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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.

Berkshire Health Systems upgrades EHR to Meditech Expanse

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Berkshire Health System
On February 1, 2020, Berkshire Health Systems went live with a new Electronic Health Record system: Meditech Expanse. Berkshire Health System migrated from Meditech Client/Server to Meditech Expanse.
 
The upgrade was the culmination of a multifaceted project planned by the hospital and its’ implementation partners. Santa Rosa Consulting, Inc. was selected to lead the Berkshire Health Systems MEDITECH Expanse system implementation. “An implementation of this magnitude only occurs once every couple of decades for providers like Berkshire. We are thrilled to play an important part in its success,” said Mark Scruggs, executive vice president  at Santa Rosa. “Our vendor-neutral EHR expertise allowed us to present a number of viable options for Berkshire to select from, to meet their defined objectives. Ultimately, by deciding to upgrade to MEDITECH’s next generation platform, Expanse, the organization will be well positioned to meet the critical healthcare demands of lowering costs while improving the health of their patient population.”
 
Tido Inc. worked closely with their partner Santa Rosa Consulting, Inc. to lead the integration project for Berkshire Meditech Expanse migration. After doing an initial assessment of the integration environment, Tido’s team worked with the BHS Information Technology team to develop an integration plan tailored for Berkshire migration to Meditech Expanse. The detailed plan included suggested timeframes, resource allocations required, and responsibilities typically associated with successful implementation. One of the first steps our team did was to ensure that there was a stable integration framework in place by completing the upgrade of the Rhapsody integration engine; which would pave the way for thorough testing of all interfaces for Expanse migration.
 
Our team worked closely with Berkshire IT and departments on interface testing, validation, and user acceptance testing. We prepared a very clear go-live plan for all interfaces, and check-off list to ensure successful switch over for all interfaces. Tido’s team also prepared testing, validation, and management plan for all physician offices integrating with Berkshire Health System. According to Rachel, IT Manager, at Berkshire Health Systems: “Santa Rosa / Tido’s integration team were very thorough in their planning and implementation of interfaces for our Meditech Expanse Go Live. We had a very successful Expanse go live and we really appreciate their partnership.”
 
Our teams continue to work with Berkshire Health System to enhance physician office integration management and ways to extend EHR in the future with interoperability in the cloud with FHIR for Analytics, Artificial Intelligence, Mobile Apps, and provide better security for integration with external partners.
 
About Tido Inc.:
For more than a decade we have been supporting healthcare providers with technology integrations, cloud services, hospital intranets-websites, and custom mobile app development. TIDO inc. started back in 2007, since then we have partnered with a number of health providers in the US and Canada. Our business is healthcare, and we work hard to ensure that we understand the unique needs of healthcare organizations and provide technology solutions and services to meet those needs.
We will continue to invest and enhance our suite of products and services to allow our health partners to provide the best patient care in their communities.
For more information, visit https://www.tidoinc.com or call (888) 778-3021.
 
About Santa Rosa Consulting:
Santa Rosa Consulting provides management advisory and technical consulting services across the spectrum of vendor and IT products and systems. We empower better healthcare by designing, creating, staffing and sustaining IT solutions that deliver quantified value. Founded in 2008, Santa Rosa Consulting is managed by industry veterans with an average of 20 years of healthcare information technology experience. Santa Rosa is recognized for delivering world-class services and solutions and has received Modern Healthcare’s Best Places to Work in Healthcare award multiple years in a row. For more information, visit santarosaconsulting.com or call (866) 944-4772.
 
About Berkshire Health Systems:
Berkshire Health Systems is the region’s leading provider of comprehensive healthcare services. With award-winning programs, nationally-recognized physicians, world-class technology and a sincere commitment to the community, BHS is delivering the kind of advanced healthcare most commonly found in large metropolitan centers. For more information, visit www.berkshirehealthsystems.org

Create a Disaster Recovery and System Downtime Solution using AWS – Mirth Connect

