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Searching for Disruptive Healthcare Innovation in 2017

Posted on January 17, 2017 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin is a true believer in #HealthIT, social media and empowered patients. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He currently leads the marketing efforts for @PatientPrompt, a Stericycle product. Colin’s Twitter handle is: @Colin_Hung

Disruptive Innovation has been the brass ring for technology companies ever since Clayton Christensen popularized the term in his seminal book The Innovator’s Dilemma in 1997. According to Christensen, disruptive innovation is:

“A process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”

Disruption is more likely to occur, therefore, when you have a well established market with slow-moving large incumbents who are focused on incremental improvements rather than truly innovative offerings. Using this definition, healthcare has been ripe for innovation for a number of years. But where is the AirBNB/Uber/Google of healthcare?

On a recent #hcldr tweetchat we asked what disruptive healthcare technologies might emerge in 2017. By far the most popular response was Artificial Intelligence (AI) and Machine Learning.

Personally, I’m really excited about the potential of AI applied to diagnostics and decision support. There is just no way a single person can stay up to speed on all the latest clinical research while simultaneously remembering every symptom/diagnosis from the past. I believe that one day we will all be using AI assistance to guide our care – as common as we use a GPS today to help navigate unknown roads.

Some #hcldr participants, however, were skeptical of AI.

While I don’t think @IBMWatson is on the same trajectory as Theranos, there is merit to being wary of “over-hype” when it comes to new technologies. When a shining star like Theranos falls, it can set an entire industry back and stifle innovation in an area that may warrant investment. Can you imagine seeking funding for a technology that uses small amounts of blood to detect diseases right now? Too much hype can prematurely kill innovation.

Other potentially disruptive technologies that were raised during the chat included: #telehealth, #wearables, patient generated health data (#PDHD), combining #HealthIT with consumer services and #patientengagement.

The funniest and perhaps most thoughtful tweet came from @YinkaVidal, who warned us that innovations have a window of usefulness. What was once ground-breaking can be rendered junk by the next generation.

What do you believe will be the disruptive healthcare technology to emerge in 2017?

Rumor Control: These are the Facts

Posted on January 16, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Why is it that one of the largest challenges on any project is miscommunication and out of control rumors? While many projects need and would benefit from more communication, even with the best of communication plans, project teams can spend more time dispelling false information than proactively communicating.

I believe in strong communication plans for EHR and ERP projects that include a wide range of communication including town halls, newsletters, emails, signage, internet sites, and other methods of sharing correct information. But on every project, no matter how much we communicate, certain hospital staff will find other sources of information.

I can see the rumor coming when an email or conversation starts with “I heard that…” or “Is it true that…”. These are telltale signs that I am about to hear a rumor. Rumors can range from minor details to far-reaching implications such as a perceived change in project scope or even the live date. While most rumors are just annoyances, responding to them and controlling them can be a significant strain on the project team’s time.

I believe that hospitals have a unique challenge in that proactive communication is more challenging than in many traditional businesses because it is common for a large portion of the staff, including nurses and physicians, to rarely check email. As a result, they are often in a position where “hallway conversation” is how they first hear information and are more likely to give it credibility.

While I admit that I have personally never been able to fully eliminate the rumor challenge, I’d like to share several ideas about what I have seen as an effective way to keep the rumor mill under control:

1) Establish a clear Source of Truth – From the very beginning of the project, communicate to every possible audience how decision and communications will be distributed and who they should contact with questions and information. If it doesn’t come from one of the accepted Sources of Truth, its not true. When I lead a project, I prefer to be the Source of Truth – if it doesn’t come from me verbally or in writing, it isn’t true.

2) Encourage questions and respond to all of them timely – When I am running a project, my motto is “Ask me anything, anytime”. At times, I will get dozens or even hundreds of questions a day through meetings, phone calls, texts, and emails. I respond to every question, providing the truth if I have it, or getting them to the person who can provide the truth. Rumors often start because staff members are not getting answers or don’t feel their questions are welcomed. How do I respond to so many requests? I do it immediately so they can’t accumulate – which also helps inspire confidence and a feeling that they can ask rather than assume.

