Health Technology, Digital Healthcare
Article | July 14, 2023
NIS2 Cybersecurity Rules Approaching: Is Your Organization Prepared? The EU NIS cybersecurity regulations are evolving for 2024, and if you’re not currently aware of how they’ll apply to your organization, now is the time to get up to speed with the desired requirements. Not only is the directive being tightened, but an extended range of healthcare and related organizations will be added to the list of ‘critical entities’ that must comply. These include certain medical device manufacturers, pharmaceutical companies, and organizations that carry out R&D. The Network and Information Systems (NIS) standards were set up in 2016 to protect essential services – such as water, energy, healthcare, transport, and digital infrastructure – from online cyberattacks. The updated legislation, NIS2, will have stricter rules,reporting requirements, and higher penalties for non-compliance. They will apply to medium-sized and large businesses that operate within one or more EU countries. Those based only in the UK can’t sit back; however, the original NIS regulations will still apply as part of British law. What’s more, a UK version of the rules is coming very soon, and it’s likely that the framework will closely resemble the EU’s. What will the requirements cover? There are a number of cyber risk management measures that all organizations that come under the scope of NIS2 will be required to put in place. For instance, they will need to conduct regular security assessments and risk analyses, adopt incident response and handling plans, and appoint a chief information security officer (CISO), among other obligations. The new directive will streamline and strengthen incident reporting requirements. Entities must notify regulators of any incident that has compromised data or had a significant impact on the provision of their services, such as causing severe operational disruption or financial loss. Applying information system security policies and business continuity plans will form part of the obligations, as will conducting cybersecurity testing and training for all staff. The use of multi-factor authentication (MFA) and encryption, wherever appropriate, will also be mandated. There is plenty of focus within the directive on the cornerstones of cybersecurity best practices particularly, the proper control of administrator-level account credentials, privileged access, and endpoints, all of which are prime targets for attackers. Under NIS2, organizations are being separated into ‘critical’ and ‘important’ entities. It’s important to determine which category yours’ will fall under, as each has different requirements. The third-party threat will also be addressed in NIS2 by pulling in managed service providers (MSPs) to the list of ‘critical entities’, with the aim of keeping digital supply chains secure. MSPs are often granted privileged access to clients’ corporate systems and networks, which creates security risks. What are the consequences of non-compliance? Organizations that come under the regulations’ purview will be subject to random checks, regular security audits, on-site inspections, and off-site supervision. For those found to be in breach, sanctions could include warnings, temporary suspension of certain activities, and temporary prohibition to exercise certain managerial functions. Financial penalties could be as high as 10 million Euros or 2% of an organization’s global turnover, whichever is higher. What steps should healthcare organizations take now? Organizations should take action to establish whether the EU or UK NIS2 regulations will apply to them and what their responsibilities will be. Having identified any gaps in existing cybersecurity processes, policies, and practices, they must determine what changes need to be made to address them. As a priority, they must review their incident response plans and incident management and reporting procedures. It’s also a good idea to begin assessing the security posture of partners and third parties in the supply chain and incorporating relevant security requirements into contracts. Given the framework’s focus on protecting privileged admin accounts, organizations should implement controls limiting the number of staff members with these robust credentials. Implementing privileged access management (PAM) will allow IT to control who is granted access to which systems, applications, and services, for how long, and what they can do while using them. Preparing for the introduction of the EU NIS2 regulations should be considered more than just a compliance exercise. By meeting the strengthened requirements, healthcare organizations will be building a foundation of resilience that protects them, their customers, and the essential services they provide.
Article | November 29, 2023
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.
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.
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.
Health Technology, Digital Healthcare
Article | August 21, 2023
Effective Healthcare branding changes how the public perceives a healthcare organization. Brands are all about perceptions. The way your customers perceive your organization determines your brand. That encompasses your doctors, your board members, your nurses, and your patients. The process of healthcare branding helps organizations ensure they are perceived the way they want to be; as trusted, knowledgeable, caring, and experienced.
More than a tagline, name, messaging, or logo, the recognizable feeling that these elements induce is your healthcare company's brand. Healthcare branding ensures that these elements meet in a cohesive system informed by positioning and personality and are constantly implemented across your brand's touchpoints.
