Health systems handle enormous amounts of data daily; by one estimate, about 30 percent of the world's data volume comes from the healthcare industry, and that's expected to grow over the next few years.
The future of healthcare will require better access to data than it has needed in the past. Data-driven insights and action are required as patient expectations evolve and reimbursement models shift.
For healthcare organizations to stay agile and meet patient demand, they'll need modern data platforms to face today's problems and plan for the future. If an organization doesn't have a solid modern data platform and the ability to use that data, it's steering a ship without direction, a destination, or even the knowledge to navigate.
Healthcare organizations need data to understand where they've been, what needs to improve and to forecast where they're going. A modern data platform involves modern modular technologies; hybrid cloud or cloud capabilities for scalability and flexibility; data governance; and updated approaches to managing data, such as a DataOps.
Recently, a healthcare organization reached out to me to discuss how it could modernize its approach to data and best manage its data needs across the organization. Turning to a modern data platform that can systematically pull in data from varied sources could help that organization break down silos and open insights across departments, from supply chain to clinical. All areas of a healthcare organization can benefit from an improved, agile and well-governed data platform from which data can be quickly and securely shared.
A significant driver for this change is the shift in healthcare from a fee-for-service reimbursement model toward value-based care. Insights and actions derived from data help clinicians understand whether their treatments improve a patient's health and provide a continuum of care rather than discrete, one-time services.
Another driver for change is the industrywide initiative to achieve the Institute for Healthcare Improvement's Quadruple Aim, including improving clinician wellness. Data and analytics are meant to support and enhance clinicians' experiences, not hamper them.
So, when should a healthcare organization change to a modern data platform? Internal and external feedback can help guide the decision.
Internally, departments may already express dissatisfaction with their current data and analytics capabilities. Perhaps the emergency department cannot make quicker decisions because it lacks real-time insights into bed capacity.
Externally, an organization can reach out for third-party input from technology experts and consultants to assess its current ecosystem and make recommendations based on the organization's hopes to achieve.
Healthcare systems don't have to reinvent the wheel; they can learn from the experiences of other providers, other industries, or expert partners. Progress has been made over the past several years that lays out a blueprint for modernizing a data platform and leveraging the cloud most effectively.
If a healthcare organization is ready to move forward to a modern data platform, it first needs to gauge its status on cloud adoption. It can be difficult for a healthcare organization to jump into modernizing its data platform unless leaders decide that the data platform will be the driver for leveraging the cloud more.
If an organization has already taken steps to leverage cloud capabilities for its electronic health record (EHR) system or financial data, it's in a better position to adopt a modern data platform. Starting from zero will delay adoption, especially since security, privacy, and compliance teams need time to plan for business continuity and personnel training.
Healthcare organizations should also consider their EHR data capabilities and how that could impact their future data platform. Will they leverage what the EHR vendor provides or build a new platform? Instead, they can leverage what their EHR vendor has and look to augment with other technologies. That's the best practice now, regardless of EHR capabilities: Leverage what the EHR vendor provides and move toward modernizing overall.
A healthcare organization that has its data together, organized, and understood in a modern data platform can help build a better future. This is no longer just nice to have; it's critical for any healthcare organization's long-term success.
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Sign up now for our webinar: How to Modernize Your Data Platform in Healthcare: The Right Fit for Every Unique Health System.
Healthcare has lagged behind in adopting new technologies due in part to a lack of buy-in from staff, resistance to adopting anything new, and associated high costs and budgetary constraints. That all changed when healthcare faced a global health crisis.
The rapid adoption of tools and technologies became necessary to continue treating patients and ensuring uninterrupted clinical care. With that door now wide open, Sirius Healthcare is redefining the patient room with Patient Room ‘Next’ (PRN). PRN is an adaptable, agile, and fully integrated model for healthcare environments that improves the quality of care and the patient experience—regardless of where care is delivered—by:
This approach is delivered through a combination of machine vision and audio, data intelligence, machine learning, touchless sensors, just-in-time data, and sensor-generated information to deliver real-time insights into each patient’s state and well-being, vitals, appropriate movement, and the overall environment surrounding the patient. And it is all implemented in a way that makes PRN and its technologies private and minimally invasive.
