Future of Healthcare Technology by Mediaplanet_USA

A Mediaplanet Guide to The Tech Shaping the Future of Hospitals

Future of Healthcare Technology

Dr. Bertalan Meskó, PH.D. The director of the Medical Futurist Institute shares why the future is now for technology in healthcare

AUGUST 2021 | FUTUREOFPERSONALHEALTH.COM

How tech could make doctors’ waiting rooms a thing of the past

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Avoiding the Telehealth “Cliff” to Maintain Access to Convenient, Quality Care Last year at this time, telehealth became a household word. From March to June of 2020, 30 percent of all outpatient care was delivered via telehealth, in contrast to 0.8 percent in 2019.

he virtual visit became a universally understood concept, and by all accounts, patients loved it: 83 percent reported overall high-quality visits, and over 75 percent said they would continue using telehealth to manage chronic diseases, including hypertension and diabetes. Today, as telehealth becomes a standard tool in care delivery, healthcare providers are striking an appropriate balance of in-person and virtual care, and we expect telehealth to account for 20-30 percent of care delivery moving forward. The telehealth cliff However, there is much uncertainty around the

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future of telehealth, as temporary policies enacted during the pandemic to allow access to telehealth will immediately end when the federal public health emergency expires, which could be any day now. This is creating chaos and concern for patients and healthcare providers alike, as this “telehealth cliff” threatens to abruptly cut off access to care, especially for underserved and rural populations, and Medicare beneficiaries. One of our biggest priorities must be to ensure passage of federal policies and state laws that support the permanent, widespread adoption of telehealth. Adding to this urgency is that the challenges our healthcare system faced

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One of our biggest priorities must be to ensure passage of federal policies and state laws that support the permanent, widespread adoption of telehealth.

before COVID are still with us and continue to escalate, including striking healthcare disparities and inequities, an aging and increasingly ill population, and an inadequate supply of providers to meet demand in the same manner we have in the past — face-to-face and one-toone care. Making telehealth a permanent option will address many of these problems as we’ve witnessed over the past 17 months. Enacting change We must make our voices heard. Urge your elected representatives to pave a regulatory path that enables permanent access to telehealth, and tell your employers and insurance providers that you want the option to

receive appropriate care via telehealth services. In September, during Telehealth Awareness Week, take the opportunity to join thousands of others to support telehealth as a quality care choice for your families and all Americans. Many of us have seen the significant contributions telehealth has made in our national response to COVID-19. Now is the time to permanently expand access to these services for the millions of people in the United States who need a safe, effective, and convenient option to access their care. n Ann Mond Johnson, Chief Executive Officer; Joseph C. Kvedar, M.D., Chair of the Board, American Telemedicine Association

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Publisher Neetu Wadhwani Business Developer Abe Freedberg Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Tiffany Jackson Lead Editor Mina Fanous Copy Editor Dustin Brennan Partnership and Content Production Manager Jordan Hernandez Cover Photo András Zoltai All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve OR Today. PLEASE RECYCLE.

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Are Artificial Intelligence and Healthcare a Guaranteed Partnership? For hospitals, the “AI revolution” has barely begun. AAMI Committee experts explain why that is and whether a future for AI in healthcare is guaranteed.

ou’re out hiking when you feel a sharp, near-icy pain in the back of your left calf; it’s a bite from a snake coiled less than a foot away. You snap a picture of the snake with your smartphone and upload the photo to an app, which uses an algorithm to produce the result: “Dangerous. Seek help.” Minutes later, help arrives with the high-pitched whir of a drone. Its cargo is a small box with bold, red lettering: “Antivenom.” This scenario remains something of a pipe dream, for now, says Pat Baird, regulatory head of global soft-

ware standards at Philips. But the technologies that can make it happen are already very real. “It’s a little off the beaten path from the typical diagnostic imaging kind of use case that people talk about,” Baird said, “but wow, wouldn’t that be so cool?” AI’s future in healthcare So, what about applying this amazing technology towards saving lives? “You know, there are only a handful of FDA-approved devices that use AI,” said AAMI AI committee co-chair Jesse Ehrenfeld, M.D., M.P.H. “The first was for detection of diabetic ret-

inopathy, which is a really important problem.” Ehrenfeld (immediate past chair of the American Medical Association Board of Trustees and a professor of anesthesiology at the Medical College of Wisconsin) explains that one of the strongest benefits of the technology is not that AI-based devices will replace clinicians. It is, rather, that they augment the capabilities and scale of medical staff. In areas where manpower is lacking, such as patient monitoring and data analysis, AI can compensate. “We can’t make ophthalmologists fast enough to screen every patient in

