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From the PRM Pro 1/9/19

January 9, 2019 From the PRM Pro No Comments

Fielding Regulatory Change in a Cloud-Based World
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.


We all know that the United States has one of the most complex healthcare systems in the world — and much of this complexity comes from regulatory oversight. The vast number of rules and regulations that govern the industry can be absolutely confusing and overwhelming. Virtually everything that happens in healthcare is overseen by at least one regulatory body — and many tasks are overseen by multiple organizations. A recent study looked at the regulatory burden placed on health systems, hospitals, and post-acute care providers just by federal regulations and found that these organizations must comply with 629 independent regulatory requirements from nine different entities, and spend nearly $39 billion annually in efforts to stay compliant.

Some of the most important regulations have a huge impact on communication with patients. These are especially important to pay attention to, as patient communication is critical to practice success. Let’s take a quick look at some of the regulatory issues you should be paying attention to as you move into 2019.

What to Watch in 2019

The first step to staying compliant with all relevant laws and any changes is knowledge — you must understand what the laws currently say. The major regulations that you should be aware of related to patient communication include:

  • HIPAA (Health Insurance Portability and Accountability Act)
  • TCPA (Telephone Consumer Protection Act)
  • CAN-SPAM (Controlling the Assault of Non-Solicited Pornography and Marketing Act)
  • CASL (Canadian Anti-Spam Legislation)
  • PIPEDA (Personal Information Protection and Electronic Documents Act)

At this point, there is nothing official in the works for the upcoming year for the regulations listed above. However, the TCPA tends to be litigated a lot, so there could be some incremental changes or rulings that you may need to adjust to in 2019. Keep a close eye on that.

In addition, patient communication may be affected by some other upcoming changes, including:

  • General Data Protection Regulation (GDPR). This is a European regulation that went into effect in May 2018, and governs privacy and the protection of consumer information. You will need to comply with these rules if you serve anyone outside of the United States in 2019 and beyond.
  • California Consumer Privacy Act (CCPA). This is a California privacy law that goes into effect in January 2020. It adds an additional layer of compliance over HIPAA when it comes to patient data.

Finding ways to quickly (and affordably!) respond to regulation changes like these is critical to the success of your organization. This is one of the benefits of cloud technology.

Compliance and the Shift to Cloud-Based Technology

Cloud computing has changed the world as we know it — and healthcare is not exempt. Cloud-based technology has been embraced as a win for both practices and patients alike. Experts note that the use of cloud-based technology has been proven to reduce costs, improve backup and disaster recovery, and make data easier to access. Cloud computing allows information to be passed easily and quickly between providers, patients, and labs. With secure, yet simple access from any location and a lack of cumbersome software updates, cloud technology is scalable — meaning that small practices can take advantage of the same technology that large enterprise organizations do without hassle. It’s easy to see why 84 percent of healthcare organizations use cloud-based services and 69 percent have plans to expand their use of the cloud.

How Does Cloud-based Technology Impact Compliance?

Cloud computing has been nearly universally embraced as a way to improve an organization’s performance, accessibility, and revenue. But it is also very good at responding to change quickly and effectively. Think about it — vendors can roll out updates and changes much faster on the cloud than old-fashioned, server-based systems (which have to be physically visited on site). In healthcare’s regulation-filled world, this speed and flexibility can be a huge benefit.

But is it Really Safe?

It hasn’t been that long since many healthcare professionals worried that using the cloud was far too risky. The thought was if all of that data isn’t locked down securely on your site, how could you be certain that the information was safe? If you could access it from anywhere, couldn’t cyber criminals do the same? Fortunately, the answer to that is a big NO.

According to one study, 91 percent of businesses said the cloud actually makes it easier to meet government compliance requirements. Data that was once stored in a physical location is now protected by advanced encryption methods online. This encryption makes sensitive information more difficult for unauthorized parties to access. In addition, the government has set up processes for organizations to take advantage of cloud-based services while staying compliant.

What should you do to ensure compliance when working on the cloud? HHS recommends the following:

  1. 1. Make sure service provider enters into a HIPAA-compliant business associate agreement (BAA).
  2. 2. Address specific concerns in a service level agreement (SLA).
  3. 3. Select a vendor that is reputable and experienced.

