Today, healthcare organizations are being challenged to provide quality care while improving accuracy, efficiency and accountability. With the additional strain of staff reductions, space constraints, budget cuts and technological advancements all competing with new regulations, there is almost a perfect storm of workflow changes for clinicians to address and adopt. While most focus on the immediate challenges of electronic health records, they may not think through all the implications when implementing the technology used to access it.
Amid the widespread adoption of EHRs, caregivers are equipped with a multitude of devices to access electronic reports – including tablets, handhelds, wall mounts and mobile carts. Furthermore, the logistics governing electrical, phone and network cabling, not to mention physical “real estate,” can stretch the ability to cope for some facilities. It’s not surprising to find cutting-edge IT equipment being used in cramped, stuffy rooms with inadequate furniture, mounting surfaces and storage. At the recent HIMSS conference, we presented to dozens of clinicians and explored how the enterprise-wide application of ergonomic principles within a hospital setting can help manage and sustain all of the often overlooked aspects of clinical workflow.
Ergonomic Factors
Ergonomics is the application of scientific knowledge to a workplace to improve the well-being and efficiency of workers. Ergonomic design considerations begin with human abilities and limitations and how they affect the work process. An ergonomic workplace increases workers’ efficiency and productivity, while helping to reduce fatigue, exertion, and musculoskeletal disorders.
Studies have shown that a good ergonomics program also favorably influences reduction of workplace injuries and absenteeism, and contributes to overall employee wellness.
Guest post by Darren Leroux, senior director of product marketing, WinMagic.
Gone are the days where all personal health information solely lived in giant filing cabinets behind a receptionist’s desk or in the administrative office of a hospital. Today, patient data resides everywhere – desktops, laptops, smartphones, tablets and USB drives. Understandably so – given the rise of mobile computing and bring-your-own-device (BYOD) policies in healthcare, the once straightforward process of protecting patient’s personal health information has since evolved into a complex and overwhelming undertaking.
Just the Facts
According to a recent study, 81 percent of healthcare organizations are now allowing employees and medical staff to use their personal laptops and mobile devices to connect to provider networks or access company email. Interestingly enough, the same study found that of that 81 percent of healthcare institutions enabling a BYOD strategy, 54 percent did not believe that those devices were secure enough in the workplace; 65 percent of data breaches reported to the Ponemon Institute occurred on laptops and mobile devices over the last five years — it’s no wonder that more than half of those surveyed aren’t confident in the security of their devices
When we refer to personal health information at risk, we’re not just talking about historical health records – the potential for a data breach casts a much wider net, including patient billing information, clinical trial data and even employee information like payroll numbers. With so much sensitive, unprotected data up for grabs, we’re inclined to ask ourselves – how? How is this significant rise in healthcare data breaches even possible, and how do we stop this from continuing?
Below are the top three gaping security holes in remote healthcare data practices that are answering our question of how is this rise in breaches in possible:
Guest post by Domingo Guerra, president & co-founder, Appthority.
Last year, 2013, was a big year for mobile applications, including medical and health-related apps. As many medical centers have sought to increase patient engagement, improve outcomes and reduce healthcare costs, digital tools, such as iPads, smartphones, online portals and text messaging in hospitals are rapidly becoming commonplace. Smart health tech has gotten serious. Patients and doctors alike use medical apps. Physicians can access symptom checkers, drug information, medical calculators and more via smartphone and tablet apps. Patients can use apps to find doctors, set appointments, order prescriptions, receive test results, track calories, measure their heart rates and even monitor chronic diseases like diabetes. Patients and doctors agree that the immediate feedback and increase in available data will change the face of medicine. But will the face of privacy change with it?
Acquiring huge amounts of personal data from individuals could enable a more personalized and data driven approach to medicine. This is a very seductive concept, based on the implicit assumption that the more healthcare providers know about the patient, from analyzing his or her data, the better (and more customized) care the patient will receive. However, personal data, now collected and collated by the user’s health gadget, will be incredibly valuable to more than just the patient and the provider. Devices, whether they’re Google Glass or fitness wristbands will need to be integrated with newly developed apps, and existing apps will need to be heavily adapted to work properly. These technology integrations can potentially open back doors that allow cybercriminals to enter and extract sensitive data.
