the technology of healthcare
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1 reinventing the technology of healthcare 1
2 3 Introduction 4 01 / Implementing electronic health record (EHR) systems 6 02 / Treating patients remotely via virtual healthcare 8 03 / Using mobile healthcare applications 9 04 / Keeping mobile information secure / Ensuring regulatory compliance 11 Conclusion
3 introduction The days of filling out forms at a doctor s office, a nurse writing notes on a chart, and then a clerk storing that chart in a file cabinet are fading into the archives of history. The digital revolution that has transformed business, entertainment, and nearly every aspect of American life is also transforming the healthcare industry. Widespread use of technology within the healthcare industry is improving the quality of patient care, preventing medical errors, increasing efficiency, reducing costs, and decreasing paperwork. The pace of this transition is picking up rapidly due to healthcare reform legislation that has already begun changing the way the healthcare industry operates. + The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted in 2009 as part of the larger American Reinvestment and Recovery Act (ARRA), provided funds for promoting and expanding the adoption of health information technology. + The United States Department of Health and Human Services is spending billions of dollars to encourage medical practitioners to make meaningful use of healthcare information and create a nationwide network of electronic health records. + The insurance exchanges being established as a result of the Affordable Care Act (ACA) will result in millions of new patients who don t have the means to travel to healthcare facilities, so providers will need to use medical technology to take healthcare to them. + Providers must develop security protocols for digital data transfers and adhere to strict requirements for keeping healthcare information private or face penalties or fines. New processes to accommodate these changes will require new technologies. Mobile applications, regulatory compliance, and the data security required for remote access are just a few of the technology challenges facing the healthcare industry as it reinvents itself. 3 3
4 01 record Implementing electronic health (EHR) systems Rising population rates, longer life spans, and new medical procedures are producing ever-increasing mountains of patient health information. For generations, this data has been generated on paper. But thanks to advances in technology, the healthcare industry has been gradually moving away from paper and transitioning to storing, managing, and accessing health data electronically. Computerized medical records seem to offer great benefits to healthcare providers. They are easy to retrieve, they can be stored inexpensively and compactly long after paper records are gone, they minimize errors that result from illegible handwriting, they make it easier for patients to be in control of their health records, and information about a patient can be transferred among providers quickly. But despite the benefits of EHRs, many providers have been slow to make the transition from paper recordkeeping. In a society where people are already concerned about keeping personal information private, patients and providers alike are not comfortable with the idea of having medical histories recorded and accessed by multiple people, says Pam Burnette, MBA, BSN, RN, director of healthcare product, Kelly. The confidentiality of the provider-patient relationship is built on a foundation of privacy, so patients are worried about that privacy being invaded. Also, many EHR systems are inflexible and only allow healthcare providers to check off boxes and delete items in electronic forms, without letting them document their personal opinions or observations about a patient. And because providers are tapping away on keyboards in exam rooms rather than talking and directly interacting with patients, people worry that EHRs may result in the loss of interpersonal touch in healthcare. Whether or not providers believe the benefits outweigh the concerns, they will soon have no choice about going digital. 4
5 + HITECH mandates the use of EHR systems throughout the U.S. healthcare delivery network as a critical goal. Providers must implement a certified EHR system by 2015 or face penalties and fines. HITECH mandates the use of EHR systems throughout the U.S. healthcare delivery network as a critical goal. Providers must implement a certified EHR system by 2015 or face penalties and fines. The government is offering incentive payments to providers to encourage widespread adoption of EHR technology by the healthcare industry. But the key obstacle to integrating an EHR system is the time it takes to learn it. People imagine that EHR systems are like ipads with intuitive applications that will make things easier for doctors, but that picture couldn t be further from the truth, says Burnette. Implementing even the best EHR systems can be challenging because of the many different screens, options, and navigational tools. And EHR systems are not standardized, so patient information can t be retrieved by various providers if their systems aren t compatible. The software industry is slowly improving EHR usability, but there will be a significant learning curve for providers for quite a while. The key to making a successful transition to digital recordkeeping may lie in transforming the management culture of healthcare organizations. Instead of thinking of EHRs as a burdensome shift from paper to IT, managers need to realize that this technology will create efficiencies such as providing the platform for new methods of coordinating work, better ways to communicate, and tools that will improve the working lives of doctors, Burnette suggests. Decision makers in healthcare must adopt EHR technology and transition to digital records not with the goal of complying with new regulations, but instead with the goal of improving outcomes for patients and providers through better technology. 5
