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Archive for December, 2011

Is it Time to Embrace ICD-10?

by on December 30th, 2011

A recent post by ICD-10 Watch sums up the ICD-10 struggle well: “ICD-10 coding is a tough sell” and “great healthcare is in the data”.   Weinberger points out that providers are stretched to their limits with the many other healthcare reforms and feel like the benefits of adopting ICD-10 simply aren’t there.  However, the ICD-10  code set is a robust, up-to-date set of codes that enable providers to better document care and causes of injuries.

Providers aren’t digging their heels in because they want to provide less data or somehow benefit from continuing to operate with ICD-9 codes.  Instead, it is the classic case of “burn out”- Burn out caused by too many changes at once.  The question then becomes – how can the negative connotation and stress associated with the transition from ICD-9 to ICD-10 change?  The answer is simple: bottom-line benefits for those who comply.

Considering the fact that the new code set improves clinical documentation, so providers will  be able to better capture what they have done and be appropriately compensated for their work.  Additionally, the new code set will provide a way to bill more accurately, which is expected to decrease rejected claims because it will mitigate the need for providers to submit additional information.  In doing so it will lower operating expenses and increase the rate of reimbursement – a bonus to any business.

Aside from benefiting the organization, the conversion will benefit society.  Programs such as pay-for-performance and care management programs, as well as many other quality improvement programs, are heavily dependent upon the country converting over to the ICD-10 code set.  Providers must move embrace the change for society – after all they did take a “Do No Harm Oath”.

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Posted in Regulatory Compliance | No Comments »

Looking Forward: Measuring Healthcare Quality

by on December 29th, 2011

Compared to other nations, the United States has difficulty measuring up to some key areas related to health care quality. In terms of life expectancy, Docteur and Berenson (2009) contend that the United States has one of the lowest life expectancy rates and the highest mortality rate from conditions that could have been prevented. These disturbing statistics may be explained by the examining how the World Health Organization’s (WHO) and the Institute of Medicine’s (IOM) “key components to achieving a high-quality healthcare system” fit into care rendered within the US.

According to the WHO and the IOM there are key components to delivering high-quality care, such as:
1. Safety,
2. Effectiveness,
3. Patient-centered,
4. Timeliness,
5. Efficient, and
6. Equitability.

If we accept that the WHO and IMO are correct, then we must ask did the HIT Act assist in improving healthcare quality? To answer this question we need two things: analytical tools and continuous patient data. Analytical tools are needed to focus on each key component deemed necessary to deliver high-quality care separately and then synthesize outcomes to provide a comprehensive illustration of actual patient outcomes. To illustrate patient outcomes, patient information must be shared amongst providers – hence EMRs and HIEs are a necessary element for all providers.

By integrating analytics with EMRs (and soon ICD-10), care rendered can be analyzed for quality from an outcome perspective. Each of the key components could be evaluated as criterion on a Provider Quality Scorecard and published and reported back to the appropriate healthcare agency.  By doing this providers are given information about the care they are providing, organizations can evaluate what constraints within their system are affecting quality and govenment agencies can evaluate overall weaknesses and strengths within the healthcare system.

Provider Quality Scorecard

Indicator

Topic

Score

Safety

 # of injured patients
# of staff injuries

Effective

 Post-op care instructions
Pre-op options education
Readmit

Patient-Centered

 Follow up w PCP
Follow up visit

Efficiency

 Discharges to LT care
ALOS

Timeliness

 Test Results
Transfers
Divert
Staff timeliness

Equitable

 LOS
EMRs
HIEs

 

Is quality the future of healthcare in the US? Only time will tell how we will use our tools to cure the ailing healthcare system.  However, the most important part is using them to provide much needed knowledge to providers and begin to the march patients, providers and healthcare organizations down their road to recovery.

 

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Posted in Collaboration, News | No Comments »

Ask the Expert: How to Connect with Patients and Members using Social & Mobile Tools

by on December 28th, 2011

Michael Porter is a Principal at Perficient for Portal, Social, and Collaboration solutions.  He leverages 13 years of experience with portal and content management projects to help clients understand and take advantage of the value provided by web technologies.  He has supported many multi-million dollar portal implementations for some of the world’s largest companies.  Michael supports Perficient’s sales and marketing organizations through the creation of industry-leading services that help clients understand their enterprise portal and has helped to position Perficient as one of the top providers of strategic portal solutions.  He regularly speaks at industry and partner events on portal and social topics.
Check out his blog at: http://blogs.perficient.com/portals
Follow Mike on Twitter @PorterOnPortal

What are the best ways that healthcare organizations can use portal technology to engage with patients and members?

