In this episode of This Week in Health Tech, Vik and Jimmy discuss the implications of Oracle buying Cerner and what this means for the future of healthcare.
Here is what they discussed:
“Oracle is buying Cerner, and Cerner is the #2 EHR in healthcare. Big Tech has made a move in healthcare”
Some big news occurred recently within the healthcare space. Oracle made their biggest purchase yet and bought Cerner for $28.3 billion. This is huge news as Oracle is one of the world’s largest tech companies. With all of the products that Oracle brings, there is massive potential that Oracle can bring to healthcare. Vik spends some time talking about various products that Oracle has.
“Anytime there is a big acquisition like this, it sends a signal that there is huge potential in the healthcare market.”
Jimmy asks Vik why the stock price of Oracle dropped after purchasing Cerner. Stock price initially dropped because of the uncertainty of Big Tech getting involved with healthcare. Vik mentions examples such as Google and Microsoft trying their hand in healthcare and failing. The difference this time being that Oracle purchased an already well-known company in Cerner, so there might be some growing pains but over time they will figure out the best way to integrate Oracle and Cerner products.
“I think there is a huge opportunity with analytics and making sense of all the data.”
A huge opportunity for Oracle now that they have acquired Cerner is being able to use their analytics and AI to make sense of all the new data they will receive from Cerner. Cerner gains a big advantage over its competitors now that Oracle will be able to analyze the data. It presents the opportunity for figuring out more efficient health systems and realizing significant ROI. This can be a huge selling point for clients in choosing Cerner over its competitors.
“Do deals like this happen quickly or is it in talks for years?”
Jimmy brings up the point that the CEO of Cerner is relatively new, being CEO since August 2021. He asks Vik if the deal with Oracle was something that they new CEO did or if it was something that was in the talks for years. Vik speaks on why the new CEO would want to do the deal, such as Oracle already having the latest tech in place.
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In this episode of This Week in Health Tech, Vik and Jimmy are joined by Dr. Laura Purdy, CEO and Co-Founder of MD Integrations. The group discuss different approaches towards Telehealth and the future of digital healthcare.
Here is what they discussed:
“So how did you first get involved with telehealth?”
This episode starts with the introduction of Dr. Laura Purdy. Dr. Purdy started her medical career in the army, where she realized early on that telehealth will be the future for healthcare.
“So when did you realize that telehealth could be the future?”
Even before the pandemic Dr. Purdy realized the benefit and future applications telehealth could bring to provide better patient care. She discusses medical challenges see saw early in her career, such as scheduling and wait times, that could have been solved using telehealth.
“What was telehealth like before mainstream technology came around?”
Nowadays telehealth can be achieved using the multitude of digital apps such as Zoom, however prior to these technologies existing, it was done very differently. Dr. Purdy discusses how telehealth was achieved prior to these new technologies. She talks on challenges such as limited technology, system requirements, connection issues, and scheduling conflicts.
“Let’s jump into what MD Integrations does.”
MD Integrations is an all-in-one telehealth solution. Outsourcing telehealth needs, they provide a complete and flexible telehealth solution for companies who want to offer virtual healthcare. Dr. Purdy addresses issues she saw when it came to telehealth and how she created MD Integrations to help solve those issues, such as EMRs. EMRs are not designed for telehealth services, as they are still designed for brick and mortar providers.
“Where do you see telehealth going in the future? Are people preferring to use synchronous or asynchronous services?”
When the pandemic started, telehealth visits skyrocketed. However over the past 6 months, telehealth visits has dropped dramatically. Dr. Purdy explains that patients would rather use the asynchronous portion of telehealth over synchronous. Just as with other industries, people prefer not to have to attend a face to face visit. She then talks on where synchronous services are applicable, such as Pediatrics.
“Why are there so many different telehealth providers and what differentiates them from each other?”
Vik asks why there are so many niche telehealth companies springing up when there are telehealth giants such as Teledoc and Livingo. Dr. Purdy explains in detail the reason behind need for niche telehealth companies and why this market does not need to depend only on the telehealth giants.
“In terms of patient data, how do you get access to the data you need?”
The group then jumps in the integration challenges related to Telehealth and how to overcome challenge of access to data from health system, clinic, telehealth portals.
