HIMSS22 shows new ways to improve healthcare delivery
In the pandemic’s third year, the coexistence of the Healthcare Information and Management Systems Society’s (HIMSS) conference in Florida and its digital counterpart has started to feel almost normal. This reflects healthcare delivery itself, where a hybrid delivery model has enjoyed much broader acceptance than before the pandemic. According to a HIMSS spokesperson, an estimated 29,000 attendees took part in the event either in person or online, up from 24,300 a year ago.
This year’s event was held under the tag line “reimagine health”. Attendees were invited to learn from uses that have optimized medical workflows in new and innovative ways, rendering the patient journey smoother, creating a deeper sense of accomplishment for providers and greater loyalty on the patient side. In short, HIMSS22 offered inspiring examples of better healthcare delivery, including a strong focus on behavioural and mental health.
All these efforts were underpinned by the application of communications technology. The prevalence of data and analytic tools has fed the trend of measuring the effectiveness of new approaches, including use of digital apps, in the healthcare space for individuals and whole populations.
Scrutinizing the Economics of Healthcare
Limiting costs while improving the quality and efficiency of healthcare delivery has always been imperative for healthcare organizations. It therefore made sense that several HIMSS sessions explored how technology matters such as interoperability, cloud, security, artificial intelligence and machine learning could be assessed from a financial angle. HIMSS also looked at other topics, such as population health measures and supply chain management, from a financial perspective.
Population Health Management through Tailored Nudges
CVS Health has started focussing on the roughly 80 million US citizens who aren’t medically literate enough to make proper use of medication, treatment options or lifestyles changes. In a move to remedy this, the company has used its rich pool of healthcare data to design a home healthcare programme, centred on four Ps: predict health scenarios of individuals, personalize interactions and information, prevent bad outcomes and promote health.
“As part of this programme, the patient receives nudges that I as GP would usually give as part of a consultation. The way these nudges are expressed is connected to a patient’s own preferences that we have on file”, explained Kyu Rhee, senior vice president of CVS Health. If the programme identifies a gap, for example when a patient doesn’t refill medication or needs an immunization jab, it prompts the person to take appropriate actions.
The Cloudy Side of Cloud Economics
One of the benefits of cloud computing is its ability to allow multiple parties to share data and processes safely and securely, with data being accessible from all devices regardless of location, finds Dr Joseph Williams, cloud economist and Seattle director of the Pacific Northwest National Laboratory. Compared with onsite solutions, cloud tools also have a lower downtime. In short, Dr Williams believes “cloud enables better patient outcomes”.
However, he also highlighted a lack of transparency in cloud technology. When looking at various offerings from a financial perspective, it’s difficult to do a side-by-side comparison. Allocating costs for cloud computing can be tricky; there are different types of service model, cloud, sales model and cloud architecture. The way that cloud expenses are classified, either operational expenditure or capital expenditure, is also an issue.
Dr Williams specified other factors buyers might not already consider, such as costs associated with talent and reworking. Talent is comprised of the training of existing staff and hiring those with cloud skills. Reworking is made up of switching to the cloud. The use of hybrid cloud models is relevant here, as these can compromise security and cause increased communication needs between onsite and cloud solutions. Users must also pay operational costs to cloud providers, and possibly service providers, as well as fees related to compliance when moving data across borders.
Because of this complexity, Dr Williams cautions to set realistic expectations on the use of cloud technology and to track usage daily, at least in the first months of operation. “People tend to spend much more on cloud than they thought. Private clouds have a significant price premium over public clouds and hybrids come at their own costs. You must do the analysis for yourself”, he recommended.
Making the Supply Chain More Efficient
Covid-19 was a wake-up call to have clinicians more involved in procurement decisions. Especially when confronted with scarcity of materials, it became critical to have clinicians evaluate alternative products to best serve their needs as well as those of patients. This has contributed to more agility in the procurement process and more robust workflows, particularly in the operating theatre.