3) Town Halls – I strongly believe that a change management and communication strategy must include town halls. During town halls, project teams should provide an overview of what is occurring that is relevant to the staff, do occasional software demonstrations, and most importantly – field questions. Creating those proactive communication channels is a powerful way to avoid people creating their own truths.

4) Provide the complete truth – Sometimes the answer to a question is not known because it has not been determined, or has not been considered. Sometimes it is not what the person wants to hear. Regardless, provide the truth – and the complete truth. There is nothing wrong with saying that you don’t know – but can find out. Or that a decision has not been made, but now that they have raised the concern we will make it and get back to them. Responding immediately doesn’t always mean providing an answer immediately, as long as the follow-up is done once the answer is available.

5) Communicate Everywhere – A communication plan must be extensive and include many different points of contact. Intranet sites can look impressive and have lots of great information on them – but usually only a small percentage of the staff will check them. Consideration must be given as to how to communicate with contracted employees, physicians, and traveling nurses. This is particularly challenging during an EHR roll-out when all of these parties must be enrolled in training classes and kept up-to-date on the go-live. Find and use every possible communication challenge. There are always questions about how much communication is too much – but they apply to the volume of communication you push through a particular communication channel – not the number of different communication channels you use.

Finally, accept that no matter what you do, rumors will form and will need to be dispelled. Its part of project management and change management that always had existed, and always will. Properly controlled, the rumors can be a minor distraction at worst – entertainment at best.

Please share any ideas you have found to be successful in keeping rumors under control.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Healthcare’s Not Good At Mining Health Data

Posted on January 13, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was really blown away by this quote from an interview with Rebecca Quammen.

The buzz around data analytics promotes the need for data scientists and data analysts as among the most sought-after roles, and that is problematic in and of itself. It’s creating a huge demand, but it’s also a demand that many healthcare organizations don’t know how to deal with right now. I see the buzz around data analytics increasing the pressure to “do something” with data, but many organizations across the nation, both large and small and in every setting of care, simply don’t have the foundational knowledge to manage the data to their benefit, and to know the database structure and how to get it the data out and what the data tells them when they get it. We are not an industry historically good at mining good, rich data out of products and doing something meaningful with it. We do traditional reporting and we may do a little bit of historical reporting, but we’re not good at looking at data to predict and promote and to work toward the future, or to see trends and do analysis across the organization.

Rebecca nailed this one on the head. I’ve seen a bunch of organizations go running towards healthcare informatics with no idea of what they wanted to accomplish or any sort of methodology for how they’re going to analyze the data to find useful insights. It kind of reminds me of the herd mentality that happens at conferences. If any sort of crowd starts to build at a conference, then the crowd quickly grows exponentially as people think that something interesting must be going on. The same seems to happen as healthcare organizations have run towards data analytics.

While I think there’s so much potential in health data analytics, I think that most organizations are afraid to fail. The culture in healthcare is “do no harm.” There are some very good reasons for this and some real fears when it comes to medical liability. There’s a lot more at stake when using data in healthcare than say Netflix trying to predict which shows you might be interested in watching. If Netflix gets it wrong, you just keep scrolling after some minor frustration which you quickly forget. In healthcare, if we get it wrong, people can die or be harmed in some major way.

I understand why this healthcare culture exists, but I also think that inactivity is killing as many or more people than would be damaged by our data mistakes. It’s a challenging balance. However, it’s a balance that we must figure out. We need to enable more innovation and thoughtful experimentation into how we can better use health data. Yes, I’m talking beyond the traditional reporting and historical reporting which doesn’t move the needle on care. I’m talking using data to really impact care. That’s a brave place to be, but I applaud all of those brave people who are exploring this new world.

“Learning Health System” Pilot Cuts Care Costs While Improving Quality

Posted on January 11, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As some of you will know, the ONC’s Shared Nationwide Interoperability Roadmap’s goal is to create a “nationwide learning health system.”  In this system, individuals, providers and organizations will freely share health information, but more importantly, will share that information in “closed loops” which allow for continuous learning and care improvement.

When I read about this model – which is backed by the Institute of Medicine — I thought it sounded interesting, but didn’t think it terribly practical. Recently, though, I stumbled upon an experiment which attempts to bring this approach to life. And it’s more than just unusual — it seems to be successful.

