15 things health systems do today that will become obsolete due to technology

Healthcare today looks much different than it did 100 years ago.

Most physicians and clinicians don't make house calls anymore, and antibiotics allow people to recover from potentially fatal illnesses. Patients may have insurance to help them cover medical expenses and hospitals have advanced techniques to perform sterile surgery on patients.

But healthcare isn't done evolving, and technology will play a big role in how organizations evolve in the future. Here are 15 things that hospitals and health systems do today that won't be necessary in the future, according to healthcare executives.

1. Invest in supporting applications and duplicative technologies. The health IT space expanded rapidly over the past decade and many health systems purchase applications that require an infrastructure footprint that is on premise or refreshing equipment, but as those applications become more cloud-centric, they will likely become more reliable and cost-effective, said Hollywood, Fla.-based Memorial Healthcare System CIO Jeffrey Sturman.

"We also have many duplicative technologies, in particular around data and analytics," he said. "As we move to more streamlined and consistent data definitions, we will see the industry making better business and clinical decisions."

2. Manage their own data centers. Health systems that fully leverage the cloud and other modern technology won't have to build their own servers or manage their own data centers in the future. "Cloud computing allows us to stop managing our own data center infrastructure," said B.J. Moore, CIO of Renton, Wash.-based Providence. "We will stop using on-premises solutions and make use of Paas and Saas instead. This has implications in our costs, our solutions architecture and our ability to deliver faster, more secure and better user experiences across the board."

3. Rely on end users as the alert systems. In many organizations, CIOs learn about an issue when the frontline user notices it and raises it up the ladder. However, artificial intelligence and telemetry tools can preempt this in the future. "Resilient and self-healing systems will correct issues before they have any impact," said Mr. Moore. "Telemetry and AI tools will help us identify problems proactively when they do occur before impacting the end user."

4. Insert computers in the exam rooms. For more than a decade, physicians have felt the presence of the computer in their exam rooms getting between them and their patients. A physician constantly typing notes and staring at the computer can leave a sour taste in the patient's mouth and make it feel like healthcare is losing the human touch. In the near future, Vice President of IT at Houston Methodist Michelle Stansbury believes that will no longer be a problem.

"Computers in the physician office exam rooms will become obsolete," she said. "With voice technology and natural language processing, portable devices will be connected to the EHR and allow better interactions between clinicians and patients.

Rich Temple, vice president and CIO of Brown Mills, N.J.-based Deborah Heart and Lung Center agrees, and he sees ambient clinical intelligence in exam rooms taking it a step further as "physician documentation that documents itself." "What it does is it listens to the conversation between the doctor and the patient, and through artificial intelligence, picks up key phrases in the conversation and completes the documentation templates by itself for the physician. At the end of the exam, the physician can review the self-documented forms and make any additional comments or modifications as needed," he said.

5. Witness physician burnout. Just as artificial intelligence and ambient clinical intelligence will make the documentation process more efficient and eliminate the need for scribes, it will also allow the physician to connect further with the patient and possibly curb some burnout. "We won't be writing notes with keyboards, hiring scribes or even doing classical dictation years from now," said Joel Klein, MD, interim senior vice president and CIO of the University of Maryland Medical System in Baltimore, noting that although automation hasn't fully penetrated the healthcare industry, it has the potential to improve both business and clinical functions.

"Assuming our documentation-based billing survives, we'll eventually find ways to get accurate records created of our care using the ambient conversation between staff and patients," he said. "This could actually improve communication and will likely have a big positive impact on the burnout problem. [But] there's still a lot of unanswered questions about how this will work and the cost."

6. Maintain dual manual data entry between systems. The healthcare industry is barreling toward interoperability to make care more efficient and effective. The current lack of interoperability is an ongoing challenge for healthcare organizations, including large physician groups, that need a data integration strategy. Paramjit "Romi" Chopra, MD, chairman, founder and CEO of MIMIT Health, a nine-location physician specialty group in the Chicago area, said his group partnered with Bridge Connector to develop their data integration strategy and uses Salesforce as well.

