8 Technologies Poised to Disrupt US Healthcare in 2017 and Beyond

8 Technologies Poised to Disrupt US Healthcare in 2017 and Beyond

8 Technologies Poised to Disrupt US Healthcare in 2017 and Beyond

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

The future of healthcare is happening right now. While that future is just barely forming, we are beginning to see how technology is now scratching the surface of an entirely different landscape when it comes to healthcare delivery both within and outside of the U.S.

According to PwC Health Research Institute’s annual report, 2017 is the year to prepare for the arrival of several technologies poised to disrupt the industry. This myriad of tech-driven innovation will impact just about everything from supply chain and operations to business models and essential healthcare management practices and procedures. Here’s a look at report’s eight proposed technologies poised with the potential to change it all:

1. Artificial Intelligence (AI)

We are already witnessing the potential of artificial intelligence (AI) in healthcare through IBM’s Watson, a supercomputer that first impressed us by beating Jeopardy opponents but is now tasked with beating a jeopardy of a different kind—cancer. Watson can identify cancer mutations by comparing it to a host of resources, including medical literature and clinical studies.

AI’s potential seems to be limitless. As Watson’s ability to decipher and recognize information from a myriad of media continues to grow, it will become one of the most powerful tools for data analytics moving forward. It’s expected that intelligent CDS systems using AI will further emerge to help doctors diagnose and effectively treat diseases.

Of course, the potential doesn’t stop there. It’s possible that AI will find itself into everything from wellness apps and wearables to customer service bots for patients. However, AI isn’t ready to diagnose or service patients on its own just yet.

2. Augmented Reality (AR)

Not to be confused with the computer-created world known as virtual reality (VR), augmented reality (AR) is a blending of both VR and the real world: think Pokémon Go. Aside from capturing fictitious characters, the potential of AR is undeniable in healthcare. In the future, AR could be built into medical devices or assistive devices like Google Glass, which has already been used in the OR for education purposes and shows promise as a telemedicine tool.

AR has the potential to take gamification to the next level via applications that assist in health management, medication adherence or incentivized wellness plans. Its ability to attract and engage patients will make it a potential component for dispelling information. According to an article from Medicalfuturist, pharmaceutical companies are developing applications using AR to explain how drugs work within the human body as well as how chronic, long-term conditions impact the body over time.

The article also explains how AR will give us visual overlays that make healthcare delivery more efficient and easier to access. For example, AR has already saved lives by allowing smartphone users to locate medical defibrillators through the use of an app called AED4EU. AR is also expected to show up as a precision tool at the point of care, whether it’s helping nurses find veins easier for blood draws or assisting surgeons in the OR.

3. Blockchain

Blockchain is being hailed as the next frontier in healthcare that will likely assist in resolving some of the industry’s challenges with interoperability, but what is it? Emerging in 2009 as the foundation for trading the digital currency bitcoin, blockchain is a permanent record of online transactions and exchanges that can be shared among network computers. Instead of a centrally located database, the online ledger is distributed to networks; each transaction is secured via cryptography and has to be approved and verified by those networks.

The exponential growth of blockchain applications could create the privacy and security that the industry has been looking for when it comes to managing data from hospitals, doctors, and insurance companies. That data includes information from electronic health records (EHRs), monitoring systems and IoT (internet of things) devices. Blockchain’s function could greatly enhance the integration of telemedicine and population health management (PHM) practices in healthcare. However, most blockchain technology is still in the early stages of development and not ready for mainstream deployment in healthcare, according to article published by Tierion.

4. Drones

It goes without saying, drones literally have the potential to deliver life-saving care to those who desperately need it. In fact, they are already doing just that by providing medications, vaccinations and supplies to remote populations in other countries. For example, Matternet, a leading drone company in Silicon Valley, has already enabled the delivery of life-saving drugs to Rwanda.

Beyond helping isolated populations, drones have the potential to replace transport services for drugs, light-weight medical devices and even organs. In October, it was reported that drones would be tested in remotes areas of Australia for organ transport. Drones could also be used to travel shorter lengths delivering samples within large hospital campuses.

Right now, the challenges of drone use seem to stand in the way its potential, including flight restrictions and functional problems such as battery life, the weight of transport, etc. While drones look to impress us heading forward, don’t expect to look up and see that potential come to life just yet.

