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Cybersecurity, Telehealth and Big Tech Entrants are Top of Mind

Posted on November 22, 2018 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.

Unease over cybersecurity, optimism for the future of telehealth, and worries about the entry of big tech companies (like Apple, Amazon and Google) are the top three concerns for 2019 according to a recent survey of healthcare leaders released by the Center for Connected Medicine.

The Center for Connected Medicine (CCM), which is jointly operated by GE Healthcare, Nokia and UPMC, partnered with The Health Management Academy for the Top of Mind 2019 survey. Conducted in three parts, the research started with a survey of health system information officers in May 2018 to determine the top areas of health IT for 2019.

According to the CCM, key findings include:

  • Hackers and other cyber-criminals are stepping up their attacks on the health care industry, leading 87 percent of respondents to say they expect to increase spending on cybersecurity in 2019; no health system was expecting to decrease spending.
  • Health information technology (IT) leaders overwhelmingly expect government and commercial reimbursement to provide the majority of funding for telehealth services by 2022; internal funding and patient payments are expected to provide the majority of funding for telehealth in 2019.
  • 70 percent of responding executives said they were “somewhat concerned” about big tech companies, such as Apple, Amazon and Google, disrupting the health care market; 10 percent were “very concerned.”

Cybersecurity

Cybersecurity was the top concern from the 2018 survey so it is not surprising to see it on top of the list for 2019 – especially as the number of cyberattacks continues to increase each year. What is surprising is the level of confidence that executives have in their ability to recover from an attack.

According to the report:

  • Only 20% of respondents reported being “very confident” in their organization’s IT recovery and business continuity plans
  • 70% of respondents said they were “somewhat confident” in those plans

I’m not sure I would want to be at a healthcare organization that was only “somewhat confident” it could recover from a cyber attack.

For me, the survey highlights how much work we still have to do around cybersecurity in healthcare. It’s not just a matter of hardening HealthIT systems, that is only part of the solution. Healthcare organizations also need to implement robust security processes and ensure staff are properly educated.  The latter is particularly important as Phishing and spear-phishing were cited by 80% of Top-of-Mind survey respondents as the most common types of cyberattacks.

My colleague John Lynn recently wrote an article that dives deeper into cybersecurity.

Telehealth

One of the most interesting findings in the survey was the optimism healthcare executives have for telehealth.

“Telehealth represents a low percentage of total care delivery at all responding health systems, yet executives unanimously anticipate growth in the next three years as reimbursement increases and consumer demand picks up. All responding health systems report 10% or less of their organization’s total care delivery is currently provided through telehealth. However, all health systems expect an increase over the next three years, with 45% expecting a significant increase of 10% or more.”

According to the survey the biggest barrier to telehealth adoption is not the technology, but rather the lack of reimbursement.

Part of the optimism executives feel toward telehealth may have to do with the final 2019 Physician Fee Schedule and Quality Payment Program issued early in November 2019 by The Centers for Medicare & Medicaid Services (CMS). As of 1 January 2010, CMS will reimburse a number of telehealth and communication-technology based services:

  • Brief communication technology-based service, e.g. using phone or other telecommunications device to decide whether an office visit is needed
  • Remote evaluation of recorded video and/or images submitted by an established patient
  • Remote patient monitoring (CPT codes 99453, 99454, 99457)
  • Interprofessional Internet consultations (CPT codes 99451, 99452, 99446, 99447, 99448, 99449)

It is widely expected that CMS will continue to expand the reimbursement for communication technology enabled services in future years.

Entry of Big Tech Companies

Companies like Apple, Amazon, Google and Microsoft have each made significant healthcare-related announcements this past year and continue to push into the healthcare space. Their entry has executives concerned, according to the Top-of-Mind survey results.

“The biggest threat is if these companies get between us and the end consumer,” said one CEO in a written survey comment. “If there is a platform regulated and controlled by someone other than us – that makes us nervous. There are many places where some of these new platforms and conveniences can and will likely succeed – we haven’t been good in this space.”

What this CEO is referring to is the consumer-focus that these Big Tech companies have and how relentless they are at providing superior consumer experiences based on data as well as deep analytics. That is something traditional healthcare organizations have only just woken up to realize – that patients want the consumer-friendly conveniences they have become accustomed to from other industries like retail and banking.

