Author Archives: Vignesh Eswaramoorthy

Data Analytics Next “Big Thing” in the Healthcare Industry!

Digital technology is instrumental in reforming businesses all over the world. Going digital is a bonanza for the industry. Though digitization makes the process quick, there are some security concerns coming along with it, Health Data Management is a challenge considering the frequency of data breach in the recent past.

Present healthcare system stores patient records in a digital form as EMR (Electronic Medical Record) which gathers all information at one place. A patient health record includes both financial and clinical data.

Clinical data includes physician feedback, prescriptions, medical imaging, laboratory, pharmacy, insurance, and other administrative data. Patients who have leverage wearable devices can sync those data to their respective patient’s record.

Data analytics means finding different patterns with respect to patient health conditions and available medical data. It allows physicians to have a deep-rooted understanding of the problem, and be able to take medically informed decisions while lowering costs.

Analytics helps providers to

Improve process
Boost outcomes
Reduces time, and
Tackles problems

Ideally developing this pattern will help gain insight in choosing better treatment options resulting in high-quality care.
All healthcare systems generate the large volume of data and this data has to be processed in an effective manner to make a huge difference in the outcome.

Engaging practice with new technology hasn’t been effective so far. Though it may look expensive, implementing a new technology and leveraging big data can be advantageous and prove to be cost-effective over a period of time.
Big data is nothing but a large volume of complex and variable data that require advanced techniques to capture, store and distribute to analyze the information.

Advantages of leveraging big data in healthcare,

Data has always been the basis of healthcare, every healthcare procedure, processes, studies, and diagnosis is recorded for better understanding. But the problem arises when understanding this data collected and generating information out of it. Big data can help in this area by turning data into information. Following are some of the advantages big data present

1. Clinical research and operations

A large volume of data can help clinical researchers to discover cost-effective ways, and diagnose and treat patients. Big data can help physicians to perform better, be more insightful during the process of decision making. Study of diseases and conditions and as a result the search for a cure lies in recognizing the underlying patterns which lead to health or diseases. Some of these patterns are more obvious than others and in some cases, the database is not sufficient to arrive at a conclusion. Big data will help in identifying such patterns faster and more accurately and can reduce the need for trial and error treatment.

2. Prevents diseases and treatments

To reduce the spending and readmission rate insurance companies have started to gather patient data to foretell, and to avoid repeated hospitalization by discovering illness pattern using analytics, also helps to restrict patients from being vulnerable to diseases.

3. Precision treatment

By identifying the disease pattern with available genetic predisposition and family history or disorder it is easy to start appropriate treatment. This treatment steps will be stored for future medication and references.

4. Population Health

Many healthcare communities follow present technology for data collection and data mining. Record tracking facility and pattern analyzing technique allows to uncover the disease outbreak and helps to deliver timely care.
With large population data, we can identify patient needs, offer required services, predict diseases and prevent the future crisis to benefit the population.

Data analytics can also contribute to

1. Evidence-based medicine

Various organized and unorganized patterns are discovered from patient’s clinical, operational and genomic data which helps physicians to tackle treatment-related problems and helps to figure out how effectively the treatment can be done to bring the desired results.
And this is done by finding patients who are at risk and providing instant treatment to better the outcome.

2. Genomic analytics

Helps to identify gene pattern more efficiently and cost-effectively. Genomic analysis is a part of the regular medical care decision process.

3. Fraud Analysis

Data analytics helps to cut down fraud requests by analyzing more number of claim requests.

4. Real-Time Monitoring

Real-time capturing of data and analyzing fast-moving data from hospitals and wearable devices for safety monitoring. It prevents adverse effects from medical errors when data monitoring is continuous and real-time.

Hence adopting data analytics technique will improve the care outcome and will also bring in most needed massive changes in healthcare delivery. Schedule a demo with us for free!

Data Reliability and Medical Errors

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Medical errors are the scariest thing for anyone who is involved in Healthcare. Patients who are the eventual victims are usually frightened each time they undergo a treatment.

The US Senate disclosed that after heart disease and cancer, medical errors are the third most noted cause of death in the United States. A report says, every year medical errors cost $1 trillion, 400,000 lives, and affects 12 million people because of the unknown mistakes made while treating the patient.

Though physicians and staff are putting their maximum effort to increase patient safety by avoiding faults, it has still been challenging to curb medical errors in the past few years. Various researchers and surveys are done each year to minimize these mishaps; still, there is no system to code these deaths.

People visit hospitals when they get sick. Although hospitals try to give their one hundred percent efforts to cure them there still occur some unknown mistakes. According to a survey report of 9.5%, people are dying due to the complications caused by medical errors.

