IS IT THE END OF THE THE BIG-BUDGET PROCUREMENT PROCESS?

We look at changing demands within the UK NHS

I am going to start this all back-to-front. My suggestion is; simply giving the NHS “more money” – is cementing out of date working practices. The problem is – there are things called “patients”. There are more of them, and they are being quite unreasonable by living a lot longer than they should. This is redolent of my Data discussions about relational databases; they are just to clunky to handle the volume of patient data we have (so goes the argument). If Hospitals are going to continue to be relevant, then they need to start with a blank piece of paper, adopt radical new ways of doing things, and that includes how they pay for stuff. Putting in place new practices is inextricably linked to finding innovative ways of paying for them.

The problem is – people don’t like change. Nobody likes change. Our comfort zone is precisely that; why not keep things the same? The common unspoken argument goes something like – It’s all worked more or less, up to now.

Except that it doesn’t any longer. As indicated above – there are just too many people wanting healthcare. And if you believe the guys at CIFS in Denmark, “hospitals” are no longer in the driving seat anyway; it is the patient – or “consumer” – that is increasingly driving us to adopt new facilities and services for which we have no plan and no budget.

But maybe we don’t need a budget. Maybe we should just” do”. One way around this obstacle, is the following:

My colleague, who is a Head of Finance at a major UK Trust – sips his coffee and says; “you know , Richard, – apart from essential capital costs – we have stopped making big budget procurements. We now pay as we go. Suppliers enter into flexible monthly contracts, and we pay for what we use.”

Companies in the UK such as System C, are already looking at these sort of innovative practices; similarly in Scandinavia, the EVRY company now offers iPad based versions of its solutions for smaller clinics, based on a mobile SIM tariff. This is the tip of a very large iceberg

And it is seismic; it brings to an end the five-year contract, the large software acquisition. It means that suppliers can no longer promise to deliver but never deliver (we have seen this several times) – or supply goods and never train their hospitals (and we have seen this too). It also means that as hospital flexible demands change, – so can their supplier, and in real-time.

There are two win/wins here. The first is that hospitals can now engage in new technology Pilots, to prove clinical concepts and prove commercial viability, without fear of long term commitment. It means there need no longer be a “budget hiatus” every year, around now, that delay the introduction of new services that clinicians are desperately calling for.

A direct result of the mobile world we live in, is that increasingly, suppliers are linking their offer to commercial or clinical results in some way. This is important, because it allows much better monitoring; the introduction of new services can be far better and much more simply controlled – with the minimisation of implicit greater risk.

But it also means that hospital management needs to throw out the hostility that routinely surfaces towards the very organisations that are able to help. For this quiet revolution to happen, there needs to be what I will call a “Scandinavian Partnership” model, of engagement. It is an ironic description; Scandinavian procurements and “upphandlings” are some of the most heavily legally monitored in the world – but that in itself misses the point.

In a world where you and I are now able to tell our Doctor and Hospital what they need for us – who needs a procurement process anyway? Just go and do it.

 

Time for Digital Transformation. We look at the new Report from Logicalis.

NEW YORK, November 15, 2017 –

Just a year after we published our own assessment that the CIO remains the biggest barrier to corporate improvement, we have received the following from the Logicalis company. According to the results of their new  global survey, CIOs around the globe are more determined than ever to achieve digital transformation within their organizations despite setbacks experienced over the past year. Logicalis is an international IT solutions and managed services provider (www.us.logicalis.com) and is making the survey results available online at their  website. You can ownload a copy of the 2017/2018 Logicalis Global CIO Survey here: http://ow.ly/jVfZ30gzqws.

And what they conclude, is this:

The survey, which polled 890 CIOs across 23 countries, unearthed surprising findings this year. Although CIOs are determined to achieve digital transformation, optimism about their strides toward success has waned over the last 12 months. While only 11 percent report their organizations have “no desire” for transformation, those that ideologically embrace digital transformation have made only minimal advancements to date:

* Just 5 percent classify their organizations as “digital innovators,” down from 6 percent in last year’s survey.
* Fewer CIOs (19 percent) see their organizations as early adopters today, a step back from last year’s 22 percent.
* However, the proportion of CIOs that characterize themselves as part of an early majority with digital transformation rose from 45 percent last year to 49 percent this year, illustrating that, despite difficulties, IT leaders are moving ahead with digital transformation plans.

The main barriers to delivering digital transformation, CIOs say, include complexity, cost, culture, skills and security issues. Notably, 44 percent of CIOs cite the complexity of legacy technology as their top obstacle, while 50 percent point to cost, 56 percent name organizational culture as their largest issue, 34 percent say it’s a lack of skills, and 32 percent identify security as their biggest hurdle.

Far from discouraged, CIOs around the world have big plans for overcoming these digital transformation barriers:
*51 percent say they plan to replace and/or adapt existing infrastructure.
*51 percent plan to attempt culture change within their organizations.
*38 percent will address skills shortages through increased training and development.
*31 percent expect to invest in extra security capabilities.

“The way businesses view technology is undergoing an exciting yet fundamental shift,” says Vince DeLuca, CEO of Logicalis US. “The goal behind technology is no longer simply about implementing and managing tools that enable people to do their jobs. In a digitally transformed enterprise, it’s about giving people access to the information they need to fuel business agility and growth and to empower collaboration that will create business models no one has yet imagined. Digital transformation is the foundation upon which this new way of doing business will be built, and as this year’s Global CIO Survey indicates, IT leaders around the world not only recognize this, but they are determined to provide the platform their organizations need to embrace the change that is to come.”

The Importance of Accurate Data!

We look at the upcoming NCQA’s Digital Quality Summit
 – Using technology to increase quality reporting and reduce the burden of data collection

WASHINGTON, DC— The Digital Quality Summit comprises highly interactive working sessions within three tracks. Attendees will work in teams to solve data challenges using specific quality measures as a use case to demonstrate successful interoperability solutions. Participants will understand how information technology can be used to increase the efficiency of quality reporting and reduce the burden of data collection. In addition, they will engage in hands-on demonstrations for efficiently extracting data for quality reporting.

WHAT: This is not the typical conference of presentations and PowerPoint slides: This is a summit. Plan for interactive work sessions, networking with peers and hands-on demonstrations. Teams will work with specific quality measures to solve data challenges and demonstrate solutions. Attendees will learn how IT can increase the efficiency of quality reporting and reduce the burden of data collection.

WHO:
The Summit convenes quality improvement stakeholders including senior decision makers, measure development experts, clinicians, government agencies, public health officials, data intermediaries, vendors, and payers to advance measure interoperability solutions.

WHEN:
November 1 and 2, 2017. Click here for schedule.

WHERE:
Omni Shoreham Hotel, 2500 Calvert Street NW, Washington, District of Columbia 20008

REGISTER:
Email Ben Hamlin for Media Registration: Hamlin@ncqa.org. Ben is also the Point of Contact during the Summit, please email him directly or call his cell: 240-423-9126 with any questions.

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