Month: October 2021

August 6, 2019

There’s a new framework for judging the success of healthcare and it’s based on outcomes. This new paradigm of patient-centered care is now the bar that must be met for reimbursement. It requires delivering healthcare that is safe, effective, efficient, patient-centered, timely, and equitable.

To meet all these standards, the use of health informatics has grown increasingly sophisticated. Health informatics is an emerging science that combines healthcare, information technology, and communications to share medical data, facilitate coordination between providers, and encourage patient participation.

The ways in which it has improved patient outcomes in the last 5 years can be observed most readily in the following areas.

(1) Reduced error through shared medical data

The increased collection and automation of electronic health records (EHRs) reduce negative outcomes due to human error. Information gathered by a primary care provider is increasingly deposited into an EHR to keep track of a patient’s medications, allergies, and possible interactions. This information can be accessed to check for potential problems when a new medication is prescribed – especially in an emergency situation, or if the patient is unconscious. 

Well-maintained EHRs ensure patients get the proper medication the first time to prevent allergic reactions. They can be set up to warn a provider before ordering a test a patient has already received or maybe it’s a high-cost to the patient. 

In a paper-based setting, identifying potential safety problems is difficult and time-consuming. This can lead to medical consequences that take years to correct. Conversely, EHRs can expose potential safety problems before they occur, and help providers avoid serious medical errors thus leading to better patient outcomes. 

(2) Increased efficiency through coordination

The last 5 years have seen a great increase in the amount of medical data created, used, edited, and viewed by multiple healthcare entities (such as clinicians, hospitals, insurance companies, and patients). As a result, many hands need to ‘touch’ these records. 

Coordinating all this has been a crucial part of improved patient care, and informatics has greatly improved this. Clinicians who use this technology and incorporate data into their daily workflow see improved provider and patient satisfaction. 

(3) Increased patient involvement, compliance through portals

A patient’s success story often depends to a large degree on their own compliance. With increasing access to portal platforms, many patients are taking a more active role in managing their health – an essential element of patient-centered care. 

Portals also provide patients with a way to educate themselves, keep track of medications, and manage symptoms. They provide a more efficient way to interact with doctors and nurses more easily, and this leads to better outcomes as well. 

Additionally, there is a rising patient demand for access to their own healthcare data. This has led to more personal use of EHRs such as providing a greater role for family and friends and sharing information and resources with others who have the same conditions. For example, the CHESS program, implemented as a result of a study by the Agency of Healthcare Research and Quality (AHRQ), has helped people with chronic illnesses (such as AIDS or cancer) more readily find access to resources, referrals, health services, and care.

Convenience is also a factor for improving patient compliance – and therefore patient outcomes. EHRs have added a great deal of convenience with regards to health care transactions such as e-prescribing (having prescriptions ordered and ready for pick-up before they leave the provider’s office), filing insurance claims from the provider’s office, and even accessing files or prescriptions away from home or while on vacation. 

(4) Improved decision support

Clinicians and healthcare providers make a remarkable number of decisions about healthcare every day. EHRs help them make more efficient, more effective decisions about the care for their patients, leading to improved outcomes. They do this by:

• Improving aggregation, analysis, and communication of patient information
• Providing alerts and reminders
• Offering supporting evidence for diagnostic and therapeutic decisions

Interfacing data from various medical devices through custom applications provides not only valuable data with regards to a patient’s health, but also provides essential clinical decision support to help prevent patient harm.

Next era of health informatics – unlocking the potential of lab data

Front office and the exam room data has been corralled and utilized to help improve patient outcomes through informatics. However, the data is still siloed.

Silos are a fact because most healthcare institutions have their own lab information systems (LIS). None of these data caches talk to each other. You can export reports, but then what do you do with the information? For example, EHRs can provide the test results, but they cannot intuit where wasteful lab testing is happening.

The answer is to transform that lab data into personalized healthcare insights with a solution like hc1 Test Utilization™. This tool takes all lab data and builds a healthcare relationship matrix so clinicians gain clearer insights. 

hc1 Test Utilization integrates everything to create a treasure trove of normalized data by:

• Removing duplication that comes from variants in naming and coding
• Standardizing the range differences (for example, normal may be a range of 1 to 5 in one place, and 2 to 4 in another) 
• Ironing out the clinical variation and getting every physician on the same page

Health informatics provides a number of efficient solutions for improving patient outcomes. However, there’s a rich source data that is underutilized because lab data is siloed. An informatics tool such as Test Utilization provides a way to see test results at a global level. It is the next step in the evolution of health informatics and patient-centered healthcare.

