The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Saturday, September 6, 2014

EHRs Linked to Higher Revenue, Lower Patient Volume

EHRs Linked to Higher Revenue, Lower Patient Volume




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Electronic health record implementation can result in reduced patient volume but can increase revenue over the long term, according to a study published in theJournal of the American Medical Informatics AssociationBecker's Hospital Review's "Hospital CIO" reports (Gregg, "Hospital CIO," Becker's Hospital Review, 9/3).
For the study, researchers from Drexel University compared patient volume and reimbursement at 30 ambulatory practices in the two years after EHR implementation with the practices' pre-implementation baseline (Pedulli, Clinical Innovation & Technology, 9/4).

Study Findings

The study found that practices' reimbursements increased "significantly," even as their number of patient visits declined (Durben Hirsch, FierceEMR, 9/2). Specifically, practices on average submitted claims for 94 additional ancillary procedures per quarter after implementing an EHR system, while patient volume decreased on average by about 108 patients per quarter ("Hospital CIO," Becker's Hospital Review, 9/3).
The researchers wrote they did not find any indication of "upcoding or increased reimbursement rates to explain the increased revenues" (Clinical Innovation & Technology, 9/4).
They noted that their finding of increased revenues "is reassuring and offers a basis for further EHR investment," while their finding of decreased patient volume indicated that EHR systems were increasing practices' efficiency.

They recommended that any practices continuing to see declines in patient volume two years after implementing EHR systems should add analytics functionality to their EHR system to "focus on seeing the right patients" (FierceEMR, 9/2).

Friday, September 5, 2014

HHS: Federal Exchange Site Hacked, No Personal Data Stolen



The inevitable 'hack' occured in July according to HHS officials.  It involved the Federal Health Insurance Exchange, health.gov .

On Thursday, HHS officials announced that a hacker in July breached part of HealthCare.gov and uploaded malicious software, the Wall Street Journal reports (Yadron, Wall Street Journal, 9/4).
A team of investigators discovered the breach on Aug. 25 during a routine security scan. I suppose HHS and federal IT infrastructure have their own "Malwarebytes" to detect and clean their systems,  regularly.  I know that good IT practices require this type of routine maintenance.
Perhaps the hackers broke in to see if they could improve health.gov for the Dept. of HHS. I am sure many were willing to help there.  Probably any videogamer could improve the web site.  It's been a whole year for things to improve, and the next enrollment period begins in about one month.
According to an HHS official, the attack appears to be the first successful breach of the website, through which millions of U.S. residents have purchased health insurance coverage since fall 2013.

Details of the Hack



Investigators found no evidence that enrollees' personal data were taken in the attack. Rather, the hacker accessed a server used to test code for the website (Wall Street Journal, 9/4).
Common malware was uploaded to the test server and designed to incapacitate other websites, a method often referred to as a "denial of service" attack. Government officials say the malware was not intended to steal consumers' data (Viebeck/Hattem, The Hill, 9/4).
"Our review indicates that the server did not contain consumer personal information; data [were] not transmitted outside the agency, and the website was not specifically targeted," HHS said, adding, "We have taken measures to further strengthen security" (O'Donnell, USA Today, 9/4).
I feel relieved
It's about like someone breaking into your house and leaving a 'stink bomb' rather than taking your large screen T.V.

Reaction

Rep. Darrell Issa (R-Calif.) -- chair of the House Oversight and Government Reform Committee -- in a statement said the revelations were "unsurprising" amid previous concerns about the website's security. He added that the administration repeatedly had "dismissed concerns about the security of HealthCare.gov, even as it obstructed congressional oversight on the issue." Issa also called on CMS Administrator Marilyn Tavenner to testify alongside GAO officials before the committee on Sept. 18 (Hattem, The Hill, 9/4).
Meanwhile, Rep. Diane Black (R-Tenn.) called on the Senate to join the House in passing the Health Exchange Security and Transparency Act (HR 3811), which would require the federal government to notify individuals if their personal information has been breached (Black release, 9/4). (A one paragraph-regulations)  I thought that was already covered by HIPAA.
Let us hope that things will get better (don't hold your breath)


Thursday, September 4, 2014

Today +Megan Smith (formerly VP at Google[x]) joins President +Barack Obama as the Chief Technology Officer of the United States of America.

Todd Park, the former CTO in the Obama administration has been replaced by Megan Smith, following his resignation several months ago.  Todd, during the rapid growth of HIT including Health Information Exchanges, and in conjunction with the Office of the National Coordinator of HIT (ONCHIT) was responsible for the successful role out of Health Information Exchanges, and later with the challenge of implementing Health.gov .

Megan Smith Named CTO of the United States!