When you talk about patients or members, you need to talk about what they want.  If you are creating a mobile site for a member, then the chances are the member won’t need that mobile site to check on their insurance claims from their mobile phone.  It’s more likely that they forgot to bring their insurance card to an appointment and need to access their insurance card information from their mobile phone.  Organizations need to think “what does the patient or member want?”  There’s a clear User Experience component that comes through.

Portals are primarily an aggregation tool.  For patients, they need to make an appointment, they need to find a doctor, they need to find information on their health condition.  The portal can go in, take that data, and surface it up to the patient or member in a way that is useful to them.  For example, many think that patients pick a doctor for a procedure based on their academic credentials.  However, doing user experience surveys we found that they want to pick a doctor for a specific procedure based on how often that doctor performs that procedure.  That information can be presented to the patient in a helpful way to provide them with the information they need to take control of their healthcare.

Portals are also a great way to personalize an experience for a member or patient.  For example, if you know that a person is diabetic, then why would you have them log in and offer them information about the pregnancy center, which might not be relevant to them?  If a patient has prostate cancer, then you ought to be targeting that content to them to help them on their path towards wellness.  This says, “I understand who you are, I understand your needs, let me give you the information that will help you feel better.”  Patients and members may feel out of their element when managing their illness, and we can help put them at east through personalization with portal.

What recommendations do you have for healthcare organizations that want to make their portal mobile friendly?

Mobile is important to clinicians and patients.  We recently had a doctor tell us “I go patient to patient to patient all day.  If you can’t put it on my iPhone, then it isn’t important to me.”

Unfortunately, the current mobile world is like the Wild Wild West.  There are lots of people, lots of ideas, and lots of technologies.  This provides a lot of options to create a mobile experience. With that in mind, I have several recommendations.

First you need to understand your options and correlate that with the skills, tools, and goals you have to meet.  The organization needs to define what they are going to do, when you are going to use the portal, and how it is going to be used.  Once you understand that, then you can begin to formulate a strategy.    Specifically, you should be looking at native applications like iPhone, iPad, Android, etc.  Then look at whether you want to enable web based applications. Finally, look at the tools to manage the sites and cut down on creating multiple code streams for what is essentially the same thing but on different platforms.

From a tactical standpoint, there are iPhone applications as well as various smart phones that can all create apps.  These apps are very convenient, but where do you start with so many forms of mobile media?  One option is to make a web application and use write once publish everywhere tool to put your application on multiple channels.  Ultimately, with so many options healthcare organizations need to dip their foot in the water first.  Don’t just dive into trying to do everything at once.  Do your first application and see if it is successful.  Use what you learn and create a plan based on what works for you and what your users demand.

What are the social media capabilities available today with portals?

To me there is a difference between social media and social networking/collaboration.  With social media you use tools like Facebook, Twitter, and Radian 6 to create one to many relationships.  Healthcare organizations are essentially building a brand to any consumer that may be interested.   You can’t control the conversation but you can be a part of it.

Social networking or collaboration, on the other hand, is much more inwardly focused.  Groups of people are brought together to share information, form communities, and learn from one another.  Online patient communities are perfect examples of this.  Healthcare organizations can build these communities internal to their organization as well.  Social networking capabilities have fantastic profiling opportunities.  Need an epidemiology specialist pronto?  There are tools that can help you find that knowledge within your organization.  There is a ton of content that is constantly being released and clinicians need to stay up on new policies, new research, and what their colleagues are doing.  Social networking tools integrated with third party sources can pull all this together.  Colleagues can be pulled together in communities around targeted content to form centers of excellence within the organization.

What are the leaders in healthcare portal up to these days?

The leaders in portal are being really smart.  They are not just saying I am going to provide you with access to claims or provide you with links.  They are saying, “I know you are a patient, and you are coming here for a purpose.”  They personalize that experience.  This makes the site harder to manage because it is not a static site.  You have to set up the infrastructure to make that work, but there is a lot of payback.  The leaders are giving better value to their constituents while gaining the economies of scale that portal and social technologies can give you.

