The pMD Blog

Welcome to the
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.



Here's The Latest in Health Care:


The Department of Health and Human Services (HHS) has extended the public health emergency surrounding the COVID-19 pandemic until April, extending key waivers for regulations on a variety of topics such as telehealth reimbursement. This is now the fourth time HHS has expanded the emergency period.  Read More

In an effort to give Medicare beneficiaries quicker access to the latest medical technology, Medicare will now cover all medical devices designated by the FDA as a "breakthrough" technology. The final rule will cover the use of these devices for four years after it receives FDA market authorization, while CMS evaluates whether to cover them permanently.  Read More

According to the health care management advisory firm KaufmanHall, the COVID crisis has shushed but not silenced hospitals’ talks on mergers and acquisitions in 2020. In fact, there are signs the pandemic may be spurring rather than slowing such deals.  Read More

CMS now requires U.S. hospitals to post a list of their standard charges, including rates negotiated with private payers, on a publicly available website in both machine-readable and consumer-friendly formats. While it sounds simple, price transparency compliance is proving to be a challenge for many hospitals. Implementing a few key strategies can help hospitals stay ahead of the curve and avoid penalties under new CMS requirements.  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.

This past year has brought on many challenges for everyone across the globe as a result of the COVID-19 pandemic. The health care industry, in particular, has had to bear the brunt of those challenges because not only did the demand for frontline health care workers increase dramatically, but the conditions under which those workers had to treat patients required them to take adaptive measures to remain safe so as to not contract the virus or spread it to others. However, this begs the question: how can the health care industry adapt to these challenges in a way that reduces the risk of contracting COVID-19, and simultaneously keeps both patients and health care workers safe within such a high-risk setting? As it turns out, one of the solutions to that problem can be found in the use of patient simulator training. They can be used as a means to safely train and prepare health care providers, staff, and even medical students in not only the treatment of COVID patients but also in the procedures and processes of various other fields of medicine. 

Patient simulator training can come in a variety of forms, such as the use of life-like mannequins or robotic “patients” that are used in place of real human patients, or even in digital spaces such as virtual reality or online computer simulators. In the case of physical mannequins, these are often used to simulate the conditions of a real human patient, requiring the trainee to monitor the patient and take the appropriate steps to treat them based on what they’re able to observe. High fidelity models can be used to prepare health care workers on how to respond to emergency care situations, training for surgeries, or even just basic health care procedures such as administering an IV.

Due to COVID-19 necessitating social distancing and limiting physical interaction, especially amongst those who have been hospitalized because of the virus, being able to train with the assistance of real human patients is almost entirely out of the question. In fact, a CDC report from October 31, 2020 showed that 6% of adults hospitalized with COVID-19 were health care personnel. As the demands of the health care industry continue to grow during the pandemic, patient simulators have emerged as an invaluable tool for new and experienced medical personnel alike. Institutions such as UC Davis have embraced patient simulators as a means to help health care workers adapt to the changes in patient care caused by COVID-19. The benefits of patient simulators have also extended to health care education as well. With many hospitals and clinical centers restricted due to COVID-19, medical students have found ways to fulfill some of their clinical hours through patient simulators in place of time spent with real patients in a clinical setting.

Even looking beyond the pandemic, patient simulators are beneficial in how they eliminate the risk of harm on human patients, train health care workers for the practical application of medical equipment, and help reduce medical errors and increase the effectiveness of personnel. A research study conducted by BMJ Open in 2017 showed that high-fidelity patient simulators revealed higher effectiveness in knowledge and performance from nursing students, compared with other teaching methods. So even after we finally overcome the pandemic, patient simulators will still prove to be a viable tool in the training and education of our health care workers well into the future, and one that might show greater effectiveness than traditional teaching methodologies. 

Building software around automating the simulation training workflow for practices is invaluable. In addition, there is huge value in designing online virtual simulators that could potentially be used by health care workers who need to obtain new certifications in different fields and specialties. Patient simulators are an innovative way to effectively train health care workers in various specialties, and pMD strives to be on the frontlines of that innovation, constantly evolving to meet the needs of the health care industry.