Today +Megan Smith (formerly VP at Google[x]) joins President +Barack Obama as the Chief Technology Officer of the United States of America. Megan co-founded Women Techmakers in 2012 with +Stephanie Liu, and seeing the potential for building on the movement to empower women in technology, Megan and I created my current role as Google's Women in Technology Advocate. Megan has been an advisor to Women Techmakers despite her busy schedule advocating for women and children globally, and I'm honored to have worked side-by-side with her to enact change. I'm proud of my friend and mentor, and look forward to seeing the impact she'll make in her new role.

More from +Barack Obama and the White House blog http://goo.gl/xqbs10.

Wednesday, September 3, 2014

Covered California To Begin Outreach for Second Enrollment Period




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Next week, Covered California will begin to prepare for its second open enrollment period by launching an advertising campaign aimed at encouraging residents to apply for first-time coverage or renew their current policies, the Los Angeles Times reports.
Covered California is the state's health insurance exchange under the Affordable Care Act.

Details of Enrollment Campaign

The $74 million ad campaign will run for the duration of the exchange's second enrollment period, which runs from Nov. 15 to Feb. 15, 2015.
During the next enrollment period, Covered California officials are aiming to:
  • Increase enrollment from 1.2 million residents to 1.7 million residents;
  • Fix problems consumers faced during the first open enrollment period; and
  • Simplify the renewal process (Terhune, Los Angeles Times, 9/2).

Details of Renewal Process

Consumers will be able to renew their exchange plans beginning on Oct. 1. However, individuals who want to change their coverage will have to wait until Nov. 15 to do so (Abelson, New York Times, 9/2).
Exchange policies will automatically be renewed by Dec. 15 if enrollees do not specify that they want to change plans, according to the Los Angeles Times. Beginning in mid-October, insurers will mail renewal notices that show a consumer's:
  • 2014 premium;
  • Current federal subsidy; and
  • Premium rate for next year.
The initial notices will not include information about the enrollee's 2015 federal subsidy. However, updated notices with subsidy information will be mailed between Oct. 10 and Dec. 15, according to officials.

Advocates Urge Consumers To Shop for Better Coverage

Meanwhile, some consumer advocates say individuals should hold off on renewing their plans and search for better deals, the Los Angeles Times reports (Los Angeles Times, 9/2).
In July, Covered California officials announced that the average premium for health plans offered on the exchange will increase by an average of 4.2% for the coming year. The rates vary depending on region, but most will see slight increases (California Healthline, 8/1). Some insurers will raise premiums by more than 10%, but others are cutting rates to increase competition, according to theLos Angeles Times.
Rates are expected to be finalized by Sept. 30.

Covered California 2015 Rates Will Increase an Average of 4.2%


The rates will be reviewed by state regulators before being implemented officially (Robertson, Sacramento Business Journal, 7/31). 
The rates vary depending on region, but most will see slight increases:
  • In Alameda County, the weighted average increase is 2.8%;
  • In Contra Costa County, the weighted average increase is 3.8%;
  • In Fresno, Kings and Madera counties, the average weighted increase is 3%;
  • In Kern County, the weighted average increase is 4.5%;
  • In Los Angeles County, which includes two pricing regions, the weighted average increases are 4.4% and 4.3%;
  • In Northern California, the weighted average increase for premiums is 4.7%;
  • In Marin, Napa, Solano and Sonoma counties, the weighted average increase is 5.4%;
  • In Mono, Inyo and Imperial counties, the weighted average increase is 3.8%;
  • In Monterey, San Benito and Santa Cruz counties, the weighted average increase is 2.9%;
  • In Orange County, the weighted average increase is 6.3%;
  • In the Sacramento area, the weighted average increase is 3.7%;
  • In San Bernardino and Riverside counties, the weighted average increase is 4.5%;
  • In San Diego County, the weighted average increase is 5.8%;
  • In San Francisco County, the weighted average increase is 6.6%;
  • In San Luis Obispo, Santa Barbara and Ventura counties, the weighted average increase is 5.1%;
  • In San Mateo County, the weighted average increase is 3.7%; and
  • In Santa Clara County, the weighted average increase is 1%.
All 10 insurers that participated in the state exchange during its first open enrollment period submitted bids and were approved to return in 2015, including:
  • Anthem Blue Cross of California;
  • Blue Shield of California;
  • Chinese Community Health Plan;
  • Health Net;
  • Kaiser Permanente;
  • L.A. Care Health Plan;
  • Molina Healthcare;
  • Sharp Health Plan;
  • Valley Health Plan; and
  • Western Health Advantage (Covered California release, 7/31).
Betsy Imholz, special projects director at Consumers Union, said, "We want to encourage people to shop first and not just default into a plan" (Los Angeles Times, 9/2).