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Hospital Patient Identification Still A Major Problem

Posted on April 18, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new survey suggests that problems with duplicate patient records and patient identification are still costing hospitals a tremendous amount of money.

The survey, which was conducted by Black Book Research, collected responses from 1,392 health technology managers using enterprise master patient index technology. Researchers asked them what gaps, challenges and successes they’d seen in patient identification processes from Q3 2017 to Q1 2018.

Survey respondents reported that 33% of denied claims were due to inaccurate patient identification. Ultimately, inaccurate patient identification cost an average hospital $1.5 million last year. It also concluded that the average cost of duplicate records was $1,950 per patient per inpatient stay and more than $800 per ED visit.

In addition, researchers found that hospitals with over 150 beds took an average of more than 5 months to clean up their data. This included process improvements focused on data validity checking, normalization and data cleansing.

Having the right tools in place seemed to help. Hospitals said that before they rolled out enterprise master patient index solutions, an average of 18% of their records were duplicates, and that match rates when sharing data with other organizations averaged 24%.

Meanwhile, hospitals with EMPI support in place since 2016 reported that patient records were identified correctly during 93% of registrations and 85% of externally shared records among non-networked provider.

Not surprisingly, though, this research doesn’t tell the whole story. While using EMPI tools makes sense, the healthcare industry should hardly stop there, according to Gartner Group analyst Wes Rishel.

“We simply need innovators that have the vision to apply proven identity matching to the healthcare industry – as well as the gumption and stubbornness necessary to thrive in a crowded and often slow-moving healthcare IT market,” he wrote.

Wishel argues that to improve patient matching, it’s time to start cross-correlating demographic data from patients with demographic data from third-party sources, such as public records, credit agencies or telephone companies, what makes this data particularly helpful is that it includes not just current and correct attributes for person, but also out-of-date and incorrect attributes like previous addresses, maiden names and typos.

Ultimately, these “referential matching” approaches will significantly outperform existing probabilistic models, Wishel argues.

It’s really shocking that so many healthcare organizations don’t have an EMPI solution in place. This is especially true as cloud EMPI has made EMPI solutions available to organizations of all sizes. EMPI is needed for the financial reasons mentioned above, but also from a patient care and patient safety perspective as well.

Hospital Mobile Device Initiatives Can Improve Patient Satisfaction

Posted on April 17, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Without a doubt, hospitals have many reasons to implement mobile technology, which can offer everything from improved communications to logistical support. But the benefits of these rollouts may offer more than operational benefits. At least according to data gathered by the following survey, hospital mobile initiatives almost always improve patient experience and satisfaction.

The study, conducted by Vanson Bourne on behalf of Apple-based mobile device management company Jamf, draws on a survey of 600 global healthcare IT decision-makers based in the US, the Netherlands, France, Germany and the United Kingdom. Respondents worked in both private and public healthcare organizations.

Researchers found that 96% of healthcare IT decision-makers currently implementing a mobile device initiative felt that it had a positive impact on patient experiences and satisfaction. Also, 32% reported that they saw a significant increase in patient experience scores.

The survey also found that among institutions currently implementing or planning to implement a mobile device initiative, the devices are most likely used in nurses stations (72%), administrative offices (63%) and patient rooms (56%). In addition, survey participants anticipate that mobile device use will expand to both clinical care teams (59%) and administrative staff (54%). What’s more, 47% of respondents said they plan to increase mobile device use in their institution of the next two years.

To exert better control over these efforts, hospitals can leverage a mobile device management solution. However, the survey found that only 48% of healthcare IT decision-makers had full confidence in their MDM solution’s capacity to do its job. That’s down from 59% in 2016.

Also, as data sharing increases via mobile devices and apps, data security becomes even more important. However, many health IT leaders aren’t sure they can pull this off. Their biggest challenges included data privacy (54%), security/compliance (51%) and keeping software properly patched (40%).

But they don’t think MDM tools can solve the problem. Ninety-five percent of respondents said their current MDM solution could stand to offer better security options, and almost a third (31%) of respondents thinking about mobile device initiatives were holding off because they weren’t sure they could secure the devices adequately.

Unfortunately, the health IT world seems to have made little progress in securing mobile devices over the past year. In a similar Jamf study conducted last year, 88% of respondents were concerned about managing security, data privacy (77%) and blocking inappropriate employee use (49%).

