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Patient Centricity

de System Administrator - miércoles, 21 de enero de 2015, 14:21
 

Are you patient-centric?

We know that engaging patients early and often is the way to better study results. Let us tell you how.

by BONNIE A. BRESCIA
Founding Principal, BBK Worldwide

Patient centricity is a philosophical commitment to understand what matters to patients as a group – such as those with a specific condition – as well as being attentive to each patient’s experience with his or her disease and within a clinical trial.

Patient-centric programs value the patients’ perspectives on what is being studied, what outcomes matter most in terms of daily living, or to what extent a patient would go to improve or expand treatment options. Patient centricity is including patients in study design, outreach, message development, site orientation, training – and ultimately in sharing the results. 

For many, being patient-friendly is more straightforward because it is tied to enrollment and retention tactics – providing study educational materials, reimbursing travel costs in a timely manner, respecting a patient’s time by being on time, extending office hours, and the like.

These two constructs are not mutually exclusive. Yet, in today’s increasingly competitive clinical research environment, being patient-friendly is a minimum requirement. Being patient-centric means caring intensely about every study participant in your study, at every visit – through every procedure. Companies that pursue true patient centricity are gaining a long-term advantage over those who wait. As it turns out, doing right by your patients is good for your study, good for the science, and good for business.

Please read the attached whitepaper.

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Patient Deception

de System Administrator - jueves, 25 de septiembre de 2014, 15:58
 

Patient Deception: Half of Patients Have Knowingly Deceived a Doctor

The reality of patient deception in the doctor-patient relationship is real. In fact,  half of patients admit to deceiving a doctor or other healthcare professional, according to an online survey of 3,075 American patients conducted by EHR selection group Software Advice. One-quarter of patients admitted to giving incorrect information or omitting information about their health at least “sometimes.” Another one-quarter of patients “rarely” withhold information, and half say they have “never” been deliberately misleading during a medical office visit. The scary part is the real number of patients who deceive doctors may be higher than 50 percent.

According to Dr. Leana Wen, emergency physician at George Washington University and author of “When Doctors Don’t Listen,” most patients don’t intend to give doctors inaccurate information. Instead, patients often leave out previously diagnosed conditions or symptoms they don’t think are related to the reason for their visit. 

Other key findings include:

Most Patients Don’t Reveal Drug, Alcohol or Tobacco Use

Patients who admitted to withholding information, drug, alcohol and tobacco use was the most common area in which patients were dishonest. 

 

Patients Often Deceive by Minimizing Health Information

Out of the patients who admitted that they had deceived a doctor, almost 40 percent did so by minimizing. Twenty-six percent deceived via exaggeration, and slightly fewer—23 percent—refused to disclose information at all.

 

Avoiding Embarrassment and Lectures Top Reason for Deceit

Among patients who responded that they had withheld information, 14 percent did so in order to avoid feeling embarrassed or being lectured by their doctor. Eleven percent of patients were seeking to protect their privacy—a worry that may be alleviated by mentioning privacy laws such as HIPAA. And 5 percent of patients were concerned with avoiding the cost or inconvenience of treatment.

 

Patients Most Reassured by Confidentiality, Lack of Judgment

Forty-three percent of patients said there was nothing a doctor could do to get them to open up. But among those who could be persuaded, 35 percent of patients would be less likely to withhold information from a doctor if they were assured of confidentiality. Twenty-three percent expressed a preference for an assurance that the doctor wouldn’t judge them.

 

The report warned although there is not anything a doctor can do to encourage more truth from their patients, it is recommended that doctors ask informed follow-up questions, maintaining eye contact, avoiding lecturing and clearly explaining confidentiality laws to improve communication and trust with patients.