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



Here's The Latest in Health Care:


Two key variables in understanding the stress to the health system due to new COVID-19 hospitalizations are the availability of staff and intensive care unit (ICU) beds. A new study found a 90% increase in hospitals reaching ICU capacity from July through December, with rural hospitals facing the biggest capacity issues.  Read More

CMS plans to adopt the AMA's code revisions and accompanying guideline changes for the E/M office or outpatient visit codes. Among the changes, health care practitioners will need to familiarize themselves with a new medical decision-making table as well as a new definition of "time" for office or outpatient visit services.  Read More

Add heart attack patients to those who may find significant value in using telehealth as a post-discharge treatment tool for recovery. A recent study showed no significant differences in safety events or medication adjustment when using telehealth with low-risk patients.  Read More

In an effort to accelerate inoculation efforts, which have fallen behind initial targets, HHS will dole out more than $22 billion to states and local jurisdictions by mid-January to support COVID-19 containment and lagging vaccination rollouts. According to the CDC, as of Wednesday morning, only 5.3 million Americans had received their first shot out of 17 million doses distributed.  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.

Imagine this scenario: you’re a provider that requires a specialist consult for your patient. You put the order into your EMR but you aren’t sure who is going to see the patient or when. You’d like to kick off the process with a phone call but you aren’t sure who to call and you don’t have the time to check so you leave it. Later that day you check the patient’s chart to find that they had received the consult hours ago but you hadn’t been notified. The consultant left their notes but you have some questions and you’re struggling to get a hold of them. Unfortunately, situations like this are commonplace for providers and are a bit of a headache. 

When it comes to referrals and consults, there are many potential points of failure that are only getting more complicated over time. In 2012, the Joint Commission Center for Transforming Healthcare found that an estimated 80 percent of serious medical errors involve miscommunication between caregivers during the transfer of patients. Not surprisingly, a separate study in 2006 found that 20 percent of malpractice claims were related to missed or delayed diagnoses because of issues in the handoff process. These are some pretty serious numbers that warrant attention. With the shift to Electronic Medical Records, it should be a priority for the software to enable providers to effectively communicate. In reality, though, it’s becoming even easier for providers to not communicate.

In theory, all the information providers need should be on the patient’s chart but that’s just not always the case. In a 2011 study, 70 percent of specialists rated the background information they usually received as fair or poor. Another study found that more than half the referring physicians needed more feedback information than was provided by the specialist. The easiest way to solve these problems is to have a direct line of communication between specialists and referring providers to clear up any confusion and to complement the data on the chart. Interestingly, a study in 2018 found that while most hospitalists prefer direct communication, 91% said direct communication happens less than 50% of the time. This makes sense - even if you have the other provider’s phone number, text messages and calls are not a secure way to communicate sensitive patient data. The solution is for providers to have an extremely easy way to directly communicate through secure software. 

Some of the same issues exist in provider-to-patient communication as well. In 2011, a study found that a significant number of providers don’t know whether their patients saw the specialists they referred them to. This could be solved with a quick call, but that’s just one more thing to tack onto a doctor’s already busy schedule.

With pMD, provider-to-provider communication is an easier and more HIPAA-compliant way to communicate Protected Health Information (PHI). Messages can even be tied to a patient in pMD so there’s never any confusion as to which patient is being discussed. With pMD® Charge Capture™, post-discharge follow-ups are automated so providers can be sure their patients schedule their referrals. Providers can even message their patients directly to clear up any confusion and answer any of the patient’s questions. pMD is making communication around patient care more streamlined so medical errors can be avoided in the future.


