Acute care in a hospital setting is no longer the norm. The continuum of care focus has shifted to seamless, integrated care plans designed around the patient and their needs instead of the setting. Sg2* recently caught up with Barbara Casey, Senior Director of Health Care Business Transformation at Cisco, to discuss trends in healthcare innovation and technology that can help provide the right care, anywhere, anytime.
In the following video snippets, Barbara Casey discusses the power of healthcare consumers to make informed decisions about care plans as well as the power of providers to use data to deliver personalized medicine and seamless care coordination.
Cisco is in a great position to provide borderless collaboration interactions between providers and patients. Cisco voice, video, and data solutions can help provide convenient access to care while ensuring the seamless handoff of secure and integrated information as patients move from one setting to another. By supporting video on any endpoint, patients and caregivers can consult from their choice of devices which could be a mobile phone, a tablet, a laptop, a video phone or any other specialized devices, even in the privacy of their own home.
Some claim the early television experiments in 1955 as the origin of TeleHealth, which means TeleHealth is more than half a century old. The adoption of TeleHealth has had multiple challenges including, but not limited to reimbursements, affordability and experience gaps.
However, of late, the stars are aligning for TeleHealth adoption to take off. According to BCC research, the global telemedicine market is expected to grow to 27.3 billion by 2016. According to the AHA (American Hospital Association) report, 42% of US acute care hospitals have TeleHealth capabilities. While healthcare reforms have given the adoption a significant boost, there are more trends that are fueling the adoption. We look at 10 such trends. On a broad level, these can be classified into three major categories:
Policies and New Business Models
Technology and Affordability
Experience and Efficiencies
Here are 10 trends that are influencing the adoption curve:
1. Paradigm shift generated by the Healthcare Reforms
The US healthcare reforms have created a fundamental paradigm shift in focusing efforts on driving wellness and preventive care as compared to episodic care. The longer term relationship between the patients and provider has put patient engagement and care coordination at the center. This need has created a renewed interest in
TeleHealth as it can provide not only a convenient and cost effective way to interact, but also drive experience and efficiencies for the patients and providers by providing better collaboration capabilities from anywhere.
2. Policy Changes and Legislation for Reimbursements
In the early days, as we talked to customers, we have constantly had the wow moment driven by technology and experience of our solutions, but when it comes to the reimbursement topic, the conversation would come to a full stop. Today, with the new long term wellness focus as opposed to episodic care, cost avoidance models, Reimbursement is no more a definite full stop. States have been catching up recently on its policies to support telemedicine. About 40 states allow Medicaid to pay for telemedicine visits and about 20 states have required private payers in the state to pay for telemedicine.
3. New business models
While the transition from pay-for-service to value based model happens, new innovative business models are emerging that drives TeleHealth towards a sustainable business. For example, a fixed flat fee based anywhere consults, corporate clinic models, cost avoidance strategies, wellness have created a renewed interest in TeleHealth
4. Pervasive Video
In the past, the promise of TeleHealth use to be ‘don’t travel 200 miles to see your specialist, you can get the services at your rural clinic”, which might still be few miles away. With pervasive video, the patient don’t have to even leave their homes and can have consults from their choice of devices which could be a mobile phone, a tablet, a laptop, video phones or any other specialized devices. The cost of video has also significantly come down lately and has improved the affordability of TeleHealth programs. Leveraging software based video solutions in addition to hardware has expanded reach not just within the enterprise boundaries, but also outside to create a borderless collaboration experience between providers. The rise of WebRTC and other video standards have increased interoperability and will further expand the adoption.
5. Evolution of the Medical devices
In the early days of TeleHealth, if you look at a TeleHealth examination room table, it can be pretty scary for a patient. There can be way too many cables and too many bulky boxes to which the devices are connected. The complexity and the cost of medical devices has been a hindrance to adoption.
The cost and complexity of medical devices have also significantly improved lately. The evolution to smaller, cost effective, consumer focused devices with wireless connectivity has improved user experience and has expanded the range of users. Internet of things enabled device connectivity and the ability to automatically obtain data from sensors can be used to track vital signs and other activities to understand early signs. Read More »
From FDA (Food and Drug Administration) to FBI (Federal bureau of Investigations), they see a core issue bubbling up: The vulnerability of Healthcare systems to cyber-attacks. Both agencies have issued an advisory in this regard in the last 1 year.
Source: DataLossDB.org -- Healthcare amounts to 17% of incidents in 2013
FDA Advisory was focused on medical devices and hospital networks, while the FBI’s communication is focused on hackers attempting to hack personal medical records and health insurance data and even goes to calling out the gaps in resiliency to cyber-attacks as compared with other sectors such as financial and retail sectors.
In addition, looking at statistics from datalossdb.org, Health Care sector has consistently been in the top 3 sectors that have had the most incidents.
But the question is, why now?
This is where the correlation with the Health Care IT transition time lines adds up. It’s the other side of Health Care IT transitions that we looked at in the previous part (At the security cross roads of Healthcare reforms and IoE – 6 Health Care IT Transitions) of this blog series – the threat that have emerged from open anywhere, anytime, any device access which has enabled convenience and transformational experience to patients and care teams.
Let’s see an example of the changing dynamics of some of these transitions from a Hackers perspective by analyzing one of these transitions: Transition from Paper charts to EMR and enabling anywhere anytime, any device access to my care teams and my patients.
Health Care IT Transitions and their Security Implications (1-3 of 6)
The saying ‘Tell me how you will measure me and I will tell you how I will behave’ could have been the perfect tag line for the US Health Care Reforms. When we look at how Health Care Information technology is getting used to enable reforms, we see that most of the technologies existed prior to the reforms, but there wasn’t a compelling reason to adopt it. Once the measurement criteria, the carrots and the sticks were defined, the behaviors changed, and to achieve the metrics, the technology adoption picked up. As an example, according to CDC’s report, the adoption of office based physicians with EHR systems has increased to 78.4% in 2013 from 17.3% in 2003.
Percentage of office based physicians with EHR systems in US
Maybe a coincidence, but the Health Care reforms and Health Care Internet of Everything (IoE) are very much intertwined. The Health Care reforms focus on the ‘why’ and ‘what’ changes are needed to enable outcomes and define how performance is measured. The Health Care Internet of Everything focuses on how technology can be leveraged to enable the goals of Health Care Reforms. By connecting the unconnected, IoE brings more information from multiple sources (things and people) to create an enhanced evidence based model to enable better outcomes.
From an IT perspective, Health Care Reforms requires breaking boundaries, opening up the access, enabling choices, improving data collection from multiple critical sources, and enabling information sharing. It is definitely a challenge to achieve these needs using the traditional approaches in Health Care. Hence Health Care approaches have evolved to leverage Health care IT as a change agent, thereby resulting in many new Health Care IT transitions.
Let us explore six key Health Care IT transitions that have significant security implications.