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Healthcare Integration: Expectation vs Reality

Competition among providers can drive greater healthcare value; however, in reality, the industry has been moving in the opposite direction — toward consolidation.

There were 90 hospital and health system mergers/ acquisitions during 2018, with average seller revenue reaching a historic high of $409 million, according to advisory firm Kaufman Hall, which has been tracking such metrics over the past decade.

“Health system leaders are seeking to acquire organizations that bring embedded expertise and resources to the deal, making these transactions more of a strategic partnership than an asset acquisition,” reports Kaufman Hall.

Integration’s Role

In many cases, strategic consolidation rides on a quest for improved information-sharing made possible by establishing a common electronic health record (EHR) system among M&A partners. As the theory goes, “EHR integration could [lower] operating costs by reducing redundant IT staffing and achieving economies of scale in costly ongoing system maintenance,” states a newly published Health Affairs study. What’s more, integration can help narrow information gaps as patients move across diverse care delivery sites.

Nonetheless, actual experience in the field paints a different picture. The Health Affairs research, based on American Hospital Association data, finds that of 88 hospitals acquired between 2012 and 2014, only one-third switched to the EHR system of the acquiring organization, while 44 percent remained on a different EHR.

“Our results suggest that one important avenue by which consolidation may result in lower-cost, higher quality care is not routinely occurring,” the study authors write. “This should be cause for continued concern that many acquired hospitals may not deliver on their promised benefits.”

Integration Headwinds

Healthcare organizations transitioning to a new EHR often run into difficulties when the old system’s data is stored in a proprietary format that can’t be deployed without first being converted into a standardized structure. To make matters worse, “outgoing” EHR vendors sometimes take weeks or months to carry out a required data conversion.

“If your patient records are not provided in a format that makes them fully accessible in your new EHR, healthcare professionals may be unable to rely on clinical decision support tools … [for functions such as] automated drug interaction checking and allergy reminders,” The Office of the National Coordinator for Health Information Technology (ONC) warns. “Further, if data is not provided in an appropriate format, you will incur the time and costs associated with converting the data to a usable format.”

Additionally, integrations can fall victim to other problems such as:

  • failing to get practical input from key system users during planning and implementation;
  • understaffing the process of extracting, moving, manipulating and repopulating large data volumes;
  • moving duplicate or obsolete data into the new system;
  • not moving all relevant documentation into the new system; and
  • choosing incomplete patient data instead of validated, real-world scripts for end-user testing.

Tightening Up Integration with the Right Approach

Despite inherent challenges, integration will continue to be a core element in healthcare’s pursuit of value-based care and operational excellence. That’s why it’s so important for healthcare providers to choose the right integration partner and methodology.

NetDirector specializes in automated integration for entities across the healthcare ecosystem, from physician practices to hospitals and health systems and affiliated facilities such as labs and radiology clinics. Our team of dedicated professionals can assess individual requirements and map out a cost-effective and efficient plan for successful integration.

To learn more about NetDirector’s cloud-based data exchange and integration platform and additional services, please contact us or request a free demo.

Interoperability Captures Spotlight at HIMSS19

Interoperability Captures Spotlight at HIMSS19

HIMSS19, health IT’s most expansive conference, kicked off on Feb. 11 with the release of a new Centers for Medicare and Medicaid Services (CMS) proposed policy rule detailing the agency’s vision for advancing industry-wide interoperability and patient access to health information.

“We believe patients should have the ability to move from health plan to health plan, provider to provider, and have both their clinical and administrative information travel with them throughout their journey,” according to the rule’s statement of purpose.

CMS Administrator Seema Verma’s public comments during the meeting added depth and clarity: “We are promoting scalable data sharing, not just an individual patient record from hospital-to-hospital, but a model that supports the flow of information across the entire healthcare system. We encourage industry to align in this direction because this is the future.”

Practical Application

The CMS proposed rule would give patients access to their health information electronically through an application programming interface (API). At the same time, providers could obtain their patients’ health information, regardless of previous sites of care. On the flip side, providers would not be able to restrict information flow to other providers and payers. Additionally, CMS expects payers and third parties to develop software that would ensure seamless data availability when patients change providers, health plans or issuers.

