Seriously Simple, and Smart, Ways to Plan Ahead for Long-Term Care
Why do you need to plan ahead for long-term care? If you have no clue how to answer this and you are planning for retirement, you could be in for a major financial surprise. Long-term care is expensive and most everyone needs it at some point, so it’s important to take these long-term care planning tips to heart before you finalize your retirement plans.
Be Aware of Medicare Limitations
If you’re looking forward to retirement, you may think you don’t need to plan for long-term care because Medicare will cover it. This is a huge mistake, however, because Medicare offers basically no coverage when it comes to paying for a nursing home, an assisted living home, or in-home care. That’s because this kind of care is considered custodial, rather than medical, and therefore is not included in the coverage that most seniors receive from Medicare. With long-term care, you are more likely to need help with daily tasks such as bathing or dressing, and this is why more involved care is necessary. Medicaid might cover some costs if you’re eligible, or you may be entitled to assistance from the VA if you have served in the military or are an eligible dependent. If neither of these is an option, you will need to come up with other ways to plan for care. However, try not to stress yet. If you are planning well ahead of time, you have some ways to prepare yourself for long-term care.
Make Healthier Changes to Your Life
There’s really no surefire way to prevent the need for long-term care. According to statistics, you may need long-term care at some point in your adult lifetime. You can, however, try to beat the odds by making some simple changes to your life and home. Falls can be a source of debilitating injuries as you get older. Those tricky stairs could lead to a serious fall in the future, so take steps to help yourself age in place at your own home. If you do have steps or stairs, have some secure railings installed on either side to provide support and reduce your risk of falling. You’ll also want to think about fall-proofing your bathroom as time goes on, by installing grab bars in slippery areas. Another simple change you can make is to add better lighting throughout your home. You can swap out to brighter bulbs or add fixtures to ensure areas are lit evenly. Finally, don’t underestimate the impact lifestyle choices can have on your long-term health. Regular exercise and diet can reduce your risk for serious conditions such as dementia and Alzheimer’s disease and give you a chance for a more independent life.
Research All Your Options for Paying for Care
Paying for long-term care can be a real financial burden, especially if the need comes up unexpectedly. Most American seriously underestimate long-term care expenses, which can run upwards of $100,000 per year if you need to stay in a nursing home. However, you have a decided advantage by choosing to plan ahead. For one, you can research just how much care could cost you, as well as how exactly you can pay for it. If you are in your 50s, for example, you may be able to snag long-term care insurance for much lower monthly payments than someone who is only a few years older than you. When long-term care insurance is not feasible, there are other financial avenues you can include in your long-term care plans. You could pre-pay, plan to receive care from a loved one, or you can get roommates to offset housing costs and allow you to tuck away more funds for care.
Planning for long-term care doesn’t have to be a headache. If you start planning early and going over all your options now, you will have more options to choose from and end up with less stress in the future if you do need some form of long-term care. So, don’t forget to add long-term care to your list of essential retirement planning steps.
eMEDICS.org has just completed its homecaremarketplace platform and invites medical professionals such as RAI evaluators or specialized nurses to register on www.YFORM.org to offer their services at home.
Several organizations have showed interests using this platform if the number of registered resources is sufficient.
Housekeepers can also register for housekeeping and meal services. Registration is completely free. Service providers can indicate their availability and their hourly rate in order to receive the right requests.
The eMEDICS.org social network, eHSN (eMEDICS Health Social Network) is being finalized. The YFORM platform should be able to integrate with eHSN but also with coreERP, software used by medical organizations, to bring these organizations closer to the medical professionals and patients.
eMEDICS.org coreERP v1.7 turnkey solution has been successfully completed for the Swiss market. The EMR (Electronic Medical Record / Medical requests) and RAI evaluation processes (RAI MDS and Household assessments) are now fully functional. When the medical staff assess RAI MDS evaluations, performance scales (ADL, IADL, CPS and DRS) as well as the GAD alarms, are automatically generated (on the fly). This helps streamline the decision making. Mental Health PHQ-9 / GAD-07 is being implemented and shall be available in the coming weeks.
We invite Swiss home-care organizations to contact us at email@example.com or +41 75 416 4140 to participate to our pilot projects. Your organization would take advantage of a substantial gain of productivity in your day to day business (ex: use of Electronic Patient record, fill-in RAI evaluations online, document generation on the fly, such as OPAS…). In exchange, free licenses and support will be provided by eMEDICS.org team in order to meet your expectations and business needs.
coreERP solution is now responsive using the same code for mobile and web, reducing by half any development cost. The solution could also be used in the field while we’re still adjusting the offline capabilities. It has been optimized to run on any type of IT infrastructure. Our framework is open-source which makes our first class solution available to large but also small to medium home-care organizations. Our solution combines quality and competitive pricing over time with a drastic cut in maintenance and operations.
