Excellent new paper from Nuance

Full PDF copy here.

In order to redesign healthcare, we need to become new students of the problem—erase the assumptions we have and approach the challenges with a fresh mind. We can achieve this by interacting with the people who will be affected by the solutions we create and observing the situations we are trying to improve.

After all, it isn’t about the specific tools or technology, it is about crafting an ecosystem focused on care, one that delivers real and meaningful value to people’s lives. Humans are hardwired to seek out meaningful connections. It falls to us to design technology that helps fortify relationships, shares information, and facilitates communication between individuals and their care teams...

Technology translates.
It turns typing, touching and speaking into digital information. It can interpret a stream of words into structured data that drives actionable systems. And it can translate medical-pharmacological- insurance terminology into something patients can understand.

Technology connects.
It sends data around the globe in seconds, immediately sharing images, impressions, and sensations. It obliterates the distance between any two points on the network, moving information from parent to child, laboratory to bedside, exam room to living room.

Technology tracks.
It records, stores and plays back. It calls up events, x-rays and prescription orders. It can tell you how many steps you took and how fast you ran last week. It can tell you when to refill a prescription and congratulate you when you’ve achieved a goal.

Technology should be the wind at our backs, not in our faces. We need to take these powerful capabilities and artfully create healthcare technology that supports and empowers the way we live, not distracts from it.

Innovations are plentiful, but cool tech alone will not solve our problems. We need to use human-centered design to improve the experience of technology and drive toward better health. It is time to redesign healthcare technology into a highly reliable point of support for the person who can do the most to improve the patient’s health: the patient.

Healthcare solutions can be redesigned to empower the patient to become his or her own best care provider. Every patient is in touch with his or her thoughts, sensations and feelings every minute of every day. We can’t continue to let their health information, plan of care, and other valuable resources be locked up in a maze of systems. We can design technology that provides them with access to the right information in the right context at the right time, and effectively connect them with their own health information and care team...

“Technology should be the wind at our backs, not in our faces.”

A very nicely rendered compilation of perspectives. Download it and read it. Well worth your time.

4. When redesigning healthcare, what really matters?
By Amy Cueva, Chief Experience Officer and Paul Kahn, Experience Design Director Mad*Pow

7. From Rockwell to reality: the evolving role of the physician
By William K. Kapp III, MD, MS, FAAOS CEO and Chairman, Landmark Hospitals and Technomad

10. A lost luxury: taking patients every step of the way
By Steven M. Schiff, MD, FACC Medical Director, Cardiac Catheterization Laboratory CMIO, Orange Coast Memorial Medical Center

12. For physicians in the foxhole, fast and easy matters
By Carl I. Schulman, MD, PhD, MSPH, FACS Director, William Lehman Injury Research Center Associate Professor of Clinical Surgery and Associate Director, Surgical Residency Training Program, University of Miami Miller School of Medicine

14. The collaborative system: transitioning to user-friendly healthcare
By Jonathon Dreyer, Director of Cloud and Mobile Solutions Marketing Nuance Communications

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Just in from Forbes:

Electronic Health Records - Expensive, Disruptive And Here To Stay
Nicole Fisher

Physicians have more to do these days and it has nothing to do with treating patients. Although staff shortages and increasing need for care are time consuming for providers and add responsibilities, the real culprit of lost work time, especially for Emergency Room physicians, is electronic health records (EHR). The need to make sure every interaction is digitally recorded for a patient’s personal archive is a necessity of improving care and future regulation, nevertheless it is also disruptive to health providers and systems spanning the country. Jonathan Handler, MD, FACEP, Chief Medical Information Officer at M*Modal says that modern EHRs are often overly focused on data entry and typically provide poorly designed data displays with rudimentary functions for searching and organizing patient data. The data entry steals physician time away from direct patient care, and that is what’s driving physician dissatisfaction.” EHRs are also exceptionally expensive, sometimes costing millions in technology, education and lost time, as well as presently remaining incomplete. Despite claims from the Secretary of Health and Human Services that great progress has been made, other federal agencies assert that there is a long way to go and measurements for EHR success are impossible. Nevertheless, with Accenture forecasting that the U.S. EHR market will hit $9.3 billion with a 7% annual growth rate by the end of 2015,  and federal requirements to comply, EHRs are not going anywhere.

Government Push For EHR
Even the Government Accountability Office (GAO) has taken a swipe at the incentive program for EHRs claiming it lacks an ability to demonstrate goal achievement for improving care. GAO specifically stated that there needs to be better strategy for establishing reliability in clinical quality measures, which will be necessary in the second stage of Meaningful Use (MU), especially since CMS Administrator Marilyn Tavenner announced there will be no ICD-10 or MU Stage 2 delay...

While EHR’s are still working towards interoperability, clinical imaging has charged forward with vendor neutral archive (VNA) technology. VNA systems archive clinical images in a vendor neutral format, provide imaging workflow, and access to all clinical images throughout the enterprise from the EHR. Jon Hamdorf, Director of Global VNA Solutions for Perceptive Software believes, “VNA technology delivers on the promise of data ownership which is the foundation of interoperability. Patient information needs to become more accessible in more dynamic ways to support new models of care.”

According to Dr. Handler the answer is simple, “Computers need to do work for physicians rather than making physicians do work for the computer. Technologies should make it faster and easier for the treating physician to view relevant information, to document a useful patient story, and to make the best care decisions”. He believes this can be accomplished through various means such as single sign-on, biometrics, speech recognition, natural language understanding, computer-assisted physician documentation, advanced data visualizations, predictive analytics, and other modern technologies. “By supplementing EHRs with these modern technologies, we can increase physician adoption and ease the burden of EHR entry,” contends Dr. Handler.

There is no slowing the EHR train, or the transition problems and costs associated with them. Therefore, as we all work towards greater access and better care, it is time for health technology companies and physicians to work together, and ensure that physicians are allowed to do what they do best for the people that need them the most.

This is not exactly a new story. One can only hope that we are on the cusp of exponential improvement in Health IT, that the next 5-10 years will see orders of magnitude of advances relative to the last. Nonetheless, technological advances may continue to be hampered by lethargic progress in reforming the health care business paradigm. That is where the principal difficulty lies.
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More to come...