5. Internet of Things (IoT)

Some may refer to the internet of things (IoT) as the internet of everything or when we talk specifically about healthcare, the internet of medical things (IoMT). What IoT describes is a steady state of interconnectivity and data stream among devices. The potential of IOT in healthcare is undeniable as the market is poised to hit $117 billion by 2020, according to a previous report from Market Research.com

From remote patient monitoring and care coordination to inventory supply and digital supply chain, IoT could greatly enhance key areas in healthcare. Its greatest potential lies in its promise to deliver on creating personalized healthcare. Connectivity among devices could help support the integration of wearables and remote monitoring devices in the growth of remote care management and telemedicine practices. However, efforts toward building supports for interoperability will be a critical indicator of IoT’s growth in healthcare.

6. Robots

When it comes to robots in tomorrow’s healthcare setting, you might want to think small—incredibly small. Aside from robots’ integration in supply chain and remote patient monitoring, we are likely to see the advent of nanotechnology and nanorobots come to life over the next several years. Ingestibles and internables will come into greater use to help monitor, manage and prevent an array of conditions and diseases; Smart pills, for example, could help monitor a patient’s internal reactions to medications.

According to CIO and the report “Healthcare Robotics 2015-2020: Trends, Opportunities & Challenges”, we are likely to see the value of robotics in three main areas in healthcare:

· Direct patient care: surgical robots (used for performing clinical procedures), exoskeletons (for bionic extensions of self like the Ekso suit), and prosthetics.

· Indirect patient care: pharmacy robots (streamlining automation, autonomous robots for inventory control reducing labor costs), delivery robots (providing medical goods throughout a hospital autonomously), and disinfection robots (interacting with people with known infectious diseases such as healthcare-associated infections or HAIs).

· Home healthcare: robotic telepresence solutions (addressing the aging population with robotic assistance).

7. Virtual Reality (VR)

Virtual Reality’s potential to disrupt healthcare is already unfolding. In April 2016, the first operation using a virtual reality camera was performed in London. It was streamed live, allowing medical students, trainee surgeons, and members of the public to experience the procedure in real time. We are expected to see its use as a teaching tool continue to grow.

Similarly, we are likely to see VR applied as a means to promote behavioral health services, whether it’s by relaxing patients and making them feel at home during their hospital stay or increasing the recovery from a stroke by helping patients “practice” how to lift their arms or move their fingers through the technology.

Physicians may also use the devices to understand the experiences of their patients better. For example, a project known as “We are Alfred” from Embodied labs provides physicians with the experience of what it’s like to be an elderly individual. Meanwhile, the development of simulated surgeries for patients using VR may help put them more at ease when it comes to going under the knife. Perhaps, this tech-enabled reality could help providers and patients better understand each other in ways the real world never could.

8. 3D Printing

According to a market research report by IndustryARC, the 3D-printing healthcare market is expected to grow by 18 percent annually until 2020. The healthcare industry has already seen significant growth in various areas thanks to 3D printing, including dental applications, medical implants, and drug manufacturing.

Many 3D-printing solutions are still in experimental stages, but the potential for its applications are looking quite promising. For example, at Princeton University they have developed 3D-printing tools to create a bionic ear, which can hear frequencies well beyond normal human range. This technology’s reasonable price points make the possibilities of 3D printing not only endless but cost effective. Shortly, we may be printing just about everything, from pills and prosthesis to biologically engineered replacement parts and organs.

New Healthcare Model Reframes Relationships, Risk-Sharing, Between Providers And Companies

New Healthcare Model Reframes Relationships, Risk-Sharing, Between Providers And Companies

New Healthcare Model Reframes Relationships, Risk-Sharing, Between Providers And Companies

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

The U.S. shift to value-based care is transforming relationships. One evolving phenomenon is risk-sharing agreements between providers and healthcare companies, including pharmaceutical, medical device and equipment makers. These agreements allow both parties to share defined risks and opportunities of a shifting reimbursement landscape

Several major med tech and medical device companies, for example, have moved to negotiate deals[1] that share the risks of technology obsolescence and enable them to work closely with the healthcare providers to improve outcomes through better workflows and appropriate technology. As evidence of this growth, in February the public-private partnership of DiA Holding FZCO and the Turkish Ministry of Health signed a five-year contract with Siemens Healthineers to build and outsource their medical laboratory service operations for two new hospitals. This new business model offers a customized solution to increase efficiency and contain costs as part of the Turkish government’s program to restructure the country’s healthcare system.

