iHT2 Health IT Summit in Austin 2012 – Lyle Berkowitz, MD, Associate Chief Medical Information...

The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

The Power of Combining Innovation + HITTHE HEALING EDGE

Lyle Berkowitz, MD, FACP, FHIMSS / [email protected] / DrLyle.com / @DrLyleMD

Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital

Medical Director of IT & Innovation, Northwestern Memorial Physicains Group (NMPG)

Associate Professor of Clinical Medicine, Feinberg School of Medicine, Northwestern University

Founder and Director, Szollosi Healthcare Innovation Program / TheShipHome.org

Founder and Chairman, healthfinch / healthfinch.com

Health IT Summit in AustinDecember 6, 2012


I’m a physician.

And… an informaticist… an innovator… an entrepreneur


The Innovation Process

AccelerateMove from pilot programs into standard operations

IncubateMove from ideas to pilot programs

DiscoverInvestigate new ideas, programs, technologies


Where to Start?

GR

OW

TH

UNKNOWN KNOWN

LITTLE BETS BIG BETS(Experimental (Planning) Innovation)

Experimentation vs. Planning


LYLE BERKOWITZ, MD

CHRISMCCARTHY, MPH, MBA


LET ME TELL YOU A STORYABOUT THE ROCKY SPRINGS HEALTHCARE SYSTEM


Chapter 1The Healing Edge

• Tell me a Story: Voice of the Innovator + Personas

• Standardized Structure: What, Why, How, Results, Lessons Learned, Future, and Conclusion

• Three Sections: EHR, TeleHealth, Edge

Innovation+InformationTechnology


Chapter 2Mad for Method

Evidence-based human-centered designObservation Synthesis Ideation Prototyping PDSA PilotOthers…



Computers are really good at

being computers, but they are lousy

at being paper! What if we really took

advantage of all we could do

with EHRs?

YouHaveAn EHR.NowWhat?


Chapter 3Inflection Navigator

Messaging and Chart Review• Physician notifies Care Coordination Team about an “Inflection Point Checklist”• Care Coordinator does authorizations, sets up tests and consults, and does final chart reviews



Chapter 4Making “Right” Easier

CDS Tools and Ordering• Allows whomever is with a patient to easily see and act upon relevant “care opportunities” , while still respecting visit workflows.



Chapter 5Prevention Every Time

CDS Tools, Ordering and Reporting• Pre-Visit Preventive Screening Tool• An Instant Quality Measures Tool• Real-Time Provider Performance Feedback Tool



Chapter 6Logic Rules

Conditional Logic, Ordering, Notes• Pre-Visit Orders: helps staff pre-order

lab tests before a patient's Annual Exam visit.

• Documentation Chooser: Helps MAs choose the correct documentation templates at an office visit.



Chapter 7Team Bundling

Alerts, Registry, Pt Outreach, Reporting• Team-based approach to care : Automating and Delegating tasks across team• All or None Bundle Philosophy: Report the % of pt who receive every element of recommended care (rather than % that achieve any particular measure).



Chapter 8Automatically Getting BetterReporting Tools•Automated Adverse Event Detection: Queries EMR for abnormal labs (e.g. low glc, high INR) or meds (e.g. Naloxone, Vit K)• Nurse-led Analysis: To determine level of harm and whether it was preventable



Office Visits are so old school!

Time for a “whole lotta tele”:

Televisit, Teleconsult,

Telemonitoring and

Teletranslation

MeetYou At01100101


Chapter 9The Connected Patient

One of the First Patient Portals!It offers patients the ability to view their medical information ("Health Record"), access relevant medical reference services ("Health Library"), and communicate with their physicians ("Mail Center").

MeetYou At01100101


Chapter 10The Virtual Consult

Consulting SpecialistsAsynchronous communication between physicians, either between Primary Care and a Specialist, or between Specialists. Assigns RVU in theirValue based Reimbursement Model.

MeetYou At01100101


Chapter 11TeleVisits Keep IT Local

Virtual visit with an endocrinologist This virtual visit includes not only the remote diabetes specialist and diabetes nurse, but also the locally based community clinic nurse and sometimes even the primary care provider.

MeetYou At01100101


Chapter 12Mommy Monitor

Home OB MonitoringA telehealth system which allows a high-risk obstetrics (OB) clinic to monitor patients with high-risk conditions at home in between office visits. Includes a Glucometer, BP Monitor, and Scale.

