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Although the 2016 HIMSS Annual Conference and Exhibition next week is coming to Las Vegas just a month or so after the Consumer Electronics Show, no one would ever mistake the two.


While HIMSS16 is likely to break its own attendance record of 43,129 set last year in Chicago, CES is in a class of its own, with more than 170,000 attendees.


CES is all about the gadgets (some gadgets, of course, being 88-inch 4K televisions or electronic cars) that technology-obsessed consumers swoon over, while the HIMSS annual conference will continue to emphasize infrastructure, policy and education for healthcare IT professionals – it’s bread-and-butter for the past quarter century. Picture1.jpg


That being said, HIMSS16 reflects the organization’s growing embrace of the roles consumerism and gadgetry are now playing in the health IT ecosystem. Sessions like “Empowering Clinicians with Smartphone Technology” and “The Internet of Healthcare Things” recognize that it’s not all about the EHR anymore. And the lunch and learn session “Holograms, Wearables and Future Technology: How Trends in Technology are Changing the Face of Patient Care” gets my vote for the most promising session at the show based on its title. I mean, holograms!


Writing over at Healthcare IT News, Penn Medicine chief information officer Mike Restuccia listed “wearables” as one of his top three things to seek out at the show. He says, “Penn Medicine successfully completed a pilot study to monitor the blood pressure of 20 postpartum women over a high risk period of time. Key components of the pilot study were a wireless Bluetooth blood pressure cuff, smartphonoe and the integration with our Epic electronic medical record. Ill be on the lookout to see what other healthcare and vendor organizations are doing in the space of wearables and remote monitoring.”


Interoperability on FHIR


I’ll also be interested to see how much attention the new HL7 Fast Healthcare Interoperability Resources (FHIR) standards framework generates. Last year, FHIR generated a lot of buzz on the strength of a couple of demonstrations and breakfast talk. This year, there are a half-dozen sessions devoted to the emerging framework, such as ‘Innovation on FHIR: Clinical Application Development using the Evolving Standard."


I did some interviews on FHIR for an upcoming research piece and I can see why developers, especially those from Silicon Valley’s start-ups, are excited. FHIR leverages standard web-based API technologies to improve interoperability — moving healthcare away from a “document” exchange model to a more granular object-level exchange.


If and when FHIR achieves maturity and broad acceptance, it will open up the often insular and complex world of health IT vendors to thousands of developers of new, interoperable apps and consumer devices.


(What I really need now is a session where an expert convinces me why we should pronounce the FHIR acronym like “fire.” I don’t get it.)


Criminal Intent


Finally, the conference continues the organization’s emphasis on security. A key topic at past shows, there are 28 individual sessions dedicated to privacy and security at HIMSS16 and a “Cybersecurity Command Center” on the Exhibit floor.


One thing that I find really fascinating is the shift in language around security topics at HIMSS. In the early days, privacy and security sessions seemed to emphasize more neutral terms like “breaches” and “noncompliance.” But look at the description for Stephen Cobb’s session on managing health IT security risks: “Criminal activity in cyber-space, commonly referred to as cybercrime, can expose personally identifiable information (PII) to unauthorized access and abuse. Some criminals derive substantial income from black market sales of PII. Data thieves have discovered that the electronic patient records held by American healthcare providers and insurers can be a rich source of PII…”


“Cybercrime…” “Black market sales…” “Data thieves…” That’s kind of scary, right? But I don’t think Cobb, who has been researching and writing on these topics for 20 years, is an alarmist. Instead, his terms convey the true severity of the problem.


I think the former language of “breaches” minimized — and attempted to defang — the criminality of hacks and attacks. It was as if hospital executives didn’t want to use stronger imagery and create doubt in their patients’ minds. Or to put it another way, the neutral terms suggested that perhaps providers feared the damage to their organizations’ reputation rather than the actual harm inflicted by the attacks on their patients.


But I digress… Having covered the industry for more than a dozen years now, I sense a greater urgency and relevancy in the topics at the HIMSS Annual Conference. They address both the promises and the problems that health IT faces. Kudos to the organizers and it will be no surprise if the show does, as predicted, break its attendance record yet again.

'All in One Day by 2020' - it's a phrase I hear often here at Intel, and this vision of a single 24 hour period in which a cancer patient’s tumor DNA can be sequenced, to ultimately come up with a better, personalized treatment plan, is a major driving force behind what we do. Doctors and researchers should be enabled to find all the information they need from all the structured and unstructured healthcare data, that will improve patient outcomes, and we want to help them do that quickly.


With that in mind, it's fantastic to bring you news of how Intel and Dell have joined forces to deliver a blueprint architecture for SAP Foundation for Health and SAP Medical Research Insights. SAP Foundation for Health serves as a platform for a number of new applications targeted at personalized medicine and allows the analysis of large amounts of data from disparate sources; and in in real-time using SAP HANA.


The new reference architecture will enable customers across the globe to deploy this solution quickly and with full confidence in its capabilities. Speed is a critical factor in personalized medicine, and with the SAP HANA infrastructure, optimized for Intel® Xeon® Processor E7, it is possible to deliver fast-paced analysis of the mission critical structured and unstructured data.


