Better Management of Clinical Appts and Theatre Processes.

We continue our study of better ways to reduce the costs of clinical and theatre processes, and better ways to automate the whole situation. Beatriz Agrana sent us this compelling announcement from Seattle. This is what she says:

The founders of macro-eyes, a machine learning company that personalizes patient care, today announced the introduction of Sibyl, a predictive scheduling solution that cuts the financial and operational impact from patient No-Shows without relying on patient behavior change.

We’ve all called to book a medical appointment to be told that the first available slot is in 5 to 6 weeks. That day, 10 appointments may go empty, even 20; often more. No one shows up to ~15% of all scheduled appointments. At many sites, No-Shows can constitute nearly 40% of appointments. A schedule filled with No-Show appointments prevents the greatest number of patients from accessing the care they need when they need it most.

“No-Shows and lack of optimization in scheduling costs healthcare providers billions, hits morale, strains operations and has implications on care that can cost lives. We developed Sibyl to solve the problem with cutting-edge machine learning and deliver long-needed, massive improvement in cutting the damage from No-Shows. Sibyl is AI that learns when to schedule individual patients to increase utilization overall,” said Benjamin Fels, CEO of macro-eyes. Healthcare is increasingly data-driven, scheduling is not. It’s mission-critical infrastructure, yet the decision-making that determines scheduling doesn’t benefit from data-driven insight or predictive analytics.

Sibyl is a predictive scheduling solution that machine learns the appointment times that are best-fit for both the patient and provider, increasing utilization overall. The software functions as an add-on to existing scheduling systems, showing schedulers appointment recommendations for each patient.

“It’s extremely difficult to change patient behavior,” explains Fels. “Likely the reason No-Shows continue to cost providers >$100B each year. Sibyl offers a proven approach based on solid science. We use patterns in behavior to learn when patients are most likely to show and the mathematics of optimization to build schedules that enable the greatest access to care.”

Sibyl uses macro-eyes core AI, refined over years at leading academic medical centers in NY and California, to analyze appointment histories and thousands of data points across provider, patient, location, time and type of care as well as weather patterns, air quality, traffic and transport data and state and federal data on the region where the care will occur. “The schedule is like a puzzle, and Sibyl is an expert at fitting together the schedule to minimize gaps,” Fels explains.

Sibyl works like x-ray glasses for the calendar, seeing through the chaotic schedule to understand where there are gaps that would otherwise be impossible to see. By integrating predictive analytics with schedule optimization, Sibyl provides a peerless tool for healthcare organizations, improving the bottom line as well as the patient experience.
During the software’s late-stage testing, macro-eyes worked with 20 clinics across the United States to analyze 2 million appointment records. The anonymized records contained reams of information, including scheduled appointment times, but the testing temporarily eliminated whether or not those appointments were kept. Sibyl churned through the records and generated its own recommended schedule. With that done, the real Show/No-Show results were compared side-by-side with Sibyl’s results.

The outcome? Sibyl predicted actual patient outcomes with 76% accuracy. Sibyl incorporated more than 60 factors to build each prediction. The appointment start time, the patient’s age and the zip-code of the clinic were frequently predictive. Sibyl is prediction + optimization. Sibyl demonstrated schedule optimization that would increase utilization by >20% without increasing investment to add hours or providers. For one group of clinics, that would translate to nearly $10 million in revenue.

At least one other scheduling platform exists for clinics and hospitals, but its core algorithms are rules-based. It ascertains an “average patient” profile and then makes recommendations based on this profile rather than learning, adapting, and making ranked predictive recommendations, as Sibyl does. Sibyl delivers the most accurate, effective results of any healthcare scheduling platform on the market.

 

Top 5 Ways Your Smart Home Can Help You Protect the Elderly

IoT has its downsides, ( see our article about hacking earlier) – but  at a time when we are banging on about personalised and community healthcare, here like a ray of sunlight, comes some essential truth, by Rafi Zauer, Head of Marketing at appropriately, the Essence company.

The ‘sandwich generation’—adults who have to simultaneously take care of their aging parents and deal with other responsibilities like work and raising their own children– is a consequence of increasing life expectancy in developed countries, and the wish of the elderly to stay independent and continue to live in their own home.

This can be a very stressful situation, and for those who find themselves in this position, every bit of help is more than welcome. And technology may be able to assist. A modern smart home will become an invaluable tool to help you take care of your aging loved ones. How? Here are five tips:

1. Be alerted about deviations from their daily routine
By installing motion sensors in strategic places around the house, you will know at what time your parents get up, or if they opened the fridge to get something to eat. You will be able to follow their daily routine and detect if anything is amiss. For example, you will receive an alert if they stayed in bed, or in the bathroom, much longer than usual. That way, you will be able to check on them and make sure they are well, without interfering with their daily habits, respecting their privacy at all times.

