Posts Tagged with innovation

posted by adgrooms on June 13, 2019

Healthcare and auto manufacturing may not appear to have a lot in common, but healthcare is experimenting with Lean, an organizational methodology that comes from the auto industry. Since patients aren't cars and doctors aren't robots, how is this going to work in healthcare? Does it belong in healthcare? Why consider it at all?

Changes to regulations in the last decade, such as HIPAA and HITEC, have led to increased administrative oversight and increasing waste. This costs the organization, staff, and patients time and money. The basic principles of Lean include mastering simplicity, eliminating waste, and constantly improving. The Lean model is thus an appealing countermeasure that could provide positive results. Well implemented Lean processes locate and eliminate inefficiencies and redundancies to create a smoother workflow.

Another basic tenant that is particularly relevant to healthcare is respect for the workforce. It is supposed to give employees more say in how things are done. Employees are encouraged to find processes to improve and increase quality. Giving employees the latitude to find and use software that makes their job more efficient, within secure parameters, could also reduce some of the waste.

Lean practices narrow the scope of work and eliminate administrative obstacles. EHRs have shifted providers' daily work away from caring for patients. They are now overwhelmed with data entry. Asking providers to give care and code for billing goes against the Lean ideal of each job having a specific purpose. Although capturing reimbursement is a very important function, according to Lean principles, a physician should be focused on the care of the patient. Another role, or ideally automation, should be responsible for coding and reimbursement.

As Lean is tried in healthcare, it is getting mixed reviews. It shows promise but is not yet proven. In future posts, we will look at the successes and failures to try to determine whether and how Lean benefits healthcare.

posted by adgrooms on June 10, 2019

Augmented reality (AR) is a developing field in medical education that is showing promise in enhancing medical training. Uses for AR are being developed across many disciplines to assist in learning procedures that require interaction with patients that range from conversation to surgery. So how do you determine if AR is right for your program?

One of the benefits of AR is that can help trainees learn hands-on procedures without putting anyone at risk. For instance, laparoscopic surgery is a popular AR training use. A simulated surgery can give realistic feedback and allow for repeated practice. Visual overlays can be added to guide the physician to optimal approaches to the procedure. Other complex procedures in disciplines such as neurosurgery or echocardiography can also benefit from AR training simulation giving a feel for spatial orientation encountered in a real clinical setting.

Another interesting application is patient interaction. It is rare that a learning physician already knows how to interact with the wide variety of personalities and socioeconomic backgrounds that one encounters in a clinical setting. This is knowledge that comes from experience, but similar to surgery, learning and practicing on real people in need of real help can lead to less than optimal outcomes. A physician can interact with a virtual patient to learn how to react to vocal and visual cues through different role-playing situations. This can reduce miscommunication and improve listening and interpretation skills in order to create a better patient experience and make communication less stressful for the physician.

AR is a fertile area for physicians to partner with startups and smaller companies that can develop ideas useful in medical learning. There are training systems on the market, but there is potential as technology improves for an even greater variety of learning experiences and even deeper immersive training applications. The cost of developing learning tools can pay off in better patient outcomes, more efficient procedures, and increased speed to proficiency.

AR will be growing in medical education in the foreseeable future. This growth should bring many benefits to all stakeholders in the medical community. What applications would you like to see? Who do you want to see benefit?

posted by adgrooms on June 6, 2019

Healthcare providers need great tools that facilitate their work and empower them. IT teams need to stay ahead of risk to their organizations; this includes all forms of system resilience, especially security risk. Leadership needs cost-effective solutions and reliable systems. To this end, healthcare IT departments have oversight of all software used in their institutions. They are charged with protecting patient data, efficient use of resources, and the overall security of computer systems; therefore, they review and approve every piece of software used. Sometimes employees find the approved software to be inadequate or prefer using solutions not provided by the institution. The use of unauthorized software without disclosure is known as "shadow IT". What are effective ways of addressing shadow IT?

Some healthcare employees may not know what a security risk shadow IT is or the HIPAA policies they are violating. For example, one common use of shadow IT is communication. Providers looking for a more efficient way to share patient health information amongst themselves could be using their personal device for messaging. It seems like a pragmatic and reasonable solution, but in reality, this is an insecure method and highly vulnerable to a data breach. How can these instances be addressed?

Many times it is the lack of a good clear process towards getting a better solution implemented. Any large organization has many rules and processes, and it is hard to be aware of the relevant steps. A solution-seeking provider may not know where to go to get the software approved. Is it an IT committee? The IT department itself? The CTO? Having a defined and published process with a clear entry point gives the progress-oriented people on the front lines a path to work within the institution's guidelines. A step beyond this is to develop an innovation committee. All approaches should show appreciation for the inclination toward improvement and steer creative souls into constructive, informed steps in partnership with IT.

Maybe you are an IT team member reading this thinking "We have a process. We still have this problem." This is an indication that a process audit would be helpful. Can you view the steps from the perspective of a healthcare provider in your organization? What are the steps to discovery? How do they become learn how to work with you? Is the process time-consuming or confusing? Can it be more clear or streamlined? Are innovators encouraged? Discouraged? Punished, even?

Shadow IT may not be any single department’s fault. Conflicting interests between leadership, IT, and the providers can cause the adoption process to be slow and painful, leading to more shadow IT. Creating and refining a collaborative and encouraging process will go a long way to reducing shadow IT, increasing security, and encouraging innovation.

posted by adgrooms on May 9, 2019

Meaningful positive changes in medical technology require input from the people who use it. With a full clinical schedule, it’s hard for healthcare providers to find the time, and this leads to a medical technology bottleneck.

A health care practitioner's time is valuable, arguably best spent providing care. They might get to vent about a software problem around the lunch table with colleagues...Or an EHR improvement insight might bubble up in transit to the next round. The ideas that need to be heard by the tech firms beyond hospital walls rarely get there.

Cultivating relationships between the medical staff and the internal IT department could be a step towards transmitting ideas for improvement. The IT department manages the software and systems that the frontline staff use every day, and are more likely to hear about problems and areas for improvement...But formalizing time for the two groups to come together and fostering a culture that encourages feedback increases the chances of fruitful exchange.

The AMA has recognized the need for physician/tech collaboration and has taken action. They have created a resource called Physicians Innovation Network. This is an online forum for physicians and tech companies to join together and develop innovations in healthcare technology products and services, including paid and volunteer opportunities to participate.

Creating forums and platforms for communication, as well as encouraging and protecting time for medical practitioners to participate is all necessary for this to work. In the end, it is all about collaboration, communication and providing busy healthcare workers an outlet for their voices and needs to be heard.

posted by adgrooms on April 19, 2019

Conferences are a great way to get a feel for what technology is doing for healthcare. Although you are probably not going to see every HealthTech company in one conference, a wide array of sizes and approaches are represented. When you spend a few days in a convention center, you get to know one another.

The large, established companies pay for the high-visibility, front-and-center or corner slots, of course, because they can afford them. They seem to keep to themselves, for the most part, perhaps protective of their corner of their market. I guess I don’t blame them. New companies are sprouting up all of the time, some offering a similar service and looking for their own place in the world.

The smaller companies scattered around the rest of the convention floor generally had more specialized solutions. Some are physician entrepreneurs who saw a niche from their professional perspective and decided to take the leap and put their solution out to the public. Some, like our company, have aspirations to make a positive change from an outside perspective.

Whatever perspective it was, it seemed that we were all in the same boat together. All on the lookout to see who on the front lines of healthcare would take a chance on a less well-known company trying to make a positive impact. Meeting and talking to our neighbors gave me hope. There are a lot of good things being grown by smart people who care.