Much of the commentary around big data analytics in healthcare seems to focus on what might be possible, at some time in the future. The joint efforts of Intel, Dell and SAP in building this software-hardware blueprint shows that it is possible to deliver real value to researchers and clinicians today, in an easy and uniform manner. Delivering value to researchers and clinicians means that jointly we will deliver maximum benefit to patients, and impact the quality of life.


To learn more about how Intel and Dell are working together in the field of health and life sciences I highly recommend watching this Translational Genomics Research Institute (TGen) video, which highlights how high performance computing is helping doctors and researchers better understand data to treat and prevent diseases.


We want to continue this conversation with you at HIMSS16 (Feb 29 – Mar 4, Las Vegas) where we will be happy to discuss Intel, Dell and SAP’s work in personalized medicine in more detail; all three companies have booths on site. To meet with Intel, contact me below to arrange a suitable day and time to meet. I look forward to seeing you.




When we look back on 2016, my hope is that the year will be a milestone in the progress toward patients owning their health. Over the years, technology has allowed consumers to own their banking, travel arrangements and cable television subscriptions. Now, it’s healthcare’s turn. Healthcare technology such as wearable devices and electronic health records (EHRs) is, for the first time, putting the patient in the driver’s seat to take control of their physical care.


Own Your Health will be a rallying cry in 2016 that works on several levels:

At the patient level, Own Your Health means understanding one’s physical well-being and taking steps to improve it. This can be done with information – doctor visit summaries, medications, medical imaging, diagnosis codes, clinical notes and laboratory results — that is available today through a wide range of wearable devices, smartphones, and sensors. These technologies enable a deeper level of participation in one’s health, and a much richer set of data so that patients understand that what they do affects their bodies.


At a broader level, owning your health contributes to insights and discoveries in populations of people. In 2016, Intel will be reporting on a clinical trial in which people volunteered to let research scientists analyze their deidentified biometric data from the Basis Peak fitness tracker combined with data captured in clinics, laboratories and in homes. I mention this example because it reflects a clear industry trend toward using consumer-grade wearables in population health, wellness monitoring and drug discovery efforts. Intel’s work with the Michael J. Fox Foundation using wearables to measure tremor events in Parkinson’s patients is another great example, enabling analysis of how various types of patients respond to specific doses of medication.


For the fast-growing consumer healthcare marketplace, Own Your Health will be a call-to-action. Intel is working with a wide variety of partners to develop this ecosystem and break new ground with devices and biosensing, data interoperability and integration, affordable and scalable storage, and predictive analytics, all delivered with an acceptable level of security and trust. Our goal is to make consumer health analytics easier on Intel® architecture.

Overall, Own Your Health is about gaining value from biometric information that has been untapped for too long. And it is based on the power of individuals to learn about and improve their health, and contribute to the well-being of others at the same time.

Where do you see consumer health technology heading this year?

Observations from 2015 Travel

In 2015, I had the opportunity to visit more than 10 countries, including Japan, Mexico, the United Kingdom, Brazil, Germany, and China. After meeting with numerous healthcare leaders and government officials, a recurring theme emerged regardless of location: how can countries and healthcare systems best care for aging populations? How can coordination among providers be improved to better provide care to the elderly, and in particular serve the needs of patients who have multiple complex chronic conditions? And how can better outcomes be achieved for such patients especially with ever tightening healthcare budgets?


Increasing investment and interest in Telemedicine and Remote Monitoring as a solution to these pressing healthcare challenges

A universal sentiment I observed is enthusiasm toward telemedicine and remote monitoring technologies as a potential solution for addressing these challenges. Government and healthcare leaders in the countries I visited are hopeful that these tools will enable patients, caregivers, and providers to work together in a more effective manner to better manage chronic disease, and in turn improve health outcomes at lower costs. Forecasts suggest the international market for telemedicine will grow from $14 billion in 2015 to $34 billion in 2020.


Telemedicine and Remote Patient Monitoring: Why now?

Telemedicine and remote monitoring are not new concepts. They have long been touted as having potential to transform healthcare for the better, and peer reviewed literature increasingly supports this view (e.g., increased patient satisfaction, improved health outcomes). For a number of reasons, though, the implementation and use of telehealth has yet to fully reach its potential. Policies are often vague or confusing, and reimbursement is still lacking for many telemedicine services. This was generally the case in every country I visited, and in the United States. However, there is reason to believe this market will soon expand rapidly. Several forces, including consumer demand, advancements in technology and data security, growth in private companies entering this field, and changes in regulatory and reimbursement policies that support the use of telemedicine, are converging in such a way that will increasingly bring these services into routine care.


Variations across countries: Use cases, policies, and opportunities for growth

Here, and in a series of blogs to follow, I will highlight how the countries I visited this past year are using telemedicine and remote monitoring tools, the country-specific regulatory and reimbursement policies that affect the use of telehealth, and how Intel Health & Life Sciences is working with partners in these countries to promote the use of this technology.


Observations from Japan

During two trips to Japan this past year, discussions about telehealth technology were of top priority. Japan is in an ideal position to use telemedicine and remote monitoring for two reasons: 1) it has the technological infrastructure and sophistication to support and rapidly implement it, and 2) more than 20% of Japan’s population is over the age of 65, and this percentage is expected to rapidly increase. In providing home care for this population, telemedicine and remote monitoring capabilities will be increasingly important.