America with diabetes, but there’s now a device that you can park in a corner of a drugstore,” he added. With the device’s aid, a high school-trained technician can screen and diagnose a patient “with a very high degree of certainty.” Trust issue However, some clinicians are hesitant to accept these new technologies. After all, the consequences of an AI causing a mistake in a medical setting are far greater than a digital assistant misunderstanding a request to turn on the lights. For instance, in the case of Baird’s antivenom example,

what would be considered an acceptable margin of error? If the wrong antivenom is delivered, a patient may die. And if a patient’s medical history is not correctly taken into account, severe allergic reactions to the treatment may occur. “Also, how do we think about reliance on the technology?” Ehrenfeld asked. “My residents in training today have never documented an anesthetic for a surgical case on paper. They’ve always had electronic health records. So what happens when an AI algorithm isn’t working, and prompts aren’t there to remind caretakers to readjust the antibiotics? Will they be prepared for this? “It reminds me of this story of this couple who drove directly into a lake because their GPS told them to,” he adds. Most of the time, mistakes like this can be avoided “because common sense kicks in.” Personally, Ehrenfeld is eager to make AI trustworthy enough to introduce into his own day job, earning more meaningful face time with his patients. “I actually think AI is going to help us re-humanize healthcare. It’s making it so caregivers have more time to give care,” he said. “To me, that’s the payoff of this technology.” n Brian Stallard, Media Relations Manager, AAMI

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Did you ever wonder what would happen if your local hospital or trusted physician went out of business because they failed financially? Did you even know that was possible? Unfortunately, it’s a stark reality we must face in today’s complex healthcare environment. According to an article published by the Healthcare Financial Management Association, between March 1 and June 30, 2020, healthcare providers lost a staggering $202 billion. Why? In part because their revenue cycle — the process of collecting out-ofpocket costs at check-in, correctly charging for services, filing claims, and receiving reimbursements from payers (primarily insurance companies) — is fraught with administrative waste and error. The good news? Many of these costly mistakes can be prevented with the right dose of technology and data — a “prescription” that can restore the financial health of providers and sustain their well-being. Here are five tips for achieving and maintaining a healthy revenue cycle: 1. Give patients accurate estimates before they receive care In healthcare, making prices transparent is the law because patients should be able to shop around for their

5 Ways Healthcare Providers Can Stay Financially Fit

care, much like they would any other purchase. But many providers lag behind in meeting this requirement, leaving patients in the dark. To make pricing accessible, providers should use technology that creates estimates that are at least 90 percent accurate and can be generated online at the patient’s convenience. Patients who know what to expect are more likely to pay upfront for services, preventing providers from incurring costly collections processes and bad debt. 2. Charge correctly for patient care That sounds easy, but it’s quite complex. Prices and industry regulations are constantly changing, making it difficult to stay current. Providers need a central source of truth, a cloudbased technology platform called a charge description

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master that provides benchmark pricing for hundreds of thousands of supplies, medications, and services. And they need auditing technology to make sure they capture every charge they are owed. These tools ensure pricing is consistent and compliant with regulations. 3. G et fast, accurate reimbursements For this to happen, providers need to: 1. file accurate, complete and properly formatted claims, 2. continuously scrutinize contracts they have with payors, and 3. efficiently collect what is owed. The right technology takes care of it all. Claims management tools can deliver a “claims acceptance rate” of nearly 99 percent. Contract management tools accurately forecast, calculate, and capture the total revenue owed from com-

plex contracts. Collections management tools analyze a provider’s accounts receivable workflow, determine the causes of delays, correct errors, and collect payments. 4. Leverage data and “bots” to improve efficiency Providers are typically blind to the meaning of all the datasets in their various billing systems. Data analytics tools integrate and map this data into one holistic view, giving providers more insights into their operations, identifying performance improvement opportunities, and informing their decision-making. In addition, providers can use software robots (bots) to perform repetitive, manual tasks, freeing up staff to focus on high-value work and increasing productivity. 5. Tap into knowledge sources to stay current

