Posts Tagged: coronavirus

Are Virtual Go-Lives the Future? The New Horizon of Healthcare Software Implementations

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healthcare software implementations

Implementing new software in your healthcare organization is no easy task. There are many hours of work and preparation that go into an implementation. We know this because we play the role of data liaison between software vendors and end-users. We convert the data from one system to another and clean and archive it, all so organizations can complete their healthcare software implementations.

Typically, in these projects, software teams actually go on-site to the hospital, pharmacy, or other entity. The coronavirus pandemic, however, has made this mostly unfeasible. Thus far, we’ve seen many go-lives pushed out to accommodate for having the software provider on-premise. With such uncertainty about travel, it’s in our entire industry’s best interest to start facilitating virtual implementations.

Top EHR Companies Show Virtual Healthcare Software Implementations Are Possible

An interesting story on virtual implementations came out this week, showing that the approach is possible. Macon Community Hospital, a community hospital in rural Tennessee, determined it needed to migrate to a fully integrated digital system and worked with EHR leader Cerner to do this remotely.

The need for the software upgrade was high, as the hospital helps fight the COVID-19 outbreak. What the new system brings to the hospital is global COVID-19 updates and the ability to more easily share information about the virus with the provider’s CommunityWorks delivery model.

The work on converting began before the pandemic but was not completed. The hospital had two choices: risk an unknown delay of this mission-critical software or work out a way to do it virtually. The hospital and Cerner were able to work out an ideal process that allowed for testing, training, and full implementation remotely.

New Healthcare Challenges Boost Demand for Better Software

virtual go live

As in the example above, the hospital needed to change to a new EHR so they could improve care and understand trends related to the coronavirus. They aren’t alone. Hospitals, healthcare systems, pharmacists, and other providers are realizing their EHRs or software platforms are not robust enough to fit their needs.

Add on top of that, the new HHS interoperability rule that defines new requirements for data sharing and patient access, and it’s evident these implementations should be a priority. They can’t stay on hold indefinitely, as the world awaits a reopening. The truth is, virtual healthcare software go-lives make a lot of sense, pandemic or not. 

Virtual Implementations Make Fiscal Sense, Too

Obviously, the most critical objective of a virtual go-live is to keep all personnel safe. However, they also deliver fiscal benefits. Consider the travel costs that can be eliminated from budgets!

The key things need for a virtual implementation come down to technology platforms that allow for secure testing and training. Virtual could also provide greater flexibility on training with specific modules directed at different users. 

As most EHRs and pharmacy software solutions live in the cloud, there are no on-site servers that need configuring. 

While there are considerations about data security and HIPAA regulations, healthcare software vendors and their partners like us, already have all the necessary pieces in place to ensure compliance and data privacy.

Virtual Go-Lives Should be the Future?

The world has shown that being locked down doesn’t mean business stops. We’ve seen a variety of applications that have seamlessly transitioned to virtual. So why not software implementations? Could this be the future for healthcare? What do you think? 

COVID-19 Tracing: Technology Woes Hinder Real-Time Data Sharing

Posted by & filed under Healthcare.

covid-19 tracing

One of the most critical aspects of understanding how a virus spreads is to trace it. COVID-19 tracing should be driving insights on contagion. Instead, a lack of technology infrastructure is impacting the collection and sharing of the data. There’s no real-time data sharing happening here—that’s because many virus hunters are relegated to outdated tools, including faxing, paper records, and Excel spreadsheets. 

It’s 2020, and although technology has improved the healthcare model, years of missed opportunities to ensure accessibility, interoperability, and portability have led us to where we are now. We’re in the middle of a healthcare crisis that depends greatly on data-driven insights. Except those insights are facing a bottleneck because of old technology.

Public Agencies Are Behind

It may seem ironic that government agencies are behind when it comes to technology. After all, federal entities like HHS and CMS define the technology requirements, just as they have in the new interoperability rule. Many areas of the U.S. healthcare system have fully adopted a digital transformation, but public agencies are lagging. 

