Wednesday, February 26, 2014

Social, Mobile, Analytics, and Cloud

On Monday at HIMSS, I signed my new book, Life as a Heathcare CIO for 300 folks at HIMSS.   During the rest of the day I met with numerous companies, leaders, and fellow IT professionals.   The theme I heard frequently was the need for care management/population health applications based on data acquisition, normalization, mining, and workflow.   Common characteristics of such applications included social networking features to gather data from patients/families/providers, a mobile component, a predictive analytics component, and cloud hosting.

I had no idea that the major consulting companies and analysts  have  already coined the SMAC acronym for this nexus of ideas (social, mobile, analytics, cloud)

As I walked the HIMSS floor, some of the care management applications I saw were real, developed in platforms like Salesforce and PegaSystems.   Others were “deployed” in Powerpoint, which is a powerful development language used by marketing departments to quickly author software :-)

As Accountable Care Organizations focus on continuous wellness rather than episodic sickness, the market for new tools will grow exponentially.    We have to be careful that social, mobile, analytics, and cloud (SMAC) does not become social, cloud, analytics and mobile (SCAM).

Here are few characteristics to look for in real care management/population health software

1.  Cohort identification - how can patients be enrolled in disease management and care management programs?  A drag and drop interface with concepts such as problems, medications, allergies, labs, and demographics should be available to specify cohort selection criteria.  Ideally, natural language processing will be available for cohort identification based on free text notes.

2.  Rules authoring - once cohorts are identified, there are likely to be protocols and guidelines that enumerate tasks to be done, gaps in care to be filled, and reminders to be sent to providers, payers, and patients.   The application should support user definable rules creation.

3.  Workflow - non-physician extenders are likely to use the application to ensure tasks are completed and to monitor patient progress.  Dashboards and automated "to do" lists should be available.

4.  Alerts  -  a change in patient status, based on patient self report or diagnostic data should result in an alert to the care manager, appointment scheduler and other care team members, triggering interventions such as home care visits.

5.  Patient Generated Data - often data about patient health status/outcomes are  best provided by
patients and families themselves.   Information such as activities of daily living, pain scores, mood, and medication compliance are not easily found in provider entered EHR data.    Interfaces to home care devices, mobile apps, and patient portals should be part of the care management suite.

Full featured care management software is a foundational strategic requirement for accountable care organizations.

Once we finish Meaningful Use Stage 2, the HIPAA Omnibus Rule, and ICD-10, we’re all likely to turn our attention to care management/population health as part of our Affordable Care Act implementation.


Medical Quack said...

I don't know if you caught this or not but Sean Nolan at HealthVault pointed out some problems with the ONC "goofing" as he said with the proposed changes in the use of Direct Secure Messaging. His quote:

"In short, the referenced Direct Edge Systems IG should not be part of any rulemaking at this time."

Here's his blog post...

Yes indeed we know the complexities are here and the ONC has a tough job to be able to ride the upcoming waves..very good video at HIMSS as well. I wrote a bit of a sarcastic post but it's true a short while back, "it's all about how the algorithms come to play with each other"...kind of like how markets work if you will, if they don't work, real world stuff doesn't work.

Anonymous said...

The characteristics you list for care management/population management and other SMAC solutions are so succinctly on point. My previous work at Partners Healthcare in Boston opened my eyes to just how needed software like you describe here would be hugely useful for clinician teams. I didn’t see any good solutions out there until I stumbled across my current employer.

I left Boston (narrowly escaping this year's winter for a warmer Nashville climate) to join an early-stage company and we’ve built exactly what you describe. We are implementing it with hospitals, clinics, private practices, ACOs, and specialty ACOs that recognize their need for a solution that handles clinician workflow, the continuum of care for patients, and healthcare payment reform.

I’d love to tell you more about us but I don’t want to come across as blatantly self-promotional. I've followed your writing for a number of years now and appreciate you and your family's consistency, life-balance and focus.

Medical Quack said...

I ran across this from Sean over at HealthVault speaking of the "Direct" project...and thought I would pass it along...

"I’m afraid ONC has goofed with the changes they’ve proposed regarding the use of Direct secure messaging in the just-released 2015 Voluntary Certification Criteria NPRM. I’ve submitted these comments to them directly (ha, get it?), but am also posting here in the hopes of generating more discussion around the issue. I think it’s pretty important."

"We’ve got a good thing going with Direct. The technology works, it’s being implemented widely, and the trust fabric is growing more complete every day. Please, let’s not mess it up now … we’re so close."

Here's the entire post..

It's been submitted to them, so just sending along:) The complexities just keep growing every direction we turn today.