The pMD Blog

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pMD Blog...

where we cover interesting and relevant news, insights, events, and more related to the health care industry and pMD. Most importantly, this blog is a fun, engaging way to learn about developments in an ever-changing field that is heavily influenced by technology.


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Here's The Latest in Health Care:


Google is continuing to push its way into health care, but its most recent partnership with Ascension has triggered a federal inquiry. The Department of Health and Human Services' Office for Civil Rights will investigate Google's efforts to collect health data on millions of Americans.  Read More

If sometimes it seems like the health care industry is stuck in the 1970’s, you are not imagining it. According to a new survey, 89 percent of health care organizations are still heavily reliant on a piece of technology that many consider obsolete, the fax machine. How can we expect these organizations to communicate effectively when they are stuck faxing important information back and forth?  Read More

It may be up to the big-box retailers to revitalize rural health care. For the millions of Americans who struggle to get affordable, timely medical care these retailers can offer a convenient place to turn to. Adding telehealth capabilities to our existing retail infrastructure could significantly expand access to top-notch care—and reduce costs for patients and the health care system.  Read More

While there is no doubt that machine learning (ML) applications will dramatically improve health care, we have a tendency to get a little overzealous with predictions. CEOs from across health care have identified three common myths surrounding the future of ML in health care.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.


Here's The Latest in Health Care:


Google is stepping further into healthcare, acquiring Fitbit for a whopping $2.1B. Amidst customer concerns, both companies have acknowledged that health and wellness data will not be used to target Google-sold ads.  Read More

• Not a shocker, but a new research survey suggests patients heavily value health care companies with better consumer experiences. A large majority of those consumers expect these companies to provide more engaging and accessible health care messaging services.  Read More

A staggering 93 percent of health care organizations have experienced a data breach in the last three years according to a new report. This year alone health care data breaches stand to cost the industry an astronomical $4 billion.  Read More

CMS is attempting to significantly reduce clinician burden that is getting in the way of patient care. To do so, the organization is conducting the first major overhaul of E/M office visit documentation and coding in more than 25 years.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.

At pMD, we are passionate about creating technology that not only improves patient care but stays up-to-date with the ever-changing needs and requirements of our practices. We realize the way in which providers practice medicine is changing, and we need to be able to support them in successfully navigating these changes. One newer feature of pMD is video calling, which enables provider-to-provider and provider-to-patient communication and brings telemedicine to our customers. While countless specialties benefit from telemedicine encounters, I’d like to highlight our friends in long term care (LTC) and how telemedicine can alleviate some of the stressors they are facing.

After working with my fair share of providers in LTC, one concern I heard repeatedly was about keeping their patients from being readmitted to the Emergency Department (ED). Of course, this is a concern because they want their patients to improve, but also because CMS is now penalizing LTC facilities when a patient who had been discharged is readmitted to the ED within 30 days. These penalties are hefty, and often have a tremendous impact on facilities where a large part of the population is covered by Medicare. Last year alone, 11,000 Skilled Nursing Facilities (SNFs) were penalized by Medicare. So why are these readmissions happening? Well, imagine this: your grandfather was discharged after a 2-week stay at an SNF. A couple of days later he complains of shortness of breath, but it’s a Sunday, and his doctor’s office is closed. Without a way to contact a member of his care team, you are left with little choice but to head back to the hospital. What if you have the ability to triage his symptoms over video conferencing? This could prevent readmissions by contacting a provider on his care team to determine whether or not a trip to the ED is necessary or if he can wait until the office is open on Monday.

Another challenge is providing care for a population that has a variety of conditions and comorbidities. The majority of providers I speak with are excellent primary care providers and feel passionate about their work. However, they are not specialists in fields such as nephrology or cardiology. For many of these patients, they come in with not just one condition, but a laundry list of problems, where outcomes would be improved if under the care of not only a primary care provider but also specialists who can monitor and treat more complex diagnoses. In order to get a care team on the same page for treatment, and thus improving outcomes, telemedicine provides an easy way to connect providers from all backgrounds and ensure the treatment plan sets the patient up for long-term success.

Lastly, the field of medicine is seeing a shortage of geriatric providers. According to the American Geriatric Society, there will be a 45% increase in demand for geriatricians between the years of 2013 and 2025. Many people are living longer due to advances in medicine and, therefore, the elderly population is growing faster than is scalable. Many providers select other specialties, either because they are unaware of this niche or because the thought of caring for geriatric patients with many comorbidities can be daunting. Telemedicine can help in this area, especially in rural areas, as providers can still see and care for these patients, even if they are not at their bedside. This technology improves provider bandwidth and allows them to manage a larger patient census remotely.

