Have you ever been frustrated by your experience as a patient? I found myself recently needing to take my husband to an urgent care on a Sunday due to an unfortunate incident. Everything about the experience from start to finish was less than ideal. The check-in involved a clip board and pen asking questions that we already answered 100 times before. The poor nurse at the front desk then had to manually enter our information into the computer. This archaic process caused delays for every patient waiting, and the room only continued to fill up.
What’s even more frustrating, is that it would not take a big investment to improve my experience. A tablet that syncs to the EHR versus a busy nurse trying to interpret my frantic scribbles, would be far more efficient.
It can only take one bad experience to deter you from returning and healthcare providers are no exception. After our experience, we would never return to that urgent care.
Improving the patient experience
Healthcare is taking the lead from other consumer-oriented industries like retail. Healthcare providers are seeking ways of removing friction from every area of the patient experience, from scheduling to check-in/check-out, pricing, payments, to follow-up care. Even the president of HIMSS points out that every patient wears three hats: citizen, patient and consumer.
Retail strategies healthcare can learn from
It is the experience of the patient as a consumer that we can apply the learnings from the retail industry to evolve the overall experience for patients. Especially when looking at ambulatory facilities, whether a physician clinic, an urgent care, or a surgical center, there is an aspect of the guest experience when you are in the waiting room that transitions to the patient experience once you enter the exam room.
Research in the retail industry shows most consumers will choose a competitor after 1-2 poor experiences. Patients today have many options including retail pharmacies offering primary care such as CVS and Walgreens, telehealth providers such as Teledoc and MDLive, and other independent urgent care providers. Are healthcare organizations keeping in mind how little room there is for error with patients?
This topic of retail healthcare is one we will be examining much further. Windstream Enterprise will be an exhibitor at HIMSS 2019. Be sure to visit us at booth #735 and attend our speaking session: Retail Healthcare Delivery Evolution on February 14th from 10 -11 AM. Dev Ashish, CIO of GoHealth Urgent Care and Rehan Shah, Regional President of Windstream Enterprise will be speaking much more on this very topic.
How do you know when it’s time to replace your organization’s legacy IT infrastructure?
There are always new technologies offering advantages over what you have. Just like there will always be questions about whether to invest in those technologies when what you have is working, however imperfectly.
Inevitably, all legacy systems get replaced. But what makes the timing right?
For Gaston Family Health Services (GFHS), adopting advanced networking became a necessity when legacy infrastructure no longer supported the organization’s mission.
Distributed organizations increasingly depend on modern IT solutions
GFHS operates 23 primary-care facilities across five North Carolina counties. These clinics address the needs of 55,000 (and increasing) patients who can’t afford insurance and would otherwise get their primary care from emergency departments.
As demand grew over the years for GFHS health services, so did the bandwidth requirements of primary applications – a double-strain on GFHS’ WAN technology. It reached the point where the GFHS team of six IT professionals were frequently consumed by responding to reports of network slowdowns that could not be permanently fixed.
GFHS was similarly hampered by an older, hosted PBX phone system that couldn’t keep up with growing call volumes – and the phone system offered no reporting on call metrics that could guide improvements.
Diagnosis, treatment and recovery
GFHS engaged Windstream Enterprise to explore potential data and voice solutions. An initial needs analysis pointed to replacing T1s with fiber, plus cable broadband back-up for redundancy and reliability, and SD-WAN for network-wide visibility with application‑level monitoring and reporting.
Calls from clinics reporting network slowdowns disappeared after implementation. Now, IT professionals monitor the system for potential issues, which they can proactively correct using the SD-WAN self-service portal.
On the voice side, new unified communications as a service (UCaaS) and contact center as a service (CCaaS) solutions overlay the SD-WAN, delivering a wealth of functionality and customization far exceeding that of the old PBX system. Spikes in call volume are no longer an issue, and a variety of reports provide insights for fine-tuning.
Improving data and voice services delivered productivity gains for the GFHS IT team, which has shifted from addressing continuous problems to initiatives that improve the patient experience. Reference the complete case study here for full details on the improvements GFHS has seen.
If efforts to wring maximum life and value from legacy IT infrastructure are impeding your own organization’s ability to achieve its mission, it’s time to consider your options.