For more information about this report, visit http://www.softwareadvice.com/medical/industryview/patient-deception-report-2014/

Link: http://hitconsultant.net

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Patient Portals

de System Administrator - sábado, 2 de agosto de 2014, 00:49
 

Patient Portals: The Key to Patient Engagement

Patient engagement is the new hot topic in healthcare information technology. Fueled by patient demands and Meaningful Use requirements, the need to get patients more involved in their own health management, and giving them a convenient platform to do so, is more important than ever.

 

Continue reading

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Patient Portals: A Win-Win for Practice and Patient

de System Administrator - lunes, 11 de agosto de 2014, 17:40
 

Patient Portals: A Win-Win for Practice and Patient

Patient portals not only help physicians comply with the Stage 2 rules of meaningful use, but can also build stronger ties with patients. Here’s how your practice can select the right portal and get both staff and patients on-board with using this emerging technology to its fullest potential.

Please read the attached whitepaper

 

Link: http://www.physicianspractice.com

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Patient's Biggest Pet Peeves about Doctors

de System Administrator - viernes, 8 de mayo de 2015, 12:15
 

Patient's Biggest Pet Peeves about Doctors

By Tracy Morris

In response to an open invitation to "rant away" on Facebook, patients ranging in age from 20-something to 75 shared their biggest pet peeves about doctors.Here is your opportunity to be a fly on the wall and learn what you might want to avoid saying — or doing — next time a patient comes to your practice.Tell us if you've heard these same issues from your patients or if these are rare cases in the comments below.

Please view the attached slides in PDF format.

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Periodic Table of Digital Health Investments

de System Administrator - miércoles, 8 de julio de 2015, 22:07
 

Infographic: Periodic Table of Digital Health Investments

by

2014 was an all-time record for digital health investments, with over $4B pouring into the health IT/digital health space, according to Rock Health. The San Francisco based full service seed fund for digital health startups recorded over ~120% growth YoY for total dollars invested, with an absolute growth of over $2.2B. The CAGR over the past four years is 44%. More than 287 companies have been funded this year—107 more than last year, representing 58% YoY growth. 

 Periodic Table of Digital Health Investments Overview

To highlight this record year, CB Insights analyzed their venture capital database to identify the key investors, acquirers and companies active in digital health to create the Periodic Table of Digital Health. The table highlights 123 key private companies, investors, accelerators, acquirers and others engaged in the health IT / digital health ecosystem in 2014. The illustration utilizes a mix of data around financial health, company momentum, investor quality and M&A/IPO activity. Digital health companies analyzed were defined within the following sub-verticals:

Healthcare cost transparency – Companies providing price transparency solutions with the goal of facilitating healthcare insurance plans and prescription complexities for consumers and businesses

Office/Patient management –  Companies that utilize software to better improve the organization of Electronic Health Records (EHR), billing and expense protocols, patient-doctor communication, and patient monitoring outside of the hospital.

Big data healthcare analytics – Companies offering verticalized predictive and prescriptive data and analytics solutions for the healthcare sector.

Quantified self – Companies using sensor and data technologies to track health and wellness areas including calories burned, steps taken or sleep rate and transmitting the information to you digitally.

Real-time healthcare – Companies offering platforms and technologies to get on-demand access to healthcare and/or licensed health practitioners, consultations and education.

See the table below or click to expand.

 

Link: http://hitconsultant.net

 


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Personalized medicine could fix patient non-adherence problem

de System Administrator - martes, 12 de mayo de 2015, 16:44
 

Personalized medicine could fix patient non-adherence problem

Emphasis on trial and error may lead to over-adherence

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Philips uses AWS and IoT to deliver healthcare in the home

de System Administrator - jueves, 22 de octubre de 2015, 11:36
 

Philips uses AWS and IoT to deliver healthcare in the home

Being able to respond in a fast, efficient and cost-effective manner to the healthcare needs of the UK’s growing elderly population is a major source of pressure for the NHS today.

Individuals in this group are more likely to suffer from chronic medical conditions that require lengthy courses of medication and frequent hospital check-ups, so the clinicians overseeing their care can keep close tabs on their progress.

