News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Despite Technical Challenges During COVID-19 Pandemic, Healthcare Networks Plan to Increase Investment in Telehealth Technologies

Survey shows more than 50% of hospitals and health systems plan to increase virtual care services within two years, a development that can change how patients access clinical laboratory testing services

If anything positive came out of the COVID-19 pandemic, it’s the growing acceptance by physicians and health payers of telehealth—including telepathology, teleradiology, and other types of virtual doctor visits—as a way for patients to meet with their physicians in place of in-office healthcare.

In earlier coverage about the rapid adoption of telehealth and virtual doctor visits, Dark Daily has observed that this trend creates a unique challenge for clinical laboratories. If the patient has a virtual consultation with his or her physician, how would a clinical laboratory get access to this patient to do a venipuncture and collect the samples necessary to perform the medical laboratory tests ordered by the physician?

Additionally, the path forward in telehealth may have other barriers to overcome. In “The Pandemic Made Telemedicine an Instant Hit. Patients and Providers Feel the Growing Pains,” Kaiser Health News (KHN) suggested that the virtual office visit may not have been as easy for patients as news headlines made them appear to be.

Nevertheless, according to multiple reports, healthcare providers are planning to increase investment in telehealth technologies.

Disparate Technologies Led to Technical Difficulties for Virtual Healthcare Providers

The terms telemedicine and telehealth are often used interchangeably. However, according to the American Academy of Family Physicians (AAFP), there are subtle differences worth noting.

Telehealth is a broad term which refers to “electronic and telecommunications technologies and services used to provide care and services at-a-distance [while] telemedicine is the practice of medicine using technology to deliver care at a distance.

“Telehealth is different from telemedicine in that it refers to a broader scope of remote health care services than telemedicine. Telemedicine refers specifically to remote clinical services, while telehealth can refer to remote non-clinical services,” the AAFP notes.

Kelly Lewis, former Vice President of Revenue Strategy and Enablement at telehealth provider Amwell, told Healthcare IT News (HIT News) that “the COVID-19 pandemic caused telehealth adoption to skyrocket.

However, “Because much of this adoption was driven out of an abundance of necessity, there was little time for organizations to think strategically about their technology investments,” she added.

“With urgency at a high, payers, provider organizations and clinicians all turned to the quickest options available so patients could continue to get care. The result, however, was what we are calling platform ‘sprawl’—the use of a number of disparate solutions that are leading to a confusing and frustrating care delivery system and experience.”

Nevertheless, according to a survey conducted by HIT News and HIMSS Analytics, “More than half (56%) of hospital and health system leaders say they are planning to increase their investment in telemedicine during the next two years.” This, “shows that the huge surge in and mainstreaming of telehealth during the ongoing pandemic has caused the C-suite and other healthcare leaders to embrace the technology that has for so long existed on the periphery of medicine,” HIT News noted.

“The clear message is that telehealth is here to stay and will continue to expand,” Lewis told HIT News, adding, “The majority of payers without virtual care offerings also reported planning to add them in the next 24 months.”

Kelly Lewis

“Clinicians agree that moving toward a fully integrated telehealth platform would be beneficial. More than 80% believe investing in a fully integrated virtual or hybrid care system would have a positive impact on clinical outcomes and patient experiences,” Kelly Lewis (above), former VP at telehealth provider Amwell, told Healthcare IT News. Considering the growing demand for telehealth, pathologists and clinical laboratories will need a strategy for supporting virtual healthcare providers. (Photo copyright: Healthcare IT News.)

The HIT News/HIMSS Analytics survey findings suggest telehealth will transition as providers aim for “smart-growth” instead of “pandemic-fueled expediency,” Becker’s Hospital Review reported.

Survey respondents expressed positive attitudes about telehealth:

  • 56% of healthcare leaders plan to increase investment in virtual care over the next two years.
  • 80% of respondents noted “very” or “extremely” important telehealth factors are integrating with existing workflows, fast video connections, and reducing administrative burden.
  • 77% called telehealth platform integration with the electronic health record (EHR) “very” or “extremely” important.
  • 80% envision positive clinical outcomes and patient experiences from a fully integrated telemedicine platform.
  • 75% of payers said a single digital platform has potential to streamline member experiences.