There are also high-profile alliances, known as Managed Equipment Services (MES) contracts[2], whereby a private sector service provides hospitals with access to innovative medical technology and equipment for an annual fee. Other aspects include:

  • A flexible program typically covers a 10- to 25-year period.
  • Companies that provide MES contracts offer to manage all equipment concerns such as clinical selection, procurement, installation, user training, on-site expertise, maintenance, and ongoing technology refreshes. Some companies also offer so-called “multi-vendor” MES, meaning a product not manufactured by that vendor can be provided within the service agreement, which enables wider clinical choice to hospitals across many technology suppliers.
  • One distinctive feature of such contracts is that they typically include performance improvement programs like workflow redesign, utilization management, and fleet optimization. The long-term nature of these contracts allow MES providers to bring in experts to work with hospital staff to improve clinical, financial, and operational aspects and implement programs using effective tools like data enabled benchmarking and performance dashboards.
  • The risk-sharing portion of an agreement may include clinical and/or economic outcomes that are measured and agreed upon prior to contract signing, and payment is contingent upon meeting those measures.

For imaging in particular, this shift to MES will eventually impact every segment of the imaging provider spectrum, according to an analysis[3] by consulting firm Frost & Sullivan, and may become the standard in five years.

Significant MES partnerships from Siemens Healthineers that have seen improvements in patient care, time efficiencies, and financial savings include:

  • SpainThe Ministry of Health of Murcia[4] signed a 15-year MES contract in 2010 with a goal to improve the technological innovation as well as the financial and planning security of two regional hospitals in Spain. This contract included procurement, installation, and management services for 20,000 medical devices, including mammography, ultrasound, laboratory, IT and third-party equipment for both hospitals. After five years, results have exceeded expectations. They include a 25 percent reduction in administrative costs, a projected €3.2 million in savings, and a 15 percent decline (from 15 to zero percent) in patient rescheduling related to equipment technical failure. Other results include an 83 percent improvement in resolution times and a 90 percent reduction in equipment damage costs for Santa Lucia Cartagena University Hospital. Los Arcos del Mar Menor Hospital saw their mammography waiting lists shrink from two years pre-partnership to no waiting time.
  • The Netherlands – Zaans Medical Centre (ZMC)[5], a 280-bed hospital that entered into a 13-year MES contract in 2013, has seen several improvements. The annual pricing fee of both the equipment and service components is significantly lower through the MES model. System downtime has been nearly eradicated (with uptime improving to 6 percent) due to on-site technical and management capabilities, and 10 extended educational programs have been implemented, increasing user confidence.
  • Canada – In 2015, the William Osler Health System in Canada[6] signed a 15-year contract for a comprehensive suite of services to manage most of its medical imaging equipment at three hospital sites. The contract redesigned processes in the emergency room, making imaging available 24 hours/7 days a week, which is essential to quality diagnostic care and treatment. To support timely response, the hospital chain also added remote reporting to allow radiologists to review exams and issue patient reports regardless of their location – in the hospital, at home or on the go.

This MES approach appeals to both med tech companies and healthcare providers. Med tech companies find MES agreements provide more stable revenues and enhance customer relationships to be more strategic than transactional. They can also activate additional business benefits by deploying technologies that showcase their product and service portfolios to mutual gain.

MES programs help healthcare providers to:

  • Drive capital cost savings through better equipment selection, improved utilization and performance with reduced operational costs. These cost benefits are due to optimized maintenance models, insurance, training and inventory management
  • Remain up-to-date (i.e. operationally effective and clinically relevant) as the med tech fleet ages and technology develops over time
  • Manage med tech service to reduce complexity (and cost) and improve quality to reach desired economic and clinical outcomes
  • Drive value-for-money decision-making around equipment renewal and upgrade
  • Increase staff satisfaction by focusing their attention on patient care
  • Transfer future med tech obsolescence and pricing risks
  • Flexibly introduce cost-effective financing, where and when needed, as a part of an ongoing commercial program
  • Improve patient satisfaction and safety with new technologies, and reduce patient wait times due to optimum fleet sizing and better utilization.

