WHAT NOW, FOR HEALTHCARE IN EUROPE?

We interview the VP of HIMSS EMEA, Sean Roberts, newly moved to the UK from his native California, for his plans for HIMSS over the next twelve months – and his view of healthcare on this side of the Atlantic. HIMSS is the largest healthcare trade association in the world. Its annual Global Conference resonates around the world; European healthcare vendors, particularly from Scandinavia, use the USA as their launch pad for their European and even domestic healthcare promotion.

It is not the first time that Sean and I have met. Sean is an anglophile. The last time of any significance, that we met, we went to a rather bijou little restaurant somewhere in south west London on one of his frequent stop-offs. It is rare to find an American with such a detailed knowledge of eating places in London where tourists don’t go.

This time it is different. We are in Zoom territory now. Sean has much shorter dark hair this time – he is wearing a dark blue t-shirt, the background in his home office is bare white, and he looks quizzically at the PC screen;

“Can you hear me now?

I get up and move around my own office.

“Yep! I’ve got a better connection if I stand just here….”

And this is no stop-off. Sean has moved his whole family, wife, and dog – across the Atlantic, to use London as the base so to say, for promoting better clinical management and outreach, in Europe. It is an irony compounded by the fact that the HIMSS Global Chief Clinical Director, who advises the PHE – is also already UK based.

Obviously, COVID dominates the first part of the conversation. And I ask; “So, at a time when each European country is fending for itself, why choose the UK?”

Sean hesitates and replies; “it is because English is de facto the international language, but above all, because your frontline NHS worker bees, are so “resilient”.” It is a word Sean uses several times in our conversation.

And it is not because the UK has best healthcare COVID outcomes. That accolade goes to Denmark. They plan on doing 5.5 million vaccinations, by July 2021 and everyone’s bet is that they will do this. I concur; my last time running through CPH just a few months ago, my passport control took just a few seconds and even before getting my bag, there was a nice young Danish girl in blue uniform asking me “would I like a COVID test? It’s free of charge for all visitors”. I was directed through the arrivals area, up some steps and into a covered area, and within twenty minutes tops, I had my first COVID test. “Yes, we will call you at your Hoel in day or two of there are any probs”, the nice nurse said.

What Sean is able to do, is make comparisons between one country and another, and make suggestions to each government, each hospital -“Look, have you thought about mirroring how these other people do it? Their outcomes are better”.

Looking outside one’s own internal bubble, and learning from others, is a key message that Sean is trying to promote in the UK. And the delivery of this message is not without its problems. It may not all be to do with technology, but more about national culture. Those countries that do best in containing COVID, are those who have an implicit trust in their governments. If the government says this is the right road, then this is what we will do.

Despite the fact that we are a Telehealth society now, we are hampered by the lowest common denominator in terms of wifi connectivity. The growth of Telehealth, of video conferencing, has not been because surgeries and hospitals want to go down that road, it is because they have had to take that avenue. The success of Telehealth and remote consultation at surgery and hospital vet, is directly related to each individual organisation’s willingness to adopt these new processes.

But having said that, Sean continues, these messages are getting through. IHE and HL7 and links with the WHO, are the new common standards, and HIMSS has a programme for 2021, for increasing its pan Europe roll out. The next Conference, which may well be hybrid, will be again based around Finland and their new initiatives, – it is scheduled for 7th-10th June.

Scandinavia remains a natural point of departure for HIMSS EMEA, and there is a sadness that only 5% of visitors to HIMSS events are from the UK. In the same way that just a year ago, nobody had heard of COVID – so life and healthcare is a different process now. Let’s see in June if the message has got through.

What Do We Mean by “Digital Health?

The recent announcement below from the HIMSS organisation of new advances in monitoring your health, digitally, – or progress within clinics and hospitals in having the tech to do so – gives rise to two questions; first, what on earth are we talking about?  and second – do our hospitals care anyway?

The Coronavirus situation has given rise to every flavour of new  monitoring  solution, but this misses the essential point that Coronavirus will not be here, at least in terms of dominating our health – too much longer (apparently) – which means that we need to get back to basics of; what does “digital”, actually mean.

If it means  more remote assessment of patients – yep, that might just now be happening. It has been a knee-jerk reaction, any old cobble together App with a video screen seems to be getting acceptance. If it means remote and/or more intelligent focus on our data, well I’m not so sure. My local surgery still prefers to see me every six months for 45 mins, and never see me in between – than monitor me in real time and have sexy use of my data. And my local hospital is even worse.  So, in brief – the take up of new advances which is what this is all about – is not properly working out. There is a divergence between what the IT vendors can develop – and the willingness of places where sick people go, to actually use the stuff.

