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Intel Health & Life Sciences

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Giselle Sholler is the Chair of the Neuroblastoma and Medulloblastoma Translational Research Consortium (NMTRC) and the Director of the Hayworth Innovative Therapeutic Clinic at Helen DeVos Children’s Hospital. The NMTRC is a group of 15 pediatric hospitals across the U.S, plus the American University in Beirut, Lebanon, and Hospital La Timone in Marseilles, France. We sat down recently with Dr. Sholler to talk about to role of precision medicine in her work and how it impacts patients.


Intel: What are the challenges of pediatric oncology and how do you tackle those challenges?

 

Sholler: As a pediatric oncologist, one of the most challenging times is when we’re faced with a child who is not responding to standard therapy and we want to figure out how we can treat this patient. How can we bring hope to that family? A project that we are working on in collaboration with TGen, Dell and Intel has brought that hope to these families.

 

Intel: What is the program?

 

Sholler: When a child has an incurable pediatric cancer, we a take a needle biopsy and send it to TGen where the DNA and RNA sequencing occurs. When ready, that information comes back to the Consortium. Through a significant amount of analysis of the genomic information, we’re able to look at what drugs might target specific mutations or pathways. On a virtual tumor board, we have 15 hospitals across the U.S. and now two international hospitals in Lebanon and France that come together and discuss the patient’s case with the bioinformatics team from TGen. Everyone is trying to understand that patient and with the help of pharmacists create individualized treatment plans for that patient so that patient can have a therapy available to them that might result in a response for their tumor.

 

Intel: Why is precision medicine important?

 

Sholler: Precision medicine is about using the genomic information data form a patient’s tumor to identify which drugs not only will work, but which ones may not work on that patient’s specific cancer. With precision medicine, we can identify the right treatment for a patient. We’re not saying chemotherapy is bad, but for many of our patients chemotherapy is attacking every rapidly dividing cell and leaves our children with a lot of long term side effects. My hope for the future is that as we can target patients more specifically with the correct medications, we can alleviate some of the side effects that we’re seeing in our patients. Half our children with neuroblastoma have hearing loss and need hearing aids for the rest of their lives. They have heart conditions, kidney conditions, liver conditions that we’d like to see if we can avoid in the future.

 

Intel: How does the collaboration work to speed the process?

 

Sholler: The collaboration with Dell and Intel has been critical to making this entire project possible. The grant from Dell to fund this entire program over the last four years has been unparalleled in pediatric cancer. The computer power has also been vital to the success. Three years ago we were doing only RNA expression profile and it took two months; now, we’re doing RNA sequencing and DNA exomes completely and it takes less than two weeks to get the answers for our patients. The data transfer and networking used to entail shipping hard drives a few years ago. Now, we can send a tumor sample from Lebanon to TGen, complete the sequence in a few days and have a report for the tumor board a few days after that. It’s just been amazing to see the speed and accuracy improve for profiling.

 

Intel: Anything else?

 

Sholler: Another very critical piece that Dell has helped provide is the physician portal. Physicians are able to work together across the country, and across the world, and have access to patient records. The database now has grown and grown. When we do see patients, we can also pull up previous patients with similar sequencing or similar profiles, or treated with similar drugs, and see what was used in treatment. And how did they do? What was the outcome? We’re learning more and more with every patient and it doesn’t matter where we live anymore. Everything’s virtual online. It’s just been incredible.

Health and Human Services Breaches Affecting 500 or More Individuals website shows that there were 97 breaches of this type involving 500 or more patients in 2014, and 46 breaches of this type so far in 2015. These breaches often occur when there are a sequence of failures. An example is show in the graphic below where the first failure is a lack of effective healthcare worker security awareness training.