PRN is making systems and technologies seamless, discreet, and more efficient, leaving healthcare workers more time to focus on what’s most important: their patients.
Want to hear more about Sirius' Patient Room Next? Sign up for the next webinar from This Week Health: Patient Room Next: Improving Care Efficiency
“Please be very careful this morning with anything unusual you receive. My mailbox is receiving hundreds of notifications of sexploitation emails we are blocking, and I have also seen other phishing emails. My phone is beeping about every two to three seconds with notifications. I have never seen anything like this. With the significant geopolitical tension in Taiwan this morning, there are other reports on the media about cyber-attacks in progress in Taiwan, and they may be expanding. The messages we are blocking this morning are from worldwide, so they are bot-driven. Please be extra vigilant. Thank you for practicing safe computing.”
This is an excerpt from an actual email.
Every day thousands of email deliveries like this happen in the healthcare industry.
Microsoft, Crowdstrike, Z-Scaler, Palo-Alto, Tanium, Proofpoint, Absolute, and many others make up an enterprise Health IT security portfolio, all chosen to provide a robust solution to a specific security need. Email security (see above), endpoint hardening, and many acronyms [MDR, SIEM, VPN, DLP, CPSM, CIAM, etc.] are all critical to enforcing your cybersecurity posture. As the head of IT security, it's not inappropriate to say that if one fails, you fail. The result of such a failure can be devastating to an organization. The pillars of ‘Confidentiality,’ ‘Integrity,’ ‘Availability,’ and ‘Safety,’ as defined by Chris Moschovitis, are all at risk.
You’ve made your selections, often after an arduous and rigorous selection process, and now you have the platforms that collectively ‘should’ provide a bullet-proof security posture that your Board can approve of. After all, they figuratively sign the checks.
Security architecture design is done, vendors are chosen to enable that design, and now it’s all about execution. How do you take the design and supporting technologies and make them functioning, adaptable, well-governed security environments appropriate for your needs?
A key area of risk in your complex, multi-vendor world is ensuring that the individual function of each vendor’s platform is implemented in such a way as to not negatively impact other solutions or, where possible, to enhance said solutions. How does your case management solution interact with your DLP, for example? Architecture should address these interactions. But as good as it can be on paper, the implementation of security architecture is critical.
An agile project manager steeped in Health IT security becomes the next and most critical step in your governance process. They are charged with bringing your environment to life and “quarterbacking” the vendors to drive to the desired end-state. They create a high-performance environment of accountability, collaboration, and a customer-first mentality. It’s equal parts art and science and incredibly powerful when done right.
Moschovitis’ four pillars, or your equivalent, are at the forefront of every decision our Project Manager makes. This being top of mind ensures that those disciplines become ingrained in all the technology partners they have been charged with managing. This is how you get a high-functioning delivery team where success is the only possible result.
Many project managers can be chosen, but few can succeed at the level required to instill a collective feeling of “job security” in the ever-changing critical world of cyber.
Wishing you secure sleep.
Healthcare providers and patients are often in the dark regarding the cost of prescription drugs. That’s more than a simple inconvenience—it also affects whether patients adhere to their treatment plans when they discover that prescribed medications are too costly.
Many physicians choose an appropriate medication during an office or telehealth visit, hit the send button, and assume the patient has picked it up at the pharmacy. Unfortunately, when patients show up later in the Emergency Department with serious complications, they acknowledge, “Doc, I couldn’t afford the medicine.”
When the high price of prescription drugs causes “sticker shock” at the pharmacy counter, patients might not purchase their medications or may ration them by taking less than the recommended dosage. In a recent survey of American consumers, half said they had abandoned a prescription at the pharmacy in the past few years because it was too expensive.
For some patients, especially those with chronic conditions like diabetes, heart disease, and COPD, non-adherence to prescribed therapies can lead to serious health problems and hospital readmissions. A study by the American Heart Association found that people with hypertension who don’t take their medications as prescribed are five times more likely to be hospitalized than patients who adhere to their treatment plans.