"When coupled with an integration solution connecting our systems more quickly and cost-effectively, we have been able to eliminate over two hours of dual, manual entry between systems per patient per day, not to mention at least 30 percent more efficiency with our bottom line," he said.

7. Ask "what should I do next?" Most physicians and nurses are constantly thinking about their next task, often prioritizing based on their proximity to the task. However, that doesn't necessarily maximize the clinician's resources and time based on institutional need. It may be better for the clinician to stop and re-evaluate a patient on the other side of the hospital than to complete a more menial, yet necessary, task.

"We already have risk-calculation and outcome prediction systems that highlight developing situations that need someone's attention; this just takes that idea a step further," says Dr. Klein. "We have all the data to help make those suggestions, but we have to put it together in real time and with a great user interface to create a staff 'air traffic control' system that guides us to the next highest yield activity."

8. Examine the patient's entire medical history, particularly around molecular testing and results. Artificial intelligence has the potential to make it easier for physicians to determine the right treatment pathway for patients, and in some cases leverage precision medicine. Pat A. Basu, MD, president and CEO of Boca Raton, Fla.-based Cancer Treatment Centers of America, points to oncology patients as a key example of how the treatment process could become more efficient using these tools. "The patient's molecular profile and clinical information could be analyzed and integrated into their electronic health records to support a physician in swiftly making a treatment recommendation that also considers many factors specific to the individual patient, including clinical history, comorbidities, and molecular analysis of the tumor and germline," he said.

As a result, physicians would not have to examine the patient's entire medical history to see whether they have had a heart attack, diabetes or other types of conditions. It would also eliminate the need to request the patient's molecular test results and then consult with other colleagues about the molecular test report.

9. Employ high fall risk sitters. Many hospitals and healthcare organizations hire retired healthcare professionals to sit in rooms with patients that have a high fall risk to make sure they don't hurt themselves. The room sitters are helpful, but costly and hard to staff on short notice. However, advancement in video surveillance and analytics can allow for remote monitoring, said Sean Owens, director of public safety technology and non-acute care at Lee Health in Fort Myers, Fla. The system partners with Axis Communications to monitor high-fall risk patients remotely and simultaneously, which eliminated the need to have multiple healthcare professionals available to sit with these patients.

"It also allows us to provide the same level of care for patients who might be borderline fall-risk patients, but don't meet the clinical requirements for an in-room sitter," Mr. Owens said. "Once we incorporated cameras, we saw a reduction in falls and an improvement in overall efficiency. Over the next few years, I think we will see less healthcare providers using 'sitters' and more opting to use in-room video surveillance to monitor patients."

10. Ignore hand hygiene mistakes. Randy Davis, CIO of CGH Medical Center in Sterling, Ill., believes healthcare organizations may be in denial about poor hand hygiene practices of their providers. "I believe location tracking and the tie into hand washing stations, along with solid evidence of their benefit, will finally compel all hospitals to quit being in denial about their true hand washing stats," he said. "All will be compelled to implement systems to ensure compliance with the most basic expectation patients should have of us."

11. Travel long distances for specialty care. Telehealth will remove the geographic barriers that some patients face to accessing high-quality specialty care. Oncology is a great example, as patients from across the country with a cancer diagnosis can now use telehealth to see specialists outside of their region instead of making lengthy car trips to see them in person.

"The possibilities for [telehealth's] positive impact on patients are limitless," said Dr. Basu. "In the future, this advancement will allow even more patients to receive care in the comfort of their own home, limit their exposure to hospital infections and provide real-time information for providers who can monitor them 24/7."

Lloyd Minor, MD, dean of Palo Alto, Calif.-based Stanford University's School of Medicine, sees a similar trend of healthcare services taking place in the patient's home. "We won't need to ask people to take time off of work, hop in their cars and drive across town for appointments," he said. "Increasingly, sensors and other technologies will enable remote monitoring, diagnosis and consults from the comfort of a patient's living room. And should a patient require urgent attention in-person, these very same tools will help conduct triage before the patient arrives at the hospital, so that they can be seen by the right person, right away."

