Tech Walgreens testing drone delivery service with Alphabet's Wing in Virginia town

Pharmacy giant Walgreens is testing an on-demand drone delivery service with Alphabet's Wing Aviation beginning next month.

As the first pharmacy retailer to test drone delivery, Walgreens will use Wing's drones to deliver food and beverage products, over-the-counter medications and other health and wellness products to eligible residents of Christiansburg, Virginia. Prescription medications will not available through this service, the company said.

The companies will test the viability of health and wellness products and retail delivery through the air, offering home delivery minutes after customers place their orders via the Wing app.

Wing, a subsidiary of Google parent company Alphabet, was the first drone operator certified as an air carrier by the Federal Aviation Administration earlier this year.

Christiansburg was selected as the test market as Wing has been working closely with nearby Virginia Tech in Blacksburg to test drone delivery as part of the U.S. Department of Transportation’s Unmanned Aircraft System Integration Pilot Program, the companies said.

“Walgreens continues to explore partnerships to transform and modernize our customer experience and we are proud to be the first retailer in the U.S. to offer an on-demand commercial drone delivery option with Wing,” Vish Sankaran, chief innovation officer, Walgreens Boots Alliance, Inc., said in a statement.

RELATED: Northwell Health wants to combine drones and telehealth to improve emergency care

“This is the kind of omnichannel partnership and offering that can redefine convenience for our customers and communities—delivering items to homes in minutes, not hours or days," Sankaran said.

Customers in the Christiansburg area will have access to more than 100 products and six “packs” via the Wing app. Customers can either choose the individual products they need or choose one of the pre-built packs in the following categories: allergy, baby, cough/cold, first aid, pain, and kids’ snacks.

Parents at home with a sick child can order the “baby pack” which includes products like children's ibuprofen and water, as one example, Walgreens said.

Wing also announced separate drone trials with FedEx and local Christiansburg retailer Sugar Magnolia.

The drone pilot project will demonstrate the benefits of drone delivery by improving access to health care products, creating new avenues of growth for local businesses, and exploring ways to enhance the efficiency of last-mile delivery service, Wing said in a press release.

Walgreens is just one of the many retailers exploring the use of drones to offer customers faster and more convenient delivery service. In June, Amazon executives said its new delivery drone should be ready "within months," according to CNBC. CVS CEO Larry Merlo said in January the company was “doing some work” to distribute prescriptions by drone, Stat reported.

RELATED: UPS launching drone delivery of medical samples with WakeMed

Numerous delivery services are partnering with pharmacy retail, including FedEx and UPS.

Technology advances are about to become mainstream, integrating telehealth, emergency medical services and delivery of medications to patient's homes and/or hospitals.

Will America Catch Up With East Africa in Adopting Medical Drones?

East Africa now has the world’s most advanced drone delivery system for medical supplies. The question for America is whether we will follow these countries’ leads, thereby reducing costs and increasing efficiency of life-saving services in our own rural and remote areas. 

The Government of Tanzania and Zipline, a California manufacturer, have just announced that in early 2018, drones will begin flying critical and life-saving medical supplies to locations across that East African republic, whose 56 million people are spread across an area over half the size of Alaska. Zipline (flyzipline.com) is supported by, among others, Google Ventures, Yahoo founder Jerry Yang, Microsoft co-founder Paul Allen, and Stanford University. Zipline will build and operate the system.

Zipline's high gain antenna structure for rural drone operating in Tanzania.
Is America ready for this?  FedEx and UPS, getting ready?
5G cellular access may create this ability without building proprietary
antenna systems.



















https://tinyurl.com/y2dbjywn

4 Things Startups Should Know about Rural American Healthcare Innovation | Healthcare IT Today

From Health Care Today, Janae Sharp

If you think health IT is difficult in metropolitan areas, take a ride into rural America.  There may be a unique opportunity for the right innovators to succeed where others have failed.  Some of the necessary components are coming into existence, even as I am writing today's Digital Health Space.

Rural areas are historically perceived as a harder market for healthcare startups: They have tighter margins, and recently many safety net and rural hospitals have closed. Yet rural areas are most in need of companies that can establish a lasting presence. In Colorado, groups like Prime Health are dedicated to improving healthcare in rural parts of the state. 

Ten years ago rural broadband was an oxymoron. Although still not optimal there is light in the outbacks of America.

1. Increased fiber and wired high-speed internet
2. Increased cellular coverage
3. The impending growth of 5G allowing broadband high speed on the cell network.
4. Rapidly decreasing cost as ISPs compete for customers.

