19 Burst results for "EHR"

Interview With Sanket Shah, the AVP of National Accounts at Blue Health Intelligence

Outcomes Rocket

05:48 min | 2 months ago

Interview With Sanket Shah, the AVP of National Accounts at Blue Health Intelligence

"Welcome back to the outcomes. Rocket saw marquez. Here today i have the privilege of hosting sank cat shah. He's the vp of national accounts at blue health intelligence. He is a highly respected and experience healthcare industry professional with expertise in healthcare data business intelligence organization strategy and advanced analytics over fifteen plus years of progressive experience as a strategic thinker. Saint cat is an executed with a history of scaling and driving brand positioning of complex health. It solutions and growth oriented environments mature an emerging verticals. He's well network with a solid industry reputation as a trusted adviser and brand advocate who continuously diversifies revenue streams via deep insight into the competitive landscape market demand risks and customer value creation to solidify dominant industry presence. He is just a an incredible mind in the business of healthcare performance. History for him is directly relations to healthcare's most dynamic trends around data analytics care management ordination population health management value base care. Ehr emr so. He's just doing an incredible job of that serving in the for blue health intelligence but also clinical assistant professor at the university of illinois at chicago. I think the perspective that he brings is unique. And i'm really excited to have them here with all of us. Oh sang cat. Thanks so much for joining us today. Thanks appreciate thank you for having absolutely so before we get into the work That you guys are doing at blue health intelligence and obviously listeners. You probably recall. We had Swati abbott who is the ceo. Blue health intelligence. You haven't had a chance to listen to the interview. Please go ahead and And take a listen but before we dive into your take and the work that you and your team are up to saint at blue health intelligence love to hear more about what inspires your work in healthcare sure. Yeah i've been in this industry for you mentioned earlier about a fifteen close years and was really firing for me is the ever. So changing landscape within the industry specifically from the technology side. It's names Where's you're seeing just tremendous growth In terms of you know back from way way back when when we were working paper charts into the high tech acted the marseille and then ultimately leveraging data to provide better outcomes for our members and our patients. So that's really really inspiring to me and kind of you mentioned the university of illinois chicago program now. A part of that's really where most of my passion is listening to these students that are rolled into the program. Those that are looking to make a difference within the healthcare industry and really helping guiding vise. V next wave of leaders. You know listening from their perspective. They come from all walks of life now nurses and analyze analytic folks doctors. You name it and just getting their perspective on how they're trying to tackle the biggest issues in coming together to help solve those issues has been really aspiring for me and Look i i look forward to talking to them and working with them and really excited about just another guy program and also in space. Yeah for sure and And so you've got this unique perspective. Where you're you know training and educating some of the rising talent as well as working in the industry and so how would you say today you know the business beheld. Intelligence is adding value to the healthcare ecosystem and in particular who is adding value to sure. Well unique about be. Hr intelligence is that we have a very Quite frankly a sought after accident. That is one of the world's largest healthcare claims databases. It's conformed it is being supported by our blue partner plans and within that warehouse database is essentially over two hundred nine lines worship data over ten plus years. So you can imagine the types of And that we can actually glean insights from the state and what we're doing that's really unique within the. Hi is taking a step beyond what i consider. The the tradition of disrupted diagnostic. Analytics really is what's happening and kind of why it's happening. But the industry itself is shifting and a lot of thought leaders and a lot of organizational leaders are really taking the next step of that journey and going from the the diagnostic descriptive analytics. More into the predictive space and the prescriptive say so not only. Do i want to know what's happening. Wife having that's kind of just you know part of business and nowadays it is now. Well what what. What should i help for. What should i be looking out for in the next say three months five years and so forth and then ultimately what should i do about it. That's that prescriptive analytics comes into place. And we've been heavily investing here in. Hi to really bolster our analytic capabilities to to help support our partners and by way Of of that collaboration certainly trickling down to the providers within the health systems that are engaged with the members and ultimately the beneficiary near as certainly most members and in our our kind of goal here is in the h. Is has always been using data to drive form decision making to lower costs for healthcare but also certainly improve quality for members.

University Of Illinois Swati Abbott University Of Illinois Chicago Marquez Marseille Chicago
"ehr" Discussed on Podcasts – Telecom Reseller

Podcasts – Telecom Reseller

01:36 min | 4 months ago

"ehr" Discussed on Podcasts – Telecom Reseller

"It does it does it work with different underlying technology platforms wage is maybe via or Cisco or teams. It does it works with all of what I would say all The Usual Suspects that you would expect to see when you you know approach a cock. Etc back office organizations. We right out of the box we've invested in Integrations to like you said Avaya and Cisco and Genesis, um and in contact and so many others as well as the workforce management systems many Learning Management systems and EHR systems. So right out of the box, it can be connected to those systems and the data starts flowing into the platform and we allow our customers and our partners to create rules and you know automation rules on the platform. Once that data starts to flow. So you you've have a set of products for the contact center, but I understand now you're looking at the back office to that's right Doug we had as we've served the contacts that are off. Our customers have come to us and said, you know, we've got the same kinds of problems in these other work forces and and the one we heard most often was the back office. And so we studied the back office to see how we could apply our technology there and in twenty-twenty. We introduced our first back office use cases and bags and began to solve those same problems for our customers in the back office and interestingly..

Cisco EHR Avaya Doug twenty-twenty
"ehr" Discussed on Outcomes Rocket

Outcomes Rocket

06:38 min | 5 months ago

"ehr" Discussed on Outcomes Rocket

"System will the provider clinical side as well as the administrator. And I think the thing that really helped me understand the true impact of technology it's on healthcare is a had the privilege of being allowed to sit in on a surgery we're back to transplant surgery a kidney transplant between a father and I thought I saw how the clinician dependent upon the technology allergist skilled on being able to move in Oregon from another person place them another human being and get it to function properly how the used technology to help navigate that process dependent that they are on that not just the electronic health record systems but the cynical technologies that were being used even music that was playing in the room to keep them calm and focused. On the part of the whole technology mechanism. Gain an appreciation of that and I realized that you know these systems. Now these computers laptops mobile devices are now clinical devices. They're no longer just about nice to have a piece of technology, but they actually have an impact on conditions ability to deliver care and far be it for back device and those systems function properly because if not, they could literally have an impact on someone flying gained an appreciation for through that. Journey on the provider side and even more of an appreciation when I had an opportunity to go out and act as a consultant and strategist working with a wide variety persistence across the country in helping up. So lacking implemented and made it infrastructure and imports of it all sorts of settings. So it's been a an interesting journey from being a labor of love the other piece I think it was that really. Helped me as well to and really have an appreciation for healthcare and healthcare technologies working with companies who had necessarily traditionally been in this space but we're trying to get into the open space and sought my advice and trying to understand how do we effectively filling solutions at healthcare and telling those stories and helping them understand that. Once you make this commitment to help cure not making a commitment. Just, to sell technology, making a commitment to save people's lives, and if you're not moving into this space with that mission and mine, you're not going to be successful because healthiest it's purely mission driven industry, and as we can see today I mean look at all the providers initiatives who are risking their lives to take care these folks who are dealing with the Kogo nineteen virus. I mean this admirable. Heroism is taking place each and every day by ordinary Americans taken that task to take care of their fellow. Man. So. Proud to be a part of the initial probably help to bring technology to support that mission and I'm proud to be a part of now dss of the company what we're trying to do to launch the next generation. Electronic Health Record System Christopher well, sad and crazy story a love a love your story. You're the service manager to CIO. And you had that pivotal moment where you are in that surgery that transplant surgery and you realize that dependence on technology, and now it's turned into a commitment to not just sell technology but to save lives and enable those people at the front line doing it. I. Mean This is such an inspiring story Christopher. Thank you for sharing. Your welcome an Uppercut, just A. Just a little bit more another. I think the final point in my life as well around how technology can impact the quality and cares with my father. My father unfortunately passed away. But at the time he was dealing with the when we're. It was going for a tremendous amount of pain and difficult Tan I remember teaching him to a rheumatologist. This was fifteen years ago, walking into the examination room and sitting down and waiting for the doctor to come in and DR GM man he brought a big stack of papers. So they which was basically my father, a medical record was probably three inches high. You walked in sat down to hijack going on, and of course, he's been paying some of your led that. This air for about three or four minutes, just paging through against three at stack of papers around my father's situation with finding close to a folder and sat with John I. Really Don't know what to do at this point for you. We can try different regiments at this point, but I you know I'm I'm not sure and so that really struck me as well that with all that information that is in that folder. Available to him cannot was not aggregated solid presented in a way to help to Baker better clinical decision of an I'll try something and that really resonated with me that we need technology to be a part of this process they help us human being aggregate and leverage information in a more effective way that we just can't take all the disinformation healthcare changes on a day to day basis at new discoveries, new protocols, all sorts of recommendations is happening on a day-to-day basis. There's no way one human being can keep that information up to date in their own. And so we have to depend on technology to be that resource for us to consolidate information aggregated, provide some level of intelligence highness health, make better decisions when retreating patients, and so I think that was another thing that stood out as to why the minute to the industry as well. Yeah. For Sure Christopher, and we've made a lot of steps forward with this You know e- HR EMAAR capability. However, they're still so much more opportunity to keep building on that, and so at the beginning you mentioned revolution I want to dig into that Psalm so. Tell us a little bit about what Juno Ehr is absolutely and. Take on kind of a roundabout way to get to where we are in terms of Gio and the revolution. That we're starting we think about just a decade or so ago. You know most providers, doctors, hospitals, Sunday great work using actively using the HR. Everything was still very much very paper based financial systems. Some of the best of breed technologies within the healthcare setting were tied to computer systems, but they weren't all integrated in a way that allow that patient information of flow seamlessly from this show registration through.

Christopher Oregon administrator Juno Ehr consultant Gio CIO DR GM EMAAR Baker John I.
"ehr" Discussed on Venture Stories

Venture Stories

04:49 min | 7 months ago

"ehr" Discussed on Venture Stories

"Everybody. Welcome to another episode of village. Globals venture stories I'm here today joined by two very special guests Nikitas ready investor are ventures and Nikos. You've ASCII founder and president at. Redux. Nico Nikita welcome to the PODCAST. Happy to be here. So we're here to talk about healthcare and and some of the newest regulations, but also more broadly in the space you really you recently wrote an article as summarizing what's so interesting about the latest new regulations what unpack with we're trying to do in that. Yeah. This is something I think a lot about at someone who invests in healthcare. Aria, as a big healthcare portfolio, but there's a tremendous amount of inertia in healthcare and I think it's more pronounced in healthcare than a number of other spaces I. Think the close corollary is probably Fintech and financial services where you have these really large incumbent players and also as in addition to that deeply fragmented on the customer side So that might look like SME's for the fintech world. And just the sheer number of people that companies that need payment processing, and then in healthcare, it's just the sheer number of provider organization and vendors and everything in between. So when you want to innovate in healthcare there needs to be a number of driving factors that really force it to happen, and we've seen it happen a couple of different times and healthcare but I think really following regulations and easy way to see this materialize one good way I think of framing that says. If. You look at the high tech fell in two, thousand and nine. which was a related to the American recovery reimbursement. act. That was one of the first times that the government said you need to adopt and demonstrate meeting use of your Marzano HR's and it's not like the industry didn't exist before that epic was already one of the biggest players in the space and so is Turner. There wasn't that forcing function from the government to have to do that, and it really solidified all healthcare institutions, not just the big health systems but also that kind of Taylor, on smaller provider groups have to use EHR's as well. But you see this in, you know not not just with electronic medical records you see this happen over and over again with different acts. So some random examples and other ones. To mention the fairness construct the fairness to contact lens consumer APP in two thousand and four that really created one, eight, hundred contacts.

founder and president Nikitas Nico Nikita Nikos SME Marzano HR EHR Turner Taylor
"ehr" Discussed on Outcomes Rocket

