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Top Ten Tech Trends 2018: In the Fight Against the Opioid Crisis, Providers are Turning to Technology

August 30, 2018
by Heather Landi, Associate Editor
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More than 40 percent of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, according to the CDC
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Editor’s Note: Throughout the next week, in our annual Top Ten Tech Trends package, we will share with you, our readers, stories on how we gauge the U.S. healthcare system’s forward evolution into the future.

Opioid abuse and addiction continues to be a national crisis, but it is being felt at a very local level. Patient care organizations across the country are seeing the impact of the opioid crisis on the health of their patient populations.

From 1999-2016, more than 350,000 people died from an overdose involving any opioid, including prescription and illicit opioids, according to data from the U.S. Centers for Disease Control and Prevention (CDC). Overdose deaths from opioids, including prescription opioids and heroin, have increased by more than five times since 1999. More than 40 percent of all U.S. opioid overdose deaths in 2016 involved a prescription opioid, with more than 46 people dying every day from overdoses involving prescription opioids, according
to CDC data.

Many industry leaders say technology can help address two key challenges of the opioid epidemic: drug diversion, including the illegal use of prescription opioids, and clinical appropriateness, including effective uses of opioids for patients with legitimate needs. Technology tools such as e-prescribing, prescription drug monitoring programs (PDMPs), and clinical data exchange, all aid healthcare professionals, by informing their care decisions with more actionable intelligence at the point of care.

Surescripts, the Arlington, Va.-based operator of a nationwide electronic network for prescription-related data and information, has been at the forefront of this area as its platform connects electronic health record (EHR) vendors, pharmacy benefit managers, pharmacies and clinicians, as well as health plans and long-term and post-acute care organizations. In 2017, 13.7 billion secure health transactions took place via the Surescripts network—a 26-percent increase from 2016—including 1.74 billion e-prescriptions. What’s more, the network connected 1.47 million healthcare professionals—13 percent more than in 2016—with secure patient data for 233 million Americans, or 71 percent of the population. Also, in 2017, more than 1.46 billion medication history transactions were made available to providers at the point of care.

There is a burgeoning health IT solutions market targeting opioid use disorder and addiction, with many of these solutions leveraging data and analytics to help providers see prescription drug usage patterns.

Jackson Tate, a research manager with Orem, Utah-based KLAS Research, who has been researching this technology market for an upcoming KLAS report, notes that there is significant innovation occurring, but this health IT sector is still in nascent stages. “There are certain technologies that we’re seeing pop up and become more popular that help doctors and care managers engage with their patients who are at high risk for opioid dependency or currently have an opioid use disorder. We still classify this market, as a whole, as being in early stages, with a few vendors that are out there in the field.”

Jackson Tate

The Louisville, Ky.-based Appriss Health is a leader in the field of PDMP analytics and tools, as its platform, PMP Aware, is now live in 30 states and provides access to mandatory pharmacy reporting. Appriss Health’s PMP Gateway platform integrates state PDMP data into EHRs and into physician and pharmacist workflows to provide real-time data at the point-of-care. Appriss Health also operates the PMP InterConnect, an interstate prescription drug data sharing platform that now includes 45 states.

One promising strategy to address the prescription opioid epidemic is optimizing PDMPs through integration with the IT systems of patient care organizations. Maryland is one state that has made inroads in this area, as CRISP (Chesapeake Regional Information System for our Patients), a regional HIE, provides access to PDMP data and has successfully integrated with a number of EHR vendors. Providers also can access PDMP data directly in their workflow through CRISP’s SMART on FHIR (Fast Healthcare Interoperability Resources app, which is accessed 100,000 times a day, according to CRISP.

As Healthcare Informatics Managing Editor Rajiv Leventhal noted in a recent article, Michigan state leaders utilized Appriss Health’s technologies in its ongoing fight against opioid abuse. Michigan state officials conducted an assessment utilizing Appriss Health’s artificial intelligence (AI) and machine learning technologies, including its “overdose risk score” that predicts the likelihood of a drug-related death to enable more advanced interventions and responses.

