Decision Support

Dr. Charles Tuchinda, EVP and deputy group head of Hearst Health and executive chairman of FDB, shares best practices for health IT executives and physicians using decision support IT for prescribing meds.

A new study published in PLOS ONE shows that CDS systems can assist providers in making skin-related diagnoses without affecting consultation time.

The new Health Foundation investment aims to accelerate the use of data to improve healthcare.

A healthcare system in which stakeholders share, adopt and apply medical knowledge in real time enables improved care, accelerated workflows, streamlined business processes and a better balance of resources with demand.

At the HIMSS APAC Malaysia Digital Health Summit session titled “Digital Health - From Innovation to Adoption” by guest speakers Wilson Choo (Chief Executive Officer of Sunway Medical Centre Velocity) and Dr Ng Xin Jun (Manager of Sunway Group Healthcare), both shed light on the various technological healthcare advancements made at Sunway Medical Centre Velocity (SMCV) as a case study. At SMCV, an integration project between its patients’ monitoring devices and electronic medical record was developed in order to achieve a seamless and wireless transfer of patients’ vital signs with “Early Warning Scores”.  A key feature of the new implemented EMR at SMCV is its Computerized Physician Order Entry (CPOE) which allows doctors to order medicine or laboratory/ radiology services via the system whilst being able to check the status of these orders. Similarly, nurses would also be able to key in their orders for medication as well as the respective procedures which they have carried out on each patient.   Clinical Decision Support is another feature embedded within the EMR which allows healthcare providers to gain access to the drug allergies as well as medications administered to patients. This results in better healthcare decisions and effectively prevents any medication errors. A system aptly named “Early Warning Score” was developed for scoring the physiological measurements of patients and routinely recorded at the patient’s bedside. Its purpose was to allow for early identification of acutely ill patients and recorded information such as a patient’s temperature, systolic blood pressure and urine output. A key success factor underlying the success of this integration project was due to the efforts of a governance committee. Frequent meetings were held every month to discuss any ambiguities or to resolve any issues within the system. Priority was given to resolve issues pertaining to patient safety and system enhancements. Relevant key stakeholders such as management personnel or members of the clinical team and vendors were brought into these meetings whenever necessary. Digitalization and innovation was also amalgamated within the hospital’s daily operations as well. Sunway Medical Centre was one of the earliest companies who adopted tele-consultation during Malaysia’s Movement Control Order (MCO) period (a form of countrywide lockdown due to COVID-19), which allowed patients to continue to consult doctors even when they were at home. A patient portal was also developed which facilitated the booking of appointments and retrieval of radiology results online.  Patients were also encouraged to download the hospital app on their mobile devices which allowed them to check the queues at the hospital to reduce their waiting times at the medical facility. Insurance integration is also in the works, which will enable patients to make electronic payment, billing and payment integration with major insurers. This will also provide greater transparency to patients as they will also be able to track the status of their insurance applications. A long term direction for the hospital was also put in place with plans to include progressive initiatives to make crucial patient information more accessible and timely, even allowing doctors to have real time visibility of vital signs on their mobile devices.

Holon's CollaborNet technology will deliver analytics data from Cerner’s HealtheIntent population health platform into clinical workflows.

In a globally broadcast conference, hosted by Clalit Health Services and HIMSS, key discussions led by world leaders, decision-makers and other thought leaders took place around the topic of responding to the COVID-19 emergency. With a focus on the three broad themes of deciding, changing and acting, useful insights were shared by the speakers in the ‘technology to the rescue’ session, outlining the UK’s experience in harnessing technology during the pandemic, innovation in Israel, and cyber-attack risks to hospitals and digital health. Speakers included, HIMSS president and CEO, Harold F. Wolf, NHSX CEO, Matthew Gould and Israel Ministry of Health, VP of information technology, Rona Kaiser. During the conference, Harold F. Wolf, shared his thoughts on innovation and technology during the pandemic. “Digital health and health tech tools and capabilities have long been recognised as providing credible support for most of these challenges. With the pandemic and the advanced tools today, they’ve really put the spotlight on the capabilities and the opportunities for digital health.” “Technology’s role in health care has expanded exponentially in the last 20 years but it hasn’t kept pace with the social technology advancements of consumerisms that other industries have already moved towards, and frankly we’ve had to continue to deal with cultural barriers and sometimes protectionisms which are often to blame for the slower games in the health care ecosystem.” The rapid adaption of technology Globally, hospitals have seen a rapid adoption and advancement of digital health over the last decades, which has accelerated even further in the last six months during the pandemic. The speakers reflected on the success of this unexpected uptake.  Wolf explained: “In many cases, the adaption has been successful. The systems and the facilities that already had the infrastructure in place and had gone through workforce development advancements, found the transition to scale of telehealth and the use of new technologies easier and the ability to serve during the pandemic crisis." "Many circumstances where providers were uncomfortable with the tools, they’ve now been faced with the situation of using telehealth where before they may have had caution. The results are coming in, people are now used to it. Doctors, nurse practitioners and clinicians are beginning to work closely with their customers, the patients, the consumers, the citizens.” Matthew Gould also shared his thoughts on the current use of technology during the pandemic: “The last few months have shown the value of technology, of digital technology in health care and given a massive boost to the digital transformation agenda across the NHS in the UK.” Gould went on to highlight remote care as an area that has made a big difference during the pandemic. “We moved very quickly when the pandemic hit to move the vast majority of appointments both at primary and secondary to remote basis. Either on the phone or online. That’s been extremely effective and very fast. In primary care, 99% of general practice surgeries now have the ability to do online consultations and a significant majority of consultations are remote whether that’s telephone or video.” On the topic of remote care, Wolf said: “One of the examples that I’ve noted from a close colleague of mine that works in a hospital system; they have three hospitals and in 2019 they had 1,950 telehealth visits. Today they’re averaging over 2,000 per week. These are the kind of advancements that we’ve seen.” The use of data during the pandemic  Data usage was also discussed as a key area in the UK that’s made a big difference during the pandemic, particularly when looking at aggregated anonymous data for managers at national, regional and local level. Gould explained: “We set up the NHS data store with all sorts of protections in place and it put the management of the pandemic on a totally different basis. "It’s given us a real push both because of the necessity of the moment but also because of the emergency regulation that came with the pandemic to sharing patient data. We’ve been able to get patient data flowing more safely and more effectively round the system so that clinicians can more easily access the information they need about the patients in front of them. “At a national level, we were able to track quite effectively, capacity against demand across the system. We knew where there were spare beds and what sort of beds, for example, whether they were ventilated beds or not.   "We knew where there was a requirement or shortages of different sorts of supplies so we were able to more effectively than we would’ve been without this quality of data to manage the flow of supplies to where they were most needed,” added Gould. Contact tracing and privacy  During the conference, Rona Kaiser shared some updates on the deployment of the contact tracing app in Israel and the importance of privacy and trust. “We need to find the balance between the need to protect lives and the need to protect our privacy and I think this is something that was a core value in the planning in how the app would work. We need to find the optimum balance between that,” said Kaiser. “How did we do that? First of all, it’s an opt-in of everything app. You have to agree to download it, it’s voluntary. Secondly, the architecture is one where all the information stays on your device. The only way to share with the Ministry of Health is by accepting the share, it does not mean you have to share it. We want to work on that trust.” “We also wanted to make sure that the app is as accurate as possible. This is something we are still struggling with but we do have hope. We hope to launch a new version of the app which is not only based on GPS and location technology but also based on Bluetooth technology which enables us to be more accurate.” Has AI delivered its promise up until now? The progress of AI during the pandemic was also touched on during the conference. When asked if AI has delivered its promise, Gould said: “I think it has in certain respects in terms of extracting insight and understanding from huge quantities of data." "We’ve seen real progress made on our understanding on how the virus affects different groups of people, but I think that’s probably a function of the stage of our understanding of the virus and as that understanding grows, the ability of AI to provide a smart triage tool will grow as well. So its moment for that may come as well.”  COVID-19 as an effective accelerator of digital health adoption The rapid uptake of digital health has clearly been inevitable and crucial in helping the world navigate the pandemic, however, facilitating understanding and education for clinicians and patients has also been a key element of ensuring a smooth adoption. “One of the things we did early in the crisis that made a massive difference was we produced a really simple one page guide to information governance for people working in health and care saying essentially, if you are in good faith, trying to look after your patients and acting in sensible ways then you’re not going to get into trouble," explained Gould.  "It was endorsed by our information commissioner and by our national data guardian and it had a really positive effect because it sent a signal, that be sensible, do the right thing, don’t get yourself caught up in knots over the massive detail of law. Just get on with it. That was extremely positive. We need to capture that can-do spirit and bottle it and keep it for the future.”  Post-pandemic - is remote care here to stay? “I suspect that after the pandemic, there will be some balancing,” reflects Gould. “We won’t necessarily stick where we are, we won’t go back to where we were before. We’ll find a medium between the two. The key thing now is the principle that actually care can be delivered remotely in a lot of cases and for a lot of patients has been established and will be more easily accepted both on the clinicians’ side and on the citizens’ side.” Touching on lessons learnt from the pandemic, Wolf said: “What we see now is the recognition that on a short-term basis we have significant gains in digital health that are fulfilling the needs. The mantel of our health care system's ready to branch out, and government funding’s going to be necessary for those systems to exist and utilise global leadership because if the pandemic has taught us anything it’s that innovation must be fed when the timing demands it.”

Defense Health Agency will use its tools to help with the delivery of tele-critical care and remote patient monitoring for service members deployed worldwide.

The healthcare organization is using a $630,000 FCC award to get telemedicine into the home, including with remote patient-monitoring devices.

With multi-cloud now the rule rather the exception, the tool can help healthcare organizations more easily access and analyze data from across their disparate CSPs.