 

A mobile device they are using either lacks encryption, or the employee has the password on or near the device, for example on a sticky note on the laptop screen, which shockingly is not uncommon. This is followed by the employee leaving the mobile device vulnerable, whether on the backseat of a car, on a desk unsecured, in a coffee shop, or other location vulnerable to loss or theft of the device. This leads to loss or theft of the mobile device containing sensitive data in the form of electronic health records, and ultimately can lead to breach.

infographic DH.png

 

The HIPAA Breach Notification Rule requires notification of HHS, patients, and media for HIPAA Covered Entities and Business Associates operating in the US. The vast majority of US states now also enforce state level security breach notification laws which also cover sensitive healthcare information. If the number of records compromised is 500 or more this can lead to a new entry in the HHS “Wall of Shame”. The Ponemon 2015 Cost of a Data Breach Study reports that the average per patient cost of a data breach was $398, the highest across all industries. Based on the number of patient records compromised this can easily result in a total average healthcare organization business impact of $6.5 million, and an abnormal churn rate of 6 percent. Clearly this staggering cost means it is imperative for all healthcare organizations and business associates to take a proactive approach to securing themselves.

 

This has propelled breaches to a top concern across all healthcare organizations, often even a higher priority than regulatory compliance, which is seen as a minimal requirement but not sufficient to adequately reduce risk of breaches.

 

The above infographic presents a healthcare breaches maturity model. As such, it is focused on healthcare, and breach risks. A holistic approach is required for effective risk mitigation, including administrative, physical and technical safeguards. This maturity model is focused on technical safeguards for healthcare breaches. Gray blocks are applicable for other types of healthcare breaches, but not so much for breaches resulting from loss or theft of mobile device or media. We will discuss these other types of breaches more in future blogs. Here we focus more on the colored capability blocks of the security model, representing safeguards that help mitigate risk of breach from loss or theft of mobile devices or media.

 

A baseline level of technical safeguards for basic mitigation of healthcare breaches from loss or theft of mobile devices requires:

 

  • Endpoint Device Encryption to protect the confidentiality of sensitive data
  • Mobile Device Management, to provide a secure managed container for healthcare apps and sensitive data
  • At least single factor “what you know” / username and password access control which his usually provided at both the OS and enterprise application levels

 

An enhanced level of technical safeguards for further improved mitigation of risk of this type of healthcare breach requires addition of:

  • Anti-Theft enables the ability to remotely locate, lock or wipe your device in the event of loss or theft
  • Client SSD (Solid State Drive) with Encryption automatically encrypts all files stored on the client device to protect their confidentiality
  • MFA (Multi-Factor Authentication) with Timeout strengthens the authentication or login with the device, and automatically times out and locks the device after some period of inactivity
  • Secure Remote Administration enables system administrators to remotely access the device to diagnose and remediate issues and can be used to keep the device secure and healthy for effective security
  • Policy Based File Encryption can automatically encrypt files on a mobile device based on their type and contents, as well as the policy of the healthcare organization, in order to protect confidentiality
  • Server DB (Database) Backup Encryption encrypts files on the server, including databases and backups. Although loss or theft of servers and backups is more rare than loss / theft of a mobile device, when it does occur it can be much more impactful to the business due to more data and patient records stored on the server

 

An advanced level of security for further mitigation of risk of this type of breach adds:

  • MFA with Walk-Away Lock which further reduces the possibility of a hijacked session by detecting when the authenticated user has left the device and automatically locking the device
  • Server SSD with Encryption automatically encrypts files stored on the server to protect their confidentiality in the event of loss or theft of the server
  • Digital Forensics enables the healthcare organization to rapidly determine if a lost or stolen device was accessed and if so what specific sensitive data was accessed. This can be important in determining if a breach actually occurred, and if so the specific patients involved. The business impact of the breach is proportional to the number of patient records compromised so this can be an important strategy to avoid or minimize business impact from a breach.

 

The reality is most healthcare organizations don’t lack ideas for what security they could add. However, budget and resources are always finite. Security is also complex. The maturity model above presents a way to address the top concern of breaches from loss or theft of mobile devices or media in three increments. Using this method an organization may choose to implement the baseline level of security in year one, add enhanced security in year two, and complete the security by adding advanced security in year three.

 

What questions do you have?

One of the topics I hear frequently from the health IT community is about barriers to innovation. From my perspective, closed loop automation is a huge issue that we face and will have to deal with. We clearly allow closed loop automation in other parts of our lives, yet somehow we have this reverence and reluctance to do it in healthcare. Why?

