Patients Like Health Information Technology

Health Information Technology (“HIT”) is defined as involving the design, development, creation, use, and maintenance of information systems for the healthcare industry.  One such example is the Electronic Health Record (“EHR”) which has seen more implementations since the HITECH Act of 2009.  It is believed by many that automated and interoperable healthcare information systems will lower costs, improve efficiency, and reduce error, while also providing better patient care and service.  There are many disrupting technologies impacting the healthcare industry at this time, causing a shift in the manner in which healthcare is delivered.

Researchers at the Scripps Research Institute conducted a survey and published the results in the Journal of Medical Internet Research.  The researchers surveyed over 1,400 providers and over 1,100 consumers.  Here are some highlights of the survey’s findings:

92% of consumers believe access to medical records could lead to better management of patient health;  only 73% of providers shared that belief.

90% of providers are concerned that patients would experience anxiety after accessing their EHR; 34% of consumers shared that concern.

82% of providers surveyed stated that patients accessing their EHR would lead to requests for unnecessary medical evaluations; only 25% of consumers surveyed believed that to be true.

65% of consumers approved of using smartphones for collecting heart rate data; 60% of providers concurred.

42% of consumers have privacy and security concerns with HIT; 35% of providers surveyed shared that concern.

40% of consumers surveyed are more likely to prefer new technologies for medical diagnosis; only 14% of providers had that preference.

39% of physicians feel that patients own their medical record (I’m surprised to see such a low percentage given all the legal and health management education that has been given to physicians over the years.)

28% of providers reported feeling uneasy about using technology for a diagnosis; only 16% of consumers had similar feelings.

The survey also showed a high percentage of both providers and consumers supported genetic testing for various purposes.  The survey as reported in the Journal of Medical Internet Research can be found here.


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Hurdles to Caring for Chronic Care Patients

One of the new payment reforms enacted by the Department of Health and Human Services (“HHS”) is the Chronic Care Management (“CCM”) program.  The HHS expects this program to decrease the cost of care for Medicare patients by reducing the utilization of many services, while resulting in an improved quality of care.  There are a few hurdles however, in accomplishing this lofty goal.  Two of the biggest hurdles are: 1) the program’s success depends upon patients being compliant, and 2) the physicians involved must find extra time to administer the program requirements.

SmartCCM just released the results of a survey titled “Challenges in Caring for Medicare Patients with Two or More Chronic Conditions.”  The survey of primary care physicians was completed in late summer by Medical Marketing Research, Inc.  Although the sample size is small, I personally have found the survey results to be consistent with the sentiments of my clients across the country.  Here are some highlights of the survey’s findings:

63% lack the time to provide the extra guidance and reinforcement that these patients require.

56% cite the complexity of managing multiple conditions is a key challenge of the CCM program.

46% were unaware that Medicare reimburses physicians under the CCM program.  (Another recent survey found that two-thirds of primary care physicians were unaware of the CCM program or unfamiliar with its details.)

38% of physicians do not currently contact these types of patients between office visits.

32% state patients are inconsistent with following treatment plans and taking medications.

Perhaps most noteworthy in the survey is that physicians cite a staggering 75% of their applicable Medicare patients are a mere “somewhat” compliant and a pathetically low 5% are “extremely” compliant.  And this is the sort of data that physicians have been trying to tell government officials for years.  Legislators can write thousands of pages of regulations to enforce physician compliance and change their medical behavior, but those regulations cannot enforce patient compliance.

The survey can be found here.


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Telemedicine Momentum

Telemedicine has proven to increase access to care and reduce costs via teleconsultations and remote patient monitoring.  Unfortunately, the adoption rate in the U.S. has been rather slow.  Millennials may help to change that as this year they are expected to surpass baby boomers in size.  In fact, the number of millennials is projected to reach 75.3 million this year, whereas the number of baby boomers is forecasted to be 74.9 million.

We have all seen the reports about how technology savvy millennials are and how they crave easy access to everything, including now their access to healthcare.  Combine this with the benefits of telemedicine and we see the reasoning behind the shift toward telemedicine acceptance.  For example, late last year, large insurer Anthem announced it is offering telemedicine visits with no copay to its Medicare Advantage members in twelve states.  UnitedHealthcare is expanding its telemedicine offerings to cover some 20 million members in 2016.  Additionally, Aetna and Cigna already provide some reimbursement for telemedicine services.  And for 2015, the Centers for Medicare and Medicaid Services (“CMS”) expanded the Medicare Physician Fee Schedule to include the following services via telemedicine:  annual wellness visits, prolonged evaluation and management services, psychoanalysis, and psychotherapy.  Walgreens has also announced that it is rolling out an app to enable patients to consult “virtually” with physicians on a host of acute conditions.

Here is some telemedicine-related data from surveys via various sources:

  • In 2014, more than 10 million Americans utilized telemedicine (American Telemedicine Association)
  • Approximately 12.5% of general practitioner appointments will have occurred in 2014, resulting in an estimated savings of nearly $6 billion (Deloitte)
  • 84% of healthcare executives believe telemedicine is important to their organizations; 9 out of 10 are pursuing telemedicine programs (Foley & Lardner)
  • 22% of employers offered telemedicine consultations in their 2014 health programs; 37% expected to make that available in 2015; an additional 34% of employers are considering it for 2016 or 2017 (Towers Watson)

There is also much legislative work being done around the country.  Over half of the states require private insurers to cover telemedicine in the same manner as in-person visits and most states reimburse for telemedicine via Medicaid.  The reimbursement remedy is beginning to pick up steam as more than 100 bills were introduced in state legislatures in 2015.

See my earlier post regarding some ongoing roadblocks to telemedicine adoption in the United States.


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