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Why Point-of-Care Diagnostic Filtering, Interoperability Are Essential in the Age of TEFCA, QHINs

by Bailey Amber
written by Bailey Amber

interoperability, rope, braid

Health data interoperability recently took a major step forward when the U.S. Department of Health and Human Services announced the first six organizations as Qualified Health Information Networks (QHINs) under the Trusted Exchange Framework and Common Agreement (TEFCA).

Many predicted the coming “data tsunami” once the floodgates opened and information was shared more widely, and discussed how increased interoperability would create both opportunities and challenges. When the QHIN approvals were announced, Micky Tripathi, National Coordinator for Health IT, mentioned “operational friction in interoperability” and the challenges of moving information between enterprises — which is a primary issue that QHINs seek to address.

The challenge of finding diagnostically relevant data

As more information flows freely between systems, it will create an even bigger challenge for clinicians: finding diagnostically relevant information amidst the flood of incoming data. Healthcare information is currently organized using different terminologies and coding systems to support classification of information into separate domains such as diagnoses, labs, medications, orders, procedures, etc., primarily to support billing transactions and internal system workflows. The terminologies and codes are not organized to enable a clinician to quickly see how well a condition is being managed for a specific patient.

Clinicians are already frustrated with their EHRs, in part because of difficulties finding the information they need to determine how well a condition is being managed or if a patient is responding to treatment. Under value-based care, it is more critical than ever for clinical users to see longitudinal views of diagnostically relevant information for each of a patient’s conditions so they can take appropriate action and document accordingly.

This means clinicians need systems that do more than just support the coding of diagnoses and transactions; they also need their systems to diagnostically filter information at the point of care and present them with actionable views. In other words, clinicians require a new form of clinical decision support that presents the specific information needed to make decisions – regardless of the source. That new capability might be called “diagnostic interoperability.”

Time for new tools

The 21st Century Cures Act, TEFCA, and the imminent establishment of QHINs will, for the first time, make the long-awaited advent of interoperability a reality. Systems will be sending SNOMED, ICD-10, CPT, RxNorm, LOINC, HCPCS, and a host of other codes and narrative notes back-and-forth as part of the data tsunami, leaving it to the receiving systems to make sense of it for clinicians. The timing is perfect for the adoption of a new set of tools that make diagnostically relevant information discoverable and actionable by clinicians at the point of care.

A core requirement for these new tools is to enable a clinician to select any diagnosis, problem, or clinical issue for a patient and quickly view the hallmark indicators for that problem.

TEFCA, QHINs, FHIR and terminology standards will facilitate the transmission and receiving of information, but the critical task for clinicians will be finding the information needed to assess, evaluate, manage and treat a specific problem. Clinical users need to quickly view the symptoms, history, physical exam findings, test orders and results, therapies, comorbidities, sequalae and other data points related to any specific condition.

In the new world of interoperability, incoming information will be in a variety of terminologies and formats: ICD10-CM and SNOMED for problems and diagnoses, LOINC and CPT for lab orders and results, CPT, HCPCS, and ICD10-PCS for procedures and therapies, RxNorm and NDC for drugs, and a number of other specialized code sets. While these code sets and terminologies are useful for classifying information in a specific domain, they were not designed to work together to present a comprehensive view of a condition, nor for use by clinicians at the point of care.

Current EHRs typically organize this information into separate “tabs” or “buckets” in the medical record. To monitor the course of a disease, a user must navigate between sections and spend time hunting for the relevant details – which takes time that could be better-spent interacting with the patient and managing their condition. The EHR may contain all the relevant information a clinician needs for decision making, but finding the precise details they need is not always easy.

A better way

In the world of value-based care, the effective monitoring and management of chronic conditions requires that all relevant information for a diagnosis be instantly available to the clinician at the point of care, without requiring clinicians to waste precious time searching for details. A better way would be to empower clinicians with a clinical toolset that allows them to select any condition and immediately see a diagnostically organized view of all the relevant details. Such technology could replace manual searches by automatically filtering information for diagnostic relevancy based on the codified details and using natural language processing and mappings to organize the items.

