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Roswell Park Comprehensive Cancer Center Boosts Telehealth With $600K From the FCC

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Roswell Park Comprehensive Cancer Center in Buffalo, New York, faced several challenges in rolling out an effective telemedicine strategy, many of which were unrelated to COVID-19. If anything, COVID-19 served as an accelerant to solving many of the challenges, since the organization had no alternative but to move forward.

THE PROBLEM

“First, while we had in place technology to enable telemedicine – in particular virtual visits – it had not been optimized for use nor integrated within our clinical workflows or our EHR,” said CIO Thomas Furlani. “Integrating virtual visits with a typical in-person clinic operation is far from trivial and even today we have challenges effectively implementing it within all clinics since the workflows from one clinic to another can be very different.

“There also is a challenge at the patient side, since not all patients have the same technical skills or have access to devices to facilitate virtual visits from home,” he continued. “What we refer to here as a great digital divide that is common across healthcare.”

Fortunately for Roswell Park, prior to the onset of COVID-19, the information technology team already had an ongoing project to develop and deploy virtual visit technology. So the organization had a solid foundation on which to build and improve its telehealth solution.

“The main problems we wanted to address with our telehealth platform prior to COVID-19 surrounded our goals of expanding the reach of our clinical care services and allowing our clinicians to meet our patients at their convenience to avoid unnecessary long commutes to our city campus,” he said. “In 2016, we began exploring various telehealth workflows to meet those needs but hit many billing-related roadblocks due to the restrictive New York State and federal regulations.

“The largest barriers involved provider licensure requirements for the treatment of out-of-state patients and geographic restrictions on billing patients for telehealth within our own state,” he added. “For that reason, we settled on piloting a self-pay, international second opinion program. The platform launched using WebEx Meetings and later migrated to Microsoft Teams.”

In the year before the COVID-19 pandemic, Roswell Park Comprehensive Cancer Center expanded its platform and developed an integrated nurse triage telehealth solution pilot to prevent critical care patients from ending up in the ER.

In this use-case, a patient would call the Nurse Triage/Assessment and Treatment Center, where with the click of a button, a staff member could escalate to a video conference with a medical staff member in order to help determine next steps. The platform was developed in-house using Cisco WebEx APIs for WebRTC. From the patient’s perspective, they received an email to start the visit from their browser with the click of a button.

“When the pandemic hit, this work on the platform development for triage gave us a major head start to replace some in-person visits with virtual visits in order to reduce the COVID-19 transmission risk to our patients and clinicians,” Furlani explained. “However, since the previous visits were designed for more on-the-fly visit workflows, they were not tied to billing and the workflows had not been optimized for use nor integrated within our regularly scheduled visits or billing to payers.”

PROPOSAL

As a next step, the organization proposed expanding the platform to integrate with its enterprise scheduling system, allowing the clinical center associates to schedule telemedicine visits that automatically appear as links on the patient schedule on their MyRoswell patient portal.

“They could use this type of scheduled visit for any visit that did not require in-person labs or hands-on care,” said CTO Paul Visco. “Example visit types include results review, surgical follow-up visits and pre-surgical consults.”

MARKETPLACE

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MEETING THE CHALLENGE

The virtual visit technology was made available to everyone at the organization at the peak of the early pandemic. The technology makes it simple for a provider to not only speak with and assess the patient but to include any friends and family they wish, third-party providers or other staff. Having a telehealth platform also makes it a lot simpler for patients who live far away to complete follow-up visits.

“The registration staff got a bit over-zealous with ease of scheduling and began to schedule virtual visits to patients without first checking they had the patient’s capability or interest in using the web or a mobile phone for a virtual visit,” Visco said. “While this issue resolved itself rather quickly, it created a sense of irritation for some clinicians who went into virtual visits and not only had to handle the clinical care but tech support, which often ended in the patient who should have never been scheduled for a virtual visit in the first place, transitioning to a telephone visit.”

As a response, staff started to customize the workflows of several clinical centers to standardize and build their in-person workflows into the platform. This included features that allowed for the passing of the visit between clinical care providers, allowing a nurse to complete the visit questionnaire with the patient and then pass the visit off to a physician as they would in an in-person visit.

“We built in the ability for patients to self-check-in their virtual appointments via a text message,” Visco noted. “This placed them on our Allscripts Sunrise EHR tracking boards within the clinic, alerting the staff a virtual patient was ready. This integration let virtual visit workflows blend seamlessly with an in-person clinic day.”

RESULTS

Metrics were critical to measure the program’s success. Virtual visits information was tracked by a structured documentation section in the provider’s EHR documentation.

Data collected included whether a visit was conducted via video or telephone, the platform used, the length of the visit, and the option to select the most common technical issues if unsuccessful. These data points were queried and reported on dashboards within Microsoft PowerBI.

“During the height of the pandemic, we conducted around 150 billable virtual visits a day,” Visco reported. “That number has since dropped to 30 a day, mostly due to preference by patients and providers for in-person visits.

