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TownHall: AI Adoption, Risks, Operational Automation and Predictions

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Today on TownHall, Brett Oliver, Family Physician and Chief Medical Information Officer at Baptist Health talks with Vik Patel, Chief Operating Officer at Tido. As we navigate through the complexities and potentials of AI adoption within health systems, Vik challenges listeners to think critically about the current landscape.

How can AI not only enhance clinical applications but also streamline operational workflows in ways previously unimagined? And with the rapid evolution of AI technologies, what are the risks and considerations health systems must weigh to protect patient data and ensure the unbiased, accurate performance of AI models? This episode doesn’t just scratch the surface; it delves deep into the practicalities and futuristic possibilities of AI in improving patient care, operational efficiency, and the overall healthcare landscape.

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How to leverage your integration engine for seamless EHR Migration and reduce upgrade costs?

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Health System Integration

In the complex landscape of Electronic Health Record (EHR) migration, having a robust integration engine managed by an experienced integration team can be a game-changer for health systems. Integration engines like Cloverleaf, CorePoint, InterSystems, Mirth, Rhapsody, Jaguar, Qvera, and others play a pivotal role in streamlining data flows and connectivity. Here’s why taking advantage of these engines can significantly ease the challenges associated with transitioning to a new EHR and also reduce costs associated with other vendor contract updates.

1. Streamlined Connectivity Timelines:

  • Having an integration engine already connected to downstream systems means a head start in the migration process. For instance, if your current EHR is sending Admission, Discharge, Transfer (ADT) messages and Orders to a Cardiology system, the workflow with the future EHR will likely perform the similar functions. This continuity significantly reduces the time spent on establishing new connections, as the connections between integration engine and the downstream system are already in place.

2. Cost-Efficiency and Resource Optimization:

  • Integrating a new EHR is a resource-intensive process. Utilizing an existing integration engine not only saves time but also contributes to cost-efficiency. The ability to repurpose established connections minimizes the need for additional infrastructure setup, ultimately optimizing resources. Depending on the workflows, timelines, etc. it may not be necessary for the downstream system to create any new interfaces, since the engine could be leveraged to send test messages from the new EHR test environment and also the existing EHR test environment. This could help significantly reduce contract update costs with the downstream system vendors.

3. Consistency in Data Routing:

  • When migrating EHRs, one of the challenges is rewriting existing interfaces. However, with an integration engine, you have the advantage of maintaining consistency in data routing. For example, even though the new EHR might require testing interfaces, your integration team can leverage the existing connections in the engine. This means that ADTs and Orders from the new EHR’s test environment can be seamlessly routed within the engine, eliminating the need for establishing new VPN tunnels or ports.

4. Optimizing Interface Reuse:

  • Many EHR vendors may create new interfaces to accommodate the testing phase of the new system. However, having an integration engine allows for intelligent interface reuse. The engine allows your integration team to review existing interface modifications, mapping etc. and provides a head start for interfacing with the downstream system. Existing interfaces could be cloned and modified as needed based on the messages from the new EHR.

5. Flexibility in Testing Scenarios:

  • The versatility of integration engines enables your team to adapt to various testing scenarios. Whether the new EHR necessitates specific configurations or adjustments, the integration engine provides the flexibility to handle diverse requirements without compromising on connectivity. Combining test automation with the engine can help clinical and IT teams test all possible scenarios without needing to take up valuable time from clinical resources.

Conclusion:

In the intricate landscape of EHR migration, the role of integration engines cannot be overstated. By leveraging the connectivity already established through these engines, health systems can navigate the migration process with greater efficiency, reduced timelines, and minimized disruptions. As technology evolves, integration engines stand as invaluable assets, ensuring seamless transitions and continuity in healthcare data management.

For over 15 years Tido Inc. has been partnering with health systems for EHR migrations and integration management. If you have any questions or need assistance with your health system’s ehr conversion, contact us today. We are here to support you in navigating the challenges of EMR migration and ensuring a smooth transition for your organization.

