Industry Watch – July 2015 | Healthcare Innovation

Secure Communications

Coming to an Apple Watch near you

If you’ve been wondering what exactly you can do with an Apple Watch in healthcare besides tell time (and look cool), the wait is over. The first integrated and secure communications apps are making their debuts – just in time for the device’s broadening availability set for late June.

Coming this summer, the Vocera app for Apple Watch will allow users to manage critical communications by viewing and responding to prioritized calls, alerts, and messages from other care team members, EHRs, and clinical systems, including critical lab values and STAT orders. Users will be able to manage key communication functions by setting their availability to enable proper message routing. Panic calls in “man-down” emergency situations can also be initiated right from the wrist.

The Spok Mobile secure texting app is also getting in on the act. Currently used by numerous hospitals, this app gives smartphone and tablet users quick access to their organization’s directory, allowing staff to communicate secure

ly through encrypted text, image, and video messages. In addition, the app can receive alerts from patient care, nurse call, and other monitoring systems to speed response to critical situations. For now, Apple Watch wearers will be able to receive Spok Mobile message notifications when they have new messages without having to access their iPhone. Additional capabilities are planned to be rolled out in the near future, which should be an exciting development given that Spok currently offers very strong integration with a number of Android wearables that have been on the market, such as Android Wear and Samsung Gear devices.

Claims & Coding

Is ICD-10 bad for the ER?

Nearly one-quarter of all emergency room (ER) clinical encounters could pose ICD-10 coding difficulties, according to a new study from the University of Illinois at Chicago (UIC). In the study, the UIC researchers looked specifically at the codes used most often by ER physicians to see where problems may arise.

The results, published in the May 2015 issue of American Journal of Emergency Medicine, found that 27 percent of the 1,830 commonly used ER ICD-9 codes had convoluted mappings that could create problems with reporting or reimbursement. When the researchers looked at more than 24,000 actual clinical encounters in the ER, 23 percent could be assigned incorrect codes if the recommendations from the Centers for Medicare & Medicaid Services (CMS) were followed.

“Despite the wide availability of information and mapping tools, some of the challenges we face are not well understood,” says Dr. Andrew Boyd, Assistant Professor of Biomedical and Health Information Sciences at UIC and principal investigator on the study.

During the past two years, UIC researchers have extensively reviewed how ICD-9 codes map to ICD-10 codes, not only for emergency medicine, but for other problem areas, including pediatrics, patient safety reporting, and long-term research. Some ICD-9 indicator codes translate well, but many have convoluted mappings – and some simply don’t map at all.

The UIC team has developed a free online tool that reports the correct ICD-9 to ICD-10 code mappings: http://lussierlab.org/transition-to-ICD10CM.

Source: University of Illinois at Chicago

Mobile Tech

Millennials pegged as corporate data security risks

They’ve been called “millennials,” “Gen Y,” and even “echo boomers,” but now workers ages 18 to 34 have a new label: highest mobile data security risks.

Results from the new Absolute Software Mobile Device Security Report of connected employees demonstrate clear differences in generational behavior and associated risks related to data security. When it comes to working millennials vs. baby boomers (ages 55+):

Sixty-four percent of millennials use their employer-owned device for personal use, as opposed to 37 percent of boomers.
Thirty-five percent of millennials modify their default settings, compared to 8 percent of boomers.
Twenty-seven percent of millennials access “Not Safe For Work” content, compared with only 5 percent of boomers.
Twenty-five percent of millennials believe they compromise IT security, compared with only 5 percent of boomers.

Interestingly, amongst the whole sample, 50 percent of respondents say that security is not their responsibility, while 36 percent named IT as being responsible.

The survey, conducted online earlier this year among 762 U.S. adults who use an employer-owned mobile device and work for a company with 50 employees or more, concludes there is more that can be done to modify behavior and educate employees about workplace data security.

Read the full study findings at absolute.com.

