Archive for the ‘Electronic Medical Record’ Category

Guest Post: EHRs, Artificial Intelligence and Empathy

March 9th, 2017 by Basil Hayek and Paul Penta, Sapient Health

social_business_strategyCan melding the best of electronic health records (EHRs) and artificial intelligence foster greater empathy among healthcare providers? Basil Hayek, Director of Business Consulting, Sapient Health, and Paul Penta, Manager of Business Consulting, Sapient Health, examine that possibility in this guest post.

EHRs, artificial intelligence, and empathy: If this were a Sesame Street segment, it would be easy to pick the one that is not like the others. But could combining the first two actually enable greater empathy?

First, let's set some context. Industry-wide, there is a high degree of dissatisfaction amongst physicians with EHRs. This can result from the increased clerical burden, poor user interfaces, and feeling of cookbook medicine. These challenges add to the burden already faced by physicians, and contribute to burnout, sub-optimal prescribing and referral behaviors, and erosion of clinician empathy.

As empathy diminishes, so do outcomes. Studies across multiple conditions, including diabetes, cancer, and the common cold, found evidence supporting this hypothesis. In addition, a broad evidence review saw a consistent positive association between patient experience, patient safety and clinical effectiveness. As clinician empathy can dramatically influence a patient’s experience, it can be surmised that empathy is a contributing factor.

There are various approaches to addressing EHR challenges. Healthcare organizations are deploying scribes, tablets and optimization programs. Legislative and policy changes are in the works. Although not enacted before the end of the congressional session, the Senate Committee on Health, Education, Labor, and Pensions Committee introduced a bill last year to help improve EHR usability. In addition, the Agency for Healthcare Research and Quality within the Department of Health & Human Services has called for certification requirements on EHR usability.

Ultimately, healthcare provider satisfaction with EHRs will improve through these tactics. That's not to say that EHRs cannot move from simply meeting a HCP’s expectations to exceeding them. This is where artificial intelligence (AI) will play a role.

When AI is mentioned, the first thing that comes to mind is probably IBM's Watson. Watson, which gained fame for winning Jeopardy against two former champions in 2011, has dramatically evolved its cognitive capability and reach to make an impact in various industries, including healthcare. Healthcare providers can use Watson to analyze medical records, assist in diagnosis, and help find evidence-based treatments, and its capabilities continue to grow. These developments are exciting, but only hint at what is achievable, which includes helping to achieve the Quadruple Aim of an improved patient experience, improved population health, reduced costs, and an improved clinician experience.

AI can contribute in realizing the Quadruple Aim due to its ability to efficiently analyze large volumes of data, discover patterns, and make logical inferences. The potential population health and cost implications resulting from AI are fairly self-evident. What is intriguing is how AI can play a role in helping improve the provider and patient experience. How this could come together is better told through two scenarios.

Scenario 1:

Consider 47-year-old Gary, recently diagnosed with type 2 diabetes. He is due for a follow-up with his doctor to review his treatment after completing blood work. In the first scenario, Gary is trying to navigate his diagnosis in the current state environment.

Because of a lab location that requires him to drive instead of taking public transit, Gary misses three scheduled lab appointments and is forced to reschedule his follow-up. When he finally completes his labs and meets with his doctor, she seems hurried and spends most of the time looking at her laptop as she updates Gary’s chart. Although she notes his A1Cs have risen, she opts to continue the same regimen until his next appointment. Gary leaves feeling uncertain about the effectiveness of his medication, and has doubts on whether the side effects of heartburn and indigestion are worth it.

Now, let’s look at a version of this same narrative where AI enables a better all-around experience.

Scenario 2:

After Gary misses his first lab appointment, the AI-enhanced EHR offers to reschedule at a location one stop away from his house. He attends that appointment and keeps his follow-up with his doctor. Prior to this appointment, his doctor reviews an AI-generated clinical summary, which highlights key factors to consider for Gary’s treatment and confirms that she has reviewed the latest research relevant to Gary’s condition and history.

