how sms can be used to to increase dental appointments

While you may think your dental practice is following all HIPAA rules, is it really? Check these seven rules from an attorney who has represented dental practices who have missed something regarding HIPAA, and paid for it. 

SEAMLESS INTEGRATION OF HEALTHCARE MESSAGING

 

If you’re a dentist, you know about HIPAA. You know that HIPAA creates rules and restrictions on the way you keep, use, and disclose patient information. However, many dentists don’t realize that HIPAA also restricts the way they and their staff can use email and text messages to communicate with patients and other providers about patients.

HIPAA applies to emails and text messages

HIPAA applies to emails and text messages sent to a patient, such as for scheduling or appointment reminders. HIPAA also applies to emails and texts sent to another provider about a referral, with diagnostic images, or to discuss treatment. Here’s the kicker—HIPAA applies when a dentist emails patient records or information from a work email account to a personal email account, even if the dentist is doing so simply to finish up work from home later that evening.

HIPAA doesn’t completely prohibit using emails and texts to communicate with patients or other providers about patients. But HIPAA does require dentists to use security measures when doing so, such as encryption or secure messaging platforms. Alternatively, dentists need to obtain consent from patients to send protected information via unsecured email or text. Sending protected information over unsecured emails or texts without a patient’s consent can violate HIPAA.

Why should dentists care about this?

Failing to comply with HIPAA can have severe consequences. If protected health information is used or disclosed in a way that does not comply with HIPAA, a dentist may need to give notice of the impermissible use to the affected individuals, the federal government, and, if more than 500 individuals are affected, the media. The federal government has stepped up HIPAA enforcement, conducting more compliance audits and seeking more financial penalties from HIPAA violators.

What does this mean?

Dentists and their staff need to know and follow the rules with emails and texts to remain HIPAA compliant. Before getting to the rules, here’s some terminology:

First, HIPAA applies to the storage, use, and disclosure of a patient’s individually identifiable health information, which HIPAA calls protected health information (PHI). PHI is generally defined as any information about a patient,—name, demographic information, past, present, or future physical or mental health condition, treatment, x-rays, pictures, and payment information—that can reasonably be linked to a specific, identifiable individual.

Second, “password protected” is not the same as “secure” or “encrypted.” To understand the difference, think of a padlock and a code. A padlock (like a password) protects against unauthorized access. But once a person unlocks the padlock (gets past the password), the person can see and make sense of everything inside. Encryption, on the other hand, is like a code. The information gets jumbled so it cannot be used or understood by a person who sees unless that person has the “key” to decode the jumble (the “encryption key”).

What are the rules for emails and texts?

1. Emails to others inside the same practice—Most practices have a secure server and network, and emails between people inside the same practice, even if located in different offices, are sent over the secure server and network. If an email is sent to another person inside the same practice over a secure server and network, the email can include a patient’s PHI and does not need to be encrypted. However, if the in-practice email is not being sent over a secure server (e.g., if the practice uses Gmail or another web-based email service), the email should not include information about a patient that can be linked to a specific, identifiable individual.

2. Emails to persons outside the practice (other than the patient)—Emails to people outside the practice other than the patient should not include a patient’s PHI unless the email is encrypted or sent via a secure messaging system. This generally means that dentists should not use emails to communicate with other providers about an identifiable patient unless special security measures are taken.

3. Emails to personal email accounts—Emails from a work email account to a personal email account should not include PHI or attach patient records or other documents with PHI. If work needs to get done from home, consider using a secure remote connection (such as GoToMyPC) to connect from home, or take the minimal amount of needed information home on an encrypted flash drive.

4. Text messages to persons other than the patient—Unless a provider or practice has a secure text messaging platform, text messages are not secure or encrypted. They are easily intercepted, often sent to an incorrect number, and usually stored indefinitely on third-party devices, such as the wireless carrier’s servers. Thus, text messages should not include a patient’s PHI. This is true even for texts to staff or other providers inside the same practice; these should not include identifiable patient information.

5. Emails and texts to patients—More patients want their dentists to communicate with them by email or text. Dentists who want to do so must do one of two things. Option one is to use an email or text messaging system that encrypts messages or requires patient login, such as a patient portal. If a secure messaging system is used, messages sent to a patient can include PHI.

Option two is to obtain the patient’s consent for using unencrypted email or text messages to communicate with the patient. This is after advising the patient of the risks of doing so, including the risk that the message could be read by a third-party. A good way to do this is by giving the patient a well-written consent form as part of his or her new patient paperwork, or to existing patients at their next visit. If a patient consents to the use of unsecured emails and texts after being properly warned, a dentist may communicate protected PHI to the patient in that way.

6. Emails and texts from patients—The above rules do not apply to emails or texts sent by a patient. HIPAA applies to health-care providers (and other “covered entities”), not patients. Patients can use unencrypted emails and texts to communicate with providers.

If a patient initiates an unsecure email or text and sends it to his or her health-care provider, the Health and Human Services Office of Civil Rights (OCR), which enforces HIPAA, explains that the provider may assume that using unsecure emails or texts are acceptable to the patient, unless the patient has explicitly stated otherwise. However, OCR has also advised that if the provider believes the patient might not understand the risks of using unencrypted email or texts or if the provider has concerns about potential liability, the provider may want to alert the patient of those risks and let him or her decide whether to continue with unencrypted email and text communications. So, if a dentist doesn’t have a signed consent and preference form from the patient, the dentist may want to get one before replying via unsecured email or text.