It’s frustrating that patients are forced to make life-and-death decisions between their daily expenses and the medications they need to stay healthy. If healthcare providers had a better understanding of our patients’ out-of-pocket costs, we could make more informed choices to get them on therapy and keep them on track.
While affordability is top of mind for some patients, providers don’t always consider the cost. That’s not because we don’t care; it’s due to the complexities inherent in each patient’s prescription drug coverage, including medication formularies and pricing structures that vary based on insurance benefits. Here are some ways we can support better prescription price transparency at the point of care:
With the average patient visit lasting no more than 15 minutes, it’s not feasible for a provider to jump into different applications or websites to look up formulary information. Even when a modern EHR can show potential tiers of coverage within the system (often with icons or color changes in picklists), this no longer goes far enough. To truly change the equation and benefit our patients, we need to make coverage and true cost information available in the EHR workflow so providers don’t have to navigate a confusing, friction-filled process to gather that data. It’s essential that the provider can see not only that a particular drug isn’t covered, but also which two or three appropriate alternatives are covered. Additionally, the provider needs to see what the patients’ actual out-of-pocket costs will be, not just an estimate or a preferred tier of coverage.
Up-to-date benefits information should reflect whether patients have hit their annual deductible, so costs are real instead of theoretical. It’s no longer adequate or appropriate to deal with estimates. When I have real-time information while the patient is in front of me, I can see that one medication will cost $100 and one will cost $5. If the drugs are clinically equivalent, I will have a conversation with the patient and make that choice right there and then. With many high-deductible plans, it might be more cost-effective for patients to pay for their prescriptions with cash and a coupon from the pharmaceutical company. Too often, patients don’t know these discounts are available. Providers can now see cost-saving coupons within the prescription workflow, that using mail orders is less expensive, or that ordering 90 pills instead of 30 will lower the patient’s out-of-pocket costs.
In industries, from banking to aviation to shopping, customized consumer experiences are a decade or more ahead of healthcare. If our booksellers and airlines, and clothing retailers can create seamless digital transactions for consumers, shouldn’t healthcare providers be able to meet patient expectations for efficient healthcare experiences? Our industry needs to leverage lessons from the consumer market to improve the patient experience in ways that increase loyalty and support better outcomes.
New rules from the Centers for Medicare & Medicaid Services (CMS) and other government agencies will mandate EHRs and Part D plans to offer real-time benefits comparison tools so providers and patients can view medication pricing information. We know the mandates are coming and solutions already exist. Rather than making patients wait for price transparency mandates, let’s get them the information they need now.
Read this Innovation Spotlight with Magnolia Regional Health Center and learn how they used price transparency and medication history tools to:
Colin Banas, M.D., M.H.A., is Chief Medical Officer of DrFirst, and former Internal Medicine Hospitalist, and the former Chief Medical Information Officer for VCU Health System in Richmond, Virginia.
Healthcare leaders don’t often talk about interoperability's dirty secret: Despite decades of digitization and standards, we still have a problem with dirty data. That means a great deal of digital information still gets touched by human hands before it can be consumed by hospital or pharmacy systems.
This is more than an inconvenience, Manually entering information can introduce errors that contribute to patient harm and readmissions.
So how can we overcome the need for manual processes that still degrade the sharing of healthcare information between systems? DrFirst is working with leading health systems to implement practical solutions that achieve true semantic interoperability, finally fulfilling the promise of efficient workflows and informed health outcomes. We address the four Cs of “perfect data:” complete, clean, consumable, and contextual.
To get complete data, we start with the industry-standard medication history feed and then work with hospitals to identify gaps in their unique patient population, where their patients have prescriptions filled at pharmacies that do not contribute to the standard feed. We do the legwork to get those pharmacies on board and share data.
To make the data clean and consumable, we apply a patented process of machine learning and artificial intelligence (AI) to aggregate duplicate records properly, safely infer missing data fields, parse free text into structured discrete elements, and map nomenclature so that incoming data matches the vocabulary and databases of the receiving system. The received data becomes semantically interoperable because the hospital EHR can import it properly—without manual intervention—and use it for clinical decision support and analysis.
