The Best Exotic Marigold Hospital: Learning digital lessons from the hospitality industry to personalize the healthcare experience
Becker’s Health IT & CIO Review (01/2017)
Healthcare environments can learn some important lessons from the hospitality industry, as well as retail and travel websites. By taking service staff out of tasks that are more efficiently done by computers, these industries are able to personalize the customer experience, improve accuracy of data entry and cut their costs.
For companies in the hospitality, retail and travel industries, efficiency, accuracy and cost control is directly related to their ability to compete successfully for customers. But just as important is the customer experience. These industries have learned that a customer irritated by the friction in the buying/checking in process is a customer who will seek out other options in the future. While some customers will put up with a poor experience to cut costs if they must, as soon as those customers find an affordable option that is less irritating, they are gone. And, importantly, companies are no longer being compared just to the competition in their own market — now their competition is any optimal experience from any industry. If our online interaction with Amazon is friction-free, then we want and expect the same experience from everyone else.
How the Cures Act will help open the data spigot and may improve care
Becker’s Health IT & CIO Review (12/2016)
In passing the 21st Century Cures Act, Congress took bold steps toward more effective and precise treatments for a wide range of conditions. The act authorizes billions of dollars for medical research and is intended to speed up innovation in treatment discovery and delivery.
Tacked on near the end of the process was an amendment that may prove to be every bit as valuable to medical research as the act’s nearly $8 billion in funding. It directs HHS and the Office of the National Director for health information technology to make EHRs interoperable and facilitate the flow of information.
Healthcare providers have been gathering and storing electronic health data for the past decade at an astounding rate. We have an enormous amount of potential knowledge just waiting to be tapped. But because of a variety of barriers, that data has largely gone unused. It’s sitting there in data centers, but we just can’t get to it. Much of the original promise of EHRs has been lost because of the barriers to a free flow of information.
Fee-for-service reimbursement inadvertently punishes our best efforts
Becker’s Hospital CFO (10/2016)
Under fee-for-service, improving outcomes and reducing the need for services means cutting your revenue. A case in point is the Seton Family of Hospital’s campaign to reduce birth injuries, a successful project that earned the group the Joint Commission’s prestigious Codman Award in 2007. This group of hospitals reduced birth trauma by 93 percent despite having one of the lowest rates of birth trauma when they began the program. Conventional wisdom at the time was that some birth injuries are just not avoidable. Since then, they’ve had years with zero birth traumas. One result of this effort has been an 80 percent reduction in the average length of stay in the neonatal ICU for babies with birth injuries, from 15.8 days to just 3.1 days.
Those are fabulous results. Though birth injuries are rare, they are traumatic for the infant and family and can be very expensive to treat. The Seton results are a real victory for families and for the health system in general. But not so much for Seton’s bottom line. The improved care and outcomes netted Seton, by one executive’s estimate, a $1 million reduction in revenue.
Think of that. A hospital system does what is right and good and is punished with a large financial loss. That pretty much sums up the basic problem with the fee-for-service reimbursement model. If all Seton cared about was the bottom line, this project would be considered a disaster. While they fortunately care more about families than revenue, it just seems wrong that doing a good job results in financial punishment.
In celebration of National Health IT Week, the SHIFT Communications Healthcare Team took to the streets (figuratively speaking) to gather insights from some of the leading minds in healthcare. We asked industry experts and veterans like Dr. Nick van Terheyden, Chief Medical Office at Dell, and Jane Sarasohn-Kahn, Health Economist and contributor to the Huffington Post, this question:
The Year is 2030 – What Does Healthcare Look Like for the Consumer?
In this eBook, these experts sound off on how they foresee technology changing healthcare for the consumer by 2030 – from more widespread use of personalized artificial intelligence to the enablement of true at-home care through the use of sensors and telehealth technology. How do you see healthcare evolving for the consumer come 2030? Share your thoughts in the comments below or on Twitter leveraging the hashtag, #NHITweek. – the extended version is here
The ABCs of Population Health: It’s a Team Sport | #NHITweek
Population health is the topic du jour for the health care industry, and I’m glad to see us all focusing on this important issue. But there is a lot of confusion as to what, exactly, constitutes population health. Or more correctly, an effective population health system.
