19 May Digital Healthcare '08: Technology empowering healthcare consumers
Madison, Wis. – The came for the content, they came for the networking, and most of all they came to find ideas they can apply in their respective organizations.
Technology managers attending the 2008 Digital Healthcare Conference were looking for thought-provoking thought leadership, and they came away with ideas that hit them where they work. With the healthcare industry now firmly entrenched in the technology march, the 2008 DHC catered to their growing interest in patient-centric services.
Consumer is king
The rise of the healthcare consumer was reflected in several conference sessions, including online service tools, personal health records, and the forthcoming need to prepare hospital systems for the integration of genomics and electronic health records.
Erik Bergman, manager of clinical research systems for the Blood Center of Wisconsin, was impressed with the presentation of Martin Harris, CIO of the Cleveland Clinic, who explained how the clinic is using web 2.0 technologies. The organization created eCleveland Clinic to deliver services to patients at home, work, or even play – the places where they spend most of their time – and that required new electronic tools to change the way they interact with the clinic.
“We decided the clinic was not a player on content side,” Harris explained. “We were not a destination for patients based on content, so we wanted to be a place where people could go for e-services.”
With one tool, MyPractice Community, physicians receive all the information known about a patient, plus a retail pharmacy service, for a monthly fee. The value of the tool not only lies in its patient-centric focus, but it also gets physicians “out of the “IT business,” Harris said. Another web-based tool called DrConnect provides physicians with real-time EMR information about the treatment their patients receive at the clinic. Another, MyConsult, is for patients who want to get a comprehensive second opinion from a Cleveland Clinic physician. A fourth, the clinic’s version of MyChart, gives patients access to their personal health information and helps them plan their own care.
For the delivery of some tools, internal development makes sense. For others, partnering with other technology firms is a possible avenue. After dismissing options like building the infrastructure (with 800,000 doctors in the U.S. alone, that’s too massive) and using regional health information organizations (too slow in developing), Cleveland Clinic is in discussions with Google enable a rapid transaction-processing model. The model could enable a more rapid exchange of information with patient consent. Privacy and security are challenges, but patients need to know where their information is and when it is moving, Harris said, and they should be able to establish an audit trail of when it moves from Point A to Point B.
When people become more knowledgeable, and have more control over where information goes, Harris said concerns about privacy drop off. “We’re are now at the point where we can get to a consumer-driven model,” Harris said. “The fundamental principle should not be that we relate to people by holding their information hostage, but if they choose to give us the information, we can do more to help them than anyone else.”
Taking a cue from Cleveland Clinic, the Blood Center of Wisconsin might add to its existing online services, but Bergman indicated it would do so carefully. “Certainly, the consumerism is something that’s pervasive, and it’s a topic that provokes a lot of emotion,” he stated. “To put it into practical uses is going to require a lot of thought by healthcare institutions.”
Some of that thought will involve whether patients have the medical literacy to take charge of their own care, and whether such tools embolden them to think they know better than doctors.
“That’s probably a fine balance of trying to take care of yourself versus going in for healthcare,” said Tanya Townsend, CIO of St. Vincent Hospital and St. Mary’s Hospital Medical Center, Green Bay.
Harris’ presentation also interested Townsend, who helped design the state’s first all-digital hospital (St. Clare’s in Weston), and now is involved with the development of a clinical integration network at St. Vincent. While it’s more modest in scale than the tools of Cleveland Clinic, Townsend said it would pull in patient data from St. Vincent, its sister hospital, and provider partners.
“The idea is we’ll have a single, integrated network with information coming in from multiple vendors, multiple facilities,” she said, “and that would not only be a tool for our providers to use so that they have a single record for a single patient, but also for the patients to go out and be educated and utilize it as a tool for their own personal health.”
Like some Cleveland Clinic tools, the idea is to make the network a revenue-producing tool. Townsend said there would be a charge for services – not to the patient, but for the provider portal piece.
Genomics also is likely to play a role on the future of healthcare consumerism. Bergman took some validation from John Glaser, vice president and CIO of the Boston-based Partners HealthCare, who described the IT infrastructure Partners Healthcare will use to link information from patient genetic tests with the patient’s electronic medical record. Glaser has touted this integration as a step in the development of personalized medicine, which is based on the ability to use genetic information to predict an individual’s predisposition to disease and tailor subsequent treatment.
“It’s something we have been talking about,” Bergman said, “but to actually see how they’re doing it validates a lot of our current thinking.”
An e-discovery discovery
For one conference attendee, the Digital Healthcare Conference provided a new twist on software development.
John Daniels, CIO of Evolvent Technologies, said e-discovery and data retention sessions translated well with the company’s efforts to develop a solution to help organizations with interoperability between business systems and data integration within their systems. The goal is to provide a common view of data sources, across the organization, on a single screen.
Evolvent, an IT services company that provides business process re-engineering, has worked mainly in the government space, but it is looking to develop products for the commercial market. “We’re looking at system interoperability and data integration because what we’re finding is most organizations have disparate data sources,” Daniels explained.
In designing an integrated solution, Daniels acknowledged that the thorny issues of e-discovery and document-retention had not entered into his thinking, but he now believes the product must include those components. The solution would have added value, he said, if it can help organizations respond efficiently to e-discovery demands.
That may involve partnering with software companies to bring search and business intelligences pieces to the eventual solution, but “we need to add some focus on e-discovery and data retention,” he said.
The conference was valuable in another sense – the importance of getting some traction on a number of issues, Bergman indicated.
“I think in general just the cross-pollination of these ideas and talking to other groups was petty significant because you see that some of the dilemmas that faced us two years ago are still facing us today, including RHIOs and interoperability of different business systems,” Bergman said. “There needs to be more discussion on how we make this happen for operational clinical care and biomedical research.”
Other DHC coverage
• Healthcare 2015: Without change, not a pretty picture
• DHC 2008: In healthcare, commercializing technology can be enticing, risky
• DHC 2008: EMRs stimulate interest in personal health records
• DHC 2008: Electronic data management top concern for CIOs
• Sharing your health information: Is California RHIO defying the odds?
• Partners CIO touts integration of genetics and electronic health records