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Benefits Of Wearable Technology In The Health Sector

Benefits Of Wearable Technology In The Health Sector | IT Support and Hardware for Clinics | Scoop.it

When most of us consider wearables, we include devices such as Bluetooth headsets. However, in the medical industry, we expect more from our wearables and only include devices that not only provide a specific function but will also store sensor data for later retrieval by healthcare professionals. This data is then analysed to aid medical diagnosis.

 

In a growing telehealth market, it is these sensor-based devices that will improve healthcare services for millions of patients worldwide. Existing forecasts indicate that the global telehealth spend will increase tenfold within five years, rising to $4.5 billion by 2018.

 

Like any new technology, early adoption figures are quite weak but luckily, in Australia, we are always eager to experiment with new innovations. In fact, a 2014 Kronos survey demonstrates that no less than 30 per cent of Australians already use wearable technology, twice that of our U.S. counterparts. In addition, more than 40 per cent use them for work-related tasks. This high adoption rate is encouraging for future increased use of wearables in the health and fitness areas.

 

For this adoption rate to continue, I believe we need our healthcare providers to embrace the use of wearables, as they are best positioned to encourage their patients of wearable benefits, with the most important being improved care monitoring and increased efficiency for early diagnosis of common ailments. When a medical professional recommends a product, people listen. There are several reasons for this but primarily these include:

 

A company with a commercial interest in the product is unlikely to achieve the same positive response level.


Patients trust their doctors to act in their best interest.
By using these technologies themselves, patients are encouraged to take a more proactive approach to their personal health.
Fitness plans were perhaps the first wearable that provided useful data for medical professionals and were primarily used by those in cardiovascular activities such as running and cycling. Like any product type, the features available vary by model and manufacturer but most are capable of acting as a pedometer and can also record pulse and heart rates. The data gathered by the device sensors is then transmitted to your smartphone using Bluetooth or possibly ANT+ for cycling enthusiasts with bicycle computers. This data is often useful to doctors as it can aid diagnostics, surpassing the original plans for the device as a general fitness monitor.

 

Wearables that are specifically designed for the healthcare industry work in an identical manner. Senses are used to gather data, which is then transferred to another device for later analysis. Smartphones are most commonly used, with apps available for several platforms including Apple’s iOS and Google’s Android, but residential users can also use Wi-Fi to transfer data to the cloud or to another monitoring device.

 

In my opinion, as this technology grows, I believe real-time reporting will be possible, where data is displayed on the health professional’s monitor as soon as new data is uploaded. The exact direction this technology will take requires valuable input from knowledgeable medical professionals. That is not to say that the existing range of devices for the medical industry is limited as this is far from the situation. There are several preventative care devices already on the market and these include:

 

Glucose meters that notify clinics of an emergency situation, ideal for remote monitoring of elderly diabetics
Remote monitoring devices that store information such as blood pressure, temperature, ECG data and more. These can save a vast amount of clinic time, allowing healthcare professionals to prioritize according to patient ailment and creating an environment where early diagnosis is certain for many common ailments.
There are several dedicated devices and applications for monitoring diets, all of which act as a virtual personal trainer who recommends a specific diet according to age and cardiovascular status.
The examples listed above are probably the most common but there are many other devices available that monitor specific conditions. All share the same properties, to gather information and to monitor patients in real-time, thereby improving doctor-patient interaction and the healthcare service provided.

 

The use of wearable technology is a win-win for both healthcare professionals and patients and can reduce individual patient costs while also eliminating unnecessary clinic visits for the patient. For example, if you have high blood pressure and are prescribed specific medication to alleviate the condition, you will no doubt have to make several trips to the clinic to verify that the prescribed treatment is actually working. However, with the use of wearable technology, this is no longer necessary, as the data gathered from the device is simply analysed without travelling to the clinic.

 

Australian healthcare professionals need to adopt wearable technology as soon as possible, given that the benefits surpass any possible costs or training headaches. It is a fact but careful selection of wearable devices and software apps can increase the efficiency of any medical practice, whether it is immediate access to patient data from anywhere, guided surgery, health monitoring tasks and more. Early adopters have already discovered that these solutions can reduce the frequency of clinic visits and related clinic hours per patients.

 

Individual patient costs are reduced substantially but this does not mean that clinics will lose revenue, it merely means that available clinic time is spent treating the seriously ill or patients that require emergency care.

 

Mobile devices, remote data access and analysis with the resulting ability to increase early patient diagnosis are the way of the future. It may take some effort to define the correct processes, workflows and procedures but it is clearly worth it. Can you really afford to ignore the benefits of wearable technology?

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Medical Software On The Cloud

Medical Software On The Cloud | IT Support and Hardware for Clinics | Scoop.it

As more and more traditional companies leverage the benefits of the cloud, it’s no real surprise that the healthcare industry has embraced technology, with electronic health records now commonplace. We have provided a cloud-based solution for clinical and practice management software since 2012 and the adoption rate among Australian healthcare practices and clinics grows each year.

 

Cloud for Health allows users of popular clinical software packages (such as Medical Director and Best Practice) to access data from anywhere by simply using their web browsers on any internet-ready device. It allows users to concentrate on core activities without worry about servers, backup maintenance or essential security updates as we take care of all that under our service level agreement(SLA).

 

Other advantages include guaranteed data storage on Australian servers (also a legal requirement) and immediate access to an ideal solution for rural GPs that often need to travel long distances between clinics, allowing the easy use of mobile clinics, taking the practice on tour, so to speak.

 

Doctors located in the middle of the desert can access their clinic records remotely, simply by using a laptop and phone, tethering the laptop to a 3G or 4G connection if available. Alternatively, you can simply use a smartphone , netbook or other portable device with a browser. In times past, you would have needed to log in directly to your practice, with low speed often the result. Not so with the cloud, as maximum performance is always available.

 

As the whole process is browser-based, it’s no longer necessary to have a high-performance laptop for productive tasks. Even older laptops will work perfectly as long as an internet connection is available.

 

Not all healthcare professionals require mobility but cloud hosting has other advantages:

 

  • You no longer need a server and can eliminate associated hardware costs and maintenance issues.
  • Data backups are automated using redundant hard drives, preventing unexpected data loss
  • 24/7 maintenance and support is offered by reputable service providers
  • Software patches and security updates are handled by the service provider


Our aim as a service provide is to remove IT as a consideration for healthcare professionals and let them focus on patient care. Even in extreme situations where all hardware in the practice has failed (due to power loss, fire or water damage, for example) vital clinical data can still be accessed using a mobile phone. The benefit to business continuity is obvious.

 

The majority of clinical software is designed for use with Microsoft Windows, with Mac users often experiencing problems. However, by use of a Citrix Desktop Viewer, the platform does not matter as everything is viewed in a standard browser, regardless of whether the user is on Windows, Android, iOS or MacOS.

 

Coming from a family of doctors, I originally considered offering a free service to make the lives of healthcare professionals easier by allowing them to focus on patient care. However, I decided to implement a licence fee structure, given the variety of experts, hardware and hosting requirements necessary to provide a reliable service. It is true that ‘you get what you pay for’ and a free service would have compromised features and defeated my original goals.

 

The licence fee structure works well and is cost-effective, regardless of the size of the practice, given the backup protection and risk managements solutions that are immediately solved. In addition, we perform a full IT and business process audit to maximise the investment, ensuring that all systems are configured correctly.

 

While some are still reluctant to move to the cloud, due to perceive security issues, I believe these concerns to be ill-founded, especially when you consider that cloud service providers are held to a higher standard than traditional networks. We are subject to regular third party audits that we cannot avoid if we are to retain our IT and industry certification status. By achieving these standards, we publicly confirm that we exercise due diligence in security, data storage and internal disaster recover processes.

 

Therefore, we can offer a complete IT solution with confidence, whether it’s on the cloud, onsite or a combination of both. Eliminate your IT concerns and focus on your business. Contact us for further details.

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Medical Device Quality: Why Software Is More Challenging Than Hardware

Medical Device Quality: Why Software Is More Challenging Than Hardware | IT Support and Hardware for Clinics | Scoop.it

The U.S. Food and Drug Administration’s (FDA) Quality System Regulation 21 CFR Part 820.30(g) states, “Design validation shall include software validation and risk analysis, where appropriate.” The words, “where appropriate,” indicate that further guidance is necessary to successfully comply with the regulation. FDA’s guidance document, “General Principles of Software Validation,” is an important first read in that regard, but many medical device manufacturers are not sufficiently familiar with it.

 

It is impossible to imagine the medical device industry today without the software revolution. From defibrillators to infusion pumps and robotic surgical systems, a broad range of devices relies on software to function safely and effectively. At the same time, medical device software has introduced a level of complexity that dwarfs anything seen before in the field. This column addresses some basic facts about medical device software and how quality professionals, together with executive management, can work together to ensure that FDA’s rigorous requirements are satisfied.

 

Note that FDA has separate requirements for medical device software and quality system software. This column addresses only the software that is part of a medical device, such as software that triggers an alarm when a product fails. Other software, such as that used by a medical device manufacturer to manage complaints in its quality system, is outside of the scope of this discussion.

 

In October 2017, FDA released two new final guidance documents on the same day: “Deciding When to Submit a 510(k) for a Change to an Existing Device” and “Deciding When to Submit a 510(k) for a Software Change to an Existing Device.” In other words, medical device software changes have so many unique challenges and risks that they earn a guidance document of their own, separate from all other device changes.