Policy Roadblocks

Japan is hardly an outlier in having policies that hinder the implementation, use, and reimbursement of telemedicine. The American Chamber of Commerce in Japan (ACCJ) and the European Business Council in Japan (EBC) have recommended amending the Medical Practitioners Act to clarify who is allowed to implement and practice telemedicine. Additionally, while some services are reimbursable (e.g., tele-radiology and tele-pathology), many other services such as disease management and patient education are not. Thus, while the technology exists to make this care a reality, policies have not always kept pace to allow it to happen.


Use cases in Japan

Policy and reimbursement challenges notwithstanding, Japan has made impressive progress in how it effectively uses this technology for patient care. For example, KOHOEN is a social welfare organization in Japan. One of its primary missions is to improve and provide community-level care, and to promote team-based care among doctors, nurses, pharmacists, and care managers. It equips care teams and patients with remote care tools, which in turn help older individuals live at home and maintain independence. One tool KOHOEN uses is a tablet solution (an Intel atom processer powered android-based ASUS fonepad) for a 24-hour visiting nurse and attendant service. The care team members use these tablets and a cloud-based information sharing system to share information with one another. The flexibility and security of this tool allows for real-time data input and transmission, which enables physicians to provide medical advice while the nurse is at the home of a patient.


Sharing best practices and learnings across countries

As countries around the world continue to integrate these types of technologies into their care delivery systems, sharing best practices will be important and valuable as other countries invest in similar tools. Policies, too, must continue to evolve to keep pace with these technological advancements for the benefits to be fully realized. Intel will continue to work with policy makers abroad and in the U.S. to encourage such progress.


With all of the media hype around breaches, and pressure from your stakeholders to avoid being the  next headline, it is easy to focus too much on one or another type of breach, perhaps the one that caused the latest headline. This risks missing many other common types of breaches, and being blindsided by a breach you did not anticipate, and therefore are unprepared for. In this blog, I look at six of the most common types of data security breaches in health and life sciences organizations. iStock_000054104746_Large.jpg


1. Cybercrime Hacking: In this type of breach, an external hacker accesses your organizations network and obtains unauthorized access to sensitive patient information. A common example of this type of breach starts with the hacker spear-phishing a worker in your organization, resulting in that worker clicking on a malicious link, and leading to drive-by download of malware. The malware then proliferates inside your intranet and key-logs the database administrator database credentials, at which point it turns into a bot that logs into your database containing sensitive patient data and exfiltrates this data "low and slow" to evade detection.


2. Loss or Theft of Mobile Device or Media: In this type of breach, a worker either loses or has stolen a mobile device or media containing sensitive patient data, resulting in potential unauthorized access to that data and a breach.


3. Insider Accidents or Workarounds: In this type of breach, a worker performs a well-intentioned action that results in unauthorized access to sensitive patient information. A common example of this type of breach involves a worker emailing unsecured sensitive patient information, resulting in potential unauthorized access to this information, and a breach. This type of breach can involve the use of either corporate or BYOD devices by workers.


4. Business Associates: In this type of breach, a third party organization contracted by your organization experiences a breach event involving unauthorized access to sensitive patient information. In this case the patient information impacted originates from your organization and was previously shared for the purpose of the third party organization fulfilling its contractual obligations. In the United States these entities are known as Business Associates, while in Europe they are typically referred to as Data Processors.


5. Malicious Insiders or Fraud: In this type of breach, a worker performs a malicious action that results in unauthorized access to sensitive patient information. This could be a disgruntled worker, or done for the purpose of committing fraud. A common example of this type of this breach involves medical claims fraud where a worker files dishonest healthcare claims in order to turn a profit, or sells sensitive patient information on the black market. Prescription fraud and financial fraud are other examples of this type of breach.


6. Insider Snooping: Insider snooping involves a worker accessing the records of patients of your organization without any legitimate need to do so, for example where a patient is not under the direct care of the worker.


Only by understanding all the types of breaches your organization is at risk of and how to defend against these can you achieve effective security and adequately mitigate your risk of breaches.


What other kinds of breaches are you considering to protect your health and life sciences organization from breaches?

By Douglas L. Wood, MD, Mayo Clinic


Wearables and the data they generate are often thought of as great solutions for health and healthcare. While the benefits of these new devices and the information they provide are many, there are some challenges that we had not anticipated with so much data flowing to physicians.


At Mayo Clinic, we have started performing experiments with patients who wear these devices. What we’ve learned is that the precise data that is generated is helpful; however, the behavioral changes we are able to recommend to patients based on the data is where true value will be recognized. The patients know we are partnering with them and that’s powerful.


Many patients who come to our facility expect us to talk with them in detail about what they are seeing in their own data. If we don’t, it undermines our credibility in the visit, in their eyes. One of our patients likened this situation to being stopped by a police officer for speeding. If you knew you were speeding and the officer talked to you about something else, you would think that was odd. That’s the current state with wearables and healthcare.


