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Avoiding Financial Losses After EMR Implementation

Posted on April 3, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While hospitals buy EMRs to improve their operations – both clinically and financially – too often they take a hit before they work out the kinks in their installation.  In fact, healthcare institutions often end up losing up to 5 percent of their gross revenue after EMRs are implemented, according to consultant Erick McKesson.

One typical story comes from Maine Medical Center, which found that patient charges weren’t appearing after its $150 million Epic installation in 2012. These billing errors were one of the reasons the medical center posted a $13.4 million loss in the first six months after the installation, hospital executives reported.

But according to McKesson, managing consultant with Navigant, it’s possible to overcome these problems. In an article for Becker’s Hospital Review, he tells the story of a group of health systems which worked together to avoid such losses. The group worked together to identify the most valuable software features that flagged mischarges or reporting errors. They then identified the five charge program “edits” which had the largest financial impact.

Areas the cooperating health systems considered the most important included:

* Administrative codes

The health systems noted that incorrect administrative codes lead to lagging revenue. That’s particularly the case when there are different codes for the same procedure. Hospitals need to be sure that clinicians use the higher code if appropriate, which can be helped by the right technological fixes.

* Anesthesia

It’s important to monitor your charges when there are two distinct aspects of a single procedure that are charged separately, particularly with anesthesia services. If your audit system flags the absence of the added codes, it can recapture a substantial level of missing revenue.

* CT

Seeing to it that radiology charges are automatically reviewed can ensure that appropriate levels of revenue are generated. For example, in the case of CT exams, it’s important to see that charges are assessed for both the exam and if needed, the use of a contrast agent.

* Emergency Department

It’s not unusual for ED physicians to undercode high-acuity patients. But it’s important to address this issue, as undercoding can result in significant financial consequences.  Not only that, in addition to generating financial losses, undercoding can create problems with performance-based reimbursement contracts. If patients are depicted as less acute than they actually are, payors may expect better outcomes than the patients are likely to have. And that can lead to lower revenue or even significant financial penalties.

* Infusions

Auditing infusion charges can be very helpful in capturing added revenues, given that they are one of the most frequent charges in healthcare. Infusion codes are very complex, including the need to track start and stop times, difficult rules regarding what charges are appropriate during infusions and issues related to “carve out periods.” Auditing systems can help clinicians comply with requirements, including simple-to-create functions which automatically flag missing stop times.

As readers will doubtless know, getting competing health systems to engage in “coopetition” can be tough, even if it helps them improve their operations. But given the need to combat post-EMR lags in revenue, maybe more of them will risk it in the future.

Database Linked With Hospital EMR To Encourage Drug Monitoring

Posted on March 31, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

According to state officials, Colorado occupies the unenviable position of second worst in the US for prescription drug misuse, with more than 255,000 Coloradans misusing prescribed medications.

One way the state is fighting back is by running the Colorado Prescription Drug Monitoring Program which, like comparable efforts in other states, tracks prescriptions for controlled medications. Every regular business day, the state’s pharmacists upload prescription data for medications listed in Schedules II through V.

While this effort may have value, many physicians haven’t been using the database, largely because it can be difficult to access. In fact, historically physicians have been using the system only about 30 percent of the time when prescribing controlled substances, according to a story appearing in HealthLeaders Media.

As things stand, it can take physicians up to three minutes to access the data, given that they have to sign out of their EMR, visit the PDMP site, log in using separate credentials, click through to the right page, enter patient information and sort through possible matches before they got to the patient’s aggregated prescription history. Given the ugliness of this workflow, it’s no surprise that clinicians aren’t searching out PDMP data, especially if they don’t regard a patient as being at a high risk for drug abuse or diversion.

But perhaps taking some needless steps out of the process can make a difference, a theory which one of the state’s hospitals is testing. Colorado officials are hoping a new pilot program linking the PDMP database to an EMR will foster higher use of the data by physicians. The pilot, funded by a federal grant through the Bureau of Justice Assistance, connects the drug database directly to the University of Colorado Hospital’s Epic EMR.

