Cloud Services Advancing in Healthcare Technology

Nine hospitals across the country have filed for bankruptcy thus far in 2017. Small facilities, in particular, continue to feel the pinch from a combination of dwindling patient volume, rising capital requirements, escalating costs of care, bad debt accruals and lack of Medicaid funding.

Clearly, something needs to be done to stem the flow of red ink.

Fortunately, we’re seeing a healthy response from health IT vendors, who’ve identified an opportunity among the chaos. Electronic health record (EHR) firms Meditech, athenahealth and eClinicalWorks have rolled out cloud-based versions of their platforms aimed at bringing cost-effective processing and simplified technology contracting to the small-hospital domain.

Even EHR stalwart Epic is joining the movement. On Nov. 1, Tahoe Forest Health System, which serves two rural counties across 3,500 square miles in California and Nevada, went live with a new version of Epic’s EHR. The health system’s CFO, Crystal Betts, anticipates “significant savings without the maintenance of eight EHRs and [retirement of] a host of third-party ancillary systems no longer needed.” Betts added, “The cherry on top is time saved and a boost to quality and safety with a tightly integrated EHR that just works.”

Likewise, athenahealth’s cloud-based EHR has made a significant impact at Coastal Orthopedics (Conway, S.C.), which implemented the technology a little over a year ago to replace separate EHR and practice management systems. “We wanted to be in a position to jump in quickly and effectively as population health management becomes [our] new top-of-mind issue,” noted practice administrator Andrew Wade. With the EHR taking on redundant data-collection tasks, providers and staff have been able to spend more time on patient care.

Above and Beyond

Meanwhile, the healthcare research/ academic community is also leveraging the power of cloud computing. For example, at the Icahn School of Medicine at Mount Sinai in New York, scientists and physicians have access to more than 100 terabytes of data generated by DNA sequences as they study the molecular basis of breast and ovarian cancer. They use Amazon Web Services’ cloud to support a genomics platform that dynamically scales to analyze tens of thousands of genomes in a matter of minutes.

In short, cloud computing has enabled management to shift from worrying about data storage, performance, and security to helping researchers understand the sequenced output data.

There’s more to come, too. “The cloud is poised to play a prominent role when healthcare organizations deploy telemedicine, mobile health applications, and remote monitoring tools — trends that are inevitable as organizations implement value-based care programs,” according to a HIMSS Analytics cloud computing survey.

Pathway to Progress

As healthcare organizations continue to put their faith in the cloud, they’re looking for partners who can facilitate implementation and replace layers of internal systems management and integration. And, not coincidentally, they want to do so with predictable ongoing costs.

NetDirector’s cloud-based HealthData Exchange fits the desired profile by normalizing data and documents to achieve EHR interoperability with an expanding array of trading partners, including physician groups, labs, registries and imaging centers. Subscription pricing meshes with organizations’ emerging reliance on scalable services made possible by cloud technology.

For more information, please contact us or request a free demo.

Healthcare, Ransomware, and Security Breaches

Ransomware, a treacherous malware exploit that encrypts victims’ data or prevents access to their devices, netted cybercriminals an estimated $1 billion in 2016.

Data-related extortion attacks on businesses rose three-fold during the first nine months of last year, equating to one every 40 seconds. Two-thirds of those hit by ransomware lost all or part of their corporate data and one-quarter spent weeks trying to restore access, according to Kaspersky Labs, a data security firm.

Perhaps even more alarming is a predicted shift from chaotic and sporadic ransomware incidents to steadier assaults in higher volumes. “There is no such thing as a low-risk sector anymore,” Kaspersky’s research warned.

Healthcare, with 16 percent of organizations having been hit by ransomware, ranks in the top 10 among targeted industries.

High stakes for healthcare

Hospitals and health systems, as HIPAA covered entities, must adopt safeguards to ensure the confidentiality, integrity and availability of electronic protected health information (ePHI). The Department of Health and Human Services’ Office for Civil Rights (OCR), which enforces HIPAA, issued guidance in 2016 presuming a breach in the event of a ransomware attack involving ePHI. In other words, it’s up to the provider organization to prove that a breach did not occur by demonstrating low probability that ePHI was not compromised.