Why is Healthcare Branding So Essential?
Healthcare branding was not always so important. Patients had the freedom to select any healthcare provider. Insurance was the principal determiner of their healthcare provider. It depended upon their workplace. Those without insurance got treatment at community clinics and emergency rooms.
As you know, times have changed a lot in a big way. Changing the entire healthcare landscape, the Affordable Care Act put patients in the driving seat. Most of the patients now have access to healthcare insurance and successfully manage their own health. Patients without insurance have the options of out-of-pocket online pharmacies and providers.
Healthcare providers have changed their performance metrics system to value-based assessments such as patient satisfaction. More than treatment, now the emphasis is on prevention. It has become a market that is direct-to-consumer healthcare.
As a result, the consumer has become the controller of the healthcare brand-consumer relationship. As patients have turned empowered consumers, the benefits of healthcare branding have grown to the point that healthcare companies cannot ignore them. If they do, it affects their business.
What are the Benefits of Healthcare Branding?
Effective healthcare branding, directed by research and a clear strategy, has many valuable benefits:
Identify Changing Patient Needs
The needs of patients today have changed from the start of COVID-19. Even when a global pandemic hasn’t fundamentally changed the healthcare landscape, patients’ needs are continually evolving. Healthcare branding gives you the tools to understand evolving patient needs better and rebrand your company to meet them.
Brand research includes qualitative research (including one-on-one patient interviews) and quantitative analysis. Insights gathered from brand research are critical in optimally positioning a healthcare brand. It is vital during dynamic and unpredictable markets, as in what happened during this COVID-19. Beyond brand research, effective healthcare branding ensures your healthcare brand is continually aligned with shifting market trends and their impact on patient needs.
It isn’t easy to think of a quality more essential to a healthcare organization's success than trust. A healthcare brand is broken or made by the degree to which it is trusted by those it serves.
When it comes to healthcare branding, trust is conveyed through everything from messaging to visual identity. Photography, colors, and typography all contribute profoundly to perceiving a brand as trustworthy. In healthcare branding, verbal identity is more important than visual brand identity in establishing it as an expert in the healthcare space.
Everything from a reassuring, confident voice in its website copy to guides designed to update patients on necessary healthcare topics and regular publication of articles are proven and well-known ways in healthcare branding to build up trust.
Set Your Brand Apart from the Competition
However, trust is not the only thing needed in the modern age for effective healthcare branding. The days, judging a healthcare organization based on its medical practice's reputation alone have gone. Patients have become empowered consumers as time passed. The competition to treat these empowered consumers too has become increasingly fierce. Here comes the importance of effective healthcare branding, tracking all your online and offline activities, and evaluating them every day.
Your healthcare brand is just one among the many other brands for internet-savvy consumers to choose from. First and foremost, all consumer decisions, including patients' decisions, are based on emotions. So, you have to think of ways to persuade your consumers' feelings to help your healthcare branding in the crowded marketplace.
Competitive differentiation is more vital than ever. Effective healthcare branding makes you find out opportunities and ways for differentiation in the challenging and competitive landscape. And, you can capitalize on these opportunities and ways with powerful storytelling and unique positioning.
Improve the Patient Journey
Patient experience, as mentioned earlier, is a game-changer in the healthcare industry today. Healthcare branding gives you various ways to shape and improve patient experience powerfully. After all, a good percentage of patient experience happens outside the healthcare facility these days. The beginning stages of the patient journey are the awareness and consideration stages. Healthcare branding tools, such as content marketing, are critical in influencing patients in these stages.
A website of your healthcare brand can make or break your patient’s pre-treatment experience. It is the selection phase of the patient journey. A premium and well-designed website optimized for conversion will enrich the patients' online experience, looking to book an appointment or answer a question.
Healthcare branding is helpful in defining the patient treatment experience. When correctly leveraged, healthcare branding allows your healthcare brand to enhance the patient journey from when the patient hears about the brand to the moment of finishing the treatment.
At every patient journey stage, healthcare branding fosters patient trust, builds patient loyalty, and reinforces patient-provider relationships.
Modern healthcare companies are operating in a competitive landscape where healthcare branding is more important than ever. Patients have become informed and empowered consumers. Digital healthcare brands have redefined the marketplace. Healthcare branding is vital if your healthcare company hopes to stand out from the rest and develop lasting and meaningful relationships with your patients.