However, Tate notes that PDMP integration with health IT systems is not yet widely adopted. Case in point, more than a year ago, Michigan state officials announced an upgrade to the state’s aging opioid-tracking system and efforts to integrate it with EHR systems, at a cost of $2.8 million. A year later, only 42 percent of the state’s prescribers and dispensers have automatic access to the PDMP, according to an article in Crain’s Detroit Business.

Leveraging Data and Analytics

Many hospitals and health systems have moved forward to leverage their own IT systems, such as their EHR systems and population health tools, to collect and analyze data in order to address opioid abuse and addiction, and to prevent overdose deaths.

At the Danville, Pa.-based Geisinger Health System, clinical leaders are grappling with the fact that Pennsylvania’s opioid overdose death rate was the fourth highest in the country, and many of the counties with the highest death rates in 2016 were served by Geisinger Health System.

As detailed in a Healthcare Informatics article, Geisinger’s clinical IT leaders developed a strategy to address this by utilizing data and health IT tools to change providers’ prescribing practices. As a result of this effort, the health system has slashed opioid prescriptions in half, from a monthly average of 60,000 opioid prescriptions to 31,000 prescriptions per month.

John Kravitz

John Kravitz, CIO at Geisinger Health System, notes that data and IT were foundational to these efforts, as physician leadership developed a provider dashboard linked to the EHR to identify current practice patterns among providers. “Having the dashboard linked into the EHR has been critical to success,” he says. The health system’s IT leaders also leverage the state’s PDMP and is currently working to build APIs (application programming interfaces) to connect to providers’ workflow. 

“There are organizations that are further along down the path and they see the vision of where technology could take them and how it could be leveraged,” Tate says. “Those who are advanced and deep into this are looking to use big data and social determinants of health to further engage and understand their patient populations, and then also looking for those tools that are going to be disruptive. There’s a growing appetite for these new, smaller, innovative technologies.”

Emerging Technologies

There are a number of startups working on digital opioid solutions. Princeton, New Jersey-based Braeburn Pharmaceuticals developed a prescription implant that provides those who are addicted with a steady low dose of buprenorphine rather than opioids. RxAssurance, a healthcare startup based in Denver, built an app that can be used by patients to fill out a survey about family and personal health histories, and the platform then gives doctors assessments to determine a patient’s risk for opioid abuse.

At Brigham and Women’s Hospital in Boston, the emergency department piloted the use of capsules embedded with ingestible wireless sensors to measure patients’ prescription opioid use. The hospital partnered with eTectRx, a Newberry, Fla.-based technology company that develops the digital pills, to test the use of the pills on patients admitted to the ED for bone fractures and who were prescribed oxycodone.

When swallowed, the capsules are dissolved by digestive acids in the stomach and emit a radio signal that is picked up by a reader worn around the patient’s neck. That wearable device then forwards the message, via Bluetooth technology, to a smartphone app, where a clinician or pharmacist can view the patient’s medication adherence. Peter Chai, M.D., an emergency medicine physician and a medical toxicologist at Brigham and Women’s Hospital, says the technology can help to detect a pattern in how patients are taking pills and can help physicians to intervene if there’s a change in that pattern.

“Prescription opioids are the only medication where the onus of how you use it is placed on the patient. Patients are told, ‘take it as needed for your pain,’ but there is a huge gap between what patients think ‘as needed’ means, and what physicians think,” Chai says. “The cool part about the technology is that now that we can detect changes in digestion patterns or dangerous escalations, so we can then develop intervention and outreach.”

Chai and his colleagues plan to test the digital pills on post-operative spinal fusion surgery patients to track digestion patterns several months after surgery.

Peter Chai, M.D.

There are also startups developing innovative tools, from wearables to therapy apps, on the consumer-facing side to aid people battling opioid addiction. Trigger, based in Chicago, developed an app that monitors phone use to determine when someone recovering from addiction is most at risk. Chrono Therapeutics is developing a wearable patch to help patients overcome nicotine addiction and has plans to make a similar patch for opioid addiction.

