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Report: Clinical Decision Support Market to Reach $4.97B by 2021

July 19, 2017
by Rajiv Leventhal
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A changing healthcare landscape that includes a shift to value-based reimbursement will transform the clinical decision support systems (CDSS) market in the U.S., according to a report from Frost & Sullivan.

The report noted that the advent of meaningful use and changing documentation requirements to achieve reimbursement are creating a complex and connected CDS infrastructure that includes digital workflow, electronic health records (EHRs) and point-of-care solutions.

EHRs are expected to be the hub for CDSS as growing volumes of patient data from a variety of sources will encourage workflow improvements to enable patient surveillance at the point-of-care.  These systems will further evolve to include the pool of patient data needed to develop predictive analytics and enhance the performance of population health systems, the report stated.

As such, researchers have predicted that the overall U.S. CDSS market is expected to be worth $4.97 billion in 2021. “The introduction of value-based reimbursements and quality performance measures will increase the value of evidence-based data to document a clinical rationale and support medical decision making," Digital Health Principal Analyst Victor Camlek said in a statement. "Essentially, the CDSS market will comprise a wide array of companies, ranging from established clinical content providers to vendors of medical devices, analytical services, and workflow tools. This emerging ecosystem will encourage alliances and merger/acquisition activity, and underscore the necessity for a dedicated CDSS infrastructure vital to improving patient outcomes,” he said.

Indeed, key growth opportunities for the market will involve:

  • Enhancing EHRs by including CDS data and working toward fully interoperable EHRs;
  • Extending CDSS to population health systems by feeding in actionable data;
  • Refining and advancing clinical surveillance technology; and
  • Including access to patients who will benefit from the ability to retrieve accurate and relevant data pertaining to their medical condition that will encourage improved adherence and outcomes.

"The challenge will be to make CDSS a resource that is appropriate for all stakeholders that is compliant with privacy and security guidelines, and flexible enough to function in a constantly evolving healthcare regulatory environment," added Camlek.

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Survey: Physician Sentiment Mixed on Benefits of Data, Analytics Tools

December 19, 2018
by Heather Landi, Associate Editor
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A new research report reveals physicians’ continuing dissatisfaction with electronic health records (EHRs) and this frustration with EHRs may slow physicians’ immediate acceptance of new data and analytics tools.

More than half of surveyed physicians say the introduction of EHRs has had both negative and positive impacts. Similarly, 57 percent of doctors say the "introduction of advanced data and analytics tools, population health software and data registries has been a positive and a negative development for practicing physicians."

Across the board, as physicians become active users of population health tools, they report an increasingly positive outlook toward these tools and the value they bring, according to a report by Geneia, a Harrisburg, Pa.-based healthcare analytic solutions and services company.

The report is based on a survey of 300 full-time physicians, and is a follow-up to a report Geneia released in October that revealed a rise in physician burnout. Two-thirds of physicians believe the challenges of practicing medicine in today’s environment have caused them to consider career options outside of clinical practice, an 11 percent increase compared to a similar survey three years ago, according to that earlier report.

According to Geneia’s Physician Misery Index, a tool the company established to measure national physician satisfaction, the physician misery index has increased to 3.94 out of 5, since the January 2015 inaugural survey.

This latest report examines physician sentiment about EHRs and data and analytics tools. Eight-six percent of physicians agree—and 51 percent strongly agree—that "the heightened demand for data reporting to support quality metrics and the business-side of healthcare has diminished my joy in practicing medicine."

Almost all the physician respondents (96 percent) say the amount of time physicians spend on data input and reporting in the last 10 years has increased, and 80 percent say they are personally at risk of burnout. Almost three-quarters (70 percent) of respondents say they know a physician who is likely to stop practicing medicine in the next five years, as a result of physician burnout.

Most physicians, particularly younger ones, accept the potential of and need for data tools, and share some positive views on the possibilities advanced analytics offers. However, physicians’ experience with EHRs may slow their immediate acceptance of new data tools, the report states.

Physician sentiment about EHRs is consistent with Geneia’s inaugural survey in January 2015. Half of all respondents (52 percent) have a mixed opinion about the impact of EHRs in the workplace, and nearly equal numbers have positive (21 percent) and negative (23 percent) views.

