In the two years since COVID-19, the number of companies and their IT departments has changed. The shift in priorities, especially when it comes to issues such as supporting remote and hybrid work models, has cut across industries. But one sector – healthcare – has many different experiences and different needs.
As someone who has managed IT for a healthcare provider and has worked on a number of healthcare IT projects since then, I was curious to know what changes need to be made to the IT department for hospitals and other medical facilities and whether these changes will survive the epidemic in the next world.
All this together
The biggest change I’ve heard from both the hospital’s IT staff and the doctors, nurses and administrators they support is that the two groups are collaborating more than ever before. It wasn’t something I expected at all. While many IT departments have close relationships with their end users, the pressure on relationships with healthcare companies is particularly intense and volatile.
A major factor in that relationship is the rollout of electronic health record systems (EHRs). Most healthcare providers were encouraged to adopt EHRs in the late 2000’s and early 2010’s because the federal government began pushing for their use through the HITECH Act of 2009 and the provision of the Affordable Care Act in 2010. Most clinical staff initially viewed EHRs as problematic because they were used Systems need to incorporate extra work into their daily routine and adjust their workflow.
And since the federal government has linked hospital funding to orders to implement EHRs, it needs to demonstrate (or certify) to healthcare agencies that the systems are being used in a meaningful way. On top of delivering the product, IT had to make sure it was being used in a certain way. This led to further frustration, as IT not only provided something that most doctors and nurses didn’t really want, IT workers then had to hang around to make sure it was being used as intended.
The epidemic – and burned healthcare workers – has given many IT departments a chance to show that they can help. As the IT director of a Florida hospital (who said his name and the hospital were not mentioned here due to confidentiality) told me, “For the first time, we really had the ability to go, ‘What can we do to help?’ It gives us the opportunity to do things that we would normally not do. It has allowed us to communicate without the need for government behind our backs. The Docs and the nurses liked that we were capable and we were willing to pitch at every point. “
Here are five trends in healthcare IT that have blossomed in the COVID era.
1. Digital Command Center
One of the most common tools that IT departments are able to provide for hospitals and hospital groups during an epidemic is a real-time interactive dashboard so that employees know which departments can take which patients. A hospital group has created a fully digital command center that allows all the hospitals in the system to share information about capabilities and requirements across the region without having to give each hospital a single data silo.
These devices did not impede the tide of patients, but they did make it more manageable. And dashboards weren’t particularly difficult to create despite having a significant impact.
2. Patient information exchange
One frustration about EHR systems is that they have traditionally not been good at exchanging records between multiple hospitals, clinics or providers. In fact, healthcare providers often rely on fax machines to shuttle patient data back and forth. In addition to being depressing, this lack of interactivity can delay diagnosis and treatment. It also hinders one of the biggest benefits of EHR – the ability for a physician or provider to view a complete patient record at a glance.
However, a system has been created by state and regional actors that is capable of doing this. The New York State exchange, called Hicksney, has become a major part of a new provider or patient visit to the hospital. In addition to providing their health history, patients are asked to choose the system.
In his book Care after Covid: Epidemic Reveals What’s Broken in Healthcare and How to Rediscover It, Dr. Shantanu Nandi describes how effective regional exchange was for the Baltimore / DC area, known as CRISP, when he saw patients with complex medical histories. Combined with the transfer to TeleHealth, the exchange allows him to “see” a patient and his history from his office without manually tracking his records and without having to visit the patient’s clinic. He was better able to arrive at a diagnosis and treatment plan in a matter of minutes, saving time for both the doctor and the patient.
CRISP is a problem, however, many doctors in the region are not aware of it. A tool is not used if almost no one likes to access it – or even knows that it exists. The Hicksney Exchange in New York has gotten better with healthcare providers.
The transition to telehealth visits (either via video conferencing equipment or even just a phone call) began shortly before COVID, but COVID gave it a big push. One reason for this slowdown is the patchwork of medical licenses and restrictions against the practice across state borders, some of which were somewhat delayed during the epidemic. It remains to be seen if this more open environment will change if Covid is not a major factor.
Dr. Nandy further mentions in his book that telehealth solutions do not have to be particularly technical. The above story was done through a simple phone call. She also shares her experience helping to create a diabetes clinic coaching system so that patients can take their medication and follow healthy eating guidelines. That system relies on plain SMS text to ensure that it is accessible to anyone with a cell phone. What really made it successful was that it wasn’t just an automatic message. A nurse was available to track how people were working and to provide coaching and conversation. Knowing that there is a person there to help them makes participants more likely to successfully follow program guidelines.
4. “Home hospitalization”
One of the more interesting trends that IT departments have adopted during epidemics is the concept of hospital-level care in the patient’s home. Practice involves providing a technician or nurse with something needed for a hospital first aid (hospital bed, IV poles, various medical IoT devices for monitoring); Patients and their families walk through everything set up; And talk about patient needs, treatment conditions, and warning signs. Video visits with a doctor are enabled, and in some cases, a technician or nurse is assigned to monitor the patient, either in person or remotely. If something unexpected happens, the patient can be brought to the hospital.
The concept has some serious advantages, the main one being that the patient does not come into contact with covid (or other infections) in the hospital. This allows the patient to experience more rest than staying in the hospital. Perhaps most importantly, it clears the bed space in an over-stressed hospital.
Here with heavy lifting patient monitoring. It is up to the IT department to source the appropriate monitors that can transmit data remotely and the technology works reliably and ensure that the patient or a caring person understands how the devices work. In some cases, IT workers may have to support patients, not just their doctors (and probably go onsite if there are problems that cannot be solved remotely), increasing the need for help desk staff.
5. Automatic patient room
Medical IoT use not only found a place in patients’ homes; It is also gaining traction in hospital rooms. Although this trend has been going on for a long time before COVID, it has really been the responsibility of hospital staff – mainly nurses – to monitor large caseloads with fewer co-workers to help.
A midwestern hospitalist I spoke with mentioned that some unit nurses’ stations have fully automated workflows, including a dedicated monitoring workstation. The result is that each nurse can quickly examine important and other information without having to go to each patient’s room. He said the setup would allow each nurse to effectively handle four additional patients per shift during Covid’s Delta and Omicron waves – without compromising the quality of care.
Like hospital admissions at home, IT personnel need to source reliable devices to plan for hospital automated patient rooms that can provide that information to the nurse’s station and create a source or a dashboard for that data. In the case of Midwestern Hospitals, the IT department has created a dashboard from scratch with direct input from nurses to make it as efficient and efficient as possible.
The big question
While all of these initiatives point to a new future for healthcare IT, the biggest question (as in other industries) is whether they will survive in a post-epidemic world. While there may be some trends among suppliers such as telehealth and regional EHR sharing, others are less certain. Will hospital groups see continued value on the multi-hospital dashboard and retain the idea of hospitalization at home? In the long run, those trends are much less certain. Only time will tell.
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