As the annual conference and exhibition opens this week in Orlando, healthcare executives are looking anxious for some good news, or at least positive ROI
The healthcare industry is in a rough spot right now, buffeted by cybersecurity issues, disruptors with big dreams, workforce declines, labor unrest, mangled mergers and closures. As the annual HIMSS conference convenes in Orlando this week, a lot of people are looking for some good news. We’re at that point in Marcus Welby, MD, or Emergency or St. Elsewhere or ER or Grey’s Anatomy or House or Chicago whatever that the patient is on life support and everyone’s just sitting around waiting for inspiration to strike,
Might AI be that shining moment? Could VR save the day? How about FHIR? Perhaps.
As the camera pans out and HIMSS24 steps into focus, here are a few thoughts on what we’ll be seeing and talking about this week in the land of Disney.
AI comes of age. As this week’s flurry of announcements can attest, healthcare organizations are turning AI loose on some of the industry’s most vexing pain points. The HIMSS agenda is filled with sessions detailing how health systems are using the technology, and a casual walk around the exhibit hall will unveil plenty of vendors armed with use cases and examples of ROI.
Indeed, many of the press releases coming out this week are focusing on new partnerships or capabilities around AI. Providers are collaborating with their EHR providers and digital health companies to move data through the platform more efficiently, giving doctors and nurses what they need at the point of care to improve their work and, ultimately, their work-life balance.
The most popular use case at present is the development of ambient AI tools to capture conversations and convert them to clinical notes. Healthcare executives are eager to see how the technology can take documentation and data entry out of the clinician’s hands, which not only gives the doctor or nurse more time to spend in front of patients but reduces the tasks that cause stress and eat into home and family time. But this isn’t the only example of how the technology is being used, and savvy decision-makers will be looking beyond the obvious to find other use cases that help struggling hospitals improve workflows and reduce cost.
A looming battle over value? While AI use cases are all the rage, there’s plenty of talk about how the technology will be governed. The Coalition for Health AI (CHAI) made news recently with the announcement of several advisory boards and a couple of collaborations aimed at creating guidelines for the ethical use of AI, but that news caused more than a few critics to wonder how a struggling health system might weigh the financial value of an AI tool against its potential to boost clinical outcomes.
The argument isn’t new to healthcare, especially as the industry tries to wrap its arms around value-based care. But the speed at which AI has moved into the healthcare ecosystem is putting pressure on health systems to take a closer look at what the “ethical use of AI’ really means. Can the industry find a common ground on which to measure value? Will recent stories around the use of AI by payers to sort and deny claims be enough of a warning sign to spur meaningful conversation? And will the industry work with the federal government to set the guardrails?
The Change Healthcare ransomware attack is having an impact. As expected, the ongoing cybersecurity attack on UnitedHealth Group’s IT platform is affecting both attendance and conversations. Some health system executives are shortening or cancelling their plans to be in Orlando to deal with the outage, while cybersecurity vendors are using the outage as a conversation starter.
The outage has elevated the “workaround” to a common topic of conversation, as beleaguered healthcare providers look for alternate strategies to keep the doors open in the wake of delayed payments. It has also forced many executives to take a closer look not only at their internal and vendor security protocols, but their cash-on-hand strategies. In fact, healthcare organizations seem more focused on how they can weather the next big cybersecurity incident than on how to prevent it.
This will be a huge topic of conversation at HIMSS. Cybersecurity incidents are occurring with such frequency in healthcare now that organizations are putting more thought into limiting the damage when something happens. And as the Change Healthcare outage proves, healthcare organizations have to plan not only for something that happens to them, but also for something that can affect a large swathe of the industry.
Setting a solid foundation. Finally, one of the bigger takeaways from ViVE was that healthcare organizations were paying more attention to how they gather, store, and manage data. That hasn’t changed in Orlando, and HIMSS’ longtime focus on interoperability will keep that conversation going. Innovation in healthcare these days is less about the new toys and more about how data is used to improve things inside and outside the hospital, clinic, or doctor’s office. From smart hospital rooms of the future that gather and funnel information wirelessly, to remote patient monitoring and hospital at home programs that create a data highway from care team to patient, to SDOH programs that mine data for healthcare challenges and barriers and create programs around addressing those challenges, the connecting concept is connectivity.
