7 Medical Technologies Revolutionizing Healthcare by Nirav Shastri

Technology has touched every single aspect of our life, making a lot of things faster and  more simple. From transportation to the food industry, and e-commerce to the manufacturing industry, technology has provided numerous solutions.

When it comes to the global healthcare industry, technological innovation has unlocked a lot of interesting possibilities to give healthy and disease-free life to everyone. Looking at the data and reports, the global healthcare industry has grasped a growth rate of 4.82 percent, according to researchandmarkets.com.

Using digital technologies like robotics, artificial intelligence, VR/AR, robotics, and blockchain, the healthcare industry builds a better healthcare ecosystem for the future.

Moving ahead, let’s talk about the seven powerful technologies that are advancing healthcare. In fact, these technologies have the power to reshape the entire industry.

1. Artificial Intelligence

The first technology on the list is Artificial Intelligence. This high-end technology allows patients to get some special diagnostic tests from a distant location. You can find a lot of technologically advanced healthcare providers who perform surgeries with AI assistance.

Yes, you read it right, many healthcare service providers perform surgery via AI, which is a growing trend providing affordable access to surgical specialists. Moreover, AI also helps in giving training to new doctors concerning surgical methods and other procedures, eradicating the need for risking human patients.

Considering the total public and private sector investment in healthcare AI, it is expected toreach $6.6 billion by 2021. Another prediction by Accenture says that some of the top AI apps may result in savings of $150 billion by 2026 annually. In short, such benefits will accumulate incrementally from precision surgery to automated operations and protective medical intervention. Within a decade, the technology will reshape the healthcare industry as we know it.

1. Blockchain

Another technology reshaping healthcare is blockchain. It is one of the most powerful and disruptive technologies in the world. There are many industries that are adopting this technology in order to transform the way they function and perform tasks.

Along with other industries, healthcare is looking to adopt the blockchain in order to streamline the medical records and share in a secure way. One of the main characteristics of blockchain technology is security, which makes it easier to trace the paths of drugs.

Every single transaction that is added in the block is immutable and timestamped, making it easier for hospitals and health service providers to track a product and ensure the information can’t be altered.

The IBM Institute for Business Value blockchain studies more than 200 healthcare executives, including both payers and buyers in 16 countries. Sixteen percent of surveyed healthcare executives are experimenting with blockchain. 

1. 3D Printing

3D printing is another technology affecting healthcare because of its ability to allow customization which decreases surgery time and medical expenses. Some of the most significant include 3D-printed scaffolds or prosthetics and medical devices such as hearing aids and dental implants.

However, the true game-changing solutions provided by 3D printing will be in human tissue printing, including printed livers, hands, eyes, hearts, and ears, or building the smallest functional units of tissues. Moreover, it also can be used as surgical grafts in order to overhaul or replace injured tissues and organs.

3D printers are already being relied on to manufacture medical equipment and surgical devices, which can match a patient’s unique body type or anatomical requirements. The specialized surgical equipment is helping doctors to treat the unique requirements of the patients more efficiently.

1. Mobile Health

Another technology that will revolutionize the health industry is mobile health. mHealth provides a number of ways for patients and providers to interact, allowing hospitals and rehab centers to leverage mobility and recover clinical work movements and results. Ranging from video remote interpretation to telemedicine and remote care use cases, the technology includes embracing wearable technologies.

In this mobile era, medical professionals have the ability to make clinical decisions based ontelemedicine apps and wearables. Moreover, mHealth provides instant access to medical data and patients’ information from anywhere, at anytime.

Making use of mobile technologies, it will be easy to deliver the best quality medical services in rural areas as well. Moreover, wearable devices and sensors will keep individuals informed and help them monitor their health.

1. Cloud

Approximately 13 percent of cloud services in health care are considered high-risk for security breaches and 77 percent of those people are at medium risk, according to recent research by Skyhigh Networks. Cloud services are known for offering several benefits for medical service providers (mainly in rural areas). The research also shows that more than 944 cloud services are in use across healthcare providers while 53 percent of employees make use of at least three devices at work.

1. Robotics

Robots have been at work in the healthcare industry for the past several years. One example is The da Vinci surgical robot, which is a robotic surgical system developed by Intuitive Surgical.

The FDA approved this robotic system in 2000, and it is mainly designed to help in complex surgeries using a minimally invasive approach. Many robotic applications are emerging in the market and we can expect more such robots operating in the healthcare industry by 2025.

The simplistic telepresence robots such as those that are offered by Intouch Health, enable the doctor to move around and examine patients from a distance. Another example is of Aethons TUG Robots, which help hospitals inside transport their pharmacy supplies and patients’ food, as well as clean trash and perform other such tasks.

1. Augmented/Virtual Reality

The applications of AR and VR are applicable to both sides of the care delivery equation — healthcare service providers and patients. Patients can even take advantage of using enabled glasses for medical education in order to study human anatomy and observe and study surgeries as they were performed to lessen stress about upcoming procedures.

Another benefit of using Augmented Reality is to see through anatomical structures during surgeries in order to know the location of organs and blood vessels. Both technologies are also already in use to treat different phobias and other mental health disorders.

MedStar Health is using VR to train healthcare workers using headsets. These headsets plunge them in replicated emergency room scenarios. According to one study, 93 percent of radiologists who used 3D VR technology to check images of arteries were successful in diagnosing splenic artery aneurysms.

On a Concluding Note

Regardless of the size, it is must for healthcare companies to be familiar with the aforementioned technologies and know the impact of using them in their practices. Companies should study the impact, benefits, disadvantages, and proper utilization of these technologies to improve health services for both health service providers and patients.

Source: https://thebossmagazine.com/7-healthcare-technologies/

7 Ways Technology can Help you Grow Business Effectively by Mukti Subedi

Latest technological innovations are the edge that really needs to grow and to boost the revenues ultimately. Using the latest business technology and innovations, small business owners and companies can leverage limited financial resources and capital in smart and most effective ways to get more sales. From resources management to business marketing, there are countless ways, technology can help you grow business effectively.

1) Quick and More Comprehensive Communication

Effective communication is one of the most vital elements that can make or break a business setting or company. It enables employees and higher authorities to interact with each other to carry out business operations and processes effectively. Businesses and companies also need to communicate with their customers/clients in the best possible way to provide them with excellent and satisfactory customer services. Nowadays, there are many business communication solutions are available like highly responsive websites, mobile apps, chatbots and social media platforms that can be used to make internal and external communication better than ever.

Due to the latest mobile technology and high-speed internet, businesses and companies can interact with their customers and clients in real time to solve their queries at the spot. Maintenance management organizations are also using CMMS software to make communication easier and effective for facility managers and technicians.

2) CRM to Keep up with your Customers

More and more businesses are using customer relationship management (CRM) systems to keep up with their customers efficiently. It is something very useful that allows a business setting or organization to keep all customer related details and information at a place. Most of the CRM systems also enable business owners to check customer purchase history to help boost sales by offering the most relevant products or services. Using a customer relationship management software/system, you can provide your customers with outstanding services to as per their interests and preferences.

3) Enhanced Market Position

In this digital world, business owners and companies can quickly anticipate market changes to get ahead of opportunities and latest trends to secure more sales and to get more new customers. Many software and solutions are accessible over the web that can be used to analyze the latest market trends and to understand customer needs and interests as per their purchasing patterns. Such software used to spy on competitors to check what they are doing right now to improve your marketing strategies and tactics to reach target customers without spending huge resources and efforts.

4) Asset Management

Managing business assets effectively not only allows you to get different business operations and procedures done but also prevent unexpected downtime as well. All businesses and companies are now using computerized asset management solutions to keep track of their assets and to create automatic preventive maintenance schedule as well according to the assets’ history and maintenance history.

5) Automation of Business Processes

BPA or business process automation is one of the great advantages of technology for businesses. Through this way, they can automate various business processes for enhanced overall operational efficiency. Staying in touch with customers via chatbots, tracking orders for delivery and payment schedules are some common examples of business process automation that all types of businesses can use of to get more work in less time even with no or a fewer human interaction.

6) Access to the Global Market

Now you can sell your products or services to international customers/clients by running an online store or e-commerce website and it is possible due to the modern technological advances and high-speed internet. Nowadays, more and more peoples are using different social media platforms to market and sell their products even without having a business website or e-store. Anyone can now sell anything to the whole world without leaving the office or bedroom. Digital marketing is making things possible for entrepreneurs and small business owners to reach the target audience more effectively.

7) Mobile Payments

Getting paid from overseas customers is not a big deal anymore. In old ages, businesses were afraid to make international sales due to the complex payment processes and strict banking rules. But now they are worry-free of international payments because of mobile payment options. Companies and businesses now can send or receive payments all around the world in real time even without waiting for hours in the bank. There are countless online payment solutions like PayPal, Payoneer, etc. that all types of businesses and companies are using to get paid and to make payments.

Source: https://www.entrepreneur.com/article/332130

Insiders reveal secrets of medical device scam targeting thousands of Floridians by Katie LaGrone

TAMPA, Fla. — Terry Combs is 63 years old but feels more like 85, he told us recently from his Bradenton, Florida home. "I can't do nearly nothing. When I walk I lose my breath," he said with his oxygen tank nearby.

Combs suffers from chronic obstructive pulmonary disease (COPD), a progressive lung disease from decades of smoking. He also deals with heart trouble, had quadruple bypass surgery and lives with diabetes.

Terry Combs, Bradenton, Florida

So perhaps it's no surprise that a few years ago a medical supply company started calling and calling some more.

"Two to three times a day, I mean they wouldn't leave me alone," he said.

The company was trying to pitch him diabetes supplies he didn't want or need since he gets supplies from his doctor. Despite telling the company no, he says the company kept calling.

"I just started yelling at them," he told us.

Shantell Williams of Tampa got the calls too.

"Harassing, harassing, harassing," she described the calls. "I told them why do you keep calling me? I told them the same thing I told the first person, I don't want your supplies," she explained.

It's happening around the country: medical supply companies that call Medicare patients to pitch unwanted medical devices, ship those supplies to them and get the government to pay the bill.

"It was easy," explained Daniel Yarbrough, a former insider. Yarbrough spent three years as a sales manager for Am-Med Diabetic Supplies Inc. in Delray Beach. "I knew what we were doing on a lot of levels was wrong," he said.

Cody Fletcher, a former assistant manager for the company at its St. Lucie County office, says he also knew what they were doing was wrong.

Cody Fletcher and Daniel Yarbrough describe how they falsified patient records for a former employer their now suing.

"We used to have a joke in the office, calling people robocop because we sold them so many products," he said. "We would send them diabetic supplies, stabilizers, then they'd get ankle bracelets, knee braces, back support, neck support, wrist supports, walkers," Fletcher explained. When asked how many supplies patients actually agreed to, he said one. In other cases it was none. 

