Healthcare & Technology

Welcome!

Welcome to the Healthcare & Technology blog. After 17 years in technology, including various leadership roles, and now as a Registered Nurse, I turn my attention to the use of technology within the healthcare industry.

Healthcare is, and remains, one of the most pressing challenges facing our nation (and the world) in the 21st century. Almost any discussion related to improving healthcare, whether it implicates reducing costs or improving patient safety and satisfaction, usually has technology as a core component.

Technology, in and of itself, will not solve the problem, but used appropriately will contribute to the transformation of healthcare, as it has in many other industries.

 

Healthcare Analytics: Mining Electronic Records Part 2

Part 2 touches on the hidden costs of Healthcare Information Technology (HIT) and drivers for improving quality of patient care.

Go to Part 1

The largest investment in Healthcare technology goes beyond installation and to the training and use of these systems. Training is often a hidden cost which impacts perspective on Total Cost of Ownership that may, in fact, be one of the largest costs.

Keep in mind that from a clinical perspective, one of the most important benefits of HIT is to reduce inefficiencies and improve the quality of care. So, there are some costs savings to be realized when the technology is used accurately.

Improving the quality of patient care is a major goal for healthcare, across all disciplines, driven by the National Quality Strategy (among others) for adoption of quality and compliance measures to monitor quality of care. Compliance with these aims can be monitored in the aggregate or at a patient level in most CDS systems.

The National Quality Strategy is driving change in healthcare to improve quality. The 3 aims of the National Quality Strategy are:

Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.

Healthy People and Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.

Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.

But a new twist on the value of Clinical Data available for "mining" and "drilling" are "databases of clinical information" that can be used for medical research.

Given this opportunity, some costs associated with traditional Clinical Trials may be mitigated by using information obtained from an EMR and Clinical Decision Support system (CDS).

Using this technology, data can be massaged and analyzed in a manner that provides retrospective views of medical data for research.  These technologies become enablers for Medical Research and Clinical Decision Support Analysis.

Healthcare Analytics: Mining Electronic Records Part 1

Link: Mining Clinical Data

Optimistic predictions by RAND Corporation in 2005 encouraged adoption of electronic medical records (EMRs) and encouraged the federal government to "give billions of dollars in financial incentives to hospitals and doctors that put the systems in place." Does HITECH Meaningful Use come to mind?

Interestingly, RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, who profited from widespread report dissimenation describing the value of technology. It is no surprise that "Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005."

"The 2005 report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. However, the study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems (EMR)."

No doubt the savings was overstated and the report (sponsored and paid for by those who could benefit) causes healthy scepticism in its results. Other reasons cited for increased costs in the report include:

• "Sluggish adoption of health IT systems, coupled with the choice of systems that are neither interoperable nor easy to use; and
• The failure of health care providers and institutions to reengineer care processes to reap the full benefits of health IT."

Although I agree there has been sluggish adoption, I disagree that we MUST reengineer care processes to reap the benefits.

EMR systems should be flexible enough to adapt to the workflow of users - even if minimal changes to the workflow are necessary. The ability to analyze the system and compare features to the clinical workflow (for example) will result in less risky patient care. Re-engineering the entire clinical workflow to adapt to the system is permeated with risk and could be a potential source for unintended patient harm. This is the "Geek Nurse" in me talking now..

 Thoughts?

Go to Part 2

Healthcare Analytics: Big Data - the next new thing in HIT

Coming from HealthIT News Week, a report on anticipated future developments for "Big Data" and clinical decision support.

Link: http://www.healthcareitnews.com/news/6-keys-future-analytics-and-big-data-healthcare?single-page=true

Excerpt:

"A recently released report by Ewing Marion Kauffman Foundation proves the value of big data is certainly something to take seriously. And as more organizations create plans to make better use of and leverage their big data, Joe Petro, senior vice president of healthcare research and development at Nuance Communications, believes the industry is on the brink of seeing some pretty remarkable things as a result."

Link to article above.

Happy New Year! Hoping 2013 brings us to higher ground..

"This past September, thousands of people in 52 countries came together to participate in the second annual Playing For Change Day. Musicians and artists, performers and fans, and people from all walks of life created a global vibration and changed the world through music." http://playingforchange.org/

Best regards to you and your loved ones for a better 2013 that takes us to higher ground!

Healthcare Analytics: Healthcare or Disease Management?

Watched CSPAN tonight and came across this documentary.. a must see..

The Washington Post reported "

Hot topic gets a human touch
By Ann Hornaday
Friday, October 5, 2012

“We don’t have a health-care system, we have a disease care system.”