Fortunately, there are many ways to differentiate your healthcare brand and make it sounds unique meaningfully. Positioning, identity, storytelling, and patient experience represent a powerful area where healthcare brands can better align themselves with their patients' needs and stand out from the competition.
Frequently Asked Questions
Why is healthcare branding important?
Healthcare branding helps you effectively project the personality of your healthcare organization and products. A good thought process to brand your healthcare product will make people remember you forever.
What is hospital branding?
Hospital branding is the process of making your healthcare organization be perceived better by potential clients. Effective branding makes your patients remember you through the best patient experience and the organization's external look.
What are the three branding strategies?
There are many effective branding strategies. Line extension, brand extension, and new brand strategy are essential types of branding strategies. You can have any strategy based on the nature of your product.
Article | December 18, 2021
“Health care is different, the data here is emotional! If you tell me you were buying a fishing rod online and were emotional about it, I’d say you are lying. But I do frequently see people helpless and confused when it comes to receiving health care, managing its costs, making sense of its data.”
- Senior Product Leader inOptum Global Solutions Pvt. Ltd.
Yes, health care is different, and so is product management in it. This piece highlights the top 4 product management trends that are specific to health care and serve beyond being just a list of technologies making their way into health care.
Health care consumerism
Lance broke his ankle in a bicycle accident and is now in hospital waiting for surgery. Which of these words would describe him more aptly— a ‘patient’ or a ‘health care consumer’? The fact that Lance holds a high-deductible health plan, manages an interactive relationship with his primary doctor, keenly monitors his fitness through his smartwatch, and learns about healthier diet plans and recipes online — I can say he isn’t just receiving health care, but making active choices on how to pay for and manage his health. This choice and responsibility that people demand, is ‘health care consumerism’. This trend has been growing since 2015 when value-based care started picking up in the US.
What does this imply for products/PMs?
These are challenging and exciting times to be a product manager (PM) in health tech. This is because people are now demanding an experience equivalent to what they’re used to from other products in their lives, such as e-commerce, streaming platforms, and digital payments, to name a few. Any consumer-facing product (a mobile app, a web-based patient portal, a tech-enabled service) needs to meet high expectations. Flexible employer-sponsored health plans options, health reimbursement arrangements, price transparency products for drugs and medical expenses, remote health care services, and government's push to strengthen data and privacy rights — all point to opportunities for building innovative products with ‘health care consumerism’ as a key product philosophy.
COVID-19 has tested health care systems to their limits. In most countries, these systems failed disastrously in providing adequate, timely medical assistance to many infected people. Prevention is of course better than cure, but people were now forced to learn it the hard way when cure became both inaccessible and uncertain. With lockdowns and social isolation, prevention, fitness, diet, and mental wellbeing all took center stage.
Wellness means taking a ‘whole-person approach’ to health care — one where people recognize the need to improve and sustain health, not only when they are unwell, but also when they’re making health care decisions that concern their long-term physical and mental health. A McKinsey study notes that consumers look at wellness from 6 dimensions beyond sick-care— health, fitness, nutrition, appearance, sleep, and mindfulness. Most countries in the study show that wellness has gained priority by at least 35% in the last 2–3 years. And wellness services like nutritionists, care managers, fitness training, psychotherapy consultants contribute 30% of the overall wellness spend.
So, what do health-tech PMs need to remember about wellness?
The first principle is, “Move to care out of the hospital, and into people’s homes”. A patient discharged after knee surgery has high chance of getting readmitted if he/she has high risk of falling in his/her house, or is unable to afford post-discharge at-home care with a physiotherapist. This leads us PMs to build products that recognize every person’s social determinants of health and create support systems that consider care at the hospital and care at home as a continuum.
The second principle is, “Don’t be limited by a narrow view of ‘what business we are in’, as wellness is broad, and as a health tech company, we are in health-care, not sick-care”. Wellness products and services include — fitness and nutrition apps, medical devices, telemedicine, sleep trackers, wellness-oriented apparel, beauty products, and meditation-oriented offerings, to name just a few. Recent regulations in many countries require health care providers to treat behavioural health services at par with treating for physical conditions, and this is just a start.