What I’m talking about is a pilot study, done by a team from Nationwide Children’s Hospital and The Ohio State University, which involved implementing a “local” learning health system. During the pilot, team members used EHR data to create personalized treatments for patients based on data from others with similar conditions and risk factors.

To date, building a learning health system has been very difficult indeed, largely because integrating EHRs between multiple hospital systems is very difficult. For that reason, researchers with the two organizations decided to implement a “local” learning health system, according to a press statement from Nationwide Children’s.

To build the local learning health system, the team from Nationwide Children’s and Ohio State optimized the EHR to support their efforts. They also relied on a “robust” care coordination system which sat at the core of the EHR. The pilot subjects were a group of 131 children treated through the hospital’s cerebral palsy program.

Children treated in the 12-month program, named “Learn From Every Patient,” experienced a 43% reduction in total inpatient days, a 27% reduction in inpatient admissions, a 30% reduction in emergency department visits and a 29% reduction in urgent care visits.

The two institutions spent $225,000 to implement the pilot during the first year. However, the return on this investment was dramatic.  Researchers concluded that the program cut healthcare costs by $1.36 million. This represented a savings of about $6 for each dollar invested.

An added benefit from the program was that the clinicians working in the CP clinic found that this approach to care simplified documentation, which saved time and made it possible for them to see more patients during each session, the team found.

Not surprisingly, the research team thinks this approach has a lot of potential. “This method has the potential to be an effective complementary or alternative strategy to the top-down approach of learning health systems,” the release said. In other words, maybe bottom-up, incremental efforts are worth a try.

Given these results, it’d be nice to think that we’ll have full interoperability someday, and that we’ll be able to scale up the learning health system approach to the whole US. In the mean time, it’s good to see at least a single health system make some headway with it.

McKesson and Infor Go-To-Market Partnership – What Happens Now?

Posted on January 9, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

A couple weeks ago, McKesson and Infor announced a partnership that will have McKesson EIS (Enterprise Information Solutions) offering Infor Cloudsuite as their cloud-based ERP (Enterprise Resource Planning) solution for human resources, supply chain, and financials. What does each party have to gain from this partnership and what does this mean for existing customers of McKesson ERP solutions?

Infor continues to be the dominant player in the ERP space for healthcare providers. Its healthcare applications, previously known as Lawson (and probably always known as Lawson to many of us), have the largest market share with the majority of larger hospitals and healthcare systems. Its closest competitor in the past, Peoplesoft, is now owned by Oracle which is focused on developing and promoting its Fusion product and has released the final version of the Peoplesoft product. Workday, the cloud-only solution that is publicly traded and making significant strives in many industries, has won deals in human resources and financials implementations but lacks a supply chain solution, critical to any integrated ERP deployment. SAP, the largest ERP provider in the world, has a strong presence in healthcare manufacturers but does not provide a supply chain solution well suited for the unique needs of healthcare providers, and therefore has a very small market share.

McKesson, once a strong player in this space, has faded over the years in ERP as they have with EHR solutions. The majority of the McKesson ERP customer base, using the products commonly referred to as Pathways, have been long-time legacy customers. Pathways has not been kept up with modern ERP needs, and it has been many years since I have seen a hospital consider Pathways as a potential solution, but rather it is typically the solution being replaced.

Infor has invested significantly in creating a cloud-based solution, referred to as CloudSuite. However, the existing healthcare customer base typically has an on-premise installation and therefore cloud adoption has been focused on new customers as well as those that are specifically looking to transition away from on-premise. McKesson has not had a cloud offering, therefore it would make sense for them to partner with someone to offer it as an alternative to Pathways.

Infor will gain access to the Mckesson customer base, many of whom are likely considering leaving Pathways for other solutions anyway. In addition, Infor will be able to provide Mckesson’s Strategic Sourcing solution for their customers.

However, it is unclear what that means for Pathways. While McKesson press releases state that CloudSuite is an alternative to Pathways, one has to wonder why Infor would want to expose their solution to someone who is actively selling a competitive solution, and why McKesson would continue to invest in Pathways when it has access to a much more mature and robust solution as a go-forward path for its Pathways customers.