How Do You See Emerging Tech Like AI and Machine Learning Improving Efficiency in Clinical Settings?

Posted on April 12, 2018 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.

The title of this post was the question that Samsung Healthcare posted to me:

Here was my knee jerk response:

At least a couple people strongly agreed including this one:

AJ is right that the tech is nearly there to do all of this. I suggested that they key is going to be the person that packages it the right way.

This is a lesson we all learned from the iPhone. Very few things within the iPhone were unique and new. It was how Apple packaged all of the components that made it special. I think it’s going to play out the same when it comes to physician documentation. All of the NLP, Voice Recognition, Machine Learning, and AI tools are out there. Everyone will have access to them, but how they’re packaged is going to make all the difference.

All of that said, I don’t see this too far off. We’re already starting to see elements of it, but the entrenched players will have a hard time doing this. They’re already getting rich off of their existing products, so they’ll continue to make incremental improvements. Some startup company is going to come along and package this all the right way and win.

Plus, let’s be clear that one of the biggest parts of the packaging will be how it transitions users from the old way of thinking to a new approach. However, once the doctor sees it in action, they’ll see it as magical. Compared to the forms they’re doing today, it will be magical.

Who do you see offering this? Are any of the EHR vendors brave enough to do this? It’s so badly needed by so many.

Health Orgs Were In Talks To Collect SDOH Data From Facebook

Posted on April 9, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

These days, virtually everyone in healthcare has concluded that integrating social determinants of health data with existing patient health information can improve care outcomes. However, identifying and collecting useful, appropriately formatted SDOH information can be a very difficult task. After all, in most cases it’s not just lying around somewhere ripe for picking.

Recently, however, Facebook began making the rounds with a proposal that might address the problem. While the research initiative has been put on hold in light of recent controversy over Facebook’s privacy practices, my guess is that the healthcare players involved will be eager to resume talks if the social media giant manages to calm the waters.

According to CNBC, Facebook was talking to healthcare organizations like Stanford Medical School and American College of Cardiology, in addition to several other hospitals, about signing a data-sharing agreement. Under the terms of the agreement, the healthcare organizations would share anonymized patient data, which Facebook planned to match up with user data from its platform.

Facebook’s proposal will sound familiar to readers of this site. It suggested combining what a health system knows about its patients, such as their age, medication list and hospital admission history, with Facebook-available data such as the user’s marital status, primary language and level of community involvement.

The idea would then be to study, with an initial focus on cardiovascular health, whether this combined data could improve patient care, something its prospective partners seem to think possible. The CNBC story included a gushing statement from American College of Cardiology interim CEO Cathleen Gates suggesting that such data sharing could create revolutionary results. According to Gates, the ACC believes that mixing anonymized Facebook data with anonymized ACC data could help greatly in furthering scientific research on how social media can help in preventing and treating heart disease.

As the business site notes, the data would not include personally identifiable information. That being said, Facebook proposed to use hashing to match individuals existing in both data sets. If the project were to have gone forward, Facebook might’ve shared data on roughly 87 million users.

Looked at one way, this arrangement could raise serious privacy questions. After all, healthcare organizations should certainly exercise caution when exchanging even anonymized data with any outside organization, and with questions still lingering on how willing Facebook is to lock data down projects like this become even riskier.

Still, under the right circumstances, Facebook could prove to be an all but ideal source of comprehensive, digitized SDOH data. Well now, arguably, might not be the time to move ahead, hospitals should keep this kind of possibility in mind.

Are We Going About Population Health The Wrong Way?

Posted on March 29, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For most of us, the essence population health management is focusing on patients who have already experienced serious adverse health events. But what if that doesn’t work? At least one writer suggests that though it may seem counterintuitive, the best way to reduce needless admissions and other costly problems is to focus on patients identified by predictive health data rather than “gut feelings” or chasing frequent flyers.

Shantanu Phatakwala, managing director of research and development for Evolent Health, argues that focusing on particularly sick patients won’t reduce costs nearly as much as hospital leaders expect, as their assumptions don’t withstand statistical scrutiny.