November 12, 2019

Efforts to implement value-based healthcare (improved outcomes for less cost) are becoming increasingly vital as global, particularly U.S., healthcare spending soars. Global healthcare spending is projected to increase to $10.1 trillion by 2022. Estimates suggest $3 trillion of that money is spent on waste, for which the United States accounts for a third. The United States healthcare spend is the highest, 5 percent more than the next highest-spending country.^1,2

Value-based healthcare has brought information technology, and particularly data management, into the forefront. Determining value, as well as increasing value, requires significant data analytics to identify, measure, and improve outcomes. For efficient and accurate analysis, data must first be accessible and relational. This means retrieving and aligning data for medical and health care services, supportive services, processes, research, and innovation.¹

Historically health system data has been anything but accessible. For years data has been collected and defined by siloed entities in non-standardized and legacy IT systems. Health informatics, however, is increasingly connecting systems and allowing real-time analysis of this complex information. Bridges can now be built between the silos and the data stored within can be combined and shared more easily.²

Improved data management resulting from the shift to value-based care is manifesting itself in several important ways. Significant improvements in clinical data exchange are already occurring and are predicted to occur in the next decade.³ These improvements include:

Improved data sharing within and across healthcare networks. More records system vendors are working together and solutions like the hc1 High-Value Care Platform™ are making data more manageable and transferable. The federal government is also calling for healthcare providers and vendors to use systems that facilitate rather than impede the exchange of information.³

Added communications capability and easier interaction for increasingly tech-savvy patients and healthcare providers. Gone are the days when a majority of patients were uncomfortable with technology and providers avoided contact with them outside of office visits. Health system portals are giving patients and providers easy access to records and efficient means of secure communication that save time and improve interactions. This increased communications capability also applies to interaction between healthcare providers, such as between primary care providers (PCPs) and specialists or PCPs and pharmacists.³

Personalized care and precision medicine. Through the use of pharmacogenetic testing, we can learn how our bodies are likely to process and react to prescribed medication. With the results in hand, as well as knowledge of lifestyle, allergies, and current medications, healthcare providers can personalize treatment. Precision medicine, however, requires analysis of these multiple data points. Solutions like hc1 PGx Advisor™ are helping providers efficiently access and analyze this data.

Faster transition from research to practice. Insights gained through research once took years before becoming part of regular medical practice. Providers strapped for time were unable to easily stay current on all of the latest publications and guidelines. With modern data systems, guidelines and recommendations can be loaded into clinical data systems and made available for reference during related patient interactions. Having relevant, real-time clinical information helps guide prescribing, testing and treatment while reducing waste and improving outcomes.³

In 2011, hc1 was born from our founder’s belief that every patient is unique and should be treated that way. Today the hc1 High-Value Care Platform™ eliminates waste and personalizes care for health systems and diagnostic laboratories nationwide by turning previously static lab data into actionable healthcare insights. Using the hc1 platform, health systems can improve clinical outcomes and reduce medical spend. Request a demo to learn more.

References

1. Leung, T. I., Merode, G.G. (2018 Dec 22). Value-Based Health Care Supported by Data Science. Fundamentals of Clinical Data Science pp 193-212. https://link.springer.com/chapter/10.1007/978-3-319-99713-1_14.
2. Kimpen, J. (12 Feb 2019). Here’s how to make ‘value-based healthcare’ a reality. World Economic Forum. https://www.weforum.org/agenda/2019/02/here-s-how-to-make-value-based-healthcare-a-reality/
3. HDM Staff. (27 Sept 2019). How IT will impact healthcare in the next decade. Health Data Management. https://www.healthdatamanagement.com/news/how-it-will-impact-healthcare-in-the-next-decade

August 31, 2020

With a global pandemic dominating the news cycle and changing our daily lives, it’s easy to forget about the other epidemic that kills Americans daily: opioid overdose. 

August 31 is International Overdose Awareness Day, a global event to raise awareness of overdose and reduce the stigma of drug-related death. Overdose death is preventable and is still occurring in spite of COVID-19. In observance of the day, we want to call attention to the impact opioid misuse has in the United States, as well as resources for learning more. 

In the coming weeks we will reintroduce the topic of opioid misuse in our conversations and in our blog because with attention, understanding, and vigilance, this epidemic too can be overcome. 

