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In Managing Finance at Hospitals, the Proof is in the Data

Assembling data is both a technical and political challenge.  I’ve been involved with multiple hospitals where the finance and clinical teams never really collaborate and therefore the lenses put on either domain is not terribly realistic.  Truly merging and using the data requires clinical and financial leaders to establish trust and shared goals that promote an environment of accountability.  The key to trusted data is transparency.

Profitablility and Cost ManagementCombining clinical and financial data for cost management is a popular topic given the political and economic environment. This activity generally includes these data requirements:

  • Claims data for diagnosis codes, patient demographics and encounter information and services provided; this data usually resides in the patient billing system
  • Clinical data such as labs for quality and outcomes ; this data usually resides in the EMR, EHA or other ancillary clinical systems
  • Accounting and finance data from the general ledger, budget and sub-ledger systems.

Assembling this data requires a robust technical architecture that easily stores the data relationships with contextual integrity along with the ability to resolve patient or person identity. Once the data is assembled, leaders of the organization can build disease registries to manage the cost of care for populations and to model service line profitability, analyze payer contracts and more. The most important benefit of this transformation is that the organization begins to speak a common language of accountability and front line managers begin to understand the relationships between volume drivers and departmental workload leading to increased ownership of controlling these variables.  The costing step is important ensure the data as well as the transaction level calculated cost is fully accessible to decision makers.  All too often we hear that “my patients are sicker than theirs” or my surgical device has better outcomes.  The proof is in the data!

The Oracle Enterprise Health Analytics (EHA) platform in concert with the Oracle Hyperion Profitability & Cost Management (HPCM) solution facilitates the merging of clinical and financial data to perform costing calculations. This fully burdened cost data associated with other clinical metrics such as quality and outcomes measures answer both administrative and operational questions.   Using the Oracle platform, patient volumes, outcomes and operational measures are not viewed in an independent environment but instead become dependencies to understanding case mix index, reasons for readmissions, and staffing mix (on a case level), among other things.

Perficient offers design, implementation and support capabilities for Hyperion Profitability and Cost Management (HPCM) and Oracle Enterprise Health Analytics (EHA) solutions as well as the full Oracle Hyperion EPM suite of solutions.  We are a silver sponsor for the #OracleIC14  and we are looking forward to talking with you about Health Analytics and Population Health.

Stop by to meet our dynamic team at the Partner Networking Zone, Marriott Copley Square, 4th Floor to discuss new ways to optimize your systems, along with new solutions that will take your organization to the next level.

Join us in Boston! Follow our healthcare experts on Twitter @Perficient_HC and check our Healthcare blog.

Follow me on twitter @teriemc

View my recent blogs:

Elevating the Role of Finance within the Hospital

Enterprise Warehouses: The Gift that Keeps on Giving

Balancing clinical effectiveness with profitability

Connecting the Dots at Oracle Industry Connect | #OracleIC14

Healthcare executives will get together to discuss how to use data to manage populations, increase efficiencies and advance personalized medicine, among other topics at the Oracle Industry Connect, an event that will take place on March 25 and 26 at Marriott Copley Place in Boston.   The agenda includes keynote sessions on big data informatics and healthcare analytics, with speakers from Mayo Clinic, Pfizer, UPMC, Walgreens, and other industry leaders.

Oracle Industry Connect

The Health and Life Sciences breakouts will showcase how these organizations are implementing enterprise-wide data warehouses and analytics capabilities that provide a comprehensive view of healthcare operations—patient visits, diagnoses, test results, prescriptions, referrals, and more—making it possible to arrive at insights that can lead to improved patient care and outcomes.

Perficient is uniquely positioned to deliver the Oracle Enterprise Health Analytics (EHA) platform as well as strategic healthcare analytic roadmaps.  Our Oracle EHA based analytic solutions and dashboards provide clients with a short time to value solution that meets immediate needs around disease management, operational efficiency, costing and profitability and quality.

