iSirona Blog — Solutions for Medical Device Integration

Health 2.0: Reinventing the Patient Record

by Jena Milan, General Manager, Data Management Solutions on March 20, 2013

Powerful new technologies and initiatives are changing the face of medicine, bringing us to the world of Health 2.0.

One emerging element of Health 2.0 is mobile health (or mHealth), the ability to use small sensors for collecting data anywhere and any time. The combination of medical device integration, mHealth, and ever-more powerful medical devices is bringing us to the point where patient records can be accurate and complete on an all-the-time, all-the-data basis.

This vision of truly complete, accurate data has led to a new and potent question: how will we deploy that data effectively? Ultimately the records are really for patients, but few patients can read or understand them. Worse, even when patients do understand what’s in the record, they don’t necessarily know what to do about it.

This problem—how can we help patients learn what to do, and then follow through on doing it—is as old as medicine itself. What’s new is our understanding of how to help patients through it. And to a surprising degree, the answer is in the way we present information. As Thomas Goetz said in his TEDMed talk on this topic, “Better health is not a science problem, it’s an information problem.”

How do you give information to patients in a way that doesn’t just inform them, but helps them make better decisions? The answer is to redesign the medical record. The Office of the National Coordinator for Health Information Technology (ONC) and the Veterans Administration (VA) recently held a contest to re-imagine the patient health record, starting with the VA’s Blue Button format. There were over 200 entries and $50,000 in prizes. The winning entries are light-years ahead of conventional patient records in terms of their readability, clarity and impact.

Rethinking the patient record is inspiring. It means the day is coming that the data you put in the patient record will not only be accurate and current, it will also be effective. That’s a great vision for Health 2.0.

To learn more, you can see Thomas Goetz’s TEDMed talk here and the winners of the ONC design contest here.

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Direct From HIMSS13

by Polly Mulford, VP of Experience Management on March 6, 2013

iSirona reps in orange, sharing info at the Interoperability Showcase

Show Floor, booth #6549

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See Us at the HIMSS13 Interoperability Showcase!

by Polly Mulford, VP of Experience Management on March 3, 2013

It’s Sunday night, and we’re all set to highlight connectivity at the Interoperability Showcase. Stop by and learn more!

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HIMSS13 Approaches; See You in The Big Easy!

by Peter Witonsky, President on March 1, 2013

Pack your bags and join us in New Orleans for the HIMSS13 Annual Conference and Exhibition! This year, you can catch up with us at the Interoperability Showcase, on the show floor at booth #6549, and in the Verizon booth.

On Monday morning, client hospital The Ohio State University Wexner Medical Center’s Kevin A. Jones, MS, and Lynn Kuehn, RN, MS, will discuss our solution in an Education Session called “Stage 7 Hospital Leverages Medical Device Integration for Safer Care.”

Can’t make it to The Big Easy this year? Follow us on Twitter to see what we’re seeing all throughout the conference.

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Health 2.0: The Future of Medicine

by Jena Milan, General Manager, Data Management Solutions on March 1, 2013

The future of medicine — Health 2.0, as some people call it — is quickly arriving. For a great overview, look at “The Robot Will See You Now” in the March issue of The Atlantic [or read it online, here]:

According to a growing number of observers, the next big thing to hit medical care will be new ways of accumulating, processing, and applying data…. a range of innovations, from new software to new devices, will transform the way all of us interact with the health-care system—making it easier for us to stay healthy and, when we do get sick, making it easier for medical professionals to treat us.

A potentially larger—and, in the short run, more consequential—data explosion involves the collection, transmission, and screening of relatively simple medical data on a much more frequent basis, enabling clinicians to make smarter, quicker decisions about their patients. The catalyst is a device most patients already have: the smartphone. Companies are developing, and in some cases already selling, sensors that attach to phones, to collect all sorts of biological data…. All of these devices would transmit information back to your provider of basic medical care, dumping data directly into an electronic medical record.