She greets Gary when he arrives and asks how he’s doing with the medication. When he mentions heartburn and indigestion, she acknowledges they’re common side effects, and recommends that he be diligent about taking it with food and using an antacid until the side effects diminish.

She turns Gary’s attention to a large wall-mounted screen showing a patient-optimized view of his health record. She uses a tablet as a second screen to direct the conversation via a physician view. Gary sees his blood glucose trends and notices that the side effects he just mentioned are in his record. As they discuss additional medication to help control Gary’s rising A1Cs, the doctor asks Gary to confirm the accuracy of the displayed list of medications and supplements. Gary mentions he has also started taking low dose aspirin.

Shortly after he says this, aspirin appears on the screen. The physician view on her tablet alerts her of new research indicating an interaction between aspirin and a candidate medication. With this information, she recommends an alternative combination drug, and Gary walks out with a new prescription and confidence in managing his diabetes.

Conclusion:

In the second scenario, AI enabled the following technologies and associated benefits to provide an alternate and improved experience:

  • Prescriptive analytics based on clinical and socio-demographic perspectives of EHR data: offloads intent from the patient and reduce barriers to care;
  • Context-aware clinical natural language processing: offloads data entry from the physician, and allows the patient to more naturally participate in the treatment conversation;
  • Cognitive computing to assess medical evidence: allows physicians to more easily review information relevant to a specific patient.

These enablers are neither new nor novel. However, combined they provide unobtrusive interventions that reduce the clerical and cognitive burden on physicians and provide improved opportunities for patient engagement. With time to think and a renewed focus on the person sitting in front of them, physicians can return to an empathy-driven encounter, and everyone wins.

About the Authors:

Basil Hayek, Director of Business Consulting, Sapient Health

Basil Hayek, Director of Business Consulting, Sapient Health

Basil Hayek is responsible for digital strategy and delivery for Sapient Health. He supports a broad portfolio of clients, with a focus on health plans, pharmacy, and retail health. He gets excited about bringing together his technology, data, and product background to drive engagement and deliver business results for companies and better health outcomes for individuals. Basil graduated from Cornell University with a BS in Computer Science.

Paul Penta, Manager of Business Consulting, Sapient Health

Paul Penta, Manager of Business Consulting, Sapient Health


As a Manager of Business Consulting at Sapient Health, Paul Penta draws on his experience building technology for patients in a clinical chronic care environment to enable digital change in healthcare organizations. With a focus on digital and technology strategy, Paul always keeps the patient at the center of the experience. Often taking on a cross-functional role, Paul excels in leading the strategic merger of process and product to achieve impactful metrics. Paul received an MBA from Boston University.


HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.

Infographic: Technology and the 21st-Century Medicine Bag

March 6th, 2017 by Melanie Matthews

The traditional clinician's medicine bag is now a thing of the past, but its replacement promises to be even more useful as a means of facilitating better patient care, according to a new infographic by Transcend Insight. Now, a doctor's visit is facilitated via laptop or with a smartphone -- technologies and products of healthcare innovation.

Healthcare innovation, in fact, is transforming everything from how physicians diagnose and treat their patients to how healthcare systems are reimbursed for their services. Here’s a quick look at how that transformation is unfolding, and how four key technologies in particular have become critical components of modern-day medicine.

Technology and the 21st-Century Medicine Bag

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System Encouraged by early success in coaching 23 patients to wellness at home via remote monitoring, CHRISTUS Health expanded its remote patient monitoring (RPM) enrollment to 170 high-risk, high-cost patients. At that scaling-up juncture, the challenge for CHRISTUS shifted to balancing its mission of keeping patients healthy and in their homes with maintaining revenue streams sufficient to keep its doors open in a largely fee-for-service environment.

Remote Patient Monitoring for Chronic Condition Management: Leveraging Technology in a Value-Based System chronicles the evolution of the CHRISTUS RPM pilot, which is framed around a Bluetooth®-enabled monitoring kit sent home with patients at hospital discharge.

