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.

NetDirector Launches Powerful Integration with Equator® for Orders and Deliverables

Tampa, FL – May 9, 2017 – NetDirector, a cloud-based data exchange and integration platform, has spent several months working alongside Equator, the leading provider of default software solutions for servicers, real estate agents, vendors and other mortgage and real estate industry professionals. The work has yielded a powerful zero-footprint integration option for default servicing firms utilizing Equator.

Equator’s infrastructure software as a service (iSaaS) solutions include EQ Workstation®, EQ Marketplace®, Midsource™ and EQAgent®/EQVendor® portals, which can be used a la carte or as an end-to-end solution. Equator’s REO, short sale and loss mitigation modules processed over $21 billion in transactions in 2015, and have processed more than $315 billion in transactions since its inception. Currently, 4 of the top 5 U.S servicers and the largest holder of real estate are on the Equator platform. With such a high volume of mortgage banking transactions taking place with Equator, it was an easy next step for NetDirector to develop the one-to-many style integration that has fueled their integration platform-as-a-service (iPaaS) business model tailored to the Equator platform.

“NetDirector has worked very closely with us to not only develop, but to thoroughly test this powerful integration suite for default servicing attorneys,” said James N. Vinci, Chief Technology Officer of the Equator business. “We’re excited to collaborate with them, and we believe this collaboration will generate serious efficiency for attorney firms utilizing Equator.”

The initial integration launch includes “Orders” and “Deliverables”, which resemble the referrals and events that are utilized by other industry standard software interfaces in the default servicing sphere. The “Deliverables” also allow for certain documents to be uploaded and other transactions and processes are on the table for future development. Automating these transactions through a cloud-based integration platform provides increases to efficiency through reduced data entry and automated processes. It also significantly reduces the labor stresses of developing and maintaining the integration internally at the attorney’s cost.

“Our ecosystem continues to expand with yet another powerhouse in the industry as we welcome Equator as a new participant,” said Harry Beisswenger, NetDirector CEO. “Our goal is to provide the integrations to default servicing firms that offer the most value, and there has been a major demand for this service. We look forward to the prospect of further data and document integration with the Equator platform in the future.”

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 SOC 2 Type II Compliant company, a 6-year member of the prominent Inc. 5000, and currently, processes more than 8 million transactions per month.

Case Study – Automation in Attorney Firm

Our new case study featuring an ROI study on integration and automation with NetDirector + CaseMax in a default servicing attorney firm is now available.

You can find the case study here:

ND_CaseMax_CaseStudy_Button

Healthcare Year in Review: The Data Perspective

As 2016 comes to a close, major developments in health information technology reveal continuing storylines for the year to come. Here’s a brief overview of progress made and ongoing opportunities for health information exchange to surmount pending challenges.

Value-based care

Medicare and commercial insurers are moving quickly toward valued-based payment models, leaving fee-for-service behind. Nonetheless, the implementation of supporting technology remains a work in progress. The 2016 HIMSS Cost Accounting Survey reveals that about half of healthcare provider organizations participate in some type of alternative payment model, but only 3 percent believe they are highly prepared to make the pay-for-value transition. “It will be critical that the industry reaches some level of consistency in terms of how providers should manage the exchange of clinical and financial information between all parties involved in an episode of care, regardless of whether they are part of the same healthcare delivery system,” explains Pam Jodock, HIMSS’ senior director of health business solutions.

Legislation

On December 13, President Obama signed into law the broad-reaching 21st Century Cures Act, which makes significant investments aimed at solving some of the nation’s biggest health challenges. Among its many varied provisions, the Cures Act seeks to improve health IT interoperability by promoting complete access, exchange and use of all electronically accessible health information for authorized use under applicable state or federal law. The legislation puts a priority  — and calls for a Government Accountability Office study — on patient-matching technology that would accurately identify patients for electronic exchange of health information among providers.

Cloud computing

The shared-resources, data-on-demand model known as cloud computing continues to evolve as a trusted healthcare technology core component “underpinning the continued development of electronic health records and big data analytics,” reports HIT Infrastructure. This aligns with increased use of software-as-a-service offerings in areas such as clinical data systems and technical support desks as organizations look to lower costs and improve overall operations, according to research firm Gartner. Cloud security and compliance concerns remain in play, however, especially in the handling of health data and protected health information.

Data sharing

Data is seemly everywhere these days, continually growing, with much of it available to be shared. Despite concerns about the privacy and security of health data, 77 percent of respondents to Rock Health’s 2016 Digital Health Consumer Adoption Report are interested in sharing their health information — especially to get better care from their doctor. Among those surveyed, 79 percent said they would divulge their health history, physical activity (76 percent) and genetic data (64 percent) with a physician. On the flip side, in regard to accessing health information, it matters most to those in poor health. Twenty-eight percent of respondents who self-rated their health status as poor or bad highly desired an electronic copy of their health records, while only 19 percent of those in good health were as interested.

Behavioral health and special care innovation

The U.S. Department of Health and Human Services projects treatment spending on mental and substance use disorders will total $280 billion in 2020. Including individuals with intellectual or developmental disabilities and those who require long-term services and support because of chronic medical conditions or physical disabilities, more than 35 percent of U.S. annual healthcare expenditures flow toward care for groups that constitute less than 20 percent of the population. Efforts to understand population health risks and intervene with preventive care models that reduce costs and improve care have started to gain traction, reports CIO. In one such initiative, Quest Diagnostics is working with University of California San Francisco to tap a database of 20 billion lab test records, combined with a five-minute cognitive assessment, for early detection and treatment of dementia.

NetDirector’s cloud-based HealthData Exchange comes into play in many areas of the developments that have shaped health IT during 2016. The service not only facilitates EHR integration and streamlines clinical workflow and communications with the extended provider community, but also complements existing IT investments.

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

Why is Interoperability Progress So Slow?

A little over a year ago, a group of electronic health record (EHR) vendors and providers gathered to map out objective, transparent measures of health information exchange.

Research firm KLAS and the College of Healthcare Information Management Executives (CHIME) shortly thereafter released a joint study of more than 240 provider and 15 vendor organizations. The resulting report identified the most-needed improvements for EHR interoperability: better coordination among vendors, timely location of patient records and greatly enhanced parsing capabilities.

“The data show that there is a lot of activity around health information exchange and data sharing,” CHIME CEO Russell Branzell added. “Providers and vendors, however, agree that effective management and use of standards is critical to moving forward.” He also cited patient identification as a major barrier to creation of an interoperable health network.

Further, the report emphasized that better data flow between providers would be essential during healthcare’s transition from a fee-for-service environment to a value-based delivery model and reimbursement system.

Recent gauge on progress

At the end of August 2016, the KLAS Interoperability Measurement Advisory Team unveiled details of its framework for benchmarking and assessing interoperability performance among EHR vendors. The work focuses on clinical end users’ experience related to:

  1. availability of needed information;
  2. ease of locating records;
  3. ability to view outside records within the clinical workflow; and
  4. impact on patient care.

Roughly a month later, KLAS published its 2016 Interoperability report, which highlighted “significant immaturities” in the marketplace. Of particular note, only 6 percent of surveyed providers confirmed delivery of information accessed from exchange partners on a different EHR in an effective way to facilitate improvement in patient care.

At the front end of the process, respondents reported reasonable access — 28 percent of the time — to information on a different EHR. The ability to locate records was “automatic or simple” a mere 13 percent of the time. Receipt and location of desired information within the clinician’s workflow via integrated display or EHR tab happened just 8 percent of the time.

“We learned that challenges related to effective sharing, especially with a different EHR vendor than your own, are experienced across all facility types and across all vendors,” observed Bob Cash, vice president of provider relations at KLAS.

Nonetheless, Cash expressed optimism that vendors and providers would work through the identified challenges, with the current results serving as a baseline for tracking progress in coming years.

A forward-looking approach

While vendors and providers continue to ramp up interoperability efforts among individual systems, NetDirector has already established expertise in EHR integration, delivering data through a cloud-based exchange. And since NetDirector’s HealthData Exchange uses HL7 standards, it can enable information exchange not only with EHRs but also with practice management systems, lab information systems, health information exchanges, PACS and radiology information systems.

Hospitals and physician practices have engaged with NetDirector to reduce the time, cost and effort involved with EHR integration. What’s more, the technology streamlines clinical workflow, an essential component of ongoing interoperability initiatives across the industry.

For more information, contact NetDirector or request a free demo.