1) Pilots and projects updates:
We’re already in discussion with a couple of home-care organizations to start pilot projects.
We’re also meeting AVASAD this month, to discuss a potential collaboration.
At this stage, we only invite Swiss home-care organizations that are interested by such a solution to contact us for free demos and licenses.
The generic international InterRAI solution is scheduled to be supported by Q4 2018. European and North American home-care organizations could still contact us to book a demo and reserve free coreERP licenses.
2) Infrastructure update:
coreERP has been tested on shared hosted environments such as InfoManiak and the solution works perfectly fine. This is a huge achievement, allowing small/medium/large home-care associations to significantly reduce their infrastructure expenses and operational costs.
InfoManiak infrastructure platform provides a state-of-the-art back-up solution: your data is backed-up daily on a second data center and previous versions could be restored in one click. This is crucial especially when dealing with high sensitive patient data information.
It is now GDPR compliant (European General Data Protection Regulation) which makes it the best choice to host our Health oriented software for European organizations.
coreERP is also being tested in other countries (OVH and HostGator) and on-premise (LAMPP and WAMPP servers).
3) eMEDICS.org Process automation update:
OPAS computations are fully functional providing the LiMA and OPAS estimates on the fly.
Approbation workflows are ongoing and should be ready in the coming weeks.
The advanced business process automation based on RAI assessments, has been refined and is functional. An updated version including end-to-end automation (from the assessment or the medical request to invoicing) shall be available by Q2, 2018.
4) Other updates:
Multilingual module is now available and any language could be supported by filling-in a single source file. coreERP could handle any new language in a week.
Activity reports and time sheets are 50% completed.
As planning of the visits may require extensive computation, we’ve decided to incorporate coreERP with existing solutions instead of implementing the whole solution ourselves. Several partnerships are currently being discussed.
eMEDICS.org Health Care Network (EHC Network): our EHC Network implementation is progressing and will be opened to all physicians, clinics, pharmacies, Home care organizations, hospitals and insurance companies (with the preservation of medical data of patients), and patients themselves, facilitating the exchange of medical information by Q4 2019. A catalog of forms will be available to medical organizations, which will allow them to set better diagnosis and share data with the patients (patients could also provide health measurements over time).
The considerable hype around blockchain is starting to be tempered by enterprises earning practical experience and identifying worthwhile use cases for the technology.
Most of the buzz around blockchain in healthcare has focused on EHRs, interoperability and security, but a new potential for value-based care, precision medicine and a patient-driven healthcare system are emerging as more clear and present opportunities for the distributed digital ledger technology.
While we don’t expect the hope for data interoperability and security to fade away, hospital executives who want to stay abreast of what’s really happening with blockchain will also need to understand these new considerations.
Blockchain and the move to value-based care
A variety of possible use-cases for blockchain are coming into focus for healthcare, ranging from clinical to financial to administrative.
“Traditional healthcare fee-for-service payment systems are overly complex and expensive from an administrative perspective. On average, payment administration accounts for about 14 percent of healthcare spending. Blockchain applications can definitely reduce the waste,” said Corey Todaro, chief product officer at Hashed Health, which leads a consortium of healthcare companies focused on accelerating innovation using blockchain.
Beyond fee-for-service, blockchain as a technical architecture can enable value-based payments to take off and thrive, some experts said.
“Blockchain can enable a smart payment system to match the distributed care teams that will take responsibility for episode- and disease-centered payment models,” Todaro added.
Claims adjudication and billing management is ripe for a blockchain-based system that can provide realistic solutions for minimizing medical billing-related fraud; this is a highly relevant use-case given the amount of fraudulent activities around improper medical billing and reimbursements across the payer industry, said Tapan Mehta, market development executive in the healthcare practice at DMI, a mobile technology and services company.
“For example, in a situation where a health plan and patient are dealing with a contract, the blockchain could automatically verify and authorize information, as well as the contractual processes, eliminating the back-and-forth between multiple parties,” Mehta said. “This would increase transparency and efficiency, leading to lower administration costs, faster claims processing and less money lost.”
Precision medicine and a patient-driven healthcare system
Blockchain-based systems could help drive unprecedented collaboration between participants and researchers around innovation within medical research, particularly in the fields of precision or personalized medicine.
Maria Palombini, director of emerging communities and initiatives development at the IEEE Standards Association, said that blockchain can enable the patient-driven healthcare system.
