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Battling the Barriers in EP/Cath Labs

Posted on December 5, 2018 I Written By

The following is a guest blog post by Tom Downes, CEO of Quail Digital.

Clear and unambiguous communication between team members is an essential component of any surgical environment. It’s particularly important – and indeed particularly challenging – in cath labs and electrophysiology (EP) labs where physicians and clinical staff in interventional cardiovascular and other minimally-invasive therapeutics are typically spread across multiple rooms and physically separated by lead-lined doors.

But as patient demand continues to rapidly grow, the inherent complexities of the surgical environment are presenting significant communication challenges between the surgeons, clinicians and nurses. These restrictions are creating great stressors for the whole operating team as they strive to continue to deliver a proficient patient service.

Creating Clear Communication

Stress amongst hospital staff is not just a recognised problem, it’s an escalating one. A study evaluating burnout among surgeons has found that 80% of surgeons agree burnout and stress are issues they should be monitored for. In light of this, it’s clear that maintaining the well-being of healthcare professionals is a challenge, and one that needs to be addressed quickly.

Previous studies have revealed that a number of potential stressors can compromise performance in the OR, including team interaction and extreme noise. It is therefore clear that problems with communication is one of the main barriers that needs to be broken down in order to achieve a tranquil, organized environment that will alleviate pressure in the operating room. The chatter of workmates, the hum of the air conditioning and the relentless drone of essential technology, combines to create a high-stress clinical environment where the multidisciplinary teams’ need for serenity is commonly confounded by practical necessities they cannot change.

Implementing clear and immediate communication will be a positive step towards reducing the complexities of the clinical space. Failure to do this risks squandering the undoubted benefits of surgical innovation; the patient implications of an avoidable clinical error due to miscommunication could, in the worst extremes, be catastrophic. Fortunately, communication technology has evolved to present a simple, affordable solution.

Adopting a Wireless Approach

Traditionally, facilities have adopted primitive measures to deliver communication between the OR and the monitoring suite, including basic hand gestures and microphones in each room. But this approach comes with challenges, for example, the likelihood of mishearing and misreading a fellow surgeon, or instruction, is naturally increased which could then delay the procedure and cause frustration. Another thing to consider is that all the medical team will be equipped with masks, making it difficult to hear and see dated visual and auditory clues.

By adopting wireless headset technology, physicians can transform the OR, EP and cath lab experience, as well as the working environment for the whole team involved in the procedure. The technology, which operates on high quality digital frequencies and is encrypted to avoid interference from other devices or emissions in the OR, enables multidisciplinary teams to collaborate and communicate – hands-free – in the interventional OR or hybrid suite, at monitoring stations, through adjacent control rooms and ancillary areas. A lack of clarity can create stress and blame amongst the operating team, but with the ability to hear instructions clearly in every clinical environment this ambiguity can be avoided. Additionally, the pressures placed upon surgeons will be drastically reduced as they have the confidence of knowing that every member of staff is able to perform their role in a more assured manner.

And as it has been suggested that high-quality teamwork among operating room professionals is key to efficient and safe practice, implementing a system that initiates better communication between staff will be extremely beneficial to the clinical environment. Creating a more attentive, focused team will also be vital to reducing significant stress-levels and enabling greater levels of workflow. Associate Professor and Director of the Robotic and Minimally Invasive Cardiac Surgery program at the University of Chicago Medicine, Dr Husam H Balkhy, has first hand experience of using wireless headsets in a surgical setting, he comments, “My ability to communicate quickly and effectively with other members of the robotic team including the table-side first assistant, the anaesthesiologist, the perfusionist and nursing staff, has led to increased efficacy and patient safety in these complex procedure.”

Balkhy isn’t the only one to have benefitted from these tools, Dr Ziv Tsafrir, a Fellow in Minimally Invasive Gynecology at Henry Ford, adds: “Using wireless headsets during robotic procedures certainly contributed to better patient outcomes by creating a calmer environment for clinicians and staff.”

