A digital front door that no one’s walking through

The Weekly Gist: The Winter is Coming Edition

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Here’s this week’s good news in health IT: over 90 percent of hospitals now provide portals or similar platforms allowing patients to electronically access their medical records, according to a new report from the Office of the National Coordinator for Health IT (ONC).

The bad news, however, is that few patients actually use them. Fewer than eight percent of hospitals report that half or more of their patients have activated their patient portal, and nearly 40 percent reported that less than ten percent of patients have logged on. This is in spite of data in the report showing that two-thirds of hospitals offer services like secure messaging, electronic bill pay, and online scheduling that are highly valued by consumers.

The root cause lies in simplicity and connectivity. Each hospital or independent physician practice has its own portal, forcing the patient to manage multiple logins and navigate myriad systems, each of which only displays a slice of their medical records. Rarely can the systems communicate with each other to allow providers access to the patient’s complete record.

Asking patients to navigate multiple portals from different healthcare providers is like asking them to use different web browsers for each site they visit—it’s cumbersome and nonsensical, the hallmark of a design driven by regulatory requirement rather than consumer value.

What’s needed is one, unified consumer portal for healthcare, which integrates all the different providers’ information feeds. For that, we’d need a truly consumer-centric healthcare system, built around and controlled by the individual. Maybe one day.

 

Machine learning is a big idea, but hospitals need business plans first

http://www.healthcareitnews.com/news/machine-learning-big-idea-hospitals-need-business-plans-first

machine learning and AI in healthcare

Elizabeth Clements, business architect at Geisinger Health, will be hosting a session at HIMSS18 on March 7.

Don’t get lost in the complexity of large-scale use cases.

Machine learning has the potential to transform healthcare through new knowledge discovery and improved productivity, but many health systems do not have a business plan in place to support advanced analytics beyond research and development.

As health systems consider how best to leverage machine learning and artificial intelligence, it will require a shift in IT strategy to focus on not just data, but managing the model itself. This means, among other things, defining the value of machine learning and providing a framework for evaluation and application.

Health systems need to keep things simple when moving into machine learning, said Elizabeth Clements, business architect at Geisinger Health.

“When working with new technology and developing a service from scratch, it can be easy to get lost and slow progress down with the complexity of a large use-case,” Clements said. “If you keep your scope narrow and define near-term goals, you will find you are able to make more meaningful progress in a short amount of time.”

And healthcare professionals dealing with machine learning must themselves learn how to partner with the business.

“Understanding the current and future state use of the machine learning solution is critical,” Clements said. “If you don’t consciously determine how much you want or need human intervention with the model, it will make your solution much more difficult to implement and gain buy-in.”

Clements said a simple framework for thinking about machine learning in the context of the business is needed. That includes understanding its value and use-cases before embarking on this type of analytics advancement, as well as knowing the basic challenges and how to design a program that takes those into account.

“Machine learning is the next wave of advanced processing technology offering us new avenues for information discovery and productivity enhancement,” she said. “It has the potential to transform how we conduct business; however, it will require a shift in our IT strategy.”

It is not just about the data or the application, it is also about the model itself. IT leaders should consider how to complement their existing IT and data scientist teams with new skill sets and consider how machine learning can advance existing task execution, she added.

Clements will be speaking in the HIMSS18 session, “Managing Machine Learning: Insights and Strategy,” at 11:30 a.m. March 7 in the Venetian, Palazzo D.

Trump signs spending bill into law: Here are health IT’s biggest wins

http://www.healthcarefinancenews.com/news/trump-signs-spending-bill-law-here-are-health-its-biggest-wins?mkt_tok=eyJpIjoiWVRobE9EazRORGhoWkRNeSIsInQiOiJSSUt5Qmo5ejNKZEZwTjBOVnU0OW01WDN4TlFUNGdqckR0c2dQUEwvVlRSOXMyWHRVS3BET3F6MVVLc0JZUWNYUTRTK29rdXQzNGZielRnWkZQN0R4R0lhS3M1R3hFcnlmOHRBclozL1Z6OXE1aTN2azBNOWYxL3l2K0RJWEszWCJ9

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HIMSS Senior Director of Congressional Affairs broke down how the massive spending bill will boost telehealth, Medicaid and other crucial health IT.