Congress approved $500 million for health data in the relief package, which should benefit virus tracing activities. Yet those tasked with COVID-19 tracing are hitting roadblocks at every turn. They are drowning in paper records and using outdated and have only inaccurate spreadsheets to track how the virus spreads. 

The entire process has become manual, and each state has its own processes and hurdles, making it extremely hard to be efficient and effective.

Inability to Connect the Dots on COVID-19 Tracing

Many states are using data streams from multiple sources to augment their tracing data, such as cell phone records. However, having access to this information isn’t really providing clarity because they can’t use it to connect the dots in real-time. 

Rather, these individuals are left with a mess of unconnected and dirty data. They are sifting through incomplete data. They may have provider information on symptoms of the virus or lab test results, but they aren’t aggregated. 

Further, there is so much MISSING data, as 25% of the country’s hospitals DO NOT feed information to federal websites about patient symptoms. It’s just bits and pieces with no guidance on how to improve data sharing. 

Data Challenges Nothing New for Tracing

covid-19 tracing challenges

The challenges the healthcare ecosystem is facing now isn’t new. Scientists and medical professionals have been lamenting over the inconsistencies for some time. It’s been years of frustrations that impede the country’s ability to track illnesses to either find the source (i.e., foodborne illnesses) or tracking contagiousness. 

Minimal investment in public health surveillance and conflicting reporting mandates are the cause of where we are now, according to experts. The problem just has more eyes on it now. 

Healthcare Data Shortcomings Now More Urgent 

Now the concerns and worry have become more urgent, with politicians looking for answers from the CDC about how they’ll use the $500 million data money. A group of senators submitted a letter to Senate leaders about the concerns, stating “Public health departments are unable to share data on cases, persons under investigation, laboratory tests and person-to-person transmission with the CDC seamlessly — instead they are forced to rely on a combination of methods: antiquated pen and paper, faxes, excel spreadsheets, phone calls, and manual entry.” 

The CDC’s response is that they will detail spending in the coming weeks. They expect to spend some of it on updating its own systems and hiring more employees. The agency also intends to give out grants to local health agencies so that they can share and report data more effectively. That money is sorely needed at the county level, where tracers are literally working on paper and Excel. These rudimentary ways to collect data means it takes hours to try to establish the medical history of patients. 

Why the Dependence on Paper?

covid-19 tracing paper

Remember when EHRs were deployed? There were incentives from the government for providers to move toward electronic records. EHRs and other applications were supposed to eradicate paper from the process. Yet, paper is still a regular part of healthcare records. 

Most tracers now have to depend on a paper-based system to gather information about infection rates. That same paper process is then supposed to provide insights for healthcare entities. Looking at the details, you can easily see the disconnect:

  • Physicians are supposed to flag public health departments when they diagnose certain conditions. 
  • This reporting requires a paper form. This means lots of cases never end up flagged, so many diseases are unreported, which some experts say could be as high as 10%.
  • Reporting standards also vary by county, and if a patient lives and works into different jurisdictions, both must receive the report.
  • Reporting is not a federal requirement of the EHR program; due to this, disease tracking technology hasn’t been fully adopted. 

What’s the Answer for Better Public Health Surveillance?

The COVID-19 tracing has brought the issue front and center. Yet, there haven’t been any real changes. CDC employees are still “digging” through paper records to understand the spread. So, what’s the answer to better public health surveillance?

The CDC and providers were testing a new system, eCR, prior to the pandemic. The system removes manual reporting and streamlines the process. It’s now available in some states with a soft rollout. It pulls data from EHRs and then formats them as case reports. Those reports end up in a central hub, which then dispatches them to the appropriate agencies.

The problem is that most providers don’t have the bandwidth to launch the eCR. They are burdened by all the stresses and demands from the coronavirus, relegating data sharing and public health surveillance to a lower priority. Healthcare systems certainly see the value, as do some EHR vendors, but don’t have the resources to improve their workflows. 

A Data Liaison Can Help You Share, Clean, and Aggregate Your Data 

In these situations, organizations should seek out data liaisons that have extensive experience with PHI data sharing. By outsourcing some elements of data sharing, cleaning, and aggregating, providers can not only contribute to COVID-19 tracing but also improve interoperability. There’s no doubt that healthcare needs to move forward with a better way to manage their data. Find out how InfoWerks can be a key partner to make this happen. 