All this, of course, comes at a cost. According to figures released in October 2015, NHS trusts chalked up a funding gap of £485m during the first quarter of 2015/16.

Their governing body, The NHS Trust Development Authority, partly attributed this overspend to the challenges trusts face when working out how to deliver ongoing care to “medically fit” patients once they’ve been discharged from hospital.

It is a conundrum Dutch technology giant Philips is trying to solve with its Healthcare Informatics, Solutions and Services (HISS) division. Its aim is to equip patients with the tools and technologies they need to self-manage and monitor their healthcare at home.

This approach can significantly cut the number of visits patients make to hospitals and GP practices, HISS CEO Jeroen Tas tells Computer Weekly, and – in turn – reduce some of the burden on the health service.

“We know everything about monitoring people in an intensive care unit setting, and we have 250 million patients hooked up to our devices each year,” he says.

“What we’re looking to do now is bring this capability into people’s homes. So, for example, if you’re an elderly person with multiple chronic diseases, what kind of devices can we give you to help with that?”

Some of the tools in this category include interactive weighing scales, blood pressure monitoring cuffs or ones that keep tabs on when patients take their medication, says Tas.

Warming to this theme, he outlines devices that can track changes in a person’s gait, which could pinpoint patients at risk of a fall or stroke in the home.  

Regardless of the device used, all would feed information back to healthcare providers– either for record-keeping purposes or to alert them that some degree of intervention may be needed ahead of time – resulting in higher levels of patient care.

“What we’re looking at is if we can create a very easy environment where these devices help people control their condition, but at the same time allow us to keep monitoring them,” he says.

“If we stream this data from the devices, we can ask questions, understand the context, and interpret its meaning in real-time, and take action.

“That action might be a daughter calling up, saying, ‘Mum, you need to take your medication, because I can see you’re not,’ or sending a therapist to someone’s home to help them.”

Using cloud to deliver clinical care

Delivering on this vision requires the ability to collect, store, analyse and cross-reference the data Philips receives from these devices on a large scale and in real-time, adds Tas. Without cloud, this would have proved impossible.

The firm has set its sights on connecting hundreds of millions of devices to its health monitoring platform, and will need to efficiently process the large volumes and varieties of data these will give rise to.

“We need a whole lot of computing power and that has to be elastic because, if we’re starting this and it’s successful, it will need to deal with petabytes of data each month. That’s what we’re designing it for,” he says.

“We’re looking for hundreds of millions of devices that will ultimately be connected. We already have seven million devices streaming data, but how are we going to deal with 100m? That will require a completely different infrastructure.”

Using a cloud-based infrastructure makes sense from a resiliency and availability point of view, says Tas. That is why the company is looking to Amazon Web Services (AWS) to support its sizeable ambitions.

“It has to be able to scale, but it also needs to be mission-critical because, if someone is wearing a device and they fall, you have to be able to help – or otherwise that person may die,” Tas says.

“We could never set up an infrastructure like AWS. Our strength is we understand the clinical world. We understand how to create good propositions for customers. We’re not going to waste our capital and talent on core infrastructure. We want to use it to craft digital solutions for healthcare.”

Using the cloud allows Philips to strip out the cost and resource barriers that often prevent companies from expanding their operations overseas. In Philips’ case, this would make the UK pilot projects it has recently embarked on much harder to do, says Tas.

An example of this is The Supported Self Care Champion Project Philips launched in conjunction with Cheshire and Wirral Partnership NHS Foundation Trust and NHS West Cheshire Clinical Commissioning Group in August 2015.

Its aim is to help nearly 1,000 people suffering with long-term medical conditions live more independently, by providing them with technology-enabled, self-care services over the course of 12 months. The project will help Philips shape how to delivers similar offerings on a nationwide basis in future.

“We run a global business and, if you need to deploy on-premise, you need to have all these people in place before you can do so,” he says. “Now we just deploy in the cloud with a small team that manages it.”