New Transaction Type: Invoice Status Request/Response

Transaction Spotlight: Fees and Costs Request

Additional Events for a Variety of Servicers

Update – Ocwen/Equator Transition

We have additional updates regarding the Ocwen/Equator transition, as the transition from Ocwen to Equator continues to move forward.

The process of creating the data integration is well underway with NetDirector and Equator. Currently, we are providing the integration with foreclosure files only.

Due to the upcoming and current changes, this integration piece should replace the previous Intelligent Data Agents (IDA) method used for the cut over. If your firm is still using the IDA method, contact your integration analyst about how to transition to the new integration.

Available integrations and specific updates include:

  • Bankruptcy Referrals (IDA Process)
    • Bankruptcy Orders, Motion for Relief, Proof of Claim, Notice of Payment Claim, Notice of Final Cure, Reorganization Plan, Supplmemental Proof of Claim
  • Foreclosure Referrals (Data Integration)
    • Finalizing the implementation process
  • Standard Events/Deliverables (Data Integration)
    • Will be for Foreclosure Orders only
    • These events will require documents to be uploaded as part of deliverable
  • Document Uploads (IDA Process, planning to move to data integration)
    • Done through Equator (formerly ResWare®)
  • Invoice Import (IDA Process)
    • Still done through REALRemit®

If you have any questions about the transition, please contact your integration analyst.

HealthCare Cloud Computing Before It Was Cool

Like its atmospheric modifier, cloud computing comes together in boundless shapes and sizes. Some say it’s a simple feat — accessing and storing data and programs over the Internet instead of on a hard drive — but a mind-boggling combination of data processing, synchronization, communication, and protection takes place beyond the individual user’s confines.

In any case, it’s big business, with public cloud companies projected to stake out an estimated $500 billion in market cap by 2020. “The depth and breadth of cloud progress is pretty shocking,” investor Byron Deeter of Bessemer Venture Partners told Forbes.

That’s a long way from the roots of the dot-com era, when Application Server Providers (ASPs) connected people via the Web to software hosted in offsite data centers, and thereby offered businesses a viable alternative to buying hardware and hiring people to manage it. Still, the drawbacks at the time — sluggish connections and sky-high ASP operations costs — kept traditionally late-adopter industries like healthcare mostly on the ground rather than in the cloud.

Healthcare’s ascent

As recently as 2014 only about 22 percent of healthcare organizations surveyed by HIMSS Analytics were planning to use cloud computing for back-office functions. In 2016, nearly 47 percent of respondents have cloud usage in their back-office plans. The same holds true for business continuity/ disaster recovery functions and health information exchange: the former rising from 31 percent in 2014 to 47 percent in 2016, and the latter from 20 to 41 percent.

“In 2014, the cloud was primarily seen as a model that could support HIE and data storage, whereas, in 2016, it is being leveraged for a full range of functions including patient empowerment,” according to the survey report.

Indeed, healthcare entities cite the following factors (in order of importance) in their move to the cloud:

  • Cost savings
  • More complete disaster recovery capabilities
  • More scalability for internal requirements
  • Speed of deployment
  • Improved user access to applications
  • Plans to scale information and virtual care to patients
  • Freeing up internal storage/compute cycles
  • Accommodation of mobile workforce
  • Regulatory compliance
  • Accessibility to compute cycles

Another way to say it is that core health IT components, such as electronic health record (EHR) systems, cannot be at risk for downtime with vital patient care considerations hanging in the balance. With technologies coalescing in the background, tens of thousands of EHR users across multiple vendor platforms now use the cloud daily with complete trust.

Additional “hot spot” cloud applications in healthcare continue to emerge in the areas of telemedicine, medical imaging, public health and patient self-management, hospital management, therapeutic interventions, and secondary use of data for analysis and clinical research.

In response, cloud service providers “need to ensure uptime and performance, deliver on compliance and service level agreements, and offer reliable technical support,” the HIMSS Analytics report states.

NetDirector, one of the originators of the cloud-based integration platform, has built its healthcare business by ensuring the movement of clinical records between providers, helping them achieve a safer and more efficient level of care. The company’s HealthData Exchange combines cloud-based technology with world-class security levels to enhance workflow — which, in turn, allows providers to focus on patient care.

Learn more about the further emergence of cloud-based healthcare data integration or request a free demo.