 

Everyone I have ever run across in the healthcare industry—from my previous role as a doctor to the role in technology—is dedicated to goodness, kindness, and supporting their patients. Yet the process is so complicated we inadvertently, systematically hurt people over and over again. The only way to cure this is to automate the automatable.

 

And just what is automatable? It’s a moving target, but here’s a start:

 

  • Respirator settings: We've talked about very simple things like automating respirator settings. Why should I as a doctor, since I have an output in mind, monitor the physiology of a patient in a stable manner? Algorithms, through experience, could do this a whole lot better than a junior doctor. I want to use the power of the most senior doctor built into the algorithm and teach the respirator to be as smart as possible and then actually learn with individual physiologic feedback and how it responds to that patient to maintain a parameter.

 

  • IV pumps: As with respirators, we could do the same with IV pumps. The IV pumps would have Ethernet or wireless connections that can talk to the electronic medical records that can talk to lab data. Why not have the pump start to deliver a drug like heparin? In this scenario, a nurse can't make a mistake and a doctor can't inadvertently write the wrong order. By the 80/20 rule, we'll default to the average most of the time, anyway. Let machines help us where they can.

 

The benefits of closed loop automation are many, but freeing doctors and nurses from mundane tasks that are repeatable would be a game changer. That’s one of the biggest alterations we can make towards improving the delivery of care worldwide.

 

Maybe it's a big transition, but we need to trust the machines. They can do a really good job at certain things. I'm not asking the machines to think for us; but where things follow well developed patterns allowing that process to occur makes sense. Naturally, there will be resistance from those who see automation as a threat to job security. It has happened in other industries where automation replaces human activity. That’s to be expected.

 

But at the end of the day, a robot can paint a car better than a human can. A robot can be better at welding. There are things that closed loop automation can do better in healthcare and we need to give it a try.

 

What do you think? How would closed loop automation be viewed in your facility?

 

In the above clip, Bill Muth, a solution architect at CDW, explains how strategies for CIOs need to complement an organization’s mission and usually focus on one of three areas: cost, differentiation, and focus. He says mobility is vital to a good health IT strategy.

 

Watch the video and let me know what questions you have. How did you develop your mobile health IT strategy?

In a time of rapid change, innovation is crucial for any enterprise. But I haven’t seen many organizations approach innovation as thoughtfully and systematically as Front Porch. This California-based nonprofit supports a family of companies offering assisted living, skilled nursing, retirement, and other communities across four states.

 

Front Porch has a Center for Innovation and Wellbeing as well as a commitment to disruptive, caused-based innovation called Humanly Possibleā„ . “We want everyone at every part of our organization to focus on what’s possible and what’s next—to look at how we can do what we do better, to bring new value to people we serve,” says Kari Olson, chief innovation and technology officer for Front Porch and president of its innovation center.

                     

Olson and other Front Porch leaders were quick to see value in flexible 2 in 1 devices based on Intel® technologies and Windows.

 

“Two-thirds of our workforce are out and about, not sitting at a desk,” Olson says. “If we can give them portable devices that let them do their computing in a secure, reliable way, when and where they need to, we can have a big impact—both on their productivity and on our ability to meet the needs of the people we serve. If we can do that and stay consistent with our enterprise applications and tools—that’s huge.”


front porch.jpg

Front Porch staff saved time and increased patient engagement by using their 2 in 1 devices in members’ residential rooms, care centers, activity rooms, team meetings, and other settings.


But could 2 in 1 devices help deliver transformative value? And how would Front Porch’s people-focused helping professionals—who often have an “I’ll use it if I have to” attitude toward technology—feel about the new devices?

 

Intel just completed a case study that answers these questions. In it, Front Porch leaders describe surprises they encountered as employees ranging from nurses to activities coordinators began using 2 in 1s. Front Porch shares best practices for mobile technology adoption, and highlights the benefits they’re seeing for patient engagement, organizational efficiency, quality of care, and more.

 

I found their results fascinating. They’re relevant not just for healthcare, but for any organization that wants to empower a mobile workforce.