Outcomes Rocket

07:24 min | 7 months ago

"ehr" Discussed on Outcomes Rocket

"Welcome back to the outcomes rocket saw Marquez here and today have the privilege of hosting Dr Jeremy or Jeremy has more than twenty years of clinical medical practice, ovulation health and healthcare. It experience he served as early signs chief medical officer before his appointment as CEO. A practicing board certified family physician Dr Ore was named a top one hundred physician during his time with Kaiser Permanente and then he went on. To launch a medical practice that became part of Centura help while an assistant professor at the University of Colorado, he was selected as teacher of the year by the residence prior to joining Medial Jeremy served as the CMO Boston based clinical data analytics firm Humanika later optum analytics and also as CMO of Los Angeles based Clinical Decision Support Company stance and Health Jeremy earned his medical degree at the University of. Buffalo and his M. P. H. Too lame and today he's making a huge impact with the work they're doing at medial early sign and so today we're GONNA be diving into the standing work that they do for payers providers and really healthcare at large and so with that introduction doctor or I want to welcome you to the podcast. Thanks for being here banks offer I've made carver's conversation today Mike Wise. In so you know I've been waiting quite some time for us to finally connect, and here we are. You've done some amazing work in the space and today the opportunity to drive change in this era of translation is big and nobody could do it alone or so before we dive into the value, you guys add at needle early sign something a little bit more about what inspires your work in healthcare. Sure. So essentially it's I wanted to maximize the impact I have. So you know we all have a limited time on this planet and we hope to do good and helped to look back on our lives someday and feel like we made a big difference and practicing medicine is extremely satisfying I think for some people, they really need that once one interaction, the feel. Like they're having an impact but for me, it was really a maths problem. Am I could see twenty five patients a day in clinical practice, my whole career, and have a great impact on lives and I have the greatest respect for clinical providers. But I'm not one of those who needs to have that immediate feedback from patients and for me, it became a question of where. Do I allocate time after it resource skill and they have the biggest impact in what we're doing in advancing technology and healthcare I can affect hundreds of thousands or millions of lives in smaller more modest way but I think overall have a more satisfying impact. So at the end of the day, that's what works for me, and that's what motivates me and that's what gets me. Up in the morning and I think the same is true for everyone at early sign are stated mission is to have a massive impact on human health period and there's working on how to get there every day I. Think it's really inspiring and you know there's that shift in physicians not everybody. But you know I've been seeing a lot more of it. You Know Physicians I. WHO. Said, there's an opportunity to do so much more than just the bedside impact populations and communities, and so you know it's great to hear that that was the catalyst for the great work that you've done. Now, the work that you guys are doing at early signs. So tell us a little bit about early sign what exactly are you guys doing and Harry adding value to the ecosystem? Yeah it's a great story. So early sign is you can consider US experts in clinical data as it relates to machine. So applying machine learning approaches to clinical data now machine learning is become quite encompasses a lot of human. Activity these days and quite a heterogeneous group of activities, and so I'll carve out our niche for you. So you know where we operate we're just working on healthcare and the data substrate we use, and it's pretty much structured, electronic medical record data and with particular attention to labs, data, medications, existing diagnoses, and things like that. So we're a little bit separate from lots of good companies doing good work in imaging that works a little bit more advanced, and that's partly because that type of data it's fully classified on my clinical data, which is very, very messy requires a lot of prep work. So that's the niche. And we've done several interesting things there. Some of our initial work has been on advancing early detection in diseases where early detection and intervention makes a big difference. So we've operated in the space of cancer screening in Christ disease progression of chronic disease understanding complications, and then more recently, we've done work in Kobe as well influenza. So infectious diseases off topic for us more recently, but taking it a little bit wider. We're also now engaging with lots of different players in the healthcare system to figure out other ways to bring machine learning insights into care. So you know a lot of. Our initial stuff in cancer screening views was really next generation restraint affiliation. This particular group of patients is very high risk for having cancer, a complication of diabetes and the next time periods take care of them I. But where we're trying to go is trying to actually move into more prescriptive types of panelists, and this is a much more challenging problem but potentially a much more impactful approach where the machine if you will and survey the sum of all the clinical data for a particular physician, a group of physicians and advise not just on whose highest risk. But what's the next best? Action or intervention the take for individual patients. So this will really beats and the true patient care and we had early signed believed that physician will always be an intermediary and care, but we want to do everything possible to bring not just the highest risk patients but the best advice in front of the tradition at the right point place in time and care so they can act on it. So we think someday it's inevitable that clinicians actions will be augmented by machines like this and we're just letting the framework for that now. Well, I think it's fantastic that you guys are daring to. Be Bold and taking that step. A lot of companies are afraid. They're afraid that they're too early and I think that it's figuring out that right timing. But at the same time, not being afraid to lay down the framework like you said, and so that prescriptive step taking mit just you know like people talk about monitoring and early warning scores a what are you gonNa do with all that accurate so that you enable a clinician to do more maybe you could talk to us a little bit more about that and what exactly you guys are doing different and better than what's available today. Short. Sure. So many of the efforts to get machine learning insecure as I mentioned, they have focused on imaging or applying them to more sorts of Assa, Terek data patient source data in some cases, genome makes proteomics and so on. So one thing that's different is we're trying to present the broadest possible use case and really work on readily available, very common elements. So some of our algorithms, for example, just the one blood test age and gender to provide very sophisticated risk profile for say a cancer and behind that effort act on routine data is a premise that routine data is not being nearly anywhere near fully. Utilize now that the current approach is actually pretty primitive. If you go to your primary care physician, get.

Dr Jeremy Clinical Decision Support Comp family physician Kaiser Permanente medical officer University of Colorado University of Marquez CMO Boston Los Angeles Dr Ore US Centura CEO Mike Wise carver diabetes Buffalo
"ehr" Discussed on 2 Docs Talk

2 Docs Talk

10:11 min | 1 year ago

"ehr" Discussed on 2 Docs Talk

"Hello and welcome to two docks talk the podcast about healthcare the science of medicine and everything in between okay so I a few definitions. You'll hear people using the terms. Electronic medical record and electric health record interchangeably. Heck I do that. But they're not exactly the same in. Mr Is a chart that is used within one specific clinic. It can't be accessed by anyone outside that clinic whereas an e HR electronic health record is usually system-wide or multi multi system wide providers from different clinics within the same health system or ACO can all access the record yes but for the purposes of this talk either Emr or E. H.. which are will do? I'm going to use 'em are okay me too now on when we say the. Mr We mean both Emr and EHR either one so moving on Comores are basically all the health records notes. Labs diagnostic studies insurance. People work demographic data for every patient and Mars have actually been around for decades in in fact the VA hospital system was one of the early adopters of Mars. Remember the Martha Audie Murphy and Mess Cooling. God that thing was the most user unfriendly no-frills eum are ever. Yeah but it was still pretty cool. I Love I would be taking care of a patient in San Antonio Audie Murphy and I could see what had happened to him when he was ed another. Va in the country. Green Flash Her sir okay to understand how cool that is. We have to talk about the battle days so back before. EMR's there were paper charts. It's yeah and they were often illegible. I mean doctors notes were hand written and most people's handwriting isn't what it should be and doctors have notoriously bad the handwriting. I don't I do. I still do horrible. Also data was often out of order. There were reams of unnecessary papers. Redundant paper someone else's papers burs and the chart and you can find charts when you need them. Someone else had them or they were just flat out. Lost or parts of the chart were lost. Yeah usually it was very important diagnostic success that was missing and also in residency. You could lose your privileges if you didn't dictate so you had to go through. I don't know if you had this. But we had to dictate the charts our own and are attending 's and they would our records of stack up down stairs in the basement and we'd have to go down there and get all these paper charts and dictate all this crap. It was horrible God too so awful. An on top of all of that hospitals and clinic seeded huge rooms to store these charts charts like the entire basement of a hospital medical records. Yeah so happily. Most of these problems disappeared with the arrival of electron ICK medical record. Right and wants wants. Things have been digitized. You can really do a lot of different things with them. You can actually find the data and read it for one. Yeah People's notes are now suddenly legible and charge. Don't get lost and the chart can be accessed remotely. You don't have to be in the radiology reading room to look at someone's x Ray for example you can which makes me a little sad but I always loved that and you can call it. Data and look at trends and that data can be sent electronically to and from other physicians clinics labs insurance companies anywhere. You needed to be sent as as as long as you will be patient privacy. Of course you should say that. Yeah anyway as with all technological advances there were a lot of promises in this case the promise was that. Mr would make make physicians better doctors. There'd be more accurate diagnoses. More timely therapies fewer mistakes streamlined billing practices and most importantly improved efficiency all this intimately physicians would have more time to spend with their patients exactly the pot of gold at the end of the rainbow more time with patients. and has this happened the the more time with patients part. I mean you know it. Hasn't there have been several studies showing that Dr Spent about twice as much time on the computer as they spend with their patient and tons of anecdotal evidence. Well Yeah Heck. I can confirm that just based on my own practice. And here's the thing. Physicians are spending more time on the computer when they're both with and away from their patients. Just look at what happened when my mom went to the pulmonologist so what is happening. Partly because of the increasingly complex regulatory environment in medicine Medicare Medicaid and insurance companies are demanding documentation for every bill submitted and the documentation must meet criteria. Set Out by Medicare Medicaid before or the physician will be reimbursed for their services so this documentation happens on. The computer is in submitted with the bill to the pair and the primary person. Who Does the documenting is? Is the physician right. Here's an example of typical day for a physician. Prior to seeing the patient will review the medical record mostly so they know what brings a patient in for the day the and also to remind them what meds the patient is on pertinent parts of the past medical history now then. The physician sits down with the patient in the exam. We're there as he gets another computer so while talking to the patient the physician enter data into the Mr about this current visit then after the visitors over the physician will finish documenting with the assessment and plan. Once the notice complete. The physician will then bill for the visit. Sometimes documenting takes so long. That notes aren't completed until the patients have been seen in. The clinic is closed for the day. That's also in. The physicians will correct any notes that need correctly so in my practice there is a person who was hired solely to review physicians knows and make sure her they meet Medicare criteria for the bill. They submitted at the notes. Don't meet criteria. They get sent back to the physician to cracked. And here's a very important point not all. EMR's ours are created equal Semimar. Great they're designed with doctors in mind the allow you to pull data Ford from previous notes. Limit the number of clicks needed to complete the relevant portions of the now they're customizable demise able in the end. Product is easy to read but most Mars have a primary function other than communication. And fortunately this is true. The primary function of many Mars uses billing. And when that's the case for the Mr for doctors will be inefficient and awkward US right. We can't customize it to our needs. We ended up doing a lot of data entry and the end product. Arctic is not something that's easy for other providers to read or understand so the physician spends more and more hours out of the working day with their face in front of a screen instead of making eye contact with her patience chance. Yeah so just a quick aside for second if there are any residents out there listening especially residents who are near the end of training interviewing for jobs. Make sure you talked to. Physicians is in the practice. You're considering and ask them about the Mar- they use exactly. Are they happy with it. Did they spend time at home documenting because they don't have time at work is is the MR efficient or awkward user friendly or the friend of the billing office if the docs you talk to your unhappy with their Mr. Then it's pretty likely you'll be too so move on so so I work with an Mr. Everyday I never look at a computer when I'm with a patient I don't have computers in the room and I don't bring my laptop into the room I had. I decided to make that time sacred without a computer to distract me. I can make eye contact with my patients Cedar subtle reactions to questions conversations. About feelings hopes expectations careers are more likely to come up although squishy subjective things. Your mom didn't get a chance to talk about exactly and I listened better my agenda doesn't dominate the visit. And I'm more likely to see the patient as a human being not a diagnosis our list of diagnoses. Some physicians might think you're no computer. Stance is a bit extreme. So be it. The time I spend with my patients is what makes my job worthwhile and meaningful and joyful and I suspect this is. This is the same for most physicians. Why would I want to compromise that the end result would be a miserable me an unhappy patient? But here's the thing you work in practice that allows you to do that. This is not a luxury Minna. Physicians can afford so what to do when the MR takes over your relationship with the patient first. We need to acknowledge that. This regulatory environment in which we practice is at the heart of the problem so we should all be you proactive about healthcare reform. Okay but short of ideology. What should doctors do? Well look at your Emr and see if it's the problem F it is lobby for a new EMR car or change practices if need be if you're Mars decent than there are a few things physician can do on a daily basis. That might improve things. Yeah so first position position computer in such a way that your back is not to. The patient also involve the the patient with a computer. Show them what you're looking at. Ask them to help update the record. Let them know what you're typing while you're doing it and make sure you spend time away from the keyboard during every visit for some doc sits at the beginning for some. It's in the middle. Whatever you feel comfortable with but at some point you should step away from the computer? Make eye contact with your patient so some practices have hired scribes to document for the physician. Yeah that's a luxury to adding additional staff as an expensive way to solve a problem. Yes it's true and it's kind of awkward to bring a third person into the examining room is so here's the thing. Technology Technology often promises to bring us together as human beings to give us more time to spend doing the things we love with the people. We love just look at the facebook motto. Bring the world closer together together. I thought it was making the world more open and connected or maybe move fast and break things. I think those are previous mottos but whatever my point is we don't always use use technology in a way that maximizes promise and the same is true for. EMR'S DO I want to go back to the paper charts absolutely not but neither do I wanna rule where I no longer remember my interactions with others because my head was buried in some form of technology. You know whether that's at home or at work amen to that so I suggest we take extreme steps to keep this from happening like keeping electronics out of the examining room or demanding a better. Mr Or as patients requesting that doctors move away from the screen. Yeah I think that's really good. Just interjecting here. Yeah as a patient. That's your time to. You can stand up for what you need in that moment with your doctor ask the doctor. Could we talk face to face for a moment if that's what you need and if a doctor has a problem with that you know maybe it's time look probably a ton of things patients. Doctors doctors could do if they combined forces. Let's our show for today if you liked what you heard right US review in eighteen tune and until selects time. Sneezing your elbow wash your hands and get a flu.