Stop by to meet our dynamic team at the Partner Networking Zone at #OracleIC14, at the Marriott Copley Square 4th Floor to discuss new ways to optimize your systems, along with new solutions that will take your organization to the next level.

Join us in Boston! Follow our healthcare experts on Twitter @Perficient_HC and check our Healthcare blog.

Follow me on twitter @teriemc

Population Health: Informatics for Clinical Decision Flow & Costs

At the Fourteenth Population Health Colloquium in Philadelphia, Perficient’s own Lesli Adams, MPA, took the stage with Sanjay Udoshi, MD and Brady Davis to present “Shared Accountability: How Informatics and Data for Clinical Decision Workflow engages Consumers on the Quality/Cost Equation.”  This Mini Summit presentation was sponsored by Oracle Health Sciences and Perficient.   The kick-off of the presentation was fun because it introduced the speakers as a business analyst geek (Lesli), an innovation and strategy guy (Brady) and a doc in the box (Dr. Udoshi). The presentation was targeted at the opportunities for quality improvement and cost control including wellness and chronic disease care gaps.  At the risk of seeming biased, this presentation was one of the more practical, down to earth approaches at this week’s Colloquium event.

Why do I believe that? Well, I felt that many of the attendees at the Colloquium were seeking real how-to knowledge.  Not that the big healthcare organization’s experience in implementing population health management aren’t valuable insights, but there was a lot of buzz about whether population health management can be done in a cost effective manner, and this presentation addressed the type of informatics required to change traditional approaches.  The first step was to outline the process in a slide called Population Health Management 101.  The key concept was moving paper processes for care management to a digital platform to analyze and manage costs, see figure 1.

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Figure 1. Population Health Management 101

 

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Figure 2. Re-engineering Clinical Care

 

The second idea was to re-engineer clinical care to identify and manage care gaps.  The first step is to identify the key populations to be managed, then determine the key Goals for that population, and finally to manage addressing the gaps in care or Action Arms (Figure 2).  Note that different populations have unique goals but subsequently could have common Action Arms.  To address creating the care gaps and related Action Arms, the healthcare organization has to have a strategic vision for these target populations and combine that with the right tactical tools, namely informatics.  The challenge of creating these informatics isn’t simply addressed with technology tools, but requires several key steps including:

  • Structured Data Capture vs Natural Language Processing (NLP)
  • Diagnosis Naming Conventions
  • Establishing the Digital “Gold” Standard”
  • Influencing the Problem List
  • HCCs and Chronic Disease Management
  • Best Practice Alerting and Health Maintenance Modifiers
  • Guideline Based Bundles and Closing Care Gaps

Addressing Care Gaps is very practical advice for healthcare organizations seeking to really manage populations. Creating informatics solutions that support closing preventive, chronic and restorative care gaps will drive health care value for patients and health plans alike.  Creating these informatics requires data mining, process re-engineering and the ability to extract data from modern electronic health record systems.  Building patient-centric plans of care based on this process will need to be supported through proactive outreach as well.  The key is applying technology tools in novel ways to enhance shared decision-making between the clinician and patient.

Lesli Adams outlined what I see as the key factor to population health management: cost management.  The integration of clinical information and financial data is key to cost management and often this data resides in silo’ed or separate software applications.  The ability to manage costs by having standardized pathways, then examine costs at a Patient Level will lead to better decision-making and more cost effective care.  Putting the disciplines in place to examine physician variability against the standardized pathways is the enforcement technique to bring costs under control.  When organizations commit to collecting and cleaning this level of costing information, then profitability reports by service line, DRG and Physician become reliable tools for key decisions about operations.  One of the highlights of the presentation was micro-costing examples to highlight the key decision points for clinicians.

Lesli Adams will be presenting at the Oracle Industry Connect event on Tuesday and Wednesday, March 25-26 in Boston.  For more information on Perficient’s informatics offerings, especially related to Population Health Management, please contact us.

