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My mother had to go to work to support four children after my father died from cancer. I was active in the women’s movement in my college years. So, I can’t imagine women not having a career outside the home if they so choose or if they have to support themselves and their families.

Starting in 2019, Centers for Medicare & Medicaid Services, will change how they pay physicians in a profound way. Unfortunately, the details are complicated and confusing, and many of the particulars have yet to be worked out, which has led many healthcare leaders to glaze over the details and focus on more immediate concerns.

Cinderblocks 3: The Partnership with Patients Continues is an art and medical conference that will be held in Grantsville, MD at Penn Alps Resturant and Little Crossings by The Cornucopia Café May 19-21, 2016.

"We believe that mobile devices such as iPhones will become the predominant means by which patients interact with BIDMC," says Beth Israel Deaconess Medical Center CIO John Halamka, MD. "Your phone will be the repository of your medical record."

(SPONSORED) As IT struggles to get out in front of enterprise security risks, mobile devices are adding another wrinkle to defense plans as they become an increasingly active attack vector.

Editor's note: This is the third piece in Dr. Smythe’s four-part series on fostering healthcare innovation to face some of the biggest challenges fronting healthcare today: Chronic and Behavioral Care, Operations 2.0, Patient as Consumer and Post-Acute Care. This post discusses treating Patients as Consumers, while the previous two addressed Operations 2.0 and Chronic and Behavioral Care. Smarter. Faster. More connected. On demand. These are the global trends that are redefining and revolutionizing every industry – and healthcare is just getting started. Today, consumers can choose to comparison shop, read reviews, crowd source recommendations for just about everything, instantly. And as consumers increasingly bear the burden of their healthcare costs, patients are starting to approach their healthcare decisions in the same way. Hence, it is critical for healthcare systems to proactively manage both the patient experience and their expectations, to increase patient loyalty, sustain the provider’s brand reputation and prevent new entrants into healthcare from siphoning patients away. Technology can play a key role in meeting the needs of both patients/consumers and healthcare system organizations. Here are a few vital areas. 1. Transparency Consumer expectations are on the rise and patients are paying more attention to their healthcare costs. As of January 2015, 19.7 million Americans had high-deductible health plans making them responsible for the first $2,000 to $5,000 of their healthcare spending. Even for those not participating in high-deductible plans, out-of-pocket costs rose substantially. From 2009 to 2015, on average, deductibles rose from $680 to $1,200. It is important to note that the business of healthcare is not exactly like other markets. While financial responsibility may encourage individuals to be more discerning about services that are optional or variably priced, it may also provide an impediment to care when needed. Regardless, it is a reality, and one of the current strategies to provide some level of health insurance coverage to everyone. Moreover, transparent marketplaces in other industries— from Airbnb to Uber—are changing consumer expectations, at a time when health systems are under increasing competition for patient loyalty. CMS, along with consumer and employer demands are elevating the need for pricing that is clear, complete and accessible. Some health systems are responding by playing offense; many are investing to meet expectations. One common patient pain point is the bill paying experience. According to a Consumer Reports National Research Center survey, in the last two years, nearly one third of Americans with private health insurance were surprised when their insurer paid less than expected, leaving a larger-than-expected bill for the patient. As described by one family, “We just wish that a doctor's office would give us a reliable statement at the time of service; we would rather be told to bring $1,000 or know up front that we can't afford this procedure. End of story.”  In fact, as reported by PricewaterhouseCoopers (PwC), 66% of consumers have never had a conversation with their physician about the cost of a visit, 57% have never discussed the cost of a prescription, and 66% have never discussed the cost of a procedure. Technology can improve this experience by making it easier for patients to understand their cost for healthcare and pay their bills. 2. Real-time insights In nearly every industry, there is a common challenge: “big data” is not enough to sort through the swirl of uncertainty and complexity in today’s modern society. To quote the Harvard sociologist, E. O. Wilson: “We are drowning in information, while starving for wisdom. The world henceforth will be run by synthesizers, people able to put together the right information at the right time, think critically about it, and make important choices wisely.” In healthcare, the deployment of technology and willingness of patients to engage in their care has led to a proliferation of data. The challenge; however, is in the synthesis – how do you glean actionable insights? In addition, are there ways to harness data previously unavailable from “non-clinical” sources? In response, many health systems are revamping their online presence, as consumer-facing physician search and rating websites proliferate. Technology can also drive powerful results to improve patient experience and satisfaction. With real-time insights, providers can know how patients feel about their experience before they leave the hospital or doctor’s office. Patients can also offer perspective into health systems’ strengths and opportunity areas that can help provider organizations build patient loyalty and acquisition strategies. One example where technology is offering new insights to improve patient experience is Binary Fountain. Binary Fountain offers a “social listening” tool that continuously monitors reviews, feedback, and mentions from the web and social media and integrates these insights with CAHPS data, point of care surveys, and other sources of patient feedback.  The solution offers a single platform where health systems can distill actionable insights to inform their operational decisions and patient experience strategies. The solution both enables health systems to address patients' needs and to take control of managing their brand. 3. Virtual access Healthcare consumers increasingly seek out convenient and immediate access to care for common conditions. A 2014 survey of 3,873 patients conducted by the Advisory Board showed the number one priority for patients, when selecting a primary care clinic, was convenience. Over 70% rated “I can walk in without an appointment and I’m guaranteed to be seen within 30 minutes” as the attribute they sought most when seeking care. In 2013, Cisco performed an international study of attitudes regarding virtual care and found that 76% of individuals would prefer virtual care over a visit to an in-person provider, and showed while 19% of respondents preferred to visit a provider in-person, 23% preferred a consultation or visit by phone. Seeking convenient access to care, patients have turned to non-traditional healthcare providers such as retail clinics and direct-to-consumer telehealth providers. As a result, health systems are losing both loyal patients and downstream referrals. However, offering convenient access requires a significant change in provider organization scheduling, workflow, clinic hours and staffing without disrupting clinic workflows or leading to physician burnout. One company addressing this challenge head on is Bright.md. Bright.md's "SmartExam" is a virtual physician assistant that helps primary care groups automate up to 90% of provider time spent on low-acuity conditions. Using online exams that are easily accessible by both providers and patients, patients are able to interact with their own health system and trusted providers more efficiently. Learn more about the patient as consumer provider challenge and emerging technology solutions at HX360 during HIMSS16. Don’t miss the HX360 Innovation Pavilion plus cutting-edge programming led by world-class healthcare executives, investors, innovators and leaders like you.  