Nonetheless, many organizations remain non-compliant or take a stance of “calculated non-compliance.” That means they deem any potential fine to be cheaper than the reporting costs or technical resources needed to investigate incidents to OCR’s satisfaction, according to James Scott, senior fellow at the Institute for Critical Infrastructure Technology.

All the same, providers should be concerned whether ePHI is properly encrypted and adequately protected against compromise by ransomware. And from a system-wide perspective, additional safeguards should include proper use of passwords, removal of outdated software and unauthorized apps, adherence to regular backup procedures, and educating users not to open attachments or click links from unknown senders. Additionally, operating systems, browsers and antivirus programs should be updated to the latest version on all devices.

Also worth noting: Security shortfalls may be present in system integrations written in-house or by contracted developers.

In any event, “negligence gives cyber criminals the incentive to continue to launch ransomware attacks,” notes security website CSO.

And — as if on cue — a newly discovered form of ransomware may be released this month, reports TechRepublic. The malware, known as RedBoot, not only encrypts files but also permanently repartitions hard drives, rendering data unrecoverable. The alert advises businesses to back up workstations to some form of network or cloud storage, refresh all antivirus software definitions, and train users to avoid phishing scams.

A big ask

Hospitals have their hands full providing the best care possible for patients, around the clock, every day of the week. In that light, they shouldn’t be expected to shoulder the entire load of locking down data against an ever-expanding array of intruders.

Networking companies such as NetDirector have the expertise and capabilities needed to properly secure and integrate healthcare data. All of our certifications and processes (e.g., HIPAA and SOC2) are maintained above industry standards in a fully redundant, cloud-based platform. Healthcare clients put their trust in NetDirector to securely handle more than 10 million data and document transactions per month.

Although ransomware and related intrusions are real concerns, NetDirector stands ready to consult and assist in hardening defenses across the healthcare ecosystem.

For more information, please contact us or request a free demo.

Why EHRs Don’t Have to be a Hindrance

Doctors persistently claim that electronic health record (EHR) systems take up too much of their time.

Bearing out that assertion, a just-published study in Annals of Family Medicine found that a cohort of 142 primary care physicians spent more than half their workday interacting with their EHR during and after clinic hours. Worse, the physicians, who were retrospectively followed through EHR event logs over the course of three years, allocated two-thirds of their computer-facing time to clerical and inbox work.

A separate commentary earlier this year issued a stark challenge to the healthcare IT industry: “[Talk] to ten practitioners at random who are involved in day-to-day emergency medicine or primary care medicine, the guys and gals on the busy front line, and find two of them who are enamored with their [EHR] tools.” The author, small-town physician Kenneth Bartholomew, MD, describes systems designed around billing and collections functions. Such EHRs, he argues, lack the ability to actually improve the workflow of diagnosis and patient management.

Closing the gap on EHR drawbacks

The clearly frustrated Dr. Bartholomew concludes that current EHRs put the wrong tools in the hands of everyday caregivers. While EHRs help assemble patient history, along with physical and laboratory evidence, the technology requires doctors to “push the chain” of information from behind — rather than “pulling it from the front.”

Nonetheless, it’s also important to recognize EHRs’ positive impacts within a digital, connected healthcare environment. Evidence of benefits include:

  • cost savings derived from prevention of adverse drug events;
  • enabling access by emergency personnel to patients’ pre-existing health information (such as medication lists, allergies, and medical histories);
  • use of medical histories to remind physicians of the best methods of care for specific patients; and
  • improvement of reporting, investigation, response, and communication between public health officials and clinicians.

What’s more, EHRs have been shown to mitigate risk for healthcare providers and health systems by enabling evidence-based decisions at the point of care, aiding in research directed toward improvements in care, and preventing liability actions by documenting complete records of care and informed consent.

Also, significant, EHRs can help drive up patient satisfaction. More than 90 percent of patients report being happy that their doctor used EHR-powered e-prescribing capabilities — and that they rarely encounter prescriptions not being ready at their connected pharmacy.