We have come to the conclusion that information, or data, is cheap. What’s priceless is the context and relevance of that data. For us, the value of data is being able to take the information and distill it into contextual frameworks that have meaning for physicians and nurses and for patients who are trying to find ways to live better.


Interestingly, when we’ve studied people with diabetes and other chronic conditions, we’ve learned that the clinical data is not that important. What is important is that these patients do not want to be considered a diabetic or labeled as some kind of condition. They want to be a person. Herein lies a challenge with big data: it makes it very easy for clinicians to apply labels to people, and that’s not going to help anyone. We have to think about this data differently.


Finally, we’ve begun to see a tremendous opportunity for physicians and nurses to use wearable computing, especially if we could link to cognitive computing to help us do our daily work and make that work more meaningful and less cluttered with some of the regulatory requirements that we have now. If clinicians had access to this type of technology, we could free ourselves from some of the very restrictive documentation and other process measures that are based on rules that were written 20 years ago, when the records were still largely paper.


Think about it: Having electronic records that are populated with real data and video would mean we would not need to rely on recreating a 20-year-old paper record. It’s time we break out of this old way of thinking and devise a new way of delivering care, namely letting actions stand on their own with the capacities of modern technology to record and advance them.


What do you think is the most valuable aspect of wearable technology?




Douglas L. Wood, MD, is the medical director at the Center for Innovation at Mayo Clinic and a practicing cardiologist.

January launched 2016 with as much velocity as any year that I recall but as I look out to how healthcare will shift this year (and probably next), what jumps to mind is an overall comfort that almost every aspect of healthcare is undergoing rapid change (or some say evolution). This is the new normal and I see it in communities all across our country.


I also must admit that our personal thoughts and ideas are largely shaped by our circle of peers and influencers so I personally work hard to keep a foot in multiple healthcare markets to understand how the majority of our communities are shifting. Here are a few consistent themes I see emerging over the next 12-18 months:


Provider expansion of services and strategies

By this I mean, whether in the city of Atlanta, Boston or San Francisco, or the rural communities of South Carolina, Texas or Massachusetts, I see and work with health systems and physician practices that are expanding services, partnerships and expanding “consumer” access. The motivations behind these expansions are diverse, but everyone is experiencing a shift in how healthcare is being consumed, where it’s being consumed and when it’s being consumed. I am also seeing a stronger focus on efficiency, but not enough yet, in my opinion. All organizations need to strategically and wisely better align their processes and operations with their revenue drivers for today as well as their revenue drivers for tomorrow.


Focus on the patient and better respecting that the patient is a “consumer”

Physician practices, clinics and health systems of all sizes are working to make conducting business with their organization easier. In that I mean align or re-align processes, services and innovation to ensure that patients can easily access scheduling, appointments and certainly, payments. While this sounds like an “of course!” statement, most, even leading health systems, don’t properly align these aspects of their organization and operation, thus leaving millions of dollars on the table. For example, ensure your organization offers simple ways to schedule an appointment. Ensure that you are researching - or better yet deploying - “community-based” strategies that offer care where the patient/consumer wants to consume care. Sometimes the best place may be inside the four walls of your organization, but sometimes it may not be. A few proven strategies here include new care settings that are convenient for your community and even a virtual care or telehealth strategy. These can offer new revenue streams and allow practices, clinics and health systems of all sizes to deploy strategies that will allow them to evolve alongside a healthcare system that is embracing value-based medicine, bundled payments and alternative payment models.


Other consumer-focused strategies that I see growing quickly are patient navigation and wayfinding to simply and profitably enhance the patient experience (and as we know from research flooding the market, consumers are paying premiums for “experience,” and as our economy shifts, everyone needs to keep an eye on this because you can offer a terrific experience and actually save money by better embracing innovation.


The other area that I see exploding for practices, clinics and health systems is around “compassionate collections” and a strong, focused strategy on the patient revenue cycle. Many innovations are hitting this from different angles, but as patients continue to pay for more of their healthcare “tab,” efficiently and effectively managing this process is key to protecting and increasing your organization’s bottom line.


Use of innovation to navigate the future of healthcare

I see innovation being deployed at every level of service, process and technology. To start, many organizations are focusing on better managing their overall “revenue cycle”. This is best deployed through a technology-enabled service whereas a specific market expertise leverages software automation, “rules” intelligence and robust clinical, financial and administrative reporting. Not only is this important today to optimize an organization’s overall financial health, but it is going to become vital to everyone’s success and preservation as healthcare quickly shifts to new payment and care delivery models, outcomes and quality-based payments and razor thin margins on traditional payment models. This experience and expertise will be worth its weight in gold…


Interoperability is still a large focus for many. Certainly more in the urban areas than rural, but I do see the rural communities picking up interoperability steam to drive care coordination, protect or enlarge their patient base as well as to participate in new payment and care delivery models. We’ve been talking about standards and interoperability for a long time now but the conversation has shifted in many communities to actionable intelligence on how interoperability is fueling coordinated and higher quality care.


We’ll see much faster progress with “connected care” that is driving innovative care and increasing care access in every community. Advancements across the board with telehealth and virtual care as laws mature and payment & reimbursement structures are solidified.