EMR Mr Or Martha Audie Murphy US Va ACO San Antonio flu EHR Comores Minna Medicare Dr Spent facebook Arctic Ford
The End of the Paper Chart

2 Docs Talk

09:50 min | 1 year ago

The End of the Paper Chart

"So I a few definitions. You'll hear people using the terms. Electronic medical record and electric health record interchangeably. Heck I do that. But they're not exactly the same in. Mr Is a chart that is used within one specific clinic. It can't be accessed by anyone outside that clinic whereas an e HR electronic health record is usually system-wide or multi multi system wide providers from different clinics within the same health system or ACO can all access the record yes but for the purposes of this talk either Emr or E. H.. which are will do? I'm going to use 'em are okay me too now on when we say the. Mr We mean both Emr and EHR either one so moving on Comores are basically all the health records notes. Labs diagnostic studies insurance. People work demographic data for every patient and Mars have actually been around for decades in in fact the VA hospital system was one of the early adopters of Mars. Remember the Martha Audie Murphy and Mess Cooling. God that thing was the most user unfriendly no-frills eum are ever. Yeah but it was still pretty cool. I Love I would be taking care of a patient in San Antonio Audie Murphy and I could see what had happened to him when he was ed another. Va in the country. Green Flash Her sir okay to understand how cool that is. We have to talk about the battle days so back before. EMR's there were paper charts. It's yeah and they were often illegible. I mean doctors notes were hand written and most people's handwriting isn't what it should be and doctors have notoriously bad the handwriting. I don't I do. I still do horrible. Also data was often out of order. There were reams of unnecessary papers. Redundant paper someone else's papers burs and the chart and you can find charts when you need them. Someone else had them or they were just flat out. Lost or parts of the chart were lost. Yeah usually it was very important diagnostic success that was missing and also in residency. You could lose your privileges if you didn't dictate so you had to go through. I don't know if you had this. But we had to dictate the charts our own and are attending 's and they would our records of stack up down stairs in the basement and we'd have to go down there and get all these paper charts and dictate all this crap. It was horrible God too so awful. An on top of all of that hospitals and clinic seeded huge rooms to store these charts charts like the entire basement of a hospital medical records. Yeah so happily. Most of these problems disappeared with the arrival of electron ICK medical record. Right and wants wants. Things have been digitized. You can really do a lot of different things with them. You can actually find the data and read it for one. Yeah People's notes are now suddenly legible and charge. Don't get lost and the chart can be accessed remotely. You don't have to be in the radiology reading room to look at someone's x Ray for example you can which makes me a little sad but I always loved that and you can call it. Data and look at trends and that data can be sent electronically to and from other physicians clinics labs insurance companies anywhere. You needed to be sent as as as long as you will be patient privacy. Of course you should say that. Yeah anyway as with all technological advances there were a lot of promises in this case the promise was that. Mr would make make physicians better doctors. There'd be more accurate diagnoses. More timely therapies fewer mistakes streamlined billing practices and most importantly improved efficiency all this intimately physicians would have more time to spend with their patients exactly the pot of gold at the end of the rainbow more time with patients. and has this happened the the more time with patients part. I mean you know it. Hasn't there have been several studies showing that Dr Spent about twice as much time on the computer as they spend with their patient and tons of anecdotal evidence. Well Yeah Heck. I can confirm that just based on my own practice. And here's the thing. Physicians are spending more time on the computer when they're both with and away from their patients. Just look at what happened when my mom went to the pulmonologist so what is happening. Partly because of the increasingly complex regulatory environment in medicine Medicare Medicaid and insurance companies are demanding documentation for every bill submitted and the documentation must meet criteria. Set Out by Medicare Medicaid before or the physician will be reimbursed for their services so this documentation happens on. The computer is in submitted with the bill to the pair and the primary person. Who Does the documenting is? Is the physician right. Here's an example of typical day for a physician. Prior to seeing the patient will review the medical record mostly so they know what brings a patient in for the day the and also to remind them what meds the patient is on pertinent parts of the past medical history now then. The physician sits down with the patient in the exam. We're there as he gets another computer so while talking to the patient the physician enter data into the Mr about this current visit then after the visitors over the physician will finish documenting with the assessment and plan. Once the notice complete. The physician will then bill for the visit. Sometimes documenting takes so long. That notes aren't completed until the patients have been seen in. The clinic is closed for the day. That's also in. The physicians will correct any notes that need correctly so in my practice there is a person who was hired solely to review physicians knows and make sure her they meet Medicare criteria for the bill. They submitted at the notes. Don't meet criteria. They get sent back to the physician to cracked. And here's a very important point not all. EMR's ours are created equal Semimar. Great they're designed with doctors in mind the allow you to pull data Ford from previous notes. Limit the number of clicks needed to complete the relevant portions of the now they're customizable demise able in the end. Product is easy to read but most Mars have a primary function other than communication. And fortunately this is true. The primary function of many Mars uses billing. And when that's the case for the Mr for doctors will be inefficient and awkward US right. We can't customize it to our needs. We ended up doing a lot of data entry and the end product. Arctic is not something that's easy for other providers to read or understand so the physician spends more and more hours out of the working day with their face in front of a screen instead of making eye contact with her patience chance. Yeah so just a quick aside for second if there are any residents out there listening especially residents who are near the end of training interviewing for jobs. Make sure you talked to. Physicians is in the practice. You're considering and ask them about the Mar- they use exactly. Are they happy with it. Did they spend time at home documenting because they don't have time at work is is the MR efficient or awkward user friendly or the friend of the billing office if the docs you talk to your unhappy with their Mr. Then it's pretty likely you'll be too so move on so so I work with an Mr. Everyday I never look at a computer when I'm with a patient I don't have computers in the room and I don't bring my laptop into the room I had. I decided to make that time sacred without a computer to distract me. I can make eye contact with my patients Cedar subtle reactions to questions conversations. About feelings hopes expectations careers are more likely to come up although squishy subjective things. Your mom didn't get a chance to talk about exactly and I listened better my agenda doesn't dominate the visit. And I'm more likely to see the patient as a human being not a diagnosis our list of diagnoses. Some physicians might think you're no computer. Stance is a bit extreme. So be it. The time I spend with my patients is what makes my job worthwhile and meaningful and joyful and I suspect this is. This is the same for most physicians. Why would I want to compromise that the end result would be a miserable me an unhappy patient? But here's the thing you work in practice that allows you to do that. This is not a luxury Minna. Physicians can afford so what to do when the MR takes over your relationship with the patient first. We need to acknowledge that. This regulatory environment in which we practice is at the heart of the problem so we should all be you proactive about healthcare reform. Okay but short of ideology. What should doctors do? Well look at your Emr and see if it's the problem F it is lobby for a new EMR car or change practices if need be if you're Mars decent than there are a few things physician can do on a daily basis. That might improve things. Yeah so first position position computer in such a way that your back is not to. The patient also involve the the patient with a computer. Show them what you're looking at. Ask them to help update the record. Let them know what you're typing while you're doing it and make sure you spend time away from the keyboard during every visit for some doc sits at the beginning for some. It's in the middle. Whatever you feel comfortable with but at some point you should step away from the computer? Make eye contact with your patient so some practices have hired scribes to document for the physician. Yeah that's a luxury to adding additional staff as an expensive way to solve a problem. Yes it's true and it's kind of awkward to bring a third person into the examining room is so here's the thing. Technology Technology often promises to bring us together as human beings to give us more time to spend doing the things we love with the people. We love just look at the facebook motto. Bring the world closer together together. I thought it was making the world more open and connected or maybe move fast and break things. I think those are previous mottos but whatever my point is we don't always use use technology in a way that maximizes promise and the same is true for. EMR'S DO I want to go back to the paper charts absolutely not but neither do I wanna rule where I no longer remember my interactions with others because my head was buried in some form of technology. You know whether that's at home or at work amen to that so I suggest we take extreme steps to keep this from happening like keeping electronics out of the examining room or demanding a better. Mr Or as patients requesting that doctors move away from the screen. Yeah I think that's really good. Just interjecting here. Yeah as a patient. That's your time to. You can stand up for what you need in that moment with your doctor ask the doctor. Could we talk face to face for a moment if that's what you need and if a doctor has a problem with that you know maybe it's time look

EMR Mr Or Martha Audie Murphy VA ACO San Antonio Facebook United States EHR Comores Minna Medicare Dr Spent Arctic Ford
"ehr" Discussed on HIT Like a Girl