The project began with a year-long building out phase, during which IT leaders created a gateway connecting the PDMP database and the Epic installation. Several months ago, the team followed up with a launch at the school of medicine’s emergency medicine department. Eventually, the PDMP database will be available in five EDs which have a combined total of 270,000 visits per year, HealthLeaders notes.

Under the pilot program, physicians can access the drug database with a single click, directly from within the Epic EMR system. Once the PDMP database was made available, the pilot brought physicians on board gradually, moving from evaluating their baseline use, giving clinicians raw data, giving them data using a risk-stratification tool and eventually requiring that they use the tool.

Researchers guiding the pilot are evaluating whether providers use the PDMP more and whether it has an impact on high-risk patients. Researchers will also analyze what happened to patients a year before, during and a year after their ED visits, using de-identified patient data.

It’s worth pointing out that people outside of Colorado are well aware of the PDMP access issue. In fact, the ONC has been paying fairly close attention to the problem of making PDMP data more accessible. That being said, the agency notes that integrating PDMPs with other health IT systems won’t come easily, given that no uniform standards exist for linking prescription drug data with health IT systems. ONC staffers have apparently been working to develop a standard approach for delivering PDMP data to EMRs, pharmacy systems and health information exchanges.

However, at present it looks like custom integration will be necessary. Perhaps pilots like this one will lead by example.

Half of Medication Errors Found In PA Study Involve HIT Issues

Posted on March 29, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study by a Pennsylvania healthcare organization has found that computerized order entry systems and pharmacy systems were the most commonly reported factors contributing to medication errors in the state.

The Pennsylvania Patient Safety Authority, an independent agency tasked with finding and reducing the rate of medical errors in the state, recently released a report on medication errors reported to the agency during the first six months of last year. Under state law, Pennsylvania-based providers cutting across several categories, including hospitals, ambulatory surgical facilities and birthing centers, are required to disclose adverse events and “near misses” to the agency.

Between January 1 and June 30, 2016, the state’s healthcare facilities reported 889 medication-error events which cited health IT as a factor in the event(s). The errors most often reported were dose omission, wrong dose or overdosage and extra dosages, while CPOE and pharmacy systems-related problems were the most commonly reported health IT issues. (High-alert medications such as opioids, insulin and anticoagulants – which pose a higher risk of harm if misused – occupied three of the top five drug categories involved in most events.)

When they analyzed the data, agency analysts found that health IT-related errors took place during every step of the medication use process, and worse, most of those errors affected the patient directly, the data suggested.  And things may get worse before they improve. To hear agency officials tell it, HIT-related medication problems have become more common as health IT infrastructures have matured.

“As more healthcare organizations adopted EHRs and such systems became increasingly interoperable, the Authority observed an increase in reports of HIT-related events, particularly in relationship to medication errors,” said agency executive director Regina Hoffman in a prepared statement.

The Authority’s data doesn’t gibe completely with other research. For example, a report by the Leapfrog Group and Castlight Health notes that CPOE use has been very effective at reducing medication error rates. The report specifically refers to a CPOE study led by David Bates, MD, chief of general medicine at Brigham & Women’s Hospital, in which rates of serious medication errors fell by 88 percent during the period studied. Elsewhere, Leapfrog has cited studies in which CPOE use seems to have cut hospital lengths of stay, as well as major reductions in pharmacy, radiology and lab turnaround times.

On the other hand, the same report notes that CPOE systems still have a long way to go before they realize their potential. According to the 2015 Leapfrog Hospital Survey, hospitals’ CPOE systems failed to flag 39 percent of all potentially harmful drug orders, as well as 13 percent of potentially fatal orders. So it’s not a huge stretch to imagine that CPOE-using Pennsylvania hospitals are still having medication errors fall through the cracks.