Population Health: Getting the Process Right

It was a privilege to attend the Fourteenth Population Health Colloquium in Philadelphia starting on a snowy St. Patrick’s Day.  One of my favorite sessions on Monday afternoon was led by Terry O’Rourke, MD who postponed his celebration of the holiday to present “Managing Populations: The Role of a Large Health System.”  CHE Trinity as a healthcare organization treats 18 million patients a year and Dr. O’Rourke had a great Snow in Philadelphiaperspective on the challenges of population health management.

Dr. O’Rourke stated that CHE Trinity was one of the largest home care providers in the United States and that their healthcare organization encompassed 86 hospitals and 21,600 physicians.  More importantly, CHE Trinity was participating in 6 bundled payment programs and 29 patient centered medical home programs.  His observation that “All Healthcare is Local, All Healthcare Standards are National” comes from an understanding of the need for clinically integrated networks and the role of data driven decision making in reducing variations in outcomes.  Terry noted that despite hard work on adopting standards that there is still a wide variation in healthcare delivery.  He also noted that the lesser but still significant variation in outcomes across a large healthcare organization was more proof of the resiliency of human body than the careful adoption of standardized procedures.

The key to his presentation was the observation that clinicians need to lead the effort to standardize care, not hospital administrations or others.  CHE Trinity created a unified clinical organization with the help of outside consultants that streamlined many silos within the large organization into a whole unit.  As a result of unifying the clinical organization, Dr.  O’Rourke noted that operating cash flow margins improved to 9.4 – 9.6% across the system.  The second step beyond unification was to improve their reporting to encourage data driven decision-making.  It was interesting to see how the metrics were converted into grades, like school grades, for easy consumption and judging performance.   The different Terry O'Rourke Presentationhospital boards had GPAs ranging from a low of 2.1 to a high of 3.6 on a 4 point scale.  The goal of the data-driven decision support process was to improve the ease of consuming and acting on the information.

To summarize, Dr. O’Rourke said that “good care is cost effective care.”  Clearly, CHE Trinity is focused on bringing a level of consistency in clinical procedures in population health management and improving cash flow margins in the process.  As with most organizational business solutions, the focus on people and process yields the best results with technology playing a supporting role was my observation.  The focus on people, patients, as the central figure in their clinical processes is real population health management.

How ProHealth is Innovating Population Health Management Webinar

The process of effectively managing population health while consistently measuring and reporting its outcomes can be a challenge for healthcare providers.

How ProHealth Care is Innovating Population Health ManagementWe will be having a conversation with Christine Bessler, CIO and VP of Information Technology at ProHealth Care and Juliet Silver, Director of Healthcare Advisory Services at Perficient on Wednesday, March 26. We will be discussing some of these issues as well as how ProHealth Care was the first healthcare system to produce reports and data out of Epic’s Cogito data warehouse in a production environment.

During the session, Christine will be answering the following questions:

  • How did they deliver clinically integrated insights to 460 physicians
  • How access to analytics allows their physicians to easily see which patients need important health screenings or care interventions, setting the stage for enhanced preventive care and better management of chronic diseases.
  • How ProHealth Care’ developed their strategy to integrate data from Epic with information from other EMRs and data sources to deliver clinically integrated BI
  • How ProHealth Care is positioning itself to deliver against an advanced self-service BI capability in the future.

Juliet will share insight into the methodology applied to establish data governance as a discipline at ProHealth Care, and how the Business Intelligence Competency Center came to be.

Christine Bessler will answer these questions and more during our free webinar on March 26th at 1:00pm CT.

To register for the webinar click here.

 

The Social Support Group Coming to a Provider Near You

What are the benefits of online patient communities?

I find myself answering this question quite a bit lately.  It struck me this week that I have never answered this question on the blog.  But, first things first, what is an online patient community?  Online patient communities are, essentially, condition specific socially enabled support groups.  These networks provide patients with an opportunity to connect with those that are experiencing similar challenges.  Together this collective of voices provides helpful discussion and the sharing of resources.  By their very nature, their benefits are many.  However, when they are organized by a trusted authority in care, namely healthcare providers, the benefits grow quite dramatically.

