CDHI,Center for Digital Health Innovation,clinical communications,EHR,electronic health record,UCSF,University of California at San Francisco,Voalte,Voalte Story

Voalte Story: A conversation with Michael Blum, MD

After attending yesterday’s closing presentation at VUE15, where Voalte’s Founder and Chief Executive Officer Trey Lauderdale unveiled three new clinical communications solutions that his company will launch in 2016 (we will publish a rundown of each solution on November 16), I had the opportunity to speak with Michael Blum, MD, Director, Center for Digital Health Innovation (CDHI) at University of California at San Francisco (UCSF). I was given this exclusive interview as a means of learning more about the origins and the goals of one of the new offerings announced at the conference, Voalte Story, a co-development venture between Voalte and CDHI that provides an interactive patient wall similar in nature to Facebook that clinicians may access to post and link texts or alarms to a specific patient. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: Please describe the history of CDHI, as well as your role within the organization today.

michael blum

Michael Blum, MD, Director, Center for Digital Health Innovation

Blum: I’m the Director of CDHI. I’m also the Associate Vice Chancellor and Chief Medical Information Officer at UCSF.

When we came out of our enterprise data and electronic health record (EHR) implementation at UCSF, it became more obvious that there were many next-generation issues and opportunities that we needed to tackle in order to leverage our evolving technologies to generate the best ideas and practices that we need for our work. We knew that we had to really get out and engage with our patients and consumers in a much deeper way, requiring us to make moves far beyond the EHR. 

While EHR is critically important to running a complex center today, that with the changes that are going on in healthcare from healthcare reform and a move toward precision medicine, we were going to need much more than electronic data warehousing.

We also understood that the digital technologies and consumer engagement were driving very rapidly towards a different, much more consumer, ambulatory look at healthcare. There were new data sources that we were going to need to consider as we went forward like patient-generated data, device-generated data, genomic data, other omic data, and we needed ways to think about those streams of information. That lead to the creation of CDHI. 

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Astellas Pharma US,bioinformatics,biomedical informatics,interoperability,wearables

Healthcare IT’s identity crisis: A conversation with James Templeton

As both a scientific director and an educator, James Templeton possesses an interesting perspective on the current power, and problems, of healthcare IT. He is an Assistant Professor of Biomedical Informatics at Nova Southeastern University. He is also a Scientific Director for Astellas Pharma, working in the pharmaceutical industry for nearly 25 years. He holds a Masters in International Business, a Ph.D. with a concentration in Biomedical Informatics, and is currently completing a Masters in Medicinal Chemistry.

I spoke with Templeton to gauge his perceptions of the past, present and future of healthcare IT. His insights describe not only an industry in the midst of tremendous transition, but also in search of its identity.

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Taylor: What areas of work do you perform at Astellas Pharma?

James Templeton

James Templeton, Scientific Director, Astellas Pharma US

Templeton: We focus on a number of disease states. The area that I focus my attention on now is urology, primarily in the field of overactive bladder and other urological diseases that are associated with that. I work with a team of field scientists, they are called medical science liaisons, and I am the director of the team for the West Coast. We bridge the internal and external research that is being conducted in the field of urology.

We work with internal research departments of Astellas and we help bring them information from the external sources as to what may be most relevant, most pertinent, most cutting-edge, and then we take our information and our research studies that we’re working on and we will work with our external colleagues to try to implement those and to move the science forward.

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Cerner,end-to-end testing,ICD-10,interoperability,key performance indicators,KPIs,Review Board Calls,Twitter chat

Preparing for the new normal of ICD-10: Cerner

Mike Hourigan was a floor nurse at a community hospital in Kansas City prior to joining Cerner in 1999. It happened to be the year of Y2K, so he ended up as an analyst. He worked his way through Cerner’s consulting organization, managing several consulting teams, and then moved into the regulatory area four years ago. Currently, he has a team of about 45 people working on regulatory issues, in particular Meaningful Use and ICD-10.

I had the opportunity to speak with Hourigan to learn how he and his team are working with Cerner clients to prepare for the lead up to, and for doing business after, the approaching October 1st mandate of ICD-10.

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: How would you characterize the typical Cerner client?

Mike Hourigan, Director of Regulatory & Compliance , Cerner

Mike Hourigan, Director of Regulatory & Compliance, Cerner

Hourigan: We run from anywhere from a one doc practice to a 10-bed, critical-access hospital all the way up to hundred doc practices, large IDNs (integrated delivery networks), academic. So, we pretty much have every size [client] possible, I guess.

