Industry Watch – Mar/Apr 2018

Feb. 27, 2018

NEW COMPANY

Amazon, Berkshire Hathaway, Chase form healthcare alliance

With the intention of improving employee satisfaction and reducing costs, Amazon, Berkshire Hathaway, and JPMorgan Chase announced that they would band together to provide healthcare for their U.S. employees.

These three major companies, which bring size and experience to the table, are pursuing this goal by creating an independent company that is free from profit-making incentives and restrictions.

The Jan. 30 press release from the three company leaders—Jeff Bezos, Amazon founder and CEO; Warren Buffet, Berkshire Hathaway Chairman and CEO; and Jamie Dimon, Chairman and CEO of JPMorgan Chase—stated, “The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality, and transparent healthcare at a reasonable cost.”

The three corporate giants are hoping to draw on their combined capabilities and resources to take a new and innovative approach to the challenges of the industry.

Buffet stated, “The ballooning costs of healthcare act as a hungry tapeworm on the American economy. Our group does not come to this problem with answers. But we also do not accept it as inevitable. Rather, we share the belief that putting our collective resources behind the country’s best talent can, in time, check the rise in health costs while concurrently enhancing patient satisfaction and outcomes.”

“The healthcare system is complex, and we enter into this challenge open-eyed about the degree of difficulty. Hard as it might be, reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort,” said Bezos.

“Our people want transparency, knowledge and control when it comes to managing their healthcare,” said Dimon. “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans,” he added.

The Wall Street Journal recently reported that Amazon Business is using its online store as a spot where hospitals can purchase medical equipment and supplies for its outpatient clinics, operating rooms, and emergency rooms. It’s currently testing a program with a Midwestern hospital system that is using Amazon Business to order medical supplies for its outpatient facilities, which number around 150. The online retailer already sells a small amount of medical supplies, but not specifically medical equipment.

The endeavor is still in early planning stages. The long-term management team, headquarters location, and key operational details will be revealed at a later date according to the release.

Since the announcement, there has been much speculation by the healthcare industry as to the potential impact of the new “ABC” (Amazon, Berkshire Hathaway, and JPMorgan Chase) alliance. HMT

CLINICAL MOBILITY

Zebra study reveals 9 in 10 clinicians to use mobile technology at bedside by 2022

Zebra Technologies announced the results of its “Future of Healthcare: 2022 Hospital Vision Study,” revealing the impact of mobile technology use in acute-care hospitals. The research, which incorporates feedback from nursing managers, IT decision-makers, and patients, offers a unique perspective from the frontline of patient care. It also highlights the transformational power clinical mobility is expected to have on global health services within the next five years.

Key survey findings:

  • Clinical mobility is rapidly becoming the global standard for patient care: Zebra’s 2022 Hospital Vision Study identified the rising adoption of clinical mobile solutions across all disciplines by 2022. Interestingly, this growth includes areas where mobility is already widely used (bedside nurses rising from 65% to 95%), as well as a major increase across other areas such as pharmacist and pharmacy technicians (from 42% to 96%), lab technicians (from 52% to 96%), and intensive care nurses (from 38% to 93%).
  • Study highlights reduction in preventable errors as key benefit: Surveyed nursing managers and IT decision-makers expect clinical mobility to reduce errors in areas including medication administration (61%) and specimen collection labeling (52%).
  • Mobile technologies allow clinical staff to spend more time at a patient’s bedside: By 2022, 91% of nurses are expected to access electronic health records (EHRs), medical and drug databases (92%), and lab diagnostic results (88%) using a mobile device, reducing time that must be spent away from patients.
  • Communications are expected to improve due to rising clinical mobility adoption: Nearly 7-in-10 of surveyed nurse managers credit clinical mobility with improving staff communication and collaboration as well as the quality of patient care, while 64% of surveyed IT decision-makers identify nurse-to-physician communications as a top area for improvement.
  • Clinical mobility will be augmented with real-time location information to streamline workflows: Real-Time Location Systems (RTLS) will be used to locate everything, from equipment, supplies and pharmaceuticals to patients and staff. This visibility will allow administrators to increase bed availability, staff workflow, and safety.
  • Improved data streams integrated through handheld mobile technology are expected to improve detection and notification of life-threatening conditions: By 2022, 98% of surveyed IT decision-makers expect predictive analytics and early notification for life-threatening conditions, such as sepsis and hospital-acquired infection, will be sent to clinicians’ mobile devices.
  • Patients are aware of the benefits of clinical mobility and becoming more active participants in the delivery of their healthcare: The majority of surveyed patients (77%) expressed positivity about clinician usage of mobile technologies to improve the quality of their care. Zebra Technologies
EHRs

Default setting in EMRs “nudged” emergency department physicians to limit opioid prescriptions to 10 tablets

For patients who have never been prescribed opioids, larger numbers of tablets given with the initial prescription is associated with long-term use and more tablets leftover that could be diverted for misuse or abuse. Patients may receive 30 or more opioid tablets in an initial prescription, for example, when a much lesser quantity, such as 10-12 tablets as recommended by current emergency department prescribing guidelines, would suffice. Implementing a default option for a lower quantity of tablets in the electronic medical records (EMR) discharge orders may help combat the issue by “nudging” physicians to prescribe smaller quantities consistent with prescribing guidelines Penn Medicine researchers show in a new study published in the Journal of General Internal Medicine.