Navigating Ambulatory EMR Data Conversion: A Step-by-Step Guide

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Physician EMR

Introduction:

Transitioning to a new Ambulatory Electronic Medical Records (EMR) system can be a complex yet essential process for healthcare providers looking to enhance efficiency, streamline workflows, and improve patient care. Ambulatory EMR data conversion requires careful planning and execution to ensure a seamless transition without compromising patient care. In this blog post, we’ll guide you through the crucial steps of this conversion process.

Step 1: Comprehensive Planning and Assessment

Before diving into the conversion process, create a detailed plan that outlines the scope, objectives, and timelines. Engage key stakeholders, including clinicians, IT personnel, and administrators, to gather insights and ensure a comprehensive understanding of the requirements. Identify the specific requirements of your healthcare organization, considering factors such as data volume, system compatibility, and workflow preferences. Identify potential challenges and develop contingency plans.

Step 2: Data Inventory

Take stock of your existing data. Identify the types of information stored in your current EMR system, including patient demographics, medical history, prescriptions, and any customized data fields. This inventory will inform the mapping and migration process in later steps.

Step 3: System / Vendor Selection

Choose a new ambulatory EMR system that aligns with your organization’s needs and goals. Consider factors such as user interface, scalability, interoperability, and vendor support. Ensure that the selected system complies with industry standards and regulations.

Step 4: Data Mapping

Create a detailed mapping of data elements from your existing EMR system to the new one. This involves defining how data will be transferred and ensuring that equivalent data fields exist in the new system. Pay attention to any variations in coding systems, data formats, or terminology.

Step 5: Data Extraction

Use specialized tools to extract data from your current EMR system. Ensure that the extraction process maintains data integrity and security. This step involves exporting patient records, clinical notes, lab results, and any other relevant information in a structured format.

Step 6: Data Transformation

Prepare the extracted data for migration by transforming it into a format compatible with the new EMR system. Address any inconsistencies, duplicate records, or discrepancies in data structure. This transformation ensures a smooth and accurate transition of information.

Step 7: Data Migration

Execute the actual data migration process. Depending on the size of your organization and the complexity of your data, this may be done in phases or as a complete migration. Monitor the process closely to identify and address any issues promptly.

Step 8: Testing

Conduct thorough testing of the new EMR system to ensure that data has been accurately and completely transferred. Test functionality, data retrieval, and interoperability with other systems. Engage end-users in the testing process to gather feedback and address any concerns.

Step 9: Training

Provide comprehensive training to staff members on the new ambulatory EMR system. Ensure that users are familiar with the system’s features, functionalities, and best practices. This step is crucial for a successful transition and optimal utilization of the new system.

Step 10: Go-Live and Post-Implementation Support

Implement the new ambulatory EMR system in a controlled manner. Monitor its performance closely during the initial days and weeks. Offer ongoing support to users, addressing any challenges that may arise. Gather feedback and make necessary adjustments to optimize system usage.

Conclusion:

Ambulatory EMR data conversion is a multifaceted process that requires careful planning, meticulous execution, and ongoing support. By following these steps, healthcare organizations can streamline the transition to a new EMR system, ultimately enhancing patient care and operational efficiency.

For over 15 years Tido Inc. has been partnering with health systems and physician practices for data conversions. If you have any questions or need assistance with your health system’s data conversion, contact us today. We are here to support you in navigating the challenges of EMR migration and ensuring a smooth transition for your organization.

 

Low visibility tech that has a high impact for clinical staff.

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Cath Lab Technology

How to avoid staff sentiment of “nothing works like it’s supposed to.”

Low visibility tech that fits so seamlessly into a workflow, we don’t know it’s there until it tells us it is.    Tech that actually saves clinical workers time and allows them to focus on patients, could it exist?

Absolutely.  There are so many systems healthcare is reliant upon, when they fail to connect, big problems arise that will have a big impact on clinical workers.  This can be such a problem that many clinical areas within hospitals will dedicate a person to check information is flowing where its supposed to.  They are not IT, they are patient care professionals taking time to check these systems because they know the problems that arise when patient information doesn’t flow.

Consider a Cardiac Catheterization Lab, the simplest lab might have 3 different systems, the most complex, maybe 10 or more.  A typical solution to checking systems within a lab:

  • Everyday, or every week, a Cath Technician or Nurse may spend 3 – 5 hours checking reports to make sure they went to the EHR, and images to make sure they went from the local system to the PACS/VNA/EHR/DICOM.  At best any interruption in transfer is caught before the patient leaves the procedure area, at worst, it is not caught until someone is looking for the results.
  • Once the interruption is caught a staff member will check operations on their end to make sure it wasn’t an issue with what they did.  Then they reach out to the IT help desk to report the problem.  IT will ask several questions and have the staff member perform checks manually to make sure everything was done correctly on the user end again.  
  • At this point the IT help desk will forward the ticket to another area or vendor if needed.  In a serial manner, the issue will get passed until the proper team or vendor is found that controls the part of the feed that was interrupted.

This is what happens during normal operating hours.  Most interruptions to connections occur when upgrades to one of the systems happen, most often during the night or weekends when staffing is lightest.  Cath labs have staff that are on call for emergencies, but not on site during those times.  If they are called in for an emergency they may discover the problem when they arrive and have a ‘network failure’ message on one of the systems, or it may not be discovered until after they have left the building and someone is looking for more information.  This will result in the physician or staff being called at home to provide the missing information.

Systems that don’t connect will inhibit the flow of patient information, and frustrate staff trying to provide patient care, this often leads to the sentiment “nothing works like it’s supposed to.” 

Low visibility tech that monitors these feeds can save staff time when things are operating normally, and can save frustration when its not by alerting the right people; often before the issue is even noticed by the user.

Imagine a Cath Lab solution with such a technology in place:

  • Cath Lab Technologist or Nurse is providing patient care, not checking different systems.
  • Feed from the imaging system is interrupted and a message alerts the appropriate IT team and/or Vendor as well as the Cath Lab.  In an ideal world this will be done on a hospital’s secure messaging platform so everyone can communicate a problem or resolution instantly.
  • All teams are checking for a problem on their end simultaneously.
  • Cath lab calls IT, confirms they have checked systems on their end, they are told that problem is known about and all teams are looking into it at the same time.
  • From experience we know that by the time the Cath Lab team finishes checking systems on their end, the other teams will have too.  The problem is often resolved by the time the Cath Lab is calling the help desk.

Since most interruptions occur during an upgrade, if the problem is found immediately, the IT team is notified immediately, likely before they are even finished with the upgrade and have left for the night.  

Implementing such a solution means you have freed up 3-5 hours per week of a highly trained patient care worker, and eliminated a major source of frustration for caregivers when systems don’t connect.  Low visibility tech that ensures smooth and hassle free operations for your staff, allowing them to focus on what really matters, the patient. 

Talk to Tido about their end to end monitoring packages to let your staff focus on their patient.

 

How to keep healthcare uninterrupted; staffing challenges

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healthcare applicationsAll health systems, no matter if they are small, medium, or large are dealing with increasing number of applications. The COVID-19 pandemic has accelerated digital transformation in every major sector, vastly increasing our reliance on technology to meet many of our daily needs. And healthcare is no exception! Our health systems have greatly expanded their digital footprint to better serve our patients, empowering them to perform routine tasks without leaving the comfort of their home—such as paying bills, requesting medication refills, and even receiving personal health updates digitally.

More than 30 percent of health systems are reporting that they can’t locate enough candidates to fill open positions, and all are feeling the effects of staffing shortages. Beyond recruiting, retention is even more difficult with the increase in turnover and employee burnout.

On top of this the applications that health system IT deals with are becoming increasingly complex. Most if not all applications whether it’s a desktop application, web, or mobile, integrate with each other to transfer information in real-time.  There are very few standalone applications in today’s integrated environment.

So we have increasing number of complex and integrated applications in a health system with fewer people to manage and support them. This presents a significant challenge for IT departments and can also impact patient care. Helpdesk ends up relying on end-users to report production application issues to start the process of diagnosing and resolving the issues. Reliance on manual identification and reporting causes significant delay in diagnosing and fixing issues. This interruption can impact patient safety and outcomes.

Currently, most healthcare organizations have basic monitoring in place for their digital assets, such as operating system errors and breaks in connectivity. However, typically there is no active end-to-end monitoring of the production environment that would catch issues in real-time and alert the appropriate staff proactively. To keep healthcare uninterrupted, we recommend using end-to-end monitoring of applications and interfaces in your production environment.

