Ever increasing computational power, advances in artificial intelligence, and the lower of the cost computation (because of cloud computing service, such as Azure and Amazon Web Services) has enabled healthcare systems and healthcare logistics companies – often laggards in quality improvement and technology adoption – to rapidly implement analytics systems. Such systems enable enterprises to analyze and model their processes, engage in meaningful quality and process improvement activities, and prepare to succeed in value and risk-based payment models.
Hewlett Packard Enterprises recently published a piece that delineated some of the benefits that enterprises can gain from analytics (specifically the predictive form):
Reducing re-admissions
Gauging operating room (OR) demand
Better manage supply chains
Staffing optimization
Intervene with care pathways prior to adverse events occurring.
Enterprises with existing, legacy analytics systems – for example those that mainly work with claims-based data or lack predicative or real-time capabilities can likewise obtain the above efficiencies. A modern data warehouse must be flexible, SQL-enabled, cloud-based, and highly secure. Snowflake Computing’s cloud-based infrastructure is an example of one such system which can be easily scaled as it is offered to clients with usage-based pricing. A data warehouse alone, however, is not sufficient for an enterprise. Tools must be provided to prep, transform, and perform analysis on the data. Alteryx Designer, one such tool, allows analysts to prep and blend data from heterogenous sources – e.g., CSVs, databases, Excel files — in an efficient and reproducible manner, and, more importantly, it includes spatial and predictive analytics. This enables organizations to move from retrospective and barely actionable data to immediately actionable real-time predictive analytics.
The implementation of an analytics systems (or the migration of a legacy system) is not a project to be undertaken without serious thought how change is managed within an organization. Many facets of an organization will be impacted by such projects. Matthew Morris, lead data enabler at an international wholesaling club based in Washington state, who has overseen both the maintenance of legacy analytics system and the migration to a modern one using a team from Decisive Data and Alteryx’s tools, noted some key behaviors or strategies that should be taken to ensure a successful project:
Get leadership buy-in – Many people naturally resist change. Ensuring that leadership across the enterprise is committed to the change will enable a coherent messaging to be addressed to all stakeholders. There are many strategies to achieve leadership buy-in. A notable one, the ADKAR model is described here.
Choosing an effective partner – Especially for mission-critical or strategically sensitive projects, external help is critical. Talented consultants can augment staff skill shortages and bring critical experience (and lessons learned from other projects).
Be there and integrate training creatively – Project leaders should spend time onsite at the various locations where work occurs to ensure proper training and data conversion. During training, don’t just rely on classroom style training; rather, sit down with users and work through actual day-to-day problems. Consider also setting up open office hours where super users or hired technology partners can guide users through specific day-to-day processes.
Train Superusers – A successful analytics systems empowers users – especially key super users – to use the application on their own and not to depend on report requests to an analytics department.
Be honest and use humor – The latter can assist in convincing people to give a new system a chance. Honestly builds rapport within an organization especially during a challenging project. If one is converting from a legacy analytics system to a new one, it is important to empathize with users. They have been doing their work on the old system for years; their apprehension is natural.
Make friends with problem persons but acknowledge that not everyone will accept change – Try working alongside so-called problem persons. It will help you as a project leader to determine why they are negative and show that you are empathetic to their concerns and are personally invested in their successful transition. Note, however, there will be a minority of users that will refuse to accept the change. For the project to be successful, it may be necessary to move on and hope that they come around once the project is successful.
Be a warrior and ignore borders – Sometimes it is important to put a stop to delaying tactics such as an abundance of meetings and just move forward. Additionally, such assertiveness must be used to modify the scope of the project if it is necessary to keep the organization functioning.
Healthcare delivery is being transformed as we speak, from technological breakthroughs and regulatory change to changing patient demographics and consumer expectations. As the healthcare landscape evolves, forward-looking healthcare providers are seeing their real estate in a new light. It’s time for healthcare providers to consider new approaches to real estate and facilities as a way to improve efficiency and patient outcomes.
Following are four ways hospitals and health systems can stay ahead of the curve.
Leverage the M&A boom to improve facilities performance and value. While 2017 seemed to be the year of hospital M&A, JLL analysis points to an even higher volume of M&A in 2018. Cost containment is often a key motivator for initiating M&As. In the aftermath of consolidation, many health systems are now sitting on large portfolios of underutilized real estate that represent a major source of value and capital investment. A data-driven analysis can help identify opportunities to drive more value from each facility and put each to its highest and best use.