Telemedicine can improve provider quality metrics by making providers more readily available during off-hours, reducing readmissions and ED visits. This availability allows patients to have their symptoms triaged in real-time, and also allows providers to more easily collaborate regarding patient care. Lastly, because LTC providers are often dealing with a growing elderly population, telemedicine broadens their reach and enables them to see more patients, without having to travel. While there are likely other use cases I haven’t yet covered, it’s clear that telemedicine will be a valuable tool for LTC providers.

To find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.


Here's The Latest in Health Care:


The NICU can be a scary, stressful place for families, but two Wisconsin hospitals made an effort to ensure Halloween was a little less scary. Aurora Health Care holds an annual costume contest to ease some of that tension, and the costumes are too adorable!  Read More

The nation's two ride-sharing giants continue to go head-to-head, each making a big push into healthcare. Uber will now integrate with Cerner giving caregivers the ability to schedule rides for patients, while Lyft will be providing covered rides for eligible Medicaid beneficiaries.  Read More

Telehealth may soon see a big boost thanks to new legislation introduced by The House of Representatives. Addressing the information-sharing and connectivity infrastructure necessary to provide virtual care programs is essential to making large scale adoption of telehealth a reality.  Read More

Sometimes we all need a little push to get us to the doctor. Add reminders for health tests and screenings to the list of notifications you will be getting from Facebook. Working closely with U.S. health organizations, the social media giant will begin to offer a new preventive health tool that connects people to resources and check-up reminders.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.


With the creation of MyHealthEData, and through current rulemaking, the Centers for Medicare and Medicaid Services (CMS) is pushing significant new data-sharing requirements into the market.  The new rule opens all types of doors in its effort to improve data transparency and data velocity throughout the system.

The core tenets are:

Ensuring patients have access to all health data where CMS has programmatic authority:

Any payors involved in the following programs are required to have open APIs (Application Program Interfaces): MA organizations, Medicaid programs (both FFS and managed care), CHIP (including FFS and managed care), and QHP issuers in FFEs.

These open APIs will allow patients to empower a vendor to access their claims, encounter data, utilization history, and any clinical health information (such as lab results when available) the payor may have. Payors are also to make their plan directory available through these APIs and have to share care coordination data with each other.

Electronic patient event notifications:  

As a condition of participating with Medicare and provided their EHR has the ability to produce and send an Admit/Discharge/Transfer (ADT) message, it is being proposed that hospitals should send notifications to those practitioners or providers that have an established relationship with the patient relevant to his or her care. (The requirement is waived if the receiving provider can’t receive such messages.)

Prevent information blocking:  

Providers who are not making patients’ clinical data readily available will, essentially, be publicly shamed into compliance as CMS aims to share provider attestations that the provider complies (or doesn’t) with interoperability requirements laid out in updated MIPS rules.  In my opinion, this is a seemingly weak penalty for non-compliance so hopefully, CMS tightens this to improve accountability.

So how might care be impacted by these changes if implemented largely as proposed?  

Where are patients likely to engage with this information?  How about providers?

Patients, to date, have shown little interest in actively engaging with their health care data on their own (consider almost every provider’s struggle to get Portal engagement) - what will Medicare/Medicaid patients do with their claims history?  It’s possible applying algorithms to claims data to identify at-risk profiles might generate patient-level demand but the marketing will have to be focused and on point.  

The first real-world test of the data typically available is Medicare’s Blue Button API (now in version 2.0).  As of October, there were 1,200 software developers in the sandbox and 100 - 200 patients had downloaded their data.  It’s possible this gap between developer engagement and patient engagement represents a lag from the time it takes to create an application to generating demand for the information.  I think it also highlights that age-old health care problem of an abundance of data and little of it valuable or comprehensible to your average individual. At the end of the day, how do you engage a patient to make their best health care choices when those choices are either deeply complex or rarely and erratically occur?

The other audience, of course, is providers.  Claims data provides a history of activity which can complement the clinical care history each participating provider can access.  They can see diagnoses and procedures which both carry useful information in any given provider’s ongoing care of the patient and supplement their clinical inquiries.

The second benefit of having access to claims data is in optimizing HCC scores.  Since a primary input of HCC scores are all the diagnoses a patient accumulates during the year, having access to a comprehensive list of billed diagnoses allows for any given provider to potentially optimize the patient’s HCC scores.  If this market evolves, payors could fully decentralize HCC scoring (with appropriate incentives) to providers. Considering the HCC score paradigm is national, and zero-sum, it can be expected there will be a rush to claim this space and a handful of winners should emerge.

The health care market continues to be pushed to evolve as the population ages and inflation marches on.  You should consider the technology companies you work with and ask if they have the history, the people, and the capabilities to help you navigate a market where changes can dramatically impact your bottom line and your outlook.  At pMD, through our expertise in mobile charge capture, secure clinical communications, and care navigation we strive to meet our customers where their future needs live.  See what we are about at www.pmd.com.