At Tido, we realized that there had to be a better way to proactively monitor applications and interfaces in production, to make IT staff aware of the issues immediately; before the end-users are even aware that there is an issue with the system. To address this ongoing problem, we have developed high-quality automated monitoring services for healthcare systems.

  • Tido’s monitoring framework uses Microsoft Azure Monitor to reduce reliance on manual reporting—helping to detect 95% of application and integration issues automatically in the production environment.
  • Tido’s end-to-end monitoring framework automates application, interfaces, and data checks in EHR and all downstream applications in the production environment: PACS, Pharmacy, LAB, Cardio, Ambulatory, and more.
  • Tido’s monitoring solution sends automated notifications to responsible parties and the IT help desk within seconds, alerting them about live application or interface issues to avoid unscheduled downtime and reduce patient safety issues.

Contact us to find out more about how your healthcare organization can subscribe to Tido’s end-to-end monitoring packages, to proactively maintain the quality of all the applications and interfaces in your digital health system and keep healthcare uninterrupted.

 

 

Tido’s Trailblazing Tech Bulletin – Issue #1 Digital Transformations

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health care applicationsIssue #1—Digital Transformations

April 20 2022

Hello everyone! We’re pleased to welcome you to the very first issue of Trailblazing Tech from Tido. 

From now on, you’ll receive exciting monthly updates that dig into cutting-edge health tech topics, such as: the future of digital health, innovative interoperability, mobile and web apps, automated monitoring services, and—of course—some juicy tidbits about what’s new at Tido.

So, from the bottom of our digital hearts, thank you for embarking on this journey with us. Wishing you all an amazing April, and a splendid spring season! And we hope you enjoy Tido’s insights on extraordinary technologies that are revolutionizing the healthcare industry.

 

End-users are actually superior to healthcare professionals at rooting out application and integration issues. Why are we passing the buck to them? We can do better!

As it turns out, 95% of integration issues in hospital applications are manually identified by end-users. On average, it takes 35 frustrating minutes for end-users to identify and report issues to the IT help desk—and a gruelling 55 minutes for staff members or vendors to initiate a fix for the issue. 

That’s why we’re working with healthcare teams to use Azure Monitor for automated system monitoring, transforming their digital services to drastically reduce reliance on manual reporting, while also significantly improving customer service. The positive feedback we’ve received is truly incredible!

 

Digital transformation is accelerating in healthcare, but don’t worry—you can keep up! How to provide the best user experience in web and mobile applications.

The COVID-19 pandemic has accelerated digital transformation in every major sector, vastly increasing our reliance on technology to meet many of our daily needs. And healthcare is no exception! 

Our health systems have greatly expanded their digital footprint to better serve our patients, empowering them to perform routine tasks without leaving the comfort of their home—such as paying bills, requesting medication refills, and even receiving personal health updates digitally.

But the process of fine-tuning the user experience has been—to put it mildly—quite complicated. To help other healthcare providers to navigate this important issue, Baptist Health’s team reveals how they’re using web and mobile test automation as a key part of their ongoing digital transformation.

 

The gift of health tech for your healthy ears! Check out this lively, illuminating new episode of our podcast: This Week in Health Tech.

In this jam-packed episode of This Week in Health Tech, Vik and Jimmy have an incredible chat with Dr. Brett Oliver (Chief Medical Information Officer, Baptist Health) to dive into several fascinating topics, such as the future of telehealth, digital transformation, interoperability, cultural change across the industry, and much more.

 

Global Health Tech Buzz:

  1. Chatbot Technology Still Has a Long Way to Go
  2. Meditech and Google Health to collaborate on clinical search in Expanse EHR 
  3. Top takeaways from HIMSS22: What CIOs need to know 

 

That’s all from Tido for now. Thanks for reading! Stay tuned next month for Issue. Subscribe Here.

Does your digital health system rely on end-users to find production application and integration issues?

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health care applications

As it turns out, 95% of integration issues in hospital applications are manually identified by end-users. On average, it takes 35 frustrating minutes for end-users to identify and report issues to the IT help desk—and a gruelling 55 minutes for staff members or vendors to initiate a fix for the issue. 