6 02 virtual Treating patients remotely via healthcare The ACA is expected to result in an influx of newly insured patients seeking treatment, many of whom will find it difficult or impossible to travel to a hospital or clinic. As a result, healthcare organizations are exploring a number of virtual healthcare technologies that will enable providers to treat patients at remote locations. The idea of virtual healthcare has been discussed and attempted for decades, with varying degrees of effectiveness. According to the New Telecom Quarterly, the first case of croup was diagnosed in 1897 by telephone. Although the healthcare industry has been enthusiastic about the benefits of virtual healthcare, its success has varied widely. Throughout the 1990s, as the Internet grew into an easily accessible source for healthcare information, virtual healthcare via telemedicine became more than just an intriguing possibility. Websites such as WebMD and MedicineNet were created to bring healthcare knowledge to patients 24/7 wherever they were without them having to visit a doctor s office. But despite enthusiasm for the idea of telemedicine, a virtual healthcare revolution wasn t possible because the slow and cumbersome dial-up Internet connections being used at that time weren t the most ideal information delivery systems. Thankfully, new connection technologies have removed those obstacles and data can now be transferred in seconds with the click of a button. Today, 70 percent of American adults have a high-speed Internet connection at home, and telemedicine is well on its way to becoming a routine part of healthcare delivery. Experts say the most radical applications of telemedicine are still a decade or more away, but advances in technology are being made with increasing frequency and the pace is picking up. + Instead of filling out paperwork when they visit a doctor for the first time, new patients may be given an ipad or electronic tablet to provide information about their medical history. + Many physicians have websites with portals where established patients can make appointments, request prescription refills, ask questions, or send in personal health data logs. 6
7 + The ACA is expected to result in an influx of newly insured patients seeking treatment, many of whom will find it difficult or impossible to travel to a hospital or clinic. + A provider can review test results on a laptop or handheld device, and access laboratory results from other facilities and providers. + Instead of a provider grabbing a pad to write out a prescription, a few clicks on a computer can send prescription information digitally to a patient s pharmacy. + In some states, providers can communicate with patients directly via s, texting, and even Skype or FaceTime. + Remote telemedicine stations fitted with medical equipment allow patients to take vital measurements and then consult with providers by video conferencing. There are pilot programs available that health systems can join for providers to learn how to use special virtual healthcare systems. Some programs use computers that enable doctors in remote locations to take vital signs, talk with patients, and relay that information in real time to clinics or other providers. These systems can potentially improve outcomes by making it possible for patients to consult with specialists promptly, even from far away. With a fast, accurate diagnosis, treatment can begin promptly. There are already nine states that provide a special license for practicing telemedicine, and 13 states are considering some type of telemedicine legislation. We already have many virtual healthcare strategies in place and the healthcare industry is actively talking about telemedicine, says Burnette. Telemedicine is a timely and necessary solution to meeting many of the challenges presented by new healthcare legislation and the incoming influx of patients who will not be able to travel to obtain care. We don t yet have a portable device that a provider can take on the road to both diagnose and treat patients in minutes, but that doesn t mean it won t be developed eventually. We have a lot of innovative technology available today and the future of virtual healthcare is very exciting. 7
8 03 Using mobile healthcare applications Americans have become adept at using smartphones to access information, and the healthcare industry is taking notice. Medical facilities are seeing how the use of smartphone technologies can clearly improve the efficiency of patient care. Mobile apps for patients and providers have become a permanent fixture on the healthcare landscape, with some apps designed for specific healthcare occupations such as travel nurses. Thanks to wireless mobile technology, nurses traveling to patient locations are able to access needed information to provide the best care. As the market for mobile healthcare apps increases, the variety of apps available is growing by leaps and bounds. Many are accessible across various platforms; some offer free trials with extra features available for purchase, and some are completely free. Healthcare travelers can find apps for a variety of functions, including: + Looking up clinical information on prescription, generic, and over-the-counter drugs, and finding how to identify a pill by physical characteristics and imprint codes + Checking for precautions, contraindications, and adverse drug reactions + Accessing treatment information for hundreds of conditions and infectious diseases + Finding emergency instructions for administering basic life support + Accessing health news and critical alerts + Viewing step-by-step medical procedure videos + Reading medical journals, abstracts, or outlines of clinical information on diseases and symptom-related topics State-of-the-art wireless technology also enables a wide array of data-intensive services, such as monitoring and management of chronic diseases, real-time video conferencing among medical professionals in different locations, and remote diagnostic evaluation of medical tests such as CT scans or MRIs. Smartphones and tablet computer technologies have evolved to the point where remote diagnoses are equivalent to the results of an exam in a doctor s office. More and more healthcare providers are finding that wireless technology is making collaboration easier and information more accessible, which translates to greater efficiency and better patient outcomes. 8