Have any other portal questions for Mike?  Please enter them below.

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Healthcare Business Intelligence – Success vs. Biting off More than You Can Chew

by on December 27th, 2011

The healthcare industry is ecstatic about the opportunity to apply business intelligence (BI) to improve healthcare quality, cost and outcomes. Providers are using BI to address process issues that limit operational efficiencies. BI is “the solution” to successfully overcoming short-comings and creating provider bottom-line benefits, patient time and efficiency benefits and overall social equity. IBM stated that “(f)orward-thinking healthcare organizations realize that data – and, thus, business intelligence – is at the center of informed and precise decision-making that will improve patient and service outcomes in addition to ensuring their organizations’ future.” However, these benefits are only revealed if a BI initiative meets its goal.

To meet a goal, a BI project must be clearly defined. For example, the goal of a BI project is not a dashboard. Instead, the goal is getting the right information about an area of opportunity to the right people. Therefore, the value of healthcare BI projects comes from a thorough analysis of the opportunity. This leads us to the first point: Get different perspectives.

Combining knowledge from throughout an organization allows those involved in the project to identify themes and examine the problem from different perspectives. This is invaluable as the outcome of a BI project must provide the right information to the right people to be successful.

Next, as BI projects are introduced to an organization, each person’s perspective may lead the project down a different path. For example, some perspectives may suggest different data is necessary to provide valuable analytics about an issue. To ensure that a project stays on track, moves forward and remains a manageable size, a project’s scope and goal must be clearly defined. Setting a firm definition will ensure that the initiative meets its goal.

Finally, staying on track and limiting scope can be frustrating, but it provides an opportunity to look forward at how one initiative overlaps with future initiatives. Success on Project A may lend itself to Project B and Project B to Project C – together these projects may paint an invaluable view to members of an organization and allow each employee to address an issue from their perspective.  Don’t bite off more than you can chew. Divide a project up into manageable pieces.

Acknowledge that each issue has its own set of players and each player has its own solution. Remember that the healthcare sector is biting at the bit for ways to address their operational efficiencies. Organizations expect BI to live up to its promise – and it can, if the projects are approached from multiple perspectives, remain goal-driven and are divided up into manageable pieces.

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Posted in Business Intelligence, News | 1 Comment »

Ask the Expert: The Successes and Pitfalls of Healthcare Portal Implementation

by on December 21st, 2011

Michael Porter is a Principal at Perficient for Portal, Social, and Collaboration solutions.  He leverages 13 years of experience with portal and content management projects to help clients understand and take advantage of the value provided by web technologies.  He has supported many multi-million dollar portal implementations for some of the world’s largest companies.  Michael supports Perficient’s sales and marketing organizations through the creation of industry-leading services that help clients understand their enterprise portal and has helped to position Perficient as one of the top providers of strategic portal solutions.  He regularly speaks at industry and partner events on portal and social topics.
Check out his blog at: http://blogs.perficient.com/portals
Follow Mike on Twitter @PorterOnPortal

Tell me a little bit about the recent healthcare portal projects you’ve been working on.

There are actually quite a few of them:

  • Kaiser Permanente receives over 5,000,000 hits per day on their KP.org site.  We have been moving that site from a rough java framework to a portal framework.  We’ve been with them since the inception, and the portal provides both payor and provider services. This includes 129 applications that they surface up on the portal as a result.
  • Blue Cross Blue Shield of Minnesota is a fantastic example of a company that wants to use social networking for their employees and those that they collaborate with, such as hospitals throughout Minnesota.  They use tools like IBM Connections to do so.
  • Blue Cross Blue Shield of Florida is another recent project.  Quite frankly, I believe they have the best member portal out there.  In fact, they spoke at the opening keynote of IBM’s Web Experience conference as a result.  When you think about what is happening in portal with patient driven engagement, they do a lot of things to enable their members by educating them on the alternatives available with regard to treatment.  This helps a member understand where and when they will use healthcare and enables them to make better decisions.
  • Premier healthcare alliance is also incorporating a portal for their member hospitals in a project that has been all about content and servicing reports in a personalized fashion.  There has been a lot of discussion about how to allow member hospitals to collaborate using social tools available on portal to develop a socially driven community of hospital members.  Premier has put a lot of time and effort into implementing this social portal.  Ultimately, this portal will allow their member hospitals to find research relevant to them and to better collaborate with colleagues across many hospital systems.  These collaboratives also use analytics to identify how to save lives and implement those findings across the care continuum.
  • Our newest project is at a well known tertiary hospital on the east coast .  They are currently focused on how to enable employees, doctors, researchers, and others that work with the hospital with an enterprise portal.  We’ve been working to create a roadmap that identifies the technologies that are the best fit for their organization, which need to be both mobile and social in nature to drive true communication among colleagues.

