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What are you #HITThankful for?

Posted on November 23, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

It’s Thanksgiving in the US and for many this means spending time with family and friends over insane amounts of cooked poultry (or tofu for our vegetarian friends). It is also the time to stop and think about all the things we are thankful for.

This year, Brian Mack @BFMack, Marketing & Communications manager at Great Lakes Health Connect and member of the #HITsm #HITMC and #hcldr communities, started the #HITThankful hashtag as way for people to share what they are thankful for in HealthIT.

From the tweets that have been shared it’s clear that being thankful for family is at the top of the list, but there have also been many who have been thankful for supportive coworkers and online friends.

This year I am tremendously thankful for the support of all my friends and colleagues in healthcare and HealthIT. I seriously would not have made it through the year had it not been for the encouragement and thoughtfulness of friends like John Lynn, Rasu Shrestha, Joe Babaian, Robert Blount, Nick Adkins, Regina Holliday, Nick van Terheyden, Sarah Bennight, Amy Hamilton, Brittany Quemby, Erin Wold, Cristina Dafonte, Janae Sharp, Tim Kinner, Dennis Nasto, Steve Nickerson, Daniel Kube and Colleen Young.

I got a wake-up call in the spring this year and it forced me to give serious thought to where I was heading professionally. Over the summer I must have spoken with at least 100 friends and family who all told me the same thing – it’s time that I get back to doing something I love doing. For me that’s helping small HealthIT companies grow into big ones. I’m thankful to have the opportunity now to pursue my passion.

I do have to give a special shout-out to John Lynn who has allowed me to contribute blogs to HealthcareScene.com and for believing in me. You are a true friend John and I’m so happy that we are now getting the chance to work together more closely.

I also have to thank everyone in the #hcldr #HITMC #HITsm #pinksocks #HTReads #HealthITChicks #HealthXPh #irishmed and #hcsmsa communities. All of you inspire me to keep the flame burning.

Happy Thanksgiving everyone!

 

AMIA17 – There’s Gold in Them EHRs!

Posted on November 13, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

If even 10% of the research presented at the 2017 American Medical Informatics Association conference (AMIA17) is adopted by mainstream healthcare, the impact on costs, quality and patient outcomes will be astounding. Real-time analysis of EHR data to determine the unique risk profile of each patient, customized remote monitoring based on patient + disease profiles, electronic progress notes using voice recognition and secondary uses of patient electronic records were all discussed at AMIA17.

Attending AMIA17 was an experience like no other. I understood less than half of the information being presented and I loved it. It felt like I was back in university – which is the only other time I have been around so many people with advanced degrees. By the time I left AMIA17, I found myself wishing I had paid more attention during my STATS302 classes.

It was especially interesting to be at AMIA17 right after attending the 3-day CHIME17 event for Hospital CIOs. CHIME17 was all about optimizing investments made in HealthIT over the past several years, especially EHRs (see this post for more details). AMIA17 was very much an expansion on the CHIME17 theme. AMIA17 was all about leveraging and getting value from the data collected by HealthIT systems over the past several years.

A prime example of this was the work presented by Michael Rothman, Ph.D of Pera Health. Rothman created a way to analyze key vital signs RELATIVE to a patient’s unique starting condition to determine whether they are in danger. Dubbed the Rothman Index, this algorithm presents clinicians and caregivers with more accurate alarms and notifications. With all the devices and systems in hospitals today, alarm fatigue is a very real and potentially deadly situation.

Missed ventilator alarms was #3 on ECRI Institute’s 2017 Top 10 Health Technology Hazards. It was #2 on the 2016 Top 10 list. According to ECRI: “Failure to recognize and respond to an actionable clinical alarm condition in a timely manner can result in serious patient injury or death”. The challenge is not the response but rather how to determine which alarms are informational and which are truly an indicator of a clinical condition that needs attention.

Comments from RNs in adverse-event reports shared in a 2016 presentation to the Association for the Advancement of Medical Instrumentation (AAMI) sums up this challenge nicely:

“Alarm fatigue is leading to significant incidents because there are so many nuisance alarms and no one even looks up when a high-priority alarm sounds. Failure to rescue should be a never event but it isn’t.”

