Living in Los Angeles, surrounded by the Hollywood “scene,” the rampant combination of hype and FOMO never ceases to amaze. As clinicians and analytical people, my peers and I were frequently perplexed by this constant race to the bottom – fueled by competitive paranoia and short term amnesia.
As I call to book an appointment with my family physician in early November, I am brought back to the days of driving my tiny Honda as a teenager on the 405 freeway in Southern California rush hour traffic. I called on November 9th and was given an appointment for January 19th for my annual checkup. Yes, the wait time of 45 days (excluding holidays and weekends) does seem extreme, but I love my doctor. I would always wait for her, but I don’t know if all patients would be that understanding.
Someone actually said to me, “But it’s not using Deep Learning, so how is it AI?”
For context, the goal of our new Evid Science platform is to read the medical literature. Just like a person, we aim to take written words and convert them into some meaningful, internal representation. As people, this representation is knowledge. For the Evid Science AI, the representation is a clean, standardized representation of the results published in the paper. In some ways, you can’t really get more artificially intelligent than trying to replicate reading.
My hair stylist recently left one salon to work at another. This morning, I googled the new salon, with the intention of finding a number to call and schedule my appointment. When I saw that they had online appointment booking, I was elated. My heart soars whenever I see a link to “Book your appointment!” How I dread scheduling an appointment that either requires a lot of back-and-forth calendar coordination or, even worse, an endless game of phone tag.
We’ve all heard that businesspeople, merchants, therapists, psychologists—really, anyone offering goods or services to customers, clients, or patients—are “Old School” if they’re still scheduling, billing, or performing a slew of other processes by hand. It may be time to start calling them something else—“Paleolithic School”?—because, more and more, you’re Old School for using even a desktop or a laptop.
Being part of the Value Prop Shop team allows us to constantly meet entrepreneurs creating products and services in the Healthcare IT space. Recently we had the pleasure of chatting with one of these entrepreneurs launching a unique business model into the startup world, Rachel Neill, founder of Carex Consulting Group. Rachel matches talent predominantly from the Madison health tech space with startups and later stage companies that need experienced resources that are often hard to find with simple job postings and network inquiries.
Any knock at my door sends my dog tearing through the house, barking like crazy. Unfortunately, any knock-like sound does the same (I’m clumsy, so you can imagine the issue…). And so, over time, her useful warnings withered first into an annoyance, and then, just shrank away into the background noise.
Sometimes friends, clients, students, or family ask: “Don’t you miss being a real doctor?” I always pause for a moment when I get this question. I’ve given up explaining that being a doctor is like being a Marine…. you kind of always get to “be” one, even after you’re no longer in active service. I once even had a local newspaper reporter refer to me as “Sanaz Cordes, a ‘former’ physician,” in an article that I’m certain no one read.
As another HIMSS conference looms around the corner, it’s time to place your bets on which healthcare trends and buzzwords will emerge from the exhibit floor. At past conferences, we have been hit over the head with the promise of Population Health, mHealth, Data Analytics, Interoperability, etc. With over 1,300 health IT companies planning to showcase their latest and greatest solutions this month in Orlando, let’s face reality – it is difficult for marketing teams to be truly innovative and not just follow the crowd year after year (similar to how the Super Bowl ads seem to get more stale as I grow older). Unfortunately for attendees, this can create a general feeling of murkiness in our brains after speaking with a couple of vendors who all seem to be claiming to do the same remarkable feats (eg, “we can be the one-stop shop for your analytics needs”; “we offer a population health solution that can be leveraged across your enterprise”; “we integrate with all EHRs”).
As clinicians, we are all first and foremost scientists. We have been trained on the “scientific method” - to clearly understand the problem, the hypothesis, the interventions, the outcome, and the implications for future study. That has been drilled into us in school, in training, and in every piece of evidence that we lovingly read in our daily news feeds. We place so much emphasis on the evidence when it comes to treating our patients, however, I am not sure that we place enough emphasis on the evidence as it applies to our healthcare programs.
