Hard agree, and not just because I'm a spreadsheet nerd. Why are we all here? Isn't it in the service…
Katie the Intern 11/27/20
Happy Thanksgiving, HIStalk! I hope you all had a wonderful and safe holiday yesterday. I know this Thanksgiving looked very different for the majority of us this year, but I hope your day was spent giving thanks and enjoying time with friends and family (distanced or not)!
This column will focus on another interview with a professional in the healthcare IT industry. This time, the focus leaned on the now and the next of healthcare IT throughout the pandemic. I really learned a lot about the nature of healthcare IT’s growth during strenuous times like these, and I hope this column relays some of that well.
Mike Pietig works for Avtex Solutions, an IT service management company founded in 1972 that offers full-service customer experience consulting and solutions. “Avtex is in the business of helping their clients deliver an exceptional experience to their own customers,” Mike said.
Mike has been with Avtex for a year, focusing on a healthcare line for customers who use the company. Avtex needed someone who was familiar with healthcare, who knew the right terms, regulatory requirements, and connections in the field. His role has helped the healthcare line of Avtex Solutions grow faster.
Because Avtex Solutions is a connection solution builder, the company is always seeking ways to solve problems and develop strategies for doing so. Mike has been in the healthcare IT field for about 17 years, and coupled with his workplace’s goals, I figured he would be a great person to talk about the major changes in healthcare IT. We broke it down into two major questions — how has healthcare IT changed and where is healthcare IT going next?
“The first big change was driven by regulatory requirements, government change that forced the healthcare industry to implement electronic medical records and other solutions to satisfy their requirements,” Mike said. “The innovation was happening within individual hospitals, but it wasn’t happening across an entire industry, so the government mandated some of those.”
Mike mentioned regulatory requirements such as the Affordable Care Act and the HITECH Act, both of which were written between 10 to 15 years ago and enforced more accessibility to health insurance and the use of EHRs. These rulings further pressed the healthcare industry as a whole to create platforms that were usable, valuable, affordable, and high speed.
Mike then turned to the pandemic itself to discuss another major change in the healthcare IT industry. COVID-19’s presence has acted as an accelerant that boosted the growth of telehealth, and prompted IT professionals to really ask how and why patients could get better care in a safe environment.
“I would say [COVID-19] probably accelerated innovation by somewhere between five years on the low end to 10 years on the high end, in terms of the technology solutions,” Mike said. “Also in terms of the adoption of telehealth, and virtual visits, and digital front doors, and the idea of consumer-driven healthcare.”
Mike also mentioned a client that had a year-long goal to implement telehealth in nine areas of their hospital. When the pandemic hit, the hospital knew they had to get telehealth going fast, and implemented all nine areas within six weeks.
Mike’s words lead me to think about COVID-19’s impact on not just healthcare in general, but at the fundamental level of how care is delivered. He said that patients need to be treated as a consumer, as someone who has choices where to go and how to get care instead of someone only interested in need-based care.
“We have to deliver a really great experience,” Mike said. “Because otherwise, those customers can take their business elsewhere. Healthcare is now really starting to recognize that.”
I was very curious about this trend, about why COVID-19 acted as a catalyst in a consumer-driven market during a time where the consumer is not necessarily the driving factor. Consumers are benefitting from the exponential growth of the healthcare IT market during a global pandemic because of how quickly providers have had to innovate solutions for safe patient care that slows the spread of the virus.
“We’ve got so many choices now that I’m going to go where I feel I can get the best outcomes and the best value and the best experience,” Mike said. “That is fundamentally different now than the way it has ever been in healthcare.”
Mike’s answers to the next part of my questions were just as interesting. Where is healthcare IT going next? If we’ve grown and adapted so quickly, what could possibly be next?
“I don’t think the technology will go away,” Mike said. “I think there is even more openness or an appetite to new ideas coming into healthcare because everybody is trying to figure out, ‘how do I do more with less?’”
Mike reflected on a recent survey of over 1,000 patients to find out what was important to them during this time in healthcare. Patients don’t want to wait in waiting rooms, touch clipboards, or touch a kiosk, Mike said. The top 10 concerns from respondents were centered on safety. The survey showed that people want quick, efficient, and safe care. Is this the trend that the future of healthcare IT will continue to follow?
Healthcare IT will continue to move forward, most likely with a heavy emphasis on telehealth and its ease of application. But Mike did say that the approval of initiatives is what takes the longest and can be the hardest to do. If an initiative or an idea can prove to be applicable not just when someone is sick, but all year round, it can move forward.
“If you’ve got a strong business case and you can generate more revenue, or measure the expected savings, people will still find the funding for it,” Mike said.