Top-of-Mind Conference

In a few weeks CCM will be hosting healthcare leaders from around the country at their annual Top-of-Mind conference. I’m really excited to attend the event and learn first-hand how leaders plan to address their concerns in 2019. Stay tuned.

MRI Installation Slip Disables Hospital iOS Devices

Posted on November 9, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The following is the story of an MRI installation which took a surprising turn. According to a recent post on Reddit which has since gone viral in the IT press, a problem with the installation managed to shut down and completely disable every iOS-based device in the facility.

A few weeks ago, Erik Wooldridge of  Chicago’s Morris Hospital, a perplexed member of the r/sysadmin subreddit, posted the following:

This is probably the most bizarre issue I’ve had in my career in IT. One of our multi-practice facilities is having a new MRI installed and apparently something went wrong when testing the new machine. We received a call near the end of the day from the campus that none of their cell phones work after testing [the] MRI… After going out there we discovered that this issue only impacted iOS devices. iPads, iPhones, and Apple Watches were all completely disabled.

According to Wooldridge, the outage affected about 40 users. Many of the affected devices were completely dead. Others that could power on seemed to have issues with the cellular radio, though the Wi-Fi connections continued to work. Over time, the affected devices began to recover, but one iPhone had severe service issues after the incident, and while some of the Apple Watches remained on, the touchscreens hadn’t begun working after several days.

At first, Morris and his colleagues feared that the outage could be due to an electromagnetic pulse, a terrifying possibility which could’ve meant very bad things for its data center. Fortunately, that didn’t turn out to be the problem.

Later the vendor, GE, told the poster and his colleagues that the problem was a leakage of liquid helium used for the MRI’s superconducting magnets. GE engineers turned out to be right that the leak was the source of the problems, but couldn’t explain why Android devices were untouched by the phenomenon.

Eventually, a blogger named Kyle Wiens with iFixit.org seems to found an explanation for why iOS devices were hit so hard by the helium leak. Apparently, even Apple admits that exposing iPhones to evaporating liquefied gases such as helium could take them offline.

While no one’s suggesting that liquefied helium is good for any type of microelectronic device, the bottom line seems to be that the iOS devices are more sensitive to this effect than the Android devices. Let’s hope most readers never need to test this solution out.

Proactive Management of End-User Experience – Flipping the Paradigm

Posted on October 23, 2018 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.

Managing the performance of HealthIT systems improves the end-user experience which leads to less burnout, better patient experiences and a healthier bottom line. Instead of monitoring individual systems, Goliath Technologies is flipping the paradigm.

Each day, hidden gremlins in HealthIT systems are eating into productivity and sapping team morale. These gremlins are relentless and just when you think you’ve caught one, two new ones rise to take its place. The net result is negative end-user experiences.

What is a negative end-user experience? It is any situation where an end-user of an IT system experience something unexpected that impacts their work in a negative way. This could mean:

  • Slow response times (click and wait)
  • Sluggish application performance (typing faster than words appear on the screen)
  • Inability to access the system at all
  • Frozen screens
  • Unexplained workstation reboots
  • Loss of network connection

…the list goes on and on.

In healthcare, when a negative end-user experience happens, patient care is impacted. Sometimes the impact is small – like having to wait a few extra seconds for the lab result to appear on the screen. Sometime the impact is significant – like having to reschedule or delay a procedure because clinicians cannot access the patient’s record to see contraindications.

Negative end-user experiences also increase the stress on the end-users themselves – adding to an already stressful environment.

“We are almost at the point in healthcare where reacting to negative end-user experiences is no longer acceptable,” says Thomas Charlton, CEO of Goliath Technologies. “When a system is slow, or not available, patient lives are impacted. Clinicians expect systems to be available when they need it and they want those systems to work as expected. It’s no longer about having an uptime of 99.999%, we have to monitor and manage the actual end-user experience itself.”

“Most of the time, people troubleshoot with free tools provided by the vendor,” says Donna Grare, EVP and Chief Technology Officer at Goliath Technologies. “When a user reports a problem like ‘I can’t connect to application A’, IT starts a troubleshooting tree from scratch because there are many things that could be the cause of the problem.  It could be limited to this user – an issue with their computer or their local network, for example.  It could be a broader issue based on changes made to profiles that impact many users – generally IT only finds this out when one call becomes 10, 50, or 500.  With that many calls coming in, it’s clearly not a simple, one person issue, but IT is stuck looking for the common thread between them.  This is very frustrating for both IT and the users.  One comment we hear often is IT saying ‘I’m very good at my job, and I can fix problems.  It would just be great if I could be proactive and get ahead of the problem instead of only hearing about it after it happens.’”