Hybrid vs. public cloud

Whether or not the HISS division of Philips will go on to join the roll call of AWS customers that have gone “all-in” on its cloud platform is difficult to say at this moment, as it is currently responsible for managing around 26,000 servers housed within thousands of its customers’ on-premise datacentres.

“These servers manage clinical data and images and some of that we still have to do because we may be supporting real-life images for someone operating on a patient, for example. Or we may have someone rushed into A&E, where they need to pull up that data and make a really quick diagnosis,” said Tas.

“For that, we can look at these datacentres and servers as edge devices in the cloud, where we can cache data and deal with latency or run some of the processing close to where we need it. But a lot of it can be run in the cloud,” he says.

For what Philips is trying to achieve right now, the hybrid approach works. Having cloud resources on tap paves the way for the organisation to essentially crowd source a diagnosis, rather than rely on the sole knowledge of a single clinician, resulting in a faster and more accurate diagnosis.

“We can go back to the cloud and say, ‘give us cases that look similar to this one,’ and we can interpret it combine this image with the medical record of the patient, their biopsies and data from relevant literature, and deliver faster patient care,” Tas says.

“Some people say 'no' to healthcare in the cloud, but I say the opposite – the benefits are just too overwhelming.”
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Physician-led ACOs: Secrets to success

de System Administrator - miércoles, 24 de septiembre de 2014, 16:09
 

Physician-led ACOs: Secrets to success

What sets these doctor-led groups apart from hospital-led ACOs?

By Katie Sullivan

As the healthcare industry considers value-based healthcare models, organizations can look to physician-led accountable care organizations (ACOs) for successful examples. Doctors lead more than 200 ACOs across the country--far greater than the ACOs run by hospitals.

Just this month, St. Mary Medical Center in Pennsylvania and 250 affiliated doctors joined together to form physician-led Quality Health Alliance ACO, set to open Jan. 1, Philadelphia Business Journal reported. "We all understood healthcare is changing and we will all be providing care in more collaborative situations with other physicians and hospitals," Benjamin Chack, M.D., an independent ear, nose and throat specialist and president of the organization, told the publication.

See the topics  below to learn why physician ACOs thrive and areas ACOs must exploit if they want to continue to grow.

In-house care

 

Doctor-led accountable care organizations (ACOs) keep costs down because they encourage their patients to use retail clinics or home visits for nonurgent care instead of expensive hospital visits. Physician-led ACO groups also have clearer incentives and stronger relationships with their patients, FierceHealthPayer previously reported. 

Hospitals face the challenge of balancing a decrease in hospital visits and the loss of the compensation for those services. But physician-led ACOs admit very few heart failure and heart attack patients, and they don't treat many low-income patients who often have trouble pursuing follow-up care, which drives up their quality numbers. Doc-led ACOs also earn significant quality-based bonusesunder the Affordable Care Act, receiving about 0.21 percent more for each Medicare patient they treated during fiscal 2012.

Physician-led ACOs are generally more successful at reducing institutional care because their incentives are aligned with reducing costs and avoiding high-priced care, while hospital-led ACOs must shift their entire business model to treat admissions as something that doesn't generate revenue, Healthcare Dive reported last month.

Experienced leadership

 

Physician-led accountable care organizations (ACOs) report some great outcomes, both in quality and financial savings.

Twenty-one of the 29 Pioneer ACOs from the Centers for Medicare & Medicaid Services were physician-led and 29 percent of those doc-led ACOs achieved greater savings than the minimum.savings rate--compared to 20 percent of their hospital-run ACO counterparts. 

Physicians also present a new set of skills to the healthcare model. They bring knowledge of the healthcare environment, professionalism, communication skills, business skills and the ability to lead and inspireFierceHealthcare previously reported.

Doctors themselves are the key to organizations' success, Mark Wagar, president of Heritage Medical Systems in Palm Springs, California, told FierceHealthcare in an exclusive interview earlier this year.

