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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.

 

Get rid of avoidable re-admissions!

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Hospital Readmissions Monitoring

Did you see this headline last month in Healthcare IT News? RPM brings 30-day mortality rate to almost zero for heart bypass procedure. Remote patient monitoring (RPM) offers to extend the reach of care and allow clinical teams to respond faster to changing patient conditions and reduce re-admissions for chronic conditions and post-operative care. While the article references a single site for the results of this RPM program, there have been numerous other studies and reports citing the promising results of these types of programs. Perhaps not a total elimination, but significant reductions are achievable.

There are a variety of companies out there trying to capitalize on utilizing various forms of RPM to capture early changes in the physiologic status of patients. Apple Watch and afib detection/monitoring is probably the most widely known out there of late. But remote monitoring or in-home monitoring devices have been around for decades, with a variety of connections, from dial-up to wifi to cellular. In addition to companies offering remote monitoring devices, there are a variety of companies offering to do the remote monitoring, hiring clinical teams to monitor patient connections. Often these companies can offer the benefit of scale to manage a smaller group of patients that would otherwise be an overwhelming administrative burden.

So what’s the catch? We know there’s always a catch! Remote monitoring sounds like a simple thing to do, and by and large the technology and FDA approvals already exist to make it happen. But as with anything data-related in healthcare, the data flows are a big pain point.

More connected devices from one ecosystem to another. There’s a lot of those in healthcare. Adding another tech burden for clinical teams to trouble shoot and figure out what happened can quickly render an RPM program ineffective. Even the most savvy clinical team and 100% compliant patients can be undone by connections that aren’t talking.

Whether the decision is to outsource and RPM program or handle it in-house, connections need to be reliable to get the right data to the right person at the right time. Anything less can result in a patient heading to an ER or Urgent Care for something that could’ve, and should’ve, been handled in the comfort of their own home. Not only is this detrimental to the patient, but it can also have a negative impact on reimbursement.

Reliable feeds and early notification of problems can keep clinical teams operating smoothly, ensuring patients receive timely care and interventions. Not only does this keep your teams working for the health of your patients, but it also gives patients confidence that your systems are working just as effectively as your clinical teams keeping them healthy.

Automated applications and integration monitoring can help quickly identify and resolve issues to minimize any downtime impact. For over 10 years Tido Inc. has been partnering with health systems to help maximize their IT systems and quickly resolve issues as they arise, often before the end user even notices. Contact us today so we can talk about how we can help you keep your systems working for you clinical teams and patients.

Rise of the [Diagnostic] AI Machines!

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Radiologist reviewing diagnostic imaging

Are we ready to welcome our AI overlords into healthcare yet? Will we welcome a fully autonomous Dr. Crusher? We’re not likely ready to completely abandon our human healers, but there have been a variety of algorithms and machine learning applications that have been creeping their way into our clinical specialties for many years now. The first AI algorithm was approved by the FDA in 1995, in the beginning of 2023 there are 520. The specialty with the largest number? Radiology! Check out this article from HealthExec, it provides some more detail on the approval and advantages of AI in imaging.

Radiology, and similar specialties that utilize imaging, have long embraced computer systems to improve quality, productivity, and sharing. The complexity behind the scenes of these systems can be quite surprising. Once an image is captured it may still go through multiple systems just to be viewed, PAC Systems, VNA, Dicom viewers, the route is anything but direct. If we want to add another step in the process to have the image analyzed, we are faced with yet another connection.

In a previous blog post we pointed out the challenges that staff face when one of these systems aren’t communicating, these certainly impact our physicians as well. As we add more diagnostic solutions to aid our physicians in treating patients, we want to ensure that their time is actually spent doing what they are trained for. The average radiologist makes roughly $300,000 per year, if we assume that radiologist works 40 hours per week, that’s about $144 per hour.

What happens when the machines stop talking? Likely the radiologist calls the help desk… 5 minutes on hold ($12), they will take 3 minutes to explain the problem to the help desk person ($7.20), who will then transfer them to a specialist where they take another 5 minutes talking over the problem ($12). Helpdesk will then forward the issue to multiple analysts and integration team. At-least 2 different analysts getting pulled into diagnosing the issue. Typically, integration and system analysts make 90k-130k per year or on average $50 per hour. These 2 analysts will work on this issue for about 30min ($100) to diagnose the issue. $131.20 may not seem like a significant amount, but now that radiologist may not be reviewing images, may not be discussing treatments with patients, they may not be doing what they’ve been trained to do. If the radiologist is only 50% as productive without this solution, every hour of outage costs $132…  That’s just for one Radiologist. And typically system issues affect all users. So once you multiply the outage costs for all radiologists and other team members it really adds up fast. There can also be significant downstream impacts to other services waiting on imaging as well that become harder to calculate.