The key to making a population health program effective is ensuring that all four components are in place and working well. If there is a break anywhere in the chain, you lose the opportunity to improve patients’ health. The best analytics in the world are useless if the results do not quickly and easily pass into the hands of the people who can take action. And very good follow up and care planning can be ineffective if the ongoing support is lacking.
Each year National Health IT week raises awareness of technology in healthcare, bringing together innovators and key healthcare leaders who are diligently working together to make the best use of information technology to improve the healthcare systems and ultimately our each and everyone’s individual health. This past year we lost one of the titans whose personal journey of uncoordinated care she shared in her attempt to correct the system – Jess Jacobs (#UnicornJess). It might be too late for Jess but let this be the year we move past the individual approach in healthcare driven by underlying economics and focus on the team sport of population health and democratize access to the best possible care and outcomes to the widest swathe of people…worldwide.
Innovation in payment for chronic disease management will have more impact on US health than all other healthcare innovations
Becker’s Health IT & CIO Review (09/2016)
When you hear the phrase “healthcare innovation,” what naturally comes to mind is technology. Genomics, analytics, telemedicine and remote monitoring, mobile apps and a dozen other technological advances are improving care in all kinds of ways. But there is another area of innovation that could have an even bigger impact on the health of U.S. residents: new ways of paying for chronic care management. Historically, U.S. physicians – and especially primary care physicians – have been paid far more for what they do with their hands than what they do with their minds. For a variety of reasons, Medicare and private health plans paid for office visits and procedures, but paid little for medical management, essentially prioritizing procedures and doing things to the patient over care to prevent the illness in the first place. The result of this short-sighted payment environment has been skyrocketing costs, inefficient use of resources and poor health outcomes. As a nation, more than 75% of our healthcare spending is on people with chronic conditions, and seven out of 10 deaths each year are from chronic diseases.
But here’s the thing: primary care physicians who practice high-value care have the power to knock U.S. health spending back into line with that of other developed countries and improve the overall health of our patients. While the specialists have skills we need, they don’t have the same influence on overall health spending compared to primary care physicians. They can help reduce costs, but it is the primary care physician that is positioned to provide the kind of care that can change the course of chronic diseases in this country. What we clearly need are more primary care physicians and a reimbursement system that prioritizes prevention over repair.
Will greater access to digital health improve healthcare in emerging countries?
Medcity News (07/2016)
The expanding role of healthcare providers is not limited to societies with “developed” healthcare systems. Diseases, such as AIDS and malaria, prevalent in the third world and emerging countries are now considered chronic or curable with the proper treatment, leaving those afflicted with greater chance of recovery. However, as the cost the typical person pays for healthcare over his or her lifetime rises, the question becomes: How will these emerging societies, especially those in less-developed countries, sustain a rising bill?
The answer is they cannot. Hopefully, they will not have to. Already, healthcare technology providers around the globe are finding new ways to reduce the overall cost of medicine by improving efficiencies wherever possible.
Is healthcare transformation ‘the age of wisdom’ or the ‘winter of despair’ for hospitals?
Becker’s Health IT & CIO Review (07/2016)
As with most major shifts – political, economic, social or otherwise – there will always be both winners and losers. There will be success and there will be failure. There will be those who celebrate the new direction, and those who mourn the passing of an era they loved.
It won’t be a slam dunk. Big changes often come with unintended consequences – side effects, if you will – and we all know how problematic side effects can be. Sometimes they are worse than the disease you are treating. So we will all need to be vigilant to be sure that we are moving in a positive direction, not just moving.
One team, not a fragmented patchwork of individual providers….Ultimately, healthcare transformation will create a more coordinated system. The lone doctor doing it all will become a remnant of history, replaced by a team of caregivers who oversee all aspects of a patient’s care. While some will mourn the loss of autonomy, the patient will win because a smoothly functioning team that supports each other and communicates well can, over the long haul, outperform even the most outstanding group of individual players.
Channeling Churchill to deal with innovation, impatience and chaos in healthcare
To say that healthcare is changing is to understate the situation dramatically. The combination of new technology and a demand by payers and consumers for more value for their money has created an environment rich in both innovation and impatience. You may think you are moving swiftly, but no matter how quickly your organization is adapting, both payers and consumers are tapping their collective feet and wondering why it’s taking you so long to get with the program.
Consumers now expect digital access to everything 24x7x365. The online world has taught us that this is not only possible, but even routine – everywhere but healthcare. So their impatience with our slowness is understandable. They can search at 3 a.m. for answers to health questions that we as healthcare providers haven’t given them. Given that many of the answers they find on the internet may be dangerously wrong, it’s time we did a better job answering their questions, even at 3 a.m.
How Can Technology Boost Medication Adherence
Healthcare Innovation News (06/2016)
Medication adherence remains a substantial problem in the last few inches of care. We know from multiple studies that a high percentage of patients don’t fill their prescriptions regularly. Those that do fill them don’t always take the medication consistently or even at all. Even the timing of medication is significant, and compliance is spotty at best.
Technology offers tremendous potential for closing the loop on medication refills. It can help us understand if and when patients refill the medication, as well as offering an opportunity to intervene when prescriptions are not filled. New pill tracking and individualized medication services provide the ability to customize packaging, making compliance easier. Additional technology can prompt and even monitor a patient’s medication adherence. And a new innovation from Proteus offers digital tracking of medication that is attached to the pill itself, which monitors and reports actual purchase, storage and ingestion time to offer the ultimate in closed loop, medication adherence.
Helping patients and clinicians confirm medication adherence with real-time support and information should be our goal. Innovations in technology allow us to simplify the process and ease the challenge associated with complex prescription requirements that are faced by many complex and chronic disease sufferers.
Fighting a shortage of skilled staff? Increasing teamwork and respect is as important as increasing salaries
Becker’s Health IT & CIO Review (03/2016)
The most difficult task — and by far the most important one — faced by a hospital executive team is building a satisfying work environment that keeps clinical staff engaged and loyal. More than any other organization, a hospital depends on a large cadre of highly trained staff, many of whom are in professions facing serious shortages. That means your best doctors, nurses, therapists, technologists and technicians have choices. If they aren’t happy working at your hospital, there are dozens of other hospitals happy to hire them, often with a competitive salary and, in some cases, a signing bonus. So poor morale among staff is a critical issue for any hospital.
Low morale and high turnover not only make life difficult for executives, they adversely affect patient safety and satisfaction. Several studies have documented this effect. A 2011 study by a group at the University of Pennsylvania School of Nursing found “patient satisfaction levels are lower in hospitals with more nurses who are dissatisfied or burned out — a finding that signals problems with quality of care.” …. Numerous other studies have detailed how low staff morale results in poorer quality work for healthcare staff in a variety of disciplines, from laboratory to imaging and pharmacy, and how high turnover disrupts patient care and safety.
Keeping staff morale high and turnover low can save lives. It’s a very, very big deal for hospitals. So in a competitive environment, how do you hang on to your best staff and ensure they are focused on high quality care?
2016 a breakout year for patient engagement
HealthcareIT News (02/2016)
I believe 2016 will be the breakout year for patient engagement as the silver tsunami of baby boomers starts to access the system and finds costs shifted into their pockets. They’ll demand technology that works for them, like when they ship a FedEx package and can track it from delivery to departure. They’ll expect telemedicine and telehealth to boost interaction with their providers, while requiring analytics and population health to bolster proactive health services, much like their calendar and mobile device.
The key to population health: Know your chronic disease patients and coach them
Becker’s Health IT & CIO Review (02/2016)
Few physicians are eager to have that data pouring into their EHR. What are we supposed to do with this stuff? How do we make it useful? We don’t need to know every step recorded by a Fitbit, and we don’t need all the data from healthy patients. That said, there is a place for some of this data within our efforts to create a healthier nation.
Population health is critical to the future of healthcare in the U.S. Compared with other developed nations, the U.S. has ranked poorly on cost and outcomes. This is predominantly our inability to effectively manage chronic disease, which shortens people’s lives, degrades their quality of life and costs the U.S. healthcare system enormous amounts of money. If we learn how to effectively manage chronic conditions, and avoid hospitalizations and serious complications, we can improve life for patients and greatly reduce the ballooning cost burden we all share.