To find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.


Here's The Latest in Health Care:


Clinician burnout has become an epidemic in the U.S., something that will certainly require major systemic changes to address. In a new report the National Academy of Medicine outlines six goals to prevent and mitigate burnout. This report is reminiscent of organizations "To Err is Human" report 20 years prior that launched a systematic overhaul to improve the quality of care and address medical errors.  Read More

Remote care technology has started to earn the trust of patients resulting in a growing appetite for online chat and diagnosis tools. According to a recent survey more than half of Americans say online tools have helped improve the relationship with their primary care provider. In addition, more than half of patients are also currently monitoring their health with at least one digital data collection tool.  Read More

CMS has keyed in on AI as a possible tool to fight fraud and abuse in Medicare and Medicaid. Among other applications, CMS is looking to the private sector to help identify how AI and other technology can be used to ensure proper claims payment, reduce paperwork, and maintain program integrity.  Read More

Digital health technology is not nearly as accessible and useful for residents of urban and rural underserved communities, or not yet at least. A collaboration between The United Health Foundation and the Morehouse School of Medicine’s National Center for Primary Care as been awarded a $1.1 million grant to address the barriers. This research will ideally lead to improved outcomes, a better patient experience and lowered health care costs.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.


instant (adjective): produced or occurring with or as if with extreme rapidity and ease

Instant replay, instant gratification, instant message, instant... oatmeal? Sometimes, when you want something done, you want it done now! Time is a valuable resource, especially for busy medical professionals who are constantly trying to whittle down their to-do list so they can focus on the most important thing - caring for patients!

Doctors have used pMD® Charge Capture™ for decades to save time and get paid faster. Here at pMD, though, the work never stops! Feedback from our user base, in conjunction with our own observations, prompted the question: could we make an already fast and easy process (mobile charge capture) even faster and even easier?

Because we have amazing software engineering and design teams, the answer to that question was happily YES! Mobile charge capture, meet Instant Capture™.

When a doctor or medical provider sees a patient in the hospital for a new admission or a new consult, there’s a lot to initially record, such as the patient’s basic information, the reason for their hospital visit, the physician who referred them, and the initial level of care they received. The doctor performing this consult needs to record all this information in order to get paid for the work she does.

Many patients then go on to stay in the hospital for a few more days for additional treatment and follow-up. It’s common that a patient’s demographic information, medical diagnoses, and referring physician would remain the same for the entirety of their hospital stay. So, while our consulting doctor may subsequently see this patient several more times, there’s no need for her to enter all this information each day. The only thing she needs to update each time she visits her patient is the date and level of care provided.

Our engineering team honed in on an idea to make capturing those follow-up visits in pMD even faster. If a provider sees a patient for a routine, subsequent encounter in which nothing medically has changed from the previous day, how could we make the recording of that visit even faster?

Our new Instant Capture™ feature allows providers to press and hold on a patient’s name from their census list and capture a follow-up charge right from the favorites menu that pops up. One screen, one action, one second - that sounds pretty instant to me! Providers using this feature can complete their daily charge capture in far less time than it takes to make a bowl of instant oatmeal. (Quaker, please take note of the definition of instant - that bowl of oatmeal is still taking a solid two minutes out of my morning.)

We’re so excited to release this update to all providers using pMD® Charge Capture™, saving them additional precious seconds each day. Go forth and capture!

 

Find out more about pMD's suite of products, which includes our MIPS registrycharge capturesecure messagingclinical communication, and care navigation software and services, please contact pMD.


Here's The Latest in Health Care:


A new partnership between Fitbit and pharmaceutical giants Bristol-Myers Squibb and Pfizer is taking aim at early afib (atrial fibrillation) detection. The core focus will be on developing digital tools and educational content to help encourage people to visit their doctor for a prompt diagnosis and reduce their risk of a stroke.  Read More

Type 1 diabetes patients may soon have the power to automatically control blood glucose levels with an artificial pancreas. The diabetes management system includes an insulin pump, glucose sensor and algorithm that automatically monitors and regulates blood glucose levels, improving the day-to-day lives of patients.  Read More

With digital health tools such as wearables on the rise, hospitals are beginning to adopt another emerging trend, technology support desks. Think of Apple’s Genius Bar, but inside of a hospital. These tech bars are are equipped with specialists to teach patients how to use the various new pieces of technology used for monitoring or treatment for chronic disease care.  Read More

Will telehealth mean the end of patient-doctor relationships? Not according to a recent survey, which found that more than 60 percent of consumers believe they can foster a relationship with their primary care physician exclusively through virtual care visits.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.
Recipe for Success