While strategies like TEFCA and FHIR aim to create a nationwide interoperability platform, providers are just as interested now in strategies and technology that can handle the data they have or want to have. They want tools to pull it in from outside the enterprise, sort it quickly and efficiently without the need for manual labor, and get it to the right people at the right place at the right time, regardless of EHR platform or HIT framework. They’re looking at more data than they’ve ever had before, and the volume or value certainly won’t decrease.
This week’s conference is more about making those connections that work, finding value in partnerships and technology that make things run easier at a time when healthcare is desperate for efficiency. So any use case this week with solid ROI will be trumpeted, as will any collaboration that “pushes the needle” on improved outcomes.
Healthcare needs some good news before the final credits roll.
On this week’s episode of HL Shorts, we hear from Betty Jo Rocchio, Senior Vice President and Chief Nurse Executive at Mercy, about how CNOs can use AI to help solve staffing issues. Tune in to hear her insights.
The tool is designed to help clinicians identify a common type of ear infection that's often overlooked or misdiagnosed
Clinicians at UPMC and the University of Pittsburgh have developed an AI algorithm that can identify acute otitis media (AOM), one of the most common childhood infections.
While some 70% of children have an ear infection before their first birthday, those infections are hard to spot and are often misdiagnosed as fluid buildup. To identify AOM, clinicians need to peer into the eardrum and identify subtle signs of an infection, often a difficult task when dealing with an infant or small child.
To help clinicians make a better diagnosis, researchers created an AI tool that can analyze a video of a patient’s eardrum, taken by an otoscope connected to a camera.
“Acute otitis media is often incorrectly diagnosed,” Alejandro Hoberman, MD, a professor of pediatrics and director of the Division of General Academic Pediatrics at Pitt’s School of Medicine and president of UPMC Children’s Community Pediatrics, said in a press release. “Underdiagnosis results in inadequate care and overdiagnosis results in unnecessary antibiotic treatment, which can compromise the effectiveness of currently available antibiotics. Our tool helps get the correct diagnosis and guide the right treatment.”
“The eardrum, or tympanic membrane, is a thin, flat piece of tissue that stretches across the ear canal,” he added. “In AOM, the eardrum bulges like a bagel, leaving a central area of depression that resembles a bagel hole. In contrast, in children with otitis media with effusion, no bulging of the tympanic membrane is present.”
Hoberman and his team created the tool by studying more than 1,100 videos of the tympanic membrane in children who had visited a doctor for treatment between 20-18 and 2023. They used the videos to develop two AI models that can detect AOM by studying the features of the tympanic membrane, including shape, position, color, and transparency.
According to Hoberman, the AI tool has a 93% success rate in identifying AOM. That’s better than various studies that have put the success rate of physicians studying a patient’s ear at between 30% and 84%.
“These findings suggest that our tool is more accurate than many clinicians,” he said in the press release. “It could be a gamechanger in primary healthcare settings to support clinicians in stringently diagnosing AOM and guiding treatment decisions.”
Healthcare organizations across the country are developing hundreds of AI tools to aid clinicians, drawing on technology that can often analyze data more efficiently than the human eye. These tools can also store the data in the EHR, enabling clinicians to review their work, show the results to parents, and use the data for training.
These nurse leaders outline best recruiting and retention practices for CNOs.
The biggest challenge facing CNOs these days is the workforce shortage. Not only are there not enough nurses entering the industry, but there are also many tenured nurses who are leaving the profession or retiring, and taking their knowledge with them.
Nursing leaders must implement creative solutions to recruit and retain nurses of all generations who will continue providing the best standard of care to patients.
During the recent HealthLeaders’ Nurse Labor and Compensation NOW Summit, Cassie Lewis, Chief Nursing Officer at Bon Secours Mercy Health, and Gail Vozzella, Senior Vice President and Chief Nurse Executive at Houston Methodist, spoke about strategies to improve nurse recruitment and retention, and how CNOs can help create and strengthen the next generation of nurses.
Challenges
Recruiting and retention challenges have always existed, but were greatly exacerbated by the COVID-19 pandemic. The nursing shortage became more evident as large numbers of nurses left the industry or went to agencies, and academic pipelines were disrupted, Vozzella said.
“Rebuilding our workforces certainly led to looking closely at recruitment strategies … nationally across hospitals,” Vozzella said, “and I think it gave us the opportunity to look and see where we had clunkiness in the recruitment process.”
