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Mount Sinai Uses AI To Manage CHF Cases

Posted on October 31, 2016 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.

New York-based Mount Sinai Hospital has begun a project which puts it in the vanguard of predictive analytics, working with a partner focused on artificial intelligence. Mount Sinai plans to use the Cloud Medx Clinical AI Platform to predict which patients might develop congestive heart failure and care better for those who’ve already done so.

As many readers will know, CHF is a dangerous chronic condition, but it can be managed with drugs, proper diet and exercise, plus measurement of blood pressure and respiratory function by remote monitoring devices. And of course, hospitals can mine their EMR for other clinical clues, as well as rifling through data from implantable medical devices or health tracking bands or smartwatches, to see if a patient’s condition is going south.

But using AI can give a hospital a more in-depth look at patterns that might not be visible to the unaided clinician. In fact, CloudMedx is already helping Sacramento-based Sutter Physician Services improve its patient care by digging out unseen patterns in patient data.

To perform its calculations, CloudMedx runs massive databases on public clouds such as Amazon Web Services and Microsoft Azure, then layers its specialized analytics and algorithms on top of the data, allowing physicians or researchers to query the database. The analytics tools use natural language processing and machine learning to track patients over time and derive real-time clinical insights.

In this case, the query tools let clinicians determine which patients are at risk of developing CHF or seeing their CHF status deteriorate. Factors the system evaluates include medical notes, a patient’s family history, demographics and past medical procedures, which are rolled up into a patient risk score.

In moving ahead with this strategy, Mount Sinai is rolling out what is likely to be a common strategy in the future. Going forward, expect to see other providers engage the growing number of AI-based healthcare analytics vendors, many of whom seem to have significant momentum.

For example, there’s Lumiata, a developer of AI-based productive health analytics whose Risk Matrix tool draws on more than 175 million patient-record years. Risk Matrix offers real-time predictions for 20 chronic conditions, including CHF, chronic kidney disease and diabetes.

Risk Matrix bases its predictions on its customers’ datasets, including labs, EHR data claims information and other types of data organized using FHIR. Once data is mapped out into FHIR, Risk Matrix generates output for more than 1 million records in less than three hours, the company reports. Users access Risk Matrix analyses using a FHIR-compatible API, which in turn allows for the results to be integrated into the output of the existing workflows.

But Lumiata is just the tip of the iceberg. CB Insights has identified more than 90 companies applying machine learning algorithms and predictive analytics to important problems in healthcare.

While many startups have flocked into the imaging and diagnostics space, expect to see AI-related activity in drug discovery, remote monitoring and oncology. Also, market watchers say companies founded to do AI work outside of healthcare see many opportunities there as well.

Now, at least at this stage, high-end AI tools are likely to be beyond the budget of mid-sized to small community hospitals. Nonetheless, they’re likely to be deployed far more often as value-based reimbursement hits the scene, so they might end up in use at your hospital after all.

Should Hospitals Track ED “Frequent Fliers” In Their EMR?

Posted on October 28, 2016 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.

Particularly as value-based reimbursement falls into place, hospitals have good reasons to track emergency department utilization across populations. As with readmissions, ED visit rates and diagnoses can tell you something valuable about patients’ conditions and the extent to which they are managing those conditions, as well.

However, tracking individual ED use, especially by behavioral health patients, may result in less-desirable consequences. In fact, according to a viewpoint article published recently in JAMA, adding icons or symbols to the records of patients who are considered to be “superusers” or “frequent fliers” can stigmatize patients and create bias against them.

“A pejorative branding, ‘frequent flyers’ are often assumed to be problem patients. In psychiatric settings, these patients are sometimes said to be ‘borderlines,’ ‘drug seekers,’ ‘malingerers,’ or ‘treatment resistant,’ according to authors Michelle Joy, MD, Timothy Clement, MPH and Dominic Sisti, PhD.

The researchers note that at least one EMR offers the capacity to insert an airplane icon beside the patient’s name, and not only that, to display the icon in different colors depending on where the patient falls among the high using population. But they consider this to be ethically and clinically inappropriate.

For one thing, they say, uses such an icon ‘encourages the use of disrespectful and stigmatizing terminology.’ What’s more, the use of such labels may change the clinician’s initial interactions with the patient in a way that affects their judgment negatively, and may subject the patient to the risk of a poor outcome from their care.