                                                                                                                                                                            

Read the case study and let me know your thoughts. Where might enterprise-capable 2 in 1s add value in your organization? Post a comment, or join and participate in the Intel Health and Life Sciences Community.

 

Learn more about Intel® Health & Life Sciences.

 

Read more about Front Porch and the Front Porch Center for Innovation and Wellness.

 

Stay in touch: @IntelHealth, @hankinjoan

Each year millions of people all over the world, including more than 1 million patients in the United States, learn that they have a cancer diagnosis. Instead of going through painful chemotherapy that can kill healthy cells along with cancerous cells, what would happen if those patients were able to be treated as individuals based on their specific genome sequencing, and a precision treatment plan could be tailored specifically for their disease? And what if it could happen within 24 hours?

 

Today, I announced at the Intel Developer Forum that we are setting our sights on making this scenario a reality through an ambitious, open Platform-as-a-Service solution called the Collaborative Cancer Cloud.

 

The Collaborative Cancer Cloud is a precision medicine analytics platform that allows institutions to securely share patient genomic, imaging and clinical data for potentially lifesaving discoveries. It will enable large amounts of data from sites all around the world to be analyzed in a distributed way, while preserving the privacy and security of that patient data at each site.

 

The end goal is to empower researchers and doctors to help patients receive a diagnosis based on their genome and potentially arm clinicians with the data needed for a targeted treatment plan. By 2020, we envision this happening in 24 hours -- All in One Day. The focus is to help cancer centers worldwide—and eventually centers for other diseases—securely share their private clinical and research data with one another to generate larger datasets to benefit research and inform the specific treatment of their individual patients.

 

The Rise of Precision Medicine                        

Precision medicine – taking into account individual differences in people’s genes, environments, and lifestyles – is one of the biggest of the big data problems and is on the cusp of a remarkable transformation in medicine. We view genomics as the first wave of precision medicine, and we’re working with our partners to drive adoption of genomic sequencers, genomic appliances, and cloud-based genomic analytics. With the Collaborative Cancer Cloud, we are combining next generation Intel technologies and bio-science advancements to enable solutions that make it easier, faster, and more affordable for developers, researchers, and clinicians to understand any disease that has a genetic component, starting with Cancer.

 

Initially, Intel and the Knight Cancer Institute at Oregon Health & Science University (OHSU) will launch the Collaborative Cancer Cloud. We expect two new institutions will be on board by 2016, addressing the critical need for larger patient pools and practitioner awareness. And from there, we can open up this federated, secure Collaborative Cancer Cloud network to dozens of others institutions—or let them create their own--to accelerate the science and the precision treatment options for clinicians to share with their patients. They can also apply it to advance personalized research in other diseases that are known to have a genetic component, including Alzheimer’s, diabetes, autism, and more.

 

In the same timeframe, we also intend to deliver open source code contributions to ensure the broadest developer base possible is working on delivering interoperable solutions. Open sourcing this code will drive both interoperability across different clouds, and allow analytics across a broader set of data – resulting in better insights for personalized care.

 

A Complementary Effort

You may be asking, “Haven’t we seen efforts like this before?” There have been numerous multi-institution partnerships formed to utilize big data analytics to look for insights about cancer and its treatment. Our focus on the federation/distribution of private datasets is complementary to the exciting work that’s happening to make public data sets more accessible to research. In CCC, each partner will maintain control of its patients’ data, while the shareable cancer treatment knowledgebase grows in availability and in impact. We want to help harness the power of that data — in a way that benefits clinicians, researchers and patients with a better knowledgebase and preserves security and privacy. By securely sharing clinical and research data amongst many institutions while maintaining patient privacy, the entire research community can benefit from insights revealed in large data cohorts.

 

In the end, precision medicine will only be as precise as available data allows. To better understand complex diseases like cancer, the medical and technology industries must collaborate to make the growing wealth of insights resulting from secure analysis of public and private genetic datasets accessible for the patient’s benefit. And if we do, we can turn an agonizing and uncertain process for the patient into a personalized process that occurs all in one day.

