THE YEAR OF THE PATIENT

Transcription

1 Health Tech REPORT An Inside Look at IT Trends for the Healthcare Market WINTER 2014 CXO THE YEAR OF THE PATIENT A SIGN OF TECHNOLOGY TRENDS FOR 2015 PAGE 4 Leveraging Technology for a Better Patient Experience PAGE 12 Patient Care Goes Virtual: Telehealth Technology is Taking Off PAGE 16 The Healthcare Social Shakeup PAGE 18

2 LETTER FROM BOB ONLINE RESOURCES FROM THE DOCTOR S BAG TO THE DIGITAL DEVICE: MORE POWER TO THE PATIENT A patient-centric mindset is certainly not a novelty for the healthcare industry. Since the days of the house call doctor toting his leather bag stuffed with homemade apothecaries, healing the sick was a steadfast mission. Over the years, delivering top-quality care has become the mantra of every medical organization. So, what has changed? Fast forward into the new millennium and take a peek inside the proverbial doctor s bag of today. Instead of brimming with syrups, a stethoscope and cloth bandages, you might find a tablet, a pocket ultrasound machine and a digital stethoscope. And that bag might now be carried by a nurse practitioner, physician assistant or home health nurse. Yesterday s satchel may be an artifact, but the expectation of receiving optimal patient care remains timeless. What have changed are the dynamics and demands of today s consumer, which when fulfilled are tied to financial incentives. Patient satisfaction ratings driving HCAHPS scores, Medicare penalties for high readmissions and more cost-effective patient monitoring through wireless mhealth technologies have become the new normal. In this issue of Health Tech Report, you ll learn about the latest HIT trends, tips and innovations your peers are using to strengthen their bottom lines and connect more closely with patients to provide exceptional care. Your role as a technology leader is paramount to empowering your healthcare organization and the patient population it serves. CDW Healthcare is here to help you achieve your business and IT priorities with a patient-first vision into 2015 and beyond. STAY ON TOP OF TRENDS Gain access to the latest news and insider perspectives for everything health IT at your one-stop shop from videos to blog posts to CDW.com/view TELEHEALTH TAKES OFF Virtual collaboration continues to trend as care moves beyond a single location. Having the right technology and supporting infrastructure to facilitate telehealth is key. Learn what s driving the need for greater efficiency and improved communication. CDW.com/telehealth STAY CONNECTED TO HEALTHCARE Keep up with peer-to-peer content, case studies, expert perspectives and more. CDW-Healthcare TO LEARN MORE ABOUT CDW HEALTHCARE AND THE LATEST IN HEALTH I.T., VISIT CDW.com/communIT BOB ROSSI Vice President, CDW Healthcare 2 Health Tech Report WINTER 2014

3 CONTENTS CXO 04 HIT WATCH EMPOWER, ENGAGE, ENHANCE The top 10 technology trends redefining the healthcare environment in 2015 and beyond VIRTUAL 16 KEY LEARNINGS Insights from the Front Lines: Priming for Integrated Patient Care Achieving patient-centered care is a major goal. Dr. Michael Hunt and Joanne Sunquist, healthcare SVP and CIO, share their thoughts on ACOs and the patient data management push resulting from this goal. SOLUTION REVIEW Leveraging Technology for a Better Patient Experience Find out how implementing an integrated nurse call system improved both the patient experience and clinician satisfaction at Sauk Prairie Healthcare. EMERGING TRENDS SPOTLIGHT Patient Care Goes Virtual: Telehealth Technology is Taking Off Healthcare IT consultant and former CMIO Dr. Alan Snell shares firsthand insights on virtual care and what technologies are making the biggest impact. 14 TECH TIPS A Clear View of the Healthcare Cloud Horizon Sandra Yu, CDW Healthcare Cloud Client Executive, shares her take on top cloud trends and considerations for healthcare organizations. 18 INFOGRAPHIC The Healthcare Social Shakeup As the healthcare discussion hits the social world in a big way, see how it s impacting care and changing expectations. 20 MEANINGFUL INSIGHTS Dynamic Digital Tools Empowering Patients and Providers Find out how patients and providers are using digital tools to enhance care quality. 22 PARTNER CORNER Cloud: Storage Solution for the Data Deluge Tony Amaddio of VMware shares insights for organizations considering cloud storage. WINTER 2014 Health Tech Report 3

4 HIT WATCH CLIMATE CHANGE THE PATIENT-CENTRIC TERRAIN OF 2015 Today s healthcare environment continues to redefine itself based on the Centers for Medicare and Medicaid s Triple Aim: improving the patient experience, improving the health of populations and reducing healthcare costs. And innovative technologies from telehealth to cloud computing to data analytics continue to play a formative role in improving care, better engaging patients and expanding access. To support your 2015 technology investment decisions, take a closer look at some of the coolest HIT trends of the new year. TOP 10 TRENDS 4 Health Tech Report WINTER 2014