Lewis agreed, emphasizing how the pandemic affected the different generations of nurses in the workforce.
“We obviously are needing to recruit different skill mixes of nurses because we have the need for expert nurses or nurses with experience,” Lewis said. “But also we are seeing a lot of new graduate nurses coming into the profession.”
This, however, creates a lack of experienced nurses at the bedside.
“Trying to ensure that we are adequately training our newer graduate nurses and giving them that experience that they’re looking for…is very challenging,” Lewis said.
Additionally, nurses now hold more power over where and when they work, since there is a higher demand for them.
“The ball is in their court,” Lewis said. “They have many competing offers, [and] they have many health systems where they can go.”
“I think as chief nurses what we have to balance [alongside directors and managers] as they hire and onboard is doing it with speed,” Vozzella said, “because certainly people are getting multiple offers.”
Another challenge facing CNOs during the recruitment process is that there are five generations in the workforce, according to Vozzella. A graduating class of nurses can now include people from several age brackets, and people who are second-career nurses, and their needs are all going to be different.
“Communication is key when you’re communicating with [different] generations of nurses,” Vozzella said. “We have to be more intentional as nursing leaders and as we implement new strategies to hopefully unburden the bedside nurse of tasks that they don’t need to be doing.”
The perception of nursing on social media also plays a big role in the modern recruitment process.
“I think one of the things that has been very eye-opening is with the presence of social media,” Lewis said. “[Nurses] do talk and there are platforms now for them to talk about organizations.”
“I think we have to make sure that we have the right environment [so] that our culture speaks for who we are,” Vozzella said. “[And we must be] attentive to what is being said on social media.”
Strategies for CNOs
The solution to these challenges involves creating an environment where nurses want to work and where they feel valued and supported, both personally and professionally. This includes providing individualized experiences and the flexibility to have a work-life balance.
“One of the things that we’re seeing with these different generations of nurses is work-life balance means something different to every generation,” Lewis said.
“Even benefits packages for employees, one size no longer fits all,” Vozzella said. “At different phases of life, you need different things.”
“What could be the game changer between one organization and another is that individualized experience,” Lewis continued, “where someone really cares about you as a person and has the ability to have some level of flexibility.”
Both Vozzella and Lewis emphasized the need to strengthen academic partnerships to create strong pipelines into the industry, and the necessity of creating robust transition to practice programs.
“Having a nurse residency program has been … beneficial, because people coming out of school are [just] getting the basics in training,” Lewis said. “When [graduate nurses] are actually starting to take care of patients, they’re mind-blown at some of the things they’re encountering.”
CNOs need to make sure their nurses can come into the industry to practice nursing, rather than getting caught up in administrative tasks. According to Vozzella, this will also help with retention.
“Being called to be a nurse is very special,” Vozzella said. “We have to create an environment [where nurses] can use their calling and can help people. So that’s not typing in a medical record for 60% of your shift, that’s not hunting and gathering for supplies, or trying to find other things.”
Nursing leaders also need to be supported so that they have time to interview, recruit, and select candidates while fulfilling the rest of their responsibilities.
“[CNOs must] make sure that our recruitment teams have those strong partnerships with frontline leaders to make those selections,” Vozzella said, “and [that] we use as much technology as we can to make that a streamlined process, not just for the candidate, but also for the leader whose time is precious.”
This is part one of a two-part piece, part two will be published Wednesday, March 13th.
The recent cyberattack on Change Healthcare has brought the conversation around cybersecurity concerns to its zenith.
The ransonware attack on Change Healthcare has affected pharmacies across the country, with the industry estimated to be losing over $100 million a day. While ransomware attacks seem popular for health systems, cyberattacks are getting more sophisticated.
As always, HealthLeaders is keeping up with the latest cybersecurity and IT developments and insights. Here’s a round-up of recent articles in case you need to get caught up:
The Health and Human Services Department raised the alarm for the healthcare sector to make cybersecurity a priority at the end of 2023. The agency presented a four-step plan to improve the sector’s defenses, which include establishing voluntary cybersecurity performance goals for the sector and providing resources to incentivize and implement cybersecurity practices.
In January, the American Hospital Association released a statement alerting members of a new threat, where hackers pose as IT help desk staff to steal information from revenue cycle or financial workers, with the goal of accessing their accounts to change payment instructions to fraudulent U.S bank accounts.