There are two truths healthcare organizations must acknowledge: Government regulations will always be a big part of the industry. And taking advantage of consumer-driven technological advancements (like the cloud) is critical to the future success of healthcare practices. Fortunately, these two facts are not mutually exclusive. With a little legwork, it is possible to stay ahead of regulatory change while still meeting the demands of today’s digital world.


Jenn, Mr. H, Lorre

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From the PRM Pro 10/10/18

October 10, 2018 From the PRM Pro No Comments

What does HIPAA Mean for the Future of Patient Relationship Management?
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.


Technology that was the stuff of science fiction just 50 years ago has now become commonplace. Nowhere is this more evident than in healthcare. From mobile communication to wearable devices to remote visits to AI-directed care, technology is rapidly evolving to meet the needs of a consumer-oriented patient base. As Tom Martin, director of healthcare information systems at HIMSS, put it, "The healthcare ecosystem is increasingly converging on patient-centric technology solutions. The role of the provider is to expand far beyond the walls of the exam room, especially as our healthcare system transitions towards value-based purchasing.”

Effective patient relationship management is defined by its ability to create meaningful connections with patients. This ensures that patients will not only return, but also refer friends and family to their provider’s practice. Implementing new technology is a big part of that — and has been shown to have significant benefits for practices. Beyond a jump in patient satisfaction and loyalty, medical facilities that take advantage of new health technology are more profitable, efficient, and productive. The future of strong patient relationships lies in the adoption and integration of a variety of different technologies.

Preparing for the Future

Whether we are ready or not, these technological advancements are here to stay. While exciting, they have also left many scrambling to understand how to take advantage of their benefits while staying compliant with regulations like HIPAA. By preparing now, you can better ensure a smooth transition when your practice does adopt PRM technology. One key to being ready is to stay abreast of the latest technologies and assess which might eventually be a good fit for your particular specialty and individual practice.

To get you started, here are just few examples of cutting-edge technology currently being used by medical facilities to improve patient relationships.


In 2017, UCLA unveiled their Virtual Interventional Radiologist. Using the power of artificial intelligence, they have created a virtual radiologist in the form of a chatbot. The VIR is able to quickly provide evidence-based answers to frequently asked medical questions. Chatbots are also being considered for use in triage, research, patient engagement, and care coordination.

Robotic Care

In February 2018, Humber River Hospital introduced Pepper, their four-foot-tall, humanoid robot. The robot is used to interact and engage with patients and visitors at the reception desk. A second Pepper robot is programmed to work specifically as a part of the hospital’s Child Life Program. In Japan, robots are doing even more. Terapio the Robot makes hospital rounds, delivers medications, and retrieves records. The use of robots in healthcare is expected to explode in coming years. In fact, in anticipation of the predicted nurse shortage, the National Science Foundation has allocated $1 million to the development of robotic nurses.

Virtual Care and MHealth

Another recent addition to the healthcare world — virtual care — is already upon us. In 2018, one in four US adults received some kind of virtual care, and there are four times more who say they would like to give it a try. Nearly half would select an immediate virtual appointment over a delayed in-person one.

Virtual access to health information and communication has also soared. The use of mobile health apps has tripled since 2014, and wearable health monitor use has quadrupled. And the vast majority of users say they’re interested in sharing that health data with their provider. Add to that the widespread use of patient texting and email use, and it’s easy to see why around 76 percent of practices say they use mobile health on a regular basis — with the main use being communication.

Organizations are Working Towards Compliance

These PRM advances bring up a lot of questions about compliance. Fortunately, many organizations are working to find solutions now — before the technologies have completely taken off. One popular idea is implementing the use of biometric data (like fingerprints, heartbeat, or even brain waves) to verify identity before sending sensitive information remotely. In addition, vendors like Fitbit, Samsung, and Apple are all working to create HIPAA-compliant options for healthcare organizations. And just this year, the AMA set new standards for the physician use of AI.

However, you cannot solely rely on outside organizations to do all of the legwork. To be ready for the future, you should start considering what you can do now to make the transition to more high-tech PRM solutions easier. Begin by creating a model of your current patient experience and identify where it would make sense to someday implement these new technologies. Once you’ve identified your anticipated additions, consider how they would be impacted by HIPAA. That way, when that technology becomes more widely available, its implementation will be much easier and more secure.

HIPAA Review Best Practices

Here are a few compliance best practices for the future of healthcare PRM technology … as well as for today:

Regular Security Risk Assessments – It’s easy to become complacent about security, but cyber-attacks get more sophisticated every day. Make sure to institute regular security risk assessments, including IT-specific assessments. Getting into the habit of conducting quarterly risk analyses (not just yearly) will keep security top of mind as you move into the future.

