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The Various Approaches to Mobility in Healthcare

Posted on September 9, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 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.

I’m about to head down to the CTIA Super Mobility Week conference. I try to attend a few conferences each year that aren’t directly related to healthcare and health IT in order to get a broader perspective on what’s happening in the rest of the world. I think this will be one such case (although, they do have some mHealth sessions and exhibitors as well).

As I started to think about mobility and where it’s headed, the industry is all about the smart phone and smart mobile devices. I think it’s an incredibly powerful concept and one that will only become more important. However, I think that many people are taking it too far. While I love my smartphone and its capabilities, I still love the productivity that’s possible with a great desktop setup with dual monitors, a mouse and a keyboard. I’m not sure we’ll replicate that in a mobile world and I’m not sure we should.

In fact, it’s one of the trends I hate most about many of the website designs that are coming out lately. They are going all in on mobile and in the process they’re killing the productivity of the desktop experience. It’s a travesty and continues to annoy me with many of the applications I use on a daily basis.

We can apply this same principle to healthcare IT. Often we need to step back and ask ourselves if something really needs to be mobile or not. Plus, if we decide to make something mobile, we need to ensure that those who still use the same application in a non-mobile environment have their workflow optimized as well.

At the end of the day, we need to create a much more sophisticated approach to mobile computing. There are many times when a doctor or nurse really need whatever they’re working on to be mobile. There are extreme benefits to having a point of care device which allows the nurse or doctor to document at the point of care. However, there are just as many times when mobility is actually a hindrance to the required workflow.

What are you doing in your organization to leverage the amazing mobile technologies that are out there while still maintaining the optimized workflow?

mHealth Technology Market Exploding

Posted on June 13, 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.

Driven largely by the growth in remote patient monitoring, the mobile health marketing is expanding rapidly, with the global market expected to reach $10.2 billion USD by 2018, according to Transparency Market Research.

According to TMR, the global mHealth market added up to just $1.3 billion in 2012, but should grow at a compound annual growth rate of 41.5 percent through 2018, with monitoring services contributing heavily to the total.

According to the researchers, the global mHealth market’s explosion is being driven by factors such as growing adoption of smartphones and the rising incidence of chronic diseases.  Also, the incredible growth in the availability of smartphone applications has created new channels for communication between patients and healthcare providers, a connection which further feeds the emergence of new applications.

According to TMR’s analysis, remote monitoring services currently make up the largest share of the global mHealth market, or about 63 percent, followed by diagnostic services and healthcare systems strengthening. And monitoring services will continue to be the fastest growing segment in global mHealth, given this technology’s ability to help ameliorate acute conditions such as coronary artery disease, hypertension, and congestive heart failure, the group notes.

These findings are underscored by related figures from Kalorama Information, which just released a report tagging the telemedicine patient monitoring market as having grown from $4.2 billion in 2007 to over $10 billion in 2012.

While they’re are clearly engaged in some forms of remote monitoring here and there, this approach is still at an early stage for most hospitals, as reimbursement for hospital-based remote monitoring is scant or non-existent in some cases, Kalorama notes.

However, the home healthcare and remote location health monitoring markets are already well-positioned to grow, and are poised to expand using wireless, handheld and ambulatory devices that replace older monitoring equipment, Kalorama researchers say.

Homecare Firm Dispatches 4,000 Android Tablets With Nurses

Posted on February 27, 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.

Could Android gear be sneaking up on Apple? Here’s one case where a national healthcare organization decided to go with the Android technology for a very large and clearly mission-critical purchase.

A national homecare agency has bucked the iPad trend in tablets, picking up 4,000 Android-based units to send with its personnel to patient homes. The company, Philadelphia-based Bayada, issued the Samsung 7-inch Galaxy Tab 7.0 plus to its therapists, medical social workers and other home health professionals.

In issuing the tablets, Bayada hoped to make its homecare professionals more efficient, especially when visiting Medicare home health patients who only get one hour each.

The tablet deployment followed a 20-person pilot in which it found that the typical nurse reduced his or her typing by one-half hour every day if using a tablet during visits instead of paper or a laptop.

Not only do workers use the tablets to document care within patient homes, they also pull up patient data before they head out on their patient visits.  This spares the nurses having to report to a central office to get their appointments before they leave in the morning.

To make clinical data entry simpler, Bayada has loaded the tablets with SwiftKey Healthcare’s keyboard software, an app which is preloaded with medical terms. It uses artificial intelligence to anticipate which words will be typed next and “learns” over time what words healthcare workers use most often.

Since implementing the SwiftKey software, 69 percent of Bayada’s nurses said they preferred using a tablet for taking clinical notes.

Given the large price difference between the iPad/iPad mini and Android tablets — with Android, obviously, at a lower price point — I’d be surprised if other large healthcare organizations didn’t follow in Bayada’s footsteps.

After all, Apple fan though I am, I have to admit that as the suite of apps available for the Android platform matures, there’s less and less reason for institutions to pay the premium Apple demands.  I wonder if we’re seeing the beginning of a major shift in Android investment by healthcare organizations.

