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We are excited to share about our new launch “Digital Health Management”, a Personalized Digital Care Ecosystem. 

Holistic, contextualized care that extends beyond the clinic… Do we have you intrigued?

Patient-centric Digital Health has never been so accessible!

With this launch, HealthViewX is providing smart, intuitive, and personalized 360 digital care ecosystems for over 70 plus disease conditions including

1)Diabetes 

2)Hypertension 

3)Pain 

4)Weight Management

5)Behavioral Health Management

Share a moment with us to know more about our solution, and how it can help your practice at https://www.healthviewx.com/digital-health-management/

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How to become a preferred health system for patients and referring physicians?

Healthcare technologies like telehealth, remote patient monitoring, referral management, etc., have simplified the process for health systems to deliver care for their patients. These advancements are uniquely qualified to help health systems attract patients to their facility and build their brand.  

So how do you become the preferred health system? What are the strategies behind becoming a preferred health system for your patients, and also for physicians referring patients to your health system?

Care coordination is the responsibility of any system of care and has the potential to transform healthcare delivery, improve the overall effectiveness, and efficiency of any health system. Thus, the key to becoming the preferred health system for patients is to have well-executed care coordination.

For effective care coordination, it is important to connect your entire physician community with specialists and make sure they work in unison to ensure your patients’ health needs are met and the required care is delivered.  

If care coordination is done in the right manner, it can improve health outcomes and patient experience along with the growth of the healthcare system. This way, patients, providers, and payers can get benefited. Though there are different definitions for care coordination, in the end all of them point to the same goal which is to become patients’ preferred care provider.  

Here are a few tips to become patients’ preferred health system

1. Connecting an entire network of physicians and specialists:

It is important to connect your entire set of physicians and specialists to provide quality care for each and every patient. HealthViewX end-to-end patient referral management connects your entire care network and helps you achieve this with ease.

2. Improve care coordination:

The major priority of all healthcare providers is to achieve care coordination and improve patient care but unfortunately, it still remains a challenge in the industry. The right coordinator may differ from patient to patient. Critical patient information should be readily available for all involved inpatient care. Improved care coordination results in better patient outcomes and patient satisfaction.

3. Effective communication channels and methods:

Software solutions that support upsurge communication and engagement among providers are still lacking. Manual processes (phone call, email, fax, etc.) can lead to fatigue and operational inefficiency. An end-to-end automated solution would help eliminate this challenge. One can improve the quality and continuity of care provided to patients by focusing on improving the transfer of patient information.

4. Gaining the trust of out-of-network providers/physicians:

PCPs prefer hospitals that are easy to work with. It is essential to build and maintain a strong referral base from out-of-network providers/physicians. Hospitals need to work to become a referral partner of choice for physicians and so creating a strong referral base with the referring physicians will pave the way to steady patient inflow. Hospitals should work to encourage out-of-network physicians to become more actively involved in patient care. Lack of communication can lead to poor patient health outcomes.

5. Closing the referral loop:

Planned integration of patient care between providers will help attain better service. As health systems grow more complicated, it is essential to close the referral loop for patient record and safety. The goal of referral loop closure is to track and support patients when they obtain services outside the practice. Closing the referral loop is one of the ways to become a preferred provider.

Health systems need to adopt new healthcare technologies that have the potential to improve patient care and satisfaction. One such technology that health services need to implement is patient referral management. The present referral management is complex, and coordinating care is hard for the health systems. Navigating the healthcare system or care set-ups can be tiring for patients too. Poor coordination can result in reduced quality of care, higher readmission rates, increased no-show rates, referral leakage, and higher cost of care. Better care coordination may result in more satisfied patients.

End-to-end referral tracking and follow-up is a must for effective patient care. Patient Referral Management is one such solution that can solve major challenges faced by health systems in their referral process.

Schedule a demo with HealthViewX Referral Management Solution experts today!

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2021 CPT Codes by the CMS for Medicare Extension Care Management Programs

Chronic Care Management:

The chronic care management program was virtually untouched by the 2021 Final Rule from CMS. There are three main CPT codes and two add-on CPT codes in 2021 that may be billed by primary care providers for CCM services.

Requirements for CCM:

Non-Complex CCM:

Two or more chronic conditions expected to last at least 12 months (or until the death of the patient)

Patient consent (verbal or signed)

Personalized care plan in a certified EHR and a copy provided to the patient

24/7 patient access to a member of the care team for urgent needs

Enhanced non-face-to-face communication between patient and care team

Management of care transitions

At least 20 minutes of clinical staff time per calendar month spent on non-face-to-face CCM services directed by a physician or other qualified healthcare professional

CCM services provided by a physician or other qualified healthcare professional are reported using CPT code 99491 and require at least 30 minutes of personal time spent in care management activities

Complex CCM:

Shares common required service elements with CCM but has different requirements for:

Amount of clinical staff service time provided (at least 60 minutes)

The complexity of medical decision-making involved (moderate to high complexity)

CPT Reimbursement Codes for CCM Service:

Non-complex CCM:

CPT Code 99490– This code requires that patients must have two or more chronic conditions, as well as documented consent to enroll in the program AND receive at least 20 minutes of CCM services from clinical staff within a given month. A personalized care plan, which shows an assessment of all patient factors and identifies gaps and barriers to be addressed, is also required. Reimbursement Rates – CPT Code 99490 – $42/patient/month.

CPT Code 99439 (formerly  G2058) -This code allows providers to bill for each additional 20 minutes spent for Basic CCM services in a given month, up to 2 times. For example, if CCM services were provided for at least 40 minutes with a patient in a given month that was not Complex, 99490 ($42) and 99439 ($38) would be billed together for that month. Reimbursement Rates – CPT Code 99439 (formerly  G2058) – $38/patient/month.

Complex CCM:

CPT code 99487– This code has a higher rate of reimbursement than the Basic CCM CPT code. To bill using this code requires moderate or high complexity in medical decision making AND acknowledgment by both patient & provider of an acute exacerbation (generally defined as a sudden worsening of a patient’s condition that necessitates additional time and resources). The patient must receive at least 60 minutes of services from clinical staff within a given month to bill for this code. Reimbursement Rates – CPT Code 99487 – $93/patient/month.

CPT code 99489 – The same as with the Basic Chronic Care Management code, the Complex Chronic Care Management code also has an add-on CPT code to cover time spent beyond 60 minutes. It allows for billing for each additional 30 minutes spent for Complex CCM services within a given month. Reimbursement Rates – CPT Code 99489 – $45/patient/month.

Transitional Care Management:

Transitional Care Management (TCM) services address the hand-off period between the inpatient and community settings. After a hospitalization or other inpatient facility stay (e.g., in a skilled nursing facility), the patient may be dealing with a medical crisis, new diagnosis, or change in medication therapy. Family physicians often manage their patients’ transitional care.

Requirements for TCM:

Contact the beneficiary or caregiver within two business days following a discharge. The contact may be via the telephone, email, or a face-to-face visit. Attempts to communicate should continue after the first two attempts in the required business days until successful.

Conduct a follow-up visit within 7 or 14 days of discharge, depending on the complexity of medical decision-making involved. The face-to-face visit is part of the TCM service and should not be reported separately.

Medicine reconciliation and management must be furnished no later than the date of the face-to-face visit.

Obtain and review discharge information.

Review the need for diagnostic tests/treatments and/or follow up on pending diagnostic tests/treatments.

Educate the beneficiary, family member, caregiver, and/or guardian.

Establish or reestablish referrals with community providers and services, if necessary.

Assist in scheduling follow-up visits with providers and services, if necessary.

CPT Reimbursement Codes for TCM Service:

CPT code 99495 – moderate medical complexity requiring a face-to-face visit within 14 days of discharge. Reimbursement  rate – $175.76/patient/month.

CPT code 99496 – high medical complexity requiring a face-to-face visit within seven days of discharge. Reimbursement  rate – $237.11/patient/month.

Allowed reported services alongside TCM services include,

Prolonged services without direct patient contact (99358-99359);

Home and outpatient international normalized ratio (INR) monitoring (93792-93793);

End-stage renal disease (ESRD) services for patients ages 20 years and older (90960-90962, 90966, or 90970);

Interpretation of physiological data (99091); and

Care plan oversight (G0181-G0182).