Hospitals need to concentrate more on their care quality and safety measures to reduce the percentage of errors.

Problems in ambulatory settings

Many treatment mistakes happen because of improper record maintenance and manual inaccuracies. The utilization of medical records is considerably low due to lack of reliable systems to record test reports which result causes a delay in diagnosis.

Also, staffs are not fully equipped with devices for updating patient data which sources to an imprecise data record.

Some common Medical errors

1. Physician Error 2. Diagnosis Error 3. Nurse Error 4. Surgical Error 5. Communication Error 6. Medication Error 7. System Error 8. Right and Left side body mix Error etc.

Some of the medical errors are very easy to find. Treatment-related errors are more noticeable compared to diagnostic and prevention errors. The reason why it is easily detected is that of its adverse outcomes.

Adverse events are visibly seen after few days of errors made. Until these adverse events take place we will not know about the occurrence of errors. These kinds of difficulties can be avoided with near to real-time record maintenance.

Will Technology help Hospitals to Reduce Medical Errors?

Present healthcare system relies on technology to avoid errors and it involves spending thousands on it to ensure patient safety. However, there are some issues with interoperability and limitations due to inconsistencies of the system.

In a Survey conducted it was figured out that system inconsistency issue between system and devices were the primary reason for most of the medical errors.

Errors not only costs human life but also costs the providers. Hospitals are moving to cloud environment to solve compatibility issues and reduce security threats. Cloud-based interoperability will ensure efficient & quick transfer of data and also data can be viewed in multiple systems simultaneously without any intervention.

Data Security is still a question!

There are few security and privacy concerns we need to look at. In August 2016 alone there were 44 reports of data breaches and in total 8,804,608 of patient records that have been breached.
To reduce the hacking, rate providers and device vendors are now focusing on cybersecurity.

Medical errors can be reduced only when providers and physicians truly come together in terms of care delivery, efficiency and show interest in the implementation of new technologies.

Rising Cost of Healthcare

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The United States government spends more on healthcare compared to other countries in the world. According to World Health Organization, US spent 17.9% of its GDP in 2011, which is considered to be the highest in the world. Experts say this will increase to 19.5% of GDP by 2017.

From a report, of each dollar spent on healthcare goes 30% to a hospital, 20% to physicians, 10% to prescription drugs, 6% for nursing and continued care, 4% to administrative cost etc.

Even after spending much more on healthcare per capita, US healthcare system has not seen better outcome while other countries spend less, but their outcome is more. The following are some of the reasons why US healthcare cost is rising.

1. Growing Aging Population

.Life Expectancy of an American has significantly increased to 79.1 years in 2015 from 77.9 years in 2007, means the United States population ages 65 and older will nearly double in future.
The aging of the population also has important implications for future Medicare spending. Because an increase in population age has a significant impact on government’s Medicare Expenditure.

Yet population aging is one factor which is not directly related to increases in health care cost.

2. Technology Advancement

Technology is one of the major contributors to increasing overall healthcare cost. Medical devices or instruments help doctors to give effective treatment.
Technology opens up to the wide range of treatment options by replacing older less cost treatment and gives the highest order possible in terms of care delivery.
Understandably the US has a big market for medical technology.

3. Drugs

Another massive reason for increasing Healthcare cost is because of increase in drug price. Production of new drug incurs the most cost, as it involves years of research & development than producing an existing product. It is a competitive market, drug manufacturers fix their own pricing depending on the market needs and supply to demand ration, which has an impact on the patient’s medical bill.

4. Physician Fees

Physicians in the US are highly paid compared to physicians in other countries. However, availability of primary care physicians are less in number, hence patients are mostly treated by the specialist whose remuneration is relatively higher than primary care physicians.

5. Administrative Cost

Approximately, the US healthcare spends 20-30% on administration. Hospitals have many departments, bills to manage and to deal with payers. Other countries have single payer so they do not have work burden and cost is comparatively less. But US hospital deals with multiple payers and contractors which makes process complex and expenditure directly proportional to complexity.

6. Treatment Process

Physicians in the US are very cautious by nature, considering patient’s health conditions they take multiple tests to diagnose and ascertain any disease to avoid any negligible chances of wrong medication. This process increases the number of people involved, and dependence on technology which automatically increases the cost.

7. Lifestyle

Living for long years does not mean living a healthy life. Due to poor eating habits and lifestyle, many people are prone to diseases.

There may be many factors like this which may be directly or indirectly linked to increase in healthcare cost but the only goal of healthcare providers is to deliver a better care to their patients. The predominant cause for why cost inflicts high in healthcare is because of its less organized system, complex regulation, and poor management.