Free: How has your background as a nurse impacted your work with compliance issues?

Hourigan: Well, I think it helps tremendously, just having lived in that world and having regulations come down, and you’re asking [yourself] the questions of, “How does this fit into my workflow? What kind of impact is this going to have on the patient?” and, those types of things. I think I always try to keep those in mind when I’m being updated on regulations, or trying to figure out is there a workflow change that’s going to have an impact that could be a potential impact to either a clinician’s workflow or a patient’s overall outcome. 

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Apple Watch,HIPAA,HIPAA audit,mobility strategy,Spok,Texting,The Joint Commission

Using communication to drive workflows: Spok

Clear and trusted communication is the foundation for all medical care, however, communication for the sake of communication is no longer enough. In order to attain the highest levels of efficiency, meet stringent regulatory requirements and keep costs low, healthcare providers must explore new ways to leverage long established and newly emerging communication tools.

This task can be quite tricky, and many in our field are still wrestling with how to locate potent positions within their working environments for even the most common forms of communication. For example, while popular culture has fully embraced text messaging, even with the distracted teenagers and sometimes confusing emoticons that often go along with it, many organizations succumb to “paralysis by analysis” when considering the tightly intertwined opportunities and dangers of texting within healthcare workflows. 

To learn more about the issues our industry must consider when devising implementation plans and establishing best practices relative to its communications systems, I spoke with Brian Edds, Vice President of Product Strategy, Spok. Not only did I develop a deeper appreciation for Spok’s expertise in creating such strategies, but I also can now see how wearable technologies may soon hold the key to maximizing the power of future communication systems in healthcare. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: Please describe your background and how your work at Spok has evolved overtime.

Brian Edds, Vice President

Brian Edds, Vice President of Product Strategy, Spok

Edds: I have been with the company for almost 5 years. I came on board to help start our mobility strategy and our secure texting implementations.

Prior to coming to Spok, I worked in mobile workforce management applications across a variety of industries. My career has been around mobile strategy probably since before it was a good idea.

In the mid 2000’s that all changed with the introduction of smartphones. Doctors and nurses were increasingly bringing their smartphones and using them at work. Spok brought me on to help address the question: How can we best leverage smartphones as a workflow tool in healthcare?

That’s really the journey we and our customers have been on over the last five years. It really started a couple years ago, when “Hey, I have this smartphone. How can I connect it to my Spok system?” We came out with our product at that time. We called it Spok Mobile, formerly referred to it as Amcom Mobile Connect. That product put an app on the phone and it allowed us to send messages to the phone. Those messages were secure as opposed to regular [short message service] SMS. Those messages were traceable so you could understand when they were delivered which was an advantage over prior communication methods. They were also differentiated. That was an important aspect too because we all know we receive a ton of different notifications and alarms and messages on our phone. What our customers told us was that the types of messages that they wanted to send from the Spok system out to these devices was special and different, and they needed to be treated as such.

That’s the genesis of our work today and my existence here at Spok.

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cloud computing,iPad,iPad Mini,Kareo,medical billing,outsourcing,small practices

Understanding that size does matter: Kareo

Too many times when we gauge the significance of challenges, we correlate difficulty with scope. We believe larger populations breed larger problems and that bigger campuses generate more opportunities for errors. This overly simplistic thinking does little in terms of creating meaningful change in the quality of care for the vast majority of patients who go to small practices.   

I spoke with Rob Pickell, Chief Strategy Officer, Kareo, to discuss how our industry’s preoccupation with larger organizations is doing a disservice to smaller practices and the patients they serve. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: You are responsible for Kareo’s overall strategy. Could you describe your company’s position and goals within the healthcare IT market?  

Rob Pickell, Chief Medical Officer,Kareo

Rob Pickell, Chief Strategy Officer, Kareo

Pickell: One of the things relatively unique about Kareo is that we are completely focused on smaller practices which, for us, typically means one to ten providers.

We very strongly believe that technology that’s purpose-built for smaller practices can be really game changing for not only those practices, but their patients as well. What’s often missed in the ongoing conventional wisdom, or what you typically do not see covered by the press, is that healthcare technology is not a one-size-fits-all solution. Our part of the market cannot use the technology designed for the larger healthcare organizations and expect the results it needs. 

