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    Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

    Contact us at PHA email and be sure to visit us at PHA Website

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Musings on 2012 Health IT

Musings on 2012 Health IT

IDC Health Insights is an advisory services and market research firm that closely follows the payer, provider and life science segments of the healthcare industry, with special emphasis on developing and employing strategies that leverage IT investments to maximize organizational performance.

According to research and conversations with health industry executives, IDC has created the following 2012 Health IT predictions. There are five overarching themes impacting the healthcare industry which will affect the future of health IT, according to IDC: health reform, analytics and big data, cloud computing, mobile devices, and social media.

1.  The majority of U.S. providers will use EHRs by the end of 2012. This will advance health information exchange functionality.

2.  Providers will establish successful ACOs, which will emerge from private or public-private initiatives.

3.  Health plans will rebrand in 2012 as the focus turns to consumers. According to IDC, in 2012 at least 70% of health insurance companies and technology resources (beyond ICD-10) will be channeled toward enhancing consumer engagement and care or health management strategies.

4.  There will be greater integration of payment systems with clinical performance and outcomes. Twenty percent of health plans will leverage investment strategies started in 2010 and 2011 to integrate care, network, and payment strategies. Integrating these systems will help differentiate health plans and will allow for an increase in analytics software investments to support outcomes-based payment programs.

5.  Pharmaceutical companies will add software that provides real-time alerts, data integration, and analytics to create actionable information that will drive operational efficiencies.

6.  ACOs will need to develop an enterprise analytic framework that includes clinical analytics. 2012 will see ACOs battling to find significant IT and human resources to meet analytic requirements. These resources will be needed to support an integrated model that will make data available for all stakeholders, anywhere and anytime.  According to Dr. Westby Fisher, the use of data to improve clinical efficiencies while simultaneously using the data to market services will become 2012’s data-driven mantra. Like the fortune-teller’s crystal ball, those centers with the foresight and wherewithal to process and puree the large volume of clinical data spewed forth by today’s caregivers data entry personnel will be richly rewarded as new pressures to the cost curve surface. There will be a distinct competitive advantage to those who can simultaneously compare treatment, demographic, and socioeconomic trends in near real-time with an eye for more financially efficient care.

7.  The relationships between pharmaceutical companies and outsourcing firms will shift from what historically has been one-off relationships with siloed systems of processes being outsourced, to broader and deeper partnering relationships across entire functional areas.

8.  As physicians, nurses, and mid-level practitioners increasingly use their personal mobile devices to conduct work-related tasks, hospital CIOs will have to deal with increased security risks.  Further commentary by Dr. Fisher, “One only has to realize the extent of the mobile-medical movement and the innovations in hand-held devices capable of fully managing patients at a distance to appreciate the futile nature of the government’s ability to enforce the HIPAA/HiTECH acts. After all, despite the government’s heavy-handed wrist-slapping in this regard, I have yet to see a story of how the government recovered any of the data lost or how they rectified damages to those whose medical information has already been compromised. Shouldn’t that be the focus?”

9.  Health plans will deploy second-generation communication strategies, developed with the aid of analytics software, to support consumer communications throughout 2012.

10. The second generation of consumer communications will leverage consumers’ social networks, including family, friends, and co-workers, to encourage healthy habits. For example, through mobile devices and social networking sites like Facebook, social connections can encourage (or prod) people to follow medical, diet, or exercise regimens, such as monitoring glucose or blood pressure readings on home health monitoring devices.

While is it exciting to see the proliferation of predictions for innovative technology with regards to patient engagement, it begs the question – how will the healthcare industry insure that pertinent messaging is not duplicated by multiple parties? Sounding strangely familiar, it would be nice to see payers, providers and vendors engage in a collaborative effort to make this 2012 New Year’s resolution come true.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

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Walmart’s Greatest Gift

Walmart‘s Greatest Gift

According to Walmart’s newest promotion, The Christmas Price Guarantee, “the greatest gift we can give our customers this holiday is great low prices on the things they want most.”  In light of their recent announcement regarding expansion beyond primary care services, one wonders if this indeed is their greatest gift?  Walmart was one of the first national companies to invest in retail clinics but has since dropped to third place with about 140 of them, well behind CVS Caremark’s nearly 550 Minute Clinics and Walgreens‘ 355 Take Care clinics, according to data tracked by Tom Charland, CEO of Merchant Medicine, a Minnesota-based research and consulting firm. About 1,300 store-based clinics are open nationwide, he says.

With more than 3,500 stores in the U.S., Walmart leases space to independent clinic vendors, while CVS owns and staffs its Minute Clinics. Few centers operated by retailers have doctors on site and most hire nurse practitioners or physician assistants to deliver care. Failing to reach their proposed target of 400 new centers by 2010, Walmart revised its strategy to include partnering with hospital and healthcare systems.

According to Jonathan Linkous, CEO of the American Telemedicine Association, pharmacies and large retail chains with in-store pharmacies continue to look for a retail health clinic business model that offers an acceptable return on investment. Early services included relatively simple diagnostic services provided by an in-store physician, nurse practitioner or physician’s assistant. And several years ago, Walmart experimented with telemedicine services in some of its retail clinics in Texas.