7. Email confidentiality notices and disclaimers—There’s a myth that including a confidentiality notice or disclaimer in an email makes the email compliant with HIPAA and allows a dentist to send PHI via unencrypted or unsecure email. The myth is false. Even the best-worded notice or disclaimer will not make an unencrypted email comply with HIPAA. The rules here still apply.

Best practice: Get consent and preference forms from all patients

All dental offices, even those that use encryption or secure messaging systems, should consider having all patients complete an email and text message consent and preference form that confirms their preferences about emails and texts. Doing so would allow dentists to communicate with their patients consistent with their desires. It would also give patients a chance to consent to the use of unencrypted emails or texts.

Consent forms would also help dentists with another significant hazard that comes with calling or texting a patient’s cell phone—the Telephone Consumer Protection Act (TCPA). TCPA is the federal law that protects consumers from unwanted telephone calls and faxes. TCPA prohibits making auto-dialed and pre-recorded calls and texts to cell phones (e.g., auto-generated appointment reminders) without the prior express consent of the called or texted party. Sanctions for violating the TCPA can be huge—$500 per violation (per call or text message).

For all of these reasons, having every patient review and sign a well-written consent and preference form, and then following the patient’s preferences, is a good idea that will keep your dental practice HIPAA compliant.

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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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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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how diabetes can be effectively managed in most patients thorugh online text messaging

Deliver better healthcare through effective use of secure mobile messaging

A US study reports people can improve their diabetes management following secure online messaging with their healthcare team.

A cohort of people with type 2 diabetes who had enrolled in an online portal of an outpatient healthcare organisation from 2011-14 were evaluated. This communication was an accompaniment to routine visits to healthcare providers.

Scientists from the Palo Alto Medical Foundation Research Institute in California wanted to see if messaging increased quality measures among the cohort. Around 72 per cent of the cohort used the messaging service, and those who frequently visited their health provider were more likely to message.

Those who used the messaging service were more likely to meet their HbA1c targets. This association grew in accordance with frequency of messaging, and regardless of whether the messages were initiated by doctors or patients. This relationship was strongest amongst those not treated with insulin.

In comparison, those who didn't use the messaging service were less likely to meet their HbA1c target.

The researchers also discovered that increased messaging frequency was also positively associated, but less significantly, with process measures such as eye examination.

"Internet-based secure messaging between patients and providers through a patient portal is now common in the practice of modern medicine".

"Patients with diabetes frequently used secure messaging for medical advice in addition to routine visits to care providers. Messaging was positively associated with better diabetes management in a large community outpatient practice."

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integrating mobile messaging with patient portals

The waiting room is full, there is a line forming in front of the scheduling desk, new patient information has to be collected, patients’ records must be updated, and appointments need to be rescheduled. The patient intake process, particularly for new patients, can be time-consuming and arduous for administrative staff.

One of the most effective ways to reduce staff’s workload, while speeding up the patient intake process, is with automated mobile-first messaging strategies. This approach provides significant efficiency boosts for many tasks, including appointment alerts, offsite check-ins, completion of paperwork such as consent forms or intake forms prior to an appointment, and reduces strain on administrative staff.

Mobile Messaging vs. Online Patient Portals

Many healthcare organizations rely on patient portals to engage their patients. The challenge, however, is that patient portals have just a 29 percent adoption rate nationally. These low rates may simply reflect that patients are unaware of these online services via portals, but patients may also be unable or unwilling to access these platforms.

Despite the cause of these barriers, this low adoption rate makes portals impractical for contacting patients quickly and relaying important information. By utilizing the immediacy (and automation potential) of texting, clinical staff is able to receive confirmation from patients so that they no longer have to send multiple alerts through patient portals or make several phone calls to contact a patient. For immediate, time-sensitive communication regarding appointment times and reminders, staff must have access to mobile technologies that patients are willing to turn to when they are needed most.

Aside from the immediacy and popularity of smartphones, mobile strategies can streamline the communication process for a healthcare organization’s staff. Mobile tools make it possible to store communication templates, save contact information to reach patients and approved family caregivers quickly, create custom surveys to gauge patient satisfaction, and offer a variety of other customizable features. By implementing these tools, providers can communicate quickly and easily with patients using a secure messaging platform.

Save Time and Reduce Data Entry Errors

Electronic patient intake forms give patients the option of providing patient health histories and other medical information (e.g. information about medications the patient is currently taking) when it is most convenient for them and via their mobile device. By allowing patients to securely complete intake forms prior to an appointment, they have time to accurately track and log their medications. This process gives patients time to verify their health histories, consulting documentation or past physicians to confirm information.

Online forms are also tremendously valuable in saving staff time as they eliminate the need to transcribe data, scan, and securely store or dispose of files. By eliminating the transcription process, the likelihood of errors resulting from data entry is reduced. This is an important factor considering that inaccurate data entry was found to be one of the leading causes of medication errors in a study conducted by the U.S. Pharmacopeia. Reducing the likelihood of errors while increasing efficiency for staff and patients is a tremendous benefit of adopting mobile technologies.

Reduce Last Minute Cancellations And No-Shows

Automating reminders about upcoming appointments and giving patients the option of canceling or rescheduling via a mobile device creates more flexibility for patients. Not only does this benefit patients, but it also reduces costs associated with missed appointments. No-shows are estimated to cost the healthcare industry $150 billion dollars annually, reducing the number of missed appointments can improve bottom lines while allowing physicians to accommodate more patients.