When systems implement new technology, the vendor it’s working with may not have the same security standards. The race for digital expansion shows no signs of slowing down, and vendors are making their own efforts to ensure the security of their solutions, but the rate at which they evolve makes it difficult for systems security standards to keep up.
New York City’s Montefiore Medical Center must pay $4.75 million dollars to the Health and Human Services Department’s Office of Civil Rights for failing to secure patient data. Investigators found that the system failed to properly monitor its electronic health records, which left it unable to stop or detect a 2013 data breach until years later.
The IT business unit of UnitedHealth was hit with a ransomware attack in late February and has affected thousands of pharmacies, resulting in a substantial loss of revenue. With the network being offline, providers have had to use alternative clearing houses to submit claims. The American Hospital Association has urged the HHS to take action and make funds and resources available to affected providers.
Three large health systems have announced plans to put AI to use to address clinical care gaps
Now that they’re seeing AI in action, health systems are putting the technology to use to address clinical care gaps.
WellSpan Health, UMass Memorial Health, and Intermountain Health have all announced new collaborations aimed at using AI in clinical settings. WellSpan Health will be developing ambient AI tools to capture doctor-patient conversations, a compelling use case that was discussed at the recent ViVE conference, while UMass Memorial and Intermountain are targeting chronic care management.
The announcements, on the eve of the HIMSS 2024 conference in Orlando, speak to the rapid state of AI development and deployment, as well as the pressure put on healthcare executives to address problems that are affecting their doctors, nurses, and patients.
WellSpan Health announced this week that it will be deploying Nuance’s DAX (Dragon Ambient eXperience) Copilot throughout the eight-hospital, 220+ care site health system to improve documentation during exam room and telehealth visits. The AI tool is designed to capture provider-patient conversations and create clinical summaries that the care provider can review immediately after the visit and enter into the EHR.
“We have long recognized the central importance of the quality of each patient’s experience in every interaction with our health system and especially with their primary care and other providers,” Hal Baker, SVP and chief digital and information officer for the Pennsylvania-based health system, said in a press release. “With DAX Copilot, we [are] … giving our clinicians additional state-of-the-art tools to lessen administrative burdens, reduce the time needed to complete documentation, enhance their ability to deliver high-quality personalized care and expand access to care. Patients also appreciate the benefits of DAX Copilot knowing that they have their doctor’s full and undivided attention during their visits.”
WellSpan and Nuance, part of Microsoft’s stable of tech companies, have been working together for several years, with an earlier version of DAX deployed in 2020. Health system officials say a survey of providers found that 94% said the technology improved the quality of their interactions with patients, while 85% said it improved their work-life balance.
UMass Memorial Health and Google Cloud, meanwhile, are joining forces to leverage AI and other tools in the treatment of patients living with cardiometabolic diseases, including heart disease, diabetes, kidney disease and obesity.
"Our mission is to provide the best possible care to our patients, and this partnership with Google Cloud is a significant step forward,” Michael Hyder, MD, MPH, executive director of the UMass Memorial Center for Digital Health Solutions and an associate professor of Cardiovascular Medicine, said in a press release issued this week. “By using data-driven insights to identify patients who would benefit from advanced cardiometabolic therapies, we aim to elevate the high standard of care we provide."
And Intermountain Health and Memora Health are partnering to integrate the latter’s technology platform into the 33-hospital, 400+ site health system’s EHR, initially to automate tasks and improve care management for oncology care teams and patients before expanding to other departments.
“The moment a person is diagnosed with cancer, their life changes,” Derrick Haslem, MD, Intermountain’s senior medical director for cancer care, said in a press release issued on Tuesday. “Being able to provide consistent communication with patients to address questions and concerns about their care is critical and very important to us. Memora’s technology helps our busy care teams with daily tasks and empowers them to focus on what matters most: delivering high-quality care to our patients.”
The partnerships point to a need for healthcare organizations to put AI to work now, rather than waiting for governance to catch up.
It's time to look at what other industries are doing, says this CNE.
On this week’s episode of HL Shorts, we hear from Dr. D'Andre Carpenter, Senior Vice President and Chief Nurse Executive at Allina Health, about how CNOs can help prevent workplace violence and create safer work environments. Tune in to hear his insights.
The Coalition for Health AI (CHAI) is staking its claim as the industry’s best option for creating meaningful and acceptable AI standards
As the drumbeat grows for AI governance, one of the biggest questions is whether the healthcare industry or the federal government should take the lead.