What are the first steps a healthcare organizations should make when considering a portal project?

First and foremost, there are far too many people that come to us and say “we’re ready to do a portal” but they haven’t thought through the stakeholders that will be impacted by this project.  The first step needs to be targeting the users and developing a roadmap by sitting down and talking to these people.  You need to learn their pain points and what a portal can do to help.  If you haven’t thought that through and spoken to people that are using this on a day to day basis, then you are only building a prototype that will have little use to those who will actually be using the tool.  I think it’s a bit like building a house without blueprints.

What are the most common mistakes that are made in portal projects?

All too often we speak to people within a healthcare organization that are leading a portal project and they say “I know what is best for the doctor, the nurse, the patient”.  If an organization rids themselves of this belief, then they will also rid themselves of ¾ of the mistakes you can make in a portal project.  We need to listen to those who will actually use the portal. There are many tools available to healthcare organizations.  By conducting User Experience studies and gaining feedback to understand how people will use the tool, the healthcare organization will get better results.

Mistakes are not limited to user experience, however.  Unfortunately, there are actually a lot of dumb mistakes people make, which prompted us to write “12 Things NOT to do on a Portal Project” (check it out under “White Papers” on our Portal Collaboration page).  Let’s talk about one of my favorites: “Methodology for Methodology’s Sake”.  There are far too many IT teams that think the waterfall approach to building out a portal project is best.  However, this approach often invites analysis paralysis.  It also invites end users to view IT as a dinosaur that can’t help the organization move fast enough.  IT can move fast enough, they just need to use the right tools in order to do so.  IT also needs to remember their reason for being.  They need to be an enabler rather than a stumbling block.

How do enterprise portals make healthcare organizations more efficient?

On the ground at healthcare organizations they are talking about analytics, they are talking about meaningful use, they are talking about getting better ratings, they are talking about providing better experiences to engage patients and members.   There are many things that an organization needs to do to be successful.  The question is, do they create another project to deal with each issue or can they use a portal to surface up all of that content in a cohesive way that helps colleagues get their work done?  Many leading healthcare organizations are turning to portal as a result.

Portals also help the management of a healthcare organization.  People who manage healthcare organizations are constantly being asked to review and approve tasks, purchase orders, patient plans and other items across various projects and platforms.  It’s easy for a task to get lost in the shuffle.  A portal is the perfect place for management to get organized.  Using portal an organization can create a universal task queue that aggregates all these tasks from many different systems.  Users simply click, review, and move on.  This saves a manager, doctor, nurse, or researcher from needing to click through 15 pages to get through another system and hope nothing falls through the cracks.  That’s just one example of how a portal can aggregate content, transactions, and processes.

Portals also help colleagues within an organization find the experts and thought leaders they need to get work done.   Let’s take a recent example of a doctor that needed to find someone with a certain specialization.  Using the traditional tools of email and directories, which can be a poor way to capture knowledge, it took him 30 minutes to find the person he needed.  Social networking and search capabilities built into portals have fantastic profiling capabilities that could have helped.  This doctor could have found the person he needed in 5 seconds instead of 45 minutes.  Colleagues can align and interact in ways they couldn’t before.

Stay tuned for the second part of this Ask the Experts coming soon.  Have any questions you want us to consider?  Enter them below.

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Posted in Collaboration, News | No Comments »

2011 Top #HITsm Contributor Awards

by on December 20th, 2011

Just in time for the season of celebrations, the #HITsm Twitter community, focused on creating discussions on Health IT, has announced its 2011 Top #HITsm Contributors list. The list is broken into Individual Contributors, Organizations and Publications. Perficient Healthcare, under the Twitter handle @Perficient_HC, is proud to be recognized in the Organizations group for its contributions. Also, Perficient’s own Melody Smith Jones was recognized as an Individual Contributor under her handle @MelSmithJones!