HIT Like a Girl

09:36 min | 1 year ago

"ehr" Discussed on HIT Like a Girl

"You hit earlier on the advances on the patient consumer and caregiver side the example with your grandmother mother and Alexa or about how your father really his choices always gonna be the schedule online and then in just a position to what she said the beginning about how. You can't even access your records when you see the general world advance aimed at a rate that is exceeding our ability to not be able to integrate at an industry SRI level. What does that feel like for you? What do you think you know the the next evolution of things are going to hold to help kind of close that divide? Yeah and it's it's going to have to to make the patient experience easy because we've all seen if it's not there's some patients who are very persistent and they're very on top of their medical conditions. They will persist but a lot of people give up if they meet resistance. They just kind of give up. So the integration challenge is going to have to be solved. There are a lot of. I'm great companies out there that are trying to tackle this now using API's into the HR's San Siro health is is one of them really familiar with is doing great work into helping mm solve interoperability challenge and I honestly believe my own opinion that a national patient identification system is is the only way way and I don't know if that's only going to happen if we ever get to single payer I don't know if that's something that is going to be a like a private company that comes in I and stewards this and gets it up and running. I don't know what the benefit would be to them but to the patient. If you think about anyone can run my social security number and get a credit score on me. What if any doctor could run my national patient identification number and get like a health score on me like a okay? Here's some red flags and and then maybe if I gave him permission they could access all the main important things about me like I'm allergic. Also sporran drugs. That's kind of a big deal but the only only hospital chain that knows that in Texas Texas health resources if I go to Baylor health they don't know that and if I come in on a code and I'm out and no one can tell them I'm allergic. Just Lewis born medication. That's very common pre-operative drug. They give you to combat infection so national patient identification system if they ran number are scan you from driver's license or Cardiac Harry. I don't know what that looks like but I think that is the future. I think that that would be the major catalyst to interoperability for sure. Because we can't integrate we can interface we h I-IT's. We can do it it. I'm I'm starting to wonder if it so we don't want to do it. Because there's not a financial interest for me as an as an organization to integrate with the organization down the road. But the your your point is well taken because the framework to do it and to safely does exist and to you your point lake releasing additional information ray Lucia foreign mental health. You know then you could give empower the patient say do or you don't WanNa share these details with this provide the right. We could possibly probably hold information back him and empower the patient having that ownership of the ID just like you're empowered to really retain. What doesn't doesn't go on with that? Social in in it's so easy. We have the technology think about facebook. If you're on facebook you can check your privacy and permissions you can do it on linked and you can say all of this be private or I just WANNA share my profound on title. I WANNA share my email facebook. You can even weed out individual people so if we we have the technology we need apply it into healthcare because then I could safe had a mental health concern or condition. I'd like to share this with these doctors who are sworn to privacy but not employers. Maybe maybe not certain payers we have a technology for just. We're not there with healthcare yet. They could see there backfiring if people don't know the settings where people like accidentally posted on main facebook when they came into proposed pretty grief. Santa Fe does face with isn't that I mean it's not the best example example but just if you look at just see site right so if you had a national patient identification system and they had a portal for example that had security settings like they spoke where I can go in and check what I wanNA share who I wanNA share with. Who's my next of kin? Who should you call if encoding like these really or if I come in from car accident these really important things? The technologies built out there. We just need to apply it to healthcare and I think it seems even easier because 'cause now have a consolidation of payers and EHR's in the marketplace. There's really less people less players in that space to manage it and honestly if you think about the payer is the key because they have all of this information they have everything about me. They knew if I'm filling my medication or if I'm not they know wearing filling it they know how often filling it so there in almost a better position to be the shares of the data than the actual health system itself. You say You know we work on a side where there's a lot of information though that has also held back and so on the payer side but I think it's a great examples what they can do and when you talk about it from that perspective people people are fearful of the information being shared. I kind of I have to go on the back of my head because you know kind of you look behind the curtain. How the sausage is made and I think they already know that unless you just cash paid a visit Ryan the film script? They know it to some extent. They're going to know it for most patients so that kind of leads US church second question and we touched on it a little bit. You're talking about national patient identifier being helpful. Although I think we have to use something other than P I if you could put on your magical thinking had and think about the wish that you would like to see come true in healthcare health. It with your background. Everything you've seen. What would be your wish if you snap your fingers and time money place are not a concern? It has to be interoperability. It has to be access to all of my data and not filling out paper forms anymore because everyone has easy access to all of my data of course it my will and I just think that would solve so many other challenges would kind the fall into place. If we could just solve that I know we can solve it if we would just work together to fix issues that we are having And maybe you maybe that needs a better infrastructure but I would definitely snap my fingers and solve interoperability and patient nation. What would would that mean for patients like your father? That has Parkinson's or if you want to tell me it's none of my business. I'll be quiet for a patient. Lake my father he. He has multiple doctors. He's he's in remission for cancer but he still has to check for for cancer every a years. So he's got an oncologist. He's got his primary care doctor. He's got a neurologist for Parkinson's but he also sees other specialists because Parkinson's is is a a multi system multi organ disease in the neurologist. kind of like the quarterback but there other providers involved in his care. He has so many medications. My mom asked me once to run home from Church and grabbed him a couple of his pills in cheek mentioned that brand name of his pillbox only had the generic name on it. And and so I think if we could get all this information where he could access everything have it right in front of a he could share it with his family members who are helping to take care of it would show the brand and the generic name together you know just make an easy view like here is a record of medication and when I need to take it and what it. It looks like each day if I haven't like I can tell if he hasn't taken his dopamine. I know that does to him but I don't know at the medicine. He is not dopamine. It's called something else. So it easier view for caregivers and babysitters think about records. When you when I send my daughter who has asthma to school? nope she's got bags of medicine if I could just show them This doctor record of here is the prescription. Here's what they say to use it when she said a an asthma level yellow yellow. We do yet red yellow Green Asthma When she's on a yellow day she needs a little bit more Shera than normal? So if I could just share that one screen view from the doctor with doctor signature on it without having to run around and get permission for her to carry her asthma medicine everywhere. Because it's right there from the source of truth the medical record I think a lot of us could just have easier. Easier lives when you have a chronic condition absolutely healthcare now complicated complicated as is and how it changes essentially you know how much it's changed. Were even just the last probably five to ten years. How do you keep up? Yep You read when you listen to. What did what are some of the more influential media that kind of influences? So when I was in the government side it was definitely. CMS push notifications on twitter and every other social media for CMS. I could find out of new. Regulations came out I have found twitter to be a godsend as I've switched over from more..

facebook Parkinson dopamine twitter Texas Alexa cancer San Siro ray Lucia US Santa Fe Cardiac Harry HR Lewis EHR asthma Ryan
"ehr" Discussed on Outcomes Rocket

Outcomes Rocket

14:48 min | 1 year ago

"ehr" Discussed on Outcomes Rocket

"Office. Doctor Levin has founded several healthcare. It he startups and served as an advisor to many more. He's a nationally recognized speaker and has appeared in academic industry and consumer media. He currently serves on multiple industry in Private Equity Advisory Boards and nonprofit governance boards he received his medical degree and Bachelor's from Brown University and with bat has created an enormous amount of value in healthcare through the many companies he's created and rolls that he's served and so without further ado I just want to welcome welcome you to the podcast Dave. Thanks for joining while thank you. That was a incredibly generous introduction there. Maybe a little bit over the top salt. So what got you into healthcare. Well a you know. Your introductions was really kind to be honest. I think of myself as an often often say I am the forrest gump of healthcare. I feel like a lot of my career his simply bed wandering around and into the frame where other are really cool smart people were doing things and I was fortunate enough to be there when it happened and my entry into my medical career kind of reflects that Sol as a very young man I had a first career in. It really came of age in the dawn of the personal computer era and had believed from from early on that there was going to be a great opportunity to combine the power of computers and information technology with healthcare where it's taken a long time for us to get from that young man's little vision to a place where we're actually doing it. The forest gump part of the the story is I was applying to college and they're literally was a check box on the application. Check here. If you WANNA go to medical school and as I said said I thought at the time yeah that maybe someday I'll combine these things and what's the harm check in the box. That's literally how I launched. My medical career. It ended up. Fortunately Brown was a place that was a good fit for an hour or oh my gosh what a story. Dave and hey you know forrest gump. There's one of my favorite all time favorite movies I I love it and and I just kind of envisioned you there with your application medical school. Okay Hey exit. You're in and now here. You are all things work for him. Somehow and they've worked for you so as you've taken a tour of of health care through your various roles and companies what do you think today's a hot topic that needs to be on health leaders agenda and how are you and San sorrow approaching legend well. There's many of them. I'm going to focus on healthcare information technology today and what's going on is we're in the midst of the next grade transition and health. It I always say health. It onepointoh got us to put down our heads and start using keyboards. Awards was the basic digitalization of healthcare. We definitely need to do that particularly on the clinical side and it sounds Kinda silly when you say it that way but it actually actually was a giant step forward. It's positioned us for what I think of as health. It two point oh which is going to look more alike the experience as we have pretty much in the rest of our lives so it's it's GonNa be more about mobile more about cutting edge technologies about the ability ability to really leverage data in new ways and to connect and collaborate in ways that we haven't before and most of us know this. I mean if you compare are your experience of the typical healthcare encounter with what you experience when you go shopping or do banking or whatever it's as I like to say every day I work work in healthcare and then I go home and live in the twenty first century so there's a real opportunity here I think it's true and at the core of this and where my company is focused is on the infrastructure for creating this new ecosystem this APP economy if you will and a lot of that is about interoperability and increasingly it's about moving to the cloud so our focus has been on really powerful cutting edge solutions that let applications applications connect on exchange data and collaborate just like they do outside of healthcare this is all based on API technology and that's. That's really what we've been focused on for. The last five years is bringing this very powerful proven approach for creating that kind of capability to health care care and we don't do specific applications. What we're focused on is enabling others to take their great ideas and implementing a into a more powerful ways? We can go deeper on that if you'd like not it's absolutely would like to and maybe we could touch on that here as an opportunity for you to talk to us about an example of how San Siro you in the team over there have created results by doing things differently sure well. I think our he and site was over five years ago when we looked at how application programming interfaces or API's have changed the rest of the digital economy this is how companies like facebook and Google and Amazon have really thrive and it's also how they collaborate so that's how Amazon and ups collaborate elaborate so to deliver a package to your front door and allow you to track it the whole way so at its core. This is technology as I said let's applications connect exchange change data and collaborate and we saw that power we recognize this is a major gap in health care and sore focus has been on building a really powerful full. API for data exchange and healthcare and okay well. That's so you know so what what does that really mean. Why is it different and it really radically alters the way you develop all up the ploy and scale applications it delivers much more robust data. Does it in real time and these are all attributes that allow you to bill much more powerful and much more user friendly applications. I like to say we were doing this before. People in healthcare could spell API and in five the years. We've gone from this kind of the newest thing to We're about to see the federal government mandate as part of the new office of National Coordinator rules. Excuse Dave. There's there's no doubt you guys are ahead of the game on this one. I do WANNA. Take a moment to recognize your work. Folks Dave also so is the host of a podcast. It's called four by four health. If you go to Sam Sora Health Dot com you'll see a little tab there on the top four by four for health. PODCAST is an incredible resource for anybody looking to get educated on on health tech API is I mean he's got some great eight episodes on Api One oh one where he had John Orosco the CTO there at San Siro Incredible Work Bay than in. I mean incredible content that you're putting out here. We'll a appreciate you highlighting that in and we do see ourselves as evangelist for this technology may obviously we're trying to to build a successful company to but we're very mission driven we have something on our website called the API learning center and a really recommend it to anyone at any level. We've actually structured up for someone who's brand new to this but we've also provide resources for very advanced users as well. It's a great starting point right We've bought together not just what San Seora thinks about this but a contributor from health level seven we've actually got content and interviews from a government officials about some of the new rags and how this all plays out so very much appreciate you highlighting that I also just want to take a moment to talk about so what why does any of this matter and I'll give you a really concrete example we partner with a company that does real time clinical surveillance and decision decision support essentially their software sits in the background in a hospital setting and is looking for clues about patients that are either getting into trouble or have had an important change in condition or lab results or something like that and in real time looks for this and can alert the appropriate Rick Clinician and also provide guidance about what to do a classic application of this to the problem of Sepsis of widespread infection action. This is a major effort underway nice states to improve our recognition and treatment and this tool basically considered in the background and look for signs of impending Sepsis us and draw the clinicians attention to it so obviously really powerful it starts to bring together the elements of clinical decision support and and even into some degree augmented intelligence the challenges you got it takes a lot of data. You need the stated in real time you don't WanNa find out three days from now that the patients developing substance and you need to be able to inject yourself back into the clinical workflow so the clinicians can get to this easily from a business this perspective this means you are going to integrate to the electronic health record and perhaps other systems and so you also eat away to deploy rapidly the and scale to enterprise. That's still going to deliver the data you need legacy technologies just don't do that and this is really where the API shine so this partner partner firm of ours has gone from a model that required hundreds of hours of interface bill and really only worked with one or two of the EHR's to a model that allows awesome to deploy an hour's can scale essentially infinitely and because our API's designed to be universal it also has allowed them to now enter markets and service other EHR's. They couldn't access before well that's certainly powerful right in with the growing number of devices that patient monitoring devices and monitors and information flowing out of the patient's room how do you connect to it all and so-. API's API's make it Easier Day oh absolutely and and likewise you know as we've seen over the last few years there these emerging niches if you will population health applications unified communications were starting to see some really practical applications of robotic process automation artificial national intelligence what all of these applications have in common is. They need rich clinical data. They work better real time and from go to market company perspective. They need a solution that they can deploy and scale rapidly love that and so is how does the cloud fit into all of this right right. I mean and what are you guys doing to leverage the cloud or help your clients leverage the cloud well so that's a really perceptive question and the whole world has basically clete moved to the cloud and is often the case healthcare is just lagging a few years. We're starting to see this as well and what my engineering Dan Product colleagues have taught me is you just can't do these modern applications and provide the kind of data and the user experience experience that people expect unless it's based in the cloud so I kind of look at it as as sort of simple you need a secure place to put your applications nations and your data and you need a really robust way to pipe data in and out and so it's very what we do is very complimentary and our our solution can be cloud hosted in a number of of our customers. Take that approach got it so if current infrastructure is using the cloud. Give give it a go if it's not give it a go. You guys could apply to both scenarios. That's exactly right and and again we've we've tried to build flexibility into our approach because we recognize recognized people are different places on that journey and they have different needs and different thresholds around security and privacy but the bottom line is healthcare is moving into the cloud. It's GonNa Happen and and fortunately there are some really terrific solutions out there to help people do that in an effective and secure way fascinating so not everything works and so I I like to hear from you. Dave something that didn't work and and how you've learned from it and how it's made you end team Esera better. Will I love this question. We devote a whole podcast or probably several episodes install of my failures in just in general Saul what I've come to appreciate is mistakes and failures are a good thing you know. Hopefully there's a little thought it went into what you're doing but they're really opportunities to learn and so I I've certainly embraced failure. I think our corporate culture does we. We basically see everything as an iteration it kind of flows naturally from our our sprinting scrum approach to software development. You try you learn you. ITERATIVE failures not a bad thing. It's a good thing I'm actually gonNA. This probably surprise you. I'm GonNa talk about one of the biggest failures in my career that it was also the most helpful was when I had a three sixty leadership evaluation done and when the results came I'm back much to my surprise and it was a very humbling experience. Dave thought he was doing an amazing job of being a coach to his various teams teams when their perception was that I was actually pacesetting which is a very different thing and it was a real important moment in my professional development development both because it it allowed me to see what I aspire to do was not what I was actually doing and the process is that I went through the executive coaching and other things that I went through in order to Kinda understand that and learn and practice other leadership ship styles has been a lifelong journey since then. I feel like it's it has been one of the most important failures if you will in my career among a career that's filled with all kinds of interesting film. I love it. It's a great thing to call out. You know if you stop trying to improve yourself. If you live in a vacuum you're really just not helping yourself or.