With all the complexity and change, providers need a cloud-based platform that continually delivers updated coding, billing, and regulatory information to reduce waste and errors throughout the revenue cycle. To maintain and grow staff expertise, they should consider offering employees an online revenue cycle education program that includes certifications and cross-training to increase engagement and retention, as well as online and easily accessible billing and coding references. With the financial health of our hospitals and physician practices so critical to maintaining the health of our nation, providers would be wise to get an end-to-end revenue cycle check-up and follow the recommendations of healthcare technology experts. n Hemant Goel, CEO, nThrive

The Healthcare Tech Hospitals Need to Focus On As the founder of Healthcare Scene, a network that consists of 10 healthcare IT and electronic health record blogs, John Lynn is a leading healthcare futurist and tech influencer. We asked him about the advancements in healthcare tech he’s keeping an eye on, and what they mean for the future of our health system. Over the past year, where have you seen technology make the biggest impact in terms of the way patients access care?

solutions as well. The good news is that telehealth will continue to get better now that more people are using it.

The biggest change we’ve seen is the confluence of a number of technologies. The first is our ability to communicate with anyone at any time thanks to a smartphone in our pocket and the ability to text. The second is the amount of data we have available to us. Third is the growth of AI and the processing power that’s needed to be able to make sense of the data. When you combine these three items together, it has opened up new doors to care for patients. The past year just forced us to use all of these technologies to push care to the home. It overcame the bureaucracy and fears that many had about changing the model of care. The last year also shared some of the disparities that exist as well. However, if implemented properly, more patients will have access to lower cost care in a modality that works for their unique situations.

What will healthcare look like in the next five years?

What kind of technology should healthcare providers be prioritizing today?

John Lynn Healthcare Futurist and Tech Influencer, Founder, Healthcare Scene The top thing healthcare organizations can prioritize today is what technologies will help them to have better relationships with their patients. Clinicians have done amazing work in the office, but the future is going to depend on how well they leverage technology to extend that relationship outside the office. Having a communication channel and relationship with your patients is going to be key to success in the future. Are the existing telehealth platforms in the industry set up to

be user-friendly and convenient enough for an older demographic? There are hundreds of telehealth technologies, so it’s impossible to make a broad statement about how user-friendly they are or are not for the older demographic. What we have seen is that age is less of an issue for telehealth than many had thought previously. Most telehealth solutions are simple enough that the older demographic can use them. Plus, many of their caregivers can help them navigate the telehealth

For most traditional healthcare organizations, the next five years will look very similar to before. However, while they continue on their traditional path, we’re going to see a large number of startup companies, retail healthcare, and national healthcare brands that start to chop off various portions of healthcare as we know it. As these new entrants take over the highly profitable segments of patients, it’s going to be a challenge for healthcare organizations to adapt and change their business models. The good news for patients is they will have a number of new options to choose from when it comes to how they access healthcare. Some will turn to new primary care models. Others will turn to telehealth. Some will want to go with the national brands that provide a better consumer than their local healthcare system. Patients’ expectations will change and a more consumer-like experience will be expected. n

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aiting frustrates patients. What’s less obvious is that long wait times also frustrate doctors. Until now, we as doctors have been powerless to change the inevitability of the paradigm. We’ve always met patients in our offices to deliver care, a system that requires organizing a schedule and providing a space for patients to wait. Our staff schedules the appointments without knowing how long a particular patient will need on any given day. Often a patient is scheduled for 10 minutes, but they need 20 or 30. And then there is the daily “unexpected.” A mass is found during a routine annual visit. A patient

Is the Dreaded Doctor’s Waiting Room Finally Going Away? The doctor’s waiting room: We all know it. We’ve all been there. Just thinking about it dredges up negative associations — boredom, annoyance, and even anger.

scheduled for a quick blood pressure check complains of acute chest pain. The hospital calls to gather information about a patient being admitted, and so on. We know overcrowded

waiting rooms and frustrated patients damage our reputations and lead to lost business. We watch our online rankings plummet; five stars for knowledge and bedside manner, one star

for wait times. And we see our patients opt for minute clinics and urgent care just to avoid our dreaded waiting rooms. But for years we’ve lacked real solutions to fix this problem.

Telemedicine One silver lining to the COVID-19 pandemic was the rapid shift to virtual care and the removal of government-regulated barriers to delivering this care. As we

Driving performance improvement in health care At Vizient, we use our unparalleled data and scale of membership to connect leaders and create customized strategies that set them up for success in a rapidly changing environment. Learn more at vizientinc.com © 2021 Vizient, Inc. All rights reserved.