In short, new partnership approaches with med tech companies give providers more opportunity to focus on their core of providing patient care and help the healthcare system restructure incentives to move towards value based care.

How Systems Engineering Can Help Fix Health Care

How Systems Engineering Can Help Fix Health Care

How Systems Engineering Can Help Fix Health Care

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

When an aircraft manufacturer decides to create a new model, it doesn’t ask pilots and crew to identify the best cabin, wings, jet engines, and other parts, and then put all the pieces together. A plane developed that way wouldn’t fly. The company begins with a goal, such as safely carrying 250 passengers nonstop from New York to London in under six hours, and follows a disciplined approach to identify the components and subsystems that meet those requirements.

By contrast, the way we build hospitals and clinics typically happens in a piecemeal, patchwork approach. Institutions purchase hundreds of individual, siloed technologies — each with its own work processes, training, and user interfaces — based on what the market offers. We then plop them into an ICU or operating room and hope that they somehow work together.

The result is a constellation of technologies that rarely connect, to the detriment of patient safety, quality, and value. For example:

  • Different monitors emit alarms that compete with one another for the attention of clinicians, who must sort out which signify serious conditions and which don’t. Sometimes they miss critical alarms amid the noise.
  • Devices, electronic medical records, and even patient beds have electronic information that can help diagnose conditions and assess risks. However, clinicians must consult each one individually, rather than seeing a unified display of information from them.
  • Time that could be spent with patients and their loved ones is instead squandered in front of computer monitors, as clinicians click through dozens of screens in search of relevant information.

All of this leads to needless patient harm, low productivity, excessive costs, and clinician burnout. Doctors and nurses feel as though they’re serving technology, not the other way around. Preventing complications, errors, and other harm too often depends on the heroism of clinicians rather than the design of safe systems.

We need a new approach, one that puts the needs of patients and clinicians first. We need to integrate technology, people, and processes so that they are seamlessly joined in pursuit of a shared goal.

While this is new for health care, it has become routine in other complex, high-risk fields. It is the realm of systems engineering, a field that has contributed to jaw-dropping achievements, such as sending a spacecraft on a nine-year voyage to Pluto and designing a nuclear submarine.

These projects would not have succeeded without clearly defined, measurable goals and a rigorous approach for achieving them.

At Johns Hopkins, we experienced how powerful systems engineering can be when we set out to improve patient safety and quality of care in intensive care units. Patient safety researchers and clinicians from Johns Hopkins Medicine partnered with the systems engineers and systems integrators of the Johns Hopkins University Applied Physics Laboratory (APL). For 75 years APL has supported the Department of Defense and other government agencies as a “trusted agent” to solve critical challenges, such as building satellites and weapons systems on ships.

The APL team guided patients, family members, clinicians, and researchers from nearly 20 medical disciplines through an exhaustive process of defining our goals, understanding our priorities, listing the functions that the system must perform, and determining measures of success. These discussions led us to set the goal of reducing seven of the most common and serious preventable harms facing ICU patients. They included five clinical harms, such as hospital-acquired infections and complications, as well as two “social harms,” lack of respect and misalignment of care with the patient’s goals. No doubt, patients are at risk for more than seven harms. But we had to focus because the Gordon and Betty Moore Foundation, which funded the project, wanted to ensure that we demonstrated results.

In interviews and meetings with stakeholders and through observing clinicians and patients interact, we identified layers and layers of requirements for a system that would achieve our goal. Our solution was Project Emerge, a system that integrates data from several sources into one easy-to-read computer display. It combined data from existing technologies, such as the electronic patient record, with new ones, such as sensors that track patient activity or the angle of a bed. In the same way that pilots get all essential information in cockpit displays, Emerge lets clinicians quickly see if patients are getting all the care necessary to prevent the seven harms. A second computer display helps patients and families engage with their care team and take a more active role in their care.

One module of Emerge, focusing on the prevention of ICU-acquired weakness, demonstrates the elegance of a systems engineering approach. Research tells us that patients regain their strength earlier and have fewer related complications when they start moving as soon as safely possible during their stay in the hospital. Yet in most ICUs there isn’t a culture to support early mobility; clinicians are not conditioned to ask every day whether their bedbound patients are able to get moving, or whether they are meeting their mobility goals. There are no devices or displays that inform patients of their progress or warn them if they are falling short.