Dave Doctor Levin advisor Brown University Private Equity Advisory Boards edge technologies partner Sam Sora Health Dot forrest gump federal government San Siro Bachelor Brown San Siro Incredible Work Bay EHR Saul
"ehr" Discussed on Health Care Rounds

Health Care Rounds

14:25 min | 1 year ago

"ehr" Discussed on Health Care Rounds

"Navigation financial resources it cetera to make that process of getting into Saint Joseph's when patients have choice to fly by other hospitals or health systems, and Ed to come here, and, you know lot. Out of those programs. We were competing with our in California, and southern California. You got sitters in your gut UCLA USC fit. And then certainly you see us out that have very significant programs. Well, we've got just as good outcomes. Great quality, great physicians. And by the way, is a lot cheaper to relocate to Phoenix for a period of time. And so the payers are also happy with that as well. So the work on that is I will call at one of our top strategies right now. We see obviously very different payer mix coming from those patients than are typical payer mix here in downtown Phoenix. So as our sisters remind me all the time, no margin, no mission as so we'd need to focus on those programs that can help offset the significant community benefit that we provide here, so now will continue and will grow. And we're working with individual providers to be able to build those programs. And market nationally and internationally that on the international side. It will tell you are main opportunity here is in Canada. There is a significant number of Canadians, who come down here for a period of time every year to live. I think it's something like twenty five thousand Canadians on homes and miracle county alone. And we have already pretty significant Canadian patient base. So working with the, the ministry of actually, as well as locally here with some of the associations with Canada and focusing on those three western provinces, and working with sky harbor as well as Mesa gateway to get the word out on that doing acquainted advertising, both Digital's as well as traditional. And so it's definitely going to be who we are in C HI. They're kind of like show possible, as well as stale, Saint Luke's and Houston. And they a pretty substantial. International program. So that's the other folks little bit different is really on international patients, and it's Morris sleek focus in the cardiac world. So we've actually just recently met with them started to talk about how we kind of bring together, you know, the focus and work together with their program, and with our si-, that's a pretty quick. I mean, we just close the deal and February and you know, we're already made into talked about that. So with that program, do you have, I've seen these setup where it's like concierge medicine where they've scheduled a hotel room will schedule. The airfare. We'll do all of that. Or is it or how much how much of that involvement? Do you expect to have in this program? Yes. All of that, for sure. And, you know, we're, we're fortunate that in, in particular in the transplant service line, a lot of that has to exist anyways, right? You know, you take a transplant patient long transplant is to go back to that example. And they will often have to relocate. To the center that they choose one of our real competitive advantages in lung transplant is that average wait time from listing from when you're listed to get along transplant to actual transplant nationally, just four months, that's the hours will say Joseph's. It's fourteen days and we're very proud of that, and very focused on maintaining that those so those patients will come out and they'll have all their pre transplant work done. And so therefore need to be relocated and all of that. And then they all have their transplant event, and then they'll typically stay anywhere from three to six months, at least after the transplant. So that's you know, that's all about transplant patients family here. No sitting out sometime schools for kids, sometimes here for other family members and all that. So we have multiple examples of patients being transferred out here and then having to also care for their family members for variety of. Reason we have a transplant patient right now and house where his wife is going to have a baby here any day. And so we had to trans- transfer her care out here, and, and that's really, well Silva by having that kind of approach, if you all in place for the for that we were able to kind of use that as the model and then we've been able to kind of copying pay. If you all to the rest of the destination programs as well. So, yeah. So we'll do all of that, all navigation all of that travel, planning all of that financial work. It's have you gone down the route, I've seen the Cleveland Clinic, I wanna say and mayo couple of the larger systems have put together bundles for employers. Is this something that, that you've been involved in, if I don't know if it's been made public, but it, it reminds me of this kind of destination program. Bundle with an employer way do. And then there's also companies that kind of middle brokers, if you will that will do that, as well Cunard's as one of those, which we just recently assigned with believe that's public now and we're starting with a couple key programs, including the long transplant so that, that is one of those we quite a while ago, we are a CEO had a partnership with Intel mostly down in the east valley. But yes, there are several employers direct that we are talking to as well as these kind of brokers, I guess, in the metal to be able to bring those together, as well because, you know, it is about outcomes and quality but also about costs what was the name broker? I can't believe it. I think it's ACC REM interesting. So you mentioned Chr, I and I wanted to wrap things up by talking a little bit about the merger way back to conversation. We had. A while ago. And that is what, what was the thinking behind bringing these two large health systems together. I mean if you look at a map, it's pretty obvious. There's not a lot of overlap and geography. But what was the thinking behind bringing these two organizations together? You know, certainly several stuff's about my pay grade by. I will tell you that I honestly and firmly believe that the dean and Kevin Lofton wanted to have a broader and deeper impact on the health of the underserved in our country. I really believe that that was a driver that the mission around, what dignity health provides for its vicious was HI has provided for their patients for for years and years. They and the two boards, had a deep belief that they could have a broader impact by coming together. And I think that drivers, I think is real. And I think you will, you'll hear that we hear that, and we're starting to see, you know, see that so that I think that's the first step, and I believe that and I think that there are certainly things happening on the national basis around healthcare that we could use a little bit more about focus and mission. Approach. So I think that's the first one certainly Secondly there is the benefit of the size and the scope around, you know, expense management in all the different things that we can do GPO, and all that, I have looking forward to seeing some of that impact at the facility level, and then, you know, third on the, you know, the -bility to work with our pair partners on the right kind of inappropriate, you know, contracts to provide the level and scope of care that, that we provide for us here at Saint Joseph's, which is when I'm really focused on. I look at it as a major opportunity for us around just getting back to those destinations services. You know, the majority of those programs have patient choice in them, obviously, not all of healthcare does, but those programs they percentage do. And so I look at it as an opportunity to even just in, in network. If you will are within common spirit to be involved to impact, our. Our volume by bringing, as many of those patients here as possible, you know, we're certainly not mandating that or, or anything like that. But when you take a look again at our outcomes and the costs, we just wanna make it easy to keep that in house, if you will heard a number of the other day, that apparently comet spirit cures for approximately twenty five percent of the country's population and that's Santeuil surprised. And I guess I'm not surprised that you answer the question that way, at least the, the number the number one reason being to care for, for more of those who can't afford it. Guess of the way to put it already produce the underserve, their patients in this country that are under served, and you don't, don't have access to care, and don't have access to the higher level of care that our system can offer somebody in the middle of you name it, right. So it's all access the appropriate level. Right. But that's also in line with I've come to know dignity. I think that I've told you the separately. But when I initially was looking through the your website a few years ago, I thought, oh, this is a little bit over the top little free. I got to know the system in the people is, you really are mission driven organization for there's no there's no doubt about it. Full disclosure by wife works for dignity and has had a very different experience than her previous employer. It wasn't quite so mission driven. So it does matter. And, you know, my background to John and I've worked in all, you know, other house systems and all that. But for those of us lucky enough to be a part of this, it matters a lot as to, you know what are what you come to work for every day. Absolutely moving forward. What is the time horizon look look like what if they I mean, I, I understand, you've got a massive integration. Process. That's you're going to have to go through getting everybody on the same HR that's going to be fun. I mean, what's as it's been spelled out to you. What is the next twenty four to thirty six months look like for this merger of a lot of things. You know, one of it is just getting the right. And I was really pleased that as early as just two weeks ago, we had a contingent of people from comments Feerick coming. They came to Saint Joseph's just to learn who we are. And it gives you can't really understand it until you feel it and get a tour and can understand the complexity will have understand that we haven't even talked about the whole academic side, but understand our, you know, our relationship with Creighton university and, and all of that. So I think the first step is to kinda get to know who we are what we are what the assets arm with similarities are with different y'all. I kinda stop. But there there's a lot happening on kind of organizational structure, and, and, and all of that we don't really know what's going to happen to your point about EHR's there, I think we've got three or four within the company now different. Once it. So I can't imagine. There's gonna be a massive overall changed. All that words if there's a reason to do that. So, you know, they'll figure that out, but certainly best practices. There are already being identified some things both ways you know the dignity. That's h I did. And so now some suppose crew level position served to get in place, and all of that will look at, you know, we'll get the operational so flake productivity and care plans and joint venture approach, and physician alignment strategies and, and all of that. So that's happening, you know, that the merger took, you know, I think a year, a half or something probably even longer. So loud knowledge, I guess it was gained during that process. So wasn't for not, I guess there's somewhere this already pretty quickly because you know again just to be selfish for Saint Joseph's. We're gonna be all about getting out there, and take it to know our partners and commissary to be able to let them know what we do here and make it really. Easy for them to transition. Mary type patients to us common spirit. I don't know how I feel about that name. If you go back last year, I was lucky enough to interview the chief marketing officer for north well, and he walked me through this whole process. He's in X Ogilvy guy. Think and I think he was head of marketing for at. Nah. And when you have something like north shore, Long Island Jewish that smushed together name come together with north. Well, that's, that's, that's nice. Now I thought that was a really successful brand. I'm not sure how feel about what was the how is that rolled out? How is that explained? I'm sorry. I've not made not making fun. It's just it's not it's not really not really resonating with me, and it's not a word, right? It's a new word because it's all one word there really is a, there was a lot of work as you can imagine on that. Apparently most of us were certainly not art of that. But I think something that was open honest, inclusive of the spirit. All and religious foundation, the both organizations was important, and even though before, and not all of the dignity health hospitals were Catholic. The goal was to have something that allowed us to have a connection to the heritage out both organizations and not be shy about the inclusion of all the different ministries that we that we serve and also backgrounds that we serve so many think, you know, there's a lot behind the, the logo in the, you know, the cross and the connection between both organizations, but will we understand at this point is in terms of the name,.