Many healthcare leaders say that while innovative digital tools can help address some aspects of the problem, the technology needs to seamlessly integrate into the health system to be scalable and to make a significant impact. “You can prescribe a digital oxycodone pill in a research study, but I think the real gold is to develop this as something that a primary care physician could prescribe and a pharmacy would know how to interact with it,” Chai says.

Chai also notes that technology alone will not combat the growing opioid abuse and overdose problem, and that patient engagement is still a key part of the solution.

“There are many innovative devices out there, a dime a dozen, but none of it is going to work unless you deliver a message about appropriate medication use correctly to the patient,” he says.

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Survey: Healthcare Orgs Ramping up Investment in AI, Confident about ROI

November 16, 2018
by Heather Landi, Associate Editor
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The majority of health care executives (91 percent) are confident they will see a return on investment (ROI) on artificial intelligence investments, although not immediately, and foresee the greatest impact of AI will be on improving health care, according to an OptumIQ survey.

Most (94 percent) health care leaders responded that their organizations continue to invest in and make progress in implementing AI, with 75 percent of healthcare organizations say they are implementing AI or have plans to execute an AI strategy, based on OptumIQ’s survey of 500 senior U.S. healthcare industry executives, primarily from hospitals clinics and health systems, life sciences organizations, health plans and employers. OptumIQ is the intelligence arm of data and analytics of Optum, an information and technology-enabled health services business that is part of UnitedHealth Group.

While many healthcare organizations have plans, progress is mixed across sectors. Of the 75 percent who are implementing AI or have plans to execute an AI strategy, 42 percent of those organizations have a strategy but have not yet implemented it. Employers are furthest along, with 22 percent reporting their AI implementations are at a late stage, with nearly full deployment.

The average AI implementation is estimated to cost $32.4 million over five years. The majority of respondents (65 percent) do not expect to see a ROI before four years with the average expected period being five years. However, employers (38 percent) and health plans (20 percent) expect ROI sooner, in three years or less, according to the survey.

The survey found that health care leaders universally agree the greatest impact of AI investment will be on improving health care. Thirty-six percent expect AI will improve the patient experience; 33 percent anticipate AI will decrease per-capita cost of care; and 31 percent believe AI will improve health outcomes.

Most health care leaders believe AI can make care more affordable and accessible. Ninety-four percent of respondents agree that AI technology is the most reliable path toward equitable, accessible and affordable health care.

AI will make care more precise and faster, according to respondents. The top two benefits respondents expect to see from incorporating AI into their organizations are more accurate diagnosis and increased efficiency.

The survey found that respondents are looking to AI to solve immediate data challenges – from routine tasks to truly understanding consumers’ health needs. Of those health organizations that are already investing in and implementing AI: 

  • 43 percent are automating business processes, such as administrative operations or customer service;
  • 36 percent are using AI to detect patterns in health care fraud, waste and abuse; and
  • 31 percent are using AI to monitor users with Internet of Things (IoT) devices, such as a wearable technology

With more organizations seeing the benefit of adopting an AI strategy, 92 percent agree that hiring candidates who have experience working with AI technology is a priority for their organization. To meet this need, nearly half (45 percent) of health care leaders estimate that more than 30 percent of new hires will be in positions requiring engagement with or implementation of AI in the next 12 months. However, health organizations seeking to hire experienced staff will likely face talent shortages.

“Artificial intelligence has the potential to transform health care by helping predict disease and putting the right insights into the hands of clinicians as they treat patients, which can reduce the total cost of care,” Eric Murphy, CEO of OptumInsight, said.

“Analytics isn't the end, it's the beginning – it's what you do with the insights to drive care improvement and reduce administrative waste,” Steve Griffiths, senior vice president and chief operating officer of Optum Enterprise Analytics, said. “For AI to successfully solve health care’s biggest challenges, organizations need to employ a unique combination of curated data, analytics and health care expertise... We are already seeing a race for AI talent in the industry that will grow as adoption continues to increase.”