This problem can be solved by measuring the actual cost of the treatment and comparing it with the outcome. This process involves only a patient and his disease, it will help us realize measurable change by calculating accurate cost and value delivered into healthcare practices. But in current system finding the actual cost is challenging, and the value of care is not proportionate either.

Appropriate treatment has to be carried out immaterial of the cost. The health of an individual in a population should be given utmost importance without any monetary constraints.

If the US government takes charge then there will be a possible reduction in cost. Government starting to negotiate costs based on health outcomes might as well help in optimizing their spending on the annual bill while achieving desired results.

Promoting transparency in healthcare and providing affordable drugs will help people to get better health at less cost.

“We need more transparency in our healthcare system; we need to drive improvements in health IT; we need to make it easier to get data on how much treatments actually cost and how effective they are so providers, payers and consumers all can make better decisions.”- Clinton said at HIMSS14

Micro Hospitals Reforming Macro Healthcare Environment

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“Great things are done by a series of small things brought together” likewise population health can be achieved by improving the individual health of the community. Small is the new big healthcare, and this rule will transform future care delivery system!

Either an ambulatory setting or an urgent care is not enough to meet the modern demand and has no sufficient facilities for inpatients. To react to this change in patient expectation large hospitals are opening micro-hospitals in the places of need.

Micro hospitals also called the community hospital, are licensed facilities which enable quicker treatment for emergency care patients, and may also offer services like outpatient surgery, primary care, and other specified services. Michael Slubowski, President, and CEO of SGL Health said Micro Hospitals will have two or three story buildings- around 35,000 to 45,000 square feet, and some are already set up near neighborhood by offering all facilities in small single place.

He also stated that none of the two Micro hospitals will look alike in facilities or services they supply. But they all have the emergency department, imaging system, laboratories, and pharmacies as facilities in common. Other facilities like primary care, women’s services, dietary services and outpatient surgeries will be included as per the needs of the community.

Fred Bentley, a vice president at the Center for Payment & Delivery Innovation at Avalere Health, said this is the right time for all healthcare systems to establish their market. If your customer is rich, and you have a service then you can fill the demand.

Why is Micro needed?

Lack of inpatient facilities in large hospitals and urgent care made people suffer. Building a full facility hospital is a big money but micro-hospital costs less and it serves the particular community needs. Micro hospitals are specially designed for EDs, inpatient beds are to accommodate people who are done with surgery. Also, some disease cannot be found at an instant, those patients need to have a closer observation. And that is the reason why micro is equipped with 8-10 inpatient facility.

Benefits of Mini Hospitals

1. Micro Hospitals are built near neighborhood so the people can access easily it makes care convenient for the population that a hospital serves.

2. They help to connect patients with specialty and primary care physician networks, For example, In Vegas, a micro hospital’s second floor is designed with separate specialty and primary care physician offices.

3. Micro hospitals cost relatively higher than urgent care but lower than hospitals. The reason why it has high cost compared to urgent care is they lack inpatient facilities.

4. Telehealth facilities are offered for integrated care and care continuity. They have trained physicians, nurses and other specialists to ensure care across the care continuum.

Connecting Rural Areas

Micro-hospitals can bridge the gap in care delivery, and quality for a population in rural and underdeveloped areas. Due to its low-cost nature, and intimate delivery model, micro hospitals proves to be ideal in a rural setup. But the micro hospital model is not just for the rural populace, it is gaining prominence in the present age when the healthcare industry is looking to reduce cost and improve patient care experience.

Mobile Health Technology

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Mobile phone usage is tremendously increasing day by day. So as a purpose of it, every industry has been reinventing their way of functioning to accommodate the changes mobility has brought in. When people start experiencing new things they become addictive to innovative technology. This transition has also affected healthcare industry on a massive scale.

Current day Health Care system faces many problems such as shortage of nurses, a fewer number of physicians and not to forget about implications of MACRA new physician payment method. It is becoming increasingly tough to operate without relying on technology.

Increase in demand has maximized the need for innovation around mHealth. It is an incredible advancement showing enormous positive results, removing the barriers of the olden days.

Digital transformation in healthcare is great, but the question is “Does technology foster customer to engage in their own health?”

Today, people have numerous options and are confused to pick out one healthcare app on the market. As on date, there are thousands of medical apps listed in mHealth space, which can be accessed from anywhere.

It is beyond certainty that mobile health will help improve care delivery and impact patient outcomes in the near future with a more reliable, and near to real-time data which makes it efficient. However, there’s a security risk attached to it while managing data from different applications.

Data integration is challenging, especially when there is more than one data source. It should be the providers call to choose an optimum health application, and induce patients to use it instead of letting patient choosing according to their choice and leaving compatibility a matter of concern.

