Health Data Management - - GROUP PRACTICES -

Sachin Gupta, MD, a pul­mo­nolo­gist and tech­nol­ogy en­thu­si­ast, is pre­dict­ing an ex­plo­sion of dig­i­tal in­no­va­tion in health­care. “With re­spect to dig­i­tal health, I think there’s a bit of an arms race go­ing on be­tween hos­pi­tals right now,” Dr. Gupta said. “Dig­i­tal in­no­va­tion pi­lots are hap­pen­ing in many health sys­tems be­cause pa­tients are de­mand­ing to re­ceive care with these in­no­va­tive tools. So, hos­pi­tals and health sys­tems are go­ing to be forced to adopt in­no­va­tive tech­nolo­gies whether they want to

About 80% of peo­ple are do­ing a Google search or some kind of dig­i­tal search to find health­care providers at a lo­ca­tion near them.

Cus­tomer is king

As such, many trail­blaz­ing health­care or­ga­ni­za­tions are look­ing to get out ahead of the tech­nol­ogy curve and pro­vide con­sumers with what they want – and need. For ex­am­ple, AMITA Health has em­barked upon what Deb­o­rah Fuller­ton, CMO and VP, calls a “dig­i­tal re­tail jour­ney” as the health sys­tem aims to fo­cus keenly on the needs of pa­tients.

“We held a re­treat for lead­er­ship last spring about the con­sumer­iza­tion of health­care. Our lead­er­ship un­der­stands that we need to en­sure our or­ga­ni­za­tion thinks and acts more like a re­tail en­vi­ron­ment,” Fuller­ton said.

As part of this con­sumer-fo­cused ef­fort, the Ar­ling­ton Heights, Ill.-based health sys­tem has im­ple­mented an on­line ap­point­ment sched­ul­ing sys­tem that in­tel­li­gently matches pa­tients with avail­able health­care providers. With this sys­tem in place, pa­tients can use on­line search tools to ac­cess the AMITA Health physi­cian di­rec­tory and eas­ily book ap­point­ments with providers who ac­cept their in­surance and match their in­di­vid­ual health­care needs. Pa­tients can quickly see which providers are avail­able at their de­sired times, with­out hav­ing to pick up the phone or wait on hold.

“About 80% of peo­ple are do­ing a Google search or some kind of dig­i­tal search to find health­care providers at a lo­ca­tion near them. So, we are giv­ing them a mo­bile-ready way to find the in­for­ma­tion that they need. We are mak­ing it pos­si­ble for pa­tients to tailor their search by ZIP code, spe­cialty, ail­ment or physi­cian. Giv­ing them the

Adding an easy, fast self-sched­ul­ing op­tion is the next log­i­cal ser­vice im­prove­ment.

ca­pa­bil­ity to search in a va­ri­ety of dif­fer­ent ways helps to cre­ate a bet­ter ex­pe­ri­ence,” Fuller­ton said. “Adding an easy, fast self-sched­ul­ing op­tion is the next log­i­cal ser­vice im­prove­ment.”

In ad­di­tion to mak­ing it eas­ier for pa­tients to sched­ule ap­point­ments, the on­line sched­ul­ing sys­tem is also ex­pected to en­able AMITA Health to make im­prove­ments to the over­all pa­tient ex­pe­ri­ence. Data gath­ered by the on­line sys­tem pro­vides de­tailed in­sights into pa­tient be­hav­ior, as re­lated to ex­ist­ing work­flows. As such, AMITA Health will be able to lever­age this in­for­ma­tion to make changes that could im­prove the pa­tient ex­pe­ri­ence, provider pro­duc­tiv­ity and staff uti­liza­tion.

For ex­am­ple, a par­tic­u­lar physi­cian might have open sched­ule slots but the data could show that new pa­tients are re­quest­ing ap­point­ments for Fri­days, a day that the physi­cian has fewer ap­point­ments. As such, AMITA Health will be able to bet­ter “align sup­ply and de­mand,” Fuller­ton said.