The Next Steps

As patient demand grows, and the global use of EP and robotics surgery increases, wireless headset technology will be an essential companion to ensure optimal, efficacious and cost-effective communications. Combine this communication tool with the below practices and clinicians will be able to further enhance the surgical environment to not only create more effective workflows and treatment, but to increase positive patient outcomes.

  • Ensuring the surgical team have a focused team discussion prior to surgery to assign roles, establish expectations and anticipate outcomes, will enable each member of the team to be prepared for any scenario that may play out. This will be beneficial to the patient’s experience and will reduce the level of stress to a minimum.
  • Whilst a briefing before the operation is an extremely important part of the medical process, a debriefing post-op is just as vital. This discussion gives the whole team the opportunity to explore the problems that occurred during the procedure and how these can be overcome before the next operation.
  • Good communication is also vital outside the cath / EP lab and amongst the rest of the hospital staff. Lack of clarity about responsibility for care and decision-making is a major contributor to medical errors and could have an extremely negative impact on the operating room.
  • In a medical setting, the person who is supposed to act on information isn’t always clearly identified. Therefore, team members should communicate clearly, both at the beginning and throughout the operation, who this person is.

By working together and communicating clearly to one another before, during and after the procedure,  the stress levels of the entire surgical team and the patient can be significantly reduced.

About Tom Downes
Tom Downes founded Quail Digital in 1995 to design headset systems for ‘team’ communication. The philosophy being that the easier and more freely a team can speak with each other in the workplace, the better their outcomes, wellbeing and productivity. Quail Digital designs and manufactures systems for the healthcare, retail and hospitality sectors, and has offices in Dallas, TX and London UK. Quail Digital is the leading provider of communications systems in the OR, and a sponsor of Healthcare Scene.

New INFRAM Model Creates Healthcare Infrastructure Benchmarks

Posted on November 14, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

During the frenzy that was healthcare organizations rushing to implement EHRs and chase government money, it was amazing to see so many other projects get left behind. One of the biggest areas that got left behind was investments in IT infrastructure. All the budget was going to the EHR and so the infrastructure budgets often got cut. There were some exceptions where upgrades to infrastructure were needed to make the EHR work, but most organizations I know chose to limp along with their current infrastructure and used that money to pay for the EHR.

Given this background, I was quite intrigued by the recent announcement of HIMSS Analytic’s INFRAM (Infrastructure Adoption Model). This new model focuses on a healthcare organization’s infrastructure and whether it’s stable, manageable, and extensible. I like this idea since it’s part of the practical innovation we talk about in our IT Dev Ops category at the EXPO.health Conference. What we’ve found is that many healthcare organizations are looking for infrastructure innovations and the benefits are great.

The INFRAM model has 5 main focus areas:

  • Mobility
  • Security
  • Collaboration
  • Transport
  • Data Center

No doubt these are all areas of concern for any healthcare CIO. Although, I wonder if having all 5 of these in the same model is really the best choice. A healthcare organization might be at a level 6 for secruity, but only at a level 3 for mobility. Maybe that’s just fine for that organization. I guess at the core of this question is whether all of the capabilities of stage 7 are capabilities that are universally needed by all healthcare organizations.

I’m not sure the answer to this, but I think a case can be made that some organizations shouldn’t spend their limited resources to reach stage 7 of the INFRAM benchmark (or even stage 5 for some organizations). If a healthcare organization makes that a priority, it will probably force some purchases that aren’t really needed by the organization. That’s not a great model. If the above 5 focus areas had their own adoption models, then it would avoid some of these issues.

