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Entries by Janice McCallum (69)

Monday
May202019

Valuing Health Data

The New England HIMSS Annual Spring Conference held on May 16, 2019 at Gillette Stadium included a range of speakers who directly—or indirectly—spoke about the uses of data in healthcare. Here are my highlights, seen through my (permanent) #healthdata lens.

Richard Parker, MD, Chief Medical Officer, Arcadia, kicked off the day describing how Arcadia strives to identify the most “actionable” patients from the most “impactable” segments of the provider’s population.

Dr. Parker described the predictive analytics process in broad strokes and referred to the foundational step of aggregating data—including claims data, EHR data, medications data—as “not easy” and that they want all the data they can get their hands on to improve their predictive models. I asked him for more detail on the biggest challenge in aggregating & cleaning the data inputs, the “non-sexy” elements of data science as I called it. For Arcadia, access to EHR data is granted by clients that provide the data feeds and who are provided access to the curated and cleansed aggregated data, as well as the outcomes of the modeling exercises.

 

Dr. Richard Parker

Micky Trapathi, President and CEO, Massachusetts eHealth Collaborative, described interoperability as a “dimmer switch” rather than an “on/off switch”. To put it in my words, interoperability is not a thing or an inherent property of a data set. Rather, it requires common data standards and communications specifications between the parties that want to exchange data. The degree of interoperability depends on how highly specified the data set is and how well the parties exchanging data follow the same specifications.

For the present, FHIR does a good job in defining standards and specifications for limited data items and use cases, but we have a long way to go before data exchange is optimized for a wide range of use cases. Tripathi illustrates the current state with a cube diagram with only a portion of the lower left-hand space completed.

 

Micky Tripathi

Larry Garber, MD, Medical Director for Informatics, Reliant Medical Group, illustrated how Reliant has created a working ecosystem that includes a larger set of data exchange scenarios than those required by current regulations. Reliant has an early mover advantage, as pointed out by my friend Matt Fisher, who has good knowledge of Reliant’s model & history.

@Matt_R_Fisher

Keys to #EMR success from @GetReliant Dr. Garber. Comes from lengthy experience that predates #regulatory forced adoption. Arguable clear advantage. #NEHIMSS 

Dr. Larry Garber

My takeaway from the CIO panel:  hospitals and physician practices are still struggling with understanding the value of data for their everyday purposes of treating patients. However, when shown how aggregated data can be applied in specific areas, such as identifying when a patient needs follow-up or what group of patients need to be prioritized, the value becomes self-evident. Presumably, the ability to recognize the value of data will improve after clinicians gain experience with early use cases that demonstrate improved efficiency and outcomes.

What about the downside of high-value data?

Juhan Sonin, Creative Sandpaper, Director of GoInvo and Lecturer, MIT, who envisioned the home-based healthcare center of the future when he spoke at NEHIMSS two years ago, tackled  some of the  problems associated with extracting  value from health data when access is restricted.  Furthermore, with so much data being generated by all sorts of devices and aggregated by firms that provide profiles and screening criteria to marketers, we’re deep in the age of surveillance. Providing patients/individuals with control or ownership of their own health data is the only way to transform the age of surveillance into a net positive for individuals according to Sonin (and I agree). 

Health Content Advisors’ Recap

In the digital age, where all content is data, we often hear comparisons that “data is the new oil” or “data is the new water”. The Lancet even published an article recently, “Data is the New Blood”. I have two disclaimers to add to those proclamations, both of which were reinforced at the New England HIMSS spring conference:

I)                    If data is the new oil, then we’re still at the stage of figuring out how to refine the data;

II)                  Data doesn’t have value until someone uses the data.


I’d like to thank the New England HIMSS chapter and the volunteers who put together an outstanding program again this year. See more info on the program, speakers, presentations and sponsors here:

http://ne.himsschapter.org/event/new-england-himss-annual-spring-conference-save-date

Finally, a special shout-out to E Ink, who not only sponsored breakfast but whose prize I won at the end-of-day raffle. I love my electronic paper wall clock! 