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Infographic: EHR and Clinical Documentation Effectiveness

February 27th, 2017 by Melanie Matthews

EHR and Clinical Documentation EffectivenessInformation technology and healthcare leaders are looking at ways to improve electronic health record (EHR) and clinical documentation effectiveness, according to a new infographic by Nuance Communications, Inc.

The infographic examines the strategies healthcare organizations are implementing to improve clinician satisfaction with EHRs and how organizations are optimizing EHRs this year.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results Between Medicare's aggressive migration to value-based payment models and MACRA's 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS's 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today. Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: Capturing the Value of Digital Healthcare Transformation

February 22nd, 2017 by Melanie Matthews

Healthcare providers across the globe are recognizing the need for digital technology in their hospitals and practices. But with ever-tightening budgets and numerous priorities, where exactly should they focus their investments? What will really drive the most value? The biggest impact comes from digitizing the ways clinicians, healthcare workers, and administrators do their jobs, according to a new report by Cisco.

A new infographic from Cisco highlights the report's findings and details potential digital health cost savings.

Capturing the Value of Digital Healthcare Transformation

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as 'connected health,' leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today. Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: EHR + CRM = Superior Patient Engagement

February 13th, 2017 by Melanie Matthews

U.S. hospitals that provide superior patient experiences generate 50 percent higher financial performance than average providers…key in today's shift from volume- to value-based healthcare, according to a new infographic by Evariant. True patient engagement is about creating trust between the patient and health system, nurturing a relationship over the course of a patient's lifetime.

This understanding is possible by integrating healthcare CRM software and EHR systems. Combined, these two systems weave together patient data from a variety of sources, including demographic, social, behavioral, and clinical data.

The infographic examines how a combined EHR and CRM can bridge the patient engagement gap and extend the EHR investment.

Infographic: EHR + CRM = Superior Patient Engagement

Patient-centric interventions like population health management, health coaching, home visits and telephonic outreach are designed to engage individuals in health self-management—contributing to healthier clinical and financial results in healthcare's value-based reimbursement climate.

But when organizations consistently rank patient engagement as their most critical care challenge, as hundreds have in response to HIN benchmark surveys, which strategies will help to bring about the desired health behavior change in high-risk populations?

9 Protocols to Promote Patient Engagement in High-Risk, High-Cost Populations presents a collection of tactics that are successfully activating the most resistant, hard-to-engage patients and health plan members in chronic condition management. Whether an organization refers to this population segment as high-risk, high-cost, clinically complex, high-utilizer or simply top-of-the-pyramid 'VIPs,' the touch points and technologies in this resource will recharge their care coordination approach.

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Infographic: Hidden Encrypted Threats Impact Healthcare

November 11th, 2016 by Melanie Matthews

Healthcare organizations are increasingly targeted by cyber criminals seeking to steal electronic protected health information, electronic health records, personally identifiable information and other confidential patient data, according to a new infographic by A10.

The infographic examines the healthcare cyber threat, the need for SSL, why healthcare organizations have been slow to adopt SSL and the top SSL decryption tools.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: The Healthcare Security Challenge

October 21st, 2016 by Melanie Matthews

The role of IT in healthcare delivery has expanded dramatically in just the last few years—and so has the threat from data thieves. A single, stolen healthcare record is worth hundreds of dollars on the black market—creating an estimated $6 billion cybersecurity problem for the industry as a whole, according to a new infographic by NaviSite.

The infographic examines the latest data on the healthcare security problem and a seven-step plan for protection.

2016 Healthcare Benchmarks: Digital HealthPerson-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: Hospital Health IT Use in Maryland

September 16th, 2016 by Melanie Matthews

All of Maryland's acute care hospitals use a certified electronic health record (EHR), according to a new infographic by the Maryland Health Care Commission.

The infographic examines the top three EHR vendors in use in Maryland, as well as the use of patient portals, IT for population health management and telehealth and the number of hospitals participating in health information exchanges.

While widespread adoption of electronic health records has generated new streams of actionable patient data, John C. Lincoln has taken data mining to new levels to enhance performance of its accountable care organization (ACO).

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care reviews the concentrated data dig undertaken by John C. Lincoln to prepare for participation in the CMS Medicare Shared Savings Program (MSSP).