MeetYou At01100101


Chapter 13Every Language Now

Tele-TranslatorsCollaborative of hospitals and providers that share the services of their trained language interpreters over a video and voice network Needed both innovative uses of technology and an organizational and governance structure to overcome the barriers that affect county-operated health systems.

MeetYou At01100101


Chapter 14Rise of the ePharmacists

Virtual PharmacistAn ePharmacist is defined as a hospital trained pharmacist who works from a remote location using secured enabling technology to support bedside clinicians with an effective and timely method of providing medication treatments for patients.

MeetYou At01100101


The future of healthcare is

here, just look around! Happy

Exploring!!! OnTheEdgeOfTheEdge


Chapter 15The Smartest Room

A Computer/Monitor in Every Room• Detects who is in a given hospital room and provides them with the information they need to complete their job efficiently and reliably. • Utilizes a real time locating system (RTLS) and a touch screen user interface designed to make input/output quick and simple for end users.

OnTheEdgeOfTheEdge


Chapter 16One EMR To Go Please

Mobile EHR (mEHR) app• Enables providers to user their consumer smart phones to securely access the organization’s electronic medical record. • Heavily leveraged existing enterprise architecture, providing for high levels of security, availability, and agility.

OnTheEdgeOfTheEdge


Chapter 17Real Time, Right Care

Ventilator-Associated Pneumonia (VAP) Quality Monitor

• Compares real time EMR data against pre-defined processes of care related to VAP. • Presents results on a dashboard tool via a wall-mounted monitor (or on desktop PC).

OnTheEdgeOfTheEdge


Chapter 18Dashboards 2.0

Over 40 dashboards have been developed • Extract and analyze data from EMR and financial systems. Uses off-the-shelf business intelligence tools. • The IT Dept isn’t the gatekeeper anymore—users are empowered to come up with creative ways to examine a problem and develop equally creative solutions.

OnTheEdgeOfTheEdge


Chapter 20The Gaming EdgeGaming , IT and Health• Improve motivation, and engagement via use of elements such as: Fun, Goals, and Rewards. • Want to get into “The Flow”: Skills, Feedback, Focus, LOC, Transformation of Time.•Examples: From Twister to Wii to Nikeplus to SnowWorld to DrHero to FoldIt.

OnTheEdgeOfTheEdge


The New CIO

Source: Innovation Leadership Study: Managing Innovation – An Insider's Perspective. CapGemini Consulting. March, 2012

Chief Innovation Officer


"The reasonable man adapts himself to the world. The

unreasonable one persists in trying to adapt the world to

himself. Therefore, all progress depends on the unreasonable

man.” George Bernard Shaw

Never doubt that a small group

of thoughtful, committed people can change the world. Indeed, it

is the only thing that ever has.Margaret Mead



THANKYOU

Lyle Berkowitz, MD, FACP, [email protected]


Szollosi Healthcare Innovation Program (SHIP)

A charitable endeavor with a mission to use creative thinking and diverse technologies to produce a better healthcare experience for patients, physicians and others associated with their care.

www.TheShipHome.org


Future of EMRs

Prototype examples which rethink the look and feel of user interfaces for Electronic Medical Records.

www.TheShipHome.org


Inflection Navigator

An ambulatory-based triage system and web-based tool that supports a navigator guiding patients thru an acute healthcare inflection point.

www.TheShipHome.org


ExpectED

A web-based application that allows physicians to electronically notify an emergency department (ED) about an incoming patient .

www.TheShipHome.org


Szollosi Healthcare Innovation Program (SHIP) A charitable endeavor with a mission to use creative thinking

and diverse technologies to produce a better healthcare experience for patients, physicians and others associated with

their care.

www.TheSHIPHome.org

THE INFLECTION NAVIGATOR - An ambulatory-based triage system and

web-based tool that supports a navigator guiding patients thru an acute healthcare

inflection point.

ExpectED - A web-based application that allows physicians to electronically notify an emergency department (ED)

about an incoming patient .

THE FUTURE of EMRs - Prototype examples which rethink the

look and feel of user interfaces for Electronic Medical Records.

iHT2 Health IT Summit in Austin 2012 – Lyle Berkowitz, MD, Associate Chief Medical Information...

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