We’re in a Healthcare Crisis. Why Are Providers Struggling to Remain Open?

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healthcare crisis

It’s easy to assume that because we’re in a healthcare crisis, providers are doing just fine. The reality is that the healthcare ecosystem is struggling mightily to stay open. In a for-profit healthcare system, revenue matters. Those being hit hardest are rural hospitals, physician practices, and dentists. A freeze on elective surgeries and patients postponing wellness visits mean profitability is sinking for many.

Many have often called healthcare recession-proof, as it’s an essential service. However, it seems the field isn’t pandemic-proof.

If Demand Is Up, Why All the Job Losses?

If the demand is so strong because of sick patients, why have healthcare jobs plummeted? According to the Bureau of Labor statistics, there were big losses, including 17,000 lost jobs in dentistry, 12,000 jobs for practices, and 7,000 other practitioner roles. These numbers are in stark contrast to the 374,000 jobs added in healthcare the previous year. 

There have been, however, hiring booms directly related to COVID-19. Hospitals are seeking more nurses, and telehealth vendors are seeking physicians to manage the rising volume. 

Yet many in the field are being laid off or furloughed, as rural facilities and independent providers are facing financial insolvency. Patients that would normally need healthcare services simply aren’t coming to their appointments. Many have been able to shift to telehealth to continue to care for patients, but that doesn’t mean they are receiving reimbursement. 

What About the Healthcare Crisis Relief?

Federal relief funding and changes in telehealth reimbursement policies, including the inclusion of more services by Medicare, may not be enough for these providers to stay afloat. The challenges right now are inconsistent reimbursement from payers and low patient volume. Plus, aid has dried up, with the first big chunk going to hospitals. 

A new survey from the Primary Care Collaborative sheds some insight. One thousand primary clinicians from 48 states and D.C. participated. The survey found that 89% reported decreases in patient visits, and 57% said that less than half of their visits in the last week were reimbursable. 

Virtual Visits Aren’t Always Viable

healthcare crisis telemedicine

Virtual health isn’t feasible, according to the survey, as well. Two-thirds replied that they can’t conduct telehealth visits because patients don’t have computers or internet service. That’s possibly surprising to hear in the modern, technology-friendly world, but it’s a reality in rural America as well as for older patients. Most respondents are using video for less than 20% of visits, using the phone instead. 

The problem is that audio-only visits equate to lower reimbursement rates than video visits. Video visits Further, CMS has a rule that diagnosis over the phone cannot be used for risk adjustment purposes. Still, reimbursement for video appointments is much lower than in-person. Providers believe this should change. 

More Spending, Less Revenue

The COVID-19 healthcare crisis required many providers to start spending more, especially as they try to obtain PPE. Preparation costs money, yet now revenue is drying up. Unless you’re treating coronavirus patients, providers are without patients, just like retailers and restaurants are without customers. 

The demand for help on the front lines is still urgent, but it’s rarely easy to suddenly switch from one specialty to another. Plastic surgeons can’t suddenly become infectious disease specialists. In the fields of medicine that aren’t necessarily connected to urgent healthcare needs, like plastic surgeons and dermatologists, they’ve completely shut down, leaving their staff unemployed.

Healthcare Will Bounce Back

Most experts agree that healthcare is a resilient industry. It’s a service that everybody needs; there are no exceptions. But what the healthcare system will look like in the future is uncertain. 

More rural hospitals are filing bankruptcy, creating medical deserts, where communities have no access to medical care. There could also be more consolidation with healthcare systems buying hospitals and practices. Telehealth is likely also to continue to gain in adoption, especially for digital native patients. 

Further, interoperability and data sharing are still challenges. The problem was widely known, and the HHS interoperability rule finalized earlier this year was supposed to close the gaps. Its enforcement has now been postponed. COVID-19 has uncovered all the cracks in the field relating to the accessibility and portability of healthcare data. With everyone’s eyes wide open to these fault lines, the hope is that healthcare will bounce back and be more agile for the current healthcare crisis and what may come tomorrow.