Editor's note: This is the second segment of Roy Smythe’s four-part series that takes a deeper look at healthcare innovation from the perspective of four Contemporary Provider Challenges: Chronic and Behavior Care, Operations 2.0, Patient as Consumer and Post-Acute Care. This post focuses on Operations 2.0 while the first focused on responding to the Chronic and Behavioral Care challenge. Today, healthcare systems and providers face the challenging headwinds of new regulations, increased competition, the need to understand and implement value-based payment models, an overwhelmed workforce, and more. At the same time, healthcare is transforming at an increasing rate - in part due to the impact of emerging technologies. All of these factors are converging to create a “perfect storm”. Making care delivery operations maximally efficient is an imperative, considering all of the above. We call this Operations 2.0. Value = Cost / Quality, and maximally efficient care means removing all non-value added components of work. We feel that there are exciting opportunities to use innovative technologies to these ends in an increasingly value-based healthcare enterprise. HX360, co-developed by HIMSS and AVIA, is focusing on the way forward by more effectively leveraging technology, along with process and structure, to improve health care. The good news is that providers actually now do have better tools and insights at their disposal – tools that can transform their operations and potentially revolutionize the delivery of care to patients. So, how is technology impacting health system operations today? Here are just a few exciting examples: Referral management One key opportunity where technology is improving operations is in the area of referral management.  Referral management enables providers to more effectively and efficiently refer to specialists that are aligned with them, or their organizations on the same EHR platform, and can provide referral guidelines based on clinical condition or need.  Innovative technologies that fit into providers’ workflow and channel patients within the desired network benefit both administrators and physicians, particularly in highly competitive markets, and this is especially true for delivery systems that have recently expanded, and/or are taking on more risk. Supply chain Another area ripe for innovation is supply chain. Across the country, health system leaders list financial stewardship as a top strategic goal and foresee increasing participation in value-based models. In this environment, understanding end-to-end cost is an imperative and as a result, purchasing is a tremendous opportunity.  Building supply chain capabilities—to understand pricing, renegotiate, and bring discipline to supply purchasing and use—grows in importance in this context. Traditionally, most decisions are based on cost, physician preference, or lack of information on inventory availability or price. Technology now allows for better information tracking and easier information retrieval of supply chain data points in real time for better decision-making and greater price/cost transparency, and can provide physicians with better data to make better collective decisions. Automation Automation or delegation is another area that will benefit from innovative technology. In this case, leveraging technology helps clinicians practice at the top of their license. With algorithm support, technology empowers clinicians to better understand which tasks should be delegated, to whom, how, when, etc., for best results. When considering technology in this area, it is important to be sure that solutions help streamline rather than become additive to the provider’s workflow. These are just a few examples of areas being transformed by technology and innovation in the era of Operations 2.0. In the months and years ahead, there will be much more to come. HX360 exists to advance the new model of care. Learn more about Operations 2.0 and emerging technology solutions at HX360 during HIMSS16. Don’t miss the HX360 Innovation Pavilion plus cutting-edge programming led by world-class healthcare executives, investors, innovators and leaders like you.