Both former employees are now suing Am-Med Diabetic Supplies Inc. as part of a federal Whistleblowers' lawsuit. The former employees, represented by Jesse Hoyer of the James Hoyer law firm in Tampa, allege the company and its owners knowingly defrauded the government by falsifying patient orders for unnecessary medical supplies and billing the government millions of dollars for it.

"We would pay anywhere from $45 to $55 per back brace. Medicare's reimbursement was $950 to $1,000," Yarbrough told us. 

He also explained that offering patients diabetic supplies was just the "in" to sending them more profitable medical devices. The goal was to send each patient they spoke with "three to five devices, minimum." Braces, he said was the most lucrative product they billed Medicare for.

While an attorney for Am-Med Diabetic Supplies Inc. told us they don't discuss clients' ongoing litigation, in a recent motion to dismiss the 2015 case, company attorneys called out the Whistleblowers for failing to show proof of "even a single record of false claim submitted to the government."

In 2015, the company shut down after the government stopped paying when other states complained about harassing phone calls. Complaints filed with Florida's Attorney General's office came from consumers nationwide and beyond the grave.

"Do you know how many people we called that were dead?" asked Yarbourgh.

"You were sending products to people who weren't even alive?" reporter Katie LaGrone responded.

"Yes, it was easy," he said.

Attorney Jesse Hoyer for the James Hoyer Law Firm, represents Fletcher and Yarbrough

What Yarbrough and Fletcher are now alleging was likely made easier since few doctors question medical device orders before signing off on them. Those forms must be signed by a doctor before Medicare will cover the costs of the device.

Dr. Joel Silverfield, a Hillsborough County Internist and member of the Hillsborough County Medical Association, is not affiliated with the lawsuit in any way but reveals how doctors can unknowingly perpetuate medical device fraud.

"Often doctors, and I'm guilty of it myself, do what's called 'zombie signing.' You've got a whole bunch of records [to sign]  What can the harm be?" he said.  

Dr. Silverfiled says medical device fraud has become so rampant at his office, he and his group have recently stopped signing order forms for medical supplies unless the patient is in the room with him and they can discuss the order in person.

Dr. Joel Silverfield, Hillsborough County

"These companies are gaming the system because they know if they send out enough of these [forms] to doctors many of them will come back signed," he said.

Terry Combs eventually received pain cream and a back brace from Am-Med. Both, he says, he never wanted or needed but in the end, we all paid for.

"I told you not to send this to me. They said well at least you've got one in case you need it down the road."  

Facts about durable medical equipment (DME) fraud in Florida:

• Since  2012, the government has open 102 cases involving durable medical equipment (DME) fraud. Across the U.S. 822 cases have been opened.

• Since 2012, 63 DME fraud cases have resulted in criminal actions in Florida, 361 across the country.

• Since 2012, the U.S. government has recovered more than $58 million dollars from DME cases in Florida and more than $611 million dollars from DME cases nationwide.

Source:  Office of Inspector General, US Dept. of Health and Human Services 

https://www.abcactionnews.com/news/local-news/i-team-investigates/insiders-reveal-secrets-of-medical-device-scam-targeting-thousands-of-floridians

Half Of Democratic Ad Spending Hits GOP On Healthcare by Bruce Japsen

Half of the political advertising spent by Democrats running for office in midterm elections this fall is on healthcare, a new analysis shows.

A new report released Monday by the group Protect Our Care shows Democrats are riding a wave of support thanks in part to Republican attempts to repeal and replace the Affordable Care Act and other efforts to strip Americans of patient protections. And healthcare is the issue these Democratic candidates are using in 50% of their ads to help sweep them back into power in Washington and governor’s offices across the country.

The ads often point out Republicans voted many times in the last two years to repeal the ACA and its patient protections during Donald Trump’s time in the White House and even when President Barack Obama was in office.  Ads also attack Republicans like Missouri Attorney General Josh Hawley for being among 18 Republican attorneys general and two GOP governors who are attempting in federal court to declare as unconstitutional protections for patients with pre-existing conditions.

The use of healthcare to boost Democrats is in sharp contrast to 2010 when Republicans swept into power, winning control of the U.S. House of Representatives largely thanks to a campaign attacking the ACA, also known as “Obamacare.” As the law has expanded health coverage to more than 20 million Americans, it’s an entitlement rising in popularity much like Medicare coverage for the elderly or Medicaid for people with low incomes. But the ACA’s patient protections hit closer to home for more Americans than just those who gained coverage.

There are more than 130 Americans who have at least one pre-existing condition. And more than 30 million individuals between the ages of 55 and 64 who have a pre-existing condition and could have been denied coverage before the ACA began to take effect.

The ads appear to be working to grab voters attention with the report showing healthcare as a "top Google search in more than three-quarters of congressional districts."

Democrats say a day or week doesn't go by that voters and constituents don't ask about healthcare and whether the ACA's protections are in place and coverage is going to remain available given Trump remains in the White House and Republicans control the U.S. Senate and U.S. House of Representatives.

"What they really are asking is: will there be healthcare for me," U.S. Sen. Maggie Hassan, (D-New Hampshire) said in a conference call with Protect Our Care Monday afternoon. "I believe on Nov. 6, Americans are going to hold Republicans accountable for their sabotage."

Source: https://www.forbes.com/sites/brucejapsen/2018/10/15/half-of-democratic-ad-spending-targets-healthcare-as-midterms-loom/#7743f39f65a0

Value-Based Health Care Facilitates Value-Based Marketing by Karina Tama

Health care has been undergoing enormous change since the passage of the Affordable Care Act. As a digital marketer, it’s been intriguing to watch how those changes have affected the ways that health care providers have responded with marketing approaches.

Before the health care changes, providers employed a fee-for-service model. Hospitals and other providers had small budgets for marketing, but they didn’t really need larger ones. Board directors often questioned if they needed to advertise at all. I remember seeing the same types of traditional ads that other industries were using -- print ads, TV commercials, radio ads and big billboard signage. Occasionally, I’d get some direct mail for health care in my mailbox.

The changes in the health care industry mean that health care providers now get reimbursed for value-based care. Essentially, they get paid by helping people stay healthy and preventing the need for more expensive treatments. The switch has caused a major shift in how digital marketers in health care must approach their craft.

Digital Marketing Transitions Advertising From A Luxury To A Necessity

The changes in the approach to the market have forced hospital boards of trustees and CEOs to review their budgets and make strategic decisions about funding allocation for patient outreach and marketing. Quality care is still the primary goal in health care, and marketing is quickly rising on the list of priorities.

Just as health care providers like to see results when their patients’ health improves, I’ve learned that the chief executives of hospitals desire to see results from the funds they’re allocating toward digital marketing efforts. Despite feeling increased pressure to perform, I’ve never been one to back down from a difficult challenge.

By showing them how search engines boost their rankings and how good content and social media channels lead to patient conversions, I’ve been able to prove to board directors and senior executives that digital campaigns work.

Four Steps To A Health Care Digital Campaign That Gets Results

I’ve developed a four-step process to help health care organizations get people to take notice of their health care needs.

1. Boost Rank In Search Engines

Health care providers that are looking to attract patients will find a willing audience using search engines. According to a study by the Pew Research Center’s Internet and American Life Project, about 80% of internet users started with a search engine to find information on a health-related topic online. And research by Google found that 44% of patients who looked on their mobile devices for a hospital followed through and scheduled an appointment. 

That information tells me that paying attention to search rankings is money well spent by health care providers. By tagging webpages with relevant keywords, writing informative page descriptions and creating strategic HTML titles, search engines will prioritize the health care provider and make it equally visible on mobile devices.

2. Create Inbound Content With CRM Planning

Using a customer relationship management (CRM) tool, you’re able to draw patient data from a variety of sources to learn more about what terms and information patients are looking for and how they tend to go about getting it. You can effectively use automation in conjunction with this data. And you can also use it for multichannel strategies and strengthening engagement with prospects and patients.

The CRM dashboard tracks my results for email, direct mail, social media and texting. The data helps me decide what kind of content to produce, so my audience gets the right content at the most optimal times. Content that is relevant and of high quality still produces the best results, so there’s no skimping on professional, informative content.

Prospects become patients when the right content meets the right marketing channels at the right time.

3. Get Active On Social Media

Social media is the place for health care providers to be because that’s where their potential patients are. Social media channels are the perfect places to engage patients in discussions and support physicians. They’re also the perfect places to educate the public about health topics, which can lead to overall improved health outcomes.

4. Adjust Your Digital Campaigns Based On The Data

One of the great things about attracting patients to health care sites is that they use various types of data while they’re searching. That makes it much easier to craft digital marketing campaigns. If the results aren’t trending as well as you hoped, review and analyze the aggregated data. Within a few minutes, I can pick up on different data, quickly change my campaign strategy in real time and watch the results in action.

Before the changes in health care, marketers often put their best foot forth using the traditional marketing ads of the day and hoped for the best. There was really no way to measure the results. Today, I’ve been able to get buy-in from senior executives by offering real results from the return on investment of their marketing dollars.

Once you have the opportunity to demonstrate how their names and practices have risen to the top of the search engine, how you’ve used data to determine the most popular topics and how active their social media campaigns have become, it’s easier to get buy-in from the top executives and board members who control the marketing funds.

Value-based care created a major change in today’s health care, and it’s also given digital marketers an opportunity to produce value-based results.

Source: https://www.forbes.com/sites/forbescommunicationscouncil/2018/10/03/value-based-health-care-facilitates-value-based-marketing/#677e93e35702

Threatened Tariffs and Taxes A One-Two Punch to American Medical Technology Companies by Brian Darling

We’ve just passed the 600-day mark since Trump took office and – to the disappointment of his many critics – the American economy is still going strong. The economy added 201,000 new jobs in August, sending the unemployment rate down to a historically low 3.9 percent. Wages are up too. Twenty straight months of continuous job growth is great news and a trend that should continue with pro-growth policies.

The success of the Trump administration’s relentless focus on enacting policies that grow the economy, create jobs, and boost innovation is impressive. The American MedTech sector in particular has earned the envy of the rest of the world and has been described as one of our country’s greatest success stories. As a high-tech, high growth industry, American MedTech brings the latest and most effective treatments to patients in need.

But there’s a looming threat on the horizon: A deadly combo of taxes and potential tariffs that may deliver a one-two punch to American MedTech. High taxes on any sector of the economy will stifle growth and the possibility of tariffs piled on taxes will hurt this one sector of the economy that has both created new jobs and increased the health of Americans.  Any policy that leads to higher burdens on growth are bad news and may slow the historic efforts of President Trump to make the economy great again.