“The lack of interoperability among data systems in a personal health network is a detriment on patient care,” she said. “Informed patients know that data is critical to enhancing their care and safety. This is beyond safety from data hacks, this is the ability for their healthcare providers to have access to information that will help them better treat the patient.”
There has been a trend in educating patients to manage their health to embrace wellness and prevention, and that may also include the data that is generated out of this practice, she added.
The best type of patient is an informed patient. If blockchain can deliver a patient-managed EHR system, the business of healthcare will be about delivering service and treatment to better health and not owning the patient’s health, Palombini said.
Precision medicine in clinical trials presents another big opportunity for blockchain innovation, Mehta said.
“According to IgeaHub, it is estimated that about 40 percent of clinical trials go unreported,” he said. “In fact, a majority of pharmaceutical research related to clinical trials is completed in silos, thereby making collaboration across an organization’s internal team impossible. This creates crucial safety issues for patients and knowledge gaps for healthcare stakeholders and policymakers.”
The contribution of wearables
Wearables and internet of things devices can also be integrated into the health IT ecosystem via blockchain.
“Health wearables are currently hoarding critical information for clinical research, outcomes of treatments, and disease prevention and management,” Palombini said. “However, in its current state, the information often sits in a repository where raw data may be inaccessible and never has the ability to be shared for other uses.”
If validated, this health data could be secured, shared and verified on a blockchain and the function of the health wearable takes on a whole new role, with, for example, clinical trial patient recruitment, clinical research and treatment of disease.
Indeed, patient-mediated health data exchange holds a big opportunity for blockchain innovation in healthcare. Blockchain can empower patients and data owners to control access to their healthcare data by using the blockchain as a system of record for patient consent and health data transfer activity.
“Today, patients have little access to their health data and cannot easily share with researchers or providers,” said Shahram Ebadollahi, chief science officer at IBM Watson Health. “Giving patients the opportunity to share their data securely, for research purposes or across their healthcare providers, creates opportunities for major advancements in healthcare. Blockchain technology is designed to make this a reality.”
As more and more patients gain that kind of control over their own data it will flow more efficiently across the system to create something a lot closer to a longitudinal view than what exists now and that, in turn, can enable more accurate data, better access to new treatment options and ultimately improved outcomes, Ebadollahi said.
Yes, this is where electronic health records come back into the blockchain picture.
Blockchain and EHRs
One big question is how might blockchain affect the evolution of the electronic health record? Blockchain can enhance EHRs in many ways, presuming healthcare CIOs and other executives want to move in that direction.
“Blockchain will help connect electronic health records across providers, to enable the full view of a patient’s health data, if patients provide the consent to do so,” Ebadollahi said. “This would be through a patient-mediated health data exchange.”
Currently, EHRs focus on clinical data. The fastest growing type of information is exogenous data, from mobile devices and medical devices and including genomics, Ebadollahi added, and blockchain can help connect these disparate sources to the more traditional clinical data.
The electronic health record, in fact, is generated from many different sources – hospitals, doctors offices, labs and more – each acting as the owner of the data. The fragmented network tying things together can be viewed as more about maintaining the business of patient care.
“If we look at the truly disruptive and emerging trend in blockchain and healthcare, the EHR will be created, maintained and distributed by the patient,” said IEEE’s Palombini. “Therefore, no longer multiple health records owned and operated by Healthcare Inc. Instead, it will be one record with multiple compartments containing data that was extracted as a service by one of these entities and given back to the person to add to their health record.”
These entities will no longer own a patient’s health record; they will merely contribute to the data in it as a rendered service, she added. Blockchain could flip the ownership and maintenance of the EHR completely upside down. It could empower patients to choose with whom, how much, and when they want to share their information, and not be beholden to any health system, she said.
Dave Watson Chief Operating Officer of SSI Group said that EHRs and blockchain working together have a long way to go.
“First, EHR vendors have so many pressing enhancements to deliver, and second, without clear and compelling use-cases, why would EHR vendors move blockchain up in the development queue?” Watson pressed. “They may entertain some proofs of concept or simply make positioning statements so they don’t appear to not be on the bandwagon, but that’s not a viable deployment of the technology.”
Blockchain and security
Another area in healthcare where blockchain could have a profound impact, like with EHRs, is cybersecurity. Blockchain can fundamentally change the way healthcare CISOs and infosec teams think about securing data.
“Blockchain offers a new combat strategy because it is not simply a security system, it is a technology that compels every enterprise professional to rethink their business operations in a digital universe,” Palombini said. “Blockchain is not a patch. It’s a whole new approach to distributing, managing and verifying information in a tamper-proof, decentralized system.”