Remind Patients What They Need To Bring to Encounters – Or How They Need to Prepare

Patients are responsible for bringing a number of items to encounters including insurance cards, ID cards, a copay, or any medications that they may be taking. Oftentimes patients must also follow specific preparation instructions, such as fasting, in order to ensure they are prepared for their visit. Mobile technologies and platforms set up with encounter-specific business rules can automatically send these reminders and instructions at precisely the right time prior to the encounter. Communicating this information directly to the patient’s mobile device increases preparedness and reduces avoidable delays and cancellations.

Connecting with patients using mobile messaging is an efficient way to send patients vital reminders, reduce errors resulting from inaccurate intake forms, decrease no-show rates, and add a layer of convenience for a mobile generation. A mobile-driven patient intake process can be implemented and tailored to almost any process or intake strategy to promote efficiency and allow staff to focus on patient care. The versatility and immediacy of a text-based strategy makes it ideal for those looking to improve provider-patient communication and the overall patient experience.

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how the health industry is using SMS to improve patient care

The growth of text messaging (SMS) has matured over the last several years, and the potential for businesses across all industries to incorporate texting into business operations and customer communication is vast. Companies in the restaurant delivery, banking, transportation, and ride-sharing industries have been successful in using SMS as a communication channel because it provides their employees and customers with an efficient, private and convenient way to interact.

Text messaging has also emerged as a popular and effective way for many organizations to improve customer experience. According to a national survey, alongside email and phone calls, SMS ranks in the top three communication methods consumers prefer when interacting with businesses. In fact, over half of survey respondents indicated they would view a business more positively if it offered SMS capabilities.

Deliver better healthcare through effective use of secure mobile messaging

The healthcare industry in particular is outpacing others in its use of SMS. Physician's offices are leveraging texting as a strategic tool to improve the patient experience and their own internal processes. Common use cases for SMS include notifications around appointment reminders, prescription refills and test results, as well as managing wait times.

Independent and hospital-owned practices that employ SMS for the processes listed above, can realize a number of benefits pertaining to internal and external procedures.
 

The following are three examples of how healthcare providers are using SMS as a communication channel to their benefit:

 

Optimized appointment schedules.The ability to manage appointment schedules by sending reminders, cancellations, and reschedule-requests via text is not only convenient for patients, it also has direct implications on the physician office's bottom line.

For example, if the office has a waitlist and the ability to text patients when there is an appointment opening - especially a last minute opening - they are able to fill the appointment slot and utilize the staff present where there would have been a no-show appointment (a major expense costing the U.S. healthcare system more than $150 billion each year).

Being able to mitigate no-shows via text alerts is a definitive way to optimize the appointment schedule and minimize operational costs such as overstaffing, improper booking of machinery/lab equipment, etc. A more organized schedule with accurate wait times results in a more relaxed environment and happier patients.

Increased flexibility for customers. SMS also gives patients the freedom to communicate with their healthcare providers in a way that is intuitive and easy for them. By giving patients the choice of how to interact with their healthcare providers, SMS has the potential to enhance the patient-provider relationship and strengthen patient loyalty, increasing the likelihood that the patient will reach out for preventative care, as well as ongoing treatment for chronic issues. In addition, offering the flexibility to communicate via text reduces much of the hassle associated with listening to voicemails or making phone calls about test results at an inconvenient time or place.

Improved treatment and patient care. Physicians' offices have also begun to use SMS in innovative ways such as reminding patients to take their medication, checking insulin levels, and sending motivational text messages that encourage positive behaviors (i.e. eating healthy and increasing activity) and reduce negative behaviors (i.e. smoking). These alerts demonstrate a level of care and involvement from the healthcare provider, while also improving the patients' health and quality of treatment.

In fact, a recent study from the American Heart Association hypothesized that using automated mobile health notifications with tracking and texting components may increase physical activity. The results showed that patients who received these motivational and informative text messages walked an additional 2,500 steps each day, compared to individuals who did not receive the messages. This strategy, although not yet widespread, has great potential to become a common and successful practice among healthcare providers due to the huge popularity of wearable activity trackers on the market today.

Together, these strategies have the potential to make a significant difference in enhancing the patient experience with a provider, as well as their engagement with a treatment plan. Healthcare providers looking to incorporate SMS as a communication channel not only have the potential to further benefit a patient's well-being, but also establish themselves as a trusted partner with a deep level of emotional investment in their patients long-term health plan.

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how digitization is transforming care in patient engagement programs

Deliver better healthcare through effective use of secure mobile messaging

American healthcare is one of the last industry holdouts when it comes to fully embracing digitization. McKinsey Global Institute has ranked healthcare 19th out of 22 sectors in its oft-cited Industry Digitization Index.

Even as health systems implement digital health tools and practices, many of these technologies remain separate, leading to a disconnected patient experience.

But there is hope for the digitization of healthcare. Many digital health tools are designed to automatically link information from different digital sources, creating efficiencies that result in a better experience for patients and better workflows for staff.

Consider the typical digital hospital-patient relationship: One hospital department asks a patient to log into a portal to check lab results. Another uses an app for appointment reminders, and yet another sends digital health information to help manage patients’ care.

This disparate sea of digital tools can be overwhelming and burdensome for both patients and providers, causing confusion and poor use of the resources the hospital provides.

Here are some ways you can improve care coordination by taking advantage of digitization without a lot of extra work on your part.