Congressional leaders passed the spending bill last night, after a 5-hour government shutdown. Senate passed the spending bill around 1:45 a.m. with a 71-28 vote, while the House pushed through the legislation at about 5:30 this morning with a 240-186 vote.

The shutdown was caused by a one-man protest by Sen. Rand Paul, R-Kentucky, who opposed adding another $320 billion to the federal budget deficit. Indeed the massive spending bill adds hundreds of billions of dollars for the military, disaster relief and domestic programs.

While budget appropriators will have until Mar. 23 to determine how to specifically dole out the funding, there are a lot of wins for healthcare, according to Samantha Burch, senior director of congressional affairs for HIMSS.

The bipartisan agreement will raise the budget cap to allow the total budget allocation for defense, non-defense and non-discretionary items, which is “a big win for HIMSS priorities,” Burch said. Those caps will not only help federal agencies with military needs, but it will support health needs and threats for the country.

One of the biggest gains from the budget was the inclusion of the CHRONIC Care Act, which unanimously passed the Senate in September. HIMSS provided technical feedback on for developing the bill, which Burch said is aimed at modernizing Medicare to streamline care coordination and improve outcomes.

Not only will the bill expand telehealth to Medicare beneficiaries, it will also generate patient data on those beneficiaries.

“We’ve been huge supporters of the CHRONIC care act,” said Burch. “Getting that bill over the finish line is an important first step. There’s all of this momentum around health IT on Capitol Hill, but it’s been incredibly hard to get bills across the finish line and signed into law.”

“This is really the first time that we’re seeing a complete package that would expand telehealth access to Medicare beneficiaries,” she continued. “It’s an incredible step forward.”

The spending bill also included provisions for Community Health Centers, National Health Service Corps and Medicare programs that help rural area providers, said Burch. CHIP was also extended for a longer period than anticipated, which provides some stability and certainty to the industry as a whole.

The budget also provides at least $2 billion for the National Institutes of Health for two years and $6 billion for the opioid epidemic.

What’s incredibly valuable is that the two-year budget gives appropriators a “longer runway for the FY19 budget.”

“But there’s much more work to be done,” said Burch. “It’s never a silver bullet… like with the CHRONIC Care bill, we’re trying to bridge this major gap where technology and innovation is, and where regulation and policy is.”

“The bill takes us a little way there, but there’s certainly more to do,” she added.

HIMSS will be continuing to work on progressing these needs moving forward, while concentrating on cybersecurity, interoperability and infrastructure.

Although the industry has come a long way, cybersecurity continues to be a major issue for healthcare, said Burch. HIMSS played a major part of Sec. 405 of the Cybersecurity Act of 2015, which it developed with the Senate HELP committee.

“[That work] got the attention of the Department of Health and Human Servicesand got the ball rolling, which created a more active relationship between HHS and the private sector,” said Burch.

But one of the biggest needs — and perhaps the biggest push — will continue to be around infrastructure needs. Burch explained that while Congress continues to have these conversations around infrastructure and public and rural health, there’s a lot of work to be done.

“We’re still trying to impress upon lawmakers that yes, our roads and bridges may be crumbling, but we still have those with no access to broadband,” said Burch. And that has some of the best use cases for health IT and telehealth.

Most Significant Epic, Cerner Health IT Achievements of 2017

https://ehrintelligence.com/news/most-significant-epic-cerner-health-it-achievements-of-2017?elqTrackId=4b11abd211d24c9f83ccaccd2971835c&elq=2d2e530ff2ce491481cadbe37c8b232e&elqaid=3157&elqat=1&elqCampaignId=2929

Epic EHR, Cerner EHR

 

Epic and Cerner continue to dominate the healthcare industry and this year the two health IT companies have made key additions to their portfolios.

Epic Systems and Cerner Corporation solidified their status as top dogs in the health IT industry in 2017.

Both health IT companies scored massive contracts this year, with Epic continuing to gain popularity among the private sector and Cerner expanding its presence in the public sphere.

Cerner and Epic have also found success expanding their health IT offerings into other areas of care management, including population health and revenue cycle management. The companies have proven their ability to stay ahead of the curve by continuing to add more products and technologies to their arsenal in keeping with developments in the industry.