As more health data is being acquired, the utility of that data in improving patient outcomes is also increasing. Artificial intelligence (AI) improves patient care by integrating health data across different platforms. In particular, some of the key areas for AI to improve health care include diagnostic imaging, patient risk analysis, enrollment in clinical trials, and patient communication

AI’s first success in health care was in the field of diagnostic imaging. Machine-learning algorithms can find patterns in images and identify specific anatomical markers. These algorithms can spot details the human eye can’t catch, perhaps greatly improving a radiologist’s workflow. When a radiologist can validate and add to an AI assessment rather than scanning hundreds of images, she has more time to actually spend with her patients. A recent example of AI improvement in radiology is LabCorp and Mt. Sinai in New York City partnering to create the Mount Sinai Digital and Artificial Intelligence-Enabled Pathology Center of Excellence. This partnership will provide doctors and patients throughout the United States access to a digital pathology solution that has been developed at Mt. Sinai. When complex cases come from a larger network, expert pathologists will have more time to analyze and diagnose such anomalies. 

Another area where AI can improve health outcomes is through finer-tuned risk analysis. Self-monitoring devices are giving patients and their doctors access to much more information about a patient’s lifestyle that can be crucial to plans of care. This data can be used to assess if patients are at risk of developing conditions such as diabetes, or even if they are at risk for non-compliance to medication or lifestyle changes. Recently, three Johns Hopkins hospitals set up machine-learning-based systems that constantly scan EHR, lab tests, notes, and radiology tests of every admitted patient. If a patient crosses a threshold for having a high likelihood of developing sepsis, the system sends an alert to just the most relevant providers.

AI can also greatly improve patient enrollment in clinical trials. The current process for clinical trial enrollment often places the onus on the patient to research and find eligible trials. With increased data on a patient’s demographics and diagnosis, integrated with inclusion criteria for ongoing trials, the whole process can be automated to get patients into life-saving treatment. This change can also increase clinical trial success rates if patients are only enrolling in trials that are more well-suited for their conditions. 

Finally, AI has the potential to completely overhaul the way in which patients communicate with their doctors. While current systems of communication have no way of ensuring if patients are understanding the information that doctors are conveying to them, metrics on patient responses can add some clarity to these conversations. There are several methods that are emerging for analysis of conversations between providers and patients. AI can look at things such as the language that providers are using (is it all jargon that the patient may not understand?), turn-taking (is the provider sending too much information all at one time and not allowing for questions?), and analysis of tone and speed of spoken communication to give providers insight into the patient’s understanding of his or her own medical condition. This analysis can also be helpful in the setting when a translator is used, ensuring that nothing is being lost in translation.

Additionally, chatbots are being piloted as an alternative where patients can get access to information on medication, doctors’ schedules or clarifications of doctors’ instructions. This can replace the unreliable information that patients find online that is not specific to his or her own conditions or perhaps just inaccurate. One research report by Juniper Research predicts that the success of chatbot interactions where no human interventions take place will go up to 75% in 2022 from 12% in 2017. This study also predicts that chatbots alone will save $8 billion annually by 2022. 

Also, chatbots can actually be used to deliver Cognitive Behavioral Therapy in much the same way that a psychologist would for patients. This can be particularly beneficial for patients in rural areas who cannot access adequate mental health care or others who do not have the financial means to pay for a mental health provider.  

Dr. Albert Wu writes that “the great irony today is that artificial intelligence may prove to be the force that helps bring that human touch back to the forefront of medicine.”

Source: Getty Images

Here's The Latest in Health Care:


• Digital services for patients are no longer just a nice to have, especially among those under the age of 25. A new study found that patients aged 18-24 are three times more likely to switch providers based on a poor digital experience than those over the age of 65.   Read More

Snapping a picture of your child for Instagram could end up preventing devastating loss of vision. A new smartphone app is using artificial intelligence to detect early signs of several serious eye diseases in children such as retinoblastoma, pediatric cataracts, and Coats' disease.  Read More

Radiologists can now accurately detect pneumonia from a chest x-ray in less than 10 seconds using artificial intelligence. This represents an enormous improvement from previous averages of 20 minutes or more, allowing the treatment process to get underway quicker for patients in the ER.  Read More

The 2019 Nobel Prize in Physiology or Medicine has been awarded to three physician-scientists for their discoveries of how human body cells sense and adapt to oxygen availability. Their work is expected to make a huge impact in the fight against cancer, playing a major role in new treatments.  Read More

Each Friday, Signor Goat reports the latest from the week in health care. Check back next Friday for your dose of our little medical corner of health care news. Brought to you by pMD, innovators in charge capture, secure messaging, clinical communication, and care navigation software.