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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.

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.


Here's The Latest in Health Care:


Surgeons may soon be armed with a new tool at their disposal to support complex structural heart procedures. 3D holograms enable heart teams to interact with patient-specific organs and tissue the same way they would with physical objects in the real world.  Read More

Genetic cancer testing may be the next frontier in healthcare fraud. The Department of Justice (DOJ) has recently charged 35 people, including nine doctors, for a scheme that fraudulently charged Medicare $2.1 billion. Seniors where offered "free" cancer screenings in order to obtain their' Medicare information for identity theft or fraudulent billing.  Read More

A recent survey conducted by HIMSS took a look at how health care organizations are using analytics to determine financial, operational and clinical success. The results showed that those using clinical outcomes improvement as their key measurement for ROI reported seeing the greatest measured success.  Read More

In an effort to cut health care costs Walmart will begin testing several new programs for their employees. These programs include connecting patients with local doctors, a concierge service, telehealth, and access to fitness clubs.  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.


By now most people have at least heard the term 5G floating around. But many are still left with more questions than answers: What is 5G? How does it work? What makes it different than 4G? When will we see it? How will it impact the healthcare industry? Have no fear, we are here to provide some clarity!

How did we get to 5G?

Before we dive into what 5G is and what it means for the health care industry, let’s explore how we got here. "G" stands for generation, so 5G is the fifth generation of wireless technology. The graphic below does a good job of explaining the evolution of wireless.

 

Source: System One


 

When not connected to WiFi, a 4G LTE connection is what most of us currently use for anything that requires an internet connection on our mobile devices - calls, texts, email, etc.

What is 5G?

5G is a new software-defined wireless network that operates largely in the cloud. The result is more than 100x more capacity that 4G networks. In a nutshell, it means much faster speeds with far lower latency. 

For example, if you want to download a 2-hour movie on 3G it would take a whopping 26 hours. With 4G, you are down to 6 minutes. But with 5G, you are only looking at just 3.6 seconds.

For a world that has become reliant on the internet to function, the reduction in time delay is critical. While 4G network sees command responses in just under 50 milliseconds, that jumps down to only 1 millisecond with 5G, which is 400x faster than the blink of an eye! This reduction in latency will challenge what we consider possible and is expected to be the catalyst that brings data-intensive applications, like autonomous vehicles, into the mainstream.

When will 5G be here?

The first two 5G-compatible mobile phones, the Moto Z3 and Samsung Galaxy S10, were released earlier this year. Meanwhile, AT&T and other carriers have been quietly running trials of 5G hotspots with businesses in various cities across the country, preparing for broader commercial availability. Realistically, expect the big 5G applications to crop up around 2021 or 2022, but analysts predict that by 2025 nearly half of mobile connections in the U.S. will be via 5G.

What will 5G mean for health care?

Now on to the million-dollar question. Just as it promises to increase speeds and reduce latency for consumers, 5G technology also has the potential to transform how health care is delivered. Especially as the use of Internet of Things (IoT) technologies continue to grow, the amount of data on networks is also expected to continue to skyrocket.

Expanding Telemedicine

Telemedicine requires a network that can support real-time high-quality video, which today is limited to wired networks. Video lag is not only frustrating for those using it but the poor quality can delay patient care, hurting outcomes in the long run.

With faster service also comes the ability to provide new value-add to the conversation. Take real-time language translation, for example. This could mean a doctor in Indiana can take care of patients in foriegn countries, regardless of language barriers.

With 5G, health care systems can enable mobile networks to handle telemedicine appointments, which can greatly increase the reach of these programs. Patients can often be treated sooner and gain access to specialists otherwise not available. It also enables doctors and other staff members to collaborate more efficiently and effectively.

Reliable, Real-Time Remote Monitoring

By using IoT devices, health care providers can monitor patients and gather data that can be used to improve personalized and preventive care. Slow network speeds and unreliable connections could mean doctors are unable to get the real-time data they need to make quick health care decisions. 

5G networks will enable the transfer of more complicated and robust patient data from remote locations. The extremely low latency can facilitate reliable home care, such as home ICUs or hospitals-as-a-home settings. In other words, the more reliable remote monitoring becomes, the more patient care can be moved out of the hospital. For example, a doctor can be alerted in real-time if a patient's blood pressure spikes while they are at home. Providers can be confident they will receive the data they need in real-time and are able to intervene before serious complications arise.

Quicker File Transfer

MRI machines and other imaging equipment typically produce very large files that must be shared with various specialists. When the network is low on bandwidth, the transmission can take a long time or not send successfully. This means the patient waits even longer for treatment and providers can see fewer patients in the same amount of time. With 5G, files could become instantly available via mobile devices. This opens up opportunities for providers to easily share large imaging files without taxing their network, furthering the ability to collaborate about patients in order to provide better and quicker care. 