Tax policy has always been discriminatory towards the medical device industry since President Obama declared them a funding source for Obamacare. In a little more than a year from now, nearly all medical devices sold in the United States will be subject to a punitive excise tax, a remnant of Congress’ 2010 attempt to make Obamacare less affordable for those who use medical devices and to make the misnamed “Affordable Care Act” not appear to cost all that much on paper. This tax will make it harder for medical technology companies to plan for the future, forcing some to delay hiring and scale back research and development investments at a time when such investment is already dwindling.

While lawmakers have been wise to suspend the tax in past years, they let it go into effect between 2013 and 2015. In that short period of time, the medical device industry lost 29,000 jobs and was projected to decline $2 billion in R&D investment each year the tax was in effect. This should be more than enough proof to show that the tax needs to be repealed. Nevertheless, it remains on the books and is slated to take effect again on January 1, 2020.

New proposed tariffs on imports from China are likely to hammer the medical device industry too. While reducing our unfair trade deficit and confronting the Chinese over their blatant theft of American intellectual property are laudable goals, these tariffs will ultimately do more harm than good if they go into effect.  Hopefully, President Trump’s threats will be enough to force the Chinese government to negotiate some better deals that provide fairness to the American consumer and worker. 

The problem is that many medical devices manufactured for American consumers have components manufactured in China. Included among the thousands of products soon-to-be subject to import duties are some of the critical components used in the manufacture of medical imaging devices – MRI machines, CT scanners, and the like. Many of these products are made in America, but by global firms whose supply chains intersect with the Chinese market. 

If these tariffs are imposed and stay in place for a long period of time, this will harm an already overburdened American medical device industry. Imposing tariffs in this respect amounts to a tax on inter-company transfers. It would also do little to correct our trade imbalance with China considering the medical imaging industry is a net-exporter that produced a $1.1 billion surplus worldwide. Instead, the tariffs will undercut the competitiveness of American MedTech companies and incentivize foreign companies to invest in other markets.

Between the device tax and the tariffs, imaging technologies will be subject to a “double tax”: one on the components they import from abroad and another on the sale of their devices. And, like all taxes, the bulk of it will get passed on to consumers, rising healthcare costs and delaying patient access to the latest treatments and technologies.

The good news is there’s still time for this disaster to be averted. The House of Representatives voted in July to permanently repeal the medical device tax and the administration has expressed its support for repeal. It’s now up to the Senate to act.  On the tariffs, the U.S. Trade Representative still has time to exempt certain goods. It already did so for defibrillators, hearing aids, diagnostic tests, and dental fillings. As life-saving pieces of equipment, medical imaging devices should absolutely be added to that list.  

Policymakers have the power to make these changes and keep American MedTech – and the economy – great.

Source: https://townhall.com/columnists/briandarling/2018/10/02/threatened-tariffs-and-taxes-a-onetwo-punch-to-american-medical-technology-companies-n2524740

Emerging Technology Could Help Fill Healthcare Gaps by Shawna De La Rosa

Healthcare that is accessible, affordable and available to all may not be all that far off thanks to advancing technology. On Thursday, Bisnow Seattle Future of Healthcare 2018 event panelists discussed how evolving technology can help bridge gaps that prevent equity in the way care is applied. There is a major shift in the industry that puts the emphasis on preventing illness rather than reacting to it. Bisnow/Shawna De La Rosa B+H Advanced Strategy Director and co-founder Bryan Croeni, UW Medicine Associate Chief Medical Officer Dr. David Flum, Virginia Mason Health System CEO Dr. Gary Kaplan, TGB Architects' Lois Jean Broadway, Swedish Health Services CEO Dr. R. Guy Hudson and OpenSquare Director of Workspace Consulting Rhonda Pollard, who moderated IN 66 DAYS! DON'T MISS THE BISNOW ANNUAL STUDENT HOUSING WEST -- Los Angeles 12.6.2018 Technology is the key, if properly applied, The Polyclinic Chief Medical Officer Dr. Marc Miller said. Technology, and the data collection made possible because of it, can expose gaps in an individual’s care that can then be addressed. Currently, the healthcare system is built on a payment structure that pays providers for giving care to sick patients. Thanks to technology, that trend is shifting from fee-for-service to a set fee for everything included, Vera Whole Health Chief Revenue Officer Jennifer Sargent said. In that scenario, wellness becomes more of a priority and, thanks to advances in technology, more affordable. Technology can help with tasks like collection of patient data and vital statistics.  “Let technology do the easy stuff and let the providers do the hard stuff,” she said. “Technology can’t replace the face-to-face care that a human can provide.” One problem is that all this technology takes up precious space in hospitals and doctors’ offices. “In 1976, when some of the hospitals were built, there were no personal computers, no robotics, no CTs,” CHI Franciscan Health Chief Operating Officer Ian Worden said. The current rooms aren't designed to handle the heat caused by all the machines. Bisnow/Shawna De La Rosa The Polyclinic Chief Medical Officer Dr. Marc Miller, Microsoft Director of Health Strategy Benjamin Shobert, OAC principal Derek Rae, Vera Whole Health Chief Revenue Officer Jennifer Sargent, PAE Consulting Engineers associate Daniella Moreano Wahler, CHI Franciscan Health Chief Operating Officer Ian Worden and Abbott Construction Project Executive Kyle Raschkow, who moderated IN 66 DAYS! DON'T MISS THE BISNOW ANNUAL STUDENT HOUSING WEST -- Los Angeles 12.6.2018 Evolving technology will always be a challenge, but buildings need to be constructed to handle the changes, OAC principal Derek Rae said. The healthcare construction industry needs to figure out a way to develop buildings that will allow for flexibility as technology changes. Buildings can be renovated to utilize technology that helps them operate more efficiently, and it is not always that expensive, PAE Consulting Engineers associate Daniella Moreano Wahler said. “I’ve seen buildings where the boiler and cooler are running at the same time,” she said. “That is not efficient. There are some really easy fixes out there that can save a lot of money.” When it comes to providing care, applying technology can be tricky, Microsoft Director of Health Strategy Benjamin Shobert said.  “Right now we are at an interesting moment,” he said. “The hope is that more healthcare technology is going to make things better. But technology misapplied can also make things much worse. It can shine a light on healthcare issues, but can’t always solve those issues.”

Source: https://www.bisnow.com/seattle/news/healthcare/emerging-technology-could-help-fill-health-care-gaps-93425?utm_source=CopyShare&utm_medium=Browser

Report: Medical Technology Industry 'Under-Investing' In R&D by Bruce Japsen

Medical technology firms aren’t investing enough in research and development to keep pace with the needs of consumers gaining more clout in a value-based healthcare system, a new report indicates.

Consulting firm EY’s 2018 report on the medical technology industry shows revenue growth of 4% last year to a record $379 billion , but investment in research and development was largely flat. And that’s a problem, EY consultants say, as those picking up the tab for healthcare demand the latest in digital technology and devices to improve quality and reduce costs.

“R&D investment growth has dwindled in recent years, declining to 4.7% in 2013–17 from an average of 15.5% in 2000–07,” EY’s medical technology industry report said. “Yet, despite the urgency to invest in new capabilities, medtech companies in aggregate are under-investing in R&D. Year-over-year investment in R&D held steady in 2017, but — as with revenue growth — the longer view … reveals that the rate of R&D investment growth has dwindled in recent years, declining to 4.7% in 2013–17 from an average of 15.5% in 2000–07.”

The report is being released during the Advanced Medical Technology Association's annual MedTech Conference. AdvaMed includes some of the nation's largest medical technology companies including Johnson & Johnson, Abbott Laboratories, Medtronic, Zimmer and Baxter International as well as scores of medtech startups, device makers and diagnostic companies.Though AdvaMed's member firms continue to grow and the venture capital climate remains strong, the medtech industry as a whole isn't keeping pace with the technology industry, EY's report indicates. The "urgency" described in the EY report is in part due to the shift from fee-for-service medicine to value-based care, which rewards medical care providers with the best health outcomes and quality. Medical technology is critical to managing the health of populations of patients, making sure they get the right care, in the right place and at the right time.

Source: https://www.forbes.com/sites/brucejapsen/2018/09/24/report-medical-technology-industry-under-investing-in-rd/#5c36401451a7

Restrictive Innovation: How Medical Device Manufacturers Confound Clinical Excellence by Paul Martyn

Across industry, evidence of planned obsolescence is revealed a number of ways. Automobile manufacturers are known to provide a great example. Whether through frequent and unwarranted changes in design, a termination of spare parts supply or the intentional use of nondurable materials, consumers "get it" and have even come to accept it.

In healthcare, the practice is known as “restrictive innovation” and its effects are far more insidious. Under the guise of innovation, the industry's medical device manufacturers have become so brazen about introducing meaningless product changes that noted Princeton economist Uwe Reinhardt openly called them out, saying, “unnecessary innovation is one of the industry’s biggest cost drivers —a tax on the system that protects OEM profits and confounds customer [hospital] strategies to save money.”  With device costs already running 60% of the total reimbursement tied to many procedures, the economics are unsustainable. Even worse, meaningless "innovation" adds cost pressures that ultimately hurt patients. Especially for hospitals that rely on Medicare/Medicaid-reimbursements, the effects invariably include a reduction in the number of patient procedures performed, meaning clinicians do not achieve the competency needed to increase success rates.

An Industry Example:  Medical Device Reprocessing

The unnecessary and rapid launch of “new and improved” products designed to confound commoditization places constant pressure on hospitals to spend money on devices that aren’t any better.  To fight back, many have successfully dealt with premium priced new technology adoption by leveraging FDA controlled device reprocessing. By collecting used devices and working with commercial reprocessing companies to refurbish them at about half the cost of new, they achieve a blended device rate that is economically viable.

It would seem that all ships might rise on such a virtuous tide, but it’s not the case. OEMs are responding by employing engineers whose specific job is to create designs that are more costly to reprocess. For example, the OEMs have recalled devices for the sole purpose of modifying operating codes so they lock after a single-use, offering no evidence of clinical improvements. They release “new and improved” versions where the only change is to make vital parts, like a chip controller, less accessible to re-program. Device company representatives will give away generic system parts, like cables, that are later discovered to only work with what they sell as single use. These same representatives are even known to withhold support from a physician who chooses to use the identical reprocessed version of the device that they sold --to the same doctor. The anecdotes are rampant and troubling. Beyond the added stress to healthcare's struggling economy, it’s a shameful tug of war that is antithetical to the interests of patients.

A Hospital Example: The Electro-Physiology Lab 

The restrictive innovation efforts of the OEMs are particularly egregious in the Electro Physiology sub category of cardiology, as the devices are notoriously expensive and the FDA has approved many of them for reprocessing. As mentioned, procedural cost pressures directly impact what hospitals do and who gets what. And because physicians don’t become great at performing procedures that are economic losers for themselves and the hospitals where they operate, patients also lose.