Unlock operational efficiencies with a centralized approach. As health systems expand their real estate portfolios with diverse outpatient facilities, centralized facility management and maintenance may be the most efficient way to manage their growing footprints. Partnering with a third-party facility management service provider is a common path to centralization, although it is critical to partner with a firm that understands the nuances of the healthcare environment.
Centralized control of facilities data and analytics provides a complete picture of how different facilities are performing, so the facilities team can make accurate capital plans based on data rather than informed guestimates. Also, today’s facility management technology supports preventive maintenance and can even generate automated alerts if a building system is malfunctioning or approaching a complete breakdown. In addition to improving efficiency, a facilities management partnership can help reduce compliance risks and improve patient and staff satisfaction.
Embrace new definitions of what it means to be a health system—and how that plays out on the map. Though hospitals remain a critical focus, traditional networks may soon be rendered obsolete as industry leaders find that new opportunity lies outside the hospital campus. From medical office buildings to healthcare-anchored retail centers, tailored care settings can improve the patient experience and increase patient loyalty—and boost the hospital balance sheet.
However, managing a complex network of medical facilities requires a thoughtful strategy informed by location analysis. Thinking differently can reap big rewards, but it’s important for executives to carefully weigh the risks and benefits of paying a little more to be closer to where patients already spend time.
Patients who are suffering from a short or long-term injury, or who have been diagnosed with a medical condition, might face difficulty when performing simple and complex tasks within the home. Thankfully, there are various technologies and assistive equipment that can support mobility and help them hold onto their independence.
There are numerous categories for assistive technology, which can enhance a person’s quality of life. Learn how patients can stay independent with the different forms of assistive technologies.
Adaptive Equipment to Support Daily Living
Adaptive equipment makes it possible for people to perform everyday tasks so that they can sustain a great quality of life. Many hospitals and facilities will also require patients to have access to these items before they will discharge them.
For example, they will need adaptive equipment to support dressing, such as dressing sticks, elastic shoelaces, sock aids, leg straps, and long-handled shoe horns. They might also need adaptive equipment for bathing, such as a supportive sliding shower chair, transfer board, mechanical lift and grab bars. Of course, there are also various technologies available for basic mobility, such as stair lifts, power wheelchairs, lift chairs and more.
Adaptive Equipment for Instrumental Activities of Daily Living (IADLS)
IADLs can transform a person’s quality of life when living with an injury or disability, as they can simplify communications and improve safety. For example, they refer to hearing aids, screen readers, amplified telephone equipment, speech generating devices, assistive listening devices and communication boards. They can also maintain their safety with medical alert systems, such as fall detection devices and wearable call buttons.
Durable Medical Equipment for Everyday Health and Safety
Durable medical equipment can effectively support a patient within their home so that they can enjoy a greater quality of life. These are items that are most likely covered by a patient’s insurance, as they will be necessary for their everyday health and safety. Examples of the assistive technologies include hospital beds, power mobility devices, patient lifts, walkers and commode chairs.
How to Acquire Assistive Technologies
While a doctor might order a piece of equipment, it is generally up to the patient to purchase the item. In some cases, a hospital or medical facility might be happy to loan an item to a patient, yet they might need to browse the market for the best option for their needs and budget.
Most likely, in one of the few lucid moments you have in your hectic, even chaotic schedule you contemplate healthcare’s greatest problems, its most pressing questions that must be solved, obstacles and the most important hurdles that must be overcome, and how doing so would alleviate many of your woes. That’s likely an overstatement. The problems are many, some of the obstacles overwhelming.
There are opportunities, of course. But opportunities often come from problems that must be solved. And, as the saying goes, for everyone you ask, you’re likely to receive a different answer to what needs to be first addressed. So, in this series (see part 1 and part 2), we examine some of healthcare’s most pressing challenges, according to some of the sector’s most knowledgeable voices.
Without further delay, the following are some of the problems in need of solutions. Or, in other words, some of healthcare’s greatest opportunities. What is healthcare’s most pressing question, problem, hurdle, obstacle, thing to overcome? And how that can be solved/addressed?
The biggest hurdle in healthcare is the adoption and ethical use of AI, and the ability to share data gathered from it in a safe and secure way to gain actionable insights. More specifically, the world is moving towards consumer genomics. This type of technology will help patients and their caregivers better understand their health and allow for more personalized care plans—this is our role in the future of precision medicine.
