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Tag: digital transformation

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.

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!

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.

Have the holidays driven us crazy? Crazy about AI maybe!

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AI in Healthcare

Have you heard all the rage in AI? ChatGPT was making the rounds last few weeks as it was open to the public to play around with. The website is pretty cool, but it did take me a few days to get on it to play around due to traffic. For last week’s blog post I decided to hop on the bandwagon and see if Artificial Intelligence could replace a content writer’s Human Intelligence (insert sarcastic comment). Don’t tell the boss I did this though, AI doesn’t have bills to pay. Seriously though, the other blog post last week was written by ChatGPT.

Whether AI, ML, or other letter combination when it comes to advanced computing, there is no doubt that language processing will find it’s way more and more into healthcare. How do I know this? Because AI told me so, go read the other post!

Integrating AI effectively into the clinical space can help nursing in a variety of ways. It can be used to aggregate information on a single patient about their current visit and past visits to help guide interventions. It can also be used to effectively aggregate patient data from large populations to help study the effectiveness of new interventions vs past interventions.

Maybe we use the AI to write custom discharge instructions that are patient specific and relevant to their care? Starting off with a basic template this can be really powerful to drive better engagement and adherence to instructions. Current discharge instructions are often pages long with information dispersed throughout a large packet, providing a succinct summary can make it much easier for patients.

ChatGPT was initially devised as a chat bot, often rudimentary forms of chatbots can be found for patient intake for medical practices, urgent care, or to guide patients toward specialists. If we can better aggregate these sessions into a basic medical history or offer guidance toward potential diagnosis, then there can be significant time savings just on the nursing triage.

Pretty cool stuff that has the potential to really improve healthcare by helping the clinician and the patient alike.

With integrating any computer process automation there are several concerns that arise.

What is the reference source material? In the case of ChatGPT it uses large databases of published material, this can include unverified sources or opinion pieces. With any AI/ML, knowing the referenced source will be important.

Is the output relevant? AI can be confused, just like me, but we often use slang terms that AI may not recognize, this can lead to some weird output. The output definitely needs to be reviewed by professionals.  In the other post there are number of inaccuracies when it comes to the semantics, but they do matter.

How will it be integrated? Is it clear to patients when they are interacting with AI vs. a real human? If not it can be upsetting and cause patients to lose faith in the care system.

How much do we rely on AI? FDA regulations are starting to address this in terms of decision support, but how far AI goes into making patient care and treatment decisions that may fall into a gray area that can be difficult to navigate and ultimately requires a trained professional to adjudicate.

Tido Inc can help your organization answer these questions and help to integrate or develop applications so your organization can effectively leverage AI and ML to help improve clinical workflows and experience.  Now let’s see how much Holiday shopping has messed with my Amazon algorithms!

AI will revolutionize nursing! – Written by AI

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AI in Healthcare

As we continue to advance in the field of artificial intelligence (AI), it’s becoming increasingly clear that this technology has the potential to revolutionize the way we approach healthcare, including the field of nursing. In the next few years, we can expect to see AI being used in a wide range of applications, from improving the accuracy of medical diagnoses to helping nurses manage their workloads more effectively.

One of the most exciting ways that AI is set to transform nursing is through its ability to improve the accuracy of medical diagnoses. AI algorithms are capable of analyzing vast amounts of data, including medical images and test results, to identify patterns and make predictions about a patient’s condition. This can help nurses to make more accurate diagnoses, and it can also help to identify potential health problems before they become more serious.

In addition to improving diagnostic accuracy, AI can also be used to help nurses manage their workloads more effectively. By analyzing data on patient visits and treatment outcomes, AI algorithms can help to identify trends and patterns that can be used to improve the efficiency of healthcare delivery. This can help to reduce wait times and improve patient outcomes, while also allowing nurses to focus on the patients who need their help the most.

Another way that AI is set to transform nursing is through its ability to improve the effectiveness of certain treatments. AI algorithms can be used to analyze the data from clinical trials and other studies to identify the most effective treatments for specific conditions. This can help nurses to make more informed decisions about which treatments to prescribe to their patients, which can lead to better health outcomes.

Overall, the potential of AI to transform nursing is enormous. As we continue to develop and refine these technologies, we can expect to see a wide range of benefits for both patients and nurses. Whether it’s improving diagnostic accuracy, helping nurses manage their workloads, or identifying the most effective treatments for specific conditions, AI has the potential to make a huge impact on the field of nursing.

**This blog post written by AI, I was busy and had holiday shopping to do.  Here was the request:  “Write a 500 word blog post on how AI will transform nursing in the style of Johnathan Klaus”

Tido Inc. can help with digital strategy and custom applications!

What’s on your wish list for the Holidays?

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Holidays Wish List for Healthcare

For many healthcare organizations software is a strategic priority for the coming year. According to a research paper by Klas Research and Bain & Company, 40% of provider organizations have software as their top strategic priority, for 80% it’s in their top three. Even for those provider organizations that did not list software as a strategic priority, 95% expect to make new software purchases.

Why a focus on software? Labor shortages are well known, physicians and other clinical staff are pressed to do more with fewer staff. Software can help ease administrative burdens, improve billing accuracy and receipts, as well as help clinical staff provide better and more accurate care faster to more patients. From the patient satisfaction perspective, the right software can improve patient engagement and experience from the first contact, improving outcomes and health.

According to he research linked above, Revenue Cycle, Security, Patient intake/flow, Clinical Systems and Telehealth were the top 5 solutions that provider organizations want to focus on. There are a lot of offerings out there promising solutions to these problems and many others. In the clinical space the internet of things, artificial intelligence (AI) tools, machine learning (ML) tools have exploded in the past few years, and there are more companies offering more solutions every day.

Beyond physician staff, nursing and other clinical support staff look to software and digital tools to improve care and coordination. Clinical staff want tools that work and ease their burden, allowing more time to focus on the patient’s that need care and attention. Nurses have been more vocal about getting the right tools for patient care, opinion pieces like this one in Nursing Times are appearing in forums more and more frequently.

Finding the right software is the first part of the challenge, and for clinicians the evaluation of software may be the easiest part to answer. There are still a variety of other questions that need to be answered before implementing a new solution. As anyone involved in healthcare knows, it’s never as easy as downloading an app from the Google Play Store.

Is the solution going to solve your problem?

How will the software be implemented?

Is the infrastructure in place to support the software?

Does the implementation require EHR integration?

Will it actually work when the switch is flipped to go live?

With any integration and roll-out there will always be more questions that come up during the process. All of these questions will need to be answered to ensure seamless integration and roll out of software packages. Patient care should be a seamless journey, so should software integration and upgrades. IT systems should work just as hard as the clinical staff to provide a seamless experience for all users.

Since 2007 Tido Inc. has a history of partnering with healthcare organizations and hospitals to help answer these questions and many more. Contact Tido Inc. to talk about their integration and test automation packages to leverage your existing infrastructure and maximize the ROI on software investments.

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.