EHRs and interoperability

Looking ahead, the federal Office of the National Coordinator for Health IT (ONC) has prioritized enhancing EHR usability, as well as facilitating seamless exchange of information among different EHR systems. In fact, the 21st Century Cures Act, enacted at the end of 2016, specifies the development of a national framework and common agreement to promote comprehensive network-to-network health data sharing. ONC will be organizing work in these areas and expects to have preliminary plans in place by next year.

NetDirector actively supports strong, automated integration of EHR capabilities throughout the healthcare ecosystem. Hospitals and physicians can deploy NetDirector’s HealthData Exchange to normalize data to standard HL7 and other formats to achieve EHR interoperability while removing the bottlenecks of traditional interfacing — all without adding hours to the physician’s already hectic schedule.

For more information, please contact us or request a free demo.

NetDirector Enters Comprehensive Agreement to Partner with My Constant Care, LLC for Integration Services

TAMPA, Fla.Sept. 28, 2017 /PRNewswire/ — NetDirector, a cloud-based data exchange and integration platform, has expanded their Integration-Platform-as-a-Service (iPaaS) offerings once again. A strong partnership has been forged with My Constant Care, LLC to provide them with a cloud based integration suite for the already cloud-centric company.

My Constant Care (MCC) provides a unified cloud-based platform for integration and delivery of preventive services such as Annual Wellness Visits, Chronic Care Management, Advanced Care Planning, and Preventative Screenings. Their turnkey delivery model provides patients with the full spectrum of preventive services to enhance overall care delivery without disrupting day-to-day operations of the practice. My Constant Care focuses on maximizing value to both providers and patients. They do this with expert coordination of preventive care options available today while strategically shaping these services to meet performance requirements expected of their future providers in the future. They offer a no-financial-risk solution to the physicians, providing the staff, software, and technology to perform their services.

Utilizing the cloud for integration was a clear next step to elevate the services offered by MCC. NetDirector’s One-to-Many style integration allows MCC to connect to NetDirector once and exchange data seamlessly with EHR systems, billing platforms, and more as the hub expands. Now, MCC’s services can integrate with existing provider platforms as well as future additions to a provider’s suite of technology solutions without relying on internal resources to bridge the gap between solutions.

My Constant Care helps primary care physicians provide a level of service to their Medicare population previously not achievable by small practices,” says Kellie Privette, the Director of Sales and Business Development at MCC. Privette added that “NetDirector’s integration expertise and technology allows MCC to seamless transfer patient data into their customer’s EHR and billing systems, without double entry of a substantial amount of information.”

This integration also increases a provider’s compliance, allowing even small practices to provide the quality and timeliness of service of a larger provider while maintaining and exceeding compliance standards for the healthcare technology industry. By eliminating data entry steps and automating the exchange of patient information securely, the integration allows for providers utilizing My Constant Care to focus more on the patients, and less on the technology behind the scenes.

“We’re very enthusiastic about our partnership with My Constant Care,” said Harry Beisswenger, CEO of NetDirector. “Their services fill a gap in the healthcare industry, and we’re looking forward to helping them achieve their goals of seamless preventive care for everyone.”

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant and SOC II Type 2 certified company, a 6-year member of the prominent Inc. 5000, and currently processes more than 8 million transactions per month.

Blockchain Technology: An Emerging Force in Healthcare Integration

Back in March, at the conclusion of the HIMSS17 annual conference, we pointed to blockchain as one of the most noteworthy recent developments in the healthcare IT space. We emphasized that blockchain technology, which uses a distributed database and cryptography to securely manage records and create a permanent record of online transactions, deserves recognition for its potential to increase IT and organizational efficiencies — highly valued attributes in light of Healthcare’s perpetually constrained resources.

An IBM Institute for Business Value study explains that data captured on blockchains can be shared in real time across a scalable group of individuals and institutions. “Every event or transaction is time-stamped and becomes part of a long chain, or permanent record, that can’t be tampered with after the fact,” according to the study report, which finds 16 percent of healthcare organizations ready to commercialize blockchain at scale in 2017.

