Health Technology, Digital Healthcare
Article | August 21, 2023
Affordable healthcare is the need of the hour and interoperability is the means to that end. The healthcare ecosystem is looking into ways they can enable this affordability as soon as possible, and that is where FHIR comes in. FHR promises an on-demand exchange of secure healthcare information. It has become an increasingly popular protocol, thanks to its commitment to ensuring interoperability in the app economy, via apps.
The privilege enjoyed by consumers and participants in most industries is the ease of accessibility of information. With most of it being on the cloud, a URL ensures access to the same information regardless of where it is being accessed from or which internet enable device. This is the privilege FHIR aims to introduce in healthcare, over the current document-based approach where forms are either faxed, emailed, or electronically exchanged.
FHIR is for
Building new healthcare apps
Develop cloud-based health apps that integrate with social networks
Providing a simple to use standards-based API for cloud-based health integration services
The government looking to implement a national EHR
FHIR Aims to Reduce Cost
The medical expenses of an average American in a year are north of $12k and rising. The reasons are the unnecessary complications in the healthcare IT infrastructure. With FHIR, HL7 aims to reduce the burden on providers in sharing and accessing healthcare data at the point of care, thereby reducing the administrative expenses spent on moving data back and forth. It also promises to grant on-demand access to patients – enabling them to make better-informed healthcare decisions.
What is part of FHIR?
Pre-defined Resources and API
A common way to represent data as building blocks and rules for connecting them
Target support for common scenarios
Implementer Friendly
Familiar tooling and technologies using web standards
Multiple Libraries available for faster implementations
Mobile Friendly
Concise and easily understood specifications, RESTful API and JSON
Leverages cross-industry web technologies
Multi-paradigm
Thick client, browser, or mobile devices
Supports human readability as the base level of interoperability
Large Community for Support
Heaps of open-source software and training events, webinars, and connectathons
Specification feedback welcomed, including update requests-tracker
Out-of-the-box Interoperability
Base resources can be used as it is, can also be adapted for local requirements
Seamless exchange of information using messages or document
Start The FHIR
Health plans are jumping on the FHIR bandwagon faster than ever thanks to the Interoperability and Patient Access rule as well as the latest proposals. Do not get left behind or sustain the ramifications of non-compliance with CMS regulations.
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Health Technology, Digital Healthcare
Article | September 8, 2023
Embark on a journey into the frontier of healthcare innovation in this article. Discover how EHR telemedicine and remote patient monitoring serve as catalysts, driving forward a new era in healthcare.
Contents
1. Integration of EHRs in Telemedicine and Remote Patient Monitoring
2. Technical Challenges and Solutions in EHR Integration
3. Financial Analysis: Cost-Benefit Assessment of Integration
4. Data Privacy and Consent in Integrated EHR-Telemedicine Systems
5. Forging Stronger Patient-Clinician Relationships
1. Integration of EHRs in Telemedicine and Remote Patient Monitoring
EHR telemedicine and remote patient monitoring have reshaped healthcare delivery by seamlessly integrating electronic health records, allowing healthcare providers and patients to exchange information effortlessly, regardless of geographical barriers. This synergy empowers healthcare professionals to access patients' comprehensive medical histories in real time, facilitating more informed decision-making during virtual consultations.
During the spring of 2020, when pandemic restrictions kept most people in the US at home, the use of telehealth rose to about 51%.
[Source: Elation Health]
Moreover, it enhances the accuracy of remote patient monitoring by providing up-to-date data, enabling timely interventions and improving overall healthcare outcomes. Integrating EHR telemedicine systems enhances efficiency and ensures that patient care remains at the forefront of modern healthcare, transcending traditional physical boundaries.
2. Technical Challenges and Solutions in EHR Integration
Navigating telehealth EHR integration and remote patient monitoring solutions uncovers a range of technical challenges, each with its own set of potential remedies. These include interoperability issues, which can be mitigated by adopting standardized data formats like HL7 FHIR. EHR interoperability solutions may involve using data exchange protocols such as HL7's Consolidated Clinical Document Architecture (C-CDA) or developing custom APIs to facilitate seamless data exchange between EHRs and telemedicine platforms. Additionally, the imperative need for data security and privacy is achieved through robust encryption and adherence to regulations like HIPAA or GDPR. Data integration challenges arising from varying EHR data storage methods can be resolved using middleware or integration platforms. Investing in telecom infrastructure and developing offline-capable telemedicine apps can address limited connectivity in remote areas. Ensuring real-time data access involves optimizing EHR databases and creating low-latency systems. Other challenges encompass integrating data from medical devices, ensuring data accuracy, scalability, user-friendly interfaces, regulatory compliance, and cost management strategies.
