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Newsday: Practical AI, Data Governance, and Tech modernization with Vik Patel and Sarah Richardson

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Vik Patel, COO at TIDO joins Sarah on This Week Health Newsday. Vik shares his journey from hospital IT to founding TIDO, discussing the nuanced challenges of integrating AI and the role of strong governance frameworks in avoiding unintended biases. Together, we tackle questions of strategic prioritization, from the intricacies of data migration and legacy archiving to the pressing need for reliable, responsive tech solutions in high-stakes clinical environments. Through the lens of real-world applications, the episode raises important considerations about balancing innovation with practicality in healthcare IT.

Key Points:

  • 04:09 The Importance of AI Governance in Healthcare
  • 07:27 Challenges and Solutions in Healthcare IT
  • 20:00 Practical AI Applications and Integration
  • 30:49 Conclusion and Final Thoughts

News articles:

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3 Steps to Better Prepare for the Retirement of Your Integration Engineer

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Healthcare Mergers and Acquisition

Our extensive experience managing integrations for various health systems has shown that it is quite common for organizations to depend heavily on one or two key engineers. When these engineers retire, it can pose significant challenges. As an IT director or CIO, it is crucial to prepare for this eventuality to ensure a smooth transition and minimize associated risks. Here are three steps to help you navigate this process effectively:

1. Planning for a Seamless Transition

a. Develop a Transition Plan:

  • Overlap Period: Plan for an overlap period where the retiring engineer works alongside new team members for 10-12 months. This period allows enough time for knowledge transfer and for new team members to encounter various interface issues. It also helps them learn organizational processes and build relationships with IT staff and other departments.
  • Engage an Integration Partner: Partner with a firm like Tido Inc., which provides integration solutions and has experienced integration engineers. Our engineers are familiar with every major EHR and integration engine, and they understand the importance of developing working relationships with IT and service departments like radiology and lab.

b. Assessment and Future State:

  • Comprehensive Assessment: Conduct a thorough assessment of the current integration environment. This allows the new team to learn the setup and interfaces and produces detailed documentation as a byproduct. This assessment should also include discussions with stakeholders to outline a future state and roadmap.
  • Enhance for Future: Tido’s integration assessments not only document the current state but also create a future vision that aligns with strategic initiatives and provides a roadmap for implementation.

2. Knowledge Transfer

a. Documentation and Guides:

  • Enhanced Documentation: During the transition period, ensure the current engineer works with the new team to update all system documentation, integration processes, and project details.
  • Create How-To Guides: Develop step-by-step guides for critical tasks and recurring issues. Tido’s team has templates to assist in creating comprehensive guides and manuals. We also use tools to make documentation easily searchable by any team member.

b. Training and Mentoring:

  • Knowledge Transfer Sessions: Organize training sessions where the retiring engineer spends dedicated time with the new team to transfer knowledge about different interfaces and special nuances.
  • Mentoring: Recognize that the retiring engineer has extensive knowledge of interfaces, organizational processes, and application workflows. Tido Inc. allows the retiring engineer to mentor and work closely with our team, who have been through similar transitions before.

3. Communication Plan

a. Internal Communication:

  • Inform Team Members: Clearly communicate the retirement plan and transition timeline to all relevant team members and stakeholders. This includes the IT team and other department managers and directors. Specially include communication about how to reach support for integration issues if this process will change. Tido’s team can share examples of previous communication plans and help draft these communications if needed.
  • Provide Updates: Keep the team informed about the progress of the transition and any changes to processes or responsibilities, especially support processes.

b. External Communication:

  • Notify Partners and Clients: If the retiring engineer has direct contact with external partners or clients, inform them of the change and introduce the new team.

Benefits of Partnering with Tido Inc.

  • Expertise: Tido’s team has over 15 years of experience providing integration management and support to health systems across North America.
  • Continuity: We ensure smooth, uninterrupted operations during transitions.
  • Scalability: Tido Inc. can scale services according to your needs, providing additional resources if required.
  • Cost-Effective: Our solutions are cost-effective, saving you the expense of hiring and training new personnel. You gain access to an experienced integration team rather than relying on a single individual.

By following these three steps and leveraging the expertise of Tido Inc., you can ensure a seamless transition, effective knowledge transfer, and clear communication, maintaining the integrity and efficiency of your integration systems. Need more information? Please contact us.