Moving beyond the frustration of the healthcare teams, there can be a detrimental impact to patient satisfaction as well. As results are delayed and the team gets backed up, every hour of delay adds to the patient’s anxiety and fear. Anxiety and fear are not feelings we want our patients to experience, we want them to have confidence in our teams and systems.

Automated applications and integration monitoring can help quickly resolve these problems. With early notifications to the right team in a timely manner, problems can be quickly resolved to minimize downtime impacts. For over 10 years Tido Inc. has been partnering with health systems to help maximize their IT systems and quickly resolve issues as they arise, often before the end user even notices. Contact us today and so we can talk about how we can help you keep your systems working for your clinical teams.

HIMSS 2023 – What did we take away?

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Tido Inc. at HIMSS Conference

From cars to healthcare, Vik and John chat about a variety of topics in the latest This Week in Health Tech podcast, but we focused on Vik’s experience from HIMSS. Check out the episode, we chatted a bit about AI generated automated responses to patient messages to physicians.

After our conversation an interesting study was released in JAMA about ChatGPT outperforming physicians on empathy responding to messages. There’s a lot to unpack there! There is some controversy surrounding the applicability of the study and how it was conducted, but it does raise interesting questions and possibilities for the future. It brings us back to the question about where to use technology in healthcare? How do we do this without unintended consequences or further alienating patients from healthcare? If patient’s know they are interacting with a computer, how does this impact engagement and adherence? What is the applicability in the healthcare environment?

Part of the promise of AI is to do what people do, only do it faster. Synthesize information into a coherent string of words delivered in a certain style. When we consider a response to a patient inquiry, LLMs have the ability to aggregate styles and deliver an empathetic response, they also have the luxury of time, being able to do it quickly. It can take about 15-30 seconds for these AI models to generate a response, it takes a clinician longer to craft a meaningful response.

If we allow AI to write a response, then we still need the human to read it over and make sure it is relevant, applicable, and appropriate. This assurance takes time from the clinician to read over the response, understand the patient question, the context, the patient background, and for some questions to dig a bit deeper and find out why the patient is asking a question.

Before we seek out another solution with many unknowns, we should start to look at what we have now and consider whether or now we are optimizing the current systems. Will a new AI solution really save time, or will it increase the burden with more back and forth? There are so many interconnected solutions out there, are we actually utilizing them, or are we working around them?

Making incremental, seemingly insignificant, improvements can have dramatic improvements to clinical efficiency. Reliable interconnected systems, making sure the information is flowing back and forth, and ensuring that any AI solutions that we will come to rely on actually have access to all the information, is just as essential now as it will be in the future. Disconnected systems can render AI just as inefficient as they render our clinical teams now.

Want to make sure your systems are talking to each other? Tido’s automated applications and integration monitoring can avoid many of the problems and inefficiencies that clinical teams, and AI, will experience when networks aren’t communicating and the information isn’t flowing smoothly. For over 10 years we’ve been partnering with health systems to ensure their getting the most from their current investments. Contact us today and see how we can work with you to optimize your technology investments.

Are your charges still floating in the clouds?

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Health System lost charges

How long did it take for those charges to drop? Was it halfway through the cycle? When did you find out they didn’t? Billing is seldom a simple process, with a variety of different systems required to communicate in order to get reports from the procedure to the billing department. Missing reports can prevent the charges from dropping, wreaking havoc on your revenue cycle.

Reconciliation can catch this, but how often is this done? Once a month? Once a week? 7 days and up to 4 weeks is way too long to find a problem. When you consider how long payment cycles can drag on, delaying them further can be problematic.

I’ve written often on the problems network breaks can cause on clinical teams. Broken networks can cause frustration for every department, not just the clinical teams. Billing is connected to almost every system in the hospital or practice, it’s even more vulnerable to these problems, relying on all these systems working to get an accurate picture of the supplies and time. If the report from Radiology didn’t cross over from the PACS to the VNA to the EHR, will it ever show as completed? If it shows as completed, is the report actually there and available to the billing department?