 

We encourage you to view the links below to learn more about our work with OHSU:

OHSU’s Exacloud

Collaborative Analytics for Personalized Cancer Care

 

Learn more about precision medicine and genomic code research at these resources:

www.intel.com/healthcare/optimizecode

https://www.whitehouse.gov/precision-medicine

With rising healthcare costs making news on an (almost) daily basis it’s essential that we push ahead with the drive for technology to have meaningful impact. One area seeing brilliant innovation is in the field of wound care where we’ve been working closely with GPC, a company based in the UK, who are combining Intel’s® RealSense™ 3D Camera capabilities with a mobile app to deliver better patient outcomes, improved clinical management and lower organisational costs.

 

In the UK alone wound care is costing the NHS some £3 billion per year. The challenges are clear to me, specialist wound care clinicians are a limited and costly resource, monitoring and managing healing can be subjective and evidence-based decision making is hampered by a lack of consistent wound information. I’m pleased that a combination of talent and technology is meeting these problems head-on.

 

Enhancing Mobility, Removing the Guesswork

GPC, with extensive knowledge of the healthcare sector, set about overcoming these challenges by designing an innovative wound care management solution. I asked Huw Morgan, Technical Director at GPC, to tell us more: “We wanted to provide an enhanced level of mobility for clinicians working in wound care by delivering applications which work across multiple devices including tablets, laptops and mobile phones. Additionally, taking away some of the guesswork by offering a standardised and consistent method of capturing images of wounds - which enables the clinician to determine changes in size and colour – enhances evidence-based decision making considerably. These two factors will lead to better patient outcomes through reducing healing time and fewer complications”

 

The team at GPC are utilising the Intel® RealSense™ 3D Camera which can be found in a range of mobile devices. The camera’s depth-sensing technology is a real win for healthcare across many scenarios and it truly excels in the field of wound care. Huw explained more: “With RealSense™ we’re able to not only record real-time data in 3D but the clinician can also rotate and interact with the wound image. This delivers a much greater understanding of a wound in respect of location, which more often than not will be sitting on an uneven surface on the body.”

 

RealSense™ Enables Quantum Leap in Clinical Monitoring

Dr. Ian Wiles, Medical Director at GPC, talked through some of the detailed clinical benefits of using RealSense™ in relation to wound management: “The widely adopted pressure ulcer classification system (four stages) is helpful to allow communication between clinicians and managers but it can be inconsistently applied. 3D cameras enable any carer to accurately assess and monitor an ulcer.”

 

“ULNITS are the accurate measurement of an ulcer using a 3D camera – maximum width x maximum length x maximum depth – note this is not a cubic measurement of tissue loss because of the complex shapes of ulcers but it is an objective, repeatable gauge that can be accurately monitored. The 3D image will be of benefit when reviewing cases or for the tissue viability experts but the progress/deterioration of the ulcer by ULNIT is far more important.”

 

“It is the monitoring of the ulcer using the RealSense™ 3D Camera that is the most powerful development. After the initial assessment the treatment can be started using locally agreed protocols and the progress of the ulcer can be accurately predicted while removing the subjective element in previous classifications. Every clinician involved in ulcer care understands this is a powerful development in measurement. RealSense™ has enabled a quantum leap in clinical monitoring, it’s not 3D for the sake of 3D but better care using 3D.”

 

Combining 3D Images with Analytical Expertise

GPC take the data from the RealSense™ 3D Camera and apply their analytical expertise to provide wound care specialists with a view that is consistent, both in terms of visual changes across time and in respect of size and colour. Additionally, GPC have developed an algorithm to more accurately measure wound severity and consequently healing.

 

The buzz from healthcare providers around these advances in wound care technology from GPC at HIMSS15 this year was fantastic and that has continued through to events in the UK in recent months. I’m really pleased to be able to share this use case with you which will allow clinicians to be more mobile, capture an enhanced level of data and benefit from innovative analytics. Healthcare providers will see reduced costs around wound management and, importantly, deliver better patient outcomes.

 

Wound care is just one aspect where the Intel® RealSense™ family of software and depth cameras enables more natural and intuitive interaction with personal computing devices and for healthcare there are many more possibilities such as:

 

  • Gesture control, facial detection and tracking for use in secure login;
  • Video conferencing where the background can be excluded;
  • Possibilities to help in the empathy and socialā€emotional factors by assessing the facial expressions with emotion detection in recovery from stroke;
  • Tracking of 22 joints in a hand could assist in the post-operative treatment after hand surgery for instance.

 

These are just some of the areas that have been discussed so far where this technology could be applied. And we must not forget that RealSense™ 3D cameras can be found in a range of laptops and all-in-one devices which opens up access to the significant benefits of solutions such as GPC’s wound care management to healthcare providers across the world.

 

GPC will be showcasing their innovative wound care technology which uses Intel® RealSense™ at IDF15.

 

We recently caught up with Roberto Rabe, chief technologist at Booz Allen Hamilton, who in the above video walks you through a real-life patient engagement and the technology that improves outcomes and collaboration.

 

Watch the clip above and see telehealth and consultation technology that is safe and secure in action .

 

What questions do you have? How would you integrate this technology into your facility?

Today’s discussions around healthcare IT usually revolve around devices, data and analytics. It’s hard to remember, but let’s not forget that in the early 2000s a technology came along that revolutionized communications overall: Wi-Fi.

 

Wireless communication was a game-changer for healthcare environments, and still is today. The launch of broadband communication somewhere around 2003 freed clinicians from Ethernet cables and having to be tethered to a chord to connect. Wi-Fi enabled a whole new way of computing and enabled an amazing amount of progress to take place. For example, wireless connectivity gave doctors and nurses the ability to: compute on-the-go, access vital data; provide decisions support and collaboration, and access remote video conferencing. These capabilities, and the devices that are used, would not be possible without Wi-Fi. It’s astounding to stop and think about that and look back at how compute went from the desktop to the mobile device. That’s true innovation.

 

The introduction of Wi-Fi has also led to the second and third order opportunities, like the freeing of healthcare from within institutions. Care delivery can occur anywhere and in multiple mediums thanks to wireless connectivity.

 

As to where we go next with Wi-Fi, my thought is that we have just scratched the surface. From a healthcare delivery perspective, Wi-Fi (and other forms of wireless RF) will continue to fuel the rise of business intelligence and clinical decision support algorithms that are going to eventually take on more and more human characteristics. It won’t be long before patients can type in a query and get a response from a human interface.

 

Every time I think about where healthcare technology might go, I believe we’re inadvertently influenced by the vision of Gene Roddenberry of Star Trek fame. How did he know 50 years ago that humans would be talking to computers to gather information? I’ve read many stories on how the cell phones were conceived and made a reality by Trekkies who grew up wanting to have a pocket communication device. The early flip phones were not that far off.

 

So when I think of that vision of where wireless will go, that's what comes to mind. Wi-Fi will be the enabler of a human-machine interface that is going to meld and it's going to be on the go. It's going to be mobile. And if patients have healthcare issues, questions, or concerns, they'll be dealt with and answered with near immediacy as the result of this freeing us from wired platforms.

 

What do you think? Where will Wi-Fi/wireless connectivity, take healthcare in the future?

BEN WILSON

Inside Mobile Health IT

Posted by BEN WILSON Aug 11, 2015

 

In the above video, Gretchen Jakway, MPOC solutions manager at PC Connection, talks about telehealth technology, how it provides patient care anywhere and improves outcomes, and tips about successful device deployments.

 

What questions do you have? How is your organization using mobile technology?

With significant growth projections, wearables have become more than a passing trend and are truly changing the way people and organizations think about managing health. I hear from many companies and customers who want to understand how the wearables market is impacting patient care as well as some of the changes taking place with providers, insurers, and employers. In the next several blogs, I'll share some of their questions and my responses. The first question is:

 

Please give an overview of the wearable technology industry as it relates to healthcare, and what is the projected growth?

 

In healthcare there are two main vectors of activity, starting with the health and fitness-oriented consumer devices such as the Fitbit, Fuel Band, and some of the emerging smart watches. These devices measure steps, sleep activity or general activity to try to encourage a healthy lifestyle.