This is a very standard approach to system management. IT departments monitor the performance of discrete systems: server response times, network packet speeds, application error logs, etc to determine if something is wrong. Although better than nothing, this approach has several drawbacks.

“This traditional approach leads to a lot of finger pointing,” explains Charlton. “If I’m the manager responsible for the servers, I will point to my server logs and say that the issue isn’t with the hardware since all the servers are ‘green’. The application managers say the same thing and on and on. Everyone is reporting green yet end-users are still experiencing issues. That’s the second problem with the traditional approach, ‘green’ is often a state defined by the vendors of the systems. Just because something is green doesn’t mean that end-user experience isn’t deteriorating. Lastly, the traditional approach ignores how healthcare applications are inter-connected. Slow performance in one application can have a cascading effect on applications that rely on it for data.”

So what does proactive management of end-user experience look like? According to Charlton, proactive management means flipping the old approach to IT systems management on its head. Instead of looking at the individual elements of HealthIT systems, Charlton and the team at Goliath Technologies approach things the other way around. They start by monitoring the actual end-user experience and help IT teams work backwards from there.

“When healthcare organizations deploy our technology, they gain visibility to key end-user experience metrics right away,” continues Charlton. “We gather the performance from all internal systems into one place. There is embedded intelligence in our platform that is based on years and years of experience troubleshooting system issues. This intelligence monitors the gathered information and alters the IT team when system performance begins to deteriorate, often before the call from the end-users start coming in.”

This early warning is key to minimizing the impact on end-users.

For a real-life account of how the Goliath platform was used to address slowness with an EHR (spoiler alert: the problem wasn’t with the EHR application), check out this article.

I have to admit that before I sat down with Charlton and Grare, I had no idea that platforms like Goliath’s existed. Their platform is the result of years of work with other industries: banking, legal and managed services. Smartly, Goliath realized that they would have to pre-build connections to popular healthcare applications before organizations would adopt their platform. They currently have connections to: Allscripts, MEDITECH, Cerner and EPIC.

Given that the Goliath platform isn’t exactly new, I had to ask Charlton why more organizations haven’t already adopted the approach of pro-actively monitoring end-user experience. “I think there are three reasons why proactive monitoring hasn’t been as widely adopted as we would like to see,” says Charlton. “First, many have spent a ton of money on their core systems, but have not allocated enough to the tools they need to support those systems. So they end up just using what came with it. Those tools are good, but they look at systems in isolation. Second, I think many believe they have ‘proactive monitoring’ but are just doing the bare minimum – like pinging a system to see if it is up and running. That is very different than true proactive performance tracking. Third, I think IT people are just not aware there is a pro-active tool available like what Goliath offers.”

“We hear it all the time,” continues Charlton. “In fact we recently had a customer tell us: ‘I had no idea that this type of technology was available. I was trying to troubleshoot issues with the tools that came with the core system. Now that I look at Goliath’s system I realize I was trying to do brain surgery with a butter knife’. I couldn’t have said it better myself.”

What’s the bottom line for HealthIT leaders? End-user experience (system performance) is a key contributor to workplace stress and clinician burnout. As competition in healthcare becomes more intense, patients as well as clinicians, will opt for healthcare organizations where negative end-user experiences are minimized. They will leave for green pastures where they don’t have to wait for a record to come up or explain to a patient how their surgery was delayed due to a systems issue.

If you would like to find out more information about pro-active end-user management, check out this upcoming live-webinar by Goliath Technologies on Tuesday October 30th at 12:30pm ET

Goliath Technologies is a proud sponsor of Healthcare Scene. 

 

AI Project Set To Offer Hospital $20 Million In Savings Over Three Years

Posted on October 4, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While they have great potential, healthcare AI technologies are still at the exploration stage in most healthcare organizations. However, here and there AI is already making a concrete difference for hospitals, and the following is one example.

According to an article in Internet Health Management, one community hospital located in St. Augustine, Florida expects to save $20 million dollars over the next the three years thanks to its AI investments.

Not long ago, 335-bed Flagler Hospital kicked off a $75,000 pilot project dedicated to improving the treatment of pneumonia, sepsis and other high mortality conditions, building on AI tools from vendor Ayasdi Inc.