The entire healthcare industry has become much more focused on improving the patient experience. That’s crucial for a number of reasons, including good old customer satisfaction. It’s easier than ever for patients to explore provider options, and they’re doing so in significant numbers.
How significant? According to a recent Accenture study, 7 percent of patients have switched healthcare providers due to a subpar experience. The potential cost to a single hospital: upwards of $100 million.
Provider organizations that seek to reverse this trend and improve patient loyalty have a proven means at their disposal. It involves adopting automated tools that other business-to-consumer (B2C) industries have broadly deployed to improve their own customers’ experience, with great success.
Improving customer contact at every point elevates consumer satisfaction
The Patient Experience as a Service (PEaaS) concept combines two popular B2C technologies – Contact Center as a Service (CCaaS) and Unified Communications as a Service (UCaaS):
PEaaS wraps these principles of patient engagement, clinical collaboration and security into a single view of the patient as a customer whose loyalty must be secured at every point of contact in their journey.
Exceptional customer experience drives customer loyalty – including patient loyalty
B2C industry leaders have benefited for years from CCaaS/UCaaS-driven improvements to the customer experience and customer retention. With studies repeatedly showing that acquiring a new customer is many times more costly than retaining an existing customer, CCaaS/UCaaS represents a sound technology investment, removing contributors to poor consumer experience that can drive customers elsewhere.
PEaaS translates those principles to healthcare, treating the patient as a valued customer with every pre- and post-care interaction.
That matters because for patients, searching for a new provider online, including reading patient reviews, takes just minutes. By improving the patient’s ability to communicate with a healthcare provider, and to have information throughout the organization readily available when they do, PEaaS can go a long way in keeping patients from searching elsewhere in the first place.
Hard to believe but HIMSS18 is behind us now. It was a terrific show with a lot of talk about how digital transformation is impacting Health Information Technology (HIT) and healthcare in both expected, and unexpected, ways. Our team led a panel discussion Preparing Your HIT Infrastructure for Digital Pathology and Beyond, about network and infrastructure requirements to support the data elements 30–60x larger than digitized radiology images. Including access, analysis, storage, disaster recovery, security and regulatory requirements.
Our panel – Dr. Cody Bumgardner and Jan Bates of the University of Kentucky School of Medicine/UK Healthcare, and Tony Thomas, president and CEO of Windstream — did a follow up interview with Colin Hung, editor of Healthcare Scene which put digital pathology, the impact of healthcare transformation overall, and relationship to patient and staff experience, into sharp perspective.
Colin Hung, editor of Healthcare Scene; Jan Bates, Systems Operations Director, University of Kentucky Healthcare; Dr. Cody Bumgardner, Prof. of Pathology and Director of Informatics, University of Kentucky School of Medicine; and Tony Thomas, President & CEO, Windstream
I’d encourage you to take a look, but if you need a quick summary, here are three key takeaways:
Is your HIT organization ready for digital transformation?
Fortunately, network technology is advancing sufficiently to keep up with the demands of digital pathology. In healthcare IT – as in all other forms of IT supporting dramatically new, innovative, data-intensive initiatives – software-defined WAN solutions, like our own fully-managed SD-WAN Concierge, provide the affordable bandwidth and increased uptime required by digital pathology, and similarly intensive, time sensitive applications. We talked with a variety of HIT leaders at the show about this and would welcome the opportunity to learn about your organization’s goals and discuss ways to help start or accelerate your digital transformation journey.
Clinical care is often described as being a blend of art and science. The rapid digitization of health data, led by widespread adoption of electronic health records (EHRs), has created tremendous opportunities for health IT to elevate the science part of the equation.
That elevation is especially evident in the rise of clinical decision support systems (CDSS), which support clinical diagnostic processes with analysis of information from beyond the exam room and the bedside. In the process, CDSS has emerged as one of the most concrete ways in which artificial intelligence (AI) is impacting healthcare and health IT.
Fulfilling a critical need
From initial patient exam through discharge, clinicians base their care decisions on a full view of the patient’s condition. In addition to information gathered in exams, care decisions are informed by the patient’s medical history, lab and test results, and evidence-based guidelines for best care practices.