The rule’s timeline is aggressive. CMS stipulated that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in federally facilitated insurance exchanges must be equipped to give enrollees immediate electronic access to claims and other health information by 2020.

Concurrent with the CMS rulemaking, the Office of the National Coordinator for Health Information Technology (ONC), which guides national efforts on health IT implementation/ usage and electronic information exchange, unveiled its own rule on data blocking. The ONC rule implements provisions spelled out by law in the 21st Century Cures Act, which Congress passed in 2016. The rule also provides exceptions to the law’s definition of information blocking. Aside from potential fines (up to $1 million per instance) applicable to health information exchanges, providers or hospitals that block information would be publicly named by CMS.

ONC National Coordinator Donald Rucker, MD, a closing speaker at HIMSS19, told attendees that, in the final analysis, patients should be empowered to access their health data “through a [smartphone] app of their choice, at no additional cost.” Rucker added, “Patients should be able to attach their smartphone to the provider’s endpoint and get their medical data … That’s what modern technology allows.”

Open APIs required for deployment of data sharing under the proposed rules would be based on HL7’s FHIR standard.

Additional Considerations

While early reaction to the CMS/ONC rulemaking has been mostly positive, the American Hospital Association (AHA) opposes a requirement that providers electronically notify other providers when a patient is discharged or moved to another hospital. “We cannot support including electronic event notification as a condition for participation for Medicare and Medicaid,” according to a prepared AHA statement. “We believe that CMS already has better levers to ensure the exchange of appropriate health information for patients. We recommend the agency focus on building this exchange infrastructure rather than layering additional requirements on hospitals,” the statement concluded.

Privacy and security considerations should also be factored into the mix during the 60-day public-comment period for the CMS and ONC rules. Cybersecurity executive Mac McMillan noted, “[The agencies] said, ‘We want you to be more open, but you still have to protect the data.’ Typically, those two things don’t go hand-in-hand … Folks are going to be very concerned they are on the hook for any downstream incidents that occur as a result of openness they have with third-party developers.”

Ahead of the Curve

NetDirector’s HealthData Exchange platform aligns well with the regulatory landscape inherent in the CMS and ONC rulemaking. In short, interoperability’s focus should be on the patient.

HealthData Exchange allows providers and vendors to electronically move clinical and financial data among disparate information systems while adhering to HIPAA and HL7 compliance standards. Less time spent on technology and inputting data frees up providers to deliver an improved patient experience by integrating information flow throughout the continuum of care.

To learn more about NetDirector’s HealthData Exchange platform, please contact us or request a free demo.

 

 

 

 

 

 

 

 

 

 

NetDirector Teams with DocPanel to Provide Rapid Integration and Data Consistency for Radiology Reads and Reports

From PRNewswire:

Tampa, FL – December 13, 2018 – NetDirector, a cloud-based data exchange, and integration platform, has expanded their healthcare data-trading ecosystem by partnering with DocPanel, a digital community of highly-skilled subspecialty radiologists who provide radiology interpretations for both healthcare providers and patients.

With a shared vision founded on providing exceptional patient care and leveraging technology to increase interoperability in healthcare organizations, DocPanel and NetDirector have moved forward with their partnership to increase the ease of deployment and level of integration available to both DocPanel, and the healthcare providers that they engage with.

DocPanel’s network of over 300 board-certified, highly distinguished radiologists across 41 states and academic institutions provide unparalleled specialization. NetDirector’s cloud-based integration-platform-as-a-service (iPaaS) model will make specialty care more rapidly accessible and easier to leverage for the providers who are directly servicing the patients by handling the complex integrations and variety of systems that are ubiquitous in the world of modern-day medical imaging data.

“DocPanel was built to make it possible for imaging providers to receive the best possible radiology interpretations available, no matter where they are,” states Cate Lloyd, COO of DocPanel. “By partnering with NetDirector, together we will make that world-class service easier to access and more cost-effective and interoperable for both the initial provider and the participating radiologist, ensuring sustainability and availability for all participants,” she continued.