5 UNLOCKING THE PROMISE OF BIG DATA Data analytics is helping healthcare providers reduce costs, improve patient compliance with care plans and even treat patients before medical conditions develop or worsen. A new study published in Health Affairs sees big opportunities for Big Data in preventing readmissions and adverse events, targeting high-cost patients and improving triage effectiveness, among others. But there are still some big hurdles to get over. These range from developing the right predictive models, to ensuring patient privacy, to managing the massive volume and diversity of the data. In fact, a Paradigm4 study found the sheer variety of data sources forced researchers to leave data on the table when doing their analyses. 91% of data scientists use complex analytics on their Big Data now or plan to within the next two years. SOURCE: healthcareitnews.com, Data Variety Bigger Hurdle than Volume, July % of the Most Wired hospitals use tools for retrospective analysis of clinical and administrative data to identify areas for improving the quality of care and reducing the cost of care delivered. SOURCE: healthcareitnews.com, Most Wired 2014 Hospitals Big on Data, July 2014 REMOTE MONITORING CONNECTS WITH CONSUMERS Three million patients in the U.S. currently use home medical monitoring devices, and that number is expected to climb to 10.3 million by Two-thirds of those involve implantable cardiac rhythm management, with sleep therapy the second most common use, according to research by Berg Insights. It also turns out that consumers like care models enabled by remote patient monitoring because these technologies support their ability to live more independently and actively. Surprisingly, 70% of the remote monitoring is still done over plain old telephone service, voice-grade analog systems, public switched telephone networks and local area networks. However, cellular has rapidly become the new standard, expected to account for nearly three-quarters of the connections by MILLION The total number of patients worldwide using connected home medical monitoring devices is expected to soar to 19.1 million over the next 3½ years. SOURCE: mhealthnews.com, Why Remote Monitoring Services are Poised for Explosive Growth, July 2014 WINTER 2014 Health Tech Report 5

6 TECH-SAVVY SENIORS DEMAND MORE For seniors accustomed to Skyping, downloading books to an e-reader, accessing Facebook on an ipad and ing with their smartphones, having a lone computer lab in their continuing care retirement community just won t cut it anymore. Robust campus-wide Wi-Fi is fast becoming a must-have to attract new residents and keep current ones happy. In fact, nearly three-quarters of senior living organizations surveyed have invested in access to the Internet and social networking sites in the past 12 months, more than double the number only two years ago. Seniors also are eager to bring their own devices with them, creating a need for in-house tech support. Yet 60% of senior providers lacked an in-house technology leader, according to a 2013 survey by Healthsense and Senior Housing News. 73% of senior living providers plan to invest in information communication technology infrastructure such as wireless and high-speed Internet connectivity, while 55% expect to invest or increase their investment in access to the Internet and social media. SOURCE: seniorhousingnews.com, High Speed Internet is Top Investment for Senior Living Providers, June 2014 CXOs IN THE C-SUITE Delivering a positive patient experience depends on savvy leadership as much as innovative technology, compassionate care and patient-friendly services. Recognizing this, forward-thinking hospitals including the Cleveland Clinic and Henry Ford Health System have been adding CXOs chief experience officers to their C-suites. Although the CXO function may fall under a variety of titles, the goal is to boost patient satisfaction scores and engagement. In turn, this supports optimal outcomes and reimbursement as well as providing a competitive edge. Candidates with a background in nursing or consumer service-focused industries such as hospitality are proving highly successful in these positions. It took a little bit of a wake-up call for many of us to come back to focusing on the centrality of the patient experience. Susan Dentzer, Senior Policy Adviser for the Robert Wood Johnson Foundation This year, the fifth annual Patient Experience: Empathy + Innovation Summit attracted more than 2100 attendees from 49 states and 39 countries. SOURCE: patient-experience.org, 2014 Patient Experience: Empathy+ Innovation Summit Recap, June Health Tech Report WINTER 2014

7 TACKLING THE INTEROPERABILITY CHALLENGE The Office of the National Coordinator for Health Information Technology (ONC) aims to accelerate interoperability progress with an ambitious new 10-year plan. The goal is to cut costs, improve population health and patient engagement, and expand patient access to and control over data by creating an integrated network of databases to share and aggregate information. Despite plenty of advances, numerous obstacles remain, given the U.S. still lacks a national infrastructure that supports a common standards framework and seamless data exchange. Researchers at Harvard and the University of Michigan found that only 30% of hospitals are part of a health information exchange (HIE), and participation varies widely state to state. The ONC says the most widely exchanged types of information are lab results (57%) and radiology reports (55%), followed by clinical care summaries (42%) and medication history (37%). HIE participation: 57% of hospitals electronically exchanged health information with ambulatory providers outside their system, a 58% increase since SOURCE: healthcareitnews.com, Interoperability Beyond Gloom or Doom, May % of not-for-profit hospitals 21% of public hospitals 8% of for-profit hospitals SOURCE: healthcareitnews.com, Hospitals Lag on Data Exchange, July 2014 NURSES EMBRACE I.T. LEADERSHIP Nurse informaticists are playing pivotal roles in information system development, implementation and optimization. Given their clinical backgrounds and understanding of workflow, they are well equipped to bridge the IT and clinical worlds to help hospitals fully capitalize on potential benefits. As they move into a growing range of leadership positions, including chief nursing informatics officer and chief information officer, nurses are guiding their organizations in everything from meaningful use to business intelligence/analytics initiatives to across-thecontinuum informatics support for home health agencies, hospices and long-term care facilities. 81% of nursing informatics specialists are satisfied or highly satisfied with their choice to pursue a career in informatics. SOURCE: fiercehealthit.com, HIMSS Survey: Nursing Informatics on the Rise, February 2014 WINTER 2014 Health Tech Report 7