“Too many nuisance alarms, too many patients inappropriately monitored. Continuous pulse oximetry is way overused and accounts for most of the alarms. Having everyone’s phone ring to one patient’s alarm makes you not respond to them most of the time.”

This is exactly what Rothman is trying to address with his work. Instead of using a traditional absolute-value approach to setting alarms – which are based on the mythical “average patient” – Rothman’s method uses the patient’s actual data to determine their unique baseline and sets alarms relative to that. According to Rothman, this could eliminate as much as 80% of the unnecessary alarms in hospitals.

Other notable presentations at AMIA17 included:

  • MedStartr Pitch IT winner, FHIR HIEDrant, on how to mine and aggregate clinically relevant data from HIEs and present it to clinicians within their EHRs
  • FHIR guru Joshua C Mandel’s presentation on the latest news regarding CDS Hooks and the amazing Sync-for-Science EHR data sharing for research initiative
  • Tianxi Cai of Harvard School of Public Health sharing her research on how EHR data can be used to determine the efficacy of treatments on an individual patient
  • Eric Dishman’s keynote about the open and collaborative approach to research he is championing within the NIH
  • Carol Friedman’s pioneering work in Natural Language Processing (NLP). Not only did she overcome being a woman scientist but also applying NLP to healthcare something her contemporaries viewed as a complete waste of time

The most impressive thing about AMIA17? The number of students attending the event – from high schoolers to undergraduates to PhD candidates. There were hundreds of them at the event. It was very encouraging to see so many young bright minds using their big brains to improve healthcare.

I left AMIA17 excited about the future of HealthIT.

Five Key Takeaways from CHIME17

Posted on November 10, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

I recently had the chance to attend the 2017 CHIME Fall CIO Forum (CHIME17) for the first time. It was a fantastic experience.

What struck me most about the event was the close-knit feeling. In the hallways and in the sessions, it felt more like a class reunion than a healthcare IT conference. It was common to see groups of attendees engaged in deep conversations and there were frequent shouts of “hello” from across the hall. I can honestly say that I spoke with more CIOs at CHIME17 than the all the other 2017 conferences I have attended combined.

I learned at lot from my CIO conversations. Below are my top five takeaways:

Hospital CIOs are real people

At every other conference, you have to search pretty hard to find a hospital CIO. They tend to hide and run quickly from one pre-arranged meeting to another. They also do not spend a lot of time visiting the exhibit hall except with companies they are doing business with. At CHIME17 CIOs roamed the halls freely and were very approachable, especially at lunch. It was easy to strike up conversations at CHIME17 and it didn’t take long before funny stories of technology gone awry were being told. I came away from CHIME17 with a much stronger appreciation for CIOs – they are funny, caring people under a lot of pressure.

Optimization is the new black

Many of the conversations at CHIME17 were around the best ways to optimize existing IT systems – particularly EHRs. This optimization had two flavors. First, CIOs spoke about optimizing the user interfaces to reduce clinician frustration and to streamline workflows. This form of optimization was seen as a “quick win”. Second, CIOs spoke about optimizing/leveraging the data collected by their various systems. Many were investing in analytics tools and talent in order to unlock the value in the health data within their EHR, imaging and other applications. Optimization was the dominant topic at CHIME. For more details, check out my blog on this topic.

Attracting and retaining talent is a challenge

Another hot topic of discussion, or more accurately, a heated point of frustration at CHIME17 was the difficulty in attracting and retaining IT talent. CIOs at large urban hospital were frustrated at losing talented staff to HealthIT vendors and to “cooler” tech companies in their cities (like Google and Amazon). CIOs at smaller rural hospitals were frustrated at losing talented staff to their urban counterparts and to those same tech companies. With healthcare budgets frozen, CIOs were having to find more creative ways to attract and retain staff – like allowing work-from-home, hiring out-of-state resources and providing time for employees to pursue their own healthcare research projects. This war for HealthIT talent threatens to stymie healthcare innovation and is a challenge worth keeping an eye on.