“Americans pay for the world’s most expensive medical care, and some of the world’s worst outcomes.”

“I’m sick and tired of being sick and tired.”

Those laments form the disheartening takeaway from “Escape Fire: The Fight to Rescue American Healthcare,” Matthew Heineman and Susan Froemke’s sobering, often infuriating documentary about medical care in 21st-century America."

 

Healthcare Analytics: Wired Magazine on Healthcare Costs

Wow, never thought I would see the day that an IT Periodical would speak to the costs of healthcare... 

According to Mike Miliard, Managing Editor of Wired Magazine, he spoke about a presentation by Andy Grove, former Chairman and CEO of Intel corporation, speaking via Skype at the first annual "WIRED Health Conference: Living By Numbers," issued a call to arms to free healthcare data, making his case for radical price transparency in medicine.

This call to "Free the Data" was also a major theme at the HealthDataPalooza in DC earlier this year. Why the call to free health data? "The industry, "plays a gigantic game of Blind Man’s Bluff, keeping patients in the dark while asking them to make life-and-death decisions. The odds that they will make the best choice are negligible and largely depend on chance. Patients need to have data, including costs and their own medical histories, liberated and made freely available for thorough analysis."

Making the data public is not a new concept. On CMS's website, you will find a variety of "Compare Initiatives" that are intended to inform the public with quality data about caregivers, physicians, hospitals and other healthcare agencies. A part of the National Quality Strategy is to inform the consumer with quality data to enable informed choices about their health care.

 

IOM Presents 2012 Lienhard Award to Donald M. Berwick

Donald Berwick, Champion of Health Care Quality Improvement, receives Institute of Medicine's 2012 Lienhard Award.

Dr. Berwick helped establish the Institute for Healthcare Improvement (IHI) where patient safety and health care quality remained at the forefront of the organization's efforts to improve quality of care. Some say his work was also a catalyst for a national movement to improve the quality of health care in the U.S.

Since the arrival of "HITECH" in 2010, health care providers, covered entities, and EHR/EMR software vendors have each experienced massive changes in their respective areas. Providers have accepted and adopted measures of quality and reporting that reflect patient care needs. Covered entities continue to aspire and achieve high quality performance measures. ..And both are seeking payment incentives for achieving quality measures reflected by Meaningful Use.

Notice in the graph below, initially introduced in 2009, the trajectory beginning with Data Capture and Sharing in 2009, achieving Advanced Clinical Processes by 2011 and Improved Outcomes by 2015. Regardless of subsequent delays along this timeline, change has affected healthcare professionals, vendors and patients. 

Measuring quality has now spanned across healthcare segments, from primary care, to acute care, and now 2013 CMS Quality Measures for Hospice.

It's a new day for healthcare... considering what will come next.....

 

Healthcare Analytics: How Healthy is your County?

Link: 2012 County Health Rankings Highlight Healthiest, Least Healthy Counties in Every State

More than 3,000 counties and the District of Columbia can compare how healthy their residents are and how long they live with the 2012 County Health Rankings.

The Rankings are an annual check-up that highlights the healthiest and least healthy counties in every state, based on key factors that influence health such as education rates, income levels, and access to healthy foods and medical care. Now in their third year, the Rankings are increasingly being used by community leaders to help them identify challenges and take action in a variety of ways to improve residents’ health.

Gratitude for the Day

Recently I began a new journey of healthcare innovation with a hospice and home health EMR vendor, Suncoast Solutions. I have known many of their professionals for several years and I have always thought they evoked ethics of respect, caring, and desire to do the best they can, each day. 

Today I came across this video which I had seen some time ago, but which has new meaning for my new journey. Hospice and End of Life Care is often a difficult and heartfelt journey for caretakers, clinicians, chaplains, aides and all who work to make each day count for the patients for whom they provide care.

This video is entitled A Moving Art original short.  "This inspirational video was well responded at TED conferences and filmmaker Louie Schwartzberg motivates those around him as happiness is revealed. Spoken word and music montage created and composed by Gary Malkin. Narration written and spoken by Brother David Steindl-Rast."

From epatients.net ... Regina Holliday’s testimony at NCVHS

Link: Regina Holliday’s testimony at NCVHS

Thanks to E-Patient Dave deBronkart for this recent post about Regina Holliday's testimony at the National Committee on Vital & Health Statistics. He wrote, "who else can weave data, HCAHPS scores, paintings and *Shakespeare* into a compelling message?? I bow."

Measure For Measure