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In this episode of This Week in Health Tech, Vik and Jimmy are joined by Shelby Sanderford, CEO of Docpace. The trio discuss changes happening in healthcare, focusing on digital transformation and on-demand care.
Here is what they discussed:
“What is Docpace?”
Vik and Shelby start off the episode talking about how they each got into health tech. Shelby then discusses her company Docpace. Docpace is an A.I. system that increases the productivity of your office while keeping patients updated on appointment times including delays.
“In the past few years, what changes have you seen in the healthcare space?”
The group discuss how health tech has changed over the years. Shelby talks on the changes she’s seen, including health providers switching to electronic health records and applications. During the pandemic, the acceptance of these digital apps has really become a necessity. Vik agrees with Shelby, adding that there is an increased expectation from patients to use digital apps for personal healthcare.
“During the pandemic, what kept you going and believing in what you were doing?”
Shelby talks on how she comes to find problems and addresses them. By putting herself in patients shoes, she is able to realize what issues need to be fixed. The biggest motivation to keep going was realizing that a problem did exist and that there was a simple solution that could reduce patient wait times and waiting room challenges.
“Why can’t healthcare be on-demand?”
Vik poses the question and wonders why healthcare is so far behind other industries when it comes to on-demand services. Pre COVID, most patients and providers were okay with the status quo. However post COVID, the shift towards digital transformation has created expectations for patients when it comes to personal healthcare. Shelby adds that healthcare is shifting to a more proactive care approach over reactive care.
“What kind of challenges have you seen?”
As with all new technology, there can be several obstacles and challenges to overcome. Vik asks Shelby about some the initial challenges Docpace had to deal with. Shelby talks on challenges with EHR integration and having to first completely understand the systems in already in place. Another challenge the group discuss deals with making sure that healthcare providers across the board are on the same page. The fragmentation in healthcare is gradually going away, and FHIR APIs will play a crucial role in reducing fragmentation in healthcare.
“How do you use A.I. to address patients needs?”
Vik and Shelby discuss the pro’s and con’s of using A.I. in healthcare. A lot of times, A.I. functionality is a black box in the sense that you really don’t know what is going on behind the scenes. Shelby discusses how Docpace uses A.I. to improve the patient waiting room experience.
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In this episode of This Week in Health Tech, Vik and Jimmy talk about healthcare system applications and integration monitoring and how they play a big role in ensuring patient safety.
Here is what they discussed:
“This might surprise you, but in health systems today, around 95% of application issues are user identified.”
Vik talks on the current state of healthcare applications monitoring. He remarks that most issues dealing with healthcare systems are identified first by the user. This presents a large patient safety issue. Vik explains the issue in detail using an example, showing how reliance on manual intervention is risky and time-consuming, which could lead to adverse patient events.
“The time that it takes to find the issue, diagnose the issue, and fix the issue is unacceptable. I don’t know how we can continue just relying on manual intervention to find the issues.”
As the reliance on health systems and digital apps continues to increase, there needs to be a better way to track the data. Using the example from before, Vik explains how E2E (end-to-end) applications monitoring would have prevented the issue by detecting the exact location of the problem thus cutting down the issue diagnosis time in production environments.
“Along with identifying and flagging issues, we’ve also built a notification framework to alert the right person to deal with the issue.”
Tido’s E2E Applications Monitoring does not stop with flagging and diagnosing issues. Also included is a well defined notifications framework to alert the appropriate staff members of a system issue.
“If it ain’t broke, then why fix it?”
If health systems have not considered using E2E systems monitoring before, then why start not? Jimmy asks Vik why there is a need for such an implementation. Vik explains that EHR digital transformation, and other electronic health systems have only been implemented within the last 10-15 years. Even within that short amount of time, reliance on such systems has increased and continues to increase. Vik states that this is the right time to implement such a system.
“We are able to see what is going on between all these systems: where data is going, how its flowing, where there is a break, and how to flag it.”
Vik explains the architecture behind Tido’s E2E Applications Monitoring. With Tido’s E2E monitoring in place, there is significant ROI, as staff members do not need to spend time locating and diagnosing the issue. Patient outcome also greatly improves under the system.