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.

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.

Freeing up staff to focus on patients… What can we learn from the ticker tape?

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Applications and Integration Monitoring - Ticker

Ticker tape was a revolutionary tool for moving information fast. Widely used by the financial industry for the quick transmittal of stock prices, sports reporters used it relay scores, and in many other industries for relaying information fast to people who didn’t necessarily know Morse code. Ever wonder where the 3-4 letter symbols for stocks and sports teams came from? How about the traditional 15 minute delay for financial information? Ticker tapes. Crazy right? Traditional ticker tapes went out with the 60’s (1960’s that is), but today we see “ticker tape” scrolls at the bottom of screens and on LED billboards.

Back to the question at hand… What can we learn from ticker tape? Getting information from the people that have it to the people that need in a timely manner can have a real improvement in operations, saving time and freeing up valuable manpower to handle other tasks.

Having a simple scroll at the bottom of the clinician’s screen showing important information can save time, and reduce frustration. Health systems have numerous moving parts and inter-connected technology. When something breaks, who reports it? The front line clinical staff. When an application / system (EHR, Pharmacy, Laboratory, PACS, Mobile, Web Applications) or interface fails , every clinician is impacted at the same time. Problem with the pharmacy network, blood bank, PACS? The front line staff calls the department first, once they are aware there is a problem, then a person from each department will call help desk. This is where the cascade begins.

In large units there will likely be 2 or 3 people calling the help desk before the word gets around to the rest of the unit. Multiply this time X number of units. The calls quickly overwhelm the most well-staffed help desks. What happens when an upgrade impacts more than one system? Gridlock, like a ticker tape parade in New York City.

Automated end-to-end applications and integration monitoring coupled with real information can be a powerful tool to alert front-line staff of application issues, alleviating the need of multiple calls to the help desk. Freeing front-line staff from calling the help desk, and associated wait time, allows them to keep their focus where it belongs, on the patients. Early awareness allows early response and early action, any clinician will tell you this is key to preventing larger health problems down the road. This is just as true for our IT systems.

Automated end-to-end applications and integration monitoring monitoring can alert IT staff to problems early, allowing faster response and resolution, before the calls to the help desk and online tickets quickly overwhelm departments. IT staff can focus on resolving the problem, not resolving the tickets.

Providing high quality patient care is the mission of any hospital or health system, the networks and systems in place are there to support this mission. At a time when health systems need to get the most out of their current FTEs, effectively utilizing technology to quickly relay important information saves time and money, but more importantly, it can help take one more burden off of our front-line clinical staff. For more than 10 years Tido Inc has been partnering with hospitals and health systems get the most out of their IT infrastructure, from advisory services, to systems integration, to Automated end-to-end applications and integration monitoring, we’re here to help extend the reach of your IT department. Want to know how?! Of course you do! Contact us today, we’re happy to connect see how we can help.

It’s winter, are your data pipes frozen?

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Frozen data pipes

Winter can be brutal on pipes, one little spot of missed insulation can cause an air leak that freezes your water pipes. Fortunately there are various systems that can alert you to problems, infrared cameras to detect leaks before there’s a problem, and water sensors to alert when there is a leak.  Imagine testing or monitoring our IT systems like we test and monitor our homes.  Check the systems before there is a problem, or alert us early to take action when there is a problem.  Healthcare is ever more reliant on data flows and pipes to connect the various systems and ensure smooth operation. But how are these problems recognized? Who reports them? Is there an early detection system to alert when there is a problem?

When we build a house it is important to ensure all the pipes are connected and all those insulation trouble spots are tightly sealed to prevent problems down the road when the new owners move in. Fortunately there are infrared cameras and blower door tests for homes to discover potential problem areas. When we’re building new solutions into healthcare networks there are countless points of failure that can occur when systems go live, and with the proliferation of new applications from patient monitoring to clinician web-based and mobile apps, the number of potential points of failure increase. Do we have an infrared camera or blower door test for the maze of networks in a healthcare facility? Testing every connection for a new system, upgrading systems, or implementing a new mobile app will quickly overwhelm even the most well-staffed IT department. Test automation can quickly, efficiently, and repeatedly test systems to ensure that all functionality will perform as expected and provide the end-user experience that is desired.