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move beyond the pandemic, we know one thing for certain: Both virtual care and in-office care are here to stay. The healthcare community now realizes that it is imperative to rethink the

traditional waiting room. Patients coming in to be seen in person will no longer tolerate crowding into a room with other sick patients for extended waits, and patients being seen virtually will

expect a virtual wait to pair with their virtual visit. Leveraging tech The pandemic also helped introduce technology solutions that address the

waiting room problem. These solutions range from mobile registration platforms for patients to fill out paperwork online, to texting platforms for patients and staff to communicate before patients arrive, to true virtual waiting rooms that predict schedule delays and send automated notifications to patients in real time. For healthcare organizations contemplating such solutions, selecting a usable platform is as important as selecting one that is robust and meets system needs. A platform that is easy for patients to interact with and can be easily accessed by staff will drive ready adoption. Designing a simpleto-use platform is often a complicated endeavor, so when selecting a platform,

it’s helpful to understand whose input went into the product design. A product designed with input from daily users — physicians, nurses, practice administrators, or office staff, will have a tremendous advantage over one designed solely by engineers who have never observed office workflow firsthand. A technology-driven waiting room is a win-win for all stakeholders. Physicians and healthcare organizations are rewarded with efficiency gains, better online reviews, and reductions in burnout from a more seamless workflow. And patients feel empowered because they’re kept informed and their time is respected. n Dr. Jennifer Meller, Internist, Founder, Navimize

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What technology should healthcare providers be prioritizing today? It’s certainly not one or two technologies healthcare providers should be prioritizing today. Instead, they should embrace two approaches: patient design and digital health. Patient design means you involve patients on the highest level of decision-making in the organization, meaning you only design physical facilities, treatment processes, and guidelines or even products with them. Embracing digital health means healthcare providers acknowledge the cultural part of healthcare’s transformation. One example clearly shows what it means in practice. If you focus on a given technology, such as virtual reality, and give devices to patients staying at the hospital for longer times expecting that they would feel less pain by virtually swimming in the ocean or visiting other countries, you won’t succeed. But if the caregivers of patients

take part in the process, acting as coaches to discuss the expectations, the technology, and the whole experience, researchers have been able to prove that patients’ pain scores get significantly lower. What will healthcare look like in the next five years? Patients will be empowered, easily and routinely reaching out to technologies, information, peer support, and second opinions. Digital health technologies will make them the point of care, meaning they will be able to receive care wherever they are through the technologies they and their caregivers use. We will see fewer interfaces in the doctor-patient meetings allowing two people to have a meaningful conversation while being surrounded by invisible, seamless technologies. Medical professionals will closely work with automation, especially artificial narrow intelligence, to remove the repetitive components of their job. n

Why the Future of Healthcare Should Include More InHome and Telehealth Visits Healthcare delivery continually evolves. Looking to the past and how care was delivered in homes and communities may lead us to a better future. Before there were hospitals, care of the sick, injured, and dying was done in the home. Most of the care was administered by family members or friends at the direction of a community physician. Eventually, hospitals were constructed, and medical and nursing care was provided where resources were readily available. Hospitals and hospital systems have continued to care for patients inside their

walls for decades, however, the complexity of patient care and the associated costs continue to rise and are not sustainable. Healthcare in the United States is increasingly costly because the system is not standardized. A system that is revamped to be more standardized would help drive costs down, and streamline billing and other payment processes. Changed times Patients who are hospitalized today have multiple comorbidities that require more nursing and medical care to treat and stabilize. Many patients with chronic conditions lack

the resources and support needed in their communities to reduce the frequency with which they are admitted to the hospital. There are many reasons for this, and there is a high likelihood they are related to social determinants of health (SDOH), which include economic stability, education, social and community context, health and healthcare, and neighborhood/environment. In the past several years, many major organizations have called on healthcare providers and nurses to address SDOH to provide better, more equitable care to all people, and national initiatives like The Future

of Nursing 2020-2030 are underway. In-home visits and telehealth As Americans age, illnesses become more chronic and complex, and healthcare costs increase, so healthcare providers are looking for better ways to provide care. One of those solutions is a return to providing care to patients in their homes. This may take two forms: in-home visits from healthcare personnel and telehealth, which became a crucial care delivery method when the COVID19 pandemic began. These methods are often used simultaneously.