The Problem: Software Is Different from Hardware
Validation is at the heart of device design, and the validation of software design is especially challenging. Even though FDA’s guidance document, “General Principles of Software Validation,” was last updated in January 2002, that guidance is still highly relevant and useful. When a medical device incorporates software, FDA expects the manufacturer to be well-read in the guidance document.

 

Furthermore, FDA does not intend the guidance document on software validation to be read only by software developers or quality engineers, as it states, “Software engineering needs an even greater level of managerial scrutiny and control than hardware engineering.” The guidance is written in laymen’s terms, so executive management is not excused from this responsibility, even when they have limited experience in software development.

To get to the heart of the problem, the guidance document on software validation includes the deceptively simple statement: “Software is different from hardware.” Actually, there are many complex differences between software and hardware, and understanding those differences is key to ensuring that software validation will pass FDA muster. The comparison chart (above and on the previous page) is adapted from, and expands on, the FDA guidance.

 

The Solution: Software Validation Driven by Rigorous Requirements


Both of the last two differences in the chart use the phrase, “a clear set of detailed requirements.” This is the most crucial element for proper software validation, and one that is frequently neglected. The flow chart figure on page 20 illustrates how requirements play an early and crucial role in software development.

 

During the phases that developers are coding and testing the software, the requirements enter a tunnel that is closed to non-developers, and the software emerges from the other side as a complete design. The resulting software can support a safe and effective device only if executive management and other stakeholders have reviewed a detailed and unambiguous set of requirements. Quality and regulatory teams can expedite this crucial phase by ensuring smooth communications between engineering and the rest of the organization.

 

At the far end of the tunnel, quality and regulatory conduct the final stages of user site testing with faithful attention to the original requirements. As noted in the list of differences between software and hardware, “user expectations are often unexpected,” and any expectations that were not properly specified as requirements are likely to emerge as errors during testing.

 

Clearly, the future of medical device development is bound up with new advances in software—wearable devices, remote medicine, algorithmic diagnostics, and robotics. FDA expects that manufacturers’ quality systems and design controls will ensure safety and efficacy, even as the software code at the heart of the device remains opaque to executive management. Software design might be more challenging than hardware, but software validation will keep the differences manageable and the quality undiminished.

 

Dan Goldstein is a manager for Quality Assurance at Musculoskeletal Clinical Regulatory Advisors (MCRA), primarily focusing on quality system requirements for bringing new devices to market and keeping experienced manufacturers in compliance with FDA and Notified Bodies. He provides MCRA clients with gap assessments, mock FDA inspections, Form 483 remediations, Design History Files, Technical Files, Summary Technical Documents, and Clinical Evaluation Reports. A graduate of the University of Maryland University College, Dan has worked since 2002 in quality assurance for medical devices, including autologous blood products for wound healing and computer-aided-detection software for lung diseases. Musculoskeletal Clinical Regulatory Advisers LLC has broad experience in the area of software validation. MCRA’s staff is especially adept at promoting and maintaining the lines of communication that keep executive management, the “voice of the customer,” and software developers on the same page with regard to the detailed requirements that drive the development process. The organization believes in requirements that follow the “four Cs”—clear, concise, correct, and complete.

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Advanced Software Offers Metal Artifact Reduction For Extremities

Advanced Software Offers Metal Artifact Reduction For Extremities | IT Support and Hardware for Clinics | Scoop.it

Carestream Health will demonstrate new optional advanced metal artifact reduction software for its Carestream OnSight 3D Extremity System at the Radiological Society of North America tradeshow (Booth #6713). Carestream’s OnSight 3D Extremity system captures high-quality, low-dose 3D extremity exams. The company’s new metal artifact reduction software is pending FDA 510(k) Clearance.

“Carestream’s second generation of software takes our state-of-the-art original metal reduction software to a new level. It provides enhanced flexibility depending on the metal content present and reduces the visual distortion caused by screws, implants, rods and other metal objects to create improved visibility and diagnostic confidence,” said Helen Titus, Carestream’s worldwide marketing director for ultrasound & CT.

The optional software makes it easier for radiologists and orthopedic surgeons to accurately diagnose a patient’s condition and develop treatment plans. Image processing can be adjusted and optimized according to the amount of metal present.

The software uses information from the original scan to eliminate the need for additional imaging studies, which reduces costs and lowers radiation exposure for patients.

An intuitive touch screen interface allows technologists to adjust for either moderate or complex metal content. The metal artifact reduction software can be activated prior to the scan or it can be applied after the original reconstruction is complete. Both the original and corrected images are always available to view and compare.

The OnSight 3D Extremity System also assists surgeons in detecting occult and non-union bone fractures. Unlike traditional CT systems, this cone beam CT system has a large-area detector that captures a 3D image of the extremity in a single rotation, which takes only 25 seconds. A patient simply places the injured extremity into a donut-shaped opening in the system. Since the patient’s head and body are not confined, patients do not experience the claustrophobia that often occurs with traditional CT systems. Dose is significantly reduced because only the affected body part is imaged.

The compact extremity system can be installed in an exam room and plugs into a standard wall outlet.

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FDA Clears IlluminOss Medical's Bone Stabilization System

FDA Clears IlluminOss Medical's Bone Stabilization System | IT Support and Hardware for Clinics | Scoop.it

IlluminOss Medical, a privately held, commercial-stage medical device company focused on minimally invasive orthopedic fracture repair, announced that it has received U.S. Food and Drug Administration (FDA) de novo clearance for the IlluminOss Bone Stabilization System for treatment of impending and actual pathological fractures of the humerus, radius and ulna from metastatic bone disease.

The IlluminOss System incorporates the use of a thin-walled PET balloon that is infused with a liquid monomer and delivered in a minimally invasive fashion into the intramedullary canal of the bone through a small incision.

Once the balloon is infused with monomer, it conforms to the shape of the patient’s specific bone. The surgeon then activates a light source which delivers visible light to the PET balloon, polymerizing the monomer. The cured, hardened implant provides longitudinal strength and rotational stability over the length of the implant, stabilizing the fracture.

The IlluminOss System, which has been commercially available in international markets and been in clinical use since 2010, will now be available to patients in the U.S. for the treatment of pathological fractures of the humerus, radius and ulna.

“The FDA marketing clearance marks a significant milestone for IlluminOss Medical, allowing us to bring our products to the U.S. market,” said Robert Rabiner, chief technology officer, IlluminOss. “The IlluminOss System was developed with an aim to provide improved patient experiences and outcomes when treating pathologic fractures. There is a critical need to make less invasive orthopedic fracture repair options available to an aging and underserved market segment.”

Surgeons’ experiences with the product in the international markets have reported smaller incisions, shorter procedural times, faster return to patient’s daily living activities, with reduced hospital stays and lower complication rates for patients.

“The IlluminOss System has significantly changed the way we are able to approach the treatment of certain impending and actual pathological fractures resulting from metastatic bone disease,” said Dr. Richard McGough, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center. “We were able to offer patients a quick, reliable surgical option that minimized pain and hospitalization. We were also able to consolidate their treatments; in some cases, we moved from two-day admissions to outpatient surgery, and we were ultimately able to complete radiation much more quickly.”

“I am delighted that we now have an improved option to help patients with metastatic bone disease of the humerus,” said John Healey, Chief of Orthopaedic Surgery, Memorial Sloan Kettering Cancer Center. “Since this device doesn’t violate the rotator cuff and can be inserted with reduced operative time and blood loss, it relieves pain and restores function more effectively than alternative treatments, in my experience. Furthermore, this new technology is versatile, and I anticipate that new applications will follow.”

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Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective

Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective | IT Support and Hardware for Clinics | Scoop.it

Neuroprosthetics—implants containing multi-contact electrodes that can substitute certain nerve functionalities—have the potential to work wonders. They may be able to restore amputees' sense of touch, help the paralyzed walk again by stimulating their spinal cords and silence the nerve activity of people suffering from chronic pain. Stimulating nerves at the right place and the right time is essential for implementing effective treatments, but still a challenge due to implants' inability to record neural activity precisely. "Our brain sends and receives millions of nerve impulses, but we typically implant only about a dozen electrodes in patients. This type of interface often doesn't have the resolution necessary to match the complex patterns of information exchange in a patient's nervous system," said Sandra Gribi, a Ph.D. student at the Bertarelli Foundation Chair in Neuroprosthetic Technology.

Replicating—and Improving—How Neuroprosthetics Work
Scientists at the lab run by Dr. Stéphanie Lacour, a professor at EPFL's School of Engineering, have developed a nerve-on-a-chip platform that can stimulate and record from explanted nerve fibers, just as an implanted neuroprosthetic would. Their platform contains microchannels embedded with electrodes and explanted nerve fibers faithfully replicate the architecture, maturity, and functioning of in vivo tissue.

The scientists tested their platform on explanted nerve fibers from rats' spinal cords, trying out various strategies for stimulating and inhibiting neural activity. "In vitro tests are usually carried out on neuron cultures in dishes. But these cultures don't replicate the diversity of neurons, like their different types and diameters, that you would find in vivo. Resulting nerve cells' properties are changed. What's more, the extracellular microelectrode arrays that some scientists use generally can't record all the activity of a single nerve cell in a culture," said Gribi.

The nerve-on-a-chip platform developed at EPFL can be manufactured in a clean room in two days and is able to rapidly record hundreds of nerve responses with a high signal-to-noise ratio. However, what really sets it apart is that it can record the activity of individual nerve cells. The research has just been published in Nature Communications.