There are dozens of systems with dozens of different tech stacks, from reporting to supplies to pharmacy, getting a hand on each one to make sure they’re talking can be difficult. With most identification of issues coming from the end user, you often won’t know there’s a problem until its too late. Automated applications and integration monitoring can avoid many of these delays. Notifying the right teams early so problems can be addressed quickly, often before the end users even notice, can keep these teams working and the revenue cycling.

Tido Inc. can help you avoid these costly delays. How confident are we in this? Quite, confident. We have over 10 years of experience partnering with health systems and hospitals on their technology needs, from application monitoring to a variety of digital packages to support their operations.

Need more convincing? Contact us! We’re happy to talk about our processes and some of the results we’ve achieved. In fact, we’re willing to give you 3 months free to try it out, but there’s a catch… Only if you mention the song hinted at in this blog! Check out the next This Week in Health Tech podcast with Vik Patel and I’ll reveal the song!

We know convincing our colleagues in the finance office of the value of this service can be challenging just on the say-so of the vendor, so we’ll help you show the results with a free trial before you have to go and ask for a bigger slice of that pie.

Value Based Care Technology!

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Value Based Care

Effective chronic disease management is the backbone of value based care and will be increasingly important in the coming decades. Value Based Care (VBC) has been getting a lot of press lately, currently it still represents a small fraction of revenue. This will likely be changing in the coming years as insurers look to reduce total spend and Medicare contracts with private enterprise increasingly rely on better chronic disease management to reduce complications.

Effective chronic disease management requires higher patient engagement and more frequent monitoring. These things typically require more time from clinical staff. There are increasing options to utilize different technologies to implement these programs, alleviating the burden on clinical teams while allowing them better insights to patient’s condition and better information to more effectively and quickly respond to changes.

There are a myriad of companies and apps promising to revolutionize chronic disease management, but how do they integrate? Does the intervention need to be all that complicated? What works for your patient population? If what works for your patient population is not available on the market today, can you effectively integrate remote monitoring technologies into your current environment?

Why do nurses always ask so many questions?!

Who knows your population better than your team of clinicians that works with them every day? They know what works and what doesn’t, the challenges patients face, the challenges they face in their daily practice. Building a whole platform can be complicated, and sometimes unnecessary. Monitoring weight for your heart failure patients can be accomplished with a scale, does the scale need to be connected? With that there will be a thousand more questions about the ability of the patient to have a connected device, want to know all the troubles? Ask the clinical staff, they already know, they’re already helping patients address these challenges.

Clinical teams can help get a remote monitoring program off the ground fairly quickly. The challenge? Getting the integration right. Rather than setting up a blue tooth connected scale, maybe it’s more effective to just text the patient every day and ask their weight. Simple, easy reminder, intuitive to use, doesn’t require a lot of support to get and stay connected.

Sometimes there is a ready made app for that. There’s an app for everything! Integrating and managing these different applications can be cumbersome. It can be beyond the expertise of IT teams who are focused on support and physical infrastructure. Poorly executed integration and support can reflect poorly on the organization, from the patient perspective and the clinician’s.

Getting the workflows right is key to digital adoption and getting the most out of IT investments. Partnering with clinical teams to get this right is key to a successful program, making sure information is going to the right place, getting to the right people, and being addressed in a timely manner.

Tido Inc. can help with a variety of digital packages, services like digital app management, custom mobile and web applications and EHR integration. For over ten years we’ve been partnering with health systems and practices on digital strategy, and systems monitoring. As more pressure is put on revenues, leveraging the most out of the current IT infrastructure will pay bigger dividends down the road, contact us and we’re happy to see how we can work with you.

Harnessing that free energy in healthcare.

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healthcare free employee time

This isn’t about powering your data center with solar cells on the helipad. It’s actually about capturing the creativity and time that you’re already paying for. Clinical staff inside hospitals are powerhouses of innovation and creativity. Have you seen what a nurse can do with a roll of 3M transpore tape?!

I only half kid about the tape, but anyone who has tried to introduce new solutions and technology into a clinical workspace has undoubtedly been met with skepticism. Anyone who has gone back to see how those systems and tools are actually used, has undoubtedly been surprised to see how and if they were used.