8 CLOUD COMPUTING PROSPECTS LOOKING UP Although privacy and security concerns initially slowed cloud adoption by healthcare organizations, they re starting to make up for lost time. Cloud use is growing 20% annually, according to MarketsandMarkets, with researchers predicting that healthcare organizations will spend $5.4 billion on cloud services by Ironically, many organizations especially small to mid-sized practices now consider the HIPAA-compliant cloud services more secure than their own systems would be. These practices also find cloud-based EHRs more affordable and attainable. When it comes to larger organizations, HIMSS Analytics found that 80% of respondents currently use cloud-based services, most frequently for hosting applications, disaster recovery/backup, primary data storage and archived data. 47% of independent practices vs. 25% of practices owned by a hospital or integrated delivery network use cloud storage. SOURCE: physicianspractice.com, Storing Data in the Cloud Gaining Acceptance in Medical Practices, July 2014 Top three cloud selling points for healthcare organizations 1. Lower maintenance costs 2. Faster deployment 3. Ability to step in when staffing resources are scarce SOURCE: 2014 HIMSS Analytics Cloud Survey, June 2014 TELEMEDICINE BARRIERS FALLING FAST Cumbersome state-by-state telehealth licensure requirements have prevented many physicians and providers from enthusiastically embracing telehealth, which often requires licensure in multiple states. But a new interstate compact drafted by officials of state medical boards across the U.S. could dramatically boost interest and participation. If passed, the legislation would allow doctors to apply for an interstate license rather than applying in each individual state. Meanwhile, effective January 1, 2015, the Centers for Medicare and Medicaid Services will begin reimbursing a host of telemedicine services, including psychotherapy, annual wellness check-ups and chronic care management. And a new bipartisan bill in Congress aims to gradually expand telehealth services covered under Medicare to include outpatient services, home telehealth and, eventually, remote monitoring of chronic diseases. The number of e-visits to primary care physicians is expected to reach 100 million globally this year, potentially saving more than $5 billion. SOURCE: computerworld.com, Almost One in Six Doctor Visits Will Be Virtual This Year, August Health Tech Report WINTER 2014

9 BRINGING CYBERSECURITY UP TO SPEED It s no secret the healthcare industry lags others such as retail, finance and utilities, making it especially vulnerable in light of stepped-up criminal attacks and a black market value as high as $500 for the full identity profile contained in a single record. The fact that healthcare had the highest volume of threats and lowest response time even led the FBI to issue a warning to providers this spring. Yet this year s HIMSS security survey found that about half the health systems spent 3% or less of their IT budgets on security. Experts say that hiring a chief information security officer (CISO) preferably a highly knowledgeable cybersecurity professional (healthcare experience is nice, but optional) can provide the critical leadership required to reduce vulnerabilities and beef up defensive strategies. 100% Data breaches cost the healthcare industry $5.6 billion annually. SOURCE: govhealthit.com, What It Takes to Avoid Cyberattacks, June 2014 Criminal hack attacks on hospital data have increased 100% from just four years ago. SOURCE: healthcareitnews.com, Data Attacks on Healthcare Flying High, March 2014 PATIENT ENGAGEMENT GAME CHANGERS Despite expressing desire to have greater access to their health information and be more actively involved in their care, most patients have little idea how to actually get from here to there. A new breed of personal mhealth technologies largely driven by tech behemoths Apple, Google and Samsung could be game changers. As part of its HealthKit software, Apple has partnered with healthcare leaders such as the Cleveland Clinic, Johns Hopkins, Mayo Clinic, Allscripts and Epic to develop integrated mobile apps that could help improve service, broaden access and lower costs. Google Fit is a fitness and health tracking platform designed to work with sensors on mobile devices and wearable technology such as Google s smartwatch. And the Samsung Architecture for Multimodal Interactions (SAMI) offers a platform for bringing together and analyzing data from multiple health-related sources. Approximately 90% of survey respondents think they should be able to access their medical records. SOURCE: govhealthit.com, Personal Health Tech Plot Thickens, June 2014 WANT MORE? FOLLOW US ON SUBSCRIBE TO INDUSTRY VIEW TO GET THE LATEST HIT TRENDS EVERY WEEK! CDW.com/HITlist WINTER 2014 Health Tech Report 9

10 KEY LEARNINGS INSIGHTS FROM THE FRONT LINES: PRIMING FOR INTEGRATED PATIENT CARE As we look to 2015, it s evident that the quest for patient-centric care is marching steadily onward. ACOs are increasingly popular as population health management continues gaining traction. 10 Health Tech Report WINTER 2014 CDW Healthcare recently spoke with two industry experts intimately familiar with these rising trends to get their thoughts on the considerations organizations face as they strive to develop infrastructures to support ACOs and population health: Chief Medical Information Officer Michael Hunt, DO, St. Vincent s Health Partners; and Senior Vice President and Chief Information Officer Joanne Sunquist, HealthEast Care System.