I also see pop health & quality reporting finally begin to receive the respect that it deserves. With many progressive organizations today, it is driving their financial and strategic bottom line. Those organizations are well-positioned to successfully navigate the future of healthcare no matter what, since managing structured data, clinical quality measures (CQMs) and robust reporting will be essential to all sustainable payment structures in the very near future.


I would be remiss not to mention the importance of data security for 2016 and beyond. While it may not feel as exciting and opportunistic as implementing cool innovations popping around consumerism, mobility and population health, having a strong data and platform security strategy and implementation will be essential to protect your information, integrity, brand and bottom line…


As I wrap up these thoughts, I realize that even after 20 years in healthcare and health IT, I just love this industry and all of the opportunity it serves each of us to help create the smartest and most sustainable healthcare system in the world.


Sepsis is one of the leading causes of hospital readmissions and death in the United States, impacting some 750,000 patients per year at a cost of $16.7 billion annually to the healthcare system. Reducing the impact of sepsis cases even slightly would significantly enhance patient outcomes and reduce unnecessary expenses.


While the understanding and treatment of sepsis is improving, early detection and diagnosis of the condition continues to be an issue. In the above video, see how Cerner developed  a solution to the sepsis challenge – the St. John Sepsis Agent, which uses Intel technology and to date has helped save more than 2,700 lives by identifying sepsis in the early stages. According to Cerner, organizations can achieve $5,882 in medical savings per treated patient, a 21 percent reduction in length of stay, and a 24 percent reduction in in-hospital patient mortality rates by implementing the St. John’s Sepsis Agent.


Also in the case study video, see how Cerner aggregates big data and utilizes analytics to enable population health, and how Intel and Cloudera allow Cerner to provide a technology platform to support massive amounts of storage capacity, scalable parallel processing with near real-time alerts,  as well as high levels of security.


How is your organization using big data to enable population health?

by Steve Leibforth, Intel Americas

Leibforth photo.jpg


It’s seems like just yesterday that we were leaving Chicago and basking in the innovation on display at HIMSS 15. Actually, since the last show was in April and now the biggest event in healthcare technology is back in its usual calendar slot, we’re ready for the second HIMSS in less than 12 months.


This year, the healthcare technology community is headed to Las Vegas February 29 to March 3, 2016, to see what innovation will be on the healthcare horizon in 2016 and beyond.  You should expect to see more conversations around how the patient, and their user generated data, plays into healthcare going forward. HIMMS_1.jpg


At Intel, we’re approaching HIMSS 16 with a critical eye on three areas that we feel are focal points for CMIOs: precision medicine, health IT and medical devices, and consumer health. All are patient-focused.


To learn more about these pillars, you’re invited to the Intel booth (#3032) to view the latest technology platforms that focus on the rise of patient engagement and consumer generated health data. We encourage you to stop by and take a guided tour, where you’ll see these demonstrations:


  • Precision Medicine: From genome sequencing to targeted treatment plan all in one day
  • Health IT and Medical Devices: Securely connecting patients, clinicians and their data for proactive healthcare wherever you are
  • Consumer Health: Engaging connections among people, their data and care community to empower health ownership


Outside of the Intel booth, you will find our technology in a number of HIMSS Kiosks that showcase real solutions available today:


  • Population Health Zone Kiosk #14099: IOT Big Cloud Analytics will share how analytics are helping to proactively improve healthcare
  • Connected Health Zone Kiosk #15208: Fujitsu will showcase a communication tool integrated EMR used at the National Cancer Center, personal health record for pregnant women and personal health records for dental solutions
  • Intel Security Kiosk and Cyber Security Challenge #9908: Come take the Security Breach Challenge and learn how to combat cybercrime through efficient breach detection and response


Finally, be sure to follow @IntelHealth on Twitter to keep up-to-date on all the happenings going on at the event. We’ll be live tweeting from the show floor and sharing pictures of new health IT products/services that we discover. We’ll also be giving away a Basis Peak watch every day during HIMSS through a Twitter contest so be on the lookout for how you can win.


HIMSS is always a great event and we are looking forward to seeing you in Las Vegas.


What are you most looking forward to seeing at HIMSS16? Tweet us @IntelHealth.


I was delighted to be invited to speak at Microsoft’s Empowering Health event in Brussels, Belgium recently, which brought together some 200 thought-leaders from across the world to discuss health IT issues in a ‘Mobile First and Cloud First World’.


I was looking forward to hearing about how some of the more progressive countries in Europe were utilising technology to deliver more personal, productive and predictive health to its citizens so it was pleasing to hear examples from the Netherlands around patient portals and from Sweden where virtual care rooms are helping to deliver a more efficient healthcare system through patient self-diagnosis. From these very real examples of today to discussions around the future of machine learning and robotics, the narratives were underpinned by the absolute need for clinical staff to have input into the technology solution they would be asked to use as early as possible.