In-home visits and telehealth will decrease costs associated with inpatient care. Patients would only go to the hospital if they have an emergency, need surgery, or require a more intensive treatment or test, or sophisticated care. Treating patients at home also reduces exposure to hospital-acquired conditions, and provides patients a familiar and comfortable environment in which to receive care. Helping people stay in their homes as they age is of paramount importance to their independence and quality of life. As technology advances to include improved connectivity of devices, remote patient monitoring, and expanded telehealth, creating smart homes that help people overcome the obstacles they face due to aging and chronic disease will allow families to stay together and decrease the costs of healthcare. However healthcare evolves in the coming years, it will be imperative that the hospital of the future promotes and ensures equitable care for all. Healthcare leaders must build these structures with an eye to patient populations that do not have the infrastructure necessary to be cared for at home, and ensure no one is left behind. n Dr. Summer Bryant, DNP, RN, CENP, CMSRN, President, Academy of Medical-Surgical Nurses (AMSN)

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rimary care physicians use apps to identify potential drug interactions when writing a new prescription. Patient records are electronic in almost all hospitals and most doctors’ offices. The coming decade will witness an even more dramatic transformation in the delivery of healthcare through artificial intelligence (AI), automation, and robotics. Bertalan Meskó, M.D., Ph.D., the director of The Medical Futurist Institute, has identified nine areas of medicine that are already experiencing significant automation-related disruption: mining medical records, designing treatment plans, assisting repetitive jobs, getting the most out of in-person and online consultations, health assistance and medication management, precision medicine, drug creation, open AI helping people make healthier choices and decisions, and analyzing a healthcare system. Here are four more in-depth explanations about how AI is affecting healthcare: Image analysis Medical imaging was the first medical specialty to witness transformation resulting from AI. The days of holding up an image

Healthcare Meets 21stCentury Technology Although lagging many other industries, the use of advanced technology in healthcare is nothing new. on a light board have long passed. Computers can often analyze and help interpret today’s digital images much more accurately and incorporate vast amounts of related data, such as lab tests, medical history, prior images of the patient, similar images of thousands of other patients, and research findings from millions of relevant clinical studies. Philips, Siemens AGFA, and IBM are already integrating AI into their medical imaging software systems. Years of studies in automated interpretation of radiology and pathology images, and cardiac scans have shown that computers are becoming (or have become) superior to humans in identifying abnormalities.

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The visual examination of PAP smears is time consuming and expensive, while successful efforts to automate the analysis have existed for more than 60 years. The results of many electrocardiograms are read by the software first and only then reviewed by the provider. Today, very few doctors would dare to read an electrocardiogram without having it first read by a computer, if one is available. Robotics Medical robots are already used to perform repetitive tasks and those that require intense dexterity. Robotic surgery has been in use in minimally invasive surgeries for over 30 years, and by 2025, surgeons could perform as many as 170,000

new robotic procedures annually. InTouch Health, manufacturer of telemedical robots, enables providers to remotely move around a hospital. The robots are in over 2,000 health facilities, boasting 750,000 documented clinical encounters. Clinical decision making Science fiction has long depicted how computers can provide medical care, but multiple projects using AI to help make medical decisions and provide treatment are here today. Many such applications use deep learning — a technique similar to our brain’s neural network — by sifting through vast, unstructured, seemingly unrelated data in order to teach themselves,

identify relationships, make classifications, and formulate predictions. It’s similar to the intellectual process used by skilled experts to make instant judgments based on years of experience and knowledge from a variety of sources. Effects on the medical profession AI, automation, and robotic applications in medicine are called “decision support,” implying that the doctor is still in control. However, these “virtual assistants” are learning fast and some medical professions could see a time when such advanced technologies are more reliable, productive, and trusted by the patient. That could result in a redistribution of some types of providers. But, like other industries, change has been constant in medicine, and such change is getting faster. It’s no surprise that the use of advanced technologies is accelerating in healthcare. Transportation, finance, and entertainment already widely use AI. With the cost of healthcare spiraling and the population aging, it’s time to discover and deploy the benefits of technology to help us take better care of ourselves. n Jonathan D. Linkous, CEO, Partnership for Artificial Intelligence and Automation in Healthcare (PATH)