I spoke with Michael Archuleta, who serves as the CIO for Mt. San Rafael Hospital in Colorado and is a judge for the Prime Health Challenge; Archuleta is a leader in digital and healthcare excellence, who cautions not to overlook rural hospitals as incubators for new technology in the health sector.  “I really think that some individuals don’t understand the needs of rural Americaƒ,” Archuleta says. “We are in rural America, but there are some really progressive facilities that are doing really well with initiatives.” Here are four great reasons Archuleta gives for celebrating rural hospitals:

INNOVATION AND ADOPTION

We are a digital company delivering healthcare. Not a hospital.

At the end of the day, it comes down to the culture of the organization. In healthcare, we’ve always been behind the curve when it comes to technology advancements. That is strange because here we are saving lives, but we are behind the finance industry and oil and gas in innovation.

Even seeing how the CIO role in healthcare organizations has evolved is encouraging. We have transformed the current role–from being a cost center and a department to being a profit center and a strategic member of the organization.  Technology can be an asset and bring profit for rural hospitals, and that saving starts with an internal culture welcoming heath at the speed of technology.

If you are talking about innovation in rural America without the baseline of building those core cultural values of progress and being a digital company, we will fall behind. The internal disruption has to happen in order for us to continue progressing. The team and culture come first. Technology is a tool to create and improve efficiencies within what we are trying to do.

If we can’t model the drive and motivation of technology companies or large healthcare systems with robust funding, how can we continue to progress in the digital age of healthcare? Great culture allows small organizations and rural hospitals to be agile and competitive.

TECHNOLOGY EXCELLENCE

A lot of people don’t like change–when I came here, we didn’t even have an electronic health record. I remember going to the med-Surg unit and there were nurses that had been documenting on paper. They saw me as the guy who was making them do records and adding more work. I had a laser focus on specific reasons for the improvement. My hospital, Mt San Rafael Hospital, has done HIMSS verification and most wired. 

All the “technology” initiatives that have improved business have also improved revenue. This focus on technology improving healthcare has Mt. San Rafael Hospital to stand out. We were laser-focused on HIMSS analytics. Our hospital is Stage 6, which only 34 percent of organizations have accomplished in the entire healthcare sphere. You need the fire of cultural change and to understand how to drive initiatives in order to have technology be an organizational asset. Providers support initiatives in technology that improve patient care.

I sit on a committee for the Southeastern Colorado area. The critical element for partners is meeting the needs that rural organizations are faced with. We use a PCO, or ROI from our key performance indicators. People need that visualization of where things are before an initiative starts and where things are after. If an initiative doesn’t match our goals and performance indicators, even if it’s great technology, we do not invest in it.

If startups can illustrate to healthcare organizations their specific gain and what it’s measuring, it can be eye-opening. In a small facility, it’s hard to fund a technology-driven project. People want to know, why are we doing this? Are we improving patient outcomes? Like cybersecurity–we need a culture of awareness.

WE KNOW WHAT WE NEED

Even though we are a small organization we don’t have to think small.  We have always started with patient-centric needs and these are the needs for our community and patients. Our hospital supports the Prime Health Challenge in facilitating that collaboration.

There is such a problem of deprivation for certain communities, particularly as far as mental health care is concerned. There aren’t enough services here in rural Colorado–we need applications and technology tools that hospitals in big cities have access to. However, you can see an increase of telemedicine. 

Rural hospitals are looking for companies that are successful at improving telemedicine, getting more mental healthcare access, continuity of care between facilities, and better ways of focusing on interoperability.

A lot of our payment is through Medicaid: Rural hospitals have a high rate of individuals with no insurance, and Colorado, in particular, has a high population of transients throughout the city since they legalized marijuana. You start seeing a larger population of transients coming into the area, and you have to provide services, but in many cases, it’s hard to find out if patients even have insurance. 

Smaller facilities aren’t always connected–look at federal programs paying for 65% of telecommunications costs. At the hospital, we just did a fiber improvement. We have 2 ISPs and 1 LAN–the site to site connections are built–and we are increasing connectivity. Always grow the initiatives–if they ever go to 5G, we can go through a 10G pipe and their technology plan is long term. A lot of rural organizations don’t know about the healthcare connect fund, wherein the federal government is paying for 65% of your telecommunications investment–that is a lot, and it’s really helped us grow, to take advantage of this program.

Rural America has a lower life expectancy. Patients in rural America aren’t able to get the best medical care that they need. Currently, one of the big scares is that a lot of facilities are closing. That is a major issue. Investors need to come in knowing what a high-stakes game this is for people who live, obtain and provide health care in rural areas. 

BUILD A LEGACY

I am looking for a business partner, not a vendor. A vendor sells me an application, but a business partner says, “Your success is my success”–holding your hand and showing strong initiatives.