The Emerge system compels clinicians to set a patient’s mobility goals and pulls data from different sources into the dashboard, where the ICU-Acquired Weakness display turns red if the patient is not on track. Clinicians can tap the touch screen, drill down for details, and address next steps. Meanwhile, patients and family members can pick up a tablet computer and learn about the importance of mobility; family members take part in getting their loved ones out of bed or walking in the ICU.

The whole team is part of this technology-enabled culture change, making early mobility something that’s routine rather than an afterthought. With this app, the percentage of patients who were given mobility goals went from 40% to 100%, and those receiving mobility therapy increased from 48% to 80%. Those who had significant functional declines in their mobility decreased from 19% to 10%.

Of course, ICU-acquired mobility is just one harm, and this module is just one of many that share data and knowledge, make processes more efficient, prevent harm, and keep families top-of-mind. These modules must be integrated so that clinicians are not overwhelmed with more information and tasks than they can manage.

Emerge demonstrated that the systems engineering approach can help reduce specific harms, but there are many other goals that it could help achieve — for example, improving productivity, enhancing patient experience, improving bed management, and enhancing transitions of patient care between providers.

Such efforts could accelerate if more manufacturers of health care technologies were willing to let their products “talk” to one another. Generally speaking, they don’t. While we were able to integrate data from several sources into Emerge, the work was highly technical and labor intensive. More innovation could occur across health care, and health care would become less fragmented, if technologies shared information more readily.

We hope our experience will give them one more reason to do so.

 

 Peter Pronovost is an intensive care physician and the C. Michael and S. Ann Armstrong Professor of Patient Safety at Johns Hopkins University. He serves as the Johns Hopkins Medicine Senior Vice President for Patient Safety and Quality and the Director of the Armstrong Institute, and helps to lead patient safety efforts globally.

Global Citizens Pick US For Health Care

Global Citizens Pick US For Health Care

How Systems Engineering Can Help Fix Health Care

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

But as these American patients leave the country for care, millions more international citizens will travel to the U.S. to be seen and treated by physicians regarded as some of the best in the world.

According to research in the November 2016 PYMNTS.com Global Citizen Index™, just under 40 percent of these patients travel to the U.S. or to Canada to receive medical treatment.

Their international voyage to seek better medical care often underpins a multitude of challenges. Increased costs are obviously huge concerns for these traveling patients and often total in the tens of thousands of dollars, forcing many of them to dip into savings in order to pay for procedures.

But those are far from the only challenges international health care patients face. According to Josef Woodman, CEO of Patients Beyond Borders, an informational resource for patients in need of medical care abroad, foreign patients often face significant cultural and language barriers in addition to the typical stressors of medical care itself.

PYMNTS recently spoke with Woodman about patients traveling to the U.S. (or inbound patients) and the international health care industry as a whole. Woodman told PYMNTS that there are a variety of difficulties for inbound patients, including increased costs and vast cultural and linguistic gaps.

Finding the funds

The U.S. has the most expensive health care in the world, whether patients travel from abroad to receive care or already living and working in the country. According to research from the Agency for Healthcare Research and Quality, the average daily stay in a hospital for an admitted patient in the U.S. runs more than $2,000.

Woodman noted, however that many patients who choose to travel internationally to the U.S. for medical care do so because of acute or serious complications and the perceived quality of care. PYMNTS research found that roughly a third of the patients who come to the U.S. for medical treatment are seeking treatment for lifesaving conditions, which often increases the cost of treatment.

Patients who leave their home countries to come to North America must also cover additional expenses such as for travel and lodging for themselves and any family, friends or caretakers who may be traveling with them. Add it all up, Woodman said, and it makes for an expensive final bill.

“Costs are a huge challenge for the inbound patient,” he said. “The United States is by far the most expensive place one can be treated. Based on the [amounts for] services we’ve received from hospitals, the cost for the average patient in the United States is $35,000 to $50,000.”

It’s no surprise then that many patients are forced to dip into their savings to pay for treatment. According to the Index, 54 percent of patients used their savings to cover the cost of international health care, and 45 percent relied on funds from their immediate or extended families.

