Lenovo

The Health Innovation ThinkTank, Adoption and Policy at a Crossroads brought together more than 50 healthcare thought leaders across the industry including care delivery systems, payer organizations and health IT innovators, to examine best practices.

Currently, the typical patient waits 29 days to see a physician, according to a recently released survey from Merritt Hawkins. And, it could get worse. The country is expected to experience a shortage of about 90,000 physicians by the year 2025, according to the American Academy of Medical Colleges.  As a result, patients are apt to seek primary care for minor ailments such as a cold of flu through emergency departments – or to simply go without any treatment whatsoever.  Delivering care under such conditions could become virtually impossible.  “Access is a huge problem in American healthcare,” said Sylvan Waller, MD, a physician executive. Waller served as one of the catalysts during The Health Innovation Think Tank:  A Collaboration of Global Health Industry Thought Leaders, an event that was co-hosted by Lenovo Health, Justin Barnes Advisors, University of Pittsburgh Medical Center/Critical Care Medicine , Inventiv Health and HIMSS Media. The good news is that virtual care could solve this access dilemma. Indeed, remote monitoring, secure communication and telehealth solutions can connect doctors to patients directly while also addressing healthcare’s triple aim and reducing the need to seek care in inappropriate, high-cost settings. “When all of these virtual technologies are leveraged, a virtual connected health eco-system is created. Consumers can then engage with providers through these virtual systems – and the home becomes the primary care setting.  Technologies such as the Alexa app, with applied health skills, becomes every consumer’s trusted health assistant,” said Tom Foley, director, global health solution strategy at Lenovo Health. The big question: Are healthcare organizations ready to migrate to virtual care delivery? “The technology is there. Consumerism is there. People expect services on demand and they want concierge care,” Waller said. “It is coming. However, [virtual care] is just not quite there yet as barriers to adopting it are much harder than we thought about.”   Steve Aylward, senior vice president of partner enablement at Change Healthcare, agreed.  He explained how he sees both strong demand and challenges on the horizon for virtual health. “Reader’s Digest recently ran an article telling its readers that they have to have three popular telehealth apps. So, when Reader’s Digest starts telling its readers they need something, it is definitely becoming mainstream,” he said. To optimize virtual health’s potential, however, organizations need to overcome a variety of challenges associated with: Regulatory and legal requirements. “In the U.S., prescribing regulations are huge,” Waller said. Many states limit clinicians to providing treatment only to patients who are located in the state where the caregiver is licensed to practice. In addition, clinicians need to establish patient doctor-patient relationships, assess the patient and come up with a treatment plan. Consumers, however, should not be restricted by such constraints, according to Foley.. “This is where we lose patient engagement,” he said. “We should have the choice and the option to work with doctors in other states to get advice. This state barrier should not be an inhibitor. The legislative policies that restrict this need to change.” Trust in virtual health services. “Consumers don’t know the difference between telehealth providers. There is no brand recognition,” Waller said. “When a health system lends their brand, however, those patients have much more trust and adoption is much better.”  Understanding payment rules. According to Jeff Coughlin, senior director of federal and state affairs at HIMSS, Medicare beneficiaries may receive telehealth services in a variety of settings. Current Medicare law (SSA Section 1834(m)), however, restricts telehealth payments by the type of services provided; the geographic location where the services are delivered; the type of institution delivering the services; and the type of health provider. The good news is that payment concerns are becoming less onerous. Indeed, a 2016 Consumer Telehealth Benchmark Survey where just 34 percent of respondents cited reimbursement as an adoption barrier, compared to 72 percent in 2015. Recognizing the sweet spot. Organizations are beginning to realize that virtual care needs to expand to be financially feasible. “Everyone in the 1.0 version of virtual care is realizing that just treating cough, cold, congestion is a losing business model,” Waller said. “So, as they move to the 2.0 version, they are realizing that they need to get into chronic care management.”

The average patient with five chronic conditions typically will sit in front of a doctor for only 15 out of the 8,760 hours in a year.