Today, physicians and care management teams typically target patients with a standard set of characteristics, including recent acute events, signs of health and stability such as recent inpatient admissions and chronic conditions such as diabetes, COPD and heart disease. These metrics come from a treatment mindset rather than a predictive one, according to Phatakwala.

This approach may make sense intellectually, but in reality, it may not have the desired effect. “The reality is that patients who have already had major acute events tend to stabilize, and their future utilization is not as high,” he writes. Meanwhile, health leaders are missing the chance to prevent serious illness in an almost completely different cohort of patients.

To illustrate his point, he tells the story of a commercial entity managing 19,000 lives which began a population health management project. In the beginning, health leaders worked with the data science team, which identified 353 people whose behavior suggested that they were headed for trouble.

The entity then focused its efforts on 253 of the targeted cohort for short-term personal attention, including both personal goals (such as walking their daughter down the aisle at her wedding later that year) and health goals (such as losing 25 pounds). Care managers and nurses helped them develop plans to achieve these goals through self-management.

Meanwhile, the care team overrode data analytics recommendations regarding the remaining 100 patients and did not offer them specialized care interventions during the six-month program.  Lo and behold, care for the patients who didn’t get enrolled in health management programs cost 75% more than for patients who were targeted, at a total cost of $1.4 million. Whew!

None of this is to suggest that intuition is useless. However, this case illustrates the need for trusting data over intuition in some situations. As Phatakwala notes, this can call for a leap of faith, as on the surface it makes more sense to focus on patients who are already sick. But until clinicians feel comfortable working with predictive analytics data, health systems may never achieve the population health management results they seek, he contends. And he seems to have a good point.

Hospitals Centralizing Telemedicine, But EMR Integration Is Still Tough

Posted on March 26, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the past few years, large healthcare providers have begun to offer their patients telemedicine options. In the past, they offered these services on an ad-hoc basis, but that seems to be changing. A new survey suggests that hospitals and health systems have begun to manage this telemedicine service lines to a central office rather than letting individual departments decide how to deliver virtual care.

The survey, which was conducted by REACH Health, polled more than 400 healthcare executives, physicians and nurses as well as other healthcare professionals. REACH, which offers enterprise telemedicine systems, has been conducting research on the telemedicine business for several years.

Forty-eight percent of respondents to the REACH Health 2018 Telemedicine Industry Benchmark Survey reported that they coordinated telemedicine services on enterprise-level, up from 39% last year. Meanwhile, 26% said that individual departments handled their own telemedicine services, down from 36% in 2017.

The providers that are taking an enterprise approach seem to have a good reason for doing so. When it analyzed the survey data, REACH concluded that organizations offering telemedicine at the enterprise level were 30% more likely to be highly successful. (Not that the company would draw any other conclusion, of course, but it does seem logical that coordinating telehealth would be more efficient.)

The survey also found that telemedicine programs provided by both behavioral health organizations and clinics have expanded rapidly over the last few years. Back in 2015, REACH found that many behavioral health providers and clinics were at the planning stages or new to delivering telemedicine, but according to the 2018 results, many now have active telemedicine programs in place, with clinic services expanding 37% and behavioral health 40%.

While healthcare organizations may be managing telemedicine centrally, their EMRs don’t seem adequate to the job. First, most survey respondents noted that the telemedicine platform wasn’t integrated with the EMR. Meanwhile, nearly half said they were documenting patient visits in the EMR after remote consultations had ended. In addition, more than one-third of respondents said that EMR doesn’t allow them to analyze telemedicine-specific metrics adequately.

Whether REACH’s solution solves the problem or not, I’m pretty sure they’re right that integrating telemedicine services data with an EMR remains difficult.

In fact, it seems obvious to me that while hospitals are still tweaking their programs for maximum impact, and getting paid for such services is still an issue, telemedicine won’t become a completely mature service line until collecting related data and integrating it with off-line patient care information is easy and efficient.

 

Mayo Clinic Creating Souped-Up Extension Of MyChart

Posted on March 19, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As you probably know, MyChart is Epic’s patient portal. As portals go, it’s serviceable, but it’s a pretty basic tool. I’ve used it, and I’ve been underwhelmed by what its standard offering can do.

Apparently, though, it has more potential than I thought. Mayo Clinic is working with Epic to offer a souped-up version of MyChart that offers a wide range of additional services to patients.