 There’s a lot of discussion around the fact that healthcare in general under consumes technology and it’s certainly true within the ambulatory space, but what I think is often missed, that part of the reason that that happens, is that the technology really hasn’t been built for the unique needs of the market that were focused on. I always use the simple example of if you’re running a small restaurant and you had to run Oracle for your financial system, it would be pretty difficult to run an effective business, right? And yet in healthcare, most of what is out there is designed for much larger deployments and so our vision as a company, and my role in it, is to change that. 

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Acupera,EHR,electronic health record,Montefiore Medical Center

Tackling the realities of population health: Acupera

Better outcomes, preventing diseases, closing care gaps and creating cost savings for providers are all promises made by those who espouse the virtues of population health. Historically, however, these promises have not been met in many instances, causing some to believe that true population health management may still be just out of our current reach. Others, like Ron Razmi, Chief Executive Officer, Acupera, feel that it is not the practice itself, but the unrealistic, misguided approaches that many practitioners of population health employ that cause so many disappointing results. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

Free: Your approach to population health management is rooted in your professional background. Could you please describe your career path?

Ron Razmi, Chief Executive Officer, Acupera

Ron Razmi, Chief Executive Officer, Acupera

Razmi: I started my career in medicine as a cardiologist, but my background is that of a physicist that went to medical school. 

 One of the first things I did in my career was developing cardiovascular applications for MRI (magnetic resonance imagingimaging. Historically, MRI or CAT (computed tomography) scans were not used in managing cardiac patients. A group of us worked on developing the initial applications of that and wrote a textbook in doing so. Through that [process], I got exposure also to the business side of things.

Using my background as a cardiologist, and as someone with an interest and expertise in technology, I switched to business development and worked in a corporate finance group at McKinsey for a good number of years focusing on life sciences and private equity buyouts. 

Back in 2009, I saw the writing on the wall around digital health and decided to start Acupera. What I was seeing at that time was a lot of overly simplistic and unrealistic solutions that worked well in a technology lab, but when you brought them to the real world, there were a lot of barriers to adoption in the clinical environment. In particular, I noticed that a lot of the solutions didn’t necessarily understand the workflow aspects of how healthcare is delivered.

Our goal early on was to to go beyond electronic health records (EHRs) and analytics, and to answer the question: How do you make the right things, specifically the right tasks, happen at the point of care? The point of care not necessarily being the doctor-patient interaction, but with the care team. We wanted to make sure that we went beyond considering just the doctor because today you must know how the entire care team collaborates in managing a patient or a population of patients.

With these things in mind, we built an engine that is intelligent, that automates a lot of work that most other solutions skip over in terms of the proper workflows needed for each member of a care team. Our system tells each member of the care team, including the patient, what they need to do. We don’t know of any other solutions in population health that accomplishes this objective as well as we do.

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Asia Pacific,Internet of Things,IOT,Machine Learning Semantic Model,managing length of stay,Microsoft,point-of-care,Predixion,reducing readmissions

Qualities of courage: The ambition of Predixion

As our industry shifts from a volume-based business to a value-based business, few mechanisms have the promise of becoming practical tools for healthcare organizations – facing the combined challenges of meeting increasing patient demands, unpredictable technological advances and, sometimes predictable, government regulatory oversight – than the effective execution of data analytics.

While the field of analytics is no longer shrouded in thick layers of mystique, it is by no means a well-defined area of practice either. Most are overwhelmed by the possibilities, few see an unobscured path forward. What is clear is that smarter, more informed decisions relative to leveraging the exponentially expanding sphere of information generated within healthcare can equate to improved patient outcomes at lower costs. 

Companies striving to lead the pack cannot shy away from challenges or the unknown as the future of our industry guarantees really only two things: challenges and the unknown. To develop the best practices of tomorrow, our industry needs its vendors to resist complacency and aggressively seek out new analytic opportunities. 

It is clear that Predixion Software is a company actively seeking opportunities both to lead and to learn. Instead of finding a safe spot in the market, it is committing to ventures that many organizations would find little in terms of comfort or familiarity. For example, Microsoft and Predixion announced in April their partnership to bring predictive analytics at the point of care in Asia Pacific. Just last week, the company released Predixion Insight 4.5 and dove into the Internet of Things (IOT). These moves do not describe a timid mindset, but rather an ambitious attitude that more vendors in our industry ought to employ.  

Nish Hartman, Director of Healthcare, at Predixion spoke with me about both of these recent ventures as well as the path the company has decided to take in terms of cultivating its knowledge of analytics. 

(Editor’s note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)

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