 

So, in the spirit of celebration, we would like to recognize some of the individuals we have had great #HITsm interactions with in 2011, some from the HL7 Standards list, and some of our own.

@OchoTex – One of the faces behind the list. While obviously not included, he has been the man behind many of the weekly #HITsm chats, responsible for engaging this great community.

@NateOsit – Never afraid to voice an opinion during weekly #HITsm chats, and always on the ball with news! Great at starting discussions, collaborating, and getting exciting conversations started.

@motorcycle_guy – The #HITsm resident standards expert who posts great content under his own blog that gets everyone thinking.

@techguy – Blogger extraordinaire and all-around nice guy! Be sure to check him out at any of our healthcare conferences, and you won’t be disappointed.

@EMRAnswers – Great friend of Perficient and passionate health IT advocate. Each family has a glue that binds them; she’s ours.

@TheGr8Chalupa – Playful instigator of the #HITsm community. Who doesn’t love a lady who likes black coffee and dark beer?

@MelissaColeHTR – We think the future leaders of healthcare will be the RN’s and doctors that truly know healthcare technology. She’s one of them! Melissa’s positive attitude and encouragement have touched many members of the community.

@SmyrnaGirl – A passionate Health IT advocate. Make sure to check out her many articles on Health IT News.

@DrNanN – Feels like an old time friend at this point. Check out the numerous podcast interviews we did with @DrNanN on how Health IT connects her to her patients.

@ahier – When we think of Health IT leaders, we want to be Brian when we grow up! Check out our interview with him at HIMSS 2011.

@2healthguru – Curious about the latest news on ACO? Just ask Gregg!

@pjmachado – One of the few Health IT geeks that has as much to say in the provider space as he does in the payor space.

@janicemccallum – She fits the definition of Health IT influencer. Check her out in the interview we did last year at HIMSS on BI and Meaningful Use.

If you’re interested in becoming part of the #HITsm community these are just a few of the people we recommend engaging with. Also, join our weekly Tweetchats, starting up again in January 2012 – more information at http://www.hl7standards.com. Thank you all for such a great #HITsm year – we are looking forward to new faces and continued conversations in 2012!

Who have been your most valuable #HITsm contributors this year? 

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Ask the Expert: How to Create a Successful Mobile Health Gamification Experience

by on December 14th, 2011

Scott Schnaars is a technology and internet sales, business development and operations professional with a passion for technology, writing & golf. Throughout his career, Scott has held various positions within companies such as Borland, WebEx, Motorola & Yahoo!  Currently, Scott is head of sales at Badgeville, the leading behavior management firm, which is a partner of Perficient.

Tell me a little bit about the recent gamification projects you’ve been working on in the healthcare arena.

There are a few of them that we are excited about.  At Badgeville, we do a lot of work in both health and general fitness.  In the fitness arena, we have projects like Everyday Health and JillianMichaels.com.  With these projects, we create gamified experiences that Influence behaviors toward the goal of physical fitness.  The success of those projects has been absolutely phenomenal.  We are getting people engaged with their fitness experience through logging workouts and logging diets.  We then reward users through reputation, access to new content, and discounts on services.

In the more specific healthcare front, we’ve done a couple of exciting projects.  One example is AviviaHealth.com, which is a software division of Kaiser Permanente.  The application is used by the employees of Kaiser sponsoring companies.  Basically, if you are an employee of one of these companies, you have access to this application.  Employees use the system to engage with health goals such as smoking cessation, weight management, improved posture, etc.  These activities are tracked in the Avivia application, and employees engage in communities that drive collaboration.  This has been a successful example of demonstrating how communities can help each member achieve their health goals through support. 

What are the first steps a healthcare organization should make when considering a gaming strategy?