Inhibiting the Activity of Specific Neurons
The scientists used their platform to test a photothermic method for inhibiting neural activity. "Neural inhibition could be a way to treat chronic pain like the phantom limb pain that appears after an arm or leg has been amputated, or neuropathic pain," said Lacour.

The scientists deposited a photothermic semiconducting polymer, called P3HT:PCBM, on some of the chip's electrodes. "The polymer heats up when subject to light. Thanks to the sensitivity of our electrodes, we were able to measure a difference in activity between the various explanted nerve fibers. More specifically, the activity of the thinnest fibers was dominantly blocked," said Gribi. And it's precisely those thin fibers that are nociceptors—the sensory neurons that cause pain. The next step will be to use the polymer in an implant placed around a nerve to study the inhibiting effect in vivo.

Distinguishing Between Sensory and Motor Nerve Fibers
The scientists also used their platform to improve the geometry and position of recording electrodes, in order to develop an implant that can regenerate peripheral nerves. By running the measured neural data through a robust algorithm, they will be able to calculate the speed and direction of nerve impulse propagation—and therefore determine whether a given impulse comes from a sensory or motor nerve. "That will enable engineers to develop bidirectional, selective implants allowing for more natural control of artificial limbs such as prosthetic hands," said Lacour.

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'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation

'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation | IT Support and Hardware for Clinics | Scoop.it

Hip replacement surgery is highly successful in relieving pain, restoring mobility, and improving quality of life. More than 330,000 procedures are performed each year in the United States, and that number is expected to almost double by the year 2030.

As with all surgical procedures, the possibility of a complication exists, and dislocation is the most common problem. The risk of dislocation is higher in patients who have had a second hip replacement, known as revision surgery. Some people need revision surgery many years after their first hip replacement when the original implant wears out. Hip instability after joint replacement is another reason a patient might need a revision surgery.

Research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery and other joint replacement centers indicates that a newer type of artificial hip known as a "modular dual mobility" implant could be a good option for patients who need a revision surgery. Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas this month.

"Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States," said Dr. Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. "Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery."

"Dual mobility" refers to the bearing surface of the implant—where the joint surfaces come together to support one's body weight. A hip replacement implant is a ball-in-socket mechanism, designed to simulate a human hip joint. Typical components include a stem that inserts into the femur (thigh bone), a ball that replaces the round head of the thigh bone, and a shell that lines the hip socket.

Modular dual mobility implants provide an additional bearing surface compared to a traditional implant. With the dual mobility hip, a large polyethylene plastic head fits inside a polished metal hip socket component, and an additional smaller metal or ceramic head is snap-fit within the polyethylene head.

"Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement," Dr. Westrich noted. "We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant and report on the functional outcomes."

The study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic, and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. "At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation," Dr. Westrich noted. "While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery."

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4 Industries That Find Blockchain Technology Useful

4 Industries That Find Blockchain Technology Useful | IT Support and Hardware for Clinics | Scoop.it

 

By 2024, the global blockchain market is expected to be worth $20 billion, and according to a recent study by IBM, one-third of C-level executives are considering adopting these technologies. Does that surprise you? Is your organization exploring blockchain or distributed ledger solutions?

 

Recent reports indicate that blockchain has the potential to reduce certain industries’ infrastructure costs by 30 percent. Additionally, there’s a $8-12 billion annual savings for certain industries that use blockchain technology. Let that sink in.

 

Companies of all industry types are using blockchain technology to help them improve transparency, traceability and trust; but here are four industry-specific benefits.

 

  1. Healthcare: Hospitals are now able to seamlessly access patient data shared between member hospitals and participating hospitals.
  2. Banking: Financial institutions are able to simplify and speed up the transfer of funds, while ensuring the identity of the user.
  3. Supply chain: Manufacturers can ensure the authenticity of goods and products with better transparency and accountability.
  4. Insurance: Companies can eliminate common sources of fraud, and use smart contracts to improve efficiency and improve customer experience.

 

With all of these sample use cases, blockchain helps companies increase efficiency and reduce friction. Sirius offers various services to help organizations define and develop their blockchain solution.

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What is telemedicine involved and how much does it cost? 

What is telemedicine involved and how much does it cost?  | IT Support and Hardware for Clinics | Scoop.it

Now that the use of telemedicine is surging to an all-time high, organizations can easily get lost in implementing the technology just to stay on top of the latest and greatest, but it is easy to get lost in the vast amount of telemedicine technology and equipment options available.

 

If you are researching your telemedicine options, applying for a grant or just need to put your budget plans together, here are six key elements and associated costs for you to consider.

1. Medical Devices for Specialties

The specific medical devices you need may vary depending on the specialties you plan to serve with telemedicine. The good news is you don't need to have all the answers right away because many equipment providers have scalable and modular telemedicine systems. This means you can purchase just what you need to get started and then add additional devices later on as your program expands into additional specialties. 

 

The cost of medical devices for basic primary care services can range from $5,000-$10,000, and this would include devices such as an examination camera, ENT scope, and digital stethoscope.

2. Communication Platform and Video Conferencing Needs

How you plan to manage the patient-to-remote encounter is also a key component to consider for clinical telemedicine applications. Since you are communicating a patient's critical diagnostic data, the optimal choice is to do it securely and in real time. After all, the beauty of telemedicine is the functionality to have a live interaction between a patient and a remote specialist.

 

AMD Telemedicine recommends using a Web-based encounter management portal to communicate and aggregate medical device data and share it live with the remote physician. This is truly the best way to offer telemedicine services that are as close to an in-person visit as possible. For video conferencing, it is best to first evaluate any video conferencing investments your organization might have already made to see if these can be leveraged for your current application. Many times they integrate seamlessly with encounter management platforms.

 

Depending on your video conferencing needs, you can complement a Web-based telemedicine portal with either software- or hardware-based video conferencing. To go the software-based route can cost as little as $1,500 per patient site with no cost for the remote provider. The cost for hardware-based video conferencing can start around $10,000 per patient site and increases with the number of remote provider sites you need.

3. Packaging Design and Mobility

Telemedicine carts, cases, wall mounts, and other equipment are all just various ways to package the telemedicine hardware and software. Although there is a difference in how aesthetically pleasing they are (or are not), the main thing to keep in mind is whether this packaging will fulfill your intended use, not just now but also in the near future.

 

Ideally, you want a telemedicine cart or case that is modular and can be easily configured for additional medical specialties so it can evolve with your program. For some applications, such as school-based health centers or long-term care facilities, it is helpful to select a telemedicine system that is an all-in-one package. This helps streamline the purchasing, maintenance, and support for those that don't have a dedicated IT team for their telemedicine programs. All-in-one telemedicine systems that include the telemedicine software, primary care medical devices and the mobile cart/case can range from $20,000 to upward of $28,000.

4. Bandwidth and Internet Connection Recommendations

You may be pleased to know that you don't need to invest in a significant infrastructure overhaul to make telemedicine a reality for your clinic. Of course, your specific needs will vary depending on factors such as location and size or your organization, but the most important consideration is not how much bandwidth you need, but rather how reliable and consistent your bandwidth is.

 

The most common Internet connections are shared with others, which can cause the upload and download speeds to lag and be interrupted at busy times. So finding a reputable Internet service provider with a commitment to reliable service is the first step. If possible, purchase a business-grade service so you experience a more consistent bandwidth capability to ensure your real-time data is not interrupted or compromised in any way.

5. Training

You already staff your organization or practice with top-notch doctors and nurses, so the next step is to provide these health care professionals with the skills and knowledge they need to best make use of your new telemedicine technology in daily operations.

 

Fortunately, clinical telemedicine equipment training isn't a complicated need to meet, especially if your staff has any familiarity with basic medical devices and modern communication technology.

 

There are two types of training programs to ensure the long-term success of clinical telemedicine programs: user training for clinicians and nurses, and technical training and installation for the IT staff. Training programs like these can range from $200 to $2,000 per site depending on the complexity of equipment, the number of users and other factors. Additionally, the American Telemedicine Association is a fantastic resource for training and education.

6. Support

Finally, the increased reliance on network connectivity and Internet technology at your office means that you'll need to ensure that you have adequate IT staff support. This is likely more of a concern for smaller practices that may not have an in-house IT department. It's a good idea to talk to your telemedicine vendor to determine if it provides installation services, as well as what technical support options are available if you don't have an IT staff of your own.

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Professional Development Advice from Technology Leaders

Professional Development Advice from Technology Leaders | IT Support and Hardware for Clinics | Scoop.it

This edition of AppointmentPlus Radio brings together two industry leaders within the tech sector. Raymond Wiley, a general manager with Sun-Tec America, shares the story of how he landed his current position, as well as the philosophy that shapes his professional interactions. Dhruv Bhate, a senior technologist who works in 3D printing, offers insight into how reflection on your true values can lead to a meaningful work life. The two also discuss:

 

  • The importance of finding your professional “sweet spot”
  • How to understand, and communicate your professional value
  • Why defining what you do also mean defining what you don’t do
  • Plus: 5 must-have personal technology recommendations and 2 must-read books to overhaul your professional mindset

 

 

About Raymond and Dhruv: 

Raymond Wiley is the general manager at Sun-Tec America, LLC where he is responsible for the go-to-market strategies for Sun-Tec’s high precision lamination, labeling, and taping equipment portfolio for the Americas and European markets. He is the primary interface between the customer and the Sun-Tec design engineers located in Japan and is charged with overseeing the entire sales process through every phase of the project. Previously, Raymond spent 21 years at Motorola in the Semiconductor Products Sector serving in a variety of increasingly responsible positions including operations manager for the Small Signal and MEMS Sensor Businesses in Japan.