11 DR. HUNT, LET S START WITH YOU. WHAT ARE YOUR ORGANIZATION S POPULATION HEALTH MANAGEMENT GOALS? The challenge has been that there s no partnership between the payers and the providers in a way that allows patients to really connect. So, our goal is to work with each of our organizational members (physicians, hospitals, skilled nursing facilities, etc.) to offer face-to-face medical services that are as efficient and highquality as possible. AND HOW DO THESE GOALS RELATE TO ACCOUNTABLE CARE? St. Vincent s Health Partners is a member of an accountable care organization. An ACO requires you to be responsible for 32 metrics if you take care of a Medicare patient. We re trying to create a much more advanced network that allows us to manage the total cost of care for each patient. We believe our clinical integration model is an ACO on steroids. JOANNE, YOUR ORGANIZATION IS ALSO AN ACO MEMBER. WHAT TECHNOLOGIES DO YOU CONSIDER ESSENTIAL FOR AN ACCOUNTABLE CARE STRATEGY IN TODAY S DIGITAL HEALTHCARE LANDSCAPE? A single, integrated electronic health record is the foundation. You then need to work with your ACO business partners, whether they re payers or other providers, to aggregate and integrate data into a data warehouse or repository. You need the capability to pull patient data from these disparate EHRs and correctly match that data with the patient so you can really understand what s going on with the patient across the care continuum. That s probably the most complex challenge and leads to a much broader set of requirements around analytics. There s also functionality required for care management above and beyond what the EHR contains, such as registries or telemonitoring capabilities, which help you identify and manage high-risk populations. GIVEN ALL THE COMPONENTS INVOLVED, IT S CLEAR THAT INTEGRATING DATA FROM DISPARATE SOURCES IS A MAJOR CHALLENGE. WHAT OTHER SIGNIFICANT CHALLENGES HAVE YOU FACED IN LEVERAGING ACCOUNTABLE CARE TECHNOLOGY? This is all so new and competitive that it s difficult to find people who have the experience you need to implement an accountable care IS strategy. Big Data and analytics expertise is rare, and individuals with this expertise are highly recruited. Even though there are knowledgeable consultants, ultimately you need to be able to manage the systems yourself. THE DRIVE TOWARD MORE ACCOUNTABLE, PATIENT- CENTERED CARE REALLY IS A PARADIGM SHIFT FOR HEALTHCARE ENTITIES. DR. HUNT, HOW HAS YOUR ORGANIZATION ADAPTED? We ve redefined the roles of care coordinators and case managers. In our operational process, case management occurs at the facility directly with the patient, and care coordination occurs at the enterprise level. So we use our care coordinators to monitor the population continuously, and we empower the case managers to interact as much as they can to overcome barriers directly with the patient. We also require our primary care providers to be certified as patient-centered medical homes (PCMHs) within two years. We ve embedded the PCMH standards into the culture of our organization, and intend to create a patient-centered neighborhood throughout the whole network. JOANNE, AS WE LOOK TOWARD EMBRACING TECHNOLOGY TO FURTHER ACO PARTICIPATION AND PRIME ORGANIZATIONS FOR POPULATION HEALTH MANAGEMENT, HOW DO YOU ADVISE OTHER HEALTHCARE ENTITIES TO SELECT THE RIGHT TOOLS? I think once you know who your partners are for your various ACO networks, it s extremely important to lay out a strategy. You need to be careful to design an IS strategy that s flexible enough so you don t have to reinvent the wheel every time you enter into accountable care arrangements with different partners. It s also important to look at the technology you want to implement from a strategic perspective, to avoid wasting a great deal of time and money. Numerous different data warehousing and analytic solutions are available, some of which are very expensive. So it s wise to analyze your needs and determine how much you can do with your existing systems, tools and resources before you invest in new ones. Dr. Michael Hunt is board-certified in pediatrics with a master s degree in medical informatics. He previously served as chief medical information officer at St. Louis-based Mercy, where he helped lead the transition from implementation to operationalization of clinical information systems. St. Vincent s Health Partners is a nonprofit physician-hospital organization (PHO) in Connecticut that includes a flagship medical center and 300+ physicians and providers in over 40 specialties. It is the first PHO in the nation to be recognized by URAC (Utilization Review Accreditation Commission) as clinically integrated. Joanne Sunquist recently joined HealthEast to lead the implementation of an enterprise-wide electronic health record system. In her previous position as CIO at Hennepin County Medical Center, she also oversaw that organization s EHR implementation. Based in St. Paul, Minnesota, HealthEast is a community-focused, nonprofit healthcare organization providing innovative technology, compassionate care and a full spectrum of family health services through its hospitals, clinics and home care. WINTER 2014 Health Tech Report 11