It’s also worth pointing out that doctors don’t necessarily see CPOE systems as their best friend either. A study published last year in the Mayo Clinic Proceedings found that physicians who use EMRs and CPOE had lower satisfaction with time spent on clerical tasks and higher rates of burnout. Of course, given that the study lumps CPOE use in with EMR use, the results are somewhat skewed, but it’s still a data point worth considering.

Emergency Department Information Systems Market Fueled By Growing Patient Flow

Posted on March 20, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new research report has concluded that the size of the emergency department information systems market is expanding, driven by increasing patient flows. This dovetails with a report focused on 2016 data which also sees EDIS upgrades underway, though it points out that some hospital buyers don’t have the management support or a large enough budget to support the upgrade.

The more recent report, by Transparency Market Research, notes that ED traffic is being boosted by increases in the geriatric population, an increasing rate of accidents and overall population growth. In part to cope with this increase in patient flow, emergency departments are beginning to choose specialized, best-of-breed EDISs rather than less-differentiated electronic medical records systems, Transparency concludes.

Its analysis is supported by Black Book Research, whose 2016 report found that 69% of hospitals upgrading their existing EDIS are moving from enterprise EMR emergency models to freestanding platforms. Meanwhile, growing spending on healthcare and healthcare infrastructure is making the funds available to purchase EDIS platforms.

These factors are helping to fuel the emergence of robust EDIS market growth, according to Black Book. Its 2016 research, predicted that 35% of hospitals over 150 beds would replace their EDIS that year. Spurred by this spending, the US EDIS market should hit $420M, Black Book projects.

The most-popular EDIS features identified by Black Book include ease of use, reporting improvements, interoperability, physician productivity improvements, diagnosis enhancements and patient satisfaction, its research concluded.

All that being said, not all hospital leaders are well-informed about EDIS implementation and usability, which is holding growth back in some sectors. Also, high costs pose a barrier to adoption of these systems, according to Transparency.

Not only that, some hospital leaders don’t feel that it’s necessary to invest in an EDIS in addition to their enterprise EMR,. Black Book found. Thirty-nine percent of respondents to the 2016 study said that they were moderately or highly dissatisfied with their current EDIS, but 90% of the dissatisfied said they were being forced to rely on generic hospital-wide EMRs.

While all of this is interesting, it’s worth noting that EDIS investment is far from the biggest concern for hospital IT departments. According to a HIMSS survey on 2017 hospitals’ IT plans, top investment priorities include pharmacy technologies and EMR components.

Still, it appears that considering EDIS enhancements may be worth the trouble. For example, seventy-six percent of Black Book respondents implementing a replacement EDIS in Q2 2014 to Q1 2015 saw improved customer service outcomes attributed to the platform.

Also, 44% of hospitals over 200 beds implementing a replacement EDIS over the same period said that it reduced visit costs between 4% and 12%, the research firm found.

ACOs Not Scaling Well, But Health IT Helps

Posted on March 13, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

ACOs were billed as the next big thing in healthcare, a model which would create economies of scale and tame rising costs of care. In theory, unifying hospitals and doctors into an overarching entity – and creating shared clinical and financial goals – should improve care and boost efficiency.

Of course, creating them doesn’t come cheap. In fact, creating even a modest ACO typically calls for between $1 million and $3 million in capital investment, according to Michael Deegan, MD, who recently developed a course on ACOs for the University of Texas at Dallas. It also takes 18 to 24 months to launch an ACO, Deegan told an interviewer at UT.

But once all of the Ts have been crossed and the Is dotted, ACOs can meet their stated goals, right? Actually, not so much, though health IT can help things along, according to Indranil Bardham, a colleague of Deegan’s at UT Dallas who serves as professor of information systems.

According to an article in HealthcareITNews, Bardhan recently completed a study on ACO performance which concluded that health IT had a measurable impact on their efficiency. The study, which drew on 2013-2015 data from CMS, reviewed the performance of 400 ACOs.

