300 other comments.
First, he wanted to make it clear that Epic customers own their own data, “and there are several easy-to-use tools to access and share it at the customer’s discretion,” DeVault wrote. He went on to say that customers can connect to and share patient records with thousands of organizations that may be using other vendors’ products. This includes, he asserted, the U.S. Department of Defense and the Veterans Health Administration.
DeVault also cites the Sequoia Project’s eHealth Exchange: “According to the eHealth Exchange, Epic shares more records with these government agencies than any other vendor,” he wrote. He added that Epic remains a leader in the improvement of interoperability standards.
Second, DeVault addressed the RAND report noted in the article and that the Mother Jones piece concluded was critical of Epic’s interoperability record.
“[Mother Jones] failed to mention that the report relied on uncited assertions, anonymous blog posts and an article from the 1990s,” DeVault wrote.
And finally, DeVault ends his letter by saying, “The world of EHR is developing rapidly, and there’s much good that remains to be done. Articles like this do nothing to illuminate the problems or the solutions ahead.”