how telemedicine is changing mobile healthcare delivery

A new survey from Reach Health unearthed the pros and cons of making use of a telehealth program.

Approximately 436 healthcare professionals, executives, nurses and physicians took part in the survey, which was conducted in January 2017. Four percent of total participants were customers of Reach Health, a telemedicine software company based in Atlanta, Georgia.

Nearly one-quarter of respondents (21 percent) indicated telemedicine is one of their organization’s top priorities. Thirty percent said it’s a high priority, and 36 percent said it’s a medium priority. Only 13 percent consider telehealth a low priority at their organization.

Despite the majority of participants agreeing about it being a key issue, they expressed a variety of different reasons for implementing a telemedicine program.

Deliver better healthcare through effective use of secure mobile messaging

According to the survey, the ten most common telemedicine program objectives are:

• Improving patient outcomes
• Increasing patient engagement and satisfaction
• Improving patient convenience
• Providing remote and rural patients with access to care
• Improving leverage of limited physician resources
• Reducing cost of care delivery
• Reducing hospital readmissions
• Improving specialist efficiency
• Providing access to new specialties
• Providing 24/7 access to specialists

Other objectives included reducing emergency department overcrowding, increasing revenue and supporting research or clinical trials.

The majority of participants (59 percent) said their organization’s telehealth platform is primarily provided by a vendor. Forty-three percent noted their platform is primarily assembled internally using specialized components.

Regardless of which side of the build vs. buy debate they’re on, participants seemed to value a number of similar features in a telemedicine platform.

A few of the most crucial features are integrated audio and video for live patient engagement; the ability to produce documentation from each encounter; support for standard services; and the ability for clinicians to communicate through HIPAA-compliant messaging.

But the journey to a successful telemedicine program isn’t a piece of cake. Respondents also addressed the difficulties they face.

Top challenges include reimbursement (from Medicare, Medicaid and private payers) and inadequate telemedicine parity laws. Survey participants also said determining ROI, physician compensation and lack of EHR integration are problems.

Looking ahead, participants were asked how they expect a potential repeal or replacement of the Affordable Care Act to impact their telehealth programs.

Thirty-three percent said such an action would increase the significance of telemedicine in their organization, and only 3 percent noted it would decrease how much of a priority telemedicine is. Another 38 percent felt the importance of telehealth would stay about the same, and 26 percent said they can’t predict how it will change.

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how secure electronic messaging helps to communicate with patients

Deliver better healthcare through effective use of secure mobile messaging

Secure electronic messaging can help patients be better informed about their healthcare and improve access to healthcare providers, but the authors of a new study say more education is needed to improve the quality and efficiency of secure communication.

Researchers analyzed 1,000 threads – defined as strings of related messages – from two Department of Veterans Affairs (VA) facilities. Patients initiated an overwhelming majority of threads (90.4%), while caregivers began 4.1% of threads on behalf of a patient. Primary care team members initiated 5.5% of threads.

Patients and clinicians also used secure electronic messaging for different purposes.

Patients most often initiated messages to ask for a medication renewal or refill (47.2%). Patients also used secure messaging for scheduling requests (17.6%), medication issues (12.9%) and health issues (12.7%).

The majority of clinician-initiated threads (32.7%) were sent to report test results, followed by medication issues (21.8%), scheduling issues (18.2%) and medication renewals (16.4%).

Although some providers have expressed concern that patients would use secure electronic messaging for urgent medical issues, the researchers found that only 0.7% of patient-initiated messages contained content deemed clinically urgent.

Overall, patients viewed the use of secure messaging as an alternative to unnecessary in-person visits. It was also convenient and enabled easy, round-the-clock access to clinicians. Secure messaging also enabled patients to discuss potentially embarrassing topics.

The authors of the study, which was published in the Journal of the American Medical Informatics Association, concluded that both patients and clinicians could benefit from further education and training on the uses of secure electronics messaging. Most current guidelines for secure messaging focus on the technical and administrative areas, and not the potential use cases.

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healthcare tops highest data breach lawsuits across industry

Mobile Healthcare Messaging from Vectramind

In 2016, the healthcare industry faced the most class-action data breach lawsuits, according to a new analysis of data breach class action lawsuits by the law firm, Bryan Cave, LLP, although the risk of litigation following a breach is still relatively low.

 According to the recent HIPPA journal report on   data  breach litigation across industry conducted by Bryan Cave  show that  the healthcare industry topped lawsuits filed by victims of data security breaches in 2016. The report explains that while there is always a threat of legal action being taken by data breach victims, the risk of a company facing litigation following a data breach is fairly low due to the difficulty by  plaintiffs to establish that an injury has been caused.

Year over year, there was a slight (7%) increase in class action lawsuits filed against companies that have experienced a data breach although there was a fall in the number of breaches that resulted in lawsuits. The report shows only 3.3% of data breaches in 2016 resulted in class action lawsuits compared to between 4%-5% in previous years. In total, 76 class actions were filed in 2016 as a result of data breaches.