12 SOLUTION REVIEW LEVERAGING TECHNOLOGY for a Better Patient Experience WHEN SAUK PRAIRIE HEALTHCARE DECIDED TO BUILD A NEW HOSPITAL FACILITY, I.T. DIRECTOR/ CIO MARYBETH BAY KNEW SHE HAD A UNIQUE OPPORTUNITY TO EXPAND AND UPDATE THE I.T. INFRASTRUCTURE TO IMPROVE PATIENT CARE AND BOOST CLINICIAN EFFICIENCY. WE TALKED WITH BAY ABOUT HER DECISION TO IMPLEMENT STATE-OF-THE-ART TECHNOLOGY AND ITS POSITIVE IMPACT ON BOTH PATIENT EXPERIENCE AND CLINICIAN SATISFACTION. 12 Health Tech Report WINTER 2014

13 What were your technology goals for the new hospital? Exploring ways to continuously improve patient care is always at the forefront of what we do as a healthcare organization, and what I do with technology in particular. I wanted to build a new data center with adequate power, cooling and capacity to support a more robust infrastructure, advanced applications and future growth. A new data center would allow me to replace our inefficient legacy nurse call system, which frustrated both patients and staff. Which solutions did you choose to implement? By completely redesigning our data center, we could now take advantage of current technology such as Windows Server We also implemented an entire new core infrastructure, including unified communications (UC), wireless networking, server virtualization, storage and security. Our new nurse call system integrates with Cisco IP handheld phones as part of our new unified communications system, which significantly improves communication between patients and nurses as well as between nurses. MARYBETH BAY and her nineperson team are responsible for the IT infrastructure, applications and operations at Sauk Prairie Healthcare, which serves more than 40,000 residents in a 700-square-mile area. The system includes a 36-bed acute care hospital and two surgical specialty practices in Prairie du Sac, Wisconsin, as well as four primary care clinics in surrounding rural communities. The hospital has been named one of the nation s 100 Top Hospitals by Truven Health Analytics and was recently ranked in the top 5% for patient satisfaction by Press Ganey. How does the unified communications technology streamline patient care and clinician workflow? First and foremost, it sends specific information about patient needs directly to the appropriate care team member, eliminating the need to go through a secretary at the nurse s station. If patients have an emergency, they can push a button and a message pops up on the phone screen, alerting the nurse who can then respond directly through an intercom system in the patient s bed. If a Code Blue signal goes out for a patient in cardiac arrest, the system sends it directly to the mobile phones of the clinicians who need to treat the patient, ensuring immediate treatment. In cases where patients want assistance with routine needs, their call goes to the nurse or CNA assigned to their care, depending on the type of request. How has the new integrated technology enhanced the patient experience? Most important, we now know exactly what patients need when they call for help, and can respond right away. This enables us to manage patient expectations, which has been key. Since the calls go directly to the nurses and CNAs assigned to a particular patient, they can immediately respond and let the patient know how quickly they will be there to assist. It s a big satisfier to patients to know that they ve been heard. We all know that when you feel ill, waiting even two minutes can feel like 20. How has the system boosted clinician satisfaction? The new call system met our clinicians two primary goals: simplicity and customization. It s simple for patients and busy nurses to use, and can be customized to our particular workflow. The nurses are pleased with the ability to talk to their patients, to each other and to other departments. They also like the non-verbal code notification system. In addition, they appreciate no longer having to track whether the call light outside a patient s room is lit, and whether or not they ve addressed the request. TIPS FOR PUTTING I.T. TO WORK IMPROVING THE PATIENT EXPERIENCE 1. PLAN AHEAD. Identify a budget and timeline so you can ensure you have the financial, operational and human resources you need to implement the technology you select. 2. INVOLVE END USERS AS EARLY AS POSSIBLE. The sooner clinicians are involved in the selection and implementation process, the better they will understand the capabilities of the technology and the more invested they ll be in maximizing its potential. A 3. CONSIDER ALL YOUR OPTIONS. Whether you re B C integrating a new nurse call system or redesigning a data center, make sure you explore several alternatives to determine which ones best meet your organization s current and future needs. 4. TRAIN EXTENSIVELY. Provide ample classroom training and hands-on practice with clinicians before going live. And expect spending several months before your IT staff is able to knowledgeably support new technologies, especially if you implement several simultaneously. WINTER 2014 Health Tech Report 13

14 TECH TIPS A CLEAR VIEW OF THE HEALTHCARE CLOUD HORIZON We recently spoke to Sandra Yu, CDW Healthcare Cloud Client Executive, to discuss cloud trends in the healthcare industry and whether the outlook is sunny as we look to Read on for her thoughts on the top three trends of the new year, security considerations and how the cloud can impact patient care. 14 Health Tech Report WINTER 2014