These high prices also mean it’s often the wealthiest and most elite citizens in foreign countries who can afford to and obtain care in the U.S. PYMNTS research revealed that 37 percent of international health care patients own a second home, often in the country in which they received care.

Cultural conflicts

Traveling across borders and overseas for medical care poses more than just financial challenges. Woodman pointed out that some of the most difficult challenges around receiving medical care abroad come from simply overcoming language and cultural barriers that can complicate interactions between a patient and their physicians.

Matching up cultures also creates a major challenge for inbound patients, Woodman said. “A patient coming to the U.S. who doesn’t speak English is going to have a real tough time.”

Nearly half of all foreign patients are age 55 or older, almost 60 percent come from Asia and Africa, and only 2 percent have immigrated to a new country before.

Woodman noted that many large hospitals in the U.S. are either currently offering or assembling international services departments or culture centers that can help patients deal with these challenges. However, many cater solely to South American or Hispanic populations, even though these patients account for just 10 percent of international health care recipients. They also often do not have employees who speak Asian or African languages, which can encompass many different dialects.

Until more hospitals bolster these departments and add diverse employees, Woodman said it will continue to be difficult for many of these African and Asian patients.

“Many times Americans are not equipped to handle different cultures or different languages,” Woodman said. “There can be a real challenge for a patient coming into the U.S. who just doesn’t speak English.”

Making care worth the challenge

Despite the cultural and financial barriers, millions of foreign citizens come to the U.S. every year seeking the best medical treatment available.

According to the Index research, they come for a variety of reasons. Thirty-three percent came to the U.S. to battle cancer or other life-threatening diseases. Twenty-three percent traveled for a specialty treatment or to consult with a specialist, because the treatment or a similar one was not available in their country.

In order to best serve these patients, whose numbers are projected to increase in the near future, hospitals must invest in infrastructure, Woodman said. Specifically, they should look for investments that can help them adapt to and care for patients who speak different languages and are from different cultures and keep costs as low as possible for those in need of lifesaving medical care.

“It’s about matching up cultures,” Woodman said. “Finding a way to address some of the nuances of language and culture is absolutely critical.”

As more global citizens travel to the U.S. seeking medical treatment, hospitals may have no choice but to find ways to extend more services and resources to these patients if they intend to keep up in this rapidly growing industry.

Preparing Doctors to Meet the Demands of the Nation’s Changing Healthcare System

Preparing Doctors to Meet the Demands of the Nation’s Changing Healthcare System

Preparing Doctors to Meet the Demands of the Nation’s Changing Healthcare System

Critics have long faulted U.S. medical education for being hidebound, imperious and out of touch with modern health-care needs. The core structure of medical school—two years of basic science followed by two years of clinical work—has been in place since 1910.

Now a wave of innovation is sweeping through medical schools, much of it aimed at producing young doctors who are better prepared to meet the demands of the nation’s changing health-care system.

At the new Hofstra North Shore-LIJ School of Medicine in Hempstead, N.Y, students spend their first eight weeks not in lecture classes but becoming certified emergency medical technicians, learning split-second lifesaving skills on 911 calls.

At Penn State College of Medicine in Hershey, Pa., first-year students work as “patient navigators,” helping the ill, injured and their families traverse the often-confusing medical system and experiencing it from their perspective.

At New York University School of Medicine, one required course delves into a database that tracks every hospital admission and charge in the state. Discussions center on why, say, the average tab for delivering a baby is $3,000 in a rural area and $22,000 in New York City.

“This isn’t a textbook exercise. This is real life and students love it,” says Marc Triola, NYU’s associate dean for educational informatics.

Century-Old Model
Medical educators say such innovations are long overdue. The U.S. health-care system is rapidly becoming ever more data-driven, evidence-based, patient-centered and value-oriented. But for reasons having to do with tradition, accreditation concerns and preparing students for national board exams, the designers of medical-school curricula have been slow to shift their focus.

“The reality is that most medical schools are teaching the same way they did one hundred years ago,” says Wyatt Decker, chief executive of the Mayo Clinic’s operations in Arizona, which include a medical school in Scottsdale, Ariz., that is scheduled to enroll its first class in 2017. “It’s time to blow up that model and ask, ‘How do we want to train tomorrow’s doctors?’ ”

Doctors today are well schooled in the science of medicine, says Susan Skochelak, the American Medical Association’s vice president for medical education. “What’s been missing is the science of health-care delivery. How do you manage chronic disease? How do you focus on prevention and wellness? How do you work in a team?”