Remote Patient Monitoring:

RPM involves the collection and analysis of patient physiologic data that are used to develop and manage a treatment plan related to a chronic and/or acute health illness or condition.

Requirements for RPM:

To qualify for CMS reimbursements for utilizing the RPM services efficiently, the service providers and hospitals need to ensure the following:

Medicare part B patients are imposed 20% of copayment (renouncing the copayments regularly can trigger penalties under the Federal Civil Monetary Penalties Law and also the Anti-Kickback Statute)

Patients must take the remote monitoring services and are required to monitor for a minimum of 16 days to be applicable for a billing period.

The RPM services must be ordered by skilled physicians or other qualified healthcare experts.

Data must be wirelessly synced for proper evaluation, analysis, and treatment.

CPT Reimbursement Codes for RPM Service:

CPT code 99453 – It is a one-time practice expense reimbursing for the setup and patient education on RPM equipment. This code covers the initial setup of devices, training and education on the use of monitoring equipment, and any services needed to enroll the patient on-site. Reimbursement  rate – $18.77/patient/month.

CPT code 99454 – This code covers the supply and provisioning of devices used for RPM programs, and the code is billable only once in a 30-day billing period. Reimbursement  rate – $64.44/patient/month.

CPT code 99457 – This code covers the direct monthly expense for the remote monitoring of physiologic data as part of the patient’s treatment management services. To receive reimbursement, the physician, QHP or other clinical staff must provide RPM treatment management services for at least 20 minutes per month. Reimbursement  rate – $51.61 (non-facility); $32.84 (facility) /patient/month.

CPT code 99458 – This code is an add-on code for CPT Code 99457 and cannot be billed as a standalone code. This code can be utilized for each additional 20 minutes of remote monitoring and treatment management services provided. Reimbursement  rate – $42.22 (non-facility); $32.84 (facility) /patient/month.

Principal Care Management:

PCM codes are intended to cover services for patients with only one complex chronic condition that requires management by a specialist. Like other chronic care management (CCM) codes (chronic care management, transitional care management), the PCM codes are intended to reimburse physicians for the additional work they do to take care of high-risk, complex patients. This includes the extra time and work required for medication adjustments, creating a care plan, patient follow-up, and more.

Requirements for PCM:

One complex chronic condition lasting at least 3 months, which is the focus of the care plan,

The condition is of sufficient severity to place the patient at risk of hospitalization or has been the cause of recent hospitalization,

The condition requires development or revision of a disease-specific care plan,

The condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities

CPT Reimbursement Codes for PCM Service:

CPT Code G2064 – requires 30 minutes of provider (allergist, NP, PA) time each calendar month to care for the patient. This code can be billed monthly (in addition to appropriate E/M codes) and approximate reimbursement is $52/patient/month.

CPT Code G2065 –  requires 30 minutes of clinical staff time directed by a provider each calendar month for patient care. Provider supervision does not require the provider to be onsite while clinical staff performs PCM services. This code can be billed monthly (in addition to appropriate E/M codes) and approximate reimbursement is $22/patient/month.

Annual Wellness Visit:

The Annual Wellness Visit (AWV) is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Keep in mind that the AWV is not a head-to-toe physical.

Requirements for AWV:

For G0438 (initial visit),

Billable for the first AWV only.

The patient must not have received an IPPE within the past 12 months.

Administer a Health Risk Assessment (HRA) that includes, at a minimum: demographic data, self-assessment of health status, psychosocial and behavioral risks, and activities of daily living (ADLs), instrumental ADLs including but not limited to shopping, housekeeping, managing own medications, and handling finances.

Establish the patient’s medical and family history.

Establish a list of current physicians and providers that are regularly involved in the medical care of the patient.

Obtain blood pressure, height, weight, body mass index or waist circumference, and other measurements, as deemed appropriate.

Assess a patient’s cognitive function.

Review risk factors for depression, including current or past experiences with depression or mood disorders.

Review patient’s functional ability and safety based on direct observation, or the use of appropriate screening questions.

Establish a written screening schedule for the individual, such as a checklist for the next 5 to 10 years based on appropriate recommendations.

Establish a list of risk factors and conditions for primary, secondary, or tertiary intervention.

Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.

At the patient’s discretion, furnish advance care planning services.

Patients are eligible after the first 12 months of Medicare coverage.

For services within the first 12 months, conduct the Initial Preventive Physical Exam (IPPE), also referred to as the Welcome to Medicare Visit (G0402).

For G0439 (subsequent visit),

Billable for subsequent AWV.

The patient cannot have had a prior AWV in the past 12 months.

Update the HRA.

Update the patient’s medical and family history.

Update the current physicians and providers that are regularly involved in providing the medical care to the patient, as developed during the initial AWV.

Obtain blood pressure, weight (or waist circumference, if appropriate), and other measurements, as deemed appropriate.

Assess a patient’s cognitive function.

Update the written screening schedule checklist established in the initial AWV.

Update the list of risk factors and conditions for which primary, secondary, and tertiary interventions are recommended or underway.

Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.

At the patient’s discretion, the subsequent AWV may also include advance care planning services.

CPT Reimbursement Codes for AWV Service:

The four CPT codes used to report AWV services are,

G0402 Initial Preventive Physical Exam – This code is used for patients visiting within 12 months after enrolling in Medicare.

G0438 Initial Visit – This visit is eligible within 11 calendar months from the date of IPPE.

G0439 Subsequent Visit – This code is used for every subsequent visit. Patients are eligible for this benefit every year after their Initial AWV.

CPT 99497/99498 – Patients are eligible for an Advance Care Planning (ACP) at any time. But if performed during an AWV, the patient has no copay.

Behavioral Health Integration:

Integrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for millions of Americans with behavioral health conditions. Medicare makes separate payments to physicians and non-physician practitioners for BHI services they furnish to beneficiaries over a calendar month service period.

Requirements for BHI:

Any mental or behavioral health condition being treated by the billing practitioner, including substance use disorders, that, in the clinical judgment of the billing practitioner, warrants BHI services.

The diagnosis or diagnoses could be either pre-existing or made by the billing practitioner and may be refined over time.

CPT Reimbursement Codes for BHI Service:

The CPT code used to report BHI services is,

CPT Code 99494 – Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified healthcare professional.

References:

https://signallamphealth.com/2021-medicare-cms-chronic-care-management-ccm-cpt-code-updates/

https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-1

https://college.acaai.org/new-principal-care-management-cpt-codes/#:~:text=G2064%20requires%2030%20minutes%20of,is%20%2452%2Fpatient%2Fmonth

https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/transitional-care-management.htm

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/BehavioralHealthIntegration.pdf

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CMS’s Journey To Value-Based Care

Most people think of CMS (Centers for Medicare & Medicaid Services) as an insurance company that covers individual services provided by physicians, FQHCs, hospitals, and other health care providers. Some people even think of it as a policy-writing agency for Medicare. It is true that CMS reimburses providers for services to millions of individual beneficiaries. However, since the Affordable Care Act came into action in 2010, CMS has been developing focused payment strategies that shift from fee for services to value-based care and a focus on population health.

Today, CMS’s second-highest strategic priority is prevention and population health. To this day, the agency is engaged in numerous activities to promote effective prevention of chronic diseases and not just its treatment.

In 2011, the federal government reported that fewer than half of all adults aged 65+ were regular in checking the core set of recommended preventive services. The Affordable Care Act took a big step towards improving the access to preventive care by eliminating out-of-pocket costs for these preventive services in most insurance markets. This resulted in guaranteed access to preventive services like diabetes screening and cervical cancer screening to almost 137 Million Americans without cost-sharing.

Despite improved access to care, the use of preventive services among seniors with traditional Medicare coverage has not changed significantly. There are several hindrances that inhibit the greater uptake of preventive services. A 2014 survey reveals that only 43% of adults were aware of the new clinical preventive benefits provided by the Affordable Care Act. Of those who were aware of the services, 18% cited cost as a barrier, even though the Affordable Care Act eliminated co-payments for preventive services.