The role of the Hospital CIO is evolving rapidly

Several sessions at CHIME17 were dedicated to the rapidly changing role of technology in healthcare organizations and to the role of the CIO itself. There was a lot of talk about the new emerging roles of:

  • CSO – Chief Security Officer
  • CMIO – Chief Medical Information Officer
  • CNIO – Chief Nursing Information Officer
  • CDO – Chief Data Officer
  • CHIO – Chief Health Information Officer

As information technology permeates everyday hospital operations, the CIO role will fracture into hybrid operational+technology roles like the ones listed above. There was heated debate as to whether all these roles should report into the CIO or whether they should be kept separate from. John Lynn wrote a great blog on this topic.

Size doesn’t matter

The challenges being discussed by the CIOs at CHIME were independent of the size of their organizations. Whether it was attracting talent, finding good vendor/partners or dealing with slashed budgets – CIOs from small rural hospitals to large urban systems, were struggling with the same challenges. On one hand it was comforting to know the problems were universal but on the other, it was worrying to see how pervasive these challenges were.

BONUS: Marketing tchotchkes are an invasive species

CHIME is one of the few healthcare conferences that does not have an exhibit hall. Despite this, there was still a lot of tchotchke available to attendees – proving that Marketing Tchotchke should really be labeled as an invasive species at healthcare conferences.

Shout-out to CHIME organizers for putting on such a fantastic event.

New York Presbyterian brings ER to patients via Mobile Stroke Treatment Unit

Posted on November 3, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

After a year in operation, New York Presbyterian’s (NYP) Mobile Stroke Treatment Unit (MSTU) continues to be a shining example of how healthcare technology can be used to facilitate true patient-centered care.

“The MSTU program was started with the singular goal of reducing the disability resulting from stroke,” explains Dr Michael Lerario, Medical Director of NYP’s MSTU Program and Assistant Professor of Clinical Neurology at Weill Cornell Medicine. “There is a term we use when we talk about stroke: Time is Brain. Every minute that passes after blood flow is even partially cut off from the brain, 1.9 million brain cells die from the lack of oxygen. This loss can lead to severe cognitive and physical disability for patients.”

Two feet longer than a regular New York City ambulance, the MSTU houses a Samsung portable computer tomography (CT) scanner, a point-of-care laboratory, a complete mobile EHR station (with super-fast WiFi) and a Cisco tele-presence system. The MSTU is staffed by four team members who are specially trained:

  • 1 CT Technician
  • 1 Registered Nurse (RN)
  • 2 Paramedics

With this sophisticated equipment, the MSTU team is able to bring stroke treatment directly to patients where they are instead of waiting for the patient to be transported to the hospital’s ER. Those precious minutes can be the difference between a full recovery and months of rehabilitation (or permanent disability).

When a 911 call comes in, the operator quickly determines if it is a potential stoke situation using a predetermined set of criteria (Plerior referrs to them as “triggers”). This specific protocol was jointly developed by NYP and the New York Fire Department which handles all 911 calls. If the criteria are met, the MSTU is dispatched to the patient’s location.

Upon arrival, the MSTU team stabilizes the patient and quickly conducts a number of diagnostic tests using the equipment onboard: PT/INR test, hemoglobin test and a CT scan. The CT images are sent wirelessly in real-time to NYP’s PACS system where the on-call neurologist reviews the results with the MSTU’s RN via a tele-conference. Based on the scans and the onsite lab work, the neurologist and the onsite team can decide the best course of treatment.

If the scans show that the patient is suffering an ischemic stroke (an obstruction within a blood vessel supplying blood to the brain) and is not already taking anticoagulant medication, then tPA (tissue plasminogen activator – a clot dissolving medication) can immediately be administered. Often referred to as the “gold standard” of Ischemic Stroke Treatment, if tPA is administered quickly it significantly improves the chances for a full recovery.

“Right from the beginning we had complete buy-in and support from within our organization,” says Lerario. “The Neurology and Emergency Medical Services departments in particular were very excited about the MSTU program. They had seen the positive impact MSTU’s were having in Europe and the team wanted to bring that treatment to the people of New York City.”

In just one year of operation, the MSTU has been dispatched on 400+ calls and the response from patients has been universally positive. In fact, a number of cases have been highlighted as good news stories in the press including one about a famous Brazilian singer.

“It won’t be long before mobile stroke treatment will become the standard of care,” Lerario continues. “The benefits are now well documented and more and more people are becoming aware of the impact an MSTU can have on your quality of life following a stroke. People are starting to demand this type of care from their care providers.”

MSTUs are also fantastic for healthcare as a whole. It costs far less to operate an MSTU than it does to treat and rehabilitate patients who suffer disabilities because tPA was not administered quickly enough.

From a patient, provider and public perspective, New York Presbyterian’s MSTU is a winning combination of healthcare technology and patient-centered thinking.

Social Media Still Controversial in Healthcare?

Posted on October 6, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Thirteen years after the first Facebook post and eleven years after the first tweet, social media use by healthcare professionals continues to be a controversial topic.

In October last year, nurse Carolyn Strom was found guilty of “professional misconduct” by the Saskatchewan Registered Nurses’ Association (SRNA) for a post she made on Facebook. On February 25th 2015 Strom posted the following comment following her grandfather’s death at St Joseph’s Health Facility (Strom did not work at that facility):

“My grandfather spent a week in palliative care before he died and after hearing about his and my family’s experience there, it is evident that not everyone is ‘up to speed’ on how to approach end of life care or how to help maintain an aging senior’s dignity.”

“I challenge the people involved in decision making with that facility to please get all your staff a refresher on this topic and more. Don’t get me wrong, ‘some’ people have provided excellent care so I thank you so very much for your efforts, but to those who made Grandpa’s last years less than desirable, please do better next time.”

André Picard wrote an excellent post earlier this year about the Strom “professional misconduct” decision by the nurse association.

This case and a recent Canadian Medical Association session on the lack of civility between physicians on social media served as the kernel of a recent #hcldr chat led by guest hosts Pat Rich @pat_health and Trish Paton @TrishPaton.

A clear sentiment from the #hcldr community was that healthcare regulatory bodies and professional associations were woefully behind-the-times when it came to social media policy.

Matthew Katz MD had a keen observation and suggestion for regulators:

Fear of fines and sanctions from regulatory bodies/associations coupled with the very real danger of being ostracized by peers, have effectively made social media into a “no-go” zone for healthcare professionals.

Robert Mahoney @mahoneyr had a very interesting take on social media posts from healthcare professionals.

Thankfully there are some progressive healthcare organizations out there who actually encourage their healthcare professionals to get engaged online. To help their staff navigate social media, they have created clear policies and guidelines so that they do not run afoul of regulatory bodies. The Mayo Clinic shared theirs with the community:

What are your thoughts about healthcare professionals, governing associations and social media?

Digital Health is Dead! Long Live Digital Health!

Posted on October 2, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Rob Coppedge, CEO of Echo Health Ventures recently wrote a provocative post for CNBC proclaiming that digital health is dead.

As evidence, Coppedge cited the work of Rock Health that shows $16 Billion in VC funding has gone to approximately 800 digital health companies since 2014 (note: Rock Health tracks VC deals >$2M for US-based digital health companies). He argued that in order for these VCs to see their expected returns, the entire digital health market would have to triple in value by 2021 – well beyond current projections. Coppedge’s conclusion was that fewer and fewer VC deals in the digital health space will happen in the years ahead – effectively signaling the death of the market.

Although I don’t agree with Coppedge’s claim that that digital health overall is dead, I do concur with his observations and commentary on why VCs may exit the space. Here are some of his lessons learned after investing in digital health:

  1. Better mousetraps are not enough. Inadequate attention was paid to solving how to go to market.
  2. Ill-equipped for enterprise health care. Subject matter expertise, outcomes measurement and political savvy is needed in healthcare – which is rarely necessary in star-ups targeting other industries.
  3. Consumers and patients are not the same. Unlike consumers, patients may not be the ones paying for the service they receive. Plus, engaging individuals in their health is surprisingly difficult and low engagement is common.
  4. Healthcare sales cycles are slow and industry adoption is measured. Growth expectations need to be tempered.
  5. DC is not to blame for stalling digital health. There is no evidence that supports the theory that healthcare innovation has stalled because of the uncertainty surrounding funding and regulations.

For long-time readers of this publication, the list above states the obvious.

Technology alone has never been enough to guarantee success in healthcare. Not only do healthcare customers need evidence a company’s solution actually works, they also need to help through (and beyond) the implementation of the technology. For companies, this often means creating new workflows that incorporate the new technology and helping their client’s staff adjust to those changes. Digital health companies cannot simply activate an account then foist self-serve instructional videos onto clients and expect success.

For me Coppedge’s post reaffirmed something I have long believed – Success in healthcare IT/digital health takes effort. Not only do you need a good product that actually solves a problem, you need a dedicated team of individuals who are healthcare-savvy that can help you navigate the complex health ecosystem. You need people on your team who are truly passionate about and dedicated to improving healthcare – those are the people with staying power and who will help you ride through the frustrating slow pace of change.

In my opinion, digital health is far from dead. It is evolving and changing. The influx of VC money has brought in smart, enthusiastic risk-takers from other industries who have now gotten a sobering dose of cold water dumped on them. Now that many companies are waking up to the reality that it takes years to become an overnight success in healthcare, we will see more consolidation and flame-outs in digital health. To me this potential turmoil represents an evolution of the market rather than a death spiral. The easy money and opportunists will soon be making an exit – leaving the market wide open for true believers and passionate hard workers.

Time for Healthcare to Look Out the Windshield Instead of at the Dashboard

Posted on September 29, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

The Society for Healthcare Strategy & Market Development (SHSMD) recently released the second edition of Bridging Worlds: The Future Role of the Healthcare Strategist. This update to the original 2014 report outlines five key imperatives that SHSMD believes are needed for healthcare success:

  1. Be nimble to exceed the rate of change
  2. Create consumer experiences, tell powerful stories
  3. Integrate and co-create
  4. Erase Boundaries of Business
  5. Generate Data-Driven Insights

“One of the biggest changes from the 2014 edition and one of the biggest opportunities that has come to the forefront is consumerism” says Holly Sullivan, Director of Strategic Partnerships at Spectrum Health and Vice Chair of SHSMD’s Bridging Worlds Committee, “It’s up to us as Strategists and Marketers to embrace this new reality and help our organizations adapt to this new level of expectation from patients. It’s definitely something that’s right in front of the windshield.”

Investing in technologies that improve and transform the patient experience will be key to meeting these heightened expectations including telemedicine, wearables, remote patient monitoring and artificial intelligence. However, technology alone will not lead to success, healthcare organizations will also need to break down their walls and collaborate in a more frictionless manner.

According to Sullivan: “Culture is the biggest challenge here. Historically healthcare organizations don’t like to share the sandbox and have believed they can do it all, own it all. We need to help our organizations lift their heads and see what’s coming at us down the road. We need to educate people that partnerships are an imperative.”

This need for collaboration and partnership is captured in the “Erase Boundaries of Business” section of the Bridging Worlds report. That portion of the report also encourages Strategists to think well beyond the walls of their organizations.

“We have to stop thinking of healthcare as a place where you go when you are sick,” adds Donna Teach, Chief Marketing and Communication Officer at Nationwide Children’s Hospital and Chair of SHSMD’s Bridging Worlds Committee. “Care is now anywhere the patient is and we need to engage patients through their entire healthcare journey rather than just points in time. Patients want to use new technologies like telemedicine and remote monitoring because it’s easy, convenient and fits nicely into their daily lives.”

Embracing HealthIT technologies permeates Bridging Worlds and Big Data in particular seems to hold the most potential in the eyes of the report authors: “Most importantly, data is only useful if it generates insights that enable better decision making. New tools, including predictive models and artificial intelligence, allow regular users to connect and visualize large volumes of data from multiple sources in ways that generate actionable insights.”

