As innovations in healthcare delivery beckon advances in technology, health IT vendors must rethink how IT systems are designed to better meet clinicians' needs.
Hospitals are looking for better ways to serve their patients by offering services such as uniquely tailored treatment plans or telehealth. Technology is a necessity, but these tools aren't always easy to use. That's because technology, historically, hasn't been designed to serve such innovative modes of care delivery.
For one, security has become a greater concern as access to data expands. Another concern revolves around how technologies are used in healthcare to support and supplement physicians, not detract from their energy or work.
While progress has been made — for example, virtual desktop infrastructures allow care teams to collaborate despite their systems' inability to exchange data — health IT is far behind where it needs to be.
The next generation of health IT systems should not only be designed with the end user in mind, but should also reflect the environments in which they operate, says Wyatt Yelverton, global healthcare solutions manager and specialist in emerging technologies and virtual care at Lenovo.
As part of the Becker's Virtual Health IT Summit, a three-day online conference on the trends, topics and technologies that empower better care delivery, Becker's Hospital Review spoke with Mr. Yelverton to discuss how the next generation of health IT systems can foster improved care delivery.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How must the technologies currently deployed at hospitals evolve to empower innovation and healthcare in the future?
Wyatt Yelverton: First, we need to understand that clinical information systems are not static nor inflexible. They are, and should be regarded, as entities that change and evolve with the organizations they serve and, ultimately, function in unique and disparate ways as to similar systems implemented in other organizations. In this way, there is no one solution to the question of how. The evolution of an EHR and complementary systems must reflect the needs and expectations of the health system, its providers, and the individuals it serves. As we begin to think about the next generation of health information systems and future requirements when deploying technologies, health systems and providers must embrace potentially dissimilar expectations and philosophies for care delivery than are traditional to the industry today. Significantly, this means health service organizations must make an active effort to be self-reflective, to understand their own needs and to be deliberate in how they go about solving for indefinite futures. That is, health systems cannot simply be reactive to momentary stimuli but, rather, must concretely plan for wholly new methodologies of care delivery as well as industry and consumer behaviors.
Q: What's next for health IT evolution and what advances in devices and hardware for data access will be needed?
WY: The end-user devices themselves are now, largely, consequences of consumerist trends translated to healthcare environments – a merger of commercial and consumer ideologies both from the perspective of providers as well as patients. Knowledge workers, technicians, patients, each come into the environment with an expectation that any platforms or technologies will be largely equivalent to the devices and software they use at home and in their daily lives. Simultaneously, healthcare is experiencing a rise in the need for and adoption of mobile technologies as part of the care delivery paradigm. Thus, we find a very real need to reconcile the user/consumer perspective of technology with that of the expectations of a formalized enterprise environment. This is often quite challenging. Consider the traditional healthcare device: it’s locked down, very secure and very well controlled. However, as information access becomes more democratized – in platform and in user – and even more data is added, often from multiple non-traditional sources, we will need to respond with novel workflows, security techniques, and data management tools.
Open access to health information and ever-greater opportunities to learn from patient-generated and environmental data are required considerations with respect to the selection and optimization of provider platforms. In many ways, the security mechanisms or, even, user training relied upon for facility-based interactions are simply not appropriate for highly mobile or home-based environments. This means systems and user interactions must be built knowing there are unique and diverse points of vulnerability, which subsequently changes the way organizations receive information, act on that information, and incorporate it back into the care delivery process.
Q: Beyond the four walls of a hospital, what must happen for interoperability to be fully realized?
WY: I think interoperability is largely a consequence of time that will advance with increasing technological maturity. As current technologies are standardized and simplified, common reconciliation and communication techniques will rise to the top. At the same time, many different players – vendors, consumers, and regulators – are demanding that non-health providers have access to health data in much the same way.
Ultimately, the systems we design and the way those systems push information out beyond the walls of a hospital are going to drive novel applications of health data. Conditioning this information for disparate users, inclusive of the patient, is a considerable point of failure at the moment and represents a necessary evolution with respect to interoperability.
Q: How are emerging technologies like artificial intelligence, augmented reality and virtual reality integrating with existing systems in technology to support higher levels of care delivery and improve outcomes?