 

Dhruv Bhate is a Senior Technologist at Phoenix Analysis & Design Technologies, Inc. (PADT) where he leads R&D efforts in Additive Manufacturing, with a focus on high-performance polymers and metals. Prior to joining PADT, Dhruv spent 7 years at Intel Corporation developing laser-based manufacturing processes. Dhruv has a Ph.D. in Mechanical Engineering from Purdue University and a Master’s from the University of Colorado at Boulder, where he developed fracture models for ductile metal alloys and to simulate adhesion in MEMS.

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Cloud Computing Supports Telemedicine Growth

Cloud Computing Supports Telemedicine Growth | IT Support and Hardware for Clinics | Scoop.it

Today’s healthcare professionals enjoy convenient access to a multitude of tools that would have amazed previous generations. Unfortunately, lack of awareness or access to technical experts means that many practices are unable or unwilling to take advantage of the latest technological advances, advances that increase efficiency, security and productivity. Others are intimidated by the technical jargon often associated with eHealth. All that is needed to eliminate all these issues is a partnership with a provider that specialises in the health industry, rather than deal with IT companies that are themselves unwilling to recommend healthcare-specific solutions that they are unfamiliar with.

 

Providers of healthcare solutions are familiar with the inner workings of practices and clinics and can easily review existing processes and recommend solutions that will integrate technology in the best possible manner. They will also support any new technological solutions, leaving medical professionals more time for patient care, which will ultimately provide substantial benefits that aid early diagnosis and prolong lives.

 

Providers without healthcare knowledge will recommend solutions that they are familiar with, ones that are normally selected by traditional commercial enterprises. Such solutions are generally unsuitable for healthcare clinics and practices and often require expensive customisation, assuming that they can even be customised sufficiently to meet existing regulations.
Smaller clinics and practices do not have an on-site IT team and often eliminate IT requirements by automating server maintenance, data backups and archiving using a cloud solution. In such a scenario, it is the provider that is responsible for all of these activities.

 

Telemedicine allows easier collaboration and involves the use of mobile or other internet-enabled devices. Advantages include instant videoconferencing, remote consults, immediate access to electronic health records and the elimination of geographical issues, where patients are unable to visit the practice or clinic in person. These collaborative features are used between medical teams in multiple locations, between mobile clinics and their headquarters and of course can be used by any medical professional on the move.

 

When cloud services are used, connectivity is possible from anywhere a broadband signal is present, whether to a PC or portable device. This is ideal for patients in remote are rural areas and eliminates the time and expense necessary to consult with a specialist in the traditional manner. With videoconferencing, for example, no travel is required yet an excellent service is provided by the healthcare professional involved. Even follow-ups are possible online. Security concerns are also eliminated as a travelling professional accesses data remotely and never stores it on their own personal devices.

 

There are additional cloud benefits for healthcare professionals and these include:


• Scalability – you pay for the amount of space you use and it can be increased on demand


• Automatic updates – the provider’s IT team install security patches promptly


• Disaster recovery – automated regular backups take place and are restored when active data is lost


• Redundancy – multiple broadband connections are available. When one fails, another takes over


• Flexibility – if additional bandwidth is needed, it is readily available. This is not possible with traditional networks


• Works from anywhere – an internet-ready device, a 3G or broadband connection and you are good to go


• Collaboration – depending on requirements, there are specific software applications available to aid collaboration between team members and patients


• Document management – a single document repository allows secure and controlled access to confidential information


• Security – the use of the cloud ensures data is never stored in portable devices, given that thousands are lost or stolen every year

 

• Green-tech – the carbon footprint for each practice or clinic is substantially reduced, with cloud servers using less power per client due to virtualisation technology


• Cost savings – every clinic and practice uses the latest in hardware and software technology but without the initial investment. Ongoing IT maintenance costs are also dramatically reduced

 

When it comes to telemedicine, in addition to data management and document control features, there are software applications available that maximise patient turnover per clinic, improve patient care and even improve follow-up treatment and remote monitoring processes.

 

With benefits of this magnitude and with evolving regulations to embrace technological advances in eHealth, clinics need to install a telemedicine solution sooner rather than later or give competitive advantage to those that adopt now. This is especially true if patients and colleagues are in other geographical areas. In fact, government services are already active for eligible aged-care homes and to patients of Aboriginal Medical Services throughout Australia.

 

 

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The Promising Future For AI In Orthopedics

The Promising Future For AI In Orthopedics | IT Support and Hardware for Clinics | Scoop.it

In their most simple form, AI applications in healthcare consist of a collection of technologies that will enable machines to sense, comprehend, predict, act, and learn. The first application for AI-based machines, as discussed at the World Medical Innovation Forum (held in April 2018), is to execute healthcare administrator and clinical healthcare functions. Current technologies are limited because they are algorithm based. The future of AI will make the leap past algorithm-only tools to become indispensable instruments for patients, providers, physicians, and payers. AI has the potential to truly augment human activity.

 

Why This Is Important
The potential to drive improvements in quality, cost, and access has made AI a notable buzzword in healthcare. The AI health market is growing rapidly and is forecasted to reach $6.6 billion by 20211 (Table 1).

 

AI Applications in Orthopedics
AI has demonstrated high utility in classifying non-medical images. A study2 looked at the feasibility of using AI for skeletal radiographs. The study authors compared an AI program against the radiography gold standard for fractures. They also compared the performance of the AI program with two orthopedic surgeons who reviewed the same images. They found the AI program had an accuracy of at least 90 percent when identifying laterality, body part, and exam view. AI also performed comparably to the senior orthopedic surgeons’ image reviews. The study outcomes support the use of AI in orthopedic radiographs. While the current AI technology does not provide important features surgeons need, such as advanced measurements, classifications, and the ability to combine multiple exam views, these are technical details that can be worked out in future iterations for the orthopedic surgeon community.

 

AI in Computer-Assisted Navigation3
Orthopedic surgeons have had access to robotic technology to help them position screws, prostheses, or tunnels for some time, but AI enhanced applications are in development (Table 2). For example, one device utilizes infrared light to locate bones intraoperatively. Another technology uses a form of AI to mill the canal for a prosthesis based on CT scans. In total hip surgery, computer assistance in placing the cup of the prosthesis is reported to have the same accuracy as with traditional methods. In the realm of knee replacement surgery, AI-supplemented robotics technology assists to align prostheses. In spine surgery, AI-enhanced computer-assisted navigation helps surgeons avoid neurovascular structures, and place thoracic and lumbar pedicle screws accurately. It is reported that the incidence of poorly placed screws has reached 42 percent with conventional surgical techniques, according to some studies, but is as low as 10 percent with AI-based computer assistance.

 

We Have Needed a Tool Like AI for a Long Time
AI will change the way healthcare work is performed. AI will fill the gaps we all know are coming in the future, such as the labor shortage in healthcare (Table 3). Through AI, we will empower clinicians and give workers tools to increase their productivity. Healthcare institutions will need an AI-trained workforce and culture. Think of the value your products will bring with AI and the ability to gain clinician face-time and recognition as they use AI to enhance efficiency, quality, and outcomes.

 

The Medi-Vantage Perspective
In almost every strategy research project we manage, when we look at adjacent technologies in consumer markets, we see AI being utilized again and again. Our strategy research helps clients understand the opportunity to integrate AI technology into their product strategies. Someday, even the most common medical devices will have an AI component.

 

Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in both small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical where she boosted the company valuation prior to its acquisition by Covidien/Medtronic, director of marketing for Philips Medical, and senior management roles at Boston Scientific Corp., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy as well as innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services, and assesses prospective acquisitions. Shepherd has taught marketing and product development courses and is a member of the Aligo Medtech Investment Committee (www.msbiv.com). She can be reached at 855-343-3100, ext. 102, or at mshepherd@medi-vantage.com. Visit her website at www.medi-vantage.com.

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EHR Hardware Basics in Health IT Guides

EHR Hardware Basics in Health IT Guides | IT Support and Hardware for Clinics | Scoop.it

Hardware Basics for Electronic Health Records

 

Basic Terms


Workstation - This refers to the hardware that holds everything a physician or office staff worker needs to perform their jobs: word processing, practice management software, EHR software, fax software, etc.


Desktop - One of three basic types of workstations. This describes a fixed, hard-wired computer that does not move around. The computer can actually sit on the top of the desk (desktop) or on the floor (tower).


Laptop - One of three basic types of workstations. This is a portable computer that has a keyboard and either a touchpad, stick, or mouse for moving the cursor around the screen. It is a fully functioning computer that can be carried or placed on a cart and moved around the office.


Tablet PC - One of three basic types of workstations. Tablet PCs contain built-in handwriting recognitions software that allows the user to "write" on the screen using a stylus, much as they would write on paper attached to a clipboard. Tablet PCs can have add-on keyboards for instances when typing is preferred.


Desktops


The basics:

 

  • A desktop computer usually has a standard configuration consisting of a CPU, monitor, keyboard, and mouse.
  • It is stationary; it resides in one location and cannot be moved from room to room.
  • It can stand alone or work with any of a variety of network arrangements

 

Advantages:

  • Desktops are low-cost and available from a wide variety of vendors.
  • Because desktop PCs are standardized, it is relatively easy and inexpensive to find spare parts and support, or to replace a machine.
  • Desktops will run just about any software you need.
  • Additional devices such as microphones, speakers, and headsets are readily available at low cost.