In addition to diagnostic filtering and presentation, the ideal clinical toolset must also integrate with existing system workflows and provide point-of-care services to evaluate the patient’s medical record for adherence to clinical best practice guidelines and mandated quality measures, appropriateness of diagnostic coding, and sufficiency of documentation.

Without a new set of tools that clinicians can access at the point of care, the availability of information from QHINs will increase provider burdens because they will struggle to find the information needed to evaluate a patient, take action, complete documentation, and move to the next patient.

Basic interoperability is about to become real. The next step is diagnostic interoperability – which could very well be the impetus for value-base care success and for the transformation of EHRs from clinician burden to essential tool.

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Self Care

Cerebral Admits That it Wrongly Shared Data of 3.1M Users

by Bailey Amber
written by Bailey Amber

Close Up of Illuminated Glowing Keys on a Black Keyboard Spelling Data Breach 3d illustration

After months of criticism about its data privacy practices, Cerebral admitted that it wrongfully shared the private health information of 3.1 million of its users. This admission comes in the form of a March 9 letter to users and March 1 government filing.

Cerebral is a mental health platform specializing in the virtual treatment of mental health conditions, mainly ADHD, anxiety and depression. In its letter, the startup said it had used pixel technologies, which are third-party analytics tools made by companies like Meta, Google and TikTok.  

These tools are usually free and can give companies insight into the way consumers use their platforms, but the tech companies who provide this software can also use patient data to profile users as they browse. People usually aren’t aware that they are opting in to having their activity tracked because they are simply checking a box when reviewing an app or website’s terms of use and privacy policies, which few people take the time to read.

Cerebral said it has used tracking technologies since it began operations in October 2019. After reviewing its use of these tools, the company found out on January 3 that it had disclosed its patients’ protected health information to third parties without having obtained the necessary assurances required by HIPAA.

The startup assured users that it had “promptly disabled, reconfigured, and/or removed” its tracking technologies. It also said that it discontinued data sharing with any third parties that are unable to meet all HIPAA requirements, as well as enhanced its information security practices and technology vetting processes.

The following types of information were disclosed in the breach: clinical data about patients’ visits and treatments, mental health self-assessment responses, appointment dates, health insurance/ pharmacy benefit information, insurance co-pay amounts, name, phone number, email address, date of birth, IP address, Cerebral client ID number and demographic data.

The type of information disclosed varied depending on how extensively each patient used the platform. Cerebral said that no patients had their Social Security number, credit card information or bank account information leaked, no matter how they used its services. The company also told its patients that it is not aware of any misuse of their data.

This HIPAA violation is not Cerebral’s only recent legal woe. Last year, one of the company’s former executives sued the startup, claiming that it had fired him for calling out the company’s prescribing practices. Matthew Truebe, Cerebral’s ex-vice president of product and engineering, had criticized the company for being too hasty when prescribing young people addictive stimulant drugs like Adderall. His lawsuit came shortly after some Cerebral employees told media outlets that the startup was taking advantage of pandemic-era prescribing regulations that allowed providers to prescribe addictive drugs without requiring an in-person examination.

But Cerebral is far from the only company to suffer negative consequences after using pixel technology. 

A week ago, the Federal Trade Commission reached a $7.8 million settlement with virtual mental healthcare provider BetterHelp for sharing its patients’ sensitive health data with advertisers like Facebook, Snapchat, Criteo, and Pinterest. In a statement, BetterHelp — which was acquired by Teladoc in 2015 — said its settlement is not an admission of wrongdoing. 

The FTC also recently accused consumer-focused digital healthcare platform GoodRx of failing to notify users that it sold their personal health information to Google, Facebook and other tech companies. To settle the case, GoodRx agreed to pay a $1.5 million penalty for failing to report its leakage of user data to third parties, but did not admit to wrongdoing. 

Additionally, the Northern District of California filed a class action lawsuit this past summer against Meta, the UCSF Medical Center and the Dignity Health Medical Foundation, claiming that they have been illegally collecting patients’ health data for targeted advertising.

Photo: Paul Campbell, Getty Images

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3 Ways Digital Health Can Curb Opioid Use

by Bailey Amber
written by Bailey Amber

Not too long ago, in the 1990s and 2000s, the health care system’s best solution for chronic pain was an opioid prescription. Today, of course, we know that opioids are highly addictive and deadly, only to be used as pain relief in moderation with careful oversight.