“EMRs + Big Data is just the tip of the iceberg”, echoes Teach. “It’s a technology will fundamentally change healthcare.”

Bridging Worlds is a useful guide. It clearly outlines the skills that Healthcare Strategists and Marketers will need to master in order to help their organizations transition from old models of care. Sprinkled throughout the report are useful instructions and examples of how to practice the skills and knowledge being outlined.

The key takeaway from report? “Marketing Strategists can be the agent of change no matter what level they are.” says Sullivan, “That’s the one key idea that I hope people will take from reading Bridging Worlds.”

SHSMD17 Opening Keynote, Ceci Connolly, Delivers Refreshing Dose of Perspective

Posted on September 25, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

On a hot and muggy day in Orlando, Ceci Connolly, President and CEO at the Alliance of Community Health Plans, delivered an opening keynote that felt like a splash of refreshing cool water at the 2017 Society for Healthcare Strategy & Marketing Development Conference (SHSMD17).

It would have been easy for Connolly, a former Washington Post national health correspondent, to focus her keynote on the impact Capitol Hill has had on US Healthcare. Instead, Connolly used her 60 minute talk to provide the SHSMD17 audience with repeated doses of perspective. You could almost hear the gears turning in people’s heads as she dispelled common healthcare misconceptions and reframed daunting challenges.

Connolly started by highlighting the problem of the rising cost of healthcare. In 1960 US healthcare spending as a percentage of US Gross Domestic Product (GDP) was just above 5%. By 2010 it was almost 18%.

According to the Centers for Medicare & Medicaid Services (CMS), national health spending is projected to grow 1.2% FASTER than GDP per year until 2025. This means that by 2025, US healthcare spending as a percentage of GDP would reach a whopping 19.9%.

This in and of itself is not news, but what Connolly did was expertly re-frame these statistics:

The more that healthcare consumes our GDP, we will have less and less money for things like building national infrastructure, fueling economic growth and oh, helping people recover from devastating hurricanes. Those priorities will suffer because healthcare will dominate our GDP spending.

Connolly’s statement was especially poignant given SHSMD President Ruth Portacci’s early comments about the heroic efforts of healthcare workers in Florida, Texas, Louisiana, Puerto Rico and the Caribbean to help those areas recover from devastating hurricanes.

From there Connolly proceeded to cast a new light on the wave of healthcare provider consolidation, payer mega-mergers, patient consumerism, aging populations, millennial expectations and retail health. Particularly noteworthy was Connolly’s take on rising drug prices and high deductible health plans (HDHPs).

According to Connolly, drug prices go up when new drugs are introduced for specific conditions. These new drugs, often with fancy names, are brought to market at prices higher than existing alternatives. The companies that own those existing drugs then raise their prices to match the new entrant and justify the increase with a mountain of evidence that their drug is every bit as good as the new one.

Connolly also took aim at HDHPs. During the industrial boom, US employers offered to pay for employee healthcare as way to entice workers to join their ranks. In short order, employer-sponsored health became the standard. Fast forward to 2017 and employers can’t shed healthcare costs fast enough. Instead of offering more health coverage, employers are offering HDHPs and transferring the burden to employees. According to Connolly the era of employer-sponsored healthcare is ending and that will have enormous consequences for US Healthcare where almost 50% of Americans still receive their health coverage through their employer.

It certainly was not your typical rah-rah opening keynote, but in these challenging times, it was courageous and refreshing to have someone stand up in front of 1,500 healthcare insiders and get us to think differently.

Consumer-centered Approach to Innovation by Thomas Jefferson University’s DICE Group

Posted on August 30, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

Sparking and sustaining Innovation is a much-sought-after goal for healthcare systems today. Some organizations have set up specialized innovation centers whose goal is to commercialize technologies developed internally by staff. Others are fostering innovation by becoming incubators and early-stage investors.