Ultimately, 5G is a catalyst that will support a decentralized health care ecosystem by making operations more reliable and accessible, further accelerating the industry trend toward providing care outside of the hospital.

 

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

Source: Amazon

Here's The Latest in Health Care:


Amazon is entering the telehealth game with their new app, Amazon Care. The pilot program, which offers a combination of telemedicine and home visits, is now being offered to the company’s Seattle based employees.  Read More

Revenue cycle management and the integration of EHRs continue to cause headaches for health care organizations. A new study conducted by Navigant found that nearly 50 percent of hospitals and health systems are turning to Health IT vendors outside of their EHR to improve revenue cycle performance.  Read More

In an effort to reduce red tape and enable transparency for both providers and patients CMS announced two new rules this week. They unveiled both the Omnibus Burden Reduction Final Rule, aimed at combating clinician burnout, and a rule for discharge planning, focused on patients moving from hospitals into post-acute care settings.  Read More

Researchers at Cincinnati Children's Hospital have grown the world’s first connected system of organoids. The liver, pancreas and biliary ducts function as one system and brings us one step closer to the ultimate goal – eliminated deaths while waiting for an organ transplant.  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.



Earlier this year the Centers for Medicare and Medicaid Services (CMS) made the biggest change to telehealth policy in decades. In one abrupt, little-advertised bulletin, it announced that it would begin paying for five entirely new “Category 2” telehealth services on January 1, 2019. In that instant, tens of millions of Medicare beneficiaries became eligible for new remote services. However, nine months later very few of their physicians know about the change, and even fewer have the tools to offer or bill for these services.

Most physicians and practice administrators still think of telehealth as largely unfunded. This is understandable because until 2019 Medicare still only reimbursed provider-to-patient video visits, and only for patients located in rural areas, and only when the patient was physically located at a medical facility such as a clinic or hospital. In effect, CMS only used telehealth to supplement specialist staffing at medical facilities in rural areas. It didn’t want to introduce competition against the traditional office visit.

So until this year, telehealth was progressing mainly in the private sector. Because of successful direct-to-consumer telehealth companies, we associate telehealth with several major benefits: convenience and time savings for patients, increased access to care, work-life balance for physicians, and lower costs. CMS took a big step towards these additional benefits in the public sector with its new Category 2 telehealth funding.

Category 2 Telehealth Services and Charge Codes


Here are the new Category 2 services that can be billed today for Medicare patients:

Interprofessional Internet Consultation
CPT® codes 99446, 99447, 99448, and 99449

This is a physician-to-physician service billed by a consulting specialist. The specialist uses phone or video to give treatment guidance to the referring physician, along with a written report. The specialist never has any contact with the patient. The reimbursement is small, but many specialists already offer phone advice to other physicians without always seeing the patient. Now they can be reimbursed for these calls - it removes a perverse financial incentive for them to always do an in-person consult when that might not be necessary and could be an extra expense and inconvenience for the patient.

Interprofessional Written Internet Consultation
CPT® code 99451

This is similar to the Interprofessional Internet Consultation above, but removes the voice or video requirement. The specialist’s treatment guidance is purely written in this scenario.

Interprofessional Referral Services
CPT® code 99452

This pays the referring physician (typically a primary care physician, family medicine doctor, or hospitalist) for their end of the interprofessional internet consultation described above. The billing is based on time spent preparing materials, reviewing documentation, and speaking with the specialist. It’s nice that both parties can now get reimbursed for something that they were already doing in many cases.

Remote Evaluation of Pre-Recorded Patient Information
HCPCS code G2010

Consumer wearable medical devices got ahead of reimbursement models, leaving physicians to wonder “how am I going to get reimbursed for interpreting this flood of patient-generated data?” Apparently by billing G2010. When a physician gets a medical recording or image directly from a patient, this code pays them to send their interpretation back. No voice or video involved, just text chat. The reimbursement is low, but then again, it’s a simple transaction and it could be high-volume with the right marketing and tools.

Virtual Check-in
HCPCS code G2012

This code pays a physician to talk with an established patient for 5-10 minutes, as long as it’s unrelated to any scheduled in-office visits from the past 7 days and doesn’t lead to an immediate office visit or procedure. Typically this would be used after the patient calls the practice with a complaint or question, and the call gets escalated to a physician. It can be proactive on the part of the practice as well. Many practices traditionally provide this service for free for their established patients - now there’s reimbursement available.

How to Get Reimbursed for Category 2 Telehealth Services


If you’re already meeting the requirements to bill for one of these services, then the remaining challenge is charge capture. Because of the time requirements and the coding complexity, it’s prohibitively time-consuming to capture the billing charges for these services unless you can do the charge capture in the same clinical communication software where the service itself took place.