Randy Tomlin, CEO and chairman of the board, MobileSmith
A pressing question for many healthcare execs is “how can I gain loyalty from the next generation of patients? With the estimated lifetime value of a new patient at $600,000, and Millennials and Generation Z making up one-half of the U.S. population, the stakes are high. Healthcare lags behind other industries in adopting a mobile-first strategy, but some health systems are branding their own mobile apps because they know that it speaks to the engaged-consumer mindset of these populations. In many cases, mobile app technology has proven to increase patient engagement, education and loyalty, while improving a hospital’s bottom line.
During my surgical training, I experienced firsthand the greatest challenge facing our healthcare system today: how we train and assess our providers. Data shows that our century-old apprenticeship based system of surgical training is struggling under a growing number of procedures and decreased hands-on time with patients. At the end of at least 14 years of education and accumulating six figures of debt, 30 percent of residency graduates still cannot operate independently. Even surgeons in practice are finding immense challenges learning new procedures and bringing them to patients. This is limiting the adoption of higher value modern technologies and limiting patient access to these lifesaving procedures. Virtual reality is opening the door for increased access and skill development in a highly precise and like-life environment. Residency programs and medical device companies are adopting virtual reality to have a much more natural learning experience with a much higher retention rate than conventional observational methods such as a book or video. We have harnessed immersive technologies to improve patient outcomes, increase the adoption of higher value medical technologies and democratize access to surgical education around the world.
Most likely, in one of the few lucid moments you have in your hectic, even chaotic schedule you contemplate healthcare’s greatest problems, its most pressing questions that must be solved, obstacles and the most important hurdles that must be overcome, and how doing so would alleviate many of your woes. That’s likely an overstatement. The problems are many, some of the obstacles overwhelming.
There are opportunities, of course. But opportunities often come from problems that must be solved. And, as the saying goes, for everyone you ask, you’re likely to receive a different answer to what needs to be first addressed. So, in this series (see part 1 and part 3), we examine some of healthcare’s most pressing challenges, according to some of the sector’s most knowledgeable voices.
Without further delay, the following are some of the problems in need of solutions. Or, in other words, some of healthcare’s greatest opportunities. What is healthcare’s most pressing question, problem, hurdle, obstacle, thing to overcome? And how that can be solved/addressed?
Lynn Carroll, chief of strategy & operations, HSBlox
Lynn Carroll
Preventable medical errors are the third leading cause of death in the U.S., and frequently can be linked to inaccurate patient data, according to a study by Johns Hopkins University. Machine learning should be used to solve patient-matching challenges by analyzing and consolidating patient data from multiple systems, such as EHRs, medical charts, e-prescribing technologies, clinical documentation solutions and revenue cycle management platforms, and by creating longitudinal patient records that can be transparently shared among the patient’s care team, optimizing care coordination. The patient-matching solution is then combined with blockchain to disseminate the relevant patient data to all parties who have permission to view it.
Extending care coordination beyond the hospital walls heavily burdens providers and healthcare administrators. As the industry continues to shift from fee-for-service to value-based care, optimizing care teams to address social determinants of health and drive patient engagement is paramount. Today’s health systems must leverage an agile workforce and intuitive technology to deliver 360-degree patient-centered care.
Dr. Samant Virk, physician, founder and CEO, MediSprout
Samant Virk, MD
As a practicing physician for the last 15 years, I had a growing frustration with the fact that more than 70 percent of my time was consumed by administrative tasks that took away from my ability to help patients. The biggest challenge of healthcare right now is that we’ve lost touch with that physician and patient connection. Question: How can we reconnect physicians with patients — tech has driven a wedge between us and it’s time to fix this. Doctors would love to spend more time with the patients that need them the most while getting paid for follow-up care and communications that eats up their day. We believe that technology is the solution here.
Healthcare must shift its focus from viewing patients as “customers” and instead consider patients as “partners” within the broader healthcare ecosystem. All of the exciting innovation underway (including the increased adoption of virtual care and telehealth) should reflect what is required for the patient/partner to better manage his/her healthcare throughout the care continuum. To solve for healthcare that is truly consumer-centric, the broader healthcare ecosystem needs to identify the best investments to make which will drive quicker and better outcomes for the individual consumer (e.g., the patient/partner), overall population health, healthcare professionals, and healthcare organizations.
Price transparency for the Employers and the patient. The explanation of benefits (EOB) does not contain real financial payments between the payer and the provider. The real numbers are considered proprietary. A patient nor employer benefit plan cannot control their healthcare costs if they do not know how much was paid and for what service. At a grocery store, each item is tagged with the name of the product and the price. In healthcare the service and or product is not presented to the patient prior to the receipt of service and the services are not itemized on the bill. What to do? Make is illegal for payers and providers to have proprietary payments on healthcare goods and services.