5 Reasons to Continue Advocating for Telehealth

So many Americans had their first telehealth experience during the COVID-19 pandemic, and for many reasons, I think telehealth is here to stay. Patients have discovered its benefits, and as we say at the American Health Information Management Association (AHIMA), “the genie is out of the bottle.” While some medical appointments are better suited for in-office visits, telehealth offers numerous benefits. Here are five:

1. R eaching the underserved People who live in areas far from medical providers can now meet with one without traveling. And telehealth is beneficial for people who don’t drive or don’t have easy access to transportation. 2. Providers are familiar with telehealth Many doctors, nurses, and other healthcare professionals have lots of experience with telehealth, and patients are often surprised how similar a

telehealth visit is to an in-person appointment.

patients must travel to the doctor’s office.

3. Reducing exposure At this point, we’re all familiar with the importance of avoiding exposure to viruses. During cold and flu season, or any time of the year, there are obvious benefits of having fewer people in a provider’s waiting room and office.

5. Making appointments easier Life happens and things come up; I’m sure most of us have had to cancel a medical appointment at the last minute. Only needing to pick up a phone or open your laptop makes it easier to meet with a provider, which reduces cancelations and benefits our healthcare system as a whole. I’m proud AHIMA recently released a policy statement that says we support “the use of public policy and other

4. Remote monitoring Telehealth makes it easier for providers to monitor patients with chronic conditions and it limits the number of times those

tools to expand access to care, reduce costs, and improve convenience for patients by using telehealth and remote patient monitoring technologies.” I believe our members — health information professionals — have the knowledge and experience to contribute to the development of public policy around telehealth so patients can continue to experience its benefits. Learn more about telehealth at AHIMA.org. n Wylecia Wiggs Harris, Ph.D., CAE, CEO, American Health Information Management Association (AHIMA) MEDIAPLANET

How Tech Advancements Are Shaping the Future of Healthcare

Dr. Sanjay Gupta, M.D., Neurosurgeon, Chief Medical Correspondent, CNN

Dr. Cole Barfield, M.D., M.B.A., Chief Medical Officer & Co-Founder, Wellview

Geeta Nayyar, M.D., M.B.A., General Manager of Healthcare and Life Sciences & Executive Medical Director, Salesforce

In the past year, overlooked technologies — like telehealth — became critical to the delivery of quality healthcare. Our panel of experts weighed in on how the growing use of these technologies will impact the future of our healthcare system.

Technology is moving into the healthcare industry in various ways — what are the benefits to this trend? Sanjay Gupta: In the world of telehealth, the doctor will always make a house call. That is, by mobile device or other technological means. Surely this is a way to improve the global health of the world. In developing countries with very little or no access to high-quality medical care, but often access to a mobile device, it has the potential to change the health outcomes for people everywhere. Over the past year, where have you seen technology make the biggest impact

in terms of the way patients access care? Cole Barfield: Telehealth has been the primary driver for improving access to care over the past year. The pandemic forced quick adoption of telehealth with both patients and providers to accommodate physical distancing while also enabling the delivery of care. In the past, telehealth was primarily driven by simple sick visits. Though this continued to be a trend, especially during the pandemic, we also saw an expansion of telehealth services for continuity of care and chronic disease management. Telehealth is a transformative way in which patients and providers can communicate and provide access to care.

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Geeta Nayyar: The pandemic necessitated, and therefore accelerated, a digital transformation that was already occurring in healthcare. Providers were forced to embrace virtual and digital solutions overnight to continue providing patients with the care they need. But what also happened is that as providers and patients began using these technologies, they found out they actually liked using these services. What kind of technology should healthcare providers be prioritizing today? CB: Remote patient monitoring (RPM) is the use of digital technologies to monitor and capture real-time health data from patients providing critical insight to providers. As

providers, we must prioritize the use and integration of this data in the EHR. Tech-enabled RPM is key to providing convenient and high-value care right now, and even more so in the future. What do you predict for the future of telehealth and health, and how it will impact healthcare in general? SG: There is no doubt that it’s coming, and fast. It will revolutionize the industry. It really shines in primary care. If you have an established relationship with your M.D. and they are available via mHealth, then continuity of care is a big win for you. Your doctor can continue to maintain a central archive of your medical records. It also means that if you live in a

restricted or rural area, it can be a good option. What will healthcare look like in the next five years? GN: We’ve opened Pandora’s box when it comes to virtual care, and there is no going back. In five years, you will see that healthcare is far more accessible from your home and your devices. Guaranteed, there will be more opportunities to virtually connect with your doctor and specialists, and easier ways for providers to monitor your health between appointments and outside of their office. As healthcare becomes easier to access, patients will become savvier about the choices available to them and the costs, and I would imagine that easier access to care will drive costs down. n