Another obstacle is that many Americans believe that preventive services are not important. Thus, even though many cost barriers have been removed, many Americans still might not perceive preventive services as valuable to their health and well-being. This mindset needs to change.

Shifting the paradigm of preventive care requires CMS and other payers to provide incentives beyond individual services to broader value-based and lifestyle interventions that can change population outcomes. To address this issue, CMMI has developed 2 payment models:

(1) The Million Hearts Cardiovascular Risk Reduction Model:

This model associates payment with population-based risk reduction. It is expected to reach over 3.3 million Medicare fee-for-service beneficiaries and involve nearly 20,000 health care practitioners by December 2021.

(2) The Medicare Diabetes Prevention Program:

This program ties payments to the achievement of weight loss through evidence-based lifestyle intervention.

CMS collaborated with sister agencies such as the Centers for Disease Control and Prevention (CDC) to develop these population health models, and they are good examples of how CMMI is using the Medicare payment structure to improve prevention and population health.

These path-breaking innovations offer an opportunity for CMS to test payment models that emphasize payment for population health outcomes rather than just individual outcomes, with the goal of better care and a healthier population.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5298510/#bibr11-0033354916681508

https://innovation.cms.gov/innovation-models/million-hearts-cvdrrm#:~:text=The%20Million%20Hearts%C2%AE%3A%20CVD%20Risk%20Reduction%20Model%20is%20expected,and%20end%20by%20December%202021

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CMS expands Telehealth Services to Deliver Care Safely during COVID-19 and Beyond

During the COVID-19 pandemic, CMS has taken the necessary steps to make it easier to provide quality care through telehealth services. This unprecedented action by CMS has encouraged healthcare providers to adopt and use telehealth as a way to safely provide care to their patients in situations like medication consultation, eye exams, nutrition counseling, behavioral health counseling, and routine health check-ups like annual wellness visits. Past data have shown telehealth to be an effective medium for patients to access healthcare providers especially for managing chronic conditions like diabetes, asthma or to obtain mental health counseling.

Advantages of CMS changes to Telehealth:

Telehealth services made permanent post-COVID-19:

CMS has announced that 60 of the 144 telehealth services that were newly offered during the pandemic will become permanent. This includes services for cognitive assessment, psychological and neuropsychological testing, and custodial care services for established patients.

They have also finalized the decision that direct supervision in telehealth visits can be provided with interactive audio and video technology through the end of the year until December 2021.

CPT Codes explained at https://www.healthviewx.com/cms-expands-telehealth-services-to-deliver-care-safely-during-covid-19/

The ongoing pandemic has resulted in an increased workload for healthcare providers across the country. Incorporating telehealth software into an existing practice can allow providers to virtually connect with patients. This can relieve the strain on practice while introducing an additional revenue stream.

HealthViewX Telehealth/Telemedicine Platform helps health systems to align clinical, financial, and operational goals by providing high-quality remote care and enhancing patient-physician collaborations.

References: https://www.beckershospitalreview.com/telehealth/cms-adds-85-more-medicare-services-covered-under-telehealth.html

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Increasing Patient Retention and Revenue with Referral Management

The ratio between the number of dentists and the population in the USA is 61:100000. More than one in five (21.3%) said that they had not visited the dentist in the last few years. One of the top reasons adults cite for avoiding the dentist is the inability to find a convenient location or appointment time. Specifically, 19% of adults had not visited the dentist in a few years because they cannot find a convenient location or appointment time. As a dentist or dental practice manager, it is crucial to not just manage existing patients but to account for lost opportunity and plan to improve patient experience, especially with appointment schedule and completion. This will result in an increase in the number of patients visiting dental centers.

Dental centers/groups can begin by leveraging technology to manage the patient referral workflow. Inbound patient referrals having dental issues usually have accompanying ailments such as diabetes or accidental injuries. A seamless experience from appointment scheduling to treatment completion will positively impact patient satisfaction and the volume of inbound patient referrals.

Existing Patient Referral Management Workflow in a Dental Center

Did you know? In a year, 15 billion faxes are sent out with patient referral information in the USA. Practices receive referrals through fax, online forms, direct messaging, email, virtual print, direct walk-ins, and other channels. A typical dental center or dental group is a high inbound referral setup. Dental centers receive large volumes of referrals weekly (ranging from 50 per week to even several hundred per week) depending on the number of patients visiting the center and the number of clinics sending referrals to them. An effective referral management solution will help manage small or big volumes of referrals by reducing manual tasks and using automation and structure where possible.

Dental centers usually have a dedicated team of referral coordinators who receive, accept, and process the referral requests. These referral coordinators manually key in the necessary details into an EMR/ EHR system and create a referral. The time spent by a referral coordinator in a completely manual process can be reduced by using technology. Productivity and efficiency are increased by introducing technology to aid the process. It results in piling up requests that are not yet processed. When the referral coordinator does not have the required information to process the referral, he has to contact the referring provider. This further incurs time and results in a slow referral processing rate. This, in turn, has a negative impact on patient experience. Hence, patient referral leakage also becomes imminent.

Consequences of a Slow Referral Network

Revenue loss is a direct result of the untimely processing of referrals

Providers stop referring to the center thereby harming its reputation

Waiting times and appointment scheduling process affects patients requiring critical and          immediate attention

Challenges Faced by a Dental Center

Multiple Referral Channels: For the specialist/imaging center that receives referrals, face more difficulties than the referring provider. They receive referrals through various channels like fax, email, direct message, website, user-filled forms, etc. Managing and tracking all of it manually is a tedious task. The chances of missing out on a referral are high.

Appointment Scheduling and Patient No-Show Rates: After receiving the referral, the specialist/imaging center schedules appointments with the patient. In some cases, the patients are not notified clearly about the appointment. When patients do not show up, it is difficult for the specialist/imaging center to track. It results in revenue loss and patient dissatisfaction.

Let us review a typical referral process to elaborate on the challenges faced by the dental centers.

Patient Visits the PCP

Andrews met with an accident recently. He met his PCP, Dr. John, immediately as he was experiencing pain in his jaw. After examining him, Dr. John wanted him to consult a dentist. The doctor then initiated the referral.

PCP Initiates the Referral

John created a referral in his EMR. He did not have time to do the insurance pre-authorization so he left it to Andrews. He then found a dentist and gave him referral information verbally. Now when he met the specialist, Andrews had to again elaborate on his condition and problems to him. This is time-consuming for the specialist as he wastes time on the same information twice.

Specialist Requires More Information

The specialist, Dr. James, is a famous dentist in the locality. After receiving the referral, he schedules an appointment with Andrews. After the appointment, Dr. James wants more information about the patient’s history and diagnostic reports. Now, he has to wait for the PCP, Dr. John, to send him the relevant information.

No Tracking System for Referrals

As Dr. James is a famous dentist in the locality, he receives numerous referrals in a day. There is no tracking system for him to know how many referrals he received, how many were processed, in what status each referral is in, etc. So it is difficult for Dr. James to understand the analytics of his specialty.

Overcome your challenges with HealthViewX Patient Referral Management Solution:

With a Referral Management solution like HealthViewX, you can eliminate all your challenges and achieve referral loop closures in an efficient way. Here are some of the key features that will help you transform your referral process:

Multi-Channel Referral Consolidation

The HealthViewX solution can capture fax, phone, email, online form referrals or any other referrals in a single interface. It makes it easy to monitor and manage all channels of referrals in a single queue.

Patient Coordination Framework

After finding the receiving provider, the referral coordinator refers the patient. When the receiving provider receives the referral, the provider will get notified of the referral. Even the patient will be notified of the referral. The receiving provider can schedule appointments based on the patient’s comfort. This will cut down patient no-show rates.

Referral Tracking

HealthViewX gives a clear picture of how a referral has progressed with the help of a timeline view. Every referral has a status that conveys in which stage the referral is in. With the help of a customizable dashboard, the exact number of referrals waiting to be processed can be identified easily.

New Referral Channel

HealthViewX Referral Management solution supports a new channel for sending and receiving referrals. This is called the desktop application. Sources like email, website, direct message, fax, etc are not secure and difficult to handle. On the other hand, desktop applications are a secure source for sending and receiving referrals. Also, documents can be attached and sent as a referral.