Atrial Fibrillation ("A-Fib") Ablation provides an outstanding example, as demand for the procedure is high, yet the number being performed has slowed, meaning the improvements that the scientific evidence indicates are available are not being appropriately reflected in patient outcomes. Although the procedure has been shown to be more effective than medication therapies, it is still only 15% penetrated in the U.S., despite significant and known quality of life improvements. So, it is not a coincidence that there are a limited number of specialists. And, it should not be surprising that the physicians who are known to be particularly effective at this procedure tend to work in profitable EP labs where OEM tactics designed to confound value, like reprocessing, are not tolerated.

Rick Ferreira, CEO of Innovative Health, whose company is doing its best to drive cardiology device reprocessing, put it very plainly: "Technology innovation in AF Ablation has opened up the opportunity for us to revolutionize the treatment of heart disease, but its impact is confounded by commercial practices that effectively restrict rather than expand access.”

We know that the medical device OEMs are under tremendous pressure to optimize their pricing for predictable, short-term gains.  And we know that they do it well, as their stock values have basically doubled over the last five years. Meanwhile, as a matter of survival, the care-provider market is consolidating. It’s a stunning juxtaposition, especially when considering that it has happened in a marketplace where supply grossly exceeds demand.

Hospital leaders must own the decisions that ultimately determine internal utilization, access and outcomes. They cannot allow them to be driven by OEM sales targets. As a starting point, they should direct their procurement staff to stop buying devices where the value-add is below the value-based reimbursement threshold. Value-based healthcare is transforming the care provider/payer/patient triad, so the idea that the industry's supply-side has somehow managed a "pass" is unacceptable.

Restrictive innovation is nothing short of a bully strategy against a vulnerable industry and patient populations that deserve better. And when considering that tax expenditures fund nearly two thirds of healthcare costs, the practice should not be tolerated.

Source: https://www.forbes.com/sites/paulmartyn/2018/09/19/restrictive-innovation-how-medical-device-manufacturers-confound-clinical-excellence/#74af6cef1e4c

How To Really Take Medical Conflicts Of Interest Seriously by Matthew Herper

If we’re going to have a central database of conflict of interest disclosures in medicine—and there is one, created by law—it’s high time that people start using it.

This weekend, the New York Times, working with the nonprofit ProPublica, reported on its front page that Jose Baselga, one of the world’s top oncologists and the chief medical officer of Memorial Sloan Kettering Cancer Center, failed to disclose financial conflicts of interest when he wrote articles for medical journals including the New England Journal of Medicine. That includes more than $3 million dollars Baselga made when Roche bought Seragon, a startup that had paid him in stock.

The big message is that most people don’t realize that doctors can be paid large sums of money by drug companies, and that making sure these sums are disclosed is important if one doesn’t want the whole enterprise of developing drugs to appear crooked. That’s why the a 2010 law called the Physician Payments Sunshine Act—which makes the highly unusual decision that a whole class of people (doctors) should have no right to privacy over payments made to them by drug companies—exists. (Baselga's conflicts, though undisclosed in medical journals, were in that database.)

“If you do science (some of it taxpayer funded, others intended to influence decisions of regulatory agencies), lead a not-for-profit academic institute, lead a professional society, then having to tell the world about your related financial interest is the price you pay for the privilege of being allowed to hold those interests in the first place,” tweeted Steven Joffe,the Emanuel and Robert Hart Professor of Medical Ethics and Health Policy at the University of Pennsylvania.

The Times story was arguably not fair to Baselga in some ways. It blurred the line between a consulting payment (what doctors usually get from drug companies) and the Roche’s purchase of stock he owned. Consulting payments create the expectation of an ongoing relationship. Purchasing a company is different, and may create gratitude, but doesn’t hold out a future incentive for Baselga to be nice to Roche. He already has the money. It is a conflict, but the distinction is worth making. Without the Seragon stake, the dramatic statement that Baselga withheld "millions" would not be true. The article also stretches to portray comments in which he called a drug's effect modest but said that was still scientifically exciting as positive spin.

But there's no question Baselga should have disclosed the payment. It's baffling that he didn't, and shows how cavalier many physicians are about disclosure. To quote from a New England Journal disclosure form: “You should disclose interactions with ANY entity that could be considered broadly relevant to the work.” An entity paid you three million bucks? Seems broadly relevant.

This leads to deeper questions: How is it that a medical journal would allow a physician not to disclose a payment that exists in a public database? How is it that Memorial Sloan Kettering isn’t checking to be sure that Baselga bent over backward to make a relevant disclosure?

The obvious solution: have a public database that includes all those conflicts, and use it. The one created by the Sunshine Act is a start, and medical journals should  check disclosure forms against it. But it doesn’t include corporate boards (Baselga is on the boards of Varian and Bristol-Myers Squibb) or companies whose drugs or medical devices are not yet marketed. In the meantime, physicians and their employers should start thinking about disclosing potential conflicts not as an embarrassment to be avoided but as an inoculation against the risk of someone else pointing out those conflicts for them. As Baselga found out, once someone has beat you at a game of "gotcha!" a defense can be pretty hard to mount.

Source: https://www.forbes.com/sites/matthewherper/2018/09/10/how-to-really-take-medical-conflicts-of-interest-seriously/#7fcd184e396e

Health, Not Health Care by Sandro Galea

Americans value health. We pour vast sums of money into health care, we obsess over diet and exercise, we lionize doctors in popular television shows, we celebrate the latest cutting-edge treatments, we even comb through our genes for the secrets to a long, disease-free life.

But does all this actually make us healthier?

The true sources of health are not the drugs we take and the doctors we see, nor how much we eat and how often we go to the gym. Instead, our health is determined by the world in which we live. The safety of our neighborhood, the amount of money we make, the people we interact with, the love and hate we encounter, the justice of our laws, the cleanliness of our air and water, the choices made by political leaders, and sometimes just sheer luck are what really decide whether we get sick or stay well. They are what we should talk about when we talk about health. This column explores these factors.

Last month, the Trump administration took a step that will likely have significant consequences for health in the US. This step did not involve the Affordable Care Act, or the opioid crisis, or the price of pharmaceuticals, or any other area we typically associate with health policy. It involved our air. The administration announced its proposal to roll back Obama-era regulations meant to prevent coal-fired plants from polluting. Under the new plan, states will be able to relax emissions standards, a move expected to help the coal industry while increasing carbon emissions across the country. In a moment of what can only be described as political cognitive dissonance, the Environmental Protection Agency, which touted the proposal, also indicated in its analysis of the plan that the emissions increase could cause up to 1,400 premature deaths each year by 2030.

Emissions from coal-fired plants can contain a range of dangerous pollutants, including sulfur dioxide, carbon dioxide, nitrogen oxide, and airborne particulates. These pollutants can cause asthma, bronchitis, and lung disease. According to the EPA, this danger will increase under the new plan, which is projected to create 48,000 cases of asthma alone. But the direct effects of pollution are not the only way that loose emissions standards can harm health. Coal-fired plants also contribute to climate change, a phenomenon with devastating health consequences, some of which we know and some of which we are only beginning to understand. Research has suggested that, as we move further into the age of climate change, rising global temperatures will contribute to an increase in heat-related mortality. Climate change also creates the conditions for natural disasters like hurricanes, floods, and wildfires. These events, in turn, cause widespread injury and death, not just when they first strike, but during their aftermath. Standing floodwater can provide a place for dangerous bacteria and disease-spreading mosquitos to breed. The disruption of infrastructure in a storm-struck region can undermine basic services like waste removal, or interfere with the effective functioning of health systems. The trauma of disasters can increase risk of mental illnesses like depression and posttraumatic stress disorder.

Pollution and climate change have little to do with doctors and medicines, but everything to do with health. They are part of the social, economic, and environmental conditions in which we live, and which shape our wellbeing. While doctors and medicines can help us when we get sick, it is these deep-rooted conditions that determine whether or not we get sick in the first place. If our air and water are dirty, if our neighborhoods are rundown, if our society is roiled by prejudice and hate, then even the most cutting-edge medical technology can do little to keep us healthy.

When we think about health, we do not often think of where it comes from, of how it emerges from our shared context. We think of health in medical terms, as something that comes when we cure ourselves. But cure is not as significant as the complex web of political policy, economic trends, cultural currents, and ecological change that truly underlies health. For this reason, we need to talk about more than health care when we talk about health. Money, power, politics, corporate governance, the moral and ethical character of our society, the basic welfare our earth—these are the subjects that must be at the core of our health conversation, if that conversation is to ever lead to a healthier world.

With this in mind, let us return to the subject of deregulation. Despite the clear hazards of pollution and climate change, we may well ask if it is right to make companies abide by rules that will help the environment. Certainly, a healthy environment is desirable, but, as Milton Friedman and others have argued, a company’s function is not necessarily to achieve such a goal. According to their philosophy, the only social responsibility a company has is to generate profits that enrich its shareholders. To acknowledge otherwise, the thinking goes, would be to open the door to a network of laws and bureaucracy that could stifle economic productivity. This opinion was operationalized at the federal level by Ronald Reagan, and further entrenched by subsequent administrations, so, unlike the socialism of which it often warns, we have a clear picture of what this economic faith looks like when it is practiced on a large scale in the US.

What does this picture show? Over the last 30 years, we have continued to spend more on health than any other country in the world, yet our health has lagged behind that of our peer countries. According to a 2013 report from the National Research Council and the Institute of Medicine, among the world’s 17 most economically successful countries, the US ranks near the bottom of the list on nearly all key health indicators. We have fallen behind because we have, in the years since Reagan, rolled back our investment in public goods—resources which benefit everyone and which all can access without limiting the good’s availability for anyone else. Public goods improve our health by improving the conditions that produce wellbeing; everything from a clean environment, to parks where we can exercise, to traffic laws that keep our roads safe, to schools that educate our children. Indeed, health itself is a public good, one which has been greatly undermined by our neglect of the policies and institutions that sustain it. From cuts to the social safety net, to less money for education, to, yes, environmental deregulation, our disinvestment in the public goods that allow for human flourishing is reflected by our mediocre health.

Should corporations, then, be required to color inside the environmental lines for the sake of our collective health? Only if the people running them wish to avoid breathing toxic fumes, drinking contaminated water, and living on a simmering earth. “Collective,” it is worth recalling, means everyone, and public goods ultimately help us all—from CEOs, to assembly line workers. Investing in public goods shores up the foundations of health in our society, the conditions in which we live. It also acknowledges the extent to which the underpinnings of health fall outside the realm of medicine. If we are to live healthy, creating a world that generates health must take priority over short-term economic gain or the creation of drugs that cure the diseases we fail to prevent. To do this, we must change how we talk about health, and place public goods at the center of the public debate.