The final step is to make the data contextual. In other words, the data should support multiple clinical workflows due to being genuinely interoperable. This step extracts information from the data and is presented to the user for actionable insights. For DrFirst, this means providing actionable data scoring to inform everyday use cases such as managing opioid therapies or working to improve patient compliance with drug therapy.
This practical, semantic interoperability is helping hospitals and health systems save significant amounts of time when gathering and entering medication history while avoiding adverse drug events and medication-related readmissions.
Full interoperability of all healthcare systems remains a far-reaching goal, but advances like these in medication history interoperability are making real, practical improvements today.
Click here and read how Cone Health achieved a medication reconciliation “hit rate” of more than 93%.
In a time of EHRs, e-prescribing, and cloud-based storage, patient medication history is not always available in clinical workflows.
Fractured data from multiple sources, inconsistent terminology between systems, and time-consuming manual entries hinder medication reconciliation. Providers are frustrated, patients are at risk of preventable adverse drug events (ADEs), and hospitals are responsible for readmissions.
Problems start early, or “upstream,” in the medication reconciliation process, with 85% of inpatient medication errors originating from information collected during admission. The challenges continue flowing “downstream” after discharge as providers lose sight of patient adherence to medication regimens. This non-adherence—and the preventable readmissions it can cause—is estimated to cost the U.S. healthcare system $290 billion per year, according to the 2019 Annual Review of Pharmacology and Toxicology.
A new infographic explores how the process inefficiencies and errors jeopardize patient safety in adverse drug events and hospital finances. See The Downstream Effects of Fractured Medication Data, then ask us at DrFirst how we can minimize medication history gaps to reduce ADEs and readmissions at your organization.
Colin Banas, M.D., M.H.A. Chief Medical Officer
Colin is an Internal Medicine Hospitalist and former Chief Medical Information Officer at VCU Health System in Richmond, Virginia. He earned a bachelor’s degree from the University of Virginia, his M.D. from Eastern Virginia Medical School, and a master’s in Healthcare Administration from Virginia Commonwealth University. In 2017, Colin received the HIMSS-AMDIS award for Physician Executive of the Year from his peers. Colin is currently the Chief Medical Officer at DrFirst.
Imagine you’re hungry and craving pizza. You go to your favorite Italian restaurant, but instead of serving you a hot, delicious slice, they give you the crust, the cheese, and the sauce separately, so you have to manually assemble the ingredients yourself. That’s how it feels to physicians when patient medication history arrives in the electronic health record (EHR) in disjointed bits and pieces rather than being assembled and served up the way they are expecting.
Unfortunately, importing patient medication history into an EHR is fraught with challenges. Incoming data often uses a different language or nomenclature than used by your EHR. This means physicians are faced with empty fields in the patient record, with yellow “caution” triangles indicating missing information that needs to be manually translated and entered. This creates work, decreases efficiency, and sets up opportunities for errors that can affect patient safety.
The more we can automate this process and make it more accurate, the less cognitive effort the care team needs to spend on translations and manual entry. Ultimately, this frees up time to add value to patient care.
When you think about manually entering information into a single patient record, the process seems tedious yet manageable. But what about when we need to transfer and translate large amounts of patient data?
That’s the problem we were facing at WellSpan Health last summer. In July 2020, we kicked off a data conversion project to consolidate medication history data from three different EHRs into a new, network-wide instance of Epic. Over time, mergers and acquisitions had added several EHRs across our care locations. This was causing gaps in medical records as our patients interacted with multiple providers using different systems. We had more than 270,000 patient records and millions of medication history records migrating from our legacy systems into one EHR; manual translation and entry would have been a monumental task. This was compounded by the limited timeframe we had to migrate data from the legacy systems while simultaneously going live on our new platform.
Yet digital transfer of the data was also problematic. This was due to disparate formulary service vendors as well as differences in EHR implementations and standards. Additionally, obsolete National Drug Codes (NDCs) made it difficult to import information in a way that would be useful in clinical decision making. In addition to missing medication history, we were struggling with inconsistencies in medication instructions (sigs) and variations in terms used between different data sources. While one prescription might use the word “orally,” another would use “by mouth.”