Data: One Size Does Not Fit All

Some great statistics from Tom Lawry, Director of Worldwide Health Analytics, Microsoft, generated a real buzz in the room. Tom started his presentation by stating that ‘we spend a lot of money ONCE people are sick, while most money is spent on small numbers of people who are VERY sick.’ Clearly there are a lot of areas where technology is helping to move the needle from cure to prevention while all-in-one-day genome sequencing to personalised medicine is something we are working towards here at Intel as we look ahead to 2020. I was interested to hear examples from across the world on how healthcare providers are dealing with increasingly large amounts of data. Within the European Union there are very different takes on what data is classed as secure and what is not. For providers and vendors, this requires a keen eye on the latest legislation, but it’s clear that it’s a case of one size does not necessarily fit all.


Digital Education of Nurses

The breakout nursing session brought together a dedicated group of nurses with a real interest in how technology can, and will, help make nursing even better. We kicked off by discussing what level of digital education nurses have today, and what they need to equip them for the future. The consensus was that more needs to be done in helping nurses be prepared for the technology they’ll be asked to use, in essence making technology a core part of the nursing curriculum from day one.


The move towards distributed care generated some fantastic thoughts on how technology can help nurses working in the community - read my recent blog for more thoughts on that. We all agreed that access to healthcare is changing, it has to if we are to meet the demands of an ageing population. For example, millennials don’t necessarily think that they need to see a medical practitioner in a hospital setting or a doctor’s surgery, they are happy to call a clinician on the phone or sit in a kiosk for a virtual consultation, the priority being quick and easy access.


Nurses Actively Championing Technology

I was particularly impressed by a new app showcased by Odense University Hospital called Talk2Care – in short, it enables patients in ICU to ‘talk’ to nurses using an icon-based dashboard on a mobile device. This new way for patients to communicate, who would in some cases only be able to nod or shake their head, has been invaluable not only for nurses but the patient’s family too. What really pleased me was that nurses were actively championing this technology, encouraging patients to utilise it to help nurses deliver a better care experience.


We closed with thoughts on how taking care into the community was being revolutionized by technology. We’ve got some great examples of the role Intel is playing in the advance towards more distributed care, from the use of Intel IoT Gateways to help the elderly live more independent lives at home through to the KU Wellness car which empowers nurses to take advanced care into the community using mobile devices.


Virtual Reality Nursing

After a short break we returned to the main auditorium where I was pleased to be on stage with nurses from across the world. The future of the workforce was discussed in some detail, particularly around how the nursing and the wider healthcare community will manage the anticipated future global shortage of nurses. Technology will go some way to alleviating this shortfall through improved workflows but I like to think in a more visionary way, perhaps we will see the use of avatars, virtual reality and (thinking of discussions earlier in the day) robots. What’s clear is that nursing is changing in response to the move to distributed care, we need to skill not only nurses but other caregivers too, i.e. families, to make better use of the technology that is available today and tomorrow.


In December, Centers for Medicare & Medicaid Services (CMS) announced final rules of Meaningful Use 3 (MU3)—the third and final iteration of the Meaningful Use Program. The principal goal of this incentive program is to ensure that electronic health records are being used by providers in a way that improves quality of care (e.g., used for e-prescribing, or for submission of clinical quality measures). MU requires providers to meet these criteria in order to receive incentive payments and avoid downward reimbursement adjustments.


As part of MU3, eligible providers will be required to integrate Patient Generated Health Data (PGHD) with clinical data in the EHR for at least 5 percent of the patient population. PGHD includes any data that is generated outside of the clinical setting. Examples include data captured by a device such as a smart phone, or self-reported data (e.g., diet, functional status, emotion well-being) that is manually recorded by the patient. The patient both captures and transfers that data to the provider.


Inclusion of PGHD in this third and final phase of Meaningful Use is exciting for several reasons  

First, this new rule has potential to incentivize providers to invest in the technology and infrastructure (e.g., data storage and security) that will support the integration and use of this data, which to date has not been systematically incorporated into routine patient care.


Second, this new rule coincides with the rapidly growing wearable device market and consumer use of these devices that allows patients to capture their own health data outside of the clinic or hospital setting. Integrating these data points with clinical data and allowing providers to use these data at the point of care will contribute to patient engagement, patient activation, and self-management.


Third, at the policy level, this is likely to drive interoperability and data security standards, which could have broader and positive implications for other types of healthcare data and analytics.


How should providers prepare?

This new ruling will go into effect in 2018, thus giving providers time to make changes to current EMRs and technology that will support the use of the transfer, use, and storage of this data.


At Intel, we are working to advance these goals through data security efforts, big data analytics, data storage capabilities, and wearable devices that promote and support PGHD.


One such initiative within Intel Health & Life Sciences involves Big Cloud Analytics and its COVALENCE Health Analytics Platform. The COVALENCE Health Analytics Platform is powered by Intel Xeon processor-based servers in the cloud, which ensures a secure, reliable, and scalable infrastructure. Big Cloud Analytics utilizes the Basis Peak watch, which provides 24x7 real-time heart rate monitoring, and supplies metrics for sleep patterns, steps taken, skin temperature, and perspiration. It collects readings on 50 biometric data points every 60 seconds and syncs the data security with the Basis Cloud.  This allows insurance providers, healthcare institutions, and employers to securely use wearable device data to engage patients with event-triggered personalized messaging.