Referral Data Consolidation

It has options for printing the consolidated data about the referrals and the referral history of any patient as a hard copy at any time in pdf/excel.

Secure Data Management

HealthViewX Patient Referral Management is HIPAA compliant. It manages all patient-related documents securely.

Referral Analytics

Helps in tracking the number of referrals and gives complete information about the referrals processed, missed, scheduled, etc. with the help of a Referral Data-centric Dashboard.

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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How to reduce referral leakage in large hospitals?

For many large enterprise hospitals, referral leakage may amount to millions of dollars in lost revenue. Patient referrals are an important revenue generator for hospitals and losing patients to other providers can cost these hospitals upto 20 percent of their revenue. Dissatisfaction with the current referral process is widespread and every patient seeking care elsewhere is now, and potentially in the future a lost revenue opportunity for the hospitals.

Signs of an underperforming referral management system that results in referral leakage:

Inability to get complete information to process referrals at one go:

Communicating complete patient information at the time of specialty referral is crucial for high-quality consultation and coordinated patient care. The inability to get complete information leads to patient dissatisfaction, delay in processing referrals and referral leakage.  

Difficulty in finding the right provider within the network:

One of the major causes of patient referral leakage is difficulty in finding the right specialist within the network. Nearly half of the physicians surveyed said they have trouble determining who is in-network. Physicians could avoid referring out-of-network if they had information about all in-network providers.

More time spent in processing each referral:

On average referral coordinators take 15-20 minutes or sometimes more to process each referral on the receiving end just for checking missing patient information. The staff time spent coordinating referrals and their visits is tedious and time-consuming.

High patient no-show rates

and referral leakage:

Patient no-show rates or missed appointments cost the U.S. health systems more than $150 billion a year. Lack of quality care and coordination among care stakeholders leads to higher no-show rates or referral leakage, due to which patient experience takes a big hit.

Manual communication and tracking systems:

Manual processes like insurance preauthorization, checking for missed patient information, etc are time-consuming Such time-consuming and cumbersome manual processes may lead to patient dissatisfaction.

Lack of referral analytics for informed decision making:

Lack of data of the referrals flowing in and out of the network affects decision making. Referral analytics gives comprehensive data on the number of patients with various referral status.

The ability to significantly improve the effectiveness of the referral process lies in the referral process standardization and technological capabilities.

Here’s how to reduce referral leakage

Standardization of processes:

Inconsistency in the patient referral process between the referring provider and the receiving provider is common. Right from obtaining prior authorization, finding the right specialist for the patient, collecting the required information for the referral, coordinating for patient appointments, etc. large hospitals are often challenged throughout the process. Hospitals need to streamline their referral workflow to achieve efficiency and have standard workflows and processes to streamline the end-to-end referral process. Achieving this efficiency in the referral process requires well-defined workflows.

Technology solution and capabilities:

Despite having an approach to monitoring and managing patient referrals, existing systems are often unable to simplify referral workflows to effectively manage the end-to-end referral process. Right from tracking authorization status, scheduling appointments, calculating referral conversion rates, staff productivity, etc. all are challenging in the current referral process. A referral solution that is efficient, technologically advanced, and has the capability to automate the end-to-end referral process is the need today. Connecting the information to objectives, understanding the workflow to obtain the information, and most importantly getting the data analytics for informed decision making will be more valuable.

Referral Management Solution – A worthwhile investment

A focused referral management process has the potential to maximize utilization, standardize processes, and enable streamlined workflows. Hospitals need to invest in solutions that will reduce referral leakage and increase patient volumes.

HealthViewX Patient Referral Management solution has features that best suit a hospitals’ Referral Management System.  A 30-minute demo with our team will help you understand how effective our solution can track and manage the referral life cycle.

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Five Ways To Reduce Patient Referral Leakage In Hospitals And Health Systems

Hospitals and health systems know that referrals are critical for their business, and failing to manage referrals efficiently can result in loss of revenue. Healthcare providers are losing more than 20% of revenue to patients going out-of-network for care. Most of these hospitals and health systems do not know why and where referral leakage occurs.

It’s only within the past few years healthcare leaders see patient referral leakage as a major issue, and fixing it is their high priority – Missed appointments alone cost the US healthcare system $150 billion annually. Healthcare organizations do not have a solution in place to monitor, track, and report patient referral leakage. They use their electronic health records to monitor and track referral leakage rather than having specific solutions, but healthcare leaders are not happy about how their EHR performs in this particular area.

Today, most hospitals and health systems leverage technology to prevent revenue leakage due to inefficient referral process. Tracking patient referral leakage through a referral solution gives them a complete view of their end-to-end referral process.  Technology helps providers enhance care delivery, improve patient outcomes and use of data, and support collaborative workflows.

Here are five ways to reduce patient leakage:

Understand their referral patterns so far:

Organizations should analyze past data to understand their referral patterns. By tracking the right metrics they will not only gain valuable business acumen but also understand how the hospital is performing. Hospitals today use EHR to get this data but it is not streamlined enough to crunch all the data in a logical and meaningful way.

Improve care-coordination:

Effective and efficient communication is crucial in healthcare. Patients need to receive the right level of care from their care providers. It is important to communicate effectively with all who are actively involved in patient care.

Proceed with a data-driven approach:

A data-driven approach will have a sustainable competitive advantage over those who haven’t. The right way to make decisions is by looking at the data. Understand where the leakage is happening and if it is addressable. Health systems/ Hospitals need to use a data-driven approach to guide patient referrals to the best care option available within the network. Such an approach will help meet both the patients’ and hospital needs.

Use prognostic modeling to know the implications of future referral patterns:

Organizations need to understand how fixing referral patterns today may change future referral patterns by using predictive modeling. It’s essential to analyze how these alterations will impact patient flow, care delivery and coordination with referring providers and payers.

Include it as strategic precedence and discuss at the executive level:

Patient leakage more often gets lost among other priorities at the executive level. Organizations need to make patient referral leakage a strategic priority. Top management should drive change and ensure necessary steps are taken to address this challenge.  

Tracking and understanding referral patterns will help the large hospitals streamline and manage high- overall performance referral networks, decrease patient leakage and notably impact care quality.

HealthViewX Patient Referral Management Solution smoothens the referral process and solves most operational challenges for Large Enterprise Hospitals. Do you want to know more about HealthViewX HIPAA-compliant Patient Referral Management Solution? Schedule a demo now!

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Improving Patient Care Through Technology Orchestration

As healthcare shifts towards a more patient-centric approach, health providers across the world are looking for innovative ways to enhance the patient care journey. The infusion of software solutions into the healthcare industry has helped providers improve the overall patient experience. One of these solutions is Care Orchestration, a method that uses Information Technology (IT) to improve the care journey. Care Orchestration can be defined as the coordination of many complex computer systems, servers, and applications in a way that enhances the care journey. In a clinical setting, Orchestration allows for a simplification of patient workflows and an overall improvement in efficiency. Care Orchestration helps healthcare providers streamline their existing care journey by identifying and addressing their current inefficiencies.

Care Orchestration and Value-Based Care

Care Orchestration is an instrumental asset for health systems that seek to adopt a value-based outlook. This system is a polar opposite from the traditional fee-for-service view as value-based care rewards health systems that can improve patient experiences and outcomes. Orchestration allows clinics to achieve this by streamlining the entire patient workflow. Patients are not met with any unwanted obstacles at any point in their care journey. The data processing efficiency of orchestration tools increases the speed at which physicians can treat and diagnose patients.

How Artificial Intelligence works with Orchestration

Artificial Intelligence (AI) has become increasingly popular as a reliable solution for modern health tech issues. AI is well known for its operational efficiency thanks to its command of complex human attributes such as comprehension, interpretation, and analysis. It becomes quite evident that AI and Orchestration are similar concepts by reviewing their capabilities. In fact, many health systems employ a software system that uses AI and Orchestration together. The difference between these concepts lies in the scale of their abilities. AI is generally used for replacing human services by introducing automation for individual tasks. This is in contrast with Orchestration which generally involves coordination of complex, multi-step procedures. Using AI and Orchestration together results in an automated workflow that requires little human input. This partnership is extremely efficient due to the ability of AI to process millions of data points in a matter of seconds. Orchestration is also quite productive as it allows AI to automate over a series of procedures rather than just one action.

