Health Technology, Digital Healthcare
Article | September 7, 2023
Workers in the healthcare industry are among the most burned out demographics following the COVID-19 pandemic. In fact, a report by Medscape on physician burnout and depression in 2022 calculated a five-percentage point increase in burnout overall, from 42% in 2020 to 47% in 2021. Critical care physician burnout was also found to increase from 44% to 51% last year, placing them at the top of Maryville University’s list of physician specialties with the highest cases of burnout. This is closely followed by rheumatology physician burnout, which was 50% in 2021. At the bottom of the list, emergency medicine physician burnout still came in close at a rate of 44%.
Burnout can result in, among other things, exhaustion and a loss of concentration, which can be dangerous in healthcare. With that, advancements in technology have been made to help mitigate stress and reduce the chances of burnout in healthcare.
Maximum Tasks, Minimum Efficiency
Reports show that many technological advancements in the healthcare industry actually aren’t appropriate for managing physician workloads. This is due to the range of tasks physicians need to perform, from creating treatment plans to managing EHRs. Our previous discussion on EHR-Generated Messages highlighted how the misapplication of this algorithm had actually led to these inboxes getting clogged. This has primary care physicians spending more than half their workday interacting with EHRs that only remind physicians to order certain tests, instead of dealing with critical messages from patients or colleagues. This has been counterproductive in terms of efficiency, leading to more burnout symptoms and the tendency to reduce clinical work hours. It is therefore important that technology integrations consistently consider the broader picture of the tasks of physicians.
Tech Developments for Reducing Burnout
Shifts in the industry have thus begun to focus on the quality of efficiency and physician assistance, rather than the quantity of technology available. Here are some notable examples of technology that has become finely integrated within the healthcare industry.
Ambient Technology in Clinical Documentation
Ambient computing streamlines the clinical documentation process by using artificial intelligence to respond to human behavior and needs. This provides front-end speech and computer-assisted documentation, reducing the time needed for physicians to work on admin tasks, and thereby minimizing burnout. Smart hospitals have started leveraging this through sensor-based solutions, and experts from Michigan University believe usage must be made easier and simpler to use for the provider if the healthcare industry is to further leverage ambient computing for CDI. As of 2021, adoption has only started to take off, especially in the revenue cycle.
Computer Modeling in Vaccine Development
The traditional process of designing novel vaccines usually lasts 10 to 15 years and can cost between $200 million and $500 million. However, a feature by News Medical highlights the recent development of COVID-19 vaccines, which uncovered the capabilities of computational modeling systems. This showed an ability to predict which parts of a pathogen may be recognized by the immune system’s B cells and T cells. This allows rapid identification of vaccine targets from a genetic sequence, which reduces the years required for preclinical research. Physicians are thus able to respond faster to vaccine developments, and reduce the overload of health systems during any future pandemics or epidemics in the long term.
Patient Placement Technology
The shortage of physicians is a common setback in the industry, one that staff at the Rice County District Hospital in Lyons, Kansas mitigated using patient placement technology. Patient placement technology coordinated care for patients inside the 25-bed, level 4 hospital, as well as those needing to be transferred to another facility. By integrating local EMS and other transport services with health systems, manual telephone calls were no longer necessary. Hence, physicians were able to quickly and effectively get patients the care they needed while managing time-critical diagnoses. This maximizes the limited resources available without stretching out the workforce. Physicians are able to focus solely on their patients, knowing that the time-consuming logistics are being efficiently handled by technology. The industry needs to continue to look into the practices of reducing burnout among physicians, more so as we continue to recover from the effects of the COVID-19 pandemic. By emphasizing physician wellness and efficient technology, we can continue to assure the health and productivity of healthcare workers into the future.
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Digital Healthcare
Article | November 29, 2023
The fall is a time of renewals and choices. It is also a time of so called “open enrolment” for health plans. It is the one time of year we can study and learn about the options offered through employers or government sponsored plans. Individuals and small business owners alike are also are faced with a myriad of choices with confusing and often contradictory language promising lower premiums with higher out of pocket costs for covered services subject to deductibles. What does it even mean anymore when your monthly premiums exceed your pay check and you still have to pay for your colonoscopy or your insulin? Where is it all going?
