GeHS (Guardian eHealth Solutions, Inc.) began in 2009. However, VRI, the provider of our backend monitoring service, was established as a medical alert company more than 20 years ago. VRI added medication adherence 13 years ago and has provided vital sign telemonitoring services for the last 6 years. Its core competency is engaging at-risk patients in RPM (Remote Patient Monitoring) to keep them safe in their homes, and rapidly getting accurate alerts into the hands of the healthcare providers. GeHS’ business model is driven by the requirements of modern managed care, including the needs of Chronic Care Management and Home Health Agency models. GeHS provides the support services that are absolutely critical to the success of any telemonitoring Care Management program. Key components are (1) GeHS’ network of support staff to orient, train, engage and coach Members to cooperate with their Care Management programs; and (2) GeHS’ call center, whose 24x7 attendants make outbound calls to confirm alerts and make sure that RPM (Remote Patient Monitoring) alerts provided by GeHS as directed by GeHS’ clients are valid. GeHS is a complete turnkey solution provider, not merely a DME provider or device manufacturer. GeHS provides a wide and growing array of telemonitoring services with call center support that provides actionable alerts and issues to our clients’ (care managers and providers). GeHS' call center is the sole CSAA Five Diamond certified dedicated medical call center in the industry. GEHS is a technology integrator and is “device agnostic.” Not being a manufacturer, GEHS has the flexibility to test, purchase, and deploy the most reliable remote monitoring devices, and to change devices as better solutions emerge. Thi... ... middle of paper ... ...ings of Members. GEHS’s implementation process for HHAs (Home Health Agencies) and MCOs (Managed Care Organizations) is quick and easy. GEHS provides an integration template, customizable for our clients’ care managers’ use, to help determine who should receive telemonitoring support. Other implementation tasks are set-up of information flows and configuration of the claims system to pay the designated telemonitoring codes. GEHS contracts with MCOs as a network Ancillary Provider and bills for its complete service package monthly for each patient actually served that month. GEHS bills using agreed codes and CMS1500 claim forms. There are no installation or other fees other than the additional cost of cellular communications where required. Where possible, our MCO customers book our expenses as a medical claim expense rather than as an overhead/G&A expense.
According Banner Healthcare (2016), “BHN collaborates with many commercial and government payers, plus large employer groups, to deliver on the triple aim of lower costs, high quality care and an excellent patient experience. Healthcare can be affordable with a design that engages the physician, patient and payer in seeking the best care and health outcomes” (p.2).
Department of Health and Human Services (DHHS) to safeguard patient privacy. It protects patients’ health information (PHI) and allows patients to have control over the distribution of their information. Due to the advancement in technology and shift from paper to electronic files, the development of both state and federal laws occurred to protect the electronic health care transactions, code sets, unique health identifiers and security (DHHS, 2016). In addition, due to e-PHI a Privacy Rule was published in December 2000, to protect health information under these entities: health plans, healthcare clearinghouses, and health care providers who conduct certain health care transactions electronically. This law implements various types of health facilities; including, hospitals, doctor offices, pharmacies, health plans, and other clinical care sites (Field, p. 199).
The Healthy Body Wellness Center 's (HBWC) Office of Grants Giveaway (OGG) provides medical grants to hospitals and facilities. The company 's mission is to promote improvements in the quality and usefulness of medical grants through federally supported research, evaluation, and sharing of information. As part of fulfilling the businesses objectives of the HBWC OGG has contracted with We Automate Anything (WAA) to design and implement the Small Hospital Tracking System (SHGTS). The SHGTS is vital in the current functioning of the OGG as part of the HBWCs mission statement, and allows for the monitoring and distribution of grant funds. The SHGTS also functions to coll...
The purpose of telemedicine is to remove distance as a barrier to health care. While telehealth is an accepted resource to bridge the gap between local and global health care, integrating telehealth into existing health infrastructures presents a challenge for both governments and policy makers (HRSA, 2011). Today there are policy barriers that prevent the expansion of telehealth, including reimbursement issues raised by Medicare and private payers, state licensure, and liability and privacy concerns.
The objective of the MCEG is to provide channels to exchange information between managed care/health plan information systems executives and to provide opportunity for personal networking. MCEG provides a forum to develop policy which relates to the use of information technology and healthcare. MCEG provides feedback to vendor sponsors and other vendors on the trends and types of technology needed to ensure that their products and strategies meet their customer’s present and future managed care needs. Additionally, their objective is to “educate executives on clinical and administrative trends in health care, new and emerging technologies, and other pertinent information to assist in achieving the key goals of cost containment, effective service and high quality health care.” (Why We Matter, 2011)
“Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s clinical health status” (American Telemedicine Association, 2013). Telemedicine is the use of technology such as email, mobile devices, and computers to communicate health information (Mayoclinic.com, 2014). Telemedicine has enabled the use of communication technologies by healthcare professionals for the evaluation, diagnose, and the treatment of patients in rural areas (GlobalMed.com, 2014). Telemedicine is used in a variety of health care services like primary care, patients monitoring, health information sharing, health education (America Telemedicine Association, 2013). These services are delivered using various mechanisms such as video conferencing, personal health apps, e-visits (Mayoclinic.com, 2014). These technologies have been proven to increase access, to be cost efficient, to improve quality, and intensify patients’ satisfaction according to the America Telemedicine Association.