This caused import and mapping issues that clinicians needed to manually resolve in each patient record. It takes a lot of clicks, scrolling, and selecting from drop-down menus to do that translation manually every time the information is presented.
Through a partnership with DrFirst, WellSpan Health extracted continuity of care document (CCD) information from each of the legacy systems and implemented the SmartProcessor℠ artificial intelligence (AI) solution. This solution converted medication history data into a standard nomenclature that our Epic EHR could understand. Working with DrFirst, we also established connections with local pharmacies to pull in additional prescription fill data for our patient populations in Pennsylvania and Maryland.
The data conversion process harnessed the power of AI and machine learning to convert clinical data. It was also addressing discrepancies and variations from the old EHRs, inferring missing data with context to prevent blank fields. By consolidating duplicate records, a patient wouldn’t be waiting while his or her physician reviewed duplicates before picking one to import.
It also saved our staff from importing medications and sigs as unstructured free text and filled in gaps in the data. Instead of simply importing “take one daily,” the AI can infer missing information to insert more complete data, such as “take one by mouth daily” for a medication that is used only by mouth. The AI process eliminated a huge number of yellow triangles by having data pre-populate into the appropriate fields automatically. Read full the case study here.
Now, instead of separate ingredients, we were delivering the whole pizza.
The manual conversion of each patient chart required 20 minutes. The AI engine saved five to seven minutes per patient record. We had budgeted $1.4 million for the migration project; we completed it for around $600,000, spending only about 40% of our budget. In fairness, the budgetary savings weren’t due entirely to this new process, but part of it was. We also were able to have our staff working from home. And by using CCD conversion combined with SmartProcessor, the time saved allowed them to focus on other priorities.
Imagine a healthcare environment where smart, IoT-connected platforms allow clinicians to focus on patient care. Leaders could focus on productivity. Staff would be enable by flexible technologies that function consistently, regardless of location or room configuration. Sensors would provide data directly to EHRs. Intuitive dashboards and sophisticated analytics would ensure that staff and leadership are acting on real-time data and diagnostics.
This environment is a reality today. Patient Room ‘Next’ is Sirius Healthcare’s vision for a flexible, technology-enabled space in which patients receive state-of-the-art treatment regardless of where that treatment is being provided. Consistent care provided from traditional in-patient rooms, exam areas, operating rooms and intensive care units to ambulatory care centers, remote clinics, “hospital at home” settings and more.
Designed by physicians, operational experts and artificial intelligence (AI) scientists, Artisight is an IoT sensor network for healthcare. It was created to improve quality of care, organizational operations and financial performance. This HIPAA-compliant platform uses AI not only to analyze data, but to generate new and previously inaccessible data sets. It integrates IoT sensors with AI based on NVIDIA® Clara™ Guardian and powered by NVIDIA GPU compute. IoT sensors passively collect information including data inputs from cameras, microphones, Bluetooth® and ultra-wide band (UWB) as well as real-time locating systems (RTLS). AI algorithms then process that information and are programmed to trigger automated responses. These include actions such as setting a flag in the EHR without clinical intervention, or notifying a surgeon that her case has left pre-op and is en route to the operating room.
The AI component of Patient Room ‘Next’ is critical to achieving the interactive functionality of the environment, as well as its advanced diagnostic capabilities. NVIDIA’s Clara Guardian makes this component possible. This application framework and partner ecosystem that accelerates the development and deployment of smart sensors and sensor fusion anywhere in a hospital or health system. Clara Guardian comes with a collection of healthcare-specific, pre-trained models, and reference applications that are powered by GPU accelerated application frameworks, toolkits, and a reference architecture for intelligent video analytics (IVA) and conversational AI. This makes it easy for ecosystem partners to add AI capabilities to common sensors.
A platform based on an open application programming interface (API) can readily integrate with other information and systems. This allows for a more seamless, comprehensive and integrated experience for clinicians. Now, they can receive and send information with other hospital systems and sensors. Artisight’s open API offers a streamlined and financially sound way to expand applications as novel capabilities develop.