The aggregated data gathered from a wearable wristband capable of tracking a user’s heart rate, and expiration rates along with their blood sugar level and, of course, location can offer a truly comprehensive view of a user. Yes, it’s still early in the healthcare wearables space, but it was “early” in the mobile and BYOD spaces not long ago. Just as BYOD has led to security concerns for sensitive corporate data, these new healthcare devices should be a concern for personal privacy. As users are now literally plugging themselves into the Internet, it’s important to remember that cyber attackers can gain details about daily routines, patterns, and lifestyle, as well as location. This private information, tied together in a dossier that can include a user’s location, income, health status, and other attributes such as sexual orientation, could be of interest to many other groups.
As someone passionate about patient engagement and using health IT and other technologies to improve care, I continue hear a great deal about how solutions can actually benefit population health. Even at the most recent HIMSS conference, “patient engagement” as a term clearly has become one of this year’s biggest buzz phrases.
Conference sessions were dedicated to the topic, vendors marketed their services to solving some of the issues associated with it and seemingly everyone in attendance had an opinion for what needs to be done or at least has some strategies for bringing more patients — or their data — directly into the care sphere.
Problem is, from my perspective, that, unfortunately, too much is still being said about population health and not nearly enough about individual health. In theory, I understand why this must be, but in practicality, I don’t understand the seemingly lack of attention individuals are receiving. Obviously, if population health outcomes improve then that must logically mean individual health outcomes are improving.
And while I understand that not everyone or every need can possibly be addressed, that doesn’t mean we shouldn’t be trying to fill those needs. The current conversations about improved population health remind me of a common business/life solution when addressing a major problem: How does one eat an elephant? One bite at a time. Likewise, it would seem the same approach could be taken to achieve improve population health outcomes: One individual patient at a time.
That said, I asked some folks within the health IT community how technology affects individual patient outcomes. Though some of the ideas here are still high level, perhaps they are a step in the right direction. Here are some of the responses I received:
What are the real-world benefits of electronic health records, for example, to a specific individual? To answer that question, let’s take a look at a fictional person we’ll call “Bill.” Bill is quite elderly and has a variety of age-related illnesses. He lives in Ohio, and decides spend the winter with his daughter in Florida.
Bill’s daughter, Susan, arranges for her father to be seen by a local specialist during his stay. Susan tries to get a voluminous paper file transferred from Ohio to the new doctor in Florida, but there are delays: phone messages are missed, handwriting is misread, and no one has time to copy and mail 100 pages of medical records.
In the end, Susan is unable to get her father’s records transferred in time for the appointment with the new physician. As a result, an unnecessary test is performed, and a drug is prescribed that had caused an allergic reaction in the past.
In the future, EHRs will enable the Florida clinic to have electronic access to the same records available in Ohio. Already, Medicare and some commercial carriers have websites that list physician visits, patient complaints, diagnoses made, lab/diagnostic tests performed, and drugs prescribed. Eventually, such websites may include a full medical profile, including doctor’s notes, lab results, x-ray images and more.
Dean Wiech, managing director of Tools4ever, a global provider of identity and access management solutions, has worked in healthcare for more than 25 years. Here, he discusses how IAM enhances the ROI for health systems, and how the solutions make patient care more efficient, how they work in healthcare, and how systems and records can be made more secure — for patients and providers — because of the technology.
Tell me about yourself and your experience in healthcare.
I have been actively selling software solutions in the healthcare market for 25 years. I have sold and/or managed teams in about 50 percent of the country. I have always focused on solutions that provided a definable ROI based on productivity and time savings.
Tell me about Tools4ever. How does the company serve the space? Tell me about your products and how they are used in healthcare.