  • Currently, most healthcare organizations have basic monitoring in place for their digital assets, such as operating system errors and breaks in connectivity. However, typically there is no active end-to-end monitoring of the production environment that would alert the appropriate staff proactively. 
  • This means that healthcare staff only become aware of issues in digital systems when end-users take the time to file a report. 
  • Help desk workers then have to use the minimal information provided by the end-user to decipher which systems might be affected, and then try to contact the appropriate analyst for specific applications or integration programs—which can take long hours to fix, compromising the integrity of essential healthcare systems. 

The reliance on manual identification and reporting of issues causes considerable delays in diagnosing and fixing issues with digital health systems, which can have a significantly negative impact on patient safety and outcomes. 

At Tido, we realized that there had to be a better way to proactively monitor applications and interfaces in production, to make IT staff aware of the issues immediately; before the end-users are even aware that there is an issue with the system. To address this ongoing problem, we have developed high-quality automated monitoring services for healthcare systems.

  • Tido’s monitoring framework uses Microsoft Azure Monitor to reduce reliance on manual reporting—helping to detect 95% of application and integration issues automatically in the production environment. 
  • Tido’s end-to-end monitoring framework automates application, interfaces, and data checks in EHR and all downstream systems in the production environment: PACS, Pharmacy, LAB, Cardio, Ambulatory, and more. 
  • Tido’s monitoring solution sends automated notifications to responsible parties and the IT help desk within seconds, alerting them about live application or interface issues to avoid unscheduled downtime and reduce patient safety issues.

Contact us to find out more about how your healthcare organization can subscribe to Tido’s end-to-end monitoring packages, to proactively maintain the quality of all the applications and interfaces in your digital health system.

Changing role of risk management with expanding healthcare technologies and digital transformation

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Healthcare organizations identify and evaluate risks as a means to reduce injury to patients, staff members, and visitors within an organization. Traditionally risk management has focused on patient safety and the reduction of medical errors. But with the expanding role of healthcare technologies and expedited digital transformation because of the COVID-19 pandemic, healthcare risk management has become more complex over time.

In May of 2017, Moody’s Investor Services released a report highlighting the link between risk management and a hospital’s operating margins: “Maintaining high clinical quality will increasingly impact financial performance and reduce the risk of brand impairment as reimbursement moves away from a fee-for-service model and towards a greater emphasis on value and outcomes.”

For above reasons, hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive.

A medium or large hospital typically has anywhere from 500 to 800 health information interfaces between health systems for registration, orders, results, charges, etc. With the expanding technologies, there are increasing number of electronic systems used in various departments and specialties. These systems are either hosted internally or increasingly hosted in the cloud.

With increasing number of systems and in turn increasing number of interfaces between systems, it is becoming a risk to rely on manual reporting of system issues in production environment. It typically anywhere from 40-60 min to identify an issue in live environments and its’ completely reliant on users finding the issue and informing help desk to begin the process of diagnosing and fixing the issue on hand. Prolonged system issues in live environment can lead to potential adverse patient outcomes because of missing critical information.

Enterprise risk management strategy of an organization are considering using proactive automated live system checks and interfaces monitoring to reduce risk associated with increasing number of electronic systems and applications in healthcare.

Learn more about Tido’s End to End Systems Monitoring to automate live systems issues detection and significantly reduce time to diagnose and resolve potential patient safety issues.

 

 

Baptist Health adds test automation as part of their digital transformation to enhance user experience

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Tido integration and digital packages

The COVID-19 pandemic has accelerated digital transformation in every major sector, vastly increasing our reliance on technology to meet many of our daily needs. And healthcare is no exception! Our health systems have greatly expanded their digital footprint to better serve our patients, empowering them to perform routine tasks without leaving the comfort of their home—such as paying bills, requesting medication refills, and even receiving personal health updates digitally.

Headquartered in Louisville, Kentucky, Baptist Health has experienced tremendous growth in recent years, with significant increases in new digital properties and public-facing websites. To better manage these digital services, Baptist Health has selected Tido to plan and implement test automation for nine hospital websites and a newly created mobile app. 

  • Kevin Smith (Asst. VP, Digital Engagement) emphasizes how digital strategy and transformation will play a crucial role in enhanced patient outcomes, greater efficiency, and financial viability for healthcare organizations. 