Connect your digital systems

Different digital health tools have different purposes, and hospitals need multiple tools to accomplish their goals of improving health outcomes. But from the patient’s perspective, it’s all one connected topic: their health.

Through links, application programming interfaces (APIs) and other simple solutions, you can connect your digital tools to make it easy for patients to navigate between these resources to create a seamless patient experience.

Add a “push strategy” to your patient engagement

Many health IT systems deal with protected health information (PHI) that must be locked behind passwords—information such as treatment plans, lab results and appointment history. Those systems use a “pull strategy,” one that depends on patients choosing to visit a website and logging in.

A push strategy, on the other hand, proactively sends information directly to patients. These messages contain population-based information and do not discuss an individual’s specific health details. With push strategies, the information is put right in front of patients—on mobile devices, for example. There is no need to remember website URLs or passwords, and this increases access and use.

You can take your digitization to the next level by combining push and pull strategies. In other words, use your push messages to educate and engage patients, while also prompting them to visit the sites that contain their password-protected personal health information.

Use the data available to you

Being digital, these tools inherently collect data that may provide insights into how your patients are doing, who is more at risk and who needs additional attention. This data may come from survey responses, secure messages, patient-reported feedback and other statistics and information.

The data enables significant improvements in care quality and customer service that, in turn, can improve patient satisfaction, drive meaningful patient relationships and discourage patients from searching online for potentially inaccurate health information.

Use your data to gain a better understanding of your patient population and to make your patient navigators’ work more efficient.

Act on that data by providing further resources to patients who need it, thereby encouraging them to become better partners in their care. Patient activation is proven to impact outcomes and cost of care.

Digitization is where healthcare is heading, even if at a slower pace than other industries. Going digital creates efficiencies for your team and your patients, and it ensures that you’re providing the right care resources in the most efficient way.

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patient prefering sms for medical appointments

Surveys have shown that patients, including dental patients, prefer to communicate with their health-care providers via text. This is more convenient for today's smartphone-carrying patients, and leads to reduced no-shows.

The days of depending on postcards and voicemails for appointment reminders might not be over just yet, but they’re coming to a close due to the rising popularity of text messaging as a communications channel for many dental offices and health-care providers. With more than 240 million smartphone users in North America in 2017, consumers have grown to depend on, and demand, text messaging services that allow them to interact with the businesses and brands they use and trust.

A recent national survey found that consumers overwhelmingly prefer using SMS over email and voice communications when engaging with businesses, finding it more relevant and timely:

● Respondents read 82% of their text messages within five minutes, versus opening only one in four business emails.

● Nearly half of those surveyed (47%) stated they would react negatively if a company did not offer SMS as a communications channel.

Dental offices, pharmacies, and other innovative health-care organizations are increasingly leveraging SMS as a strategic communications channel to make the patient experience easier and more convenient. Here’s what it can accomplish.

Reducing no-shows—Missed appointments have a big impact on a health-care provider’s revenue. On average, about 10% of dental appointments are no-shows. However, with well-executed appointment reminders, dental practices and other appointment-based businesses can minimize the number of no-shows and increase their revenues as much as 20% Patients have responded well to this move. In fact, 55% of the survey respondents noted text messaging as the preferred method of communication of appointment reminders versus email, which was preferred by only 35%.

Maximizing schedules and minimizing operational costs—SMS has also been shown to optimize appointment schedules and staffing. Offices with waitlists have the ability to text patients with last-minute openings, which allows patients to fill appointment slots, and the staff on hand stays busy during what could have been a down time.

SMS is also more efficient than phone calls in terms of time. Weave, a patient communications software company, notes that the average phone call takes about 90 seconds, while the average text message takes only 13 seconds to send. This adds up to a savings of about 12 hours per month, not to mention that patients are happy they have a quick and intuitive way to coordinate their appointment scheduling.

Mobile Healthcare Solutions

Keeping patients engaged between visits—Messaging can play a key part in ensuring that patients continue their at-home care between visits. Smartphone apps can send users text reminders to brush and floss, and can send notifications for tasks such as taking premedication before a dental visit. Preventive care reminders and others like these establish a strong patient-provider relationship and may increase the likelihood that patients will return for regular cleanings.

Giving patients a choice of communications methods (phone, direct mail, SMS, etc.) gives them the flexibility to interact with their dental office in the way that feels most comfortable to them. Creating an enjoyable patient experience goes beyond just what happens during an exam or dental procedure.

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how virtual desktop infrastructure supports patient care

VDI allows clinicians to use technology at the point of care to quickly access EHRs, improving patient care.

Value-based care initiatives have pushed healthcare organizations to embrace more advanced technology as priorities have shifted from security concerns to how to access information securely, quickly, and conveniently.

Virtual desktop infrastructure (VDI) and virtual infrastructure solutions have become more prominent ways for healthcare organizations to consolidate health IT systems and save on infrastructure costs while increasing operational efficiency.

As health IT grows more advanced, patients expect clinicians to use technology that allows them to easily and securely access necessary information.

VDI supported by virtualized infrastructure consolidates processes and allows clinicians and IT administrators to cut down on the time spent logging in or monitoring systems, devices, and applications.

HITInfrastructure will review the basics of VDI, and discuss how some organizations have successfully utilized it to improve workflow and patient care.

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network connectivity, storage challenge healthcare push

As organizations adopt the healthcare IoT, significant infrastructure considerations such as network connection and storage need to be addressed.