John D’Amore, president and chief strategy officer, Diameter Health
The most pressing problem for US healthcare is improving quality of care while reducing cost. Intelligently leveraging clinical information — for predictive analytics, precision medicine, population health analytics and other analytic purposes — is critical to solving this problem. The largest impediment to actionable analytics is dirty clinical data entered by more than four million clinicians into more than one hundred certified EHRs resulting in a clear and present need for scalable technology to normalize, de-duplicate and enrich clinical data so that data scientists can spend more time identifying actionable insights from data, and less time fixing clinical data.
I see our shortage of primary care physicians as the biggest challenge the American healthcare system faces over the next 20 years. PCPs are crucial to the patient experience, and preventative care that can help drive value. Tied to this is my concern is the lack of investment/acceleration in technology designed to improve physician experience and utilization. PCPs spend way too much time entering data when there are opportunities like voice assisted scribe or authentication that reduce data entry and allows them to spend more time completely focused on patients providing quality care.
Most likely, in one of the few lucid moments you have in your hectic, even chaotic schedule you contemplate healthcare’s greatest problems, its most pressing questions in need of solving, obstacles and the most important hurdles that must be overcome. And how solving these problems might alleviate many of your woes. That’s likely an overstatement. The problems are many, some of the obstacles overwhelming.
There are opportunities, of course. But opportunities often come from problems that must be solved. And, as the saying goes: For everyone you ask, you’re likely to receive a different answer. What must first be addressed? In this series (see part 2 and part 3), we ask. We also examine some of healthcare’s most pressing challenges, according to some of the sector’s most knowledgeable voices.
So, without further delay, the following are some of the problems in need of solutions. Or, in other words, some of healthcare’s greatest opportunities — healthcare’s most pressing questions, problems, hurdles, obstacles, things to overcome? How can they be best addressed?
Nick Knowlton, VP of strategic initiatives, Brightree
Throughout the healthcare ecosystem, patient-centric interoperability has historically been a huge challenge, specifically throughout post-acute care. This problem results in poor outcomes, unnecessary hospital re-admits, patients not getting the treatment they deserve, excessive cost burden and poor clinician satisfaction. This challenge can be solved through creating better standards, adapting existing interoperability approaches to meet the needs of post-acute care, implementing more scalable interoperable technologies, and involvement with national organizations, such as CommonWell Health Alliance and DirectTrust, amongst others.
Cybersecurity is one of the most pressing hurdles in the healthcare industry. The life and death nature of healthcare and the shift to electronic health records (EHR) creates an environment where hackers that successfully deploy ransomware and other cyberattacks can extort large sums of money from healthcare entities and steal highly sensitive data. To address this challenge, healthcare entities need to continue to increase their investment in cybersecurity and focus on improving their overall security posture by implementing tools and processes that will monitor all devices and assess their compliance with security policies; stop phishing attacks; keep all servers patched and current; ensure third party vendors comply with policies; and train employees on proper security hygiene.
Cyberattacks continue to expose the security vulnerabilities of healthcare institutions, keeping many industry stakeholders awake at night. This is why every organization handling protected health information (PHI) needs to build security frameworks and risk sharing into their infrastructure by implementing risk-mitigation strategies, preparedness planning, as well as meet industry standards for adhering to HIPAA requirements. Hospitals and healthcare systems must keep their focus on strategies and tactics that ensure business continuity in the event of an attack as it’s clearly not a matter of if a breach can happen but when.
The core problem for healthcare isn’t science, technology or caregiving intervention. It’s making sure that the systems of delivery and communications are thought through and actually respond to the way patients need and expect healthcare to be delivered. This means it doesn’t matter how advanced and perfected your health system may be — unless it conforms to culture — the way people think and behave — it will do nothing but confuse and frustrate patient needs, which are psychological and social, as well as physical and mental.
If you ask doctors, you’ll hear that electronic health records (EHR) have been both the best thing and worst thing to happen to medicine in the past 40 years. Having real-time information at your fingertips is an incredible advancement, but it’s only helpful if you can see what you need to diagnose and treat your patient. Healthcare providers consistently state their frustration with the lack of consistent, accurate data within the EHR system.
Without accurate data in the patient’s chart, doctors struggle to provide accurate and appropriate care. That’s why clinics and hospitals need to go the extra mile and customize their records in the following ways:
Invest in consulting to configure software
It’s too much to ask of our healthcare providers for them to become IT and software experts. Accessing records of earlier care and making accurate diagnoses is dependent on doctors and providers’ ability to input and extract relevant information quickly.
