mnblatt

The Future of Healthcare Apps

Posted by mnblatt Jan 24, 2013

At the mHealth Summit in December, I had the opportunity to speak with Aetna Vice President Martha Wofford about the future of consumer healthcare apps, access to care and using big data to improve outcomes.


Watch the conversation below and let me know what questions you have about healthcare apps and how they impact health IT going forward.


By now, many of you have likely heard about the four V’s of Big Data: Volume, Velocity, Variety and Value. The ideas behind this construct for Big Data were conceived by Gartner over a decade ago. In the coming months, you will find a number of blogs, papers, videos and other resources here that discuss Big Data solutions for healthcare and life sciences in greater detail.

 

These solutions will take advantage of advanced platform capabilities from Intel and ecosystem partners to improve the reliability, scalability, and security of these solutions.  As an introduction, I wanted to use this space to set the stage for what Big Data means to healthcare, and why these solutions are needed:

 

•    Volume: The amount of healthcare data that needs to be stored, managed, processed and protected is growing at an ever-increasing rate. This situation is exacerbated by strict data retention requirements. Medical imaging is one area where the growing volume of data is especially evident. According to IBM, 30 percent of the data stored on the world’s computers are medical images. Advances in the life sciences industry in the area of cost effective genomic sequencing are causing data storage needs in this segment to explode. Many traditional solutions have trouble scaling to accommodate this growing volume of data. “Scale-Out” solutions, where computing nodes are added to an existing cluster to meet growing demand have several advantages to traditional “Scale-Up” solutions, where one big, powerful server is replaced with another bigger more powerful server.

 

•    Velocity: Many existing analytics / data warehouse solutions are batch in nature. Meaning all the data is periodically copied to a central location in a ‘batch’ (for example every evening). Clinical and administrative end users of this information are, by definition, not making decisions based on the latest information. Use cases such as clinical decision support really only work if end-users have a complete view of the patient with the latest information. Solutions that make use of in-memory analytics or column-store databases are typically used to improve the velocity of the data or “time to insight.”

 

•    Variety: Traditional analytics solutions work very well with structured information, for example data in a relational database with a well formed schema. However, the majority of healthcare data is unstructured. Today, much of this unstructured information is unused (for example, doctor’s free form text notes describing a patient encounter). Sophisticated natural language processing techniques and infrastructure components such as Hadoop Map-Reduce are being used to normalize a variety of different data formats, unlocking the data in a sense for clinical and administrative end users.

 

•    Value: Analysis by McKinsey Global Institute has identified a potential $300 billion value for Big Data per year in the healthcare industry in the U.S. alone. The majority of this value would be realized through savings/reduced national healthcare spending. For individual healthcare organizations, Big Data value will be realized by more efficient, more scalable management and processing of a quickly growing volume of data, and by enabling faster, better-informed decisions by clinicians and administrative end users.

 

If you would like more information on the role Intel plays in Big Data for healthcare, visit this site: Big Data and Analytics in Healthcare and Life Sciences.

 

What questions do you have about Big Data in healthcare? What challenges is your organization facing in regards to the four V’s? Leave a comment or follow me on Twitter @CGoughPDX.

Implementing cloud computing technology means choices. Do you choose public cloud, private cloud, or a hybrid cloud? We asked some industry insiders for their opinions and thoughts on cloud computing in healthcare technology.

 

In the below video, you'll hear from Chris Gough, Intel Healthcare Solutions Architect, Mark Woodward, Healthcare CTO at EMC, and Chris Mertens, Vice President of the Personal Systems Group/Healthcare Practice at HP, on their thoughts and recommendations for setting up a healthcare cloud environment.

 

What questions do you have?

 

Mobility is at the center of healthcare information technology. These days doctors need the ability to review medical records, see images and make clinical decisions wherever they are. And it’s the CIOs job to manage these devices that allow this process to happen.

 

In the below video, learn more about the rise of mobility and hear what some health IT experts recommend. You will hear from: Justin Steinman, VP/GM of Marketing, Clinical Business Solutions, GE Healthcare IT; Gary Zegiestowsky, CEO, Informatics Corporation of America (ICA); and Justin Barnes, Industry and Government Affairs, Greenway Medical Technologies.

 

What questions do you have?

 

The consumerization of mobile devices poses unique challenges for healthcare CIOs, who are tasked with maintaining security, streamlining productivity gains expected of the industry’s growing mobile workforces, and implementing information technologies that ultimately lead to improved quality of care.

 

For a glimpse into how one leading healthcare organization is managing the bring-your-own-device (BYOD) trend, I reached out to Hal Baker, M.D., vice president and CIO at WellSpan Health Systems.