Biometric sensor data gathered from the device is also transmitted to the cloud or on premise data storage and aggregated in the COVALENCE Health Analytics Platform. This platform transforms data into business intelligence and predictive analytics. It then generates wellness scores, bio-identity scores, and many others. Insights based on analysis of the data points and trends provide an early indication of potential health issues or lack of progress toward health goals.


PGHD as part of routine care: opportunities and challenges

While PGHD will substantially increase the number of data points that can inform healthcare and lead to new insights, we recognize that operationalizing the transmission and use of PGHD will not happen instantly, nor effortlessly. Many questions remain as to how this data will be most effectively used by providers and patients. For example, what is relevant data?  How should providers communicate this to patients so that the appropriate data can be collected and transferred? How much data will providers want and need to obtain in order to make this data useful for patient care? How often will providers want to see this data? How might this influx of data affect staff or clinic workflows? From a user experience perspective, how will this data be best displayed so that providers and patients alike can act upon it? Perhaps further research, particularly ethnographic research that takes into account both the clinician and patient perspective, is needed if we are to use this data in way that translates to better patient outcomes.

One of the most promising areas of innovation and transformation in healthcare today is the move to distributed care, achieved through the creation of patient-centered networks of intelligent, connected devices that span across the home, workplace, community and the mobile spaces in between. Data capture and analysis, and communication between the patient and their care team can all be enhanced and harnessed to deliver more effective healthcare to more people at lower cost.


Connected Care, Everywhere

In the home, this will be driven by new types of consumer medical devices and smart-home connectivity and features. In the workplace and the community, new mobile devices and services including kiosks will be available. And for persistent real-time data and connectivity, new purpose-built and general purpose devices will fill in critical gaps.


Community Care Impact

In the home, sensors are transforming the way we care for the elderly, helping them stay more independent and spend longer at home, thus improving general well-being and reducing costs to the provider. Mimocare’s sensor solution is a great example of just how the Internet of Things can help us move the focus towards prevention rather than cure.


For community nurses this kind of distributed care is a win-win, they’re alerted (remotely) to patients showing abnormal signs earlier which enables a more speedy intervention and appropriate care is delivered more quickly, while also reducing the need for unnecessary monitoring visits too.


Patient-Centered Connectivity

I’d highly recommend reading a recent blog on the use of the Intel® RealSense™ 3D Camera by GPC too, which can help clinicians in a hospital setting make better-informed decisions in the area of wound care management. It’s an exciting development as wound care management accounts for a high-spend by most care providers, for example,  in the UK the NHS spends some £3 billion per year in this area.


RealSense™ is available across a range of mobile devices today so I see a future where patients are able to play a greater role in their wound care management in the home setting by recording the healing progress of wounds using the 3D camera and sharing the results with clinicians. This is undoubtedly more convenient for patients and more efficient for clinicians and providers.


Balancing the Demands of Modern Healthcare

These patient-centered networks of intelligent, connected devices generate significant volumes of data which can be analyzed by healthcare providers to help balance the demands of an ageing population with increased pressure on costs.  Patient preference to stay - and be clinically managed - at home is driving this shift to distributed care. The tools are available today, so let’s embrace a more connected vision of healthcare where we deliver even better care to patients.



Joan is speaking on the 'Technology empowering nurses with mobility, collaboration and communication' panel at Microsoft's EU Innovation Empowering Health event in Brussels, Belgium on 01/26/16

Technology can solve complex healthcare problems, whether that be analysing large volumes of genomic data or allowing a specialist to see a 3D image of a beating heart, but sometimes we often overlook the simple, day-to-day tasks where technology is having meaningful impact for patients and healthcare professionals today.


Providing Efficiency in Clinician’s Workflow

I’m seeing a lot of interest and excitement here in China around the Internet of Things in healthcare. Sensors are increasingly being used to not only provide more efficiency in a clinician’s workflow in a hospital setting but also to help those patients who require care in the home to live more independent lives.


A great example in development that I’d like to share is the Intel Edison-based uSleepCare intelligent bed which is able to record a patient’s vital signs such as rate and depth of breathing, heart-rate and HRV without the need for nurse intervention. Movement sensors also help to identify where there may be cause for concern over pressure ulcers or patients may fall out of their bed for example, which may prolong a hospital stay.


Early Identification of Abnormalities

The sensors not only collect data but also use WiFi to transmit that data seamlessly to a cloud platform for analysis which can then be used in a variety of meaningful ways. The most obvious and pressing data use demand is for early identification of abnormalities which can alert nursing staff to the need for human intervention, thus reducing the requirements to have nurses ‘doing the rounds’ which is resource-intensive and costly for providers.


Additionally the archive of data helps clinicians tackle chronic diseases at the patient level, spotting trends where patients may having a worsening or improving condition. This is particularly valuable as devices such as the UsleepCare intelligent bed become available in a homecare setting. Imagine a community nurse being able to prioritise visits to those patients who are showing abnormal signs as recorded by IoT sensors via alerts, all on a mobile device in real-time. This is truly mobile healthcare, delivering the right care where it is needed and when it is needed, with the right information at their fingertips.


Data Collection Bring Efficiencies

And as this sensor technology becomes more prevalent in both the hospital and homecare setting, the data becomes increasingly useful at a population level too. It will assist providers in spotting trends which will in turn help them to become more efficient and allocate resources where appropriate.


