Posts Tagged with HealthTech

posted by adgrooms on June 7, 2019

When a patient makes an office visit, the provider may send home information, prescribe medicine, and schedule a follow-up appointment. What patients lack are points of accountability and reminders to help stay on track in order to make health improvements. Patient care should not have to stop at the clinic door, and it does not have to add to provider workload. In fact, messaging can reduce it.

A recent review of studies on SMS health reminders showed a range of positive outcomes for patients. Automated messaging improves compliance through appointment reminders, immunizations, and prescription reminders. Behavioral reminders for smoking cessation and diet reminders for patients with diabetes or heart disease are also shown effective.

The study references articles showing "major financial savings" in the reduction of missed appointments, alone. Reminders can be automated for frequency, duration, and helpful custom information, such as addressing each person by their first name. Even two-way messaging can be automated using chatbot technology. This can be the first line of communication to answer patient questions, with a path to escalate to a provider, if needed. More sophisticated integration of messaging with EHR can measure the effectiveness of messages to hone the system.

SMS is not encrypted and not a secure method of communication. Although text messaging is an accepted daily risk for most people, reminders must be crafted to contain no PHI. Care should be taken to obtain permission to use this channel of communication. It is also important to inform each patient of the risks to their personal information and the types of messages you intend to send. Examples of the types of messages and the information they will contain will be helpful for patients to make an informed decision.

Automated messaging is a low-cost method of communication that has been shown to improve patient compliance. There are still more areas where this approach can be explored.

posted by adgrooms on May 29, 2019

Physician-led team-based care is widely used as a coordinated effort to provide higher quality care to patients. Team members of different specialties are included to provide different strengths in a coordinated effort to create better outcomes. A team effort in a clinical setting has its challenges, and technology can help.

To accomplish effective team care, exceptional communication and information sharing between team members is needed. A tool that pulls data from an EHR and distributes to individual team members while seamlessly incorporating communication would be beneficial. Providing individual team members the ability to select and view relevant information would help them both focus attention and reduce preparation time before a conversation with the patient or other care team members. Dictation and voice recognition could be used to record and share notes and observations from patient visits. In addition, an integrated secure messaging system could ensure the team can coordinate care more efficiently.

Effective communication to and from the patient is essential to provide a sense of trust in the team. If different team members relay contradictory messages, trust is eroded. Trust could be supported by consolidating and making treatment and planning information accessible to the patient and family. The patient-facing interface could provide an easy to understand summary of procedures, prescriptions, and visits from care providers. Bi-directional notes from both patient to provider and provider to patient could further aid communication and improve trust. These notes could be written at any time, providing a way, for example, for a patient to log how they are feeling at a particular time, drug interactions, or a question for a particular care team member.

The physician, as a leader, should have an interface that provides an overview of patients and team members that is easy to read and manage. They should be able to dictate a plan of action for the patient that automatically coordinates and notifies team members what is required of them. Visualizations could be implemented, such as a patient timeline, to quickly understand and assess a patient’s progress.

Team-based care could benefit from a comprehensive, easy-to-use coordination system that integrates seamlessly with the EHR and encourages patient participation.

posted by adgrooms on May 17, 2019

We have talked about how EHRs can benefit physicians and hospital staff by improving the quality of information and facilitating communication. One of the things severely lacking from EHRs is communication TO the patient about their care. Patients and their families want to be informed about treatments, and providers need patients to participate in their care management.

Currently, information is presented to patients and family verbally across many individuals in the health system - physicians, nurses, assistants, techs, therapists, social workers, dietitians .... There are so many people stopping by the room, talking, writing down notes, scanning medicine and IV bags, evaluating various aspects of the patients status. When family members or a patient advocate staying in the room switches out for a break, they must hand off information to someone else. If the information is not centralized and consolidated, then how accurate will the information be after several hours and possibly several handoffs?

What if EHR companies could develop a patient facing interface with all of this information accessible anytime for the patient. Not like the current clunky patient portal containing just part of the picture, it needs to be a robust, user-friendly interface with the information presented in an easy-to-read and easy-to-navigate format.

This information could include charts, prescription information, timelines, and other notes pertain to treatment and recovery of the patient, utilizing data visualization for easier understanding. Furthermore, you could have a log available to the patient and advocates in the room keeping track of who has stopped by and what action has been performed or what instruction was given at what time. This system could have an option for hospital personnel to scan in, to record their visit. It could include a manual input, to record "civilian" visitors, in case a friend or religious figure stops in. This piece would not impact the patient's health but in the interest of serving the patient, may be a nice benefit.

Patient participation is needed to help physicians and medical staff do their jobs well. An informed patient is better able to participate in their own care.

posted by adgrooms on May 16, 2019

We have come a long way in medicine, developing cures and treatments for the most daunting diseases and ailments. For the most part, science has discovered remedies by treating whole populations indiscriminately. This tactic has been successful for many individuals, but a few have not seen the benefit. Some are now approaching healthcare from a model that uses genetics and other traits from subpopulations to customize treatment called “precision medicine”.

Instead of treating cancer from a one-dimensional approach for anyone diagnosed, precision medicine takes into account genome structure, lifestyle and environmental conditions. Treatment is then tailored to the person’s traits and known response to treatment. So, what is information technology’s role?

In order to treat with precision medicine, large amounts of genetic data need to be collected and analyzed to find the ideal remedies. At this scale, block chain is being utilized to securely store massive amounts of population data. AI is used to analyze the data and sift out patterns and nuances needed to customize a particular treatment to a population trait.

To apply these new technologies, we need EHRs as input. EHR systems seem to serve the purpose of keeping a timeline and details of patient’s data, but to serve this need, they need to integrate well with analytical systems and distribute data in a complete and consistent manner. The pipeline of data from collection to secure storage to analysis to improved techniques and then back to the bedside has not yet been established.

It is exciting to see this approach take shape. The technology that offers a collaborative integrated process will succeed in providing the necessary infrastructure for the physicians moving precision medicine forward.

posted by adgrooms on May 15, 2019

The other morning for breakfast, I ordered eggs and a biscuit, but they brought me eggs and bacon. It seems like a pretty minor mistake in the grand scheme of things, but when messages are miscommunicated in a clinical environment, it is patient safety that takes a toll. So, what can technology do to help in a clinical setting?

We always talk about face to face communication being hampered by technology because technology distracts people and blocks them from engaging. What if we used it to enhance verbal communication?

Everything old is new again. Medical transcription has existed for more than a century. It originated with medical stenographers taking dictation into shorthand. Onsite stenographers were replaced when recording devices became widely available, but human transcribers still recorded the notes, if asynchronously. When EHRs were introduced, they seemed to take transcribers out of the process, which placed the burden of data entry on physicians. But now the misstep seems to have been caught and transcription is returning in all its forms and more. The new approach is to use voice recognition in dictation. Instead of using a transcriptionist, a doctor can dictate to the software and have notes entered into a patient record, which, arguably increases speed and accuracy.

Even the best of listeners, in a noisy, confusing environment, can get words mixed up. Headsets can be used between team members to take away background noise and improve clarity in conversations. This increases the mobility of a team as the headset would allow them to coordinate as they move between rooms. And it decreases the time it takes to connect with a team member.

Recording patient interaction is a good way to document how a patient is vocalizing how they are feeling. Sometimes reviewing the conversation or having someone else hear the interaction can bring to light nuances or words that were missed during the live interaction. This can also be used as a valuable teaching tool when trying to improve provider-patient interaction.

Where else can we use technology to assist verbal communication? There will always be verbal communication in a clinical setting, and we can continue to implement and improve technologies that help fill in the gaps where communication is falling short.