2. Make sure they aren’t wandering out of the house
Thanks to a smart lock you will be notified every time they enter and leave the house. This is not about spying on their every move, but about making sure they are safe. This is especially useful for seniors who are becoming increasingly frail or infirm, as well as for those in the early stages of dementia, for whom it may be dangerous to leave the house on their own. Also, with a smart lock you can even lock and unlock the door for them. For example, if they tend to forget to lock the front door at night, you can set a rule to lock it automatically at a specific time every night.

 

3. Keep track of their medication schedule
By installing a magnetic door sensor on the medicine cabinet door, you will know if your senior parent remembered to take his daily pills. By consulting the activity log from your smartphone app, you will be able to check if the cabinet was opened and when. What’s more, thanks to smart rules you can get creative with the way you remind them to take their medicines! For example, you can set the smart light in the kitchen to turn a different color when it’s time for the night pills, and not to return to its original color until the sensor in the medicine cabinet detects the door opening.

4. Ensure they are safe with smart safety sensors
Smoke, CO2 and water detectors will add an extra safety measure which could even become a life-saver in certain situations. Suppose your elderly parent forgets to turn the stove off while cooking or heating food up, and something starts to burn. You will receive an immediate alert on your smartphone, allowing you to react on the spot and prevent any serious damage. Likewise, with a smart thermostat you’ll be able to make sure the house is never too hot or too cold. This is not only a matter of comfort and convenience, as seniors are very sensitive to temperature changes, so on cold winter days forgetting to turn on the heat could put their health at health .

 

5. Use cameras to keep them safe while ensuring their privacy
Although some people may find it intrusive to have a connected camera in their home, there is no doubt that it is a very useful tool to take care of seniors as it allows you to check in on them at real time. For example, you can create a rule for the camera to send real-time video when any of the sensors detects an anomaly in the house, such as smoke in the kitchen. Also, if you can’t get in touch with your parents, you can turn on the camera and make sure they are well and haven’t perhaps fallen and are unable to answer the phone.

Beyond panic buttons, smart home technology is also useful in providing a helping hand for those taking care of seniors. It does not only offer peace of mind for everyone involved, both the caregiver and the elderly person, but can also become a life-saver in situations when time becomes a life or death matter, such as in the case of a fall, injury or accident, where a quick response is essential. Smart homes are helping enhance the quality of life both for seniors and caregivers, helping seniors remain at home and stay independent for as long as possible.

Rafi Zauer is Head of Marketing at Essence, providers of intelligent end-to-end IoT platforms for service providers offering home security, automation and senior care services. http://www.essence-grp.com

 

How To Create The Better Hospital

We invite you to be part of this necessary discussion.

It is an acknowledged truth that the provision of healthcare, across all of our mature societies – has to change. There are too many issues, from provision of elderly services, to personalised ways of dealing with serious illness, and every issue in between – where conventional services are rapidly no longer fit for purpose. eHealth is all very well – but at some point, there is a need to deliver practical changes.

These changes will result in less hospital provision, and more community based healthcare, which will impact on costs, and also open new areas and market opportunities.

The question until now, has been ; “Well, practically speaking – what are we going to do about it – and are you ready for it”?

The upcoming HOSPITAL PLUS INNOVATION Conference, (www.hospitalplusinnovation.com) – is your Forum to meet with other practical vendors of answers, and purveyors of new services, and thought-leaders – to help define what are these new services that will carry healthcare provision forward . Taking place in Denmark, one of the leading areas of advanced healthcare provision, on the 10th/11th October, the Conference covers everything from new twists on current services, i.e., EHR, Theatre Management, Community Services – through to cutting edge Genomics, Personalised medicine.

HOSPITAL PLUS INNOVATION is a unique scenario that brings together for the first time, conventional hospital demands but with new and advanced ways of dealing with these.

This is an essential venue for you to be a part, if you are serious about your company role in this future. The List of Sponsors is already extensive and comprehensive, from all areas of public and corporate healthcare.

This Conference will help you shape your own roadmap, where you can learn from others who have complementary experience.

You have two choices; please register online at: http://hospitalplusinnovation.com. Or call Mr Bogi Eliason, Conference Thought Leader, on +45 3311 7176 or +45 60 82 62 26, to discuss a deeper involvement.

Technology for its own sake – Does not work.

