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FDA-Approved Digital Health Should Save $100B+ Over Next Four Years

Posted on June 8, 2015 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.

Here’s some research which suggests that a lack of “medical grade” digital health tools is perhaps the final obstacle holding healthcare back adopting them full scale — and reaping the benefits.

Accenture released a study last week concluding that FDA-regulated digital health solutions should save the U.S. healthcare system more than $100 billion between now and the next four years.

The scant number of digital health solutions the FDA has already approved has already had a meaningful impact, generating $6 billion in cost savings last year courtesy of improved med adherence, fewer ED visits and digitally-supported behavior changes, Accenture reports.

But that’s just a drop in the bucket, if Accenture is right. The consulting firm expects our health system to save $10 billion this year thanks to use of such devices. And then, as the FDA approves more digital health technology, the savings figure should make dramatic jumps over the next few years, hitting $18 billion in ’16, $30 billion in ’17 and $50 billion in ’18.

What’s intriguing about these numbers is that they assume each FDA approval will seemingly generate not only more savings, but also a cumulative “whole is greater than the sum of its parts” effect.

After all, in raw numbers, the number of devices Accenture is relying on to achieve this effect is small, from 33 approved last year to 100 by the end of 2018. In other words, 67 devices will help to generate an additional $44 billion in savings.

That being said, what makes Accenture so sure that the ever-so-slow FDA will approve even 70-odd devices over the next few years?

* Provider demand:  At present, about one-quarter of U.S. doctors “routinely” use tele-monitoring devices for chronic disease management, researchers found. As hospitals and medical practices look to integrate such solutions with their core EMR infrastructure, they’ll look to please providers who want digital health tech they can trust.

Reimbursement shifts:  Accenture argues that as value-based reimbursement becomes more the norm, health leaders will increasingly see digital health solutions as a means of meeting their goals. And medical device providers will be only to happy to provide them.

Regulatory conditions: With FDA guidelines in place specifying when wellness tools like heart rate monitors become health devices, it will be easier for the FDA to speed up the process of digital health technologies, Accenture predicts. This should support 30% annual growth of such solutions through 2018, the study found.

Consumer health tracking:  Consumer demand for health tracking devices, especially wearables, should continue its rapid expansion, with the number of consumers owning a wearable fitness device to double from 22% this year to 43% by 2020, according to the consulting firm.

While Accenture doesn’t address the impact of digital health tech that doesn’t get FDA approval, there’s little doubt that it too will have a significant impact on both health outcomes and cost savings. Ultimately, though, it could be that it will take an FDA seal of approval to get widespread adoption of such technologies.

Department of Defense (DOD) and Open Source EHR

Posted on February 25, 2015 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.

I was intrigued by a report by the Center for New American Security that was covered in this article on HealthcareDive. In the report, they make a good case for why the Department of Defense (DOD) should select an open source EHR solution as opposed to a commercial solution. Here’s an excerpt from the article:

“I think the commercial systems are very good at what they do,” Ondra said. However, “they are not ideally designed for efficiency and enhancement of care delivery, and I think the DOD can do better with an open source system both in the near-term, and more importantly in the long-term, because of the type of innovation and creativity that can more quickly come into these systems.”

Reports like this make a pretty good case for open source. Plus, I love that it also pointed out that commercial EHR vendors were built on the back of the fee for service model which doesn’t matter to the DOD. It was also interesting to think about the DOD’s selection of an open source EHR system as an investment in other hospitals since the money they spend on an open source EHR could help to catalyze the ongoing development of a free open source EHR solution.

While these arguments make a lot of sense, it seems that the DOD has decided not to go with an open source EHR solution and instead is opting for a commercial alternative. In this article (Thanks Paul) the DOD has narrowed the list of contenders for the $11 Billion DOD EHR contract (DHMSM) to just: CSC/HP/Allscripts, Leidos/Accenture/Cerner, and IBM/Epic who “fall within the competitive range.” They reported that PwC/Google/GDIT/DSS/Medsphere and Intersystems did not fall within the competitive range.

I’ll be interested to hear Medsphere’s take on this since every report I’ve ever read has Medsphere and their open source Vista solution as much less expensive than the commercial alternatives (Epic, Cerner, Eclipsys). So, I can’t imagine that the Medsphere bid was so much more than the others. Unless the consultants are charging through the nose for it. Or maybe the open source Vista option wasn’t “in the competitive range” because it was too cheap. Wouldn’t that be hilarious to consider. Hopefully the government isn’t that stupid, but…

I don’t claim to have any clue on how these $11 billion government contract bids work. I’m just a casual observer from the sideline. It seems like 3 companies remain in the ring. I guess the Google juice wasn’t enough for the PwC/Medsphere bid.

Patient EMR Access May Be The Biggest Cultural Shift

Posted on April 15, 2013 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.

As most readers probably know, U.S. doctors are skittish about giving patients full access to their medical records. That fact was underscored by a recent Accenture study, which concluded that 65 percent of doctors think patients should only have limited access, and 4 percent feel patients should have no access.

While I have no proof of this, my gut feeling is that these results aren’t just a snapshot in time, but rather a sign of a stubborn problem that’s not likely to melt away quickly. Though much of the high-level thinking about EMRs counts on building collaborative patient relationships over shared records, that thinking may be flawed.

Why are doctors hanging back from full and free disclosure of electronic health data?

Self-consciousness:  Doctors may say things in records that they’d be a bit embarrassed to reveal. To some extent, this is a problem whether the doc is  using paper or an EMR, but EMRs are trickier for doctors to use, adding to the awkwardness factor if a patient questions their work or feels offended by the commentary.

Poor collaboration skills:  If patients get to see their records, they’re likely to become all e-patient-ish and want to have more control of their care.  Old-school doctors aren’t trained to think this way, nor are they likely to want such a relationship temperamentally.

Low digital comfort generally:  Even among younger physicians, there are those that are naturally wired and those that only use computing devices when they must. I’d argue that when you toss in the generation of doctors who trained 100 percent on paper, you’re looking at a large population of physicians who may never quite be on board with touchy-feely data sharing.

Bottom line, data sharing with patients requires a cultural shift which a surprising number of healthcare pros seem ill-equipped to embrace.  I believe it is this cultural shift — from patient as object of notes to patient as co-creator — which will ultimately pose the biggest obstacles to getting value from EMR investments.

Yes, it’d be nice to think that as doctors get more used to living with EMRs, a large number will loosen up, but I doubt that’s the case. Let’s hope the cynic in me is wrong this time.

Accenture: Five Questions Hospital Boards Should Ask Before EMR Buys

Posted on January 24, 2013 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.

As we’ve noted in the past, hospitals are on not only an EMR buying binge, they’re doing a lot of switching from one EMR to another. Check out these stats from Accenture:

Accenture research shows that 4 to 4.5 percent of hospitals plan to make an EMR buying decision each year. This
could exceed 110+ EMR contracts or 200 to 250 hospitals per year. This trend is expected to continue well into the
future. In fact, in 2012, 50 percent of EMR deals [were] replacements, up from 30 percent in 2011, according to KLAS Research.

Whether your hospital is a switcher, a late adopter or  planning some kind of EMR upgrade, it’s making a decision of grave importance. So what are some of the key considerations boards should bear in mind? Here’s Accenture’s list of five key questions boards should keep front and center as they consider (more)  big EMR investments and plan for the future:

*  Does your current system offer enough functionality to meet up and coming Meaningful Use requirements, such as the ability to make patient family health histories and imaging results available? Does your current or contemplated EMR vendor have plans in place to keep up with future requirements/changes?

*  Is the EMR vendor’s development strategy in line with your strategy? “Boards should ask of the EMR vendor: do they have adequate resources…to help complete the business roadmap on time and successfully?” Accenture asks. And just as importantly: “Can the vendor help ensure that future product functions are strategically aligned to the healthcare [system’s] key initatives?”

* Is your hospital currently on track to meet ICD-10 adoption and Meaningful Use Stage 2 requirements?  Is your vendor going to be able to help support you in these efforts as your hospital works to meet these multiple goals, or does it lack the resources to do so?

* If we decide to switch EMRs, do we have the internal resources needed to support such a bandwidth-sucking effort? Given competition for healthcare IT labor today, will you have the ability to hire on additional resources if needed? And while you’re at it, is your C-level and IT leadership solid enough to make such a treacherous journey?

* Can your hospital afford to switch EMRs, bearing in mind not only direct costs such as licensing, implementation and new technical support, but also ongoing support costs in the neighborhood of 20 percent per year?

To answer these questions, Accenture recommends you conduct an independent analysis of EMR vendors (presumably, rather than relying on analyst firms or peer feedback exclusively).  This sounds like a very good idea to me.

Hospital EHR

Posted on June 20, 2011 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.

To kick things off on the Hospital EHR and EMR blog, I decided I’d do a Google search for the term “hospital EHR.” I thought it would be fun to see what Google lists as the top resources online for hospital EHR software. I must admit that I’m mostly disappointed with the result.

There was a “Hospital EHR Adoption Database” for $3550. Sounds like a great deal, but I think HIStalk was putting out the info they had for free. At least that resource was from 2011 along with a couple KevinMD blog posts about hospital EHR. One of which was very recent. I guess Google’s rewarding it for being so recent.

I won’t go over all of the links. Some required a registration which I didn’t want to do. Others were from 2007 or talking about the hospital EHR certification being open for public comment. I did like this post by Fred Trotter about “What does it mean to have a hospital EHR?” That article is a little dated too, but I always love Fred’s in your face style of writing. He calls it the way he sees it and I love that about him.

I also have to admit that I was happy (and a bit surprised) that EMRandHIPAA.com had the category for Hospital EHR posts listed 10th on the Hospital EHR search as well. That’s particularly interesting, because I just created that category on EMRandHIPAA.com about 10 minutes before I did the search.

What’s probably more interesting is the EHR vendors and other EHR related companies that are advertising for the keyword Hospital EHR. Here’s a list of the EHR vendors that came up with my search:
Clear Practice
Athena Health
eClinicalWorks
Care 360 (Quest Diagnostics)
Allscripts
Practice Fusion

Pretty interesting list of “Hospital EHR.” Ok, I am being facetious. How many of those even have a hospital EHR software? Allscripts does. I think Athena Health and eClinicalWorks have some services for hospitals, but they don’t really get in the hospital EHR space. I think they are interested in the ACO stuff which is what the Athena Health ad was really about. I do find it interesting that none of the major hospital EHR software vendors are doing advertising on Google. Plus, it seems that some of the ambulatory EHR companies might want to work on their Google Ads targeting.

There were also 3 “EMR List” websites that had paid ads on there as well:
EMR Consultant
Business Software EMR List
Capterra

Then, it made sense why Accenture would want to sell their hospital EHR consulting services. I’m not sure what Bio Visual Tech is, but it was on there as well.

There you go. Now we’ve got this blog kicked off. It’s taken a while to get this blog started, but now we’re ready to go. In fact, I have 3 other writers that are planning to write on this blog. So, check back often to see the latest and greatest info on hospital EHR software.

If you have any must read resources and/or perspectives on the hospital EHR world, please do share them in the comments.