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

Infographic: Healthcare Cyber Security Threat Prognosis

August 24th, 2016 by Melanie Matthews

The 10 largest healthcare cyber attacks of 2015 affected over 100 million records, valued at up to $154 per record breached, according to a new infographic by FireEye.

The infographic examines the depth of the healthcare cyber security threat, why the healthcare industry is a top target for cyber crime and the potential cost to healthcare organizations of a security breach.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare IndustryFrom cost pressures, consumerism and consolidation to a proliferation of patient-centered, value-based delivery and payment models, the state of healthcare continues to challenge organizations in the industry.

Healthcare Trends & Forecasts in 2016: Performance Expectations for the Healthcare Industry, HIN's 12th annual business forecast, pins down the trends destined to impact the industry in the year to come and proposes tactics C-suite executives can employ to distinguish their operations in a dynamic marketplace. Click here for more information.

Get the latest healthcare infographics delivered to your e-inbox with Eye on Infographics, a bi-weekly, e-newsletter digest of visual healthcare data. Click here to sign up today.

Have an infographic you'd like featured on our site? Click here for submission guidelines.

Care Transitions Playbook Sets Transfer Rules for Post-Acute Network Members

July 28th, 2016 by Patricia Donovan

St. Vincent's Health Partners best practices care transitions playbook documents more than 140 patient transfer protocols.

St. Vincent's Health Partners best practices care transitions playbook documents more than 140 patient transfer protocols.

A primary tool for Saint Vincent’s Health Partners Post-Acute Network is a playbook documenting more than 140 transitions for patients traveling from one care setting to another, including the elements of each transition and ways network members should hold each other accountable during the move. Here, Colleen Swedberg, MSN, RN, CNL, director of care coordination and integration for St. Vincent’s Health Partners, explains the playbook's data collection process and information storage and describes a typical care transition entry.

The playbook is made up of several sections, including one with current expectations, based on the Michigan Quality Improvement Consortium, which we can review online. From an evidence-based point of view, they’ve listed the evidence for many common conditions patients are seen for in medical management. This is kept up to date. This is an electronic document stored on our Web site that can only be accessed by individuals subscribed to the network. We’ve also put this on flash drives for various partners.

A second section contains actual metrics for any network contracts. The metrics appear in such a way that the highest standard is included. For example, physician providers, as long as they provide the highest level of care in the metric, can be sure they’re meeting all the metrics. Those metrics are based on HEDIS® standards.

The third section is the transition section, laid out in two to three pages. For example, a patient moves from the hospital inpatient setting to a skilled nursing facility, such as Jewish Senior Services. For that transition, the playbook documents all the necessary tools for that patient: a personal health record, a medication list, whatever is needed. Also included is any communication with the primary care physician, if that provider has been identified. Finally, this section identifies the responsibility of the sending setting—in this case, the hospital inpatient staff. What do they need to organize and make sure they’ve done before the patient leaves and starts that transition, and what is the responsibility of the receiving organization?

That framework is the same for every transition: the content and tools change according to the particular transition. A final section of the playbook details all of the tools used for care transitions. For example, in our network, we’re just now working on the use of reviews for acute care transfers, which is an INTERACT (Interventions to Reduce Acute Care Transfers) tool. In fact, many settings, including all of our SNFs, as it turns out historically, have used that tool. This tool is in the playbook, along with the reference and expectation of when that tool would be used.

Source: Post-Acute Care Trends: Cross-Setting Collaborations to Align Clinical Standards and Provider Demands

http://hin.3dcartstores.com/Post-Acute-Care-Trends-Cross-Setting-Collaborations-to-Align-Clinical-Standards-and-Provider-Demands_p_5149.html

Post-Acute Care Trends: Cross-Setting Collaborations to Align Clinical Standards and Provider Demands examines a collaboration between the first URAC-accredited clinically integrated network in the country and one of its partnering PAC providers to map out and enhance a patient's journey through the network continuum—drilling down to improve the quality of the transition from acute to post-acute care.