DocPanel is initially utilizing NetDirector’s HealthData Exchange to receive digital orders from customers and return diagnostic results back to its ecosystem of Imaging Centers. NetDirector allows them to fast-track onboarding of new trading partners and significantly reduce IT resource overhead to maintain a multitude of data interfaces. They are also looking to potentially expand services by utilizing NetDirector’s new DICOM image converter to automate the inclusion of PDFs to DICOM directly into the radiologist’s reading protocols and eliminate on-premise licensed software.

Additionally, NetDirector’s new Health Data Monitor (HDM) makes the whole integration environment easier to monitor and maintain compliance than ever before. Network participants are notified of delays or connectivity concerns in real time through the HDM dashboard and can respond as needed or engage with their dedicated integration analyst who are domain experts in healthcare workflow and integration technologies.

“Partnering with DocPanel is very exciting – they are at the forefront of their industry, much like we are,” said Harry Beisswenger, CEO of NetDirector. “Being able to provide a strong and secure integration solution, while simultaneously reducing costs, ensures that the amazing services provided by DocPanel’s team of radiologists can be accessed in a simple and straight-forward way.”

About NetDirector:

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 10 million transactions per month.

About DocPanel

DocPanel is the world’s first subspecialty radiologist marketplace bringing together the largest network of fellowship-trained radiologists across every major subspecialty into one single online platform. DocPanel’s subspecialty radiologists offer final reads and educational consultations to imaging centers and radiology groups, and second opinions to clients and patients across the United States and the world. The company offers a new flexible and customizable model of subspecialty radiology to help overcome challenges related to errors, high costs, staff shortages and more.

Why Interoperability Still Matters

When HIMSS asked hospital leaders to rate their most pressing 2018 concerns, “Health Information Exchange, Interoperability and Data Integration” ranked a rather middling 13th out of 24 total IT priorities. On a scale of 1 to 7, where 1 meant “not a priority” and 7 designated an “essential priority,” respondents gave interoperability a group score of 4.85.

Consider that outcome against the top 5 priorities among hospital respondents:

  1. Patient Safety 6.07
  2. Privacy, Security and Cybersecurity 5.90
  3. Process Improvement, Workflow, Change Management 5.70
  4. Data Analytics/Clinical and Business Intelligence 5.50
  5. Clinical Informatics and Clinician Engagement 5.50

Compared to 2017, “Leadership, Governance, Strategic Planning” and “Connected Health and Telehealth” jumped ahead of “Health Information Exchange, Interoperability and Data Integration” in this year’s priority ranking.

Nonetheless, the HIMSS survey findings shouldn’t be construed to mean that interoperability has fallen off the boardroom table as a point of emphasis. Instead, the onus for achieving interoperability may be shifting from internal IT departments to collaborative colleagues in the commercial health IT sector. In fact, vendors and consultants surveyed by HIMSS rated interoperability as their 2nd highest current priority, with a mean score of 5.60.

One key aspect of what’s in play here is that 75 percent of hospitals are dealing with 10+ disparate electronic health record (EHR) systems in use at affiliated practices, while only 2 percent of hospitals use a single vendor’s EHR.

Vendors will have to work toward agreement on interoperability standards, not only as it applies to their customers’ reimbursement under value-based payment models but also “because of consumer demand as things like Apple Health Records gain traction,” according to Blain Newton, executive vice president of HIMSS Analytics. He added, “You’re going to see consumer health apps that have been playing at the fringes now be able to plug into the mothership and pull data from it, add to it.”

A Milestone for Progress

Despite pending challenges, the future looks promising for emerging interoperability initiatives. In mid-November, Carequality and CommonWell Health Alliance, two of the nation’s largest interoperability communities, announced that mutually enabled healthcare providers would be able to connect and bilaterally exchange data via leading EHR vendors.

Approximately 80 percent of U.S. hospitals and ambulatory offices use EHR systems that are part of either Carequality or Commonwell, noted Micky Tripathi, CEO of the Massachusetts eHealth Collaborative. “Imagine a mobile wireless world where Verizon and AT&T weren’t connected—both networks provide great services to their own customers, but you couldn’t talk to anyone on the other network,” he explained. “This milestone is [on] that level of significance for interoperability.”