The Seven Steps to Workplace Wellness Living during and through a global pandemic has raised some very important questions about how to operate our businesses and how to achieve employee wellness. If you think about the workplace as a microcosm of broader societal issues, there is a lot to learn from the different ways people are or are not thriving during this pandemic. How can treating the organization as that microcosm make us better at navigating wellness? Access to proper care, social connection, resources for healthy living, and adequate physical

safety are all basic human needs that also need to be fulfilled in the workplace. Wellness is more prominent in the workplace than it ever has been before. This means organizations need to think about whether their employees feel taken care of and safe. Organizations looking to bring people back to work need to reassess the basics of human need. Do employees feel their organization has cared about their needs and safety through this pandemic? Not feeling supported by an employer could have some serious consequences for both employee

wellness and employee engagement. Organizations should start with asking questions like,“How can I help fulfill my employees’ needs?” The goal is to create a microcosm of wellness that makes employees feel truly cared for in the midst of uncertain times. In order to achieve true wellness at work, here is a list of basic human needs that should be reflected in the workplace: 1. Health Beyond the absence of mental and physical illness, health is a feeling of strength and energy from your body and mind.

2. Meaning This includes feeling part of something bigger than yourself, knowing your work matters, and having purpose. 3. Safety Knowing you are safe from physical and psychological harm, and being able to trust your organization and team is paramount. 4. Connection Experiencing positive, trusting relationships with others. Feeling a sense of belonging, acceptance, and support. 5. Achievement Feeling you have the sup-

port, resources and autonomy to achieve your goals. 6. Growth Learning and being challenged to use and expand on your strengths. 7. Resiliency Viewing life with optimism. Feeling grateful and expressing appreciation. Wellness requires investing in what humans are motivated by and what they truly need. Let’s get back to what we know about basic human needs, and let’s think about that in the context of the future of work. n Sara Martin, CEO, WELCOA MEDIAPLANET 13

Making Health Information Accessible Where and When It’s Needed Public policies drove the adoption of electronic health records across the United States, but they did not include some types of providers, hampering healthcare’s ability to achieve complete interoperability. Consumers today expect instant access to all types of information at their fingertips, whether it be banking transactions, map data, or any number of other pieces of data available on personal electronics. Accessing healthcare information, on the other hand, is anything but instant, but that may be changing as the U.S. government has gotten serious about data exchange. Thanks to landmark legislation known as the Health Information Technology for Economic and Clinical Health (HITECH) Act contained in the American Recovery and Reinvestment Act, a big

investment in healthcare technology was made beginning in 2009. Importantly, HITECH gave much-needed funding to hospitals and clinicians to invest in electronic health records (EHRs) and, as a result, most of these healthcare providers have EHRs today. These investments were an important down payment focused on fostering greater digitization of patient data, although it fell short of enabling providers to exchange information seamlessly with one another. One reason for this shortfall is that not all types of healthcare providers were eligible for the above-mentioned programs and, consequently, interoperability across the healthcare sector has not been uniform or without challenges. A seamless experience Then in 2016, the 21st Century Cures Act pushed healthcare providers, EHR vendors, and

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other stakeholders to ensure patient data is appropriately shared with other providers and accessible to patients themselves. Congress specifically called for — and federal agencies have subsequently mandated — the use of application programming interfaces (APIs); the technology in widespread use today across other industries to facilitate rapid and seamless access to information via third-party apps on smartphones. These APIs should, one day, bring healthcare to the level of seamless data access enjoyed by banking and other consumer-facing industries. For healthcare, the hope is that APIs will make it easier for patients and clinicians to download, exchange, and manage healthcare information through both EHRs and third-party applications like smartphone apps. The U.S. Department of Health & Human Services’ Office of