All transactions are time-stamped and replicated in every block visible to permissioned users but can never be altered, only appended. The decentralized nature of the blockchain provides the ability to distribute anonymized, encrypted data that can be verified by credentialed users.
“This can provide traceability for all health data access, with transparency to auditors,” said IBM’s Ebadollahi. “Blockchain can provide integrity of data by maintaining indelible hashes of the data, so that any alterations of the data are detected.”
The distributed digital ledger technology can also can maintain keys for access to data, adding another level of security by working in concert with other systems to produce immutable audit logs, thereby making illegitimate access more difficult, Hashed Health’s Todaro said.
The largest opportunity is rethinking the movement of data in the healthcare ecosystem. Todaro explained that blockchain enables the development of light-data transactional models in which partners can get expanded utility without having to do large-scale data transfers or availability, both of which are sources of cybersecurity risk.
“One might argue that it may not be blockchain the technology that is oversold, but the amount of work to fix existing taxonomies, protocols and policies to fully maximize blockchain may be undersold.”
Maria Palombini, IEEE Standards Association
Hype outpacing reality?
In the end, one might wonder whether blockchain is all it’s cracked up to be. Evangelists sure make blockchain sound like a panacea for all of healthcare’s woes. But is it? Or is there more hype than promise?
Today, the challenge in truly driving innovation in the healthcare system is the inability to obtain and share clean patient health data while maintaining data privacy. The current crop of data management systems are not designed to evenly negotiate the ability to share data while retaining privacy, so the default has been to safe-harbor the data and let data-sharing fall to the wayside.
“The lack of data-sharing has become a true impediment to advancing innovation in drug development and healthcare,” Palombini said. “The true value healthcare providers offer is not the service or product but the data they provide. The data is the key to innovation in finding treatments, disease prevention and more.”
The very nature of blockchain – to distribute information with anonymity in an encrypted and tamper-proof environment – provides the platform to overcome this critical barrier of data-sharing and privacy, Palombini said.
As history has shown time and again, however, technology for technology’s sake cannot fix all problems.
“One might argue that it may not be blockchain the technology that is oversold, but the amount of work to fix existing taxonomies, protocols and policies to fully maximize blockchain may be undersold,” Palombini said.
“It’s important to remember we are just at the beginning of blockchain’s potential in health, so it will take some time before its benefits are fully realized.”
Shahram Ebadollahi, IBM Watson Health
An evolutionary journey
Palombini said that there are already more than 100 blockchains in existence across multiple vertical industry sectors.
“It’s important to remember we are just at the beginning of blockchain’s potential in health, so it will take some time before its benefits are fully realized,” IBM’s Ebadollahi said. “But it’s potential should not be underestimated.”
In the next five to 10 years, patient consent and data exchange backed by blockchain could fundamentally change the way healthcare services are provided by making patient longitudinal data readily available and opening the door to new treatments, new care delivery models and better coordination of care, IBM’s Ebadollahi explained. He pointed to blockchain underlying precision medicine and wellness programs outside the health systems as potentially having a large impact on outcomes.
And the matters of blockchain’s inherent limitations with respect to scalability, confidentiality and governance still need to be ironed out, SSI Group’s Watson said.
Working through those thorny issues will be an evolutionary journey for blockchain-based healthcare applications. Trust and governance are key as the interval between proof-of-concept production-quality technologies gets shorter. And building blockchain networks will require a lot of heavy lifting by software vendors and hospitals alike.
A visit to the hospital typically ends in a doctor prescribing a particular set of medications, the details of which are printed on a physical form and handed to the patient. The patient must then take the form and submit it to a pharmacist.
Looking to overturn this traditional model, South Korea has set out to start digitizing prescription forms and make them accessible via mobile devices.
The Korea Internet & Security Agency said Tuesday that it has signed a Memorandum of Understanding with Seoul National University Hospital and Samsung Medical Center to create and implement a new service that digitizes prescription forms.
Under the agreement, the two hospitals will deploy a new system that lets patients receive and access prescriptions via their mobile devices, offering them convenience and an organized digital database of their prescription records that can be used for future personalized medicine services, KISA said.
The system will be adopted by the two hospitals within the first half of 2018, according to the Seoul-based internet technology agency.
In addition, implementing mobile-based prescriptions will save 2 million pieces of paper per year and allow pharmacies to retain their prescription records in an organized way without physical hurdles, it added.
KISA did not state whether it would expand its prescription digitization project to additional hospitals.
Digital platforms – As Australia’s healthcare system creaks under the strain of ageing baby boomers and a looming chronic disease crisis, digital solutions like telehealth, big data and the internet of things (IoT) are joining to drive more effective and affordable care, while helping to identify solutions to problems that are yet to even arise.
