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Doctors in hospitalWe have a long way to go but things are accelerating in the world of healthcare. Thanks to improved technology and enlightened healthcare administrators, information technology investments are being deployed at a rapid pace and adoption by caregivers is growing. I am especially pleased to see IBM jumping into this arena and leveraging its considerable resources and talents. Not that it is a new area for IBM. A year after I joined the company in 1967 three IBMers saw a big opportunity to provide mainframe outsourcing for hospitals and left to form Shared Medical Systems. SMS went on to become a $billion company with more than 7,500 employees. It was subsequently acquired by Siemens which is one of today’s leading solution providers in healthcare. IBM was a partner and supplier to SMS and is today a strategic partner with Siemens. IBM’s focus has shifted dramatically over the last half-decade. In addition to providing servers, storage, and software, IBM provides highly advanced services. It has supplemented it’s legions of PhD’s in physics, math, and engineering with medical doctors, nurses, and others with clinical experience. The strategy to assist in the transformation to a “smarter planet” approach for healthcare is to engage in deep partnerships in areas that can have high impact. A couple of current examples follow.
IBM and the University of Pittsburgh Medical Center (UPMC) are teaming up to bring “smarter” hospital rooms to patients. The system, created by UPMC three years ago, features a system to automatically organize and prioritize the work of nurses and other caregivers.  The IBM SmartRoom uses ultrasound tags to identify health care workers as they walk into a patient’s room, displaying the person’s identity and role on a wall-mounted monitor visible to patients. It also automatically provides various physician, clinician and support staff with the relevant real-time patient information pulled from the electronic medical record, including allergies, vital signs, test results and medications that are due on their monitor. The system also evaluates tasks for each patient and helps determine which tasks should be completed in which order to most effectively and safely provide care needed by the patient. It also alerts the appropriate caregiver by mobile device or when they walk into a patient’s room. Unexpected interruptions — from new physician orders to lengthy discussions with a patient’s family — are factored into the dynamically changing priority list. Using a simple touchscreen interface on a monitor in the patient’s room, a nurse or aide can document the completion of tasks in just a few seconds. The SmartRoom provides real-time links to key clinical systems, including pharmacy and lab services. Patient email, testing schedules, education and other features are also offered through the SmartRoom technology.
In the electronic medical record arena IBM and ActiveHealth Management, an Aetna subsidiary, have announced the Collaborative Care Solution — a low cost, cloud computing based subscription service that gives medical practices, hospitals and states collaborative and analytics technologies for their accountable care and medical home efforts. (These two new approaches are fundamental to the reshaping of how healthcare will be delivered in the months and years ahead). Sharp Community Medical Group in San Diego announced that it will use the new solution. The Sharp network includes over 200 primary care physicians and over 500 specialists who care for more than 165,000 patients in   San Diego county.
The IBM cloud computing approach combines information from electronic medical records, claims, medication and lab data with ActiveHealth’s advanced analytics software so care can be coordinated among teams of physicians, nurses, nurse practitioners, aides, therapists and pharmacists. Additionally, the solution provides advanced analytics that help physicians, or entire healthcare organizations, measure their performance against national or hospital quality standards. The solution can also show trends in how patients are responding to treatment for chronic asthma, or adhering to drug regimens and automatically alert doctors to conflicting or missed prescriptions.
John Jenrette, M.D., CEO for Sharp Community Medical Group says, “This is going to revolutionize how we practice medicine. Instead of digging into volumes of paper to coordinate services, we’re going to have that information available at our fingertips. It’s going to make us all more efficient.” Using Collaborative Care, hospitals and medical practices will be able to connect, analyze and share a wide range of clinical and administrative data from disparate systems and sources via a regional health information exchange. The system will automate the measurement, tracking and reporting of clinical quality performance at the patient and practice level using the Active CareTeam, and it will improve patient care through the use of evidence-based, clinical decision support powered by the ActiveHealth CareEngine. The by-product will be a transformation of practices that will assist them in achieving the goals needed to achieve Patient Centered Medical Home status and become Accountable Care Organizations. There are also a range of tools to engage patients in their own care. The Collaborative Care Solution analyzes multiple patient data sources to give doctors actionable decision support on their desktop – highlighting gaps in care, clinical research or potential drug interactions. It also helps doctors see trends in patient populations, for example by showing among 2,000 patients how many have uncontrolled diabetes, or how many women haven’t had their mammography screening, a snapshot they haven’t been able to see before. All of these things combined move us one step further away from anecdotal medicine toward information based medicine. The result will be better outcomes at lower cost.