This trend will be especially helpful for patients with chronic conditions, including those who need dialysis. Ahmad Sharif, MD, senior vice president and CMIO of Waltham, Mass.-based Fresenius Medical Care North America believes technologies are driving the growth to more home dialysis because there are more frequent, coordinated touchpoints between patients and their care team. "Sophisticated remote monitoring tools generate a more complete and real-time window into patients' health, which has been shown to reduce hospitalization and technique failure rate," he said. "Predictive learning models are improving the ability to detect and intervene before serious complications happen."

12. Employ front desk staff. "The registration and front desk areas will no longer need to be staffed due to smartphone enabled direction and instructions with digital access keys that will allow patients the full digital experience for clinic visits or hospital outpatient services," said Ms. Stansbury. Advancements in intelligent automation and the digital workforce will become more prevalent in the healthcare space as well to fill in the gaps where there is a talent shortage.

13. Have supply chain management silos. The health system supply chain has traditionally been a very complex and fragmented process, especially for systems with multiple hospital locations across a widespread geography. However, organizations are now using technology to make the process more cost-efficient in the value-based landscape, and the future holds potential for continued advancement, said Ed Hardin, vice president of supply chain for Froedtert Health in Wauwatosa, Wis.

"We are eliminating supply chain management silos and replacing them with enterprisewide electronic requisition processes to greatly streamline our clinical value analysis," he said. "This systemwide virtual platform extends to physicians, clinicians and staff across Froedtert Health. This tech advancement will enable us to create a more streamlined decision-making process with an enterprisewide approach to purchasing the right technology at the best value."

Mr. Hardin is also implementing a technology to make the product recall process more efficient by promoting greater dialogue between the health system and suppliers. The technology will reduce the number of notices from providers and limit the alerts to areas of the organization that use the recalled product. "While an early adopter, we have every reason to believe that this technology will greatly disrupt in a positive way the recall management process," he said.

14. Throw out expired or unused medications. U.S. hospitals and pharmacies lose billions of dollars every year due to expired or unused medications that must be disposed. Driving a more efficient medication management automation processes is a passion for Gee Mathen, director of pharmacy applications and technical services at Texas Children's Hospital in Houston. The hospital deployed a phased implementation of an automation system to improve patient safety, workflow and realize cost savings.

Prior to the implementation, Texas Children's purchased more than $150 million in pharmaceutical products, but without real-time visibility into the inventory, staff members manually searched for inventory, a time-consuming and inaccurate process. Every year, the system disposed of $2.5 million in expired medications and $17 million in dead stock inventory.

"Automation and intelligence are transforming the way health systems are managing inventory," he said. "Through cloud-based platforms, pharmacies can capture a total view of patient health and leverage real-time data for more guided care on a patient-by-patient basis. Through the autonomous pharmacy, applying connected automation and integrated data intelligence throughout the pharmacy care delivery process, we have the opportunity to improve safety, efficiency, financials and compliance."

The data-driven insights will allow real-time actions that will impact care and get the "pharmacist out of the basement and onto the patient floor," Mr. Mathen said. "The autonomous pharmacy is the future of medication management, and will have significant impact in streamlining workflows, driving cost savings, and transforming patient care."

15. Have waste in claims processing and billing. The revenue cycle, particularly claims processing and billing, is one of the biggest areas for improvement at University of California System in Oakland, according to Vice President and CIO Tom Andriola. "There is so much inefficiency and waste in that part of the healthcare business that the introduction of advanced technology, like robotic process automation, will be of great help and hopefully not only reduce cost but also improve the patient experience," he said.

He also sees technology allowing healthcare organizations to treat patients like customers and design a more personalized experience. "We should strive to only ask a patient once for their information and then be able to recognize them whenever they come back to interact with our system," Mr. Andriola said. "This can be everything from simplifying their making of appointments to sending a text message to let them know their clinician is running 15 minutes behind, and with one click [they] can order a coffee while they are parking their car. Is that too much to ask?"


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