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So, here is my list of the benefits of online patient communities.  Have any more to share?  I’d love to hear more from your experiences in the comments section below.

  • Social provides connections to those that are not mobile.  Let’s just be honest, appointment scheduling conflicts and transportation difficulties are typically a part of the patient experience.  It is oftentimes the case that patients and patients-by-proxy (caregivers) cannot physically attend a support group.  Any opportunity to lift barriers during the course of treatment is a welcomed reprieve from everyday turmoil.
  • Patients-by-proxy are more likely to open up.   According to Pew research, while 33% of patients participate in online patient communities, more than half of patients-by-proxy do so.    In that same survey, 34% of these caregivers actively read patient commentary about a specific medical issue online and 22% of those caregivers actively reach out to those that might have similar concerns.
  • Online patient communities provide support without bounds. Social networks are used, quite frequently, by the retail and consumer goods industries for consumer outreach purposes.  I don’t know of a loyalty program  stronger than one that could be used to save lives.     Social communities are a fabric of ties that lead to sources of support, information, and collective experience.  The goal of these communities is to foster communication between those without knowledge and experience to those that can “mentor” and provide support.  More informed patients are healthier patients.  Some of the tangential benefits of this enablement include: 1) Better understanding of health and medical conditions, 2) Improved recall of the care plan, 3) Feeling more in control of care, 4) Taking better care of themselves, and 5) Better adherence to medications as prescribed.

There are some additional benefits for the healthcare provider as well:

  • Better sample groups mean better research.  For those researchers aimed at helping through analysis, online patient community demographics are actually a more accurate representative sample of a given patient population than can be found in a traditional support group.  There are two studies that back this claim up.   One study looked at an online patient community specific to scoliosis.  Researchers found that the members of this community had similar demographics to the scoliosis population as a whole.   Another insight is taken from the fibromyalgia group on PatientsLikeMe that showed this group to be representative of those with that condition at large.  Why is this?  Breaking down geographic boundaries is a great way to also break down the socioeconomic and cultural chasms that often exist in traditional groups.
  • Time efficiencies in group care. Check out any online patient community and just underneath the surface you will find the voice of the members mentioning that they were unable to get the medical information they needed from their clinician.  So, these patients often turn to Dr. Google.  Using these communities, clinicians can provide accurate information is a mass customized format to an entire community of similar patients.  This is particularly helpful in those instances when new information or alerts need to be provided to the entire population at one time
  • Strengthens the partnership between patient and provider.  Let’s just be honest, a typical physician schedule does not often leave time for participating in support groups.  With a provider sponsored online patient community, a clinician, in the form of the community manager, is on call 24/7.  Provider sponsored clinicians that act as patient advocates to address general and condition specific questions to the entire community are a valuable asset.  Many clinicians are surprised at how different the questions patients will ask in online patient communities are from those they will ask in the doctor’s office.  For example, migraine patients will often ask Dr. Google “will I die from this?” while physicians rarely if ever hear that question in the office.
  • Social synchronization with care protocols.  When these social features are enabled through the patient portal, patients become truly enabled with knowledge.  There, within a single view, patients can take their new found knowledge and then apply that knowledge to their care protocols.  This experience can be taken a step further through gamifying that experience.  For more information, please check out “Healthcare Gamification: Is it time for Physicians to prescribe gaming to patients?” and “Beyond Gamification: Revolutionizing Healthcare with the Quanitifed Self“.

Getting Scientific About Healthcare Social Media: Medicinal Sites

© elkor 2009The journey into the (officially scientific) exploration of healthcare social media would not be complete without a look into the realm of healthcare specific networking sites that I’ll playfully call “medicinal sites.”  These are closed sites that are aimed exclusively for those with either a certain designation or disease state.

In today’s lineup, we will explore two specific sites.  One of these sites is meant for physicians and the other is meant for patients.

