by February 24th, 2014
I’ve waited 20 years for my Treasure Map. Yes, a map with hidden passages, remote islands and an “X” to mark the spot. As kids, some of us hunted in our yards looking for buried treasures. Kids today use smart phone apps for activities like “Geocaching” to explore public and urban spaces. What do we use in Healthcare?
Many of us desire a chest full of clinical outcomes, protocol conformity, activity based costing, provider scorecard, genomic studies, Pharmacogenomic markers, Adverse Event analysis, and coordination of care analytics.
But lately, we have been lost – adrift at sea, hopping from one raft to another, and from one stranded island to the next more barren island. We’ve bought point solutions that offered the holy grail for a niche activity, all while knowing the vendor or the quick fix would evaporate before we had achieved broad-based adoption.
Oh, I’ve been there – tasked with implementing the pet project for a clinical director or department chair. I’ve no sooner got the data in and one cycle of analysis out, than the provider champion would change their focus and the solution implemented didn’t transfer to the next project. (Sigh.) Read the rest of this post »
by February 20th, 2014
Once upon a time last year, in a town not too far from you, there was a big hospital where a bright, young physician was providing care to a sick, old patient. Okay, let me save you some time. This fairytale, unlike those you are used to, doesn’t end simply by having Prince Charming (the physician) swoop in and save the beautiful, damsel in distress (patient). This fairytale has a bit of twist that changes the standard storyline. This twist is referred to as Patient Engagement.
Changing of the Patient-Provider Fairytale
The concept of patient engagement has changed the way providers tell their patient stories. It is no longer, once upon a time, a patient was sick, the physician cured him/her, the end.
The fairytale now reads more like this…
- Patient came in.
- Physician introduces him or her to supporting characters (care team).
- The patient and physician discuss the plot (disease state) with alternative endings (treatment options).
- They co-write the script (care plan), including ideas for props (patient education, care communities, etc.) that will enhance the story.
- The physician quickly publishes (uploads to portal) the manuscript and associated material for review and follow-up (provides email, direct scheduling option, mobile alerts, etc.).
- And instead of “the end”, it is more like, “to be continued…”
Patient engagement is not a new concept, just one that has been brought to the forefront as part of the healthcare industry’s increased efforts around coordinated care. Read the rest of this post »
by February 19th, 2014
Today, a report by market research consulting firm RNCOS released findings that predict the healthcare technology market will grow at a compound annual growth rate of about 10 percent between now and 2018.
About one-third of healthcare organizations now use cloud technology.
According to Fierce Health IT:
Continued innovation and government suppport for such tools will factor into the market’s success, according to the report’s authors. The report examines five trends, including an increase in:
- Wireless and cloud technology
- Government initiatives
- Strategic consolidations
- Reduced operating expenses
- “Technological upgradation”
The cloud offers the advantages of:
- Quickly scalable on-demand infrastructure and storage, which clinics, hospitals and provider offices require.
- Accessibility to healthcare data across multiple settings and geographies, creating a unique opportunity to better serve the patient by sharing information more easily than ever before, and improving operational efficiencies.
- Vendor technological expertise to support the cloud model.
What about compliance, security, and privacy?
Healthcare organizations must comply with complex medical coding and billing rules, along with HIPAA (Health Insurance Portability and Accountability Act) privacy and security regulations. Healthcare data, including Protected Health Information (PHI), must be kept secure, confidential, available only to authorized users, traceable, reversible and preserved for long periods of time. The right cloud solution for a provider must account for all of these concerns while conforming to HIPAA and Meaningful Use requirements.
Read the rest of this post »
by February 12th, 2014
What’s transforming the ways in which healthcare is provided?
- new competition
- innovative incentives
- a call to refocus on priorities
- a more empowered and digitally engaged consumer, who has more and greater expectations for quality of care and convenience of care.
- a renewed attention on healthcare by the consumer market thanks to ongoing press about healthcare.gov and the Affordable Care Act
- new services and business models in healthcare that we’d never seen before recent reform
…and much more.
Susan DeVore, CEO of our partner and client Premier healthcare alliance, wrote a post yesterday fro HealthAffairs.gov titled, “The Changing Health Care World: Trends To Watch In 2014.” In the article, she introduces the new trends she expects to see in healthcare this year. We are also seeing each of these trends impact conversations about investments our clients need to make this year and next year.
I have summarized the trends below.
1. Investments in Chronic Care -
- Chronic conditions increase costs by 3X, so, ”The biggest health care consumers are those with multiple chronic conditions.”
- We should see more investments in Ambulatory ICUs and patient-centered medical homes as providers work to improve their shared savings payments and better manage chronic conditions within primary care facilities.