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AWS disaster recovery
Providing continuity of care is a top priority for every healthcare organization. This includes the ability to access critical information during planned or unplanned downtime as a result of any number of possible reasons like infrastructure failures or malware attacks. Most health organizations have a suite of health information interfaces that provide all necessary patient information that can be utilized to provide a level of care needed, even during system downtimes.
For disaster recovery and system downtime solution, it is ideal to have a solution that is not relying on existing organization infrastructure. For example, a downtime solution will be of no help if it is also compromised along with all the other hospital systems because of a ransomware attack. To reduce risk, we recommend developing the solution in one of the highly trusted, standards and HIPAA compliant cloud infrastructure. In this example case, we are using Amazon Web Services, but the solution can also be implemented with Google Cloud or Microsoft Azure. AWS HIPAA Compliance whitepaper provides information necessary for processing and storing patient health information (PHI) that every health organization should read to get a good understanding of AWS HIPAA compliance.
Mirth Connect Overview
Using open source technologies on AWS, health organizations can build a system that transforms, stores, and processes HL7 and other data feeds. The solution can scale to meet the ever-increasing demands of modern medicine including the option for mobile apps to connect securely via AWS Health API. Open-source engine supported by NextGen that ingests and processes this data is called Mirth Connect. Mirth Connect is an open-source, cross-platform, bidirectional, healthcare integration engine. Running Mirth Connect on AWS provides the necessary scalability and elasticity to meet the current and future needs of healthcare organizations.
AWS Overview
To meet the needs of scalability and elasticity with the Mirth Connect application, in this example we used Amazon EC2 instances with Amazon EBS storage. This allows organizations to take advantage of AWS features such as Auto Scaling for instances. EBS allows you to deploy encrypted volumes, readily provision multiple block devices with varying sizes and throughput, and create snapshots for backups. Mirth Connect also requires a database backend that must be secure, highly available, and scalable. To meet these needs with a HIPAA-eligible AWS service, use Amazon RDS with MySQL. For easy access to critical patient data during downtime, implement JSON to facilitate easier document query and retrieval. With the core functionality of Mirth Connect as well as other open-source software offerings, you can convert each message type to JSON. The storage and retrieval of these converted messages require the use of a database. With the ever-updating standards and increases in data volume and complexity, it can be advantageous to use an easily scalable database engine. In this case, we used Amazon DynamoDB. DynamoDB is a fully managed, fast, and flexible NoSQL database service providing scalable and reliable low latency data access. For monitoring of the infrastructure and facilitate automation, we used Amazon CloudWatch. CloudWatch uses Mirth Connect metrics to enable AWS alerts and actions that ensure optimal system availability, efficiency, and responsiveness.
Conclusion
Health organizations should design solutions to account for planned and unplanned system downtimes. Organizations can take advantage of existing health information interfaces along with reliable and trusted partners like AWS and Mirth Connect to create a solution that provides continuity of care even during system downtimes.

Focus on the integration strategy. Don’t lose on patient care, workflow, and revenue!

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 healthcare Integration
Integrated health system plays a very important part in delivering top notch patient care, and sustaining healthcare system. There are numerous systems and solutions available in the market today to assist with healthcare integration. Most healthcare organizations have some type of solution in place to manage integration, though there are many health organizations that still have point to point interfaces in place.
 
Strategy Recognition
Even if a health system has some integration product in place does not always mean that the integration solution is providing the most meaningful and efficient information flow to improve patient care.
Mission of health systems in some form or the other is to deliver exceptional patient care and improve overall health of the population. Health systems focused on this end result of providing exceptional patient care should focus on improving organization’s communication and integration efficiency as integration brings together all systems within the health system and external partners.
Focusing on improving organization’s information flow requires recognition and commitment to developing an integration strategy.
Organizations that overlook need to develop and execute an integration strategy might lose on patient care, workflow, employee efficiency, and revenue.
 
What is successful integration?
Do we consider a connection and exchange of data between two systems successful integration? Maybe, if all you are focused on is the short term goal of exchange of data between the two systems.
But if you want assurance that your integration is successful and will meet your organizations’ short-term and long-term goals, then your integration should adhere to carefully planned integration strategy.
 
What is Integration Strategy?
Sorry to disappoint but there is no one-size-fits-all model for integration strategy and successful integration. Integration strategy follows basic principles for healthcare integration such as:
 
  • Focus on patient’s needs, engagement, and participation
  • Continued patient care across all points of access
  • Commitment to quality of services and continuous care improvement
  • Use of latest technologies for efficient communication-information flow and protect personal health information
  • Treatment and care interventions linked to clinical outcomes
  • Engage providers with integration of provider ambulatory clinics
Integration strategy is customized for each organization. Strategy includes assessment of current environment, performing a gap analysis of technology, resources, and processes. Integration strategy should clearly define strategic initiatives needed for the organization and a roadmap to achieve these initiatives.
 
Don’t lose on this opportunity
As per Gartner’s latest forecast, IT spending is going to reach $3.85 trillion in 2019, and communications counts for biggest IT spending. Investing in integration solutions and resources will continue to increase however organizations with a clear integration strategy will maximize potential of their investments in integration solutions and resources for successful continuum of care across all points of access and increase in patient satisfaction.