 

Disadvantages:

  • Because it's stationary, you need to buy a desktop PC for each room in which you need access to your EHR software.
  • Desktops typically take up more space than a laptop or tablet PC. While flat screen monitors and tower units save actual desktop space, the standard desktop computer requires more room than either a laptop or tablet PC.
  • You must purchase additional equipment to take full advantage of voice recognition and/or handwriting recognition programs.

 

What your peers have to say:
"Have had wired computers [desktops] in the exam room since 1998 and think it is the best way. I find it less hassle than carrying a computer around all day, worrying about batteries running out or losing wireless connectivity or dropping the computers. The computers are much cheaper both to buy initially and fix if something does happen. Tried a tablet but did not like it all. Never had a problem with children or adults interfering with the computer in the examining room and if you log out when you leave, HIPAA is not an issue."
-- Keith Stafford, MD, Greenville, South Carolina


Laptops


The basics:


A laptop is a fully functioning computer that is small enough to be portable. Laptops can take advantage of wireless as well as traditional networks. A laptop can easily serve as a desktop machine and can connect via a docking station to a larger monitor and a standard keyboard.

 

Advantages:

  • A laptop has a smaller footprint and can easily be turned to allow patients to view information on the screen.
  • A laptop is less obtrusive during patient interviews.
    Most have fairly long battery life and/or an A/C adaptor.
    Laptops use standard PC inputs such as keyboard and mouse and/or touchpad.

 

Disadvantages:

  • Although laptops are portable, they can be heavy to carry, typically weighing five to eight pounds.
  • Repairs and maintenance tend to be more expensive because laptops use non-standard or proprietary parts. You may have to send a laptop off-site for diagnosis and repair.

 

What your peers have to say:
"

  • We work wirelessly with laptops. All [prescriptions] print from one central printer right outside the exam rooms. Benefits of laptop:
  • Can open the note and chart before entering the room and bring up appropriate templates. Can enter the room already knowing what HM is late and what the purpose of the visit is.
  • Can close the note right outside the room if you want to go ahead and have the patient leave before finishing a note.
    Can see with bifocals; no neck strain.
  • Can have all my personal settings and programs handy all the time - PDR, links, hospital links, etc.
  • Can look at patient easily over the top of the laptop and can easily show patients what I'm doing.
  • Touchpad is always in the same place in relation to keys; easy to switch from it to typing or tabbing without looking. I like having a full size keyboard.

 

"I'm hooked on my laptop and am so accustomed to carrying it around that I don't even notice even though it is Dell's heaviest one."
-- Sue Andrews, MD, Murfreesboro, Tennessee

 

Tablet PCs


The basics:
There are two main types of tablet PCs: a slate tablet PC, which is a tablet with no attached keyboard (although one can be added), and a convertible tablet PC, which is basically a laptop computer with a screen that can swivel and fold onto the keyboard to create the tablet.

 

Advantages:

  • Tablets are truly portable and lightweight, typically weighing three to four pounds.
  • It is as powerful as a PC, but it doesn't require a keyboard. Instead, you add information by writing on the screen with a digital pen or stylus, much like you do in a paper chart.
  • Handwriting recognition software developed for tablet PCs is excellent, even for very poor handwriting.
  • Tablet PCs have integrated dictation capability with voice recognition software that transcribes directly into the patient record.


Disadvantages:

  • Writing with a stylus takes getting used to; there is a longer learning curve in adapting to a new way of using a computer.
  • Handwriting recognition dictionaries have not yet fully integrated medical terminology and acronyms, requiring more correction.
  • There is not as much standardized software yet available for tablets.
  • Screens are easily scratched and can become unusable without screen protectors purchased at additional cost.

 

What your peers have to say:
"I have been using a Gateway tablet in the room with my OB patients for the past two years. We use an ASP prenatal record called eNatal. I wouldn't trade for it. It has three methods of entering data on the screen, all vastly improved with the SP2 for Windows XP for Tablet.

 

"The first method is through tapping on a screen-based keyboard with the stylus (slow but very accurate). The second is through straight handwriting recognition. I have relatively poor handwriting, but it is amazing how accurate and fast this is! The only thing that seems to trip it up is some abbreviations, acronyms, or words that it can not find in the dictionary. The third option is a letter-by-letter handwriting recognition panel that is slower but extremely accurate.

 

"We've had no downtime. The wireless connection works well. The battery life is good (I plug it into the docking cradle between OB patients). We have used laptops and desktops for eNatal in the rooms and the tablet works best by far. As we look to add a full EMR, we hope to use a tablet-based system, probably the Motion Computing tablets with the biometric (fingerprint) access."
-- G. Jeffrey Young, MD, FAAFP, Levelland, Texas


Using EHR technology require a certain adjustment in the way you're used to interacting with your patiens and their charts. Deciding how to do this in the way that makes you the most comfortable will help guide your choice of hardware -- e.g. using a desktop, laptop, or tablet PC.

 

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Tips To Help Ensure A Successful Surgeon Design Team

Tips To Help Ensure A Successful Surgeon Design Team | IT Support and Hardware for Clinics | Scoop.it

Design surgeons and surgeon design times have been at the core of the significant advances that have occurred in the medical device market in the last few decades. Working with surgeon design teams is inspirational, mentally demanding, and exciting.

 

Let’s assume a new opportunity has been identified that will improve your organization’s financial position. The marketing team has studied the market space—that is, classified at least three types of current and potentially new innovative strategies this opportunity should incorporate (as was described in the March/April 2018 issue of ODT, “Innovation and the Development Engineer”).

 

Once a complete financial plan, which includes cost to develop/introduce, and a sales/marketing plan have both been vetted and approved by the organization’s senior staff, it is time to move ahead to develop the surgeon design team.

 

I have had experience with two different types of surgeon design teams. The first—a “Hub and Spoke” model—was utilized in situations where aligning with a given group of surgeons or an institution would alienate others from using the product once it was released. The second is the more traditional surgeon design team with a group of surgeons selected to work on a project from beginning to end.

 

The Hub and Spoke model concept relies on one or two core key opinion leading (KOL) surgeons to serve as the hub of the wheel. Different surgeons or groups of surgeons meet independently with the KOL surgeon and the development engineering lead at a series of low-key meetings held at various time points to obtain feedback on different aspects of the design. There is a significant amount of reliance placed upon the KOL surgeon as the amount of involvement of the non-KOL surgeons is substantially less than in a traditional surgeon design team model. In this model, the non-KOL surgeons are assisting with validating the market assessments and need requirements, as well as providing market acceptance feedback of the new product later in the process. It is the responsibility of the KOL surgeon and the development staff to turn that information into a viable product.

 

With the more common traditional surgeon design team, assembling a good design team is critical to the success of the endeavor. The product development team needs to work closely with the marketing department in the selection and assembly of the surgeon design team. The selection process is very much like picking players for a team sport. The desire is to pick the most talented team, with personalities that mesh with each other while becoming aligned to win in the same way.

 

The training and clinical experience of the surgeons, the number of surgeons on the team, and their geographic locations are just a few of the important factors to be considered. The surgeon’s CV is a great reference as are their publications to discover where and by whom they were trained, as well as if they have any won any awards or honors. This process helps an organizer begin to understand a surgeon’s philosophy so as to determine if it matches with the objectives of the project. If these elements do not seem to align, it is best to move on. Further, there are other important considerations—is this the first design team the surgeon has been a part of or is it just the most recent? Has he or she been a part of prior design projects, and if so, what has been the success of those products? You need to fully understand the motivation of a surgeon to be a member of a design team.

 

It is critical the surgeons understand the commitment they will need to make to be part of the design team, as there will be meetings and other activities that will take them away from their clinical practice and surgery. Provide an understanding of the duration of the project and the time periods where their involvement will be greater than other periods as the project progresses. For example, one design project required great commitment from the surgeons as it met approximately every two to three weeks and for full weekends. As a result of the commitment from the surgeons and support of the company, a very large implant/instrument project was conceived and introduced in 18 months. Conversely, projects without full commitment from all surgeons has resulted in the opposite effect, significantly delaying the project, and doubling the anticipated time to market. Therefore, if the surgeon is not willing to commit the time, they are not a good candidate.

 

I have had the opportunity to work with a wide group of surgeons from around the world on numerous design teams. All were excellent surgeons, but their interests and how they assisted the design teams varied greatly. There were some true innovators and designers who would design or create their own drawings of new and innovative products. When the product was introduced, they were willing to stand behind the new concept until it was clinically proven, even in the face of being questioned by traditionalists. Others were known for performing clinical studies or understanding the issues surgeons were facing. Still others offered their strengths in addressing the surgical technique. It is crucial to understand the strengths and weaknesses of the members of the design team.

 

Regarding the project itself, it is vital to have the project well-scoped. The scope needs to be flexible in nature but, at the same time, there need to be boundaries in place to avoid creep and to ensure the end results fulfill the original unmet market requirement. What is the new product or service expected to perform and what is it not going to address? What shouldn’t be addressed is, many times, more important than determining what needs to be. Ensure everyone understands the project’s clinical scope, the financial objectives, and the other innovative aspects desired. In order to keep the team focused and grounded as time progresses, it is often necessary to reflect back upon the scope to avoid derailing and delaying the project.