Australia’s healthcare digital system faces some daunting challenges over the coming years and decades.
With an ageing population and rising incidences of chronic disease, current healthcare resources and funding models are already buckling under the strain, demanding that policy makers and health professionals develop new ways of thinking and problem-solving.
According to Philips Australia and New Zealand managing director, Kevin Barrow the immediate challenge facing healthcare systems is how to develop proactive, rather than reactive, approaches to patient care.
Typically, the older people get the greater the chances they will require hospitalization when they are ill. This is one of the biggest cost burdens on Australia’s healthcare system, while the rising incidences of chronic diseases like diabetes and heart disease across the board, put further pressure on the system.
Data from the US Department of Health and Human Services, and other sources, reveals that in developed countries, as little as three per cent of patients are deemed sufferers of chronic disease. Yet this group uses up to half the available healthcare resources.
This should come as a wake-up call for Australia’s healthcare industry, which has so far been slow to adapt, Barrow says. “Most of our healthcare digital systems haven’t changed in 100 years in terms of how healthcare is delivered.”
Many health facilities and organizations are still bogged down in proprietary legacy systems that can’t talk to each other.
For instance, there are several different imaging and health record systems in Australia, meaning that hospitals and clinicians waste time trying to access patients’ medical histories.
This helps to explain why the fax machine remains an essential – yet extremely wasteful – tool for hospitals and health professionals. Delegates to the recent Royal Australian College of General Practitioners (RACGP) eHealth Forum in Melbourne, were told that some 1 billion pieces of paper are generated by Australia’s healthcare system each year.
Barrow says that often when patients are admitted to hospital, or visit a doctor, the issue is something that could have been dealt with without a physical consultation, if the right systems were in place.
Strong telehealth – or digital telemedicine platforms – allow patients and doctors to interact and engage remotely. Combined with robust, secure digital systems supporting easy access and sharing of patients’ health records, a picture begins to emerge of a more efficient, cost-effective system able to support true continuity of care.
In mid-2016, Philips published the Future Health Index (FHI), a comparative international study analyzing the readiness of healthcare operators around the world to meet the challenges of the future. Some 200 healthcare professionals, and 2,000 patients were surveyed in Australia.
All respondents revealed a strong desire for systems supporting better interaction and data sharing between doctors and patients. However, the survey also showed there’s quite a long way to go.
Most notably, almost three-quarters (70 per cent) of patients said they were having to repeat information about their health each time they visited a different health professional. Other data revealed frustrations around accessing health records, both for patients themselves and people trying to provide homecare to sick relatives.
As one of the world’s leading providers of healthcare innovation, Philips has been involved in a number of important initiatives helping chronic disease sufferers better manage themselves.
Mid-2016, Philips published the results of a three-year ‘self-supported care’ program involving almost 2,000 patients in UK city Liverpool living with chronic, or long-term conditions (LTCs) including diabetes, heart failure and chronic obstructive pulmonary disease (COPD).
The trial sought to improve patient awareness and emotional well-being by combining innovative telemonitoring equipment with a ‘clinical hub’ and a program of case management, monitoring, education and coaching for patients with varying levels of long-term disease. The results included reductions in emergency admissions and secondary care costs ranging from 22 to 32 per cent.
In late 2014, Philips and US-provider Banner Health, commenced a six-month ‘at-home’ telehealth trial for patients with multiple chronic conditions, which saw a 45 per cent drop in hospitalizations, 32 per cent drop in acute and long-term care costs, and a 27 per cent reduction in the total cost of care.
“One of the key themes we see emerging in the sector is the needs of patients becoming increasingly linked with those of the clinician,” Barrow explains, adding that connected digital tools coupled with improved clinical capabilities are driving better collaboration and improved ways to manage health.
How big data will disrupt the future of digital healthcare
Healthcare is an extremely data-intensive industry, with no one expecting the deluge to abate anytime soon.
Added to the huge volumes of conventional patient information, such as x-rays, CT scans, pathology reports and the like, personal health records will increasingly contain genetic, proteomic, 3D and other complex data sets, in turn bringing the promise of personalized medicine closer to reality.
Massive shared, or ‘cloud’ computing grids are increasingly able to process and correlate these sorts of data sets with those charting family histories, as well as data on drug compounds, allowing clinicians to finely calibrate treatments in ways undreamt of five or 10 years ago.
As one of the leading innovators in the personalized health space, Philips is working with New York cancer specialists, WMC Health, to build a large-scale informatics platform designed to create individually-targeted oncology treatments based on each patients’ specific genome. The solution features Philips’ IntelliSpace Genomics Solution which will integrate large-scale genome analysis with large patient clinical data sets.