As much as we can prepare our home ahead of time, sometimes there are events outside of the home that will cause things to go awry. Problems with the electrical grid, gas network or even water distribution can lead to unexpected problems in the home and cause catastrophic leaks. Fortunately we also have tools to monitor the state of our home in the event a change on the outside causes a problem on the inside. Leak detectors can alert homeowners to potential problems, allowing quick action to prevent flooded basements and avoid the physical and emotional stress that comes with clean-up. Similarly in healthcare continuously monitoring networks and automatic notification of an issue can prevent stress on the end-user that relies on these systems for patient. Too often when networks go down, often due to an upgrade or issue beyond the walls of the facility, the end-user is the first to notice. It’s not just one end-user that’s impacted, it can be thousands, and they will start calling the help desk. Applications and Integration monitoring can sound an early alarm and allow IT teams to respond quickly to an event, end-users can be notified early, and IT teams can work quickly to minimize disruption and stress. IT teams should be aware of an IT issue before the end-user, network monitoring can facilitate this.

Back in 2021 research found that one-third of healthcare workers felt that technology contributed to emotional exhaustion, and were frustrated at least 3-5 days per week. In the past 2 years since the study was done, the number of applications and solutions has only increased, as has the technology burden on clinical staff. Clinical staff works to take care of the patient, they seek to prevent problems for patients before they occur, shouldn’t IT systems do the same?

Nobody wants to deal with frozen pipes or disconnected networks. For over 10 years Tido Inc has helped healthcare organizations save over $30 million with our integration and testing packages. Connect with us today and see how Tido Inc can partner with your teams to help build a tighter, better connected, healthcare house.

Healthcare technology in 2023 and beyond!

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Healthcare 2023

We’re not making definitive predictions here, but the rapid changes seen in healthcare have been remarkable these past years, and going into 2023 we can be certain there will be new challenges and opportunities. We do expect some themes to continue into 2023 and beyond.

Challenging margins for health systems and independent practices. As reimbursements to health care organizations has languished, the importance of ensuring the maximum returns on existing investments will be key. Over the past decade there have been massive investments in new systems and networks, every part of healthcare operations has been connected to a tech-enabled system. To realize the gains promised these networks need to be functional and reliable. Are your systems working like they’re supposed to? Or does the staff have the impression that ‘nothing works like it supposed to!’ Disconnected applications or unforeseen application issues can cause significant delays, frustrate staff, and waste valuable time. Applications and Integration monitoring can ensure those technology investments are pulling their weight and maximizing return, supporting clinical staff and powering seamless operations.

Healthcare worker burnout and moral injury are likely to be concerns into 2023 and beyond. Network reliability can be a source of frustration for clinicians, reliable systems are one component of providing a high quality experience, interfaces and tools that provide a better working environment will certainly be another. The proliferation of apps and tools to enhance user experience for both patient and clinician will likely continue, albeit at a slower rate than prior years. Having the best possible tools and apps can be a key strategy to keeping employees engaged and patient focused, whether it is a third party app or custom mobile and web applications, new solutions will continue to be front and center.

Over the past few years we have seen a massive shift in how healthcare is delivered, from a largely in-person environment toward more telehealth and virtual solutions than ever before. While there has been slowing in the market for many of these independent services, telehealth will continue to be a necessity for any health service moving forward. In a distributed clinical environment current systems may not be enough to have a fully functional clinic. EHRs optimized for in-person care may not work with distributed clinical staff, will other solutions be utilized? What portions of intake can be automated, how will those answers be populated into the EHR and get to right clinician at the right time? Is the right patient information populating over, medication history, allergies, radiology reports, the list can be daunting. If a new system is being implement over existing infrastructure ensuring adequate testing and integration will be key to enabling high quality patient care. Moving to a new EHR can pose even more challenges, migrating data is complex and requires a high degree of certainty. Managing these data sharing challenges will continue to be a priority as care becomes more distributed beyond a single physical site.

Maybe we’ll offer one prediction for 2023… Tido Inc. will be here and continue partnering with health systems and practices to face a challenging and changing technology landscape! Reach out today, we’re happy to work with you to face the healthcare challenges in this year, and beyond.