Further, providers who have already invested in integration know that it directly impacts interoperability. Technology that streamlines payment processing alleviates non-value-added time spent on documentation and processes required for maximized reimbursement.

A recent case study shows how front-end benefit verification enabled American Health Imaging (AHI) to reduce labor costs by about $480,000 annually through integration and automation on NetDirector’s cloud-based data exchange service.

Click here to read the entire AHI case study.

 

 

Cost Control Essential to Managing Healthcare IT

C-level executives at Boston’s Brigham and Women’s Hospital realized two years ago that the medical center needed to shed at least $50 million from its $2.6 billion annual spending budget.

“It was very clear we had to become a much leaner, more efficient organization,” said Ron Walls, the hospital’s chief operating officer.

The Harvard-affiliated facility’s financial crunch followed comparable actions taken by the Mayo Clinic, which was striving toward $1 billion in cost reductions over 10 years, and the Cleveland Clinic, which had pared expenses by $800 million over four years.

The IT Impact

Austerity initiatives tend to affect all aspects of hospital operations from staffing to supplies, and ultimately reach into IT planning and implementation. Consequently, healthcare CIOs should pursue digital transformation opportunities that deliver improved care without bumping up costs, according to IT research and advisory firm Gartner.

The path forward recommended by Gartner places priority in the following areas:

  • Collaborating with the chief financial officer and chief medical officer when designing IT solutions aimed at improving monetary and clinical outcomes. A pilot project addressing a specific use case can provide proof-of-concept for reigning in costs while promoting system adoption. If successful, the project can be scaled up across the organization.
  • Evaluating the organization’s ability to create and manage digital business architectures. Again, feedback from operational managers and clinical leaders should inform strategies needed to reach a state of real-time readiness.
  • Establishing key performance indicators to measure digital progress. Optimization efforts should be focused on delivering positive health outcomes for patients.
  • Assessing whether existing IT investments are being optimized. For example, is the electronic health record (EHR) system providing anticipated value to the organization? Gartner’s 2018 CIO Agenda Survey found that 80 percent of respondents felt their EHR had not yet delivered the intended return on investment, and 50 percent reported only moderate or minor returns.

A separate analysis of leading organizations from the College of Healthcare Information Management Executives (CHIME) reveals a number of shortfalls in the use of hospitals’ foundational technologies. To name a few: almost all physicians have access to the EHR system, but only half can access EHR resources using mobile applications; similarly, nearly all physicians can contribute to a Continuity of Care Document, but just 60 percent can consume discrete data from a home health agency or skilled nursing facility.

Similar imbalances exist in regard to what CHIME refers to as “transformational technologies” at organizations considered at the forefront of using IT to improve the delivery of care. Significantly, 76 percent can perform retroactive analysis for care improvement and cost reduction; however, only 43 percent can manage bundled payments or do real-time identification and tracking of value-based care conditions. Additionally, less than 60 percent use clinical and billing data as well as health information exchanges to identify gaps in care.

Overall, integration, interoperability, security and disaster recovery capabilities, along with technologies that support population health management, value-based care, patient engagement and telehealth “need to be in place for an organization to leverage tools to effectively transform healthcare,” the CHIME report stated.

NetDirector’s cloud-based document and data-exchange platform unifies clinical and billing data to help healthcare organizations drive down costs and improve patient outcomes. As such, HealthData Exchange can be an essential component of any IT cost-control or efficiency initiative by moving data among disparate systems among hospitals, labs, pharmacies, imaging centers, and government agencies while adhering to HIPAA security and HL7 compliance standards.

 

To learn more about NetDirector’s HealthData Exchange platform, please contact us or request a free demo.

No More Healthcare Faxes? Moving Away from the Fax and Legacy Technology

A few minutes into her address at the ONC Interoperability Forum in Washington on August 6, CMS Administrator Seema Verma let fly with an imposing order. “If I could challenge the developers in this room here today to achieve one mission, it would be this: Help us make every doctor’s office in America a fax-free zone by 2020,” Verma said.

