The Ankota Healthcare Delivery Management Blog

Healthcare Cost Cutting Hinges On IT

Posted by Will Hicklen on Aug 13, 2012 5:35:00 PM

As this article below from Information Week Healthcare discusses, technology will be key to reducing healthcare costs and increasing operating efficiency. With the rise in Accountable Care and focus on reducing avoidable readmissions, EMRs will only provide a piece of the puzzle. Ankota focuses on Care Coordination, developing technology that connects healthcare providers into "ecosystems" so that they can collaborate on care planning and delivery: the process of planning and coordinating care. 

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Several of the nation's top healthcare experts, led by bioethicist Ezekiel Emanuel, believe that building an IT infrastructure that supports the electronic exchange of patient data and integrating administrative data with clinical information from electronic health records (EHRs) will cut the nation's healthcare costs and increase efficiency.

In a recent paper in the New England Journal of Medicine, Emanuel and his colleagues, supported by the Center for American Progress, an independent nonpartisan think tank, confront the issue of out-of-control healthcare spending which, in this election year, will reach $2.8 trillion or about 18% of U.S. gross domestic product (GDP).

The authors cite estimates suggesting that by 2037, national health spending will grow faster than the economy, increasing from 18% to about 25% of GDP. Federal health spending will also increase from 25% this year to approximately 40% of total federal spending by 2037.

"These trends could squeeze out critical investments in education and infrastructure, contribute to unsustainable debt levels, and constrain wage increases for the middle class," the authors wrote.

The authors point out that the nation spends nearly $360 billion on healthcare-related administrative costseach year.

Although the Patient Protection and Affordable Care Act requires health plans and providers to adhere to uniform standards and operating rules for electronic transactions between these organizations, the authors lament that while "plans must comply with these standards and rules, the law does not require providers to exchange information electronically."

To create greater efficiency in the system, Emanuel and his colleagues recommend that payers and providers quickly adopt the practice of electronically exchanging eligibility, claims, and other administrative information among their respective organizations.

Additionally, the authors suggest that during the next five years providers use EHRs to integrate clinical and administrative functions such as billing, prior authorization, and payments.

By implementing business intelligence tools to collect actionable information from administrative systems, providers and health plans can discover inefficiencies within the system as they seek to improve their workflow while reducing administrative tasks and costs. For example, in one step a clinical service could be ordered electronically for a patient and automatically be billed to the payer.

Emanuel and associates also recommend establishing a task force comprised of payers, providers, and vendors to "set binding compliance targets, monitor use rates, and have broad authority to implement additional measures to achieve system-wide savings of $30 billion a year."

In an interview with InformationWeek Healthcare, Emanuel indicated that he sees the integration of physicians' EHRs with administrative data, as "a very good step in the right direction" and "one very important element" that can reduce healthcare costs.

The article also says technology can reduce the cost of defensive medicine, explaining that the risk of a malpractice suit causes physicians to order moretests and procedures. But implementing a strategy that imposes arbitrary caps on damages for patients who are injured as a result of malpractice would result in only a 0.5% reduction in national health spending.

"A more promising strategy would provide a so-called safe harbor, in which physicians would be presumed to have no liability if they used qualified health information technology systems and adhered to evidence-based clinical practice guidelines that did not reflect defensive medicine. Physicians could use clinical decision support systems that incorporate these guidelines," the authors said.

They added: "Under such a system, the physician could use the safe harbor as an affirmative defense at an early stage in the litigation and could introduce guidelines into evidence to avoid a courtroom battle of the experts."

According to Emanuel, using technology to provide evidence that a doctor followed the correct practices and procedures while attending to patients is a useful tool to defend against lawsuits.

"Part of what we are suggesting is that we use malpractice reform to incentivize better behavior in terms of installing electronic health records, installing decision supports, and following guidelines. That is a much more meaningful way of getting malpractice reform," Emanuel asserted.

Topics: Patient Data Security, Care Coordination, transitional care, Will Hicklen, Care Transitions, Accountable Care Organizations, ACO

Home Care Software Can Learn from the Mars Curiosity Rover

Posted by Ken Accardi on Aug 6, 2012 10:42:00 AM

The Home Care Software Geek posts in this blog don't talk about Home Care Nursing Software, Private Duty Telephony, DME Delivery Software, Home Infusion Care Management or the other topics we focus on regularly at Ankota. Instead, these posts are intended to keep our readers up to date with technology trends that might be useful to your agencies, such as social media technologies, mobile devices, and what's happening from the big-boys like Microsoft, Google and Apple.

Back when I started my career, I worked for GE Aerospace (now part of Lockheed Martin) on software that flew and controlled satellites.  In my case the satellites circled the earth and we could send new commands to them from the ground for around 1 minuteMars Curiosity Rover every two hours.  But still, it was a hard engineering problem and when we occaisionally had a failure in the communications or the instructions, the results were measured in big numbers (more than a large home care company makes in a year).  I've been out of the aerospace business for quite a long time now (note that I edited and removed the number of years because it made me feel old) but seeing the latest NASA achievement and what went into it gave me pause and prompted me to ask myself what I can learn from it as a home care software developer and what the home care industry can learn from it.

Before going much farther, I'd encourage you to watch this video to see what it required to get the Curiosity Mars Rover to its landing point on Mars.  For those of you who don't choose to watch the video, think of it this way:

The entire landing was done without human control 127 million miles away, and they were within 200 meters of their landing zone.  To put this in context it’s equivalent to throwing a dart, have it circle the earth 339 times, and then take a right turn by itself and hit a bull’s-eye!


So what can we learn from this?  Here are my thoughts:

  • Seeing that this is possible inspires me to beleive that there are no home care software challenges that we can't achieve
  • It further reminds me that when we have a tough problem to solve with our software, that there are tougher problems out there
  • It inspires me to be more perfect with what we do
  • But at the same time I'm proud that we can build software with much smaller teams and at a much lower cost in order to make it affordable for small businesses in the home care industry to afford it and benefit from it
  • Lastly, and I guess that this one is a little bit strange, but sometimes I think about the sad tragedies that I hear about like September 11th and the recent Aurora Colorado tragedy and those things make me realize that my worst days are not really that bad.  It's fun for a change, to be inspired instead by something as awe inspiring as this accomplishment
What do you think?
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.

Topics: Elderly Care, home care software geek, Home Care Technology, Home Care, Home Care Blogs, Video

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About Ankota

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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