 Out of those 76 lawsuits, there were 27 unique defendants. The report confirms that the healthcare industry reported the most data breaches of any industry – 70% of the total – yet only 34% of class action lawsuits name healthcare organizations as the defendants. 

Healthcare was the leading industry for class action data breach lawsuits (26 complaints), closely followed by email providers with 33%. The figures for email service providers was heavily influenced by the disclosure of two massive data breaches by Yahoo! Restaurants were in third place with 11% of the total followed by the retail industry with 7%.

Healthcare data breach lawsuits fell slightly year over year. Lawsuits are most commonly filed following the exposure or theft of sensitive information such as Social Security numbers, medical data, health insurance information, and security Q&As – 89% of class action lawsuits resulted from data breaches where these types of information were exposed or stolen. 65% of the lawsuits alleged negligence as the primary theory. Data breach lawsuits are most commonly filed in the Northern District of California (32%), followed by the Middle District of Florida (11%), the District of Arizona (11%), and the Western District of Pennsylvania (7%).

social media sharing of patient info gets doctor fired

A doctor has recently been fined $500 by the State medical board after posting personally identifiable information about a patient on Facebook, a number of months after the incident caused her to lose her employment. This is a HIPAA violation that all healthcare professionals should take note of. The doctor, Alexandra Thran, did not post the patient’s name in her post, which would be an immediate violation of HIPAA Rules, but she did post sufficient information to enable the person to be identified. Another individual who visited Thran’s Facebook page was able to determine the identity of the patient from the information she wrote on the page, even in the absence of the patient’s name.

The disclosure of Protected Health Information, which includes references to medical treatments as well as health records, along with Personally Identifiable Information (PII) can result in civil penalties being brought against the covered entity and any individual responsible for the HIPAA breach. The penalties can involve time in jail. This is not the first incident of its kind. Nurses and doctors have been fired by their employers in California and Wisconsin for having social media discussions about patients via social media.

One problem is that users of social media are encouraged to share all manner of information with friends and relatives, yet in a work setting the potential for HIPAA violations means extreme caution should be taken. In this case the incident involved an ER doctor, and the conversation was not had with the patient. Some doctors may be choosing social media channels to interact with patients but there is considerable potential for a HIPAA violation.


Increasingly hospitals and healthcare institutions are slowly beginning to  tackle the issue and  healthcare providers start to develop policies covering the use of social media, the sharing of PHI and communicating with patients through secure channels. Social media use is only likely to grow, and with it so will the risk of causing HIPAA violations.

It is essential  to train the staff on HIPAA compliant Privacy Rules and to set strict policies covering the use of Facebook and other platforms. Many hospitals have identified the risk and have taken action and put together policies for staff to make it clear on what is allowed and what is strictly forbidden. Children’s Hospital Boston, for example, has just developed a 6-page document detailing allowable uses of social media and do’s and don’ts, with many other hospitals now electing to do the same.

how secure messaging helps in sharing medical record

Experience patient portal users have changed their views of secure messaging since adopting the tool, but still need some guidance on how to leverage it. 

Even seasoned patient portal users need more direction using various tool functions, primarily secure messaging, according to a recent study published in the Journal of Medical Internet Research.

The researchers set out to determine how experienced patient portal users perceive that technology. Although healthcare professionals and hospital leaders are concerned with both patient and provider perspectives on the portal, much of this concern comes prior to implementation. This kind of data asks whether the patient and provider would be willing to use the patient portal.

“One important limitation of this literature on patient portals is that studies of patient and provider perspectives on portal use focus on the pre-implementation or initial implementation phases and do not reflect how use and perspectives may change as users gain more experience,” the researchers said.

Understanding how experienced patient portal users perceive the tool is growing more important. Most hospitals and clinics have already adopted the patient portal in some capacity – in 2016, 92 percent of hospitals had adopted the patient portal, per an AHA report.

It is now less important to know whether stakeholders are willing to adopt the portal, and more important to understand how to improve the patient portal experience.

The research team also sought to understand patient and provider opinions about secure messaging functions. Secure messaging is emerging as a popular portal function because it allows patients and providers to forge deeper relationships.

Through qualitative interviews with 13 primary care providers and 29 of their chronic disease patients who are familiar with the Epic MyChart, the researchers found that perceptions about the patient portal have evolved over time.

“Our study suggests that initial concerns about overuse and security of information expressed by patients and providers in pre-implementation studies may no longer apply as users gain experience,” the team found. “Instead, experienced users identified concerns beyond the technical aspects of using a portal.”

In previous literature, providers expressed time constraint concerns about using secure messaging, for example. Now, patients and providers are more concerned about how to appropriately use secure messaging.