Still, even after more than a decade of trying to curb opioid use, overdose deaths continue to ravage the country, with each year’s death count higher than the last. In a single 12-month period ending in April 2021, more than 75,000 people were estimated to have died from opioid overdoses – nearly 20,000 more deaths than the previous year.

Clearly, the nation’s strategies to lessen opioid-related deaths are not working. Even though opioids are off the table in many instances, people still experience pain. So how do we address pain management effectively with little or no opioids?

One solution is digital health, an effective – though underutilized – tool for pain management. In my role as a chief clinical officer of a virtual physical therapy platform, I get to see firsthand how solutions like these can help reduce opioid reliance and regain mobility.

Recently a patient with a significant amount of pain and reliance on opioids began virtual physical therapy. Through the program, she began the process of learning how to safely move without injuring herself. With this practice, she was able to overcome her fear of movement, which is a typical reaction for those living in pain. The patient regained her independence in activities she used to enjoy, simple things like going out to dinner with friends or putting away the dishes, and her reliance on opioid medication was reduced.

She explained how she could do things she couldn’t do before, such as lift some heavier things, and how her mobility increased. Most importantly, she was no longer in pain all the time and had significantly reduced the use of medication.

As we see in this example, virtual physical therapy can help individuals overcome barriers that they thought could only be solved by medication. When leveraged correctly, digital health offers three advantages over in-person care and can reduce the need for opioids and improve pain management.

Get upstream on pain management

Digital health allows us to get upstream of chronic pain problems by connecting with patients early and before it feels unmanageable. Many health plans now offer members access to various digital programs, which they can sign up for without needing a referral from a provider or having any existing health conditions. By lowering the barrier to access, digital health providers and their partners can begin building relationships with members even before they enter the medical system.

For example, once a member is onboard, digital health programs have the ability to identify people in pain or at risk of pain and offer to begin working with them before their pain becomes chronic. Dealing with chronic pain is both physically and emotionally stressful. It can cause depression and greatly reduce a person’s quality of life. The development of chronic pain is even associated with structural and functional changes in the brain.

Building a solid foundation to manage pain early on will allow patients to better cope. And, better pain management strategies are thought to also undo or prevent the changes in the brain that can propagate pain and lead to emotional disorders.

As Benjamin Franklin famously said: “An ounce of prevention is worth a pound of cure.”

Accessibility, when pain is calling

Access to brick-and-mortar clinics is restricted to certain hours and days of the week. Conversely, digital health can fit into the palm of someone’s hand, with programs that are accessible 24 hours a day, seven days a week.

Access is vital because chronic pain doesn’t mind a schedule. A pain crisis can occur at any time. Having unlimited access to digital health programs – such as virtual physical therapy or mindful meditation – during a crisis can help reduce suffering and promote patient empowerment.

For patients, digital health tools are something tangible, something real they can use in the moment to lower and manage their pain. That in itself can make a world of difference for the person suffering, helping them turn away from the need to use opioids for pain relief.

Providers gain increased insights

In collaboration with digital health, health care providers gain access to robust data that they wouldn’t normally get through in-office visits.

Digital health programs that track members’ progress and monitor outcomes are able to present providers with regular updates and insights into their patients, such as physical activity level, medication intake monitoring, pain level, function level and engagement. That level of granularity is not possible through regular medical or wellness check-ins with a primary care doctor.

It isn’t uncommon for one doctor to tell a patient the pain isn’t a big deal, while another prescribes pain pills. Digital health can act as the connective tissue among solutions, patients, providers and clinics, improving communication among a patient’s care team and keeping them up-to-date in real-time. With all the providers on the same page, it is easier to maintain consistent messaging around pain, avoiding those mixed messages.

The power of digital health in helping people manage pain is clear, yet it remains untapped potential. All the players, from digital health vendors to payers and providers, need to work together to make it a scalable reality.

More than 200 hundred people are dying a day from an opioid-related overdose. Having access to alternative opioid options for pain management is essential in lowering this outrageous death toll.

