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Majority of Healthcare Organizations disappointed by ICD-10 Delay

The recent decision on delay of the ICD-10 deadline, a large number of healthcare organizations being reported unhappy and very disappointed. Right after the news which ICD-10 will likely be delayed, many healthcare organizations seems to be unhappy. This is surprising to some, because lot of the previous polls found providers were not prepared for the transition. Not more than 10% providers were ready as per the MGMA report in February.

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An opinion poll conducted by the Deloitte Center for the Health Solutions, inquiring providers about the way they considered the latest ICD-10 delay. Only 11% stated that they are happy, 21% stated they are not concerned with the delay but the majority over 50% (58%) stated to be unhappy with the delay. Further it inquired about the right time for the implementation, 49% stated October 2015, 30% needed the 2014 date to be reinstated, and simply 6% stated they will prefer the date to get moved ahead of October 2015. According to the Healthcare Informatics, 59% of providers say that they assume a lack of momentum because of the delay and 58% believe that there will be a great impact on their resources and funding. Whereas, 14% said that the delay will provide them time to compensate on testing for the latest coding system. What exactly the providers are planning to do since ICD-10 isn’t due till 2015 the following year? 30% say that they will stick to their initial strategy and keep going with their testing schedule. According to 26%, the delay will provide a chance to stop and allow them to reevaluate their plans. While 20% will make use of the extra time to slow down and choose their time while moving towards the implementation.

In the meantime, the Coalition for ICD-10 has sent a letter to HHS encouraging the department to reconsider the decision about the October 2015 deadline. Lynne Thomas Gordon, CEO at AHIMA and a Coalition member said in a statement that, as the transition to ICD-10 continues to be unavoidable, it is extremely challenging for organizations to make appropriate preparations and investments with no knowledge of the execution date and the announcement for the new implementation date would give the industry the understanding required to prepare within the mos economical, wise and also strategically.

A senior Vice President and CIO of children’s Medical Center Dallas, Pamela Arora stated that the delays of ICD-10 are concerning. She also said, ultimately both the delays might cost over $1 million to the hospital. With the use of this money, for an instance, they could manage to buy approximately 170 physiological monitoring devices and could have provided more tools into the hands of their physicians, she stated. Further, she said a majority of these kinds purchases will now be postpone if the funds are restricted. Overrun of 2 years of cost and missed deadlines will be called an effective project within the private industry concerned with profits, she added. Ralph Johnson, CIO at Franklin Community Health Network based in Maine and President at New England HIMSS, stated that he is certainly disappointed with the delay on the whole and also disappointed particularly the way it had been passed from the House and Senate. Further he said, nobody could glow light regarding the delay during the debates and was buried in the large legislation.

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How effective is mHealth In Treating the Elderly?

With more and more people accessing internet on their mobile devices, mobile health (mHealth) has emerged as a popular sub-segment of eHealth. The term mHealth is being used to refer the practice of medicine and public health supported by smartphones, tablets, phablets and mobile-enabled diagnostic devices. In addition to gathering clinical and community health data from various sources, the mHealth applications further enable the patients, clinicians, researchers and caregivers to access both healthcare information and health related services through their mobile devices. Many organizations, nowadays, invest in mHealth application development to improve and expand healthcare services, while reducing costs of care. A number of reports have also highlighted how mHealth applications can contribute hugely towards treating the elders more effectively.

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Why mHealth Applications are Effective in Treating the Older Adults?

Chronic Disease Management
The cost of healthcare is hugely impacted by chronic diseases. As a person ages, his burden of chronic diseases grows. Further, the prevalence of multiple chronic conditions is much higher among older adults. The multiple chronic conditions also make the health care needs complex and expensive. For instance, an elder must avail effective care immediately to avoid frequent hospitalization, duplicative tests, adverse drug events and conflicting medical advices. The mHealth application will allow the elderly patients to support and manage their personal health efficiently by accessing the required health information and care.

Medication Adherence
Along with facilitating chronic disease management, the mHealth application will further help the older adults to adhere to the relevant medication. As poor medical adherence affects the individuals and community negatively, each patient must adhere to the recommendations made by the healthcare provider. However, the medical adherence of a patient can be affected negatively by a number of factors including understanding the instructions, forgetting to take medication and remembering the medication-taking instructions. The mHealth applications make it easier for the older adults to understand and remember the medication regime. Further, they can receive regular notifications to obtain proper medication information on a regular basis.