Source: http://fortune.com/2018/09/06/healthcare-environment-public-health/

How to develop IT services for healthcare vertical opportunities by Esther Shein

With its niche opportunities and heavy reliance on technology, the medical vertical market is viewed as strategic for managed services providers to operate in. However, providing IT services for healthcare organizations isn't easy.

Yet MSPs say that the efforts required, such as to meet complex regulatory demands, pay off.

Versatile, a Boston-based solution provider, "has always been drawn toward complex and challenging areas of IT," explained CEO and co-founder John Barker. As a result, Versatile acquired a healthcare IT managed and professional services company and launched an ambulatory IT healthcare practice called Versatile Healthcare Solutions in May 2018. "We really felt that technology solutions will provide the major hope for improving our nation's healthcare situation," he said.

Company officials thought it made sense to combine Versatile Healthcare Solution's expertise for working with healthcare customers with the company's more than 20 years of experience providing IT solutions and services, Barker said.

Healthcare organizations want to work with providers that have a deep-rooted understanding of the complexities of their industry, as well as their IT concerns, added Chris Pond, president of cloud services at Burwood Group, an IT consultancy and MSP. Pond said about 35% to half of Burwood's business is in the medical vertical market.

Technologies that partner firms implement for healthcare customers can improve the quality of care and responsiveness to patients and critical issues within care facilities. "That's a big issue in healthcare. You may be in IT, but the work we do can have a profound impact on people's lives -- literally," Pond said. If you don't have "an acute understanding of the impact of these technologies not being available," it can have a profound effect on a customer's ability to deliver care, he added.

Healthcare customers continue to grapple with security, creating an opportunity for IT services providers to step in and help.

How to develop IT services for healthcare

Once Versatile made the decision to enter the medical vertical, the first step was to ensure that all the existing customers that came with the acquisition were comfortable with the transition to the new company, Barker said.

"From there, it was critical to get all of our new employees acclimated to their new company and to understand how we operated and what we brought to the table that was different," Barker said.

Although Versatile's newly acquired company and its customers viewed the acquisition as a win-win, "you still cannot discount the work involved when integrating new customers, new employees and different ways of getting things done," Barker noted.

As Versatile demonstrates, one way to start delivering IT services for healthcare customers is through a merger or acquisition. However, this requires a significant amount of work to ensure a successful integration. Despite the amount of time invested in the due diligence of a transaction of this nature, there are always "surprises" that crop up post-acquisition, which may require more time and energy than originally predicted. The lesson here is that you need to make sure that you allocate a significant amount of time for integration of new people, customers and processes to ensure a smooth transition.

Jason Record

One of Versatile's lessons coming out of this was that "we needed to continue the same level of effort we put in before the acquisition as we did [after] the transaction. Getting the deal done wasn't the end; it was really just the beginning."

Then, of course, there were compliance concerns to address. "One of the biggest challenges when focusing on ambulatory healthcare IT is enabling standardization and centralization in a distributed environment," said Jason Record, managing consultant at Versatile. It helped that they were adept at choosing technologies and standards over the years that make sense for their customers and demonstrating recognizable return on investment, he said.

We want our customers to be able to focus on providing care to their patients and not on troubleshooting IT issues.

Jason Recordmanaging consultant, Versatile

Ambulatory care providers with distributed sites of care "can really benefit from using an experienced healthcare IT solutions provider to leverage economies of scale for their members with solutions that would be unfeasible or too costly to implement on an individual basis," he said. These solutions include centralized antivirus and authentication services and encryption, which Record said "provide significant benefit to a distributed organization," meaning a physician's organization that has "so much sensitive data to protect and regulations like HIPAA [Health Insurance Portability and Accountability Act] to follow."

Technology systems that may be easy for a healthcare organization to implement may be daunting for an independent family practice without the right technology partner, Record added. "We want our customers to be able to focus on providing care to their patients and not on troubleshooting IT issues. Our goal is to make technology seamless for our customers by providing success-enabling solutions along with top-notch support and customer service."

It is critical to have policies and procedures in place when developing IT services for healthcare customers, Pond added. "Building a foundation from a managed services perspective, we found, was the best way to address new markets and existing markets."

Developing a HIPAA-compliant practice was not that much of a challenge, he maintained, since Burwood was already versed in following the Payment Card Industry Data Security Standard. Even though the healthcare vertical is a different industry, most of the regulatory frameworks "are fairly well-aligned," he said.

Burwood is already SOC 2-compliant, which Pond said is "probably a bigger challenge for people starting up," along with the investment it takes to build out infrastructure, including staff, monitoring and reporting tools, and redundancy and backup -- not to mention processes and procedures.

The real challenge comes in the "ability to govern and have stringent policy management and really address customer needs," he said. People may enter the medical vertical market thinking that if they purchase a monitoring tool subscription they can monitor their customer's environment. "They might get a couple of customers that way, but to get a sustainable business and create partnerships with customers, those investments really need to be made."

Where the medical vertical opportunities are

Because technology is still often viewed as cumbersome, there are enormous MSP opportunities in healthcare consolidation, Barker said.

"At the practice level, there are far too many technology variables associated with a good or bad experience," he said. "There is still a general view that healthcare workers want to focus more of their time on patient care and less on fumbling with their IT."

For example, several application providers are pushing cloud and managed IT services for healthcare customers, Barker noted, "but they want little to do with the infrastructure-related items. [Yet] those two things are completely intertwined. Being able to provide some level of end-user support that encompasses the entire end-user experience is critical."

 
He advised that MSPs interested in entering the healthcare market concentrate on a specific area of expertise, such as providing IT services for small medical offices, and build that practice out first before broadening their portfolio. Even with its many challenges, there are opportunities for innovative companies to solve problems and build additional business and services.

"Furthermore, it's been encouraging to see that the government is starting to embrace some of the innovative healthcare solutions, such as e-medicine, as it pertains to reimbursement, and that should further open the door for technology providers to get involved," Barker said.

Pond said Burwood is finding big opportunities in the healthcare vertical because of consolidation, "which always creates chaos, which creates opportunities for someone to help through that."

However, when consolidation happens, there are several things to think about. There tends to be a lot of disparate technologies that have to be operated separately until a provider integrates them, he said. Often, there are also a lot of employees in transition, "so depending on the path the merging organizations are taking, it can create lot of anxiety where people start leaving."

You’ll Never Guess Which Company Is Reinventing Health Benefits by Reed Abelson

It’s hard to think of a company that seems less likely to transform health care.

It isn’t headquartered in Silicon Valley, with all the venture-backed start-ups. It’s not among the corporate giants — Amazon, Berkshire Hathaway and JPMorgan Chase — that recently announced, with much fanfare, a plan to overhaul the medical-industrial complex for their employees.

And it is among the most hated companies in the United States, according to many surveys on customer satisfaction.

It’s Comcast. The nation’s largest cable company — the $169 billionPhiladelphia-based behemoth that also controls Universal Parks & Resorts, “Sunday Night Football” and MSNBC — is among a handful of employers declaring progress in reaching a much-desired goal. In the last five years, the company says, its health care costs have stayed nearly flat. They are increasing by about 1 percent a year, well under the 3 percent average of other large employers and below general inflation.

“They’re the most interesting and creative employer when it comes to health care benefits,” said Dr. Bob Kocher, a partner at Venrock, a venture capital firm whose portfolio companies have done business with Comcast. (The cable company declined over several months to provide executives for an interview on this topic.)

Comcast, which spends roughly $1.3 billion a year on health care for its 225,000 employees and families, has steered away from some of the traditional methods other companies impose to contain medical expenses. It rejected the popular corporate tack of getting employees to shoulder more of the rising costs — high-deductible plans, a mechanism that is notorious for discouraging people to seek medical help.

Most employers now require their workers to pay a deductible before their insurance kicks in, with individuals on the hook for $1,500, on average, in upfront payouts, according to the Kaiser Family Foundation. Instead, Comcast lowered its deductible to $250 for most of its workers.

“We believe that no one should be required to be an expert in health care,” Shawn Leavitt, the executive overseeing benefits at Comcast, said in a 2015 interview with a consultant. “Our model is based on providing employees support and assistance in making the right decisions for themselves and their families. Employees should not feel alone, confused and overwhelmed when it comes to understanding and selecting their benefits.”

Cable TV subscribers who have felt confused and overwhelmed when dealing with Comcast customer service may be surprised to learn how nimbly the company has upgraded services for its employees. While Comcast continues to work with insurers, it has largely shunned them as a source of innovation. Instead, it has assembled its own portfolio of companies that it contracts with, and invests in some of them through a venture capital arm, Comcast Ventures.

Turning to health start-ups for new benefits

One such company is Accolade, in which Comcast is an investor, and which provides independent guides called navigators to help employees use their health benefits. Another, called Grand Rounds, offers second opinions and help in finding a doctor. Comcast was also among the first major employers to offer workers access to a doctor via cellphone through Doctor on Demand, a telehealth company.

 

“We see the start-up community as where the real disruption is taking place,” said Brian Marcotte, the chief executive of the National Business Group on Health, which represents large employers. “We weren’t seeing enough innovation.” The group now vets some of these companies for employers, including Comcast.

Comcast “is the tip of the spear,” Mr. Marcotte said.

The corporation, of course, is controlling costs and offering these unusual benefits out of self-interest. And these services are sometimes handed out at the expense of improving wages. In a tight labor market, Comcast also needs to remain competitive for not only highly skilled employees, but also lower-wage workers whose direct contact with customers has generated so much dissatisfaction over the years. “We do these things because it’s great for business,” Mr. Leavitt said.

But much of what sets Comcast apart is its willingness to directly tackle its medical costs rather than relying on others — insurers, consultants or associations. It’s a luxury only the largest companies can afford, and roughly a fifth of big companies continue to see annual cost increases of more than 10 percent, according to Mercer, a benefits consultant.

While fate may play a role — a single expensive medical claim can drive up a company’s costs in any given year — employers, like Comcast, that use a variety of strategies tend to have the lowest annual increases. “You attack this thing from different angles,” said Beth Umland, Mercer’s director of research for health and benefits. “The intensity of effort pays off.”

Some companies are shaking up hospitals and doctors

Other employers are focusing more attention on unsatisfying hospitals and doctors. Walmart has been at the forefront of efforts to direct employees to specific providers to get medical care, even if it means paying their travel to places like the Mayo Clinic.

The retailer said it had found, for example, that employees were being told they needed back surgery even when they would not benefit from the procedure. “Walmart isn’t going to stand for this,” said Marcus Osborne, a benefits executive, at a health business conference. “We aren’t going to sit around to try to build another coalition or bureaucracy.”

The majority of working-age Americans — some 155 million — get their health insurance through an employer, and most companies cover their own medical costs. The companies rely on insurers to handle the paperwork and to contract with hospitals and doctors. Insurers may also suggest programs like disease management or wellness to help companies control costs.