Last month, WHO released a report titled “Ethics and Governance of Artificial Intelligence for Health”. The report cautions researchers and health tech companies to never design AI algorithms with a single population in mind. One example I read was, “AI systems that are primarily trained on data collected from patients in high-income settings will not perform as effectively for individuals in low or middle-income communities.” During COVID-19, we came across countless studies that talked about the disproportionate impact on minorities in terms of infections, hospitalizations, and mortality. A student at MIT discovered that a popular out-of-the-box AI algorithm that projects patient mortality for those admitted in hospitals, makes significantly different predictions based on race — and this may have adversely moved hospital resources away from some patients who had higher risks of mortality.
How should I think about health equity as an AI health-tech PM?
Health equity means that everyone should have a fair chance at being healthy. As a PM, it’s my job to make sure that every AI-assisted feature in my product is crafted to be re-iterative and inclusive, to serve any community or subpopulation, and is validated across many geographies. To prevent any inequitable AI from getting shipped, it is important to ensure that the underlying AI model is transparent and intelligible. This means knowing what data goes into it, how it learns, which features does it weigh over others, and how does the model handles unique features that characterize minorities.
Integrated and interoperable
In every article that I read on topics such as digital platforms, SaaS, or connectivity with EMRs, I always find the words: ‘integrated’ and ‘interoperable’ therein. Most large and conventional health tech companies started by offering point-solutions that were often inextensible, monolithic, and worked with isolated on-prem servers and databases. To give a consistent user experience, leverage economies of scope, and scale products to meet other needs of their customers, started an exodus from fragmented point-solutions to interoperable, integrated solutions. The popularization of service-oriented architectures (SOAs) and cloud vendors like AWS, Azure, and GCP has also helped.
The what and how of integrated-interoperable solutions for PMs:
Integrated solutions (IS), as I see them, are of two kinds — one, in which as a health tech company, we help our customers (health systems, insurance companies, direct to consumers) accomplish not just one, but most/all tasks in a business process. For example, a B2B IS in value-based care contract management would mean that we help our customers and health systems by giving an end-to-end solution that helps them enter into, negotiate, plan for, manage, get payments for their value-based contracts with health plans.
In the second type of IS, we offer products that can be easily customized to different types of customers. For example, a health management app that people can subscribe to for different programs such as obesity, diabetes, hypertension, cholesterol management, as needed. The app works with different datasets for these programs and uses different analyses and clinical repositories in its backend, but still delivers a consistent user experience across programs to a user who enrolled in multiple programs, say diabetes and weight management.
‘Interoperable’ simply means that one product should be able to talk to other products both in and out of the company. For example, if product-A can alert a doctor about any drug-drug interactions or allergies a patient might have, while she is writing prescriptions for the patient in product-B (an EMR), then product-A does talk to product-B, and hence, is interoperable. This trend is picking up further with the growth of IoT devices, and industry-wide participation in adopting common standards for data exchange.
Though the article derives much of its context from US health care, I have tried to keep a global lens while choosing these topics. For developing economies like India, digitization is the number one trend as much of the health system is still moving from manual records to digitally store patient and medical data in EMRs. The good news is that India is booming with health-tech innovation and that is where consumerism, wellness, and equitable AI make sense. Once companies develop enough point-solutions for different health system needs and use-cases, Indian health tech will see a move towards creating integrated, interoperable (IGIO) systems as well.
There are some other trends such as — use of non-AI emerging tech such as Blockchain in health information management, cloud infrastructure for health tech innovation, big data and analytics to improve operational efficiency in areas such as claims management and compliance reporting, Agile product management for co-developing with and continuously delivering to clients etc. — but I see them either as too nascent, or too old to feature in this list.
Finally, as a health tech product manager, you can use the following questions to assess your products against the above trends — (Consumerism) do the products that I manage, empower consumers with choice, information, and actionability? (Wellness) Does my product emphasize keeping them out-of-hospitals and healthy in the first place? (Equitable AI) Am I sure that my product doesn’t discriminate against individuals belonging to underserved populations? (IGIO) And finally, is my product scalable, integrated and interoperable to expand to a platform, in the true sense?