 

Having the development engineer/staff gain the respect of the surgeon design team is also important. The engineer must have a wide base of knowledge to keep multiple elements of the development project within his or her view. As the process progresses, certain elements of the product are being locked down that impact the long-term commercial success, design attributes, manufacturability, inventory costs, marketing/sales, user experience, and clinical outcomes. Throughout the project, subject matter experts (e.g., the surgeons, manufacturing engineers, etc.) will provide input and support, but the development engineer is ultimately the one who must sift through all the information and recommendations to decide which to accept, modify, or reject. As such, the development engineer must be a jack-of-all-trades. Leading a development program should not be handled as if it is a democracy, but rather, as a benevolent dictatorship. The leader must listen, assess the situation, make a decision, and move on. Attempting to satisfy all parties will only cause delays.

 

There are techniques that can be used to help sort through the issues to attempt to make the best decisions. One technique is to note how many times the same concern is raised. If the issue is repeated by numerous surgeons and/or other advisors, it likely requires further exploration. If it is rarely stated or only by one surgeon, it may be safe to consider it a much lower priority. If the factor significantly impacts cost, however, determine how significantly it could impact the marketability of the product.

 

If a new, creative solution is conceived by a surgeon that seems to have originated from out of left field, it should not be automatically dismissed. Instead, challenge the surgeon to “sell” the idea to the rest of the design team. If he or she cannot earn their acceptance, it may be best to move on. This does not mean the concept was not worthy, but perhaps it needs to be sidelined from the current program and examined independently on its own merits at a later time or for a future generation of the product. Some creative solutions may seem like an idea that makes sense, but ultimately, must be considered within the scope definition for the project.

 

When having a design meeting, it is important to know the outcome ahead of time. Since design meetings can sometimes become confrontational, first addressing key topics individually with surgeons to understand their concerns and issues will provide a means to be better prepared for the full meeting and make it more productive. If there are controversial issues to be addressed, have one of the surgeon designers present them, which can also assist in making the meeting more productive.

 

After the concept for the product design has been finalized, enroll a second group of surgeons not part of the original design team to objectively review the new product concept. This can help ensure market acceptance and help identify issues that may have been overlooked. All members of the design team are too close to the project to objectively review the new product. While this review occurs late in the design process, it is still early enough to allow for modifications to be made relativity inexpensively.

 

Surgeon design teams have been and will continue to be a critical element for the advancement of healthcare in the development of new and innovative medical devices. Leading surgeon design teams is a skill a development engineer needs to hone and refine. It involves technical knowledge, psychology, business acumen, and most importantly, strong leadership attributes.

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EMPOWR Porous And Complex Primary Knee Systems

EMPOWR Porous And Complex Primary Knee Systems | IT Support and Hardware for Clinics | Scoop.it

DJO, a provider of medical technologies designed to get and keep people moving, introduced the EMPOWR Porous Knee System and EMPOWR Complex Primary Knee System at the 2018 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS). These new additions to the EMPOWR Knee Platform expand one of the industry’s most modern total knee replacement systems, which now offers primary, cementless primary, complex primary, and tibial revision solutions for surgeons and patients.

EMPOWR Porous Knee System is based on two decades of clinical experience and highly porous materials designed to enhance early implant fixation, while creating an ideal environment for both immediate and long-term biologic fixation.1 DJO’s surface coating technologies, including DJO’s proprietary, highly porous coating, P2 aids in bone apposition for superior in-growth performance.1 EMPOWR Porous’ bladed keel has a bone sparing geometry optimized for cementless application.2 The bladed keel of the asymmetric baseplate was developed to provide robust fixation, while the cruciform pegs provide initial component fixation and durable rotational stability.2

EMPOWR Complex Primary Knee System, with the EMPOWR Universal Tibial Baseplate and EMPOWR Varus Valgus Constraint (VVC) Tibial Insert expand the utility of the EMPOWR Knee Platform and provide a wider range of solutions for complex primary and revision knee arthroplasty. These new implant technologies are designed to provide an efficient and seamless transition from standard primary to revision knee procedures, with a minimal number of additional instruments and trays. The EMPOWR Universal Tibial baseplate maintains the EMPOWR System’s characteristic asymmetric footprint which maximizes cortical coverage and prevents component overhang to ensure long-term fixation without tissue irritation4. This baseplate also provides the ability to stem and augment when more supplementary fixation is required. The VVC insert is offered in e+ polyethene, formulated to reduce long-term wear3, while the insert is designed to provide the necessary support and stability in knees with supportive soft tissue deficiencies.

“DJO has a proven record of bringing high-quality products to market with incredible cadence—faster than any other implant company today,” said Dr. Eugene S. Krauss, an orthopedic surgeon with Northwell Health. “In 2018 alone, the EMPOWR Porous Knee and EMPOWR Complex Primary Knee launches have significantly expanded our ability to treat a wide variety of patients in our practices.”

“The efficiency of DJO’s instrument trays and the streamlined instrumentation enables my surgical team and I to perform up to 12 knee replacements in a single day, making the system well-suited for both hospital and ambulatory surgery center environments,” said Dr. Krauss.

Over the past decade, the science of highly porous metals, including DJO’s P2, has significantly advanced, helping to improve implant longevity and ultimately patient outcomes. These scientific advancements coupled with a younger, healthier patient population, have resulted in a resurgence of cementless knee arthroplasty. Therefore, the contemporary design of the EMPOWR Porous Knee, is certain to have a meaningful impact on the market.

“DJO Surgical’s strong growth over the past few years is a reflection of our commitment to developing products and solutions that help improve clinical outcomes and enhance patient experience,” said Jeffery A. McCaulley, Global President of DJO Surgical. “Our continued expansion of the EMPOWR Platform reflects the overwhelmingly positive reaction we’ve received from surgeons and patients since the first EMPOWR Knee System was launched here at AAHKS in 2015.”

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Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients 

Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients  | IT Support and Hardware for Clinics | Scoop.it

The Hong Kong Polytechnic University (PolyU) recently developed a robotic arm to facilitate self-help and upper-limb mobile rehabilitation for stroke patients. The lightweight device enables the patients to engage in intensive and effective self-help rehabilitation exercise anywhere, anytime after they are discharged from the hospital. The robotic arm, called “mobile exo-neuro-musculo-skeleton,” is the first-of-its-kind integration of exoskeleton, soft robot, and exo-nerve stimulation technologies.

Stroke is the third leading cause of disability worldwide1. In Hong Kong, there are about 25,000 new incidences of stroke annually in recent years2. Research studies have proven that intensive, repeated and long-term rehabilitation training are critical for enhancing the physical mobility of stroke patients, thus helping to alleviate post-stroke symptoms such as disability. However, access to the outpatient rehabilitation service for stroke patients has been difficult. Due to the overwhelming demand for rehabilitation services, patients have to queue up for a long time to get a slot for rehabilitation training. As such, they can’t get timely support and routine rehabilitation exercises. Stroke patients also find it challenging to travel from home to outpatient clinics.

The “mobile exo-neuro-musculo-skeleton,” developed by Dr. Hu Xiao-ling and her research team in the Department of Biomedical Engineering (BME) of PolyU, features lightweight design (up to 300g for wearable upper limb components, which are fit for different functional training needs), low power demand (12V rechargeable battery supply for 4-hour continuous use), and sportswear features. The robotic arm thus provides a flexible, self-help, easy-to-use, mobile tool for patients to supplement their rehabilitation sessions at the clinic. The innovative training option can effectively enhance the rehabilitation progress.

 

Dr. Hu Xiaoling said development of the novel device was inspired by the feedback of many stroke patients who were discharged from the hospital. They faced problems in having regular and intensive rehabilitation training crucial for limb recovery. “We are confident that with our mobile exo-neuro-musculo-skeleton, stroke patients can conduct rehabilitation training anytime and anywhere, turning the training into part of their daily activities. We hope such flexible self-help training can well supplement traditional outpatient rehabilitation services, helping stroke patients achieve a much better rehabilitation progress.” Her team anticipated that the robotic arm could be commercialized in two years.

The BME innovation integrates exoskeleton and soft robot structural designs—the two technologies commonly adopted in existing upper-limb rehabilitation training devices for stroke patients as well as the PolyU-patented exo-nerve stimulation technology.

Integration of Exoskeleton, Soft Robot, and Exo-Nerve Stimulation Technologies
The working principle of both exoskeleton and soft robot designs is to provide external mechanical forces driven by voluntary muscle signals to assist the patient’s desired joint movement. Conventional exoskeleton structure is mainly constructed by orthotic materials such as metal and plastic, simulating external bones of the patient. Although it is compact, it is heavy and uncomfortable to wear. The soft robot, made of air-filled or liquid-filled pipes to simulate one’s external muscles, is light in weight but very bulky in size. Both types of structures demand high electrical power for driving motors or pumps, thus it is not convenient for patients to use them outside hospitals or rehabilitation centers. Combining the advantages of both structural designs, the BME innovative robotic arm is light in weight, compact in size, fast in response and demands minimal power supply, therefore it is suitable for use in both indoor and outdoor environment.

 

The robotic arm is unique in performing outstanding rehabilitation effect by further integrating the external mechanical force design with the PolyU-patented Neuro-muscular Electrical Stimulation (NMES) technology. Upon detecting the electromyography signals at the user’s muscles, the device will respond by applying NMES to contract the muscles, as well as exerting external mechanical forces to assist the joint’s desired voluntary movement. Research studies found that the combination of muscle strength triggered by NMES and external mechanical forces is 40 percent more effective for stroke rehabilitation than applying external mechanical forces alone.