An almost-year-old coalition of health systems and tech companies is addressing that question with plans to work with federal regulators.
The Coalition for Health AI (CHAI), which formed in April 2023 as a collective featuring Stanford, the Mayo Clinic, Vanderbilt, Johns Hopkins, Google, and Microsoft and now comprises more than 1,300 members, recently unveiled its first CEO and board of directors. The group also announced plans to collaborate with both the National Health Council and health standards organization HL7 to “craft a comprehensive framework for the deployment and management of artificial intelligence (AI) within healthcare settings.”
"AI is transforming the practice of medicine in ways that seemed unimaginable just two years ago,” CHAI co-founder John Halamka, MD, MS, president of the Mayo Clinic Platform and chair of the group’s new board of directors, said in a press release. “CHAI will bring together policymakers, technologists, healthcare providers, health plans, and a range of stakeholder advocates to develop guidelines and frameworks for evaluating AI. We have a shared mission to empower clinicians and patients with AI tools that maximize benefit and minimize harm."
The partnership is the latest and largest effort to date to create guardrails around the fast-growing phenomenon of AI in healthcare. Health systems and hospitals are launching AI programs by the hundreds to address administrative and clinical pain points, but many worry that they’re going too fast too soon.
The Biden Administration has been pushing for a combined approach to AI governance, with an October 2023 Executive Order that puts the Health and Human Services Department and the Office of the National Coordinator for Health IT (ONC) at the forefront of regulatory efforts and a December 2023 final order that calls for more rules around transparency by the end of this year.
CHAI’s efforts have drawn support from US Food and Drug Administration (FDA) Commissioner Robert Califf, who spoke about AI at CES 2024 in January and addressed CHAI at a meeting earlier this week.
“As part of our AI strategy, the Agency is collaborating with public/private partners to develop a framework for assessing the potential risks and benefits of healthcare AI—this issue is too large to be contained within the FDA,” he told the group. “We’re also developing guidelines for the responsible deployment and ongoing monitoring of AI-driven health care solutions, including those using both adaptive and generative AI methods. The aim is to adapt general AI regulation and standards where needed to the unique characteristics of the health care sector. For instance, general AI regulations often stress the importance of accountability and transparency, which are also crucial in the health care domain due to the sensitive nature of health-related data.”
But Califf also said he worried that health systems “do not have the infrastructure and tools to make the most important determinations about whether an AI application is ‘effective’ for health outcomes.” He listed two conditions for proper review of AI tools:
First, the industry and federal regulators will need to monitor AI tools continuously, since the technology is constantly evolving and the threat of drift over time. “With the proliferation of AI applications and the fact that they evolve over time, it is unclear how the performance of the models will be monitored at the scale that will be needed,” he noted.
Second, AI governance must include complete follow-up of the population affected by the AI tool. “The lack of an interoperable national approach to enabling follow-up of patients leads to a situation in which none of our health systems have a systematic ability to do the requisite monitoring of the model except for the duration of an acute care hospital admission,” Califf pointed out.
Califf also sounded a note of caution on “effectiveness” metrics for AI evaluation, saying he worried those analyses might focus on a health system’s financial interests rather than whether the technology can improve clinical outcomes.
Aside from appointing MITRE co-founder Brian Anderson, MD, senior advisor for clinical trial innovation at ARPA-H and an associate professor of biomedical informatics at Harvard, as CHAI’s CEO, the group named a board of directors, led by Halamka, and advisory boards focused on health systems and providers, patient and community advocacy, the healthcare industry, start-ups, and the government.
From the top post, Wang leads a plan that serves the world.
For 113 years, International Women’s Day has celebrated the social, economic, cultural, and political achievements of women and is designed to accelerate equality. IWD’s 2024 theme is the campaign theme for International Women's Day 2024 (March 8) is Inspire Inclusion.
One way to inspire inclusion is to represent it with excellence. In honor of IWD, HealthLeaders followed up our July 2023 interview with Pat Wang — the Healthfirst president and CEO who is also in her second year of serving as a director with the New York Fed.
Gaps in the C-suite
A designated day to recognize women shows both how far we’ve come and how far we have to go. In 2023, women held just 8.2% of CEO positions at S&P 500 companies (Catalyst, cited by Harvard Law). The numbers are much higher in healthcare and outside of the S&P but still need work: 15.3% of health system CEOs and 15.8% of health plan CEOs were women as of 2021 (JAMA).