Over midway through 2017, here are a few of the most significant achievements of the year by the biggest players in health IT:

Why Kaiser added tech execs to its med school board

https://www.bizjournals.com/sanfrancisco/news/2017/07/11/kaiser-permanente-medical-school-board-23andme.html?lipi=urn%3Ali%3Apage%3Ad_flagship3_me_share_analytics%3BlvxxuqaBTIiOEUeGO7Ntwg%3D%3D&licu=urn%3Ali%3Acontrol%3Ad_flagship3_me_share_analytics-analytics_suggested_article

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Kaiser Permanente has selected 13 board members for its new medical school in Pasadena.

The roster includes Kaiser medical executives and Silicon Valley technology leaders, including Anne Wojcicki, CEO of 23andMe, and Mary Hentges, former chief financial officer of PayPal and CBS Interactive. Dr. Holly J. Humphrey, dean for medical education at the University of Chicago, will serve as board chair.

The move shows Kaiser’s continued emphasis and investment in technology integration and innovation: Kaiser was one of the first to use an electronic medical records system, and in 2015 Kaiser reported 52 percent of its primary care encounters were telemedicine visits, completed by email, phone or video.

Medical students at the Pasadena school will apply what they learn immediately within the Kaiser system, said Dr. Edward M. Ellison, board member and executive medical director of Southern California Permanente Medical Group. Many existing medical schools involve two years of basic science and lots of lectures.

“Medical school education hasn’t changed for a hundred years. Engaging physicians from the very beginning … and teaching them to be a part of our system, that’s something that other medical schools can’t do,” Ellison told the Business Times.

“We knew we wanted to create physicians who will lead care and innovations in the country. We’re integrating that with technology because it allows us to see care everywhere.”

Half of residents stay at Kaiser, and half go elsewhere after completing their training, according to Ellison. The school can accommodate 100 students on campus and is discussing plans to start satellites in other locations.

In 2015, Kaiser said it would open a nonprofit “national school of medicine” in Southern California. The Oakland-based nonprofit system, which trains more than 600 physicians in residency every year, plans to start classes in the fall of 2019. It will start accepting applications in 2018 and expects full enrollment of 192 students by 2022.

 

Cerner, Epic, McKesson Among Top 5 Global Health IT Vendors

https://ehrintelligence.com/news/cerner-epic-mckesson-among-top-5-global-health-it-vendors?elqTrackId=893d096a291d4cf5b90e75c601c7c5a1&elq=ff9dcb339dd14c5e807c6af05a723d2f&elqaid=2665&elqat=1&elqCampaignId=2463

EHR Vendors

IDC ranks Cerner, Epic, and McKesson Technology Solutions among the top 5 largest health IT vendors to healthcare payers and provider institutions.

The winners of the IDC Health Insights 2017 HealthTech Rankings released this week named Cerner, McKesson, and Epic Systems among the leading global health IT suppliers.

IDC Health Insights supplied the rankings indicating new benchmarks for health IT hardware, software, and services vendors.

Among the top five largest health IT companies worldwide are Cerner, Epic, and McKesson. This list is the second annual global revenue ranking by IDC Health.

The 2017 HealthTech Rankings comprise the following two lists:

  • The Top 50 features the largest companies that derive more than one third of their revenue from healthcare payer and/or provider institutions. The largest of the Top 50 companies is Optum, a subsidiary of UnitedHealth Group.
  • The Enterprise Top 25 features the largest companies that derive less than one third of their revenues from healthcare payer and/or provider institutions. The largest of the Enterprise Top 25 companies is IBM.

Cerner was listed as the second largest vendor in the HealthTech Top 50.

GE Healthcare ranked third, McKesson Technology Solutions came in fourth, and Epic Systems ranked as the fifth largest health IT vendor to healthcare payers and providers worldwide.

“IDC Health Insights is excited to release the second annual HealthTech Rankings,” said Research Vice President for IDC Health Insights Lynne Dunbrack. “These global revenue rankings offer a valuable industry benchmark of the leading global technology and service suppliers within the healthcare payer and provider services industry.”

The top five largest vendors listed in the HealthTech Enterprise Top 25 in descending order were IBM, Royal Philips, Siemens, Intel, and Microsoft.