Doximity

Although Doximity was not mentioned in the University of British of Columbia study that spawned this blog series, I am going to start here for good reason.  Although they are a relative newcomer to the space,  Doximity has experienced very strong growth.  Last year Doximity doubled their network to a total of 250,000 members, which is 25% of all physicians in the US.  What I find fascinating about Doximity is that it was started by the AMA.  It’s oftentimes the case that, in the David vs. Goliath world of social media, hip start ups are the ones that people want to follow.  The AMA now finds themselves in a situation where they have more users of their social network than they do actual members.

Doximity does a few things right.  It’s most popular features, beyond making upgrades that make the user interface more like Facebook or LinkedIn, include:

  • An API that enables “Facebook Connect” for easy authentication
  • A built in recruiting tool called Talent Finder
  • A continuing medical education (CME) platform
  • A “digital fax line” that allows physicians to receive their faxes (I know…don’t get me started) through their network via a personal fax number

PatientsLikeMe

PatientsLikeMe is a site where e-patients can collaborate with one another in a peer-to-peer supportive setting.  The site was launched in 2004 by the family members of an architect that contracted amyotrophic lateral sclerosis (ALS) at the age of 29.  They had originally raised millions, literally, in a failed attempt to find a cure for ALS.  They also created this patient social network to go along with that effort.

PatientsLikeMe now has over 200,000 members with groups for approximately 1,800 disease states. The most popular networks are neurological diseases such as ALS, multiple sclerosis and Parkinson’s, but there has been growth in members with HIV/AIDs and mood disorders like anxiety and depression.  Cancer, with its numerous subtypes, has been a more challenging group to tackle.  I have found that these subtypes often form their own online patient communities.  You can find a list of these on e-Patient Dave’s website, which I definitely recommend you visit if you want to learn more about how patients are using social in life altering ways.

One of the most incredible things about PatientsLikeMe is not as obvious.  Let’s consider a typical patient journey: we get sick, we go to the doctor, the doctor captures data during that visit including family history, bloodwork, scans, biopsies, etc.  Then there is the follow up appointment.  Perhaps a follow up call by a nurse.  But as I often say, that’s only 1% of the story.  It is the other 99% of the time when that patient is out there in the real world that matters a lot.  So, where do we get all of that data that takes place during the “meantime”.   PatientsLikeMe is often heralded as the producer of the most compelling clinical data the health care industry has ever seen for this reason.

As compelling as this data may be, it’s only a speck of sand on the beach.  There is far better data capture to be had by socially integrating patient and physician in a meaningful way.  This takes me back.  Way back.  To a post I actually wrote in 2011.  What I said then will be where I end here today:

“Patients are online.  Physicians are online.  However, these two groups are running in different social circles…this presents a true medical problem.”

What will it take to decrease nursing home readmissions? #HIMSS14

HIE, clinical data, quality measures, financial and claims data along with healthcare analytics – what does it take to decrease readmission rates in nursing homes?

There is so much attention these days on making the most of all of the clinical and financial data regarding healthcare, hospital readmission costs and reimbursement, but do we really know what changes can or will make a difference?

It has been a long time since I have done bedside nursing, but I can remember how often I would have one or more patients assigned to me who had come from a skilled nursing facility, long-term care facility or “nursing home.”

home_care_nursingThe American Health Care Association (AHCA), the largest association representing skilled nursing care centers in the country, reports that every year, nearly 2 million Medicare beneficiaries are readmitted to the hospital within 30 days of being discharged, at a cost of $17.5 billion. Of readmissions, one fourth are skilled nursing care patients, receiving post-acute care (recuperative or rehabilitative services).