Additionally, an open, scalable platform can consolidate algorithms on one server and easily update and add new algorithms and applications as emerging use cases and challenges arise. In the case of Artisight, they will continue to update algorithms for users as long as the organization continues to subscribe to their platform.
For many organizations, this kind of patient room transformation often means a dynamic, multiyear journey. Starting points typically include the adoption of one or two application-based solutions such as telemonitoring, telehealth, or operating room coordinator.
The advantage of this kind of application-by-application approach is that initial technology investments often deliver fast returns. These advantages can help proponents justify additional investments and pave the way for new applications as hospitals scale. But to achieve longer-term effectiveness, it’s important to establish an open, scalable foundation with the initial investment, rather than adopting incompatible technologies on a vendor-by-vendor basis. Without an open, scalable platform technology investments will cost more time and money, limit outcomes. Teams can lay a foundation that allows for smarter growth and expansion, rather than cobble a strategy that results in a “rip and replace” consequence later down the road.
Artisight and NVIDIA open platform provides this a scalable, flexible foundation that allows new applications and functionality to be added. Therefore, teams can make adjustments as they develop or their health systems can afford the investment. All the while, they can protect the technologies and investments already in place.
Health system leaders can enable greater agility and scalability for their Epic EHR, while also maintaining its performance, by developing a cloud strategy tailored around the use of the hybrid cloud.
Epic EHR changes at a rapid pace due to necessary upgrades required to keep up with the rapid changes in healthcare. Many times, this causes organizations to refresh their on-premise hardware before the typical lifecycle timeframes. Additionally, digital health initiatives, and the state of healthcare cybersecurity, adds to the burden of IT and security departments as organizations require applications and infrastructure to scale quickly. Organizations also expect business continuity and disaster recovery to be seamless to all IT offerings. As such, organizations may overcome these challenges by utilizing strategies to employ a hybrid cloud offers.
It is critical that IT departments understand the overall requirements, business drivers, IT strategies, and cybersecurity strategies of their organization. Therefore, they can develop a fully encompassing cloud and data center strategy that will accomplish the right objectives. This strategy has proven crucial to setting the vision for the department and becomes the focal point when developing a roadmap, planning projects, and evaluating new technologies.
As a result, many organizations find that the first projects utilizing this framework are often focused on quick wins financially to prove the concepts are successful (for example, Hybrid Disaster Recovery environments). From an Epic EHR perspective, this may include moving their presentation tier or web and service tier to Azure. In some cases, they choose to move the Cache/Iris tier as well.
To be successful in cloud transformations, IT organizations must address the following foundational topics:
As organizations’ data and users continue to move, so must its security program platforms. This ensures solutions can be run physical and virtual, as well as in private and public clouds. Picking the right security platforms allows security teams to operate efficiently in any environment, while allowing IT teams to take advantage of hybrid cloud-scale and agility.
To optimize the management of your hybrid cloud environment, we recommend automating as much as possible. This includes standardizing toolsets, and utilizing cloud-native features where possible. Many organizations are moving to an infrastructure-as-code and DevOps approach to help minimize the risks of service misconfiguration. Additionally, this enables rapid deployment of environments.
The best adoption rates occur when an organization and its IT department are excited about the new possibilities they can achieved. As workloads begin to shift, the best practices below will help you drive a successful adoption plan and avoid pitfalls:
A hybrid public cloud strategy can deliver value, speed, and security. It can minimize challenges and maximize application and service delivery, while safely migrating, managing, and running applications. But these attractive opportunities beg the question: who owns cloud in your organization?
Join Sirius Healthcare and This Week In Health IT on February 24th for an informative webinar. Experts will explain how to navigate today’s healthcare challenges, gain support, and properly collaborate with solution providers. Get into the gritty of understanding, building, and deploying a successful hybrid cloud strategy in your organization. Join the conversation to learn how to make the entire process faster, more affordable, and less frustrating.
The rise of new virtual care, remote work, and high-tech solutions that began in 2020 continued on in 2021, making it another landmark year for health IT adoption and innovation. The 24 months of rapid change has incentivized healthcare leaders to try and align with health IT trends as they enter the new year.