Thorough Vetting of Vendors – Taking a hard look at the vendors you work with is critical — especially as patients demand the latest tech. Choose carefully. Do your research before signing on — look at each individual component of a new technology to ensure it is not vulnerable to attacks. Consider having a specialist on standby for instances when you are unsure about the security of a particular technology.

Up-to-Date Business Associate Agreements – It is very important that you require all vendors to follow proper security protocols to reduce compliance risks. These agreements should clearly outline the vendor’s responsibility and compliance protocols.

Employee Training – One of the most common causes of HIPAA breaches is employee behavior. Make sure that every person who may come in contact with Protected Health Information (PHI), from your cleaning crew to your executives, is trained on HIPAA compliance on a regular basis. You can never do too much training.

Technological advances are coming to your PRM and it’s up to each individual practice to be prepared. As you take the time to review new technologies and actively pursue regular HIPAA compliance activities, you will be prepared to meet the future head-on.


Jenn, Mr. H, Lorre

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From the PRM Pro 8/22/18

August 22, 2018 From the PRM Pro No Comments

Motivating Your Practice to Communicate Effectively Starts From Within
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.


For years, the healthcare industry has been undergoing a dramatic shift in the way providers communicate with their patients. Modern patients demand timely, effective communication from their practices. If you don’t provide it — they leave. But somewhere in the rush to improve patient communication, internal office communication has fallen by the wayside.

Intra-office communication is the glue that holds a practice together. Poor collaboration and communication within the office leads to mistakes. Whether this is double-booking a last minute appointment, multiple staff members contacting a patient for the same info, or letting a patient walk out the door without scheduling their follow-up visit, these mistakes can be stressful for your staff and may make your patients feel like your practice is disorganized.

Disorganization and poor communication contribute to an unhappy staff. One study found that the top three reasons people don’t like their jobs were all related to communication (lack of direction from management, poor communication in general, constant change that is not well communicated). Motivating your staff to improve internal communication is a multi-pronged process.

Start by making training a focus of your practice. Communication does not come naturally to everyone. Each of your employees will have different backgrounds and different abilities. They may all communicate slightly differently. But cohesive communication is critical to the success of your practice. Studies show that we spend between 70-80 percent of our day in some form of communication. This number is likely even higher in the healthcare industry. Strong communication is really the backbone of a strong team. Scheduling required training sessions on a regular basis where your entire staff can be taught how to ask clarifying questions and practice active listening skills is crucial. This will not only help as they communicate with one another, but as they interact with patients as well.

It is crucial that you practice what you preach. It’s not going to be enough to simply tell your employees about the importance of communication; you’ve got to show them. Healthy, open communication should be a fundamental part of your practice’s culture. And it starts with you. This may mean that upper staff members (including you!) need to receive extra training in communication methods. Then, in every interaction with staff members, model the type of communication you expect from them.

At least yearly, use anonymous internal surveys to allow a way for employees to freely share concerns they have about how things are running. Surveys are a great way to open the floodgates of communication that some employees may not feel comfortable sharing in person. Best practices for internal surveys include being digital, easy to understand, and short enough to complete within just a few minutes. There are a variety of survey tools you can use, including free options like Survey Monkey. The key is to make sure that employees feel comfortable that their responses will be anonymous. In order to get high participation levels, make sure employees recognize the benefit of filling it out. If employees see that changes are made based on survey results, they are much more likely to participate.

Make sure you meet regularly. Practices are busy. Crazy busy. It can be easy for everyone to just move directly to their regular area in the practice, address their duties, and never efficiently communicate with one another. Regular meetings provide the opportunity for additional collaboration among your staff. These meetings do not need to be extremely long or formal to be effective. One of the most successful ways to do this is to provide lunch for your staff once a month to sit, eat, and share ideas with one another.

Finally, find ways to use technology to fill any communication gaps. It’s important to find a messaging tool to improve communication between official meetings. At any given time, your staff members maybe be spread throughout the practice. Giving office staff the ability to communicate with each other, either through group messaging in a chat room or direct messages to a specific team member, can help your team circulate information quickly without ever leaving their desks. The average practice staff spends over an hour every day just trying to track down coworkers and find important information, adding up to over 20 hours each month spent just trying to communicate with each other. With a tool that allows them to quickly message each other and share information, that time can be better used to interact with the patients in the office.