Harvey Fineberg, president of the Institute of Medicine and former dean of the Harvard School of Public Health, addressed the same topics in The New England Journal of Medicine, in March of last year [available online here]:

“The burgeoning availability of data [will] provide a foundation for new functionality in health IT, which is already beginning to show promise as a way of improving the efficiency and effectiveness of care.”

For more depth on the future of medicine, be sure to catch Eric Topol’s keynote address at HIMSS. Perhaps more than any other one person, Topol is shaping that future. He was named Doctor of the Decade by the Institute for Scientific Information; in 2012,Modern Healthcare ranked him as the most influential physician executive in the United States. He is a cardiologist at the Scripps Clinic in California, a professor of genomics at the Scripps Research Institute and one of the ten most cited researchers in medicine.

Topol’s recent book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, has been reviewed everywhere from The Wall Street Journal to Wired. In the next three blog posts, we’ll look at his main ideas.

In the mean time, don’t forget to drop by the iSirona booth (#6549) or the Interoperability Showcase to learn about how we help leverage patient data!

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The Future of Medical Device Interoperability

by Jena Milan, General Manager, Data Management Solutions on February 19, 2013

The current issue of Patient Safety & Quality Healthcare has an excellent article on the state of interoperability today, and where it needs to go. It’s a conversation with Julian Goldman, the medical director of biomedical engineering for Partners HealthCare System and director of the Program on Medical Device Interoperability at MGH and CIMIT (Center for Integration of Medicine and Innovative Technology). He is also the founder of the Medical Device “Plug-and-Play” (MD PnP) Interoperability Program.

Widespread, safe interoperability is a game changer in healthcare because it will affect so many different things, from the mundane and trivial, to sophisticated, advanced practice capabilities.

The need for interoperability will continue to increase with distributed care, remote care, and other innovative care models. Meanwhile, the scope of interoperability goes beyond medical devices to include health IT and the information needed in clinical workflow.

It all has to be integrated to provide sufficiently rich context to interpret data… [U]sing current sensors, actuators, and communication technologies in new ways, and lowering the barrier to introducing new technologies into the system of care will generate a road map for the future.

— Julian Goldman

Continually lowering those barriers is key to iSirona’s founding vision. In pursuit of that vision, we’ve built solutions that work with any vendor’s devices. Networked or standalone. Any CIS. No special-purpose hardware required. No changes to current workflow. Implementation times that are measured in weeks. Our aim throughout is to lower every barrier we come to, so hospitals can get on with the business of interoperability.

You can read the full Goldman interview here. Or better yet, catch his HIMSS presentation on “Medical Device Interoperability: The ‘Wicked HIT Problem’ of Our Generation.”

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Fixing the biggest cause of EHR safety issues

by Peter Witonsky, President on February 11, 2013

The Pennsylvania Patient Safety Authority has published one of the largest compilations of safety issues related to EHRs, giving an unprecedented look at their causes. The Authority is the only state agency collecting this volume of data about EHRs and analyzed 3,099 EHR-related events. [Fortunately, the vast majority (89%) were reported as ‘event, no harm.’ Ten percent were reported as unsafe conditions that did not result in a harmfulevent, and only 15 reports involved temporary harm to the patient.]

The study found that the most common cause was human error. A total of 1,950 of the events, or just under 65%, involved wrong inputs. The program director reported that:

Among the problems this study identified are data entry errors not caught by the system, data entered into wrong fields, misreading or misinterpreting displayed information and providers incorrectly accepting default values when entering orders.

When most people talk about the safety of health IT, they’re thinking of software bugs, hardware failures, or network problems. But our data show issues that are much more about the human-computer interface or the ways healthcare providers interact with the technology.

— Bill Marella, program director, Pennsylvania Patient Safety Authority

These kinds of problems are exactly what medical device integration (MDI) was created to solve. With MDI, data goes directly from the medical device to the chart. Since the clinician doesn’t have to copy the data or hand-key it, there are no wrong inputs: all the clinician needs to do is verify, make notes if needed, and authenticate.

As Meaningful Use incentives drive the growing adoption of EHR systems, it will become more and more important that those systems get their data from MDI and not from the keyboarding efforts of busy clinicians.