The on­line sched­ul­ing sys­tem is just one of many tech­nolo­gies that AMITA Health is us­ing to im­prove the over­all pa­tient ex­pe­ri­ence. The health­care or­ga­ni­za­tion is im­ple­ment­ing a va­ri­ety of con­sumer fac­ing tech­nolo­gies such as:

An omni-chan­nel con­tact cen­ter. “This cen­ter will en­able con­sumers to com­mu­ni­cate with us in the medium they choose, whether that’s tex­ting or email or phone call or snail mail,” Fuller­ton said.

AMITA Health Check, a pa­tient-gen­er­ated health data app. This app sim­pli­fies com­plex care plans into daily steps/re­minders and en­ables pa­tients to com­mu­ni­cate di­rectly with their care teams about ev­ery aspect of health, from med­i­ca­tion doses and side ef­fects to fol­low-up ap­point­ments. The app uses ar­ti­fi­cial in­tel­li­gence to cus­tom­ize a symp­tom word cloud. Pa­tients also en­ter their pain lev­els and reg­is­ter their ac­tiv­i­ties. All of these en­tries are mon­i­tored daily by nurses on a cus­tom­ized dash­board, which quickly iden­ti­fies when pa­tients need an in­ter­ven­tion.

“AMITA Health first in­tro­duced this app to joint re­place­ment pa­tients be­cause of the many ac­tiv­i­ties re­quired by pa­tients be­fore they show up for surgery – and the fact that if they fail to com­plete these, surgery would be can­celled, which is not good for the pa­tient or the hos­pi­tal,” said Fuller­ton. “Now AMITA Health uses this app for pa­tients with anx­i­ety, de­pres­sion, stroke and bariatric surgery.”

A med­i­cal trans­porta­tion app. “This app uses Lyft driv­ers for pa­tients who need fol­low-up phys­i­cal ther­apy. A driver, with a spe­cial ve­hi­cle and who is spe­cially trained to pick up health­care pa­tients is sent to pick them up,” Fuller­ton said.

A be­hav­ioral medicine app. This app is ini­tially be­ing used with ad­dic­tion pa­tients. “It has a GPS, so if the pa­tient is in an area that’s near a temp­ta­tion – say, their fa­vorite bar – then it sends them pos­i­tive mes­sages and tells them where the near­est Al­co­holics Anony­mous meet­ing is,” Fuller­ton said. The app also con­nects pa­tients to

With the blue-tooth tech­nol­ogy in place, clin­i­cal staff will re­ceive up­dates in real time, elim­i­nat­ing the need for fre­quent check-ins.

coun­selors, who are avail­able around the clock.

Cre­ate a bet­ter ex­pe­ri­ence

Dr. Gupta agrees that health­care providers need to meet es­ca­lat­ing con­sumer de­mands by pro­vid­ing a more con­nected health­care ex­pe­ri­ence.

“There is a bell curve de­vel­op­ing. The most con­nected pa­tients that live in cities like San Fran­cisco, Chicago and New York City are al­ready start­ing to de­mand it. And, I think we're go­ing to see an uptick now where even less tech-savvy pa­tients are go­ing to start look­ing at avail­abil­ity of health tech­nol­ogy as an im­por­tant fac­tor when mak­ing de­ci­sions about which in­surer and hos­pi­tal sys­tem they go to,” Dr. Gupta said.

To meet these needs, Dr. Gupta is count­ing on the fact that in­no­va­tive tech­nol­ogy can not only look­ing to make health­care more con­ve­nient and ef­fi­cient but more ef­fec­tive. More specif­i­cally, Dr. Gupta is work­ing to de­velop a sys­tem that uti­lizes blue­tooth con­nected de­vices (blood pres­sure cuff, scale, pulse oxime­ter and ac­tiv­ity tracker) that pul­monary hy­per­ten­sion pa­tients can use at home to pro­vide in­for­ma­tion to clin­i­cians who can mon­i­tor their health sta­tus.