Scrutinizing the supply chain also highlighted inefficiencies in stocking up on surgeons’ preferred supplies as specified on their paper “preference cards”. Jimmy Chung, chief medical officer at Advantus Health Partners, suggested introducing more standardization and using artificial intelligence to predict the needed supplies: “Physicians’ needs can be quite variable, which makes forecasting demand and planning so difficult, especially for procedures and materials when there are many choices”.
He reckons that 20% of preference cards are inapplicable, as surgeons change their minds and products phase out, resulting in wasted resources. So far, there’s been very little work to automate this process; Mr Chung wants to use technology to do so, such as compiling all preference cards for the same procedure and deciding what can be standardized.
What’s in Store for the Future?
The conference proposed a swathe of new approaches to shape healthcare delivery in the next five to 10 years, depending on an institution’s digital maturity, aspirations and budget. Although some of the following suggestions aren’t necessarily new, advances in technology and medical research have enabled some trends to emerge stronger than before.
More Effective Use of Drugs with Pharmacogenomics
Pharmacogenomics examines how people’s genomes affect their response to a drug. These insights help the prescribing clinician to select medication, cutting costs associated with the trial-and-error approach of prescribing. In this way, adverse effects of medication can be reduced. This also paves the way for precision medicine.
Non-Drug-Based Interventions Obtain Regulatory Clearance
Non-profit Cedars-Sinai Medical Center in Los Angeles has been pioneering virtual reality (VR) for some time. Dr Brennan Spiegel, director of health services research, has been a leading figure in VR’s explorative use. “VR is here to stay and complies with data security and privacy”, he claimed.
His team helped establish a new field recognized by the US Food and Drug Administration called medical extended reality. “We started using VR in everyday care. Being in a hospital is not a place of healing, so we wanted to give people a means to escape the hospital, at least virtually”, he explained. Talking to over 3,000 patients about their VR experience, Dr Spiegel and his team developed a VR programme that expands patients’ ability for lateral thinking, particularly beneficial for pain management.
Push for Digital Platforms to Enable Digital Transformation at Scale
The pandemic accelerated changes in healthcare delivery, moving away from traditional settings toward retail outlets and the home and requiring caregivers to deal with new sources of data and new ways to connect with patients.
Software developers are gearing up to offer healthcare providers applications that help patients manage their illnesses remotely; this increases pressure on IT professionals in hospitals to implement new ways of supporting their colleagues with operational and clinical data. In the face of these needs, hospitals must re-evaluate their IT strategy. A platform approach will allow them to accelerate the speed of implementing new features and, ultimately, the pace of their digital transformation journey.
Will Future Hospitals Be Smaller?
If we were to build a hospital from scratch, how would it differ from current facilities? The clinical practice is changing, moving healthcare closer to the home. But it can only go so far. The pandemic has equipped providers with important insights about delivering care remotely, which could affect the size of new hospitals, although this will be determined on an individual basis.
For example, during Covid-19, only about 30% to 40% of knowledge workers needed to be physically present. Because of this, radiology and pathology departments have already changed their staffing models to need less space. Furthermore, significant parts of cancer care will continue shifting to the home, such as chemotherapy. For cancer-related surgeries, it’s expected that 50% to 60% of surgeries won’t involve an overnight stay, so fewer beds will be needed. Additionally, more care can be provided through outpatient services or entirely at home, also requiring less bed capacity.
Facing the growing pressure for delivering better patient outcomes with restricted financial means and a shortage of personnel means reimagining healthcare to be more personalized and connected, with more data collected, shared and analysed.
The future of healthcare delivery requires an appropriate infrastructure and devices that can communicate with each other securely in the privacy agenda of each country. More than before, providers must offer evidence of their solution’s value; this can be in the form of cost savings, but also in terms of improved quality of care, reduction of readmission rates, sick days taken by care workers and staff’s ability to cut overtime. Technology will remain crucial in helping this vision come to life.
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