Category Archives: Healthcare

Data Can Relieve the Healthcare Budget Pressure

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Interesting week in the healthcare space in Australia with the federal budget and then the Royal review’s recommendations for the PCEHR made public. We certainly live in interesting times!

I believe there is an incredible opportunity for us all, as they say in the classics ‘necessity is the mother of invention’. It seems the perfect storm is brewing; aging population, rise of chronic disease, rising costs and budget pressure. The question is how do we set a course through this storm, to ensure the destination is much better than where we have come from? (Poetic even if I say so!)

A couple of words caught my eye in the PCEHR review, ‘meaningful use’. The concept is to achieve a state where the health records are used to improve the health of the community, drive diagnosis accuracy up as well as improving the research and development of new drugs and more effective treatments. This is all about the data! Getting it to a point of completeness and accuracy so it can be used meaningfully!

This may sound familiar as its part of Obama’s plan to change healthcare in the USA. To achieve ‘meaningful use’ and they have defined a 7 stage process to guide their industry along. Similar to the Royal review’s recommendations, Obama has put in place a series of investments as well as ‘consequences’ for not achieving these milestones. When you consider the ‘private’ or corporatized nature of the USA healthcare system, you would assume that it is against their business model to help their ‘customers’ go next-door. So surely there are less vested interests here inhibiting us from creating a national health record system?

Perhaps the idea has not been fully ‘sold’ to the public and the implementation not optimal. Speak to any GP and they will bemoan the integration and the additional workload… which the review recommendations address. So once these issues are sorted out, we begin down a path where the accumulation of data drives every facet of the industry forward and towards a better, faster and cheaper healthcare system!

Marc Andreessen founder of Netscape, a web browser that competed with Microsoft in the early days of the internet is attributed to saying that “Software is eating the world.” He was referring to the dramatic shifts that happened to the music and video industries as they became digital. I think he was wrong, ‘Data is eating the world.’ It’s the use of data to understand that can transform everything we do! The trick here is to not look at digitisation as just a substitute for the old, but as a new way to do things. (For example a CD was more convenient, however on-line music has changed the industry.)

In healthcare there has been a lot of ‘substitution’ but not a great deal of leveraging the potential of eHealth. For example having an electronic patient record is more convenient, however being able to aggregate a large number of histories and understand how treatments are affected by lifestyles which affect long-term health outcomes, has the potential to produce new protocols which deliver better outcomes which will lower costs.

Thinking about the ‘use’ of data once its digital, will lead us to a situation where we are thinking beyond the horseless carriage and to driving efficiency, lowering costs and opening up new ways to revolutionise the way people are kept well.

How IT Buzzwords Impact Healthcare

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Picture from: http://www.healthcarereformmagazine.com/issue-16/feature-issue-16/healthcare-cheaper-better-faster/

Every industry loves their buzz words, and IT does more than most. Today you can’t talk about technology without one of the big four, (Social, Mobile, Big Data or Cloud), being dropped into the conversation. The question is, what has this to do with Healthcare? Well let me discuss this in the next few blog posts, but first context is required.

According to many commentators, such as analyst firm IDC, IT is entering its third epoch. Starting with the birth of IT in the form of the original mainframes, through the current ‘pc’ dominated client server and into the emerging 3rd Platform, typified by the ‘web-scale’ organisations. What I find interesting is that I can see the parallels with healthcare, let me explain.

The first platform was a time shared infrastructure which you would go with a particular job and walk away with a certain outcome. Sound like a hospital?  The issue with this model is that a massive infrastructure investment is required, and it makes use of very high levels of expertise, to use it effectively. That is why today, while there are still many mainframes in use, the ‘jobs’ they tackle are very specific to what it was designed for and where it is the most efficient way to achieve that outcome.