Michael Sanders, a physician who serves as chief medical informatics officer for the hospital, told the publication that the idea was to “let the data guide us.” “Our ability to rapidly construct clinical pathways based on our own data and measure adherence by our staff to those standards provides us with the opportunity to deliver better care at a lower cost to our patients,” Sanders told IHM.

The pilot, which took place over just nine weeks, reviewed records dating back five years. Flagler’s IT team used Ayasdi’s tools to analyze data held in the hospital’s Allscripts EHR, including patient records, billing, and administrative data. Analysts looked at data on patterns of care, lengths of stay and patient outcomes, including the types of medications docs and for prescribing and when doctors were ordering CT scans.

After analyzing the data, Sanders and his colleagues used the AI tools to build guidelines into the Allscripts EHR, which Sanders hoped would make it easy for physicians to use them.

The project generated some impressive results. For example, the publication reported, pathways for pneumonia treatment resulted in $1,336 in administrative savings for a typical hospital stay and cut down lengths of stay by two days. All told, the new approach cut administrative costs for pneumonia treatment by $800,000.

Now, Flagler plans to create pathways to improve care for sepsis, substance abuse, heart attacks, and other heart conditions, gastrointestinal disorders and chronic conditions such as diabetes.

Given the success of the project, the hospital expects to expand the scope of its future efforts. At the outset of the project, Sanders had expected to use AI tools to take on 12 conditions, but given the initial success with rolling out AI-based pathways, Sanders now plans to take on one condition each month, with an eye on meeting a goal of generating $20 million in savings over the new few years, he told IHM.

Flagler is not the first, nor will it be the last, hospital to streamline care using AI. For another example, check out the efforts underway at Montefiore Health, which seems to be transforming its entire data infrastructure to support AI-based analytics efforts.

Problems We Need To Address Before Healthcare AI Becomes A Thing

Posted on September 7, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Just about everybody who’s anybody in health IT is paying close attention to the emergence of healthcare AI, and the hype cycle is in full swing. It’d be easier to tell you what proposals I haven’t seen for healthcare AI use than those I have.

Of course, just because a technology is hot and people are going crazy over it doesn’t mean they’re wrong about its potential. Enthusiasm doesn’t equal irrational exuberance. That being said, it doesn’t hurt to check in on the realities of healthcare AI adoption. Here are some issues I’m seeing surface over and over again, below.

The black box

It’s hard to argue that healthcare AI can make good “decisions” when presented with the right data in the right volume. In fact, it can make them at lightning speed, taking details into account which might not have seemed important to human eyes. And on a high level, that’s exactly what it’s supposed to do.

The problem with this, though, is that this process may end up bypassing physicians. As things stand, healthcare AI technology is seldom designed to show how it reached its conclusions, and it may be due to completely unexpected factors. If clinical teams want to know how the artificial intelligence engine drew a conclusion, they may have to ask their IT department to dig into the system and find out. Such a lack of transparency won’t work over the long term.

Workflow

Many healthcare organizations have tweaked their EHR workflow into near-perfect shape over time. Clinicians are largely satisfied with work patterns and patient throughput is reasonable. Documentation processes seem to be in shape. Does it make sense to throw an AI monkeywrench into the mix? The answer definitely isn’t an unqualified yes.

In some situations, it may make sense for a provider to run a limited test of AI technology aimed at solving a specific problem, such as assisting radiologists with breast cancer scan interpretations. Taking this approach may create less workflow disruption. However, even a smaller test may call for a big investment of time and effort, as there aren’t exactly a ton of best practices available yet for optimizing AI implementations, so workflow adjustments might not get enough attention. This is no small concern.

Data

Before an AI can do anything, it needs to chew on a lot of relevant clinical data. In theory, this shouldn’t be an issue, as most organizations have all of the digital data they need.  If you need millions of care datapoints or several thousand images, they’re likely to be available. The thing is, they may not be as usable as one might hope.

While healthcare providers may have an embarrassment of data on hand, much of it is difficult to filter and mine. For example, while researchers and some isolated providers are using natural language processing to dig up useful information, critics point out that until more healthcare info is indexed and tagged there’s only so much it can do. It may take a new generation of data processing and indexing tech to prepare the data before we have the right data to feed an AI.

These are just a few practical issues likely to arise as providers begin to use AI technologies; I’m sure there are many others you might be able to name. While I have little doubt we can work our way through such issues, they aren’t trivial, and it could take a while before we have standardized approaches in place for addressing them. In the meantime, it’s probably a good idea to experiment with AI projects and prepare for the day when it becomes more practical.

Optimizing Expensive Medical Device Utilization in Hospital Systems

Posted on July 23, 2018 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.

At the HFMA Annual Conference, Healthcare Scene had a chance to interview Brett Reed, CEO of Cohealo, where we learned about their unique approach to expensive medical equipment in hospitals and health systems. We loved their novel approach to helping hospitals and health systems save money and better utilize the assets they’ve already purchased since it’s not something we’d seen many healthcare organizations do effectively. Most have been too distracted by their EHR implementations to think about this. Now’s a great time to move past the EHR into other technologies that can help a hospital or health system.

In our interview, Brett shares the origin of the company and how Cohealo can help a healthcare organization with tracking equipment, sharing equipment, and managing equipment requests. Considering the cost of these expensive medical devices, there are a lot of opportunities for healthcare organizations to save or make more money by using these underutilized resources more effectively.

To learn more, watch the video interview below or on the Healthcare Scene YouTube channel.

If you enjoyed this video interview, be sure to check out the full list of Healthcare Scene interviews.

Also, let us know what you thought of our interview with Brett Reed from Cohealo. Do you think this is a valuable solution? Are you doing this type of medical device tracking in your organization? Do you hear the complaints from nurses and providers that there’s not enough medical equipment for them to do their job effectively? Let us hear your thoughts in the comments or on Twitter @HealthcareScene.

What? In Some Cases, Additional IT Spending May Not Prevent Breaches

Posted on June 11, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new research study has come to a sobering conclusion – that investing more in IT security doesn’t necessarily reduce the number of breaches.

The research, which appeared in the MIS Quarterly, looked at how many breaches hospitals experienced relative to their IT security spending. The study authors started with the assumption that hospitals spending more on security would enjoy better protection from breaches.

The researchers assumed that looked at broadly, some security investments were “symbolic,” making superficial improvements that don’t get to the root of their problem, while others were substantive investments which met well-defined security needs.

After reviewing their data, researchers noted that many classes of hospitals turned out to be symbolic security investors, including members of smaller health systems, older hospitals, smaller hospitals and for-profit hospitals. They also noted that faith-based and less-entrepreneurial hospitals were prone to such investments. The only category of hospitals routinely making substantive security investments was teaching hospitals.

But that’s far from all. Their more controversial conclusions focused on the role of IT security investments in preventing security breaches. In short, their conclusion was pretty counterintuitive.

First, they found that larger IT security investments did not in and of themselves lower the likelihood of security breaches. Not only that, researchers concluded that the benefits of substantive adoption wouldn’t generate greater breach protection over time.

Researchers also concluded that the benefits of substantive IT security adoption by hospitals would take time to be realized. If I’m reading this correctly, mature IT security systems should offer more advantages over time, but not necessarily better breach protection.

Meanwhile, researchers concluded that the negative consequences of symbolic adoption would grow worse over time.

I don’t know about you, but I was pretty surprised by these results. Why wouldn’t substantively increasing security spending reduce the occurrence of breaches within hospitals? It’s something of a head-scratcher.

Of course, the answer to this question may lie in what type of substantive security investment hospitals make. The current set of results suggests, to me at least, that current technologies may not be as good at preventing breaches as they should be. Or maybe hospitals are investing in good technology but not hiring enough IT security experts to get the installation done right. Plus, purchasing security infrastructure can only do so much to stop bad user behavior. The issue deserves further research.

Regardless, this study offers food for thought. The industry can’t afford to do a bad job with preventing breaches.

Investment in IT Infrastructure Needed to Power Healthcare Transformation

Posted on May 11, 2018 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.

Genomics, artificial intelligence, chatbots and a host of other technologies are accelerating the transformation of healthcare from a paper-based system to a digital one. In order to power this transformation, IT infrastructure (storage, computational power, security, etc) needs to move from an implementation afterthought to the forefront of strategic planning. Windstream Enterprise is one company that is working closely with healthcare providers to ensure their IT infrastructure is ready for the challenges ahead and helping to put the infrastructure conversation front-and-center.

Windstream is part of the wave of companies that have successful track-records in other industries that are now bringing their solutions to healthcare. This wave is being led by technology giants like Amazon, Apple and Google. The moves they make in healthcare get a lot of attention and rightfully so. Check out the excellent coverage by Christina Farr over at MSNBC for more information.

Although I am intrigued by what the big tech companies are doing, what I truly find fascinating (and frankly inspiring) is the work of the hundreds of companies not named Amazon, Apple and Google. Windstream is one of the companies I have been interested in ever since I saw them at HIMSS17 and wondered “What is an Internet access provider doing in healthcare?”

Windstream was formed back in 2006 when Alltel spun off it’s landline business and merged it with VALOR Communications Group. Back then they provided 3.4 million access lines (telephone and internet connections) in 16 states. Over the years they have continued to grow through acquisition, expanding into fiber transport networks and fixed wireless. Windstream Enterprises, a division of Windstream, has had tremendous success helping clients in the retail and banking industries build and manage their technology infrastructure.

I recently had the chance to sit down with Windstream’s President and CEO, Tony Thomas and one of their clients, the University of Kentucky Healthcare (UK), to talk about why healthcare needs to continue to invest in good IT infrastructure.

You can watch the full recording of our conversation here:

Thomas sees a lot of similarity between the digital transformation happening in healthcare and the ones that swept through the financial services and retail sectors.

“When you look at the success we’ve had in retail and banking, and then you look at where healthcare is heading, the commonality is the push to technology,” explained Thomas. “You can see that technology is changing the way that healthcare gets done. There is a focus on the patient experience and cost transformation.” This same focus on improving customer experiences and reducing costs is what helped spur the adoption of cloud and other advanced technologies at banks and retailers.

One driver of technology adoption in healthcare is the higher expectations patients have of healthcare provider. These higher expectations are fueled by the prevalence of (and convenience of) consumer technologies that have made our lives so much easier: online shopping, online banking, booking appointments through our smartphones, etc.

In 2016, Deloitte released a study that compared consumer use of technology for health vs other aspects of their lives. Not surprisingly their findings showed that healthcare lagged behind.

I see the delta between the use of technology as a consumer vs as a patient as a demand gap. The more healthcare lags behind, the more demand patients will put on healthcare organizations to adopt technologies that mirror what they experience as consumers.

To close that gap, organizations have accelerated the implementation of technologies like chatbots, omni-channel communications, artificial intelligence and data analytics. However, when you couple these new technologies with the use electronic health records and advanced lab systems, the result is explosive data growth.

“Over the last two years we have generated over 1.2 Petabytes of pathology data,” noted Cody Bumgardner PhD, Assistant Professor of Pathology & Laboratory Medicine at the University of Kentucky Healthcare (a Windstream client). “Pathology is really the collection of different points of data: images, genomic & laboratory data. Digital Pathology is taking all that data, making it both operationally effective and ready for computational analysis – transforming it into something useful and actionable for clinicians. Pathology and pathological reports arguably provide the most actionable data in the patient record and it is relatively low-cost relative to other data sources.”

“As the number of health and wellness devices increases,” continued Bumgardner. “It means we will have to collect and analyze more and more data. You will need some solid infrastructure to allow that data to flow and you will need good computational power as close to the point of data generation as possible.”

Getting funds and resources to keep IT infrastructure up to date is not easy. Jan Bates, Director of Systems Operations at the University of Kentucky Healthcare summed it up succinctly: “It’s hard to get buy-in from executives because it’s not something they have a keen interest in discussing. In fact, many find it boring. You HAVE TO relate infrastructure back to the business. You have to answer the questions: What benefits will the organization realize? and What will the organization be able to do when the infrastructure is well maintained?”

The answer according to Windstream’s CEO Tony Thomas is nothing short of transforming the way healthcare is delivered: “We are really at an exciting time in healthcare. There are tons of new technologies emerging [like AI]. We’re going to need solid investments in the underlying infrastructure to support those technologies which will revolutionize the way healthcare is delivered.”

It gives me hope that companies like Windstream are bringing their extensive data and infrastructure management expertise from the banking sector to healthcare. Although healthcare is a unique industry, that doesn’t mean we are restricted to adopting solutions developed by healthcare insiders. We can (and should) leverage the best from other industries and adapt them to the unique aspects of healthcare.

“Given the opportunities we see in healthcare, we are increasing our investment here.” stated Thomas. “We think we can be a provider of choice for many healthcare organizations. In the end it’s all about the application of technology to solve problems in healthcare.”

Well said.

Henry Ford Rolling Out Analytics In Neuro ICU

Posted on April 25, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Not long ago, the chair of neurology at the sprawling Henry Ford Hospital decided it was time to bring his idea to life. Dr. Stephan Mayer, who had previously created a data analytics system at New York Columbia-Presbyterian Medical Center, felt he could bring what he learned to Henry Ford Hospital — and that it could save lives.

According to a story in Crain’s Detroit Business, Mayer was convinced that if the hospital analyzed data generated by patient monitors, it could reduce mortality and complications by predicting negative patient events.

“This is all about lost opportunity and making the most of the data we have,” Mayer told Crain’s. “There is nothing unique about the data we have. We have EMRs connected to pharmacy, radiology, billing, this and that, but there is a doughnut hole. The empty spot is the ICU, where the sickest  of the people are.”

Acting on that belief, Mayer put together an initiative bringing such tools to the health system’s neuro ICU.

After searching for a partner that could make this happen, Mayer settled on Medical Informatics Corp.’s FDA-cleared clinical intelligence platform, Sickbay, which monitors real-time vital signs issued by any connected device. The Sickbay product also comes with related apps such as Multimon, which allows clinicians to view multiple patients remotely across units, the hospital or multiple facilities.

Once deployed, Sickbay collects patient monitor data, stores and organizes it in a manner making it easier for clinicians to predict future patient events. For example, it can produce data on patient alarms that fall within specified critical ranges. This allows clinicians to see and act on patterns more quickly, Mayer said.

Working with Henry Ford’s IT Department, Mayer is rolling out Sickbay. Starting in June, Henry Ford will launch Sickbay and begin storing patient data. Over the next six months, the neuro ICU should collect data on 600 patients. Hopefully, this data will offer clinicians the insight and context they need to help patients.

If Mayer gets the results he’s hoping for, this could be just the first in a series of rollouts, potentially across the 22 ICUs operating across the five-hospital system. “Our organization is eager to push boundaries,” he told the magazine. “What we are doing, if it works as planned…it will change the way we round in the ICU.”

This sounds great, but Mayer is still lucky he’s at Henry Ford rather than other less-entrepreneurial organizations. The health system has worked to promote technology innovation for many years. Its efforts include an innovations program rewarding employees for standout inventions in areas like clinical applications for wearable technology.

Is EMR Use Unfair To Patients?

Posted on April 24, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we all know, clinicians have good reasons to be aggravated with their EMRs. While the list of grievances is long — and legitimate — perhaps the biggest complaint is loss of control. I have to say that I sympathize; if someone forced me to adopt awkward digital tools to do my work I would go nuts.

We seldom discuss, however, the possibility that these systems impose an unfair burden on patients as well. But that’s the argument one physician makes in a recent op-ed for the American Council on Science and Health.

The author, Jamie Wells, MD, calls the use of EMRs “an ethical disaster,” and suggests that forced implementation of EMRs may violate the basic tenets of bioethics.

Some of the arguments Dr. Wells makes apply exclusively to physicians. For one thing, she contends that penalizing doctors who don’t adapt successfully to EMR use is unfair. She also suggests that EMRs create needless challenges that can erode physicians’ ability to deliver quality care, add significant time to a physician’s workday and force doctors to participate in related continuing education whether or not they want to do so.

Unlike many essays critiquing this topic, Wells also contends that patients are harmed by EMR use.

For example, Wells argues that since patients are never asked whether they want physicians to use EMRs, they never get the chance to consider the risks and benefits associated with EHR data use in developing care plans. Also, they are never given a chance to weigh in on whether they are comfortable having less face time with their physicians, she notes.

In addition, she says that since EMRs prompt physicians to ask questions not relevant to that patient’s care, adding extra steps to the process, they create unfair delays in a patient’s getting relief from pain and suffering.

What’s more, she argues that since EMR systems typically aren’t interoperable, they create inconveniences which can ultimately interfere with the patient’s ability to choose a provider.

Folks, you don’t have to convince me that EMR implementations can unfairly rattle patients and caregivers. As I noted in a previous essay, my mother recently went to a terrifying experience when the hospital where my brother was being cared for went through an EMR implementation during the crucial point in his care. She was rightfully concerned that staff might be more concerned with adapting to the EMR and somewhat less focused on her extremely fragile son’s care.

As I noted in the linked article above. I believe that health executives should spend more time considering potentially negative effects of their health IT initiatives on patients. Maybe these execs will have to have a sick relative at the hospital during a rollout before they’ll make the effort.