Therefore while it is likely that McKesson will keep Pathways supported and up-to-date with regulatory improvements for the time being, it seems very unlikely that they would continue to enhance it – and inevitable that it will eventually be sunset in favor of transitioning those customers to Infor Cloudsuite. If history is indeed an appropriate predictor of the future, consider that McKesson announced its BetterHealth 2020 plan – in which they announced a focus on Paragon as their EHR but continued support of the older Horizon EHR product. Shortly after that they went back on that commitment and announced they would sunset Horizon in 2018.

Meaningful Use has led to a focus of resources on Electronic Health Records implementations which have led many customers to hold onto their older ERP solutions past their useful life. I suspect that the next two years will see a re-focus to ERP solutions with customers with more modern solutions focusing on upgrades and new feature deployment while customers with older solutions making a change.

Those customers who stayed on Horizon for too long are currently in a rush to implement replacements before the March 2018 sunset date.Customers on Pathways products should likely start the conversation now about their long-term ERP plans and consider if they want to get ahead of any sunset announcement.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Indecision in Upgrading Infrastructure – Blamed on Meaningful Use

Posted on January 6, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a conversation I had with Steve Prather, CEO at Dizzion, he made a really interesting observation about meaningful use causing delays in upgrading infrastructure at many healthcare organizations. It’s not hard to see how spending millions, hundreds of millions or even billions of dollars on EHR and related services in order to meet the meaningful use requirements could cause budget cuts in other areas like upgrading infrastructure.

Of course, the opposite can be true as well. I know when we first implemented an EHR, a good portion of the EHR budget was to upgrade some of the infrastructure needed to support the new software. I’m sure that probably means that some infrastructure benefited from the EHR upgrade and meaningful use, but I’m sure some infrastructure spending also got cut or delayed.

In my conversation with Steve he went on to observe that much of the hardware in healthcare organizations had gotten so old, indecision and delays were no longer a choice. Having talked to many CIOs, they feel this in their organizations. While many CIOs want to move on to more strategic efforts, there’s still a big part of any CIOs job that requires them to maintain and upgrade their IT infrastructure. Although, it seems that many of them are looking to push this responsibility off to a kind of IT COO position.

I’ll be interested to watch and see how these organizations approach their infrastructure upgrades. Will most continue to do all the work in house or will they start to outsource this essentially commodity task to an outside company? There’s a really interesting case for why organizations should outsource this work as opposed to continuing to do it in house. All of this points back to the CIO becoming a vendor management organization.

Has your infrastructure upgrades been delayed by meaningful use? Is your organization looking to finally upgrade or is MACRA going to delay things further?

Some Projections For 2017 Hospital IT Spending

Posted on January 4, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A couple of months ago, HIMSS released some statistics from its survey on US hospitals’ plans for IT investment over the next 12 months. The results contain a couple of data points that I found particularly interesting:

  • While I had expected the most common type of planned spending to be focused on population health or related solutions, HIMSS found that pharmacy was the most active category. In fact, 51% of hospitals were planning to invest in one pharmacy technology, largely to improve tracking of medication dispensing in additional patient care environments. Researchers also found that 6% of hospitals were planning to add carousels or packagers in their pharmacies.
  • Eight percent hospitals said that they plan to invest in EMR components, which I hadn’t anticipated (though it makes sense in retrospect). HIMSS reported that 14% of hospitals at Stage 1-4 of its Electronic Medical Record Adoption Model are investing in pharmacy tech for closed loop med administration, and 17% in auto ID tech. Four percent of Stage 6 hospitals plan to support or expand information exchange capabilities. Meanwhile, 60% of Stage 7 hospitals are investing in hardware infrastructure “for the post-EMR world.”

Other data from the HIMSS report included news of new analytics and telecom plans:

  • Researchers say that recent mergers and acquisitions are triggering new investments around telephony. They found that 12% of hospitals with inpatient revenues between $25 million and $125 million – and 6% of hospitals with more than $500 million in inpatient revenues — are investing in VOIP and telemedicine. FWIW, I’m not sure how mergers and acquisitions would trigger telemedicine rollouts, as they’re already well underway at many hospitals — maybe these deals foster new thinking and innovation?
  • As readers know, hospitals are increasingly spending on analytics solutions to improve care and make use of big data. However (and this surprised me) only 8% of hospitals reported plans to buy at least one analytics technology. My guess is that this number is small because a) hospitals may not have collected their big data assets in easily-analyzed form yet and b) that they’re still hoping to make better use of their legacy analytics tools.