9 04 information Keeping mobile secure As healthcare organizations increasingly turn to the Internet to access confidential health information, it is critical for providers to be sure they have solid strategies in place for maintaining the privacy of information transmitted using wireless technology. There are several ways to protect and secure information when using a mobile device: + Configure the device to require a password or personal identification number (PIN) to gain access to it. + Install and enable encryption capabilities to protect information stored on or sent by the device. + Do not install or use file sharing applications that allow unauthorized users to access information without permission. + Install remote wiping or remote disabling to permanently erase data or lock out other users in case the mobile device is lost or stolen. + Research mobile apps before installing them to be sure they will perform only the functions required, and download only from trusted sources. + Do not send or receive health information when connected to a public Wi-Fi network unless the connection is secure and encrypted. Before discarding or reusing a mobile device, all stored health information must be deleted. The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has issued guidelines for the proper steps to take when removing sensitive health information stored on mobile devices. These guidelines discuss solutions such as overwriting media with non-sensitive data, purging the media by exposure to a strong magnetic field, and physically destroying the device. + Install security software and update it regularly to protect against viruses, spyware, and malicious applications. 9
10 05 Ensuring regulatory compliance Healthcare providers challenged by a changing regulatory landscape are faced with numerous mandates to satisfy. Every system, application, and interface in a healthcare organization will need to be evaluated and adapted to comply with HITECH and other healthcare reform legislation. The long list of processes to be overhauled includes financial reporting, management, operational reporting, case management systems, disease management logs, and even provider contracts. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule requires specific protections for safeguarding electronic health information. As healthcare organizations make the transition to certified EHR systems, they must comply with HIPAA regulations by building in data security measures such as access control tools, encryption of stored information, or audit trails identifying who accessed information and what changes were made. In the event of a security breach, federal law requires doctors, hospitals, and other healthcare providers to notify patients as well as the Secretary of Health and Human Services. In cases where a breach affects more than 500 people, the provider must also notify local area media outlets. HIPAA standards require healthcare providers to protect the confidentiality and integrity of individually identifiable health information by requiring users to verify their identity before they can access patient information. Passwords have traditionally been used as a means of authentication, but because they are the easiest to hack, other methods of authentication are growing in popularity, such as biometric solutions, smart cards, and USB tokens. Providers must limit information sharing to the minimum amount necessary, unless they are sharing information for treatment purposes. Training programs must be implemented to instruct employees about how to protect health information. Providers must also put in place administrative, technical, and physical safeguards to protect health information. 10
11 Conclusion Mobile telecommunication and remote technology have forever changed the way healthcare providers deliver services to patients, and the changes are a work in progress. The future of healthcare could be a place where health examination tools, apps, and sensors are available to everyone, patients have 24/7 access to a virtual doctor who can access their health histories privately and securely, physicians can monitor patients remotely and answer their questions quickly, and virtual teams of providers can easily access digital data and make informed diagnoses quickly so treatment can begin. This vision of the future gets closer every day. Healthcare providers already have an arsenal of mobile technologies that can empower them to provide a much higher quality of care in treating patients, and exciting new technologies are just over the horizon. Sweeping healthcare reform legislation is reinventing how the healthcare industry provides affordable care to patients, and the future is a bright one. Mobile technology that makes healthcare easier, faster, more efficient, and less expensive for providers and patients is a critical component of that transformation. + Sweeping healthcare reform legislation is reinventing how the healthcare industry provides affordable care to patients, and the future is a bright one. 11
12 References Denning, Steve. Why Is Your Doctor Typing? Electronic Medical Records Run Amok. Forbes Magazine, April 25, Electronic Medical Records: The Pros and Cons. HealthWorldNet.com, March 1, Gutnam, Ron. How Mobile Tech Can Transform Health Care. CNNMoney, September 25, Kuhar, Mark S. Twenty Mobile Apps to Check Out. Healthcare Traveler, January 1, Awarded the Gold Seal of Approval TM The Kelly healthcare specialty service was awarded the Gold Seal of Approval from The Joint Commission by achieving certification for Health Care Staffing Services (HCSS). This highly credible and reputable designation demonstrates our compliance with the highest quality and safety standards in the healthcare staffing industry. About Kelly Services Kelly Services, Inc. (NASDAQ: KELYA, KELYB) is a leader in providing workforce solutions. Kelly offers a comprehensive array of outsourcing and consulting services as well as world-class staffing on a temporary, temporary-to-hire, and direct-hire basis. Serving clients around the globe, Kelly provides employment to more than 560,000 employees annually. Revenue in 2012 was $5.5 billion. Visit kellyservices.com and download The Talent Project, a free ipad app by Kelly Services. Our healthcare specialty places professionals across all levels of healthcare in multiple disciplines, including medical laboratory, medical device, pharmacy and pharmacology, nursing, allied health, behavioral health, healthcare billing/coding, utilization, case management, occupational health, special education, and physical therapy. Want more information? Visit kellyservices.us/healthcare today. This information may not be published, broadcast, sold, or otherwise distributed without prior written permission from the authorized party. Kelly Healthcare Resources is a registered trademark of Kelly Services All other trademarks are property of their respective owners An Equal Opportunity Employer 2013 Kelly Services, Inc. Y1458B kellyservices.us/healthcare exit
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