Are those tablets waterproof? They make great trays for carrying medications and water.

Giving clinical staff back time to focus on their patients and get creative with solutions for systems, processes, and technology innovation can be invaluable. In a time when doctors, nurses and technologists are leaving the bedside and joining tech companies, it can be more important than ever to retain that staff and capture those ideas. Many of these ideas are not large scale changes to the macro environment, they are small and relatively simple ideas that make interactions and workflows easier that can lead to better engagement.

How do you give back time? When we think of the time wasted on inefficient processes, especially when it comes to inefficient IT systems, there is a large opportunity to free up time. In previous posts I’ve written about the inefficiency of reporting application and integration outages and how early notification can save clinical time.

How do you harness that “free” energy? Since you’re already paying for it, it’s not really free, maybe it’s more akin to installing a co-generation plant. When you alleviate the burden of reporting IT issues by clinical staff, they are free to focus on their patients, to address their patient’s needs, concerns, and monitor for their safety. Time and attention lead to fewer safety incidents and better outcomes. Beyond that when clinical staff have time to consider their workflows and systems interactions they will come up with better ideas.

Consider all the money spent on “solutions” and upgrades that do not yield expected results. When a new solution is proposed how much engagement are clinical staff able to give before a purchase? How much time and energy are they able to spend making the new solution work? How much thought are they able to give to iterating and improving EHR user interfaces and workflows? All of these things take time, and if they don’t have time, all these solutions will seldom achieve their full potential.

Leveraging IT assets to their fullest potential will improve the ROI, in addition to improving margins. For over 10 years Tido Inc. has been partnering with hospitals and healthcare organizations to leverage the most from their IT infrastructure. Automated applications and interfaces monitoring and alerts, application integration, and assisting with digital strategy. Contact us today to see how we can help capture some of that energy!

I wonder if solar panels on a helipad would work? I think I’ve found today’s rabbit hole!

Is there an orchard full of apples just outside the windows of the hospital?

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Have you ever switched from an Apple iPhone to a Samsung or other Google based phone, or vice versa? It looks familiar, but it’s just different enough to be confusing. I know… I’ve done it. Work issued iPhone, personal Samsung phone. I was able to turn my iPhone notification to vibrate when I first got it… For the next 5 years I could not turn any notification sound on. I’m not new to smart phones, but I’ve always had a Samsung, the IOS screen looks familiar, but it just doesn’t work the same.  I only used the work phone for texting and phone calls, everything else was my personal phone, good thing my scrubs had two pockets.

Websites and apps can experience similar issues with back-end functionality. With the patients, visitors and employees all having different smart-phones, ensuring a seamless end-user experience can be more important than ever. Developing a website or app for a Windows based system may not be able to viewed in the Apple ecosystem.

Everything from way-finding apps, employee intranet sites, public websites, to patient access apps all need to be customized to ensure an end-user experience that is accessible and usable. Imagine telling a patient “there’s an app for that!” only to have them frustrated when they can’t access the information they were directed to. It doesn’t provide a good experience for the patient that can negatively impact things as serious as missing important appointments, to just experiencing un-warranted stress when trying to get to an appointment. Is a patient going to rate you 5 stars if they can’t find the doctor?

Similarly for employees, frustrations can abound when apps are not optimized for different mobile devices. Apps for time and attendance, intranet sites for policies and procedures, are all often made accessible for employees to use on their mobile devices. Apps and sites that are not optimized for their device can frustrate staff trying to request a vacation, or trying to look up policies for titrating insulin drips.

Accessibility in the physical world is important for healthcare, it is just as important in the digital age to have accessibility online as well. Ramifications can be a minor inconvenience or a major frustration. More and more information resources are moved online to save paper and ensure the most up-to-date information is being used, having access is vital to smooth patient experience and care.

How do you test apps and mobile sites for compatibility against thousands of different versions of mobile devices? Ten thousand engineers typing on ten thousand phones for ten thousand years? That might work, or you might get a mobile friendly version of Shakespeare. Hope you have a good IT recruiter!

Automated testing at every stage of development can help ensure accessibility is maintained across desktops and mobile devices. For over 10 years Tido Inc has partnered with hospitals and health systems to provide automated mobile and web testing at every stage of development. Ensuring minimal issues on launch, and faster development times. Contact us today to see how we can help, from development of custom apps and intranet sites, we can extend your IT teams when you need.