 

The second vector includes devices found in clinical settings. For example, a company called Sotera Wireless has a vital signs monitoring device that is worn by the patient in the hospital. The key value proposition is that you have continuous monitoring rather than having a nurse come in periodically to take the patient’s vitals. Plus, the patient is not tethered to the wall or the bed so they can move and walk around more freely.

 

Another example that was not necessarily designed for clinicians is Google Glass, which has received a fair amount of press. It has been approved for use in some hospitals, and there are a number of use cases emerging. One is around streamlining clinician workflow support, so the clinician doesn’t have to interact with other screens in other areas of the patient room or the operating room.

 

In this first wave of wearable device adoption in the healthcare industry, we see a lot of repurposing of devices that were originally designed for other uses. Over time, we’ll see more sophisticated devices targeted at the industry. Some wearable devices will likely be regulated, for example, those for real-time glucose monitoring. But the payoff will be that purpose-built devices can better meet the complex needs of the healthcare industry, whether it’s, for example, remote monitoring of patients or encouraging health plan members to adopt a healthier lifestyle.

 

According to IDC, vendors will ship over 45 million wearable units in 2015; an increase of over 133 percent from 2014 worldwide shipments. They predict 45 percent annual growth for shipment volumes over the next several years, meaning roughly 126 million devices in 2019. If you look more broadly at the Internet of Things (IoT), in which wearables are a category, IDC is predicting a 36 billion dollar market for healthcare by 2018, so there are very aggressive growth projections.

 

In healthcare, the key driver of growth is moving from periodic monitoring, traditionally associated with the occasional visit to a doctor, to daily or even continuous monitoring of the patient’s specific conditions and general wellness. Wearables won’t replace the doctor visit, but they can establish baselines to measure against, and the streaming patient-generated data they sense and collect will improve the accuracy of predictive models to give insight into how a patient is really doing in near-real time. We are seeing just the tip of the iceberg today as companies target the healthcare vertical and build more sensing capabilities into devices.


What questions about wearables do you have? What do you think?


In my next blog, I'll look at some of the ways that wearables are impacting providers, payers and employers as well as patients.

 

Now that organizations have the computing power to gather meaningful information on patients and understand the trends that can lead to better outcomes, what are their plans for population health management and what are the next steps?


Watch the clip above and let me know what you think. What are you doing to prepare for population health management?

 

Martha Thorne is the Senior Vice President and General Manager for Population Health at Allscripts. We recently sat down with her to discuss the important of electronic health records (EHRs), the growing trend toward population health, and the ever-present need for data security. Read the interview below, watch a clip in the video posted above and let me know what questions you have about EHRs.

 

Intel: What is the importance of electronic health records (EHR) today and how are they progressing toward the future?

 

Thorne: EHRs continue to be an incredibly important tool for physicians and all health practitioners. What’s interesting to me is that there are many who consider EHRs to be a commodity. What we’re seeing now is that the EHR adoption rate has continued to grow, and what organizations are looking for today is more value. They are seeking ways to make it easier to do documentation, to make sure that information is available at the fingertips of the providers, and to make sure they are reaching out to the consumers and have a way to impact their health behavior. Healthcare organizations have to do all of this with very little extra budget.

 

Intel: How are consumers fitting into the healthcare information equation?

 

Thorne: One of the areas that’s really critical right now is consumer engagement. Not just patient engagement, but consumer engagement. There are many consumers who are high users of healthcare and need information about their healthcare status, clinical records, laboratory information and radiology, and diagnostic test results. Many consumers are now coordinating their own care and they’re having to go from specialist to specialist or their primary care to specialist and they need to be able to have that information and communicate appropriately with that next provider. What we’re also seeing in this space, which is really interesting, is that as consumers become more empowered, healthcare providers are needing to understand what it will take to get consumers more engaged in delivering changes to their own health status. So, this really is that next piece beyond just the basics of providing access to a clinical record, but now how do we make sure that we’re engaging with the consumer and they can impact their own health behavior?

 

Intel: What are you doing to focus on population health, and where do you see that headed in the next few years?