Saint Joseph Phoenix California Canada UCLA Saint Luke Ed Cleveland Clinic Digital Morris Intel Silva Ogilvy head of marketing CEO Santeuil Houston Mesa EHR
"ehr" Discussed on KQED Radio

KQED Radio

12:55 min | 2 years ago

"ehr" Discussed on KQED Radio

"Let's let's let's go to the phones. Yeah. Let's go to says she in San Antonio. Hi sachet. Hi, go ahead. So I am a third year medical student Popo today distant future by education, clear question a. Records with thought to be you know, the save all was going to get all the information. It's going to help us, and then we get that doesn't companies creating and now we have a whole nother beast to deal with how do you foresee the development and implementation of a I feel that this should be a public endeavor where it can integrate all these different electronic health records are inputs of information. Or do you see the private industry again taking over a possibly creating another beast of various is at various humbles us. That is a great one says she I wish I could go back to third year med school because the medicine in the future is going to be so much better in this regard. But what we had the debacle that occurred with the latronic records was just unacceptable software. But now, we have the tech titans, and so many really innovative startups that are in this space, and the kind of functionality and user interface whether that be for doctors, and now for patients, the problem really gets down to that these EHR's were made for billing, they had no business all business. But no patient care. No. There was nothing patient centered about them or Dr centered for that matter. So this was the fiasco, I think explained now we're changing that and we've already seen in other countries. Dave. I've been able to adjust the software to be patient centered. So I do think it's chief -able. This is basically, you know, software algorithms dealing with data. And I think one thing to keep in mind. So she's that. Re as people are have early society with data. But when you get working with the right algorithms, it has insatiable hunger can't get enough data, and it can do things that will never be able to do. There is a trend in internet of things. There's so many personal sensors now, I know that you very familiar with these on our phones and watches, in fact, my brother was motivated to go to the hospital when his apple watch showed heart fibrillation. Aren't these sensors? Good ideas. You know, I mean. Yeah. I know that you've worked with sensors. And actually, I remember watching you tweet to how you I diagnosed one of your own kidney stones with your own sensor. Right. So what is the path we should take? I we should we depend on our lives on these centers and feed data ain't are we going to be to dependable on. What's the best way to integrate them? Right. I think the problem was sensors is the appropriate use. So if you have risk for atrial fibrillation or symptoms, and you're in a group of people that it would be high suspicion, that's one thing. But it might not be something. An atrial fibrillation detection watch for everybody. This when I diagnose my on my smartphone that I had dilated kidney, you know, when I showed up to the emergency room and emerged from doctor thought, I was an alien when I showed him the picture and so sent me for a cat scan. So that kinda shows you that's emblematic of not fully trusting the sensors and the the the things that we're working with today. But I think over time will will will figure out really who are the right people. The right circumstances to apply these things we don't want it done in a willy nilly way. Because then you just wind up with more in incidental findings more trouble. We we have to be really particularize the way we apply. Thanks. I want to talk about what I mentioned at the top of the hour. I I was talking about radiologists who couldn't who couldn't see a man in a gorilla suit harnessed scan that really happened. Right. Yeah. Tell us in our experience, quite an experiment where. It shows that humans, and he in this case was radiologists their attention. Their ability to see things can be impaired. And they missed a gorilla suit. Eighty percent of the time. Now, why is that important? Well, we get tired doctors, all nurses, all clinicians. We have bad days. You know, we have moods we need time off. And of course, machine algorithms can take on things all the time. They can get sick to of course. But for the most part, they're not distracted, and they can get trained. I think one of the things to note is that they have exceeded already so quickly what we had expected to see in the healthcare seen, and it's just going to get more impressive over time. A lot of this still needs validation replication in surveillance, but I think this is that the point that's quite noteworthy is, you know, pe- people can only do so much, and we need the complementarity it'll augment human performance. And then as I mentioned earlier outsourcing, so we can have that human. To human bond. Now, you did say before the getting to the break that is able to see granularity in the data. And that we can't people can't see picking out Trump. That's very very hard to C N B M would be very significant. Yeah. No. We the data a flood from high resolution images from continuous censor wearable, sensor output from the electronic records from all these other sources is overwhelming. And in general, you know, the whole world where were already exceeding Yata by removing into willing. We hell of a bite. You know, it's really so we need help. And this is this is a rescue for for that ability to cope with this overwhelming flood of data for each person. I mean, each person isn't a high numbers of terabytes already today, and that's just going to increase. Here's a relevant question to that. Mike in Sugarland, Texas. Welcome to science Friday. Thank you. Go ahead throw. The question is I m in a and M L field. I'm in IT. I'm deliver deep learning. So I get that. Art the question as we have so many data coming in from that apple watch each specialists each hospital system has their own data system and repository. So how are we gonna get all this data into one analytical repository? So we could do this deep learning. Yeah. Great question. Mike, it's been done in Estonia of all places, they have all the data sits on every citizen their own data on a blockchain format, and it's continually updated if they can do it. I think we can do it. But you're absolutely right. This is the problem. We have right now things are so fragmented and in order to as as you know, to get the work work through the neural net. You've got to have those inputs, and we are not well positioned for that to help each person. It it's really a vial stepped. It's necessary. Well, do you think that a and these systems will be adopted faster in countries that have universal health care where things may be more centralized? Absolutely. I just finished a year and a half a commissioned by the the UK government to work with a team to review the NHS. I saw they already are taking off with AI. They're already in emergency depart. Percents using voice to synthesize notes and not not using any keyboard? And so they're they're planning ahead for the AI workforce, which is going to have very substantial impact. So universal healthcare does help this in China where they have all the data for each person. Of course that is brings up the issues about privacy, but they are moving much faster because they have all in one place, and they are way ahead in implementing just an incentive Tonio. Hi, you're next. Welcome to science Friday. Yes. Actually right off of that comment. Are you concerned that we don't have the civil rights in place to deal with this type of technology coming in Massachusetts? And also are you concerned about the society as a whole relying more on the diagnostic medicine because of the extreme improvements in their diagnosis? Okay. As opposed to preventative medicine. I guess, you know, well, I mean, I think I am worried in in a road quite a bit indeed medicine about the twenty seven reasons why everyone has to own their data. We just talked about how we can't really do. Well without that. So this is something that you will we have to support who it's going to require activism, but eventually it's it's it's because a lot of the data today for each person is homeless you don't have your sensor data sitting in your electron record. And you don't want your genome sequence or other genomic data in your electronic record. So we don't even have a place for it all and we need that. So eventually, we'll get there. But in order to get to that dream of prevention that we will no risk of many common conditions early in one's life. But in order to actually prevent it. You have to have that data continuously brought in so that the neural net can work with it. And so. So step one is having all your data, and at least in this country, very few people if any have you have a tweet from Kelley, you says will really lead to a doctor spending more time with patients or will they just schedule. More patients per hour. You know, Kelly and IRA that's my fundamental concern. A lot of people is I am are worried about privacy and worsening inequities and security data in biased. But the biggest thing for me is if we don't stand up for patients, this is the time because there's going to be this big revving up a productivity efficiency workflow. And if we don't say that's gotta be if the gift of time to spend with patients, which is so vital a has been loss. If we don't do that. We're gonna lose perhaps the biggest opportunity that we're going to see for a long long time you. Yeah. You see that is one of the main messages of your book. The takeaway, yo people have let's talk about nutrition because you mentioned nutrition as one area where the guide guidelines keep changing how can be used in nutrition. That's fascinating IRA because the chapter on deep diet. I I get into the point that we didn't. No had individualize diet until we had machine learning and the group in Israel at the Wiseman institute led by Aaron Siegel. What they did is now studied thousands of people they got all their data that we've been talking about plus their gut microbiome glucose sensor, everything they ate, and what they were able to show is you could predict from all that data. What would be good for you to avoid glucose spikes after we, and that's something that although we don't know that getting rid of these spikes when you eat will prevent diabetes, but it certainly is suggestive. And of course, now, we're learning about other things that are very heterogeneous. So if you and I ate the exact same thing the exact same amount in time. We would have very different glucose in response, and triglycerides and other labs, and so the question is can we individualize diet, and we're chipping away at it. But if it wasn't for a I. We wouldn't have been able to bring all this data together to to fashion to have a bespoke diet if one wants to follow it talking with Eric Topol, author of deep medicine and science Friday from WNYC studios. This is a gift you can have a book about IB a page Turner, Q, certainly. Let me go to the phones to John in Denver..

apple Mike San Antonio diabetes EHR Eric Topol AI Dave China UK Trump NHS Turner Texas Tonio M L field Israel
"ehr" Discussed on Voice First Health

Voice First Health

11:21 min | 2 years ago

"ehr" Discussed on Voice First Health

"Have you taken your insulin yet today? No, I haven't. Would you like to take it now? No, not really. I'm I'm sorry to hear that. How are you feeling? You know, talk to me. And so there's just this augmented interaction. That is available with voice, and bought and chat. That is another level of engagement that we haven't seen before. Tastic. So the way I am standing this is that it's almost at this point any healthcare provider, if they can come up with some type of idea of how voice can improve their interactions with patients their management of their systems. But they wanna have this specific voice element to the way, they're doing things they can turn to orbit a and get some help in terms of producing that type of skill and technology. Is that fair to say? Yeah, that's definitely something we're doing today. We have probably our largest vertical is with healthcare providers, but we are live cost provider payer farm, on fortune five hundred companies. So orbit is actually working with some really interesting players that you wouldn't necessarily think of as traditional legacy healthcare, players, some examples that jump to mind that I can't name out, right? But are would be telecom companies. That are looking at really augmenting their existing presence with aeging in place solutions. And so the healthcare specific focus of orbit is important because understanding what the context means behind saying, I have a broken bone in the front of my front of my right leg is exactly the same thing as saying. I have a right side for moral anterior fracture. And so being able to Augmon existing natural language processing. That's available in the market with very specific healthcare on holidays and content is important as you mentioned, not just to providers, but really across that deliveries ecosystem and spectrum where players from outside. The traditional healthcare market are now very involved because that's where patients live. That's great. Now, one of the use cases that I know or has been involved with, and I want to highlight this, because there was the inaugural voice in healthcare technology award. That was given out here at hymns by the intelligent Health Association and orbit in partnership with pillow was the recipient of that. So I want to congratulate you first of all, and the rest of the team. That's fantastic. Can you comment a little bit on that partnership in what you created with pillow? Yeah. I can I can tell you a little bit about it. That's one example of where we are operating as an enabling technologies over, really augmenting, supporting pillows, conversational interfaces behind the scenes in, we use our AI tools to help get that up and running very quickly. It's interesting because we're operating in, in a funny space where we are both augmenting existing technologies and products and workflows. But then also offering direct out of the box solutions as well. All of it being selling directly to the enterprise. Wonderful. One of the big challenges with voice technology that many people seem to be bringing up is the issue of hip compliance. How is orbit a dealing with that issue? That's a great question. So at orbiter we are hip a secure the platform itself, and there are hip secure devices in the marketplace today. So the smartphone in your pocket is a great example of one, actually, the pillow device, that you also previously mentioned also hip secure, and so at orbit to having that platform layer that middleware layer that is hip secure is really critical, regardless of the device, that's used in the market, and we take that privacy and security, extremely, seriously, our team has spent a lot of time exploring not just the workflows around that. And what that looks like. But obviously the back end is, well, we brought on a vice president that's focused exclusively on that space in really making sure that as we grow that. That's our number one priority across the. Board. But what's really interesting is that a lot of our customers are playing around with voice in, in ways that don't require that out of the gates to get comfortable with this new technology? And then as they become more comfortable have started adopting, some of those solutions. So I think one sign of maturity in the market will be when we start seeing a lot of organizations at scale implementing hip secure solutions out of the gates. That's great. Another question that comes to mind when it comes to voice technology is the issue of, are you on Amazon? Alexa, are you on Google assistant? Are you a chap Bhatt and I know orbiter has looked at that very closely? And what's orbit is approach to that issue. That's a great question. So the term we use for that is called Omni channel or multiple channels. And what's funny there? So orbital is Omni channel, and we like to tell people that we transcend in work across devices. So we'll augment your smartphone your mobile app. We can work with chat bot within a web browser a smart speaker or a lot of people are calling Alexis or Google assistant devices and even an analog phone. Yes, I'm referring to the old school either flip phone in your pocket. Or or home phone, hard, hard, wire landline and what's critical to understand about that is that, especially in healthcare. A lot of patients, especially an older. Generations. That's what they're comfortable with. And that's what they use. And so in orbit Asaf wear and platform, you can write within one of those modalities and deploy to the other is a relief to say build once and deploy everywhere, which I think, is going to be critical for large organizations because similar to what we saw with large enterprises trying to figure out. Are they going to be a MAC shopper Microsoft shop when it comes to their computers in, we don't want to force those decisions because patients in the home are never going to have all of just one for the most part and organization, especially if you talk about a health system needs to be Omni channel and needs to be able to be flexible as that dynamic shifts in just over time. So that's a great great feature that you have built into your platform, because I know that not everybody starts off that way. Sometimes they'll start on one platform, and then say at some point, I roadmap we're going to add another platform in so that's that's really great. What can you? Comment on where you see the voice technology going in the future. What, what has you really excited about where we're going over the next couple of years? Great question. So if you look at how long it took a Dopp shin of certain disruptive technologies to reach a quarter of the US market, web took over twenty years. If you look at smartphones for example, or or, or mobile in general, it took five years for a quarter of a US population to adopt a mobile technologies voice has already done that. And it did it in four and so the scale of adoption is extrordinary, many of us have personal examples of, you know, octogenarian nonagenarian family members, that love their smart speaker. And so a lot of us didn't see that coming because those same folks won't touch, tablet or a smartphone. And so, I think that's one thing the other thing we're seeing is we're starting to see a lot of point solutions single channel. Point solutions in the marketplace with a lot of success. And I think some of those will continue to do really well, so we're excited about that. But I think similar to what we saw with EHR's when epic concerned those players came into the market many years ago, oftentimes, they weren't necessarily just changing a paper workflow to electric workflow. They were sunsetting fifty sixty legacy systems. So if you look back in the seventies and eighties, a lot of the market started with a back end green screen that was for claims processing, and then they started having clinical front end for CPO e clinical provider order entry, and then when bay concern not to call the big dogs came along, they were enterprise platforms that really met the needs of enterprise organizations. And so I think we're going to see that in conversational technologies and so for us at orbit a being enterprise and Omni channel is kind of our secret sauce in, we're excited to see that. Continue to play out. That's marvelous. You're doing incredible work. The listeners the regular listeners of this podcast will know that I'm always just so thrilled to hear about these different people that are doing such interesting things in the space and orbit as a group is a great example of that. I think we should stop there. Thank you so much for spending some of your time and letting our listeners know a little bit more about what orbit as doing if they if the listeners wanna learn more about what organised doing or doing what would be the best ways for them to connect with you or with the company. Absolutely. You can find us on social channels, or our website at orbiter. O R B, as in boy, IT, a dot A. I feel free to reach out to me personally on Lincoln happy to get connected, but just Terry, it's been a pleasure. Thank you so much for having me. Thank you again. So there you go. Big thanks to Christie for spending some of her busy time while at the conference. Chatting with me for a little while as you heard orbit is a big player at the intersection of voice, technology and healthcare in particularly if you are an enterprise company on you're looking for some type of solution that can be deployed everywhere, as Christie was saying an Omni channel solution their secret sauce as she called it, then you, definitely want to reach out to Kristy, and the orbit A-Team to find out more about what they can do for you show notes with the links for everything that we spoke about today are, of course, on the website as usual, today's link will be found at voice, I health dot com slash thirty and you can go check it out there, and I will have some links to orbit and things that Christie mentioned. Thank you again for tuning in. I'd also just like to let you know that I recently launched a new. Component of the voice, I health website, which can be found at voice, I health dot com slash press. And this is a place where I am curing. Some of the best and most interesting articles that are being written about this intersection of technology and healthcare. So if you are interested in checking that out and seeing a list there for your reading, pleasure. I'm gonna do my best to keep this up to date. You just go to voice for self dot com slash press. And if you have an article or you know, of a really well written article that can really add some value to the community then please, let me know. And I will certainly consider adding it to that page as well. Okay. So have a great week again. Check out the links from today's episode voice, I health dot com slash thirty and other four to chatting with you next week..