Where will things go from here?

Room to grow

In practical terms, blockchain could be used in areas such as population health to aggregate patient and financial data that formerly would have been available only from separate sources such as health information exchanges and claims databases.

Further, blockchain’s ability to enable secure and irrevocable data exchange systems would provide “seamless access to historic and real-time data, while eliminating the burden and cost of data reconciliation,” explains Reenita Das, senior vice president of transformational healthcare at research firm Frost & Sullivan.

Micah Winkelspecht, founder and CEO of blockchain start-up Gem, characterizes blockchain as a tool for interoperability — in essence, an open-source protocol layer incorporating rules to which software can be written. “It’s basically like a language that all [participating] companies agree to speak in order to be able to interoperate with each other,” he adds. Unlike the current EHR-centric healthcare system, blockchain would be the “underlying fabric” for the entire continuum of care, “a decentralized, distributed, global data repository that’s basically shared and controlled by everyone,” he envisions.

Cross-industry philosophy

Related, in the mortgage industry, a similar foundational approach has experts believing in blockchain as an enabling technology empowering lenders to overcome current challenges in electronic processes.

Blockchain would be applied as a thin layer atop an existing document management system to effectively “freeze” a copy of the signed documentation, thereby proving it has never been altered and that the original document resides in its original location. Focus would shift from e-signature tools to blockchain as the core technology structure for compliance and document management — without requiring a completely reworked electronic process.

NetDirector recognizes ongoing and changing security needs in industries such as healthcare and mortgage banking. Companies on the front lines shouldn’t have to rewrite existing integrations or pay multiple vendors in their respective networks to operationalize individual system connections.

Within the healthcare ecosystem, NetDirector’s HealthData Exchange builds on a standard data model to map to HL7 or other data formats and achieve EHR interoperability while removing the bottlenecks of traditional interfacing. Such integrative technology holds the promise of making future security updates and landscape changes far more manageable.

For more information, please contact us or request a free demo.

What Can We Learn from eClinicalWorks’ Big Mistake?

Electronic health record (EHR) vendor eClinicalWorks (eCW) and several of its executives are on the hook for $155 million to resolve a False Claims Act lawsuit alleging that the company misrepresented the capabilities of its software. The U.S. Department of Justice announced the settlement on May 31.

Resolution of the case also required eCW to enter into a Corporate Integrity Agreement (CIA) with the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS-OIG), which oversees “meaningful use” incentive payments to healthcare providers relating to their adoption and implementation of certified EHR technology.

According to the government, eCW concealed that its software was “hardcoded” to meet certification requirements for standardized drug codes instead of actually retrieving the proper drug codes from a complete database. Other cited faults in eCW’s software included:

  • not having an audit log for accurate recording of user actions;
  • not reliably recording diagnostic imaging orders;
  • not reliably performing drug interaction checks; and
  • failing to satisfy data portability requirements for transferring patient data from eCW’s system to other vendors’ software.

All told, because of the deficiencies, “eCW caused the submission of false claims for federal incentive payments based on the use of eCW’s software,” HHS-OIG charged. $125 million of the company’s fines will go to repay Medicare and Medicaid for incentive disbursements under their respective meaningful use programs. (eCW customers who successfully attested to meaningful use in good faith will not be linked in on the government repayments.)

Aside from the financial penalties, eCW’s CIA, which extends for five years, requires the company to retain an independent oversight organization to assess its software quality control systems, with semi-annual written reports to be filed with HHS-OIG. The CIA also mandates that eCW allow its customers to obtain free software updates; customers also have the option of transferring their data to another EHR vendor without penalties or service charges.

Industry fallout

eCW agreed to the settlement without acknowledging any wrongdoing. The company said it did so to avoid lengthy and costly litigation. eCW’s EHR system remains certified under the meaningful use program. Nonetheless, the underlying facts of the case appear to have cast a broad shadow across the health IT landscape.

