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Mayo Clinic and IBM Watson Health have announced the results of a cutting-edge project putting the supercomputer to work for patient matching: Watson brought in more patients than before to participate in recent breast cancer clinical trials. Only 5 percent of patients with cancers participate in clinical trials nationwide, according to Mayo Clinic officials, who noted that that low enrollment makes for many clinical trials that are slow to finish or not completed. That delays advances in research and results in less access to better therapies. [Also: Next-up for EHRs: Vendors adding artificial intelligence into the workflow] What’s more, matching and enrolling patients in appropriate trials has proven to be a time-consuming, manual process. “Novel solutions are necessary to address this unmet clinical need, advance cancer research and treatments, and, in turn, improve the health outcomes of patients,” Tufia Haddad, MD, a Mayo Clinic oncologist, said in a statement. Watson for Clinical Trials Matching is programmed to accurately and consistently match patients to clinical trials for which they might be eligible, so that healthcare providers and patients can consider appropriate trials as part of a care plan. Mayo Clinic implemented the system in July 2016 in its ambulatory practice for patients with breast cancer. In the 11 months after implementation, there was about an 80 percent increase in enrollment to Mayo’s systemic therapy clinical trials for breast cancer. Also, the time to screen an individual patient for clinical trial matches was lower when compared with traditional manual methods. “This has enabled all patients to be screened for all available clinical trial opportunities,” Haddad noted. Based on the initial testing phase, Mayo and IBM agreed to continue developing the system to include trials for other types of cancer and aspects of cancer care beyond medical therapies, such as surgery, radiation and supportive care. Watson is programmed to support clinical trial matching for breast, lung and gastrointestinal cancers, and training on trials for additional cancer types is underway. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

When it comes to revenue cycle, a patient-centric culture is the future. By the way, make sure you include your employees in that philosophy and understand how technology can help get there. The dominant themes emerging from HIMSS18 when it comes to revenue cycle were all about putting the patient first and recognizing that it's people driving your revenue cycle operations. Hospital executives must recognize what will be driving the healthcare industry from a patient and employee standpoint in the coming years and acknowledge the consumer-centric experience taking hold just about everywhere -- and, increasingly, that includes healthcare. The emerging philosophy around revenue cycle is that not only is it part of the overall care experience, but that it will bookend most episodes of care, with pre-authorizations, registration and taking of POS payments at the front-end and then post-care billing on the back end. The policies and procedures surrounding this front-to-back operation should be built on personalization of patient interactions, knowledge of consumer preferences, flexibility, and clear communication where the patient understands what they will be responsible for and will have options to fulfill their obligation that suit their particular situation. It's the experience they have come to expect, and it's something that may be present in other areas of care delivery but that has been lost a little in the realm of revenue cycle. Consumers also welcome digital options for registration and billing. Sharp Healthcare in San Diego created a self-serve billing portal where patients can view statements, pay bills, download statements and view current invoices broken down by hospital clinic.  "Patients can pay their full balance or for a specific visit. There is a document repository as well so they can see any forms provided to them at the hospital," said Gerilynn Sevenikar, vice president at Sharp.  Since its launch in 2017, patients have paid more than 10,000 invoices online. Patient communication of the high- or low-tech variety can play a pivotal role in increasing collections across the various stages of revenue cycle, but is likely most effective when frontloaded. Having focused, clear and personal conversations with patients at the beginning of their care experience made all the difference for stand-alone system Goshen Health in Indiana. Their former CFO Amy Floria addressed the audience at the HIMSS18 Revenue Cycle Solutions Summit and told listeners that bad communication equals bad debt, and that lack of communication and standard procedures for financial aid qualification hurt them badly.  "We had everyone apply and just charged off bad debt when they didn't end up qualifying," Floria said. Goshen redesigned its website, met with every patient while they were in the facility to address issues and questions, and expanded payment plan options, especially for consumers with high deductible health plans. The system also started offering all patients financial informational material in english and spanish to accommodate their hispanic community. All that resulted in a whopping 7,200 percent increase in monthly POS collections from $2,500 a month before the changes three years ago to $240,000 a month in 2017. Flexibility and creativity in creating an adequate array of payment plans and options for patients will be even more crucial moving forward, as healthcare costs show no sign of shrinking. On the contrary, a recent Transunion study showed that out-of-pocket costs spiked 11 percent in 2017, while at the same time 35 percent of American adults would struggle with, or be unable to pay, a $400 bill. If the care isn't going to get any cheaper, than something has to give when it comes to how patients are allowed to pay. Revenue cycle leaders also can't forget that while new technology can help refine operations and expand capabilities, if the people who staff your department don't understand it or hate using it, you've wasted your investment. Choosing software that is intuitive and creates efficiencies will inspire more productivity in your staff. So it might not hurt to get their feedback or even give them a say in what technologies gets selected -- and do so as early in the procurement process as possible.  Finally, driving a successful revenue cycle department requires motivating and rewarding the staff who do the work. Since over the course of the next decade, consumerism will constitute a bigger piece of all industries, healthcare included, creating a system of performance monitoring, real-time feedback and employee rewards can inspire your rev cycle staff to work smarter and, in turn, that will benefit your system's bottom line. "That's what makes a difference to that next generation healthcare consumer and employee," Sevenikar said. Twitter: @BethJSanborn Email the writer: beth.sanborn@himssmedia.com