• 128 people die every day from an opioid overdose. Forty-one of those deaths involve a prescription opioid. 
• During 2018, there were 67,367 overdose deaths in the United States and 46,802 of those overdose deaths involved opioids.
• Many opioid overdoses also involve other drugs.
• Anyone who takes prescription opioids can become addicted to them. As many as one in four patients receiving long-term opioid therapy in a primary care setting struggle with opioid addiction.
• An estimated 10.3 million Americans aged 12 and older misused opioids in 2018, including 9.9 million prescription pain reliever misusers and 808,000 heroin users.
• More than 191 million opioid prescriptions were dispensed to American patients in 2017.
• Responsible opioid prescribing practices that include risk assessment, checking the state’s prescription drug monitoring program (PDMP), laboratory testing and patient education can prevent misuse that may lead to addiction and overdose. 
• Opioid Stewardship Committees can be an effective way to start implementing consistent, responsible prescribing and vigilant monitoring practices in healthcare organizations. 
• More information about opioid misuse and overdose can be found by visiting:
  • Health Resources and Services Administration 
  • American Society of Addiction Medicine 
  • U.S. Food and Drug Administration 

December 3, 2020

On November 13th, 1789, Ben Franklin, wrote a letter to Jean-Baptiste Leroy saying, “Our new Constitution is now established, and has an appearance that promises permanency; but in this world, nothing can be said to be certain, except death and taxes.” Ben Franklin’s words certainly still hold true today. However, in this article, I plan to draw attention to a crisis that requires major action and change to prevent premature death, and, unfortunately, I will also draw the necessary correlation to the almighty dollar and tax revenue.

While preparing to write this article it has been difficult to find words or examples to put the year 2020 into perspective while bringing up yet another heart-wrenching topic. There is no doubt that this year will always be remembered for a time of uncertainty. This moment in our country’s history will leave an indelible mark on all generations, hopefully, many positive changes will take effect but there is no doubt some will have negative memories. Specifically, the pandemic has been devastating on so many levels, and racial injustice (and the following riots) have been tragic. These events have shaken up the United States and have forced individuals to ask themselves very difficult questions about their personal health and safety and the health and safety of their loved ones. What’s worse? We have other life-altering healthcare crises that continue to persist. The opioid crisis was already serious, but it has intensified during the pandemic.

Recently, my colleague, Lauren VenDenBoom, brought it to my attention that Monday, August 31st was International Overdose Awareness day. She wrote a blog post articulating the harsh truth that 128 people die every day from an opioid overdose!! She cited many other staggering and sobering facts here: https://www.hc1.com/blog/lets-not-forget-the-other-epidemic-opioid-overdose/.

My CEO, Brad Bostic, also sent me an article on Sunday evening that argues how the opioid crisis is “a unique product” of US health care. In the article written by Alexis Keenan and Adriana Belmonte of Yahoo Finance, they reported that “U.S. states are claiming that opioid manufacturers, distributors, and others who fueled the country’s decades-long opioid crisis will cost the economy at least $2.15 trillion by the year 2040. Between 2007 and 2019, the states estimated that their systems took a $630 billion hit. Anticipated costs of $1.53 trillion from 2020 to 2040 are estimated to run up the rest of the tab. The figure was reported in a filing made public Monday in the Southern District of New York in the bankruptcy case for OxyContin maker Purdue Pharmaceutical.” You can access the entire article here: https://news.yahoo.com/opioid-crisis-health-care-system-165837992.html

+ The picture above is of Cataldo Ambulance medics and other first responders reviving a 32-year-old man who was found unresponsive and not breathing after an opioid overdose on a sidewalk in Everett, Massachusetts. (REUTERS/Brian Snyder)

$2.15 trillion dollars is as shocking of a number as I can imagine being linked to the opioid crisis. Do I even have to start contextualizing how big a number that is when it starts with the letter “t”? I have spent my career in some sort of sales capacity which typically requires me to create cost-benefit analysis or return on investment calculations. Those analyses have provided justification for the various organizations I engage that are evaluating an investment in software solutions. It made me think, do we really need to cost-justify lives being lost? I hope not but change is often slow unless we create the necessary urgency to gain attention and priority. Thus, the cost of the loss of lives is unfathomable when you look at it from a tax revenue perspective, but much more importantly, the loss of life means that a mom or dad, son or daughter, brother or sister are no longer with us because of an opioid overdose. Is there anything more precious or urgent than the value of a life?

The best news is that these premature deaths are preventable! Many new innovations have spawned to put real-time insights into the hands of prescribing providers that detail what is in the patient’s body (lab tests) and what should be in their body (prescription drug monitoring program). Timely insights and #clinicaldecisionsupport will help providers make better opioid prescribing decisions. That gives me optimism that as we continue through this tumultuous year, we can make a difference by delivering the appropriate interventions to improve opioid prescribing while better informing clinical practice. These innovations will identify and protect at-risk patients and can make a dramatic and positive difference in outcomes!

I have asked a number of questions in this article and I will reiterate two important questions we need an answer to…. how many premature deaths, or in the more unfortunate view, how much tax revenue has to be lost for our federal and state legislators to start enforcing more stringent policies and procedures when it comes to the distribution of opioids? Ben Franklin may have been right about death and taxes, but people pay taxes and taxes help pay for critical services that can be used to prevent the tens of thousands of unnecessary deaths we continue to see each year by the opioid crisis.