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


Source: HealthExec

Here's The Latest in Health Care:


With the first doses of COVID-19 vaccines now being administered across the United States, questions abound about who can safely get them. Expect answers to these questions to evolve as the vaccines go into broader use, but here’s what is known so far, and what experts at or advising the CDC recommend regarding their use at this point.  Read More

Experts say that the COVID-19 pandemic has accelerated the adoption of digital health and virtual care forward by at least three years. The industry has fast-forwarded in areas like telehealth, remote monitoring, and artificial intelligence, which is predicted to cause disruptive changes that will significantly impact the technology market. Many of these experts, for example, expect that communication and collaboration tools will explode in 2021.  Read More

Three of the most influential associations in U.S. health care joined forces this week to ask all health care workers to get vaccinated for COVID-19. The American Hospital Association, American Medical Association, and American Nurses Association present their plea in a short open letter, addressing the audience as fellow workers whose duties transcend their job descriptions.  Read More

HHS began distributing the third phase of COVID-19 relief funding for providers this week, with $24.5 billion to go to more than 70,000 providers through the end of January. This phase opened applications up to providers who had previously received or been rejected for, provider relief funds as well as behavioral health providers and those who began practicing between January and March of this year.  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.

Over 1.4 million Americans identify as part of the transgender community and, moreover, are faced with increased mortality rates and lower life expectancies. This is due to many factors such as acts of violence, suicide, acquired immunodeficiency syndrome, cardiovascular disease, drug abuse, and various cancers. 

Some may not feel like there’s much that can be done to change these factors, but in the sphere of health care, that’s changing. Improving the patient experience from beginning to end is a starting point. Making simple changes such as ensuring that the patient’s correct name and pronouns are being used during registration, throughout the patient’s stay, and through any follow-up appointments, can actually make a huge difference in patient outcome. In doing so, health care teams can provide validating experiences and build trust with the patient. 

Inclusive software has been proven to improve the patient experience and promote patient safety. Members of the transgender community have historically low rates of cancer screenings. In one study published by the American Cancer Society, eligible transgender patients were approximately 70 percent less likely than cisgender patients to be screened for breast cancer, 60 percent less likely to be screened for cervical cancer, and 50 percent less likely to be screened for colorectal cancers. According to one physician in this study, these patients “remain susceptible to cancers of reproductive organs that are no longer in alignment with their gender.” Some contributing factors to these historically low rates of cancer screening include the individual’s fear of discrimination, lack of provider education, and electronic systems failing to send out appointment reminders based on patients’ documented identifiers. Health care systems and the software platforms they use can implement guardrails so that no patient is missed. 

The transgender population is also at increased risk of cardiovascular disease, specifically transgender men. The Journal of the American Heart Association published a study that revealed transgender men had greater than a two-fold and greater than a four-fold increase in the rate of myocardial infarction compared to cisgender men and cisgender women, respectively. How can health systems clearly indicate and identify these risk factors and display them to providers? 

Lab results pose another potential risk factor for this population. Lab reference ranges are often split out by male and female, and what’s considered an elevated level for one sex may not be for the other. If we had a trans man, for example, their legal identification might be male, and their health care provider compares their lab to the standard range for males. This lab may not appear to be elevated. But when comparing it to the biologically female population, perhaps that same lab result would potentially be flagged as abnormal. Health systems need to help ensure that providers are using proper reference ranges based on their patients’ anatomy to prevent patient harm. 

What can we do in the sphere of intervention and mental health? Transgender teenagers and adults face increased substance abuse and suicide rates. The largest survey of transgender people in the U.S. to date found that 81.7 percent of respondents reported ever seriously thinking about suicide in their lifetimes, while 48.3 percent had done so in the past year. What are practices doing to increase outreach to these populations? How can electronic health systems help automate that process? 

At pMD, we can create customized workflows designed to streamline patient engagement for various scenarios. We can all help move the needle forward to improve patient care, whether it’s embracing new education and new workflows, or continuing to develop inclusive software with the patient in mind. pMD is ever-evolving to serve the needs of patients and practices. Contact us to learn more about how pMD can best assist you and your practice!