Nonetheless, the HIMSS announcement is good news; this is what they say about themselves:

“The current pandemic has challenged every global health system to rapidly scale services to meet the growing demands for care, while public health agencies strive to keep people and populations healthy by mitigating risks of infection, which also serves to reduce demands on health systems. To support global health systems as they look for ways to accelerate and strengthen capacity and resilience as the future unfolds, HIMSS is proud to unveil its global solution, the Digital Health Indicator (DHI).

The HIMSS Digital Health Indicator measures progress toward a digital health ecosystem. An ecosystem that connects clinicians and provider teams with people, enabling them to manage their health and wellness using digital tools in a secure and private environment whenever and wherever care is needed. Operational and care delivery processes are outcomes-driven, informed by data and real-world evidence to achieve exceptional quality, safety and performance that is sustainable.

Based in the principles and evidence described in the recently released HIMSS Digital Health Framework, DHI measures the four dimensions of digital health:
1. Person-Enabled Health
2. Predictive Analytics
3. Governance and Workforce
4. Interoperability

To support and inform health system decisions to advance digital health capacity given the current global pandemic, HIMSS is providing free access to the DHI Rapid Assessment tool, a 12 indicator assessment that provides an estimated DHI score mapped against the four dimensions of digital health.

A DHI score provides a baseline understanding of an organization’s digital health capacity and identifies the strengths and opportunities for development of a strategic plan to advance toward a digital health ecosystem.

The Digital Health Framework and DHI are the latest additions to HIMSS’ innovative offerings. Over the past two decades, HIMSS, a not-for-profit organization, has established a portfolio of assessment tools and maturity models that have been readily adopted by health organizations in 50 countries, contributing to their strategic and operational decisions. The DHI builds on these internationally recognized tools to create its comprehensive framework.

“When individuals can connect with their providers and personal ecosystem, they can actively and collectively help manage their personal health and wellness; health system costs are lowered and improved quality outcomes, such as reduced error and adverse events, are achieved,” said Hal Wolf, President and CEO of HIMSS. “The governance frameworks and solutions of most health systems are no longer effective or adequate to achieve the necessary digital health systems of the future. Driving adoption of the Digital Health Indicator (DHI) will help move global healthcare forward to become more accessible, equitable and better performing for every human. This speaks to the heart of our mission.”

“We believe a comprehensive, evidence based framework to define and measure progress towards digital health ecosystems will provide a foundation to advance digital transformation of traditional healthcare delivery. Currently, the dominant focus of health systems is disease management and care for patients that are sick, while the goal of digital health ecosystems is to enable prevention, with people empowered to manage their health to stay well,” said Anne Snowdon, Director of Clinical Research for HIMSS.

IF A.I. IS SO IMPORTANT… CAN SOMEBODY PLEASE EXPLAIN WHAT IT WILL ACTUALLY DO?

We look at some examples of the  new focus in healthcare and ask; really?

The recent announcement of the upcoming HIMSS Impact 2018| Leading Digital Transformation and Big Data in Medicine – conference in Berlin later this year, coincides with an announcement in the uk from the Government, that it is now investing zillions into “AI”, to combat various troublesome diseases.

In theory,  and indeed in reality, a new focus on a different way of  handling patient information, will save time, not necessarily save money, but enable our services to do lots more. And it comes about because there are just too many people, needing too many services. And as one clinical director told me; ‘we can hardly put a new clinic in the hospital car park..”

But  at a time when most Hospitals are still coming to terms about moving from Windows XP, there are three major stumbling blocks, and it is important to spell these out before we all get too excited.

First – if the UK Gov attempts to roll out this Finance in the same way as it has done for previous bjg deals, let’s say such as COGDE or Scan 4 Safety, etc.. then nothing much new will happen at all. Those hospitals that did take up either of the above, have largely  spent money on things they were already doing – so it just became a way of getting finance but not improvement; or they embark on a lengthy process of milestones that alas could have been done cheaper and faster with existing tech in the private sector. 

The result is that those Hospitals that did not make the cut, so to say, have become confused, and do nothing, as opposed to at least try to do “something”. What we have found is that if the management of a hospital wants to advance its healthcare performance, it will do so, regardless of Gov announcements.

Second – AI is not a Hospital process, but a Community process. This means that the data from a patient does not require said patient to come to a clinic or be seen by anybody in a place called a hospital. The data is patient driven and comes from his/her smartphone, his Apple Watch, her Fitbit, etc – without anybody doing anything much. In other words, AI in health is consumer driven,   and there are already plenty of Apps that harness very specialist health data from each and everyone of us, that can already be viewed by our GP or Hospital. The secret to AI health is by increasing patient engagement.