Meaningful Use

CHIME: Stage 3 plans ‘unworkable’

In official comments dated May 27, 2015, and submitted to the Centers for Medicare & Medicaid Services (CMS), the College of Healthcare Information Management Executives (CHIME) called federal plans for the third stage of Meaningful Use too ambitious and in need of several important changes. However, the professional organization of healthcare CIOs and senior IT executives did voice overwhelming support for a CMS proposal that would shorten Meaningful Use reporting in 2015 from a full year to any continuous 90-day period.

While recognizing the agency’s effort to streamline program participation through a reduced number of objectives and harmonized reporting periods, CHIME deemed the sum total of proposals for Stage 3 of the EHR Incentive Program “unworkable.”

“Were all requirements finalized as proposed, we doubt many providers could participate in 2018 successfully,” CHIME wrote. “And with so few providers having demonstrated Stage 2 capabilities, we question the underlying feasibility of many requirements and question the logic of building on deficient measures.”

CHIME urged CMS to make several changes to the proposed rule for Stage 3, including:

A 90-day reporting period for the first year of Stage 3 compliance, at least for payment adjustment purposes;
Modify requirements for, and retain the 90-day reporting period for, providers attesting to Meaningful Use requirements for the first time, whether in a Medicare or Medicaid context;
Eliminate patient action thresholds for the care coordination objective;
Reduce the number of required measures in multi-measure objectives, health information exchange, and care coordination;
Create hardship exceptions for providers switching vendors;
Allow providers to take a 90-day reprieve during any program year for upgrades, planned downtime, bug fixes related to new technology, or optimizing the use of new technology within new workflows; and
Allow, in limited circumstances, paper-based means to achieve measure thresholds.

Patient action requirements related to care coordination and “unrealistic” thresholds for health information exchange requirements were of particular concern for CHIME. Additionally, the organization said it was troubled over the requirement that all providers must attest to Meaningful Use Stage 3 by 2018, regardless of prior participation and experience with the program.

Read the full text of the CHIME comments at chimecentral.org.

Source: CHIME

Analytics

Truven names top 15 health systems

What does it take to be one of America’s 15 Top Health Systems? According to Truven Analytics’ seventh annual study, “winning health systems achieve higher survival rates and fewer errors at a lower overall treatment cost.”

The Truven study analyzed data from 340 health systems and 2,812 member hospitals to identify 15 hospital systems that achieved superior performance based on a composite score of nine measures of care quality, patient perception of care, cost per episode of illness, and operational efficiency. The study relied on public data from the 2012 and 2013 Medicare Provider Analysis and Review (MedPAR) data and the CMS Hospital Compare datasets.

Specific winning health system performance metrics include:

Lower cost per episode: The winning 15 top health systems spent 7 percent less per care episode than non-winning peer systems.
Better survival rates: The winning systems experienced 1.2 percent fewer deaths than non-winning peer systems.
Fewer complications: Patients of the winning health systems had 5 percent fewer complications.
Better patient safety and core measures adherence: The top health systems had 10.9 percent better patient safety performance and better adherence to core measures of care than their peers.

The study divides the top health systems into three comparison groups based on total operating expense of the member hospitals. The 2015 winners are:

Large Health Systems (more than $1.5 billion in total operating expense): Allina Health, Minneapolis, MN; Mayo Foundation, Rochester, MN; OhioHealth, Columbus, OH; Spectrum Health, Grand Rapids, MI; and St. Vincent Health, Indianapolis, IN.
Medium Health Systems ($750 million to $1.5 billion in total operating expense): Alegent Creighton Health, Omaha, NE; Exempla Healthcare, Denver CO; Mercy Health Southwest Ohio Region, Cincinnati, OH; Mission Health, Asheville, NC; and St. Luke’s Health System, Boise, ID.
Small Health Systems (less than $750 million in total operating expense): Asante, Medford, OR; Maury Regional Healthcare System, Columbia, TN; Roper St. Francis Healthcare, Charleston, SC; Saint Joseph Regional Health System, Mishawaka, IN; and Tanner Health System, Carrollton, GA.

Truven Health introduced new performance measures this year that may be used in future studies, including emergency department (ED) efficiency, 30-day readmission rates for chronic obstructive pulmonary disease (COPD) and stroke, operating margin, and long-term debt-to-capitalization ratio.

Learn more about the study at truvenhealth.com.