Health IT reimagined: Threats and opportunities from Yale, BJC HealthCare execs

Laura Dyrda (Twitter) -

The pandemic has accelerated the use of telehealth, remote work, data analytics and precision medicine.

It required IT teams to collaborate more with their organizations and communities to develop innovative solutions to critical problems facing healthcare systems. Now, healthcare organizations are looking ahead to a more focused digital transformation, and how that is executed will differentiate the good systems from the great ones.

During an Oct. 9 panel for the Becker's Health IT + Revenue Cycle Virtual Event, Allen Hsiao, vice president and chief medical information officer at Yale New Haven (Conn.) Health and Matthew Modica, vice president and chief information security officer at St. Louis-based BJC HealthCare, discussed the big threats and opportunities for health IT.

Click here to view the session on demand. The conversation below is lightly edited for length and clarity.

Question: How is Yale New Haven Health using clinical analytics today and what do you expect in the future?

Dr. Allen Hsiao: We are a data-driven organization. Over the last five years, we have consolidated joint data analytics teams for both our health system and our school of medicine. Even though they're actually two very separate entities, they are brought together by our patients that we have in common and our common EHR foundation. We have a common language, common truth, and they've been very experienced with the kind of the traditional retrospective reporting, using data to identify and drive lots of things.

We have a whole great system called clinical redesign, where using data, we identify all these opportunities for improving patient care, decreasing length of stay, saving money, frankly, which has been really critical for us as we now look to navigate this whole COVID craziness and the difficult financial times that is for all of us. Our teams have taken a lot of steps to now create real-time monitoring tools and dashboards for our quality and operational leaders so that they can monitor the changes and improvements as they happen over timeā€¦

We're using predictive analytics to model our patient volume, our OR case load and how long a case might take and how long the expected admission rate for the length of the stay for that patient might be based on their comorbidities. This all helps us project what our volumes might be and whether we will have any available beds down the road. I think we need to get much better where things are prescriptive and that automatic interventions can kick in automatically so that a rapid response team or a nurse might be deployed to evaluate a patient who's getting sicker.

We are doing that on a small scale with our teleICU, but really need to do this for all of our patients in all of our beds. It's definitely a journey to get there, but I think the future in analytics will really help us take much better care of our patients and have computers are watching 24/7 for the smallest little changes that might be really significant, but might not be picked up by a human until later.

Q: Matt, what is the next evolution of data security for health systems as they continue to amass more information about patients?

Matt Modica: Security professionals think of things in kind of three contexts. One is confidentiality. Integrity is the second and the third is availability. From a confidentiality perspective, we need to make sure that that data is protected at all times and in accordance with the wishes and the acceptable use that our patients and others have defined as well as HIPAA.

We will have to build [that protection] in and a lot of organizations already are building that into the solutions that are being developed for virtual care and other data analytics and insights. From an integrity perspective, the data has to be there. It has to be consistent. It has to be accurate at the end of the day. Security isn't always about people stealing the data. Sometimes it's about them tampering with the data and manipulating the data for a financial benefit or for potentially worse health outcomes. The integrity of that data, making sure that we are looking at the systems of truth and the systems of record for as those key data elements change and especially with the rate of change that's going to occur with a lot of the IOT devices and the other things are coming into play around virtual care. It's wonderful to have all that instrumentation, but you have to make sure it's all tied together and actually talking about the same patient at the end of the day.

The third context is really around availability of that data. Once data becomes available and once those insights start to make their way to the patient and they can start making some decisions around their own health outcomes and also the physicians helping them and guiding them through ultimately getting to the outcome they're desiring, it has to be available anytime, anywhere, any place. That's my vision for what I would love virtual care to be in the future. So, how do we build in the resilience into our systems? How do we make sure we have backups and recovery strategies that allow for that? How do we allow for appropriate downtime and availability of the data while we're patching systems and securing systems and doing some of the things that are required just to keep that data safe and ultimately integrated?


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