For more information about the EHR study, go to the December Pennsylvania Patient Safety Advisory article The Role of the Electronic Health Record in Patient Safety Events, on the Authority’s website at www.patientsafetyauthority.org.

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A Response to David Brooks’ Column on “Data-ism”

by Dave Dyell, CEO on February 8, 2013

Earlier this week, New York Times Op-Ed Columnist David Brooks ruminated on what he believes to be “the rising philosophy” of the day: data-ism, or the belief that data will help us do “remarkable things.”

Brooks openly admits that he is skeptical; he is no big believer in big data. “We tend to get carried away in our desire to reduce everything to the quantifiable,” Brooks writes. But Brooks also concedes in his column that data can do some things—like reveal previously unseen patterns—very well. For example, Brooks notes that analysis has revealed that the more confident a person, the less he or she will use the pronouns “I” or “me” when speaking. The illumination of this pattern was, naturally, of interest to a high-profile writer.

Like Brooks, I am interested in how an existing data set (like, say, the speeches of U.S. presidents) can reveal patterns. But I’d like to note that this sort of after-the-fact analysis differs greatly from real-time analysis.

As hospitals invest and move towards becoming “meaningful” users of data, they are moving towards a reality wherein data is not only leveraged retrospectively, but one in which data is leveraged in real time at the point of care. For example, when a patient’s data is analyzed in real time, behind-the-scenes algorithms can detect when that patient is trending towards a dangerous condition. When a pattern like this is detected in real time, clinicians can be alerted in real time—and that can save lives.

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Addressing the Top Challenges in Health Technology Management

by Dave Dyell, CEO on February 8, 2013

AAMI, the Association for the Advancement of Medical Instrumentation, recently released its annual survey of the top ten challenges in health technology management (HTM). One of those challenges—second only to managing devices—is how to integrate those devices into electronic health records (EHR) systems.

All indications are that device integration is not just a challenge today, but will become even more so. The number of devices is increasing rapidly, with the industry growing at 6-7% annually and projected to reach $300 billion by 2017. At the same time, integration is becoming more critical because of the growing adoption of EHRs.

Accenture reports that the United States is expected to leapfrog a number of countries in terms of hospital-based EMR adoption, reaching 62% by the end of 2013. This is partly due to the clear benefits of EMR systems, and partly due to Meaningful Use guidelines: physicians who either have not adopted EMR systems or cannot demonstrate meaningful use by 2015 will see their Medicare reimbursements reduced by 1%.

A further complication is a growing shortage of resources. “As hospitals, primary care physician offices and clinics around the world implement and improve EMR systems, the number of end users is expected to increase rapidly. This increase will lead to the need for a greater number of clinically trained IT resources to support EMR systems. The United States, Canada, Australia and England, among other nations, are expecting and planning for significant shortages of resources and appropriate training” [Accenture].

That has all the ingredients of a perfect storm: more devices, more EHRs to integrate them into, greater pressure to integrate and fewer resources to do it with. To cope with that storm, HMT departments will need good tools for easy, efficient integration.

You can read more about AAMI’s survey here: Top 10 Medical Device Challenges.

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Forbes Magazine Names iSirona One of America’s Most Promising Companies

by Dave Dyell, CEO on February 7, 2013

I’m honored to announce that iSirona has been identified as one of America’s most thriving, privately held businesses by Forbes Magazine.

Every year, Forbes Magazine investigates high-growth companies in order to identify companies with the greatest potential. Companies are ranked based on compelling business models, strong management teams, investment capital, market size, and strategic partners.

iSirona ranks 29th on this year’s list, alongside companies such as Anytime Fitness and popchips. We’re pleased, of course. What we’re really thrilled about, though, is why we were selected. Yes, we have the people and skills to run a good company. But a company can only succeed if it delivers something of real value to its customers. Our success as a company tells us that we’re doing what we set out to do: helping people in healthcare get the accurate, current data they need for making good clinical decisions.

You can see the complete list of America’s Most Promising Companies at http://www.forbes.com/most-promising-companies/list/.

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