Safety Monitoring
Many reports have highlighted that hip fractures, falls and similar injuries contribute hugely towards the death and disability of the older adults. So the mHealth applications come with special features to prevent injuries and promote safety among the elderly people. These features make it easier for the healthcare providers to monitor the patient in terms of his location, balance and gait. As most mobile devices support GPS tracking and accelerometers, the applications use fall detection technology to identify the location and nature of the fall, along with notifying others about the fall by sending alerts.

Access to Health Information
As the mHealth application specifically target mobile devices, it becomes easier for the user to access, share and coordinate his personal health information. In addition to facilitating communication and interaction between the elderly and the healthcare provider, the application further helps the older adult in improving self-management. At the same time, the user can further use the application to access his personal health records (PHRs). So he can constantly track his important health records, along with tracking his healthcare services. Most healthcare providers, nowadays, allow patients to control the PHR and share the information with others. Thus, it becomes easier for the elderly people to share crucial information like allergies, drug interactions and medication along with the narrative of their immunizations and diagnoses.

Facilitate General Wellness
The mHealth applications even contribute towards facilitating general wellness of older adults without any chronic conditions. The general wellness facilitated by the applications, however, can be divided into several categories including nutrition, fitness and overall quality of life. For instance, a user can use the mHealth application to access information related to weight loss, healthy eating, smoking cessation, exercise and yoga. He also has option to use different applications to facilitate fitness nutrition and quality of life. So each older adult can download the application according to his mobile device and operating system, and avail the benefits in a flexible way.

The older adults also have option to choose from a variety of mHealth applications according to their specific healthcare needs. So it becomes easier for a user to avail personalized and prompt care simply by using his mobile device, regardless of his current location.

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What Impedes Ubiquitous Adoption of Health IT?

Many reports have highlighted how a clinic can avail several benefits by adopting personal health record (PHR) systems. The electronic health records (EHRs) will provide a secure and private environment to patients to access, update and share their health information. At the same time, the systems will further make it easier for physicians to instantly access information about a patient’s health and medical history. Thus, they can provide more manage a patient’s record more efficiently, while reducing the chances of medical orders. However, there are several barriers that affect the ubiquitous adoption of health IT in a negative way.

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7 Barriers that Affect the Ubiquitous Adoption of Health IT Systems

1) Required Training: A physician can avail many benefits by adopting health IT systems. But he needs to put some amount of time and effort to become familiar with the system, and implement it properly. At the same time, the physician must train his colleagues and staff about the features and capabilities of the system. But many physicians lack time to become familiar with an EHR system and avail all its features.

2) Initial Investment: Each clinic has to invest some amount of funds to create and support its own IT structure. However, it also has option to avail the health IT services from external vendors. The initial cost will include the expensed related to purchase, coordination, monitoring, upgrading and governance. The small and medium sized clinics often do not have adequate IT budgets. So the cost of IT health system adoption also impacts its ubiquitous adoption.

3) Level of Compute Skills Needed: Many physicians even find it difficult to use PHR systems in real time. Many system providers also develop complex systems to complement the varying needs of individual clinics. So along with the physician, his colleagues also need to possess the computer and typing skills required to listen to a patient’s complains, assess its medical relevancy, and type the details at a time. Also, the staff must be familiar with the EHR application interface to simultaneously perform several activities.

4) Cluttered and Restricted Workspaces: A clinic also requires adequate space and infrastructure to accommodate the computers. As the staff has to type the information while listening to the patient, it becomes essential to place the computer in private rooms. Further, the clinic has to decide the most appropriate location to place the server and other system. On the whole, the cluttered workspace and insufficient physical space can also affect the health IT adoption rate.

5) Complexity of the System: Each physician wants to pick an EHR system that complements its needs over a longer period of time. That is why; often physicians opt for complex systems that provide multiple screens and navigation options. The complex features, however, require physicians to learn the system completely to take notes while listening to a patient’s complains. But a number of surveys have highlighted that the physicians find it a daunting challenge to operate the HER system without disrupting the clinical encounter. Many physicians even stop using the system to optimize the clinical encounter.

6) Technical Support: Each clinic requires technical support to create and maintain an IT infrastructure. So it expects the vendor to provide constant support the initial days, and afterward. The support staff also needs to be helpful and knowledgeable enough to provide the required support without causing any delay. However, many physicians feel that the support staffs deployed by the vendors are not available 24 hours a day. The lack of technical support during holidays and off-hours also affects the health IT adoption rate.