The Case for Deconstructed PACS: Proprietary PACS, basic VNAs will be extinct
The move toward value-based reimbursement is shaking up traditional healthcare in all kinds of ways, as connectivity and cost-effectiveness become critical attributes in care delivery. Proprietary PACS used in image acquisition systems are starting to feel the squeeze from this dual pressure, as vendor-neutral archives (VNAs) take over many of their functions.
A recent study by research firm MarketsandMarkets predicts a PACS-less radiology world by 2018. Consultant Donald Dennison told attendees at the opening session of the Society for Imaging Informatics in Medicine’s (SIIM) 2015 meeting that there are three external market forces trickling down into the imaging informatics world and leading to the demise of PACS: money, electronic health record (EHR) adoption, and consolidation.
While PACS have traditionally been the workhorses of departmental diagnostic imaging (providing workflows, viewing, and archiving), their departmental focus creates silos that severely limit the ability of an organization to share images freely. PACS has also created unnecessary and expensive complications in managing storage. With the move toward value-based care, this siloed approach is rapidly being replaced by a patient-centric information model, and proprietary applications are rapidly going the way of the dinosaur
Gives Texas Physicians Glimpse of Future in Austin
Texas Medical Association (01/2016)
From telemedicine to medical intelligence, research to individualized care, new data analysis and care delivery technologies are enabling some medical sectors to thrive while sounding the demise of others. Physicians can expect technology to change the way they practice. Those that ignore the oncoming disruption risk becoming a physical rental store in the age of digital delivery.
Disruptive innovation is currently happening in medicine. Although it is unlikely that medical IT departments will eliminate the need to hire surgeons any time soon, access to today’s latest medical technologies is allowing physicians to better compete with specialty centers, research labs and large medical networks.
“They have to stop thinking in traditional terms and acting with yesterday’s logic,” said Dr. Nick van Terheyden, M.D. “They should focus on what is and what could be. If they ‘wait and see’ they will be relegated to observers of the new age of medicine.”
2016 Will Set The Agenda For The Future Of Health IT
HealthIT Outcomes (01/2016)
2015 was an incredible year in technology and healthcare; from consumer technology and personalized devices coming to market to the introduction of supercomputers that reduce the time and cost of healthcare data analysis. It’s been great to see how innovation continues to penetrate the medical profession, improving patient services and care. As we look to 2016, there are some areas that we can expect technology to further impact.
EHRs are like junk drawers — but there’s a way to declutter them
Becker’s Health IT & CIO Review (01/2016)
Searching for patient data in an EHR is rather like rummaging in that catch-all drawer most people have in their kitchen. You know the one — it’s where everything goes that doesn’t have a designated place or somehow doesn’t get put where it belongs. That drawer has many useful items in it. All those jumbled bits and pieces may be useful someday, but you don’t need them right now. An EHR is a lot like that drawer. It has plenty of useful data in it, and a lot of other bits and pieces that, with the right integration tools and the right analytics, will be useful someday. The problem is that right now you need a specific piece of patient data, and to find it you end up rummaging through a lot stuff that isn’t of any help at the moment.
Worse yet, the data you need can be a test result that is locked up in another system. It’s like knowing that you have a small screwdriver that is perfect the task at hand, but you loaned it to your neighbor. You could go knock on the door and ask for it, but they might take forever to answer the door, and then they’d have to rummage through their catch-all drawer to find it, and you just don’t have time to mess with it. So you buy a new one. Like that screwdriver, the data you need is often locked up in another nearby system, and you could get it if you asked for it, but you don’t have time to knock on the digital door and wait around for the other system to find it and send it to you. So you order a new test.
The future of healthcare
Future Ready Economies – Dell PowerMore (12/2015)
I am passionate about habits because poor lifestyle choices—or bad habits—are the number one driver of today’s health crisis. Chronic illnesses—such as heart disease, stroke, asthma, diabetes, and obesity—are responsible for 7 of 10 deaths each year, and treatment of chronic diseases accounts for 86% of U.S. healthcare costs. However, while they are among the most common and costly of health problems, chronic diseases are also the most preventable and manageable, because they often result from choices we make in our daily lives. To conquer chronic illness, we have to change our bad habits. And that’s not easy.