Not only that, they point out, while it might be useful to know that a patient presents in the ED frequently, determining why this happens can only take place if the clinician does a deeper dive into their utilization history. And slapping a high utilization icon the patient record actually discourages such in-depth examination, they contend.

On top of all that, if the patient is assumed to be visiting the ED frequently for largely psychiatric reasons, “diagnostic overshadowing” may occur, to the patient’s detriment. For example, they note, if a patient has a co-occurring mental illness in a condition such as cardiovascular disease, the patient is less likely to receive adequate medical care than patients without a medical condition, as the psych diagnosis overshadows their medical problems.

To avoid creating signifiers like the icon, which may build in the makers’ implicit biases, EMRs and behavioral health apps should be filled and tested in collaboration with patients, consumers, ethicists and other parties sensitive to the broader ramifications of using such language and iconography, the authors suggest.

In the meantime, readers of this publication might want to stop and think if there are any other ways in which the health IT systems they design and use reflect other unhelpful biases. While placing a frequent flyer icon beside a patient’s name seem like a particularly egregious instance — or does to me anyway – there may be subtler ways in which your HIT systems foster negative or inappropriate assumptions. And it’s good to dig those out and examine them. After all, nobody wins when patients fail to get the care they need.

Access To Electronic Health Data Saves Money In Emergency Department

Posted on October 24, 2016 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 study has found that emergency department patients benefit from having their electronic health records available when they’re being treated. Researchers found that when health information was available electronically, the patient’s care was speeded up, and that it also generated substantial cost savings.

Researchers with the University of Michigan School of Public Health reviewed the emergency department summaries from 4,451 adult and pediatric ED visits for about one year, examining how different forms of health data accessibility affected patients.

In 80% of the cases, the emergency department had to have all or part of the patient’s medical records faxed to the hospital where they were being treated. In the other 20% of the cases, however, where the ED staff had access to a patient’s complete electronic health record, they were seen much more quickly and treatment was often more efficient.

Specifically, the researchers found that when information requests from outside organizations were returned electronically instead of by fax, doctors saw that information an hour faster, which cut a patient’s time in the ED by almost 53 minutes.

This, in turn, seems to have reduced physicians’ use of MRIs, x-rays and CT scans by 1.6% to 2.5%, as well as lowering the likelihood of hospital admission by 2.4%. The researchers also found that average cost for care were $1,187 lower when information was delivered electronically.

An interesting side note to the study is that when information was made available electronically on patients, it was supplied through Epic’s Care Everywhere platform, which is reportedly used in about 20% of healthcare systems nationwide. Apparently, the University of Michigan Health System (which hosted the study) doesn’t belong to an HIE.

While I’m not saying that there’s anything untoward about this, I wasn’t surprised to find principal author Jordan Everson, a doctoral candidate in health services at the school, is a former Epic employee. He would know better than most how Epic’s health data sharing technology works.

From direct experience, I can state that Care Everywhere isn’t necessarily used or even understood by employees of some major health systems in my geographic location, and perhaps not configured right even when health systems attempt to use it. This continues to frustrate leaders at Epic, who emphasize time and again that this platform exists, and that is used quite actively by many of its customers.

But the implications of the study go well beyond the information sharing tools U-M Health System uses. The more important takeaway from the study is that this is quantitative evidence that having electronic data immediately available makes clinical and financial sense (at least from the patient perspective). If that premise was ever in question, this study does a lot to support it. Clearly, making it quick and easy for ED doctors to get up to speed makes a concrete difference in patient care.

Should You Buy Pop Health Tools And EMRs From One Vendor?

Posted on October 17, 2016 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 a new story appearing in HealthITAnalytics, EMR vendors are increasingly moving into the population health management space. In fact, according to an IDC Research market report featured in the story, the lines between the EMR and population health management marketplaces are beginning to blur, with vendors offering products tackling both documentation and patient management.

While this is not news to anyone who’s attended a major industry tradeshow in the last few years, the extent of the transition might be. Apparently, half of the top population health management vendors featured by IDC – including athenahealth, eClinicalWorks and Allscripts — also offer EMR platforms. (According to HealthITAnalytics, other pop health vendors identified as leaders by IDC include Wellcentive, Medecision, Optum and IBM Phytel.)