Now, Linkous said, some retailers are looking at using remote patient monitoring technologies to track people with chronic diseases and disorders. Offering blood pressure, weight or other vital sign measurements and storing them for future tracking via an electronic database can help keep a customer loyal to the store where they buy their prescriptions, he noted.  While loyalty is certainly one significant advantage, retail operators also have a compelling opportunity to engage patients in managing their healthcare.

With the sheer volume of stores, Walmart has the ability to draw customers for prevention and wellness activities, as well as, acute episodic management.  Similar to the Mayo Clinic Healthy Living at Mall of the America, a diabetic patient could be assessed for proper foot care and transitioned to a nurse educator to learn more about preventive measures, wellness products and technology that could assist the individual living with this disease.  Taking it one step further, personal health records could be introduced and demonstrated since they are being offered by a growing number of hospital and healthcare systems.  And while capturing key vital sign measurements in a customer relationship management database represents an important first step, finding ways to link this information to a patient’s electronic health record would be even better.  Armed with data from multiple points in the continuum of care, a patient’s multi-disciplinary care team then becomes better prepared to determine the most efficient next steps.

According to Forbes contributor, Tim Worstall, six Walton family members account for more than 30% of the nation’s wealth.  Given their negotiating power on Pennsylvania Avenue, Wall Street – and hopefully – Main Street, Walmart’s greatest gift is to help patients acknowledge, engage and gain control of their healthcare.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Personal Health Record rEvolution

Personal Health Record rEvolution

As hospitals and healthcare systems move toward establishing “meaningful use” of electronic health records (EHR), one of their primary objectives remains engaging patients and families in their health care.  Personal Health Records (PHR) and related technologies can further this objective.  While an EHR is maintained by an institution, a PHR contains health data that is curated by an individual patient.  The intention of a PHR is to provide a complete and accurate summary of an individual’s medical history which is accessible online. PHR data can be accessed via a free standing vehicle, as in the soon to be defunct Google Health, or in a format that is linked to an existing EHR.

 According to the National Committee on Vital and Health Statistics, key potential benefits of PHRs include:

  • Support wellness and preventative care
  • Strengthen communication with providers and improve understanding of health issues
  • Increase sense of control over health and access to personal health information
  • Support healthcare decisions and responsibility for care
  • Verify accuracy of information in provider records
  • Support home monitoring for chronic diseases
  • Support understanding/appropriate use of medications and reduce adverse drug interactions and allergic reactions
  • Support continuity of care across time and providers
  • Manage insurance benefits and claims
  • Avoid duplicate tests
  • Provide convenience via online appointment scheduling and prescription refills
  • Increase access to providers through e-visits

Despite these tremendous benefits, a recent survey found that only seven percent of Americans had used online personal health records, and less than 3.5 percent used them with any frequency.  So what can be done to boost the use of personal health records? According to Ross Koppel, Chair of the Evaluation Working Group for the American Informatics Association:

  • Instead of requiring patients to be data entry clerks, we should encourage (require?) healthcare technology vendors to agree to common data formats and use rules that would allow information to automatically flow from doctors’ offices, labs, and hospitals into patient’s personal health records. At the same time, we must recognize that some information is best conveyed in person by experienced medical professionals. Just because we can send information instantly doesn’t mean it’s always a good idea to do so.
  • The automatic flow of data would make these systems far more user friendly, especially to the elderly and sick. Freed from data entry duty, the health records software could focus on presentation of information with better graphics. We need to make visualizing healthcare information easier and therefore easier to understand.
  • We need to alter privacy rules so physicians can safely respond to patients’ email questions while protecting sensitive information. Telephone use norms emerged slowly, eventually encompassing even cell-phones. Emails via healthcare-system websites are considered safe, but all other emails travel on legal quicksand.
  • Insurance companies will have to figure out how to reimburse doctors for reviewing and responding to patients’ emails. When patients view their information via the internet, they are going to have questions; and not every question requires an office visit. The same process that provides instant information can facilitate fast responses.

Assuming that these road bumps can be overcome and patients seize the opportunity to access their personal health record, how does the information become actionable and not a lifeless repository?  Perhaps, the time for a true revolution…not just evolution, has arrived.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

*graphic courtesy of the National Committee on Vital and Health Statistics

Mobile Health: Tsunami or Spring?

Mobile Health: Tsunami or Spring?

Having just celebrated the world’s sixth billionth connection, mobile health (mHealth) is poised to make a grand splash in the public health arena.  The term mHealth was coined by Professor Robert Istepanian as the use of “emerging mobile communications and network technologies for healthcare.”  With advances in the development of mobile technologies and applications, growth in cellular networks and new opportunities to integrate mobile health care delivery, there is no denying the transformative nature of this medium.