As 2021 came to a close, many health IT leaders identified key trends that health systems may grapple with in the new year and beyond.
Despite extensive investment, healthcare has not yet reached true interoperability. Tony Thornton, a principal advisor on federal healthcare for World Wide Technology, has faith that newcomers to the healthcare industry will help drive improvements.
Thornton noted that it is not really a technology problem: other sectors already transmit complicated, secure data sets between entities with relative ease. Rather, it’s a people problem. Often, a lack of motivation and concerted effort has been the main barrier to interoperability.
He provided an example of how younger consumers could apply pressure to healthcare. His daughter, a member of Generation Z, has been tested for COVID-19 many times throughout the pandemic. For her, it was frustrating that she could not access her results easily from a mobile device.
“She has the greatest expectation that the results are going to be where she needs them when she needs them,” he said. “She looks at me as a healthcare guy and says, ‘Dad, this has to get better.’”
These pressures can increase demand, Thornton explained, and help make interoperability a point of focus in 2022.
Additionally, the pandemic highlighted the importance of health information among systems. And yet, Thornton noted that it also escalated it as a priority for patients.
“It's a must in order for us to improve outcomes from a clinical delivery perspective, but also to meet the demand signal from the patients,” he said. “People typically are most interested in their healthcare when they’re older or have a chronic disease. I think the pandemic has become a forcing function to improve our interest around quality care delivery.”
Patients’ heightened expectations will continue to drive change, according to Thornton. The telehealth and virtual care boom caused by the pandemic will also drive interoperability, he continued, as health systems improve their inter-industry communication to keep up with the new disparate care environment.
Big tech players in healthcare are nothing new in industry conversations. However, with the pandemic paving the way for further disruption in 2022, patients expect convenience and ease-of-use in an increasingly virtual industry. Big tech firms have mastered those features, according to Tivity CIO Sarah Richardson.
“How many times in the last 5 to 10 years, when describing what you would want an experience to be, have you literally said ‘It's like having an Amazon experience?’” she asked. “Now they’re just doing it in healthcare.”
For example, Amazon made waves in 2021 by widening their employee-facing concierge care service and expanding in-person care for the public to 16 cities in 2022. The company has reportedly spoken to many major health insurers and employers about getting their telehealth and in-person care services covered in-network.
“They have an easy-to-use app where patients can speak to a care navigator or a clinician very quickly. It has dispatch capabilities, so a clinician can come to you where you are,” This Week In Health IT's founder and host Bill Russell said. “It has that convenience factor, and there’s no way to compete with Amazon on logistics.”
To Richardson, big tech’s logistical capabilities and built-in brand loyalty make them formidable in a competitive landscape.
“Amazon shows up at my house every single day. Why not bring a doctor next time?” she said.
In contrast, Russell expressed that big tech efforts like Amazon Care could serve as a model for traditional healthcare players, rather than their replacement. Large local providers could deliver similar local convenience if they partnered with these companies. While people may trust companies like Amazon for logistics, they trust their local providers for their healthcare, he further explained.
“People want to get their healthcare from the doctor they see on a regular basis. They have a high degree of trust in those organizations, much more so than big tech,” he said. “But big tech is slowly cracking the code on accessibility and ease of use, and those are the areas where health systems will need to bolster their capabilities moving forward, both digitally and logistically.”
Since its onset, the pandemic has contributed to mass shifts in the labor market. In healthcare, this has only added stress to an already tight staffing situation. Entering 2022, the healthcare industry is projected to continue its struggle in filling staffing roles, both clinical and administrative. Sue Schade, a principal at StarBridge Advisors, and Rick McElroy, a cybersecurity strategist at VMWare, point to a number of factors driving this difficult trend.
To Schade, it is a matter of generational priorities and burnout. Many older professionals who were nearing retirement chose to pull the plug early rather than navigate the shifting remote work environment through the final years of their career, she proposed. As for younger professionals, they might not have the same financial goals as previous generations—or the same willingness to subject themselves to burnout and frustration.
