iht2 health it summit in austin 2012 – lyle berkowitz, md, associate chief medical information...
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The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
The Power of Combining Innovation + HITTHE HEALING EDGE
Lyle Berkowitz, MD, FACP, FHIMSS / [email protected] / DrLyle.com / @DrLyleMD
Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital
Medical Director of IT & Innovation, Northwestern Memorial Physicains Group (NMPG)
Associate Professor of Clinical Medicine, Feinberg School of Medicine, Northwestern University
Founder and Director, Szollosi Healthcare Innovation Program / TheShipHome.org
Founder and Chairman, healthfinch / healthfinch.com
Health IT Summit in AustinDecember 6, 2012
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
I’m a physician.
And… an informaticist… an innovator… an entrepreneur
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
The Innovation Process
AccelerateMove from pilot programs into standard operations
IncubateMove from ideas to pilot programs
DiscoverInvestigate new ideas, programs, technologies
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Where to Start?
GR
OW
TH
UNKNOWN KNOWN
LITTLE BETS BIG BETS(Experimental (Planning) Innovation)
Experimentation vs. Planning
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
LYLE BERKOWITZ, MD
CHRISMCCARTHY, MPH, MBA
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
LET ME TELL YOU A STORYABOUT THE ROCKY SPRINGS HEALTHCARE SYSTEM
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 1The Healing Edge
• Tell me a Story: Voice of the Innovator + Personas
• Standardized Structure: What, Why, How, Results, Lessons Learned, Future, and Conclusion
• Three Sections: EHR, TeleHealth, Edge
Innovation+InformationTechnology
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 2Mad for Method
Evidence-based human-centered designObservation Synthesis Ideation Prototyping PDSA PilotOthers…
Innovation+InformationTechnology
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Computers are really good at
being computers, but they are lousy
at being paper! What if we really took
advantage of all we could do
with EHRs?
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 3Inflection Navigator
Messaging and Chart Review• Physician notifies Care Coordination Team about an “Inflection Point Checklist”• Care Coordinator does authorizations, sets up tests and consults, and does final chart reviews
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 4Making “Right” Easier
CDS Tools and Ordering• Allows whomever is with a patient to easily see and act upon relevant “care opportunities” , while still respecting visit workflows.
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 5Prevention Every Time
CDS Tools, Ordering and Reporting• Pre-Visit Preventive Screening Tool• An Instant Quality Measures Tool• Real-Time Provider Performance Feedback Tool
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 6Logic Rules
Conditional Logic, Ordering, Notes• Pre-Visit Orders: helps staff pre-order
lab tests before a patient's Annual Exam visit.
• Documentation Chooser: Helps MAs choose the correct documentation templates at an office visit.
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 7Team Bundling
Alerts, Registry, Pt Outreach, Reporting• Team-based approach to care : Automating and Delegating tasks across team• All or None Bundle Philosophy: Report the % of pt who receive every element of recommended care (rather than % that achieve any particular measure).
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 8Automatically Getting BetterReporting Tools•Automated Adverse Event Detection: Queries EMR for abnormal labs (e.g. low glc, high INR) or meds (e.g. Naloxone, Vit K)• Nurse-led Analysis: To determine level of harm and whether it was preventable
YouHaveAn EHR.NowWhat?
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Office Visits are so old school!
Time for a “whole lotta tele”:
Televisit, Teleconsult,
Telemonitoring and
Teletranslation
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 9The Connected Patient
One of the First Patient Portals!It offers patients the ability to view their medical information ("Health Record"), access relevant medical reference services ("Health Library"), and communicate with their physicians ("Mail Center").
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 10The Virtual Consult
Consulting SpecialistsAsynchronous communication between physicians, either between Primary Care and a Specialist, or between Specialists. Assigns RVU in theirValue based Reimbursement Model.
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 11TeleVisits Keep IT Local
Virtual visit with an endocrinologist This virtual visit includes not only the remote diabetes specialist and diabetes nurse, but also the locally based community clinic nurse and sometimes even the primary care provider.