We publish an essential Truth, kindly sent to us by Hope Pittard at the Ascom company in USA.  It reflects the misunderstanding of so many Hospitals, CIO’s etc, who put in place great technology – which in itself delivers no clinical benefit.  There are other factors that are far more important – as Hope describes:

When considering an investment in workflow and mobility technology, hospital leaders should consider three specific metrics. By understanding these metrics, they can select the technology that delivers a great ROI, including tangible improvements in staff and patient satisfaction:

  1. Workflow Efficiency
  • Efficient staff workflows help hospitals reduce pain points by eliminating workflow bottlenecks, reducing nurses’ steps and improving patient response times.
  1. Staffing Satisfaction
  • Right-sizing the staff: Tracking and documenting workflows and patient events in real-time can help managers make more informed staffing decisions.
  • Staff satisfaction (retention): Reducing staff turnover is a key objective for many hospital leaders – particularly given the high cost of turnover. Creating more efficient workflows improves staff satisfaction by enabling nurses to focus on what they are passionate about – spending time with patients at the bedside.
  1. Patient Satisfaction/HCAHPS Scores
  • HCAHPS scores from patient satisfaction surveys are tied closely to hospital reimbursement. By increasing efficiency, hospital leaders can reduce patient response times – a key criteria evaluated in patient satisfaction surveys.

Ascom are a leading US based ICT provider. You can contact them via their Pr people, on +1 919.459.6462

 

Is the EHR in Terminal Decline?

We ask the question that nobody wants to admit..

When the slides failed during Mahad Huniche’s erudite address on the personalisation of healthcare at the recent HIMSS eHealth Europe Conference – he did what every speaker should do.  He ad-libbed, and carried on.  And in doing so – he said two things that were seismic in their importance.

The first – that we are entering an era of disruptive clinical IT – everybody “got”.  The second – that healthcare will now be driven by you and I as “consumers”, and as such, will be governed by eCommerce technology, rather than clinical technology – nobody got.

Whether we like it or not, the wearable technology that is ever more prevalent, will be the source of our own health data – and it will be transmitted, in real time, to wherever we want to send it – i.e., to places where they can monitor this and do something about it.  In short what this means is a reversal of the current necessity of a/having to travel to a place called a hospital;  and b/ having to use monolithic IT called “EHR Solutions” – to manage said information. It also means that the driver of future health improvements will be you and I, as we will insist that our healthcare givers can monitor us remotely; and that the hospital importance of people like CIOs etc, will fade into one of support. We just don’t need it any more.

This will do two things;  first, at a General Doctor level, fewer people will need to see their local GP – he will already know their info; this means that the GP (according to one that was discussing this with me on the plane recently) – can now spend as much time as they wish, sorting out the patients who are truly sick, as opposed to those who just “think”  they are.  It means less people coming into the A&E areas of hospitals (for the above same reason). And more important – less people requiring on demand beds in hospitals.  Our doctors will be able to tell us straightaway, remotely, if we need to be admitted as such.

The interesting point about all this – is that it;’s not like this technology is not available already,  Even places such as Turkey have their own regional connected patient record App, that will be the platform for the sort of enhanced personalisation we describe above – and this explains why Steve Leiber, CEO of HIMSS was already on a plane to Turkey even before the applause had died down from his opening Conference keynote speech.

The other interesting point, is that this consumer driven change – flies in the face of existing Hospital wisdom, who are continuing to invest in ever larger and all embracing “big patient record systems” – that will both be too cumbersome to give any actual clinical benefit, and too inflexible to cope with the personalisation that is not just required by the mobile wearable world we are all embracing, but by even now, some of the key modules that need to be stand alone in their own right – Theatre Management is a good example – if they are to cope with how individual communities want their healthcare.

What is worse – is that very few “communities”  are geared up at a bureaucratic level – to handle this. When we talked to several Kommuns in Scandinavia recently, their assessment was that it will be at least twelve months before they could look at a “Procurement” to put in place relevant services.

The result – is that not only will you and I start to define our own healthcare needs – but that we will go to places called Supermarkets, to obtain this.  The ICA supermarket  in Scandinavia is deep in expansion of its Apotek chain of walk in healthcare shops.  It can only be a matter of time before those services expand.

How so?

Because retail and supermarkets are the bedrock of eCommerce. And the very technology that drives the analysis of every purchase that you and I make in a store, is already being used to calculate the personalisation of Genomes and Genomics, as well as manage the health data wirelessly sent, all the time from yours and my Apple Watch.

Which brings me back to Mahad and his unfortunate slides. Sometimes you need to get to the horses mouth, the deeper vision. Who needs powerpoint anyway?

