Breaking down the silos between data sources and departments involves a complex blend of technology and people that, not surprisingly, can result in conflict along the way. However, the ultimate goal remains the same for all: protect the patient. Understanding the concerns of each department and encouraging communication amongst the groups can reduce this tension, allowing for innovation to take hold and enhance care throughout an organization.
We are currently at a crossroads in the healthcare industry. Executives are working overtime to try to figure out how to connect and integrate data to best support clinical practice and patient care management. With health systems concerned about balancing both needs, they now need to figure out how to leverage data to get the best value out of their investment. Improvement and innovation in technology are slowly but surely enhancing the industry, but health systems are constantly being assaulted with software companies trying to sell them something. Thus, healthcare executives are left with the eternal question: Which pieces fit together best to create value and improve patient care?
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.
As a father, I have loved seeing my children grow into mature and independent adults. There’s something incredibly special about seeing your children leave the nest and start the next chapter of their lives. As the chief executive of West Health, I have been fortunate enough to have some of those same feelings when it comes to the progress of Sense4Baby, one of the first technologies researched at our organization.
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.
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.
The pace of mHealth innovation shows no signs of slowing down. New technologies are not only improving the lives of patients, but also empowering clinicians. However, healthcare is a highly regulated space dominated by major vendors, and it is vital that the regulatory environment keep up with the changing world. Specifically, it’s time for the Department of Health and Human Services (HHS) to take a fresh look at the Health Insurance Portability and Accountability Act (HIPAA) to ensure it better fits today’s mobile world.
Current HIPAA guidelines – while critical – need to be revised to support smaller companies that can transform the space. Leading app developers across the industry are working together to seek clearer guidelines that will encourage innovation. The App Association recently joined with AirStrip, CareSync, and other mHealth companies urging government representatives to look at this issue so we can better align our practices with theirs and together work towards the goal of improved patient care.
The Office of the National Coordinator for Health Information Technology (ONC) just released what it calls “A 10-Year Vision to Achieve an Interoperable Health IT Infrastructure.” The directive generating the most attention calls for “a common set of electronic clinical information…at the nationwide level by the end of 2017.” According to ONC, the common data set would consist of about 20 basic elements, such as patient demographics and lab test results.
At first blush, the ONC directive is a small step in the right direction, but sets the bar awfully low. Rest assured that vendors will consider 20 basic elements the maximum data set, not the minimum. A more effective approach would, for example, specify vocabularies (LOINC, RxNORM), document types (JSON, XML) and transport mechanisms (HTTPS or other TLS) to be used when sending or receiving data instead of focusing on the data elements themselves.
We are currently experiencing the biggest transformation in healthcare ever. Technology plays a significant role as an enabler of this transformation, but will not drive it alone. Improving patient care and driving toward patient engagement are crucial goals in this next phase of the healthcare industry. To make adoption ubiquitous and implementation effective, there are several things we should focus on as we dive into 2015:
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.