Mike talked a lot about how much he reads HIStalk and how impactful it is to him for work and for understanding the industry. I wanted this column to focus more on healthcare IT, but Mike did say that HIStalk is in his top three reading recommendations for newcomers at his work and for anyone new to the industry.
I know I mentioned doing some research on COVID deaths, but I received an interesting comment that I’d like to do a column on beforehand, if possible. User Kermit mentioned that a friend of theirs is a therapist, and I’d love to interview a therapist currently using a telehealth service to hear their ideas of the pros and cons surrounding its usage. Mr. HIStalk and I discussed the importance of researching the provider side of telehealth. I’d also love to interview a doctor about these aspects, so if you’re either of those or know someone, I’d love to connect.
That’s it for today! I hope you had a great Thanksgiving, and happy Friday!
Katie The Intern
TLDR: Katie The Intern interviewed Mike Pietig from Avtex Solutions. Mike said that the two major changes in healthcare IT over the years have been regulatory requirements and the pandemic as an accelerant for growth.
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It’s actually not surprising that the changes associated with the pandemic fueled telehealth adoption. In addition to the safety related concerns, CMS and insurers changed their policies on billing for telehealth services. If their policies revert back again after the pandemic, telehealth will wither again. Why would they change back? Because more people are getting services now and this is particularly true in mental health which can be done quite effectively by telehealth. Previously going to an in-person visit could take many hours in arranging time off, transportation, parking, child care, etc. Now people can seek care during their lunch break without added transportation time/costs. However, now insurers are worried about having to pay more money for “unnecessary” care. However, it’s not that the care was unnecessary before, it’s just that if the health system erects multiple barriers to getting care, many people just give up.
“We’ve got so many choices now that I’m going to go where I feel I can get the best outcomes and the best value and the best experience”
Is that actually true though? Like most other people in this country, my health insurance is offered by my employer, who provides 3 plans for me to choose from. For the most affordable of these, if someone in my family develops some sort of serious condition, our PCP will have to be the gatekeeper before getting a referral to a specialist (likely first, one within the same organization, and MAYBE a second opinion from another group with providers known to be strong in that specialty). There’s a lot of talk about the “consumerism” of healthcare, but the idea that most people have the financial resources to just pick up and go to whatever provider of whatever service they like is blatantly false, in my opinion.
It’s only true for discretionary clinical matters, and even then it assumes that the patient has access to metrics that matter to them. And was motivated enough to read up on those metrics. And believes in the quality and accuracy of those metrics.
In my jurisdiction, if you call an ambulance, you go where the ambulance takes you.
I’m reluctant to be too critical of such pronouncements because they come from a desire to improve service delivery. The energy and enthusiasm this displays is worth protecting.
But honestly, if there’s one thing we do know: All too often, healthcare does NOT “have to” deliver a great customer service experience. If it did then we’d see that achieved routinely. The fact that we talk about a need is telling.
I can point to at least a half-dozen different initiatives in my organization, all with general or specific aims at delivering better service to the patients.
To employee:
I think your concern is what we are trying to get at. It is not consumer friendly right now. It is clunky. Its confusing. Its frustrating and it seems to change year to year. As a provider, I have this conversation with patients on a daily basis. There are too many hoops, and as clinicians, we have voiced this concern as well. We want the best care for our patients, but do not always have the power to facilitate that.
I think the idealist view of consumerism, and what we are trying to promote, recognizes social determinants of health and financial strain and provides affordable, quality-driven solutions to current problems.
My theory is that telehealth is a bigger benefit for the patient than it is for the clinician (though there are clinical benefits too). We’ve seen a lot of foot-dragging on supporting telehealth over the years. Things like “will I be able to bill for a telehealth consult?”
Despite that, telehealth has been slowly catching on. And Covid has accelerated interest and support.
When a better clinical delivery model is deployed, there’s no going back. Telehealth increases access and lowers costs of delivery. It’s a win, especially at the diagnostic phase. Active treatment is often going to require an in-person visit.
Thus it is best to view telehealth as a “go-with” instead of a replacement for office/clinic visits.
In spite of AMA lobbying, regulatory changes in the early 2000s allowed pharmacists to give flu shots. Costs fell, accessibility went up, public health improved, and doctors wallets weren’t quite as fat as they could be. Maybe half of flu shots still occur when people happen to be in the doctors office for another reason, but for the most part the doctor “establishment” has been cut out of making money on flu shots.Telemedicine cuts out your local doctor from making money on all those non procedural episodic office visits.
Brian Too is right that your local doc is not going to do telemedicine unless it is convenient for her and the billable rates make sense.