As big data technologies continue to improve, the possibilities for developing even deeper insights into the factors influencing human health and our environment appear vast.
For instance, healthcare organizations are now realizing the potential to correlate data on chronic or communicable disease with factors such as geography, climate and pollution, socio economic background, age, ethnicity and family history to develop more targeted, cost-effective and measurable healthcare solutions.
The huge amounts of data already being generated within digital healthcare are set to increase by orders of magnitude over the coming years as the expansion of the Internet of things (IoT) gathers pace, potentially linking billions and billions of electronic devices and sensors.
These digital devices and sensors will generate and share still more data, and with them will come more opportunities for discovery. New and emerging systems will add further impetus, morphing and adapting environments as they evolve.
As one of the world’s leading makers of high-end medical devices and solutions, Philips sees IoT as a critically important driver of healthcare innovation moving forward, with implications at the individual level as well as the macro level helping us develop a better understanding and better strategies to prepare for the healthcare challenges that lie ahead.
Harvard researchers predict that contact-free continuous monitoring platforms have the potential to save the healthcare industry as much as $15 billion. By Jeff Lagasse, August 04, 2016
Contact-free continuous monitoring, a platform that taps into sensors to measure patients vital signs and other metrics, hold the promise to save health systems $15 billion a year.
That’s according to a new peer-reviewed paper published in Critical Care Medicine.
CFCM is used to monitor heartbeat, respiratory rate, ulcers and patient motion. The technology’s components include sensors placed under a patient’s mattress or in a chair, bedside monitor, central display station and in handheld devices.
The sensors measure vibration and calculate motion, heartbeats per minute and breaths per minute, which detect any changes from regular patterns. If a patient’s status changes, the platform alerts nurses through large screens set up in conspicuous locations, as well as handheld devices.
Researchers from Harvard School of Medicine in a new Frost and Sullivan report entitled “Finding Top-Line Opportunities in a Bottom-Line Healthcare Market” claimed each hospital bed monitored with the EarlySense CFCM approach enables hospitals to achieve a cost savings nearing $20,000.
The cost savings are attributed to clinical outcome improvements published by hospitals implementing CFCM. Evidence suggests the technology can assist clinicians in earlier detection of patient deterioration, helping to reduce patient length of stay, minimize use of intensive care units, reduce falls and pressure ulcers and avoid cardiac and respiratory arrests.
The $15 billion figure was arrived at by extending the savings to all 750,000 relevant beds in the U.S. hospital system. The estimate does not take into account those patients in beds outside the hospital setting.
Clinical data also estimates that use of EarlySense has the annual potential to reduce patient falls by 301,809; reduce pressure ulcers by over 1 million; slash ICU days by about 1.7 million; eliminate more than 259,000 “Code Blue” events; and avoid close to 208,000 deaths.
“The healthcare industry is constantly working to improve efficiency,” said Charlie Whelan, Frost and Sullivan’s Transformational Health North America consulting director, in a statement. “These studies show that continuous monitoring presents a unique opportunity to create both top and bottom line benefits, while simultaneously improving quality of care.”
CEO Spotlight: American Well’s Roy Schoenberg on the U.S. coming out of a 10-year telehealth war zone
By Bill Siwicki, August 05, 2016
As providers, payers and patients align in what Schoenberg calls a national play for delivering real-time care anywhere patients and providers can connect, telemedicine stands ready to revolutionize healthcare the way Amazon has rewritten retail.
After a long decade of struggle, the stars have aligned for telemedicine, according to Roy Schoenberg, MD, CEO and co-founder of telehealth technology and services vendor American Well. And the understanding and acceptance of providers, payers and patients have united to the point where the electronic delivery of healthcare is poised to become part of the norm.
“First, medical authorities, policymakers, and healthcare’s movers and shakers have acknowledged that delivering healthcare through technology can be valuable and safe; that has been the war zone for the last 10 years of telehealth,” Schoenberg said. “Medical boards and medical associations were hesitant about embracing telehealth; physicians were concerned about diminishing the relationship they have with patients. But the experiences with telehealth during the last couple of years have been reassuring, and telehealth increasingly has become one of the ways physicians interact with patients.”
Second, insurance companies that while label American Well technology including Anthem, United Health Group and several of the big Blues have finally begun to take the stance that, like in any other industry, digital mechanisms are here to stay and will be a major part of the industry’s future; as a result, payers are getting on top of telehealth and discovering how to conduct such care safely, Schoenberg said.