(SPONSORED) Technology has significantly disrupted the healthcare industry, creating a whole new matrix of threat and opportunity.

I have the pleasure of meeting or speaking with many digital health, health IT, med-tech, and life sciences startups every week. And, as a #HIMSS16 Social Media Ambassador, I’m looking forward to meeting many more at HX360 during HIMSS16. Since I’m a serial entrepreneur and angel investor myself I know how hard it is these days to get to product/market fit while working with top-notch investors who understand how to help scale a business. The path from an idea to product/market fit, profitability, and long-term success for any startup is what I refer to as the “Venture Development Lifecycle” (VDLC). VDLC is the path from an idea to product/market fit and profitability. As you go from one phase to another in the VDLC and are seeking investors to join you on the journey you’ll have one key task at each phase: show how you’ve already reduced risk in the previous phases and which risks remain in future phases. The VDLC has risks throughout the process but some of the highest risks come when a venture is moving from one capital raise phase (e.g. seed or angel) to another (e.g. VC, growth equity, or PE). Experienced investors already know that de-risking startups as they move from seed to angel to VC to later stage capital is necessary. Unfortunately, investors don’t always work together in a strategically integrated approach throughout the VDLC, putting earlier stage capital at more risk than is necessary. Traditionally it’s the entrepreneur that has had the job of understanding each investors’ risk tolerance and de-risking approach. However, many entrepreneurs don’t know really how to evaluate their product/market fit risk, capital risk, execution risk, and the myriad other problems they’re likely to face. Entrepreneurs shouldn’t be left to integrate the various investors on their own; instead, investors should form strategic partnerships with other investors where they formally form a vertically integrated supply chain throughout the VDLC. Since some of the highest risks for startups come when a venture is moving from one capital raise phase (e.g. seed or angel) to another (e.g. VC, growth equity, or PE), entrepreneurs need to figure out how you’re going to explain the risks in your business and de-risk your innovations. Try and answer these questions for the various digital health investment phases: Seed: how high is the innovation risk? Can you show that the idea works elsewhere? Angel: have the requirements and innovation risks been ironed out enough so that a product’s technical risks are all that remain before landing a customer? Super angel: Have the technical risks been ironed out so that pilots and initial customers are showing success? Series A institutional: Have the product/market fit risks been ironed out so that it’s clear that scalable sales are the next barrier? Series B and further: Have the initial sales risks been removed so that further scale and support are now the next barrier? As you go through the VDLC you’ll see it’s mostly a matter of understanding your risks and ironing out the key ones at each stage. You should seek out investors at each stage that clearly understand the de-risk’ing process and could potentially work together as either a syndicate or a strategically integrated value chain. When you interview investors, see how many of them have worked together in the past in either a vertical integrated manner or even as a loosely affiliated approach. The more you lay out your process, the more you understand your risks and help investors understand how you’re de-risked, the easier time you’ll have in the capital raise process. If you’re attending HX360 at HIMSS16 try and discover how angels and earlier stage capital can better collaborate with payer investors and VCs through more diverse and sophisticated syndications. When early and late stage capital get more involved in advisory roles with their investments throughout the VDLC, de-risking innovations becomes easier and more successful innovations will get to market faster.  

Electronic health records are typically touted as providing two primary and vital services: readily accessible patient records and protection against contraindicated medications. But Intermountain Healthcare is benefiting from a growing and transformative versatility in the application of its EHRs.