The growth in value of healthcare Internet of Things (IoT) analytics pressures organizations to examine their IT infrastructures and assess how they can support the influx of healthcare IoT data and device connections.

The healthcare industry is one of the most data intensive verticals using IoT devices. Healthcare organizations are looking to the analytic capabilities of IoT devices to save on overall costs.

IoT devices allow organizations to remotely monitor devices and also collect invaluable data that can be applied to current and future patients, providing otherwise impossible insight into certain conditions.

A Gartner report released late last month stated that analytics enables the most visible impact of the IoT because of the reach it has for analytic possibilities.

“The possibilities for analytics are limitless, and ever-growing data sources present more opportunities to innovate through holding novel insights,” Gartner stated. “But currently, data and analytics leaders should narrow their focus to deriving additional value from the ongoing IoT implementations.”

“Examples are an increase of the equipment life span, asset optimization, predictive maintenance of devices, anomaly detection in the manufacturing processes or finding new product usage patterns.”

Gartner report authors found that the IoT market has no single preferred way to implement analytics capabilities. The report confirmed that organizations take varying approaches to IoT analytics with no approach taking precedence over another in any vertical.

Organizations also often used a mix of methods to collect, process and sort IoT data.

Gartner advised organizations to familiarize themselves with the full range of IoT infrastructure innovations and best practices, and to also remain aware of opportunities, risks, and new technologies and services.

Network connectivity is one of the biggest infrastructure challenges organizations run into when implementing IoT solutions.

Taoglas Co-Founder and Co-CEO Dermot O’Shea told HITInfrastructure.com that medical IoT devices benefit organizations greatly. However, network connectivity can make or break an IoT solution.

“It’s been shown that medical IoT devices save a lot of money because they get people out of the hospital,” O’Shea explained. “If IoT devices can diagnose people in advance then that saves huge costs. We can see nothing but benefits from medical devices being connected. Working with medical device companies brings a much larger delta of savings and benefits than any other vertical.”

Most healthcare organizations use cellular connections over WiFi connections because they are more reliable and don’t have the same lengthy login protocols or physical network restrictions as WiFi.

“Most organizations use cellular because it’s the only reliable way to really communicate with the devices,” O’Shea stated. “If you’re only using WiFi then you’re relying on the user, patient or caregiver to do all the WiFi connectivity in terms of selecting the WiFi network and putting in the password.”

Connected medical devices need to meet certain certifications and a certain level of performance. Each device is tested on how well it sends and receives data. The devices need to be tested on how weak a signal they can give off while still being connected.

Medical IoT devices are often a unique shape and contain other high powered electronics that can interfere with network connectivity.

Ensuring that medical devices are properly equipped with the proper antennas for cellular connectivity is vital for the devices to pass certifications required for healthcare IoT devices.

Organizations need to focus on how they are going to store the IoT data collected for analytics after working through IoT device connectivity.

Healthcare organizations can store collected data on-premises, in the cloud, or a combination of the two. Cloud computing is the preferred method of storage for analytics because many analytic platforms run in a cloud environment.

Cloud storage is also much more affordable at meeting the scale demands of IoT analytics data.

However, healthcare organizations find a certain level of comfort in storing clinical data on-premises. Forward Health Group CTO Jeff Thomas told HITInfrastructure.com that there is a comfort level for organizations in knowing that their data is in their data center.

“They can walk up and touch it, and sometimes it's that emotional comfort factor that has some healthcare organizations leaning toward keeping data in house,” Thomas noted.

On-premises servers offer healthcare organizations more control over their data, but are costly to maintain which is a major reason many organizations are migrating to cloud.

“Cloud solutions are very beneficial from the standpoint that as you migrate data, you don't need to maintain your own datasets which can be costly and expensive,” continued Thomas. “I’m saying costly but maintaining datasets on-site can also be expensive in that it takes up real estate which can sometimes be used for something else.”

Cloud storage also trumps most on-premises solutions by scaling up on-demand rather than having organizations wait for new physical server to arrive and be set up. Organizations only need to pay for the cloud services they are using so they can scale cloud infrastructure down as analytics projects are implemented and completed.

Network connectivity and storage are two of the main infrastructure requirements for a fully supportive IoT analytics deployment. Organizations cannot more forward with IoT analytics incentives without the proper infrastructure solutions and tools to support it.

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employee healthcare data security awareness: top industry threat

A recent study conducted by HIMSS Analytics found that lacking employee education and awareness are top healthcare data security threats.

Approximately 80 percent of surveyed health IT executives and professionals report that employee security awareness is their greatest concern regarding healthcare data security.

The 2017 Level 3 Healthcare Security Study was conducted by HIMSS Analytics and sponsored by Level 3 Communications, Inc. HIMSS interviewed 125 individuals who worked in or alongside the IT department at a healthcare provider organization.

Half of the respondents – 49 percent – were a director or manager of IT, while 30 percent were listed as IT security officers or other IT positions.

Exposure from partners or third-parties was the top concern for nearly 69 percent of those surveyed, followed by securing wireless or BYOD devices (54 percent of respondents) and a lack of actionable intelligence (36 percent of respondents).

HIMSS Analytics Senior Director of Research Services Bryan Fiekers maintained that security “cannot become an out-of-sight, out-of-mind problem."

“While the research uncovered only a 'modest' concern around the prospect of a security breach within hospital organizations over the next 12 months, providers are looking for closer partnerships with their network providers,” Fiekers said in a statement. “My interpretation of the findings is that healthcare organizations must remain vigilant against cyber security threats and leverage all of their resources effectively to ensure every individual knows their role.”

