Readers Write: Should Your Patients Trust You With Their Data?

Should Your Patients Trust You With Their Data?
By David Thomas

It seems innocent enough. Collect email addresses and birthdays so you can reach out to your most loyal patients on their special day. But where is this data stored? Who has access to it? How is it protected?

In the digital economy, customer experience is paramount. Data lets us deliver a personalized experience in real time. But making the patient record richer and more valuable to your organization also makes it more valuable to others.

Data is the new oil. It’s the fuel powering growth and innovation, and bad actors can’t wait to get their hands on it. Even a seemingly innocuous piece of information such as an email address or birthdate can be used in identity theft. Today, all personal data is sensitive and there’s more of it all the time.

If you’re in the healthcare industry, you handle sensitive personal data about customers, employees, and partners; and you’re about to handle much more of it. As digital transformation expands across new areas of our lives, increasingly sensitive types of data will need to be shared and accessed by more entities, more frequently. We may not mind our ride-sharing service knowing our favorite destinations, but we care who sees our medical, legal, and financial records.

The days when organizations could be casual about personal data are officially over. It’s time to assess the situation and put technologies and practices in place to ensure your patients can trust you with their personal data. Building that trust will reinforce a positive view of your brand, and protect you against the damaging effects a high-profile breach can have on your organization’s reputation.

It’s also a matter of regulatory compliance. All over the world, regulations are evolving to address growing concerns about protecting personal data. Complying can be complicated and consequences for missteps serious. Europe’s new General Data Protection Regulation for 2018 includes fines of up to four percent of global annual revenue. A fine of $10 million on $250 million in earnings is a significant incentive (or penalty, depending on your perspective). Technologies and regulations will continue to change, requiring companies to be vigilant and proactive about protecting personal data.

Find your data

The first step to improving security is discovery. You’ll need to ask a series of questions to determine the extent of the personal data you collect and hold. What types of personal data do you ask for? Where is this data held? What systems and processes handle it? Who has access to it? What security measures are in place to protect it? Which partners need access to this data, and how do they ensure it’s handled securely? How might personal data assets expand in the future?

Craft your data security strategy

For many organizations, data is fragmented and spread across multiple divisions and partners, with varying degrees of security in place to protect it. To prepare for the rapid expansion of data and access that digital transformation is bringing about, you need to craft and implement a strategic plan for governing and protecting personal data. Every partner contract, for example, should spell out requirements for data security standards and practices.

Consult with IT

As marketing becomes more involved with data-driven analytics and personalization, it’s important to look to the IT organization for guidance, expertise, and best practices. The right data protection policies, processes, and training need to be prioritized and fully ingrained in organization functions. At a minimum, baseline security technologies and capabilities such as encryption need to be selected, deployed, and routinely tested.

Choose your partners wisely

Given the complex and dynamic nature of protecting personal data, it makes sense to minimize what you hold. For most organizations, the right course will be to partner with a technology provider focused on streamlining the handling of personal data. Some new API-based services can help deliver the information you need without saddling you with the responsibility of keeping and protecting sensitive data. The right solution should ensure that data is dispersed, not held centrally. It should pull information from authoritative sources. It should depend on permission from the individual for access. And it should be continuously refreshed with the latest updates.

We need these solutions in order to support the expansion of digital business. Last year’sEquifax breach exposed 145 million Americans to identity theft. That was followed by Yahoo’s three billion customer accounts being compromised. Still, significant progress is possible. Equifax not withstanding, the financial services industry has long pioneered leading-edge data security strategies and technologies, making online banking and credit card transactions reliable and secure. Now healthcare is in the personal data hot seat as they transition to digital – so get ready.

New and more serious threats, rising patient expectations, the expansion of our digital lives, and new technologies such as AI and the IoT mean that protecting personally identifiable data will be an ongoing challenge in the healthcare industry. Now is the time to find ways to protect your organization and your patients from data breaches, and to build relationships with the technology partners who can help you implement effective security strategies now and in the future. Giving your patients the confidence to share the details of their lives with you may already be a competitive differentiator.

David Thomas is CEO of data security company Evident in Atlanta.

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5 Questions with Vincent Siasoco, MD Medical Director, Metro Community Health Centers

Vincent Siasoco, MD is medical director of Metro Community Health Centers (NY). MCHS employs between 90 and 100 staff to care for 220 patients daily across its five FQHCs. MCHS is working with its physicians, some of whom also work for other healthcare providers, to help them meet the various stages of Meaningful Use. “Gathering data can be challenging,” Siasoco explains, “however, we continue to work with our providers to meet MU measures. We’re also considering submitting for MIPS as an ACO.”

