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Category Archives: Digital

Healthcare M&A… Another present for the holidays?

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Healthcare Mergers and Acquisition

HLTH 2022 has come and gone and the technologies out there promise great things from healthcare in the future, but these technologies take time to mature and prove there efficacy. While there is hope for the future, the specter of decreased valuations and funding looms over an industry poised for change. There is one thing has been clear these past few months, consolidation is continuing, the holiday sales season is in full swing for the healthcare industry. While a large merger, or smaller consolidation may be an early holiday present for executives and investors, it creates challenges and headaches for IT teams and clinical staff. Tylenol certainly won’t help cure these woes.

Migrating different EHR systems is probably the largest hurdle, but there are also systems for pharmacy and radiology that can create a nightmare for IT teams that are already taxed maintaining existing systems. The additional burden can be overwhelming and cause systems to grind to a halt.

For clinical staff focused on seeing patients and taking care of their needs, the disruption to smooth operations can likewise be overwhelming. Did all the information transfer over? Has a patient’s medication allergy been missed? Has an existing medication been missed that could interact with a new one? These are concerns that need to addressed to put the clinical staff’s mind at ease and ensure that they can provide the best possible care to the patient’s.

Beyond patient safety concerns, there are also productivity concerns. Ineffective integration can lead to slowdowns in clinics, creating long wait times and dissatisfaction among staff and the patients who are waiting to be seen. Missing radiology reports, delays in diagnostic testing, lab results not showing, and prescriptions not getting routed properly are just some of the problems that can arise without proper integration and testing of systems.

Clinical staff are not IT experts and likely have little idea of what happens behind the scenes to ensure the smooth flow of information and data that enable safe and effective care. The clinical teams just want systems that work. When systems fail clinical staff safety can be compromised, staff frustration will grow as they resort to work-arounds. Most clinical staff have experienced this when EHRs and other systems were first rolled out, they are often jaded by these experiences that were disruptive and disconnected.

How do you ensure that transition to a new EHR will populate the data where it is expected? Will there be conflicting patient information? Will the images be migrated over to the right patient? Will prescriptions be sent to the pharmacy?

There is no end to the questions from clinicians about how it will work and what the experience will be after. How prepared are the teams behind the scenes to enable this migration? Do IT teams have the experience necessary to carry out this operation in an efficient and effective manner, after all, it’s not something they do every day.

There are many stresses associated with mergers and consolidation, IT systems should not be one of them. Tido Inc. can help handle these questions and work with IT teams to enable efficient and effective systems integration and migration. Check out Tido’s integration and migration packages.

An app a day keeps the doctor away.

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Healthcare applications on phone

Apps for digital health are proliferating throughout the healthcare ecosystem. Not just consumer facing, apps for clinical teams are growing as well. EHR companies have their own app stores, there’s the SMART App Gallery, and more apps are being created every day for use by healthcare professionals. As federal regulations start to kick in, the proliferation of digital apps for clinical use is only likely to increase. According to the ONC research, it shows more than 20% rise in the number of apps that integrate with certified electronic health records (EHRs) at end of 2020. The number of new clinical and administrative apps with SMART on FHIR integration is increasing at a very rapid rate.

There are many benefits of apps used by clinicians, better patient care and engagement, increased efficiencies, time management, records access, clinical decision support, education and training are just some of the tools available in app stores today. They have the potential to help clinical staff perform and manage their day better, improving patient care and staff satisfaction. It is widely reported that clinical staffing is becoming an increasing challenge to healthcare organizations, frustration with ineffective or difficult technology is just one of the issues, and it can be an important barrier to enabling staff to provide the best possible care to patients.

While there is a lot of news focused on the shortages of nurses and doctors, IT teams are also feeling pressure. Competition for healthcare IT personnel is increasing, new digital app developers, virtual first practices, and existing brick and mortars are just some of the employers seeking to hire experienced IT staff. Is there a plan to maximize the expertise and focus of these teams? What is the core competency of the healthcare organization’s IT team? Is it new app development and integration, or is it ensuring a safe and secure IT network and connectivity of existing physical infrastructure?

Much like patient care has become highly specialized, IT teams are becoming more focused to respond to increasing threats and internally connected equipment. Additional resources are often not allocated to allow IT teams to focus on adding to digital apps to the clinical toolbox. Doctors and clinical staff asking for more tools and integrations can often get lost in all the background noise, or are just told “we don’t have the bandwidth for that right now”, especially if its a small specialized department. Does the organization want to hire and train a professional team to assist in one-off choices or development?

Apps and other tools that do not meet the needs of clinical staff are a wasted use of increasingly scarce resources. Anyone working in Healthcare IT or Biomedical engineering can tell you, clinical staff are very creative when it comes using tools and equipment. Nurses and doctors will find all sorts of new uses for existing tools and infrastructure that was never envisioned by the creators, or it just won’t be used at all. But, they also have great ideas for new tools to help make their job easier and better. An organization seeking to harness this creative energy will likely need help managing the myriad of choices, or the creation of new tools.

How are new apps implemented? How are they supported? Maybe the Physical Therapy team has an idea that will save hours per day, how do we get that developed? Maybe there’s an existing app out there? If healthcare organizations are looking to increase employee engagement and efficiency, these are questions that will need to be answered moving forward. Whether a smaller physician practice, or a large multi-hospital system, retaining and maximizing existing staff resources will be key to success in the current healthcare environment. Apps and other tools can help improve efficiency and effectiveness, but getting them done right is just as important as getting them in the first place.

Tido can help healthcare organizations manage these questions. Check out Tido’s Digital Apps Strategy and Management and Custom Mobile and Web Applications solutions. See how Tido can help healthcare organizations implement existing tools, or help to harness the power and creativity already inside.