Investors Eye Telehealth

Healthcare providers are not the only organizations mining telehealth’s potential. Worldwide telehealth investments grew to $5B in the second quarter of 2021. This represented a 169% increase from the same time in 2020, reported an American Hospital Association Center for Health Innovation Market Scan that covered a CB Insights report, titled, “State of Telehealth Q2’21 Report: Investment and Sector Trends to Watch.”

“With telehealth visits stabilizing at roughly 10 times pre-pandemic levels, digital transformation initiatives are rising across the field. As a result of the pandemic, 60% of healthcare organizations are adding new digital projects, with telemedicine becoming a higher priority for 75% of executives (vs. 42% in 2019) to improve the patient experience,” the AHA reported.

As Dark Daily covered in “Cigna Subsidiary Evernorth Acquires MDLIVE as Demand for Telehealth Grows Among Insurers and Healthcare Consumers,” the COVID-19 pandemic has elevated virtual care into the mainstream, creating opportunities to increase access to care, including clinical laboratory testing, and drive down healthcare costs.

Medical laboratories and anatomic pathology groups are advised to keep pace with the changing healthcare landscape which increasingly puts a premium on remote and virtual visits. This has become even more critical as healthcare providers and investors infuse more capital into telehealth technology.

As physicians expand telemedicine virtual office visits post-pandemic, a clinical laboratory strategy to reach patients and acquire specimens will be required.

—Donna Marie Pocius

Related Information:

The Pandemic Made Telemedicine an Instant Hit. Patients and Providers Feel the Growing Pains

New HHS Study Shows 63-fold Increase in Medicare Telehealth Utilization During Pandemic

Most Provider Organizations Boosting Telehealth Investments, Survey Finds

Amwell Industry Telehealth Survey Paints Picture of an Integrated Streamlined Digital Care Future

Insights From Amwell’s 2021 Survey of Health Plans, Hospitals and Health Systems, and Clinicians

Telehealth Investment Shifts Signal Market Maturity

CBC Insights: Telehealth Trends 2021

Cigna Subsidiary Evernorth Acquires MDLive as Demand for Telehealth Grows Among Insurers and Healthcare Consumers

Sorting through EHR Interoperability: A Modern Day Tower of Babel That Corrects Problems for Clinical Laboratories, Other Providers

Despite the widespread adoption of electronic health record (EHR) systems and billions in government incentives, lack of interoperability still blocks potential benefits of digital health records, causing frustration among physicians, medical labs, and patients

Clinical laboratories and anatomic pathology groups understand the complexity of today’s electronic health record (EHR) systems. The ability to easily and securely transmit pathology test results and other diagnostic information among multiple providers was the entire point of shifting the nation’s healthcare industry from paper-based to digital health records. However, despite recent advances, true interoperability between disparate health networks remains elusive.

One major reason for the current situation is that multi-hospital health systems and health networks still use EHR systems from different vendors. This fact is well-known to the nation’s medical laboratories because they must spend money and resources to maintain electronic lab test ordering and resulting interfaces with all of these different EHRs.

Healthcare IT News highlighted the scale of this problem in recent coverage. Citing data from the Healthcare Information and Management Systems Society (HIMSS) Logic database, they note that—when taking into account affiliated providers—the typical health network engages with as many as 18 different electronic medical record (EMR) vendors. Similarly, hospitals may be engaging with as many as 16 different EMR vendors.

The graphics above illustrates why interoperability is the most important hurdle facing healthcare today. Although the shift to digital is well underway, medical laboratories, physicians, and patients still struggle to communicate data between providers and access it in a universal or centralized manner. (Images copyright: Healthcare IT News.)

The lack of interoperability forces healthcare and diagnostics facilities to develop workarounds for locating, transmitting, receiving, and analyzing data. This simply compounds the problem.

According to a 2018 Physician’s Foundation survey, nearly 40% of respondents identified EHR design and interoperability as the primary source of physician dissatisfaction. It has also been found to be the cause of physician burnout, as Dark Daily reported last year in, “EHR Systems Continue to Cause Burnout, Physician Dissatisfaction, and Decreased Face-to-Face Patient Care.”