According to the recent Office of Inspector General (OIG), Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring report, in Fiscal Year 2011, one quarter (24.8%) of Medicare residents in nursing homes were transferred to hospitals for inpatient admissions, at a cost of $14.3 billion for the hospitalizations. The hospitalizations were required for a wide range of conditions with septicemia the most common. While the majority (67.8%) were transferred to hospitals only once, 20% transferred two times, 7.2% transferred three times, and the remaining 5% transferred four or more times. Of the Medicare costs for hospitalizations in FY2011, care for a nursing home resident cost an average of $11,255 per hospitalization, which is 33.2% higher than the average Medicare hospitalization ($8,447). Read the rest of this post »

Getting Scientific About Healthcare Social Media: Social Networks

shutterstock_126905108Thus far we have covered both blogs and microblogs as we walk through the official scientific study that was completed by the University of British Columbia on the uses of social media in medicine and healthcare.  Today we move into the wide world of social networks.  Ask ten people in the know to define what a social network actually is, and you will get as many answers.  The study provides a legitimate definition as follows:

Social networking sites are defined as Web-browser and smartphone accessible services that allow users to create social connections in a public or semi-public form (through the use of profiles) in order to share information updates with other site users.

Today we will focus on a current leader in social networks:

Facebook

Here are some fancy facts on some pretty neat uses of social networking sites in the practice of medicine and healthcare:

  • Researchers found that most common type of groups on Facebook were peer-to-peer networks centered on specific medical conditions These groups fall into four broad categories including:  1) fundraising, 2) awareness, 3) marketing, an 4) general support
  • Researchers often join these groups as a means of disseminating information.
  • With the good come the bad.  While there are plentiful examples of epatients using online patient communities to support one another through illness, there are also a select few that self-aggregate in “negative-behavior support groups”, which are typically focused on the promotion of alcohol consumption.
  • Here’s an idea I’d love to import.  In Taiwan a well-known emergency physician blogger created a public group on the topic of improving patient wait times in the ER. The group went viral in less than a month.  A majority of emergency department staff from around Taiwan joined the group and commented.  The group got so much attention that the Minister of Health and his staff joined the group and commented directly.  As a result, the minister began making visits to ERs in ten different cities with a promise to improve funding to reduce wait times in collaboration with the Taiwanese Bureau of National Health Insurance.

One of the great features of social networks like Facebook, which have yet to be used much in healthcare are third-party applications.  Here we integrate application programming interfaces (APIs) into Facebook.  This allows outside software and data to be visualized and tied directly to the social network.  Candy Crush is likely the most popular third-party application at this time if I had to wager.  We have a long way to go until health apps are actually helpful in Facebook.  In fact, less than 30% of listed applications in the health category are real.  The rest are spam.  Of the ones that do exist, many focus on weight loss, smoking cessation, fundraising, and health education on specific conditions.  From what I can tell those are dwindling.  In fact, of the three mentioned in the study, only one still exists.

  • Get Up and Move: (no longer exists) allows users to challenge their friends to engage in physical activity and report on it after they have completed it
  • START: (no longer exists) Brought to you by the American Heart Association, this app allows users to answer questionnaires on the topic of cardiovascular health and upload the data to a health portal
  • HealthSeeker: this is a diabetes app that provides health education and the ability to win points as an incentive

In an attempt to reach as many people as possible all at once, social networks are no longer the “up and coming” medium.  They are the “here and now”.  There are many ways that Facebook is being used in medicine and healthcare, and there are still much open opportunity.

 

The Importance of Marketing in Healthcare – #HIMSS14

Joan Rothman, Director at Perficient, recently wrote a blog post about the new landscape of healthcare marketing:

You see the commercials on TV, the alluring websites, digital advertising in airports, on billboards, on the radio, in magazines, everywhere. Let’s face it, the war for patients in healthcare is in full swing. Whether you are a hospital, a physician, a pharmaceutical company or any combination thereof, you are now operating in a highly competitive environment. Frankly, it was inevitable.

The shift from company to consumer is happening everywhere, and healthcare is no exception. To read Joan’s full blog post, click here.