EHR integration continues to be a challenge, the survey found. Nearly all physicians (96 percent) believe EHRs should be better designed to seamlessly integrate with the technology systems used by their office and its insurance providers. However, more than half (57 percent) say their EHRs don’t currently integrate.

A significant majority (68 percent) say they lack the appropriate staff and resources to analyze and use EHR data to its full potential, which may be a contributing factor to the frustration they express with the time and quantity of data required.

Physicians with more exposure to data and analytics tools – those who self-identify as current population health users – have a more positive outlook on some of the benefits—64 percent of population health users have a positive view of the ability of data and analytics tools to help "efficiently assess patient history and needs" compared to 50 percent of non-users.

More than two-thirds of physicians (68 percent) say advanced analytics tools are important "when it comes to treating and being compensated for care under value-based care arrangements in today's U.S. healthcare system." Nearly 8 in 10 physicians say they value having a seamlessly integrated EHR analytics tool able to produce predictive analytics reporting on existing data.

Strong majorities of users and non-users of population health tools say value-based care models and the population health tools that support them prove useful in a number of areas—identifying high-risk patients who need screenings or care management; quickly narrowing and flagging patients who need proactive screenings or monitoring; and providing risk assessment data and analytics to stratify patients into low-, rising- and high-risk.

The survey revealed that physicians feel data and analytics tools are most helpful on gathering information and assessing patient history and needs, but the tools fall short on their ability to improve work efficiencies and time with patients. About two-thirds of population health users think data and analytics tools can help “efficiently assess patient history and needs” compared to only half of non-users.

Only about one in four of all surveyed physicians (44 percent) say data and analytics tools help improve quality performance, Medicare Star ratings and HEDIS reporting. Among population health users, this percentage grows to 55 percent.

“We are encouraged that contemporaneously with an increase in the Physician Misery Index, physicians also see the potential for EHRs, data and analytics to help them succeed in value-based care,” Heather Lavoie, Geneia's president, said in a statement. “Nevertheless, there's much more to do to restore the Joy of Medicine to doctors. That's why we're calling on all health IT companies to involved physicians in the design and implementation of health technology products and to measure physician satisfaction.”

 

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Dr. AI Will See You Now: Machines and the Future of Medicine

December 18, 2018
by Dr. Gautam Sivakumar, Industry Voice, CEO, Medisas
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Artificial intelligence (AI) has been a hot topic lately. Much has been said about its promise to improve our lives, as well as its threat to replace jobs ranging from receptionists to radiologists. These wider discussions have naturally led to some interesting questions about the future of medicine. What role will human beings have in an ever-changing technology landscape? When AI becomes a better "doctor," what will become of doctors? How will patients and medical professionals adjust to these changes?

While it is, of course, hard to make accurate predictions about the distant future, my experience both as a doctor and now CEO of a software company that uses AI to help doctors deliver safer care, gives me some insight into what the intermediate future will hold for the medical profession.

Medicine is one of the great professions in every culture in the world—an altruistic, challenging, aspirational vocation that often draws the best and the brightest. Doctors spend years in training to make decisions, perform procedures, and guide people through some of their most vulnerable points in life. But medicine is, for the most part, still stuck in a pre-internet era. Entering a hospital is like walking into a time capsule to a world where people still prefer paper, communication happens through pagers, and software looks like it’s from the 1980s or 1990s.

But this won’t last; three giant forces of technology have been building over the last few years, and they are about to fundamentally transform healthcare: the cloud, mobile, and AI. The force least understood by doctors is AI; after all, even technophobic doctors now spend a lot of time using the internet on their smartphones. Even so, AI is the one that will likely have the biggest impact on the profession.

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A lot of people believe that AI will become the primary decision maker, replacing human doctors. In that eventuality, Dr. AI will still need a human “interface,” because it is likely patients will need the familiarity of a human to translate the AI’s clinical decision making and recommendations. I find it an intriguing thought—going to the doctor’s office and seeing a human whose job it is to read the recommendations of a computer just to offer the human touch.