But employers, including that Amazon-Berkshire-JPMorgan alliance, are increasingly unhappy with the nation’s health care systems. Companies are paying more than they ever have. And their employees, saddled with escalating out-of-pocket costs and a confusing maze, aren’t well served, either. “The results haven’t been there,” said Jim Winkler, a senior executive at Aon, a benefits consultant. “There’s frustration.”

At Comcast, some workers probably miss out on the new ventures altogether and others don’t have much choice but to go along. The company’s relationship with labor is often strained, and it has largely managed to fend off efforts by groups like the Communications Workers of America to organize its employees. Robert Speer, an official with a local of the International Brotherhood of Electrical Workers in New Jersey that represents about 180 workers, noted the company’s use of independent contractors to do much of its work, none of whom are eligible for benefits and can be paid by the job rather than hourly. “You are making no money,” he said.

And, like many other workers, many employees are being pinched by the rising cost of premiums, Mr. Speer said.

Comcast workers with company coverage are told to go to Accolade first. Its phone number appears on the back of their insurance cards and on the benefits website. “The key to Accolade’s success is being the one place to go,” said Tom Spann, a co-founder of the company.

Geoff Girardin, 27, used Accolade when he worked at Comcast a few years ago and he and his wife were expecting. “Our introduction to Accolade was our introduction to our first kid,” Mr. Girardin said. He credits Accolade for telling him his wife was eligible for a free breast pump and helping find a pediatrician when the family moved. “It was a huge, huge help to have somebody who knew the ins and outs” of the system, he said.

For employees like Jerry Kosturko, 63, who survived colon cancer, Accolade was helpful in steering him through complicated medical decisions. When he needed an M.R.I., his navigator recommended a free-standing imaging center to save money. “They will tell me what things will cost ahead of time,” Mr. Kosturko said.

A nurse at Accolade helped him manage symptoms after he had surgery for bladder cancer in 2014. He developed terrible spasms because, he said, he wasn’t warned to avoid caffeine. The Accolade nurse thought to ask him and quickly urged him to call his doctor for medicine to ease his symptoms.

Mr. Kosturko also turned to Grand Rounds when his doctor thought he might need to stay overnight in the hospital to be tested for sleep apnea. The second opinion convinced him he did not.

In complicated cases, Grand Rounds can serve as a check on the network assembled by the insurer. It pointed to the case of Ana Reyes, 39, who does not work for Comcast and had contacted Grand Rounds after treatment for cervical cancer. When she continued to have symptoms, she says, she was told to wait to see if they persisted.

“This is my life at stake,” she recalled in an interview. “I need to know what I’m doing is the best plan.” Grand Rounds asked a specialist at Duke University School of Medicine, Dr. Andrew Berchuck, to review her case.

“Grand Rounds was able to get all my medical records, which is over 1,000 pages,” Ms. Reyes said. Dr. Berchuck reviewed and wrote his opinion in one week, recommending a hysterectomy because she was likely to have some residual cancer. “The same day, my treating physician, she called me to schedule a hysterectomy,” Ms. Reyes said.

Insurers are usually none too pleased with the employers’ use of alternatives: They’re reluctant to share information with an outside company and poised to undercut a potential competitor by offering a cheaper price. They may even refuse to work with some of the companies.

The largest employers push back. Fidelity Investments insists on cooperation between insurers and outsiders, said Jennifer Hanson, an executive at Fidelity Investments. “Those who don’t will be fired,” she said at a health business conference.

For Comcast, the next frontier is the financial well-being of its employees, many of whom live paycheck to paycheck and may not be able to afford even a small co-payment toward a doctor’s visit. Employees who run into financial trouble have no independent source of information, Mr. Spann said.

After talking to hundreds of companies, Comcast Ventures could not find a financial services start-up that would help employees without trying to sell them a product or earning their money on commissions. So Comcast recruited Mr. Spann to serve as chief executive of a new company, Brightside, that it created and invested in.

Employees who are less worried about their finances may be less likely to miss work or suffer from health problems, Mr. Leavitt said. Ultimately, he said, “there is a productivity play for Comcast.”

Source: https://www.nytimes.com/2018/08/31/health/comcast-health-insurance-employees.html

Medical group sees the future in value-based healthcare by Dave Bernard

Moving to value-based healthcare requires passion and investment in technology and staff, but the Hatfield Medical Group believes the move, which leads to better patient care, is worth it.

"I've been doing this for 24 years and I have seen the fee-for-service model," said David Hatfield, D.O., president and CEO of the medical group. "I'm not going to say I didn't make a good living -- but for me I never felt like, 'Wow, I'm giving quality care.' I was giving quality care only from the aspect that patients had access to me because I would see a lot of them."

The medical group, which comprises four primary care practices in Arizona, has spent the past five years moving from a primarily fee-for-service model, which Hatfield said is broken, to a value-based healthcare model.

It's about bending the cost curve

"To us, population health means quality, compassionate care to every patient every day," Hatfield said. "If you do quality, compassionate care to every patient every day, you're going to bend the cost curve, which is what CMS is trying to do [with value-based healthcare] -- bend the cost curve so the spend on medical doesn't continue to rise ... and eventually get so out of control that everybody throws up their hands and says we need a single payer."

Hatfield is passionate about value-based healthcare because "it's a better way to take care of the patients. Our providers have more time with the patients; they're able to manage chronic disease conditions in a better fashion, we're able to build a team around them. We strongly believe we need a team to treat a population of patients or treat a panel, so we have chronic care managers, we have our front office staff, we have our back office staff. Anybody who touches a patient understands what we're trying to do when it comes to population health."

David Hatfield

Jim Schafer, the medical group's population health strategist, said the move to value-based care requires "a lot of investment in technology. You have to train your staff to fully understand the functionality of [an] EHR, taking the time to understand quality metrics that are set by the [National Committee for Quality Assurance] to know who falls into a certain metric."

"We analyze and track quality metrics in our [Greenway Prime Suite] EHR," Schafer said, "and aggregate multiple sources of disparate claims data, pharmacy data and other sources. ... We had to make certain we optimized and leveraged the full functionality of our EHR -- specifically, tracking data, capturing data and taking action on that data at the point of care."

Once providers have data, payers will be on board

Insurance carriers are looking to boost value in healthcare, but won't do so without data to prove the shift in care models works.

"Once [payers] see there are medical groups and providers who can improve healthcare outcomes and they have the data to support it," Hatfield said, "[payers] are sure to adopt and allocate those dollars to those providers because they know ultimately they will reduce the per capita cost of healthcare for patients and improve the quality."

The value-based healthcare model starts taking shape, Hatfield said, "when you get into shared savings contracts or full risk agreements, where you take on the risk of the population of the patients and have to indeed do population health."

Jim Schafer

And that transition, he said, means managing patient health "from readmission to a hospital to ER diversion to pharmacy to making sure they're getting preventive screening exams done." Then, he said, "the health plan or the payer puts it in your lap and says 'Hey, here's the money, you're in charge of it, you get to spend it on claims; whatever is left over you get to keep.'"

"You have to manage that money, but you still have to do the right thing. You still have to show the data that says your patients'... blood pressure is controlled, they're getting their colorectal cancer screening. We live in a data-driven world. Without that data to support what you're doing, it's nothing; it's thin air."

Take the challenge: Move to value-based care

The advent of EHRs, Hatfield said, helped spur the move toward value-based healthcare. Prior to EHRs, he said, "it would have been very difficult to try to put your finger on the pulse" of patient care.

How far along the path to value-based healthcare is your organization?

"But now," he said, "you can actually get into the weeds of how well are you taking care of your patients, how well your team is taking care of your patients, how well you are managing those chronic disease conditions that ... are the ones that really cost the healthcare system a lot of money."

At the end of the day, it's being able to show in your electronic health record what you are doing to move the needle to improve the health of your patients.

David Hatfield, D.O.CEO, Hatfield Medical Group

"At the end of the day," he said, "it's being able to show in your electronic health record what you are doing to move the needle to improve the health of your patients."

Despite the potential benefit to population health, "a lot of practices, aren't ready for [value-based healthcare]," Schafer said. "They haven't gone through the consolidation phase of making sure they fully understand IT functionality and their EHR functionality. They aren't quite understanding all the data and the mandates from CMS, so there's a struggle."

Hatfield added that "the reason why a lot of people aren't doing it is because it's hard work, it requires daily monitoring and you have to be passionate about it."

But he said healthcare providers need to take on the challenge of moving to value-based healthcare. "If you don't change and move toward value-based care," he said, "you will become obsolete."

Source: https://searchhealthit.techtarget.com/feature/Medical-group-sees-the-future-in-value-based-healthcare

7 Life-Changing Medical Technology Smartphone Apps Too Good to be True by Jessica Miley

Technology and health have been coming together more and more over the last decade. From AI-powered prosthetics to sugar level reading tattoos, researchers and scientists are constantly developing new technologies that make us healthier and happier.

Some of the research is focused on common diseases such as diabetes while other research aims to increase general human health. Here we have curated a list of the 7 life-changing medical technology smartphone apps developed in the last few years.

These apps range from diabetes monitoring tools to Artificial Intelligence powered diagnostic devices. Turning our phones into medical tools is one way scientists are helping people battle the rising costs of healthcare.

“In five years’ time, smartphones — or whatever device we use to access information — will take the burden away from the limited number of human specialists we have,” says Keith McNeil, chief clinical information officer of the NHS. 

 1. Diabetes Manager by WellDoc

Diabetes affects more than 29.1 million people in the United States with about 1.4 million new cases being diagnosed every year. More than one in every 10 adults who are 20 years or older has diabetes.

Diabetes Manager by WellDoc is an FDA approved app acts as a coach and a medical record for people living with type two diabetes. The app works by capturing its users' blood-glucose information and transmitting it in real-time to health care professionals.

WellDoc’s system analyzes the data and offers a personalized coach to help patients manage their medication and treatment. It encourages its users to track their food, general health and medications to assist healthcare professionals in giving tailored medical assistance.

Users of the app can access a huge range of information from lists of appropriate foods to helpful menu guides of local restaurants. The app also helps doctors by collating information about their patient's personal health management in one place.

Last but not least, the app can send reports to medical professionals ahead of time so they are ready with advice and help even before they see their patient. 

2. Medici

Medici is a medical app that connects patients and doctors via their mobile phones. The app makes healthcare accessible by connecting people with their medical professionals anytime and anywhere.

Medici has two apps, one for practitioners and one for patients. Once a patient connects with a doctor they can describe their symptoms and send pictures and get advice from a doctor immediately.

Doctors can advise patients to have a follow up physical exam or prescribe medication through the app. Medici aims to help people avoid unnecessary and expensive trips to the doctor and make doctors accessible to a wider range of people all while staying HIPPA-compliant.