All of which ultimately benefits the patient, particularly those with chronic conditions. They will perhaps spend less time in hospital with an improved level of care and be able to spend more time at home, with the confidence that their condition is being monitored by a healthcare professional 24/7.


The Internet of Things is having a rapidly transformative effect on healthcare. Investment by providers in sensor technology such as the Intel Edison-based USleepCare intelligent bed is helping to drive efficiency-savings while also having a meaningful impact on patient care. In China we’re already pushing forward with implementation in this area and I look forward to sharing the results in the future.


Read Part I: Transforming Healthcare with Patient-Generated Data

Read Part II: How Wearables are Impacting Healthcare

Read Part III: Challenges of User-Generated Data

Read Part IV: Wearables for Tracking Employee Movement


This blog series has been about how 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. So far, I've shared some of their questions and my responses. The final question in this series is:


What kinds of organizational and cultural changes are driven by patient-generated data?


There is definitely a cultural shift, and you get different adoption and excitement on a clinician-by-clinician basis. It is still early days.Some clinicians are championing patient-generated data while others aren’t buying into its significance.

Where I hope Intel can play a role both near term and going forward is with predictive analytics and using streaming wearable data to help inform predictive models and make them more accurate. As I mentioned in earlier posts, we want to make it easier for health systems and clinicians to adopt a data-driven approach, enabling better allocation of limited resources and, ultimately, improving patient outcomes.


I am most excited about the ability to monitor patients and members continuously rather than periodically, moving from episodic to real time. That’s the game changer. And it’s enabled by technologies with the combination of very low power consumption, very small form factor or package, and the ability to send sensor data (either directly or via the ubiquitous smartphone) to the cloud or to backend information systems.


As wearables become more pervasive it will be exciting to see the industry move beyond consumer-based wearable devices that were developed for fitness purposes to devices with more sophisticated sensing capabilities targeted for healthcare use cases. I feel these devices will have a significant impact on reducing costs and improving outcomes by monitoring conditions and patients 24x7.


What questions about wearables do you have?

As much of the developed world faces the burden of escalating healthcare costs, ageing populations, and increased incidence of chronic diseases, countries and localities are experimenting with innovative approaches to address these challenges.


In a recent visit to Greater Manchester, England, I learned of an innovative initiative recently launched that aims to use technology to create a civic partnership between NHS and social care providers. The principal goals of the initiative are to 1) improve health outcomes, 2) reduce healthcare disparities, and 3) reduce income inequality. While many nations and municipalities are working to achieve these goals, Greater Manchester’s approach to achieving these goals is multi-pronged and systematic, and will use technology in a way that will integrate social services into healthcare delivery.


Using Technology for Data Storage, Analysis, and Interoperability

Greater Manchester’s plan calls for the creation of “Connected Health Cities” (CHCs), which will be powered by health innovation centers. These centers will assemble the data from multiple sources. What is especially novel about these CHCs is that the collection, management, and analysis of both health and social care data will happen at a scale that until now has been impossible. Shared protocols for data analysis across the CHCs will allow for timelier and more powerful research studies, and ultimately better informed decision-making.


Interoperability and integration of myriad data sources will be a vital component for realizing these goals. Clinical, community, and patient-generated data will be used to inform decision-making not just among clinical providers, but also among public health policy makers, planners, social care providers, and researchers. Finally, technology will also support continuous evaluation of the program, and use of actionable measures to drive decision-making.


Decision Making at the Local Level

Another unique feature of this plan is that the UK will provide the locality with 6 billion pounds for Greater Manchester to use at its own discretion. Granting control of the budget to local municipalities will allow for decision making to happen at the lowest possible level.


The Greater Manchester Board will set strategies and priorities, but local boards will devise plans that will be tailored depending on the needs of the local environment. The budget will be used not just for healthcare, but also for social programs and public health activities. The technology and data will help to bridge health and social programs at this local level.


Tackling Priority Care Pathways

Greater Manchester will focus initially on optimizing four “care pathways.” One pathway will use support tools for self-care to reduce hospital admissions for patients with chronic conditions. Another will support schizophrenia patients by linking self-reported symptoms to responses from community psychiatric nurse visits. Studying the effects of the program on specific pathways will allow for evaluation and iteration to help ensure the program’s success.


Public and Patient Engagement

Involvement from the public and from patients is a central pillar of this devolution plan. A panel of 10 patient and public representatives will have a say in how the data is used. The program leaders believe such involvement will ensure sustainability and transparency of these CHCs, and ensure that citizens’ needs are met in this civic partnership.


Insights for other Countries and Cities

I am eager to observe the implementation and early results that come from this Greater Manchester initiative, as it is a test bed for the devolution of health and social care. The potential for this initiative to accelerate and scale innovation to reduce disparities and improve population health is exciting. Data will be used from multiple streams in ways that haven’t before been possible, and will be used in a way that is tailored to the local environment. With a growing body of research that highlights the impact that social determinants (e.g., housing, social services and support, access to care) have on healthcare, using technology and data to tackle these issues could help other nations and cities in their efforts to improve population health.


Contact Jennifer Esposito on LinkedIn