Omni Google Christie US Amazon Alexa Augmon intelligent Health Association vice president Microsoft Bhatt EHR Alexis Lincoln Terry Kristy twenty years
"ehr" Discussed on 77WABC Radio

77WABC Radio

13:55 min | 2 years ago

"ehr" Discussed on 77WABC Radio

"Route and you had to run out into the market with what you had and whatever you could build on the fly to try to have an opportunity to get part of that some, you know, sudden opportunity to electrify these paper based practices and institutions and Shamin for use. In somebody's got a little bit backwards. The jump teletransportation transportation without thinking about the interoperability or is interrupted is following and what they're driving was the adoption of HR, which we're not designed for interoperability interoperability is not a problem when very few people have your system or have a system that's electric in the first place when you're living in a paper base world, your interoperability solutions, the fax machine and interoperability was great in paper world for people interoperability being a little tongue in cheek there. Of course. But the reality is that that was not a problem. It suddenly became a problem in a very quick timeframe artificially because of meaningful use and what happened in two. Thousand twelve and thirteen timeframe when the HR's started realizing, hey, this is the way the world is going. We're all going to have electric records, you know, whether mine on my competitors. The reality is to have these records build exchange with each other. And given the knowledge of how federal regulation tends to act coming from top down as in from the federal government on down to the HR vendors was just bound not to be as good as solution as the industry had just taken it themselves. So we took it upon ourselves. You know at that time and common. What was just founded it was just five substantial vendors athenahealth's, Greenway, health sooner. All scripts and McKesson. So those five got together and said, hey, we believe that data exchange is going to be critical. We should be enabling caregivers across the country to be able to find the patient's data, regardless of what the HR record the current or previous providers have used and so we came together and decided create basically a shared services platform, which included a record look at a service and a t-shirt index. So that we really could tell where the patient has been regardless of what each are using. And and something wonky I'll call it the data broker, but it allowed us to be able to exchange amongst each other without having to build point to point connections to find the data whether the patient was on the Greenway healthy HR or seen by Friday using healthier and devastate Genesis officials this notion that we know where we need to go as an industry, we know how we can get there. Let's build something that we know were because we are going to be. On the hook to though them. And then let's open it up. So they're being tired industry. Can join us. The government can join us, and we really can't take care of the patients across the care continuum. The notion that you think we're on this precipice of having the data flow, and certainly to make that happen. We need to sort of understand the standards that are required to facilitate the building of the infrastructure, and there's this growing enthusiasm for something called fire, and that's not the flame. But rather this is a fast healthcare interoperability resources f H I R technology, and that was developed by the folks that H L seven of the global authority for interoperability and health information technology and h l seven has defined their goals for advancing interoperability through the Argonaut project. And I'm wondering if you could tell us more about the role of fire and why it's so vital to scaling up innovation and the health information technology arena. So I was one of the founders of the Argonaut project as well. Number of the founders of the Commonwealth health alliance also founders of the Argonaut project, so. What is fire? It comes down to this fire Nabil's to thinks it is based off of much more modern twenty-first-century internet protocols to share like traffic data, and it represents a data format for exchanging. What what an industry luminary name west racial likes to call molecules of data. In other words, share with me just to did. I am interested in not necessarily the entire patient charter the entire encounter summary. It's a little bit like the difference between sharing a tweet versus sharing full word document and the ability to work with modern protocols means now you can attract into this industry, a younger newer generation of participants from Silicon Valley you can across folks from technical colleges and universities across the country to come and participate meaningfully in developing innovations without requiring a lengthy. Participation in the industry in the first place to really understand how these old ancient protocols that'd be used typically in this industry that you know, have been the mainstay of the industry these last forty something years. So if you get it, right and everybody implements the same modern protocols everywhere in other words, actually standardize it then that means that somebody who's building a startup can work with several different EHR's without having to rebuild their sock for again. And again, then that second part about the data itself. The data being available molecules me and she can participate in have other types of exchange. The fact that you now can share, you know, just immunization. So just allergy is the fact that you can kind of pick and choose the type of data on exchange intuitively. It should be a game changer. You should be able to create innovations that are very very focused on particular things people need like being able to find immunizations for your child or something, you know, if you if you're if you're going to take them to soccer camp, and they need all of that. And things like common. Well. Who provide the ability to go and find where the data is to correlate it to a single individual come even more useful in this scenario. And in fact, it reduces our costs because right now, we do entirely document exchange with these old legacy systems and our ability to X participate with those participants became cheaper because everybody is now using much more modern protocols as directed by Argonaut project legitimate. I really appreciate your your optimism and excitement about moving away from the ancient code into this new era. Yeah. Just recently. I think there was a fair amount of anticipation leading up to this year's hymns global conference. It was marked by some big announcements from the centers for Medicare and Medicaid services from the administrators seem Verna and others within h h s who I understand announced him pretty bold new rules for advancing health data liquidity. And I understand that this rule says that by twenty twenty no patient should have to wait more than twenty four hours to gain access to their own health records electrically and at no cost to them. That's certainly a pretty big difference from the thirty days that people have to produce those records. Now, this is huge. It signals a new incentive certainly for health systems to improve health information sharing. This is a radical shift. Tell us why you think these new CMS rules are so significant. If you just think about what the experience is today for an individual participant healthcare. You know, we've heard we heard stories from our neighbors, and our friends, and then we've heard from very high profile individuals like Seema Verma, but care of her husband, or, you know, former vice president Biden and the care of his son who who segments cancer, and and be like if you think about all these scenarios underlying theme, there's just a lack of empowerment as an individual in this country when you're participating in healthcare. Whether you're outcome is good or bad. You are a victim of the healthcare system here. That's the issue. When Commonwealth was formed on notion was, you know, the caregiver should really get the data. No matter where the patients receive care, and the caregiver was always broadly defined to be it could be the clinical provider. It could be the patient themselves. It could be the parents to teachers whoever we expect it to the book of the change would would be driven. Even by clinical providers physicians nurses, and the like and that has borne out to be true. But from the very beginning. It was all about enabling it for whoever needs to have authorized access to take care of that. And as initially thought this rules, depend to thanks. They have said that. Yes. The individual must be empowered. And they're focused on the individual even though I'm not sure the immediate volumes will come from the individual. Although you could certainly argue that over the next three to five years, we expect more healthcare to be driven by individuals themselves. Not only are we moving in the direction of more interoperability. We're really moving in the direction of greater empowerment, and that's what I really love about the rules set have come out. And the second thing is this notion that there's really forcing adoption off these fire API's, and to the extent that we know everywhere that the same set of API is going to be utilized for. For the majority of the health system that participates with CMS as they appear that enables higher interrupted body. Not only will it become utilized for the purposes of enabling patients to get their kid. But will also be utilized. But others who wanna participate in the care. What Commonwealth has done in the posh? We already have patients to connect to us. In fact, we've been able to for the last three years, and I think this I think will in search that kind of confidence that HR patient app developer is gonna feel that hey, guess -ticipant here. I know for sure that other people I participated will have the data will have it in a format that I can reliably dosed software that can build innovations on top of we've already done some parts of it in common. But the fact that CMS is really going to drive the industry to standardize and to accept the patient has a right to their data. I think would be a big boon for all of us who are just trying to make make interrupted. Ability. With us ninety the first executive director of the Commonwealth health alliance. A not for profit trade association of healthcare and technology organizations working together to create universal access to health data nationwide and was one of the founders of the Argonaut project. Didn't you say that we've reached an interesting pivot point where we've gone from not having enough data to all of a sudden having too much of it seems that there's just increasing demand for information. We at that our health center and engaged with the all of us project, tearing together, genomic information, health information, social determinants, there's just an enormous amount of new streams of data flooding into the system. And what's the next five years? Look like in terms of synthesizing this information. You know, if you if you just think about the different pieces, you need in your health, data puzzle as a provider, you know, you have disparate data. Sources you have the clinical charge. The social determinant data genomic Stater, and the like, you have a system that faces to you, right and actual EHR other issue system. But you don't you don't touch them. Feel commonwealth. That's sort of like the Verizon network somewhere in the background doing its thing. And you need to know where these data sources are. And get them connected at the tiny needed for the patient. You need it for. Here's what I see happening. As folks realized that there is a lot more data that they need in their locality in order to be able to exchange data. I see them making a lot of point to point connections. Let me just connect to the local state agency that has the housing information for these patients who have socioeconomic issues. In the meantime, I'm gonna connect to common ball because we only get the clinical chart data on the patient. And then it's gonna come up here into my ear Sharma, your Chuck provided by XYZ vendor for the patient for whom I really need that information. I get to license. I'd see that bearing on even right now Mark because the. Participants on the common while network who immediately started using the service to a great degree. We're actually PCP's who are seeing brand new patients because they were so desperate for any data that even if they did I came across from some location, and it was not a well formatted, David still at least skim through it had something and over China's the data's become better. We have more and more use cases where people are utilizing it in more situations. I think this is the big transformation as either jars meet the transition from enterprise software systems that have interrupt ability as a feature towards interoperable web based systems that have user facing functionality that makes you more intelligence the experience of users can get better as goal post moves from. Hey, do I check the box and functionality to have my creating an experience. That's so good. In light of the fact that I'm seeing more and more data coming into my SIS. You know, as we make that transition. I think the experience for providers and caregivers is going to dramatically improve. My my sense is that CMS has already seen this. I mean, they are trying to drive more usability related regulation. My sense is that each vendors investing more and more in the states and some of the newest EHR's on the block kind of really think of themselves as interoperable platforms that have HR functionality built on top of it. And so I think as the world moves in that direction the realization that there are all these other data sources out there. It's just gonna be table stakes..