“Payers are understanding that the efficiencies and even the humanitarian value of allowing healthcare to be delivered in this manner are overwhelming,” he added. “If you can shift healthcare via the internet to more private home care settings, for example, you not only are saving costs of emergency room visits and inpatient stays, you are changing how and when appropriate healthcare can be rendered. Telehealth, for instance, can have a very deep impact on how chronic patients are managed.”
And third, enough time has passed that telemedicine technology vendors have gained the experience – and learned lessons from mistakes – so that the vendors are completely capable of providing safe and comprehensive care via technology, Schoenberg said.
“Vendors have made corrections to the patient experience and physician usability, for example, and have learned how to foster intimacy in these kinds of healthcare encounters,” he explained. “Between the adoption of electronic delivery as a valid way of doing medicine, the payment structure, and all of the factors that affect the physician-patient experience, the stars have aligned to cause what we see today, which is a booming market.”
What’s more, telemedicine tools and practices are becoming more embedded into the routine delivery of care among providers that also white label American Well services such as Cleveland Clinic, Community Health System, Intermountain, Miami Children’s Hospital, Providence Health System and others — even employers are getting into the act, such as clients Oracle and Honeywell.
So what are the next steps? Schoenberg points in two directions.
“From the patient standpoint, we will see very quickly the transition of telehealth from just the myopic quick urgent care example of finding a physician to prescribe antibiotics to something that envelops all of healthcare, especially patients who need serious longitudinal care and frequent interaction with physicians, which increasingly is tied into things like accountable care organizations,” Schoenberg said. “We will see telehealth serving as a part of the overall relationship with patients.”
Schoenberg said American Well today is seeing provider organization clients developing telehealth programs around things like heart disease and autism, and that this sort of care will become the prevailing way healthcare executives and providers think of telehealth.
“No longer just the mother with a child in a stormy night who needs to see a physician kind of stuff,” he added. “Telehealth for ongoing clinical relationships will become the avalanche of this technology.”
On the other end of the spectrum, at the national level, Schoenberg said another next step in the evolution of telemedicine will be the realization of benefits derived from the notion that healthcare can be extended through technology so that patients are no longer married to a facility.
“If we bring together organizations that represent demand for healthcare and allow them to electronically interact with care delivery organizations, then that will not be unlike what online retail has done to the retail industry – we will be able to expand on how healthcare is being rendered and where it is being made available,” Schoenberg concluded. “This is a national play for the delivery of real-time healthcare that is embraced by the provider and the payer brands that will be available wherever the internet goes. That is how Amazon has rewritten the retail industry.”
Digital health tools: a new study found that patients of all ages, with Baby Boomers leading the charge, are interested in accessing medical records online and tapping into portals to book appointment, pay bills, and refill prescriptions.
By Jack McCarthy
Nearly 75 percent of patients expressed a high level of interest in accessing their electronic medical records via digital tools, according to new research, and 33 percent indicated that EHRs have already changed their experience for the better.
“The patient experience is dramatically transforming,” CareCloud CEO Ken Comee said in a statement. “Patients of all ages are actually embracing digital online patient engagement tools from scheduling appointments to accessing their medical records and making online payments.”
Contradicting stereotypes that millennials are the leading technology adopters, a CareCloud survey of 1,443 patients determined that Baby Boomers (51-65 years of age) are the group most likely to use healthcare tools.
Sixty-two percent of baby boomers, in fact, use technology to access their health records, while 50 percent engage with health IT tools to request prescription refills, and 43 percent to ask their providers care-related questions.
When asked what was the preferred platform of interaction with a medical group, 35 percent listed online patient portal; phone calls, 29 percent; emails, 21 percent; mobile application, 8 percent; and text messaging, 7 percent.
More than 25percent of patients have completed an online review of their doctor.
“This survey of the patient experience only reinforces the importance of technology in modern medicine,” Comee said.
The healthcare industry is at a unique crossroads in regards to innovation. Has the urge to innovate accompanied with the consumerism of care driven us down a path that could impact clinical quality? Perhaps. At least that is what American Medical Association’s (AMA) CEO James Madara, MD cautioned in his original and expanded comments regarding digital health technologies as the 21st century’s “digital snake oil.” These three little words generated strong reactions on both sides.
HIMSS, PCHA and many others agree that misleading technologies guised as clinically valuable applications have no place in healthcare. But we must be careful not to lump all digital health technologies under one umbrella as many have already had a positive impact on people’s lives and our healthcare system as a whole.