Looking at these stats as a whole, I get the sense that the hospitals surveyed are expecting to play catch-up and shore up their infrastructure next year, rather than sink big dollars into future-looking solutions.

Without a doubt, hospital leaders are likely to invest in game-changing technologies soon such as cutting-edge patient engagement and population health platforms to prepare for the shift to value-based health. It’s inevitable.

But in the meantime it probably makes sense for them to focus on internal cost drivers like pharmacy departments, whose average annual inpatient drug spending shot up by more than 23% between 2013 and 2015. Without stanching that kind of bleeding, hospitals are unlikely to get as much value as they’d like from big-idea investments in the future.

The Millennial Paradox and My New Year’s Resolution

Posted on January 2, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Simon Sinek always has some incredible insights. My wife pointed out this interview, the Millennial Paradox – it tackles the question of what Millennials are looking for in the workplace and also addresses issues with technology overload and our increased need for constant communication.

He speaks quite extensively about how technology is preventing us from establishing meaningful relationships. Its discussed in relationship to why Millennials have workplace challenges but while I am a generation removed from them I see that I share in these challenges and would likely find that many readers of this article do as well.

I suspect I’m not alone, but I have to admit that I’m allowing my phone to dominate my daily life and priorities. In the video, Simon describes how people take their phones to meetings and as a result, are not spending time building relationships with those they work with. I’ve been doing that lately – I put my phone on the table and feel the constant pull to check it. I need to check my email. I feel the siren call of the the vibrating phone and must see what it is.

I don’t generally do New Year’s resolutions. But this year, I’m making an exception. 2017 is the year I don’t carry my phone at every moment, the year that I might not respond to every text or email regardless of the hour, and overall the year that I reclaim control of my life from my iphone.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Top Hospital EMR and EHR Blog Posts for 2016

Posted on December 30, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

It’s that time of year when you look back at the past year and think about what you’ve accomplished. At Hospital EMR and EHR, we like to look back at the stats for the top blog posts we’ve published. It’s always interesting to see what’s resonated with people. Plus, it’s interesting to see how things have changed since we’ve posted on a topic. So, without further ado, here’s a look at the top blog posts in 2016 for Hospital EMR and EHR along with some commentary on each.

1. Why Is It So Hard to Become a Certified Epic consultant? – This is by far the top post generating 4-10 times as much traffic as the posts below.  It’s also why I’ve wanted to make the time to do a whole series of blog posts on Epic Certification and along with it Cerner Certification, MEDITECH Certification, etc.  When you make something like Epic Certification hard to get, people want it even more.  It’s just too bad they’re so closed since it drives up the prices for Epic consultants and thus the cost to implement Epic.  Certainly, we’ll be writing about this more in the future.

2. NYC Hospitals Face Massive Problems With Epic Install – This was a big story back in 2013 and still is today.  We should probably look at doing a follow up story to see what’s happening at NYC hospitals a few years after this story hit.

3. Epic Install Triggers Loss At MD Anderson – No surprise, people love to read about challenges in EHR implementations.  We saw quite a few of these from Epic in 2016 and people were interested in what went wrong.  The problem from the outside is it’s really hard to know who is to blame for the failure.  What has become clear over this year is that many healthcare organizations are blaming Epic for their revenue issues.

4. Hospital EMR and EHR Vendors – This page needs some work, but no doubt many people want to know who the big players in the hospital EMR and EHR market are.  This is true if they’re selecting a new EHR, switching EHR or looking to partner with EHR companies.

5. Why Do People Dislike Epic So Much? Let Me Count The Ways – This post is 5.5 years old and still going strong.  I imagine many people are still counting the ways they hate Epic.  I think I read that Epic finally hired a PR person.  Maybe that new hire can work on this.