Rehabilitation Effect Proven in Trials
An initial trial of the robotic arm on 10 stroke patients indicated better muscle coordination, wrist and finger functions, and lower muscle spasticity of all after they have completed 20 two-hour training sessions. Further clinical trials will be carried out in collaboration with hospitals and clinics.

The robotic arm consists of components for wrist/hand, elbow, and fingers which can be worn separately or together for different functional training needs. The sportswear design, using washable fabric with ultraviolet protection and good ventilation, also makes the robotic arm a comfortable wear for the patients.

The device also has a value-added feature of connecting to a mobile application (APP) where users can use the APP interface to control their own training. The APP also records real-time training data for better monitoring of the rehabilitation progress by both healthcare practitioners and the patients themselves. It can also serve as a social network platform for stroke patients to communicate online with each other for mutual support.

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Health Care Providers Face More Direct Billing, More and Tougher Collections

Health Care Providers Face More Direct Billing, More and Tougher Collections | IT Support and Hardware for Clinics | Scoop.it

Opponents figure that they pretty much killed the Affordable Care Act in December when they ended the individual mandate. They may be right. The mandate – the part of the ACA that required Americans to buy health insurance or face a minor penalty – was a key to trying to broaden and deepen the insurance pool, mitigate payers’ risk and, not least, keep premiums at least remotely tethered to people’s ability to pay.

 

Another part of the ACA is also under threat. The law allowed states to agree to an expansion of Medicaid that was meant to help people who couldn’t afford to meet the mandate on their own.  Still another: it also offered subsidies to help payers meet the expenses of covering all the previously untreated people they’d have to insure and of covering everyone’s pre-existing conditions. 

Premiums in fact did not grow as fast in states that accepted the Medicaid expansion during the past three years and as an estimated 40 million more people gained some form of health insurance.

The end of the individual mandate, the junking of one of the subsidies for health insurers and last year’s drastically truncated open enrollment period for the remaining Exchange plans, however, have again started to reduce the number of Americans with health insurance.

 

These changes affect more than practice volume. They impact operations for practices that retain patients, too.

For without increased attention to “revenue cycle,” all health care providers can expect to be doing more direct billing of patients, doing more collections work and assuming more bad debt from people with higher, tougher-to-pay deductibles in the coming months and years.

 

Here’s why: No one yet knows how many people who bought insurance only because they were required to. There’s reason to believe the end of the individual mandate will start making them drop out of all kinds of plans during the next open enrollment period.

A federally truncated open enrollment period October-December, 2017 has already reduced the number of insured people in the nation.  A number of forces are leading fewer people – and fewer younger, healthy people – to buy plans, and some predictions have premiums rising an extra 10 percent this coming year.

 

More shrinkage is coming. Newly permitted work requirements for Medicaid coverage promise to push still more people into the ranks of the uninsured. Kentucky’s new rules, for example, will drive an estimated 40,000 people out of Medicaid coverage during the next five years. As of this writing, nine other states are considering imposing new restrictions on who can qualify for Medicaid coverage.

 

The increase in the numbers of the uninsured obviously has disturbing implications for the nation’s health as a whole. It will also force payers to raise premiums to make up for the rising costs of being able to spread their risk across smaller, riskier customer pools.

 

The uninsured aren’t the only ones threatening practice finances.

Rising premiums, in turn, are leading employers to offer employees more high-deductible health plans. These HDHPs have lower premiums but higher risk for patients, who in addition to their premiums must pay an average of the first $2,400 of their families’ medical bills out of their own pockets. Some plans have deductibles as high as $10,000.

 

The lower premium costs, however, are attracting more and more people.

 

They are also higher risks for physician practices, which have a harder time collecting from patients with HDHPs. Thirty-seven percent of the people working for employers who offered plans in 2017 chose high-deductible plans. That’s up from 28 percent in 2016. The same year, that accounted for 39.3 percent of all Americans on employer-based health plans. All told, up to 37 percent of insured Americans, regardless of where they bought it, were using HDHPs.

 

But there have been dire unintended consequences. With the costs of care so high, 64 percent of those with high-deductible plans say they’ve put off care because they didn’t want to or couldn’t pay the deductible. And 62 percent said that, despite the lower premiums, they end up spending more on health care than under their previous plan.

 

People with the high-deductible plans thus tend to be bigger financial risks for providers.

Of HDHP customers, 15.5 percent reported having trouble paying medical bills in 2016 (versus 10.3 percent of those with “traditional” plans).

 

In sum, this means everyone in health care – providers, hospitals, practices – are going to chance offending more patients by billing them directly and, at minimum, going to have to devote more resources to revenue cycle and collecting what patients owe them.

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Cloud performance tests reveal the impact of location

Cloud performance tests reveal the impact of location | IT Support and Hardware for Clinics | Scoop.it

If a cloud-based EHR isn’t fast enough to meet the needs of hospitals and other medical facilities, quality of care will suffer, clinicians and support staff will become frustrated, and provider organizations operating on thin margins will have wasted valuable IT dollars on inadequate technology.

 

Several industry trends make it clear that providers are increasingly confident cloud-based EHRs can deliver data and applications at sufficient speeds because vendors have dramatically reduced latency. Epic Systems, the largest EHR vendor in the U.S., began offering cloud services in 2014 to medical groups and small hospitals. The company said in 2016 that it has seen a big shift among its customers toward cloud-based systems. One of those customers is University of California San Diego Health, which announced in August 2017 that it is migrating its Epic EHR to the cloud.

 

Cerner has also revealed that a number of healthcare systems are moving onto its hosted cloud environment. Inspira Health Network, a nonprofit healthcare organization that serves communities across New Jersey, and Bay State, an integrated health system in western Massachusetts health system, have both moved to Cerner’s cloud hosting model.

 

Another EHR vendor, Athenahealth, offers only cloud-based EHR services to its network of 56 hospitals and 106,000 providers that serves more than 100 million patients. Ellenville Regional Hospital in upstate New York, reports that running its EHR on a single network gives staff in all departments real-time access to patient records.

 

For health systems that will select their own cloud host, after considering the cost of strategic planning and security, the success of a migration ultimately rests on performance. Can EHR data, applications and services be delivered fast enough to support the needs of clinicians? Cloud performance is generally measured by average latency which represents the delay between the time when a client computer requests data and the cloud platform responds.

 

Tests have shown that distance between the cloud provider and the enterprise can have a significant impact on latency with delays of as much as 50 percent when the cloud is at a great distance.

 

Cedexis tested services and found distance was a leading indicator of performance

 

Monitoring company Cedexis performed tests throughout the United States that quantify this. Tests were performed on all of the major cloud platform vendors. The determining factor in latency performance was distance from the test client system to the servers at the cloud data center, with a deterioration of as much as 50 percent seen over longer distances within the same region.

 

For example, tests performed in the northwest region recorded latency was as low as 63 ms. when the cloud was near; a latency of 92 ms. was recorded on a cloud system at a greater distance from the test location. A test on cloud platforms in the northeast found 66 ms. latency on the low end and 78 ms. on the high end.

 

A number of vendors offer cloud performance tests that are free to be used during an evaluation process. One example is

 

CloudHarmony who offers a free service that will test performance for many of the leading vendors at a variety of their geographic locations. The test, at Cloud Harmony Speed Test will provide results for DNS query, downlink and latency.

Integration challenges


Migrating an EHR system to the cloud rarely is an all-or-nothing process. Rather, many healthcare IT managers are moving incrementally, evaluating the success of each application migration, learning from mistakes, and carefully preparing the next move based on need and experience. For example, some may decide to first migrate back-office or HR applications, and eventually, migrate clinical apps and billing data at a later date. Providers certainly can choose a one-shot migration to the cloud, but they run the risk of network and system disruptions, loss of productivity, and bandwidth limitations.

 

After cloud migration goals are set, computing models are chosen, and a migration plan established, healthcare providers can begin choosing a CSP (or more than one). For providers with concerns about potential latency issues, selecting a CSP with a hosted location close to the provider’s facilities makes sense. The provider’s IT staff and the CSP can then begin the cloud migration. This process involves addressing several integration challenges.

 

Perhaps the primary challenge is to prevent disruptions to systems or services during or as a result of the migration that would impact clinical care, staff productivity, or IT processes. Other challenges include protecting and backing up migrated data and connecting to and integrating disparate systems.

 

Integration may involve linking cloud-based apps and data with non-cloud apps in legacy systems. “An illustrative scenario could involve a multi-hospital operation which chooses to retain on-premises EHR for inpatient operations but wants to leverage public cloud services for geographically distributed outpatient clinics,” according to the Cloud Standards Customer Council (CSCC).

 

The CSCC argues that a successful cloud EHR migration depends on security and network connectivity.

 

“Whether you are ensuring insurance coverage for the public, developing the next generation of cancer drugs, or providing critical care/tier I trauma services, the new emphasis is being put on providing network availability, performance and security,” CSCC writes. “Although creating a highly available network might be expensive, those costs can be offset by the capabilities provided to the organization.”