In celebration of the recent mHealth Summit, HIMMS has published it’s 1st Annual Mobile Technology Survey.  According to the report, key survey results include:

  • Maturity of Mobile Technology Environment: Respondents characterized their environment at a middle rate of maturity, with an average score of 3.88 on a scale of one to seven, where one is not at all mature and seven is a high level of maturity.
  • Mobile Technology Policy: Existing mobile technology policies cover a wide variety of information, from tools needed to secure devices, use of personal devices for work purposes and the types and brands of mobile devices to be used at an organization.
  • Clinical Access to Data: Respondents were most likely to report that clinicians at their organizations use apps either to look up non-PHI health information (such as accessing clinical guidelines) or to view patient information. Respondents were much less likely to report that clinicians used their mobile devices to interactively record patient data.
  • Access to Data from Off-Site Locations: Three-quarters of respondents indicated that their organizations allow clinicians to access clinical data via a mobile device using a public network with approved security, such as a VPN.
  • Benefits of Using Mobile Technology: Respondents were most likely to identify improved access to patient information and the ability to view data from a remote location as key benefits to the use of mobile technology at their organizations.
  • Barriers to Mobile Technology Use: Inadequate privacy and security was most frequently identified by survey respondents as a barrier to the use of mobile technology at their organization. When asked to identify the top concerns of reported to them by clinicians, respondents were most likely to report speed of accessing data.
  • Use of Personal Devices: Slightly less than half of respondents noted that their organization supports personal devices owned by the end-user but are enabled by the organization to support daily work activities.
  • Means for Securing Data on Mobile Devices: Most respondents offer a variety of methods for securing data on mobile devices at their organizations. Passwords are the most widespread security device in place.

As a tool directed primarily to health information management and hospital personnel, it is promising to note the survey’s estimated clinical utilization rate.  While mobile technology appears to be actively used inside the confines of the hospital, one has to wonder if it is being implemented in the roughly 220,000 physician practices throughout the US?  Dr. William Riley, Chair of the National Institutes of Health (NIH) mHealth Interest Group, had these thoughts to share:

Taking into account Dr. Riley’s comments, what could be a tsunami of change is, for now, a mere gurgling stream.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website

Telehealth Today, Not Tomorrow

Telehealth Today, Not Tomorrow

According to the American Telemedicine Organization, telemedicine is the use of electronic communications and information technologies to provide clinical services when participants are at different locations. Closely associated with telemedicine is the term telehealth. This term is often used to encompass a broader application of technologies to distance education, consumer outreach, and other applications wherein electronic communications and information technologies are used to support healthcare services.  Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth.

The delivery of remote health services is used for a variety of purposes:

  • Direct patient care such as sharing audio, video and medical data between a patient and a health professional for use in rendering a diagnosis, treatment plan, prescription or advice. This might involve patients located at a remote clinic, a physician’s office or home.
  • Remote patient monitoring uses devices to remotely collect and send data to a monitoring station for interpretation. Such “home telehealth” applications might include using telemetry devices to capture a specific vital sign, such as blood pressure, glucose, ECG or weight. Such services can be used to supplement the use of visiting nurses.
  • Specialist referral services typically involve a specialist assisting a general practitioner in rendering a diagnosis. This may involve a patient “seeing” a specialist over a live, remote consult or the transmission of diagnostic images and/or video along with patient data to a specialist for viewing later.
  • Medical education and mentoring, which range from the provision of continuing medical education credits for health professionals and special medical education seminars for targeted groups to interactive expert advice provided to another professional performing medical procedure.
  • Consumer medical and health information includes the use of the Internet for consumers to obtain specialized health information and on-line discussion groups to provide peer-to-peer support.

Remote health care relies on several means for the delivery of data:

  • Networked programs link tertiary care hospitals and clinics with outlying clinics and community health centers in rural or suburban areas through either hub-and-spoke or integrated networked systems. The links may use dedicated high-speed lines or the Internet for telecommunication links between sites. It is estimated that there are about 200 telemedicine networks in the United States involving close to 3,500 medical and healthcare institutions throughout the country.
  • Point-to-point connections using private networks are used by hospitals and clinics that deliver services directly or contract out (out sourced) specialty services to independent medical service providers at ambulatory care sites.
  • Health provider to the home connections involves connecting primary care providers, specialists and home health nurses with patients over single line phone-video systems for interactive clinical consultations. Such services can also be extended to a residential care center such as nursing homes or assisted living facility.
  • Direct patient to monitoring center links are used for pacemaker, cardiac, pulmonary or fetal monitoring and related services and provide patients the ability to maintain independent lifestyles.
  • Web-based e-health patient service sites provide direct consumer outreach and services over the Internet.

With the looming physician shortage, this technology delivers much needed access for small and rural healthcare providers.  CMS (Centers for Medicare & Medicaid Services) has taken notice and developed a new credentialing and privileging process for practitioners delivering healthcare services remotely.  In the presence of faster and more reliable networks, wireless devices, high-definition digital images and video, telehealth could be the fulcrum for this long overdue multi-pronged approach.

Principle Healthcare Associates is an expert resource and dedicated advocate for Nurse Practitioner, Physician Assistant, Physician and Healthcare Executive job seekers. With many years of recruiting experience, we deliver strategies to help clients identify diamonds in the rough and candidates stand head and shoulders above the competition.

Contact us at PHA email and be sure to visit us at PHA Website