When an organization is approaching a facility that is not as progressive and hasn’t adopted the digital process, I ask myself, “What are some of the quality-based initiatives that this organization needs from me?” Some of the small organizations fear proof of concept agreements. When a rural hospital looks at a startup- they know that many startups fail. They ask themselves: Does the startup have a strong financial background? Where they will be there 5 or 10 years down the line? The hospital is taking a risk every time, and showing the startup can meet specific needs is key.

Many startups fail, and rural hospitals and healthcare, in general, can’t afford to invest in a partner that will need to be replaced a few years down the road. Building lasting success is key. If you want to succeed in rural healthcare, include rural hospitals as partners in building your solution. Someone that lives and sees the issues you are trying to solve has invaluable insight.

Startups need to look at the funding options. Ask yourself, “Can we incorporate into necessary programs?” You should know about initiatives and funding that are in place. Before you meet with a group you should do your homework about the potential funding sources you will have. There are so many opportunities that startups can use to help improve health. Not knowing what they are before your meeting shows a lack of interest.

FCC gets approval for a plan to subsidize fast rural internet access

We are all here for one reason–that reason is patient care and patient outcomes. The patient is our CEO; thus, the patient should determine if you keep their loyalty. You need to improve on their care. 









Michael Archuleta: 4 Things Startups Should Know about Rural American Healthcare Innovation | Healthcare IT Today:

Only for the discriminating physicians. User friendly, Apple-like interface (GUI)

As a clinician, you know how medicine has been overrun by insurance companies, payors, CMS and consultants. I did some time ago.

Today I look back after retiring from patient care due to a multiplicity of health challenges and have dedicated my end of career activity to studying, researching and writing about health information technology.  Fort those of you who know my acerbic writing style, you have read my blog here and Health Train Express.  For those of you who have not, here, here, and here are another opportunity to do so.

Admittedly I do a great deal of copying and pasting or scraping as bloggers call it.  Another elite term is 'curating'.  The archives of my blogs are dusty, full of spider webs, and discarded bits and bytes of obsolete news.  The half-life of health information technology breakthroughs, paradigm shifts, sea-changes, transformations, or a quantum leap forward is about 12 months.



EMA, developed by Modern Medicine is a no-nonsense EMR with an almost cartoon-like graphic user interface.. It spoon-feeds clinicians requiring little intellectual energy and allowing cognitive functioning to focus on the content and processing medical information, rather than the ABCs of the EHR.  It follows KISS philosophy (keep it simple, stupid).

Some EHRs claim to be built for practices of any specialty. But how can that be true when each specialty is so drastically different? Unlike other one-size doesn’t quite fit all EHR systems, our solution, EMA®, is tailored to fit your workflow as a specialist for the fields of Dermatology, Ophthalmology, Orthopedics, Otolaryngology, and Plastic Surgery.

Built for and by practicing physicians in various medical specialties, you’ll experience the built-in knowledge that can make all the difference. With its adaptive learning engine, our dermatology EHR system will learn how you frequently describe certain diagnoses and like to treat patients.

For example, if you’re performing a biopsy by shave, EMA will know how you like to set up your biopsy tray. When using our ophthalmology EHR in the exam room, you can pinch and zoom on any diagram and the system will automatically suggest ICD-10 codes for you. EMA is so specific, it’s even built for ophthalmic subspecialties. For example, if you’re a retina specialist, easily review an OCT by touching and clicking on an image with our native iPad EHR.

For orthopedic surgeons, easily order and document x-ray interpretations within the exam using dictation, and sticky findings. As an otolaryngologist, you can quickly document a chief complaint such as hoarseness and indicate the area of concern using drawing tools. If you work in a plastic surgery practice, EMA adjusts to your unique style of practice and recognizes your preferences, such as a suture or implant types.

Once you have the clinical flow in place with our specialty-focused EHR system, you can give your practice an added boost by combining the power of practice management technology with our professional business operations services. Known as modmed® BOOST, we focus on addressing the operational and financial aspects of your practice while you focus on your patients.

Then, by using Modernizing Medicine’s Analytics platform, you may gain valuable insights to help improve visibility into practice performance by visualizing and benchmarking data. Now, how about patient engagement? By harnessing the power of tools such as patient portal, kiosk, reminders and surveys, our solutions can save your staff valuable time.

Here are some useful examples from various specialties,

Radiology
Dermatology
ENT
Plastic Surgery
Ophthalmology
Orthopedics.
Urology

There are also some Practice Management Modules for Revenue cycle management (RCM) MIPS Advisory Program, and Exception Programs.












