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Smartphones Are Driving Clinical Transformation

Session #81, February 12, 2019

Howard Landa MD, VP of Clinical Informatics, Sutter Health

Gregg Malkary, Managing Director, Spyglass Consulting Group

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Gregg Malkary, Managing Director, Spyglass Consulting Group

Has no real or apparent conflicts of interest to report.

Howard Landa MD, VP of Clinical Informatics, Sutter Health

Has no real or apparent conflicts of interest to report.

Conflict of Interest

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• Examine

– Limitations of existing clinical processes & tools

• Identify

– Why hospitals focused on enterprise-wide deployments

• Analyze

– How Smartphones are driving clinical transformation

• Explore

– Future Smartphone growth opportunities

Agenda

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• LO1: Define what smartphone-based unified communications is and how hospitals are using these solutions to achieve Quadruple Aim and potential ROI models to justify large scale investments

• LO2: Identify how smartphone-based communications are driving clinical transformation and can address mission- and patient-critical communications requirements of clinical and non-clinical mobile workers

• LO3: Recognize how to address and overcome the associated pitfalls in operationalizing a large-scale health system-wide deployment across different care settings

• LO4: Discuss future growth opportunities integrating solutions with evidence-based clinical pathways and care management programs including support of bedside documentation and clinical surveillance

• LO5: Recognize how hospitals can leverage an evidence-based approach using RTLS; intelligent rules-based engine and predictive analytics to reduce alert, alarm and notification fatigue at point of care

Learning Objectives

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• Conducted

– Nationwide end user market study

• Interviewed

– 400 US-based thought leaders

• Explored

– Clinical communications inefficiencies

– Mobile communications usage models

– Barriers for widespread adoption

• Footnote

Spyglass Consulting, Trend in Clinical Communications & Collaboration, 2018

Research Methodology

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Market Opportunity

• US Dept of Labor Statistics

– 950K physicians, 3M RNs, 5M allied professionals

• Joint Commission

– Root cause of 70% treatment delays & sentinel events

• Caused by breakdown in communications

• Hospital IT imperative

– Evaluate next generation communication solutions

• Footnotes

US Dept of Labor Statistics, 2019, https://www.bls.gov/

Joint Commission, Sentinel Event Alert and Infographic, Sept 2017

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Communications Problems

Communications

Overload

Lack of standardized

processes

Antiquated tools

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Enterprise-Wide Deployments

• Deployed

– 47% large-scale Smartphone deployments

• Identified

– 48% compelling ROI models

• Evaluating

– 62% mobile documentation tools

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Mobile EHR Messaging Tools

• Ease of support

• EHR integration

• Clinical workflow integration

• Attractive licensing

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Clinical Transformation

• Developed

– 73% mobile technology strategies

• Leveraged

– 68% middleware to orchestrate patient care

• Optimized

– 64% clinical workflow processes to support patient centered care models

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• Optimized

– 89% wireless network for mobile voice and data

• Deployed

– 73% MDM solutions to protect hospital assets and data

• Expanded

– 93% BYOD programs to support mobile workers

Infrastructure Upgrades

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Emerging Opportunities

• Structured clinical communications

• Real-time location services (RTLS)

• Real-time clinical surveillance

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HOWARD LANDA MDVP OF CLINICAL INFORMATICSSUTTER HEALTH

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Howard Landa, MD

• Pediatric GU/Clinical Informatics for > 20 years

• Vice President of Clinical Informatics

• Sutter Health

– 24 Acute Hospitals,

– 12000+ Physicians

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CMIO’s perspective

Clinical Collaboration at Scale

• Healthcare Technology in Evolution

• Current Clinical State

• IT Challenges

• Communication Integration

• Emerging opportunities

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Healthcare Technology in Evolution• EHR evolution

– Documentation (Electrified paper/word processor)

– Communication/Reference

– Information/Decision SupportClinical transformation

• Care/Reimbursement Evolution “In the day” vs. Today

Single physician Team based care

Always available Complex/Varying Schedules

LOS as needed Discharge ASAP

Pagers/Desk phone EHR, Texting, HIE Mobility

Simple Alerts Complex Alert Management

Limited tools set Complex and Evolving Tech…

But Smartphones are ubiquitous

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Smartphone-based communications are supporting current but provide opportunities to transformation practice

Insecure Texting/Tools

The (other) elephant in the room

Difficult to monitor and control

Efficient and straightforward

EHR

Standard for clinical information

Support of workflow and clinical process transformation

Mobility

Secure texting

Promises, Promises (Panaceas?)

CCC: Current clinical state

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Real Challenges for IT

• Security is another major challenge

• Organizational vs BYOD

– Bandwidth / Support / Security

– Human Resource issues

• How many is too many?

• Size does matter (with respect to use case)

• Benefits, Real and Imagined

– Communication/Information/Workflow

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CCC Integration

• Integration is how communication evolves to tools that support the quadruple aim.

• Use(full?) cases

– Stand alone (Communication, Reference)

– Interfaced (Information, Alerts)

– Integrated (Workflow tool)

– Assimilated (Camera, Voice Recognition, Adjunct)

• Organizational size and complexity are both challenges and opportunities

• Somewhere in the Middle(ware)

– Alarm Management Clinical Decision Support (CDS),

– Is secure chat + EHR mobile app Middleware?

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Emerging Opportunities• Healthcare Technology in

Evolution

• Current state

• IT Challenges

• Communication Integration

• Early adopter,

Mainstream or Laggard

• Strategy (HW/SW)

• Leveraging Size and

complexity challenges

New technology to support integrated clinical workflows,

surveillance, evidence-based pathways and bedside care

management:

AI/ML, RPM, PROM, NLP, “One Ring”

IOT: RTLS, Visual, Spatial (Gyro), Haptics

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Conclusions

• Hospital IT imperative

– Evaluate next generation comm solutions

• Hospital IT making significant investments

– Purchasing large quantities of Smartphones

– Deploying mobile unified communications

– Optimizing workflow processes

• Hospital IT addressing operational challenges

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Additional Information

Gregg Malkary, Managing Director

Spyglass Consulting Group(650) 575-9682

gmalkary@spyglass-consulting.com

www.spyglass-consulting.com

Howard Landa MD

VP Clinical Informatics

Sutter Healthlandah@sutterhealth.org