A Perfect Ten

January 10, 2013

Imageby Donn Wurts, Nexus Director, Healthcare Practice

In gymnastics, competitors strive to receive a score of “10”.  To receive a ten, the gymnast must perform their routine flawlessly, without even the slightest error in execution or form.

Perfection is also the goal for today’s healthcare organizations.  Propelled by demands for improved patient safety, improved outcomes, government regulations, and payment reform, healthcare organizations must transform existing IT models designed to support business applications (email, billing, simple communications) to ones focused on critical care (electronic health record, clinical collaboration, telemedicine,  bio-medical engineering).  With this transformation, comes the need for not only 100% network and application availability, but also the ability to support key initiatives like those published by the Institutes of Medicine and the Office of the National Coordinator of the American Health Information Management Association that include:

  • Immediate clinician and patient access to health information and data
  • Access to new and past test results
  • Remote ordering of prescriptions, test, and other services
  • Bedside decision support systems that include reminders, prompts, and alerts
  • Secure communication between providers and patients
  • Scheduling systems for providers, staff, and patients
  • Access to federal, state, and private reports

To achieve this information delivery perfection, healthcare organizations will need:

  • The right technologies – Healthcare organizations must implement systems and applications that are designed from the ground up to be redundant, reliable, scalable, and secure.  They must also be easy to manage and maintain and provide the flexibility to support changes in treatments, processes, or the regulatory environment. The right Core Foundation Services.
  • The right processes – Change management, security management and disaster recovery are just a few of the processes that must be altered to ensure 100% information availability.  However, these processes must also be combined with and supported by the “right” management systems and software to guarantee continuous access enabling clinical workflows and information at the point of care.
  • The right people – In many cases, the most significant challenge that healthcare organizations face, is to find the “right” people and trusted partnerships.  Currently, there are just not very many IT professionals whose skill sets combine experience in both healthcare and large system design, implementation, and management.  As a result, many healthcare organizations are turning to companies like Nexus Connected Healthcare that have the clinical experience, methodology, and processes to support them throughout the transformational, almost evolutionary process.

Not many gymnasts reach their goal of a “perfect 10”.  But for healthcare organizations, perfection isn’t just a goal, it’s an obligation.

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Leveraging Technologies in Poison Control Centers

September 7, 2012

Nexus Connected Healthcare– by Kathleen Gaffney, Healthcare Transformation Specialist, Nexus Connected Healthcare

The poison control system, an established network covering the United States, is in place to reduce poison-related morbidity, mortality, and hospital admissions.  Poison Control Centers (PCC) receive calls from the public and healthcare facilities for toxicological consultation after a suspected poisoning or overdose has occurred. The PCCs are staffed by pharmacists, physicians, medical toxicology specialists and nurses with specialized clinical toxicology training and operate 24 hours a day, every day of the year.  For every dollar spent on poison control, at least $7 is saved in public health care costs due to instant intervention and effective use of resources, often by preventing unnecessary and costly visits to the emergency room.   PCCs are state and federally funded but funds have been cut significantly making it more important that the PCCs operate as efficiently and productively as possible. 

PCCs currently perform most of their duties through the use of telemedicine – which in the majority of cases means a telephone.  Typically, PCCs provide the following services:

  • Poisoning triage and treatment to the public
  • Poisoning triage, consultations and medical recommendations to ED physicians and emergency medical transport personnel
  • Toxicological consultation after and medical recommendations to rural healthcare facilities and medically underserved regions
  • Toxicological services to non-healthcare organizations such as correctional institutions, cruise ships, etc.
  • Input and advice regarding hazardous materials toxicity and management to the state’s emergency management agencies
  • Analyzes calls in real-time for trends and events that might be of public health significance (e.g. food poisoning, terrorism, product recalls)
  • Public health services during disasters (with adaptation to workflows)
  • Perform patient “follow‐ups” and/or home management of poisoning services
  • Consultation services to patients (e.g. counseling and information for drug and other exposures during pregnancy and lactation)
  • Training site for pharmacy students, nurses, EMS/paramedic students, and physicians and residents in emergency medicine, pediatrics, family practice and other specialties
  • Increase public awareness, education and prevention services to the public of common toxic substances, specifically as they relate to young children
  • Poisoning triage, treatment, education, and prevention services for animals

In the near future, PCCs will provide many of these services via technology.  Easy to implement and cost-effective use of technology will include connecting with the public through text messaging, Twitter and Facebook or publishing Podcasts on YouTube to share health content with the general public.  Clinical toxicologists’ collaboration with physicians and emergency medical personnel will take place via desktop sharing and web conferencing.  The use of emerging telemedicine technologies that leverage audio and videoconferencing within poison centers will enhance the ability of the clinical toxicologists to deliver services to their patients.  For example, PCCs may use a telemedicine kiosk or cart that supports visual clinical toxicologists/patient encounters through the use of telepresence, remote-controlled point-of-care camera, FDA approved medical devices and an EMR.   Many organizations currently utilizing telemedicine are considering a model that is internet based.  This would allow PCCs to work with doctors and patients from any location utilizing any computer or similar device. 

All of these technologies will help PCCs achieve the primary goal of improving access to care while lowering the overall cost of care.


EMR Readiness

June 26, 2012

Is your IT environment ready for an EMR implementation?

Does your organization have a plan for identifying the gaps in your IT infrastructure?

Can your data network provide secure mobile access?  

Is your organization in full compliance with regulatory mandates like HIPAA?