Much like the EMRAM model, the INFRAM model has 7 stages as follows:

STAGE 7
Adaptive And Flexible Network Control With Software Defined Networking; Home-Based Tele-Monitoring; Internet/TV On Demand

STAGE 6
Software Defined Network Automated Validation Of Experience; On-Premise Enterprise/Hybrid Cloud Application And Infrastructure Automation

STAGE 5
Video On Mobile Devices; Location-Based Messaging; Firewall With Advanced Malware Protection; Real-Time Scanning Of Hyperlinks In Email Messages

STAGE 4
Multiparty Video Capabilities; Wireless Coverage Throughout Most Premises; Active/Active High Availability; Remote Access VPN

STAGE 3
Advanced Intrusion Prevention System; Rack/Tower/Blade Server-Based Compute Architecture; End-To-End QoS; Defined Public And Private Cloud Strategy

STAGE 2
Intrusion Detection/Prevention; Informal Security Policy; Disparate Systems Centrally Managed By Multiple Network Management Systems

STAGE 1
Static Network Configurations; Fixed Switch Platform; Active/Standby Failover; LWAP-Only Single Wireless Controller; Ad-Hoc Local Storage Networking; No Data Center Automation

STAGE0
No VPN, Intrusion Detection/Prevention, Security Policy, Data Center Or Compute Architecture

As this new model was announced, I had a chance to talk with Marlon Harvey, Industry Solutions Group Healthcare Architect at Cisco, about the INFRAM model. It was interesting to hear the genesis of the model starting first as an infrastructure maturity model at Cisco and then evolving into the INFRAM model described above. Marlon shared that there had been about 21-24 assessments and 35 organizations involved in developing this maturity model. So, the model is still new, but has had some real world testing by organizations.

I do have some concern about the deep involvement from vendor companies in this model. On the one hand, they have a ton of expertise and experience in what’s out there and what’s possible. On the other hand, they’re definitely interested in pushing out more infrastructure sales. No doubt, HIMSS Analytics is in a challenging position to balance all of this.

That said, a healthcare CIO doesn’t have to be beholden to any model. They can use the model where it applies and leave it behind where it doesn’t. Sure, I love having models like INFRAM and EMRAM to create a goal and a framework for a healthcare organization. There’s real value in having goals and associated recognition as a way to bring a healthcare IT organization together. Plus, benchmarks like these are also beneficial to a CIO trying to convince their board to spend more money on needed infrastructure. So, there’s no doubt some value in good benchmarking and recognition for high achievement. I’ll be interested to see as more CIOs dive into the details if they find that INFRAM is focused on the things they really need to move their organization forward from an infrastructure perspective.

Combatting Communication Problems in Community Healthcare Clinics

Posted on November 7, 2018 I Written By

The following is a guest blog post by Tom Downes, CEO of Quail Digital.

The notion of a community healthcare clinic is constantly evolving from the traditional model of a local clinic staffed by general practitioners and nurses, serving mainly rural populations. There is now a renewed interest in these organisations and their potential to deliver a more integrated care service within the community. However, in order to successfully make this transition, there is a need to better equip these clinics with the tools to ensure they’re able to cope with the extra demand and the ever-evolving medical treatments that are being practised.

With an estimated 33 million people visiting community healthcare clinics each year, these organisations are an essential part of the healthcare system. Whilst they are investing vital time into evolving their structure and delivering a focused range of medical services, without the right technology in place staff productivity will suffer, hindering their ability to make the most out of not only the current resources available, but any new, innovative resources they decide to invest in.

A collaborative approach

To foster a more productive, collaborative environment, communication should be implemented across the entire team. From diagnostics to preventive treatment, clinical procedure and rehabilitation, delivering a diverse set of services can create a stressful environment, if the team, from receptionist to clinicians, are wasting valuable time trying, without success, to communicate. But as services expand, enabling staff to speak easily with one another to seek answers to questions, locate the right individual and better manage the flow of patients through the appointments process, has become even more important.

Community healthcare clinics traditionally rely on telephones to communicate internally, but these can often go unanswered. Additionally, this device commonly only works when just two people want to communicate with each other, restricting the ability to send messages, updates and instructions to the whole team. Naturally, therefore, the likelihood of missing key information or mishearing a fellow colleague is increased, creating unnecessary stress and delays.