Do you enjoy a good game of poker or blackjack? Does anteing up money, taking calculated risks, and hoping for financial reward get you excited? I bet you never imagined that your hospitals and doctors would have to participate in similar games! In the hospital Value-Based Purchasing (VBP) program for 2017, participating hospitals will be placing 2% of their base operating MS-DRG payments up for grabs, working hard to improve their performance scores, and competing against other hospitals in hopes of recuperating their dollars and winning an additional 2% bet for their hospital.
I recently watched the 2016 movie “Arrival.” The film explores the idea that what you think and how you think may actually be closely intertwined. “Arrival” is a story about humanity’s first contact with aliens and how a pair of scientist find ways to communicate without a common language. As they spend more and more time with the octopus-like creatures, they get increasingly frustrated with their lack of progress and must get creative in order to effectively communicate with these new visitors to Earth. I won’t spoil it for you, but this film beautifully illustrates how powerful and difficult the use of language can be, whether it’s between a linguist and a 10-foot-tall mollusk or with each other.
Unfortunately, it happens all the time. You take your elderly father into the hospital for a routine surgery such as a total hip replacement, and while being treated for the hip, he ends up with a Hospital-Acquired Condition (HAC). Think of an HAC as your bothersome Aunt Ethel, an unwanted house guest who shows up when you least expect her, bringing in suitcases full of complications, and leaving a trail of havoc in her wake. Simply stated, an HAC is a potentially avoidable infection or complication that occurs while a patient is hospitalized for an unrelated condition. Years ago, people referred to these conditions as Healthcare-Associated Infections (HAIs) or nosocomial infections. However, today many preventable conditions, which are not infections such as pressure ulcers or DVTs, have been added to the list and term broadened to HACs.
When I meet someone for the first time and am asked what type of work I do, I typically need to pause and make a quick assessment of whether the inquiring person is a clinician and how much exposure he or she may have around the concept of “clinical decision support”. You would think that as a physician who has worked almost 15 years in this space that I would have a rote response to this commonly asked question, but the more I have been exposed to and learned firsthand about the constantly changing clinical decision-making “ecosystem,” the more complicated I realize the answer is in real life.
Hospital margins are narrower than ever, and hospitals dedicate many resources to understanding and capturing their reimbursement dollars. Medicare is the single largest purchaser of healthcare in the US – spending $610B in 2014, which is almost a quarter of all spending on medical goods and services. With inpatient hospital reimbursement being one of the largest pieces of the pie, accounting for 23% of all Medicare spending, sharing how Medicare regulations affect your hospital reimbursement with your staff is paramount in protecting your nest egg of reimbursement dollars. This is the first in a series of blogs simplifying complex CMS reimbursement programs.
"Knowledge is Knowing Frankenstein isn’t the Monster, Wisdom is Knowing Frankenstein is the Monster”
- Alexandra Melnick
Before the EMR came on the scene, the physicians I work with tell me the extent of patient “data” was what could be stuffed into a manila file folder bursting at the seams. In whatever condition it lived in, healthcare data has been collected and used not only to treat patients, but to support the billing and claims process, as well. With the advent and expansion of EMRs, the amount of patient data being recorded has expanded exponentially. Reports say that in 2011 the data from the U.S. healthcare system alone reached 150 exabytes. At this rate of growth, big data for U.S. healthcare will soon reach the zettabyte (10^21 gigabytes) scale and, not long after, the yottabyte (10^24 gigabytes)!
I had a physics professor in college that would say “there’s no free lunch.” With physics being the only class in my academic career that I ever received a “C” in, I wasn’t really sure what he meant (and honestly still don’t as it pertains to physics). But it’s always stuck with me, and over the years, I’ve found myself using it regularly. It is such a simple yet profound reminder of what we all know to be true, but often chose to forget because we’re too impatient, busy, or resource-strapped.
The word is out that I am working with healthcare startups and the soccer moms are bringing me their latest healthcare access problems. Sitting on the sidelines at my daughter’s last soccer game, a mom shared her frustration with her daughter’s bouts of strep throat and the difficulty with scheduling an appointment with her family physician.