3. Financial Analysis: Cost-Benefit Assessment of Integration
When contemplating the integration of EHR telemedicine and remote patient monitoring systems, conducting a comprehensive cost-benefit analysis is crucial. This assessment covers financial aspects, including initial implementation costs (software development, hardware upgrades, training, and data migration), ongoing operational expenses (maintenance and data storage), and potential efficiency gains (streamlined workflows and improved data accessibility). It also evaluates the impact on patient outcomes, satisfaction, and financial benefits of enhanced healthcare quality, reduced readmissions, and increased patient engagement. Healthcare organizations can estimate cost savings in remote patient monitoring and explore expanding telemedicine services to underserved populations to make informed financial decisions.
Additionally, this analysis considers long-term financial viability and alignment with organizational goals, including regulatory compliance costs, risk assessment, scalability considerations, and the competitive advantages of integrated telemedicine services. By calculating ROI and assessing potential risks, healthcare entities can develop risk mitigation strategies, ensuring that EHR integration in telemedicine and remote patient monitoring enhances healthcare delivery and aligns with the organization's financial sustainability and long-term success.
4. Data Privacy and Consent in Integrated EHR-Telemedicine Systems
Data privacy and obtaining informed consent are paramount in integrated EHR and telemedicine systems. Patients should provide explicit consent, understanding the data collected and its intended use, with strict encryption protocols safeguarding data during transmission. Access controls and data minimization practices restrict unauthorized access, while patient portals enable individuals to manage their data-sharing preferences and revoke consent if needed. Compliance with regulations such as HIPAA or GDPR is crucial, as is maintaining comprehensive audit trails to track data access. Training, awareness, and robust incident response plans fortify data privacy efforts, fostering trust and transparency in these integrated systems where healthcare organizations and patients share responsibility for secure data handling.
5. Forging Stronger Patient-Clinician Relationships
Integrating EHR telemedicine and remote monitoring systems goes beyond mere efficiency and accessibility objectives. It serves as a catalyst for nurturing more substantial and meaningful patient-clinician relationships. This fusion of technology and healthcare has the capacity to bridge physical distances, allowing clinicians to truly understand and engage with their patients on a deeper level. Patients, armed with increased access to their health data, become more active participants in their healthcare, while clinicians, with their comprehensive information, can offer more personalized and informed guidance. The potential of EHR telemedicine reaches far beyond the digital screen; it empowers both patients and clinicians to collaborate in pursuit of improved health outcomes, ushering in a new era of patient-centric care grounded in trust, communication, and shared knowledge.
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Health Technology, Digital Healthcare
Article | September 7, 2023
In today's uber-fast-paced world, the human race, in general, has gotten highly comfortable running on all cylinders in the rat race of life, especially people in India. Our country is a land where opportunities are aplenty, and competition is ever-present, which makes every day life so tedious and constant that taking a breather is something that people can rarely afford. This has led to increasing cases of anxiety, depression, high blood pressure and insomnia. These cases rose to such high numbers that it gave way to one of India’s most prominent industry sectors: The Wellness Industry.
Though the industry captured global attention between 2015 and 2017, a study conducted by McKinsey & Company found that the wellness industry is currently valued at $1.5 trillion globally. This sudden boom can be attributed to the realisation that it is more important to remain healthy than getting healthy. Furthermore, the report, produced after analysing 7500 consumers in six countries (including India), has offered keen insights into consumer behaviour. When it comes to wellness consumers, their trends can be grouped into six categories:
Health: People are now investing in many remote medical devices that can constantly monitor their state of well-being. With the increase in popularity in digital wearables, telemedicine, and remote patient monitoring services, this trend is bound to increase.
Fitness: People are exercising more. Whether it’s jogging, going to the gym, investing in a pedometer, FitBit, etc., there has been a steady increase in people exercising more.
Nutrition: Dieting has always been a significant part of being healthy. An increase in dietary food, supplements, nutrition coaches can be observed in recent years.
Aesthetics: With a major chunk of India’s youth population getting invested in their social media, notably the pictures that they post, aesthetic well-being has seen a sharp increase. This includes investments in specific Athleisure clothing apparel (Nike, Addidas, Puma), skincare products (collagen supplements, face masks), and plastic surgery.
Sleep: Burning the midnight oil is counterproductive. There has been a steady increase in consumers willing to invest in sleep medications, specialised mobile applications that track their sleep and the state of their sleep, ASMR generating devices, White noise devices, and other products that can enable a consumer to maintain a healthy sleep cycle.