Wang is one of them. She is also Chinese-American. Those factors are important, but it’s equally important to ask about them in the right way.
"I really appreciate your sensitivity towards that,” says Wang. “I don't have a strong reaction because I think it's legit. When I first took this job, the Chinese and Chinese-American community just couldn't believe it.”
“There are a lot of people in these communities who run businesses and have leadership titles,” Wang notes, adding: “But my role was a kind of Main Street, American company, so it was all the more notable from their perspective. I thought that was really interesting."
Leading by example
Wang reflected further.
“Which focus is more important: woman? Asian woman? I don't know, but 70% of Healthfirst employees are women. Those with children are by definition working moms who are setting important examples for their families. This is a community we celebrate and honor!”
Healthfirst and Wang understand how much this matters, on International Women’s Day but every day. Last year a female executive administrative assistant brought her daughter to the Healthfirst office and asked if she could meet Wang.
"She said to me, ‘I want her to see that somebody like you exists.’ There is a pride and an obligation to signal and set an example: You can do this too. It's really important to be aware of that."
A hyperlocal approach that delivers for women
Healthfirst’s hyperlocal approach is a recognition of its multi-cultural membership. Healthfirst is New York state's largest not-for-profit health insurance company, serving New York City's five boroughs, Long Island and the mid-Hudson Valley. Its 1.8 million members span multiple lines of business and speak 76 languages and dialects.
Nearly 1.5 million of those members are in Medicaid. More broadly, 19% of total U.S. Medicaid members are women (KFF, 2022). Female Medicaid members face unique health challenges, access to preventive care and screenings.
“Women with Medicaid are less likely than women with private health insurance to receive a mammogram,” notes Wang. “To help address this, Healthfirst performs culturally informed outreach to members and connects them with our provider partners who are committed to clinical quality and who we can recognize through incentives that are designed to improve health equity.”
“We are energized by the results of a controlled pilot in our Healthfirst Cares Maternity program which showed that model was able to identify high-risk members more than seven weeks earlier than traditional clinical decision tree methods, allowing earlier intervention by care managers working with our trusted provider network.”
The CEO adds: “Evidence-based approaches like this are helping us evolve and improve what we do for women.”
Street smart and book smart
"As one of my VPs for external sales says, we have to be street smart and book smart."
"To be truly hyperlocal — in any aspect of the way that people access their healthcare — getting member trust is a cornerstone. We have a lot of offices in the community,” adds Wang. “We hire people from the community who speak the language, who look like our members, who understand the culture, and can really communicate in a way that people feel like they can trust that person.
Another example? “Many of the local residents we serve — especially the Chinese-, Spanish- and Russian-speaking communities — have a unique relationship with their local pharmacists. They trust their community pharmacy and often consult them for any clarifications on the medications they may be taking.”
Noses in, fingers out
Wang may be one of the few Chinese-American women in the C-suite but her experience lends insight that all leaders can apply: understand your role, be willing to stretch, and never be afraid to ask questions.
"There's an expression: noses in, fingers out. As CEO, you've got to keep track of what's going on but it’s the lead manager's job to pay a lot of attention to what's going on a daily basis."
Wang has applied these principles to one of her newest posts: Class C director on the Federal Reserve Bank of New York’s Board of Directors.
"The New York Fed has been really interesting for me. It's a tremendous opportunity to meet people from completely different backgrounds and to start learning. In situations like that, the most important thing is to feel secure in knowing who you are and not be embarrassed about what you don't know."
Not just one day
So how is Healthfirst celebrating International Women’s Day on Mar. 8? With an entire month of initiatives to honor women’s contributions.
“Our WISE Employee Resource Group [Women in Search of Excellence] is spearheading a variety of events in March aiming to encourage, inspire, inform, and empower our female employees. I look forward to participating in these events, as do all of our female executives.”
Wang understands how novel it is to be one of those executives. She also understands what it's like to be a working mother and a single mother.
"Working mothers are a very special group of people. It's important to let them know, 'I am here for you. And I understand because that was me.'”
Healthcare executives are looking for technology and ideas that promote connected care, but to make those connections they need to know how to handle data
AI may have ruled the roost at last week's ViVE conference, but the underlying theme to both that event and the upcoming HIMSS conference will be data management.