15 WHAT ARE THE TOP THREE HEALTHCARE CLOUD TRENDS YOU SEE FOR 2015? First, leveraging the cloud for HIE and meeting meaningful use Stage 2 requirements both to achieve increased collaboration and sharing of data across departments and locations. Second, organizations are looking to cloud and hosted technologies for disaster recovery getting out of the data center business to concentrate more on their core missions. And third, analytics and Big Data using cloud technologies to help harness information to predict better patient outcomes and improve the decision-making process for clinicians, as well as improving payment models. It s interesting to note that the HIMSS Analytics 2014 Cloud Survey mirrored what I m seeing the top three uses cited by respondents were hosting of clinical applications, HIE and backup/disaster recovery. CAN YOU ELABORATE ON THE BENEFITS OF LEVERAGING THE CLOUD FOR BIG DATA? By moving Big Data sets to the cloud, organizations have a lower cost of entry or a lower barrier to risk when it comes to deploying an analytics model. In addition, they have the scalability to help drive that infrastructure. For example, maybe they want to look at a chronic care patient to see their past two, three or four years of admissions. With the cloud, they re able to scale up and add more storage as needed, versus in the traditional data center sense where they d just have that infrastructure sitting idle. SECURITY IS A MAJOR CONCERN FOR HEALTHCARE ORGANIZATIONS. HOW DO YOU ALLAY THAT FEAR WHEN IT COMES TO THE CLOUD? It s important to note that those breaches we hear about every week are occurring on premise and not in the cloud. So I tell customers to be sure to encrypt their data at rest, as well as to move their PHI offsite, as required by the HITECH Act. And keep in mind that for cloud-based storage, any provider worth its weight will encrypt the data at rest and in transit. But no matter which provider you choose, you must be aware of who will have access to the encryption keys! And finally, not all business associate agreements are created equal. There may be variances in customer reference ability, whether the provider will ensure a data center tour of its operations, financial stability of the provider, and its service level agreements and compliance (e.g., HIPAA, PCI, SSAE16). If cloud providers are solid on all these points, organizations can put stock in their security. ASIDE FROM SECURITY CONCERNS, WHAT WOULD YOU SAY ARE THE BIGGEST BARRIERS TO GREATER HEALTHCARE CLOUD ADOPTION? The greatest barrier really is the fear of the unknown. The this is the way we ve always done business with on-premise solutions notion is hard to get past for a lot of organizations that are used to seeing and touching their storage. The second biggest barrier, I d say, is concern over storage file size and accessibility when moving to the cloud; for instance, the need to have files deduped and compressed because PACS images are large. HOW CAN INVESTING IN THE CLOUD IMPACT THE OVERALL PATIENT EXPERIENCE? Cloud technologies ultimately allow organizations to be more productive and efficient, since they support clinical mobility and the notion of a ubiquitous application experience whether it s being accessed on a mobile device, tablet or desktop. This translates to decreased patient wait times and improved decision making. Leveraging analytics, for example, can help cut down readmission rates for chronic patients. From an inpatient perspective, things like wireless access points (they can watch Netflix!) and ordering food from their mobile devices (concierge services) support a more comfortable experience. And, as we know, a positive patient experience can help improve HCAHPS scores. WINTER 2014 Health Tech Report 15

16 EMERGING TRENDS PATIENT CARE GOES VIRTUAL 16 Health Tech Report WINTER 2014

17 TELEHEALTH TECHNOLOGY IS TAKING OFF Virtual care and the shift away from hospital and practice-based care is one of the fastest growing trends in healthcare these days. Both patients and providers are seeing new opportunities to engage beyond the confines of the clinical walls with a connection that transcends the limitations of a face-to-face appointment. Innovative mobile devices and developments in secure remote access are contributing major benefits to healthcare systems and care delivery as a whole, with promises toward improving patient satisfaction and increasing care efficiency and effectiveness. We asked Alan Snell, MD, MMM, healthcare IT consultant and former CMIO at St. Vincent Health/Ascension Health, about the current state of telehealth and the evolving role it s playing in patient care and health management. Q: What are the biggest trends you see in the healthcare space related to virtual care? What s driving these trends? A: An explosive trend right now is virtually connecting to patients in their home setting. To be in contact with patients and monitor them especially in the case of patients with chronic illnesses offers a huge advantage. You know quickly if they begin to deteriorate, can provide early intervention and can ultimately avoid an ER visit or hospitalization. Virtual care also gives you the opportunity to provide patient education. The whole patient engagement aspect is really what s capturing the emotions of providers and patients new ways to connect with and educate patients so their health literacy level is higher. Patients need to know how to better manage their disease, and technology is the enabler. Visit CDW.com/communIT to learn more about the latest telehealth technology and gain access to case studies. Q: What technologies are having the greatest influence in virtual care? A: By far the mobile platform (3G, 4G) is having the biggest impact. There have been many attempts in the past by providers, payers and others to do this by PC or via phone-based applications, which have been met with limited success. The mobile platform has changed everything. It s ubiquitous: With 3G or 4G, users don t need broadband, WiFi or even a computer in their homes. There are very few places where you can t get a strong enough signal to make it work, and the cost of mobile technology is dropping rapidly. There are also changes happening in terms of user comfort level and adoption. Many senior patients are using technology, and the use is growing rapidly. They re not averse to using a device in their homes. Also some of the devices can now be diverted to TV sets with an adapter your TV becomes your home health station, enabling communication with your provider. Q: What are the biggest benefits to patients, and for providers and healthcare organizations as a whole? A: The biggest opportunity is to educate patients. In the past, this was often limited to the office visit, paper handouts and the patient interacting occasionally with someone like a diabetes educator. Now, healthcare reimbursement is moving to tying care to financial risk, readmissions and outcomes. Patients with multiple chronic diseases are high risk and high utilization, and typically are your most expensive patients. How do you help these patients be better educated? Beyond handouts, you can send them videos or education programs that can be very specific to their particular conditions. You can embed questions to obtain feedback and make sure they re absorbing the information and retaining it. The more engaged a patient is, the greater the payoff. For providers, insurance carriers and healthcare organizations, this means cost avoidance and improving patient satisfaction. Q: What are the biggest challenges healthcare organizations face in moving toward more virtual care solutions? A: How do you do this in a world where we still have small, independent practices? More doctors are consolidating to become part of larger networks, but many are still practicing in small, individual sites. The challenge for smaller practices is how to put all of this technology into motion from your practice location. This is much easier if you re part of a larger network where you can aggregate and centralize the monitoring process and contact center. Clinicians also need software and tools that can aggregate the data obtained from this virtual care process. Alan Snell, MD, MMM Healthcare IT consultant; former CMIO, St. Vincent Health/Ascension Health WINTER 2014 Health Tech Report 17