In his first State of the Clinic, Cleveland Clinic CEO Tom Mihaljevic, MD, called on the health system’s 57,000 employees around the world to focus on caring: “how we care for patients, care for each other, care for the organization, and care for our communities,” he urged. Mihaljevic succeeded Toby Cosgrove, MD, who held the top executive position for more than 12 years. Mihaljevic joined Cleveland Clinic in 2004 as a cardiothoracic surgeon, served as CEO of Cleveland Clinic Abu Dhabi since 2015 and took over the post here in the U.S. on January 1, 2018. In his speech, Mihaljevic called on staff to continue to improve healthcare by best using new technologies, notably artificial intelligence and the latest in data analytics as well as digital platforms. [Also: With patient experience, 'We need to dream bigger,' Cleveland Clinic leader says] Mihaljevic also revealed new initiatives for 2018, including efforts to improve patient safety and reduce caregiver and physician burnout. Cleveland Clinic reduced readmissions, improved care coordination, and increased hand-washing among caregivers in 2017. “We have a right to be proud of our work in patient experience,” he said. “It is inseparable from quality. But we need to go further.” He said Cleveland Clinic would continue to bolster its culture of safety, become an ultra-high reliability organization, and he promised to set bold goals, particularly regarding hospital-acquired infections and serious safety events. [Also: Cleveland Clinic's remote revenue cycle program saves money and makes employees more productive] A recent survey within the Cleveland Clinic, for instance, found that more than one in three physicians met the criteria for burnout. “We are here for patients first,” Mihaljevic said. “But we can’t succeed unless we take care of ourselves.” To that end, he announced that Cleveland Clinic has established the new Office of Caregiver Experience to address wellness, burnout and career development. Mihaljevic also praised Cosgrove’s achievements and his legacy. Today, Cosgrove has a new title: Executive Advisor and former CEO and President. He has been with the Cleveland Clinic for more than 40 years – as cardiac surgeon, department chair and ultimately CEO. Under Cosgrove’s leadership Cleveland Clinic saw increases in revenue, patient volume, research funding and community benefit. Mihaljevic delivered the State of the Clinic speech late last month. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com

In healthcare, there’s likely been no more critical investment in technology they’ve had to make than in mobile engagement and the infrastructure required to support it.