A report compiled by market research firm Reaction Data after announcement of the settlement found 71 percent of respondents saying they would be extremely unlikely to consider eCW in the future. What’s more, 27 percent indicated that the case had lowered confidence in their current EHR vendor, and 35 percent reported being “significantly more suspicious” of other EHR vendors.

Healthcare attorney Bob Ramsey told Healthcare Informatics that the eCW allegations may be an extreme case, but added, “Interoperability and data portability is viewed as necessary in the health world, but it’s easier said than done.”

Peter DeVault, vice president of interoperability at EHR vendor Epic, recently noted that healthcare providers would be well served to rely less on EHR certifications moving forward and to concentrate more heavily on demonstrated benefits.

NetDirector’s vendor-neutral approach to data exchange elevates providers’ ability to achieve EHR interoperability while working toward meaningful use incentives. In an environment currently clouded by skepticism, the HealthData Exchange platform automates integrations in a manner that exceeds industry standards.

NetDirector CEO Harry Beisswenger puts the technology in perspective: “It’s important for us to aid healthcare providers and vendors in reaching meaningful use benchmarks because we know that ultimately impacts the level of patient care.”

For more information, please contact us or request a free demo.

Midyear Healthcare and Technology Progress Report

High availability, interoperability, and utility in population health management all figured prominently in an early 2017 forecast of areas where healthcare CIOs expect information technology (IT) to deliver significant impact for their organizations.

Here’s a look at how things are shaping up at the year’s midpoint.

Systems availability

While natural disasters or cyber-attacks can knock out — or lock out — critical IT systems without warning, healthcare entities still need to prepare for such events. In fact, the HIPAA Security Rule requires health care covered entities to have a contingency plan for responding to unavailability of electronic health information systems.

The Department of Health and Human Services’ Inspector General reported last year in a survey of 400 hospitals that about two-thirds have contingency plans addressing data backup, disaster recovery, emergency mode operations and testing/ revision procedures. Nonetheless, over half of the surveyed hospitals confirmed an unplanned disruption to their electronic health record (EHR) system, and about a quarter of those experienced delays in patient care as a result.

So far this year, EHR outages continue to make headlines:

  • An April 2017 poll, conducted by online physician community Sermo, found that 55 percent of 1,678 responding U.S. doctors had experienced an EHR outage or malfunction that jeopardized the health or safety of a patient.
  • Also in April, Erie County Medical Center and an associated long-term care facility experienced a system-wide shutdown attributed to a ransomware attack. The hospital’s backup process prevented loss of any patient records or financial data, but its EHR was taken offline for six weeks, during which time activities such as patient admissions and prescription writing had to be handled manually.
  • In a separate incident at the end of February, an ophthalmology-specific EHR experienced “technical difficulties” due to outages of Amazon’s S3 cloud-based hosting service.

Data center and cloud services provider Peak 10 recommends that healthcare entities not only review their IT privacy and security policies and procedures but also insist that their service level agreements with technology providers specify agreed-upon security objectives and how compliance will be ensured.

Interoperability

In late March, the Office of the National Coordinator for Health IT (ONC) shared several examples of what it described as “interoperability in action from coast to coast.” Among the programs ONC showcased:

  • An app that imports patient data — including personal and medical device data, remote monitoring and reminders — into a comprehensive family health dashboard.
  • A solution that allows clinicians to create customizable push notifications that can be tailored to individual patients or groups.
  • A smartphone app that allows patients to grant or revoke permission for providers to access, send or receive health information electronically.
  • A secure system for users to seamlessly store and share data with trusted care professionals.

Additional projects outside of ONC’s purview are taking aim at other aspects of interoperability. In April, Ascension Health, Cedars-Sinai Health System and Hospital Corporation of America opened the Center for Medical Interoperability. The lab will provide resources for researchers to test data-sharing connections for medical devices and EHRs. In February, the Personal Connected Health Alliance agreed to partner with the Integrating the Healthcare Enterprise initiative in efforts to improve health data exchange through conformity testing and certification with a focus on standards-based, open specifications.