Alarmingly, most healthcare organizations do not have a technical infrastructure that is prepared to adequately handle the needs of an EMR system. The typical state of infrastructure includes spotty wireless coverage, poorly maintained servers, inadequate bandwidth, insufficient space and environmental controls in the data center,  insufficient security  and  redundancy, and poor operational management.

Written by industry veteran and Nexus Business Transformation Specialist Kathleen Gaffney, the EMR Intrastructure Readiness white paper is full of important technology and operational considerations. From Device Messaging to Wireless Coverage to Business Continuity Plans, there’s more to a successful EMR implementation than the patient records themselves. These 13 concrete recommendations will help ensure your implementation goes smoothly.

Download the whitepaper now!


Strategic Initiatives for Tough Economic Times

March 26, 2012

– by Kathleen Gaffney, Business Transformation Specialist

The current challenging economic conditions have forced healthcare executives to postpone IT strategic initiatives and look for ways to reduce overall costs and increase return on investment. It is estimated that 80% of an IT non-payroll budget is spent on maintaining existing system and software infrastructures within the organization. To meet this challenge, it is imperative that executives have strategies that enhance their decision making in identifying, selecting, financing, monitoring and maintaining a mix of assets that balance the desired outcomes with alignment of IT to the organization’s goals. This full pdf presents several key strategies, which are summarized here:

  • Technology Portfolio Management
  • Lifecycle Management
  • Contract Management

Technology Portfolio Management
Technology Portfolio Management (TPM) is the identification and assessment of technology assets. These assets include the hardware, software, operating systems, data and projects within the organization. Items frequently forgotten but which should be included are telephones, PDAs and cell phones, printers, copiers, TVs, hands-free communication devices and others.

Asset Lifecycle Management
Many organizations do not plan and budget for critical technology assets such as desktops, servers or storage primarily because they are unaware of when items need to be replaced or upgraded. They are then surprised by a purchase requisition or worse yet; do not have funding due to the lack of accurate planning and budgeting. The goal in having a lifecycle management program is to lower net costs and to support a finance-driven process of cash flow planning and capital allocation for IT expenditures.

Contract Management
Knowing that a large portion of a healthcare organization’s budget is consumed by commitments for maintenance and support services in the form of contracts, licenses, support maintenance, and warranty agreements, it makes sense to manage these contracts. Gaining control over IT spending requires a complete inventory of all technology contracts (including those not under the control of the IT department). The goal is to develop a comprehensive inventory of the contracts in place to assess renewal/cancellation deadlines, identify opportunities for cost avoidance, and assess current usage levels against licensing.

The strategies discussed rely more on processes, procedures and low-tech solutions such as an Excel spreadsheet or simple database. Software solutions that automate and consolidate the TPM, Lifecycle Management and Contract Management processes have only been available in the past few years, but are catching on. Whether the solution implemented is low-tech or high-tech, both will improve an organization’s decision making by providing visibility into its assets, lifecycle stage and maintenance costs, and the ability to closely manage them. This can lead to cost savings, improved budgeting, risk reduction, and enhanced regulatory compliance.

Click here to download the full pdf white paper


U.S. Healthcare Needs Another Elvis

March 18, 2011

Two issues which dominate discussions in every country in the world are Healthcare and Education. In the US, the per capita cost of healthcare today is $7000, an increase of 700% since 1980 and more than twice that of other developed countries, including Canada. The United States spends 17.5% of GDP on healthcare and it will grow another two percent in the next few years unless something dramatic is done to limit it.

Recently, someone asked the question: “Who is the one individual that has helped save the most money in the US healthcare industry in the last century?” The answer – surprisingly – is Elvis Presley. On October 28, 1956, Elvis got a polio vaccination on national TV. That single event was responsible for raising immunization levels in the US from 0.6% to over 80% in just 6 months. No other single individual has had that kind of impact on healthcare in the US.

More recently, the Obama administration has started focusing on Information Technology to help bring healthcare costs down. Everyone has heard about the ARRA – American Recovery and Reinvestment Act of 2009, a $787 billion stimulus package to help improve the US economy. A very small ($19 billion) and little-known part of ARRA was set aside to help jump-start the use of technology in healthcare, specifically the use of EMR – Electronic Medical Records. Under this provision, every hospital and healthcare provider in the country must implement EMR by 2015 in order to receive 100% reimbursement from Medicare and Medicaid.

EMRs will save money in several ways. Electronic records would allow for physicians to treat traveling patients without duplicating any tests which might have already been done by their normal care providers at home. Digital transmissions of records will also greatly reduce costs associated with human errors – for example pharmacy errors due to handwriting misunderstandings. And digital transmissions will speed the care process, helping lower costs as well. The number of other cost-saving benefits to the adoption of EMRs is huge.

To help offset the cost of implementing EMR, the current administration is offering $44,000 per healthcare provider, paid in three stages over the next 3 years with the highest amount being paid in 2011. In order to receive the money, physicians and hospitals must implement the technology and be able to demonstrate it’s Meaningful Use. What’s astonishing is that 90% of care providers don’t currently know about EMR incentives and time is quickly running out for them.

EMR is only one way to reduce HealthCare costs. Other areas currently being addressed include:

  • Comprehensive coordinated care
  • Change of workforce model
  • Support of open standards for technology
  • Provider transparency – patients will be able to rate the services they receive from their physician.
  • National licensing – physicians should be able to provide service anywhere in the US
  • Tort reform – this will reduce the practice of Defensive Medicine; i.e., physicians ordering unnecessary tests to cover themselves in case of a lawsuit.
  • Globalization and virtualization of care delivery.

All these initiatives will change how healthcare is delivered in the US. We have only two choices in order to bring the rising costs under control: adopt these reforms or find another Elvis.


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