Competing priorities and budget concerns were listed as the top barriers in adopting a comprehensive security program, with 79 percent and 74 percent of respondents citing them respectively.

Impact to clinical workflows, employee awareness and training, and in-house expertise were also top five security program barriers.

One-third of respondents also said they had a high level of concern towards a breach impacting patient care at their organization, according to the survey. Respondents were asked to rank their level of concern on a scale of 1 to 7, with 1 being “no concern at all,” while 7 was a “high level of concern.”

Approximately one-quarter of those surveyed ranked their concern as a 6, while 12 percent said their concern was a level .

The majority of organizations are employing multiple practices to mitigate data security risk. Eighty-seven percent of those surveyed said they utilize remote access/secure access controls, with nearly 85 percent reporting their organization uses internal/employee security awareness program.

Security consulting services (i.e. vulnerability assessment, penetration testing), next-gen firewall (i.e. sandboxing, data loss prevention, application control), and Distributed Denial of Service (DDoS) mitigation were also listed by over half of responses as a mitigation technique.

When it comes to protecting the organization from potential data breaches, 34 percent of respondents said they use Cyber Threat Intelligence (CTI). Just over 31 percent said their organization uses next-gen firewall, and 27 percent stated their entity utilizes DDoS mitigation for mitigating breaches.

Level 3 Global Security Services SVP Chris Richter explained that healthcare data security threats are only going to continue to increase as bad actors keep seeking out PHI.

“Aside from fostering and maintaining a culture of security, which includes regular employee security training, healthcare organizations should implement a security governance framework and appropriate technology controls,” Richter said in a statement. “These include threat intelligence, DDoS mitigation and next generation firewalling and sandboxing – all critical next steps for healthcare providers to secure their networks."

As healthcare providers look to implement necessary security techniques, employee training and regular education cannot be overlooked.

The Identity Theft Resource Center (ITRC) and CyberScout found in a survey released earlier this year that one of the leading causes for healthcare data breaches was employee error or negligence.

There were 43 reported incidents that exposed 1,183,893 records, the report found. In comparison, the second leading sector for employee negligence was the government/military, which had 14 breaches and exposed 35,800 records.

“With the click of a mouse by a naïve employee, companies lose control over their customer, employee and business data,” CyberScout CEO and Vice Chair of IRTC’s Board of Directors Matt Cullina said. “In an age of an unprecedented threat, business leaders need to mitigate risk by developing C-suite strategies and plans for data breach prevention, protection and resolution."

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most healthcare institutions using non HIPAA-compliant messaging apps

Dive Brief:
A new study from Infinite Convergence Solutions finds just 1 in 4 healthcare institutions that have designated an official mobile messaging platform are using an internal app. The others are directing staff toward regular consumer messaging apps that do not provide the security required to comply the Health Insurance Portability and Accountability Act (HIPAA).

The study also finds just 8% of healthcare institutions prohibit the use of consumer apps for employee communication.

The company concludes many healthcare institutions lack the knowledge popular consumer apps do not meet the technical safeguards that HIPAA requires.

Dive Insight:
While much of the issue is around lack of knowledge by healthcare institutions, those grappling with the issue may be pleased to hear employees overwhelmingly say they would embrace a secure solution.

According to the study, 51% of healthcare employees report their institution does not have an official messaging platform, but 92% of them say they would use a company-wide platform if one was implemented, and 64% said it would make communication at their job easier.

"Healthcare institutions need to get serious about meeting their employees’ needs and providing a secure, internal messaging platform that not only allows HIPAA compliance, but also replaces outdated communication systems, like pagers, in order to increase productivity and serve patients faster,” Anurag Lal, CEO of Infinite Convergence Solutions, said in a prepared statement.

The company launched the study in October and surveyed 500 professionals in the finance/banking, healthcare, retail and legal industries.

Among its other findings:
Sixty-five percent of healthcare respondents said they use email the most for business communication, followed by 22% using mobile messaging the most and 13% using voice-calling the most.

As for why more respondents aren't using mobile messaging the most: Thirty-one percent prefer email or phone; 19% say there’s no paper trail; 18% say it’s not as secure as phone or email; 17% say it’s too informal; and 16% say it isn't authorized by their company.

Vectramind Healthcare messaging Platform

Message security is the top concern with mobile messaging for business communication.

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global mhealth (mobile health) market to grow at a cagr of 38.02% by 2020

The mHealth services dominated the market in and are expected to grow over $55.63 billion by the end of the forecast period due to the increasing usage of mHealth solutions by healthcare providers and pharmaceutical companies along with end users (patients). However, device segment is expected to grow in near future with a high CAGR of 38.02%, from 2015 to 2022, due to increasing integration of mHealth devices with smart phones and weareables, and also, increasing opportunities of connected health solutions are predicted to promote the growth of this market through the forecast period.

The detailed study on Mhealth (Mobile Health) market is done by compiling information from primary as well as secondary research points. It comes from journals, databases, white papers and updated press releases. It understands the factors driving the market and what inhibits the development of Mhealth (Mobile Health). There is a systematic compilation of trends and key opportunities of this market with its maximum authenticity. The current size of the market and the anticipated changes have also been discussed in detail.

