The presentation I enjoyed most at the recent IT Roadmap Conference and Expo in Chicago was Tom Arkins’ Mobile Data Access: The Next Generation of Health care IT. Mr. Arkins is currently the Chief of IT and Informatics for Indianapolis Emergency Medical Services. The Indy EMS is a division of the Indianapolis Department of Public Safety and is a partnership between the city, Indiana University’s School of Medicine, and Health and Hospital Corporation of Marion County.
His talk was enlightening in so many ways. Perhaps most importantly, it showed me what health care IT leaders are thinking and dreaming (and sometimes nightmaring) about in 2015:
There’s no way to argue the impact smartphones have had in general. They’ve better connected people to each other, and now it looks like they’ll better connect people to Things (as in, Internet of Things — like thermostats, home security systems, and DVRs). For health care IT leaders, mobility is changing how providers and hospitals treat and interact with patients nowadays. Health care today is increasingly moving out of the hospital, and mobility is driving this change. Mr. Arkins exhorted CIOs and tech leaders in health care to go out “in the field” with health care providers to understand every place where health care is delivered. “Don’t just keep to the psych ward or emergency clinic ... go to the pharmacies, ride in ambulances with paramedics, and shadow doctors when they visit patients in their homes to better understand the environments in which health care is delivered. Only by doing this can you begin to develop empathy for what your users really need to do their jobs,” he said.
Mr. Arkins illustrated the need to tailor technology needs to specific users with an interesting joke: “If you put a paramedic, a bowling ball, and a pen in a room ... when you come back ten minutes later, the bowling ball and the pen will both be broken, and the paramedic will have no idea how it happened.” Mr. Arkins is not belittling paramedics; rather, he’s trying to explain the laser focus that paramedics need in order to do their jobs, i.e., providing emergency medical response in sometimes dangerous situations.
A good college friend of mine was a paramedic, and he often told me hair-raising stories about having to extract people via stretcher from difficult situations, such as when bullets were flying, or during episodes of domestic violence. So I can easily see how a paramedic may not pay close attention to the tech they carry when they’re out trying to saving lives. And consequently, a health care IT leader must also take these circumstances into consideration when providing paramedics technology.
“Meaningful use is a bear,” Mr. Arkins said. The other health care IT professionals in the room nodded their heads vigorously at this statement. Meaningful use is about leveraging electronic health records technology to improve coordination between industry stakeholders to provide a more comprehensive experience for patients. The end goal is to improve the quality of the health care experience while maintaining safety and efficiency.
But it’s a “bear” because data collaboration must meet HIPAA privacy requirements, which is something stakeholders are still juggling right now. One solution is to join a healthcare information exchange (HIE) — a network that connects healthcare databases, health care providers, hospitals, and insurance companies. This way, the hospital doesn't need to connect to Epic, then connect to McKesson, etc. With one connection, they connect to many. However, there are challenges when it comes to HIEs as well — there is the potential to lose control over 1) use cases specific to provider needs, 2) the storage and usage of patient data, and 3) setting up privacy and security controls. HIEs come with high stakes in terms of risk and responsibility — risk for the provider, and responsibility towards patients.
Hospitals are looking to reduce recidivism, or how often people come back for treatment after they've been released. Hospitals can actually be fined by insurance companies for how often patients return to hospital care, and many times, the underlying causes of recidivism - substance abuse, domestic violence, homelessness — are out of their control. Luckily for health care providers, IT can play a helpful role.
Mr. Arkins described the sophisticated data collection efforts underway to better understand the urban and suburban areas surrounding his hospital's Emergency Medical Services. They are creating maps of homeless camps in their city, identifying whether there are children, animals, women, or violence in those camps. They're also looking to integrate more closely with police departments and social services to create the "big picture" of how and why people come to the emergency room in the first place. The desire is, of course, to forge a partnership for preventing recidivism with the other stakeholders in the equation.
Maybe the most eye-opening portion of Mr. Arkins’ talk came at the end. He talked about how new technological innovations like drones and 3D printing are delivering improved health care. For example, drones can be used to deliver medicines and supplies to disaster areas, or to home-based care settings. He also talked about the possibility of drones delivering automated external defibrillators (AED) during cardiac emergencies, potentially with the push of an icon on a smartphone. It made me think of how frequently AEDs are located in public places that are not that easy to access or dislodge from their storage locations (behind glass cases, for example), and how much simpler this solution would be.
As for 3D Printing, Mr. Arkins discussed how limbs and organs could be “printed” using this technology. He told us about a young girl getting a new arm in her favorite color, pink, as well as an infant receiving a 3D-printed trachea to help him breathe. There are plenty of fascinating advances in health care technology, and it's clear that we have exciting times ahead as health care IT leaders work with their physicians and providers to figure out how to best leverage new technologies and new ways to solve health problems.
Mr. Arkins’ talk was inspirational and informative. It showed me how the healthcare industry is progressing toward digital and mobile technology, using the benefits of both to better serve its patients. By leveraging this new tech, hospitals and providers can help reduce the frequency of repeat hospital visits by using data to develop a better understanding for what patients need to successfully move back to optimum health.