By Hai Tran

As recently as 10 years ago, telemedicine was generally thought of as the ability for remote clinicians to conduct phone consults, meaning a phone interaction with patients or with another physician on a remote basis. That is no longer the case. Advancements in telecommunications coupled with 1) the growth of video technology, 2) the general acceptance of consumer-type applications such as Skype or FaceTime, and 3) the normalization of video-to-video communications, have transformed the very definition of telemedicine. Today, most people expect telemedicine to be more of a video-to-video exchange.

This new paradigm in adoption can be seen across the healthcare continuum, including the acute setting where response time is critical and patient care is more complex. A few short years ago, the notion that telemedicine could be deployed effectively in a clinically complex case such as a critically ill stroke patient was a fairly foreign concept. 

The industry remained skeptical regarding this type of use of telemedicine until recently. Today, data exists that demonstrates why a comprehensive telemedicine program can be good for business: significantly reducing a hospital’s response time in a consistent and sustainable manner; improving coverage and volume; reducing operational costs; and generating actionable data for further improvement. [Read more…]

What to consider before jumping into direct-to-consumer telehealth

By Mike Baird, MBA

The interest in direct-to-consumer (DTC) telehealth is soaring as healthcare organizations seek new ways to improve patient access to medical care.

As noted by a widely publicized Health Affairs report, the healthcare industry performed 1.25 million direct-to-consumer telehealth visits in 2015. That number is projected to rise as stakeholders uncover new uses for virtual care. For example, DTC telehealth can help partners in an Accountable Care Organization (ACO) or patient-centered medical home collaborate better and coordinate care more smoothly. It can help physician practices offer a broader range of services to patients. And it can provide real value to patients.

However, DTC telehealth must be implemented mindfully, with careful consideration of everything from the remote providers servicing patients to the strength of a vendor’s virtual care platform. If a DTC telehealth program is implemented carelessly — with no objectives other than to give patients more “face time” with actual doctors — healthcare providers run the risk of losing out on telehealth’s most important benefits.



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By Cara Sloman, executive vice president, Nadel Phelan, Inc.

One of the biggest challenges in the healthcare system pertains to the access and protection of sensitive medical information. Though blockchain technology was initially developed to support financial transactions, its decentralized, distributed ledger also holds great promise for the healthcare industry. For instance, a recent report by Deloitte notes that blockchain has significant potential to improve data interoperability, privacy and security.

Blockchain technology is poised to help the healthcare industry overcome multiple industry pain points, including the need for health information exchanges, varying data standards and inconsistent rules and permissions. The application of blockchain in healthcare is still in the early stages of development but is envisioned to solve the following challenges.

1. Medical Data Management:

Blockchain can be applied in healthcare to enhance the management of electronic health records (EHRs) because it would simplify the exchange of data across authorized parties. Current health information exchanges (HIEs) are hampered by a number of technology issues, including the need for an intermediary trust network, data interoperability issues and inconsistent rules and permissions. These issues prevent the safe transfer and sharing of data. However, it is now possible for healthcare organizations to build blockchains based on data pulled from existing databases, creating a complete data picture and single source of truth.

So then, HIEs would radically change from their current form to one that is patient-mediated. Patients would be the owners of their own data, accessible to each individual via the blockchain’s private key mechanisms. Patients could share this data with whomever they choose within their healthcare team. This would give patients and the caregivers of their choice a longitudinal history of their health. [Read more…]

By William Shea and Patricia Birch

Amazon, JPMorgan Chase and Berkshire Hathaway joining forces to create a new healthcare entity may seem like an odd partnership.  Yet that triumvirate, plus Cigna’s planned acquisition of ExpressScripts, signal the continued tightening of the healthcare industry’s value chain. These developments also point to the rapid shifts in the industry’s business models—shifts that will upend traditional industry value propositions.

Drawing on industry research and client visioning exercises, we have identified several emerging healthcare business models being driven by ubiquitous smart phones, the Internet of Things, data analytics, and platform technology. The new models also are being shaped by consumers who now expect anytime, anywhere service and the industry’s shift to value-based care. These forces are giving rise to an on-demand healthcare economy, the foundation of which will be one or more consumer-to-business (C2B) on-demand healthcare platforms. These platforms will help deliver an Uberized version of healthcare, with consumers selecting providers on-demand based on price and quality ratings.

Other emerging business models include:  doubling down on traditional insurance capabilities (underwriting, actuarial, and risk management) as the industry accelerates its shift to high deductible products and away from proprietary networks and managed care models.  We expect to see more creative and individualized coverage from health insurers, as well as from insurance powerhouses re-entering the healthcare market; new plays from financial services providers to incorporate healthcare into consumer’s overall financial management strategies; and a rise in wellness offerings.



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By Bill Ho

Every few years, a company tries to make a big push to solve the problem of easy and secure access to our healthcare information. The prospect of getting better access to my medical information — and the ability to share that more easily — has always excited me. On the consumer-facing side, a number of companies have attempted to solve the patient access problem, notably Microsoft (HealthVault in 2007), and Google (Google Health in 2008). Most recently, Apple announced the latest update to its health app, which could make it even easier to see our own health information. Not all have succeeded, however. Google Health, for example, discontinued its service in 2012. The journey to health information nirvana continues to be a difficult one.

While consumer access to health information is important and exciting for all of us as patients, the back offices of healthcare organizations are the workhorses when it comes to sharing patient information. The volume of patient data being shared behind the scenes — from consents and referrals to lab reports, H&Ps, and prescriptions — is several orders of magnitude greater than information shared with patients directly. All of this data are shared between internal departments, among specialists, private medical groups, and across a myriad of institutions and business associates, including insurance companies, laboratories, pharmacies, clearinghouses, law firms, and more.

While the HITECH Act pushed the adoption of electronic health record systems to new heights over the last decade, those systems can be notoriously difficult for sharing information between different EHR systems. And while EHR vendors are ostensibly interested in solving this problem, it seems vendors are more incentivized to have customers migrate to their own system than build a bridge between them. While multiple efforts around a digital highway for better interoperability and communication are currently in play, the one technology that continues to work diligently without any compatibility issues for sharing information is the humble but enduring fax.



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By David Fetterolf

Picture your last doctor’s appointment or hospital visit. You probably checked in at reception or administration, maybe you were weighed and had your blood pressure taken, but before long you were in an exam room having a conversation with your doctor about your health. Good healthcare relies heavily on effective doctor/patient communication. Whether you are discussing your symptoms, a diagnosis, or your treatment plan, most of what we experience as patients is conversation. Now imagine that your doctor speaks another language. Suddenly that interpersonal communication breaks down. Not speaking the same language as your healthcare provider is a scary reality for more than 25 million limited English proficiency Americans.

The limited English proficiency population in the United States is growing. Between 1990 and 2013, the LEP population grew by more than 80%, from 14 million to more than 25 million. In addition to growing, the population evolved. In 1990 the top three languages other than English were Spanish, French and German. In 2010 the top three languages other than English were Spanish, Chinese, and Tagalog.

Under Federal Law, healthcare institutions are required to provide meaningful access to language services, but with populations changing so rapidly and drastically, many of our nation’s hospitals struggle to keep up with the growing demand for medically qualified interpreters.



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