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.

 

 

mHealth: The Way Forward


The rate of development in the mobile technology industry is unparalleled and it is now making headway in the field of health IT. The recent influx of medical professionals adopting the latest sophisticated tools to enhance care delivery and engage patients has meant that consumers now expect technology to simplify everything.

Healthcare providers are not the only ones looking to accept these technological advances, as their patients are demanding mobile applications to monitor their own health. Mobile health or commonly known as mHealth refers to the practice of medicine, public health surveillance and patient engagement through mobile devices such as tablets, phones etc. This can provide a means for care givers and patients to access clinical records from anywhere, patients able to request prescription refills or appointments and most importantly the ability for patients to monitor their health constantly and from anywhere in the world.

In a recent hearing launched by the Subcommittee on Communications and Technology, Jonathan Spalter, chairman of Mobile Future, an organization that represents innovators across the wireless community said, “Nowhere is that promise of future innovation and opportunity greater than mobile health. Our message today is that the innovation and vision exist now in both the medical and technology communities working together collaboratively. This progress will proceed, in many respects, as rapidly as government allows.”

The mobile health market is expected to reach around $26 billion by 2017. According to a recent report, there are close to 100,000 mobile health applications and more in development by well known health IT vendors. Not only are there a number of mobile phone applications for patients but there are many in the making for healthcare professionals.

The Manhattan Research Survey estimates that in 2012 there were approximately 75 million users of Mobile Health or mHealth, who not only searched for health related issues on their mobile phones through popular search engines, but also actively used mobile phone applications to monitor and improve their health. In the same report, it was stated that almost half of the older population (55 plus) were using mobile devices to search for health related issues.

Electronic Medical Records or EMRs were originally built to be run on devices which were platform specific. This has changed with the rapid development and commercial use of technological innovations. Web-based EMRs have now allowed doctors to be truly mobile and can run on any platform or device; whether it be a computer a standard office computer, a laptop, tablet or a Smartphone. Although the demand for mobile-health solutions is increasing, some in the healthcare community remain skeptical about the implementation of such solutions.

David Levy, MD, global healthcare leader, PwC says, “Despite demand and the obvious potential benefits of mHealth, rapid adoption is not yet occurring. The main barriers are not the technology but rather systemic to healthcare and inherent resistance to change. Though many people think mobile health will be ancillary or bolted on to the healthcare industry, we look at it differently: mHealth is the future of healthcare, deeply integrated into delivery that will be better, faster, less expensive and far more customer-focused.”

There are always obstacles for any potential technology to fully integrate with and possibly overtake current technological systems, but there is no denying that mHealth is the way forward for the healthcare industry. A recent study undertaken by PwC shows that a majority of consumers predict that in the next three years, mHealth will vastly improve the quality, cost and convenience of the entire care delivery process.

 

Medical Device Interoperability


Medical devices are of paramount importance to patient care and well being such as the equipment used for clinical measurement, for instance x-ray imaging, temperature, blood pressure and critical life support. Although we depend heavily on modern medical equipment to treat patients, the devices used in practice are usually not interoperable and cannot connect with other devices. This inadvertently causes accidents which may easily be prevented through an interoperable network of devices.

In a traditional intensive care unit, patients are given treatment with the help of numerous devices such as ventilators, electrocardiographs and vital sign monitors. Most of the time, the manufacturers are different for each of these devices, which makes it harder for these devices to be integrated accordingly.

According to a report by the World Health Organization, there are approximately 1.5 million various medical devices in more than 10,000 different types of device groups available globally. These devices are instrumental for effective prevention, diagnosis, treatment and rehabilitation of diseases, and can be used in different settings such as clinics, hospitals and homes by patients, individuals and healthcare workers. They can also be integrated to a cloud Electronic Medical Records network which can make it easier for healthcare providers to record and monitor the performance of these devices.

Peter Pronovost, MD, Medical Director for the Center for Innovation in Quality Patient Care at John Hopkins University sheds some light on the reasons we need interconnected medical devices. “Medical devices need to share data, so that they can better inform clinicians and help patients,” said Mr. Pronovost. “By doing so, we can both improve quality and reduce costs.”

Similarly, a report by Deloitte states that 61% consumers are interested in using a medical device for checking their condition and electronically share that information with their healthcare providers through the use of technologies such as the EMR or Patient Portal.

medical devices

Through the use of medical devices integrated with Electronic Medical Records, precious lives can be saved. For example, surgery procedures require surgical instruments and radiotherapy units are required to treat cancer patients. In the example of a cancer patient, an infusion pump giving pain medication to the patient can share and exchange data with the vital signs monitor to ensure that the patient is not being given a higher dose.

Joseph M. Smith, MD, Chief Medical and Science Officer of San Diego-based WHI said, “We see an enormous opportunity to use information technology and device innovation to bring about the much needed transformation in healthcare delivery.” He further added, “Today’s hospitals are filled with medical devices that are unable to share critical data, creating potential dangers to patients, as well as inefficiencies that put a tremendous financial burden on our healthcare system.”