6. A Study on the Impact of ICD-10 on Coding and Revenue Cycle – This was a good study that illustrated the impact of ICD-10.  It also gave some good words of caution about the impact of ICD-10 going forward.

7. Epic EMR Costs Drag Down Finances At Brigham and Women’s – Another example of the cost to implement Epic.  I knew this was a hot topic this year and the stats show that people were interested in the details.

8. The Argument for Meditech – I can’t believe this post is 5 years old already, but it still rings true today.  MEDITECH is not without its challenges, but it also doesn’t get the credit it deserves either.  I had a chance to visit their offices near Boston this year.  I’ll be really interested to see where MEDITECH takes their product next.  Many people have counted them out, but I certainly haven’t.

9. Can HIM Professionals Become Clinical Documentation Improvement Specialists? – We’ve published a lot about the changing world of HIM thanks to our new series of HIM Scene blog posts.  This post was a great example of how there are a lot of new opportunities for HIM professionals that are willing to embrace change and adapt as needed.

10. Great Healthcare IT Leaders – This is a great list of healthcare IT leaders as shared by David Chou.  David made the case for meeting up with them at HIMSS 2016, but the nice part is thanks to social media you can follow most of them year round.

An honorable mention to the 11th post on the list which talks about Dr. Rasu Shrestha helping an injured passenger on his way to HIMSS 2016.  Love stories like this.  Did you have a favorite post on Hospital EMR and EHR?  Was there an idea or concept you read on Hospital EMR and EHR?  We’d love to hear about it in the comments.

A Look At Geisinger’s Big Data Efforts

Posted on December 28, 2016 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

This week I got a look at a story appearing in a recent issue of Harvard Business Review which offers a description of Geisinger Health System’s recent big data initiatives. The ambitious project is designed not only to track and analyze patient outcomes, but also to visualize healthcare data across cohorts of patients and networks of providers and even correlate genomic sequences with clinical care. Particularly given that Geisinger has stayed on the cutting edge of HIT for many years, I think it’s worth a look.

As the article’s authors note, Geisinger rolled out a full-featured EMR in 1996, well ahead of most of its peers. Like many other health systems, Geisinger has struggled to aggregate and make use of data. That’s particularly the case because as with other systems, Geisinger’s legacy analytics systems still in place can’t accommodate the growing flood of new data types emerging today.

Last year, Geisinger decided to create a new infrastructure which could bring this data together. It implemented Unified Data Architecture allowing it to integrate big data into its existing data analytics and management.  According to the article, Geisinger’s UDA rollout is the largest practical application of point-of-care big data in the industry. Of particular note, Geisinger is crunching not only enterprise healthcare data (including HIE inputs, clinical departmental systems and patient satisfaction surveys) and consumer health tools (like smartphone apps) but even grocery store and loyalty program info.

Though all of its data hasn’t yet been moved to the UDA, Geisinger has already seen some big data successes, including:

* “Close the Loop” program:  Using natural language processing, the UDA analyzes clinical and diagnostic imaging reports, including free text. Sometimes it detects problems that may not be relevant to the initial issue (such as injuries from a car crash) which can themselves cause serious harm. The program has already saved patient lives.

* Early sepsis detection/treatment: Geisinger uses the UDA to bring all sepsis-patient information in one place as they travel through the hospital. The system alerts providers to real-time physiologic data in patients with life-threatening septic shock, as well as tracking when antibiotics are prescribed and administered. Ninety percent of providers who use this tool consistently adhere to sepsis treatment protocols, as opposed to 40% of those who don’t.

* Surgery costs/outcomes: The Geisinger UDA tracks and integrates surgical supply-chain data, plus clinical data by surgery type and provider, which offers a comprehensive view of performance by provider and surgery type.  In addition to offering performance insight, this approach has also helped generate insights about supply use patterns which allow the health system to negotiate better vendor deals.

To me, one of the most interesting things about this story is that while Geisinger is at a relatively early stage of its big data efforts, it has already managed to generate meaningful benefits from its efforts. My guess is that its early successes are more due to smart planning – which includes worthwhile goals from day one of the rollout — than the technology per se. Regardless, let’s hope other hospital big data projects fare so well. (Meanwhile, for a look at another interesting hospital big data project, check out this story.)