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Tido Inc. is currently offering a promotion for 6 months free E2E Applications and Integration Monitoring. Visit https://tidoinc.com/contact-tido-inc/ and include E2E in your message to claim this deal. This promotion lasts until November 30, 2021.
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In the latest episode of This Week in Health Tech, Vik and Jimmy are joined by Dr. Brett Oliver, Chief Medical Information Office for Baptist Health Kentucky and Indiana. The trio discuss telehealth, eVisits, and how COVID has impacted digital transformation and cultural changes.
Here is what they discussed:
“Why is there a rise/spike in COVID cases?”
The group start off the episode discussing the rising number of COVID cases. Dr. Oliver indicates the main factors for this are due to Delta variant’s high transmission rate along with rural areas having low vaccination rates. Rural facilities are being overwhelmed with cases, and they cannot transfer patients to larger facilities because larger facilities are overwhelmed as well.
“Are you hearing any feedback or concerns from patients when it comes to virtual care?”
COVID has definitely accelerated the shift towards virtual care. Vik asks how patients/providers feel about the virtual care being provided now and what the future holds for virtual care. Dr. Oliver states that the feedback they have received so far has been very positive. Virtual care is a great advantage for patients that are unable to visit a location easily. Being able to provide care virtually reduces the burden put on patients. Prior to COVID, Baptist Health had already implement virtual care for urgent care and eVisits. When it comes to providing virtual care for the future, Dr. Oliver emphasizes improving asynchronous remote visits, convenience, safety and utilization.
“Do you think the cultural shift towards virtual care is too soon or is this the right time?”
As the digital transformation is accelerated due to COVID, Jimmy poses the question whether this is the right time or not for this shift. Vik states that this is the right time, however he also indicates that we could go from a very basic experience to a very overwhelming experience, where patients have to choose from hundreds of apps which could again defeat the purpose of digital transformation. Dr. Oliver agrees and talks about having a process in place so that patients know exactly which app to use. Another concern Dr. Oliver brings up is the issue with patient data and interoperability.
“Even today in 2021, interoperability is still a main topic”
Vik and Dr. Oliver discuss how interoperability is a main focus moving forward with digital transformation. For the patient, being able to access your own data directly is a huge step in providing better and more reliable healthcare. Dr. Oliver talks about gaps in interoperability when it comes to post-acute care, such as nursing homes or rehabilitation centers. They also discuss how CMS/ONC is pushing for better interoperability with Patient/Provider FHIR APIs.
“How do you feel about A.I. in terms of healthcare?”
Both Vik and Dr. Oliver give their thoughts and opinions on the future of A.I.. Vik agrees with Dr. Oliver that it is too soon to integrate A.I. in terms of providing better healthcare. The duo then discusses using A.I. in terms of analytics.
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In the latest episode of This Week in Health Tech, Vik and Jimmy review the 2021 HIMSS Conference that took place in Las Vegas, NV.
Here is what they discussed:
“The main topic of the conference revolved around interoperability and digital integration, something that TWITH has been talking about for months!”
Jimmy and Vik discuss what the hot topics were at the conference this year. Since the onset of the pandemic, the digital transformation within the industry has been drastic. As value-based care and personalized care become more valued, it makes sense for organizations to invest in the right strategies and technologies. Vik delves into these strategies, focusing on integration between EHR’s, hospitals, and new innovative applications to provide the best user experience for patients and providers.
“I attended this years conference digitally and the digital experience could have been better.”
This years HIMSS conference was held in-person as well as virtually. Attendees were down from the usual 50,000-60,000 to around 18,000 participants. Vik explains to Jimmy that there was a web and mobile app for virtual attendance but overall virtual experience could have been better with more online sessions and interactive sessions. He elaborates on the limited number of digital sessions and the difficulty in connecting to these digital sessions.
“The number one reason to attend is networking.”
Jimmy asks Vik what he looks most forward to in attending these types of conferences. For Vik, its all about networking. He explains that there is great value in being able to talk with industry peers about what new technologies are coming out and what the future holds. For CIO’s, the conference allows for insight into outside perspectives within the industry, such as finance, marketing, etc.
“Can you walk us through what the virtual experience was like?”