2. New Job Roles in Healthcare
- DeVore has seen an increase in the popularity of hiring “health coaches” who are there to listen, inspire and motivate and spend time getting to know the patient’s family and life situation as it affects their ability to both access care and to care for themselves.
3. Home Health Care
- Back to the days of the house call.
- “Marketing firm BCC Research predicts that the market for remote monitoring and telemedicine applications will double from $11.6 billion in 2011 to about $27.3 billion in 2016.”
- Technology is increasing access and convenience of healthcare from outside the traditional care setting, especially for rural, hard-to-access locations.
Read the rest of this post »
by February 11th, 2014
I just finished watching a quick slideshow on the Health Data Management website, “Enterprise Analytics: Moving on Up” and as luck would have it, I also watched several sessions of the live Webcast from the Healthcare Innovation Day Conference 2014 in Washington, DC, sponsored by West Health Institute and the Office of the National Coordinator for Health Information Technology (ONC).
While I was watching these, I was intrigued by the thought of how Accountable Care Organizations (ACO) can leverage existing solutions, combined with point solutions, to accomplish their reporting, analytics and beyond, and use interoperability wisely. One of the key learning points for me from these sessions was this: “Reframe the problem”….advice from Malcolm Gladwell’s keynote address.
How do we “reframe the problem” when it comes to ACO reporting and analytics? There are defined metrics that are required for these organizations, so how can we leverage existing systems to create these reports and analytics? Do we “build vs. buy”? Depending upon the organizational size, legacy systems and IT support, the decision can be difficult. What is good for one system may not work in another. So where do we start?
A strategic evaluation of current state and desired future state with the development of a road map may be a logical first step. Data Governance also needs to happen early on in the process to allow an organization to create data standards that will drive reporting and analytics. Once these steps have occurred, an organization can feel confident that they can make an informed decision to “build or buy.”
Read the rest of this post »
by February 6th, 2014
Recently our company has increased our focus on what healthcare organizations are looking for when it comes to cloud computing, in large part due to our acquisition last year of two fantastic Salesforce partners (ClearTask and CoreMatrix). I found this article in Healthcare Informatics to be very interesting. It’s titled “The Many Flavors of the Cloud” and includes interviews with some key CIOs regarding how they view private vs. public cloud solutions and the sensitivity – and often the mandated security requirements – around health data when stored in the cloud.
There are some obvious advantages to providers moving to private cloud storage for all types of data across the organization, but also some critical considerations for any CIO or CMIO. Here are the key takeaways I got from this article.
Medical imaging takes up a lot of storage space in the healthcare space. Imagine a 24 hour study of your heart that takes up a terabyte of space. The cloud can enable better scale for this type of need.
Key insights about cloud computing in healthcare:
- CIOs interviewed prefer “private cloud” solutions over public cloud solutions like those of Google, Amazon and Microsoft – more control around access & rules
- CIOs don’t want to deal with power issues, cooling issues, and capitalizing hardware over time – 3 reasons they enjoy Cloud
- They enjoy reduced costs in scaling a storage room, servers, etc..
- CIOs take personal ownership over creating their own stringent security requirements for their cloud vendor, making them feel better about storing PHI or other sensitive healthcare data in it.
Read the rest of this post »
by January 29th, 2014
The healthcare industry continues to undergo dramatic change due to regulatory reform including Meaningful Use Stage 2, which stipulates requirements and feedback on what a patient portal should be. As a result, we see a challenging dynamic between patients, providers and payers.
An exceptional digital experience is one way to help each stakeholder get through the regulatory transition.
Our principal of portal and social solutions at Perficient, Mike Porter, says “The patient portal may be the most complicated portal one can build due to government regulations, physician requirements and patient needs.” Porter is presenting at IBM Connect 2014 this week. He says about IBM technologies, “Fortunately, the IBM toolset gives us the agility to get around the complications and create great experiences for customers.”
Perficient has developed best practices for implementing exceptional digital experiences for patient and member portals that include the core functions each healthcare organization must implement to succeed
- mobile access
- physician location information
Read the rest of this post »
by January 16th, 2014
A health insurance client of mine recently embarked on an initiative to truly have “trusted data” in its Enterprise Data Warehouse so that business leaders could make decisions based on accurate data. However, how can one truly know if your data is trustable?? In addition to having solid controls in place (e.g., unique indexes on the primary AND natural key), it is also necessary to measure how the data compares to defined quality rules. Without this measurement, trusted data is a hope – not an assured reality.