Thomas Jefferson University (TJU) in Philadelphia PA is taking multiple approaches to innovation. They created the Jefferson Accelerator Zone (JAZ) where they hold Health Hackathons, host in-person keynotes and have meeting space for local innovators. TJU also created an internal innovation team – the Digital Innovation and Consumer Experience (DICE) Group – a hidden gem.

I had the chance recently to sit down with Neil Gomes @neilgomes – Chief Digital Officer and Senior VP for Technology Innovation and Consumer Experience at TJU and Jefferson Health, who leads the DICE team – to talk about their unique approach to healthcare innovation.

How is DICE different than other healthcare innovation centers that we read about in articles?

We are not an innovation center as people have come to know them. The DICE Group isn’t focused only on commercializing technologies that have been developed by physicians or staff. DICE is an internal group that’s focused on designing and developing solutions to problems faced by the institution, from both a healthcare and educational perspective. Often our solutions incorporate a new technology innovation – but just as often we end up implementing an innovative process without replacing the existing technology. DICE is more like a team of internal catalysts. We enable the design and development of consumer-focused, value-driven, digital-ready solutions. Our goal is to build an efficient, agile, and future-focused organization that delivers value and quality to patients, students, employees, donors, and the community.

How do you find problems to work on?

Our team spends a lot of time out in the field with front-line staff. Not only do we listen to their ideas but we also observe how things are working or not working as the case may be. Through this first-hand interaction with our stakeholders and consumers (aka end-users), we develop focused projects and strategic initiatives.

What are some of the projects you have worked on?

We work on varied projects, some extremely complex such as enabling the implementation of a new Electronic Health Record (EHR) along with other project teams and others that could be as simple as moving equipment to a more efficient location.

On one such simpler (but impactful) project, we enhanced patient experience while at the same time reduced stress on staff – all by moving a label printer from one side of the room to the other. This project started off as a request to reduce delays in the Emergency Room (ER). Through direct observation, we discovered several improvement opportunities. One of the delays we addressed was in the processing of urine samples from patients. Instead of jumping in with a new technology, we took the time to really dig into the problem and just by moving a label printer, we solved it.

On another project, we helped improve our US News & World Report (USNWR) survey scores by assisting our own and referring physicians with setting up their Doximity account. The USNWR annual ranking of Best Hospitals is based on a survey that is distributed online exclusively via Doximity. What we found, however, is that many of the physicians that refer their patients to Jefferson Health and our own physicians did not have their Doximity accounts set up. If a physician is making a referral then they must believe we are a good facility…but without an active Doximity account they wouldn’t be able to participate in the survey. So we created a process along with some technology to help them set up their account when they made a referral. We ended up capturing a lot of that positive sentiment on the USNWR survey and that helped us get to our current ranking of the 16th best hospital in the nation.

We have also done a lot of work with our EHRs (EPIC and several others) as well as designed and developed our own digital apps such as: myJeffHealth, myBaby@Jeff, JeffDocs and Strength Through Insight. While several of our apps are directed at patients and students, we also develop apps and applications for our employees to enable efficiency, data collection, reduce process latency, enhance business processes, and build future-focused competitive advantage. While developing these solutions, we work in partnership with internal and external stakeholders and even with industry partners such as Google, Apple, Adobe, IBM, ServiceNow, EPIC, Harman Kardon, AllScripts, etc. who co-innovate with us.

What is the DICE secret sauce?

If I had to pick one thing that makes us unique it’d be our approach to innovation. We don’t go into situations with a “we must build something” mindset. We remain open to the possibility that a workflow change or additional training may be the best solution to the problem. Our team really takes an ethnographic look at the situation. Nothing is assumed. We give ourselves the time to really dig deep into whether the proposed solution will really achieve the desired outcome and whether it is even aligned with the problem.

We’ve worked hard at building close working relationships with operational leaders and our consumers. We have taken the time to really understand their world and we don’t just come in and try to impose our ideas on them. We build things together with our employees, partners, and consumers. That’s our secret sauce.