But to understand what the future could hold, we must first understand the different types of problems that need to be solved. Broadly, problems can be split into simple, complicated, and complex ones. Simple and complicated problems can be solved using paradigmatic thought (following standardized sets of rules), something computers excel at. What makes complex problems unique is that they require judgment based on more than just numbers and logic. For the time being, the modern machine learning techniques that we classify as “AI” are not well suited to solving complex problems that require this deeper understanding of context, systems, and situation.

Given the abundance of complex problems in medicine, I believe that the human “interfaces” in an AI-powered future won't simply be compassionate people whose only job is to sit and hold the hand of a patient while reading from a script. These people will be real doctors, trained in medicine in much the same way as today—in anatomy, physiology, embryology, and more. They will understand the science of medicine and the decision making behind Dr. AI. They will be able to explain things to the patient and field their questions in a way that only people can. And most importantly, they will be able to focus on solving complex medical problems that require a deeper understanding, aided by Dr. AI.

I believe that the intermediate future of medicine will feel very similar to aviation today. Nobody questions whether commercial airline pilots should still exist, even though computers and autopilot now handle the vast majority of a typical flight. Like these pilots, doctors will let "auto-doc" automate the routine busy work that has regrettably taken over a lot of a clinician’s day—automatically tackling simple problems that only require human monitoring, such as tracking normal lab results or following an evidence-based protocol for treatment. This will let doctors concentrate on the far more complex situations, like pilots do for takeoffs and landings.

Dr. AI will become a trusted assistant who can help a human doctor make the best possible decision, with the human doctor still acting as the ultimate decision maker. Dr. AI can pull together all of the relevant pieces of data, potentially highlighting things a human doctor may not normally spot in an ocean of information, while the human doctor can take into consideration the patient and their situation as a whole.

Medicine is both an art and a science, requiring doctors to consider context when applying evidence-based practices. AI will certainly take over the science of medicine in the coming years but most likely won't take over the art for a while. However, in the near future, doctors will need to evolve from being scientists who understand the art of medicine to artists who understand the science.

Dr. Gautam Sivakumar is the CEO of Medisas


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Have CIOs’ Top Priorities for 2018 Become a Reality?

December 12, 2018
by Rajiv Leventhal, Managing Editor
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In comparing healthcare CIOs’ priorities at the end of 2017 to this current moment, new analysis has found that core clinical IT goals have shifted from focusing on EHR (electronic health record) integration to data analytics.

In December 2017, hospitals CIOs said they planned to mostly focus on EHR integration and mobile adoption and physician buy-in, according to a survey then-conducted by Springfield, Va.-based Spok, a clinical communications solutions company, of College of Healthcare Information Management Executives (CHIME) member CIOs.

The survey from one year ago found that across hospitals, 40 percent of CIO respondents said deploying an enterprise analytics platform is a top priority in 2018. Seventy-one percent of respondents cited integrating with the EHR is a top priority, and 62 percent said physician adoption and buy-in for securing messaging was a top priority in the next 18 months. What’s more, 38 percent said optimizing EHR integration with other hospital systems with a key focus for 2018.

Spok researchers were curious whether their predictions became reality, so they analyzed several industry reports and asked a handful of CIOs to recap their experiences from 2018. The most up-to-date responses revealed that compared to last year when just 40 percent of CIOs said they were deploying an enterprise analytics platform in 2018, harnessing data analytics looks to be a huge priority in 2019: 100 percent of the CIOs reported this as top of mind.

Further comparisons on 2018 predictions to realities included:

  • 62 percent of CIOs predicted 2018 as the year of EHR integration; 75 percent reported they are now integrating patient monitoring data
  • 79 percent said they were selecting and deploying technology primarily for secure messaging; now, 90 percent of hospitals have adopted mobile technology and report that it’s helping improve patient safety and outcomes
  • 54 percent said the top secure messaging challenge was adoption/buy in; now, 51 percent said they now involve clinicians in mobile policy and adoption

What’s more, regarding future predictions, 87 percent of CIOs said they expect to increase spending on cybersecurity in 2019, and in three years from now, 60 percent of respondents expect data to be stored in a hybrid/private cloud.

CIOs also expressed concern regarding big tech companies such as Apple, Amazon and Google disrupting the healthcare market; 70 percent said they were somewhat concerned.

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