Benefits of Orchestration

The introduction of Orchestration into a clinical setting has brought many positive results for both care providers and patients. Here are some of the primary benefits:

Smoother Care Journey: Having a straightforward care journey greatly benefits patients as their once tiresome and time-consuming clinical visits are now simple and convenient. By displaying command of complex methods, Orchestration ensures that there are no gaps in the care journey. Patients are expedited through the care journey in an efficient manner, enhancing the patient outcomes and improving the overall experience.

Increased Operational Efficiency: Care Orchestration helps health systems simplify their workflow processes while maximizing the available resources. Effective orchestration performs tasks such as data organization in a fraction of the time that humans would take. This means Clinical staff can perform their duties more effectively while also gaining the ability to spend more time with patients.

Increased Profits: Another operational benefit of Orchestration is its ability to positively impact a clinic’s bottom line. The aforementioned efficiency allows clinics to expand their capacity and serve more patients. This allows for an increase in revenue without compromising on quality of care. Clinics are simultaneously able to lower their costs as orchestration prevents expensive rifts in operation such as referral leakage.

Care Orchestration is extremely powerful with the potential to transform health systems across the country. The extensive multi-faceted approach in improving the experience of both patients and care providers separates orchestration from other IT solutions.

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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The Evolution Of The Health Tech: Positive Change Through Interoperable Solutions

The American Healthcare Industry has experienced many large-scale changes in the past few decades. This timeframe has afforded us many drastic reforms in the industry such as the Affordable Care Act (ACA) or the widespread shift towards Value-Based Care. However, the most noteworthy and significant change is the gradual adoption of software solutions into the healthcare industry. The digitization of healthcare has brought numerous benefits to healthcare organizations that are able to streamline their day-to-day operations. More importantly, these solutions have made life easier for care providers and patients by simplifying the delivery of care. In order for these complex systems to operate, they need to display competency in Interoperability.

How Interoperability Ties It All Together

Interoperability in the context of healthcare refers to the use of many complex systems and information technology (IT) to exchange and interpret health-based data. As many software systems were designed for specific tasks, the transfer of data between different systems emerged as a significant challenge. Interoperability allowed for different computer systems that operate on different platforms to interact with each other. This gave health organizations the ability to employ multiple systems for their varying needs. At the foundational level, interoperability is present in roughly 75% of health systems in the US. The incorporation of more advanced levels allows organizations to expand the scale of their services.

How Technology is Combatting COVID-19

The COVID-19 Pandemic has proved to be a challenging obstacle for the healthcare industry. While the pandemic continues to test the industry’s existing abilities, the prevalence of computer systems currently in use have helped in the fight to control COVID-19. The use of virtual health services has skyrocketed since the outbreak as clinics across the country shift their focus to COVID-19. Patients are able to access health services like routine check-ups from their tablet or computer. The significance of this service is that it ensures patients with chronic conditions can receive medical services without the risk of being infected with COVID-19. It also helps clinics establish stable cash flow and make up for revenue shortfall due to the pandemic.

Examples of Interoperable Health Tech Solutions:

Telehealth

Telehealth involves the transfer of healthcare services through a telecommunications platform. While the primary use of telehealth is for virtual conferencing between patients and physicians, it is also used for monitoring and educating patients. The most popular form of telehealth is video conferencing where patients and physicians can perform most tasks required in a typical check-up. According to the American Hospital Organization (AHA), 3 out of every 4 hospitals offer some form of telehealth service. Telehealth has proven to be a valuable tool in the fight against COVID-19, while also eliminating long wait times and nonessential clinical visits. Telehealth must be interoperable with other platforms in order to share Electronic Health Records (EMR). Reviewing these records is crucial for physicians who are deciding the next course of action for a patient.

Remote Patient Monitoring

Remote Physiological Monitoring (RPM) uses real-time technology to collect vital parameters such as heart rate, blood pressure, weight, or any other relevant health-based measure. These devices are worn by patients to track the parameters of their health while simultaneously sending the results to a qualified health professional. This professional can analyze the information and intervene if there is any abnormal data. These gadgets have been extremely helpful for chronic care patients who can avoid the hassle of regular clinical visits. Clinics who effectively use these devices can significantly reduce the number of readmissions, which costs the industry over $41 billion a year. Interoperability is crucial in the RPM care delivery as data must be transferred from the patient’s device to the health system without any errors.

Workflow and Referral Management

The goal of Workflow Management is to streamline the patient workflow by eliminating inefficiencies in the process. Tech solutions such as Smart Rooming help nurses room the patient and transfer the responsibility of care in a time-efficient manner. Referral Management is also an extremely crucial part of clinical operations. Referral Leakage, which occurs when a patient’s Referral loop is not closed, costs the industry millions of dollars a year. Interoperable platforms would transfer information from the physician to the specialist in a timely manner and without any gaps.

Artificial Intelligence and Machine Learning

While still extremely developmental in nature Artificial Intelligence (AI) and Machine Learning (ML) provide a glimpse into the future of healthcare. AI and ML both use machines to perform human activities such as comprehension, interpretation, and analysis. Despite a limited role, they are both currently used for routine activities like streamlining workflows, patient education, diagnosis, and predictive analysis. AI/ML can help health tech innovators attain interoperability by assisting computer systems in receiving and analyzing data.

Primary Benefits

The influx of interoperable systems has revolutionized the healthcare industry. Listed below are the main benefits of these solutions.

Improved Patient Experience: One of the main focuses of these innovative software solutions was to improve the overall experience of patients. The introduction of Telehealth and RPM increases access to healthcare for all patients. Tools such as AI and ML are life-saving as they quickly and accurately diagnose conditions.

Simplifying the Care Journey: In the traditional Care Journey, patients may have to spend an entire day in a clinic while physicians shuttle back and forth to tend to them. Software Solutions have streamlined this process by assisting clinics with scheduling, rooming, and diagnosis. Nurses, Physicians, and Clinical staff can allocate their time more efficiently, resulting in a smoother Care Journey for patients.

Optimal Operational Efficiency: Health Organizations are able to maximize the use of their resources thanks to health tech solutions. Using tools like Referral Management and Care Orchestration allows organizations to streamline patient workflows. This helps them serve more patients without having to expand or increase costs.

Increased Profit: Perhaps the greatest benefit for organizations is the ability to increase clinical profits. Efficient software solutions help organizations identify and eliminate inefficient practices. At the same time, solutions like RPM provide additional revenue streams for clinics with little additional cost. While Interoperable solutions may incur an initial cost, effective development and use of the product will have a positive impact in the long run.

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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How Patient Rooming Checklists Streamline the Patient Care Journey

Patient Rooming is the process where nurses greet and familiarize patients with their clinical surroundings before transitioning the responsibility of care to physicians or other health professionals. It is an integral part of the care journey as patients can address any pressing concerns before their doctor or specialist arrives. Despite this, many clinics fail to maximize the patient experience of the rooming process. Long wait times, inefficient use of staff, and the lack of centralized patient records are the primary issues that clinics face when rooming patients. Smart Rooming Checklists can prevent these issues by simplifying the rooming process for patients and nurses.

What are Smart Rooming Checklists?

Smart Rooming Checklists remind Medical Assistants to perform important tasks related to the Rooming of each patient. They contain three sections: Pre-Rooming, Rooming, and the Handoff. Pre-Rooming involves any preparation work that assistants must take part in before the patient arrives. Rooming is the most important section as it requires assistants to greet patients and address any concerns. Finally, the Handoff is when the assistant briefs the physician on any important information in relation to the patient. Each of these sections contains many subsections that detail individual tasks that the assistant is responsible for.  