Among the key takeways Bardhan took from his research was that the larger an ACO was, the more likely it was to be inefficient. This flies in the face of conventional wisdom, which would suggest that bigger is better when it comes to improving efficiency.

On the other hand, health IT use had the effect its champions might hope for, though modest in scope. The study concluded that a 1 percent increase in HIT usage was associated with an 0.5 percent increase in ACO efficiency.

The thing is, these measures represent just a couple of ways to evaluate ACO performance, making it hard to tell just what is working, Bardhan told HIN. “Healthcare, with respect to ACOs, is fascinating because there is not just one single output measure that you are using to compare performance,” he told the magazine’s Bill Siwicki. “…It is difficult to measure the performance of organizations against each other when you have multiple outputs that cannot easily be transformed into a single dollar number.”

This squares with commentary by other ACO researchers, who seem to agree that the whole ACO evaluation process is a bit mysterious. As health policy analyst David Introcaso notes, in a review of ACO-based Medicare Shared Savings Program, CMS isn’t helping either. “While CMS details financial and quality performance results, the agency does not explain, at least publicly, how results, favorable or unfavorable, were achieved.”

Without knowing more about what we should measure, and why – much less what steps helped in achieving their results – it’s too soon to tell what type of health IT should be deployed in ACOs. But looked at more optimistically, once we have a better idea of what ACO success factors are, it seems likely that health IT tools will help execs address them. (For a look at one completely health IT-based ACO concept, see this piece on the Virtual ACO.)

EMR Add-Ons On The Way

Posted on March 3, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study backed by speech recognition software vendor Nuance Communications has concluded that many healthcare leaders are planning to add new technologies to supplement their EMRs, Popular add-ons cited by the study include (naturally) speech recognition, mobility options and computer-assisted physician documentation tools. While the results are partially a pitch for Nuance, of course, they also highlight the tension between spending on clinical improvement and satisfaction and boosting the bottom line with better documentation tech.

The study, which was conducted by HIMSS Analytics, was designed to look at ways to optimize EMRs and opportunities to improve care at hospitals and health systems. Conducted between August 17 and September 6 of last year, it draws on 167 respondents from 142 different healthcare organizations. Forty percent of respondents hold C-suite titles, and an additional 40% were in IT leadership. (It would be interesting to see how the two groups’ perceptions vary, but the study summary doesn’t provide that information.)

According to HIMSS, 83% of respondents reported having confidence that their organization would eventually realize their full potential, particularly improving care coordination and outcomes.

To this end, 75% of respondents said they’d boosted their EMR efforts with training and support resources, while two-thirds have increased staff in at least one IT area since implementing their system. Respondents apparently didn’t say how much they’d increased their budget, if at all, to meet these needs – and you have to wonder how these organizations are paying for these efforts, and how much. But the report didn’t provide such information.

To increase clinician satisfaction with EMR use, 82% of respondents said providing clinician training and education, 75% are enhancing existing technology and tools and 68% adopting new technology and tools. To read between the lines once again, it’s worth noting that hospitals and health systems seem to be putting a stronger emphasis on training than new tech, which somewhat contradicts the study’s conclusions. Still, EMR add-ons clearly matter.

Meanwhile, about one-quarter of survey respondents said that they planned to introduce EMR-enhancing tools at the point of care, primarily to improve documentation and boost physician satisfaction. Those included mobility tools (44%), computer-assisted physician documentation (38%) and speech recognition (25%). These numbers seem a bit lower than I would have expected, particularly the mobile stat. I’m betting that establishing mobile security is still a tough nut to crack for most.

While increasing clinician satisfaction and improving care outcomes is important, boosting financial performance clearly matters too, and respondents said that improving documentation was central to doing so. Fifty-four percent said that better documentation would reduce the number of denied claims they face, 52% expect to improve performance under bundled payments, 38% predicted reduced readmissions and 38% thought documentation improvements would better physician time management and improve patient flow.