Let’s imagine you twist your ankle playing basketball. You might go to an urgent care, receive an X-ray, probably be examined by a non-physician, and then referred to your primary care, who can’t see you for a few weeks but eventually sends you to an orthopaedic who takes another X-ray and treats your injury. Weeks have passed, multiple visits, time out of work, and co-pays, not to mention the out-of-pocket fees associated with imaging and perhaps a $100 ace bandage. What stops you from going straight to the ankle specialist in the first place? First, we have become conditioned to follow the directions dictated by the insurance companies, even when restrictions are not in place, patients have been convinced that stepping out of line will make all insurance promises null and void resulting in catastrophic bills and financial ruin. Second, the doctors and their office staffs have been conditioned to deny entry to any patient who does not have the proper referral, authorization, or identification. There are dire consequences for both if the insurance rules are not followed and fear keeps both sides aligned.
The past two decades have seen an explosion of healthcare costs. Health insurance has become the single biggest line item second only to payroll for most businesses. It is no coincidence that as the government increased its role as payor with state subsidies, the prices have gone up. Much like college tuitions, when loans are easy to obtain and guaranteed by federal support, there is little to deter those in charge from increasing the price. After all, everyone is doing it, it must be OK, and even if students end up in debt, it will be repaid because they have received the value of a great education. Right? But unlike higher education, healthcare is a necessity. We cannot avoid it, and there needs to be a reliable mechanism in place to guarantee access.
Ironically, as charges and prices have continued to escalate, payments to doctors have diminished. Why medicine is the only service industry where there is no transparency is truly astounding, especially since the there has been no increase in so called “reimbursements” for decades. As physicians, we have been complicit, being fully aware of the discrepancies between what is charged and what a patient’s insurance will pay. Even as patients began to have higher deductibles, and therefore higher out of pocket expenses, we continued to follow the rules, asking insurance permission to collect payment from the patient. It is not surprising that bad debt accounts for over 50% of most account receivables and why over 70% of doctors are now employed by hospital networks or private equity, who not only go after patients, but benefit from the repricing that occurs when insurers pay a negotiated amount as opposed to the charge. In other words, we pay more not just for less, but for nothing.
But what if we twisted our ankle and went directly to that specialist and paid out of pocket a transparent price? What would it take for that to happen? Not much, the cost of care is predictable, and because payments have always been decreasing, most physicians have learned to be economical. Plus, out of pocket costs are capped by federal law, so no patient is really responsible for catastrophic bills. Charges inflate to cover overhead, but if payments were guaranteed and immediate, then the cost of doing business goes down. Add technologies like telemedicine to a practice and you have increased patient access to a doctor without adding more personnel. Direct pay doctors are emerging all over the country and have consistently offered better access and more affordable care. The bar is also being set by independent surgery centers and imaging centers who offer better outcomes at lower costs. Perhaps motivated by prohibitive pricing, better options have emerged that have moved patients away from expensive operating rooms to safe, office-based procedures. Even cutting-edge cancer therapies can be delivered at home, preserving more of the healthcare dollar for medical care rather than the complex system built to manage it.
Competition and choice inevitably drive prices, but in a monolithic system the price is not negotiated, but instead it is set by only a few, in this case the big insurers. Small businesses cannot compete when bigger companies come to town. Eventually, the local hardware store gives way to a national brand, and the consumer is left with fewer choices and eventually higher prices. Amazon disrupted this equation by creating a marketplace for individual buyers and sellers. The convenience of finding a trusted brand, no longer available locally, is irresistible and the reason why we became loyal consumers. Healthcare is no different. Trust exists implicitly between a physician and patient, because it is an authentic, empathetic, and logical relationship. Trust does not exist between a patient and their insurer, on the contrary it is an unsympathetic business relationship without transparency or consistency. Few doubt the insurance company’s top priority is the premium, not the patient. Creating a direct relationship between the doctor and patient is a common-sense approach that serves both stakeholders well, and requires merely a fair and affordable price. But do doctors have the capability or the will to do it and if so, can the rest of the system follow?