Mindfulness: Introspection, understanding the body and its processes to the molecular level, and figuring out ways to implement clarity of thought and methods for improving focus have been huge draws for the wellness industry. Furthermore, with central government’s schemes like AYUSH and the introduction of International Day of Yoga by the United Nations, this particular trend has seen enormous growth.
Impact of these trends on the future of Indian wellness industry
Organic Products: According to APEDA, India has become one of the largest producers of organic products. A growing number are actively investing monthly in organically grown produce, meat that is organically processed, oil that is wood-pressed or cold-pressed, cosmetics made from organic materials, and clothes made from pure cotton instead of manufactured materials. People becoming more conscious of what they put in their bodies has led to a steady increase in organic shops across India.
Exercise, Dieting & Nutritional Supplements: From using simple Calcium supplements and energy drinks to adhering to a strict diet regimen, today’s consumers are genuinely worried about falling sick. This has led to an increase in purchasing supplements. Another trend can be observed where an increasing number of consumers have started buying vitamin, Zinc, and iron tablets, to shore up immunity. Furthermore, Indians have begun consuming gluten-free cereal, cold-pressed juices, Kale products, Avocados, and other food products recommended to be healthier alternatives. Indians have also become BMI-conscious, and an increasing number of them have started to invest in gyms, yoga/cardio classes, exercise-wear, sports wearables, and other products that can enable a person to work out more effectively.
Constant Increasing Demand for Oxygen: Even before the second wave of the COVID-19 pandemic, getting access to 99% breathable oxygen has pure oxygen was a necessity considering the rising concerns of pollution in Indian cities. As per the ‘World Air Quality Report, 2020’ prepared by Swiss organisation, IQAir, 22 of the world’s 30 most polluted cities are in India, with Delhi being ranked as the most polluted capital city globally.
Moreover, people who indulge in extreme physical workouts exercise, or suffer from high-altitude sickness, need oxygen handy to maintain their wellbeing. In India, prominent wellness companies like UCS Wellness Pvt Ltd have made significant strides to ensure that every individual has access to oxygen through their innovative specially outfitted 18-litre aluminium-bottled oxygen cans of 18 litres under their brand gO2therapy. With the pollution rate showing no signs of slowing down, and the steady increase in demand for oxygen, it would be no surprise to find every household medical kit fitted with a portable oxygen cylinder.
Transitioning to Digital Platforms: With the increase in popularity of Telemedicine and Remote-patient monitoring, healthcare and the wellness industry are gaining an aggressive online presence. There are many online exercises/online videos, fitness apps, meditation apps, motivational apps, power coaches, and so much more. Indians find it easier to use these online tools combined with a digital wearable to keep their well-being in the best of conditions.
Investing in Social Media Influencers: With the increase in online dependence, the voice of social media influencers is soon to be gospel when it comes to maintaining a fit body and healthy mind. Much like how mainstream celebrities endorse various products, the wellness industry has seen great rewards in deploying online influencers to support their products. Typical examples can include a famous workout specialist advertises particular apparel, gadget, energy drink, or brand of Whey Protein distributors as part of their video.
Alternatives to Allopathy: In the Indian market, the wellness industry has seen a shift in paradigm where an increasing number of consumers opt for Siddha, or Ayurveda substitutes, instead of conventional medicine. This is seen more in the age group of 40+. This particular age group has patients with a long history of high BP, high cholesterol, and other ailments that require continuous monitoring and medication. They feel that the healthier choice is in traditional medicine or treatments like Panchakarma, Ayurveda, or Siddha. Conventional medication provides them with little to no side effects, which is the primary reason for its increasing popularity.
India is expected to become a wellness hub in the global community following a 12% growth per annum. The Make in India initiative is expected to bring in more investments and opportunities in this sector. The Ministry of AYUSH, with a separate department for Yoga, has been exempted from service tax. A budget of around ?3,400 crores has also been earmarked to be spent over the next five years to help set up and strengthen Ayush Wellness Centers under the National Ayush Mission. This has sparked an increase in startups and businesses focusing on the wellness sector.
Meanwhile, the global pandemic is also giving rise to a new consumer behaviour called wellness rebound where they are becoming more health-conscious and striving towards regaining their health soon after recovering from an illness. Considering the aftermath of the pandemic, the aggressive implementation of technology, and the constant consumer market in India, it can be inferred that the wellness industry will evolve and expand further with little to no backslide.
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Future of Healthcare
Article | February 19, 2022
Anesthesia groups face major challenges in the aftermath of the pandemic: Financially strapped hospitals are increasingly unwilling or unable to pay anesthesia subsidies, and a shortage of qualified anesthesiologists and CRNAs is making recruitment extraordinarily competitive.