Being consumer-centric isn’t ground-breaking. The retail, hospitality, travel, and banking industries have been doing this for years. We have just started to bring consumer-centric thinking into healthcare. For the DICE Group, focusing on the consumer is the most organic and natural way we approach problems and devise solutions.

Many organizations have tried to create internal innovation teams, why has DICE been so successful?

Being close to our end-users has been a cornerstone of our success, but there are few other key things that we do at DICE that we think contribute to our success. One of the core principles we live and breathe every day is human-centered design. This is something that is ignored or overlooked by many in healthcare today – and some HealthIT vendors are especially bad at this. When you subscribe to a human-centered design approach, you realize that building and implementing the technology is only part of the solution. You also have to help end-users incorporate that technology into their daily routines. You have to help them through the disruption and help them bridge the knowledge gap. You can’t just drop in the technology and move onto the next project. Without proper follow-up people will revert back to past patterns – which means the organization will not see any improvement.

That’s another key to our success. We are no longer on the see-problem-solve-problem hamster wheel. In the first few years we “followed the problems” and we racked up early wins. These quick wins helped us build trust, credibility, and most importantly, internal momentum. However, you can’t succeed in healthcare by just solving one problem after another. Healthcare will not be fixed if everyone is just focused on organic point solutions. We need to look above the day-to-day and build solutions that push us in a particular direction. Basically we need to focus on larger, bold, and strategic goals and then creatively innovate towards them.

For example, rather than just looking at streamlining the ER at our Jefferson-Abington hospital, we set ourselves a goal that we would optimally utilize our ER to the extent that we could triage a patient to a room and team in the ER even while they were on the ambulance to the ER. It seemed impossible when we started, but as we worked with our stakeholders and end-users we eventually achieved this goal through a combination of technology and process improvements.

What’s next for DICE?

Now that we are deeply integrated in the organization, we see ourselves getting even more closely involved with the organization’s strategy. With the support of our President and CEO, Dr. Steve Klasko, our staff, board, and co-innovating industry partners, we continue to move from just solving the problems of today to helping TJU solve the problems of tomorrow, develop competitive advantage and value, and deliver closed-loop consumer experiences digitally and in the physical world that engage, enchant, and improve lives.

For more insight into DICE and to see what projects they are working on, follow them on Twitter @DICEGRP

 

Healthcare Robots for Elderly – Triumph or Tragedy?

Posted on August 21, 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 speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

When most people talk about robots in healthcare they often are referring to the self-guided machines that help deliver medications, food and other items to patient rooms.

Robots of this type can be very helpful and alleviate some of the mechanical tasks on overburdened staff. There is, however, another type of robot that is making in-roads in healthcare – companion robots like Softbank’s Pepper and Intelligent Systems Research’s PARO.

Instead of performing a physical action, the aim of these robots is to serve as patient companions. PARO, for example, has been used extensively in Japan with patients suffering from Alzheimer’s and Dementia – where it has helped reduce wandering, agitation, depression and loneliness. Below is a short video from Alzheimer’s Australia about PARO.

From a technology standpoint this is an amazing triumph. A machine providing emotional support to a patient was the stuff of Science Fiction a decade ago. At the same time, however, do these robots represent a failure of society? Does the fact that these robots exist demonstrate that we would rather delegate human contact with elderly patients to machines rather than go ourselves?

The #hcldr community debated this topic on a recent tweetchat.

A manual analysis of the tweets shows that approximately 80% of the community saw robot companions as a positive development. Most people, like Grace Cordova, pointed to the fact that our aging population already outstrips the existing infrastructure so why shouldn’t we invest in robots to help us manage (as a society).

Some responded with tempered positivity. Jon McBride saw the potential in robots but cautioned against relying on them solely for human companionship.

Many echoed Jon’s sentiment.


Personally I see robots as an innovative solution to addressing a problem that already exists – the lack of human interaction with elderly patients. I believe we have to admit to ourselves that staff are stretched thin in elder-care facilities and there are long stretches where patients are on their own. If those hours can be filled by interacting with a robot companion that responds in a human or animal-like way…I’m all for it.

What are your thoughts?