Keeping up with (and Getting Ahead of) an Ever-Changing Healthcare Model

At this year’s annual HIMSS conference, a common topic of discussion was around how to continue to bring the technological and medical aspects of healthcare together to evolve, grow and support one another.

Each semester, I share with my Health IT students the many reasons that it is such an exciting time to be in healthcare. As we transition from a volume-based to a value-based incentive model, healthcare is going to look significantly different by 2020. This transformation is no longer a wish, it is no longer an option; it is our collective future. People who were previously one-foot-in and one-foot-out will be fully planted in the value-based healthcare model.

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Telehealth Brings Non-Stress Tests to the Home

Non-stress tests (NSTs) are the current standard of care for monitoring high-risk pregnancies. Intended to reduce the risk of stillbirths, these tests are for those who have one or more risk factors, whether they be maternal, fetal or obstetric complications.

Currently, these tests can be very time-consuming for patients. NSTs involve attaching the mother to fetal and contraction monitors to watch the fetal heart rate tracing and uterine activity. However, many rural and remote areas don’t have ready access to NSTs. Consequently, mothers sometimes travel up to several hours each way to get to our facility for their NST appointments once or twice a week. Once they arrive, there’s the usual wait time, the 30-60 minute testing process, plus an additional wait time for the test to be interpreted by a staff member and a clinician. These appointments, on top of any additional prenatal visits the mothers have scheduled, can therefore add up to a considerable amount of time, even for patients who live nearby.

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Healthcare in South Africa – Two Systems, Common Challenges

When it comes to mHealth, most industrialised nations such as the U.S. and Europe have a head start. Money for healthcare technology investments is available, the infrastructure is in place, and most of the population is already engaged in the healthcare system.

As a country of about 52 million people, South Africa shares many characteristics with its larger brethren. There is a mix of public and private healthcare providers and health insurance plans, physician shortages in key areas, and South Africa is beset by many of the same chronic diseases that industrialised countries face (cardiovascular and obesity-related diseases, diabetes, etc.).

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Today’s Pressure Breeds Tomorrow’s Solutions

It is no secret that health systems are under intense pressure to deliver better outcomes at lower costs, and standardizing acute care workflow will only carry providers so far. Truly moving the needle on cost and outcomes will require a fundamental redesign in care delivery; otherwise, health systems may well find themselves left out. Care keeps shifting to environments in which hospitals have less influence: what was once critical care can now be managed in an in-patient unit; what was once in the hospital is now in an office; what was once in the office is now at home.

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Creating a Friendly Environment for Adoption of Clinical Decision Support

In recent years, our ability to stream large amounts of data in real-time has improved dramatically. This enhancement can transform how clinicians offer care by sourcing unprecedented opportunities for clinical decision support. However, the capability to process, store, and display data in and of itself does not transform care. Rather, it is how the clinicians adopt and apply decision support that will make all the difference to patients. However, the current environment must be altered to create a clinical decision support-friendly climate.

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Future of Health Care: Keeping the Patients in Mind

imagesThe key to successful health care technology is making sure it improves both the patient experience and the quality of care. While technology is sometimes seen as a barrier to human connection and interaction, the right tools can transform the health care experience for the patient. At Dignity Health, our focus for 2015 is centered on making population health a reality by looking toward the ambulatory side of care. The mobility strategy we put in place in 2014 is enabling us to empower our providers and care teams with telehealth solutions so they can have alternate ways to connect with and care for their patients.

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EMRs won’t prevent the spread of Ebola (or the next scary outbreak)

about-ebolaAccording to IBM, there are 2.5 exabytes of data created every day, and most of it is unstructured. Imagine receiving all the words ever spoken by human beings on your doorstep each and every day. Now, imagine consuming that, making sense of it and trying to keep up with the ever-accelerating pace of data creation each day.

As a physician, I experienced firsthand the angst that comes with trying to keep up with even a very specialized scope of expertise. Thanks to the overwhelming quantity of peer-reviewed publications and practice guideline updates that only increase each year, we are long past the time when a clinician could possibly keep up with all the advancements in their own practice area, let alone those of adjacent areas of medicine or the latest public health concerns on a global scale.

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