Surveys say physicians are reluctant to recommend the use of health applications to their patients. Adapting quick changes is not an easy step for doctors.

Of course, it is neither been easy for patients. Following are some of the benefits of mHealth:

1. Patient engagement

Mobile apps are user-friendly and come free of cost but success ratio to engage patient is relatively less. People have easy access to health tools via smartphones but are not willing to learn to make full use of it.
Progress is possible only when patients show real interest in improving their health. Unless patient’s show dedication there will not be any positive results, and intervention of health applications may not yield desired results.

2. Better Clinical Support

Clinical Decision Support process becomes easier after the integration of EMR with mobile technology. Traditional system has more complexity in the integrated workflow of clinicians. Now, with the use of apps, clinicians can recommend drugs, diagnose and treat patients, and also be aware of current practice guidelines, which reduces their burden of work.

3. Better Communication

Though patients and doctors have face-to-face interactions, problems are not communicated effectively. Improper and non-scientific communication of symptoms makes it difficult for doctors to diagnose the disease.

Also, people with one or more chronic diseases face difficulties in meeting their doctor’s post-discharge. With the help of wearable synced with mHealth apps, doctors can track progress, and also deliver appropriate guidance to ensure they are healthy.

4. Improved Practice Workflow

Doctors can view their patient record instantly anytime, anywhere, and can send the right patient data to specialist during referral process.
Clinically integrated EHR helps a physician to effectively use it in and out of the network. Physician practice workflow becomes convenient and efficient with technology enhancement.

5. Access to Information

Patients can access their health information from portal through mobile apps, and view their record online, download or transfer. Providers can communicate with patients electronically to remind about their meetings with the physician, prescription refill etc.

6. Enhanced Care

Mobile health helps in monitoring patients after they get discharged.
Patient’s 30 days post discharge is the critical time of recovery, and which can avoid possible readmission. Patient health app opens doors to insightful information which can be used to enhance care quality significantly.

Interestingly, mHealth is a fortune that healthcare industry hasn’t utilized to fullest of its potentials.

In Defense Of MACRA

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The changes made in the healthcare space by the Federal Government over the past few years has been a concern for the family physicians and small practices. In addition, the proposed Medicare Access and CHIP Reauthorization Act (MACRA) which is scheduled to come next year have been a major source of excitement.

“This piece is not to support or oppose the act but proposes a rational dialog about its advantages when the general sense has not been very receptive.”

Family physicians and small practices fear MACRA because of its complexity (the act is almost a 1000 pages) and also for the fact that it can impact their revenue generation capabilities. The opponents of the act point out that small and medium practices lack the capital and infrastructure to implement the changes required to adapt to the new reporting requirements. But the act also has a few benefits and the most important are listed below:

Declutter the reporting
Chance for positive revenue
Clinical Integration
Departure from fee-for-service

1. Declutter the reporting:

MACRA is an attempt to declutter the complex reporting requirements and make it into one, which will reduce the burden of separate reporting. With MACRA the PQRS, Advanced care, Meaningful use are brought into one Quality Payment program QPP. Although there are two models under this program, the provider is only in either of the two.

2. Chance for positive revenue:

MACRA proposes to incentivize providers on the basis of their published rank, which will be a direct increase in their revenue, unlike the system in place now which gives no incentives but penalties. MACRA allows for positive payment adjustments, besides MACRA’s maximum potential penalty for failing to meet standards are less than the current reporting programs.

3. Clinical Integration:

MACRA Act promotes clinical integration with incentives. The model is designed to encourage practice, to provide joining efforts and to improve population health. This aspect is, what the critics like to call ‘kills individual practices’, changing the old model. Yes, the old model is being changed, and it is not just MACRA. Every new legislation, step, the procedure that CMS employs is to create this change in the system, not just MACRA. Clinical integration can improve patient care quality and lead to the reduction in cost.

4. Departure from Fee-For-Service:

This is what it all boils down to. CMS aims to reduce the amount spent on healthcare and improves the quality of care the population receives. MACRA is yet another organized step in this direction; with its strong words MACRA will allow American healthcare industry to take a giant leap in the direction of value-based service.

It will not be easy to embrace MACRA, with all its complexity and questions, it is yet to answer. But, the fact remains that MACRA is absolutely an improvement on the systems now in place. A lot can be done to improve and make it easier for the benefit of all that is involved, but scrapping is not an option at this point. The unprecedented support this legislation enjoys from both side of the aisle is a testament to public support the act receives.

MACRA is certain to create a few hiccups which in any case can be discussed and ironed out. After all, no solution is perfect and results uncertain till testing.