Pressure from Technology Giants Fuels Push for Interoperability

According to HITECH Answers, the Centers for Medicare and Medicaid Services (CMS) has paid out more than $38-billion in EHR Incentive Program payments since April 2018.

Experts, however, point out that government incentives are only one part of the pressure vendors are seeing to improve interoperability.

“There needs to be a regulatory push here to play referee and determine what standards will be necessary,” Blain Newton, Executive Vice President, HIMSS Analytics, told Healthcare IT News. “But the [EHR] vendors are going to have to do it because of consumer demand, as things like Apple Health Records gain traction.”

Dark Daily covered Apple’s progress into organizing protected health information (PHI) and personal health records (PHRs) earlier this year in, “Apple’s Update of Its Mobile Health App Consolidates Data from Multiple EHRs and Makes It Easier to Push Clinical Laboratory Data to Patients.” It is one of the latest examples of Silicon Valley tech companies attempting to jump into the health sector and providing patients and consumers access to the troves of medical data created in their lifetime.

Another solution, according to TechTarget, involves developing application programming interfaces (APIs) that allow tech companies and EHR vendors to achieve better interoperability by linking information in a structured manner, facilitating secure data transmission, and powering the next generation of apps that will bring interoperability ever closer to a reality.

TechTarget reported on how University of Utah Hospital’s five hospital/12 community clinic health network, and Intermountain Healthcare, also in Utah, successfully used APIs to develop customized interfaces and apps to improve accessibility and interoperability with their Epic and Cerner EHR systems.

Diagnostic Opportunities for Clinical Laboratories

As consumers gain increased access to their data and healthcare providers harness the current generation of third-party tools to streamline EHR use, vendors will continue to feel pressure to make interoperability a native feature of their EHR systems and reduce the need to rely on HIT teams for customization.

For pathology groups, medical laboratories, and other diagnosticians who interact with EHR systems daily, the impact of interoperability is clear. With the help of tech companies, and a shift in focus from government incentives programs, improved interoperability might soon offer innovative new uses for PHI in diagnosing and treating disease, while further improving the efficiency of clinical laboratories that face tightening budgets, reduced reimbursements, and greater competition.

—Jon Stone

Related Information:

Why EHR Data Interoperability Is Such a Mess in 3 Charts

EHR Incentive Program Status Report April 2018

New FDA App Streamlines EHR Patient Data Collection for Researchers

AAFP Nudges ONC toward EHR Interoperability

A New Breed of Interoperable EHR Apps Is Coming, but Slowly

Top Interoperability Questions to Consider during EHR Selection

EHR Design, Interoperability Top List of Physician Pain Points

2018 Survey of America’s Physicians: Practice Patterns & Perspectives

ONC: 93% of Hospitals Have Adopted Most Recent EHR Criteria, but Most Lag in Interoperability

Open Standards and Health Care Transformation: It’s Finally Delivering on the Value It Promised

Apple’s Update of Its Mobile Health App Consolidates Data from Multiple EHRs and Makes It Easier to Push Clinical Laboratory Data to Patients

EHR Systems Continue to Cause Burnout, Physician Dissatisfaction, and Decreased Face-to-Face Patient Care

 

Banner Health Has 17 Hospitals Recognized for Achieving Stage 7 of the HIMSS EMR Development Model

Clinical Laboratory leaders can expect increasing demand for LIS-physician EHR integration

Hospitals are adopting electronic health records (EHR) at an accelerating rate. That’s the good news. But many hospitals lack the resources to acquire an EHR and implement it in a fast and robust manner, as many pathologists and clinical laboratory managers know from experience.

That makes the accomplishment of Banner Health all the more impressive. Last week, it was announced that 17 of Banner’s 22 hospitals have achieved Stage 7 of the EMR Adoption Model (EMRAM) developed by HIMSS Analytics, which is part of the Health Information Management and Systems Society (HIMSS).

Banner Hospitals Reach Higher EHR Functionality

InformationWeek Healthcare published a story about this news. It stated that those 17 Banner hospitals “have developed a comprehensive EHR that includes everything from computerized physician order entry and electronic documentation to a data warehouse, closed-loop medication administration, and health information exchange capability.”
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