Medici could be a gamechanger for people living in remote areas with limited access to healthcare. By being able to access real doctors in real time, people who live in remote areas or have mobility issues can get the help they need without painful or expensive travel.

3. Clinical Trial Seek

This app is aimed at people who have a late stage cancer who have exhausted all current medical help but are compelled to seek new treatments that are still in clinical trial stages. Clinical Trial Seek lets users search up-to-date databases for the latest information on new and up and coming trials.

The app provides detailed information on each trial including the types of cancers it may treat and its location and length. For many being part of such initiatives is their last hope for treatment. The app bridges the gap between the medical research world and critically ill patients bringing hope to the hopeless.

4. SkinVision

SkinVision is an app that lets you check your skin for risky moles. Skin cancer is rapidly growing, particularly in Western countries. The SkinVision app lets people take photos of their risky moles and get an assessment without having to go and see a specialist.

If you receive a high-risk assessment on a mole the photo will be double checked personally by an in-house dermatologist who will provide a more in-depth report within 48 hours.

The SkinVision app can help assist with early detection of skin cancer. While SkinVision is not a replacement for your specialist dermatologist it can be a really useful tool for people with fair and freckled skin to get in the habit of monitoring their moles and post soft signs of unusual growth or change.

Source: SkinVision

5. Ada - health guide

ADA is an AI-enabled healthcare app that aims to give power to patients. Ada uses a chat box technique to question its users about their symptoms. By asking simple, relevant questions, Ada then compares your answers to thousands of similar cases helping you find possible explanations for your symptoms.

6. Babylon

Babylon works in a similar way to both Ada and Medici, but rather than chat with an AI-powered bot, users of Babylon can book a video appointment with a real doctor via the app. If after your appointment your doctor prescribes you medication from a pharmacy, you can order it and have it delivered to your home or work all within the app.

Rather than aiming at people in rural areas, Babylon markets itself to the busy city dweller who doesn’t have the time to travel to doctor appointments. In addition to its medical assistance tools, the app also has a health tracking aspect that encourages its users to monitor their calories intake, weight, pain experiences, and illnesses.

7. Lumify

Lumify is a portable ultrasound developed by Phillips. Doctors only need to attach the scanning device to their smart device to have an ultrasound diagnostic tool wherever they are.

Doctors pay a subscription to the service, download the app, plug in the scanning transducer and they can begin to complete ultrasounds on the go. Lumify means doctors can perform important diagnoses wherever they are.

This is a life-saving tool for hospitals in remote areas or in areas where funding is not available for bulky and expensive ultrasound machines. The app optimizes each image making it ready for analysis and doctors can quickly and confidently share images between professionals for second opinions.

This ultrasound scanning super app can be used to diagnose thousands of illnesses and conditions from internal bleeding to pregnancy.

Source: https://interestingengineering.com/7-life-changing-medical-technology-smartphone-apps-too-good-to-be-true

Morale, technology are keys to staff, patient retention for medical practices, MGMA Stat poll shows by Beth Jones Sanborn

In an effort to thwart costly and disruptive staff turnover, medical practices are prioritizing staff and patient retention efforts. That's according to the Medical Group Management Association's 2018 MGMA DataDive Practice Operations survey.

A key strategy being utilized is the implementation of formal employee appreciation programs, with 77 percent of practices surveyed saying they have one in place. They've proven to be highly effective, too, as practices with appreciation programs reported lower turnover rates across nearly every role in their practice. The biggest gains were in surgical practices, where a 12 percent lower median turnover rate was observed.

When it come to patients, practices are making technology a cornerstone of their retention efforts. First, 89 percent of primary care practices surveyed said they actively manage their online presence to bring in patients and, according to an MGMA STAT poll, 90 percent of practices offer patients an online portal to manage their health records, scheduling, billing, or other tasks. 

Reducing patient wait times can attract patients, and 62 percent of primary care practices said they take active steps to reduce patient wait times.

"For better or worse, we now live in a digital age where consumers expect convenience from every business they patronize. And medical practices are no different," said Pamela Ballou-Nelson, a registered nurse and MGMA Consulting Principal. "...Implementing technological solutions like patient portals are a win-win: patients receive the convenience they demand while practices save time and money by giving patients more control over their medical records, scheduling, and billing."

The 2018 operations survey was based on comparative data from more than 1,000 organizations that represent a variety of practice types nationwide, including physician- and hospital-owned as well as small and large practices.

Another byproduct of the digital age is the growing necessity of closely managing the image of your practice and the picture that available online information paints of it. A recent MGMA Stat poll revealed that 67 percent of respondents said their practice manages its online reputation, including review sites and social media. One-quarter said their practice does not, and the remaining 7 percent weren't sure.

MGMA also cited other research in arguing for the importance of online vigilance, including a A recent survey conducted by Binary Fountain that showed 75 percent of healthcare consumers said online ratings and reviews influence their decision of what physician or provider to choose for care.

"In this age of online information, transparency and an ever-increasing trend of consumerism in healthcare, patients make choices based on information, and the easiest information for them to find is just a Google search away. Managing your practice's online reputation is a critical component of your business plan."

MGMA Principal Consultant Kenneth T. Hertz  said there are useful steps practices can take to ensure the information that's out there serves your practice well. 

First, Google your practice's name using different variations of the name, then note your findings, including the sites your practice appears on and the information presented. Correct any inaccuracies. 

Practices should also google their physicians and other providers and note the findings. Also, it's important to monitor and document where your practice stands on rankings of various sites or entities over time. Audit these rankings regularly.

You can also search your specialty for "doctors near me" in your specialty and see where your practice and providers rank. It's also crucial to document bad reviews and comments, making sure to respond to them in professional manner, thanking the writer and offering to speak with them personally to discuss their issues and hopefully resolve them. 

You should also use these "bad reviews" as teachable moments for staff and strategize on how to prevent similar incidents.

Finally, if your practice has a presence on social media, make sure the content is regularly update. 

"Produce content that is relevant, carefully curated and helpful to your patients," said Hertz.

Source: https://www.healthcarefinancenews.com/news/morale-technology-are-keys-staff-patient-retention-medical-practices-mgma-stat-poll-shows

Individuals’ use of online medical records is on the rise by Fred Bazzoli

It’s taken years, but healthcare consumers are now becoming comfortable with the notion of accessing their medical records online. In fact, the use of portals and other mechanisms to access medical records is rising, according to the Office of the National Coordinator for Health Information Technology.

And the pressure will rise in coming years, with the 21st Century Cures Act including provisions intended to improve patients’ access to and use of their electronic health information. Using data from the National Cancer Institute’s 2017 Health Information Trends Survey, ONCHIT earlier this year analyzed consumer access and use of online medical records and the use of technology such as smartphones, tablets and electronic monitoring devices for health related needs.

More than half of individuals offered access to records

Researchers from ONC’s Office of Technology—Vaishali Patel and Christian Johnson—say individuals’ access to online medical records increased by 24 percent between 2014 and 2017.

Nearly one out of three individuals accessed their records in the past year

While almost half of individuals were not offered access to an online medical record, some 28 percent of respondents viewed their medical record at least once within the past year. However, about a quarter of all individuals who could access their online records did not do so.

Access is getting to be a habit for some individuals

In analyzing the frequency of viewing an online record in 2017, those who had been offered an online record by a provider or insurer, researchers found that about a quarter of individuals accessed their records three or more times. Of those who accessed their records, most did so once or twice.

Patients say provider encouragement prompted them to look at records

Researchers found that 75 percent of providers encouraged patients to use online medical records. That makes a difference in consumers following through—63 percent of individuals encouraged to use their online records did so, compared with 38 percent of individuals who were not encouraged.

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Reasons why consumers didn’t access their online records

Researchers asked individuals who didn’t access their records for two reasons why they hadn’t. About three-quarters of individuals cited their preference to speak with their healthcare provider directly. In addition, about six in 10 of respondents said they did not have a need to use their online medical records.

Laboratory results most frequently offered in online medical records

Researchers say that at least three-quarters of individuals who accessed their records online within the past year reported that they were able to get information on their laboratory tests, current medications and summaries of their office visits. Clinical notes were available to slightly more than half of all respondents, with about 55 percent able to access immunization or vaccination information.

Tasks that individuals can do with their online records

Individuals with access to their records typically view test results, but results of the research show that users also are able to do important tasks with their online records. Some 85 percent of respondents just viewed test results online, and 62 percent performed one or more health-related tasks, such as requesting prescription refills, completing paperwork or making appointments. However, individuals were far less likely to download their online medical record or transmit data to an outside party, such as another healthcare provider or a caregiver.

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Online records deemed both useful and easy to understand

When the notion of online medical records were initially suggested, providers voiced concerns that patients wouldn’t be able to understand their records and wouldn’t be able to navigate them online. Researchers now find quite the opposite—some 82 percent found their records both useful for monitoring their health and easy to understand.

Online records are useful for caregivers

Researchers found that nearly one out of every five respondents also serve as a caregiver to another person, such as a child or to an elderly parent. Of these caregivers, nearly one quarter accessed the online medical records of the person for whom they’re providing care. Of those accessing information, about half did so one or two times during the year. About one out of 10 accessed medical reocrds three or more times during the year.

Source: https://www.healthdatamanagement.com/list/individuals-use-of-online-medical-records-is-on-the-rise

7 connectivity challenges for those in medical technology by Nicholas Leider

Never has so much data been available—but those in medicine face the ongoing challenge of making the most of what’s available.

A new report from Deloitte examined just how medical technology companies can improve outcomes, reduce costs and bolster efficiency.

“The health care and life sciences industries are in transition from reactive and largely episodic models of care that are proving increasingly costly and inefficient to operate, to care models that are proactive, digitally-enabled and deliver better value for patients,” wrote the researchers, led by Karen Taylor, direct of Deloitte’s U.K. Centre for Health Solution. “Medtech companies and the IoMT can capitalise on the possibilities presented by these changes to help to connect patients, providers and payers and enable them all to become more patient centric, productive and cost effective.”

MarketsAndMarkets, a research and consulting firm, estimates the medical technology industry is set to quadruple in value by 2022—to an astonishing $158.1 billion from $41.2 billion in 2017. The Internet of Medical Things (IoMT), as report describes, is a connected infrastructure of devices, software applications and health systems.

It will face seven major challenges in widespread adoption:

1. Funding
2. Interoperability
3. Cybersecurity
4. Regulatory change
5. Digital talent and building capabilities
6. Maintaining trust
7. Scale

“While the IoMT has the potential to help alleviate some of the cost, access and care coordination challenges facing health care, the generation of data points through millions of connected medical devices will have little impact unless turned into actionable insight,” Taylor et al. wrote. “Medtech companies will need to develop new strategies to harness the data provided by their digitally-enabled products and make their business and operating models relevant and competitive. For some medtech companies, this will include shifting from a product-based model to a value-based system.”