Commonwealth health alliance HR Commonwealth Shamin Argonaut soccer EHR McKesson Silicon Valley China Verizon Nabil twenty twenty
"ehr" Discussed on Venture Stories

Venture Stories

04:09 min | 2 years ago

"ehr" Discussed on Venture Stories

"I think there's hesitation among a lot of companies in especially Silicon Valley companies to sort of shy away from talking to the regulatory bodies at least until they're ready. And and I think that's a big mistake. Because then I think it's gonna take time from the first time you talked to the FDA onward to to actually get it. Right. So I've seen companies having to do multiple FDA pre submissions before they actually get it. Right. Which takes them extra time. What are other mistakes companies make as it relates to go to market, or what are some things that they should understand her to do differently or that are fundamentally different in healthcare? You know, build it, and they will come doesn't exist. At least for the diagnostic side of things. I think the other thing is almost every founder that I've spoken to in the space underestimate how long it's going to take it will take much much longer than you could possibly imagine. It you look at some of these diagnostics companies of the past they took ten plus years to get their first product out. And let's say that machine learning is this wonderful magical thing, and you know, that can greatly accelerate your research and development, research and development is the first step to getting a product out. And then if you're on the diagnostic side, you have to get, you know, some kind of clinical validation, whether it's Cleo or FDA, and then you have to go for reimbursement. If that's what you're really wanting to do you could you could have a test that's out of pocket for people if your market speaks to that. But then even after you get reimbursement for cancer screening, specifically ends and screening tests specifically, you have to get into the medical guidelines the guidelines that clinicians follow when they offer a clinical tests for patients. Right. So in the screening case there is something called a USPS the United States preventative screening task force. And they that is the guideline that most primary clinicians in the United States follow. Oh as far as offering screening tests. They will not use your screening tests on this. You're in those guidelines USPS Jeff meets every five years to make decisions on new screening tests. So you miss whatever deadline that you're coming up with your you're talking about waiting another five years right in. Yeah. So the they're these kinds of things that I really didn't know about you know, how to get a diagnostic. I think when I started a company that I wish I knew, and you know, they're for therapeutics these barriers that take time, and there's really not much you can do about it to make faster. I mean, I have a certain things I've learned about working with bio specimens specifically. Right. So like this won't wouldn't apply to people who are doing EHR's or structure date onto healthcare. But for example, into cancer screening space, specifically, if you're using machine learning methods, or if you're just trying to do research and development to come up with new tasks, the exact nature of the blood tests that you collect matters. So we've worked with some of the finest institutions. In the United States in terms of hospitals that send us these blood samples where we do research and development and even then probably about five percent of the time. We get samples that are labeled male that have to x chromosomes, you know, the samples that are labeled female to have accents y chromosome. And so there's some mislabeling that's happening there on top of that. It makes a difference. For example, if the blood sample was drawn from somebody who already knew that they had cancer versus a true screening application like somebody who didn't know there that was about to go and get the diagnostic tests done while why does this matter? Well, when somebody is told that they have cancer they rightfully become really stressed out when they get stressed out. There is a stress response in your body. There's chemicals that cortisol and things like that that gets released into the blood d- actually changes higher DNA fragments how cell free DNA gets degraded in your body. And so oftentimes what you see these companies that are trying to make these tests they train on. Samples that are, you know, post diagnosis, but then what they're really fitting to is not cancer versus healthy. But the stress response versus not stressed. And then when they go to validate the test that.

FDA United States Silicon Valley founder cortisol Jeff EHR five years five percent
"ehr" Discussed on DataFramed

DataFramed

03:59 min | 2 years ago

"ehr" Discussed on DataFramed

"One of the main limitations on the right of adoption of I in healthcare. Yeah. Good question. So, you know, we talked a little bit about what are sort of the policy hurdles, and we've talked about how do we think about you know, approaches I think what is the biggest rate? Limiting step in healthcare is going to be. The ability of good quality data, and this is sort of the the biggest challenge that I think has been plugging healthcare for decades. Now is that you know, as soon as a novel data set is released into the healthcare wild. Everybody gets really excited about it. So, you know, as soon as the government may standards for health records EHR's became sort of competitive domain for any organization that had the record, right? And then challenge was getting access to that data. Same thing with genomics. Now, we're starting to see I oh banks and be -bility to have gentlemen, genetically sequence data genetically Tebas data that is sort of the next domain. That's where people are sort of trying to get to. But none of this matters unless the data is Lincoln, unless there is a standard unless there is labeled data, you know, we talk a lot about imaging today. But radiologists suffer from the fact that imaging data is stored within these hats warehouse this access the are having system and then they're not waiting bold. So we don't know what we're necessarily looking at. And what that all those the show is. That the biggest hurdle for induction in healthcare is good quality data, which is why I mentioned, you know, standards like fire and others trying to create some kind of harmony inconsistency in the data in very chaotic world. And the other thing is that you know, hospitals and other organizations that have the data are very much willing to work with players. But there's quite a bit of overlap in terms of what companies are promising the restarting to see a lot of companies tread into different spaces than say that they're doing on development or they're looking at molecule identification, target validation, and they're trying to be jack-of-all-trades. And I think that is sort of getting, you know, the company actually does though might might Gushin is just having a very clear refined focus on what you think you are doing and what you're good at versus trying to then Wade into a lot of other murky waters, you know, with that setting the market is so hot right now that you will see a tremendous amount of Arnor ship and an opportunity. Or start out. The biggest step is access to the data finding the right partner being able to demonstrate a use case and then the application of that algorithm within within clinical practice, so but one little question from one of our listeners. And then I'm gonna ask you one. Final question. This is from and it's a relatively generals question that I'd like to interpret in whatever way, you you say fit, a do you think of fischel intelligence will democratize medicine interesting? I think that we will get to a place where I'm going to be liberal about the use of the word democratize. I think what that means is any anymore access to care. And perhaps, you know, are maybe they'll sit condition that will choose to use. You know, I think patients are increasingly interfacing with the health system in different ways. And the fact that the majority of divest majority of patients go online to look up health information over ninety almost ninety percent. Now, the fact that there is still, you know, there's a lot of ways for patients to share their data now with physicians with companies, we all know, the work that Apple's doing and in sort of work in hell kit and research kids and try to get out. More access to data. I think there is going to be some greater role for a I m maybe technology to help with access to care in mid. Hopefully, I'm addressing your question, but feel free to raise at the same time. The US is suffering from tremendous endemic health Halsey challenges that I don't think I will fix. I think AI will enable and help certain things maybe power diagnoses. Maybe it'll be improved better health outcomes over time..

Lincoln EHR US AI partner Apple Gushin Arnor Wade ninety percent
"ehr" Discussed on NEJM This Week - Audio Summaries

NEJM This Week - Audio Summaries

02:00 min | 3 years ago

"ehr" Discussed on NEJM This Week - Audio Summaries

"Long run are less clear subscribing to your patients reimagining the future of electronic health records up perspective article by catherine choi from the university of pennsylvania philadelphia nearly all us healthcare systems and many physician practices have by now migrated from paper charts to electric health records ehr's but though this shift could have been a transformative change current ehr's are largely digital remakes of traditional systems and clinicians engagement with them seems limited and effort full hospital based clinicians for instance must still go to the chart to check on their patients what would it be like to instead subscribe to ms jones in room three twenty eight these authors developed a web application to pull real time information from their health systems multiple digital sources and allow it to be reassembled into customizable dashboards mobile display as and push notifications the result was a platform that can tailor streams of data for particular clinical scenarios and measure the impact in an early pilot residents who opted in were subscribed to push notices about their patient's medication expirations similarly inpatient teams subscribed to text reminders for their patients who needed total parental nutrition reordered before the three pm administrative deadline it was one more checklist item that providers were relieved to have off their minds furthermore subscription services can shorten the lag time between when information becomes available and when it's used they can allow filtering to emphasize what's important and relevant and they can permit management of panels of patients.

catherine choi philadelphia ms jones university of pennsylvania
"ehr" Discussed on NEJM This Week - Audio Summaries

NEJM This Week - Audio Summaries

02:21 min | 3 years ago

"ehr" Discussed on NEJM This Week - Audio Summaries

"Ah protein truncating hss d seventeen b thirteen variant and protection from chronic liver disease by nora who abortion from the regeneration genetic center tarrytown new york elucidation of the genetic factors underlying chronic liver disease may reveal new therapeutic targets these investigators used xm sequencing to identify variants associated with serum levels of allah nina aminotransferase and aspartame you transfers markers of parasite injury using data from discovery ehr a cohort study that links xm sequence data to electric health records and three additional studies they then evaluated the associations between implicated genetic variants and chronic liver disease a splice variant in hss d seventeen b thirteen encoding the hypnotic lipid droplet protein hydroxy steroid seventeen beta dehydrogenation thirteen was associated with reduced levels of alan aminotransferase and aspertain aminotransferase among discover ehr study participants this variant was associated with a reduced risk of alcoholic liver disease by forty two percent among heterosexual goats and by fifty three percent among jose hosego's non alcoholic liver disease by seventeen percent and thirty percent respectively alcoholics psoriasis by forty two percent and seventy three percent and non alcoholic cirrhosis by twenty six percent and forty nine percent associations were confirmed in two independent cohorts the splice variant was associated with reduced risk of non alcoholic seattle hepatitis but not st joseph's in human liver samples a loss of function variant in hss d seventeen b thirteen was associated with a reduced risk of chronic liver disease and of progression from st toasts to statal hepatitis.

chronic liver disease nora alan aminotransferase liver disease jose hosego joseph new york nina aminotransferase seattle forty two percent seventy three percent fifty three percent forty nine percent twenty six percent seventeen percent thirty percent
"ehr" Discussed on Let's Talk Bitcoin!

Let's Talk Bitcoin!

01:55 min | 3 years ago

"ehr" Discussed on Let's Talk Bitcoin!

"So i i think that um you know i it's really hard for me to imagine that there's gonna be one world where there's one block chain that rules them all and everybody is happily participating on it there's gonna be many many value networks and and and we're already starting to see lots of projects are trying to find ways to unify those blockchain's like polkadot in cosmos and others right so i think the industry's moving in that direction away from one block chained to rule at all bitcoin you know two we're going to live in a world where there's literally thousands and thousands of different networks that you can connect to why isn't blocks in living as it bicknell gene good doom to devote minimum data she or making some of data liquids yeah so i think uh you have to look at the alternatives so the way data's moved in shared between our prizes today is one of two ways one is that you have uh some central aggregation service that basically act says a especially broker of data between parties great they're like a central a central hub of all the data for foreign industry on like health records are you know centered around ehr hubs uh but then there's many different age hr hubs and so yeah this challenge of uniting health data from one ehr system to another so they've created these ideas of a health information exchanges which operate like at a state level and those become a central hub for interoperability of health records from different systems uh but then the to the child with that is that there's many of those hubs because they're only state statewide so if you travel for california arizona now you're dealing with a different network so it's this idea of trying to centralise data is always a problem you just end up creating more and more hubs and those become more and more silos.

arizona california
"ehr" Discussed on Epicenter Bitcoin

Epicenter Bitcoin

01:55 min | 3 years ago

"ehr" Discussed on Epicenter Bitcoin

"So i i think that um you know i it's really hard for me to imagine that there's gonna be one world where there's one block chain that rules them all and everybody is happily participating on it there's gonna be many many value networks and and and we're already starting to see lots of projects are trying to find ways to unify those blockchain's like polkadot in cosmos and others right so i think the industry's moving in that direction away from one block chained to rule at all bitcoin you know two we're going to live in a world where there's literally thousands and thousands of different networks that you can connect to why isn't blocks in living as it bicknell gene good doom to devote minimum data she or making some of data liquids yeah so i think uh you have to look at the alternatives so the way data's moved in shared between our prizes today is one of two ways one is that you have uh some central aggregation service that basically act says a especially broker of data between parties great they're like a central a central hub of all the data for foreign industry on like health records are you know centered around ehr hubs uh but then there's many different age hr hubs and so yeah this challenge of uniting health data from one ehr system to another so they've created these ideas of a health information exchanges which operate like at a state level and those become a central hub for interoperability of health records from different systems uh but then the to the child with that is that there's many of those hubs because they're only state statewide so if you travel for california arizona now you're dealing with a different network so it's this idea of trying to centralise data is always a problem you just end up creating more and more hubs and those become more and more silos.

arizona california