18 INFOGRAPHIC The Healthcare Social Shakeup From hospitals to individual health providers to patients, healthy (and health IT) discussions are impacting the social scene in a major way. As connections and shared knowledge grow, the potential for greater engagement is endless. Social media interaction is on the rise 87% of physicians ages and 65% of physicians ages are using social media. 1 72% of all Internet users are active social media users. 2 Hospitals utilizing social media grew from 79% in 2012 to 91% in % of physician practices have a Facebook page. 1 SOURCES: 1. HCSMMonitor.com, How Do Tech Savvy Physicians Use Health Technology and Social Media, January AfiaHealth.com, The Increasing Importance of Social Media in Healthcare, August Health Tech Report WINTER 2014

19 Healthcare professionals find social media useful for: Health and research discussion 60% of physicians say their most popular activity on social media is following what colleagues are sharing and discussing. 3 Patient care physicians now spend twice as much time using online resources as paper resources to make clinical decisions. 4 Job searching healthcare professionals use of social media for job searching purposes doubled from 2010 (21%) to 2013 (42%). 3 Social s growing impact is changing expectations 60% of doctors say social media improves the quality of care delivered to patients. 3 And more than ever, patients are using social to be more active participants in their own healthcare: 45.6% of U.S. adults searched for health information when using social media % rated the quality of care they received from a healthcare provider % asked for health advice. 5 SOURCES: 3. EmedCert.com, 8 Shocking Statistics That Show How Social Media Affects Healthcare, March Health.Ketchum.com, Health-E Minds Series: Healthcare Providers and Technology Top Statistics of 2014, April HCSMMonitor.com, Digital Healthcare Check-up (infographic), April 2014 FOR THE LATEST ON HEALTH I.T. TOPICS AND TRENDS, GET SOCIAL WITH CDW-Healthcare CDW.com/view WINTER 2014 Health Tech Report 19

20 MEANINGFUL INSIGHTS DYNAMIC DIGITAL TOOLS EMPOWERING PATIENTS AND PROVIDERS The digital patient is here to stay. Patients are using digital tools such as search engines, social media platforms, wearables and gamification to maintain their overall health and well-being. At the same time, providers are taking advantage of the very same tools to enhance care delivery and follow-up as well as to better communicate and connect with patients. More than one-third of Americans use social media to research health conditions. SOURCE: medcitynews.com, Healthcare in the Age of Dr. Google: The 2014 Digital Patient Journey, March Health Tech Report WINTER 2014

21 DIGITAL DRIVING PATIENT PROACTIVITY Online tools and mobile technology empower patients. From searching online for a physician, to tracking fitness goals through wearable technology, to learning about a chronic condition s treatment through game playing, patients are taking advantage of taking better care of themselves. Here s how: LEARN. Patients can research symptoms, nearby doctors, medications and treatment options as well as access information via useful portals. Being more informed means people can be more proactive about their health. SHARE. More and more people are sharing information about healthcare, including doctor reviews, personal experiences with illness and opinions on available therapies. Communities such as Patients Like Me encourage members to share their health experiences and foster a community with others who might have a similar condition. CONNECT. Patients can use social media to seek advice, search for information on the go, or consult with a physician (near or far) via their mobile devices for a virtual care visit. 86% of patients conduct a health-related search before scheduling a doctor s appointment. 90% of adults ages say they would trust medical information shared by others in their social networks. SOURCE: medcitynews.com, Healthcare in the Age of Dr. Google: The 2014 Digital Patient Journey, March 2014 TOOLS HELPING PROVIDERS CONNECT, BUILD TRUST WITH PATIENTS Patients aren t the only ones using digital and mobile technologies to maintain better health. Clinicians and providers not only see tremendous value in using these tools, but also make key decisions based on their findings. For example, 85% of doctors who watch professional videos online have taken action as a result, including searching for more information online (49%), sharing information with a patient (38%) and changing or making a decision about treatment for a patient (34%). Providers and clinicians are using digital tools to: EXPAND THEIR ROLES IN PATIENTS LIVES. Healthcare providers are interacting with patients beyond hospitals and physician offices; e.g., by monitoring patient progress or encouraging them to educate themselves on their conditions. ENHANCE COMMUNICATION. Transparent, real-time social media communication platforms can foster higher-level conversations. Providers can start educating patients earlier to encourage preventive, proactive self-care. IMPROVE PATIENT SATISFACTION. Providers can use patient evangelists to spread goodwill and build brand equity to help maintain trust and confidence. The gamification of healthcare Video games aren t just for kids. The idea of competing by using your physical body has created a new world of gaming that s gaining popularity as providers continue to look for creative ways to engage their patients. From smartphones to the doctor s office, gamification can help consumers become more involved with their own health and enable patients to become better at managing their own conditions. SOURCE: searchhealthit.techtarget.com, Gamification in Healthcare Isn t Just About Playing Games, April 2014 Digital tools are transforming our lives, including how our doctors care for us and how we care for ourselves. Are you an empowered digital patient? Learn more about how clinicians and patients are using digital tools and channels to connect and improve healthcare by visiting Industry View at CDW.com/view. WINTER 2014 Health Tech Report 21