 

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


Source: Getty Images

Here's The Latest in Health Care:


Pfizer’s Covid-19 vaccine passed a critical milestone this week when a panel of experts formally recommended that the Food and Drug Administration authorize the vaccine. The agency is likely to do so within days, giving health care workers and nursing home residents first priority to begin receiving the first shots early next week.  Read More

The U.S. passed yet another gruesome pandemic milestone, with states reporting more than 3,000 coronavirus deaths in a single day for the first time. The extraordinary death count represents an all-time high for the pandemic, which is also expected to pass the tragic point of 300,000 deaths in the coming week.  Read More

No search for an open COVID-19 testing center. No waiting in line. No need to even venture outside the house, in fact. That's the promise of LabCorp's Pixel test, which has secured an FDA green light for home delivery without a prescription, the first test to reach that milestone.  Read More

HHS has proposed changes to HIPAA rules that aim to improve care coordination and give patients more access to their health information. The goal is to enable greater family and caregiver involvement in the care of individuals experiencing emergencies or health crises and boost flexibilities for disclosures in emergency or threatening circumstances.  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.

Being more than just a public health issue, the pandemic has drastically changed our way of life - the way we work, learn, socially interact, and especially how health care is practiced and delivered. For most health care organizations, this event has been a shock, not to mention an unexpected spike in demand for virtual care.  With the massive response to the pandemic, of the groups who weren't already utilizing this technology, many had to rush to incorporate services to keep up with the growing demand of patients needing care from afar.  It has forced telehealth to the forefront, now proven to provide quality care virtually. Whether it’s a phone call, video, or messaging, telehealth can come in many forms that can cover a variety of mediums.

In a new survey conducted in October of 2020, the COVID-19 Healthcare Coalition Telehealth Workgroup found that more than 75% of the almost 1600 physicians polled said that “ telehealth has allowed them to provide quality care for a variety of specialties, from COVID-19-related care to behavioral health.”

Unsurprisingly, telehealth has become a lifeline for both patients and providers alike. But with any new service or technology, it’s extremely important to measure both effectiveness and satisfaction, all the while making it accessible, time and cost-efficient, and compliant under federal regulations relating to patient care during COVID-19. A practice also needs to evaluate the impact telehealth might have. They need to understand the nature of these services, assess the needs of patients, and collect and analyze measures relevant to accurately measure the success of telehealth medicine. 

If a practice can optimize their systems to expand both the use of telehealth and their ability to measure, track, and report on the quality of telehealth, it could change the outcome of care for many patients. So how would a patient or a provider make sure they are using telehealth correctly and efficiently? These questions can be sought through a framework of measurable data identifying the level of accessibility, financial impacts, user experience, and effectiveness of a system. 

A great way to collect metrics is through the use of pre- and post-telehealth visit surveys for both patient and provider, and also Electronic Clinical Quality Measures (eCQM).  eCQMs are measures specified in a standard electronic format that use data exported from electronic health records (EHR) and/or health (IT) systems to measure the quality of health care provided. The Center for Medicare and Medicaid Services (CMS) use eCQMs in a variety of quality reporting and value-based purchasing programs. Each eCQM is documented in a special way defining its intent, populations included, logic, data elements, and value set identifiers. 

CMS, required by federal law,  provides a quality incentive program, rewarding providers one of two ways, one being a merit-based incentive payment system (MIPS) and another through Advanced Alternative Payment Models (APMs).

In light of this year’s unparalleled events, telehealth is being pushed more now than ever, but with so many variables and deterrents, how does one solve problems and address barriers relating to virtual care? The pMD platform offers a great solution to meet CMS MIPS requirements with our point-of-care data capture which provides a robust dashboard to monitor performance metrics and offers real-time data for reporting purposes. Having the ability to enter these eCQMs at the point of care can help providers focus more on patients. Rather than spending hours on paperwork, providers can save time, improve on and assess the quality of treatment, and foster a goal of access-driven real-time data to help decrease medical errors.  When a provider seeks out a telehealth solution, it’s a no-brainer that pMD is a perfect solution, not just for now but for the future of patient care.