In traditional care, accounting for all this information can vary from case to case and from clinician to clinician, and key information can be overlooked or unavailable when needed. When that happens, care outcomes and patient safety can be severely compromised, extending hospital stays, contributing to readmissions, and in some cases causing death.
CDSS systems minimize these dangers with real-time diagnostic analysis and timely alerts delivered to clinicians at the point of care. CDSS is by no means a substitute for the skills clinicians acquire through years of education and experience. It is instead a unique opportunity to support clinicians with intelligence that could never have been automated before the digitization of health data.
How CDSS works
Advanced CDSS continuously monitor the documentation of care in EHR systems while communicating with unrelated information systems, such as those in labs and radiology departments, and ambulatory settings. They are also typically programmed with rules informed by established clinical guidelines.
As clinicians record care steps in the EHR, the CDSS analyzes documentation entries in real-time relative to all other available patient information. When this analysis detects that an important clinical detail has been overlooked, CDSS issues an alert. When the system performs as intended, false alarms are minimal, and those that do appear can inform care decisions in a variety of important ways:
These are just a few examples of the contribution that AI is making today to care improvements through CDSS. As CDSS become increasingly sophisticated, we can expect them to assume a still greater role in improving care outcomes and patient safety.
Implications for health IT
For CDSS to deliver maximum value, they must serve as effective conduits of data flow between the EHR and multiple health information systems. For maximum positive impact on care, data collection and alert delivery must happen in real-time. To deliver their value throughout a hospital or health system, this process must be sustained for all episodes of care at all times.
This represents an entirely new network demand for capacity, often involving extremely data-intensive transmissions such as when relaying imaging. It also represents an entirely new need for 100% network uptime, as a down network can mean an instant return to greater risk to patient safety and care outcomes.
Fortunately, networking technology is advancing sufficiently to keep up with these demands. In healthcare IT – as in all other forms of IT supporting dramatically new, data-intensive initiatives – software-defined WAN (SD-WAN) solutions provide the affordable bandwidth and increased uptime CDS requires. As SD-WAN takes hold within healthcare systems, patients and clinicians alike will reap new benefits from the digital transformation sweeping healthcare.
I had a grad school marketing professor who used to talk about a famous ad campaign for chemical giant BASF that said something like, “We don’t make a lot of the products you buy. We make a lot of the products you buy, BETTER.”
It reminds me in a way of what we do at Windstream Enterprise, especially as we approach HIMSS18. Not just because our initials are “WE.” Rather, there are so many innovative new technologies people will be seeking out @HIMSS – EHR, analytics/BI, machine learning/AI, informatics, payment tech, mobility, IoT, population health, precision medicine, etc. – that we don’t technically provide. Yet, what we do with regard to network infrastructure is absolutely critical to making every one of the technologies deliver on expectations. So in effect, what WE do at Windstream Enterprise is deliver services that makes all these other innovative technologies “better.”
In fact, without the appropriate network infrastructure, these exciting HIT technologies can’t live up to their full potential to affect and transform patient care.
HIT networks: Critical for moving critical care apps to the cloud
It seems obvious but always worth a reminder that as more clinical apps move to the cloud, the network becomes increasingly critical to delivering patient care. For example, a major EHR vendor recently had a security breach that made the application inaccessible to their cloud subscribers, impacting those organizations’ ability to access data and keep appointments with patients, and negatively impacting quality of patient care. This highlights not only the need for enhanced cybersecurity for the vendor, but also the increasing dependence on the network/application availability to deliver care.
HIT networks are more critical than ever to delivering cloud-based and data intensive critical care apps and services
Impact of the IoT on patient care (and network performance)
Next up—The Internet of Things (IoT) and the growing myriad of time saving, process automating connected devices that are being welcomed into healthcare organizations everywhere. The key word here is “CONNECTED.” As in, keep in mind what those connected things are connected to. Suffice to say, it’s more critical than ever that healthcare organizations’ enterprise networks are designed and secured to optimize the performance and reliability of those devices if they are to impact their ability to improve patient care. The more devices connected, the greater the need for additional high-quality bandwidth, and/or tools to manage and prioritize access to it.