22 PARTNER CORNER CLOUD: A Storage Solution for the Data Deluge By Tony Amaddio, Director of Healthcare Strategy, VMware The digital data deluge is real. The sheer amount of data continues to grow, and it s having an especially significant impact on healthcare. Today I m seeing two aspects really driving digital data growth for healthcare organizations first, the hard data that s in patient records stored in EMRs; second, image data that s either scanned, like insurance documents, patient signatures and notes, or medical images themselves from PACS, x-rays, CTs and MRIs. It s this last part I mention medical images that s driving the largest file size and data growth in healthcare. Organizations are finding the need to update storage systems yearly to keep up with capacity demands. And it s the first part I mention patient records that s driving the need to keep so many files for so long. Most healthcare entities must, in effect, keep patient records in some form forever, especially for legal and compliance reasons. This increases storage demand, particularly when disaster recovery is thrown into the mix. The big question becomes How do I store all this data in a way that keeps what I need easily accessible, while protecting all of it from threats and disasters? 22 Health Tech Report WINTER 2014

23 Considering the cloud The cloud can certainly help address storage overload. But some organizations are reluctant to try it because of accessibility concerns over tiered storage from a workflow standpoint. I hear, Will it take long to call up data stored in the cloud? The truth is that cloud can help maintain access to all vital records while helping prevent the need to upgrade storage so often. This is a significant benefit, given that one of the major pain points I hear from healthcare organizations is how much it costs to maintain their storage, and the upgrades and data relocation that come with it. Cloud can help save capital. Rather than spending budget on new storage, new servers, etc., organizations can leverage the cloud and pay only a set monthly fee for the service. Another benefit of a subscriptionbased cloud service is that it frees up your internal IT resources to work on more strategic organizational initiatives versus spending time moving files around on legacy systems. It s especially effective as part of a hybrid virtualization solution. Protecting data In addition to data access issues, organizations struggle with the idea of data protection in the cloud, and this delays their adoption. Most healthcare organizations still feel that in order to protect PHI and meet compliance requirements, they must file everything on premise. But that s not the case. Cloud providers today are willing to sign business associate agreements (BAAs), adhere to HIPAA compliance and even allow customers to tour their data centers. A slow evolution is occurring where there s a tipping point and healthcare organizations can see the value of cloud, and how that value now outweighs the risks. Cloud providers today can, and do, meet data protection requirements. Looking ahead to 2015 I m seeing the idea of cloud storage for healthcare becoming more accepted, especially as consumer adoption grows. There has been some success with medical image archiving in the cloud, and there will be some organizations that enter the healthcare cloud business specifically to address the storage growth challenge. In addition, I see continued growth in flash storage adoption, as it has proven to accelerate performance extremely well. Even just a year ago, flash storage was not widely accepted and was very expensive but neither is the case any longer. Now it s leveraged with a virtual SAN to help with VDI adoption and clinician access. I definitely see its uses continuing to expand next year. 3 KEY CONSIDERATIONS FOR DESIGNING AN ENTERPRISE STORAGE STRATEGY 1. Look beyond a single level of storage to today s modernized storage subsystems 2. Tier your storage based on application requirements 3. Include a virtualization strategy to create a private or hybrid cloud environment for better provisioning, including automation Tony Amaddio has 17 years of experience in healthcare, and is responsible for working with clients to address healthcare transformation by leveraging VMware s vision for the healthcare industry. Prior to that, he was the Healthcare Industry Sales Leader for IBM Healthcare and Life Sciences, bringing IBM s capabilities focused on healthcare reform such as ICD-10, analytics for accountable care, health information exchange (HIE), electronic medical records (EMR) infrastructure and integration, medical image archive and PACS infrastructure, wireless, mobility and RFID. WINTER 2014 Health Tech Report 23