 

Wednesday
Sep052018

Digital Health Management: Hype vs Reality Webinar #SPMLearning

Who remembers the Quantified Self movement? I recall attending meetups of the QS community years ago and considered the quantified self group central to consumer adoption of digital health technologies—through advocacy and example.

Today, we don’t hear the term ‘quantified self’ as often, but a recent Rock Health survey indicates that the young ‘worried well’ between the ages of 18-35 with incomes greater than $75,000 remain the dominant users of digital health technologies. In comparison, those who might benefit most from monitoring vital signs to identify changes in health condition are not heavy users of digital health tools.

 

Why haven’t we made more progress in directing digital health technologies to the populations most in need? The Society for Participatory Medicine’s Learning Exchange webinar on September 11 with guest speakers who are leaders in advancing the adoption of digital health technologies that improve patient outcomes will help answer that question.

We are fortunate to have a stellar panel of speakers to provide context on where we have hit roadblocks and where we have made the most progress in serving targeted populations.  Joining S4PM members Vera Rulon, Sarah Krüg and me will be:

Patient Perspective
Donna Cryer, JD

President  & CEO, Global Liver Institute

Digital Health Experts:

Joe Kvedar, MD

VP, Connected Health, Partners Healthcare

Lygeia Ricciardi, EdM

President, Clear Voice Consulting

Former Director, Office of Consumer e-Health, ONC, HHS

We will have time for questions from the audience, so please come prepared with questions or information you’d like to share.

The Learning Exchange webinars (#SPMLearning) are sponsored by Accenture and Vocera; registration is free. Register for the Sept 11, 2018 Digital Management Hype vs. Reality webinar at 1 pm here: https://www.cvent.com/c/express/87a15da5-cee1-4f32-b36b-140082717f67

Tuesday
May162017

Engaging Physicians Through Intelligent Workflow

Part I of my HIMSS17 commentary described how patient engagement applications have evolved into value-added patient workflow solutions. In this part II, the focus is on the emergence of an ecosystem that delivers integrated workflow solutions for physicians.

Ecosystems don’t arrive ready-made. As much as we wanted healthcare to vault over the development cycle that other industries followed in establishing enterprise resource planning (ERP) systems and other productivity platforms, we’ve found that healthcare has had to follow a similar path that begins with a fragmented group of limited-purpose billing, clinical, administrative, and patient-facing software systems and progresses toward platforms that connect information from multiple sources to enable more efficient workflow.

Once the foundational ecosystem is sufficiently established, value-added analytics can flourish and systems can be further tuned to improve utility, usability, and efficiency. Have we achieved success in delivering workflow systems that delight rather than deter physicians yet? Not quite, but at HIMSS17 there were good signs of progress in the foundational infrastructure, the building blocks and the interfaces that constitute a viable ecosystem.

Technology has delivered some amazing tools for mining insights from massive datasets by applying data science and cognitive computing methods. IBM Watson stands out in this area and IBM Watson Health was definitely in the spotlight at HIMSS17, given the opening keynote by IBM’s CEO, Ginni Rometty.  But, we need to remain aware of the importance of a strong data foundation for the advanced applications. Data need to meet minimum levels of accuracy, normalization, timeliness and breadth.  And, let’s not forget security and access control.

 

Can AI help the future of health? Here’s @janicemccallum’s take on the matter 

Debating Physician Engagement

A highlight for me at HIMSS17 was a brief debate with fellow social media ambassador Rasu Shrestha, MD, MBA, Chief Innovation Officer at UPMC. Our topic was “Physician Engagement” and the conversation quickly turned toward better design of products for physicians so that the product enhances productivity, with interfaces that delight rather than frustrate.  The example of EHR development, which is viewed in retrospect as including too little input from intended users and almost no vision on how digital records could interact with other digital systems to dramatically improve productivity, sits in everyone’s mind as the wrong way to develop health IT software.