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Breaking: The 2019 Healthcare Informatics Innovator Awards Program is Open

November 15, 2018
by the Editors of Healthcare Informatics
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Providers and vendors can now submit their entries to the Healthcare Informatics Innovator Awards Program

The 2019 Healthcare Informatics Innovator Awards Program is now open for submissions. As always, it’s a great privilege and pleasure for us to sponsor this program.

And as many readers know, the concept of team-base recognition, which began with the 2009 edition of the program, has encompassed numerous sets of multiple winning teams that our publication has recognized for their achievements across a very broad range of areas.

As it always does, the Healthcare Informatics Innovator Awards Program recognizes leadership teams from patient care organizations—hospitals, physician groups, clinics, integrated health systems, payers, HIEs, ACOs, and other healthcare organizations—that have effectively deployed information technology in order to improve clinical, administrative, financial, or organizational performance.

The Innovators Program, as it has in the last few years, also recognizes vendor solution providers who are asked to describe their core products or services in five categories. We are asking vendors to submit their innovation in one of five critical health IT areas: Data Security; Value-Based Care; Revenue Cycle Management; Data Analytics; and Patient Engagement.

Indeed, again this year, the Innovator Awards program will again include two tracks for innovation recognition—one for healthcare provider organizations and one for technology solution providers.

The submission form link for both tracks is right here. The deadline for submissions is January 4, 2019.

What’s more, the winning teams will be featured in an upcoming issue of Healthcare Informatics, and winning vendor teams will be awarded free digital distribution of whitepapers to all HIT Summit Series attendees.

At Healthcare Informatics, we are honored to be able to showcase these kinds of case studies from both providers and vendors, which we believe embodies the spirit of innovation around adaptive change that will light the way for their colleagues from across the industry.

At a time of extraordinary change in healthcare, now is as great a time as ever to showcase your innovations. Please consider submitting an entry to our program, and good luck in your entry!

--The Editors of Healthcare Informatics


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New Blockchain Project Sets to Tackle Provider Credentialing

November 12, 2018
by Rajiv Leventhal, Managing Editor
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A group of five healthcare enterprises—National Government Services, Spectrum Health, WellCare Health Plans, Inc., Accenture, and The Hardenbergh Group—are linking up to participate in a distributed ledger program aimed at resolving administrative inefficiencies related to professional credentialing.

The project, Professional Credentials Exchange, is being developed by ProCredEx and Hashed Health, a blockchain innovation consortium. The exchange leverages “advanced data science, artificial intelligence, and blockchain technologies to greatly simplify the acquisition and verification of information related to professional credentialing and identity,” according to officials.

In an announcement, officials noted that credentialing healthcare professionals “is a universally problematic process for any industry member that delivers or pays for patient care.  The process often requires four to six months to complete and directly impedes the ability for a healthcare professional to deliver care and be reimbursed for their work.”

They added, “Hospitals alone forfeit an average of $7,500 in daily net revenues waiting for credentialing and payer enrollment processes to complete.  Further, nearly every organization required to perform this work does so independently—creating a significant administrative burden for practitioners.”

As such, the groups, via the exchange, will aim to address the time, cost, and complexity associated with these processes by facilitating the secure, trusted exchange of verified credentials information between exchange members.

Included in the collaboration are WellCare Health Plans, which serves about 5.5 million members, and Spectrum Health, a 12-hospital health system in western Michigan. National Government Services is a Medicare contractor for the Centers for Medicare & Medicaid Services (CMS), and processes more than 230 million Medicare claims annually.

"A fundamental component of developing the exchange lays in building a network of members that bring significant verified credential datasets to the marketplace," Anthony Begando, ProCredEx's co-founder and CEO, said in a statement.  "These are the leading participants in a growing group of collaborators who bring data and implementation capabilities to accelerate the deployment and scaling of the exchange."

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