Population health

No single type of data serves as a comprehensive source of information for population health management. For example, claims data includes patient demographics, diagnosis codes, and dates and costs of services; however, the information is retrospective and limited to just billable aspects of care, explains a recent HealthITAnalytics report. Likewise, EHR systems provide clinical details but often contain unstructured, free-text descriptions that are difficult to extract and analyze.

Still, healthcare organizations continue to press forward with population health initiatives. Vanderbilt University just released a report card — the first of its kind in the nation — intended to guide the planning, implementation, and evaluation of programs and policies to improve men’s health across the entire state of Tennessee. It identifies heart disease and cancer as the leading causes of death in the state and reveals a deficit in men having a personal health provider. Meanwhile, Stanford University’s Center for Population Health Sciences has awarded $275,000 in pilot grants to fund studies seeking to improve population and community health, including a mobile surveillance system that will map autism and gaps in treatment services.

Efforts such as these will help drive discovery of what works in real-world practice of population health management. “As an industry, we can increase the socialization of toolkits and case studies so that healthcare organizations can more clearly define all aspects of population health management model design,” observes Jennifer Rogers, an analyst at Chilmark Research. She adds that optimal IT deployment will speed up gains in value for current and future adopters of population health models.

Availability, interoperability, and population health projects face a balance of challenges and opportunities as we enter the second half of 2017. NetDirector continues to innovate with cloud-based, foundational integration solutions that will help healthcare organizations seamlessly handle the electronic exchange of information in each of these areas within their respective ecosystems. For more information, please contact us or request a free demo.

Addiction Care 101 Partners with NetDirector to Automate Key Pieces of the Opioid Addiction Recovery Process

Tampa, FL – June 13, 2017 – NetDirector, a cloud-based data exchange and integration platform, continues to solidify their presence in the healthcare industry as a leading provider of integration services. Most recently, NetDirector has partnered with Addiction Care 101 to aid in the delivery of treatment for the growing opioid crisis around the country.

Addiction Care 101 (A101) is a cloud-based software platform that assists doctors in performing Medication-Assisted Treatment (MAT) for people with prescription opioid and heroin use disorders. Medications (such as Suboxone) are used to prevent the patient from experiencing opioid withdrawal while they receive the necessary treatment, provided via telemedicine by their network of doctors and therapists to assist their recovery.

The software is based on a proven, successful model delivered on a solid platform of risk management and compliance to physicians and patients. The A101 platform allows for users to anonymously go through treatment and recovery without requiring family or employers to know. Technology including telemedicine and e-prescribing allows members (assisted by the network of doctors, drug counselors, and the A101 team) to pursue sobriety without having to worry about being seen in an addiction care facility.

Laurie Peregoy JD, Director of Program Compliance, states that “NetDirector’s cutting edge integration technology allows A101 to more accurately monitor their member’s compliance. Specifically, the ease in which we are able to routinely access the Controlled Substance Database using their automated process gives A101 the critical assurance that members are not seeking drugs beyond their treatment program.”

By providing an automated integration to Controlled Substance Databases, NetDirector helps prevent “medication farming” – a major contributor to the abuse of opioid recovery drugs that has hindered the opioid rehabilitation efforts in the past.

William Beasley, one of A101’s network of Drug Counselors, further stated “NetDirector’s bidirectional integration with our lab testing partners makes my job of treating my patients more thorough due to immediate alerts to both myself and my patient if the results expose compliance or other potentially life-threatening outcomes.”

By integrating with labs via a cloud-based, one-to-many style integration, NetDirector allows the practitioners and counselors that are part of the A101 network to stay informed and to expand their ability to treat opioid addiction disorders in recovery patients with greater accuracy. The compliance gains noted by A101 are a key benefit to the integration, as well, so that the program can continue to function while maintaining the highest levels of transparency and discretion when needed.

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently processes more than 9 million transactions per month.

When a Health IT Rollout Runs Off the Rails

If ever a large-scale health IT project needed a reboot, it was the rollout of Healthcare.gov. Fortunately, it got one — in the form of an emergency, behind-the-scenes “tech surge” assembled to salvage the government’s new health insurance portal after a halting launch.