Calling Dr. Data: A new consultant is set to make medical care more effective
Beckers Hospital Review (10/2015)
Much of medical practice is as much a mystery to doctors as it is to patients. Human physiology is so complex, and the external variables so numerous, that we often have no sure knowledge of why one patient did well or another patient didn’t. Every physician longs for some way to really know what will work for each patient. While we have come a long way, even in just the past five years, there is still so much left to be learned. The one thing that can help us reach greater knowledge faster is data and analytics.
That’s really the underlying value of electronic medical records: they represent a treasure trove of data waiting to be mined. With the right algorithms, we can use that data to find patterns that tell us what factors make a tangible difference in outcomes. It’s the wisdom of the ages waiting to be read.
Patient engagement lessons from Africa
Medcity News (09/2015)
I was raised in Africa and though I’ve never practiced there, I consider myself African and continue to be interested in the delivery of healthcare on the continent. Though health resources are scarce, my colleagues there have made creative use of the tools available. Across much of the rest of Africa, text messages are routinely used to provide timely health messages about medications, clinic appointments, health risks and general health information. They are way ahead of the U.S. in proactive use of mobile technology for health improvement.
Process matters as much as technology
It’s an exciting time to be a chief medical information officer (CMIO), especially at a hospital or health system with forward-thinking leadership. New technologies are emerging that will help us make huge strides toward truly effective, precise and personalized medicine. That said, it’s also a very complex time. New technology comes with a host of challenges, and the biggest lie not so much with the technology but with the people involved. New clinical technology inevitably disrupts established workflows, and while it can be a big improvement, it has to be handled carefully if you want the project to succeed.
Accelerating the sequencing and analyzing of genomic data opens the doors to using it in a clinical setting, enabling easy sharing of this data, which often comes in data sets too large for sending via email. This rapid speed also makes possible the collaboration between experts around the world, further accelerating the pace of scientific advancement.
Doctors find little value in the way fitness activity data from patients’ wearable devices is presented to them now.
In fact, far from improving patient care, the data deluge makes doctors feel “overwhelmed” and prevents them from getting key, helpful information, according to Dr. Nick van Terheyden, the recently appointed chief medical officer at Dell Healthcare and Life Sciences.
Genomics, cloud security on agenda for new Dell Healthcare CMO van Terheyden
Medicity News (07/2015)
A month after stepping down as CMIO of Nuance Communications, Dr. Nick van Terheyden has been named CMO of Dell Healthcare & Life Sciences.
While famous for hardware, Round Rock, Texas-based Dell actually is one of the world’s largest providers of IT consulting services, the result of the company’s 2009 acquisition of Perot Systems. “It’s not as well-known as you would expect, given how much we’re doing,” van Terheyden, known in health IT circles as “Dr. Nick,” told MedCity News.
Dell Appoints Dr. Nick van Terheyden as New Chief Medical Officer
Long time readers will know that we’ve regularly done videos with Dr. Nick (@DrNic1). He’s one of my favorite people to sit down with and talk healthcare IT. I first met Dr. Nick when he was CMO of MModal, but our relationship really flourished when he was CMO at Nuance and we shared a cab together to the airport at one of the healthcare IT conferences. Ever since then I’ve counted him a good friend and someone I enjoyed talking about anything healthcare IT related. The beauty with Dr. Nick is that you can go pretty deep with him on any science and technology topic.
9 Ways to Gather Useful Feedback from Patients
Physician Practice (06/2015)
“I don’t recall my physician ever asking for my feedback on their practice. As a patient, if I want to provide feedback, I have to scour the Internet looking for a place to leave comments and ratings. Physicians need to take the onus off off patients and follow the examples of hotels and restaurants, some of which promote rating services such as TripAdvisor in order to make it easier for customers to deliver feedback.”
The constant flux in healthcare regulations and policy has left physicians feeling frustrated and disconnected from the Art of Medicine. Pulled in disparate directions and forced to change how they allocate time, use technology and document patient notes, has made them feel that the most rewarding part of their responsibilities — patient care — has been subsumed to less important administrative duties.
How to Improve Patient Portal Use in Emergency Care
EHR Intelligence (06/2015)
Initiatives around patient engagement and the push toward widespread patient portal use are continually being developed throughout the medical care sector. With the federal government establishing meaningful use objectives on patient engagement and requesting clinicians to report electronic clinical quality measures based on their patient care outcomes, healthcare providers are obligated to work toward increasing patient engagement with wellness and overall health on an ongoing basis.