Michigan, like much of the rest of this country, is in the midst of an opioid crisis. The number of opioid prescriptions, individuals in substance use disorder programs and, worst of all, opioid-related drug overdose deaths have all increased from 2011 to 2015 in the state. Michigan has turned to health IT to try to accomplish two goals: prevent overprescribing and over-dispensing by health professionals, and improve patient care for individuals suffering from substance use disorders. “We are attempting to prevent overprescribing and over-dispensing in two ways,” said Kim Gaedeke, acting deputy director of the Department of Licensing and Regulatory Affairs for the State of Michigan. “First, equipping Michigan physicians and dispensers with real-time patient data to be viewed prior to prescribing and dispensing schedule 2-5 controlled substances and dissuading overprescribing through disciplinary and enforcement actions.” [Also: Senator proposes bill to incentivize states to share PDMP data with law enforcement] Michigan health officials selected specialized vendor Appriss Health for its substance use disorder system NarxCare. The vendor works with 46 states that are sharing PDMP data across state borders to inform physicians and pharmacists at the point of care of a patient’s Rx history to avoid overprescribing or those who are doctor shopping. NarxCare provides participating physicians and dispensers with an abundant amount of patient history and data to help determine the degree to which the patient is at risk for substance use disorder, Gaedeke added. This helps inform a health professional’s clinical diagnosis.   "In the past, it would take health professionals on average 5-10 minutes to pull up a patient report. The state has experienced a return on its investment with an annual savings of roughly $1 million in staff costs." Kim Gaedeke, State of Michigan “Additionally, we are able to use individual and statewide prescription and dispensing data to determine overprescribing and over-dispensing by health professionals,” she said. “The state uses this data to follow up with disciplinary actions against health professionals who are overprescribing or over-dispensing.” [Also: Joining opioid fight, North Carolina signs on to PDMP data sharing collective] The second way Michigan is attempting to prevent overprescribing and over-dispensing is through the system’s ability to determine the degree to which a patient is susceptible to substance use disorder and, if necessary, provide ways to help that patient. “The additional resources can be presented within the health professional’s clinical workflow,” Gaedeke said. “This assures that the patient immediately receives appropriate assistance during a visit. This technology has helped transform the traditional model of a Prescription Drug Monitoring Program to a more robust clinical, care management, analytical and prevention tool.” The NarxCare technology fits into the clinical workflow by being integrated into a physician’s electronic health record system or a pharmacist’s dispensation system. This direct integration of the systems allows for the physician or pharmacist to stay in the software, and if the same patient is also in the state’s PDMP, called MAPS for Michigan Automated Prescription System, the patient’s data in MAPS automatically appears in the health professional’s EHR or pharmacy dispensation system without requiring the practitioner to log in and out of two separate interfaces. “Once the provider clicks to view on the NarxCare report, the practitioner can see the full data set of the patient such as risk scores, Medical Morphine Equivalent, and history of schedule 2-5 controlled substances that have been prescribed and dispensed to the patient,” Gaedeke explained. “In addition, it includes any red flags such as whether the patient has gone to multiple doctors or pharmacies in a short period of time to obtain the same prescriptions, indicating possible substance use disorder or drug diversion.” Based on an interactive visualization of usage patterns to help identify potential risk factors, the physician or dispenser can determine the appropriate course of action for treatment, she said. Since implementing the Appriss Health technology in April 2017, Michigan has documented a decrease in the number of Michigan residents receiving an opioid prescription and decrease in the rate of doctor shopping by patients, she said. She added the state expects a drop in the total number of controlled substance prescriptions filled in Michigan from 2016 to 2017 once the data is tabulated and finalized. “Additionally, the improvement in technology has increased the number of health professionals using the new MAPS/NarxCare platform,” she explained. “The increase in the number of users further contributes to aggregated data that is collected and analyzed to better inform clinical diagnoses by individual health professionals and potential enforcement actions by our department.” The state’s Department of Licensing and Regulatory Affairs, where MAPS is housed, has also experienced overall efficiencies with the new system compared to the old system by instantly providing data in real time along with system reports in less than half a second for its users, she added. “In the past, it would take health professionals on average 5-10 minutes to pull up a patient report,” she said. “The state has experienced a return on its investment with an annual savings of roughly $1 million in staff costs. Prior to replacing the state-maintained system, the state went from 13.5 FTEs to now 4.25 FTEs.” And ultimately, Gaedeke said, with the innovations and efficiencies created with the new MAPS/NarxCare platform, the Department of Licensing and Regulatory Affairs has been able to better identify licensed health professionals who are overprescribing, over-dispensing and diverting drugs, which has allowed for improved regulatory actions and in many cases more swift action taken by the department and its licensing boards. “Technology plays a vital role in our fight against the opioid epidemic and substance use disorders in Michigan overall,” she said. “Technology allows health professionals to go beyond their individual instincts or preconceived notions by providing them with access to comprehensive real-time data with a single click in their existing electronic health records.” Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com

New suite brings tools designed for doctors, clinicians and hospital managers, the company said.

Executives from Wolters Kluwer, 4D Healthware and Femwell Group Health suggest finding mentors among women and men alike, breaking down stereotypes and surviving in the age of #MeToo and #TimesUp movements.

Now that President Trump has officially removed Veterans Affairs Secretary David Shulkin, the future is uncertain for the Cerner contract.

Northwell threw down two challenges and in return got several hackathon participants set up to interview for summer internships along with bright ideas to build on innovations that emerged from the event.

Spyglass survey uncovers varying degrees of understanding which tools can be used for early warning and predictive indicators to prevent adverse health events.