As health care transformation intensifies, we’re hearing leaders urge either a slower pace, or inspiring a new push for deeper, wide scale health care changes.
Girish Navani, CEO of eClinicalWorks, a leading developer of ambulatory health care IT solutions, is clearly in the second camp. As CEO and co-founder since 1999, Navani knows provider issues well. His customer base extends to all 50 states – now moving into a dozen European countries — and he engages many at the company’s user conferences.
The issues, for him, are keenly familiar: Value (not volume) is now the key driver, so providers need a practice-wide population health “lens,” tracking patients across the continuum of care. They need granular, new data and toolsets to engage patients, especially rural patients where telemed consults reflect a growing wave of care.
In our interview, Girish Navani reflects on 5 key trends converging to deliver better results for health care providers and patients.
1 – Anytime, Anywhere Access to Health Information
What do you see as truly new in healthcare IT, and how will EHR systems play a role in that?
Healthcare technology will continue to advance over time and it is important to have technology that enhances the user experience. For instance, our new cloud services platform, 10e, approaches electronic health records in a different way. Not only does the system incorporate population health and patient engagement for a single, unified user experience, but it was built on HTML5 which allows providers to use this system on any platform, with the same usability. With this updated technology, providers are able to use our services via the device of their choice, even within the same organization. The integration of patient engagement, telehealth visits and population health functions in one single product will help streamline workflows for our customers.
“Anytime, anywhere access to health information” has been an HIT goal for some time. Which new technologies are empowering provider mobility, and which ones will help drive future progress?
Telemedicine is one innovation that is constantly improving and truly enables provider and patient mobility. The convenience telemedicine offers is particularly helpful to patients who live in rural areas. This population often has difficulty meeting with their doctor in-person, so instead of potentially missing appointments, these services allow patients to connect with providers via the mobile devices they already own. This technology improves patient care in remote populations so much so that the U.S. Department of Agriculture has awarded nearly $40 million to aid telemedicine projects for rural populations. Telemedicine is benefiting patient care already, but as it further develops, it will continue to drive innovations.
2 – Analytics for Collective Decision Making
You’ve talked elsewhere about how analytics brings new benefits to healthcare. How are today’s analytics tools adding depth and precision to workflow decisions – for individual providers and entire teams?
With today’s technology, there is an ample amount of data, although this information is only valuable and impactful depending on how it is analyzed. Technology now allows providers to access real-time analytics, enabling more informed decisions at the point of care. These analytics will also help provide solutions for population health management, as the data being generated can help track health trends and patterns from several sources. The goal of utilizing analytics is to improve health outcomes through preventative care, which in turn will reduce costs. In ACO settings, access to claims data is delivering insights into patient utilization of hospital visits, which is driving workflow changes. With this amount of detail in analytics, providers can proactively reach out to patients who frequently use the emergency room and offer those patients ambulatory alternatives, which, in most cases, are lower cost per episode and yield better outcomes.
Analytics data can also give a medical team more accurate data on patient trends, including no-shows for a particular day of the week. That, combined with data on specific patient behavior, can give the team more precise decision making ability on how they should book their appointments. This directly impacts practice revenue. Similar principles and analytics data are applied to predict payment behavior from insurances and patients, giving the provider of care an arsenal of information to make better decisions about a patient’s care. One example of how this impacts healthcare outcomes is visible by looking at a particular patient’s symptoms while also looking at population trends from a recent outbreak of a disease.
How will analytics for collective decision making play a bigger role in healthcare beyond 2016 – and what will drive that development?
Analytics has become a hot ticket item as the industry moves away from fee for service toward value-based reimbursement models and is top of mind for most organizations. ACOs, clinically integrated networks and similar organizations are getting access to EHR data along with information from several sources including claims, wearables and health risk assessments. This information will need to come together in order to paint a true picture of the patient population and to strategize protocols that achieve the triple aim of lower costs, better outcomes and improved patient satisfaction. Value-based purchasing plans will continue to drive the demand for analytics, both retrospective and prospective, stimulating supply chains to deliver on the promise that analytics hold.
3 – Intelligent Messaging
Healthcare messaging has evolved since the dawn of pagers. What is “intelligent messaging” and what are some key examples of it?
Intelligent messaging takes into account patient preferences — voice, text or e-mail — and connects with the person using that preference. Another key is to have that message be actionable. A practice, for example, can begin a campaign searching for patients who have not had a mammogram and send out a message to those patients allowing them to schedule one directly from the message. The patient can also specify if they received the mammogram elsewhere, which updates the provider’s record.
Another way intelligent messaging benefits care delivery is when home monitoring devices are connected with the electronic record. A provider can message a patient who is using these devices at home, such as a blood pressure cuff, when he records a value that goes over a particular threshold.
Which technologies help leverage “intelligent messaging” in novel ways for providers?
Messaging campaigns have been demonstrating significant ROI for practices. These campaigns can apply to any patient population that can benefit from additional health reminders, including for flu shots, mammograms and other preventative care initiatives. Improved outreach means higher patient satisfaction, improved overall population health and reduced costs. It also can give a patient the needed nudge to get a preventative service that can detect health issues at an early, more easily treatable phase.
4 – Telemedicine Consults
One big step in expanding healthcare access is the uptake in telemedicine. While telemed still faces some issues, we are at a new stage in telemed consults. What are the challenges in the growing uptake in telemedicine consults and which areas are ripe for telemed growth?
One of the challenges we have faced with telemedicine is the issue of reimbursement for providers. In response to this legitimate financial concern, insurers are now increasingly including telemedicine in their plans, which will enable adoption of the technology to soar as this becomes common practice. Another financial concern cited among telemedicine adoption critics is the cost of the equipment. This challenge will become mitigated for providers as EHR vendors increasingly incorporate telemedicine capabilities in their platforms. The cost of equipment for patients is minimal because they can use the technology they already own such as mobile devices, tablets and laptops in order to consult with their physicians.
Telemedicine use is most likely to grow once these consultations begin to be covered by employee health insurance, which is already on the rise. When employees do not have to miss hours or even full work days to visit their doctors for checkups, they can be more productive. These services are also bound to gain even more popularity with rural populations because it allows patients to receive checkups without having to travel long distances. The ease of telemedicine, for patients and providers alike, will encourage its growth over the coming years.
As the 2016 US election looms on the horizon, will telemed continue to grow, or might there be post-election bumps along the way?
Based on current trends in telemedicine’s adoption, consultations are unlikely to be hindered by the next person elected to the presidency. The facts speak for themselves—telemedicine benefits patients and providers, especially in the area of behavioral health and follow-up visits. States now realize this, which has encouraged many to adopt telemedicine legislation.
5 – IoT Connected to a Rules Engine
The growing array of connected devices, the “Internet of Things,” offers a wealth of new data for healthcare. Where will it impact healthcare best, and how will rules engines manage these sensor-driven IoT devices?
The Internet of Things takes ordinary devices, like your home weight scale, and connects them to the Internet. Data from these devices can be automatically collected, shared and analyzed. It also allows for the integration of several tools, including home monitoring devices and fitness trackers. Information gained from IoT allows doctors to have access to more complete information, helping them make more informed decisions at the point of care. By giving healthcare providers as much data as possible, patients will receive more accurate and personalized care.
If there is one sentence that offers a “crystal ball” view of the “next generation” healthcare environment, how would you describe it?
We have been experiencing the digitization of the healthcare industry, and now are entering the next logical step by bringing the consumer experience to healthcare, which has to be agile, nimble and cost effective.