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Tag: Healthcare Systems

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.

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.

Winter is coming…

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Birds migrate south for better climates.  Is it time to start re-evaluating your EHR climate?

Well known among clinicians are the challenges with many EHR systems, troubling user interfaces, difficulty navigating screens, and the number of mouse clicks required for even the most mundane tasks. As different EHR systems improve and provide more user-friendly interfaces, the challenges associated with choosing the best system for patient care should not be insurmountable.

Staff have finally gotten used to the existing system, so why change? Just because the current system is what everyone is used to, does not necessarily mean it is the best choice.

Health systems and physician practices have more choices than ever for EHR systems. Cloud based systems allow great flexibility and decreased infrastructure costs, traditional licensed software systems can offer more customized security and storage options. Practices may outgrow one EHR and have a need to move on to a new one, maybe the price has become prohibitive, maybe the nature of the practice itself has changed. The reasons for changing the EHR can be numerous.

Physicians, nurses, techs, and whole practices have likely spent countless hours customizing interfaces, connecting numerous devices and apps, and reducing their reliance on fax machines. Choosing a new EHR, for whatever reason, should not be a step backwards.

How do you choose a new EHR to begin with?

How do you handle the data migration?

What about all the existing patient data?

What about all the clinical workflows?

Where do you even start?!

Larger health systems may have an army of IT specialists at their disposal to help answer these questions, but even for large systems a migration of this size is a challenge. Are there the right people in place to begin with? What does the current infrastructure look like, can it even support a new system? For smaller hospitals or independent practices all these questions can seem overwhelming.

In 2016 the ONC published a guide to selecting EHR vendors, while published six years ago, the information is still relevant. For clinical and patient care staff one of the most important questions to be answered is whether or not the patient’s information will be present on day one. All patient data and information should be readily available to provide the continuity of care that everyone expects. All equipment used to enable patient care should be connected and functioning from day one.

Anyone who has been through systems and EHR implementations in healthcare is likely aware of the challenges and pain points that can occur. No matter how much training and testing has been completed, on day one, there will be questions and something will be missed. Clinical staff want systems that just work, and if something is broken, they want it fixed quickly so they can focus on their patients.

If you’ve experienced the challenge of implementing an EHR system, the thought of migrating to a new one might give you nightmares. Don’t let data migration, testing, and support be a barrier to implementing the best system for clinical staff and patients. Tido Inc. can help answer many of these questions with advisory services and assist with EHR migration and post go-live support.

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.

Social Determinants of Health and Network Reliability… Is there a connection?

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Healthcare Virtual Visits

Are my cables crossed? Perhaps, but consider the different systems that can power payment and insurance verification.

For the majority of readers of this blog it is probably an inconvenience when insurance verification services are down, but for people with limited income, and little to no savings, this can be an insurmountable barrier to accessing healthcare.

Increasing the utilization and access to telehealth and virtual services is one of the goals of Healthy People 2030 to improve access and quality. While we have seen a proliferation of expanded virtual health options during Covid, there can still be barriers to accessing care beyond internet availability.

Virtual urgent care or virtual ER visits can vastly improve easy access to care with a connected smart phone to access these services. While this can still be a challenge for many, they are becoming far more ubiquitous and affordable than ever before. With a connected smart phone there is no need to take time off work, or travel to a physical location with an unknown wait time to seek care. Virtual visits can be powerful tools for those in society who are not economically stable, where each hour of pay is allocated to purchasing necessities.

Most virtual visits require upfront payment or insurance verification of coverage. This author’s recent experience to a virtual urgent care visit highlighted this. Due to a recent upgrade the health system’s insurance verification was unable to be completed, requiring a credit card and upfront payment of $70. I’m fortunate in that I have both readily available, but does everyone?

Submitting a claim to an insurance company is complicated, to put it mildly. It is highly unlikely this task could be completed easily on a smart phone. Factor in that reimbursement may not arrive before the credit card payment is due. Assuming the patient has access to a credit card, will they be able to pay that balance before reimbursement? If they have to wait until they receive reimbursement they are now subject to late fees and interest charges, which will quickly add up.

If the patient cannot pay the upfront costs, will they go somewhere else? Will they just delay care? Delaying care can lead to a downstream effect of worsening outcomes and greater expenses later on.

Studies regarding medical debt are focused on amounts greater than $250, like this study from Kaiser Family Foundation, and these large amounts can be devastating. But we also know from other studies that even small amounts of medical expenses can be enough to delay care or avoid care totally. Avoiding care can ultimately lead to more expenses and missed work later on. In the event care is paid for, what necessities may be skipped? Food? Rent payment? Vehicle Repairs? The downstream impacts can be significant.

Even as more American’s have been able to get health insurance, co-pays or up front payments can be still be a barrier to accessing the healthcare system. Automatic insurance verification is a good step toward reducing unnecessary up front payments, if it’s working. If it’s not working, it can be another barrier for those seeking healthcare.

