Remote Patient Monitoring

As a result of the growing healthcare needs of an aging population, technologies such as remote video monitoring have transpired into a reduction in hospital visits and ensured cost effectiveness within the industry.

Pertaining to various technologies envisaged to manage and monitor a wide array of health related conditions, remote patient monitoring includes the use of devices such as blood-pressure monitors, weight scales and blood-glucose strips among many others. These technologies are useful in the collection and reporting of data and can also be integrated within a healthcare system such as EMR which transmit data to every element in the system and help in alerting clinicians in the event of declining patient health conditions.

Especially beneficial for the elderly who find it difficult to access traditional care settings, these technologies support care coordination and decision support systems for patients. They also incorporate features of remote patient monitoring which can be used by providers such as the Patient Portal.

A report by ‘Kalorama Information’ states that, “Patient monitoring systems with advanced features, especially wireless or remote capability, are among the fastest-growing medical devices. The aging population and the associated increase in diseases such as congestive heart disease and diabetes as well as the cost of treating those conditions, is driving sales of such devices. Use of new patient monitoring technologies can result in a need for fewer personnel, increased coverage by existing personnel, and a reduction in errors and are expected to lead to better patient care and the recognition of serious health problems before they become an issue.”

The report also stated that remote patient monitoring grew to $10.6 billion in 2012 from $8.9 billion in 2011. A future forecast estimates that the value of the market would increase to a staggering $20.9 billion in 2016.

Talking about the growth of the remote patient technology, Melissa Elder, an analyst at ‘Kalorama Information’ said, “We expected growth and that growth was certainly seen between 2011 and 2012. The market has benefited from the demand to move to a more wireless and streamlined operation both within major health facilities and in the home treatment markets. The demand to integrate data processing capabilities and EMR transfer options has also fueled the market.”

According to recent research, sales of remote patient monitoring technologies have increased by 20% in 2013 from the previous year. The United States Healthcare industry can reduce the costs of healthcare by $200 billion in the next 25 years if used with patients suffering from chronic diseases. David Lindeman, Director of the Center for Technology and Aging states, “Remote patient monitoring (RPM) technologies have been shown to be effective in helping to manage chronic disease, post-acute care and monitoring the safety of older adults. These technologies can help slow the progression of chronic disease, speed recovery after discharge from an acute care setting and help vulnerable adults avoid injuries.”

Numerous studies have proven that despite the initial high costs associated with implementation, remote patient monitoring technologies are cost beneficial and have been shown to reduce the amount of hospital visits by at least 26%.

Conclusively, remote patient monitoring technologies are instrumental to the future of the healthcare industry as they will allow providers to keenly engage patients and help them manage their medical conditions with the help of integrated Electronic Health Records and Health Information Exchange. These technologies will be able to monitor patient condition in real-time and improve the overall quality of human life.

Health Information Exchange (HIE) – Is it the right way?

Increasing dissemination and exchange of health information electronically between multiple care providing bodies has led to the emergence of Health Information Exchanges (HIE). General opinion has been that these HIEs will inevitably enhance the quality of care, but newer studies debate whether this is the right way to encourage information sharing across the healthcare community.

Recent research by experts in the industry questions the ability of Health Information Exchanges to operate fully in compliance with Meaningful Use as required by the HITECH Act. Instead, researchers suggest developing a cloud based Health Record Bank.

THE HRSA website defines a health record bank as an “electronic consumer-controlled warehouse that gathers, stores and disseminates patients’ health records. A patient can, for a fee, establish an account with a health record bank. When the patient has new medical information – such as information relating to an upcoming physician’s appointment - their provider can send it directly to the bank. The patient can also submit their own information as well as determine who can have access to review their personal medical records.”

One of the original researchers for this study shared his idea that since Electronic Health Records are usually banked in communities across the country, it would be prudent for patients to share their information on a single platform. Not only would this give them better accessibility, it would give the government a better chance to monitor and analyze the trend or pattern of population health.

Cloud-based banks would perform functions of data maintenance for patients’ electronic health records in different communities throughout the country with a local or regional provider having a separate copy of the records which the patient will be able to transfer to any other provider, if he or she chooses to.

Researchers believe that current health information systems are faulty and unstructured. The crisis in healthcare and the need for urgency in reforms lead the research team to think about better ways to share large amounts of medical information across the community, connecting all stakeholders related to the industry.

One of the main issues with current health information exchanges is that it Is largely based on an assumption that one can get information about any patient from any provider. This is ineffective because if you go to a doctor for information about a patient, the doctor will have to contact some other doctor and ask for that specific information which the other doctor will have to search for first, and then relay the information back to the doctor you are sitting with.

If all the information related to every patient across the country was kept on a single database, without the need to check with other parties, information sharing would become easier, quick and efficient. The dilemma now is that, considerable amount of money has already been spent on health information exchanges across the country. This leaves little desire to look for alternative ways of information sharing and a lack of capital for more research into health record banks.