The research team found that physicians from two Penn Medicine emergency departments prescribed a fewer number of opioid pills to their patients when the EMR default setting was set to 10 tablets. Initial prescriptions for that amount shot up by 22%, from a pre-default rate of 21% to 43% after the default option had been introduced. Conversely, the number of prescriptions written for 20 tablets decreased by almost 7%, and prescriptions for 11 to 19 tablets decreased by over 13%.

In the new study, researchers analyzed prescription data from the emergency departments of the Hospital of the University of Pennsylvania (HUP) and Penn Presbyterian Medical Center (PPMC) between late 2014 and mid-2015, before and after the default was in place.

In 2015, both departments replaced an EMR that required clinicians to enter the number of tablets for opioid prescriptions with an EMR that now includes a default quantity of 10 tablets. The clinician could also “opt-out” by selecting a quantity of 20 tablets, which was displayed second, or they could modify their orders. The researchers compared weekly prescribing patterns for oxycodone 5mg/acetaminophen (325 mg) for 41 weeks. In all, physicians wrote over 3,200 prescriptions.

After the default implementation, the median number of opioid tablets supplied per prescription decreased by a small amount from an already low baseline of 11.3 to 10 at HUP and 12.6 to 10.9 at PPMC. However, across the two emergency departments, there was a marked increase in the proportion of prescriptions written for 10 tablets, from 20.6% to 43.3%, whereas prescriptions for larger quantities dropped.

With implementation of the default of 10 tablets, there was a small unintended decrease in prescriptions written for less than 10 tablets. “This suggests that future efforts to set default quantities should provide a default option for the lowest baseline prescription,” the authors wrote. Penn Medicine News

CYBERSECURITY

Consumers’ overconfidence helps hackers up the ante and steal $172 billion in 2017

Consumers are confident they’re safe online, but hackers have proven otherwise, stealing $172 billion from 978 million consumers in 20 countries in the past year, according to the 2017 Norton Cyber Security Insights Report, released by Norton by Symantec.

Globally, cybercrime victims share a similar profile: They are everyday consumers who use multiple devices whether at home or on the go, but have a blind spot when it comes to cybersecurity basics. This group tends to use the same password across multiple accounts or share it with others. Equally concerning, 39% of global cybercrime victims despite their experience, gained trust in their ability to protect their data and personal information from future attacks and 33% believe they had a low risk1 of becoming a cybercrime victim.

In the U.S., 143 million consumers were victims of cybercrime—more than half the U.S. adult online population. Losses totaled $19.4 billion and each victim lost an average of nearly 20 hours (19.8 hours) dealing with the aftermath.

Consumers used device protection technologies such as fingerprint ID, pattern matching, and facial recognition, with 45% using fingerprint ID, 21% using pattern matching, 19% using a personal VPN, 14% using voice ID, 16% using two-factor authentication, and 16% using facial recognition. However, consumers who adopted these technologies often still practiced poor password hygiene and fell victim to cybercrime.

  • Consumers express confidence, but are more prone to attacks as they protect newer and more devices. Forty-six percent of U.S. cybercrime victims owned a smart device for streaming content, compared to about one quarter of non-victims. They were also three times as likely to own a connected home device.
  • Despite experiencing a cybercrime within the past year, nearly a quarter of victims in the U.S. used the same online password across all accounts and 60% shared their passwords for at least one device or account with others, negating security efforts. By comparison, only 17% of non-cybercrime victims reuse passwords and 37% share their passwords with others. Additionally, 41% write their passwords down on a piece of paper and are almost twice as likely to use different passwords and save their password to a file on their computer/smartphone than non-victims.

Eighty-one percent of U.S. consumers believe cybercrime should be treated as a criminal act. However, when pressed, contradictions emerged. Nearly one in four believe stealing information online was not as bad as stealing property in “real life.” When presented with examples of cybercrime, 41% of consumers believed it’s sometimes acceptable to commit morally questionable online behaviors in certain instances, such as reading someone’s emails (28%), using a false email or someone else’s email to identify themselves online (20%), and even accessing someone’s financial accounts without permission (18%). Symantec

Reference

  1. Respondents’ attribution of cybercrime risk is based on their personal beliefs and definition of cybercrime.

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