To recap, only six people completed the online enrollment process on Oct. 1, 2013, the day Healthcare.gov officially opened for business, according to notes from war room meetings at the Center for Medicare and Medicaid Services (CMS), the agency charged with implementing the site. Things didn’t improve much the next two days, with a cumulative total of 248 enrollments successfully submitted and at times up to 40,000 consumers stuck in a waiting stage.

Malfunctions crashed Healthcare.gov twice more the last week of October, the second time while Kathleen Sebelius, Secretary of Health and Human Services (HHS), the parent department of CMS, was testifying before Congress about the website’s problems.

Administration officials advised consumers who experienced trouble with the online process to apply by phone — or even mail in a hard copy form.

President Obama called it a “well-documented disaster” and pundits had a field day.

“Only the government could come up with a website that’s slower than sending something by mail.” — Jay Leno

“If you are in need of healthcare, you have two choices: You can wait for them to get the site fixed, or you can enroll in medical school, graduate, and then just take care of yourself.” — Jimmy Kimmel

“People are getting a busy signal when they try to apply over the phone. You can’t use the Internet and you can’t use the phone. So now fax machines are like, ‘Look who’s come crawling back!’” — Jimmy Fallon

To its credit, the administration retooled and relaunched the site by December 2013 and hit its stated goal of signing up 7 million people by the end of the first quarter of 2014. Nonetheless, substantial damage had already been done. Hundreds of millions of dollars had been spent, and by April 2014 Sebelius had resigned after taking ultimate responsibility for the launch debacle.

What went wrong

In retrospect, the management and technical problems that plagued Healthcare.gov throughout its development seem fairly apparent.

A February 2016 report issued by HHS’ Office of the Inspector General stated that the most critical misstep made by the project team leading up to launch was “absence of clear leadership, which caused delays in decision-making, lack of clarity in project tasks and the inability of CMS to recognize the magnitude of problems as the project deteriorated.” Other contributing factors included devoting too much time to policy issues rather than to actual site development, poor technical decisions and improper management of the key development contract. The report also criticized CMS’ organizational structure and culture, which hampered coordination, pushed back against warnings of “bad news” and failed to alter plans in the face of problems.

The Government Accountability Office (GAO), in a separate analysis, pointed out CMS shortcomings in the areas of capacity planning for the site, as well as failure to correct software coding errors and implement full functionality prior to launch. Additionally, GAO said, “Healthcare.gov and its supporting systems were not fully tested prior to launch, and test documentation was missing key elements such as criteria for determining whether a system passed a test.”

A CIO retrospective summarized the project’s faults and how the fiasco could have been prevented: “Healthcare.gov was a single, Big Bang rollout that couldn’t be stopped.” The huge undertaking should have been tracked forward in incremental stages, with early and complete testing, and a more flexible scope to find areas of risk before they unexpectedly appeared.

Not a singular instance

Despite all the negative fallout, perhaps we shouldn’t be surprised with Healthcare.gov’s early-phase stumbles. Standish Group, an advisory firm focusing on software project performance, studied 3,555 projects from 2003 through 2012 that had labor costs of at least $10 million.

The takeaway: Only about 6 percent were deemed successful. A majority, 52 percent were “challenged” — meaning over budget, behind schedule or failed to meet user expectations. The rest, about 42 percent, were either scrapped or started anew from scratch.

Further research, from Forrester Consulting, shows that less than 40 percent of IT executives believe their internal IT organizations can regularly deliver projects on time and within budget, due in large part to continually changing user requirements and overburdened departmental resources.

In general commercial environments, such a low success rate may be accepted as a “cost of doing business,” and the worst outcome could be scope creep or project delays. In healthcare, the stakes are higher, with patient lives potentially on the line when IT systems don’t work or aren’t available when needed. That’s why many healthcare entities are looking for trusted third-party help in gaining control over their interconnected systems and expanding ecosystems.

NetDirector has been around for almost 15 years, offering cloud-based services that are now considered a staple solution for data integration in healthcare and other industries. Learn more about the HealthData Exchange platform here or request a free demo.