That’s going to be a major test of innovation, diligence, and persistence. A 2017 poll conducted by IT website Spiceworks showed 89 percent of small- to medium-sized businesses still using some form of the fax. Further, separate research from International Data Corporation (IDC) found fax usage actually increased year-over-year for 82 percent of survey respondents. In the healthcare sector, fax usage expanded by 9 percent in 2017, IDC reported.

IDC’s study stated, “[Fax] remains a vital communication tool, is relied upon by businesses of all sizes and in all industries, and has an important role within organizations as they embrace digital transformation.” Significantly, such transformation will create value and competitive advantages for organizations that deploy cloud, mobility, data analytics and social technologies in evolving fax solutions.

So, it seems Verma’s directive wouldn’t literally eradicate fax technology from medical offices over the next few years. Instead, IDC predicts an increased presence of software- and cloud-based fax technology that can be integrated with enterprise applications through “secure, trackable and auditable information exchange.” The report adds, “Today’s digital fax server-based systems and cloud services eliminate the standalone fax machines of old and enable integration with users’ desktops, email, back-end applications, and multifunction peripherals.”

Perhaps most promising in IDC’s outlook: About 90 percent of fax users have already integrated or are evaluating the integration of fax with other technologies or applications.

Future of Fax

Faxing, in one form or another, will continue to be used by healthcare providers for years to come, according to Jonathan Coopersmith, the technology historian at Texas A&M University. Part of the support comes from doctors and hospital administrators who believe faxing is more secure than emailing for transmitting protected health information under HIPAA regulations.

At the same time, new generations of electronic faxes have become easier to use. “Faxing is a network technology,” Coopersmith points out. “The more people who use it, the more valuable it becomes.” Future iterations will likely incorporate electronic fax-like capabilities with smartphones, which would make the technology more readily accessible for on-the-go doctors and other caregivers.

And although physical fax machines retain a place in most U.S. emergency rooms, the devices will eventually be phased out, says Peter Alperin, MD, an internist and vice president of connectivity solutions at medical networking company Doximity. “Whether that’s a steep slope or a gradual one is hard to tell,” he comments.

Looking forward, as the design of electronic health record systems improves, data transfer should become increasingly simplified as a matter of course. For example, the 21st Century Cures Act requires EHR systems to exchange data in a way that requires “no special effort.” While that language has yet to be fully parsed, it provides guidance for a more integrated approach to what was formerly known as faxing.

NetDirector supports this vision now. The company’s integration options for healthcare make a digital paperless system much more complete and cost-efficient, from billing to record keeping to lab and imaging work.

To learn more about NetDirector’s cloud-based HealthData Exchange platform, please contact us or request a free demo.

Telehealth on the Rise Across Delivery and Payment Components

Momentum in key areas will drive telehealth to new heights in the coming years. Academic investigation confirms telehealth’s effectiveness, according to a review of 145 articles conducted earlier this year by the Agency for Healthcare Research and Quality. The study finds evidence that recognizes the advantages of telehealth, particularly for remote intensive care and specialty care consultations.

Aside from improving access to care and delivering clinical benefits, the technology is gaining additional traction in the form or emerging payment models and regulatory support, MobiHealthNews reports.

Doctors are onboard, too. “There’s no question that providers are embracing virtual care more than ever before,” says Jason Gorevic, CEO of telehealth trailblazer Teladoc.

“However, this is a case of ‘and’ not ‘or.’ This is additive because health plan, employer and consumer adoption are rapidly increasing,” Gorevic points out.

Developing Business Models

The most successful telemedicine providers “are those who shift their mindset from reimbursement to revenue,” observes the healthcare practice of law firm Foley and Lardner. Current examples include:

  • Academic medical centers with a surplus of specialist physicians contracting with rural hospitals or other sites of care to supply on-demand medical expertise through professional service agreements such as monthly retainers (as opposed to external fee-for-service reimbursement).
  • Telemedicine companies contracting with accountable care organizations (ACOs) to implement virtual care as a means for ACOs to realize quality and cost improvements, and thereby qualify for Medicare incentive payments.
  • Provider networks offering telemedicine-based care to employer workforces via varying compensation approaches, such as per-encounter fees, capitated per employee per month payments or shared-savings models.