To encourage med schools to move their curricula in that direction, an AMA initiative called Accelerating Change in Medical Education is giving $1 million to each of 11 schools to help fund novel programs. Of the nation’s 141 medical schools, 118 competed for the 11 grants.

The push for change comes at a time when medical educators are also trying to address a critical shortage of physicians. No new med schools opened in the U.S. from 1985 to 2000, amid fears of a doctor glut. More recently, however, predictions of a shortfall of 90,000 physicians by 2020 have sparked a building boom: Some 17 new schools have been accredited since 2002 and nine more have applied for accreditation.

A few of the new schools have made it their mission to address acute shortages of primary-care physicians in certain areas. Texas Tech University’s Paul L. Foster School of Medicine, which opened in El Paso in 2009, emphasizes community medicine and Spanish-language skills. The University of Kansas School of Medicine’s new branch in Salina takes just eight students a year—all with a strong desire to practice medicine in rural areas.

Med schools old and new are looking for a broader range of qualities in applicants—particularly students who are empathetic and have experience relating to diverse kinds of people.

New MCAT
To that end, in April, a new MCAT—the Medical College Admission Test—will be administered, the test’s first major revision since 1991. The new version is 2 hours longer (6 hours and 30 minutes) and tests knowledge of behavioral and social sciences as well as biology, physics and chemistry. One sample question has applicants read a passage, then asks which of four statements “is most consistent with the sociological paradigm of symbolic interactionism?”

Some schools have replaced the traditional one-on-one interview with a series of simulations in which applicants are asked to show how they would make a tough judgment call or deliver bad news. At the University of California, Davis, School of Medicine, community residents join faculty members in rating the applicants, providing a broader range of views.

Styles of teaching and learning are also changing.

“We’ve replaced ‘the sage on the stage’ with ‘the guide on the side,’ ” says Richard Zimmerman, a neurosurgeon and medical director for education for the new Mayo med school in Scottsdale.

At both the new school and Mayo’s existing medical school in Rochester, Minn., much of the material traditionally taught in lecture classes will be converted to electronic formats that students can absorb on their own, leaving class time for discussions and case studies.

Mayo also is creating a new course of study, called the Science of Health Care Delivery, which will run through all four years and include health-care economics, biomedical informatics and systems engineering. With a few additional credits, students can graduate with both an M.D. and a master’s in health-care delivery from Arizona State University.

In a course called Checkbook, Mayo students will track all of the services provided to their assigned patients during clinical rotations and look for redundancies or routine tests that add little value.

Focus on Teams
Learning to work in teams is a main focus at Mayo—and a sharp departure from traditional training for doctors.

“The old model was, you’d go on rounds; the attending would ask a question, and the young resident had to get the right answer,” says Dr. Decker in Scottsdale. “In the new model, you’re part of a team, and somebody else might have the right answer.”

To understand the roles of team members who aren’t doctors, first-year Mayo students spend half-days shadowing clinic schedulers, registered nurses, nurse practitioners and physician assistants. They also assist in managing a panel of patients, as care coordinators do. For example, they review records to see which diabetes patients aren’t managing their health well; they call the patients on the phone to discuss why they are struggling; then the students consult with the patients’ primary-care doctors to determine the next steps.

In another departure from med schools past, Mayo is making an organized effort to help students avoid burnout. Classes in the first two years are pass/fail, not graded, and students can evaluate their level of stress, fatigue and risk of suicide in a confidential Med Student Well Being Index, which also offers resources for help.

“When I went to med school 30 years ago, I don’t remember anybody asking how we were doing,” says Michele Halyard, vice dean of Mayo’s medical-school programs. “But you can’t heal the health-care system if you’re sick yourself.”

Less Memorization
What’s being left out of medical education to make room for the new material?

Some schools are placing far less emphasis on memorizing facts, such as which drugs do what and how they interact with other drugs. Such information is now readily available electronically.

“The fund of medical knowledge is now growing and changing too fast for humans to keep up with, and the facts you memorize today might not be relevant five years from now,” says NYU’s Dr. Triola. Instead, what’s important is teaching “information-seeking behavior,” he says, such as what sources to trust and how to avoid information overload.