The Certification Commission for Healthcare Information Technology (CCHIT) is a private, non-profit organization formed to certify EHRs against a minimum set of requirements based on functionality, interoperability, and security. It was founded in 2004 by three industry associations: the healthcare Information and Management Systems Society, the American Health Information Management Association, and The Alliance for Health Policy and Systems Research. In 2005 CCHIT was awarded a three-year, $7.5M government contract to assist with developing certification criteria and inspection processes for EHR systems. The U.S. Department of Health and Human Services has partnered with the CCHIT to certify EHR pr...
Three areas that define the provisions of comprehensive health care services and are commonly used for utilization monitoring and control are gatekeeping, case management, and utilization review (UR). Gatekeeping is used by HMOs where each member designates a primary care provider (PCP) that is responsible for coordinating all care services needed for the enrollee in a managed care plan. Case management involves an experienced health care professional with knowledge of available health care resources. `Case management services are designed to identify spec...
Electronic Health Record systems (EHR) are essential to amending health quality and managing health care distribution, whether in an extremely immense health system, hospital, or primary care clinic. The U.S. Department of Veterans Affairs (VA) has developed and perpetuates to maintain a strong EHR kenned as VistA - the Veterans Health Information Systems and Technology Architecture. This system was designed and developed to strengthen a high-quality medical care environment for the military veterans in the United States. The VistA system is in maintained today at hundreds of VA medical centers and outpatient clinics across the country. (http://worldvista.org/AboutVistA)
Over the last 5-10 years the healthcare system has begun reformation to increase safety, efficiency, cost reduction, increasing continuum of care, and increases in information technology (IT). There are many influences that are creating this need for change including laws, regulations, and the consumers of the healthcare system. The consumer is beginning to take charge of their health and become an advocate of their healthcare needs and plans of action. This transformation has created a greater need for the healthcare system to increase the use of health management information system (HMIS). HMIS is meant to help all departments within a healthcare organization, such as a hospital, to communicate easier creating a better care experience for both the care providers and consumers. These HMIS initiatives include systems such as computerized physician order entry (CPOE), electronic medical records (EMR), health information exchange (HIE), and other electronic systems. It is these initiatives that are reforming the healthcare system. However, there is not much information analyzing these new trending initiatives and how they will help or hurt the medical field. It is these systems that will be analyzed to determine the challenges they may have for the healthcare system, and the leadership of healthcare organizations.
Telephonic coaching is a means used by both patients and insurance companies because this is one way of keeping the patients healthy. Leeder (2014) believed that private health insurances are providing additional services, such as telephone-based coaching, to encourage the patients to have a healthy lifestyle who are at risk of chronic diseases. Considerably, meeting the needs of the people requires a change in how insurance companies deliver health services. Instead of providing services episodically, the use of telephonic coaching creates a system of continuing care which involves both the hospital and community support. Further, patients are able to absorb new information when they are talking to that person providing
The new healthcare technology that is spreading nationwide it the EHR programs that are being implemented and updated in healthcare organizations. Government policies are in place for societies protection and privacy, it also helps to create a place where healthcare information can be utilized to its fullest potential. ONC authors’ regulations that set the standards and certification criteria EHRs must meet to assure health care professionals and hospitals that the systems they adopt are capable of performing certain functions (HealtIt, 2015).
It enables healthcare organizations to monitor patient safely and care. According to IOM essential elements for an EHR are: the collection of longitudinal data on a person’s health, immediate electronic access to this information, establishment of a system that provides decision support to ensure the quality, safety, and efficiency of patient care. The Health Information Technology for Economic and Clinical Health (HITECH) Act, until 2015, offers incentives for physicians and other healthcare professions to adopt health IT. After that, the apt spells out penalties for noncompliance of health IT. The Office of Nation Coordinator (ONC) for Health Information Technology (HIT) is responsible for implementing the incentives and penalties program. The ONC has been working to create ‘meaningful use’ guidelines for physicians and others that will help them receive incentive payments and avoid penalties in the future” (Niles, 2015, page 261).
These clinical staff will make house calls to United Healthcare clients secured by Medicare who face perpetual, and conceivably costly, conditions, for example, diabetes or congestive heart failure (Triad Business Journal, 2013). It 's a speculation United Healthcare trusts enhances tolerant health through more financially savvy, higher-quality care, and thus, helps the organization 's main concern (Triad Business Journal, 2013). It is expected that the House Calls system will be looking after 75,000 Medicare patients before the current years over (Triad Business Journal, 2013). United Healthcare right now covers around 250,000 seniors in the state with its Medicare Advantage items. Moreover with the strategic plan to hire more nurses and healthcare providers, such as in home visits offer the opportunity to assess the patient’s medication regimens, offer routine physical evaluations and react to any healthcare demands (Triad Business Journal, 2013). United Healthcare plans and suppliers envision such normal, preventive care will take off emergency room office visits or healthcare facility stays for more genuine, and costly, problems in the future (Triad Business Journal,
Haddad,M (2010).Technology helps track healthcare providers. Health Management Technology, 31 (5), 24-25. Health Source-Consumer Edition