Effective internal communication is important for every single practice. No exceptions. Effective communication boosts employee morale, reduces mistakes, and improves processes. The best communication starts with the practitioner and spreads to each member of the practice. As meaningful communication becomes the culture of your practice, your patients will feel the benefits, too.


Jenn, Mr. H, Lorre

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From the PRM Pro 6/20/18

Why Every Medical Practice Should Make the Leap to the Cloud
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.


Just over a decade ago, the only cloud we knew about was that big, white, fluffy thing in the sky. Since around 2006, however, “the cloud” has changed life as we know it. We use the cloud to binge watch Netflix. To create a work report via Google Docs. It enables us to protect and save pictures through apps like Dropbox. We use the cloud to connect with loved ones on Facebook or Skype. And — without question — cloud computing has completely changed the face of business. It is estimated that by 2020, 60-70 percent of all software, services, and technology spending will be cloud-based.

While healthcare traditionally lags behind the rest of the business world, research shows that cloud computing is making its mark here as well.

  • Ninety-two percent of healthcare providers see the value of cloud services.
  • Sixty-seven percent of healthcare offices are currently using SaaS applications.

Moving to cloud-based applications has a number of advantages for medical practices. The top reason people in the industry like cloud computing is because it saves money. But beyond the financial advantages, there are many other reasons every practice should consider moving to the cloud:

1. Improved patient satisfaction. The cloud gives patients unprecedented access to their own medical information, keeping them informed and engaged in their own care. And they like it. In fact, the majority of today’s patients say that they would choose a doctor that uses the cloud over a doctor that does not.

Today’s patient platforms (powered by the cloud) make it possible for patients to “meet” with their doctor virtually. For those patients who live far from healthcare facilities, have a strong fear of the physician’s office, or don’t have readily available transportation, this option can be the difference between being seen or not. The growing desire for cloud-based virtual visits is backed up by research that shows three out of four patients (77 percent) say that they want access to virtual care and telehealth.

In addition, the cloud gives physicians unparalleled access to information about a patient’s potential condition, based on data from thousands of patients with similar symptoms — all accessed via the cloud. As doctors are able to more accurately diagnose disease in their patients, patient satisfaction rises.

2. Disaster protection. A few years ago, one of our clients experienced a devastating fire that destroyed their entire practice. Fortunately, they had all of their appointment information set up on the cloud. This meant that they were able to know which patients were scheduled to come in that day and easily shoot off a text letting them know about the disaster.

Using patient communication through the cloud keeps you in contact with patients no matter what your situation (even if the only problem is a power outage). In addition, when patient files are stored on the cloud, they are easily accessible if you move to a temporary facility while rebuilding. In the case of a large-scale disaster, where the patients have been impacted as well, the cloud gives patients access to their own medical information—making available everything from important prescriptions to a full health history.

3. Better collaboration. It is generally agreed upon that collaboration is one of the most important aspects of effective healthcare, indicated by the 96 percent of executives that say a lack of intra-office collaboration or poor communication leads to mistakes. Cloud computing is a great way to improve communication and cooperation between doctors, staff members, and office managers.

By allowing professionals to communicate instantly via the cloud, everyone in the office can have the information they need — wherever they may be at that moment. If something unexpected pops up during the course of a regular day, cloud-based applications make it possible for the entire team to handle the change without needing to hunt each other down.

4. Reduced burden on everyone. More than half of all practices say that using systems via the cloud reduces the burden on staff or allows them to function with fewer staff members. In addition, 68 percent of patients say they feel relief when their provider offers the ability to complete tasks through the cloud. The cloud moves some of the burden from staff to patients — giving them a feel of more control over their care at the same time.

By moving many administrative tasks to the cloud, practices also leave the window open to growth. Administrative tasks that once took up a large part of a practice’s day can now be taken care of without any work required by staff. A majority of patients say they have paid their bill over the cloud via a patient portal. And 77 percent of patients say the ability to schedule appointments online is important to them. The cloud allows practices to be flexible and scalable when it comes to adding new patients.

Simply put, cloud computing is no longer just a nice-to-have option for healthcare practices. It is critical to the future growth and competitiveness of every office. By moving to the cloud, you can maximize your resources all while making patients happier. It’s become a no-brainer.