Even a lively family physician practice needs assistance to set up and configure an electronic healthcare record system. Even with technical staff, it’s unrealistic to expect them to configure and customize a highly complex software system to suit a unique workflow. As organizations upgrade or adopt new technology, they are relying on artificial intelligence or a technical sales support representative to migrate data.
Data is only as good as the input
Without expert configuration and data migration, the accuracy of the data is in question. Patient records need to be correct, and it needs to appear in the right place in the record. Relying on a software program to migrate data accurately may preserve your data, but if it doesn’t populate the proper fields, it’s not useful.
Efficiency is key
With only 20 minutes to see each patient, the data needs to be more than accessible. Many small offices find it cost prohibitive to fully take advantage of the software system’s features and discover it’s even more challenging to configure and customize the software to meet its full potential. Although the cost is a prominent factor, the value of a properly configured and deployed EHR is priceless.
Hire a consultant
Setting up an electronic health record is a complex endeavor. Innovative software design makes it possible to customize fields, provide reporting, and give alerts. Used efficiently, an EHR can help doctors reach conclusions more quickly and show information in a way that leads to faster diagnoses.
If the EHR isn’t configured efficiently, or if the data isn’t captured in a way that providers can access and leverage it to make smart clinical decisions, it becomes more of a roadblock than a powerful tool. Apathetic software users create inaccurate or missing data.
By Drs. Will Brandon, PhD., president and CEO of Learning ARTS, and Michael Harrington, PhD.
Dr. Will Brandon
About one in 59 children has been identified with autism spectrum disorder (ASD), according to recent estimates from the Centers for Disease Control and Prevention’s Autism and Developmental Disabilities Monitoring Network.
Though it is still unclear whether the difference is primarily due to increased incidence of such disorders or more accurate screening procedures, ASD has become a national priority. The demand placed on treatment service is outstripping availability. One organization, Learning A.R.T.S., is turning to information technology to meet this soaring demand.
Founded in 1994 and based in California, Learning A.R.T.S. has embraced applied behavior analysis (ABA) and its focus on in-home, one-on-one instruction to improve patients’ social and life skills. It has enjoyed rapid success expanding to 11 regional locations spread across the state.
Learning A.R.T.S. programs help teach patients skills—from tying shoes to writing résumés—and foster an information- and communication-rich environment. Initially, as the organization expanded its services, the challenges were to communicate and coordinate operations across geographically dispersed facilities and client locations using traditional paper and telephone-based communication.
Applied behavioral analysis and treatment programs involve Board Certified Behavior Analysts (BCBA), specialists, and technicians. Coordination between team members is central to success of ABA, placing a premium on the flow of information among them.
Increased demand has doubled the organization’s caseload, however. To meet this demand, Learning A.R.T.S. developed a new case management strategy driven largely by the adoption of an information management technology system by Laserfiche.
Previously, Learning A.R.T.S. dealt with volumes of paper forms and data records that needed to be authenticated, reviewed, duplicated, stored and retrieved. The organization now works with the same records in digital form stored in a central computer repository. This transition required the digitization of hundreds of thousands of existing paper records, and then training staff to work with the information in a new, digital format.
The effort resulted in seemingly endless opportunity to apply new technologies for information management that could not be applied to paper records. More importantly, those opportunities mean many more ASD children and families are getting the timely assistance they need.
For example, Learning A.R.T.S. field workers can now use mobile devices, such as tablets and smartphones, to gather and file patient information in real time, on location. The data is managed through digital workflow processes that eliminate reams of redundant paperwork, and can be stored in archives and accessed immediately through a central server. This translates into significant efficiencies in HR management of staff, accounting and billing, as well as in faster delivery of client services.
The organization has seen cost savings in terms of staff accounting, new employee onboarding, payroll and billing. But one benefit outweighs any monetary return: better patient care and more positive results.
Learning A.R.T.S. has found that response times are critical to successful treatment. ASD patients frequently act out in frustration, often becoming violent, which also can be emotionally draining for field staff. Treatment response involves not only accurate and timely communications, but also a considerable amount of orientation and training relevant to the technician’s functions.
If you ask doctors, you’ll hear that electronic health records (EHR) have been both the best thing and worst thing to happen to medicine in the past 40 years. Having real-time information at your fingertips is an incredible advancement, but it’s only helpful if you can see what you need to diagnose and treat your patient. Healthcare providers consistently state their frustration with the lack of consistent, accurate data within the EHR system.