In order to fully capitalize on these codes, health care organizations should invest in integrated charge capture and clinical communication software. This software can be used for interprofessional and provider-patient text chat, voice, and video. The same software then can guide the physician to bill the appropriate Category 2 charge code based on the type of service (provider-provider or provider-patient), type of communication (text, phone, or video), and the duration of the call. It has to be mobile because who is in front of a computer every time they talk on the phone? And it has to be easy and integrated so that the time spent on charge capture doesn’t exceed the time spent on the actual encounter!

Why miss out on telehealth reimbursement? Contact pMD to find out how our easy-to-use, integrated charge capture and clinical communication software can streamline your telehealth services!

Further Reading
https://www.aappublications.org/news/2019/01/04/coding010419
https://practice.asco.org/sites/default/files/drupalfiles/2018-12/Final-Rule-2019-Resource-FINAL-12-5-18.pdf
https://acpinternist.org/archives/2014/01/coding.htm

 

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:


Peanut allergy sufferers are one step closer to a treatment after an FDA committee voted to approve Palforzia. A form of oral immunotherapy, the powder can desensitize the immune system to peanuts, reducing allergic reactions. This could be the first FDA-approved treatment for peanut allergies.  Read More

An inexpensive pill consisting of low doses of three blood pressure drugs and a cholesterol drug has recently been tested in the U.S., successfully lowering participant blood pressure and LDL. Similar drugs have been effective in treating conditions leading to heart attacks and strokes in other countries and may be a valuable treatment option for those with limited access to medical care in the U.S.  Read More

A recent study found that nearly 20 percent of surgeons in the U.S. predict they will need to retire early due to the physical strains of laparoscopic surgery. While close to 80 percent of those surveyed have experienced some sort of muscular or back pain, 13 percent have also required a consult with another healthcare professional for their injuries.  Read More

A new machine learning model can better predict heart failure in patients with type 2 diabetes. Researchers have been able to generate a risk score for patients based on the top 10 predictors of future heart failure. By integrating this risk score into bedside practice or EHR systems, it may help identify patients who would benefit from therapeutic interventions.  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.


Since the very first version of pMD on the Palm Pilot nearly twenty years ago, security has been a foundational principle in how we design and build our software. As technology has advanced, the challenges have grown but security has remained a steadfast commitment to everything we do. From how data is stored and transmitted to how we operate internally and with customers, security is as much a cultural value as it is a set of encryption algorithms or protocols.

Service Organization Controls (SOC) 2 Type 2 is one of the highest industry standards for software as a service, and is particularly relevant to health care technology. It helps potential customers to measure and assess the risk of using different services and tools, like pMD. Earlier this year, pMD successfully completed its third-party security audit, achieving SOC II Type 2 and HIPAA certifications. These reports are a validation of the things we've always done, yet it allows an easier and industry-standard medium to communicate our security commitments to our users.

Handling personal health information is a privilege. So much of health care is based on trust -  trust in your doctors, trust in your tools and their privacy protections, and trust between everyone involved in helping provide the best possible care for patients. At pMD, even though we're proud of this milestone, we never take this for granted and will continue to keep security practices a core focus of everything we do.

 

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 recent study has shown that adults who are regular tea drinkers tend to have better organized brain regions than non-tea drinkers. Regular tea drinking has been found to have positive effects against age-related cognitive decline.  Read More

• As hackers become more innovative and begin to finely tune their techniques, health care organizations are more and more at risk of having their data stolen and sold on the black market. Most medical records contain all the pertinent information needed for identity theft, such as full name, address, date of birth, phone number, emergency contact, Social Security number, and more.  Read More

• The Food and Drug Administration (FDA) is finalizing a policy that will enable it to remove many non-tobacco flavored vaping products from the market. This is in response to the rising use of e-cigarettes by young people and reports of recent deaths and illnesses tied to vaping.  Read More

• Last year, the Apple Watch received FDA clearance for its electrocardiogram feature. The watch now falls under the classification of a medical device and is capable of alerting the user to abnormal heart rhythms. Apple will be using its new Research app on the watch to crowdsource health data from its users for research studies.  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:


• The Centers for Disease Control and Prevention (CDC) have had over 200 reported cases across 25 states of severe lung disease with possible links to vaping. There have been 2 deaths so far from severe lung illness after vaping and federal authorities from the CDC and the FDA are working with state investigators to identify what toxin or substance might be causing the problem.  Read More

• The American Medical Association is launching its new Practice Transformation Initiative in an effort to fight physician burnout. The goal of the initiative is to support research and solutions surrounding the causes and impact of fatigue and burnout among practicing clinicians.  Read More

• While staying cool during the summer months is a matter of comfort for many of us, for those with mental illness, heat can be a dangerous hurdle in managing their conditions. Prescribed medications can play a major factor because some medications can interfere with the body's ability to regulate temperature and cause dehydration and even hallucinations.  Read More

• A recent study has found that individuals using homeless shelters visited the emergency department the most before entering and after exiting the shelter. There is potential for effective collaboration between hospitals and government programs to address housing insecurities as a way to improve health outcomes.  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.