HIT network manager’s laments: Increase everything, except cost
With Healthcare organizations heavily focused on evolving their reimbursement models and how they transition to value-based payments, there is an obvious need for network options that deliver superior ROI. With razor thin margins, healthcare organizations need to find cost efficiencies wherever they can, presenting a bit of a catch-22 with regard to network services. As in, how can we increase bandwidth, availability, performance, resiliency, security, scalability and agility, without increasing costs?
Putting networks on the agenda at #HIMSS18 (WE make it better)
If you’re heading for HIMSS18, and healthcare transformation figures anywhere in your strategy, the right network technology – solutions like SD-WAN, wavelength services, access diversity, and UCaaS – delivered by a provider with deep category experience and insight should be on your agenda, too. It’s a simple but essential way to make any other investments you make in innovative healthcare technologies and make it even better. Which takes us back to where we started, about how what WE do helps make every other innovative technology work better.
Looking forward to seeing you all at HIMSS. You can find Windstream Enterprise at booth #12222. Or catch our team at Session #85, “Preparing Your HIT Infrastructure for Digital Pathology and Beyond,” Tues, March 6, 4-5 pm, at the Venetian Convention Center, Lando 4301.
Traditionally a pathologist would have spent their entire career behind the microscope looking at samples from patients in a single hospital. Now pathologists must collaborate with an entire care team to ensure the best treatment possible. Fortunately, advances in HIT infrastructure are ready to make the collaborative process a lot easier. Same thing for the basic process of sitting down in the lab to review samples. It’s all changing with at least one manufacturer of a digital pathology system being approved by the FDA for primary diagnosis last spring. And this is likely just the first of many to get approved in the years to come.
Digital transformation marches on in healthcare IT
The precedent for digital transformation in pathology began with the digitization of radiology in the 1990s, an event that dramatically changed that space. While it may have seemed logical at that time, the digitization of pathology did not occur because glass slides were considered an efficient, cost-effective way to store tissue samples. More importantly, the infrastructure to support it was barely a blip on the horizon. Digital storage was far more limited and expensive then compared to today and even worse, the network hardware and connectivity required to transmit such graphically/data intensive image files didn’t exist (this was after all the early days of the web when dial-up was still a big thing). In the 90s, 300 whole slide images that were digitized with a 10 Mbps transfer rate would take 3 days to transmit. Today that process would take only 4 minutes.
Implications on network and storage infrastructure
Mayo Clinic noted that “an estimated 60-70% of all decisions regarding a patient’s diagnosis, treatment, hospital admission and discharge are based on laboratory test results.” So it’s important to look at every aspect of care and to realize that digital transformation’s impact on pathology will ultimately have a huge impact on patient care. The digital transformation journey is just now beginning for pathologists and is not just limited to individual patient care. The untapped data for data mining and analysis within those tissue samples to analyze trends and affect population health is also a huge opportunity.
While taking advantage of it all was technically and/or financially unfeasible/impossible until a very short time ago, the technology to deliver and store digital pathology files has now caught up with the promise it holds for practitioners and patients alike.
That said, few HIT environments currently have the computational, storage/data warehousing and network infrastructure to access, share, archive and handle the increased demands of data elements 30-60x larger than digitized radiology images.
The path to digital pathology starts at HIMSS18
This promises to be a hot topic at HIMSS18, March 5-9, 2018, and will certainly be so for our health IT team at Windstream Enterprise. Those interested in planning a path to digital pathology are invited to:
WE look forward to seeing you at HIMSS18.
Even if your EHR is in the hospital data center vs. a cloud deployment, there are many other geographically dispersed locations such as other hospitals and practice locations that rely on the network to connect to it. As EHR deployments become more widespread, the cost of unplanned downtime grows rapidly—up an estimated 30% in the past 7 years to more than $634 per physician per hour, according to a study by the AC Group.
Healthcare’s what ifs
The number of those familiar with hard copy records will only continue to decline as more recent nursing grads take over more and more positions.