 

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



Here's The Latest in Health Care:


The U.S. set a pair of alarming coronavirus records this week, surpassing 200,000 new infections and topping 100,000 COVID-19 patients hospitalized, the first time the country has reached either metric in a single day. The CDC warns the worst might still be ahead, predicting the death toll could reach 450,000 by February.  Read More

CMS further cemented the use of telehealth in Medicare by permanently allowing Medicare providers to use telehealth to carry out home visits for evaluation and management services and some visits for people with cognitive impairments. It also temporarily continues telehealth services for emergency department visits and other services with an eye toward making them permanent.  Read More

Federal officials say they predict vaccinating as many as 100 million people by March. This announcement is based on the anticipated vaccine supplies from Pfizer and Moderna, the two vaccine frontrunners. While neither vaccine has yet to receive emergency approval from U.S. regulators, officials expect 20 million Americans to be vaccinated by the end of the year.  Read More

CMS is giving hospitals facing a surge of COVID-19 patients expanded flexibility to care for Medicare patients in their homes. The new Acute Hospital Care At Home program will allow Medicare patients to be admitted into the program from emergency departments and inpatient hospital beds. The program will require in-person screening protocols to assess both medical and non-medical factors before care can begin at home.  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.

There have been a number of news stories recently which have highlighted the potential impact of ransomware. Being unable to admit patients, or worse, unable to provide critical care in a life and death situation, are the stuff of nightmares for health care providers. The changing landscape of health care due to COVID-19 has further disrupted the ability of health care organizations to mitigate the impacts of cyber threats. As more workers require remote access to hospital systems, more avenues of attack become available to hackers. It is now more important than ever to be aware of ransomware and broader cybersecurity threats.

What is ransomware?

The FBI defines ransomware as "a type of malicious software, or malware, that prevents you from accessing your computer files, systems, or networks and demands you pay a ransom for their return". Like many other viruses and malware, ransomware typically finds its way onto computers accidentally through unaware users installing or downloading it. In contrast to other computerized threats, ransomware is primarily used to extract payments from affected individuals directly. 

How does it work?

Ransomware generally requires some action on the part of a computer user to begin its work. This is often achieved through phishing scams, or more targeted “spear phishing” emails that are used to trick users into downloading ransomware. Once the software is installed on a computer, it will lock the user out of the computer, encrypting the data on the drive so that it can’t be readily recovered. The more advanced and dangerous versions will also worm their way through attached network drives and other systems that the infected computer is able to access. Often, ransomware has the biggest impact on large, connected networks like those you would find in a modern hospital system.

More infamous ransomware, such as WannaCry in 2017 and Ryuk this year, have made headlines with their financial impacts. Other instances have more dire consequences, as in the case of Düsseldorf University Hospital. As a result of ransomware, a patient was unable to be admitted to the hospital. Instead, the patient had to be rerouted to another hospital farther away and died in transit. The hospital’s admission systems remained affected for more than a week.

How can health care organizations prepare & defend against ransomware?

(1) Keep operating systems and software updated. Install and use updated antivirus to perform regular scans

The vast majority of these attacks take advantage of vulnerabilities in software, many times for known problems that could have been mitigated or prevented by up-to-date software. As organizations decrease the number of insecure and outdated software systems running in their network, the likelihood of a successful ransomware attack decreases.

(2) Educate members of your organization about social engineering

Social engineering relies on subtle tactics, such as posing as a trusted source or creating a sense or urgency, to trick individuals into downloading malicious software or divulging sensitive information. Email phishing scams are a frequent vehicle for ransomware. By encouraging individuals to think critically before clicking unknown links, organizations are less vulnerable to ransomware.

(3) Perform frequent backups of critical systems and data and store them in another location

Ransomware’s biggest threat is preventing access to critical systems or data. By backing up and maintaining systems in another physical location and on another network, successful ransomware attacks will have less data and system access to ransom in the first place. 

(4) Practice and plan for the possibility of a ransomware attack

Being prepared to restore access and data in the event of a ransomware attack is just as important as prevention. The financial impact of a day’s worth of lost business pales in comparison to a month of loss. When data can be easily recovered, there is little reason to pay the ransom for lost data. 

If the organization suffers a successful attack, having a response and restoration plan can make a world of difference. Be sure to regularly test the efficacy of your plan to ensure the process stays current and succeeds in restoring the most critical systems.

Additional Resources:
https://us-cert.cisa.gov/ncas/alerts/aa20-302a
https://www.cisa.gov/sites/default/files/publications/protecting_your_networks_from_ransomware.pdf

 


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