But finally – we need to understand what all this will do to our actual lives. What AI means, is that our diabetes, our heart, our fitness, can be monitored remotely – and we ourselves will take greater ownership of our lifestyle. 

This means that conventional financial models of where money comes from and for what – have to change. The focus will be empowering the community, and paying hospitals to monitor that – rather than get paid only when we physically make a visit.

Because if this does not happen, then health provision will move to pharmacies, etc, who will provide this monitoring for us – and we will pay them money to do so, because it will be immediate and in real time – instead of waiting to see our local GP or clinic appointment.

Which in turn will distance us from the very organisations we already pay money to, to look after us.

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eHealth and Digitalisation at Work

The big question at HIMSS Europe in Malta just 8 months ago – was that “eHealth is all very well as a concept  – but how does it work in practice?”  We publish the recent announcement of Hospitals that are at the forefront of this process, for you to see what they are doing – and learn from that?

We will be present and covering HIMSS at Las Vegas in March. If you want a specific report about those Hospitals and Vendors that fit your own needs for 2018 – talk to us soonest – we will be pleased to help!

HIMSS Davies Award Recipients

The following 2017 HIMSS Davies Award of Excellence recipients have been announced:

Explore the links above to view each organization’s press release and to learn about their award-winning use cases. Keep checking Health IT Pulse for the remaining award recipient announcements. All HIMSS Davies Award recipients will be recognized at the HIMSS18 Awards Gala .

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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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.

 

 

Bridging Data and Genomics, for Personal Health.

We look at how healthcare provision is moving from a one size fits all approach – to a personalised and more insight driven delivery

We are delighted to say that we will be moderating the above session at the prestigious eHealth Conference, in Malta later this May.  The specific time and date is 12.15 – 13.15 on the 10th May, the first day of the Conference.

Hosted in the Nordic Community, the session brings together key speakers from Pharma and Government, to look at how we deliver a personalised healthcare to each one of us.

We will publish deeper details as soon as these are made public.  But in meantime – do make a point of meeting us at the Session. Please register your Comments below, so we can include as many of these as possible in our time together.

Time to take healthcare security seriously.

We look at the rapid rise of Sasa  Software, and ask; has their time come?

The image of Oren Dvoskin, Commercial Manager at Sasa Software, sitting in his nondescript office, black t-shirt and headphones, looks Californian, as he spells out the pessimism of his profession.

“There are two types of hospital” – he says; “those that have been hacked and know it; and those that have been hacked, but don’t know it.”

Oren’s office is nowhere near Orange County. It is on the border of Israel and Lebanon. If anyone knows about pessimism, it is he. As Sasa Software prepare to face its growing and exponential market at HIMSS 2017 – it surely does not get any more black than this.

Cyber hacking and ransomware, is growing to the point where it cannot be ignored and assumed it is for someone else. But its growth is not the most alarming feature. It is that, for hospitals, any cyber attack would have to be pre-meditated and unique and specifically tailored to find the weak spot, the easiest point of entry, into that particular hospital.

What is worse is – because health records (which are the prime target) are deeply personal and full of personal ID info – any attack is inevitably immediately visible. Unlike say a Bank etc, a Hospital cannot pretend it has not happened and just pay the money.

This is no simple phishing attack.

What that means is, and why Sasa Software believe that this 2017 will be our most “challenging”, i.e. most concerted and worrying – is that Hospitals are still not waking up to this important threat, despite the evidence that 75% have suffered some sort of breach – and that is just those that are publicly noted.

The answer, according to Oren – is to have a mix of baseline protection, the sort that all of us have on our PCs and office servers and Cloud access. This stops the initial and simplest access. But to combat the precise and targeted attack mentioned above, Sasa take the view that every incoming email, data request, every file transfer – is a threat of some sort. Their range of solutions is designed to neutralise any incoming malware or suspicious entry, at source.

But it is also a realisation that files we take for granted – the DICOM image, the voice recording – that we regularly append to our EHR records, are the new source of threat. Viewing images online across the globe, that holy grail of Clinical Consultant interoperability – may be the one area that is the chiles heel for the modern Hospital.

If there is a light at the end of the tunnel, it is not in the fingers crossed hope that that things can get better,. It is the realisation that you can do something about it. Oren is a philosopher with a positive view of human nature, despite the nature of his profession and the market he develops.

The cost of your sorting out a cyber attack ranges from $230.00 – $400.00 per patient record. Sasa Software will be addressing both the Pharma and Clinical markets at HIMSS. Worth having a serious chat.