Today, however most computing is performed on the second platform – client server – enabled by the birth of PC’s and networks. This new model enabled new capabilities, such as interactivity, specialisation and a lower cost of production. The ‘work’ was split into different layers and specialist organisations created software solutions which automated processes.  (Think a PACS, RIS, EMR.) This structure is mostly a hub-and-spoke, with specialists performing their specific task and then passing on to the next layer. I would argue much like the delivery of healthcare outside of the hospital today, where a GP refers to a specialist that refers to an ‘ology’ that reports back to the specialist that diagnoses/treats and then reports back to the GP – each performing a task and passing off to the next entity. Now this model is effective at automating a processes but does it inherently improve that process or add to the quality of what is being done?

In my previous blog post I spoke about Big Data and some of what is enabling this… “What’s changed? Over the last decade technologies that can economically store and reason over disparate data types have been developed… (carry on reading here).”  This leads us to the 3rd Platform, if you like consider how the ‘web scale’ organisations do what they do! Such as Amazon predicting books you would like to read, Google giving you the latest information and Facebook changing social connectivity.

What does this mean to healthcare?  You are familiar with the past, computers have helped add up numbers and do accounting, (mainframe), they have automated processes like patient record keeping and image management, (client-server), now technology is help us to predict, understand and tap into the collective. In doing this we get assistance in diagnosis, discovering new protocols and drugs, and predicting likely outcomes. The advantages to healthcare of better planning, decision support and accelerated innovation are dramatic. In essence this is the platform enable healthcare to move into ‘Personalised Wellness’ or ‘Patient Centric Healthcare’. Consider the 3rd Platform as now helping improve thinking, the human process!

Three ‘platforms’ for technology and three ‘platforms’ for healthcare delivery. The IT industry delivers better, faster and cheaper, our challenge now is to use these technologies effectively to deliver better, faster and cheaper healthcare!

No Silo’s in a Healthy Foundation.

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Last week I was lucky enough to listen to a number of you describing your IT environments and the current issues you face, and I’m a little shell shocked!

As EMC is an international company, we can sometimes convince international experts to visit and share their experience and knowledge with us. (Easier to do in our summer!)  Last week we had two such experts, (Healthcare and Life Sciences), tour the country. A great opportunity for me to meet hospitals and researchers, and learn first-hand about your issues. My lesson learnt from the week was that your issues are shockingly consistent: Growth and Budget, (too much of one and not enough of the other, you know which!). Living the ‘doing more with less’ cliché.

What might surprise you was that in each case the prime cause is ‘stovepipes’. Segregation of departments, budgets, projects, planning, leading to the implementation of disparate systems, applications and  datasets. (One person told us they had about 2000 applications in this single hospital, wow). So its not surprising that no-one seems to be able to provide a single patient view!

How were people thinking about solving this problem. Well on the whole a lot are not, they are too busy doing ‘business as usual’ or keeping the lights on, to even think about it.  Others were very optimistic about implementing an organisational wide EMR/EHR, but as many were very sceptical about getting a business case up and showing any return on the investment.

In my experience, working in other verticals, the journey has always started within IT.  The first step is to consolidate the environment, perhaps starting with the IT support systems and then moving into the ‘business’ applications. If you are a producer or consumer of IT services the goals remain the same:

  • To cut costs: by increasing utilisation when moving to shared infrastructure.
  • To become more responsive: by using virtualised technologies.
  • To improve the service: by using automation.

At the end of the day the results have been impressive across the board, as an example EMC itself has taken this journey from consolidation to virtualisation to automation and we estimate the savings in the millions but more importantly:

  • the amount EMC spends on ‘keeping the lights on’ from over 70% of the IT budget to less than 40%, and now invests in innovation.
  • the time it takes to stand up a new service from over 3 months to under 1 day, freeing up people to help drive business outcomes.

If you are a customer of IT how about asking what are they doing, this year to cut the cost of the services they provide by x%, and how are they going to be more responsive to your requests?

While this may sound very tech-centric it’s a good place to start.. it’s the foundation that needs to be laid in order to move into the making healthcare healthy, (sorry)!