Jenn, Mr. H, Lorre

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From the PRM Pro 4/11/18

April 11, 2018 From the PRM Pro No Comments

Putting the “Value” in Value-based Care
By Jim Higgins

Jim Higgins is the CEO and founder of Solutionreach in Lehi, UT.


Healthcare in America has struggled with multiple challenges in recent years. Costs are at an unprecedented high while health outcomes are subpar. As of 2017, the cost of healthcare in the US averaged $10,345 per person — the highest healthcare costs in history. And yet, despite spending twice what other developed nations spend for health care, Americans experience a lower life expectancy, greater prevalence of chronic disease, and overall poorer health outcomes. Walter Cronkite once echoed the thoughts of the general public when he said, “America’s health-care system is neither healthy, caring, nor a system.”

In an effort to make care more convenient, effective, and affordable, the healthcare industry has recently been shifting away from volume-based care towards value-based care. This means providers are increasingly receiving payments based on the value of care they deliver rather than the amount of treatment completed. While the push to make this move has been going on for nearly two decades, it’s only recently that the shift has really picked up steam with both government and commercial payers. Experts note that the trend towards value-based care will continue into the foreseeable future. According to a 2016 survey from ORC International, 58 percent of payers are moving towards full value-based reimbursement, and 63 percent of hospitals were part of some ACO. Those numbers continue to grow about 10 percent each year.

What does value-based care mean?

As with any big change, adopting a value-based care model leaves providers with questions. Many of these questions revolve around the meaning of value. How is value defined? What services constitute value? How can a practice determine if they are providing sufficient value? To understand how to implement value-based care, it is critical to know how value is defined. The following are the key initiatives payers use to determine value in a value-based care payment model.

1. Patient experience. At the center of value-based care is the patient experience. Not to be confused with patient satisfaction (which is a subjective measurement), the patient experience encompasses every interaction that can be easily measured. Measurement is key. The patient experience includes things like ease of scheduling, wait times, patient access to healthcare records, and clear communication between the patient and provider. To provide excellent value, every aspect of the patient experience should be as seamless and easy as possible.

2. Proactive care. A major goal of the value-based care model is to improve poor health outcomes through proactive care. Proactive care includes preventative care as well as on-going care for patients with chronic conditions. In days gone by, proactive care often meant simply outlining a health plan and hoping patients adhered to it. Today, practices are expected to implement specific strategies to actually motivate patients to follow those health instructions and show up for regular appointments. Proactive care starts with uncovering the reasons behind non-adherence and then removing those barriers. This often requires more touch points of communication than many practices have historically given. Proactive care strategies can include everything from appointment reminder texts to educational newsletters to video explanations of treatment to medication reminders and more.

3. Patient risk assessment. Using technology, patient data can be analyzed to identify those who have potential health risks. These are the patients most likely to have poor health outcomes and, subsequently, need proactive care. According to a recent Chilmark Research report, current risk stratification models account for only 10 percent of a patient’s health outcomes and are not sufficient to meet the standards of value-based care. These risk models focus on the needs of the practice rather than the needs of the patient. Value-based healthcare organizations should include social, behavioral, and environmental factors in their risk assessments. These social factors account for as much as 70 percent of health outcomes.

4. Care coordination. One “value” pillar that practices should examine is the effectiveness of care coordination across the entire healthcare system. Care coordination, while important for all patients, is especially critical for those patients deemed to be high risk. When care is coordinated across all specialties, practices are better able to eliminate gaps in treatment. Care coordination requires comprehensive and timely communication between all of a patient’s providers and, when done well, leads to improved care and better health outcomes.

5. Patient-reported outcomes. Using a combination of surveys and questionnaires, patients are being asked about their healthcare experiences more than ever. Patient-reported outcomes are defined by the FDA as "any report of the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or anyone else." It is through PROs that the more subjective information about a patient’s experience is gathered. Collecting and evaluating this information provides insights that enables practices to develop a more patient-focused (i.e. value-based) process.

The shift to value-based care is often overwhelming at first, but knowing the basics helps ease the transition. The growing pains are worth it. As practices adopt value-based care, the entire healthcare system will benefit — including providers, patients, payers, and society as a whole. Value-based care reduces costs, increases efficiencies, boosts patient satisfaction, and results in better health outcomes. Dedicating the time and training needed to put the “value” in value-based care is a win-win for everyone.


Jenn, Mr. H, Lorre

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