7) Problem with Health IT Vendors: The lack of adequate training and technical support for external vendors also contribute towards ubiquitous adoption of health IT. Many physicians hesitate to adopt EHR systems due to the quality of EHR system vendors. As the products are relatively new in the marketplace, physicians often feel that they will incur losses by choosing systems provided by unreliable companies. The unreliable vendors will not further provide the service and support required to avail the benefits of EHR system in the longer run. So the vendors must take several initiatives to win the trust of clients, and encourage them to invest in health IT solutions.

The health IT system providers must address these issues to encourage more and more clinics to adopt health IT systems. At the same time, they must build web-based PHR systems to overcome the factors that divide health IT adoption.

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Ethical considerations for Physicians?

The desire and need to have a better healthcare delivery system has necessitated implementation of a number of regulatory mandates and adoption of healthcare IT. This requires physicians to make considerable amount of investment in their clinical setups to obtain the required level operational efficiency and subsequently to avoid the risk of punitive actions by the government in the event of failure in compliance. All this has resulted in making the existence of independent medical setups very tough. The jobs of physicians now go beyond just patient care and involve understanding the implications of regulatory norms and changing their working styles so as to abide by them. In order to avoid the pain of dealing with so many factors, which are generally looked upon as nothing by hindrance to their core work of providing care, and risk profitability, physicians are actively getting into agreements with larger provider setups and picking up a payment method with suits their deal. It helps them avoid to a large extent the headache of keeping their clinical setups updated with evolving regulatory norms and making sizable investment in healthcare IT. All this is automatically taken care of by the larger organization they enter into a contract with. Physicians thus have all their energies to focus on their primary area of work and draw financial benefits based on the agreement they hold. This is where there is a need for them to be proactive and take into account ethical concerns around those financials incentives, offered as a part of financial arrangements, which influence their clinical decision making.

healthcare software developmentCapitation is a popular payment arrangement model, comes in different variants and can potentially result in offering cost effective and efficient care. However, there is a lot of scope for conflict in such systems too. The onus lies on physicians to guard against those. It starts right from the time they are about to get into one such agreement. Two factors which they should never compromise on are the quality of care and the range of services they offer. While arriving at a rate-of-capitation the existing conditions of enrolled patients should also be taken into account. While evaluating plans, they should look at the size of the plan and the duration; both of which should be large to bring in more predictability. Physicians generally get concerned when treatment expenses go beyond predictable limits. It has a possibility of influencing their behavior since outcome generally results in a financial loss for them. Stop-loss provides a good option to handle such situations. Finally, the sanctity of a physician-patient relationship needs to be kept intact. Although it is an obligation on the part of the physicians to consider and meet the broader needs of a patient population, in order to achieve it, they have to focus their energies into every one-to-one relationship that they share with their patients. Any financial reimbursement system which acts as an impediment to this has to be avoided or worked around at any cost.

Health plans generally tend to set expectations for physicians which are not always easy to meet. For e.g. it could be in the form of a steep utilization rate which is difficult to achieve or making physician payment dependent on so many factors that it is next to impossible to get a good deal without affecting clinical behavior. All health plans have financial incentives. Physicians should keep a few things in mind before entering into a contract with any plan:

  • large incentives generally make it difficult for physicians to turn down but more often than not require them to make commensurate compromises on clinical standards
  • show more preference towards those types of incentives which are applied across broad physician groups
  • advocate increase in the time-duration over which incentives get determined. It helps in negating the impact of fluctuations in utilization
  • prefer those plans which have a large pool of patients
  • avoid agreeing to a tiered system of incentive/penalty payout
  • advocate for a stop-loss provision as a solution to handle outliers
  • ensure that patients are informed about financial incentives which could affect the level-of-care that they receive.

Physicians should always urge for incentive programs which do not just primarily focus on utilization, efficiency and cost reduction. On the contrary, they should emphasize on those which lay importance to quality-of-care and patient satisfaction as well. Physicians ought to be given flexibility to accommodate the varying needs of patients. No incentive plans should tempt them towards selectively treating healthier people and avoiding the high-risk ones in order to improve their own and their groups’ chances of gaining financially. Creating custom solutions for your healthcare practice can help you immensely. Healthcare software development companies can assist you in this.

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