An organization should start with their business goals.  Sometimes organizations want to dive straight into focusing on behaviors and less on the actual results.  This can become difficult when they need to have that practical conversation with the CFO to justify budget.  The guidance I give to new customers is to establish goals and understand the metrics that show we are on the right track with those goals; that’s the only way you will actually know that your gamification project is a true success.   Once these goals and metrics have been accessed, we then help clients identify the correct behaviors that need to be targeted and how to engage consumers around those behaviors.  For example, in the case of AviviaHealth.com, healthy employees are an asset for a company.  We came up with a gamified experience that helped those employees to become more healthful as a result.

How does gamification change behavior? How can healthcare organizations use gamification to teach healthy behavior?

I recently answered a similar question on Quora.  While many see gamification as a relatively new phenomenon, there is actually a long history that helps explain how these activities modify behavior.  In the late 1700s retailers came up with a concept called “premiums”.  Using this concept, consumers visited stores on a certain day and they were given a premium item such as a colored lithograph.  These premium items were essentially collectible items that the customer could then showcase to their friends and family to showcase that they had demonstrated a certain behavior. 

The study of martial arts is another great example.  Once a karate student succeeds in learning certain behaviors they are recognized for those behaviors with different color belts.  In an elementary school, students work very hard to earn gold stars from their teacher.  Essentially, this comes down to some essential ingredients in human behavior.  If you do something, then you are recognized for that positive behavior.  It’s human nature to want to be rewarded.  Gamification and human nature are essentially one in the same.

What are the most common mistakes that newcomers make?

As I mentioned earlier, newcomers often fail to be specific about their business objectives.  They simply say, “I want more engagement.” This is akin to a patient going to the doctor, saying there are sick, but not stating any symptoms.  People will inevitably say “I want more engagement”. 

Another common mistake is creating a social rewards program that is either too easy to get through, which provides easy entry into the community, or too difficult to get through, which makes the environment too difficult to thrive within.  Also, if you build a poor experience, then the impact of rewards can have a serious negative ramification on your bottom line.  This is why rewarding people through social rewards can be very cost effective. 

Lastly, one must consider their audience when developing a gaming strategy.  For example, Jillian Michael’s audience is very competitive.  Active.com, on the other hand, has a more collaborative community.  You need to consider your core audience and how they want to interact with one another. 

What are the leaders in healthcare gaming up to these days?

Leaders in this space are using the data that is available to them and identifying behavior profiles that help them succeed with their gaming strategy.  It is easy for companies to limit their strategy to social networks, which are essentially a collection of information about users and their friends, and user profile information, which adds additional data around interests.  However, there is a wider world of behavior that is lost if a gaming strategy is limited to these two pools of information. 

By integrating behavior into the equation, healthcare organizations can track information about users based on what they are doing on the site. This information is stored and understood in the context of what other users are doing at any given time, and in relation to the specific objects on the site. You can easily configure a Behavior Graph to track the behaviors that matter most to your organization no matter how unique those behaviors are. 

Have any additional questions for Scott about gamification in healthcare?  Enter them below.

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“Help! My Healthcare Choices are Limited Due to Limited Health IT”

by on December 12th, 2011

This morning I went to my doctor due to some low blood pressure issues.   After doing some initial tests, my doctor stated that she needed to refer me to a specialist in Cardiac Electrophysiology.  At the end of the appointment, we made our way towards the registration desk to explore our referral options.  The receptionist informed us that I could be sent to a specialist at the Ohio Heart & Vascular Center or to Christ Hospital, which had a unit that specialized in Cardiac Electrophysiology.  Christ Hospital is ranked as one of the top hospitals in the country for heart care and surgery.  It’s well known in my part of the country that if you, or a loved one, are experiencing a sudden heart attack, then you should tell the emergency crew to head over to Christ Hospital.

“No, I can’t refer her to Christ Hospital,” my doctor answered, “ Our data systems are not connected.  I’ll never get my data back.”

That’s when my bubble burst.

You must understand that I pick my healthcare providers based on their Health IT prowess.  This is not because I’m “in the biz” (as they say).  Rather, I am in the biz because I care so much about this topic.  I was a child of Kaiser Permanente in San Diego, and, therefore, have had my health documented electronically since elementary school (read: a long time ago).  Over this vast expanse in time, I have witnessed my doctors share and deep dive into my medical history in a way that is just not available by way of paper records.  As such, when I am vetting a new physician my questions typically exceed the “Where did you go to school?” and “How often have you done this type of procedure?”  Relevant questions to ask a physician’s practice in this day and age are, “How do you collect my data?” “How do you share that data with me?”, and “How do you share that data with other physicians and researchers?”