The new version integrates Epic’s MyChart Virtual Care – a telemedicine tool – with the standard MyChart mobile app and portal. In doing so, it’s following the steps of many other health systems, including Henry Ford Health System, Allegheny Health Network and Lakeland Health.

However, Mayo is going well beyond telemedicine. In addition to offering access to standard data such as test results, it’s going to use MyChart to deliver care plans and patient-facing content. The care plans will integrate physician-vetted health information and patient education content.

The care plans, which also bring Mayo care teams into the mix, provide step-by-step directions and support. This support includes decision guidance which can include previsit, midtreatment and post-visit planning.

The app can also send care notifications and based on data provided by patients and connected devices, adapt the care plan dynamically. The care plan engine includes special content for conditions like asthma, type II diabetes chronic obstructive heart failure, orthopedic surgery and hip/knee joint replacement.

Not surprisingly, Mayo seems to be targeting high-risk patients in the hopes that the new tools can help them improve their chronic disease self-management. As with many other standard interventions related to population health, the idea here is to catch patients with small problems before the problems blossom into issues requiring emergency department visit or hospitalization.

This whole thing looks pretty neat. I do have a few questions, though. How does the care team work with the MyChart interface, and how does that affect its workflow? What type of data, specifically, triggers changes in the care plan, and does the data also include historical information from Mayo’s EMR? Does Mayo use AI technology to support care plan adaptions? Does the portal allow clinicians to track a patient’s progress, or is Mayo assuming that if patients get high high-quality educational materials and personalized care plan that the results will just come?

Regardless, it’s good to see a health system taking a more aggressive approach than simply presenting patient health data via a portal and hoping that this information will motivate the patient to better manage their health. This seems like a much more sophisticated option.

Health Leaders Say Automating Patient Engagement Efforts Will Have Major Impact

Posted on March 12, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Over the last few years, many vendors have rolled out products designed to engage patients further in their care. According to a new study, these solutions may be just the tip of the iceberg. In fact, many healthcare executives see patient-facing, engagement-enhancing technology as critical to the future of healthcare, according to a new study.

The study, by the World Business Group, focuses on technology that can link patients with care in between visits to their primary care center. Patient engagement technologies, which they call “automated care,” have the potential to bridge such gaps by providing AI-based assistance to consumers.

The survey, which was also backed by Conversa Health, drew on direct interviews and survey responses from 134 health execs. The researchers looked at how those execs viewed automated healthcare technologies, how these technologies might be used and whether respondents plan to adopt them.

Respondents were clearly very enthusiastic about these tools. Nearly all (98%) said they believed automated healthcare will be important in creating a continuous, collaborative relationship with providers. The survey also found that 87% of respondents felt that automated healthcare will be helpful in getting patients to engage with their own care.

The next step, of course, is throwing resources at the problem — and it’s happening. Seventy-nine percent of survey respondents said they expected to work on integrating automated healthcare in their organization within the next two years. Also, 44% said that they had a chief patient experience officer or other executive with an equivalent title on board within their organization. This development is fairly new, however, as 40% of these organizations said that the role has existed for two years or less.

Meanwhile, several respondents felt that automating patient healthcare could generate a positive feedback loop. Forty-nine percent of those surveyed reported that they were either integrating or have already integrated patient-generated health data, which they expect, in turn, to integrate into the patient experience efforts.

Among organizations working with patient-generated health data, 73% were gathering patient health histories, 64% treatment histories, 59% lifestyle or social data, 52% symptoms data, and 32% biometric data.

Thirty percent said they were beginning to integrate such data and collect it work effectively, 28% said they could collect some PGHD but had trouble integrating with their systems, 14% said they were just beginning to collect such data and 9% said they were not able to collect this data at all. Just 19% reported they were fully able to collect integrate PGHD and use it to improve patient experiences.

All told, it appears we’re on the cusp of a major change in the role patient services play in provider outreach. It will probably be a few more years before we have a good idea of where all this is headed, but my guess is that it’s heading somewhere useful.

#HIMSS18: Pushing Inpatient Care Out

Posted on March 9, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

At present, we need acute care hospitals. Despite the fact that many types of care can now be delivered in outpatient settings, and chronic conditions managed remotely for connected health, there are still some treatments and procedures which can only be done in a big, expensive building.

That being said, some of what I saw at HIMSS18 has convinced me that the drive to push hospital-type services into the community has begun to pick up speed. While nobody seems to have a completely mature solution to decentralizing acute care, I saw some tools that might begin to solve the problem.

Perhaps the most direct example of this trend was offered by a Taiwanese company called Quanta Computer. (The booth was staffed with five company representatives who had flown here all the way from Taiwan, which may suggest that they are not fooling around.)

Quanta was here to pitch QOCA, whose capabilities include offering a “smart hospital at home.”  QOCA Home, an eldercare/assisted living solution including a central, easy to use terminal supporting a wide range of telehealth and connected health services. While the idea is not completely new, the way this blends a smart home approach with connected health intrigued me.

Other vendors took a different approach to some of the same core problems, i.e. managing the patient effectively outside of the hospital. For most exhibitors, this seemed to involve a blend of connected health, care management and patient/provider collaboration.

For example, vendor Virtual Health promises to deliver “whole person health” by tying together providers, healthcare execs, patients and care coordinators. Two points of interest: its solution include a collaborative workflow tool which seems to include patients, something I don’t believe I’ve seen before. Its platform, which is designed to support patients with highly complex medical needs, also addresses social determinants of health, including financial concerns and nutrition.

Now, I’m not here to tell you that any of this is revolutionary. The industry has been kicking around concepts like virtual hospital care, care coordination platforms and the integration of social determinants of health for quite some time, and I’m not suggesting that any of the vendors I saw seem to be all the way there.

Still, what I saw suggests to me that tech vendors are further along in delivering these options than they have been. If you haven’t looked into new platforms that address these issues, now might be the time. They may not be completely ready for prime time, but they’re well on their way.

E-Patient Update:  Patients And Families Need Reassurance During EMR Rollouts

Posted on March 5, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Sure, EMR rollouts are stressful for hospital staffers and clinicians. No matter how well you plan, there will still be some gritted teeth and slammed keyboards as they get used to the new system. Some will afraid that they can’t get their job done right and live in fear of making a clinical mistake. All that said, if your rollout is gradual and careful, and your training process is thorough, it’s likely everyone will adjust to the new platform quickly.

The thing is, these preparations leave out two very important groups: patients and their families. What’s more, the problem is widespread. As a chronically ill patient, I visit more hospitals than most people, and I’ve never seen any effective communication that educates patients about the role of the EMR in their care. I particularly remember one otherwise excellent hospital that decorated its walls with asinine posters reading “Epic is here!” I can’t see how that could possibly help staff members make the transition, much less patients and family members.

This has got to change. Hospital IT will always be evolving, but when patients are swept up in and confused by these changes, it distorts everything that’s important in healthcare.

Needless fear

A recent experience my mother had exemplifies this problem. She has been keeping watch over my brother Joseph, who is critically ill with the flu and in an induced coma. For the first few days, as my brother gradually improved, my mother felt very satisfied with the way the clinical staff was handling his case.

Not long after, however, someone informed her that the hospital’s new Epic system was being deployed that day. Apparently, nobody explained what that really meant for her or my brother, and she felt that the ICU nurses and doctors were moving a bit more slowly during the first day or two of the launch. I wasn’t there, but I suspect that she was right.

Of course, if things go well, over the long run the Epic system will fade into the background and have no importance to patients and their families. But that day or two when the rollout came and staff seemed a bit preoccupied, it scared the heck out of her.

Keeping patients in the loop

Don’t get me wrong: I understand why this hospital didn’t do more to educate and reassure my mother. I suspect administrators wouldn’t know how to go about it, and probably feel they don’t they have time to do it. The idea is foreign. After all, communicating with patients about enterprise health IT certainly isn’t standard operating procedure.

But isn’t it time to involve patients in the game? I’m not just talking about consumer-facing technology, but any technology that could reasonably affect their experience and sense of comfort with the care they’re receiving.

Yes, educating patients and families about enterprise IT changes that affect them is probably out of most health IT leaders’ comfort zones. But truthfully, that’s no excuse for inaction. Launching an Epic system isn’t inside-baseball process — it affects everyone who visits the hospital. Come on, folks, let’s get this right.