the National Coordinator for Health Information Technology (ONC) and U.S. Centers for Medicare & Medicaid Services are overseeing the implementation of the 21st Century Cures Act and the ensuing provisions by working to unlock this data long trapped in inaccessible siloed systems. Easy access Also included in the 21st Century Cures Act is a set of terms and conditions for how this data exchange will operate, known as the Trusted Exchange Framework and Common Agreement (TEFCA). Currently planned to be finalized by ONC in 2022, the TEFCA will serve as a voluntary set of policies intended to work as an “on-ramp” to nationwide connectivity and data sharing across the care continuum. With the TEFCA in place, much of healthcare will have

both the means and opportunity to share data with other providers and patients with few barriers. That is, of course, if you are one of the providers that is able to actually participate and benefit from these programs. As mentioned previously, not all provider types have benefitted evenly from programs and policies intended to drive better healthcare data sharing, with many still effectively locked out or with limited ability to meaningfully participate. All the goals of advancing interoperability across the United States are laudable but will ultimately fall short of being revolutionary unless everyone is included in the interoperability conversation. Healthcare as an industry must continue to push forward into the future, innovating and creating new technologies. While we do so, however, it’s crucial we raise the floor to ensure all provider types have access to this evolution of care. If all providers aren’t able to gain access to patient data, it ultimately is the patient who suffers as they must continue to navigate a partially interoperable health system without the complete seamless flow of data they were promised so many years ago. n Mari Savickis, Vice President, Public Policy, College of Healthcare Information Management Executives (CHIME)

Ensuring Security and Privacy in an Age of Patient Empowerment Patients are better positioned to take ownership of their health and care, thanks to recent advancements in digital health. These benefits come with some security and privacy risks, though.

wo recent advancements in d i g i t a l health have empowered patients by making their health information easily accessible to them. The 21st Century Cures Act is helping usher in an era of consumerism by focusing on ensuring patients can easily attain electronic access to their health data through third party apps. In addition, the pandemic accelerated the adoption of telehealth, with patients and providers embracing the use of digital technology in the delivery of care. Thanks to these innovations, patients are in a better position to take ownership of their health and care. These benefits come with some risk, though, because patients and providers are not the only ones who seek to access a

patient’s protected health information (PHI). Bad actors — cyber criminals, unfriendly nation states, rogue employees — look for vulnerabilities in technology to exploit in hopes of gaining access to data. Their reasons can range from greed to malice. According to the Cybersecurity and Infrastructure Security Agency, an American’s PHI is up to 20 times more valuable than credit card data on the dark web, making it an attractive commodity for cyber criminals. Ransomware attacks appear to be on the rise, too, with breaches like the attack on software supplier Kaseya making headlines this year. Protecting data Healthcare IT executives are aware of these threats, and it is our responsibility to protect patients’ PHI within our organizations. As the footprint of digi-

tal health expands beyond the walls of hospitals and health systems, so does the threat surface. Each digital device a patient or provider wears creates an exploitation opportunity for a bad actor, and once a weakness is found, the increasing interconnectedness of devices can facilitate the spread of malware. Application programming interfaces (APIs) present another challenge. The Cures Act has the laudable goal of promoting interoperability across the healthcare continuum, allowing data to flow seamlessly from one provider to another or from a provider to a patient. APIs that securely share data across disparate applications and systems are seen as the lynchpin; they make it easier for patients and clinicians to download, exchange, and manage healthcare information.

Cures and related provisions outlined by the Office of the National Coordinator for Health Information Technology (ONC) are now serving as the policy levers for the adoption and use of APIs in healthcare. Sensible steps We can mitigate security and privacy risks with common sense measures. The first is education. We are still early in our digital health journey, making it an opportune time to educate users in best cybersecurity practices. Many healthcare organizations conduct yearly (or even more frequent) trainings to promote good cyber hygiene by employees, including clinicians. By extending that level of education to patients, we can harden our defenses against bad actors. Our second resource is federal policy. Just as the

Cures Act set the stage for patient empowerment, policies that safeguard patient data can prevent exploitation. Several leading healthcare associations have voiced their concerns about APIs under the current rules and asked for appropriate oversight to govern how patient data is used by third parties. We can never eliminate risk entirely, but we can minimize it. Many digital health leaders believe we are going in the right direction with telehealth and data sharing. If we manage the risks diligently and wisely, we will reap the many benefits these technologies offer. n Scott T. MacLean, Senior Vice President and Chief Information Officer, MedStar Health; Acting Chair, Policy Steering Committee, College of Healthcare Information Management Executives (CHIME)

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