 

With more than 9,000 employees, volunteers, and physicians, the health system includes WellSpan Medical Group, 35 outpatient health care locations, and three respected hospitals: WellSpan York Hospital, WellSpan Gettysburg Hospital, and WellSpan Surgery & Rehabilitation Hospital.

 

Dr. Baker reports his organization is down to less than 40 Blackberrys, given the rise in popularity of Droid and iOS devices among physicians, nurses, and administrative staff.

 

While hourly administrative staff member’s mobile devices are not connected to the health system’s network because labor laws prohibit such employees from working off-hours, physicians’ and medical salaried staff’s devices are loaded from Exchange Server to ensure confidential information is adequately protected. This approach can work well for health systems, provided Exchange Server runs on the server side and the organization can provide access from client software running on a mobile device.

 

Virtual desktop

To better manage the BYOD trend—and to make the organization’s own devices easier to support and less expensive to manage—WellSpan has begun implementing a virtual desktop solution running Windows 7 in a server array. Unlike thin client solutions, it functions similarly to PC Anywhere, bringing up what is essentially a brand new PC for laptop and desktop users every morning.

 

“Our virtual desktop set-up is nice because none of the data leaves the data center,” says Dr. Baker, “so, there’s no footprint on the laptop. Users can log out and have it sit in a suspended state without worrying about anything being resident.”

 

In addition, Dr. Baker’s team has set up a throttled guest network that is shared by staff bringing in their own devices, as well as patients, families, and guests. Doing so has helped WellSpan reduce internet saturation due to bandwidth intensive sites such as YouTube.

 

As his department disables older encryption networks, such as WEP, Dr. Baker anticipates the creation of another guest network for workforce and medical staff. This additional network will run off WellSpan’s domain because he doesn’t want to put unmanaged devices on the organization’s domain for security reasons. A full-time security team prevents issues from developing among users who may seek workarounds.

 

Encryption

For healthcare organizations, the age of accountable care hinges on being able to reach people in their homes, especially patients who are at high risk of readmission.

 

However, the same mobile technology that empowers staff to send photos of a patient’s condition to a physician may also place the entire health system at risk of a HIPAA violation if those images end up on an employee’s iCloud, or accidentally posted to Facebook. It’s not that a staff member would deliberately share such information, more a risk of unintentional connectivity that extends from the consumer realm into the healthcare space.

 

In WellSpan’s case, the health system made a business decision to connect mobile staff, such as visiting nurses, via email not text. Information shared among medical staff through mobile devices remains encrypted during transmission and does not enter the EHR until a physician forwards it to the records department so it may be added to the EHR.

 

“Our challenge,” says Dr. Baker, “is to try to leverage the consumerization of communications—text messaging, pictures, Skype, Facetime—to allow connectivity for the coordination of care, which is all the good stuff, while doing it in a way that protects the sanctity of security that HIPAA, I think, reasonably expects of us.”

 

Toward that end, WellSpan has installed a Symantec product on all laptops and USB drives, and has enforced encryption on all connected smart phones. Any file downloaded, copied, or received as an email is now automatically encrypted.

 

The IT team also has educated staff and physicians on why it’s necessary, for example, to enter a password to access a PowerPoint presentation.

 

Yes, it’s a pain, but already the approach has paid off. Last year, a WellSpan employee’s car was broken into and a laptop that contained protected health information (PHI) was stolen. The organization was able to sidestep a breach—and appearing on the dreaded Wall of Shame—because the IT Department could show the laptop was fully encrypted and in a locked state.

 

Mobile apps

Although WellSpan does not formally participate in an ACO program, the health system provides significant primary care through its medical group, effectively serving as an accountable care organization for the uninsured population in its community.

 

While many in this population don’t have a computer or high speed internet in their homes, a surprising number regularly access the Web via smart phones.  With so many patients now bringing their own devices to facilities, WellSpan has opted to develop its own mobile app for patients, a move Dr. Baker expects to further improve quality of care.

 

The health system’s mobile app will offer appointment reminders, directions to offices and facilities, and barcode scanning for refilling medications—for starters.

 

Granted, such apps are widely available through third party vendors, but Dr. Baker feels mobile offers an opportunity to stay connected with a population of patients for whom it is WellSpan’s mission to keep healthier. After all, four 15-minute visits per year aren’t as effective at keeping a diabetic patient under control as a provider who can stay in touch monthly, or weekly, via the Web.

 

“If we’re going to reach our patients and give them information, then lBYODet them see what their lab results show, let them communicate with us when they get off their night shift at 4:00am, or after working a second job,” Dr. Baker says. “We need to be able to reach out to them through this technology.”

 

What questions do you have?

 

As a B2B journalist, John Farrell has covered healthcare IT since 1997 and is Intel’s sponsored correspondent.

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