Pre-Rooming Preparation

The first section of the checklist is the Pre-Rooming preparation. This part involves any tasks that the medical assistant would need to perform before meeting with the patient. The medical assistant would start off by Reviewing the Patient’s Medical History. This helps the assistant understand their existing conditions and treatment plan. After this, assistants would review the patient’s recent test/screening results. To finish off the preparation, assistants would take note of any additional relevant information. This could include feedback from past visits. The objective of pre-visit preparation is for assistants to be proactive about the questions or concerns the patients may have. By planning for these in advance, assistants can save time and generate better responses while rooming the patient. Once this section of the checklist is complete, the assistant can approach the patient and begin the formal rooming process.

Rooming

The Rooming section is the most important portion of the checklist as it highlights the tasks that must be completed when interacting with the patient. To maximize rooming efficiency, assistants must ensure that the time from Patient Introduction to the Handoff is minimized without compromising on quality. Assistants can refer to their pre-visit research to streamline this process. Here are the common steps involved in Patient Rooming:

Patient Introduction: Greet the patient in the waiting room and lead them to the appointment room. Ensure that you are engaging with the patient in a warm and welcoming fashion.

Inquire About Appointment Objective: In a kind and compassionate manner, inquire about the patient’s objective of the appointment. Understand why they are there and what they seek to accomplish from the visit. Identify the most high-priority health concerns.

Update Health Records: Add any new conditions or symptoms to the patient’s health record. Be sure that any recent tests or screenings have been indicated on the record.  

Address Patient Questions: Encourage patients to be open about any concerns they have about their treatment or condition. Inform the physician of any questions that are relevant to the appointment.

Conduct Patient Screening: Screen the patient using standard protocol to determine any tests or procedures that they will need to undergo. Prepare the patient for any tests that the physician will be performing and if necessary provide them with the appropriate protective gear.

The Handoff

The Handoff occurs when the responsibility of care is transferred from the assistant to the physician. This occurs directly after the Rooming process is complete. Just before the handoff, assistants must take note of the most important takeaways from the Preparation and Rooming process. This can include reaction to treatment, recent test results, or any new concerns. They must then articulate this to the physician in a very direct and brief manner. Once the Handoff is complete, the rooming process is officially over.

Why are Checklists Important?

Smart Rooming checklists can help medical assistants perform their everyday activities in a more efficient manner. By tracking every step of the rooming process, assistants can make sure they don’t forget important tasks. Using this guide will also help them tend to patients faster, which in turn means the clinic can serve more patients and maximize revenue.  

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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Why Interoperability is Crucial in Healthcare Operations

Healthcare Interoperability involves the use of many complex systems and information technology (IT) to exchange and interpret health-based data. It has been a key aspect of the extensive shift towards computerizing the healthcare industry. As of 2019, a fundamental level of interoperability has been achieved by roughly 75% of healthcare providers in the US. The ability to transfer data from one health system to another becomes quite challenging when acknowledging the differences in technological platforms. The main objective of Interoperability is to ensure a smooth exchange of data across various systems.

Interoperability and COVID-19

The COVID-19 Pandemic has exposed the need for better interoperability in the healthcare industry. The Pandemic has resulted in a significant uptick in the transfer of patient data. This data is crucial for public health officials as it includes testing results, pre-existing conditions, and potential hotspots. Interoperability would allow county and state officials to identify and assist clinics with shortages in essential resources like staff, beds, or ventilators. Without a clean exchange, lots of patient data could slip through the cracks, leaving public officials and health administrators with inaccurate or insufficient information. The inability to make well-informed decisions could impede health officials from containing the spread of the virus. This data must also be shared between clinics, health systems, and insurance providers to determine the scale and responsibility of payment. The lack of a robustly interoperable platform could cost millions to both healthcare organizations and their patients.

Despite exposing a weakness with existing practices, the Pandemic could actually be beneficial for the future of healthcare interoperability. COVID-19 has allowed healthcare providers to address the inefficiencies that plague their existing practices. Many health organizations across the country are fast-tracking the rate at which they establish interoperable systems. By adapting on the run, these providers are positioning themselves for optimal performance during the pandemic while investing in their long-term sustainability.

Levels of Interoperability

Different health systems possess varying levels of interoperability that depend on their size, scale, and complexity.  

Foundational Interoperability: The most basic level involves a health system that can send and receive data from another system. It is ideal for smaller systems that need basic interoperability functions.

Structural Interoperability: An intermediate level which allows health systems to exchange data and interpret information with certain limitations. This level is useful for systems that are expanding.

Semantic Interoperability: The most complex level where data can be exchanged across multiple platforms and interpreted without limitations. This level is ideal for large health systems with complex and multidimensional data transfers.

Key Benefits

Emphasis on Efficiency

Interoperability allows organizations to prioritize operational efficiency. The speed at which providers and patients can access Electronic Health Records (EHRs) greatly cuts down on the time spent on each patient without compromising on quality. This allows providers to care for more patients and increase clinical revenue. Easily accessible health records also let health professionals understand the patient before they even meet. Care providers can anticipate the issues the patient might be having and prepare a treatment plan ahead of time. Most notably, Interoperability decreases the burden on Administrative staff by streamlining the data exchange process.

Enhanced Patient Experience

Patients can expect higher quality care due to a faster and more insightful care journey. Digitizing the care journey eliminates unnecessary paperwork which is inconvenient for patients and time consuming for staff. In the case of referrals, the emergence of EHRs helps smoothen the transition of care between physicians and specialists. With a comprehensive summary of the patient’s health history, care providers are able to treat and diagnose patients with greater efficiency.

Deeper Understanding of Healthcare

Healthcare Interoperability involves large amounts of valuable health-related data which can be extremely useful in multiple ways. Patient data can help scientists and researchers understand more about general and demographic health trends. In a pandemic situation, this data can be used to create an organized and systematic response which increases the likelihood of containment. In addition, patient data can be used in the trial stages of potential vaccines. From a holistic standpoint, interoperability can help public health officials gain insight into the condition of the industry.  

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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Innovative RPM Developments that will revolutionize Care Delivery

The efficiency and effectiveness of Remote Physiological Monitoring (RPM) has allowed it to emerge as a popular practice in the healthcare industry. RPM has greatly increased the accessibility of healthcare, especially for chronic care patients. It has also allowed care providers to increase their revenue through the CPT reimbursement codes. The industry shift towards a patient-centric, Value-Based Model has allowed for sustained growth for RPM devices in the market. The current innovations in RPM devices have the opportunity to reshape the overall Patient experience.

How COVID-19 is accelerating RPM growth

The COVID-19 Pandemic has expedited the large-scale adoption of RPM. As health centers across the world focus on treating COVID-19, patients with other conditions have been encouraged or instructed to avoid health facilities. This has caused a large deficiency in the transfer of care. This disproportionately affects small clinics that need periodic cash flow and chronic care patients who require frequent clinic visits. RPM devices allow patients to bypass the restrictions by monitoring their health conditions from home. These machines help patients and providers stay up to date with their care plan progress. It also allows clinics to recover some of their lost revenue due to the pandemic. Moving forward, it appears that RPM will increasingly become an integral part of care delivery.

Robot Assistants

The prospect of robotic devices has long been entertained in the healthcare industry. Developments in Artificial Intelligence (AI) and Machine Learning (ML) in the past decade have made a future with these devices more realistic. Acting as a personal assistant to long-term patients is one way that robots could make their way into mainstream healthcare. Many patients with chronic conditions require periodic monitoring and extended hospital stays. Robot Assistants could track the vitals of the patients and input the results into the patient’s Electronic Health Record (EHR). These machines would be especially beneficial to patients at rural or undermanned health clinics. It is at such places where Robot Assistants would significantly enhance the quality of care without replacing a human. A significant issue associated with Robot assistants are liability/legal concerns. Should any issues arise while the patient is under the robot’s care, it is unclear who would be responsible.

Remote Surgery Robots

A more complicated manner in which Robots can enter the industry is through Remote Surgery. These machines can assist surgeons by simplifying complex procedures in ways that are not humanly possible. For example, they can use AI or ML to improve the accuracy of existing practices. Another benefit of Remote Surgery is the opportunity for long-distance procedures. An advanced Remote Surgery Robot could allow for a surgeon to perform on a patient thousands of miles away. The primary hurdle facing Robot devices involve high development and operational costs. Both the software and hardware of these machines are extremely intricate in nature. If this concern is addressed, Robots could become a cornerstone of modern healthcare.

Wearable Devices

Wearable RPM devices are already in common use by chronic care patients across the country. In a more loosely defined manner, fitness and smartwatches can also be considered as they perform many similar tasks as a medical RPM device. In this sense, over 20% of Americans already use one of these wearable devices. The main reason wearable RPM devices have yet to take off is the lack of multi-use devices. While a smartwatch has multiple functions, many medical RPM devices have very specific uses. This causes many patients to shy away from making a financial commitment to these products. An example of how this issue can be solved is exemplified in DexCom’s partnership with Apple. DexCom is using the Apple Watch as a platform for people to access their Glucose monitoring products. By using an established, multi-dimensional platform, DexCom is able to generate a larger outreach. A breakthrough in wearable RPM devices would greatly benefit patients with diabetes or cardiovascular issues. A device that they could wear around the clock would provide medical professionals with the data to better understand their condition.

Future of RPM

The RPM market has significant potential for growth in the upcoming decades. The shift towards a more patient-centric focus has resulted in a positive outlook for future RPM development. Advancements in the overall quality and scale of RPM devices can transform the Patient Care Journey of tomorrow.

Schedule a demo and talk to our RPM solution experts and get your RPM started in a jiffy!

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Improving Patient Experience through Patient Smart Rooming

The Traditional Patient Care Journey is an inherently time and resource inefficient process. Many patients dread clinical visits due to long and uncomfortable wait times. For clinics, this improper use of staff and money results in increased costs and lost revenue. However, a centralized planning system that streamlines the patient workflow could transform the Care Journey. This is where Patient Smart Rooming can emerge as an efficient tool for streamlining the patient journey. Before diving into this innovative solution, it is important to understand the Patient Rooming process.

Pre-Visit Preparation

Before engaging with the patient, it is important for the medical assistant to understand more about them. Medical Assistants can use a pre-visit checklist to prepare for the appointment by learning more about the patient’s medical history. Assistants should review the patients’ current condition, treatment plan, and feedback from past visits. Previous test/screening results should be readily available for the physician to observe. Ensure that any age or condition-specific tests, screenings, and immunizations are up to date.

By preparing for the patient prior to the visits, medical assistants can be proactive about what they may be facing during the rooming process. They better anticipate any patient questions/concerns and prepare accordingly. This also allows them to share any glaring concerns with the patient and physician. A Pre-Visit checklist can also save time by identifying areas of concern before the patient even arrives. After completing this checklist, the assistant can approach the patient and begin the rooming process.

Patient Rooming Tasks

Efficient Patient Rooming requires the medical assistant to perform a variety of tasks. Here are the common steps involved in Patient Rooming:

Patient Introduction: Greet the patient in the waiting room and lead them to the appointment room. Ensure that you are engaging with the patient in a warm and welcoming fashion.

Inquire About Appointment Objective: In a kind and compassionate manner, inquire about the patient’s objective of the appointment. Understand why they are there and what they seek to accomplish from the visit. Identify the most high-priority health concerns.

Update Health Records: Add any new conditions or symptoms to the patient’s health record. Be sure that any recent tests or screenings have been indicated on the record.  

Address Patient Questions: Encourage patients to be open about any concerns they have about their treatment or condition. Inform the physician of any questions that are relevant to the appointment.

Conduct Patient Screening: Screen the patient using standard protocol to determine any tests or procedures that they will need to undergo. Prepare the patient for any tests that the physician will be performing and if necessary provide them with the appropriate protective gear.

Briefing The Physician: After collecting all the required details from the patient, be able to summarize this information to the physician. Highlight any glaring issues from the health record or any urgent patient concerns.

The Rooming process ends when the Medical Assistant transfers the responsibility of care to the physician. An efficient exchange of care means minimizing time without compromising on the quality of care.

Characteristics of Patient Smart Rooming

Patient Smart Rooming has risen from the increasing acceptance of Value-Based Care. This shift emphasizes the importance of patient outcomes as opposed to the purely profit-based “fee-for-service” outlook. Patient Smart Rooming can increase the convenience of care and subsequently enhance patient satisfaction.

Centralized Platform: An all-inclusive software platform that has relevant data at readily available.

Pre-Visit Checklist: Acts as a guide for what Medical Assistants should cover in the rooming process.

Access to EMR/EHR: Informs the Assistants about the patient’s existing conditions or previous tests/procedures.

How Patient Smart Rooming Streamlines the Care Journey

Due to the many different steps involved, Patient Rooming is often a long and tedious process for both patients and care providers. HealthViewX’s Patient Smart Rooming software provides clinics the opportunity to digitize the entire care journey. By utilizing a centralized software, care providers can access any important patient information on one platform. This tool also allows clinics to track valuable data like wait/rooming times or availability of assistants. This allows clinics to identify inefficiencies in their practice by tracking every step of the patient journey.

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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Could AI Transform the Way Healthcare Operates?

Artificial Intelligence (AI) involves the use of machines to perform human activities such as comprehension, interpretation, and analysis. AI has been an emerging force in all computerized fields and has gained significant attention amongst health tech innovators in the past few years. While AI remains heavily experimental, the results have been extremely promising with regard to the future potential of AI-based procedures. The prospects of AI-related technology have the opportunity to transform the future of healthcare delivery.

Current Status of AI in Healthcare

AI is still in the early stages of development in the health tech industry and it has yet to fully penetrate the market. However, AI investment is projected to grow from $600 million to $6.6 billion between 2014 and 2021, indicative of the large and growing demand for such services. AI is already used by many health systems for everyday activities such as streamlining workflows, patient education, diagnosis, and predictive analysis. Including these practices has helped clinics save millions of dollars and serve patients more efficiently. Thanks to the rapid growth of AI, the healthcare industry will experience an influx of innovative techniques to help solve modern healthcare problems.

Machine Learning in Healthcare

Machine Learning (ML) is a method within AI in which machines are given the opportunity to learn through experience rather than constant programming. In essence, this trains machines to think like humans and learn from practical examples. Areas of healthcare where ML is already prevalent include data collection, diagnosis, and clinical trials. This method is being experimented in the health industry due to the abundance of data needed to make informed decisions. ML can allow computers to process millions of data points in just seconds, resulting in a faster and more efficient result. In the future, effective use of ML could hold the key to vaccine development and cancer treatment. One hurdle ML faces is that it would need large-scale testing in order to become readily available for use in all areas of healthcare. This is due to ML being rooted in experience-based learning rather than rigid programming.

Precision Medicine

Precision Medicine involves diagnosis and treatment plans that are specialized to the individual patient. This method greatly differs from traditional diagnosis and treatment as it analyzes millions of relevant variables to produce a patient-specific care plan. AI/ML-based machines can analyze more variables than humans could in a fraction of the time. One intriguing aspect of this technique is Whole-Genome Sequencing, which involves the analysis and discovery of an individual’s entire DNA sequence. AI/ML makes this technique possible by simplifying an extremely complex process. Ultimately, a streamlined version of Precision Medicine can shift healthcare away from standardization and towards personalized care. Like many AI techniques, Precision Medicine is highly developmental and will likely require large financial investments. Additionally, this method is quite controversial as it is still unproven and involves information about patients’ DNA.

Robotics

Robots are a clear example of how AI could be put into practice in the near future. Many large or high-budget clinics already employ the use of robotic machines. These instruments can carry out different tasks depending on their design. During the COVID-19 Pandemic, robots are being used to direct patients within a health facility to eliminate the risk of patient to care provider transmission. They have proven to be very effective in guiding patients when a human is unavailable. In a non-Pandemic context, robots would be useful in rural or undermanned health clinics, where similar situations could arise. Robotic AI machines could also be used for long term care patients who need daily monitoring and reminders related to their treatment. One area where Robotic-based AI can drastically reduce discrepancies in rural health accessibility is through Remote Treatment. Robotic devices could allow doctors to operate on patients without being physically present. The incorporation of Virtual/Augmented Reality devices could help with both clinical training as well as virtual appointments. The main obstacle associated with robots is that providers must make a significant financial commitment. This will subsequently make healthcare costlier for all parties involved, including patients and the Federal Government.