Is your digital front door open or closed?

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Healthcare digital applicatioons

According to a recent JD Power survey the majority of their respondents have accessed telehealth services and for many services it is the preferred method of interaction. 80% of their respondents report that telehealth is the preferred method for prescription refills. 51% of providers offer an online scheduling option according to a recent survey from Optum. It doesn’t stop there, the digital front door is the modern gateway for health systems to welcome patients.

Imagine walking into a hospital or doctors office and finding a void or blank wall. Sounds a little dystopian, but it is quite possible this can be the experience of customers coming to a website and trying to enter an appointment.

A digital front door is the modern access point for healthcare, and it’s more than just a front a door. Digital strategies require a seamless digital experience for all services offered by the organization. A seamless transition from the digital to the physical front door if needed. Consider all the options available for enhancing the digital experience beyond the front door.

Is the health system going to be offering online appointment scheduling?

Want to steer patients away from the ER and towards Urgent Care with chatbots and digital symptom checkers connected to the first available appointment for telehealth or virtual urgent care?

Customers and the Federal Government clamoring for price transparency, is your system connected to health insurance and billing to offer price estimates?

SMS options offer easy appointment reminders and many other opportunities for engagement, are the messages going through?

Are you offering SMS or online intake questions to speed registration? Are they feeding over to the EHR for the receptionist to see?

Few would argue that the customer’s digital health experience should be as seamless and reliable possible, providing an early opportunity to build engagement and trust. The digital front door may be the first experience a customer has with the organization, if the digital experience is not seamless, doubt starts to creep in about the rest of the experience. Systems that have disrupted connections can lead to a rocky experience for the customer. If they’ve already filled out the registration information online, why do they need to do it again?

High reliability organizations require high reliability systems. While most networks are stable and function as expected, even a small glitch can have large consequences and disrupt the customer relationship. If the patient and clinician experience is that none of these systems work, or do not work consistently, why should they keep using them? Customers place a lot of trust with clinical staff, if the staff doesn’t have faith in the systems, they will steer customers away from digital solutions, negating the time and investment spent on these solutions.

Are you pro-actively monitoring for network disruptions? Is the IT system meeting the expectation of clinicians and staff? Pro-active monitoring, reporting and resolution of disruptions builds faith in the systems that support clinical staff and customers.

Healthcare should be welcoming, are you slamming your digital front door in the face of customers? Check out Tido’s end to end monitoring and digital apps test automation solutions, ensure your digital front door leads to the services your customers want and need.

Hospitals are losing billions in 2022, how can IT improve ROI with existing infrastructure?

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healthcare financials

Hospital margins have been challenged by increases in labor expenses and shortages coupled with declining admissions and procedures. As financial pressures increase so too does the pressure on all departments to provide more value, more savings, and a greater ROI. Costs are rising faster than hospitals can raise revenues and prices.

There are a lot of solutions out there that offer promise of greater efficiencies for clinicians, new cloud based software that can provide greater insights into care practices and increased billing. Beyond the internal benefits, there are additional advances in hospital at home programs, and remote monitoring for chronic conditions. There is a learning curve to these systems, and for most it can often take months or years to realize the promised return.

How do you provide greater cost savings and efficiencies in care through existing IT networks and infrastructure? What can IT departments do now that doesn’t require education and training campaigns, massive investments in infrastructure or new systems?

In healthcare we know that early identification of problems is key to the most effective treatment. This is no different when it comes to IT systems ensuring safe and effective patient care.

How about monitoring the reliability of their current networks? All of these interconnected solutions require connected networks to function optimally and provide the necessary advances in patient safety and clinician efficiency. Buying the latest cloud-based AI solution to improve diagnosis, treatments, safety, and insurance denials, is only useful when the network is functioning.

Back in 2018 network reliability was identified as one of the risks to patient safety, what have systems done since then to ensure reliability? The pandemic likely radically changed or accelerated certain IT investments, moving up some upgrades or canceling others.

Calculating a basic ROI for pro-active network monitoring can be accomplished, just looking back at previous blog posts we can often see the time used by staff on this activity. If end-users are monitoring the network and checking for transmission of data and reports, their time is easily measured and value assigned. Are the IT departments measuring this time? Unlikely, but the unit managers can tell you how many hours each person spends on this.

  • When we considered the Cath Lab in a previous post, an RT or RN spends 3-5 hours every week checking feeds. Multiply this by every imaging area in the hospital, the numbers add up very quickly, at the most basic there may be 4 different imaging areas connected.
  • Pharmacy systems were also previously reviewed, how much time is spent reporting issues? It can be up to 20 minutes of a nurses time on the phone troubleshooting, likely with at least one additional call back.
  • How about remote monitoring programs? How much time will a nurse or physician spend on the phone with a patient trying to troubleshoot transmissions only to find that a connection was interrupted within the hospital’s own system?

Taking a look at the overall IT infrastructure the numbers can quickly add up throughout a hospital or health system. How often are feeds interrupted? Likely not that often, but even a single interruption after a monthly update can have significant ramifications to productivity when spread across an organization.

Those are the simple calculations to measure ROI, more difficult to measure are the ramifications to patient safety, staff satisfaction, and perhaps even future IT investment. If “nothing ever works around here” then there will be difficulty getting clinician buy-in to adopt the newest and best technologies.

Pro-active monitoring can enable early detection and warning. A simple message from IT can alert staff that IT is already aware of a problem and working on a resolution. Is IT optimizing the existing infrastructure to provide the best ROI?

Tido provides automated end to end monitoring solutions that will automatically alert your teams there is a disruption.

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.

 

 

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.