There’s plenty of discourse and dissent about the future of healthcare in the United States. Value-based care, however, seems to be eliciting support from all corners, according to Jeff Coughlin, senior director of federal and state affairs, HIMSS. “Everyone is on board with value-based care” as there is both economic and clinical quality justification for the model, Coughlin said during The Health Innovation Think Tank: A Collaboration of Global Health Industry Thought Leaders held on June 22nd at Lenovo headquarters in Durham, N.C. The challenge, however, rests in overcoming obstacles that stand in the value-based care path, according to some of the approximately 50 healthcare delivery system and healthcare IT vendor thought leaders gathered at the symposium, which was co-hosted by Lenovo Health, Justin Barnes Advisors, University of Pittsburgh Center for Connected Medicine, Inventiv Health and HIMSS Media. Holly Miller, MD, CMO at MedAllies, Fishkill, N.Y., for example, pointed out that innovative technology only accounts for about 20 percent of the transformation equation with the other 80 percent hinging on process and workflow redesign.  “In the United States, we have spent 30 billion on the adoption and implementation of digitized healthcare information. We have made progress but we have not really leveraged that investment,” said Miller, who was serving as one of the thought leader “catalysts” at the event.  Consider the following: One in five patients experience an adverse event after being discharged from the hospital, despite the fact that technology is capable of performing real-time document transfers to primary care physicians. The problem is that such electronic communication only accounts for 20 percent of the critical components of the discharge process. To truly experience value, organizations must heed the other “80 percent,” which includes processes such as discharge medication reconciliation, clinician-to-clinician hand-offs, scheduling an appointment with a primary care provider within three days of discharge and placement of a phone call to the patient within 24 hours of discharge. Patient identification is another challenge that organizations must address as they share health records across the continuum of care – regardless of EHR. Tom Foley, director of global health solution strategy at Lenovo Health, reflected on the fact that he, like many other consumers, sees various providers and “all of my data is in different locations and they all know me differently.” As such, when transitioning from one care setting to another, organizations are often besieged with problems such as duplicate medical records, medical identity theft and payment fraud. Unique patient safety identifiers can eliminate these problems by enabling organizations to match patients with records. A unique patient safety identifier is not an alphanumeric value someone can view, but it is an encrypted token that can also be leveraged in a deterministic-matching algorithm that allows healthcare organizations to know with 100-percent confidence they have the right person. These identifiers can outperform other methods such as the enterprise master patient index, which employs probabilistic matching and is only accurate about 80 percent of the time. While leaders must address issues such as process redesign and patient identification, they also simply need to make the move to value-based care. The fact of the matter, however, is that the majority of care is still delivered via fee-for-service models and many healthcare organizations are not quite ready to make the change. The situation reminds Leigh Williams, administrator, business systems at the University of Virginia Health System, of an old fishing theory that says a fisherman can catch a large bounty of fish while a storm is coming in, but “you have to do a risk/reward analysis to know when to bring the ship in from the storm.” Indeed, although organizations know that they will need to come in and adopt a value-based model, it is difficult to “pivot because [they] are still catching fish in the fee-for-service model,” she concluded.

HIThinkTank is a dynamic group of health industry leaders dedicated to leveraging their collective wisdom in an effort to share best practices and positively affect public policy.

Although most of the health industry has moved records and administrative processes from paper to digital, human error remains a costly issue. Implementing health IT solutions, particularly a unique health safety identifier (UHSI), can eliminate the ongoing challenges of duplicate records, patient identity theft and payment fraud.

The cost of payment fraud not only significantly diminishes provider revenue, but also creates extensive losses within health delivery along the entire care continuum. Implementing health IT solutions to eliminate payment fraud will successfully address these losses, as well as simplify and maximize payment collection.

As medical identity theft continues to rise, so does its impact on the healthcare industry and patients. Prevention is possible with the right health IT solutions.

Health IT solutions must address patient ID challenges along the care continuum. As virtual care grows to engage a wider breadth of patients, the industry needs to look at innovative ways to ensure ID security.

How do duplicate records impact patient outcomes? Lenovo Health dives into the risks and how they impact everything from patient safety to revenue.