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This report considers the main regions i.e. North America, Middle East & Africa, Asia Pacific, Europe and Latin America. Top manufacturers in global market, their capacity, production, revenue, price and shares are covered in detail.

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Key segmentations and sub segmentations are elaborated with right information for Mhealth (Mobile Health) market. The popularity and anticipated opportunities for all the segmentations are well explained in order to give a clear idea about the market trends. On the basis of estimations of the key segmentations, Mhealth (Mobile Health) market has been elucidated. Technological developments which have taken place during the ongoing market situation and the predicted scenario during the forecast period are presented systematically.

The future potentials of this market are analyzed and the prevalent trends are been looked upon with utmost detailing. The growth in all the major geographic regions are been studied in detail in this particular report. With exact data on the top most regions for this market and the reason they hold that position is studied and elaborated.

Moving forward, a competitive landscape of Mhealth (Mobile Health) market is presented for understanding the market importance. This section gives the prime strategies, weaknesses and strengths and the major contributed of the growth have been highlighted. Gross, revenues, product overview, contact information and many such points are explained for Mhealth (Mobile Health) market in depth.


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mobile health (mhealth) services market is expected to cross us$ 59 billion by 2020

The mHealth services market is expected to exceed more than US$ 59 billion by 2020 growing at a CAGR of more than 33.0% in the given forecast period 2015 to 2022.

mHealth services are preferably located to maintain a patient centered approach to health care. mHealth also called as mobile health is the sub segment of eHealth which uses the ICT that is information and communication technology includes mobile phones, computers, tablet computers and more used for health service. mHealth service contains different mobile devices which having healthcare information, clinical information and community information which deliver these information to patients, researchers, practitioners and monitor real time vital signs of patients. mHealth service give advice and information anywhere and anytime. Monitoring blood pressure, monitoring blood glucose, tracking body weight and tracking exercise are some example of mHealth services. Rising of 3G and 4G technology, the use of mHealth service for doctors and patients becomes easier. It provides two parties to clasp video calls and making the communication friendlier and closely.

The major driving factors of mHealth services market are as follows:
• Rising use of Mobile Phones, Tablets, Smart phones other Mobile Platforms

• Growing consumption of mHealth App and Connected Devices in the organization of Chronic Diseases

• Robust Access of 3g and 4g Networks to Supply Continuous Healthcare Services

• Increasing Focus on Patient Centric Health care Delivery
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The restraints factors of mHealth services market are as follows:
• Opposition from Conventional Health care Providers

• Require Data Security Increasing Concerns Regarding Health care Fraud And Data Theft

• Lack of Regulations And Standards resultant in Low Interoperability of results

• Complexity in Judgment mHealth Apps on Android Or Apple Stores and Low Guidance From Physicians in Selecting Apps

The mHealth services market is segmented on the lines of its product, applications and service. The mHealth services market is segmented on the lines of its product like connected medical devices includes blood pressure monitors, blood glucose meters, multiparameter trackers, ECG monitors, pulse oximeters, peak flow meters, neurological monitoring devices, sleep apnea monitors, coagulation monitors, digital skin sensors, pregnancy, and women’s health monitors. Under application segmentation it covers healthcare applications market, by activity and medical applications market for professionals. The covers healthcare applications market, by activity is further segmented into chronic care management, general healthcare and fitness apps, women’s health, medication management and personal health record (PHR). The chronic care management further contains mental health and behavioral disorders, blood pressure and ECG management, diabetes management and cancer management. The general healthcare includes health tracking tools, weight loss and fitness & nutrition. Under women’s health segmentation it covers pregnancy, fertility and breastfeeding. Medical applications market for professionals’ segmentation covers medical reference, continuing medical education (CME), diagnostic tools and alert and awareness. The mHealth services market is segmented on the lines of its service like remote monitoring, diagnosis and consultation, treatment fitness and wellness, prevention and healthcare system strengthening services. The mHealth services market is geographic segmentation covers various regions such as North America, Europe, Asia Pacific, Latin America, Middle East and Africa. Each geography market is further segmented to provide market revenue for select countries such as the U.S., Canada, U.K. Germany, China, Japan, India, Brazil, and GCC countries.

This report provides:
1) An overview of the global market for mHealth services and related technologies.

2) Analyses of global market trends, with data from 2013, estimates for 2014 and 2015, and projections of compound annual growth rates (CAGRs) through 2020.

3) Identifications of new market opportunities and targeted promotional plans for mHealth services

4) Discussion of research and development, and the demand for new products and new applications.

5) Comprehensive company profiles of major players in the industry.

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five digital health trends investors are watching in 2017

Digital health technologies will transform healthcare. Mobile phones have given health care providers the ability to engage with patients 24-7 and patients are able to capture and share data that may be helpful in tracking and personalizing their health care. Genomics, analytics, artificial intelligence and deep learning technologies are all making inroads in this emerging sector. Although the amount of money invested in the sector slightly decreased from last year, according to Rock Health, venture capital interest in the digital health sector is still significant with $4.2 billion invested in 2016.

It’s a very diverse sector that spans from general wellness applications targeting consumers to highly clinical solutions that typically require FDA approval. At AMV, we focus more on clinically oriented digital solutions tackling healthcare problems and have invested in dozens of early-stage companies since we began looking at digital health in 2003.

The healthcare market is enormous with over $3.2 trillion of annual spend in the United States in 2015, and the sector has had significant regulatory changes over the past seven years largely driven by the Affordable Care and HITECH Acts. Most observers are expecting further significant changes as the new administration pursues legal and regulatory reforms.