 

EMR adoption and Meaningful Use


As the rate of EMR adoption grows across the country, physicians are beginning to express doubt regarding their ability in meeting the latest interoperability benchmarks.  According to a study, approximately fifty percent of hospital administrators across the U.S felt that their hospitals were ready to meet the set forth in Meaningful Use stage 1 requirements. However, the remaining fifty percent were uncertain about the readiness of their organizations to comply with the latest CMS guidelines.

While the American Recovery and Reinvestment Act (ARRA) was a clear attempt to lure practices into early adoption of an EMR system, it also initially created new revenue opportunities for IT vendors. These vendors now face a greater challenge because the second stage of Meaningful Use will require providers to actually perform the tasks that they merely needed the capability for in Stage 1. Most vendors assured their clients of their system’s compliance with stage 1, but stage 2 requires much more from these systems than many providers anticipated. Hence, industry experts suggest that doctors should start their stage 2 preparations right away, as they will require help from their staff, patients, hospitals and most importantly their EMR vendors in order to comply with stage 2.

Providers should initiate their practice evaluation process by assessing what they already have and what they need to purchase or upgrade. On one hand, it is encouraging to see the number of practices endorsing electronic documentation rising consistently. However on the other hand, a rush to adopt electronic medical records has led to unwarranted side effects, namely lack of training and poor quality of implementation. The eventual result of such incomplete implementation is that providers are unable to achieve the level of productivity and efficiency which can be expected from the usage of EMR technology, while this can also have a negative impact on the quality of patient care.

Meaningful Use stage 1 is currently under way, while stage 2 starts in January, 2014. Physicians will be required to adopt EHR technology and comply with the meaningful use criteria by October, 2014 or the payments they receive from Medicare will be reduced in 2015. Patient Portals are a major part of the stage 2 requirements and physicians will have to determine whether their current system has the functionality for patients like secure messaging, access to health information, lab results, ability to request prescription refills etc. Stage 2 will also be focusing on the exchange of health information to enhance care coordination along with information security and privacy. Providers will need to determine which regional; state or private health information exchanges will be involved in clinical data sharing.

Providers may have received incentives for stage 1 Meaningful Use compliance, but later stages will require greater commitment than initially anticipated by many. As a conclusion, it is evident that now is the time for action and providers must immediately direct their efforts towards the acquisition, implementation and utilization of an EMR solution, one that will consistently comply with any updates in the Meaningful Use requirements over the next few years.

Read more: 9 Steps to Successful EHR Implementation

 

EMRs – Specialty Conundrum


A specialty EMR versus a generic electronic medical records solution is the hot new debate in the health IT community. To get to a reasonable conclusion, we first need to understand what specialty EMRs actually are. Any EMR which is tailored to meet the exclusive requirements of a specific medical specialty is regarded as a “specialty EMR”. A specialty solution differs from a generic one in a number of ways. It comprises a rigid tool-set to accommodate the unique workflow of specialists like dermatologists, cardiologists and ophthalmologists etc. As a result once they are utilized, specialty EMR systems are more flexible to the immediate requisites of a specialist clinician than a generic system.

Conventionally, vendors have developed their solutions to handle the clinical workflow of a general or family practitioner, rather than that of a specialist. Naturally, such systems will lack the intricacy necessary to function with medical specialties. When one ponders the matter, the inevitable conclusion reached is to have a unique system design, that caters to the specialty specific requirements of each clinician. When EMR data templates and components are designed specifically for each specialty, providers are able to accomplish one of the main causes of implementation: expedition of clinical documentation. Therefore, general practitioners often do not need to search for an EMR that can accommodate their specific requirements and prefer to use the most affordable EMR with basic functionality. However, the rapid surge in EMR adoption has meant that clinicians are now more demanding, with hundreds of different vendors trying to beat competition with advanced features related to various specialties.

One of the advantages of a ready to use generic EMR is the limited implementation lifecycle, when compared with the amount of time and input required to implement a specialty EMR. However, implementation is merely the start of the journey and we notice a complete contrast once the clinician actually starts using their system. Clinicians using a specialized system have a smooth transition, as the new solution accommodates their existing workflows and questionnaires without much customization. However, providers choosing an off the shelf EMR system often need to maintain their existing paper based documentation methods, as their generic system lacks the tool-set required to manage their existing intricate documentation.

Many EMR analysts and implementation specialists have identified the lack of specialty components as the main cause of EMR implementation failure. A dermatologist may need high resolution images of the patient’s body in order to elaborate the extent of their clinical assessment, whereas a obstetricians would need to analysis and overview of patient’s pregnancy lifecycle. Each of these specialists would need the right tool-set to accommodate the relevant information, hence selecting an EMR with a mere capability of recording textual information would result in duplication of data entry and workflow. In the examples above, both cases would require a different set of panels to display the clinical findings along with the corresponding ICD/CPT codes. This feature of identifying the relevant ICD/CPT codes and recommending the right clinical procedure is inherent to specialty EMR(s).