 

The vast majority of healthcare providers today have moved or are moving applications, infrastructure, or development platforms to the cloud because they recognize the performance benefits and cost savings. For a cloud migration to pay off, providers must develop a realistic migration strategy and goals, choose the appropriate cloud computing and services models, find one or more CSPs whose services, support, and pricing match their needs and ensure that their networks have the bandwidth capacity to handle cloud-based workloads.

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8 Health IT Trends to Watch

8 Health IT Trends to Watch | IT Support and Hardware for Clinics | Scoop.it

“We’re in the middle of an incredible moment in the healthcare industry, where expectations and standards are shifting.”

 

That statement was part of the opening remarks from Cerner’s Senior Vice President of Population Health John Glaser at the 2017 Cerner Health Conference. His position was a strong one: The industry, he says, is shifting from reactive sick care to proactive health management, from fragmented niche care to a cross-continuum care system and from reward for volume to reward for quality, efficiency, and safety.

 

Today, we’re watching as the physician, long considered to be at the center of the healthcare universe, is moving aside in favor of the consumer.

 

These shifts aren’t happening in a vacuum: They’re touching in every area of the industry, and they are reshaping the way the business of healthcare is done. Here’s a look at some of the top trends that will push the industry forward in 2018.

 

Consumer-centered health care


We talked a lot about the rise of consumerism in health care over the last year, and that train is not going to slow down in 2018. Increasingly, we're seeing people wanting to have a more active role in managing their own health and care (this is particularly clear when we consider the rise of mobile health apps and wearables). They expect the same level of information, detail, and options that they have in other industries when it comes to making purchase decisions, and there is a rising call for data transparency and access.

 

While there have been some great strides toward empowering the individual with healthcare organizations working to improve the patient experience, we're still waiting for the healthcare industry to wholly adapt to the needs of the consumer.

 

At Cerner, we recognize this as a new era, where the consumer will, at last, join their own health care team. That's why, at this year's CHC, Cerner President Zane Burke announced that we’re making a free consumer-directed health record available within our clients’ enterprise portals, providing individuals more control over how their data is used and shared. Each patient will have his or her information compiled on their behalf and can direct the use of that information to create their own experience.

 

The era of the consumer is here – and it’s time for the healthcare industry to embrace that.

 

IoT


From controlling the thermostat on your phone to monitoring your health with technology, the Internet of Things (IoT) is transforming the way we work, live and interact with the world around us. IoT has been a popular phrase in health care for the past few years, but today, the conversation is shifting. The primary issue now is understanding how we can take the plethora of big data available from connected systems and tailor it to provide person-centric care.

 

Moving forward, we need to harness the potential of IoT to drive better efficiencies. From a data collection perspective, the advantages of connected medical devices are vast. When we can provide data bridges from disparate health care systems within a single organization, we’re making critical patient information more accessible to clinicians and care teams and ultimately impacting patient outcomes.

 

Through the use of IoT devices, we have the opportunity to deliver true virtual care for chronic condition management, virtual visits, and other care coordination activities to streamline and benefit the patient. Connected devices enable more real-time insights and health status for a person.

 

“IoT is tied to consumer enablement, which ranges from remote patient monitoring to mobile applications,” Hamilton says, “and it certainly includes the ever-increasing trend of telehealth, which isn’t going to go away.”

 

Artificial Intelligence


“Intelligence isn't a new idea,” Glaser said at CHC. Our cars tell us when the oil is low, and they’ve been doing that for years. But we’re about to take a significant leap in the intelligence of our devices. We’re already seeing this with products from companies like AWS, Azure, and Google.

 

We're in the early stages of seeing how artificial intelligence will play out in the healthcare industry. One example is in precision medicine, an approach for disease treatment and prevention that accounts for individual variability in genes, environment, and lifestyle for each person. This approach relies heavily on big data analytics, where machine learning algorithms and precision molecular tools make it possible to understand the mechanisms of disease and match up individual problems with personalized treatments. The implications for genomics and precision oncology are significant.

 

We’re also beginning to see AI algorithms affect and enhance medical imaging. These algorithms find patterns in images, identifying specific anatomical markers and scoping details that the human eye can’t – while simultaneously combing through a patient’s history, helping clinicians make efficient and quick diagnoses. The future of AI in health care won’t see clinicians being replaced by machines but rather empowered by them.

 

Big Data


“Data is the new oil,” Andreas Weigend, Amazon's former Chief Scientist, said recently. It’s a bold statement, but he has a point: Big data and cloud technology are changing how we interact with data, and previously untapped data sources are now attainable.

 

One of the greatest examples of big data’s implications for the healthcare industry is in predictive analytics, where data is used to identify behavior patterns in a patient or population and forecast outcomes. For example, when EHR data is organized into meaningful groups, such as social determinant factors, it can help predict hospital readmissions and can shed some insight on strategies to improve readmission rates.

 

This power to affect additional value and efficiencies within a hospital setting is no small thing. Perhaps most critically, these newfound big data insights are pushed to those that can make a difference: clinicians and care team members. Acute and ambulatory decision support, for example, can be enhanced by creating an empowered care team with a clear picture of the patient, thanks to increased access to patient data that's built directly into the existing daily workflows. And big data has exciting implications for precision medicine.

 

Whatever route organizations hoping to take with big data, it's clear that it will be a catalyst for change for the better good and health of society.

 

Data governance


As organizations begin to share data across departments and with other health systems, there can be a few questions: Who owns this data? Have the appropriate parties consented to its release? What are the rules, conditions, and terms of data sharing?

 

“Data governance is a huge thing that organizations are struggling with right now, even as they try to solve for it,” says Hamilton. In a recent survey, only 44 percent of hospital leaders said they had data governance capability across their entire organization, while 56 percent said they had inefficient governance standards.

 

What organizations really need is a governance strategy that everyone understands and can abide by, Hamilton says. In the future, we’ll see more and more healthcare organizations looking for help from external experts to create and refine their data governance protocol and practices.

 

Open platform development and API usage expansion


Open data access and increased interoperability are continuing to clear the road for development in health IT (HIT) – particularly when it comes to academic medical centers and rural health care systems. This trend will only continue to grow as open standards, like SMART Health IT and the HL7 FHIR standard, encourage a new level of collaboration and innovation.

 

As the FHIR standard matures, we’re going to see an explosion of new apps that can integrate with EHRs to help improve workflow efficiencies and achieve better outcomes. Application programming interfaces (APIs) offer direct programming access to the underlying health IT system and enable 'app' developers to create tools that can ingest EHR data and provide new services to consumers.

 

In a previous blog post, Cerner's Dr. David McCallie discussed how, through projects like SMART® on FHIR®, providers are becoming familiar with APIs that support customization of the EHR experience. However, API access is not limited to providers. A new class of APIs will give consumers the ability to access their health information on demand via apps of their choice. These APIs are emerging thanks to consumer demand, and they are also driven by major regulations coming into effect – particularly Meaningful Use Stage 3.

 

Consumer-directed access will place control of personal health information in the consumers' hands. APIs that allow the transfer of discrete data will help drive the advancement of interoperability by delivering more specific data where it makes sense within the workflow, in a way that positively impacts outcomes.

 

UX and health IT


On the coattails of the rise of consumerism in health care is a growing emphasis on integrating user-centered design into healthcare products and solutions. To optimize any solution, user experience (UX) must be engineered in at every step of the solution design process. This way, the experience for the HIT user – be they a clinician or a patient – should meet or exceed their expectations.

 

Cerner's Vice President of User Experience, Paul Weaver, discusses the integration of UX design thinking and health IT through the example of mobile health apps. "When you think about consumer apps today, there is a huge amount of competition to get people's attention," Weaver says. "If you search for a notes app on the Apple store, for example, there's probably a few hundred for you to choose from. So, if I'm an app developer, how do I design the app of choice?"

 

The answer, Weaver says, is by providing a quality user experience.

 

"In the health space, historically, this has been a little bit of a walled garden," he adds. "You go to a health provider, and they give you a link to the app they want you to use, and there's no choice in the matter." It's the responsibility of the UX team to think about that application in the context of all their other solutions available so that whatever they're designing sits alongside its contemporaries in an equal level of quality.

 

UX is about more than just creating user-friendly applications. It’s a state of mind – a perspective that favors taking a human-centered approach to creating solutions. "That's what we're starting to achieve here," Weaver says, "and we're on the cusp of it becoming real for our end users, which is fantastic. How there be anything more exciting than an application that actually helps your health?"

 

Payer-provider convergence


One of the most significant trends in today’s market is the blurring of roles between providers and payers. As the industry shifts toward value-based care, it should become increasingly easy for payers and providers to collaborate at the point of care. A person’s relevant medical history, including medications and treatment plan, should be available to both the healthcare provider and payer – that way the patient’s insurance benefits are included in the provider network and are in sync. Shared access to this data means that clinicians are empowered to provide the right care at the right time to the right patient.

 

That’s payer-provider convergence in theory – but the reality is that there are two dynamics happening in tandem.

 

“You've got providers trying to take on characteristics of a payer because they’re doing at-risk relationships, and you’re seeing the payers making a direct play into the provider market,” says Ryan Hamilton, Cerner’s Senior Vice President of Population Health. Recent moves, such as UnitedHealth’s Optum purchasing DaVita Medical Group and Amazon’s push into pharmaceutical distribution, suggest that the trend of payers and providers merging together will continue to rise.

 

Along the same lines, there’s a lot of interest right now around provider network management – and that focus is only expected to grow. “How you actually recruit, manage and maintain a high-quality network of providers is and will continue to be a huge focus for our client base,” Hamilton says.

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