Photo: sorbetto, Getty Images

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Intermountain Partners with Story Health to Better Manage Heart Failure Patients’ Care Plans

by Bailey Amber
written by Bailey Amber

Intermountain Healthcare recently partnered with a startup named Story Health to help manage patients’ heart failure by increasing access to specialty care. Under the partnership, Intermountain clinicians are working with Story’s health coaches to help patients keep up with their treatment plans while they’re outside the walls of the doctor’s office.

Founded in 2020 and based in Cupertino, Story has raised over $26 million to date, according to Crunchbase. Like many digital health startups, the idea to form the company came from the CEO’s personal experience with the U.S. healthcare system.

Story CEO Tom Stanis’ father suffered a stroke years ago. Though much time has passed since the event, it’s still a struggle to manage his recovery.

“This gap between the intensivist and the coordinating primary care physicians is a place where many of us fall behind. Our specialists are overburdened — unable to manage the constant tweaking and deluge of data being generated from patients at home. Primary care is often out of the loop, not knowing or having the confidence to optimize a complex ongoing recovery process. My father fell into this hole,” Stanis said.

Patients are presenting to clinicians with increasing complexity and incomplete care experiences, he pointed out. This problem is made worse by the fact that clinicians are short on time. Constricted by growing administrative tasks and shortened appointment lengths, clinicians often do not have the time they need to contextualize a patient’s full story (hence the startup’s name) and how that story can directly impact their outcome, Stanis said.

To address this issue, Story’s platform offers two key solutions. 

The first is its electronic health record-integrated AI. This technology allows providers to easily connect disparate data from various sources, such as EHRs, medical devices, remote patient monitoring databases and lab results.

“By leveraging data, we can find patients that need support and then automate a personalized care plan based on clinical guidelines, which can be further customized by the physician. This removes the administrative requirements for clinicians to find those patients that aren’t at optimal or goal therapy and makes it easier to get them back on track with the care plan,” Stanis declared.

Once a personalized care plan is established, Story integrates a human touch element. Through its health coaches (which are real people, not AI bots), Story helps ensure that the care plan is followed and the treatment goal is achieved.

Stanis said that Story’s health coaches are an essential part of the business because they serve as an extension of the clinician to identify and resolve challenges like medication optimization, lab draw coordination, transportation arrangements and prescription assistance. These coaches also respond to patient questions via texts and calls.

Story is currently focused on cardiology and heart failure because only 1% of heart failure patients receive the appropriate medications, Stanis pointed out. 

The startup partnered with Intermountain because the startup is seeking to expand its reach and serve more patients. Stanis declined to comment on whether Story’s services are covered for Intermountain patients or how the partners will measure the success of their collaboration. However, Story said that whitepapers detailing the program’s results will be published later this year.

Photo: kieferpix, Getty Images

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Teladoc Unveils New App, Adds Spanish Language Capabilities

by Bailey Amber
written by Bailey Amber

Virtual care company Teladoc Health launched a new app Thursday that allows users to access its full suite of services in one place. The app is also available in Spanish.

Purchase, New York-based Teladoc is a virtual “whole-person” care company, providing services including primary care, mental health, complex care, condition care and chronic condition management. It works with employers like SAP, American Heart Association and AAA Northeast, and health plans like UnitedHealthcare, Aetna, Centene and Blue Cross Blue Shield.

Through the new app — which is available to just select clients this month — users can navigate between all of Teladoc’s services, see all their physicians’ care plans and can seek care coordination services to be connected with in-person providers. Offering a range of services together can have major benefits on consumers’ health, said Kelly Bliss, president of U.S. Group Health at Teladoc. For example, people who are enrolled in the company’s chronic care program as well as its mental health program have proven to reduce A1C levels, improve their blood pressure and achieve weight loss, she said.

“[The app is] a front door, but I also think it helps that member navigate,” Bliss said in an interview. “A lot of times people talk about that front door and the front door only leads to one bedroom. So what I think is important and different for this integrated app is that it’s a front door and it’s really allowing you to navigate in a way that is personalized into services that matter most to your health.”

All of the services are available in Spanish. After determining that there was a gap among the company’s Hispanic users, Teladoc hired more than 100 new Spanish-speaking providers in the last year. It also added new components to its programs, like expanding its nutrition plan to include foods from users’ cultures, Bliss said.