Let’s celebrate how far digital health has come
Digital technologies have already improved care delivery in a number of areas. Organizations such as the Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center (UPMC) have implemented digital technologies that provide warning alerts for patient deterioration; in the program’s first year, UPMC clinicians prevented 132 intensive care unit visits for children and $5 million in savings. Missouri Health of the University of Missouri Hospital demonstrated the power of clinical decision support with catheter removal procedures as they reduced their Catheter-Associated Urinary Tract Infections by 25 percent (rates went from 6.0 to 4.5 in one year).
These are just two from hundreds of examples across the U.S., Canada, and around the world. And clinical studies havetime andtimeagaindemonstrated the value of remote monitoring technologies.
Mobile apps, sensors and remote monitoring devices and trackers are also demonstrating significant benefits in improving health, wellness and clinical outcomes. For example, congestive heart failure patients monitoring their vital signs and then transmitting personal health data to their provider, reduce their hospital readmissions by over 50 percent. Mobile apps and texting programs help to improve medication adherence and empower individuals to make important behavior changes to better self-manage their health and wellness.
Digital health: onward
Health and wellness tech have the highest Compound Annual Growth Rate (CAGR) in the mobile market (48.1 percent); and 78.5 million consumers will use home health technologies by 2020, this market represents a significant opportunity. As Christina Farr of Fast Company wrote, however, “not every app is created equal.”
Two things to keep in mind: first, as with any new market, there’s a flood of products – some good, some bad. This is healthy because an environment of innovation and creativity is in the best interests of the consumer. We need tools like data analytics, clinical testing, product evaluation, and design and needs assessment; all of which help ensure a more personalized and seamless experience for users.
Looking ahead, we must work to bridge the “app and research gaps” – i.e., aligning product development with consumer needs. Abody of evidencesubstantiating the tangible value of health IT is freely available online to help users understand how to extract value from adopted technologies and achieve long-term successful use of personal connected health devices.
As an industry, our focus is clear:
Person-centered design is a must. Personal health technologies and devices must be plug-and-play, easy-to-use and intuitive.
Reimbursement for connected health devices will be key to achieving widespread support and adoption from clinicians and engagement by consumers.
Interoperability, the seamless, standards-based, secure exchange of personal health information between individuals and their care team, is a must as well. PCHA’s Continua Design Guidelines, as well as cross-sector alliances such asIHE and the CommonWell Health Alliance are actively ensuring the right information is available to the right people at the right time.
Personalization is necessary in order to achieve long-term engagement. Data analytics allows us to finely tune the messaging and interactions, thereby creating a highly personalized experience to keep an individual engaged and motivated to achieve their health goals.
Consumer choice driving innovation
“Snake oil” and the degree to which it has captured headlines is indicative of the crossroads we have reached. We can innovate and move forward, but we must do so within the Hippocratic oath, to “first do no harm.”
The sector must ensure that there is a systematic way that consumer-facing mobile apps and other digital health technologies are being clinically validated.
As consumers, we all also have the responsibility to use the power of choice to our advantage. We have the ability, and duty, to make informed choices about what gadgets we put on our bodies or technologies we use to improve our health. Consumer demand and preferences for digital health technologies, accompanied by ongoing product innovations and highly-credible studies to evaluate effectiveness, will drive health improvements over time and leave accusations of “snake oil” in the dust.
Africa market – eMEDICS.org (YFORM Ltd) has come up with an innovating way of allowing users to convert their paper forms to mobile and start collecting data from anywhere instantly.
YFORM Ltd builds forms that are suitable for worldwide market and especially Africa. We share these forms with our clients through a form catalog. Using the app, team members can log in and start collecting data on mobile devices.
The aim of the technology is to collect data better including pictures, GPS locations, sketches, audio and video, with the platform working both online and offline.Africa is an economy that relies heavily on paper forms for 60 per cent of its processes. Another 20 per cent collect data in silos, are not integrated and face a huge challenge collecting data from remote areas with little or no internet connectivity,”
Moreover, paper-based data collection moves slowly, taking hours or days to get from the point of capture to the point of entry, and is also prone to damage and loss. YFORM Ltd aims to tackle all that.
The possibilities for YFORM Ltd, are unlimited.
“We can replace paper forms completely and be the gold standard for data collection in Africa,”
“It’s a huge market, and we have not even scratched the surface in Africa yet. We have a few contacts who have expressed interest in our product from other African countries, and also India.”Initially, YFORM Ltd struggled to understand how to implement its technology, and how to handle the extremely poor connections in remote areas. We eventually got the hang of it.
“Now all we struggle with is meeting the ever-increasing demands of our clients, always a good sign,”
“In five years we expect to be the data collection tool of choice for all NGO projects in Africa and endorsed by major NGO funders like USAID, the WHO, and the World Bank.”