  • Erik Helton (Manager of Digital Optimization) recognizes that it is critical for every mobile and web application to be thoroughly tested for functionality, compatibility, performance, accessibility, accuracy, compliance, and usability to provide an excellent experience for everyone and improve patient outcomes. 


  • Katie Jimenez (Director of Digital Strategy) has been an incredible ally in this partnership. Since Baptist Health invested in their automation strategy and implementation, Tido has been thorough in our support—testing applications at every stage of development and monitoring their performance post-launch.

 

What is “Automated Website Testing” and why is it Important?

Web-testing always needs to be performed when a change has been made to a webpage—to ensure no errors have occurred, and that the change was initiated by the company, instead of a bug or other issue. Traditionally, this process was done with live manual testing. However, as the number of pages grow on a website, continuous live-testing can become an impossibly arduous task to complete. 

This is where automated testing makes an enormous difference. Tido has developed an incredibly efficient protocol for optimizing this process. As we live-test websites and other digital assets, Tido simultaneously writes test scripts while building a robust test suite to completely automate the process—saving precious time and resources for healthcare organizations.

Why it’s important:

  • Improved time management, so teams don’t need to spend as much time live-testing. 
  • Cost savings for quality assurance (QA) resources.
  • Increased ROI, as fewer internal resources are needed for testing web and mobile properties. 
  • Efficiency of test suite reuse for other projects.
  • Faster feedback from running tests/regressions. 
  • Detailed test analytics and live monitoring of web and mobile properties.
  • Higher test coverage.

Different Types of Testing

  1. Functionality Testing: Testing all forms, web apps, and other functional features of a webpage.
  2. Compatibility Testing: Testing to ensure webpage displays correctly across a multitude of different devices.
  3. Performance Testing: Testing to make sure webpages work under heavy loads. Gathering and testing data such as load time.
  4. Cross-Browser Testing: Testing to ensure webpage displays correctly across a combination of different browsers.
  5. Accessibility Testing: Testing to ensure that the webpage is usable by people with disabilities.
  6. Usability Testing: Testing all menus, buttons, and navigational links.

 

Tido’s Test Automation Strategy 

Understanding our client’s needs and mining their web analytics is the first step in figuring out the priorities for each client. Along with understanding which sites are visited the most, web analytics provide crucial data—such as which browser, device, and platform are preferred by patients. Once we establish our goals and priorities, we can begin the process of testing.

For our test suites, some of the tools and frameworks that assist us in the automation process include:

  • 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, and 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 organization’s website using a combination of different 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: A library to run web accessibility tests in Java projects with the Selenium automation tool.

 

Tido’s Test Automation Services Makes Digital Transformation Easy!

Tido’s EHR and Digital Test Automation services provide end-to-end testing of all workflows, establishing the best user experience for your EHR, hospitals systems, web, and mobile applications. Contact us today for more information!

 

About Tido Inc.

Since 2007, Tido has partnered with many health systems, agencies, vendors in the US and Canada to provide top-of-the-line integration, digital, and test automation packages. 

Tido’s digital team consists of full stack mobile and web developers, test engineers, designers, business analysts, quality assurance analysts, and project managers. Our team uses cutting-edge technologies and the most up-to-date standards to develop high-quality mobile and web applications for healthcare organizations. We also place a high priority on accessibility for staff and patients, to provide best experience possible for all users. 

As stated simply by Vik Patel (COO, Tido) on This Week in Health Tech Podcast, “You can never have enough testing!”

 

About Baptist Health System

Founded in 1924, Baptist Health has been bringing advanced medical technology, modern facilities, and many of the region’s most prominent physicians and medical professionals to our communities for nearly a century. With nine hospitals, Baptist has more than 2,700 licensed beds.

Baptist Health has more than 300 points of care including outpatient facilities, which offer urgent care, occupational medicine, physical therapy, and diagnostics. Home care is also available in 39 counties in Kentucky, six counties in Illinois, and six counties in Southern Indiana. Our physician network of more than 3,000 employed and affiliated physicians continues to grow, as we endeavor to improve access to healthcare and enhance the health of Kentucky as a whole.