“I would argue that it’s not just language in an app,” Bliss said. “That’s relatively easy to do, especially for a tech company. We weren’t just trying to add Spanish, we were looking to improve health outcomes for Spanish-speaking members.”

The Spanish language feature is partially what sets the revamped app apart from what the company previously offered, as well as its additional care coordination services and allowing patients to review their care plans in one spot. By offering this new app, Teladoc hopes to make it easier for patients to receive care, Bliss said.

“Our mission has been to improve the healthcare experience so that it’s more personalized, it’s more convenient, it’s more targeted at what the members’ needs are to drive better health outcomes … People are sick and tired of five apps that all manage different components of their health,” she said.

Other virtual health companies include chronic disease care companies like Omada Health or Virta or telemedicine companies like MDLive.

Photo credit: Sorbetto, Getty Images

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How Much of a Risk Is a Potential Class-action Lawsuit against CommonSpirit?

by Bailey Amber
written by Bailey Amber

CommonSpirit Health, one of the nation’s largest health systems is facing a proposed class-action lawsuit over a ransomware attack it suffered last fall.

How perilous is this for a health system already strained by challenging finances?  At least one lawyer believes that like many lawsuits following a data breach, it will be settled out of court.

“It’s almost axiomatic,” said David Balser, a partner at Atlanta law firm King & Spalding. “If a data breach is announced, litigation is going to follow — whether or not the claims are meritorious.”

That litigation is being brought by Leeroy Perkins, who is one of the 623,774 patients notified by the health system that their data had been breached in a ransomware attack. Perkins filed the complaint December 29 against CommonSpirit, a nonprofit health system with headquarters in Chicago. Perkins has been a patient at Seattle-based Virginia Mason Franciscan Health, one of CommonSpirit’s subsidiaries, since 2003.

CommonSpirit operates 140 hospitals and more than 1,000 care sites across 21 states, according to its website. The health system did not respond to MedCity News‘ request for comment on the lawsuit.

An unauthorized third party obtained access to “certain portions of CommonSpirit’s network” from September 16 to October 3, according to a notice the health system posted about the data breach. During this time, CommonSpirit experienced EHR downtime and suffered appointment cancellations across its network of hospitals.

The exposed patient information included names, addresses, phone numbers, dates of birth, and “a unique ID used only internally by the organization,” according to CommonSpirit’s notice. The health system said it “has no evidence” that any of this personal information was misused as a result of the cybersecurity incident.

The lawsuit claims that the health system “failed to properly implement basic data security practices” and did not “employ reasonable and appropriate measures” to protect against unauthorized access to patient data. The complaint also said that this negligence has left patients vulnerable to identify theft and financial fraud. 

In his complaint, Perkins asked for class-action status. He also demanded damages, restitution, all other forms of equitable monetary relief, and declaratory and injunctive relief.

The vast majority of hospitals’ data breach lawsuits get settled, though, Balser declared. This is because there must be “some concrete harm or injury” to permit the case to go forward into court, he said. 

The mere fact that information was accessed by ransomware attackers doesn’t automatically create a claim for a plaintiff, Balser pointed out. He also said that health systems usually have insurance that will kick in to cover data breach claims.

Last year, Balser represented Capital One for a data breach case. The company faced a lawsuit over a 2019 data breach that exposed the information of more than 100 million customers, and the banking giant ended up issuing a $190 million class-action settlement. Balser said that to his knowledge, that case got further than any other data breach lawsuit. It went all the way through class certification and summary judgment briefing, but the case settled before the court could move on any of those motions. 

“At the end of the day, there is not a data breach case that I’m aware of that has actually gone to trial. Either the defendant gets the case thrown out or it gets resolved,” he said.

Photo: Valerii Evlakhov, Getty Images

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‘Uber for Nurses’ Launches Updated App As Employee Base Grows

by Bailey Amber
written by Bailey Amber

Fed up with poor staffing levels and excessive burnout, nurses continue to leave their hospital jobs in droves. In fact, experts predict that the U.S. healthcare industry will be short 2.1 million nurses by 2025.