The good news is that anesthesia opportunities are plentiful in the ambulatory surgery center (ASC) market. As more inpatient procedures migrate to ASCs, anesthesia practices can help meet demand by working with hospitals and ASCs. A dual-contracting approach can help increase revenue, reduce operational risk, enhance recruiting leverage, and present opportunities for equity investments in ASC ventures.
Expanding ASC Case Mix
Multiple factors are driving increased ASC volume.Consumers have long been attracted to the convenience andfast turnaround timesASCs offer, and as the pandemic began to take hold and patients worried about becoming infected in hospitals, theirpopularityincreased.
But even before the pandemic hit, theuse of ASCs was growing,with the number of centers increasing 7.1% annually since 2016.1No doubt this was in part driven by Medicare restricting fewer surgeries to the inpatient only (IPO) setting. This year alone, Medicare is adding 11 orthopedic procedures to the ASC-approved list, including total knee arthroscopy (TKA) and total hip arthroscopy (THA).2Commercial payersare alsofuelingASC volume by promotingthis venue as a lower-cost option to members.Lastly, with more than 90% of ASCs at least partially owned by physicians,providers themselvesare driving moreprocedures to this setting.
Hospitals Become ASC Buyers
For years, hospitals viewed ASCs as direct competition and discouraged or even prohibited inpatient anesthesia practices from contracting with them. But that dynamic is changing as more hospitals become buyers or majority investors.
According to a recent survey, the percentage of hospitals and health systems planning to increase their investments in ASCs rose from 44% in 2019 to 67% in 2020, with 75% of 200-plus-bed hospitals already owning more than one ASC.3Hospitals view these investments as a way to enhance physician relationships and increase surgical capacity.
The Benefits of Practice Diversification
For anesthesia practices that elect to contract with both hospitals and ASCs, a key benefit is improved profitability, since average ASC case reimbursements are higher than average hospital cases due to better payer mix and more efficient room turnover. Groups that work with multiple organizations also reduce their institutional or operational risk by limiting their exposure to potential financial problems associated with a single contracted entity.
Practices likewise gain an edge when it comes to recruiting in today’s highly competitive anesthesiologist and CRNA market. One of the chief benefits of ASC involvement is being in a position to offer a better work-life balance by spreading call responsibilities across a larger physician call pool. The math is simple: If a hospital group has seven physicians, each must provide call coverage once a week. But if the group also contracts with five ASCs and brings on five additional doctors to staff the facilities, individual call responsibilities are reduced to once every 12 days.
The importance of mitigating call duties to improve the work-life balance for both experienced clinicians and new hires can’t be overstated, particularly as hospitals work to streamline OR throughput by increasing the number of surgical procedures. Groups can also explore a range of creative compensation approaches, including essentially selling call opportunities to newly hired or recent graduate anesthesiologists as additional avenues to attract qualified clinicians while easing the burden on senior anesthesiologists.
Equity Opportunities
Among the most intriguing aspects of ASC involvement is the potential for becoming an equity stakeholder in the business. Surgeons traditionally have been the primary drivers in creating ASCs, but new opportunities exist for anesthesiology groups, particularly if their hospital is buying an existing ASC or developing a new ASC venture and looking to diversify the ownership group.
The idea of anesthesia ownership isn’t as crazy as it might sound. Like surgeons, anesthesiologists are integral to the success of an ASC, and like surgeons, they get there early and stay late. It’s no secret that joint ownership can greatly improve relations between the practice and the hospital, since both are now working toward the same objectives.
Groups can also make more money. I met with a surgical group not long ago with a 49% ownership stake in a hospital. That equity generated an additional $80,000 per year for each physician partner. How much you can make, of course, depends on your specialty, your level of ownership, and the volume of business. But you’ll never know until you try.
Outside Expertise
The pandemic has unleashed numerous changes throughout healthcare, and where the dust will eventually settle isn’t entirely clear. But what is certain is that for organizations to remain viable, they’ll need to be flexible and look hard at nontraditional business opportunities. Contracting with both hospitals and ASCs represents one such approach for anesthesia groups.
If you’re interested in exploring this and other business possibilities but don’t know where to start, Change Healthcare can help. Our team of expert anesthesia practice-management consultants have an average of 18 years’ experience in the specialty. We can be engaged on a per-project basis or we can provide our consultant services as part of our turnkey anesthesia-billing solution.
Our anesthesia revenue cycle management services can be deployed either on our own proprietary anesthesia-billing platform or on your hospital billing system. Either way, we’ll provide seamless, end-to-end service.
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