 

We weren’t able to solve the issue of the ideal product development process for health IT systems in our seven minute session (although I’d love to spend more time on this topic). However, the following takeaways relate well to other hot topics at HIMSS17.

Physicians as detectives

Rasu described the work of physicians as similar to detectives who search for clues and put the pieces together to come up with the best solution. EHRs and other installed health IT systems weren’t designed to solve this core functional need of physicians. Early clinical decision support (CDS) systems have existed alongside EHR/EMRs, but have only recently begun to be integrated into workflow.

Zynx Health, which was a pioneer in workflow software for creating order sets, is celebrating its 20thanniversary.  They now work more closely with EHR vendors to integrate CDS and care plans into core workflow.[1]

It’s encouraging to see that in both consumer-facing apps and provider-focused health IT products the cluttered and disjointed landscape of health IT products and mobile apps is coalescing into a connected health IT ecosystem. But, it didn’t happen overnight. All the buzzwords from previous HIMSS conferences, including standards, interoperability, meaningful use of EHRs, data warehousing, data security, privacy, population health management, patient engagement, big data/data analytics, cloud computing and APIs have served as building blocks to get us to where we are today. AI and virtual reality systems may be awe-inspiring, but a sustainable ecosystem still needs a solid foundation built on best practices in data management, security and infrastructure.

Furthermore, the drudge work that Rasu describes in seeking clues from multiple systems and sources that often present repetitive navigation challenges is precisely the type of task suited to healthbots, as I described in my pre-HIMSS17 Industry Perspective article. Let’s offload the annoying, time-consuming drudge work to bots that perform these tasks better than humans and allow the physicians, researchers and other clinicians to focus on improving outcomes and providing better care.

[1] Note that Zynx Health’s sister company, FDB, known for its drug database, has introduced FDB Prizm, a master database for medical devices.

This article was orginally published by HIMSS on March 28, 2017 and can be found here: http://www.himss.org/news/part-ii-engaging-physicians-through-intelligent-workflow-solutions

 

Wednesday
Apr192017

Patient Engagement Tools Mature into Workflow Solutions

In this part I of my HIMSS17 commentary, I describe how the array of patient engagement offerings at this year’s annual conference has matured to include many connected workflow solutions that benefit both providers and patients & their families: 

It has taken a long time for common standards and a sufficient installed base of EHR software to be adopted to create the necessary conditions for a connected health ecosystem. But there’s good news: based on advances reported at HIMSS17, all signs indicate that we are turning the corner toward the next phase where advanced analytic and productivity applications can be built upon the basic infrastructure layer. It’s still not plug and play, but enterprise-wide systems like customer relationship management (CRM) platforms for the healthcare sector are providing the backbone, along with APIs that supply the connective tissue to related apps, for a sustainable connected healthcare ecosystem.

At HIMSS17, one pleasant surprise was witnessing the progress that has been made on the patient engagement workflow front. Prior to HIMSS17, I was quoted as saying “Without fully including patients in their own health care decisions, patient engagement programs are nothing more than paternalistic compliance programs”. That statement garnered a lot of attention on social media and led to requests for meetings with several companies that offer a new generation of patient engagement tools that far outshine the first generation of prescription adherence apps and rudimentary patient portals.

HealthGrid, for example, has created a CRM platform, CareNarrative, which helps providers communicate with patients at appropriate times and offers solutions for ambulatory care, acute care and post-acute care. CareNotify is HealthGrid’s consumer-facing platform that enables patients and their family members/care team to access real-time information on inpatient care, discharge instructions, as well as education materials. CareNotify can be used to request appointments, complete check-in, fill in surveys and more.

Geisinger Health System also has found that a CRM platform is the best way to connect and manage patient-related data to engage patients on a personalized basis. Geisinger is working with Salesforce and Accenture to develop a custom CRM that can tailor care plans to individuals. This article in MobiHealthNews provides more detail on how the team at Geisinger has maintained a patient-centric mindset with a focus on improving outcomes.