Tools4ever is a company that focuses on the identity and access governance space. We assist the healthcare market in insuring that the lifecycle of user accounts are managed in a timely and accurate manner. We also have solutions that save care providers time by eliminating repetitive login tasks and avoiding the need to call the help desk for password resets
How is Tools4ever different than some of the competitors in your space?
I believe our primary differentiator is time to implement. We can get the basics up in running in a few days to a few weeks, depending on the solution. The majority of our competitors take months to years to complete an install. The result is the healthcare organization can realize a much quicker benefit from the product and a quicker ROI.
What’s your footprint like in healthcare and who are some of the organizations you work with? How do you help them?
We have numerous hospitals and long-term care providers across the country. One example is South County Hospital in Rhode Island. It utilizes our Self Service Reset Password Management (SSRPM) solution to allow end users to reset forgotten network passwords. We then synchronize that password to several other solutions to allow a reduction in the number of credentials the employee needs to remember.
Another example is a major university hospital in New York City. It uses our user management solution for several tasks. The most recent example is provisioning patients to the network to allow them to view their records on a mobile device provided by the hospital for the duration of their stay. We also implemented a password self-service reset function to allow the patients to reset their passwords without a further burden on the help desk.
The image provides a pretty concise view on some of the prevailing thoughts on the use of consumer’s mobile technology and how perceptions of the technology might potentially improve patient outcomes.
Not surprising, one third of smart phone users look up health information on their devices via the web. Most surprising to me, though, is that according to the graphic, 25 percent of low-income adults own a smartphone; I shouldn’t be surprised given people’s passion for the latest devices. Hopefully, though, this will help improve their care and outcomes, individuals who, of course, would likely fall into the class of people most likely needing care but not receiving it or receiving it through non-traditional means.
If nothing else, as Aetna suggests through the image is that technology and personal devices may allow greater access to care and to information to improve care.
Such technology, and its use, is clearly the future of individual care and actionable outcomes for individuals. I only wonder what it will take to harness and implement real programs that help real people received sustainable care and guidance at the individual level, and how long it will take to become wide spread
Patient-centered healthcare technology is putting the power of good health into patients’ hands. All of the changes in American healthcare regulations point to one top priority, and that’s patient centered care. Why does this matter? Because patients who are empowered to manage their own health are more likely to be proactive and, theoretically, therefore healthier.
Knowledge in the world of healthcare can be a great thing, and the technology community is responding with thousands of apps and other healthcare IT initiatives, such as activity tracking devices and websites designed to help consumers keep close track of their wellness.
Researchers at the Mayo Clinic provided FitBits to 149 post-surgical heart patients. The researchers determined that using the FitBit to monitor mobility wirelessly was “easy and practical, and led to a significant relationship between the number of steps taken in the early recovery period, length of stay and dismissal disposition. The research indicates that an activity monitor such as a FitBit could positively affect post-discharge outcomes by empowering patients to take their recovery into their own hands. Better discharge outcomes leads to lower costs in the long run. This is just one example of many.
Received the following study recently that is quite interesting; thought it worthy of sharing:
Emergency department physicians are less likely to admit patients to the hospital when they have readily available electronic access to those patients’ health records, Weill Cornell Medical College researchers have found.
Its study, published March 12 in Applied Clinical Informatics, illustrates the value of combining multiple providers’ digital patient charts into a single source for health care providers – particularly in an urgent setting like the emergency department. With information such as previous test results, prescriptions and other patient history immediately accessible, providers are able to treat patients more efficiently and effectively than when they lack that data.
“New York State has made significant investments in health information exchange,” said Dr. Joshua Vest, an assistant professor at Weill Cornell and the lead author on the study. “Our study shows that providing physicians, nurses and allied health care professionals such as physician assistants real-time access to community-wide, longitudinal health records does in fact benefit patients.”
With federal and New York State government backing, hospitals and medical practices across the state are investing millions of dollars to make health records sharable among physicians when they need the information. The digitized charts contain doctors’ notes from every patient visit; family medical history; immunization records; lab results; medication history; allergies; reminders for preventative care and more.
Received the following study recently that is quite interesting; thought it worthy of sharing: