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.
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.
Over the past year, the perception of mobile technology in healthcare has changed dramatically. mHealth is now being recognized as a tool that can help address the challenges our healthcare system is facing, including a shortage of caregivers, an influx of newly insured patients, decreased reimbursements and readmission penalties. Historically, there have always been barriers that kept hospitals from making the leap to mobility – lack of infrastructure, costs, or the fear of security breaches, among other reasons. Yet as mobile technology becomes deeply ingrained in our day-to-day work and social lives, healthcare is following suit and migrating toward mobility as a component of care delivery.
However, concerns about security remain at the forefront. According to data from the Department of Health and Human Services (HHS), more than 41 million people have had their protected health information compromised in a reportable HIPAA privacy or security breach. Additional data from the 2014 Healthcare Breach Report from Bitglass suggests that 68 percent of all healthcare data breaches are due to device theft or loss and 48 percent of breaches involve a laptop, desktop or mobile device.
In today’s digital world, electronic patient data is growing exponentially and moving faster than healthcare organizations can imagine. At the same time, clinicians suffer from information overload, and high-volume and increasingly complex clinical patient loads, alongside dwindling time and resources.
Now more than ever, the pressure is building to harness the power of big data and digital technologies to help clinicians make faster, patient-centric decisions that increase quality of care and enhance health outcomes all while decreasing costs.
Clinicians want two things from data. On an individual patient level, they need to be able to see the data whenever and wherever they want – in a clean at-a-glance format and with essentially zero lag time. And at a cohort (population) level, they want the data presented as meaningful information in a way that enables conclusions, decisions, and actions about a group of patients.
These statements may seem like self-evident Data 101 to many of you, but in my decades of experience working clinically as an emergency physician and being responsible for operations of multiple emergency departments, it is clear that we have not delivered on this vision. In fact, the healthcare world lags other industries by 15-20 years in the availability, presentation, and use of information. Although our industry is catching up, there is still more effective use of information technology in banking, aviation, on-line retail, and a multitude of other industries. Even though many of the concepts of optimum presentation and use of data have been around for decades – the quest for electronic health records began in the 1980s – their breadth of execution and the realization of their value propositions have not been sufficient to become the norm. Healthcare has moved at a glacial speed of change, at least until recently.
According 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.
There are more mobile devices than there are people on the planet. Many of us look at our phones more than 70 times a day. We bring them with us everywhere we go – to the movies, to our children’s soccer games and to work.
Many of us even have work environments that allow us to ‘bring your own device.’ If that is not an option, our work devices (thankfully!) are looking more and more like our personal devices. And in healthcare, we are now successfully addressing challenges to building mobile healthcare solutions that support our natural use and knowledge of these devices in our life flow.
Health IT is often considered a silent partner in healthcare – not seen by patients, but a critical part of the system. As we celebrate National Health IT Week, it’s important to realize that although health IT already has a long history, the constant and rapid evolution of this space continues to transform the market. Information has been collected and stored for years, but the promise of clinical decision support has us at the cusp of all this information becoming valuable in new and innovative ways.
Just a decade ago, I was documenting patient encounters in paper charts. Although the transition to electronic medical records (EMRs) has been perceived as slow, in the grand scheme of medicine it actually happened almost overnight. These systems were not designed with our continuously changing workflow in mind, with user interfaces and workflows that aligned to our practices. They served as repositories for patient information, but did little else. In fact, our workflow changed to support the EMR, sometimes to the detriment of the patient. Instead of focusing directly on the patient, we often must split our time and attention between the patient and the computer terminal.
Since patient care and well-being is at the center of Rockdale’s mission, attracting the best and brightest clinicians in the region is an important effort for us. Part of distinguishing ourselves from our competitors is providing the resources and advanced technological support clinicians want. In fact, to support this shift, we formed the Information Technology Physician Engagement Group in 2013 to identify exactly what were the technology priorities for our physicians:
- Improved cellular service
- Improved physician Wi-Fi
- Single sign-on access
- Mobile technology for better efficiency
While most hospitals and health systems are in agreement that mobility will play a key role in their future, many are overwhelmed on where to start. Each organization has its own unique infrastructure, workflow and set of needs – not to mention a range of different technology systems – to fit into the equation. However, there is a standard equation healthcare leaders should follow when selecting a mobility solution that will lead to quality, efficiency and financial gains – and position them for future success, regardless of regulatory changes that may come down the road. When added together, the following elements will equal success for every hospital or health system’s mobile health efforts: