EHR’s financial benefits may be elusive
Acfee’s stance on EHRs is that they’re an investment in health and healthcare, not an initiative to increase healthcare organisations’ income. The Acfee eHealth Impact Database contains over 60 evaluations. A common theme is that the extra cash needed for eHealth exceeds its cash savings. Healthcare quality and productivity are the main sources of benefits. The affordability planning and management lessons are clear for Africa’s health systems.
It seems that US healthcare may see it differently. An article in Modern Healthcare says hospitals and health systems each spent millions and sometimes billions of dollars on EHRs. Examples are:Trinity Health reported a US$107.8 million asset impairment charge in 2018 to switch to a single version of Epic EHR and revenue cycle management software over four years and undisclosed costsMayo Clinic spent US$1.5 billion on Epic HERPartners HealthCare spent $1.2 billion on an Epic HERScripps Health reporting weakened financial results when started an EHR conversion budgeted at US$300 million over ten years, with estimated operating costs of US$360.5 million, 20% more than the non-recurring costsBanner’s US$45 million project contributed to a US$92 million hit to university delivery operations 2017 when it spent US$24.3 million on EHR conversion.
Modern Healthcare says the promised clinical and financial benefits have been elusive. Some healthcare organisations have suffered financial problems when eHealth has worked against them. In particular, hospitals and health systems have faced financial stress when implementation costs drive up operating costs, a Capex Opex imbalance.
Doctors and other clinicians have been wary of embracing eHealth too enthusiastically. Concerned that they may feel held back by it and causing clinician burnout.
A literature review in the Journal of the American Medical Informatics Association said it revealed evidence that “Data entry requirements, inefficiently designed user interfaces, insufficient health information exchange from outside institutions, information overload, and interference with the patient–physician relationship are … factors associated with physician stress.”
Some explanations are:There’s going to be some disruption when implementing EHRs so budgeting and financial planning, including contingencies helps to avoid financial crisesTo ensure successful EHRs may need extra resources after implementation to mitigate financial risksLooking at EHRs in the long-term, rather than two- or three-year returns, can be helpfulIt’s inevitable that new eHealth, especially large-scale EHRs, will slow patient volume temporarily as providers learning to use them, so are less productivePlan for eHealth complexities that diminish returns EHRs, including procurement costs, deployment and increases in higher ICT operating costs, higher departmental operating costs and lower productivity and lower employee satisfaction.
Africa’s health systems can’t afford these outcomes. Rigorous business cases, an emphasis on health and healthcare benefits and top class eHealth leadership can help to avoid them.
- 246 views
- October 19, 2018
- Tom Jones
Rural India uses eHealth with containers
Shipping containers re-appear in many guises, from roadside cafés to holiday homes. It should come as no surprise that they should have become part of the future of India’s eHealth network.
A report in The Nation Online says in 2013, Dr. Anurag Agrawal, of the New Delhi-based Institute of Genomics and Integrative Biology (IGIB), saw the possibilities of including shipping containers’ versatility in his work towards a link between genes and lung disease. His plan was to use the movable containers to house and collate health records in rural areas so specialists could analyse the data to identify links between height, weight and predisposition for developing specific lung diseases. The analysis leads on to developing and delivering treatments.
A container appeared in a village in Uttar Pradesh. Villagers soon had video access to a doctor and could see a paramedic in person. They could also leave blood samples and submit cardiograms.
This initial success was hindered by IGIB’s link to government. It is one of India’s 39 state-funded Council for Scientific and Industrial Research laboratories, and is limited its scope to expand.
Then IGIB partnered with the Indian hospital chain Narayana Health (NH) and Hewlett-Packard (HP) to install over 40 eHealth container centres across India. The service includes EMRs, bio-metric patient identification and integrated diagnostic devices. It’s a business model that could be appropriate for Africa’s drive towards UHC.
India has one doctor for every 11,000 people, well below WHO’s recommended rate of one per 1,000lth. The eHealth container with HP cloud technology offered a dynamic solution. Clinical and administrative data is monitored and medical advice provided remotely.
Dr Agrawal believes more benefits are available. Telemedicine has improved access to second opinions and international consultation in urban areas. It’s benefits in rural India may be more limited.
- 163 views
- October 18, 2018
- Matt Jones
Robots could be good for your health
In his book The Rise of the Robots, published by One World, Martin Ford proposes social and economic scenarios for robots that are good for output, but not so good for people. He sees significant upheaval and displacement from employment across a wide range of commercial and industrial activities and across middle and low income families. The drop in income, so spending power, will degrade economies.
Simultaneously, robots aren’t paid and don’t spend money. He sees this as exacerbating the social and economic impact.
Healthcare’s the activity that’s different. He sees the robots marching into healthcare that’s already over-stretched as needs and demands continuously outstrip supply. Four roles are crucial:Artificial intelligence in medicineHospital and pharmacy roboticsRobots that care for the elderlyUnleashing the power of data.
For low and middle income countries and health systems, sustained investment in robots could be part of the solution. They can improve healthcare professionals’ productivity and help to meet demand.
They should find a place in Africa’s eHealth strategies. Small scale investment will lay out a trajectory for the future.
- 134 views
- October 17, 2018
- Ameera Hamid
Acfee’s director supporting SIL-Asia
eHealth proponents know the importance of standards and interoperability. In Asia, it has an effective regional umbrella. The Standards and Interoperability Lab – Asia (SIL-Asia)’s powered by the Asia eHealth Information Network (AeHIN). It has significant, sustained support from the Asian Development Bank (ADB) and co-sponsorship by the People's Republic of China Poverty Reduction and Regional Cooperation Fund (PRCF).
This substantial support has enabled SIL-Asia to provide a wide range of services to its members. Its Tooling page includes:Investing in Digital Health: Digital Health Impact Framework (DHIF)Guidance on Investing in Digital HealthDigital Health Terminology GuideTransforming Health Systems with Good Digital Health Governance: Health Governance Architecture FrameworkHealth Enterprise Architecture FrameworkSIL-Asia Cloud Set-upSIL-Asia FHIR Service.
Countries can use SIL-Asia’s tools for their digital health implementation programmes. There’s more to come, including :A technology benchmarking frameworkInteroperability toolkitImplementation guide.
SIL-Asia’s assets for countries’ use include:RxBox, a telemedicine device OpenMRSCHITS, an OpenMRS EMRBahmni,a HIS based on OpenMRSZato.io, a python based Enterprise Service BusWSO2, a Java-based, open source enterprise service busMedicCR, a Master Patient Index (MPI) developed by Mohawk LabOpenHIM, a JS-based mediator developed by Jembi Lab. OpenEMPI, a Java-based MPIOpenInfoMan, a health worker and facility registryDHIS2.
Having completed his initial work on the DHIF, Acfee’s Tom Jones has taken on the role as a SIL-Asia partner. As Acfee’s Director of Strategy and Impact, it will provide a valuable bridge between Asian and African eHealth initiatives and challenges. Acfee envisages that Africa’s health systems will benefit considerably.
- 303 views
- October 16, 2018
- Sean Broomhead
Asian Development Bank presents eHealth guidance at AeHIN conference
Weak eHealth strategies lead to weak digital health investment. Maximising success and minimizing failure’s a core ADB eHealth theme. It sees effective eHealth strategies as requirement, and it presented its Guidance for Investing in Digital Health to the Asia eHealth Information Network (AeHIN) 6th annual conference this week in Colombo, Sri Lanka
The guidance describes the healthcare context that’s needed for eHealth strategies. Peter Drury, the project lead, then set out essential issues that included identifying and engaging with stakeholders and pursuing digital health strategies that are drawn from health and healthcare strategies and that achieve a balance between value for money and affordability.
He sees strategies as only part of the process, and similar to his word association of fish and chips and bacon and egg. For eHealth, it’s strategies and investment. Sharing experiences of the two are important. There are examples of effective strategies that he’s seen across Asia available from AeHIN’s Standards and Interoperability Lab (SILA). These provide valuable insights for Africa’s health systems and for African countries contemplating new national eHealth strategies.
- 220 views
- October 15, 2018
- Sean Broomhead
Mongolia’s completing a big scale eHealth project
Remote, large and sparsely populated; Mongolia offers a lesson on pursing a wide range of eHealth investment. Tucked in between Russia and China, it’s a country of about 3.1m people spread across 1.5m km. About half the population live in Ulaanbaatar, the capital.
Dr Sereenen Enkhbold, Mongolia's eHealth Project Coordinator presented his country’s Role of E-Health Project in improving health information interoperability in Mongolia at Asia eHealth Information Network (AeHIN) 6th annual conference in Colombo, Sri Lanka. The objective’s to improve integration and utilisation of health information and eHealth solutions for better health service delivery. It’s about half way through four-year the project that started in 2016.
The project, financed extensively by the World Bank incorporates:Health sector enterprise architectureHealth data and information technology standards DICOM, LOINC and HL7Health data dictionariesHIE platformHealth statistics and dashboardeHealth appsInvestments in primary healthcare facilities.
The next phase includes benefits realisation and change management. Taken together, the project is a benchmark for Africa’s health systems.
- 241 views
- October 11, 2018
- Tom Jones
Sri Lanka’s eHealth story stretches over 20 years
The reputation of Sri Lanka’s continuing eHealth story is considerable. At the Asia eHealth Information Network (AeHIN) conference in Colombo, Prof Vajira Dissanayake of the Health Informatics Society of Sri Lanka (HISSL) described the from1998 to 2108 and beyond.
It’s set out in Digital Health in Sri Lanka. This describes the sustainable implementation of digital health solutions through local capacity building. The lessons for Africa’s health systems are essential reading. It extends over 17 topics, including:Strategic planningPersonal health numbers and master patient indexElectronic indoor Morbidity and Mortality Register (eIMMR)Hospital Health Information Management System (HHIMS)HIMSElectronic Patient Information Management System of the National Programme for Tuberculosis and Respiratory DisordersElectronic Reproductive Health Information Management System (eRHIMS)Electronic Non Communicable Diseases System (eNCD)Registering and Verification of the Electronic Health Information SystemsSuwasariya telehealth programmeStroke Clinical RegistryEssential Drug Stock Alert Tracker Sri Lank Journal of Biomedical Informatics (SLBMI)HISSLS’s short history.
Beyond 2018, other initiatives are coming through. Partners include UNICEF and Bloomberg Philanthropies. UNICEF provided finance for the app District Nutrition Monitoring System. Children’s nutrition won the prize for the best early stage app in South Asia.
The sequence reveals a continuing strategic eHealth trajectory. Equivalents for Africa will be valuable in learning from the past and setting strategic trajectories, road maps and investment plans.
- 388 views
- October 10, 2018
- Tom Jones
Asian Development Bank presents its Digital Health Impact Framework at AeHIN conference
eHealth investment decisions usually end up by balancing value for money with affordability. It’s a regular end point for business cases for eHealth and a core ADB eHealth theme for its Digital Health Impact Framework (DHIF). It presented this and other components to the Asia eHealth Information Network (AeHIN) 6th annual conference this week in Colombo, Sri Lanka
DHIF is a methodology for estimating and analysing socio-economic costs and benefits over time to identifying value for money and how long it takes to achieve it. Then it converts these into financial and accounting estimates to assess affordability. Tom Jones, the project lead, set out these issues that included:Deriving eHealth benefit requirements for health and healthcare strategiesIdentifying and engaging with stakeholdersManaging assumptions and estimateseHealth leadership, change management and new business models.
The methodology has ten steps, but modellers and decision takers using DHIF for the time should choose only those components that are critical to the immediate decisions. From these, they can build up expertise and move towards using the full set.
Risk is a constant in eHealth investment. DHIF can be used to estimate risk exposure that leads on to risk mitigation plans.
Optimism is also common. DHIF provides adjustments for optimism bias, which can increase cost estimates with a range of lower than 40% up to 200%.
Other material from the presentation is available from AeHIN’s Standards andInteroperability Lab (SILA). They can help Africa’s health systems improve their Health decisions, especially where parallel investment is needs in healthcare resources and new business models.
- 269 views
- October 10, 2018
- Sean Broomhead
How do Africa’s mHealth strategies match the modern profile?
With mHealth a standard component of Africa’s eHealth strategies, what’s a good benchmark to test them against? Spok, a US communications firm, as a profile of mHealth strategies that can help. Its eighth annual survey shows some marked priorities.
Mobile Strategies in Healthcare Results Revealed says mHealth that reflects overall clinical goals for the health system or hospital are most successful. It also underpins larger eHealth strategies to deliver more efficient, higher quality care and increase satisfaction for patients, carers and health workers.
mHealth strategies extend across a wide range of information and areas. The top two are:mHealth management and security, for 56% of respondents Device selection, at 52%.
The bottom two are mobile, and business development and reporting strategies.
The full profile’s:Management and security 56%Device selection 52%EHR integration 48%Infrastructure assessment 45%Clinical workflow evaluation 43%Device ownership, including BYOD 34%Mobile app strategy 29%Mobile app catalogue 16%Mobile strategy governance 14%Business development and reporting strategy 12%
The third item, EHR integration, matches findings from another Spok survey of hospital CIOs. They said integrating with the EHR was their top priority for respondents. Clinical workflow evaluation’s high score on is seen as revealing. It’s an indication that doctors, nurses, and other health workers in direct patient care roles use mHealth to define safe, efficient and effectively managed workflows.
- 253 views
- October 02, 2018
- Tom Jones
Biggest financial support achieved by Egyptian start-up Vezeeta
Start-ups need a financial prop in their early years. They often need a second wave to finance expansion. A report in Disrupt Africa says Egyptian start-up Vezeeta has raised US$12m. It’s the largest single investment ever received by an Egyptian start-up. It builds on its US$5m support achieved in 2017, as reported in Disrupt Africa.
Set up by its Ceo Amir Barsoum in Cairo in 2015, Vezeeta’s eHealth enables users to find and book appointments with over 10,000 doctors. It’s available in Jordan and Saudi Arabia too. For the region, it manages three million bookings for 2.5m patients. It also provides Software as a Service (SaaS) solutions using cloud computing and big data for patients and doctors.
The financing round was led by the Saudi Arabia-based STV Capital. It included existing investors BECO Capital, Vostok New Ventures, Silicon Badia and CE-Ventures. Vezeeta’s will deploy its extra finance to two initiatives.
One’s to continue its expansion in Saudi Arabia. The other’s to develop new products.
Will a subsequent investment phase turn Vezeeta’s attention towards the rest of Africa? For this, it may need expanded commercial opportunities driven by large numbers of users.
- 143 views
- September 26, 2018
- Tom Jones
eHealth and a new business model can reduce inpatients’ mortality
It’s more than just ICT. A current research programme in Germany shows how eHealth’s role in precision medicine can reduce hospital patient’s mortality when it’s integrated with investment in a part of a new business model. A report in HealthManagemnet.org on continuing research in Germany says how to optimise and streamline hospital care by separating patients into routine and complex groups improves quality and saves lives, so major benefits.
Separate and concentrate – a sustainable business model for general hospitals describes how a new business model can use new technologies to support precision medicine and improve effective bespoke healthcare. It assigns patients to routine and complex care pathways.
Routine patients are not emergencies and have up to two co-morbidities. Complex patients are emergencies and have three or more co-morbidities. Both groups benefits from better quality. Routine patients’ mortality has dropped by more than 13%; complex patients; by more than 11%. These are attributed to the new business models opportunities to:Optimise the impact and benefits of precision medicineAddress the specific critical care management differences of the two patient groups Minimise the impact of operational factors on healthcare qualityReduce hospitals’ management complexity.
The research’s currently in phase two of three phases. So far, it has disrupted the conventional view that greater patient volumes achieve better mortality results. The new business model emphasises that:Specialisation as a crucial determinant of quality and mortalityBusiness as usual with eHealth may not optimise its opportunities to maximise healthcare quality gains.
It also confirms that eHealth is more than just ICT. The report confirms that redesigning routine and complex patient flows and care pathways has implementation challenges. It also shows that eHealth can offer more benefits when integrated with investment in new business models.
- 210 views
- September 25, 2018
- Tom Jones
Will the new Apple watch be a big hit?
Apple is renowned for technological advancement and innovation. During their annual product launch this year, Apple announced the new series 4 watch. It’s not your average wearable. This watch boasts mHealth features such as electrocardiogram (ECG) monitoring and fall detection, and allows you to share this data with your healthcare practitioner.
These features are impressive. Apple is snapping up opportunities to break into the rapidly expanding mHealth market, from fitness tracking to a health app and now wearable ECG. But there’s a nagging concern too. What impact will this wearable ECG have on the healthcare system? Could Apple’s new innovation spur an increase in unnecessary healthcare utilisation?
These are concerns that I seem to share with other healthcare practitioners who worry that consumers may incorrectly attempt to diagnose complex cardiac conditions themselves. There are also concerns about the sensitivity and specificity of the device, which if not great, could spark a mass of panic-stricken consumers due to false positives.
While this new innovation is an important movement towards better patient management, it is vital that the counsel of healthcare practitioners is not diminished. Consumers must be advised to use it cautiously to augment their healthcare management rather than replace professional management.
Similarly, the medical community needs to work more closely with companies like Apple who drive much needed innovation.
- 317 views
- September 20, 2018
- Ameera Hamid
Medical apps need better UX and UI
With the ubiquitous use of smartphones today, mobile users have great expectations from their apps: fast loading time, intuitive workflows, ease of use and aesthetic appeal. Digital health and mHealth organisations hoping to compete successfully in this vivid ecosystem, can no longer ignore user experience(UX) and user interface (UI) design as an essential component of their product strategy.
So, what is UX and UI?
UX is the process of researching, developing, and refining all aspects of a user’s interaction with a product to ensure that it is meeting the user’s needs. UI is more cosmetic and takes into consideration the visual interaction with a product, including the colour schemes, the size and colour of a button, the consistency of a theme and so on.
Simply put, UX makes apps useful, while UI makes apps beautiful. Together these aspects play an important role in highlighting the value of your product and creating a lasting connection with your users. They also have a positive impact on the bottom line, by reducing development time, increasing sales and improving customer retention.With over 318,000 health apps across the most popular app stores, the difference between a successful and unsuccessful mHealth app will lie in the quality of its UX and UI. The importance of good UX and UI cannot be overemphasized.
- 418 views
- September 11, 2018
- Ameera Hamid
Dr Conuslta’s eHealth and technology business model’s transforming Brazil’s healthcare
Extending healthcare access is one of eHealth’s objectives. Using it to improve healthcare efficiency can help, but modestly. Dr Conuslta, a Brazilian start up in 2011, shows that an imaginative and innovative business model that uses eHealth and medical technology to relocate blocks of healthcare and slashes its costs for low-income families may have more impact. It’s a model that can fit Africa’s UHC goals.
An article in Forbes describes the initiative. Dr. Consulta charged patients a flat $30 fee for a consultation with a physician of their choosing from 50 specialties. Some patients pay nothing, depending on their health condition and ability to pay. Prices for on-site exams, such as MRIs, blood tests and mammograms range from $3 to $30.
Typical premiums for Brazil’s health insurance plans for access to one GP can be about $120 a month Off-site exam fees for lab work or specialist visits can be about $200 each, more than six times Dr Consulta’s higher rates. Only about 25% of Brazil’s population can afford this.
These low prices are achieved by a business model that invests in diagnostic technology and services in clinics and using AI to develop its own EMRs. It also engages some healthcare professionals as co-workers who use Dr Consulta’s clinics as a resource, not as employees. These combine to achieve high patient volumes, long-term relationships with patients and low-price out-of-pocket payments that sustain financial viability. The large, stored clinical data volume helps to achieve precise medical outcomes, which in turn, reinforces this long-term relationships with patients
Dr Consulta’s eHealth includes AI to analyse scientific and medical statistics to identify the probability of people contracting chronic health conditions. It can then treat them promptly to minimise or eliminate the risks. It engages patients with updated information and recommendations about their illnesses or conditions.
These bespoke communications are constructed from information in the core health management data warehouse using the Oracle marketing tool Responsys. For each patient, using age, health history and treatment plan, the Responsys automatically recommends:The new health services provide links for patients to schedule services. After each visit, Dr Consulta sends follow-up surveys to solicit feedback on patients’ experiences with their doctors and their results. Cloud applications support its marketing, finance and supply chains complete the eHealth profile. While it’s extensive and modern, its benefits depend on the transformative impact of its business model. Large, established hospitals with eHealth legacies are often less agile in reaching under-served, low-income patients. Dr Consulta’s a healthcare model that Africa’s health system could consider as part of their UHC pursuits.
- 245 views
- September 06, 2018
- Matt Jones
AI helps to predict cancers’ trajectories
Many years ago, people in the UK referred to cancers as “a growth.” While it might have lacked scientific precision, it encapsulated cancers’ changing characteristics. The country’s Institute of Cancer Research (ICR) at London’s Royal Marsden Hospital, and part of University College London (UCL), says tumours’ constantly changing nature’s one of the biggest challenges in treating cancer, especially when they evolve into drug-resistant forms.
It reports that its ICR scientists, working with colleagues at Edinburgh University have used AI to identify patterns in DNA mutations in cancers. The information can forecast future genetic changes to predict how cancers will progress and evolve. The technique, Repeated Evolution of Cancer (REVOLVER), predicts cancers’ next moves so doctors can monitor tumour’s progress and design the most effective treatment for each patient.
Three organisations financed the research, published in Nature Methods. They were the Wellcome Trust, the European Research Council and Cancer Research UK. Their support for REVOLVER’s created what’s seen as a powerful AI tool. It’s revealed previously hidden mutation patterns located in complex data sets.
Teams from ICR and the University of Edinburgh working with colleagues from the Birmingham University, Stanford University and Queen Mary Universities London found a link between some sequences of repeated tumour mutations and survival outcomes. It suggests that repeating patterns of DNA mutations could be prognoses indicators. This can help to specify future treatment.
AI success stories provide material to consider in Africa’s new eHealth strategies, to support leading specialist hospitals to set up a wide range of AI initiatives. They could focus on Africa’s current and emerging health and healthcare priorities.
- 300 views
- September 04, 2018
- Ameera Hamid
Digital Health Week (DHW) 2018 starts 7 October in Sri Lanka
A full week on eHealth’s coming up in Sri Lanka. DHW combines an array of initiatives:Commonwealth Digital Health AwardsBiennial Conference of the Asia Pacific Association for Medical Informatics (APAMI)International Medical Information Association (IMIA) Global TelehealthAsia eHealth Information Network (AeHIN).
The first day includes the AeHIN’s 6th General Assembly. Its main theme’s interoperable digital health for UHC. There’s an AeHin pre-conference event too. It includes presentations on Asian Development Bank (ADB) initiatives:Guidance for Investing in Digital HealthDigital Health Impact FrameworkCurrently in draft format and scheduled for completion in September.
Other pre-conference topics includethe Standards and Interoperability Lab for Asia (SIL-Asia) project HIE Implementation Costing ToolData science for the SDGs and UHCVarious M&E methods for national eHealth programmesDHIS2 Knowledge Exchange And Latest UpdatesGlobal public goods from the Health Data Collaborative.
The main DHW theme’s Transforming Healthcare through Digital Health Innovation. The wide range of eHealth perspectives should provide everyone with sufficient takeaways to step up sharing and convert ideas into practice.
- 404 views
- September 03, 2018
- Tom Jones
Patient portals are under-utilised and need promoting
Portals are a routine way to access information from entities. It seems that US residents haven’t been as keen on them for health and healthcare information as they are for other requirements.
A US survey of more than 5,000 people aged over 17 in 2015 by the Council of Accountable Physician Practices (CAPP) and the Bipartisan Policy Center found that most Americans were either unaware of, or don’t have access to the technology they could use to communicate with their doctors for better quality healthcare.
Conducted by Nielsen Strategic Health Perspectives, the results were:
While portal use was low, it had the highest growth rate of the nine components, 13% since 2014, the year before. Does it mean it’s on the rise? If it is, will it a slightly rising or steep trajectory?
Four groups most interested in using digital and electronic technology for greater access to their doctors are:Parents with children covered under their health plansChronically ill patientsPatients with acute conditionsAdults younger than 35.
These factors of reluctance and specific high-use groups are important insight for Africa’s online services. Determining the high-use groups is helpful in determining capacity and content. Both need establishing to ensure a foundation for future growth.
Identifying the time scale to reach high levels of utilisation was beyond the survey’s goals. With specific high-use groups, it may take several years for contagion to change other groups’ portal behaviours.
- 216 views
- August 31, 2018
- Tom Jones
Can duplicate records be eliminated?
Operational and health analytics benefits from EHRs can be diminished by duplicate records. Minimising them’s a step forward, but can they be eliminated. Northwell Health in New York State thinks they can. Its case study, available from Health IT Analytics, describes its plan.
Eliminating Duplicate Records Once and for All says after implementing its Master Patient
Index (MPI), it still had a large and growing queue of potential duplicates in over two million records that needed manual reviews to resolve. It tied down health workers’ time. Northwell’s solution was to deploy Verato Auto Steward™ which:Reduced task queue by 87%Shifted staff from tedious task review to higher-value projects.