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New Advances in Personalised Remote Monitoring

Spry Health — a leader in health management technologies and remote patient monitoring announced today “Loop” — a first-of-its-kind combination of clinical-grade wearable and disease management platform. Loop enhances timely care to chronically ill patients, with individualized analytics to improve patient outcomes, reduce hospitalization; and decrease spending by healthcare organizations.

Following in the footsteps of similar but complementary devices from Sahlgrenska Science Park, Sweden,   the heart of Spry Health’s mission is empowering better care – the right care at the right time – for patients who are coping with chronic conditions. Spry Health, incubated at the highly-selective Stanford-affiliated accelerator StartX, began in 2013 in the minds of founders Pierre-Jean “PJ” Cobut and Elad Ferber while Stanford business school students. In 2013, Business Insider named them among 17 Stanford business school graduates who will change the world.

Both founders have watched family members struggle with navigating the healthcare system with chronic illnesses: they came together with a mission to bring proactive care to chronically ill patients. “The body is a system in constant change — but nobody is monitoring the micro-changes in patients with chronic conditions”, says Cobut, “We are building a solution to bridge gaps in traditional chronic care management.”

By design Spry Health developed Loop to be a catalyst for both better care and lower costs.

“In a given year, over 28 million hospitalizations are attributed to chronically ill patients, resulting in an average bill of $37,300 per stay with some patients winding up in the hospital three or more times per year,” says Ferber. Empowering chronically ill patients is what drives the company’s dedicated team of experts in advanced health informatics, biological signals analysis, and medical research.

The Loop wearable continuously and noninvasively collects vital signs to assess the patient’s baseline,  and monitor how their condition evolves. Loop’s analytics platform pinpoints subtle physiological changes and delivers relevant, actionable insights to healthcare organizations before new symptoms are noticeable to the patient.

Healthcare organizations can then guide their most vulnerable members to the right care at the right time. The combination of an easy-to-use wearable with individualized analytics increases peace of mind and compliance for patients, improves their outcomes, and prevents costly hospitalizations.

Spry Health conducted “one of the more comprehensive pre-market evaluations of a digital medical device ever published”, said Steve Steinhubl, MD, at Scripps Translational Science Institute. The evaluation had over 250 participants to prove the clinical equivalence of Loop against standards of care for blood pressure, heart rate, oxygen saturation, respiration, and CO2 monitoring.

Spry Health has submitted with the FDA and is seeking clearance for Loop by early 2018.

How Advanced is UK Healthcare?

We take a look at the upcoming eHealth Europe HIMSS Conference in Malta, and ask; where does the UK figure?

According to  the Independent Newspaper recently,  UK Healthcare provision, is on a par with some of the “lesser” countries in Europe.  It is now no better than places  such as; Poland, Turkey, etc.

This is  both a kick in the teeth to the good people of Poland and Turkey, and it  is also misleading. It is not the case that the UK is falling downwards.  It’s just that other places are doing better. Turkey in particular, ever since Mehmet Atasever, former VP Health Ministry in Ankara,  met me at a HIMSS Conference in Brussels, and handed me his 5 year Plan – has been progressive and focussed on new solutions, custom built, but (despite recent politics) – open to European links. Key areas of advance are the provision of Insurance based treatments, to help finance the general population access to five-star hospital Treatment, etc.

And it is not the case that the NHS is completely underfunded. We have shown in earlier Posts, that Hospitals can usually find the money when needed. The question may be that surprising answer, which is;  maybe Hospitals don’t actually “want”  to find the answer?

To get to that conclusion, you need to compare UK Health provision, with that in Scandinavia.  Because of the growth of Medical Science Parks, in Sahlgrenska Gothenburg; and Pharma, in Lund and Gothenburg – there is a stimulated market in acceptance of new technologies, to help drive better care, which is now regarded as the top area in Europe (including the UK).  This explains why some 20% of Visitors to eHealth Europe in a few weeks, are from Scandinavia – but only 5% are from the UK.

The UK has its own Health Conference, the week before, in London.  Our question is therefore  – why so? It surely has to make more sense to bring everyone together under one common roof?  As we have seen above,  going our own way is not helping us in terms of keeping up with better services.

Nevertheless, things might be changing. Although we ourselves will be Moderating the Nordics session of eHealth Europe, on “bridging data and genomics” – the Genomics England organisation has just appointed a new Commercial Director.

There are key and specific areas of clinical provision, where the UK is expert. What is now needed is to bring this acceptance of new processes – into other areas, particularly IT.