McElroy also acknowledged burnout, but noted that the pay scales in cybersecurity have “gone through the roof.” Now, potential employees have a larger pool to choose from when regarding their employment. They can choose what is best for their situation, McElroy explained. Remote work has loosed many of the past ties to employers—proximity, convenience, and in-office friendships.
In both cases, the experts acknowledged that the labor force is now steering the ship. Additionally, they pointed to employee engagement and development as the way out of this troubling health IT trend.
“I think it's absolutely critical that managers and organizations provide a level of flexibility to their employees at this point, because it is a worker’s market right now. They can move wherever they want, so flexibility I think is key,” Schade said. “It’s about really knowing your people and understanding their situation and supporting them through whatever they're working through.”
For McElroy, the situation underlines the importance of developing talent in-house.
“There are a lot of initiatives globally to grow our own cyber professionals, and wider campaigns to look everywhere for anybody that's interested in learning some stuff and contributing,” he said. “Because recruiting is still taking too long and then of course retaining our people is very hard right now.”
The COVID-19 pandemic has resulted in rapid innovation and technology adoption. However, health IT leaders are finding a major roadblock: they have the tools and the willpower, but not the ability to scale the solutions. Chris Logan, senior vice president and chief security officer at Censinet, held that the ability to rapidly scale new solutions depends on cultural adjustment. Once in place, however, he explained how that capacity to scale will in turn change the culture.
In Logan’s experience, health systems can easily see new tools that they believe will change their business. However, it is harder for them to recognize and accept the time and effort it could take to implement them. Seemingly quick, sleek fixes often turn into years-long builds that can already be outdated by the time they are up and running.
“COVID did some very interesting things to us. It made us scale innovation at breakneck speed, which we've never had to do before. If you think about just the whole work-from-home mentality, how many health systems do you know that actually had the flexibility for people to work from home? None,” he said, referring to the beginning of the pandemic.
Making remote work feasible at scale was a big challenge, Logan said. But sustaining the pace of change will be a different story, as health systems will need to be agile.
“Scaling to get [remote capabilities in place] was a phenomenal event for healthcare, a lot of people did a lot of work,” he said. “But to try to bring in all these fancy new technologies to solve real critical business issues, we're just not there yet. We've got to shift that culture and we've got to start to learn more about what's taking shape outside the walls of our hospital.”
Health policy and innovation moved quickly throughout the pandemic. But one thing actually slowed down: the new information blocking rules. First outlined by the 21st Century Cures Act in 2016, these regulations were delayed while hospitals dealt with surging COVID cases. By October 2022, health systems must make both structured and unstructured individual health data available to patients “without special effort.”
Charles Boicey, CTO for health analytics company Clearsense, acknowledged that this is not an especially long time. Therefore, health IT needs to get to work soon.
“It's absolutely going to happen, there's no getting around it, and we can't hang out and wait for our EMR vendor partners to set the stage,” he said.
According to Boicey, healthcare companies need to understand the rules “backwards and forwards.” Then, preparations can be underway for all stakeholders.
But when new federal rules arrive, Russell has noticed a pattern he hopes the industry will soon learn to avoid. Even with great forewarning, organizations will often drag their feet and miss the deadline entirely. Once ONC has had enough, they can make an example out of a few larger health systems with big fines. Then, other systems will begin their work in earnest.
“It feels like Groundhog Day,” he said.
The rules are there for a reason: to improve interoperability and empower patients, he explained. Intentional noncompliance will only hurt innovation and agility.
“We're going to be charged with the responsible and ethical transmission of that data, and we're going to be on the hook to make sure that it gets where it needs to and that it's done in a secure environment,” Boicey said.
Despite the delays, attaining full compliance with the new information blocking rules may be a scramble for some healthcare organizations. However, they could embrace the innovation and implementation lessons learned in 2021. In this case, health systems would be in a better position to get there before the end of the year.
“Assign people to this project. Fund this project. Make progress every week towards defining the data that you’re going to share. Ensure the mechanisms get put into place. Test them, and move it along,” Russell said. “Don’t be surprised in October 2022: Have a headline in September of 2022 of how you are using the data on behalf of the community. That is what we do in health IT.”