My current primary care physician is on an Epic interface and provides me with data using a pretty good attempt at patient portal.  I live in a city, Cincinnati, which is home to one of the best HIE’s in our land.  Cincinnati’s HealthBridge has been around for over a decade and is one of the nation’s largest, most advanced, and most financially sustainable HIEs available.  They have a mission statement to help clinicians make smarter decisions that enhance patient care and lower health care costs.

So, here I am the Health IT enthusiast who has had my healthcare choices limited due to limited Health IT.  Have you had a similar experience?  I’d love to hear about it with a comment below.

Posted in Health Information Exchange, News | No Comments »

Ask the Expert: How to Create the Most Collaborative Healthcare Site in the Nation

by on December 7th, 2011

Robert Sumner is a Technical Director and leads the Web Content Management (WCM) practice within the National ECM Business Unit at Perficient. As a director, he manages all WCM projects and provides internal strategic consulting, including business plan & sales strategy development for the Practice. He is an expert in the web content management space and has over 13 years experience leading ECM and WCM type initiatives, all with a delivery focus. From a technical perspective, he is well versed in ECM and Portal Technologies. 

Q: What are some of the common issues faced by healthcare organizations today with regard to web content management?

A: This depends on the organizational unit that is approaching the problem.  Two different organizational groups are often responsible for the challenges associated with web content management.  The first group is the marketing group that is dealing with the challenge of connecting with patients and welcoming them into conversations with doctors and the organization as a whole.  The second group, the IT group, is supporting marketing’s initiative to create a web presence by providing marketing with capabilities to manage their own content in a secure fashion. This can present some challenges.  Giving full reign to the marketing team is not something that IT generally wants to do.  These organizations need to decide the right mix of control and delineation over management of the site.

A second challenge comes when deciding how the content is best structured.  The process needed to author, maintain, and present can be very complex, but it needs to appear to be seamless.  Take, for example, a symptom tracker tool on a hospital website.  Each disease state could require a multitude of images that the user navigates through to become more educated and aware of their symptoms and when it would be helpful to reach out to set an appointment.  The marketers and editors, who are oftentimes not website pros, need the ability to create these tools and sites in a way that helps them broaden their reach and awareness.  In order to make this a reality, a healthcare organization needs to have great structure around the creation of content.

The third challenge speaks to where the web content management market is really headed.  How can we provide healthcare marketers with the analytics information necessary to drive and modify campaigns and achieve better success towards their marketing goals?  Using a traditional system of data capture results in marketing making decisions based on what could be a hunch about the market.  Based on what could be faulty information, they figure out what changes need to be made in web presence, provide that information to IT to reconfigure, then finally go live with the public facing content that is relevant to the patient.  This could take weeks, or even months, to complete, and that hunch may not have been a good one.  This often leads to bad investment decisions.  Using real data and analytics, which are built into the content management system, will provide the marketer with actionable data about market conditions.  If workflow issues have been properly remedied, then healthcare organizations can communicate with patients regarding timely public relations issues in an expedient fashion. 

Q: You speak a lot about the importance of a refined workflow to meet demand for patient information.  What tools do healthcare organizations have at their disposal to streamline this workflow?

A: New platforms allow a marketer to retrieve analytics data, as I mentioned earlier, and pull it back into the content management system quickly without having IT involved at all.  Marketers need to be given the data and react to that data as quickly as possible with immediate feedback and the ability to make changes at will.  From a workflow perspective, when I’m doing an assessment for a healthcare client, I look at operational efficiencies.  Is the client taking advantage of some of the features that come with new platforms that allow you to get the data you need and generate processes using that data that could otherwise be difficult to follow?  You can capture a current state, a future state, and then build a roadmap to cover that gap.

Q: What are the first steps a healthcare organization can take to create a content rich web presence for patients?

A: The first step involves segmentation and targeting.  Marketing engines can be built directly into content management tools and marketers can build profile groups.  For example, say that an organization wants to identify males over 40 or mothers of infants.   All identified patients that meet those criteria are segmented, and the marketer can then create and assemble content that speaks to those specific segments.  Creating this targeted content is the best first step, and a powerful content management system allows just that.  The system allows a healthcare marketer to analyze data for each market segment and it offers changes to increase results.  When a homepage is created, for example, there are areas of the page where a marketer can drag or drop content that would draw in a specific segment, which makes that homepage feel tailored and relevant to the user at hand.  This is consumer-driven healthcare at its finest.