WY: Everyone likes to talk about emerging technologies, but when they are asked to quantify and systematize the value of these tools, they often get stuck. Many systems have embraced the concept of innovation labs specifically dedicated to designing, testing, and conditioning new technologies and workflows for broad implementation. While it can often be difficult to scale these innovations, this is a highly positive approach to designing for the unique needs of the organization and its users while quantifying value.
Some technologies, like augmented reality represent novel platforms by which value is realized through the simultaneous development and implementation of complementary tech. “Internet of things” devices allow for incredible visibility into workflows, resource utilization, and even behavior. Combined with advanced analytics, relevant and actionable insights are delivered to caregivers, family, and patients in a way the industry has never seen before improving compliance, easing anxiety, and, overall, improving the opportunity for patients be well and live well. The prospect here is we allow technology to serve as an augmentation of our capacity to deliver care, rather than allowing it to interfere with care delivery. This is something really quite revolutionary in concept and has great potential but is still very abstract.
Q: How are the needs of physicians and clinicians evolving when it comes to health services delivery?
WY: Everyone – physicians, clinicians, family caregivers – are being asked to do more with fewer resources. This trend is simply unsustainable and will require providers to embrace the use of technology in order remain effective and deliver high quality care.
Healthcare is changing. From a quality-cost-access standpoint, objectives are shifting to keep patients out of the hospital and realize a higher level of precision for each individual. Meanwhile, resources are not becoming more plentiful, budgets are not growing, and patients are not becoming less complicated medically. The industry must take a legitimate and tenable position on cost controls, access, engagement, and outcomes. This is a point of opportunity with respect to technology. In particular, mobile technologies, external IoT, and AI empower asynchronous, at-a-distance care delivery. A robust virtual care platform limits synchronous consultation-based interaction between providers and patients. In this way, we can substantively improve the utilization of available resources, focus in on those most in need, precisely manage complex needs, and continuously engage patients even while not face-to-face with our providers and staff.
Q: Is today's IT and infrastructure able to accommodate the new demands of delivering higher-quality, more personalized care?
WY: We are seeing a lot of focus on adapting existing IT systems. In particular, organizations are demonstrating a greater maturity around EHR systems and are spending considerable time and resources on optimizing and tailoring these systems to specific workflows and demographics. That puts an increased focus on data and making data valuable to the business. In this way, data opens new lines of business for healthcare organizations, such as [precision medicine or population health].
At the same time, this focus on data has strained health systems' infrastructure. Hospitals must now put more consideration behind how they store, secure and access their data. In many instances, answers to those questions involve conditioning users to appropriately interact with the platforms. For instance, we are seeing a greater move toward virtualization in which information can be secured and, at the same time, made available from anywhere. However, virtualization also means shifting end user and data center requirements. The result is a fragmentation away from the middle, where very robust, high-powered end user devices are no longer necessary. That's because the ways in which we access, manipulate and react to data don't necessarily correlate with those devices' specifications.
Q: How should IT systems evolve to align with clinician demand?
WY: IT should be a consequence of clinician demand, which is a change we are beginning to see more significantly. Historically, we have taken a technology or information system and thrown it into the hospital environment. Then, we'd have to adjust workflows or even clinical practice to meet specific documentation or interface requirements. Now there is more diversity in the market — more advanced understanding of how capabilities influence utilization — and we are more easily able to change the technology to meet clinicians' needs.
Q: How will interconnected systems in healthcare benefit hospitals' broader health objectives, such as improving population health?
WY: The more clarity we have of a patient's health and well-being — what their lifestyle is like, what resources are available to them, what their financial situation is — the better we can facilitate precise, individualized care and begin caring for the whole person, instead of the conditions that afflict them at any given moment. This is wholly positive — for the cost of care, for the distribution and availability of resources, and for outcomes. However, it really relies on the confluence of many technologies consolidated into clinical practice. External IoT without analytics amounts to data without a purpose. Clinical insights without a patient communication and engagement platform becomes a failed opportunity. And, a desire to live healthy without access to relevant, quality answers to your questions results in assumption making and disenfranchisement.
As we mature technological capabilities individually, we should focus on making them a highly interactive system such that we can leverage the benefits of each technology in a way that doesn't self-limit by brand, format, or function. In this way, the tech would be capable of realizing a truly transformative role in advancing health service delivery.
To access additional information from the summit on advances in care collaboration for improved outcomes, click here.