In addition to its focus on MU and MIPS, MCHC implemented population health management technology from HealthEC to stratify risk, identify high utilizers of care, and give its physicians access to benchmarking tools and analytics. The organization is also working on adding specialized templates for behavioral health to its EClinicalWorks software, as well as dental-specific software developed for ECW. “We’re implementing a new VOIP phone system to better track and log calls and voicemails to the health centers,” Siasoco adds. “We’re also collaborating closely with the residential leadership of the Cerebral Palsy State Association to develop workflows to transmit clinical information digitally from their group homes to our health centers.”

Why did Metro Community Health Centers decide the time was right to implement population health management technology? What benefits do you hope to gain from deployment?

As an FQHC, we routinely monitor over 12 different clinical quality metrics through our EClinicalWorks EHR with the support of the Comprehensive Primary Care Initiative data reporting system. CPCI draws clinical, operational, and financial data nightly from our five health centers’ EHRs. Some of the quality metrics include HgBA1C, colon cancer and cervical cancer screenings, obesity, and tobacco use and education. We monitor these metrics on behalf of all primary care providers on a monthly basis and review at our QA meetings. Moreover, we break down the metrics even further by presenting each PCP with an individual, custom report disclosing quality metric scores for their seen patients. Internally, the metrics have been exceptionally beneficial, gauging not only each health center’s performance including practice variations and patterns, but also providing insights to help our physicians identify high-risk and rising-risk patients.

Besides serving as senior medical director of MCHC, I’m also the medical director of our ACO, Alliance for Integrated Care of New York. Through the ACO, we use the HealthEC population health management platform to access a tremendous amount of patient data via Medicare claims. A large number of our ACO patients have intellectual and developmental disabilities and live in group home settings. One of the challenges of providing services for IDD patients is that the group homes have their own nursing triage system in place. Therefore, although we have an after-hours on-call service, the decision to send patients to the ER is made by the group home’s nursing staff. While this triage system works well for the group home, our health center providers are not always aware of the date and time when patients are transported to the ED, nor the reason why. We usually learn about ED visits when these patients are seen at follow-up visits. Access to HealthEC data has changed this scenario in that we now track outside care administered to our patients. In fact, we can use the data to pinpoint which patients use the ED the most, which EDs treat the majority of our patients, and which patients have incurred the highest overall health spending. This valuable information has led to the enhancement of individualized care management plans and the ability to appropriately identify and address barriers to care.

The data also helps us achieve the Triple Aim’s three goals of improving the health of populations, enhancing the patient experience of care, and reducing costs. With a network of five health centers throughout NYC providing services to a highly complex patient population, MCHC’s implementation of population health technology is key to providing the best care possible for our patients. Knowing exactly when and where our patients are receiving care outside our network empowers our physicians and medical staff to appropriately coordinate with those providers and gain critical information. Essentially, we can collect all the pieces needed to view a holistic picture of a patient’s health to make more informed health decisions.

Aside from population health management technology, what other types of health IT is MCHC looking at?

I view telehealth as another promising solution to better coordinate care and expand the reach of healthcare delivery. Medical information can be exchanged as clinicians remotely diagnosis, consult, monitor and treat patients via electronic communications. Studies show that telehealth applications can enhance information access, improve the quality of care, increase patient and provider satisfaction, and reduce costs. However, equipment startup costs, as well as the billing and reimbursement rules applicable to telehealth delivered services, present several ongoing challenges for FQHCs. We’re looking at the possibilities of employing telemedicine at our FQHCs and how it could enhance our after-hours on-call service. We’re also exploring the chronic care management module and how best to support using it.

Given your ACO efforts and diverse patient populations, what coordinated care initiatives are underway?

We’re a Level 3 NCQA recognized Patient Centered Medical Home. As a result, systems are in place to ensure we provide continuous, comprehensive, and well-coordinated care. For example, our processes track referrals for labs, diagnostic tests, and outside specialists; monitor high-risk groups; and track transitions of care. We’ve implemented pre-visit planning huddles to ensure the clinical team can best prepare for patient visits.

How is MCHC working with staff to help everyone adjust to the adoption of the new technologies you’ve mentioned?