Hydreight was founded in 2018 as a telehealth platform and medical network that addresses this issue by letting nurses be their own boss and work as independent 1099 contractors. Last week, the Las Vegas-based company launched an updated app so that the hundreds of nurses on its platform can have a more streamlined experience.

The startup’s platform makes it possible for nurses, med spa technicians and other licensed healthcare professionals to be in control of their own schedules and deliver services outside of a hospital or traditional medical facility, said Hydreight CEO Shane Madden.

“The platform operates as a marketplace, essentially as an ‘Uber for nurses,’ allowing them to connect directly with patients and deliver services anywhere,” he said. 

Nurses use Hydreight’s platform to offer services such as IV drip, Botox, Covid-19 testing and other medical and med spa treatments. These services can be delivered at the patient’s home, hotel, office or any other suitable location, Madden said.

Patients who join Hydreight’s medical network can use its app — which operates similarly to popular food delivery apps — to order a medical service from its pharmaceutical IV menu or aesthetic services menu.

Hydreight’s platform provides medical director oversight, liability insurance, HIPAA-compliant documentation and access to a digital pharmacy, Madden added. This means that nurses can work for themselves without the stress of operating their own business.

Across all 50 states, Hydreight currently has 688 accounts that provide medical services and tens of thousands of patients using its app. The startup said it’s difficult to say the exact number of nurses on its platform because each account is different — some have one nurse working solo and others consist of a team of nurses who joined using one account.

Some Hydreight nurses went viral on TikTok last year for posting videos saying they earn higher wages than travel nurses. Hydreight nurses said they earn as much as $3,500 a week. The average monthly salary for travel nurses is $9,790, which breaks down to about $2,500 a week.

Madden said Hydreight was founded to give nurses more autonomy and freedom, and the company will remain dedicated to serving their best interests.

“We are committed to continuous improvement and listening to what users need. This update gives nurses and other health and wellness service providers more control over what they offer, as well as overall improved performance, usability, reporting, and aesthetic and functional upgrades. For both patients and service providers, it includes an improved booking experience and more options for how each wants to use the platform,” he said.

Still, Hydreight is not the only company offering at-home IV services — there’s also The IV Doc. Madden believes his company differentiates itself with its proprietary HIPAA-compliant software, medical director oversight, medical liability insurance and infusions protocols.

“There is no other mobile wellness organization that provides its partners with everything they need to run their business all in one place,” he said.

Photo: Dilok Klaisataporn, Getty Images

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Withings Unveils Urine Analysis Device That Sits in Your Toilet Bowl

by Bailey Amber
written by Bailey Amber

Withings, a company that makes connected medical devices, announced on Tuesday that it is developing a miniaturized platform that can analyze urine at home.

The company, which was founded in 2008, is based in France and has offices in the U.S., China and Hong Kong. With its new offering, Withings is seeking to sell a device that taps into the wealth of health information that is present in daily urine.

More than 3,000 metabolic biomarkers can be assessed via urine, which makes it one of the gold standards of health assessment, said Withings CEO Mathieu Leombe. Analyzing these biomarkers can help diagnose and monitor certain diseases like diabetes, chronic kidney disease, kidney stones and urinary tract infection, he pointed out.

Withing’s new device, called U-Scan, sits within a toilet bowl. It consists of a pebble-shaped reader and a changeable analysis cartridge designed to assess specific biomarkers. The device automatically captures small amounts of urine and channels it into the analysis cartridge, which quickly begins chemical analysis. U-Scan automatically transmits readable results via Wi-Fi to Withings’ app.  

The device is being developed for the consumer sector as well as the professional medical market. Leombe acknowledged that his company is often compared to other companies like Apple and Fitbit, but these companies have not come out with an at-home urine analysis product yet.

For the consumer market, Withings will sell a U-Scan with an analysis cartridge for women’s monthly cycle tracking and a U-Scan with a cartridge for nutrition and hydration monitoring. These devices will be available for purchase in Europe this year following regulatory clearance, Leombe said. 

He also said each U-Scan starter kit will be priced at $499. There is an additional subscription cost of $30 per month, which provides customers with automatic cartridge refills every 3 months. 