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 12Mommy Monitor
Home OB MonitoringA telehealth system which allows a high-risk obstetrics (OB) clinic to monitor patients with high-risk conditions at home in between office visits. Includes a Glucometer, BP Monitor, and Scale.
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 13Every Language Now
Tele-TranslatorsCollaborative of hospitals and providers that share the services of their trained language interpreters over a video and voice network Needed both innovative uses of technology and an organizational and governance structure to overcome the barriers that affect county-operated health systems.
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 14Rise of the ePharmacists
Virtual PharmacistAn ePharmacist is defined as a hospital trained pharmacist who works from a remote location using secured enabling technology to support bedside clinicians with an effective and timely method of providing medication treatments for patients.
MeetYou At01100101
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
The future of healthcare is
here, just look around! Happy
Exploring!!! OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 15The Smartest Room
A Computer/Monitor in Every Room• Detects who is in a given hospital room and provides them with the information they need to complete their job efficiently and reliably. • Utilizes a real time locating system (RTLS) and a touch screen user interface designed to make input/output quick and simple for end users.
OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 16One EMR To Go Please
Mobile EHR (mEHR) app• Enables providers to user their consumer smart phones to securely access the organization’s electronic medical record. • Heavily leveraged existing enterprise architecture, providing for high levels of security, availability, and agility.
OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 17Real Time, Right Care
Ventilator-Associated Pneumonia (VAP) Quality Monitor
• Compares real time EMR data against pre-defined processes of care related to VAP. • Presents results on a dashboard tool via a wall-mounted monitor (or on desktop PC).
OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 18Dashboards 2.0
Over 40 dashboards have been developed • Extract and analyze data from EMR and financial systems. Uses off-the-shelf business intelligence tools. • The IT Dept isn’t the gatekeeper anymore—users are empowered to come up with creative ways to examine a problem and develop equally creative solutions.
OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Chapter 20The Gaming EdgeGaming , IT and Health• Improve motivation, and engagement via use of elements such as: Fun, Goals, and Rewards. • Want to get into “The Flow”: Skills, Feedback, Focus, LOC, Transformation of Time.•Examples: From Twister to Wii to Nikeplus to SnowWorld to DrHero to FoldIt.
OnTheEdgeOfTheEdge
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
The New CIO
Source: Innovation Leadership Study: Managing Innovation – An Insider's Perspective. CapGemini Consulting. March, 2012
Chief Innovation Officer
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
"The reasonable man adapts himself to the world. The
unreasonable one persists in trying to adapt the world to
himself. Therefore, all progress depends on the unreasonable
man.” George Bernard Shaw
Never doubt that a small group
of thoughtful, committed people can change the world. Indeed, it
is the only thing that ever has.Margaret Mead
Innovation+InformationTechnology
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
THANKYOU
Lyle Berkowitz, MD, FACP, [email protected]
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Szollosi Healthcare Innovation Program (SHIP)
A charitable endeavor with a mission to use creative thinking and diverse technologies to produce a better healthcare experience for patients, physicians and others associated with their care.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Future of EMRs
Prototype examples which rethink the look and feel of user interfaces for Electronic Medical Records.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Inflection Navigator
An ambulatory-based triage system and web-based tool that supports a navigator guiding patients thru an acute healthcare inflection point.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
ExpectED
A web-based application that allows physicians to electronically notify an emergency department (ED) about an incoming patient .
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12
Szollosi Healthcare Innovation Program (SHIP) A charitable endeavor with a mission to use creative thinking
and diverse technologies to produce a better healthcare experience for patients, physicians and others associated with
their care.
www.TheSHIPHome.org
THE INFLECTION NAVIGATOR - An ambulatory-based triage system and
web-based tool that supports a navigator guiding patients thru an acute healthcare
inflection point.
ExpectED - A web-based application that allows physicians to electronically notify an emergency department (ED)
about an incoming patient .
THE FUTURE of EMRs - Prototype examples which rethink the
look and feel of user interfaces for Electronic Medical Records.