A significant benefit is staff liberated from resolving duplicate records are now redeployed to training other people on creating accurate records and preventing duplicates. The case study doesn’t estimate when the lower, 13% duplicate rate’ll be eliminated, but it does show that it it needs two initiatives.
As Africa’s eHealth programmes expand EHRs, Northwell’s lessons are:Include a patient matching systemBegin to redeploy staff from patient matching to training staff dealing with patient identification and managing EHRs. While duplicate records may not be eliminated for some time, or maybe not at all, the two initiatives will enhance the benefits from EHRs. The longer it’s deferred, the bigger the removal task will be.
- 227 views
- August 30, 2018
- Tom Jones
China’s tertiary hospitals’ social media offer a good strategic template
Social media’s increasingly prevalent and important for health care. This doesn’t mean that it’s easy to succeed with it. Charles Mingus, the jazz bassist, composer, bandleader and legend, said “Making the simple complicated is commonplace; making the complicated simple, awesomely simple, that’s creativity.” A survey of social media use in the Journal of Medical Internet Research (JMIR) in China’s tertiary hospitals provides insights and experiences that other hospitals can use as a foundation for their creative social media initiatives.
The objective of Social Media Landscape of the Tertiary Referral Hospitals in China: Observational Descriptive Study was to map out the social media use in patient engagement by China’s best tertiary hospitals, 705 of them. They’re usually in city centres, serving as medical hubs providing specialised medical care for several regions. Their social media initiatives using Sina Weibo and WeChat are often seen as pioneering and innovative in connecting and communicating with their patients.
Data collected and analysed had three main characteristics:Hospital characteristics of time since established, number of beds, hospital type, and regions or localitiesStatus of social media use of China’s two most popular local social media platforms defined as post-initiation time, number of followers and number of tweets or postsA logistic regression model to test the association between hospital characteristics and social media adoption.
About 76%, 537, hospitals have created official accounts on either Sina Weibo or WeChat, with the latter being more frequent. The larger and newer the hospitals, the greater resources were for social media. Hospitals type and affiliation with universities were not significant predictors of social media adoption.
The highest penetration rate was about 97%, the lowest 20%. The investment profiles is perhaps more important than the penetration rate. Since 2009, investment in Sino Weibo climbed steadily then flattened. Later, from 2014, WeChat investment plodded along until 2016 when it surged and became the most used in 2017. In parallel, Sino Weibo use we sustained. Now, both services are used.
WeChat’s bigger profile is only part of the comparative profiles. While it has about 75% more hospitals as users compared to Sino Weibo, over 25% of the hospitals had inactive Sino Weibo accounts over six months. WeChat’s equivalent rate was less than 7%. Their time scales were different too. Sino Weibo’s nine years compares to WeChat’s four.
- 286 views
- August 29, 2018
- Tom Jones
Texting between healthcare professionals and patients increases
For Africa’s health systems, investment in mHealth could be laying the foundation for an increasing trend in relationships between healthcare professionals and patients. A survey by West Corporation, sponsored by Tele Vox Solutions, and available from mHealth Intelligence, says more patients are texting with their healthcare providers.
It’s gone beyond appointment reminders. Provider-Patient Texting Is Poised for Growth has identified five other activities that have a large texting component. Demand by patients is:Preventive care 95%Chronic condition management 87%Post-treatment instructions 85%Check-ins based on remote monitoring data 84%Co-payment information and reminders 83%Delays that impact appointments 80%Appointment reminders 71%.
In addition, 60% of patients say it is very or extremely important for their healthcare provider to text them about five other topics:Remote health monitoringPreventive careDisease managementBillingScheduling delays.
There’s a mismatch between supply and demand. For example, for preventive care patients demand 95% and providers text 25%, and chronic condition management patients demand 87% and providers text 31%. A similar trend is found across services such as post-treatment instructions (85% vs 7%), check-ins based on remote monitoring data (84% vs 6%), co-payment information and reminders (83% vs 6%), and delays that impact appointments (80% vs 49%).
It seems that USA patients are more mobile-savvy than their healthcare providers. The findings indicate that Africa’s health systems may have an opportunity to build on their mHealth investment and expand their direct connections and engagements with their patients.
- 392 views
- August 27, 2018
- Tom Jones
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