"[For] everything I've been involved in with healthcare that was a success, there was always a clinical leader either leading it, providing input, collaborating, supporting it and advocating it,"  he said. 

These leaders must be open to new ideas, understand primary care, and recognize the patients' and their family's needs--skills that many physicians have, Wagar said. 

Upcoming challenges

 

There are various strategies and models for physician-led accountable care organizations (ACOs) to follow. But all of them face challenges.

For example, independent physician groups, which are owned by a single physician group and don't contract with other providers, can't affect the delivery of inpatient care and don't have access to a lot of capital.

On the other hand, physician group alliances, which are owned by multiple physician groups but don't contract with other providers, must figure out how to integrate culture and work together.

Meanwhile, expanded physician groups, which only provide outpatient services but offer hospital services via contracts with other providers, must set up operational arrangements with hospitals to better manage patient health. However, these ACOs don't have to the stress of hospital involvement, which means fewer revenue pressures.

Rural and small-physician-led ACOs face tough challenges because they must come up with substantial upfront capital and infrastructure to establish a strong foundation, despite limited financial resources, Farzad Mostashari, M.D., a visiting fellow of the Engelberg Center for Health Care Reform at the Brookings Institution, and Anna Marcus, a staff assistant in economic studies at the organization, wrote in a post for The Health Care Blog. 

Link: http://www.fiercepracticemanagement.com

"Drive-by doctoring" drives up hospital costs

Out-of-network specialists show up briefly, then bill thousands

By Ron Shinkman

Specialty surgeons insert themselves into medical procedures--often without the knowledge of the patient--driving up costs considerably, the New York Timesreported.

In one case, a spinal surgeon who assisted in a fusion procedure after the patient was anesthetized billed the patient $117,000 for out-of-network charges, the Times reported. That was nearly 20 times what the patient's primary surgeon received. A neurosurgical nurse or physician assistant can often perform the assistant's work. 

"I had no choice and no negotiating power," the patient, Peter Drier, told theTimes. The surgeon, Harrison Mu, apparently entered the procedure as an assistant after an anesthesiologist placed Drier under general anesthesia.

Another patient, Patricia Kaufman, was charged $250,000 by two plastic surgeons for suturing a surgical wound--a procedure that medical residents previously performed.

Such practices are known colloquially as "drive-by doctoring," used by some medical specialists to increase their revenues. It is apparently fairly prevalent among spinal surgeons, who compete with orthopedic specialists for business and have seen their incomes go down in recent years, although their salaries still approach $600,000 on average.

"The idea of having an assistant in the OR has become an opportunity to make up for surgical fees that have been slashed," said Abeel A. Mangi, M.D., a professor of cardiac surgery at Yale, who told the Times the practice was commonplace.

Hospitals also pack in extra charges during surgery. Sutter Health recently settled charges it double-billed patients for anesthesia services.

However, the use of stealth medical specialists can extend well beyond the use of assistant surgeons. It is not unheard of for physical therapists (who bill at their professional rates) to walk patients to their bathrooms, according to the Times. Drier received a bill for $679 for occupational therapy charges regarding a device intended to help him put on socks that he never used.

"The notion is you can make end runs around price controls by increasing the number of things you do and bill for," said Darshak Sanghavi, M.D., a health policy expert who most recently was affiliated with the the Brookings Institution.

 

To learn more:
- read the Times article

Related Articles:
Sutter Health settles anesthesiology billing lawsuit for $46M
Hospitals dismiss significance of chargemaster prices
Billing trends could signal rise in upcoding
Selling practices to hospitals can hurt profits
Much improper billing is well concealed

Link: http://www.fiercehealthfinance.com

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Physicians' Top Tips for Remote Patient Care

de System Administrator - viernes, 17 de abril de 2015, 17:05
 

Physicians' Top Tips for Remote Patient Care


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