To enable this measurement, I designed a repository for storing
- configurable data quality rules,
- metadata about data structures to be measured,
- and the results of data quality measurements.
I experienced the need to be able to perform a degree of “inferencing” in the relational database (DB2) being used for this repository. Normally one thinks of inferencing as the domain of semantic modeling and semantic web technologies like RDF, OWL, SPARQL, Pellet, etc. – and these are indeed very powerful technologies that I have written about elsewhere. However, using semantic web technologies wasn’t a possibility for this system.
Read the rest of this post »
by January 8th, 2014
Today, Masachusetts moved into phase 2 of a very important Health Information Exchange (HIE) project. It’s called Mass HIway Health Information Exchange, and it was announced at Beth Israel Deaconess Medical Center, where Healthcare CIO, John D. Halamka works.
John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.
Halamka is one of my favorite people to follow in healthcare technology (@jhalamka). He blogs at “Life as a Healthcare CIO” and wrote about the news today in a post titled “The Next Phase of Healthcare Information Exchange.”
Halamka gives us a sense of all of the work that went into this next stage of the project, including:
- a patient index to track which patients have opted into exchanging their patient data with other providers
- a portal for providers to log in and access the data
- an EMR request system to support the request & release workflow
- a system to keep audit trails of all of the activity
For those who are fans of a “No More Clipboards” type of future in their own patient care experience, news like this is very exciting. Halamka talks about how this massive project taking place in Massachusetts is an example of how the future of healthcare information exchange can be convenient, secure, and lead to better care and health outcomes for us all.
“I can imagine a day in the next few years, when all patients in the Commonwealth, with their consent, benefit from secure, coordinated care. My mother suffered a major medical error in California because of inaccessible primary care records. I truly believe that my 20 year old daughter, attending Tufts University, will see significant reduction in preventable harm in Massachusetts during her 20′s.”
That’s very inspiring.
by December 12th, 2013
I enjoyed an article today in IT Business Edge about the ways that Big Data is improving outcomes. We hear that all the time, right? But what does it really mean? Why does more (and better) patient data lead to improved healthcare for all? When business intelligence is leveraged properly to deliver insights to healthcare providers, we see the following:
- Learning what we never knew before:
“Allowing for previously unknown factors involved in disease to be discovered and utilized as drug targets or disease biomarkers.”
- Comparing data points from various sources to individualize treatment plans, improving outcomes.
“We are able to align and compare multiple data points from various sources, tailoring individualized treatment plans for each patient.”
- A move from subjective interpretation to objective diagnosis.A coworker of mine said to me yesterday, “Can you imagine when our kids are older? They’ll be laughing at our stories of how doctors once said to us, ‘Based on your symptoms, I think you have [X disease].’”
She’s right. Diagnoses vary from physician to physician based on his or her background and experience. Not any more! As this article states, we’re facing a “datafication” of patient samples.
“A vast quantity of knowledge that can be statistically analyzed and quickly reviewed by multiple clinicians for solid diagnosis”
- Better – and faster – decisions about treatment as a result of more and better patient data
“Clinicians can systematically extract more information from each patient without requiring multiple rounds of testing.”
- More accurate diagnosis and more appropriate spending on treatments due to reproducible testing”Consistently reproducible test results are possible between clinicians and doctors for more accurate diagnosis and appropriate spending on therapy options.”
by December 11th, 2013
You’ve heard of wearables in healthcare technology, but have you considered swallowables? Swallowing a piece of electronics is something that people are actually willing to try.
- Wrist monitors that can monitor things like respiration, blood pressure, heart rate and more, without a cuff – you’ve seen these in Nike Fuel Band and the FitBit Flex, among others.
- Toilet sensors – you read that correctly.
- Prescription bottle sensors
- Blood pressure cuffs
- The swallowable sensor
- and more
More than 80% of those surveyed said they were willing to share “de-identified data” to help further science and cures, so security of information is as important as ever.
by December 10th, 2013
I was recently a panelist for a Dataversity webinar/discussion focused on the future of data modeling tools, functionality, and practice. Given the holiday season, the panelists discussed their wish list for modeling tools – from currently practical (but maybe not economically viable) to futuristic (e.g., using a 3D printer to print models for model reviews, using Google Glass to move objects around on the model).
Of course, many modeling tools already support a vast array of functionality and sometimes can be difficult to use some of the non-core functionality without experiencing some unintended consequences, and so more intelligent guides and better semantics in the modeling tool will make these easier to use – so modelers can focus more on modeling and less on the technology.
More important than the technology – as important and interesting as that is – is having solid processes and modeling standards in place to ensure better model quality, reuse, and understandability.