Q: Many discuss the importance of social media capabilities for healthcare organizations?  Do you have any tips?

A:  Many new web content management platforms have modules or components that execute on the run time website such that when you have a social interaction on your site (through blogging, forums, general tweets, etc.) that information can be added to a repository and analyzed by the marketing team.  Take, for example, page level feedback via a “Share this on Facebook” button.  Once a user clicks on that button, the components capture that information and write it back to the runtime repository, which is used at the page level to show the marketer how content is being shared socially.  This creates a feedback loop directly into the content management system.  You don’t want to wait to learn that you have had 40 people interact negatively with a piece of content.  You want to know that on demand to shorten the response time. 

Another question I’m often asked is “How do I know what people are saying about my organization off of my website?”  Social integration technologies are a hot market.  Many tools are available to “listen” for certain content.  They Spider the web to find out anything they can about your hospital to respond and protect your brand. 

Q: Many patients are using mobile devices to access healthcare information.  How can a healthcare organization best respond to that?

A: This is a good question. Today’s WCMS platforms are extremely advanced. They allow for raw content to be collected as part of the content creation process and delivered to many different media vehicles, like a mobile device. These devices are responsible for presenting this content via presentation templates on the media platform of choice, e.g. mobile device use the same data, but may use less of it, or may present it differently on a tablet device because there is less real estate on a mobile. So in response, there are some cutting edge WCMS out there that are enabling authors to literally emulate the look and feel of content across any device by using inline mobile/tablet design views prior to publishing. This is a powerful feature.

Q: What are the leaders in healthcare enterprise content management up to these days?  How can one create “the best website in the nation” available today?

A: This is a hard question to answer, but I would say the key component of a successful enterprise content management system is one that allows the marketing team to be enabled.  These organizations take advantage of the newest web content management capabilities and are not afraid to introduce these new platforms into existing systems.  This does not all need to be completed at once.  These changes are best done gradually by introducing the new platform to test areas within the site.  By conducting these pilot tests you can see how in a future release other areas of your site will be impacted.  The most successful additions can then be rolled out across the entire site.

The best sites also allow and encourage the patient to interact with you at all times.  With the advance of mobile application development and content delivery integration into these applications, the web becomes a secondary means of communication for most healthcare organizations.  To respond, healthcare organizations need to collect information and interact with their community through doctor and patient participation.  Are doctors participating and blogging on topics that are relevant to their areas of expertise?  What content is practical to patients and do you offer updated content on those topics regularly?  With the advent of consumer driven healthcare, the organizations that thrive are those that are good at breaking down barriers around siloed content (audio, video, print) and integrating them across their sites and mobile initiatives in a seamless fashion.   

Do you have any other questions for Robert about enterprise content management and the healthcare websites of the future?  Enter them below.

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Connecting the Billions of Little Pieces in Mobile Health

by on December 5th, 2011

Having interoperable, and mobile, health data sounds like a great plan. However, there are a few problems that stand in our way. First, one must consider the pure volume of connected devices.  It is estimated that the number of mobile devices will reach a total of 50 billion by 2020. Then one must consider that these devices are often industry focused and tied to proprietary software, which makes interoperability among these billions of mobile devices a challenge.

How can this seemingly impossible task be accomplished?

Fortunately, we can accomplish this task using today’s innovations. A prime example is the work being done by the Eclipse Foundation, founded by IBM, which is innovating around Message Queuing Telemetry Transport (MQTT). MQTT takes the billions of embedded devices, which can include RFID tag readers, smart phones, cardiac monitors, GPS-aware systems, etc., and interconnects them to one another. The architecture that the contributed technology enables can easily adapt to existing systems and does not require significant programming or reconfiguration of legacy monitoring systems.

By connecting mobile devices with an open-source, cross-industry messaging technology, there is potential to create new systems of systems that can operate with one another like never before. This would help organizations embrace new opportunities and allows clinicians to interact with patients in a way that will transform connected healthcare.

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