Cynthia Burghard, Research Director with IDC Health Insights, says that providers want to integrate patient management and big data analytics to support their ACO deals and meet tregulatory requirements. In an IDC press release, she notes that providers need to manage both clinical and financial outcomes to survive under value-based reimbursement.

While all of this makes sense to me on paper, I’d like to raise a question here. Does buying both your EMR and your pop health tool from the same vendor have a meaningful downside? I’d argue that it might.

Yes, from a high level, buying an EMR and population health management engine from the same vendor is a good idea. In theory, the two are likely to work together more effectively than two platforms from two separate vendors, as there’s unlikely to be any conflict between the purposes of the EMR and the purposes of the population health tool.

But in practice, it’s worth bearing in mind that we haven’t yet evolved a standard feature set or business model for managing patients at the population level (though you might be interested in some of these emerging best practices). So this is a far bigger risk than buying, for example, a practice management tool and an EMR from the same vendor — after all, practice management software has been around long enough that it’s fairly standardized.

On the other hand, if you buy a population health tool and an EMR from, say, Allscripts, you’re buying not only technology but their view of how population health management should be done. And the two platforms are somewhat, for lack of a better word, inbred if they try to cover your entire scope of patient management. Whatever blind spots the EMR may have, the pop health management platform may have as well.

I guess what I’m trying to say here is that while it makes great business sense for the vendors to offer both EMR and pop health products, it’s not necessarily in the provider’s interests to pile both of those products onto their infrastructure. At this stage, I’d argue, it’s worth preserving your flexibility, even if you spend more or have to work harder to develop the business logic you need on the population health side.

But I’m willing to change my mind. Readers, what do you think?

E-Patient Update: Hospitals Should Share Ransomware Updates

Posted on October 14, 2016 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 few weeks ago, a California hospital quietly fended off a ransomware attack without paying a ransom to the attackers. According to Health Leaders Media, Keck Medical Center of USC was hit with a ransomware assault on servers at two hospitals, but managed to fix the problem and retrieve its data.

Employees at Keck Hospital of USC and Norris Comprehensive Cancer Care found ransomware on two servers on August 1, said Keck Hospitals CEO Rod Hanners in a statement on the matter. The attack encrypted files on the servers, which made their data unavailable to hospital employees. However, Hanners reported, the hospitals had no evidence of a breach of patient information.

Still, given that some sensitive information was contained in folders encrypted by the malware, USC notified patients about the breach, Health Leaders reports. Data that could (at least theoretically) have been accessed by the attackers included names and dates of birth, health information such as treatment and diagnosis information and some Social Security numbers.

If what I’ve read is accurate, the crew at Keck did a great job. They got things under control very quickly, and chose to do the right thing in notifying patients about the breach. (And in all truth, the attack might not have been much of a big deal — perhaps one launched by a script kiddie using Ransomware as a Service tools — which could explain why the hospitals seem to be relatively unruffled.) Still, my feeling is that they could have communicated more.

A patient’s perspective

As I ponder the events above, I do wonder whether the professionals managing this particular ransomware attack understand what it’s like to be on the receiving end of a ransomware episode. So here’s a few things to consider from a patient’s perspective:

  • Ransomware is scary: While I’m healthcare technology writer and somewhat familiar with ransomware attacks, they are still new to most of the public. They may turn out to be just another infection vector for your network, but they come across as a dark force to consumers. Be prepared to educate and calm us.
  • People don’t know what to expect: I was due to have a cardiac procedure done by a doctor affiliated with Washington, D.C.-based MedStar Health a couple of weeks after it suffered a ransomware attack. While the news media made it clear that the hospital chain was paralyzed for a time, nobody bothered to tell me what the impact of this paralysis would be. It would have been better if MedStar facilities and doctors reached out to patients in immediate and near-term need of care to clarify.
  • We need progress reports: Clearly, the Keck attack didn’t amount to much, but other ransomware attacks, such as the MedStar incident, can’t be resolved overnight. As patients, we need to know roughly how long our providers may be at less than full capacity. Keep us updated or you’ll lose our trust.

With any luck, healthcare organizations will continue to improve their ability to fight back ransomware attacks, and in time, be prepared to treat them as little more than road bumps in their security efforts. But until then, it makes sense to pull out all the stops and keep patients extra well-informed.

Does Clinical Integration Call For New Leaders?

Posted on October 10, 2016 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.