Deliver better healthcare through effective use of secure mobile messaging

Patients reported worrying about abusing provider time and the lack of compensation providers receive for answering secure messages. Patients also expressed confusion about what is and is not an urgent matter that should be discussed via direct message.

Providers said they were concerned about communicating appropriately and sensitively with their patients.

“Unlike other portal features such as scheduling appointments or requesting prescription refills, secure messaging requires interaction with another individual and therefore users need to understand more than simply the technical aspects of how to access a feature,” the research team pointed out.

“Appropriate use requires an understanding of the type of information that should be conveyed via the portal and the etiquette rules of electronic communication,” the researchers continued.

Informed by patient and provider responses, the investigators offered a series of suggestions for enhancing patient-provider communication via the patient portal. The team suggested adding links in the sidebar of patient-facing messaging screens to help patients decide if their need is urgent.

The researchers also recommended guided messages that allow patients to fill in the blanks about their health needs. These templates should be flexible for patient editing and be offered in multiple formats to fit different needs.

While these findings are notable for improving patient and provider use of the patient portal, they also highlight how opinions about the tools can evolve over time.

“Patients struggle to balance their desire to respect their provider’s time with their need for answers to health-related questions,” the researchers said. “Providers are still figuring out how best to communicate with patients via portals in a way that addresses patient needs without overstepping boundaries.”

“These findings suggest that additional information and training on the ‘rules of engagement’ may help address the concerns of both patients and providers and improve the efficiency of communication via patient portals,” the team concluded.

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how direct secure messaging is a standardized protocol for exchanging clinical messages

As more patients incur high out-of-pocket healthcare costs, they're turning to methods like secure direct messaging to boost their level of care without hurting their wallets.

Better communication through secure direct messaging may be the key to helping patients navigating an increasingly financially rigorous healthcare industry.

Patients are facing the surge of high deductible health plans, incurring on them higher out-of-pocket costs and a disincentive to seek certain healthcare services.

But patients, especially those managing chronic illnesses, still need and want to access care whenever they face a health complication. To reduce high out-of-pocket costs while still getting the care they need, patients can turn to their own online engagement to help serve their needs.

Secure direct messaging functions, which are already part of most patient portals, can help patients keep their costs low while keeping their care quality high. Secure direct messaging and email messaging between patients and providers help patients access their care in the right place.

This is a tenet of providing value-based care. Patients with mild health symptoms that can be treated with easy-to-access over the counter medications may be better served through direct secure message.

“In a lot of cases patients secure message their doctors and they ask, ‘I’ve had this concern about chest pain or a rash that won’t go away, should I come into the office?’” said David Clain, manager at athenaResearch. “A lot of times the answer is no, and you can address a lot of concerns a patient has just through secure messages and they don’t have to come in.”

Such logic works in reverse, too. Doctors can instruct truly urgent cases to come in as soon as possible, helping to reduce the issue before it becomes too catastrophic.

“But in some cases the answer is yes, and sometimes there are rather urgent issues that come up and a cardiologist can say ‘if you’re having chest pains I’d actually like to see you today,’” Clain noted.

Helping the patient get the right care at the right location is very important for patient’s finances, as well as the healthcare system at large.

Research shows that not only does secure direct messaging help patients access care less expensively, but patients want to engage this way.

Deliver better healthcare through effective use of secure mobile messaging

Patients with higher out-of-pocket healthcare costs are notably more likely to engage with their providers through secure direct messaging over the patient portal, a study in the American Journal of Managed Care says.

In a survey of over 1,000 chronically ill patients, the research team led by Mary Reed, DrPH, determined that several financial factors may influence the extent to which patients contact their doctors through secure email.

A total of 85 percent of patients with high deductible health plans reported selecting secure direct messaging with their providers, while only 63 percent of patients with low deductible health plans reported the same.

Not only did secure direct messaging help patients access care in a less expensive way, but it also had positive effects on their health.

Thirty-two percent of patients primarily using secure direct messaging reported that method of contact improved their overall health. Only 22 percent of those not using secure direct messaging during the test period saw an improvement on their health.

One possible explanation for this is that patients using secure direct messaging may not have otherwise sought any form of guidance on their health. Experts say patients with higher out-of-pocket costs are less likely to access care on their own.

The researchers predicted that this trend toward secure direct messaging will only increase going forward. While there certainly is a convenience factor for patients using secure direct messaging, this method of communication also helps reduce costs for patients with high deductibles.

As noted above, high deductible health plans are becoming more prevalent. As this continues, patients will seek care that is more budget-friendly, or else potentially forego care altogether.

Going forward, providers will need to encourage their patients to utilize their patient portals not just for the informative benefits, but for the communication benefits. If patients and providers can work together to drive positive care outcomes outside of the office, they can help achieve industry goals of delivering quality care to the largest amount of patients possible.

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