As for the professional medical market, Withings has some research collaborations underway with Dr. Marie Courbebaisse and Dr. Franck Perez, who are both medical researchers based in Paris. Dr. Courbebaisse is beginning a clinical study to see how the device improves follow-up care for patients with cystine renal lithiasis and uric acid renal lithiasis. Dr. Perez is studying how the device can be used to non-invasively detect bladder and ovarian cancer relapse.

Collaborating with medical professionals to understand the best use cases for U-Scan’s technology will remain a priority for Withings, Leombe declared.

“Presently [U-Scan’s analysis cartridges] can be tailored to analyze a combination of markers such as pH, specific gravity, ketones, vitamin C, albumin and creatinine, but Withings chemistry teams are available to help medical professionals create bespoke cartridges for their use case,” he said.

Photo: Withings

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Technology Will Be Critical To Move Healthcare Organizations Forward in 2023

by Bailey Amber
written by Bailey Amber

Turning the page on 2022 will be a cause for celebration in the healthcare sector.

The past year was one of the worst financial years on record for hospitals, according to Kaufman Hall. New data from the healthcare consulting firm and the American Hospital Association indicates that 53% to 68% of the nation’s hospitals will end 2022 in the red. At the same time, hospital employment is down approximately 100,000 from pre-pandemic levels.

This is all happening amid a backdrop of growing margin pressures and an aging population.

So, what will the coming year hold for healthcare organizations and their patients? And how can businesses in the healthcare sector best position for success in 2023 and beyond?

Let’s examine the situation, assess what 2023 will look like and identify the best treatment.

High costs will dissuade people from getting the care they need

Past experience shows us that in recessions, Americans are quick to cut routine visits and medical advice that comes at a cost. Expect continued media coverage on the questionable economy, recession nerves and layoffs to keep people away from healthcare in the year ahead.

Concerns about the economy and the fact that as many as 15 million Americans could lose Medicaid access when the pandemic ends could exacerbate the trend of people putting their health on the backburner to save time and money or try to avoid stress.

Staff shortages and wage demands will pack a one-two punch

Healthcare employees are stressed as well. A recent report explains that nurses are “beyond burnout.” This problem has prompted the launch of a multimillion-dollar burnout prevention program pilot. But research suggests that turnover is highest for health aides and assistants.

High burnout keeps employers struggling to recruit and retain staff. And increasing wages make it increasingly difficult for healthcare institutions to afford the help they need and turn a profit.

One of the reasons there aren’t enough people to serve patients and generate more revenue is because there’s a lot of friction in the current model. Rather than spending time with patients, healthcare workers have to dedicate significant time to dull, inefficient administrative processes. If healthcare organizations don’t address it, this problematic pattern will continue.

A growing number of healthcare companies will automate back-office work

In a move to improve their situation and that of all healthcare stakeholders, healthcare companies in 2023 will automate accounts payable, claims processing, collections and other back-office work. At the same time, health insurance providers will automate most of the administrative work associated with processing claims. This will be especially prevalent at mid-sized companies, many of which previously felt automation technology was out of their reach.

Automation will free up employees to spend more time serving patients, which is what attracted many of these workers to healthcare to begin with. It will enable healthcare organizations to know that administrative tasks are done exactly right every time. And it will allow healthcare organizations to improve efficiency and scalability and reduce their costs.

Typically, automation has been the domain of large organizations, which have the resources to do heavy integration work and bot maintenance. But now, platforms that don’t require such integration and continually optimize bots put automation within reach of mid-sized businesses.

In-person care will take a hit as more people embrace telehealth

Expect growing adoption of telehealth in the coming year and beyond. Many Americans now understand the value and ease of telehealth, which took off amid Covid-19 stay-at-home orders and dramatic policy changes. In the first year of the pandemic alone, 44% of continuously enrolled Medicare fee-for-service beneficiaries had a telehealth visit, totaling more than 45 million visits.

Baby boomers and those in dire scenarios utilize in-person visits most often. Chronic pain cases, mental health concerns and pain points of younger people – who will look to mobile-first experiences rather than considering physical locations – will funnel into telehealth.

Meeting patients where they are, rather than requiring them to travel or overcome other barriers to get service, will help patients and every other stakeholder in the healthcare system.