In any of these pathways, there’s potential for cost savings through telehealth, as providers gain the ability to monitor patients remotely, identify symptoms before diseases get worse, and prevent expensive subsequent treatments.

Nonetheless, providers need to be proactive with their telehealth strategy, reports Health Data Management. That means reviewing and updating compliance programs, as well as billing, coding and documentation procedures and policies.

Integration in a Burgeoning Market

Venture capital funding for telehealth-focused companies nearly tripled between 2013 and 2016, according to an analysis conducted by Rock Health.

Meanwhile, the push is on to position telehealth as a low-cost alternative to hospital or physician office visits for non-emergency issues. An employer survey from Willis Towers Watson shows that offerings of telehealth services to employees rose from 64 percent of employers in 2016 to a projected 92 percent in 2018.

“Today, we focus on urgent care, but over time we will be able to focus on other things … [such as the] parts of patient care that are routine and can—and should—be done online,” comments Lyle Berkowitz, MD, the chief medical officer at MDLive. He predicts further emphasis on telehealth within routine care environments, helping set the stage for greater provider efficiency.

NetDirector agrees and also views telehealth as part of automated billing and payment processes. NetDirector can integrate telehealth options to EMR, billing or imaging systems, allowing telehealth to no longer be a standalone service, but a true end-to-end solution.

To find out more about NetDirector’s cloud-based HealthData Exchange platform, please contact us or request a free demo.

New VPN Network Monitoring Enhancements and Alerts

Monitoring that’s a cut above!

NetDirector is excited to announce an advanced VPN networking monitoring service that provides alerts and deep insight to help healthcare clients quickly identify and troubleshoot VPN issues and to ensure systems are running smoothly. This service provides:

Continuous Monitoring – NetDirector’s advanced VPN monitoring solution runs 24/7/365 gathering critical data about transactional and network performance that provides a quick insight into current & potential network and transactional anomalies.

The Complete Picture – Proactive alerts and insights are available when transactions are not being received or acknowledged by a targeted facility. Our VPN monitoring can help pinpoint where the issues are occurring, from NetDirector to the facility, including network layer.

Choose your Alert Delivery – Alerts can be delivered via email, text, or both.

Please contact your integration analyst if you’re interested!

NetDirector now offers real-time integration with the Tennessee Controlled Substance Reporting System

NetDirector, a cloud-based data exchange and integration platform, continues to solidify their presence as a leading provider of integration services. NetDirector has partnered with The Recovery Platform (TRP) to aid in the delivery of treatment for the growing opioid crisis around the country. NetDirector now offers direct integration with North Carolina and Tennessee Controlled Substance Reporting Databases.

TRP 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.

NetDirector’s cutting-edge integration technology allows healthcare providers to more accurately monitor their patients’ compliance. By providing an automated integration to Controlled Substance Databases, NetDirector helps prevent “doctor shopping” – a major contributor to the abuse of opioid recovery drugs that has hindered the opioid rehabilitation efforts in the past.

Interested in finding out more? Contact Harry Beisswenger at harry@netdirector.biz or by phone at 813-774-4797, or click here to request a demo.

Want to learn more about how NetDirector works? Take a look at our case study about American Health Imaging, who saved almost $500k per year by automating with NetDirector!

Organize and Automate your DDF Process with our New Toolkit

Looking for an easier way to implement Events and Dynamic Data Forms (DDFs) in Black Knight v2/v3?

NetDirector recently created an Event and DDF Helper Toolkit – the toolkit items are available to all NetDirector customers, including new implementations! Combined with the powerful automation options available through NetDirector, the DDF Helper can truly refine the Black Knight V2/V3 integration suite currently available.

This toolkit will help to identify various DDF’s and the critical information required for implementation. We’ll show you how to create and fill out our EventDDF spreadsheet with the help of the Black Knight DS1012 report, and how to use our Event DDF helper utility to streamline DDF implementation in your firm.

Interested in finding out more? Contact our National Account Manager Gretchen Borer at Gretchen@NetDirector.biz, or click here to contact us.