And this dated communication tool will not be able to facilitate the growing numbers of staff working in these clinics. As nearly 62 percent of all community healthcare clinics are in an urban setting they are providing services for extremely dense populations, therefore they require a greater amount of staff to help accommodate this demand. Team this up with the intense competition these urban clinics have with multiple clinics and medical centres serving the same geographic, and the need for a better communication tool that will help them provide a positive experience is even more important.

Clear Communication

Providing clear, discrete communication to all members at reception and in the clinics will have an extremely positive impact on the running of the community healthcare clinic. Lightweight headset technology will help the team working in these clinics to reduce unwanted hold-ups, improve workflow and offer a much improved experience for each of those patients who walk through the door. And with the ability to coordinate easily with one another, the team can become more productive and efficient to ensure they’re prepared for the demands felt by this expanding healthcare system.

Critically, in this most challenging of jobs, adopting a headset system that operates on a single channel will ensure all members of staff are in permanent communication. This way, doctors, nurses or receptionists are able to approach their colleagues who are working in another part of the clinic with any urgent query or question they may have. This immediate and non-obtrusive communication method is particularly important during times of expansion and innovation, as every team member will be learning and adopting new methods and structures.

Conclusion

Community healthcare clinics are evolving and there is now a growing need to implement digital solutions to provide staff with the ability to hear everything clearly, at all times. There are also other daily practices that can help facilitate a more tranquil environment. Along with headset technology, eliminating unnecessary, frantic noise across the clinic will drastically reduce the distractions all doctors, nurses and receptionists have to face. Not only will this have a positive impact on stress-levels, but it will also make it a lot easier to communicate effectively amongst the team. Daily team meetings are also vital for every member of staff in a community healthcare clinic. With a better understanding of everyone’s workload for that day the team will have greater visibility of who is available to assist with other tasks and enquiries.

By implementing communication tools and ensuring greater visibility across the team clinical operational efficiencies will be increased while staff stress levels will be reduced and their wellbeing improved.

About Tom Downes
Tom Downes founded Quail Digital in 1995 to design headset systems for ‘team’ communication. The philosophy being that the easier and more freely a team can speak with each other in the workplace, the better their outcomes, wellbeing and productivity. Quail Digital designs and manufactures systems for the healthcare, retail and hospitality sectors, and has offices in Dallas, TX and London UK. Quail Digital is the leading provider of communications systems in the OR, and a sponsor of Healthcare Scene.

Can Providers Survive If They Don’t Get Population Health Management Right?

Posted on August 27, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Most providers know that they won’t succeed with population health management unless they get some traction in a few important areas — and that if not, they could face disaster as their volume of value-based payment share grows. The thing is, getting PHM right is proving to be a mindboggling problem for many.

Let’s start with some numbers which give us at least one perspective on the situation.

According to a survey by Health Leaders Media, 87% of respondents said that improving their population health management chops was very important. Though the article summarizing the study doesn’t say this explicitly, we all know that they have to get smart about PHM if they want to have a prayer of prospering under value-based reimbursement.

However, it seems that the respondents aren’t making nearly as much PHM progress as they’d like. For example, just 38% of respondents told Health Leaders that they attributed 25% or more of their organization’s net revenue to risk-based pop health management activities, a share which has fallen two percent from last year’s results.

More than half (51%) said that their top barrier to successfully deploying or expanding pop health programs was up-front funding for care management, IT and infrastructure. They also said that engaging patients in their own care (45%) and getting meaningful data into providers’ hands (33%) weren’t proving to be easy tasks.

At this point it’s time for some discussion.

Obviously, providers grapple with competing priorities every time they try something new, but the internal conflicts are especially clear in this case.

On the one hand, it takes smart care management to make value-based contracts feasible. That could call for a time-consuming and expensive redesign of workflow and processes, patient education and outreach, hiring case managers and more.

Meanwhile, no PHM effort will blossom without the right IT support, and that could mean making some substantial investments, including custom-developed or third-party PHM software, integrating systems into a central data repository, sophisticated data analytics and a whole lot more.