Technology is also changing how med students learn. Simulators that look like patients and can be programmed to go into cardiac arrest, have strokes, spike fevers, cry, vomit and eliminate are particularly useful for teaching.

“Some schools don’t use cadavers anymore,” says the AMA’s Dr. Skochelak. “But others think it’s an important way to learn respect” for the real human body. “They tell students, ‘This is your first patient.’ ”

Some schools are condensing the typical four-year curriculum into three years, to let students start their residencies sooner and graduate with less debt. The Association of American Medical Colleges is also studying ways to let students master needed skills and competencies at their own pace—an innovation that has come to medical residency programs as well.

“We should have done this 10 years ago,” Dr. Decker says of the many med school changes. Then he quotes a Chinese proverb: “The best time to plant a tree is 20 years ago. The next best time is tomorrow.”

Ms. Beck is a health reporter and columnist for The Wall Street Journal in New York. She can be reached at melinda.beck@wsj.com.

Medical Transcription and EMR – Digitizing Patient Health Record to Provide Health-Care Solutions

Medical Transcription and EMR – Digitizing Patient Health Record to Provide Health-Care Solutions

Medical Transcription and EMR – Digitizing Patient Health Record to Provide Health-Care Solutions

The present day health-care industry faces enormous challenges to satisfactorily deliver quality health solutions to the masses in a cost effective manner. The challenge gets stiffer, when remote communities are involved.

To … maximize the reach of medical personnel, it is important to merge wireless technology with medical documentation technologies like EMR and medical transcription.

The objective is to deliver health-care solutions through Telemedicine to near or distant communities, by creating a seamless health-care web.

A proper medical documentation system makes it easy for the physician to maintain a complete record of the patient. Medical documentation system like EMR or electronic medical record allows the physician to quickly enter the patient health information into relevant pre-structured templates through point-and-click mechanism. As a result, during medical diagnosis of patient, the physician directly enters the medical observations into computer to create an electronic record. This saves time and money as no additional staff and storage area is needed for maintaining bulky file cabinets.

In medical transcription, the diagnostic report of patient is dictated into the voice recorder and the voice file is sent to the transcriptionist. The voice file is converted into electronic text and sent back to physician. This is a manual process and takes time. The speech recognition software overcomes this drawback by directly converting dictation or spoken words into electronic file, which is then edited by the transcriptionist. This setup increases the transcription speed and at same time ensures high degree of accuracy.

EMR, medical transcription and speech recognition software make it easy to digitize the patient health information, in a safe and secure way. The digital data is then converted into suitable microwave signals by WIMAX (World Wide Interoperability for Microwave Access) and transmitted over large distances. All the security features are incorporated in the network to ensure that the bi-directional flow of the patient health data is as per HIPAA norms.

The wireless technology like the WIMAX, provides the last mile connectivity and allows for easy integration of the remote communities with urban centers, where majority of hospitals are located. Through WIMAX, it is possible to simultaneously receive and send, audio and video signals, an essential requirement of Tele-monitoring. The ECG and EEG of the distant patient can be easily monitored by a doctor in the hospital, situated thousands of miles away. In case of emergencies like accidents in remote areas, where the patient requires prompt medical attention, the paramedics can easily interact with hospitals. They can send medical observations, reports, videos and other records, online to hospitals and simultaneously receive instructions from doctors, on how to treat patients. This all can be easily done as the patient is being rushed to the nearest hospital. Thus WIMAX provides mobility to health-care delivery.

This type of health-care setup reduces patient visits to the hospitals or clinics, unless in case of an emergency or when it becomes necessary for patient. The stored health information can be easily updated regularly by doctor after each online interaction with the patient, during the course of the treatment.

Thus Medical transcription and electronic medical record can be smoothly integrated with WIMAX technology in such a manner that it reduces the cost of treatment. The patient does not have to pay for the transportation and accommodation charges, as he or she can easily avail online treatment.

Medical Transcription, EMR and WIMAX technology can together provide online health solutions in a cost effective manner.

Jason Gaya, Read more on medical transcription and EMR at www.mediscribes.com

Article Source: http://EzineArticles.com/?expert=Jason_Gaya

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