 

Thorne: Population health is a really broad category. It’s like describing the finance category with many applications underneath. We view population health the same way. There are a variety of different aspects of population health, but, ultimately, what it drives down to is providing a way of managing your patients, your consumers, in helping to improve the health status. First thing we have to do is understand what the current state is. We also need to understand how we’re now going to deliver a way to impact that current state and do it in a cost effective way. What we’re starting to see is information being delivered to providers, and then providers can take on a lot of different forms. It might be health coaches. It might be care navigators. It might be physician providers. It could be the surgeons. But we’re finding ways to deliver information at the point of care and where it makes the most sense, so that data could impact that health behavior of the patients.

 

Intel: What’s your view on information security now that data is more accessible to many sources?

 

Thorne: As we see healthcare information becoming more readily available, especially to consumers, they are going to be very interested in how we’re securing that data. What we need to do is look at how we can make information available in the cloud or another secure place that brings with it a high degree of confidence that the information is secure. I suspect that we’re going to see a whole new degree of security coming our way that we haven’t even yet imagined. My sense is that smaller startups could lead on this.

 

Intel: What type of healthcare IT trends are you seeing?

 

Thorne: There are several different trends in play right now. In the core EMR environment, we’re going to see a trend towards easier-to-use software for the providers that makes it very fast, simple and intuitive to do documentation and get the basics done. We’re also going to see inclusion of data analytics and genomics in organizing treatment plans. The second trend is a focus on better and more effective care coordination with the consumers. There are a number of different aspects to it, but different patients have different capabilities of engaging in their own health behavior. Ultimately, analytics is going to play a very important role, now and in the future, that will start to inform a lot of what we do and start to provide us with more information and more detail that will help us be more precise in terms of how we manage health. Lastly, we’re seeing a reduction in the inpatient census. What that’s doing is driving a higher inpatient volume in the post-acute network. We’re starting to see a shift towards patients being managed in the post-acute stay, which is more around the lines of home care, skilled nursing facilities and rehab facilities. Allscripts does very nicely with our Care in Motion suite and something that we’re going to continue to grow into the future to help manage those transitions of care and help those patients move back into a home setting where they’re less likely to have a preventable readmission.


Why are today’s most complex diseases so difficult to fight? They are mobile, opportunistic and have the ability to quickly adapt and change. To take on these diseases, and win, we need coordinated care that operates with the same flexibility, responsiveness and focus.


Patient care coordination is dynamic and highly interactive, involving many processes, stakeholders and activities. At its core, it is about organizing patient care so that the right care services can be delivered as fast as possible, without sacrificing quality.

 

With the enactment of penalties for preventable readmissions, healthcare providers need to address current gaps in care transitions that lead to poor outcomes, readmissions and patient complaints.

 

Israel’s Maccabi Health Services conducted several studies that revealed a close link between frequency of care delivery and health outcomes in patients with chronic conditions. Based on those results, Maccabi and the Gertner Institute established the MOMA* Video Conferencing Call Center. This new technology-based service delivery model will help enhance quality of care and reduce costs by:

 

  • Reducing travel demands placed on patients
  • Increasing the frequency of doctor-patient interaction with mobile technologies
  • Eliminating unneeded and costly in person visits for routine checkups

 

Today’s mobile solutions help healthcare professionals provide care to their patients throughout every stage of care. The ability to communicate, facilitate transitions and assess needs and goals is no longer dependent on infrequent and costly face-to-face interactions.

 

Now healthcare professionals can use mobile video conferencing technology to create a proactive care plan, monitor their patients and respond to change in real time.

 

Dr. Galit Kaufman R.N.PHD, director, department of nursing services at Urgent and Online Medical Centers suggests, “The Intel technology-based tablets are very easy to work with. We came to the conclusion that this technology will be successful if it supports, not replaces, human interaction. Video conferencing is the next best thing to being there. It supports the personal nature of the interaction between the nurse and the patient, and contributes to the quality of care clinically. Having a lot of contact creates a lot of motivation.”

 

What question do you have?

 

Read the Case Study: Improving Health Outcomes and Reducing Costs with Video Conferencing Technology

 

In the above video, John Chuang, president of Onyx Healthcare, talks about how technology can reduce patient readmissions while increasing engagement.

 

What do you think? What's your solution for reducing readmissions?

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