Visit (http://www.curemd.com/Webinar.htm) to register for upcoming webinars and learn more about Health Information Exchange.

Healthcare and Social Media: Impact, Issues and Governance

The radical global growth in information and communications technology has given rise to the number of internet users who account for 37% of the world’s total population according to ‘Internet World Statistics’.

With this growth, burgeoning use of social media has also increased which includes collaborative projects such as Wikipedia, blogs and content communities such as Twitter and YouTube, and social networking sites such as Facebook and LinkedIn.

The world has seen the influence of social media on global political and community initiatives which has lead to its widespread recognition and use.

Social media has also influenced the healthcare industry and has widespread implications for its stakeholders. The World Health Organization has pages on social networking websites which share information regarding disease patterns and potential epidemics to its global followers.

Impact

Like other industries, social media has had an astounding impact on healthcare. Consumers can now express concerns or share information with healthcare professionals or other consumers through social networking websites. Through social networks, blogs, forums and communities, healthcare providers and consumers can communicate their issues and get immediate responses. According to research, 30% of adults in the U.S have been found to have received help through information found on the internet.

Indeed, social media has spread like wildfire and its outreach has influenced even the busiest individuals such as healthcare professionals. Providers and nurses have the opportunity to stay up-to-date with recent developments in the healthcare industry. Care providers professionals can now interact with others in the industry and share ideas and experiences.

Use of Social Media in healthcare has updated the way patients and care providers can connect. Ramona Nelson, co-author of a book explaining the impact of social media on healthcare states, “Patients are becoming our colleagues. It’s changing relationships and the kinds of questions and services a patient asks for.”

Issues

Increased use of social media has provided a new platform where the healthcare community can interact and interconnect, but it has brought with it several risks as well.

Healthcare providers are worried about the credibility of content being shared and used on social media . Since information is shared at such a rapid pace, moderation of healthcare related content is very important so that inaccurate information such as rumors about spreading diseases are dispelled as quickly as possible.

When people are sharing healthcare information on unmonitored social media websites, there is high risk of someone sharing private and confidential company information. This can be done deliberately or by mistake, nevertheless causing significant damage to providers, patients and the company. Such issues usually involve employees sharing confidential information about patients or the employer on social networks like Facebook or Twitter in the form of posts, comments or multimedia.

Other issues consist of disgruntled healthcare employees or patients trying to manipulate, bully and negatively criticize their employers or patients. Such occurrences not only pose risks to the individuals involved in unethical behavior which might lead to divorce with their employers, but also a threat to healthcare organizations who may find their reputation tarnished in the industry.

Governance

It must not be forgotten that healthcare professionals are responsible for the confidentiality of patient health information and company privacy laws, which is why the industry leaders in collaboration with regulatory bodies should develop, educate and implement stringent policies regarding healthcare information so that the risks posed by free and open information sharing platforms are minimized. The Royal College of General Practitioners in the United Kingdom recently developed the ‘Social Media Highway Code’ for its GPs to ensure that they meet their professional obligations and protect patient health information.

It is clear to see the vast benefits that the healthcare industry can utilize through responsible usage of social media. The most important thing now is for regulations such as HIPAA and HITECH to include and implement stringent rules governing the use of social media in order to protect all parties involved.

Contact scott.parker@curemd.com to learn more about Healthcare and Social Media or call (212) 852-0279 for more information.

The future of CPOE

Almost everyone in the healthcare industry today is familiar with the term CPOE (Computerized Physician Order Entry), due to a significant increase in its usage over the last few years. Quality patient care is rapidly becoming a priority for providers and this has improved significantly due to a sudden surge in rapid health information exchange possibilities. The benefits of CPOE alone has convinced the healthcare community to become an advocate for its usage.

CPOE

When a computer is able to allow direct entry of medical orders by an authorized or licensed individual, it is essentially enabling CPOE. In healthcare today, faxing and emailing are no longer the most advanced means of communication available. Providers now transmit healthcare information to other stakeholders such as hospitals and laboratories, by means of CPOE. The physicians can order a particular test for their patients in a few clicks and are able to receive results electronically, streamlining care delivery.

While CPOE is merely a component allowing physicians to order procedures and labs in a matter of seconds, transmission of patient health summary via Electronic Medical Records can make care delivery even more efficient.  Eradicating the use of paper-based records and eliminating handwritten data is of paramount importance for both doctors and patients as valuable time is managed efficiently.
Numerous studies have shown that the use of CPOE decreases errors due to illegible handwriting as well as harmful drug interactions. A recent research supported and funded by the Agency for Healthcare Research and Quality (AHRQ) showed that medical prescription through CPOE has shown to reduce drug related errors by 50%.