In my discussions with Chanin Wendling, AVP Informatics and Jonathan Slotkin, MD, Medical Director, Division of Applied Research & Clinical Informatics at Geisinger, they further described use cases where an entire community will be served by its CRM by connecting to related organizations and retail health outlets across the community, as is being done in a pilot program in Scranton, PA. The Scranton pilot provides a glimpse into how social determinants of health (SDOH) could be incorporated into a CRM system to create a community-wide population health management system.

It is also worth mentioning that telemedicine services can be integrated into a CRM-based patient engagement system. Salesforce, the leading worldwide CRM vendor, offers a telemedicine capability through its own-branded HealthCloud patient relationship management solution.

B.well approaches patient engagement from a different angle. Kristen Valdes, founder and CEO of b.well, brings her experience working in the health plan segment to bear on improving the patient experience. B.well’s patient engagement platform for health plans, employers and brokers offers a single solution for providing patients and their care team access to care management and wellness tools, with an emphasis on understanding benefits and costs. At the same time, the platform serves as a population health management service that incorporates cost information for the payers that offer b.well.

The examples above represent just a fraction of the enhanced patient engagement solutions that were on display at HIMSS17. Although questions remain about control, access and security of patient relationship management platforms, integrated workflow systems serve a vital function in creating a health ecosystem that can help connect providers, patients, health plans and over time, the larger communities.

Growth in patient relationship management platforms has benefited from standards and IT advances that were developed for the provider market, as well as innovations in the consumer sector, (smartphones and mobile access, in particular). Part II of my HIMSS17 commentary will focus on workflow developments that enhance physician engagement.

For the original article, please see: http://www.himss.org/news/himss17-commentary-crm-platforms-elevate-patient-engagement-programs-workflow-solutions

Friday
Mar032017

MA-based Social Media Ambassadors Meet OnPage at HIMSS17

 

Janice McCallum & Judit Sharon, CEO, OnPage at HIMSS17

Matthew Fisher and I, both HIMSS17 Social Media Ambassadors, met with OnPage, a Waltham, MA-based secure messaging company at the HIMSS annual conference. We decided to post a combined blog, reporting from our different perspectives: Matt as a healthcare lawyer with expertise in HIPAA and security; me as a healthcare market strategist and analyst. 

In my pre-HIMSS17 industry perspective article, I wrote how the core IT infrastructure at provider organizations needs a level of enhanced communications services that connects data from EHR and other database systems to build workflow solutions. OnPage represents a good example of the type of enhanced communications service I envisioned.

Judit Sharon, CEO, described how OnPage was a BlackBerry-based secure messaging service that evolved into a cloud-based escalation scheduling service that connects to available on-call physicians.

New opportunities for OnPage arose when telemedicine and other remote care services became more widely used. By providing a fast and reliable means of connecting telemedicine patients to the right clinicians, OnPage has uncovered a winning workflow solution. See this case study on Sage NeuroHospital Management Group for more details.


Matt Fisher & Orlee Berlove, Marketing Director, OnPage at HIMSS17

Matt’s discussions included greater emphasis on privacy and security issues. OnPage recognized fairly quickly that demonstrating satisfaction of HIPAA requirements would be critical to driving adoption. To this end, OnPage determined applicable standards and implemented those requirements into its product.

The ability to securely connect multiple devices is a serious issue within healthcare. Finding tools that can be used on multiple devices is important, especially if those tools can segregate data, since accessed documents automatically saved to a phone is an often overlooked security issue.  A tool like OnPage, which can seamlessly fit into workflow and meet regulatory requirements, is one worth investigating.

To me, OnPage is representative of the evolution of health IT devices and apps from single-purpose tools to workflow productivity services. Matt emphasizes that extra care needs to be taken to protect the security of patient data when new communications services enable the quick and easy flow of information across internal and external networks.