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Getting Scientific About Healthcare Social Media: Microblogs

hashtag3-ccIn this blog series, we are highlighting the social media categories presented in “Social Media: A Review and Tutorial of Applications in  Medicine and Health Care.”  This was a study conducted by the University of British Columbia, which offers an extensive digest of the vast uses of social in medicine and healthcare.  Today we’re going to talk about the emergence of Twitter as an important communication medium in this industry.

The study correctly titles Twitter as a “microblog.”  With microblogs, we take many of the same concepts found in my previous post about blogging, namely community and collaboration, and we widdle them down to 140 characters or less.  Twitter is that place where communities of people that are interested in a similar topic, be that interoperability or Oscar night, digest a lot of information quickly together.  I rely on Twitter heavily to keep me up to date on everything related to #hitsm (health it), #hcsm (healthcare social media), #mhealth (mobile health) and #connectedhealth (I’m sure you’ve got that one without need of assistance).

The study gets extra points for classifying three broad categories of tweeting styles:

  • Substantive Tweets: a tweet that is independently understandable (e.g.,  title of a paper or blog, a brief comment, and a link to the publication)
  • Conversational Tweets: fragments of a new or ongoing conversation that draw on professional or personal interests or comment on current events. (e.g., there is no greater example of this than the Twitter discussion at HIMSS (#HIMSS14)
  • Hybrid Tweets: substantive and conversational at the same time (e.g., “let’s discuss patient engagement tonight at Sidewinder Coffee”)

According to the study, there have been over 140 documented uses of Twitter.  I’ve not met the person that is actually documenting these uses, but some favorite examples include:

  • The Pennsylvania State College of Medicine has used Twitter to augment peer-to-peer and instructor-to-student learning by stimulating topic discussions, providing feedback on critical thinking, conducting course evaluations, disseminating writing prompts, soliciting class responses, and monitoring student progress.
  • A junior doctor and a medical student started a Twitter Journal Club that functions in the same manner as traditional journal clubs, except that the means for discussion is Twitter. By using a combination of blog posts, where the paper and discussion questions are posted in advance, along with the hashtag #TwitJC, students, doctors, and anyone interested in the subject can engage and interact in a meaningful way.
  • Live tweeting surgeries and medical procedures.  Henry Ford Medical Center was the first to live tweet a surgery back in 2009.  Swedish Medical Center in Seattle has used this tactic very successfully.  One notable example was an overnight tweet up they did on sleep disorders.  Those impacted by sleep problems were able to watch what happens during a sleep study.

As mentioned above, the use of Twitter at conferences is powerful. Not the least of these examples is taking place this week in Orlando at the HIMSS conference.  At these conferences, Twitter is used to enhance learning through real-time interaction.  See for yourself by following the #HIMSS14 thread.

Analyzing the healthcare industry tipping point using Therbligs

Do you remember therbligs from your Operations Management class? 

The word therblig was the creation of Frank Bunker Gilbreth and Lillian Moller Gilbreth, American industrial psychologists who invented the field of time and motion study. It is a reversal of the name Gilbreth, with ‘th’ transposed. Therbligs are 18 kinds of elemental motions used in the study of motion economy in the workplace. A workplace task is analyzed by recording each of the therblig units for a process, with the results used for optimization of manual labor by eliminating unneeded movements. (Wikipedia)

shutterstock_128890124I remember, and it was a lifetime ago.  But then again, the Gilbreth’s were turn-of-the-century industrial psychologists who invented the field of time and motion study.  I consider them the founding parents of Industrial Engineering.

So why are we talking about therbligs in Healthcare?

Ah, young Jedi, the time has come to learn our lessons much the same way that the industrial giants like Ford, Carnegie Steel and General Electric learned 100 years ago during Teddy Roosevelt’s administration.  These early lessons became the standards of the mid-century boom in manufacturing and production output.

So the healthcare technology space has finally gotten to its tipping point.  In order to survive, the healthcare industry will need to invest in Industrial Engineering principles and it will need to do product line, service line, episodic, acute and outpatient time and motion studies.

Read the rest of this post »