“Patient engagement is critical as we move from fee-for-service to value-based care,” Dr. van Terheyden went on. “If more individuals take an active role in their care by following treatments, knowing their own medical history, and tracking symptoms, it is more likely they will stay out of the hospital, be more informed in the healthcare decision-making process, and avoid unnecessary tests and procedures because they will have access to their health data. This can only happen when patients are connected to their health, and the patient portal is a key pathway to achieve this.”
Is Health IT Guilty of Being a Worm in Horseradish?
There’s a saying, “To a worm in horseradish, the world is horseradish,” meaning we are predominantly aware of that which we are surrounded by on a daily basis. Health IT, in all its intricacies and expansiveness, has become hyper focused on making sense of its nebulous infrastructures, working hard to prepare healthcare organizations for next new wave of regulations. Our world, while not horseradish, is composed of goals and milestones that are 100 percent contingent upon these systems.
Marrying Voice and Text Within the EHR
For the Record (04/2105)
The role of speech recognition technology within EHR clinical documentation workflows has been debated for years. And the verdict appears to be in.
Industry professionals agree that while speech recognition is no longer a product differentiator for the average EHR, it has carved out a noteworthy niche within today’s evolving technology-driven workflows—one that is likely here to stay.
NY Times (04/2015)
Industry executives, however, argue that devices that simply collect and display numerical information about users’ behavior are unlikely to spur them to make durable changes in their habits. People typically use fitness activity trackers for only four to six months and then lose interest, says Dr. Nick van Terheyden, the chief medical information officer of Nuance Communications, a language-processing and voice technology company.
“Technology that is static, that is passive, doesn’t persist and doesn’t engage you,” Dr. van Terheyden says. So Nuance has joined with 22 Otters, a health app developer, to introduce capabilities that allow users to obtain customized health information from their apps by voice.
Social Media Leads the Way in Patient Engagement
Diagnostic Imaging (04/2015)
Before a patient even walks in the door, he’s already generated a first impression of his physician and practice based on what he’s found online.
“Our patients have formed an impression before they’ve met us [in person],”said Nick Van Terheyden, the chief medical informatics officer for Nuance Communications during the Healthcare Information Management and Systems Society (HIMSS) Annual Conference.
Why The Patient Story Should Always Take Center Stage
HIT Consultant.net (03/2015)
Stories are the backbone of who we are. They provide context, insight, subtle and not-so-subtle hints about ourselves and those around us. They teach us lessons and help us determine similarities and differences so that we can avoid mistakes and replicate success.
What health care experts are expecting in 2015
Boston Business Journal (12/2014)
2015 will be the year when the healthcare industry begins to more fully realize the power of mobility and its impact on patient engagement. With an eye on population health management, health systems will identify patients with, or at risk of, chronic disease, and work with them to energize patient engagement and adherence. Wearables and other mobile devices will be integrated into patient treatment plans to provide support for patients transition to healthier lifestyles. Physicians, too, will turn to mobile devices more and more, not just to connect to one another, but to actively treat patients, order labs, and work with medical records on-the-go to free up more of their time for patient care. Speech recognition will be a big driver of this, as it simplifies the interactions for both physicians and patients, and provides an extra layer of engagement.”
Access to information critical despite trade offs
Orlando Sentinel and Sun Sentinel (12/2013)
Our data will never be 100 percent secure. This is a reality we all face as denizens of the 21st century. We live in a world where everything from our banking transactions to the diagnostic reports mechanics run on our cars rely on digital capabilities that have been designed to provide real-time results in a user-friendly way. Potential data breaches are the trade-off we make for that instant access; in health care, access to information is critical to providing the best patient care.
5 Common Misconceptions With EHRs
Becker’s Health IT & CIO Review (08/2011)
For many hospitals and providers, the costs and issues involved with “electronic health records” might make them known as “electronic hated records.” Hospitals must be meaningful users of EHRs by 2015, or it will result in Medicare payment penalties. However, there are several misconceptions with EHRs, ranging from purpose of their function as well as how to achieve meaningful use with an EHR. Nick van Terheyden, MD, chief medical information officer of communication technology company Nuance Communications, debunks five common fallacies associated with EHRs and explains how to get the true value of the technology.