What Do Patients Need From EMRs?

Posted on November 14, 2012 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 countless times in this space, EMRs aren’t going to get any better unless vendors and doctors communicate freely. But what about catering to the needs of patients.  But given that by Stage 3 of Meaningful Use, EMR data will need to be accessible to and available for comments by patients and caregivers, it’s time patient needs were taken into account.

In that spirit, here’s my list of a few EMR features that might benefit patients and their caregivers. Bear in mind that this is me speaking as a patient and family caregiver, but perhaps that’s a good thing.

Patient data needs

*  Multiple views of the data:  Doctors are used to standardized reports, but patients and their families will still be learning the game.  Patients should be able to do pull data by history, by current status, by lists of drugs, allergies and other key factors affecting current care, as well as by a simple overview similar to patient discharge papers.  It should be possble to pull down these reports into Word, PDF, Excel and other popular formats for re-use.

* Access to contextual data:  Being able to fit data into a larger context is very helpful. As a caregiver, I’d want to know if the pulse ox number my asthmatic son was low relative to other asthma patients, particularly pediatric asthma patients. I’d also want to compare his current number to numbers from the past, preferably in easy-to-read chart form.

* Links to medical information: If I’m reading a report on my care, and I run into medical terminology I don’t recognize, I should be able to pull up a pop-up window and search for the definition of that term. I should also have access to full-length reports on my condition — from validated sources such as WebMD — to give me a broad understanding of my care.

* Ability to comment on data and notes:   While I realize this could become very time-consuming for doctors, it might be worth the trouble to give patients the ability to comment on elements of the data or notes. (A Microsoft Word-style comment function would probably be sufficient.)  To contain the time doctors need to spend, comment functions could be constrained to medical notes and other areas where impressions could be clarified or corrected — rather than the entire EMR data set.

*  Portal:  Portals, of course, are on the way regardless. But I wanted to underscore, as the caregiver to two chronically-ill family members, that accessing data through an organized interface will be a welcome method for skimming key indicators and raising the questions I need to ask doctors.

* Mobile access:  Another obvious one. Patients are as likely to access data on the road as physicians are. Patients need an adequate mobile app which offers a reasonable amount of access to key EMR data on a real-time basis.

Readers, what other types of data access do you think patients and caregivers need to participate effectively in care?

Health IT Can Change Delivery Models From The Outside In

Posted on July 2, 2012 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 all mull over the implications of the recent Supreme Court decision affirming the key pillar of the health reform law, transformation is definitely in the air.  Hey, if nothing else, we’ve got a presidential election on the way, and it’s likely there will be big changes — either yanking back parts of PPACA or expanding it significantly — when the new POTUS steps in.

This is a great time for the health IT world to assert its place in the system and change the way care is delivered. Of course, I don’t have anything like the space to cover this topic in full  but a few ideas that I think have high potential include:

* Hospital At Home:  This Johns Hopkins model delivers care at home to patients who could use hospital-level care but aren’t likely to deteriorate. It can lower costs by almost one-third and reduce complications, researchers say. Let’s step up and bring sophisticated mhealth apps and remote monitoring to power this further.

*Medical Body Area Networks: With the approval of specifically-dedicated spectrum for MBANs, the FCC has kicked off what should be a revolution in health monitoring, both for consumers interested in self-care and for clinicians. Where can we take it this year?  For example, will consumers wear their network, connected to a receiver in their car, and transmit their own data as they come into an ED for care?  The mind boggles.

* Prescribe An App: This is an area which is juuust getting a foothold in American medicine — though as the linked article notes, the Department of Health in England has created a list of 500 apps for primary care docs to prescribe to patients. The practice can only grow here as evidence helps us sift out the best apps.

*Patient Portals:  Yeah, so what, they’re required under Meaningful Use anyway. So why am I listing them here? Because a nice interspersing of the above technologies with a robust,  user-friendly portal has nearly unlimited potential for medical collaboration:  video visits, telemedicine, mobile visits and check-ins and so on. Although, John also wrote about some of the challenges of patient portals recently on EMR and EHR.

Of course, I’ve said nothing about EMRs themselves, which obviously lie at the center of this Web.  But for a reason. I’m taking the position that in most cases, given the incredible mhealth explosion, care delivery change is going to push in from outside the hospital rather from within. Am I wrong there?

Billing App For Doctors Should Catch Hospitals’ Eye

Posted on April 2, 2012 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.

Today, I’m going to do something I seldom do — talk about a specific app and what it represents in terms of trends.  The product, SwiftPayMD, is interesting not only because it seems to be solving an important problem, but also because it may be one of the early entrants in a new category of mobile software.

The product,  which runs on the iPhone/iPad, is made by a startup called Iconic Data. Iconic describes SwiftPayMD as a “mobile revenue cycle management app” which lets doctors submit diagnosis and billing codes directly to their office while still at their local hospital.

Hmmm. A mobile revenue cycle management app. What, you mean a product that acknowledges that doctors on the move need not only to access, review and enter clinical data, but also to keep the money coming in?  It’s astounding!  It’s revolutionary!  It’s…a no-brainer.

While I admit I didn’t find any major studies on the subject, it does look as if the app developers and (slow moving) firms on the revenue cycle management side are starting to get it that if you’re going to document, read data and diagnose on the road, you might as well bill for your time too.

A Google search on the words “mobile revenue cycle management” doesn’t turn up a lot that’s on  point, though it does seem that there’s a few small providers in this space, including one focused on anesthesiology.  But my guess is that this will change dramatically within the next six months. The idea just makes sense.

In summary, I guess I’m saying that we’re looking at something really important here. While I haven’t tested SwiftPayMD — and thus, can’t begin to predict whether it will be a major player — the idea is almost certain to catch fire.

Now, I’m tossing the ball to you, hospitals. Is this an opportunity for you?  Should hospital IT departments supply branded apps which allow doctors to collect money faster (and perhaps their own institutions as well)?  Seems like a good idea to me.

Consumer Health IT Tools Could Allow Self-Prescribing

Posted on March 23, 2012 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.

Should patients be allowed to use online questionnaires, patient kiosks or other self-assessment technologies to determine the need for and obtain medications which now require prescriptions?  The FDA is taking up just that question this week in hearings at its DC headquarters.

The FDA is looking at ending prescription requirements for drugs used for several chronic conditions, including diabetes, asthma, high blood pressure, migraines and high cholesterol. It seems that the FDA has been paying close attention to the tech world, including movements like mobile tracking of health and the general trend toward self-assessment and consumer data collection.

According to iHealthBeat, the FDA thinks it might be a good idea to let consumers figure out whether they need certain medications by answering questions posed on a Website (a practice which, it should be noted, has been common on what are now rogue pharmaceutical sites) or perhaps respond to questions at a patient kiosk. I imagine that if enacted, such rules would apply to smartphones and tablets too.

A pharmacist from UC-San Diego quoted in the story argues that while some members of the public will be able to manage the information needed and make good decisions, others won’t. This is definitely a legitimate concern.

As I see it, though, our job in the health IT industry is to study models like these and see what failsafes we can put into to make self-prescribing as bulletproof as taking money out of an ATM machine.

It’s going to take sophisticated logic to get the right questions out there, smart machines to make inadvertent answers almost impossible, and crystal clear UIs to keep consumers oriented, but I think this has to happen.  After all, consumers are adopting health IT more and more each day. The barn door is open and the horse is running around, so let’s saddle it and leverage that energy!

Verizon Takes On Healthcare Security, Gives Free Credentials To Millions of Providers

Posted on December 7, 2011 I Written By

Katherine Rourke is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Want to know how badly Verizon wants to take a quick leading role in the emerging mHealth business?  Executives are willing to admit right out that the marginal value of using their networks for good ‘ol landline phone calls is effectively gone. Their future lies in solving thorny problems for rapidly evolving verticals like the healthcare industry, it seems.

“Today, the real cost of making a phone call is zero,” said Dr. Peter Tippett, vice president and chief medical information officer for Verizon Connected Healthcare Solutions, who spoke to us on the floor of this week’s mHealth Summit exhibit “That’s why we’re becoming a technology (read, network applications and services) company.”

Among the more interesting services pitched by Dr. Tippett and colleagues was Verizon’s Medical Data Exchange, which, if I understood our chat correctly, is an HIE add-0n which they’ve built to be more flexible and secure than the existing HIE models out there.

Unlike HIE systems, MDE doesn’t store patient data, Dr. Tippett explained. It’s Web services platform allowing providers to push both structured and structured information to each other through transcription platforms and the Verizon Healthc are Provider Portal, along with traditional medical records data.

To keep data secure, Verizon supports the exchange through its related Universal Identity Services for Healthcare, which lets providers get digital health data through the MDE using a secure, private inbox accessible through the provider portal. The identity credentials meet HIPAA requirements for HIST level 3 authentication, allowing for e-prescribing of controlled substances or accessing electronic patient data.

To support the MDE play, Verizon has begun issuing free medical identity credentials  to 2.3 million U.S. doctors physician assistants and nurse practitioners. These credentials should meet HITECH standards for strong identity credentials, VZ  says.

But wait, dear readers — I started out this item telling you I’d offer info on Verizon’s mHealth position. Well, at the risk of being cruel,  if it has any front-end apps or middleware to directly support mHealth deployment in play, Dr. Tippett wasn’t discussing them.

Still, to be fair, there’s approximately a gajillion front-end developers, and many many companies capable of creating middleware which can normalize mobile data and fit into the EMR space. (SAP, for example, told us it was all over the problem.)

It will certainly be interesting to see how Verizon fares in a world where brute force network ownership doesn’t impress, but technical know-how and new mobile deployment models do. Hospital leaders, have you seen any signs that Verizon will be a player in your mobile strategies as of yet?