New Tech Tackles Workflow, Reimbursement, Patient Engagement

Laird Harrison

October 14, 2015

SANTA CLARA, California — A dizzying array of software options to help healthcare providers with the demands of electronic healthcare records, Medicare requirements, and patient engagement benchmarks was presented here at the Health 2.0 Fall Conference 2015.

The time physicians would rather spend with patients is being taken up with government regulations and insurance company mandates, said Courtney Greenwood, MBA, a product marketing analyst at Pri-Med. "Physicians are sick of it, and the primary practice is in trouble as a result."

To support primary care physicians who treat patients in a direct primary care system, in which patients pay a monthly fee for comprehensive care rather than a fee for specific services, Pri-Med has developed the web-based InLight EHR program, Greenwood reported.

InLight EHR tracks the details of each patient's membership plan, and allows doctors to order medications, laboratory tests, and radiology, and to make referrals to specialists all from one box in the software program.

And the program can make modifications on the basis of a physician's previous behavior. In the way that Pandora or Spotify learn what you like to listen to, "this learns how you practice medicine," Greenwood explained. For example, the program might recommend a medication a physician has frequently prescribed for a particular condition.

Rather than offering a completely new electronic health records system, Avhana Health is creating an add-on that autopopulates forms such as the ones used for medication preauthorization, said Noah Weiner, chief executive officer. For each patient, it also provides guidelines on how to maximize reimbursement.

Add-on Autopopulating Forms

The company is working with Allscripts, Epic, Greenway, and Athenahealth to integrate its add-on into their systems, he said, and has just begun looking for its first customers.

Care managers at hospitals face similar challenges, said Jennifer Crisp, product manager at CipherHealth. She demonstrated a program that lists a patient's care plans, demographic characteristics, goals, and notes entered by any of the patient's providers.

The program also provides a list of questions to guide conversations with patients, and allows care managers to send text messages directly to their patients.

And it can generate a simple report that complies with the billing requirements of the Centers for Medicare and Medicaid Services, Crisp said.

Such requirements are changing clinicians' practices, said Caroline LeCates, who works in business development at CipherHealth.

"Now that they are actually at risk for Medicare penalties, there's a huge focus on this area," she told Medscape Medical News.

Other CipherHealth programs help providers meet patient engagement benchmarks stipulated in the Health Information Technology for Economic and Clinical Health Act (HITECH), she said.

For example, CipherHealth can provide automated phone calls that invite patients to signal their condition by pressing a number on their key pad. CipherHealth sends this information back to practices or hospitals, and a decision is then made on whether to follow-up with a call from a nurse, pharmacist, or physician.

Communication Among Staff Members

Argusoft is approaching regulatory mandates from another perspective, said Ram Gopalan, managing director of the company. It's program facilitates communication among staff members in skilled nursing facilities.

Nurses, nursing assistants, and physicians can fill out forms on their smartphones and transmit them to each other, rather than relying on phone conversations or faxes.

But no new system can work unless the staff gets proper training, said Trond Ase, cofounder of Attensi, which offers digital simulations of hospitals, similar to the environments created in first-person computer games.

He demonstrated a simulation of a nurse's rounds on a hospital ward. In the scenario, the nurse starts by picking up a smartphone. The user sees the screen on the phone and enters the required log-on information, which then sends information about patients under that user's care to the user.

The program issues warnings if the user fails to follow a procedure, such as disinfection, before entering a patient's room.

"The belief is that to implement new procedures and to really affect behavior, you need to practice," Ase said.

A lot of time we're reinventing the wheel.

After the demonstrations, a physician from San Francisco General Hospital asked how these new technologies will help "human-to-human relations rather than human-to-screen interaction."

Gopalan explained that Argusoft improves human relations because menu-driven apps on smartphones cut down on the time otherwise spent typing.

Ase explained that Attensi has been used to teach psychotherapists how to work with patients. "It's about training interpersonal interaction," he said.

Many providers are limited in the software changes they can make, explained session moderator William Sellman, MD, from Stanford University and Alameda Family Physicians in California. Often they have already invested in electronic health record systems and, in some cases, have modified the systems so much that they can't be easily upgraded, he said.

"There is some cool stuff here, but I don't know how practical it is," he told Medscape Medical News. "A lot of time we're reinventing the wheel."

The most promising approach might be the one taken by Avhana Health, because it is designed to interface with some of the leading electronic health record systems that providers are already using, Dr Sellman added.

Dr Sellman has disclosed no relevant financial relationships.

Health 2.0 Fall Conference 2015. Presented October 6, 2015.


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