Putting all of this in place is a huge challenge. Usually, providers lay the groundwork for a next-gen strategy in advance, then put infrastructure, people and processes into place over time. But that’s a little tough in this case. We’re talking about a huge problem here!

I get it that vendors began offering off-the-shelf PHM systems or add-on modules years ago, that one can hire consultants to change up workflow and that new staff should be on-board and trained by now. And obviously, no one can say that the advent of value-based care snuck up on them completely unannounced. (In fact, it’s gotten more attention than virtually any other healthcare issue I’ve tracked.) Shouldn’t that have done the trick?

Well, yes and no. Yes, in that in many cases, any decently-run organization will adapt if they see a trend coming at them years in advance. No, in that the shift to value-based payment is such a big shift that it could be decades before everyone can play effectively.

When you think about it, there are few things more disruptive to an organization than changing not just how much it’s paid but when and how along with what they have to do in return. Yes, I too am sick of hearing tech startups beat that term to death, but I think it applies in a fairly material sense this time around.

As readers will probably agree, health IT can certainly do something to ease the transition to value-based care. But HIT leaders won’t get the chance if their organization underestimates the scope of the overall problem.

Healthcare CIOs Focused On Patient Experience And Innovation

Posted on August 2, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Not long ago, 22 healthcare CIOs had a sit-down to discuss their CEOs’ top IT-related priorities. At the meeting, which took place during the 2018 Scottsdale Institute Annual Conference, the participants found that they were largely on the same page, according to researchers that followed the conversation.

Impact Advisors, which co-sponsored the research, found that improving patient experiences was priority number one. More than 80% of CIOs said patient engagement and better patient experiences were critical, and that deploying digital health strategies could get the job done.

The technologies they cited included patient-facing options like wearables, mobile apps and self-service tools. They also said they were looking at a number of provider-facing solutions which could streamline transitions of care and improve patient flow, including care coordination apps and tools and next-generation decision support technologies such as predictive analytics.

Another issue near the top of the list was controlling IT costs and/or increasing IT value, which was cited by more than 60% of CIOs at the meeting. They noted that in the past, their organizations had invested large amounts of money to purchase, implement and upgrade enterprise EHRs, in an effort to capture Meaningful Use incentive payments, but that things were different now.

Specifically, as their organizations are still recovering from such investments, CIOs said they now need to stretch their IT budgets, They also said that they were being asked to prove that their organization’s existing infrastructure investments, especially their enterprise EHR, continue to demonstrate value. Many said that they are under pressure to prove that IT spending keeps offering a defined return on investment.

Yet another important item on their to-do list was to foster innovation, which was cited by almost 60% of CIOs present. To address this need, some CIOs are launching pilots focused on machine learning and AI, while others are forming partnerships with large employers and influential tech firms. Others are looking into establishing dedicated innovation centers within their organization. Regardless of their approach, the CIOs said, innovation efforts will only work if innovation efforts are structured and governed in a way that helps them meet their organization’s broad strategic goals.

In addition, almost 60% said that they were expected to support their organization’s growth. The CIOs noted that given the constant changes in the industry, they needed to support initiatives such as expansion of service lines or building out new ones, as well as strategic partnerships and acquisitions.

Last, but by no means least, more than half of the CIOs said cybersecurity was important. On the one hand, the participants at the roundtable said, it’s important to be proactive in defending their organization. At the same time, they emphasized that defending their organization involves having the right policies, processes, governance structure and culture.

Some Of The Questions I Plan To Ask At #HIMSS18

Posted on February 23, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

As always, this year’s HIMSS event will feature enough noise, sound and color to overwhelm your senses for months afterward. And talk about a big space to tread — I’ve come away with blisters more than once after attending.

Nonetheless, in my book it’s always worth attending the show. While no one vendor or session might blow you away, finding out directly what trends and products generated the most buzz is always good. The key is not only to attend the right educational sessions or meet the right people but to figure out how companies are making decisions.