We expect more regulatory changes but we believe the dramatic shift towards industry digitization and value-based care will continue unabated. We will begin to see the next wave of technology innovation, such as Internet of Things (IoT), Machine Learning and Artificial Intelligence (AI) move from consumer and commercial use into healthcare applications. As the digital health industry moves into the second wave of innovation, we see the following as exciting areas that entrepreneurs are focused on.

1. Digital Interventions
We’ve seen a wave of new apps that seek to improve patient health in ways that are clinically demonstrable. These digital interventions use health, behavioral and contextual data -- such as glucose levels, sleep, weight, food, activity, time of day and weather -- to improve patient treatment plans. Interesting companies in this sector target diabetes prevention (Omada Health), Type 2 diabetes (WellDoc), mental health (Pear Therapeutics) and respiratory illness (Propeller Health). In some cases such as WellDoc, these interventions are FDA-approved therapeutics. These apps have such compelling clinical efficacy that insurance companies are starting to pay for them due to improved patient outcomes at reduced cost.

Pharmaceutical companies are also interested in integrating digital interventions with their drugs to improve outcomes, differentiate their products, and engage directly with patients. For example, Proteus Digital Health, which manufactures an FDA-approved sensor that is embedded in pills and tracks medication adherence, is working with Otsuka on a bundled solution that treats bipolar disorder and schizophrenia.

2. Provider Workflow Solutions (or Healthcare Scalability Solutions)
In the United States we have a problem efficiently delivering care. It often takes weeks or months for patients to schedule an appointment. Physicians are often rushed when providing care and, according to a study by the AMA, spend twice the time entering patient data into electronic medical records that they do seeing patients. I believe digital technologies can help give our time-crunched healthcare professionals the ability to see more patients in less time, while delivering a better patient experience, by using data analytics for decision support, more efficient workflow and different forms of mobile communication.

Additionally, we can shift the cost curve to less expensive labor. Given decision support tools, artificial intelligence and data analytics, primary care physicians should be able to do some of the work specialists currently do. Nurses and case managers will be able to reduce a physician’s workload and, increasingly, patients will be able to administer self-care at home with mobile devices.

In this sector I’d keep my eyes on companies like HealthTap (enabling patient/physician interaction outside of the office), Augmedix (utilizing Google Glass to enable remote scribes to enter patient data into the EMR) and Welkin Health (tools to improve communication with patients.)

3. Data Integration and Analytics
In the past few years we’ve seen a dramatic increase in the amount of digitized health data stored in EMRs, health data captured from smartphones, and genomic data.

There are many uses for these new healthcare datasets. For example, insurance companies and companies that pay for employees’ health care directly, can use additional data to help refine actuarial models. Physicians can use analysis of this data for diagnosis and decision support. Lastly, patients may benefit from the mining of data for predictive prognosis. Consequently, real-time alerts to patients and healthcare professionals are becoming feasible.

Startup companies such as Human API and Validic are trying to help third parties aggregate and integrate these datasets into other applications. We are beginning to see the potential of data analytics in oncology with companies like Flatiron Health and Foundation Medicine. Evidation Health facilitates large, rapid clinical trials with their software and applications.

4. Behavioral Health
The insurance industry and self-insured employers now recognize that the costs of mental health, including depression, should be dealt with upfront and, although long-term efficacy has yet to be demonstrated for most digital solutions, insurers and employers are increasingly willing to pay for digital health pilots in this arena. Behavioral health issues also often go hand-in-hand with other diseases. I have always been skeptical of investing in this sector because it is traditionally services-oriented and diagnosis is difficult and subjective, making outcomes hard to measure. Still, today it is increasingly reimbursed by Medicare and venture capitalists are beginning to fund this sector with companies like Lyra Health, Pear Therapeutics and Lantern all raising very large rounds to tackle different problems in this sector. The idea is that more engagement and interaction, facilitated by digital technologies, may help patients with depression, anxiety, substance abuse, PTSD and other behavioral health issues.

5. New Model Insurance Companies
The most surprising area of investment for venture capital dollars in digital health is in novel insurance companies. Oscar ($720 million), Collective Health ($125 million) and Clover ($295 million) have all raised significant amounts of money. These startups often compete directly with industry heavyweights such as Aetna, United Health and Humana, which have also been investing in, and deploying, digital health solutions. The venture-backed insurance industry entrants have some advantages over the incumbents: for example, these entrants are unencumbered by existing infrastructure and relationships, and thus can establish tighter relationships with provider networks. These companies can also build their technology stack from the ground up which enables them to more effectively use digital health data and solutions to target specific, stratified, patient groups.

Conclusions
The digital health sector has moved from the first wave of simple wellness devices and applications to companies that are beginning to have a deep understanding of how technology can be used to make healthcare more effective and efficient. We see consumer companies such as Fitbit, Apple and Samsung beginning to partner with major payers, providers and pharmaceutical companies. Despite this shift, most venture capitalists I talk to who are investing in the sector agree that there are a lot of companies targeting the same, and rather niche, problems. A typical digital health founder comes from the tech industry and tries to solve a problem that they have personally encountered with our often-dysfunctional health system. I believe that the founders who deeply understand the complexities of this ecosystem, including who will pay (such as insurance and pharmaceutical companies), will be more successful. And no matter what the product or services startups offer, they will need to generate some clinical evidence that outcomes are improved and costs are reduced, or no one will pay for their solution.

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