For quite some time now, U.S. healthcare reforms have been built around the idea that we need to achieve clinical integration between key care partners. Under these emerging models of integration, it isn’t good enough for physicians and hospitals to have a general sense of what care the other is delivering. Instead, the idea is for independent entities to function as much as possible as though they were part of the same organization.

Of course, for these partners in an integrated system to work together, they have to share a great deal of data on a patient, if not necessarily every scrap of their lifetime medical record. In other words, some degree of data integration isn’t “nice to have,” it’s a “must have.”  In fact, I wouldn’t be the first to suggest that without data integration, effective clinical integration is basically impossible.

However, while readers of this publication aren’t ignorant of this fact, my sense is that some participants in such schemes are hoping to jump in with both feet first, and figure out data sharing models later. This is mostly a hunch, but I’m pretty sure it’s happening, and moreover, I’m convinced that the mediocre performance of most ACOs is due to a leap-before-you-look approach to data sharing.

I don’t know if any models exist that emerging integrated clinical entities can use to lay out data pathways before they’re under the gun. But my sense is that we spend too little time figuring this out in advance.

Generally speaking, my guess is that these ACO partnerships and other integrated care projects are being driven by old-school healthcare execs. By this I mean folks who understand very well how to build for cross referrals between entities, forge partnerships that help all hospitals and doctors involved do better in insurance negotiations, know how to negotiate with health purchases such as large employers and the like.

Having followed such folks for some 25 years, I have nothing but respect for their strategic skills. However, I sort of doubt that they are the right people to guide larger healthcare organizations into the age of clinical and technical integration. While they might be very smart, their intuition tells them to hold back data as a proprietary asset, not share it with partners who might be competitors again in the future. And while it’s understandable why they think this way, it’s not constructive today.

Don’t get me wrong, I’m not suggesting that CXOs with decades of experience have suddenly become dinosaurs. There’s still plenty of work for them to do, and most of it is vitally important to the future of the health system. But if they want to be successful, they’ll have to turn their thinking around regarding data integration with partners. And if they can’t do that, it very well be time to bring in some fresh blood.

Mobility Strategy Becoming More Important To Hospitals

Posted on October 7, 2016 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.

An annual study of healthcare mobility has found that hospitals may be at a tipping point when it comes to mobile strategy. The study also suggests that hospitals are struggling with Wi-Fi coverage and BYOD issues, but when you add on the fact that mobile EHR access is maturing, you still have a picture in which mobile is playing a rapidly-expanding role.

Spok’s fifth-annual Mobility in Healthcare Survey, which gathered 550 responses in July of this year, found that the number of hospitals reporting having a documented mobility strategy has almost doubled since year one. Specifically, 63% of respondents said that they had a documented strategy in place, a huge shift from 2012, when only 34% of respondents had such a strategy.

Another interesting piece of data derived from the study is that the roles of those involved in forming mobile strategy have shifted meaningfully between 2014 and 2016.

For example, the number of respondents saying IT helped or would help drive mobile strategy changes fell 12 points, while those who said nurses were involved climbed 12 points. The number of respondents said doctors and consultants were involved climbed 9 points, and clinical leadership eight points. The greatest change was the role of nurses, whose current or planned involvement climbed 69% in absolute terms.

Mobile strategies emerging
When respondents that did not have a documented mobile strategy in place were asked why, 31% told Spok that they were in the process of developing such a strategy, 30% didn’t know, 17% said they had a verbal strategy in place which had not been written down or documented and 15% said budget constraints were holding them back.

Another notable set of data collected by Spok focused on which devices the respondent’s hospital was supporting. The fact that 78% percent supported smartphones was no big surprise, but it was a bit unexpected to find that 71% of hospital respondents support in-house pages. (I guess they’re like faxes — some technologies just won’t die!) Wi-Fi phones were supported by 69% of respondents, wide area pagers 57%, tablets 52%, voice badges 20% and smart watches/wearables 8%.

Meanwhile, among the key shifts in support for devices is that Wi-Fi phone and voice badge support were up 24% and 18% respectively in absolute terms. It’s also worth noting that support for smart watches/wearables has climbed to 8% near zero just last year. Clearly these are categories to watch.

Wi-Fi, BYOD challenges
As part of the support discussion, respondents also answered questions about Wi-Fi coverage, and the results highlighted some serious issues. In particular, while 83% of respondents said that their Wi-Fi connection is business-critical, they didn’t seem to feel in complete control of it.