Below, here are some of the questions that I hope to ask (and hopefully find answers) at the show. If you have other questions to suggest I’d love to bring them with me to the show —  the way I see it, the more the merrier!

-Anne

Blockchain

Vendors:  What functions does blockchain perform in your solution and what are the benefits of these additions? What made that blockchain the best technology choice for getting the job done? What challenges have you faced in developing a platform that integrates blockchain technology, and how are you addressing them? Is blockchain the most cost-efficient way of accomplishing the task you have in mind? What problems is blockchain best suited to address?

Providers: Have you rolled out any blockchain-based systems? If you haven’t currently deployed blockchain technology, do you expect to do so the future? When do you think that will happen? How will you know when it’s time to do so? What benefits do you think it will offer to your organization, and why? Do you think blockchain implementations could generate a significant level of additional server infrastructure overhead?

AI

Vendors: What makes your approach to healthcare AI unique and/or beneficial?  What is involved in integrating your AI product or service with existing provider technology, and how long does it usually take? Do providers have to do this themselves or do you help? Did you develop your own algorithms, license your AI engine or partner with someone else deliver it? Can you share any examples of how your customers have benefited by using AI?

Providers: What potential do you think AI has to change the way you deliver care? What specific benefits can AI offer your organization? Do you think healthcare AI applications are maturing, and if not how will you know when they have? What types of AI applications potentially interest you, and are you pilot-testing any of them?

Interoperability

Vendors:  How does your solution overcome barriers still remaining to full health data sharing between all healthcare industry participants? What do you think are the biggest interoperability challenges the industry faces? Does your solution require providers to make any significant changes to their infrastructure or call for advanced integration with existing systems? How long does it typically take for customers to go live with your interoperability solution, and how much does it cost on average? In an ideal world, what would interoperability between health data partners look like?

Providers: Do you consider yourself to have achieved full, partial or little/no health data interoperability between you and your partners? Are you happy with the results you’ve gotten from your interoperability efforts to date? What are the biggest benefits you’ve seen from achieving full or partial interoperability with other providers? Have you experienced any major failures in rolling out interoperability? If so, what damage did they do if any? Do you think interoperability is a prerequisite to delivering value-based care and/or population health management?

What topics are you looking forward to hearing about at #HIMSS18? What questions would you like asked? Share them in the comments and I’ll see what I can do to find answers.

Is A Cerner Installation A “Downgrade” From Epic? Ask This Guy

Posted on January 8, 2018 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

I don’t know if I’ve ever quoted a letter to the editor in a column for this publication, but I have to this time. I thought it had an interesting story to tell.

The letter, written by a patient at the Banner University of Arizona Medical Center in Tucson, offers a scathing critique what he sees “degradation of services” taking place after the institution switched from an Epic to a Cerner EHR, a change he refers to as a downgrade throughout the letter.

Since the “downgrade,” said the patient, John Kimbell, appointments take much longer. “Three weeks after the downgrade, my 30-minute appointment took three hours and 40 minutes,” he complains.

His other concerns include:

  • Data exchange problems: “My local doctor has TWICE sent results of a scan to my oncologist, and they never arrived.”
  • Privacy issues: With the automated paging system gone, “nurses call out names in the waiting areas in each clinic,” Kimbell notes.
  • Useless information: After Kimbell’s most recent appointment, he says, he was “handed out a 13-page printout that gave 12 pages information I didn’t need.” Before the Epic to Cerner switch, he reports, he was able to access this information online.
  • Communication issues: Kimbell says he never gets telephone call reminders of appointments anymore.

As Kimbell sees it, the quality of care has slipped significantly since Epic was switched out for a Cerner system. “All the cancer patients I have known while a patient there are in need of better care than Banner now provides,” he writes.

It’s important to note here that the Epic-to-Cerner switch-off took place in October last year, which means that the tech and administrative staff haven’t had much time to work out problems with the new installation. It may be the case that the concerns Kimbell had in late December won’t be an issue in a couple of months.