NetDirector Enables Next-Generation Integration in Radiology with American Health Imaging

Tampa, FL – May 24, 2017 – NetDirector, a cloud-based data exchange and integration platform, has engaged in a rapid expansion strategy in the healthcare industry over the last few years. Recently, the Integration-Platform-as-a-Service (iPaaS) has completed implementation with American Health Imaging, a regional network of radiology providers across multiple states, to provide increased accessibility and data utility in their company.

American Health Imaging (AHI) began providing diagnostic imaging services in Decatur, Georgia, in 1998, and has since expanded to 21 locations. In each area, they distinguished themselves by providing excellent customer service and high quality diagnostic imaging for their patients and referring physicians. By partnering with NetDirector to provide cloud-based integration services, it is the goal of AHI to create an automation platform that will increase overall customer satisfaction through streamlined processes and to create internal manpower savings through enhancing their ability to scale the business without having to add staff.

“We want to provide the best possible patient care, to the maximum number of patients, while minimizing the need for human intervention in the process,” said Dan Balentine, Chief Operating Officer at AHI. “By utilizing the NetDirector integration, it has allowed us to take our staff’s focus off of the day to day busywork, and shift focus to providing unmatched patient care.”

With traditional integrations, a company like AHI could be paying upwards of $20,000 plus an 18% annual maintenance fee for each vendor that would be integrated with AHI’s EMR and other in-house systems. For AHI, this was clearly not the optimum solution. Several vendors might not have the volume of transactions to justify the integration cost, creating a system built around the exception and not the constant. NetDirector’s one-to-many integration approach allowed AHI to integrate once with NetDirector, and use that single integration to connect to the entire hub of HealthData Exchange participants.

Three main technologies formed the backbone of the AHI-NetDirector integration – HealthLogix, Exchange EDI, and IntScripts.

HealthLogix Integration – Patient Check-In, Appointment Confirmation, Patient Billing

AHI utilizes a patient engagement platform called HealthLogix to help follow up with patients after exams or appointments, confirm scheduling, prompt for surveys, create a seamless check-in process, and more. The cloud-based integration model helped AHI bring this information directly into their Fuji Radiology Information System (RIS) and patient billing databases, to keep patient records current and to leverage the data they were collecting most efficiently, and allowed the utilization of HealthLogix’s full functionality such as automating check-in procedures at a digital kiosk, and more.

Exchange EDI Integration – Insurance Coverage Confirmation & Verification

Additionally, in a time where high-deductible insurance policies are increasingly commonplace, insurance confirmation simply isn’t enough information. AHI utilized NetDirector to connect with Exchange EDI, which not only confirms the participation in an insurance policy or group but analyzes policy levels and remaining deductibles. This allows patients and providers alike to understand the patient’s responsibility up front – the transparency provided by this data allows for accurate collection of copays during visits, reduced collection costs down the line, and overall reduced revenue leakage for providers.

IntScripts Integration – Physician Referrals and Radiology Communication Integration

Finally, it was critical to make the ordering process for their referring physician population as simple as possible, so an integration was performed with IntScripts, which provided the ability to directly receive orders from the referrer’s EHR and have the results automatically dropped right into the patient’s chart.  This automation eliminates the traditional manual processes that were previously encountered by both AHI and referring physicians.

For patients, the NetDirector integration platform provides not only an elevated level of understanding of their coverage and responsibility through stronger integration between provider and vendor, but also makes life easier for their primary care doctor or other referring physician to communicate and refer patients. This increases the likelihood of single-service care, as primary care physicians are more likely to refer patients as needed, and patients can trust they are receiving the right treatment for them.

“The integration that we have created for American Health Imaging is a model case for the value of cloud-based integration in healthcare,” said Harry Beisswenger, NetDirector CEO. “When we set out to enter the healthcare industry, our primary goals were to reduce costs for providers, increase potential care level provided to patients, and create an environment of data transparency and communication. AHI’s integration has accomplished all of this and more.”

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently processes more than 8 million transactions per month.