“There’s a con­di­tion called pul­monary hy­per­ten­sion, which is ba­si­cally a form of heart fail­ure where the heart fails due to high pres­sure in the lung’s ar­ter­ies. Pa­tients need to be on di­uret­ics to con­trol the swelling. So, help­ing these pa­tients reg­u­late their di­uret­ics is re­ally key,” Dr. Gupta said. “These pa­tients re­quire high touch ser­vices. So, with the ex­ist­ing tra­di­tional sys­tems, nurses or phar­ma­cists need to man­u­ally call pa­tients at set in­ter­vals. They check in to see what their weight and blood pres­sure is. The pa­tients of­ten record these mea­sures on a piece of pa­per and then re­cite them. This is OK but there are times when this process fails, and these vul­ner­a­ble pa­tients can slip through the cracks.”

With the blue-tooth tech­nol­ogy in place, clin­i­cal staff will re­ceive up­dates in real time, elim­i­nat­ing the need for fre­quent check-ins. Per­haps more im­por­tantly, though, the sys­tem lever­ages an­a­lyt­ics to “iden­tify trends in a pa­tient’s blood pres­sure, oxy­gen lev­els, ac­tiv­ity, or weight that in­di­cate they are pro­ceed­ing in the di­rec­tion to­ward heart fail­ure based on pre­de­fined vari­ables,” Dr. Gupta said.

“Just be­ing able to dig­i­tize this process, in and of it­self, is valu­able be­cause it can en­sure that pa­tients are be­ing prop­erly mon­i­tored. Ap­ply­ing the al­go­rithm to de­ter­mine which di­rec­tion pa­tients are mov­ing in, that’s what re­ally dis­tin­guishes the value of this tech­nol­ogy,” Dr. Gupta said. As such, the tech­nol­ogy is ex­pected to im­prove pa­tient sat­is­fac­tion, and hope­fully demon­strate it can help re­duce hos­pi­tal read­mis­sions and im­prove mor­bid­ity rates.

Hav­ing an app that pro­vides and, at the same time, doc­u­ments my re­view of the clin­i­cal guide­lines and NIH (Na­tional In­sti­tutes of Health) stroke scale is es­sen­tial.

Go-to guid­ance

In ad­di­tion to as­sess­ing pa­tient progress, ar­ti­fi­cial in­tel­li­gence can also be used to help clin­i­cians pro­vide more ef­fec­tive care (see side­bar). For ex­am­ple, Mar­cus Scar­brough, MD, a hos­pi­tal­ist with Lawrence Memo­rial Hos­pi­tal in Kansas, is us­ing a mo­bile app that helps to pre­vent er­rors by pro­vid­ing clin­i­cians with stan­dard­ized, step-by-step guid­ance and de­ci­sion sup­port dur­ing crit­i­cal health­care events such as stroke, car­diac ar­rest and sep­sis. The app pro­vides stepby-step nav­i­ga­tion sim­i­lar to a GPS ap­pli­ca­tion to a some­times 40 to 50 step al­go­rithm fol­lowed by clin­i­cians dur­ing a crit­i­cal med­i­cal event. In essence, the app in­tel­li­gently au­to­mates a clin­i­cal al­go­rithm and of­fers a sim­ple, in­tu­itive way for providers to nav­i­gate that sce­nario for time crit­i­cal di­ag­noses.

The app has proved es­pe­cially help­ful when deal­ing with stroke pa­tients in in­pa­tient units – be­cause clin­i­cians work­ing in this en­vi­ron­ment typ­i­cally do not ex­pe­ri­ence these events very of­ten, ac­cord­ing to Scar­brough.

“When pa­tients have a pos­si­ble stroke in the in­pa­tient unit it can be chal­leng­ing be­cause of the low fre­quency of this oc­cur­rence but the ob­vi­ously high stakes. Hav­ing an app that pro­vides and, at the same time, doc­u­ments my re­view of the clin­i­cal guide­lines and NIH (Na­tional In­sti­tutes of Health) stroke scale is es­sen­tial. All the while, the timer is prompt­ing and re­mind­ing me how much time we have to get the TPA (tis­sue plas­mino­gen ac­ti­va­tor) in,” Scar­brough said. “I don’t want to be with­out the app any­more when I go on shift.”`

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