Keeping the end goal of enhanced clinical care and expedition of clinical workflows in perspective, an electronic medical records solution tailored to a particular specialty proves to be more effective and subsequently more practical. Statistics show that roughly fifty percent of the clinician population across the nation has already implemented electronic medical records on some level. After having the bitter experience of an off the shelf EMR, many physicians are now turning to specialty based systems. EMR vendors now need to heed to the huge gap that exists in the market and become more sensitive to the needs of their customers.

 

Read more:  How Secure is Your EMR?

SaaS & Healthcare – Where is the link?


We have seen the influx of information technology revolutionize almost every industry over the last few years, with one innovation after another expediting the exchange of information among organizations and individuals. The same holds true for the healthcare industry, where the term health IT has dominated discussion between physicians, hospitals and government funded institutions. The rate of innovation in health IT has been incredible, especially with the advent of Cloud-based Electronic Medical Records (EMR) and Health Information Exchanges (HIE). These new solutions have helped providers escape the barriers of traditional server based technology and be connected with their patients from virtually anywhere in the world.

Today, mobile technology is paving the way for the future of affordable and accessible care delivery. Physicians have always looked for ways to respond to the needs of their patients quickly even from outside of their offices. SaaS EMR(s) and online Patient Portals have made this possible, as physicians are able to access the medical records of their patients directly from their cell phones, tablets and laptops. However, many physicians across the nation remain unaware of the functionality and benefits of SaaS EMR(s) or why it has become so popular.

The influence of SaaS upon the healthcare continuum is evident once we take a closer look at solutions such as EMR, practice management, patient portals. SaaS allows for a pay as you go service, where the data captured at the provider’s practice is stored on virtual servers outside of the physician’s office. This means that via SaaS, providers no longer need to maintain hardware equipment or perform data backup.Subscription fees are usually paid on a monthly basis, while customer support is usually available round the clock.

As with other innovations in technology, drawbacks and concerns always emerge after implementation. In this case, the primary risk of implementing SaaS in healthcare is the potential threat to safety and integrity of sensitive patient information.The long term preservation and confidentiality of this datais the responsibility of the respective SaaS EMR vendor. Most SaaS vendors today assure their clients of the safety of their information by complying with strict HIPAA guidelines. There are additional guidelines outlined in the Meaningful Use program by the CMS, thanks to which SaaS in healthcare will experience a 20% growth by 2017.

Providers must ensure their due diligence when choosing a SaaS health IT solution. The vendor must assure the provider of their compliance with HIPAA and other information security standards such as ISO 27000 etc. Providers should ideally request their vendor for copies of recent audit reportsalong with the any information security certifications before making their final decision. In light of the aforementioned characteristics of SaaS and health IT, it is easy to construe that providers looking to go paperless at this stage must give preference to Cloud technology over traditional server based technology. This will ensure the long term viability of their health IT investment.

 

The Road to Meaningful Use – Certified EMR


With the enduring efforts of promoting interoperability by the federal government and health IT vendors alike, we have observed a surge in the adoption of certified EMR across the nation. For some providers, the prime reason for adoption is avoiding penalties, while others view it as a professional responsibility. Regardless of their motives, it would be reasonable to deduce that the utilization of certified EMR technology in practices has raised the bar for the quality of patient care and staff productivity as well. All providers looking to comply with the Meaningful Use objectives must employ a certified EMR. The definition of certified EMR changes with the corresponding stage of Meaningful Use. As of now, we are in Meaningful Use stage one while stage two should begin in 2014.

Stage 2 of Meaningful Use requires the use of patient portals in order for providers to qualify for the apportioned incentives. The fundamental reason for the government’s focus on the use of patient portals is for the improvement in health management for patients. Once the patient feels involved, the level of satisfaction he/she experiences increases as well. As a result, there is better coordination between patients and physicians ensuing in a lot of time and hassle being saved for both.

According to a recent report published by KLAS, more than 50 percent of all clinics and hospitals varying in specialties nationwide have implemented patient portals in their practices. Moreover, this statistic is improving by the day. The current figure strongly indicates the sensitivity of physicians towards their patients’ needs along with a willingness to comply with the Meaningful Use guidelines. The final precept of stage 2 in regards to patient portals mandates that a minimum of five percent of a provider’s patients have to be active on their portal in order for the provider to qualify for their share of incentives.

Given the aforementioned benefits and the overall response of the physician community across the U.S. towards the use of certified EMR and patient portals, we can conclude that the implementation of this technology substantially improves practice efficiency and patient health management. The results may require time to become evident; slowly but surely, we are witnessing the benefits which are inherent to the use and utilization of health IT.