Increasing access to care is a capability which many health systems are expanding. Once the resource is built, is it functioning as intended, or just creating another to barrier to care. Check out Tido’s end to end monitoring and digital apps test automation solutions. Ensure the most vulnerable customers are able to easily access high quality affordable care.

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.

B+ when transfusing blood.

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Blood Groups

Blood transfusions in hospitals are a common occurrence to treat a number of conditions and diseases, from traumatic events to sickle cell. They are becoming more and more common for a variety of conditions, it now a medical specialty called transfusion medicine. Blood must be matched, at a minimum by type (ABO compatibility) for emergencies, but as transfusions have become more common to treat other conditions, additional testing and matching will occur for various other antibodies. Transfusions are largely regarded as a last resort when other treatment methods have failed, and related critical events are rare, depending on source 0.2%-1%, but they are still common and necessary occurrences. Critical to the safety of transfusions is ensuring that right blood gets to the right patient.

Each blood component must be tracked to ensure that when a patient needs it, they are receiving blood that is compatible, from the blood type to different antibodies in the components. Information systems help ensure this safety by providing a means for tracking blood products, which go through multiple processing steps after donation and are often collected far from the recipient.

Once blood products arrive in the hospital, they will often undergo additional testing to further discriminate sub types and antibodies. Patients that have received multiple transfusions are more likely to have antibodies against certain bloods, increasing the risk of a transfusion, increasing the need for more checks. Within the hospitals ordering blood products follows a similar pathway to medication ordering and administration, which was discussed in last week’s blog.

Similar to pharmacies, blood banks (where the blood is stored and distributed) often have a dedicated system for testing and tracking blood products. These systems are connected to the hospitals EHRs for physician ordering, distribution, and finally administration by the nursing staff. At any point along the chain if a connection is broken there can be a safety consideration that is missed. Healthcare workers are extremely vigilant when ordering, dispensing, and administering blood products, each step along the way involves checks and double checks to ensure safety.  As complexity in matching grows, the risk for missing a critical element increases.  As a safety double check blood products will be electronically scanned at each step, including administration, to make sure the right blood is being administered.

As the utilization of blood products increases to treat more and more diseases and conditions, and more specific matching becomes ever more critical, there is always an increased likelihood that a break in one of these systems can cause a critical check or piece of information to be missed. Transfusion events are rare, but they do occur, and it is often because of an unknown on the patient side. Until a patient receives a transfusion, we may not know how they will react.

If a transfusion event does occur, there is a process that occurs to figure out why. Critical to this process is knowing what blood was administered, it’s components and sources, and why the patient had a reaction. All of this information is documented, not only in the EHR, but also in the blood bank systems, to ensure that the risk of future events can be minimized, not only for that patient, but for other patients as well.

Interconnected systems ensure the safety of the blood supply and the safe administration of life saving therapies for patients in need. Are we positive these systems are operating as they should be? Can we B+ that all critical information and safety checks are happening as expected?

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

Blood donation and transfusions remain safe and effective treatments to help those in need. For more information on donating blood, please visit the American Red Cross.

Changing role of risk management with expanding healthcare technologies and digital transformation

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Healthcare organizations identify and evaluate risks as a means to reduce injury to patients, staff members, and visitors within an organization. Traditionally risk management has focused on patient safety and the reduction of medical errors. But with the expanding role of healthcare technologies and expedited digital transformation because of the COVID-19 pandemic, healthcare risk management has become more complex over time.

In May of 2017, Moody’s Investor Services released a report highlighting the link between risk management and a hospital’s operating margins: “Maintaining high clinical quality will increasingly impact financial performance and reduce the risk of brand impairment as reimbursement moves away from a fee-for-service model and towards a greater emphasis on value and outcomes.”

For above reasons, hospitals and other healthcare systems are expanding their risk management programs from ones that are primarily reactive and promote patient safety and prevent legal exposure, to ones that are increasingly proactive.

A medium or large hospital typically has anywhere from 500 to 800 health information interfaces between health systems for registration, orders, results, charges, etc. With the expanding technologies, there are increasing number of electronic systems used in various departments and specialties. These systems are either hosted internally or increasingly hosted in the cloud.

With increasing number of systems and in turn increasing number of interfaces between systems, it is becoming a risk to rely on manual reporting of system issues in production environment. It typically anywhere from 40-60 min to identify an issue in live environments and its’ completely reliant on users finding the issue and informing help desk to begin the process of diagnosing and fixing the issue on hand. Prolonged system issues in live environment can lead to potential adverse patient outcomes because of missing critical information.

Enterprise risk management strategy of an organization are considering using proactive automated live system checks and interfaces monitoring to reduce risk associated with increasing number of electronic systems and applications in healthcare.

Learn more about Tido’s End to End Systems Monitoring to automate live systems issues detection and significantly reduce time to diagnose and resolve potential patient safety issues.