Again, I doubt that C-suite execs and IT leaders will pay equal attention to tools which improve their finances and those which meet “softer” goals – and financial goals have to take priority. But these stats do suggest that hospitals and health systems are giving EMR add-ons some attention. It will be interesting to see if they’re willing to invest in EMR enhancements — rather than burrowing deeper into their existing EMR tech — over the next year or two.

Cleveland Clinic Works To Eliminate Tech Redundancies

Posted on March 1, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The Cleveland Clinic has relied on its EMR for quite some time. In fact, it adopted Epic in the 1990s, long before most healthcare organizations were ready to make a bet on EMRs. Today, decades later, the Epic EMR is the “central data hub” for the medical center and is central to both its clinical and operational efforts, according to William Morris, MD, the Clinic’s associate chief information officer.

But Morris, who spoke about the Clinic’s health IT with Health Data Management, also knows its limitations. In an interview with the magazine’s Greg Slabodkin, he notes that while the EMR may be necessary, it isn’t sufficient. The Epic EMR is “just a digital repository,” he told Slabodkin. “Ultimately, it’s what you do with the technology in your ecosystem.”

These days, IT leaders at the Clinic are working to streamline the layers of additional technology which have accreted on top of the EMR over the years. “As an early adopter of Epic, we have accumulated quite a bit of what I’ll call technical debt,” said Doug Smith, interim chief information officer. “What I mean by that is multiple enhancements, bolt-ons, or revisions to the core application. We have to unburden ourselves of that.”

It’s not that Clinic leaders are unhappy with their EMR. In fact, they’re finding ways to tap its power to improve care. For example, to better leverage its EMR data, the Cleveland Clinic has developed data-driven “risk scores” designed to let doctors know if patients need intervention. The models, developed by the Clinic’s Quantitative Health Sciences group, offer outcome risk calculators for several conditions, including cancer, cardiovascular disease and diabetes.

(By the way, if predictive analytics interest you, you might want to check out our coverage of such efforts at New York’s Mount Sinai Hospital, which is developing a platform to predict which patients might develop congestive heart failure and care for patients already diagnosed with the condition more effectively. I’ve also taken a look at a related product being developed by Google’s DeepMind, an app named Streams which will ping clinicians if a patient needs extra attention.)

Ultimately, though, the organization hopes to simplify its larger health IT infrastructure substantially, to the point where 85% of the HIT functionality comes from the core Epic system. This includes keeping a wary eye on Epic upgrades, and implementing new features selectively. “When you take an upgrade in Epic, they are always turning on more features and functions,” Smith notes. “Most are optional.”

Not only will such improvements streamline IT operations, they will make clinicians more efficient, Smith says. “They are adopting standard workflows that also exist in many other organizations—and, we’re more efficient in supporting it because we don’t take as long to validate or support an upgrade.”

As an aside, I’m interested to read that Epic is tossing more features at Cleveland Clinic than it cares to adopt. I wonder if those are what engineers think customers want, or what they’re demanding today?

Do Hospital CIOs Have the IT They Need?

Posted on February 27, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at a CIO reception at the HIMSS-CHIME Forum, I took part in an interesting conversation with a group of CIOs. They were talking about the number of phone calls they get from vendors. They had some unique insights and approaches into how they handled all the incoming messaging from vendors. I’ll save most of those insights for the Healthcare IT Marketing and PR conference that I host, but he also offered this interesting nugget when he said the following:

Our organization more or less has what we need to be successful. We aren’t looking to add more.

He did later acknowledge that if that wasn’t true, that they would go out and search for the vendors as opposed to an incoming call from a sales person.

This CIO’s comment struck me. I don’t think he was being so arrogant as to say that they weren’t going to purchase any more IT solutions. However, I think he was saying that he didn’t see any major enterprise purchases on his horizon.

On the one hand, I think that’s a sign of a maturing of the industry. His hospital organization finally had the IT tools they needed to be successful. That’s a good thing since I think if we’d had the conversation 3-5 years ago it would have been very different.