Advances in AI will take wearable technology, healthcare applications to the next level

Major wearables companies like Apple and Google Fitbit have amazing proprietary data sets. Recent artificial intelligence (AI) breakthroughs will allow these major wearable companies to use their unique data and devices to unlock new and even more exciting applications.

OpenAI’s new GPT-3 chatbot, which delivers more advanced results than people expected, is one sign of where things are headed. This signals that AI models are becoming more advanced.

To date, wearable technology has primarily involved consumer applications that track how many steps you take or capture your workout history. And with recent advances in AI modeling, we’re likely to see some interesting new use cases in the healthcare and insurance arenas over the next year. But now, the major differentiator won’t be how you interface with AI but rather who has the unique training data needed to unlock new experiences and applications for end users.

Technology will move healthcare in the right direction

Running a healthcare operation and delivering quality care to patients isn’t easy, as the past year clearly demonstrated. Inefficiency and unnecessary friction are a large part of the problem. And healthcare is far more expensive than it needs to be. The U.S. spends nearly twice as much as the average OECD country yet has some of the worst outcomes.

But, with the right technology, healthcare organizations in the year ahead can become more efficient, make quality care accessible to more people, reduce their recruiting and hiring costs, prevent mistakes, and deliver better outcomes for themselves, their workers and their patients.

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Self Care

This Year’s 3 Most Expensive Hospital Construction Projects

by Bailey Amber
written by Bailey Amber

Hospitals’ operational margins are shrinking, and some financial analysts have said that 2022 may have been the worst year for hospital finances in decades. And the outlook for next year isn’t rosier — increases in hospitals’ labor and supply expenses are expected to continue to outpace their revenue growth.

Though hospitals’ financial circumstances were dire this year, some expansion projects have managed to move forward. Below is a rundown of the three of the most expensive hospital projects that were pursued in 2022.

$5 billion medical campus in Nevada

In March, the city of North Las Vegas, Nevada sold a 135-acre property for nearly $37 million to Pacific Group, a Salt Lake City-based developer. The developer bought the property to build a multibillion dollar medical campus that includes a hospital and research center, as well as office and retail buildings.

In October, Pacific Group broke ground on the medical campus, called Helios. The developer estimated that construction would cost about $5 billion and take 10 years to complete.

Pacific Group is building Helios to expand healthcare offerings in North Las Vegas. The city’s population exceeded 260,000 people in the 2020 U.S. Census, but North Las Vegas only has 209 hospital beds aside from its Veterans Affairs hospital, which is nearby the construction site. More than 70% of people transported to a hospital by the city’s fire department have to receive care outside the city, officials told the Las Vegas Review-Journal in March.

Helios’ hospital will have more than 600 beds, according to Pacific Group. The developer also said the campus will create more than 10,000 jobs for North Las Vegas once it’s complete, as well as add $3.2 billion to the economy each year.

Pacific Group has not yet found a healthcare partner for Helios.

UCSF’s $4.3 billion hospital

In May, the University of California’s board of regents granted approval to the University of California San Francisco to construct a $4.3 billion hospital at UCSF Helen Diller Medical Center, which is located in San Francisco’s Parnassus Heights neighborhood.

UCSF Health is building the new facility to address its capacity constraints. The health system said the new hospital will increase its overall inpatient bed capacity by 37% — from 499 beds to 682. UCSF also said the new facility will create about 1,400 new jobs.

The new hospital is scheduled to open in 2030, and it will meet California’s new earthquake-resistance standards set to go into effect that year. UCSF Health said it is funding the project through external financing, philanthropy and hospital reserves.

UC Davis’ $3.8 billion tower

In May, the University of California Davis Medical Center started demolishing temporary offices so it could begin construction on a nearly $3.8 billion new tower.

Just like UCSF’s new hospital, UC Davis’ tower is slated to open in 2030. The 14-story tower and five-story pavilion will replace parts of the medical center that don’t meet California’s upcoming earthquake-resistance standards.

The project, which spans a million square feet, will include about 400 single-patient rooms, new operating rooms, an imaging center, a larger pharmacy and more burn care units. Once the expansion project is finished, the medical center will have 675 to 700 inpatient beds.

Photo: Paul Bradbury/Getty Images

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