More than half (54%) of respondents said they saw Wi-Fi coverage as a challenge, and 65% said they believed that there were some areas of poor coverage within their hospital. Other mobile device support challenges cited by respondents include data security (43%), user compliance with mobility, BYOD and EMM policies and procedures (39%) and IT support for users (37%).

Meanwhile, BYOD support and policies continue to be a contentious issue for hospitals. Nineteen percent of survey respondents said that their organizations hadn’t created any sort of BYOD program, an 8-point drop from 2015. The proportion of facilities with some type of a BYOD program also fell, from 73% to 58%, though – exercising survey options available for the first time – 5% said they were planning for BYOD and 18% said they didn’t know what was up on this front.

When asked why they chose to allow BYOD programs to exist, 60% of respondents said cost savings was a factor, 50% care team communication, and 46% said both physician demand and workflow time savings for users were important reasons. On the flip side, eighty-one percent of respondents said security issues were the primary reason they didn’t allow BYOD.

Hospitals Offering Broad Access To Health Data, But There Are Limits

Posted on October 5, 2016 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 released by the ONC concludes that hospitals are almost universally offering patients ability to view their data electronically, with large numbers offering patients the ability to view and share their data digitally as well.

While the data reveals that hospitals have become more ready to offer electronic access to patient records, it also suggests that they are struggling to provide a full array of electronic access options. The fact that some hospitals still haven’t gotten there may be just a phase, but it may also suggest that issues still remain which they need to address before they offer a full range of patient data functions.

On the one hand, the results of the study are promising. The ONC data demonstrates that there’s been a very substantial uptick in the deployment of patient data access technologies between 2012 and 2015. The data shows that in 2015, 95% of U.S. hospitals gave patients the ability to view their health information electronically, 87% allowed them to download their health information and 69% offered the trifecta (patients get to view, download and transmit the health information).

These numbers represent huge changes that took place during the period studied. For example, in 2013 no state had 40% or more of its hospitals offering patients the ability to view, download or transmit their data, and now all states have at least 40% of their hospitals offering all three options. Meanwhile, the volume of hospitals offering view and download availability has grown 70% when compared to 2012, the ONC reports. And the proportion of hospitals providing view, download and transmit capabilities increased seven fold from 2013.

These numbers track closely with data reported by the American Hospital Association earlier this year, which found that 92% of hospitals responding to its survey offered patients access to the medical records in 2015, up from just 43% in 2013. The AHA also found that 84% of hospitals allowed patients to download information from their records, 70% let patients suggest changes to their medical record and 70% had made it possible for patients to send a referral summary electronically.

All that being said, however, I find it a bit troubling that roughly 30% of hospitals aren’t offering the all three major functions mentioned above. It appears that a failure to offer patients the ability to share their data is what disqualifies most of the 31% from being included in the list of broadly-functioning data sharing candidates. And that’s just too bad.

I guess I shouldn’t be surprised that a substantial subset of hospitals haven’t enabled such sharing, given that many still seem to see the data as proprietary. (I can’t prove this but I’ve heard many anecdotes to that effect.) But I’m still disappointed to find that many hospitals haven’t enabled such a lightweight model of interoperability.

Hospitals Face Security Risks In Expanding Mobile Footprint

Posted on October 3, 2016 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 suggests that hospitals are deeply concerned about their ability to protect patient data and their technology infrastructure from the growing threat of mobile cyberattacks.

The study, by Spyglass Consulting Group, found that 71% of hospitals consider mobile communications to be an increasingly important investment, in part due to the growth of value-based reimbursement and emerging patient- centered care models.

Thirty-eight percent of hospitals surveyed by Spyglass reported having invested in a smartphone-based platform to support these communications, with the deployments averaging 624 devices. Meanwhile, 52% have expanded their deployments beyond clinical messaging support other mobile hospital workers, researchers found.

That being said, 82% of hospitals weren’t sure they could protect these assets, particularly against mobile-focused attacks. Respondents worry that both smartphones and tablets could introduce vulnerabilities into the hospitals network infrastructure through malware, blastware and ransomware attacks. (These concerns are backed up by other Spyglass research, which concludes that 25% of data breaches originate from mobile devices.)