On the other hand, it’s kind of scary to think that this hospital CIO isn’t really looking at the IT environment around him and looking for new tools and solutions that could make his organization even better. This is a simple illustration of how every IT organization can get in a rut and stop innovating if we’re not careful.

At some point in any IT implementation, you have to step back and double down on the investments you’ve already made. There are huge opportunities in every healthcare organization I’ve seen to maximize the benefits they’re receiving from the IT they’ve already implemented. It’s fair to say that this CIO was at that stage of the game. It was time to stop searching and implementing other systems and time to optimize what’s already in place. That’s a good thing as long as it’s not taken too far.

I think the hospital health IT industry is largely in the same place as this CIO. Most aren’t looking to make new purchases. Instead, they want to extract value out of their previous purchases. What do you think? Have you seen this same sort of market maturity? Any idea on what will be next that will change this CIO and the industry’s thinking?

The Distributed Hospital On The Horizon

Posted on February 24, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If you’re reading this blog, you already know that distributed, connected devices and networks are the future of healthcare.  Connected monitoring devices are growing more mature by the day, network architectures are becoming amazingly fluid, and with the growth of the IoT, we’re adding huge numbers of smart devices to an already-diverse array of endpoints.  While we may not know what all of this will look when it’s fully mature, we’ve already made amazing progress in connecting care.

But how will these trends play out? One nice look at where all this is headed comes from Jeroen Tas, chief innovation and strategy officer at Philips. In a recent article, Tas describes a world in which even major brick-and-mortar players like hospitals go almost completely virtual.  Certainly, there are other takes out there on this subject, but I really like how Tas explains things.

He starts with the assertion that the hospital of the future “is not a physical location with waiting rooms, beds and labs.” Instead, a hospital will become an abstract network overlay connecting nodes. It’s worth noting that this isn’t just a concept. For an example, Tas points to the Mercy Virtual Care Center, a $54 million “hospital without beds” dedicated to telehealth and connected care.  The Center, which has over 300 employees, cares for patients at home and in beds across 38 hospitals in seven states.

While the virtual hospital may not rely on a single, central campus, physical care locations will still matter – they’ll just be distributed differently. According to Tas, the connected health network will work best if care is provided as needed through retail-type outlets near where people live, specialist hubs, inpatient facilities and outpatient clinics. Yes, of course, we already have all of these things in place, but in the new connected world, they’ll all be on a single network.

Ultimately, even if brick-and-mortar hospitals never disappear, virtual care should make it possible to cut down dramatically on hospital admissions, he suggests.  For example, Tas notes that Philips partner Banner Health has slashed hospital admissions almost 50% by using telehealth and advanced analytics for patients with multiple chronic conditions. (We’ve also reported on a related pilot by Partners HealthCare Brigham and Women’s Hospital, the “Home Hospital,” which sends patients home with remote monitoring devices as an alternative to admissions.)

Of course, the broad connected care outline Tas offers can only take us so far. It’s all well and good to have a vision, but there are still some major problems we’ll have to solve before connected care becomes practical as a backbone for healthcare delivery.

After all, to cite one major challenge, community-wide connected health won’t be very practical until interoperable data sharing becomes easier – and we really don’t know when that will happen. Also, until big data analytics tools are widely accessible (rather than the province of the biggest, best-funded institutions) it will be hard for providers to manage the data generated by millions of virtual care endpoints.

Still, if Tas’s piece is any indication, consensus is building on what next-gen care networks can and should be, and there’s certainly plenty of ways to lay the groundwork for the future. Even small-scale, preliminary connected health efforts seem to be fostering meaningful changes in how care is delivered. And there’s little doubt that over time, connected health will turn many brick-and-mortar care models on their heads, becoming a large – or even dominant – part of care delivery.

Getting there may be tricky, but if providers keep working at connected care, it should offer an immense payoff.