Given the dependence on the network will only continue to increase, It may be a good time to think about a few “what ifs:”
Identifying patients is already a challenge with everything in working order, but without network access, how do you validate a person is who they say they are? That exposes not just the health system but also patient to risk from fraud. The health system is at risk depending on the size or scope of the network outage because HIPAA Security rules require a business continuity plan to be in place to limit business disruption and to make sure protected information can still be accessed. Any HIPAA related fine would add to the financial risk to a healthcare organization for unplanned downtime.
Network availability = improved patient care and reduced risk
Patients are impacted if all of these things have not been fully thought out in your organization’s business continuity plan. There are a wide variety of ways to ensure and/or guarantee network and application availability and uptime. These range from sophisticated diversity solutions providing multiple coordinated connectivity options, to hybrid networks incorporating backup circuits. Or they may necessitate an updated network solution that incorporates automated failover to an active redundant circuits such as SD-WAN.
The important thing is to have a plan in place – a network provider with specific experience in this space can help you make great strides – and be sure everyone in the organization is well trained in implementing alternate processes.
As we approach the start of Health IT Week, I find myself asking a lot of questions. Like, has anyone had a confusing, complicated healthcare issue where they needed multiple doctors involved in their care? I have this unnamed auto-immune disorder which causes eye inflammation. I’m often confused about it and can’t pronounce some of the things I’ve been tested for. Sometimes I have trouble explaining to other practitioners, like my primary care doctor, what their peers told me about my health. While I don’t think I have white coat syndrome, my mind seems to go blank with all the questions I need to ask my doctor when I see them. Finally, just to complicate my own patient experience more, I have doctors in two different health systems. Before they both got on the same electronic health records/EHR system, I had to use a complicated process to get records faxed from one system to the other. Despite having to do this several times, I never knew if the records ever got to the doctor that needed them.
Health IT is all about the patient experience
You know what I love? I love health IT because now that records are shared between my two health systems, it’s made the process of communicating with my doctors not only easy but helps take my care forward. And if you haven’t tried secure messaging your doctor through an online portal, you definitely should. I have great doctors, but I don’t always have time to hold for a nurse to carry a question to them. Through a portal I can write out my questions and they can reply to help clear up my confusion. I don’t think my doctors get paid for answering those questions, but it definitely saves me from having to come in for an appointments just to get a question answered. This shows that patient experience does really matter. I love my doctors more when they make it easier for me.
Windstream is proud to be a Health IT Week corporate sponsor, October 2-6, 2017.
I love Healthcare IT because the other day through a combination of sharing records between my doctors and having access to a secure messaging portal, I finally understood which medication I was taking was addressing my eye inflammation and which was addressing other symptoms. I don’t think this would have happened before this technology was available. I just knew I should take this white pill twice a day. Health Information Exchange needs to be available nationwide and available no matter the EHR vendor.
The network that drives the experience
As the computing world continues moving to the cloud, it is essential to mention the critical role of the network in making any such solution perform in a way that makes everyone pleased with the experience. A transformative patient experience is only as good as the technology behind it, and a highly secure, reliable and fast network can provide the connectivity required to power portals and health information exchanges and deliver them to where clinicians and patients access them. For anyone at any event during this Health IT Week, please keep this in mind and reach out to us if you’d like to discuss. We’re proud to be a Health IT Week corporate sponsor for 2017 and would welcome an opportunity to learn about your organization’s goals and discuss ways to take the patient experience forward as we look towards 2018.
So how are these seemingly unrelated topics Cloud and Value Based Payments related? Both of these things are happening in the healthcare industry. Is one affecting the other? I would say yes.
All seem to agree that the move from fee-for-service to value based payments is a bell that has already been rung or a train that has already left the station. Any changes to legislation will only refine this trend and not reverse the course. At the center of all of this is the patient and the whole goal is to drive patient centered care that provides healthier patients at a lower cost with the best patient experience.
So how do organizations balance delivering a great patient experience with value based care? More organizations are turning to the cloud to enable a holistic view of patient information so that the best treatment can be prescribed. As more applications and health records live in the cloud, having a network that ensures great cloud based application performance with no downtime is key.
Is your network cloud optimized? Use of technologies like SD-WAN can help your network to be prepared for the transition to the cloud. See here for more information about Windstream’s SD-WAN solution.