Metro’s move from paper to digital documentation has eliminated many inefficiencies and restructured our service delivery model to maximize the collective strength of our care team members. We’re now engaging RNs, LPNs, and MAs to help with care provision and management, pre-visit planning, care transitions, health education and patient self-management support, and accessing community-based supports and services. The challenge (or rather excitement) is to determine how we can make the most of advanced technologies. We’re aiming to institute a good plan for workflow transitions. For example, we organized a number of team meetings and on-site training sessions for our staff to begin using eClinicalWorks for our pre-visit planning huddles. Our goal is ensuring our staff has the necessary support managing successful transitions.

What advice can you share with other physicians who are looking to adopt PHM technology and programs?

Talk with other physicians who are involved with similar projects. Compare programs and health centers, and discuss and share best practices so you can identify what works best and is specific to your healthcare organization’s needs.

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Jenn, Mr. H, Lorre

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News 1/24/18

Top News

The Senate votes along party lines to confirm Alex Azar as HHS Secretary. Azar was most recently president of Eli Lilly and Co.’s US division. Past HHS positions include deputy secretary and general counsel under President George W. Bush.

Webinars

February 13 (Tuesday) 1:00 ET. “Beyond Sliding Scale: Closing the Gap Between Current and Optimal Glycemic Management Practices.” Sponsor: Monarch Medical Technologies. Presenter: Laurel Fuqua, BSN, MSN, EVP/chief clinical officer, Monarch Medical Technologies. The glycemic management practices of many hospitals and physician staff differ from what is overwhelmingly recommended by experts and relevant specialty societies. As a result, they are missing an opportunity to improve the quality, safety, and cost of care for their patients with diabetes and hyperglycemia, which commonly represent more than 25 percent of their inpatient population. Hospitals that transition from sliding-scale insulin regimens to consistent use of basal / bolus / correction protocols are seeing reductions in hyperglycemia, hypoglycemia, and costs. Making this shift more effective and efficient is the use of computerized insulin-dosing algorithms that can support dedicated staff using a systematic approach.

February 14 (Wednesday) 2:00 ET. “Time is Money: Aurora Health’s Journey of Implementing and Advancing Cost Accounting.” Sponsor: Strata Decision Technology. Presenter: Patrick Nolan, VP of finance, Aurora Health Care. Aurora Health Care’s implementation of Strata’s Decision Support module involved not only building an improved cost accounting model, but improving the process to engage a cross-functional team in cost development. It now has accurate, consistent cost data to support decision-making. Aurora’s next phase will be to use actual procedure and visit times to allocate costs. This presentation will provide a detailed view into both the implementation and future direction of the Strata Decision Support program within Aurora.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Announcements and Implementations

Northeast Indiana Urology selects ISalus Healthcare’s UroChoice EHR,PM, billing, and virtual consult technology.

Nonprofit homeless services provider Community Healthlink (MA) will implement behavioral health EHR software from Qualifacts.

Altarum Institute develops an interactive online tool to help physicians predict and improve their MIPS scores.

YMCA of Greater Houston will replace the state’s refugee resettlement database with care coordination technology from Eccovia Solutions. The YMCA is one of four Regional Replacement Designees in Texas, and has been tasked with finding a new, statewide database.

ChiroFusion adds billing functionality from OpenEdge Payments to its EHR for chiropractors.

People

Point of Care Decision Support promotes Jennifer Glen to VP, clinical services.

STD-focused telemedicine company Besafemeds names Dina McKenna (The Requisite Balance) CEO, Dawnyell Bowen (Leo Burnett) CMO, and Modupe Ishmael COO.

Community Care of North Carolina appoints Tammie McLean, Tara Kinard, and Jennifer Wehe-Davis to regional VPs.

Acquisitions, Funding, Business, and Stock

CNBC dissects the sizeable differences (from $7 million to nothing) predicted in Practice Fusion employee payouts once the company’s sale to Allscripts is finalized. It also uncovers documents that show Allscripts initially offered $225 million for the company, but backed out once news broke of the trouble EClinicalWorks was in related to certification of its software.

Telemedicine

Austin, TX-based startup Medici launches a text-based telemedicine app for physician practices. The company launched its app in South Africa – birthplace of founder Clint Phillips – a few weeks ago, and plans to expand to another 20 countries by the end of this year.

Champion Sports Medicine (AL) rolls out telemedicine services from Healthy Roster, a Dublin, Ohio-based company focused on meeting the health IT needs of trainers, physical therapists, and physicians.