Explaining the affect of CPOE on medication errors, the researchers said, “We conducted a systematic literature review and applied random-effects meta-analytic techniques to derive a summary estimate of the effect of CPOE on medication errors. This pooled estimate was combined with data from the 2006 American Society of Health-System Pharmacists Annual Survey, the 2007 American Hospital Association Annual Survey, and the latter’s 2008 Electronic Health Record Adoption Database supplement to estimate the percentage and absolute reduction in medication errors attributable to CPOE. Given this effect size, and the degree of CPOE adoption and use in hospitals in 2008, we estimate a 12.5 percent reduction in medication errors, or 17.4 million medication errors averted in the USA in one year.” The study effectively proves the relationship between CPOE and a reduction in medical errors.

One must not forget that EMR, Clinical Decision Support, CPOE and other patient engagement tools are merely aimed at helping providers making their administrative, clinical operations and eventually the quality of care delivery more efficient. These advancements do not aim to replace the physician, so it is up to the care community to work together and improve the very foundation of a safer, more efficient and reliable healthcare network.

HIPAA Omnibus Rule: What has changed and what needs to be done

March 25^th, 2013 marked the beginning of the 180 day transitioning period in which covered entities, business associates and subcontractors will start to modify and update their policies, agreements, procedures, practices and forms to fulfill the compliance requirements of the Omnibus Rule which has a deadline of September 23, 2013.

In the transitioning period, covered entities and business associates should be preparing and executing modified business associate and data use agreements. They should train their staff regarding the changes in the previous rules and educate them on their responsibilities to comply with the requirements of protected health information and breach notifications. With the new changes taking place, it is extremely important for stakeholders to know if they fall within the scope of HIPAA and HITECH regulations.

Covered Entities & Business Associates: Which one are you?
Under the HIPAA Privacy Rule, a Covered Entity includes three different groups which include healthcare providers, health plans and healthcare clearinghouses. The healthcare providers group includes all entities transmitting electronic health information including, doctors, clinics, psychologists, dentists, chiropractors, pharmacies and nursing homes. The second group includes Health Maintenance Organizations, Medicare & Medicaid and different Health Plans. The third group refers to organizations which process the healthcare information received from another organization and turn it into a standard format, including billing services, re-pricing companies, community health management information systems and value-added networks.

Business Associates include all organizations conducting business with covered entities involving the use and access of protected health information. Businesses dealing in Electronic Health Records, EMR software, data analysis, billing claims processing, and provision of services such as administrative, consulting and financial will fall under the category of business associates. All subcontractors of such business associates are also regarded as business associates if they are in any way required to view, use and analyze protected health information. If an entity is creating, receiving, accessing, maintaining or transmitting Personal Health Information, then they will become Business Associates. Entities that come across protected health information but only pass on the information without viewing or accessing it will not be regarded as Business Associates.

So what has changed and what needs to be done?
Previously, covered entities were responsible for reporting data breaches to the department of Health and Human Services (HHS). Covered entities were also required to contractually obligate their Business Associates to safeguard any Protected Health Information they handled. Business Associates were under no obligation to report data breaches to anyone else except the covered entities. With the new HIPAA Omnibus Rule, there have been a few important changes.

Business Associates are now required to directly report any Protected Health Information data breaches to the HHS. They are also required to abide by the same rules which apply to covered entities and to be held liable to the same penalties.

Regarding the changes brought with the Omnibus Rule, Leon Rodriguez, Director of Civil Rights at the HHS said, “This final omnibus rule marks the most sweeping changes to the HIPAA Privacy and Security Rules since they were first implemented. These changes not only greatly enhance a patient’s privacy rights and protections, but also strengthen the ability of my office to vigorously enforce the HIPAA privacy and security protections, regardless of whether the information is being held by a health plan, a health care provider, or one of their business associates.”

The HIPAA Omnibus Rule contains modifications to the HIPAA Privacy, Security, Enforcement and Breach Notification rules. With the implementation of this rule, HIPAA wants to make sure that every organization that accesses or uses health information comes under the same scrutiny which applies to covered entities and business associates.

By September 23, 2013, every liable stakeholder must recognize their status as a business associate and guarantee their compliance with the Omnibus Rule.

The adjustment in the HIPAA Rules will allow for increased control and protection of public’s health information. Individuals will be given increased rights over their personal medical information so that they will be able to take electronic copies of their Electronic Medical Records and they will be able to ask their providers to not share their treatment information with their health plan. The new rule also forbids organizations to share the patient’s information for marketing or selling purposes without permission. Patients will hence be empowered since they will have authority over the use of their health information.

Talking about the new rule, Secretary HHS, Kathleen Sebelius said, “Much has changed in health care since HIPAA was enacted over fifteen years ago. The new rule will help protect patient privacy and safeguard patients’ health information in an ever expanding digital age.” Get HIPAA Compliant EMR for your practice today.