Posts Tagged: data sharing

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

Posted May 11, 2020 by Beth Osborne & filed under Healthcare.

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 There’s no real-time data sharing happening here—that’s because many virus hunters are relegated to outdated tools, including faxing, paper records, and Excel spreadsheets.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 They are drowning in paper records and using outdated and have only inaccurate spreadsheets to track how the virus spreads.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

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?

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.

Dirty Data Is Useless—Learn Why Healthcare Data Cleaning Matters

Posted May 6, 2020 by Beth Osborne & filed under Healthcare.

Is dirty data impacting your operations? Or making it impossible to launch new applications? Healthcare systems collect, analyze, and share protected healthcare information (PHI) every day, but it’s not always accurate or properly structured. To ensure the portability, accessibility, and interoperability of such information, healthcare data cleaning is often a necessity.

But how can you do it efficiently and cost-effectively?

What is Healthcare Data Cleaning?

Typically, most organizations store data in databases. These could be associated with your EHR, decision support system, revenue cycle management, and many more applications designed to enable the healthcare ecosystem to work more cohesively. The value of healthcare big data is immense, helping improve care, boost revenue, and drive better decision-making. Dirty data makes that virtually impossible.

Dirty data describes information that is inaccurate, outdated, redundant, incomplete, or formatted incorrectly. Using healthcare data cleaning, you can bring consistency to your data. This consistency is necessary when integrating disparate streams of data. If you merge dirty data, then its ability to be actionable is lost.

Where Hospitals and Healthcare Systems Stumble

In an ideal world, all healthcare information systems (HIS) would work together in harmony. Field matching wouldn’t be a roadblock, nor would duplicates or other inconsistencies. Unfortunately, that’s just not the case. There is currently no standardized practice for healthcare data interoperability. There are best practices, and the new HHS Interoperability Rule is the most significant step the country has made to improve on this.

However, it’s still not as easy as moving data from one system to another or quickly aggregating different data sets and automatically have a working process. As healthcare data management experts, we see on a daily basis how difficult it is to map data from one system to another, even when they are in the same category. So, if you can adeptly move from one EHR to another, then it gets really tricky when combining data outputs or moving information into a completely different type of platform.

Key Causes of Healthcare Dirty Data

Dirty data is not the result of one thing; it’s a culmination of lots of factors, some more significant than others. One of the biggest concerns is duplication. According to research, duplicate records make up 5-10% of a hospital’s EHR. That number expands to rates of 20% for healthcare entities that have multiple locations.

Duplications happen for many reasons, including errors in spelling or other patient data. Depending on the parameters of the system, it may be unable to search for duplicates as new patients are added.

Another symptom of dirty data is that it’s incomplete. Without all the appropriate fields, records may be useless. If a patient record list omits things like preexisting conditions or allergies, it’s not only incomplete but could impact care. Incomplete information can be attributed to user error or system limitations.

The third significant cause of dirty data is inaccuracies. Errors might have occurred in the original set-up (i.e., misspelled names, transposed numbers), or the data may not have been updated correctly. If you don’t have accurate information about your patients, from contact information to insurance codes, then it’s harder to communicate with them and leverage your information for better outcomes and insights.

The Cost of Dirty Data

The consequences of dirty data can be numerous. First, there are the monetary losses. Gartner researchers revealed that the cost of poor data equates to $9.7 to $14.2 million for businesses every year. Those numbers reflect all types of companies, but it’s still an important figure to know.

Where do these losses come from? For healthcare, it could be from several things, such as opportunity costs associated with being able to launch new applications to the higher hard costs of unpaid reimbursements from payers and additional labor needed to strip out the bad data.

The costs are more than fiscal. You’ll lose time because you can’t seamlessly convert data into new platforms. You’ll miss out on insights that could help you find ways to cut costs and work more efficiently. Worst of all, it could impact patient care.

Feel Confident in Your Data

If you don’t feel confident about the health of your data, then you know it’s holding you back. You may also like the bandwidth or expertise to clean your data. Rely on InfoWerks to be your data liaison. We’ve been cleaning and purging healthcare data for years, enabling easy, compliant data sharing and data conversions for any system.

Make your data work for you again. Learn more about how we can help by getting in touch.

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

Posted May 1, 2020 by Beth Osborne & filed under Healthcare.

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

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.