“However, for many patients who live outside our area, this technology is critical as it allows them to schedule their follow-up visits without a long drive to the hospital. It has also proved useful during the cold winter months when many local patients would prefer that a checkup visit be virtual to avoid dealing with possible bad weather.”

USING FCC AWARD FUNDS

Roswell Park Comprehensive Cancer Center was awarded $600,456 by the FCC telehealth fund for network upgrades and security equipment, as well as teleconferencing software licenses, to provide virtual patient visits to continue comprehensive cancer care, including surgery, chemotherapy, immunotherapy, radiation therapy, imaging diagnostics and regular checkups, while reducing the exposure of an at-risk patient population and clinical staff.

“As our virtual visit platform rolled out and rapidly expanded we hit some infrastructure roadblocks,” Furlani said. “These issues centered on our internal firewall and network hardware, degrading the performance WebRTC video. WebRTC is the technology backbone that powers most of the modern telemedicine and collaboration platforms including WebEx, Doxy.me, Doximity, Teledoc, Zoom and MS Team.

“Luckily, with the help of the FCC grant, we were able to upgrade our network hardware to accommodate the remote workers/patients increased bandwidth, as well as to provide better experience with WebRTC by reducing packets lost.”

The organization also moved from requiring an app to a telehealth experience that revolved around simply getting a text message with a link and clicking on that link, all still through the portal and based on WebEx APIs.

“We also used FCC money to provide iPads and better cameras and microphones so clinicians could appear in higher quality to the patients,” he concluded.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.

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Health Care

Singapore’s Public Health System Rolling Out the Clinician’s ZEDOC Platform

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Singapore’s health tech agency Integrated Health Information Systems has partnered with Auckland-headquartered digital health firm The Clinician to deploy a patient-reported outcome and experience measures platform across the island state’s public healthcare system.

WHAT IT’S FOR

The Clinician’s ZEDOC platform, the company describes, assists healthcare providers in managing patient-generated health data outside the hospital through digitisation. Integrated with HIS, the system supports timely exchange of health data and information between providers and patients, including subjective PROMs and PREMs, objective wearable device data, and other communication or educational materials. By streamlining the digital collection of critical health data, ZEDOC is able to render real-time, actionable information crucial for improving health outcomes and experiences.

The partners are working on multiple ZEDOC integrations with existing health information systems (HIS). A privacy-preserving hybrid infrastructure has been implemented which ensures that all personally identifiable information stays within the IHiS’s private health cloud while all anonymised health data are collected through a secure commercial cloud platform.

WHY IT MATTERS

Singapore intends to measure and improve health outcomes and patient experience with the rollout of The Clinician’s ZEDOC platform. Their partnership will “bolster patient engagement and enable clinicians to more effectively assess patients’ health status before, during and after receiving a health service – closing the loop when they are outside the hospital,” said The Clinician CEO Dr Ron Tenenbaum. It will also allow providers to deliver “more holistic and personalised care for patients by taking into account their perspectives for the first time,” he added.

To demonstrate the benefit of routine collection and analysis of PROMs, The Clinician shared that this has resulted in over 50% reduction in 90-day complications for hip and knee surgery patients in one study and a five-month improvement in the survival of cancer patients in another.

Among benefits for care providers, the ZEDOC integration will replace existing paper-based forms with an integrated digital platform that automates data capture, as well as benchmark outcomes across providers to reduce variability and waste. For patients, they can become more involved in the treatment decision-making and be informed early of health risks and warning signs.

THE LARGER TREND

Last month, Cabrini Health and The Alfred, two of the largest healthcare providers in the Australian state of Victoria, deployed the ZEDOC platform to automate the collection and analysis of health data from colorectal cancer patients. The installation is said to adhere to the colorectal cancer standards outlined by the International Consortium of Health Outcomes Measurement.

Original Post: healthcareitnews.com

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EU Analysis Highlights Digital Health Lessons From COVID-19

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An EU analysis has outlined the effect of COVID-19 on healthcare systems in Europe and the role of digital innovation in building their resilience.

Experts from the Organisation for Economic Co-operation and Development (OECD) and the European Observatory have published a set of 29 country health profiles, covering all EU member states, as well as Iceland and Norway. A companion report also highlights a selection of cross-country trends.

Speaking at a virtual launch event on Monday (13 December), Josep Figueras, director, European Observatory, highlighted two main lessons learnt from the use of technology in the pandemic.

Using telemedicine as an example of digital health innovation, he said the number of teleconsultations had increased in all EU countries during 2020. However in some countries, such as France, teleconsultations had decreased when lockdowns ended.

“The key issue here is how we harness and sustain innovation – how we make sure that these improvements in the use of telemedicine (as an illustration of the use of other digital technologies) can be maintained and sustained to increase the effectiveness of the health system,” Figueras said.

He also highlighted that the technology for telemedicine and other innovations was already available in many European countries before the pandemic but was not being used.