Simply put, AI won't work unless you know what to do with the data.
Healthcare's decision-makers are focused on information, as both a tool to improve clinical care and a means of defining and extracting value. But as new strategies and technology give hospitals, health systems, payers, and others access to more and more data, there are growing problems with how to analyze and store data, how to push the right data to providers and payers, how to move it from one entity to another, and how to secure it.
Andrew Trister, MD, PhD, chief medical and scientific officer at Verily, Alphabet's research arm, says many healthcare organizations are actually putting the cart before the horse on innovation. They're moving quickly with new programs that use AI tools without taking the time to make sure they have a handle on data storage and analysis.
"The decision-makers aren't thinking ahead," he said. "You have to be very deliberate in how AI is going out."
That's going to be crucial, he says, as healthcare organizations pivot from using AI for back office and administrative tasks to focus on clinical programs that affect patient outcomes.
Data is also the catalyst for the growing number of collaborations between health systems and large tech companies, as hospital executives are quickly realizing they don't have the resources or the expertise to handle what's coming into the enterprise. Whereas Amazon, Google, Microsoft, and others were initially seen as disruptors in the healthcare space, they're now becoming valued partners and collaborators.
Highmark Health, for example, announced a partnership with Google Cloud and Epic to extract and analyze data from its payer and provider platforms to improve care management.
"We're data rich but insight poor," said Richard Clarke, the Pennsylvania-based health system's chief technology officer, echoing a lament that many health system executives are saying. By leveraging the resources of Google, he said, Highmark can pull out and sort the data it needs to put before its care providers, giving them actionable information when they need it.
"They're going to get information that they've never had before," he added, referencing the health system's strategies for addressing social determinants of health and creating virtual care platforms that target health as well as care.
Understanding innovation
Data is both a curse and a cure in healthcare. At ViVE, health systems and vendors touted programs and strategies aimed at reducing the workload for doctors and nurses—a workload that has been built up over the years by new technologies that bring more data into the industry. In a sense, the industry has come full circle, embracing technology to improve healthcare and now looking for ways to clean up the problems caused by technology.
In one sense, the industry's biggest problem has been embracing and adapting to change. EHRs were originally viewed as an important platform for gathering and managing data, but providers weren't ready for the technology, and we all know what happened. At a ViVE panel on innovation, executives from four large and forward-thinking health systems said change management is the first and most important step in introducing new technologies and strategies. The soil has to be tilled and fertilized before new ideas can grow.
That may be why concepts like telehealth and virtual care have taken so long to sprout. Health systems and hospitals saw single-digit adoption until the pandemic, when everyone jumped on the bandwagon out of necessity and adoption surged to roughly 75%. While the pendulum has swung back since then as patients look to restore that in-person connection, both they and their doctors have seen enough data to understand the value of both telehealth and virtual care.
Likewise the acute care at home movement and remote patient monitoring, the subject of more than a few conversations on the ViVE floor. Healthcare providers are intrigued by the data they can get from their patients outside the hospital setting, especially at home, and how that data can be used to improve care management and outcomes.
Those strategies are part of a much larger effort to move healthcare away from periodic, or fee-for-service, care. Harnessing data from outside the traditional healthcare site gives providers and payers more insight into how care can be delivered more effectively.
Jennifer Goldsack, CEO of the Digital Medicine Society (DiMe), says the healthcare industry is coming around to the idea of using technology—specifically, digital health technology—to care for the whole patient, not just the sick or injured patient. She feels healthcare organizations are adopting digital health at a faster pace than expected.
Giving Value to Data
Which brings us back to data, and where events like ViVE, HIMSS and HLTH will go. Interoperability is an important topic because health systems, payers, and others in the industry need to be able to exchange data without barriers or hiccups. Hence the federal push for TEFCA and FHIR. Data that can only live in one place loses a lot of its value.
And data gains value in how it is shared and used. That's why connected care is a buzzword. Some have suggested a connected care showcase, much like the interoperability showcases at ViVE and HIMSS, where attendees can see how data is collected and used to connect disparate elements of the healthcare ecosystem, from providers and payers to social services, housing and food services, employers and retail services, schools and senior care facilities.
Today's healthcare executives are looking for these connections. They want to see technologies like AI and digital health that can collect and use data to connect the dots. And they want those tools and programs to make seamless connections, so that doctors and nurses are spending less time working with the technology and more time working with patients.