The local paper looks at the surge in telemedicine visits prompted by this year’s flu outbreak, which has put stress on brick-and-mortar healthcare facilities. Doctor on Demand CMO Ian Tong, MD says the company has seen visit volume increase 100 percent over the last two months, with most flu-related consults being for patients in early stages of the virus. Competitor PlushCare is experiencing a similar uptick in volume, with 2-3 percent of patients being sent to the ER for more severe flu symptoms.

Sponsor Updates

• AdvancedMD will exhibit at the Expert Roadshow January 24 in Salt Lake City.
• EClinicalWorks will exhibit at the 2018 Star Ratings Congress January 29-30 in Scottsdale, AZ.
• PerfectServe publishes a new success story featuring The University of Tennessee Medical Center, “Streamlined follow-up appointment scheduling aims to reduce readmissions.”

Blog Posts

• Automating Your Patient Care (AdvancedMD)
• Physician Lifestyle Profile: Dr. Michael Haghighi (Aprima)
• Attract More Patients with Health Education – 4 Ways to Up Your Online Game (Healthwise)

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News 1/22/18

Top News

Physicians in Fredericksburg, VA express their frustration with the ransomware attack that took down Allscripts systems late last week. Moss Free Clinic Medical Director Patrick Neustatter, MD believes the situation is bigger than Allscripts is letting on, given that the colleagues he has spoken with are in “frantic meltdown mode.” The clinic didn’t have to cancel appointments, but did have to revert to paper – a move that had scribes up in arms over illegible physician handwriting.

Allscripts has kept customers apprised of recovery efforts via daily conference calls, and expects to bring customers back up on a rolling basis, presumably over the next several days. Operations were back to normal at the clinic as of this morning, with the exception of e-prescribing.

Webinars

January 24 (Wednesday) 1:00 ET: “Location, Location, Location: How to Deploy RTLS Asset Management for Capital Savings.” Sponsor: Versus Technology. Presenter: Doug Duvall, solution architect, Versus Technology. Misplaced or sub-optimally deployed medical equipment delays patient care and hampers safety-mandated preventive maintenance. It also forces hospitals to buy more equipment despite an average utilization that may be as low as 30 percent, misdirecting precious capital dollars that could be better spent on more strategic projects. A real-time locating system (RTLS) cannot only track asset location, but also help ensure that equipment is properly distributed to the right place at the right time. This webinar will provide insight into the evaluation, selection, and benefits of an RTLS-powered asset management solution.

February 13 (Tuesday) 1:00 ET. “Beyond Sliding Scale: Closing the Gap Between Current and Optimal Glycemic Management Practices.” Sponsor: Monarch Medical Technologies. Presenter: Laurel Fuqua, BSN, MSN, EVP/chief clinical officer, Monarch Medical Technologies. The glycemic management practices of many hospitals and physician staff differ from what is overwhelmingly recommended by experts and relevant specialty societies. As a result, they are missing an opportunity to improve the quality, safety, and cost of care for their patients with diabetes and hyperglycemia, which commonly represent more than 25 percent of their inpatient population. Hospitals that transition from sliding-scale insulin regimens to consistent use of basal / bolus / correction protocols are seeing reductions in hyperglycemia, hypoglycemia, and costs. Making this shift more effective and efficient is the use of computerized insulin-dosing algorithms that can support dedicated staff using a systematic approach.

February 14 (Wednesday) 2:00 ET. “Time is Money: Aurora Health’s Journey of Implementing and Advancing Cost Accounting.” Sponsored by Strata Decision Technology. Aurora Health Care’s implementation of Strata’s Decision Support module involved not only building an improved cost accounting model, but improving the process to engage a cross-functional team in cost development. It now has accurate, consistent cost data to support decision-making. Aurora’s next phase will be to use actual procedure and visit times to allocate costs. This presentation will provide a detailed view into both the implementation and future direction of the Strata Decision Support program within Aurora.

Previous webinars are on our YouTube channel. Contact Lorre for information.

Announcements and Implementations

Nuance announces GA of Dragon Medical Practice Edition 4, featuring Windows 10 touchscreen compatibility, and enhanced usability and voice capabilities.

People

Oak Street Health hires David Buchanan MD, (Erie Family Health Center) as Executive Medical Director for Illinois.

Greg Novak (Presidio) joins CareCloud as VP of channel sales.

EHR vendor Welligent names Matt Chamberlain (Open Minds) COO.

Telemedicine

Blue Cross Blue Shield of Arizona taps American Well to power its new BlueCare Anywhere virtual consult service.

The USDA awards $23.6 million via its Distance Learning and Telemedicine Grant Program to rural communities in need of broadband equipment. The funding will assist virtual projects related to job training, education, and healthcare in 28 states. Telemedicine projects in several states will focus on offering patients greater access to mental healthcare and opioid abuse treatment.