Figueras asked: “What did we do within the pandemic that literally within a couple of weeks, we got all this telemedicine in place?”

To sustain the use of telemedicine and other health technologies, he said it was important to look at the regulatory measures, financial incentives, training and changes in culture needed.

“Something the pandemic has taught us loudly and clearly is the importance of digital innovation – not only the new technologies, but the ability to implement them,” Figueras added.

WHY IT MATTERS

The State of Health in the EU cycle is a two-year process initiated by the European Commission in 2016, designed to improve country-specific and EU-wide knowledge in healthcare.

It aims to gather data and in-depth analyses on health systems and make the information accessible to policy makers and stakeholders.

THE LARGER CONTEXT

During the pandemic, digital tools have been used in the EU to boost public health measures such as the implementation of the EU Digital COVID Certificate, vaccination booking systems, and cross-border interoperability for contact-tracing apps.

There has also been investment in EU-wide COVID recovery initiatives such as the EU4Health programme.

ON THE RECORD

Maya Matthews, head of unit performance, European Commission said: “COVID-19 illuminated the fact that in many European countries we do not have a strong public health system. We cannot do testing and tracing. Even surveillance is done sometimes in a very fragmented fashion.

“I think if one thing comes out of COVID-19, it’s to say that public health matters – that public health is a very important part of health systems and has not really received the attention it deserves.”

Source Here: healthcareitnews.com

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Clinical Messaging Platform Hospify to Close, Bupa Arabia Invests in Global Ventures, and More News Briefs

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Clinical messaging platform Hospify to close

British healthtech startup Hospify has announced it will close its secure clinical messaging platform on 31 January 2021.

Hospify said it suffered a decline in demand after the government suspended the UK 2018 Data Protection Act in relation to healthcare last year for the duration of the COVID-19 pandemic.

It also cited difficulties caused by “post-Brexit uncertainties surrounding the future of the UK’s data adequacy agreement with the EU”.

A statement from the Hospify team says: “It’s a sad end to a wonderful vision, a vision of universal health care communication that was both free of data exploitation and free at the point of use.”

Insurance giant Bupa Arabia invests in Global Ventures

UAE-based international venture capital firm Global Ventures has announced new investment from Bupa Arabia, the leading health insurance company in the region.

Bupa Arabia’s participation in Global Ventures Fund II as strategic partner aims to foster the healthcare ecosystem in the region and particularly in Saudi Arabia.

The investment is part of the Bupa Arabia’s strategy to participate and invest in disruptive healthcare and insurance technologies, amongst other targeted growth sectors.

Noor Sweid, Global Ventures founder and general partner, said: “Bupa Arabia shares our outlook and ambition on the digital health sector, and its potential for technology and innovation to deliver long-term economic benefits particularly in emerging markets.”

Liverpool Heart and Chest Hospital achieves EMRAM Stage 6

Specialist NHS trust Liverpool Heart and Chest Hospital (LHCH) has been awarded Stage 6 of the EMRAM, or Electronic Medical Record Adoption Model, by HIMSS.

The EMRAM measures the adoption and maturity of a health facility’s inpatient EMR capabilities from 0 to 7. Achieving Stage 6 means the trust has established clear goals for improving safety, minimising errors, and recognising the importance of healthcare IT.

Kate Warriner, chief digital and information officer said: “Digital excellence must be the cornerstone if we are to continually improve the care that we provide for our patients in the years ahead. Therefore, whilst we are rightly proud of this achievement, we have ambitions for further pioneering innovation and advancing our use of technology to become a Stage 7 hospital.”

More than $110m raised by Sheba’s ARC Innovation Center

Israel’s Sheba Medical Center has announced that six companies from its Accelerate Redesign Collaborate (ARC) Innovation Center raised more than $110 million (EUR97.2m) in 2021.

ARC brings new technologies into the hospital and community ecosystem focusing on digital health technologies including precision medicine, big data, artificial intelligence (AI), predictive analytics, telemedicine and mobile health.

Sheba MedTech startups receiving investments this year included: Aidoc, BELKIN Laser, Starget Pharma Append Medical, Innovalve Bio Medical and TechsoMed.

Professor Eyal Zimlichman, ARC director and founder, said: “The ARC Innovation Center has been focusing on ground-breaking, innovative technologies with a prime directive to redesign healthcare.”

Konica Minolta named as part of NHS Digital Documents Solutions framework

Konica Minolta Business Solutions (UK) Ltd has been named as one of 46 suppliers on the new ?5 billion Digital Documents Solutions framework.

The firm will provide solutions across five key areas: internal print, external print, digital mail room, scanning and electronic document management solutions.

Jason Barnes, head of public sector, Konica Minolta, said: “Having been chosen through a competitive tender process, we are especially pleased to be newly appointed to the LPP framework, which deepens and furthers our reach into the NHS health sector.”

Original Source: healthcareitnews.com

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