The surveyed hospitals said they were especially concerned about personally-owned mobile devices used by advanced practice nurses and physicians, noting that such devices may lack adequate password protection and may not have security software in place to block attacks.

Also, respondents said, APNs and doctors typically rely on unsecured SMS messaging for clinical communications, which may include protected patient health information. What’s more, respondents noted that these clinicians make heavy use of public Wi-Fi and cellular networks which can be compromised easily, exposing not only their device but also their data and communications to view.

But the hospitals’ fears aren’t limited to clinicians’ personal devices, Spyglass noted. Despite making increased investments in mobile security, hospital respondents said they were also concerned about hospital-owned and managed mobile devices, including those used by nurses, ancillary professionals and nonclinical mobile hospital workers.

“Cybercriminals have become more sophisticated and knowledgeable about the capabilities and vulnerabilities of existing security products, and the strategies and tools used by hospital IT detect potential intrusion,” said Gregg Malkary of Spyglass in a prepared statement.

Still, hospitals have a number of reasons to soldier on and solve these problems. For example, a HIMSS study released in March notes that hospitals feel mobile implementations positively impact their ability to communicate with patients and their ability to deliver a higher standard of care. Not only that, 69% of respondents whose hospitals use mobile-optimized patient portals said that this expanded their capability to send and receive data securely.

The HIMSS study found that 52% of survey respondents used three or more mobile and/or connected health technologies, with 58% mobile-optimized patient portals, 48% apps for patient education and engagement, 37% remote patient monitoring, 34% telehealth, 33% SMS texting, 32% patient-generated health data and 26% concierge telehealth.

In addition, 47% of HIMSS respondents said that their hospitals were looking to expand the number of connected health technologies they used, with another 5% of respondents expecting to become first-time users of at least one of these technologies.

Telemedicine Center Is “Hospital Without Beds”

Posted on September 30, 2016 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.

You don’t usually read cutting-edge healthcare stories on the CNN Money site, but the following blew me away.  Chesterfield, MO-based Mercy Virtual Care Center is a first, a four-story facility focused entirely on virtual care.

As I’ve noted previously, hospitals seem quite interested in rolling out telehealth services — and virtually all seem to be experimenting with them to some extent — but technology concerns seem to be holding them back. This is happening, in part, because EMR vendors have been slow to integrate telehealth functions.

But this doesn’t seem to have been a problem in this case. The $54 million Mercy Virtual Care Center, which describes itself as a “hospital without beds,” launched in October 2015. It employs 330 staffers focused on a variety of telehealth services, according to CNN Money.

The Center, which calls itself the world’s first facility dedicated to telehealth, offers four programs:

  • Mercy SafeWatch, which the Center says is the largest single hub electronic intensive care unit in the nation
  • Telestroke, which offers neurology services to emergency departments across the country which don’t have a neurologist on site
  • Virtual Hospitalists, a team of doctors seeing patients within the hospital around the clock using virtual care technology, and
  • Home Monitoring, a service which provides continuous monitoring more than 3,800 patients

Center medical director Gavin Helton told CNN Money that the programs it runs are focused on cutting down the cost of care reducing the admissions. “The sickest 5% of patients are typically responsible for about half of the healthcare spend and many end up, unnecessarily, back in the hospital,” he told the site. “We need an answer for those patients.”

One activity run by the Center is a pilot program focused on remote care for patients in their homes. The initial phase includes 250 patients with complex chronic illnesses for whom care is not readily accessible.

For example, one patient enrolled in the program is Leroy Strubberg, who is recovering from three mini strokes and also has heart problems, CNN Money reports. Strubberg, who lives more than an hour away from parent hospital Mercy St. Louis, participates in the Center’s in-home care program, speaking with Virtual Care staff members twice a week.

The staffers, dubbed “navigators,” call him on his hospital-provided iPad and ask him about his status. They also encourage his wife to use a blood pressure cuff and other devices connected to the iPad to check his health.

Since Strubberg enrolled in the program, Mercy Virtual Care clinicians were able to help him avoid hospitalization twice while providing him with appropriate care, the article says.

All of this would be exciting regardless of how it played out, but the fact that seems to be successful at managing care effectively is an added bonus. Mercy told the site that the Virtual Care program has cut emergency department visits and hospitalizations by 33% since the program opened just under a year ago. They attribute their success, in part to seeing that the patients usually see the same navigator, as well as working closely with the patient’s primary care physician.