Never in the history of modern medicine have physicians been more dissatisfied. US healthcare used to lead the world in innovation and outcomes, now we struggle to break the top thirty. We may have the most brilliant doctors and scientists with access to the best resources, but the need to maximize profits while catering to special interests, be they commercial or political, has led us to favour certain therapies over others despite marginal proven benefits. Doctors have little autonomy and less authority; prescribed treatments are routinely denied by insurance companies without a second thought or appropriate peer review. In fact, insurers even renamed us “providers”, a term used to by Nazis when referring to Jewish doctors to devalue them professionally. Over 56% of physicians are burned out, nearly all report moral injury and as hospitals have systematically replaced doctors with non-physicians with limited training, we have watched the standard of care deteriorate. It is no wonder we have witnessed the single biggest loss in life expectancy since WWII. The prognosis is grim, but there are solutions.
We need to reinvent healthcare by removing the middleman. We don’t have to set the price, but we can make it transparent so patients can decide for themselves if it is worth the inconvenience, the delay, and the co-pay to use insurance or just pay directly. Health savings accounts are tax deferred and can cover an out-of-pocket maximum in just a couple of years. Paying for care means there are no surprise bills or out of network costs, because there are essentially no networks and therefore no need to follow restrictions. You’d be hard pressed to find a doctor or hospital unwilling to accept an immediate cash payment, especially when it costs nothing more than the service provided. There are no billing cycles, or claims to prepare, no up coding, or authorizations. Doctors free to care for patients, patients treated individually and not subject to protocols designed to maximize charges. There are literally thousands of direct pay primary care and specialists now available all over the country and they are building alliances with likeminded people providing imaging, ancillary services, surgery centers, and prescriptions all at fair market prices. More and more employers are moving toward medical cost sharing plans that not only lower the cost of care but the cost of administration. Even the biggest payor, namely the government, sees the benefit of price transparency and is piloting models of direct contracting.
We will always need coverage for those unexpected events, emergencies, or hospital-based services, but all the rest - doctor visits, screening tests, and outpatient procedures - are easily affordable. After all, do we use our car insurance to pay for an oil change? If we did, the cost would be prohibitive and few of us would drive. But health insurers have lost our trust, they no longer cover necessary services and no longer honour contracts with physicians or patients. It is time to offer another option and let the patients and doctors get back to the real business of medicine.
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Health Technology, Digital Healthcare
Article | August 21, 2023
While many United States healthcare providers are returning to their in-person offices, many others are digging in to offer hybrid telehealth or exclusive telehealth practices moving forward. Understanding the future of telehealth reimbursement is then a pivotal issue. As a hub for telehealth consultants and trainers, the Telebehavioral Health Institute (TBHI) is receiving daily requests for assistance from behavioral health groups and independent practitioners seeking to position themselves for telehealth expansion optimally.
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Health Technology
Article | July 13, 2022
Long-term care comprises all the health services that help patients with chronic illnesses or disabilities meet their medical and non-medical needs. It caters to those who cannot care for themselves for extended durations. For care providers, it becomes critical to meet the needs of patients on time while delivering top-notch quality, especially at a time when virtual care is more important than ever.
To remedy this, many of the tasks and processes within long-term care are supported by digital solutions. These long-term care software applications enable care providers to automate aspects of patient scheduling, inventory control, regulation and compliance, data management, care delivery management, and much more. Some of the end users of long-term care software include home healthcare agencies, nursing homes, and residential hospice care facilities.
What is Driving the Growth of Long-Term Care Solutions?
Digitalization has swept the healthcare industry, and medical technology now occupies a significant area of medical care delivery. With the demand for a robust healthcare infrastructure aggravated by a shortage of medical professionals, the need for automation is driving the growth of medtech across all areas of healthcare. In addition, fewer medical specialists and medical cost reduction initiatives combined are powering the long-term care software market’s growth.
Challenges for the Long-Term Care Software Market
Despite the rapid growth in the use of digital solutions to manage administrative and compliance tasks, technological transformations are expensive. The high maintenance costs incurred by care providers are a major hindrance towards a full-fledged adoption. Many care providers are also unwilling to adopt new applications due to the implementation and staff training costs involved in doing so.
What the Future Holds?
With an increase in remote care and the use of technologies like the Internet of Medical Things to deliver diagnostic services and preventive care, medtech is witnessing a revolution. Long-term care is bound to follow suit thanks to areas like remote patient monitoring and wearable technology. While the long-term care market is slated to grow by leaps and bounds, solution makers must find a way to help care providers warm up to the use of technology and de
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