Artificial Intelligence is opening the door for more efficient and accessible health care. The astronomical increase in AI investment proves the effectiveness of new developmental methods. If the industry is able to address the remaining financial obstacles, we can experience AI leading the healthcare industry into the future.

Talk to us to understand more about the advancements in the healthcare industry and we will guide you to achieve our common goal “Quality Care for All” seamlessly.

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How COVID-19 is changing the Healthcare Industry

The COVID-19 Pandemic has greatly challenged the existing capabilities of the Healthcare Industry. The rapid spread of the virus has brought the world to a standstill and has health leaders scrambling to find new approaches to healthcare. Despite the obstacles that have been thrust upon the industry, the prospect of technological advancement gives the healthcare industry an opportunity for accelerated growth.

Short-Term Impacts of COVID-19

One of the main consequences of the Pandemic has been undermanned or under-equipped health staff. The intensity of the virus has left many clinics with less than the required resources to help COVID patients. Another related issue faced mainly by urban health clinics is Hospital Overcrowding. Non-COVID related patients will also see delays in their care journeys. The healthcare industry must also prepare for the following long-term impacts of the COVID-19 Pandemic.

Increasing Role of Virtual Health services

The pandemic has revealed the importance of virtual health care services such as Telehealth and Remote Physiological Monitoring (RPM). The contagious nature of COVID-19 has forced many clinics to close their doors to non-COVID patients. Without virtual care technology, many patients with chronic or other severe conditions would lose access to essential healthcare. In addition, clinics would be losing a significant portion of their revenue. However, providers who utilize a virtual telemedicine platform are still able to connect with their patients. As of 2017, some form of Telemedicine platform is employed by over three-quarters of hospitals in the US. The pandemic will cause that number to increase while encouraging existing users of telehealth to make their platforms more extensive.

Eliminating the Traditional Care Journey

The emergence of telemedicine has allowed for the virtual exchange of high-quality health services. By using virtual technology, physicians are able to provide check-ups, patient education, and care plans. Patients can access these services from the comfort of their homes. This new development due to the pandemic has brought into question the future of traditional clinical visits. Hassle-free telemedicine solutions have exposed the inefficiencies of conventional care journeys. Previously, patients might waste an entire day for a simple check-up due to long wait times and large clinical facilities. In the end, they may not even receive conclusive treatment if they are referred to another practice. These inefficiencies contribute to a high patient no-show rate, which costs the American healthcare industry over $150 billion/year. Convenient telemedicine platforms remind patients ahead of their appointments and provide them with effective and timely care.

Altering the future of Value-Based Care

While the “Value-Based Care” movement has been gaining momentum for a few decades, the COVID-19 pandemic might slow down the shift. The decrease in elective surgeries and non-COVID related care has been financially crippling for many practices. While RPM and Telehealth reimbursement codes cover for some of these losses, clinics are still seeing a decline in revenue due to the pandemic. The deal-breaker for most clinics involves the financial risk involved in a Value-Based model. Many Value-Based contracts involve a great deal of downside risk, or potential financial shortcomings due to missed targets. This financial risk may have over half of Accountable Care Organizations (ACO) consider abandoning this model. This may also encourage current fee-for-service providers to avoid adopting a Value-Based platform in the future. In order to mitigate a large-scale exodus from the Value-Based scheme, the CMS could subsidize providers by removing downside risk clauses for the near future.  

Accelerating the Adoption of Artificial Intelligence

Artificial Intelligence (AI) is emerging as a new solution for the current healthcare-related issues. AI involves the use of machines to perform human activities such as learning, interpreting, and analyzing. While AI in healthcare has not yet reached its full potential, investment in this field is expected to grow tenfold between 2014 and 2024. While AI systems are still in an early developmental stage, they are already used by many providers in areas such as diagnosis, patient education, and predictive analysis.

Robotic machines are an example of how AI could be put into action in a healthcare setting in the near future. These systems could carry out tasks like patient engagement, or even remote surgery. When dealing with infectious diseases like COVID-19, AI based robots could eliminate unnecessary human interactions, thus decreasing the risk of transmission. When used for diagnosis and treatment, these machines are significantly more accurate than existing technology. In the long run, AI could lead the way for virtual/augmented reality to make its way into mainstream healthcare.

The COVID-19 pandemic has proven to be a watershed event in the history of medical care. While the industry continues to face immense challenges, greater opportunities for growth lay ahead.

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Emerging Technologies that will shape the Future of the Healthcare Industry

The Healthcare Industry has witnessed a great deal of innovation over the past few centuries. Some pioneering breakthroughs include the discovery of vaccines, antibiotics, and insulin. Developments such as these have drastically increased the overall quality of life for billions of people across the planet. These substantial improvements over the past two centuries have led to the emergence of recent tech-based health innovations.  

How the move to Value-Based Care affects Innovation

The Healthcare industry has witnessed a shift towards “Value-Based Care” over the past few decades. This model focuses on the patient outcome more than any other factor. This has influenced technological innovations to be patient-centric rather than purely profit-focused.

RPM Devices

Remote Physiological Monitoring (RPM) is a form of real-time telehealth that employs the use of technology in the live collection of vital parameters such as heart rate, blood pressure, weight, or any other relevant measure. These compact gadgets track and send these parameters to qualified health professionals who can analyze the results. RPM devices give patients the opportunity to monitor their condition on a daily basis without constant clinical visits. These devices have allowed providers to remain updated with their patients when a physical visit is not possible. Effective use of these devices is proven to decrease the number of readmissions, which costs the industry over $41 billion a year. The RPM market is expected to grow to $2.7 billion by 2020, per a projection by Research and Markets. If RPM devices can prove their value in a competitive health tech market, they may become an integral part of human life. Their compact nature can allow them to become as ubiquitous as a wristwatch, especially for aging populations.

Telehealth

Telehealth involves the transfer of healthcare services through a telecommunications platform. While it includes monitoring and education, it is most commonly used as a tool for virtual appointments between providers and patients. Commonly used Telehealth platforms involve the use of a video/audio system with the ability to send EHR/EMRs or other health records by message. Telehealth acts as an added revenue stream as the CMS reimburses providers who employ telehealth services. For patients, telehealth means they can access high-quality healthcare from the comfort of their homes. The use of telehealth has rapidly grown over the past decade as 75% of hospitals utilized a telehealth platform in 2017 as opposed to 35% in 2010. In the long run, telehealth can help eliminate nonessential patient visits which waste both time and resources. With technological advances, telehealth might soon adopt a “virtual reality” based format. This can increase patient-provider interaction while enhancing the quality of care.  

Artificial Intelligence

Artificial Intelligence (AI) involves the use of machines to perform human activities such as comprehension and analysis. In a healthcare setting, it can be used to make an advanced interpretation of health-based data. The amount of investment in health-based AI is projected to grow from $600 million to $6.6 billion between 2014 and 2021. AI can make patient-specific care plans by accounting for millions of variables involving the patient’s health condition and trajectory. AI could potentially open the door for “Precision Medicine,” which could be a landmark development in modern medicine. While this method is still highly experimental and embroiled in controversy, the prospects of an effective model remains promising.  

The Impact of COVID-19 on Health Tech Innovations

The COVID-19 Pandemic has placed a heightened focus on the current capabilities of the Healthcare industry. The pandemic has offered both challenges and opportunities for technological innovation. One of the primary flaws of the industry that COVID-19 has highlighted is the prevalence of unnecessary and inconvenient patient visits. As health centers across the country have been focused on tackling the pandemic, patients with other conditions have been encouraged to stay home and receive virtual care. Many patients are able to mitigate their existing conditions without time-consuming visits to a clinic. At the same time, this provides an opportunity for a widespread adoption of telehealth services. Many providers have experienced the efficiency of virtual health services and will continue to invest in these solutions. Clinics without such platforms will likely adopt telehealth to address their lack of virtual care services. The pandemic will no doubt leave an enduring mark on the healthcare industry. The lessons learned from the pandemic will surely shift the focus of innovations towards virtual health solutions.

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