Developers of medical technology face an opportunity, though, as the industry trends toward value-based care. According to the report, these company can become more than suppliers of innovation. They can become partners with healthcare providers.

“Technology itself will become a treatment, as evidenced by the new generation of mobile apps increasingly appearing in treatment guidelines—initiatives like point-of-care testing to improve the diagnosis of sepsis, tests to differentiate between bacterial and viral infections to reduce over-prescribing of antibiotics and the FDA’s call for [medical technology] to help find alternative treatments to the opioid crisis,” the authors wrote.

The report further details opportunities in artificial intelligence, voice-recognition and data sharing.

Source: https://www.clinical-innovation.com/topics/interoperability/7-connectivity-challenges-medical-technology

Four steps to fight off high medical expenses by Darla Mercado

When it comes to staving off skyrocketing medical costs, having insurance is only half the battle.

That's because cost-sharing — expenses you cough up in the form of deductibles, copayments and coinsurance — has been increasing in employer plans, according to the Kaiser Family Foundation.

The foundation recently analyzed medical bills from large employer plans and found that nearly 1 in 5 inpatient hospital admissions include a claim from an out-of-network provider.

The cost difference can be significant when you go in-network: Doctors and facilities that are in-network have agreed with your plan to a set price for service.

Your insurer may only partially cover an out-of-network expense and leave you to pay the remainder.

Even going to an in-network facility won't necessarily keep you from encountering out-of-network costs. More than 15 percent of in-patient admissions who used an in-network facility still wound up with a claim from an out-of-network provider, Kaiser found.

Here are four tips from Carolyn McClanahan, a certified financial planner and an M.D., to help you become an empowered patient and prepare you to contest unreasonably high bills. McClanahan is director of financial planning at Life Planning Partners in Jacksonville, Florida.

1. Understand your coverage

Know what your policy covers, including the details on out-of-pocket maximums, deductibles and co-insurance.

Get familiar with your state's laws against "balance billing" — a practice in which insurers only partly cover an out-of-network cost and leave consumers to pay the remainder, which can be thousands of dollars.

More than 20 states have some kind of legislation on the books to protect consumers from balance billing, according to the Commonwealth Fund. See below.

When you are admitted to the hospital in the event of an emergency, write on all of your paperwork that you will only permit in-network care, McClanahan said. Be sure to take a photo of this document or make a copy of it.

"Once you get the bill, if they charge you for out-of-network care, you have ammunition," McClanahan said.

2. Ask the right questions

"Will you take my insurance?" isn't enough to head off an out-of-network charge.

"When you're making an appointment, don't ask if you're covered under your plan," said McClanahan. "Everyone will take your insurance."

Your doctor's office may accept your insurance, but that won't spare you from a surprise bill weeks later if he or she is out of your network, McClanahan said.

The correct question for your doctor's receptionist is, "Are you in my network?"

Be sure to document who gave you the answer and the date so that you're prepared to fight back if you get a bill that says otherwise, McClanahan said.

Speak up when your doctor recommends tests and prescriptions. Ask questions such as: "Is the testing facility in-network?" or "Are the doctors evaluating the tests in-network?"

"Once you get the bill, if they charge you for out-of-network care, you have ammunition."-Carolyn McClanahan, director of financial planning, Life Planning Partners

Don't be shy about asking your doctor for an explanation if he or she recommends that you undergo a test. Learn more about the test and find out how the results will affect the approach to treatment.

"If they can't provide a clear answer, ask, 'Is this test really necessary?'" McClanahan said.

Finally, curb costs on prescriptions by asking whether your medication is covered under your plan and if a cheaper version is available.

Sometimes it's cheaper to pay cash for your medication than to claim it on your insurance, McClanahan said.

She suggested digging up drug price information on GoodRx.com and comparison shop.

"Know the benefits and risks, how long will you be on medication, and what are the alternatives to the medication prescribed," McClanahan said.

3. Keep records

JGI/Jamie Grill | Blend Images | Getty Images

Maintain a health-care log so that you're equipped to fight back in the event of a dispute with your insurer. Keep track of any communications you have with your insurance company and your doctor.

If needed, hire an expert to act as your advocate, McClanahan said. She suggested reaching out to the Alliance of Claims Assistance Professionals.

4. Call your regulator

If balance billing is illegal in your state and you receive a massive out-of-network bill, be sure to reach out to your doctor first, as it may be an error. Pull in your insurer to help.

If neither your doctor nor your insurer will help you address the bill, then it's time to contact the regulators, said McClanahan.

That means you should reach out to your state medical board and your state's insurance department.

If your insurance plan is self-funded — one in which your employer assumes the financial risk for providing your health-care benefits — then you should contact the U.S. Labor Department's Employee Benefits Security Administration.

Source: https://www.cnbc.com/2018/08/15/four-steps-to-fight-off-high-medical-expenses.html

Will Blockchain Transform Healthcare? by Randy Bean

The Wall Street Journal recently noted that the United States “will soon spend close to 20% of its GDP” on healthcare. While it might not be possible to address the rising costs of healthcare in the immediate future, there are steps that can be taken to address issues of customer service and efficiency to improve the overall healthcare experience, while ensuring the protection of customer privacy. In recent months, there has been a flurry of excitement about the role that blockchain technology might play in the long-term transformation of U.S. healthcare.

I recently spoke with a few individuals who are deeply conversant in the challenges facing healthcare and how solutions like blockchain can be brought to bear.   John Halamka is Chief Information Officer of Beth Israel Deaconess Medical Center in Boston, a Harvard University teaching hospital, a position that he has held since 1998. He also held the position of CIO for Harvard Medical School from 2001 through 2012. Halamka recently assumed responsibility as Editor-in-Chief of the new academic journal, Blockchain in Healthcare Today. In the inaugural issue, published in March of this year, Halamka proclaimed his manifesto, “As the Editor-in-Chief of Blockchain in Healthcare Today, my goal is to publish high-quality opinion pieces and research papers about use cases that really require blockchain”. Halamka continued, “Just using blockchain in healthcare because it's cool does not make sense”.

Halamka knows of what he speaks. In his Journal call to action, Halamka goes on to note, “In 2017, I worked on several production blockchain applications, so I have a sense what works and what does not. Blockchain is not meant for storage of large data sets. Blockchain is not an analytics platform. Blockchain has very slow transactional performance. However, as a tamperproof public ledger, blockchain is ideal for proof of work. Blockchain is highly resilient”. I asked Halamka about what he sees as the greatest healthcare challenges where blockchain could make a difference. Noting that blockchain is ideal for ensuring data integrity where control is decentralized, Halamka cites three prominent opportunities:

• Medical Records. When a medical record is generated and signed, it can be written to the blockchain, which will provide absolute proof and confidence that a medical record cannot be changed. The integrity of the medical record is ensured. The same concept can be applied to clinical trials. This has impact in legal cases as well where the integrity of the medical record is pivotal.
• Consent management. In the current healthcare environment where every state has different privacy and consent regulations, blockchain could be used to record patient consent for purposes of data sharing.   Any party seeking to exchange medical data about a patient could check the blockchain for permission to do so.
• Micropayments. The idea that patients mighty be incented is gaining traction. If a patient follows a care plan, keeps their appointments and stays healthy, there might be rewards offered through the blockchain. Similarly, patients might be rewarded for contributing their data to clinical trials and clinical research using the same approach.

Tory Cenaj, founder and publisher of Blockchain in Healthcare Today, adds, “Blockchain technology can elevate care excellence, and enhance the participation of owning one's health and data”. Greg Matthews, whose mission is data-centered innovation in healthcare, and is creator of MDigitalLife, a platform for tracking digital trends in healthcare, offers an additional perspective, “Blockchain could make the biggest impact in healthcare in enabling health outcomes that take a 360° view of the patient’s genetic profile, their demographic and socioeconomic status, the behaviors that impact their health, and their response to different treatments or combinations of treatments”. Matthews continues, “This data exists today in one form or another, but can be tremendously difficult to stitch together at an individual level. Blockchain can enable “profile stitching”, and do so in such a way that the patient’s identity is protected”.

A Blockchain Future?

Halamka observes how blockchain is ideally suited to addressing the challenge of decentralization of medical data. “Most healthcare data is centralized at the level of a corporation, healthcare facility or government registry” notes Halamka. “Blockchain is decentralized and therefore not impacted by the behavior of any one organization.     In the future we might see blockchain as a component of a system in which patients serve as stewards of their own data, rather than relying on any central source”. Matthews concurs, “We haven’t been able to aggregate patient data in one place and secure it so that only the patient has control of it and can make decisions who they want to share it with”.

Matthews envisions a future where blockchain would play an integral role in healthcare improvement.   He observes, “By using blockchain in combination with AI and machine learning, we should be able to discover potential solutions to health problems that are devastating to us today”. Matthews continues, “The dream of personalized medicine looked like an almost-insurmountable problem 10 years ago because of technical challenges in linking data types and using them to find patterns across massive amounts of data. Today, the dream is more threatened by the harm that personalized medicine could do if the data and insights it yields were improperly used”. He concludes, “Blockchain could be at the foundation of the solution, with the patient having ultimate control over their data and how it’s used”.

Halamka remains cautious however. He notes that technical challenges pose obstacles to the adoption of blockchain initiatives in healthcare. “It’s slow, it’s awkward to use, the number of steps required to get and put data to blockchain are numerous and complex”. There is hope though. “There are emerging “blockchain-as-a-service” products that attempt to solve these problems, but they are very early” observes Halamka.

Matthews and Cenaj note that, in addition to these technical challenges, there are significant cultural obstacles that stand in the way of blockchain adoption as well. “Regulation, policy, and legacy practices hinder the US from assuming a leadership role. Shareholder value does not equal patient value. It may take 10-15 years unless policy changes are implemented rapidly”, comments Cenaj. Matthews remarks, “Until we have a policy change at the highest levels of government, I don’t think that blockchain will be more than a point-solution for data security. I am convinced however that when we do finally have clarity on who owns patient data, transformation in personalized medicine could happen fast”.

In spite of his pragmatism and caution, Halamka is optimistic about the future of blockchain in healthcare. “There are production applications in healthcare using blockchain now, and they will become more commonplace over the next year.    Like any innovation, we’ll go through a hype phase, a disappointment phase and eventually achieve broad adoption.    Expect three years before there is universal adoption of blockchain related products”. If Halamha is correct, we could see blockchain driving healthcare transformation sooner than expected.

Source: https://www.forbes.com/sites/ciocentral/2018/08/05/will-blockchain-transform-healthcare/#5a71b36553d3