A new MGMA poll of just under 1,300 respondents finds that 15 percent are planning to implement telemedicine this year, 20 percent are unsure, and 39 percent have no plans to. Survey results saw a 3 percent year-over-year decrease in physicians that plan to add virtual visit services.

Research and Innovation

Using data from 2014, a RAND study on the EHR utilization of 39,000 hospital-affiliated physician practices finds that nearly 40 percent are under-utilizing the technology, and close to 25 percent are leveraging them to their full potential. Practices struggling with utilization tend to be in rural areas out West with fewer physicians than their metropolitan super-user counterparts.

Other

TechRepublic highlights the way Walgreens uses prescription data to power its online flu-tracking map. “This is an innovative way where customers can benefit from geospatial analysis,” says David Attaway, MD of Esri, which hosts the Flu Index. “We can use predictive analytics to determine the next area that might be hardest hit.”

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From the PRM Pro 1/22/18

The State of the Patient-Provider Relationship in 2017
By Jim Higgins

The relationship between a patient and their provider has always been at the root of positive outcomes for patients and success for a practice. Unfortunately, this relationship has hit some bumpy spots in recent years. Providers can no longer rely on clinical care excellence alone to keep patients coming back. Patients expect the full customer experience. Never has this been truer than in 2017.

Here are some of the trends we saw in the patient-provider relationship throughout 2017:

The “Amazon Effect” moved to healthcare

It is a well-known fact that Amazon revolutionized the customer experience. As founder Jeff Bezos explained, “We’re not competitor obsessed, we’re customer obsessed. We start with the customer and we work backwards.” Their strategy worked. The Amazon effect created a shift in the way individuals view their relationships with businesses. Today’s customer now assumes that companies will anticipate and meet their needs ahead of time. These expectations have made the leap to healthcare. Patients now expect an Amazon-like experience, and they don’t just want stellar care, but connection and accessibility as well. Excellence is now expected to be the norm for providers, not the exception. Meeting these rising demands is difficult. In fact, a study of healthcare CEOs found that meeting these consumer-based expectations is one of the top three challenges facing those in the medical industry. Why?

Practices must juggle competing priorities

Declining insurance and Medicare/Medicaid payouts have left practices spread thin. Today’s doctors are seeing more patients than ever before, and yet their incomes are either flat or falling. Falling reimbursements have forced practices to increase the number of patients being seen—leading to extra stress on staff and a “Jiffy Lube” experience (where practices try to get patients in and out of the office as quickly as possible) for patients. Unfortunately, such an experience is not what Amazon patients demand. Today’s patients want personal, connected relationships with their practices—the opposite of a Jiffy Lube experience. The result of such a disconnect? One in three patients report they will switch practices in the next couple of years.

Patient relationship management tools — the “Amazon” of healthcare relationships

For the foreseeable future, the number of patients that practices must see each day to stay profitable will not change. Reimbursements are largely out of a provider’s control. How do practices meet the demands patients have for high-quality personalized care when seeing such large numbers of patients? Technology. Technology is healthcare’s answer to meeting the needs of Amazon patients. Connection through technology is not only effective, but it is what patients want. Studies show that 60 percent of patients would like to receive text reminders and 70 percent want text communication that goes beyond reminders. The same is true for email. Nine out of 10 patients prefer doctors who email their patients.

Patient relationship management tools enable practices to reach out to large numbers of patients and create real relationships. They support on-going communication through different mediums, making it much easier for practices to develop and nurture relationships with their patients. In addition, using technologies like these reduces the stress placed upon practices. For example, practices can save hours of time on phones. The average phone call to set up an appointment takes 8.1 minutes. Multiply that by the number of patients seen in a practice and the time wasted is astronomical. In fact, administrative tasks are one of the biggest irritants for practices. Using text, email, or online self-scheduling reduces the workload. Unfortunately, the majority of practices still do not use text or email to communicate with their patients. Implementing better patient communication technology is an easy fix that practices can—and should—tackle in 2018.

Looking to the future

The world is marching forward. It is critical that practices evolve with it. Embracing technology that helps move the patient experience from Jiffy Lube to Amazon is going to play a critical role in a practice’s success. According to McKinsey, over half of patients say they have the same customer service expectations from healthcare that they have from non-healthcare businesses. This trend is only going to grow. Now is the time for practices to embrace that reality and start making changes.

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.

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