HIMSS offered a mobile app that listed all the digital events and also a digital directory to find individuals. Vik explains that while it was easy to locate certain individuals, being able to connect with them directly was difficult. Vik states that a round-table session would have been preferred. Another criticism Vik talks about is how not all events were available digitally.
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In the latest episode of This Week In Health Tech, Vik and Jimmy continue the series on Test Automation in the healthcare space, focusing on EMR and Health Systems Test Automation.
Here is what they discussed:
“What is so different about testing in EMRs as opposed to web based applications?”
Web based applications may or may not deal with patient data. However, EMRs and other hospital systems all have patient health information (PHI). Vik states that because patient data is involved, the impact of an EMR error or hospital system (PACS, Ambulatory, Laboratory, etc.) error is much higher as it could lead to critical adverse effects for patients.
“How are things typically done now in regards to testing?”
Changes are continuously being made to health systems, based on feedback from clinical staff for different workflows. When these changes are implemented, testing needs to be done in order to ensure bugs have not occurred. Vik explains in details the traditional approach for testing changes in a healthcare organization, which still relies heavily on manual testing and cross-department collaboration.
“If testing is so important, why do organizations place it on the back burner?”
Jimmy asks Vik why emphasis on testing is so low. The traditional manual testing approach involves feedback from hospital staff. Vik talks on how it is not the staff’s (Doctors, Nurses, etc.) top priority to test every aspect of a system, since they are dealing with their own job deadlines. Vik details how much time is needed to manually test properly and the staggering cost involved with such a process.
“What can be done better in the industry in terms of testing?”
Vik states that an organization cannot simply rely on manual testing. Using technology to automate testing will save an organization time and costs. Initially, once an assessment is done to capture all the different workflows and downstream systems used, the team can then develops test scripts. They also use integration framework since all the information to downstream systems going through the interfaces can be used to cross check information between EMR and downstream systems.
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The development cycle for a product/service involves many stages. From gathering initial design requirements up to after-launch maintenance, each stage plays a crucial role in providing a reliable product. Often times however, emphasis on testing gets under emphasized, especially in the healthcare industry because that web development / testing is not and should not be the focus of healthcare IT teams. Tido Inc. believes testing to be one of the most important steps in making sure the best product is available to consumers. As stated before by Vik Patel, COO of Tido Inc., “You can never have enough testing.”. This blog focuses on how we at Tido Inc. implement Automated Web Testing for healthcare organizations.
What is Automated Website Testing and why is it important?
Web Testing needs to be done on a when a change has been made to a webpage to make sure no bugs have occurred and that site quality is top notch. Traditionally, this is done with live manual testing. However as more content and the number of web pages grow, continuously live testing can become an almost impossible task to complete, not to mention regression testing. This is where automated testing comes into play. During the process of manually live testing an organizations’ web and mobile properties, we simultaneously write our test scripts, building our test suite along the way.
Why it’s important:
Time management greatly improved. Teams do not need to spend as much time live testing
Cost savings and significant ROI as fewer resources needed for testing web and mobile properties. On average it would take about 25,000 hours for manual testing of all web and mobile properties, change testing, and regression testing. This would amount to at-least $1.25 million dollars per year for cost of QA resources.
Once test suit has been built, its very easy to reuse suite for other projects
Feedback from running tests/regressions much quicker
In-depth test analytics and live monitoring of web and mobile properties
Higher test coverage
Different Types of Testing
Functionality Testing: testing all forms, web apps, and other functional features of a webpage
Compatibility Testing: testing to ensure webpage displays correctly across multitude of different devices
Performance Testing: testing to make sure webpages work under heavy loads. Gathering and testing data such as load time.
Cross-Browser Testing: testing to ensure webpage displays correctly across combination of different browsers.
Accessibility Testing: testing to ensure that the webpage is usable by people with disabilities
Usability Testing: testing all menus, buttons, and navigational links
Our Strategy
Understanding your clients needs and digging into their web analytics is the first step in figuring out what the priorities are. Along with understanding which sites are visited the most, web analytics provide crucial data such as which browser, device, platform, etc., are used the most. Once we establish our goals and priorities, we can begin the process of testing.