On the other hand, I do think it’s possible that as the letter implies, UMC owner Banner Health may have had reasons to push the Cerner install into the facility, most particularly if all of its other properties already operate using Cerner.

Regardless, if everything is as Kimbell describes, let’s hope it all gets back in order soon.  From the looks of things, UMC seems to offer a renowned cancer treatment program. Let’s hope that a quality program isn’t undermined by IT concerns.

Health IT Leaders Spending On Security, Not AI And Wearables

Posted on December 18, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

While breakout technologies like wearables and AI are hot, health system leaders don’t seem to be that excited about adopting them, according to a new study which reached out to more than 20 US health systems.

Nine out of 10 health systems said they increased their spending on cybersecurity technology, according to research by the Center for Connected Medicine (CCM) in partnership with the Health Management Academy.

However, many other emerging technologies don’t seem to be making the cut. For example, despite the publicity it’s received, two-thirds of health IT leaders said using AI was a low or very low priority. It seems that they don’t see a business model for using it.

The same goes for many other technologies that fascinate analysts and editors. For example, while many observers which expect otherwise, less than a quarter of respondents (17%) were paying much attention to wearables or making any bets on mobile health apps (21%).

When it comes to telemedicine, hospitals and health systems noted that they were in a bind. Less than half said they receive reimbursement for virtual consults (39%) or remote monitoring (46%}. Things may resolve next year, however. Seventy-one percent of those not getting paid right now expect to be reimbursed for such care in 2018.

Despite all of this pessimism about the latest emerging technologies, health IT leaders were somewhat optimistic about the benefits of predictive analytics, with more than half of respondents using or planning to begin using genomic testing for personalized medicine. The study reported that many of these episodes will be focused on oncology, anesthesia and pharmacogenetics.

What should we make of these results? After all, many seem to fly in the face of predictions industry watchers have offered.

Well, for one thing, it’s good to see that hospitals and health systems are engaging in long-overdue beefing up of their security infrastructure. As we’ve noted here in the past, hospital spending on cybersecurity has been meager at best.

Another thing is that while a few innovative hospitals are taking patient-generated health data seriously, many others are taking a rather conservative position here. While nobody seems to disagree that such data will change the business, it seems many hospitals are waiting for somebody else to take the risks inherent in investing in any new data scheme.

Finally, it seems that we are seeing a critical mass of influential hospitals that expect good things from telemedicine going forward. We are already seeing some large, influential academic medical centers treat virtual care as a routine part of their service offerings and a way to minimize gaps in care.

All told, it seems that at the moment, study respondents are less interested in sexy new innovations than the VCs showering them with money. That being said, it looks like many of these emerging strategies might pay off in 2018. It should be an interesting year.

AMA Connects Doctors With Health IT Ventures

Posted on November 22, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Maybe I’m wrong, but the following strikes me as coming straight from the Redundancy Department of Redundancy…but let’s see. Maybe I’m just being mean. Or maybe it’s because I just couldn’t taste The Rainbow in my last package of Skittles.

Anyway, recently AMA announced the launch of an online platform, the Physician Innovation Network (PIN), designed to connect physicians together with health tech firms.

The PIN will give HIT companies will have a straightforward channel for collecting physician input on the products and services they’re developing. The health IT ventures will also be able to search for physicians who have the expertise they need and are willing to exchange information with them. Meanwhile, the platform will help physicians to find paid and volunteer opportunities to work with health tech companies to work with the health take ventures that suit them.

In recent years, the AMA has taken several steps to bring the world of health IT and physicians closer together. Most recently, the trade group announced that it had created a data standardization organization known as the Integrated Health Model Initiative. The physician group and its partners say the new data model will include clinically-validated data elements designed to speed up the development of improved data organization, management, and analytics.