EMA®, the Specialty EHR System from Modernizing Medicine on Vimeo.

EHR-related medical malpractice claims tripled since 2010, study finds

Physicians are always concerned about minimizing risk and avoiding malpractice claims.  Malpractice claims can be a game-changer and a source for high-anxiety, depression, and burnout.  The EHR has already been labeled a source for burnout by increasing workload and introducing a multiplicity of factors, including penalties for technological issues in the EHR. HHS and CMS have upped the stakes by requiring metrics measured by MIPS.  The playing field is constantly in flux.  It is akin to changing the length of a football field from 100 yards to 200 yards in mid-game.

A total of 216 EHR-related medical malpractice claims closed between 2010 and 2018, according to a recent Doctors Company study.

Which Specialties Are Most at Risk?
In an effort to identify and communicate system failures that result in patient harm, The Doctors Company identified the specialties who receive the highest percentage of claims where EHRs are a factor.

EHRs typically remain contributing factors rather than the primary cause of claims, with 1.1 percent of all claims that have an EHR factor closed since 2010. However, the pace of claims in which EHRs contributed to injury is growing, from seven total cases in 2010 to an average 22.5 cases per year in 2017 and 2018, according to the report.

The EHR-related claims closed from 2010-18 were caused by system technology and design issues as well as user-related problems.

Here are the top technology and design issues cited by The Doctors Company, a physician-owned medical malpractice insurer.

· Other: 14 percent.

· EHR/technology failure: 12 percent.
· Lack of or failure of EHR alert or alarm: 7 percent.
· Fragmented record: 6 percent.
· Failure/lack of electronic routing data: 5 percent.
· Insufficient scope/area for documentation in EHR: 4 percent.
· Lack of integration/incompatible systems: 2 percent.

Which Specialties Are Most at Risk?

In an effort to identify and communicate system failures that result in patient harm, The Doctors Company identified the specialties who receive the highest percentage of claims where EHRs are a factor.

Top 12 Clinical Services with EHR Factors

Family medicine 8%
Internal medicine 8%
Cardiology 6%
Radiology 6%
Obstetrics 5%
Orthopedics 5%
Nursing 5%
Hospital medicine 4%
Gynecology 4%
Emergency medicine 3%
Anesthesiology 3%
Plastic surgery 3%
Urology surgery 3%
General surgery 3%

Case Examples: System Technology and Design Issues

Case 1: Electronic Systems/Technology Failure

Presentation: An elderly female patient presented to an otolaryngologist for sinus complaints. The physician intended to order Flonase nasal spray. The patient took the medication as directed. Two weeks later, the patient went to the ED for dizziness.

Outcome: The ED physician discovered the patient was taking Flomax—a medication for enlarged prostate, one side effect of which is hypotension. The original ordering physician had entered “FLO” in the medication order screen, and the EHR automatically selected Flomax. Not noticing the error, the physician selected it. There was no EHR drug alert for gender.

Case 2: Fragmented Record

Presentation: A 55-year-old male patient presented to the ED with back pain. He was diagnosed with severe lumbar stenosis. Following surgery, nurses noted neurological changes. They documented the changes and called the physician, but no action was taken.

Outcome: Due to a fragmented record (both paper and EHR), information was not communicated to the correct physician. The delay in contacting the correct physician resulted in a delay of return to surgery and partial paralysis.

Case Examples: User-Related Issues

Case 1: Copy and Paste

Presentation: A physical medicine physician followed a patient with extreme weakness due to cervical vascular malformation. Nurses and a physical therapist noted neurological changes, but the physician’s note indicated no changes. The physical therapist contacted the attending physician to discuss neurological changes including increased weakness. The physical therapist asked the physician to order a neurological consult due to the patient's deteriorating condition.

Outcome: The physician ordered the consult but did not explain why his documentation did not address the patient's changing condition. The patient was taken to surgery and now has incomplete quadriplegia. The physician was criticized for copying and pasting the same note for four days and delaying the intervention.

Case 2: Copy and Paste

Presentation: A 38-year-old obese patient presented for medical clearance. His test results were normal. Three months later, the patient presented with shortness of breath and dizziness. His blood pressure was 112/90 and pulse was 106. No tests were ordered.

Outcome: Five days later, the patient expired from a pulmonary embolism. Experts questioned whether the physician had conducted a complete assessment. The progress note was identical to the previous note from three months earlier, including old vital signs and spelling errors.

Case 3. The dangers of templates

To access the full report, click here.











EHR-related medical malpractice claims tripled since 2010, study finds: A total of 216 EHR-related medical malpractice claims closed between 2010 and 2018, according to a recent Doctors Company study.