For our test suites, here are some of the tools and frameworks to assist us in the automation process:
Real devices cloud – Sauce Labs: this cloud-based continuous platform enables us to run our automated test suite across desktops, emulators, simulators and real devices. Along with Cross-Browser and Compatibility testing, Sauce Labs provides performance reports and real-time feedback of tests in progress.
Selenium and Appium: We incorporate both of these test automation frameworks in conjunction with Java using Eclipse IDE. Selenium is an open-source test automation tool used for desktop testing. The Selenium WebDriver allows for easy Cross-Browser/Platform testing. Appium is an open-source test automation tool suite used for mobile app testing. The Appium framework allows us to test an organizations website using a combination of different of mobile platforms and devices.
TestNG: An open-source automation testing framework for writing unit tests and generating test results. TestNG allows the execution of multiple tests in parallel.
Deque AXE: library to run web accessibility tests in Java projects with the Selenium automation tool.
What makes working with Sauce Labs great is they also provide a Live testing suite to handle Cross-browser, Mobile real, or Mobile virtual tests:
Using the Live Testing suite also provides a recorded video of your live testing session:
When it is time to automate our tests, we can always look back at our previously recorded live tests and base our scripts from there. For developing the automated test suite, we used the Page Object Model. Page Object Model is an object design pattern in Selenium that creates an Object Repository for web UI elements. Under this model, each webpage will have a corresponding Page Class. From these Page Classes, we can write and call our test methods.
Page Object Model
File Organization
Collecting and analyzing test results is done using Sauce Labs Insights:
Click here for more information about Tido’s test automation packages.
In this episode of This Week Health Tech, Vik and Jimmy talk on website test automation strategies for healthcare. This is the first part in a month long series focusing on Healthcare Web, Mobile, EHR Testing and Test Automation.
Here is what they discussed:
“What is test automation?”
Vik begins this episode by defining testing and the importance of test automation. Testing within the healthcare space is underrated, mainly because of low QA resources. Vik explains why test automation should become a top priority for healthcare providers.
“Who is in charge of managing the website, testing, etc.?”
Website management is a collaboration between departments, including IT and Marketing. Vik elaborates on how different departments have specific roles in terms of maintenance, updating, testing, etc.
“Let’s divide testing into 3 categories: Continuous, Automated, and Live”
Along all stages of development, continuous testing needs to be performed. When the test script development is finished, then those scripts can be used to automate testing against a combination of browsers/OS. Live testing must be done as well, to ensure a correctly working user experience.
“Once you have the Selenium automated test scripts written, you can fire them off anytime.”
Vik describes the process of using a testing framework, such as Selenium, to perform automated tests. Test scripts can be written in a multitude of languages (Java, Python, C#, etc.). By using a real cloud device, the automated scripts can be ran against hundreds of browser/device/OS combinations.
“Lets talk about testing techniques.”
Typical techniques include Functional, Compatibility, and Performance testing. Vik goes into detail on how each type relates to testing.
“The number of web and mobile applications will continue to grow.”
Vik makes the case again on the importance of testing for the future. The number of health apps will continue to grow, especially because of COVID. Continued testing for mobile apps is the only way to ensure that the consumer will receive a correctly working product.
Listen to the full episode:
Click below for more information regarding Tido’s test automation packages: Test Automation Packages
In the latest episode of This Week in Health Tech, Vik and Jimmy are joined by Mark Bowman, CIO of Commonwealth Healthcare Corporation.
Here is what they discussed:
“Digital change basically happened overnight..”
Mark discusses the impact COVID-19 had regarding the quick digital transformation needed. In particular, he discusses the rapid adoption of Telehealth.
“How have practitioners adjusted to Telehealth?”
Jimmy asks Mark how practitioners feel about telehealth and if they will continue with it post COVID-19.
The trio next elaborate on remote monitoring and in-hospital monitoring.
“The industry is clearly moving over to the cloud.”
The adoption of Cloud services is inevitable. Mark discusses his views on cloud adoption within the healthcare industry.
Vik indicates a hybrid approach, local + cloud, could be optimal.
“Have you noticed a work-culture change in response to virtual workspaces?”
Jimmy asks Mark how the change to virtual work has impacted the culture. Mark agrees that the culture has changed, and elaborates on the effects.
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