Its other HIT initiatives include:

  • Co-founding Health2047, a company designed (like PIN) to bring together physicians with established healthcare companies and help them launch useful services and products
  • Serving as one of four founding organizations behind Xcertia, an organization intended to foster knowledge about clinical content, usability, privacy, security and evidence of efficacy for mHealth apps
  • Managing a student-run biotechnology incubator in collaboration with Sling Health,

But what is there to say about PIN that distinguishes it from all of these efforts? It resembles Health2047, mais non? And what benefit does it add over LinkedIn? Specialty interest groups within the MGMA and HIMSS? AngelList? A giant digital corkboard and some virtual Post-It notes?

Don’t get me wrong, I know I’ve come down hard on the AMA’s product launch announcements rather often, perhaps too often. Depending on how it actually works, PIN may actually offer some incremental value over all of these other options. And hey, if the trade group wants to throw its money around, whom am I to say that they shouldn’t have at it.

The thing is, though, the AMA doesn’t work in a vacuum.

Look, as we all know, we’re absolutely drowning in initiatives and proposals and great new ideas for interoperability and the collection of consumer-generated health data. And don’t forget scoping out the best architecture for deploying two tin cans with a piece of string between them, getting budget approval from a Magic 8 Ball (signs point to no), and repurposing some BASIC code from a  Commodore 64 to develop your next mobile health app. (Yes, it tired me out to write that sentence but it was worth it.)

Silliness aside, when you have the kind of resources the AMA does, you want to the profession to say something meaningful when you open your mouth, professionally speaking. Other than that, you’re just sucking air out of the room that could be used for people with a differentiated idea in real value to deliver.  Hey, but other than that, the PIN announcement is just fine.

Searching EMR For Risk-Related Words Can Improve Care Coordination

Posted on September 18, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Though healthcare organizations are working on the problem, they’re still not as good at care coordination as they should be. It’s already an issue and will only get worse under value-based care schemes, in which the ability to coordinate care effectively could be a critical issue for providers.

Admittedly, there’s no easy way to solve care coordination problems, but new research suggests that basic health IT tools might be able to help. The researchers found that digging out important words from EMRs can help providers target patients needing extra care management and coordination.

The article, which appears in JMIR Medical Informatics, notes that most care coordination programs have a blind spot when it comes to identifying cases demanding extra coordination. “Care coordination programs have traditionally focused on medically complex patients, identifying patients that qualify by analyzing formatted clinical data and claims data,” the authors wrote. “However, not all clinically relevant data reside in claims and formatted data.”

For example, they say, relying on formatted records may cause providers to miss psychosocial risk factors such as social determinants of health, mental health disorder, and substance abuse disorders. “[This data is] less amenable to rapid and systematic data analyses, as these data are often not collected or stored as formatted data,” the authors note.

To address this issue, the researchers set out to identify psychosocial risk factors buried within a patient’s EHR using word recognition software. They used a tool known as the Queriable Patient Inference Dossier (QPID) to scan EHRs for terms describing high-risk conditions in patients already in care coordination programs.

After going through the review process, the researchers found 22 EHR-available search terms related to psychosocial high-risk status. When they were able to find nine or more of these terms in the patient’s EHR, it predicted that a patient would meet criteria for participation in a care coordination program. Presumably, this approach allowed care managers and clinicians to find patients who hadn’t been identified by existing care coordination outreach efforts.

I think this article is valuable, as it outlines a way to improve care coordination programs without leaping over tall buildings. Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence, and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Obviously, we’re going to see a lot more emphasis on harvesting information from structured data, tools like artificial intelligence and natural language processing. That makes sense. After all, these technologies allow healthcare organizations to enjoy both the clear organization of structured data and analytical options available when examining pure data sets. You can have your cake and eat it too.

Still, it’s good to know that you can get meaningful information from EHRs using a comparatively simple tool. In this case, parsing patient medical records for a couple dozen keywords helped the authors find patients that might have otherwise been missed. This can only be good news.

Yes, there’s no doubt we’ll keep on pushing the limits of predictive analytics, healthcare AI, machine learning and other techniques for taming wild databases. In the meantime, it’s good to know that we can make incremental progress in improving care using simpler tools.