A recent KLAS global EHR market share report similarly named Epic and Cerner among the EHR companies enjoying the highest level of worldwide success across the industry in 2016.

While Cerner maintained its hold as a top contendor, Epic Systems and InterSystems gained more clients than any other EHR vendor last year due in part to the technologies’ vast scope of functionalities and usability.

Epic and InterSystems both boast a wide array of functionalities and user-friendly technologies, but InterSystems won more contracts last year due to its more affordably priced product packages.

However, Epic contracted 8,190 beds in 2016—3,000 more than the next closest competitor.

While Cerner was less lucrative abroad in 2016 than it has been in years past, the vendor still earned the majority of the market share in foreign markets including the Middle East.

The recent spike in contracts for EHR vendors both within the US and abroad are indicative of the widespread adoption of EHR technology in healthcare systems around the globe.

What will become of MACRA, Obamacare, health IT? HIMSS boss weighs in (podcast)

What will become of MACRA, Obamacare, health IT? HIMSS boss weighs in (podcast)

HIMSS Chicago 2015

The annual Healthcare Information and Management Systems Society (HIMSS) conference gets under way Monday in Orlando, Florida, with numerous preconference activities starting Sunday.

As more than 40,000 people descend on Central Florida for the grueling event, MedCity News talked to HIMSS CEO and President H. Stephen Lieber for what has become an annual ritual, at least for this reporter. As usual, it’s on tape.

HIMSS17 is the last HIMSS conference with Lieber in charge; he announced in December that he would retire at the end of 2017.

Lieber is preparing to depart at a time when health IT is at a crossroads.

Healthcare organizations in the U.S. have spent the better part of the last 10 years installing and now optimizing electronic health records, though they continue to lag when it comes to sharing data across systems. And they continue to gripe about EHR usability and Meaningful Use requirements.

Providers in recent years also have grappled with updates to HIPAA regulations and the conversion to ICD-10 coding. Now, they face some new regulations affecting health IT.

Notably, the 2016 Medicare Access and CHIP Reauthorization Act (MACRA) is coming into force for ambulatory care. The rise of accountable care is “certainly having an impact already in terms of how care is not only delivered,” as well as how payers calculate reimbursements, Lieber noted.

They also face the uncertainty that comes with a change in administration in Washington.

Still, some things do remain relatively constant in health IT.

“The ongoing challenge in dealing with security, there is going to be an even greater focus this year as we try to bring more attention, more focus on what it takes to make sure that we’re handling data in a secure way,” Lieber said.

Clinical analytics has become a normal course of business in the field as well, though it has changed from merely clinical decision support and retrospective analytics to predictive analytics and machine learning. “As the field evolves, we’re evolving the programming with it.” Lieber noted.

Policy seems to be where a lot of intrigue is right now. It’s easy to make assumptions about what the new Trump administration might do, but assumptions are just that.

21st Century Cures Act: 4 health industry impacts summarized

http://www.healthcaredive.com/news/21st-century-cures-act-explained/431491/

On Wednesday, the Senate voted 94-5 to pass the long-awaited 21st Century Cures Bill. As it has backing from the current White House administration, President Barack Obama is expected to sign the legislation into law.

The law has been called the “most important bill of the year” by Senator Lamar Alexander (R-TN), as Politico Pulse reported Tuesday. The bill, while bipartisan, is not without controversy. While the House version of the legislation passed swimmingly with a vote of 392-26, the bill did have its share of opponents in the Senate– including Sen. Elizabeth Warren (D-MA) and Sen. Bernie Sanders (I-VT) – who think the bill is too favorable to pharmaceutical companies. Both Sanders and Warren were among the five Senators to vote against the measure.

And as Modern Healthcare’s Merrill Goozner notes in an editorial, it’s likely the true impact of the bill won’t be known right away but will be realized as the years pass. “The final details of the 996-page legislation…weren’t known until five days before it passed,” Goozner wrote.

About three years of work and efforts from 1,400 lobbyists for 400 companies went into the making of this $6.3 billion package. It seeks to deliberately speed medical research and treatments. Because seemingly no healthcare legislation can be a reasonable length (it’s about 90 pages longer than the ACA) and because nothing in healthcare is simple, we’ve summarized some of the notable implications of the bill in four buckets: Health IT, mental health, FDA reform and research and care funding.