Guest post by Joel Rydbeck, director, healthcare technology and strategy, Infor.
Healthcare is undergoing rapid “digitization” – a move toward an integrated ecosystem of mobile applications and data exchange that integrate consumer data into the enterprise. For healthcare, this could enhance patient engagement and enable care to become more efficient and “real time”.
Nonetheless, moving to a more digital healthcare enterprise presents a series of challenges:
How will the data be transmitted and is it semantically interoperable?
Where and how much should be persisted?
How can the data be made “actionable” for the clinician?
We’ve all visited a doctor and been asked “How are you sleeping?” and “Are you getting exercise?”. If you are among the growing number of people with a fitness tracker, you may think, “Hold on, I have that recorded”. So, you pull out your mobile phone and respond “I am getting six to seven hours of sleep a night and about 11,000 steps a day. Is that good?” While your doctor may understand your quick synopsis of the data, imagine if they were getting the data real-time. Would they know what to do with it? What if it contains disturbing trends? It would be unfortunate if crucial information wasn’t put to good use. But how?
Interactions like these prompted Washington University’s Olin School of Business and Infor Healthcare to collaborate on improving the usability of personal tracker data. This collaboration included conducting a small survey of 39 physicians from a broad spectrum of specialties asking their thoughts about the use of tracker data for clinical care.
The survey uncovered differing views on what information would actually be useful, showing:
56 percent thought active hours would be useful,
46 percent said miles walked or intensity of movement,
36 percent included steps taken as a useful metric,
and 10 percent the said the degree of upward incline during movement would be useful.
The survey also asked providers what factors would enhance their likelihood of using tracker data for patient care. Majority would like to see better integration with their electronic health record (EHR), more patients using the devices, and additional data, such as blood sugar, being collected.
Physicians reported lack of education as a barrier to effectively using the data. About 50 percent believed that education, in the form of a short presentation or discussion, would be useful while 31 percent thought that a short guide would suffice.
While two-thirds of providers were open to discussing personal trackers with their patients, they did express concerns in using the data for care. The data must be proven accurate before physicians will place trust in it. Inconsistent or inaccurate data could lead to unnecessary anxiety and possibly harm. Also noted is that extraneous data can clutter the EHR and complicate patient care. Many of the providers mentioning drawbacks to using device data stated that the devices might work best as motivational tools for patients. More study towards interpreting tracker data for clinical use is needed.
Health IT’s most pressing issues may be so prevalent that they can’t be contained to a single post, as is obvious here, the second installment in the series detailing some of the biggest IT issues. There are differing opinions as to what the most important issues are, but there are many clear and overwhelming problems for the sector. Data, security, interoperability and compliance are some of the more obvious, according to the following experts, but those are not all, as you likely know and we’ll continue to see.
Here, we continue to offer the perspective of some of healthcare’s insiders who offer their opinions on health IT’s greatest problems and where we should be spending a good deal, if not most, of our focus. If you’d like to read the first installment in the series, go here: Health IT’s Most Pressing Issues. Also, feel free to let us know if you agree with the following, or add what you think are some of the sector’s biggest boondoggles.
Michael Fimin, CEO and co-founder, Netwrix
The largest concern of any healthcare organization is protecting patient personal data. Every year healthcare entities of all sizes become victims of data leaks, fresh examples are both Anthem and Premera Blue Cross, and lose thousands of dollars mainly because of employee misbehave or human error. Being not an easy one to prevent, human factor sets IT pros a number of challenges to cope with:
1. Insider threat. Unfortunately, privilege abuse is a primary root cause for many data breaches. No matter if an employee is breaking bad or his credentials were stolen, sensitive data is put at risk. The only way to prevent insider threats is to have visibility into the IT infrastructure and be able to track any changes made to both security configurations and data. Monitor user activity and establish rigorous control over accounts with extended privileges. Regularly review all access rights to ensure that permissions are granted adequately to employees’ business needs.
2. Security of devices. In 2014 healthcare organizations suffered from physical theft or loss of electronic devices more than any other industry, said the Verizon 2014 DBIR. Without proper identity and authentication management personal data stored on these devices can be easily accessed by adversaries, leading to financial and reputational losses. If your employees’ laptop or tablets end up in the wrong hands, encryption, two-factor authentication and ability to manage the device remotely will protect your data, or at least will make hacker’s job much harder.
3. Employees’ negligence. Deliberate or accidental mistakes pose more danger to data integrity than you might think. A simple email with confidential data sent to the wrong address may lead to a huge data leak. Make sure that your employees are familiar with the company’s security policy and are aware of what they should do to maintain security each person in the company should clearly understand that integrity of information assets is their personal responsibility.
Dr. Barry Chaiken, chief medical information officer, Infor Healthcare providers organizations invested billions of dollars purchasing and implementing electronic medical records with this investment driven by the economic incentives provided by the HITECH Act. Now that these systems are installed an up and running, organizations struggle to obtain real value from these investments. These systems were implemented with speed in mind rather than clinical transformation that improved quality and reduced costs. Now, organizations must embrace clinical transformation and change management to redo workflows and processes to effectively impact care. Organizations cannot justify their investment in EMRs unless they rework their EMR implementations to obtain true value from their deployment.”
Guest post By Barry P. Chaiken, MD, FHIMSS, chief medical information officer at Infor.
In many ways healthcare is like a symphony orchestra. Although information technology can enhance care planning, assist in medication administration and reduce duplicative testing, it cannot replace the people required to deliver care services to patients. Nurses are needed to administer medications, therapists are needed to provide treatments, and physicians are needed to diagnose illnesses and provide treatment plans. On average, hospitals devote close to 70 percent of their budget to labor costs. Until robots replace humans in the delivery of patient care, selection of the proper skill mix and number of professionals remains a significant factor that determines cost in provider organizations.
Although information technology cannot replace the staff delivering care to patients, it can assist organizations in choosing the best talent available, help develop that talent and determine the best way to utilize the skills of these professionals.
To identify the best talent, information technology tools allow the extraction of an employee’s “behavioral DNA” – the measurement of behavioral, cognitive and cultural traits. Organizations then compare this prospective employee’s “DNA” to the “DNA” of existing high performing employees within the organization in an effort to identify individuals who possess a high probability of excelling within the organization.