Cybersecurity and Privacy

Data and Technology in Healthcare: Perspectives from an Entrepreneur Turned Digital Transformation Leader

The digital transformation impacting our daily lives

John Lock

HIMSS is proud to be a collaborating partner for Health Datapalooza—AcademyHealth’s annual convening on health data and technology. The collaboration furthers HIMSS commitment to meaningful transformation of data into new capabilities that deliver innovation in health transformation. As part of that collaboration, we’ll be exploring some of the issues and themes that are prevalent to Health Datapalooza.

Today, we meet John Lock, the chief futurist and entrepreneur-in-residence from the MedStar Institute for Innovation, MI2, with responsibility for Digital Transformation across MedStar Health, a nonprofit 501(c)3 and the largest healthcare provider in the Maryland and Washington, D.C., region.

Lock was interviewed by Gregory Downing, AcademyHealth senior scholar and former executive director for Innovation in the Immediate Office of the Secretary at the United States Department of Health and Human Services. Downing and Lock give us a look forward on data, technology and innovation in healthcare, and reflect on Lock’s journey from entrepreneur to in-house digital transformation leader.

You are well known for your passion and talent for creating consumer-centered services. Overall, healthcare delivery has lagged behind other market sectors in adopting this focus, so what steps is MedStar taking to meet patients’ demand for choices, flexibility and personalization of services?

Thank you for that compliment! And, thanks to MedStar for its commitment to the same! MedStar has always been focused on expanding the choices that consumers have for accessing the highest quality healthcare. Over the past decade, this has included building out an expanded care delivery network throughout most of Maryland, the D.C. metro area, and northern Virginia.

Most recently, we’ve been very focused on how we can more easily facilitate consumer access through an integrated digital experience, realizing healthcare consumers are demanding a healthcare experience more attune to what they experience in other facets of their daily, digital life. And, because of the work completed in other heavily consumer-focused industries, we can quickly and efficiently leverage the extraordinary learning expense they had in transforming from analog to digital by leveraging many of the same technologies.

Mobile connectivity and telehealth services offer technical capabilities to bring services to patients where and when they need them. How are you going about adapting the provider community and support services to leverage these capabilities?

At the end of the day, it’s all about how we treat you, our patients (consumers), whether it’s restoring you back to “normal” or it’s about maintaining and improving one’s wellness. And, I know that our providers are all fully committed to making this possible. Therefore, they understand that digital isn’t a negative for them, but a tool that can help them dramatically improve care delivery. We all understand that technology will require us to change, but we want to be focused on change that results in better patient outcomes.

For example, through MI2, we worked with our emergency physicians to launch an emergency triage program utilizing telehealth to improve the efficiency of care delivery and patient experience. In this model, a triage nurse interviews the emergency department patient, then connects to the off-site attending physician and summarizes the patient’s symptoms. This has dramatically improved patient access through time to care. Additionally, interesting human elements resulting from this model include that nurses can demonstrate even more clinical judgement, and physicians feel they can practice with more focus and efficiency, with potentially less exhaustion and frustration. Today, after achieving success in recording more than 35,000 patient visits, we are expanding beyond this program to new use cases, for telehealth as well as consultation for visiting nurses.

What are your perspectives and predictions for consumers’ access to their own health information and the mobility of the data in health systems to support consumers’ desires for choice?

My personal view, and I am sure that there are folks out there who would disagree, is that primarily as a result of the ubiquity of the smartphone, the true dawn of consumer access and even portability of records is finally upon us. There is also so much data, some of which only patients (and their exercise platform or life platform companies) can access, which is likely relevant when combined with other data and then ingested and analyzed using various algorithms, resulting in meaningful, actionable insights. When this truly starts to happen, consumers’ demand for access to their data will expand exponentially.

To serve our consumers, we’re working to allow patients to access their medical records via FHIR® (Fast Healthcare Interoperability Resources) on their phones, and to be able to combine that information with data from other providers. My optimism, though, is tempered somewhat by the fact that it’s not as easy for patients to transfer that information from their smartphone to another provider – or, even to reach the point where providers implicitly trust the information recently gathered by another provider unknown to them. In other words, imagine that you put your credit card information into one of the pay apps, then used that same app to make a purchase, only to be asked to produce the physical card to swipe through the machine to verify that it’s you!

There must be many ideas and interests among providers for creating apps to improve their clinical work. How is MedStar coordinating and supporting these interests?

The digital age and the availability of apps on all sorts of devices has created the sense that, “There must be an app for…” In our case, we are trying to focus on consumers first, who are already telling us they have a tough time navigating all the apps out there. Many of the people with whom we’ve talked say something like, “I’ve downloaded probably 10x-20x more apps than I actually use.” Therefore, through our digital transformation efforts, we are focused on creating and maintaining as close to a singular healthcare experience as possible – whether through an app, a web interface, or even a telephone – that is simple to navigate through an integrated and contextualized experience. We’re thinking in terms of being digital, not doing digital. And, being digital means that the consumer has fully integrated our tools into their life, digitally and physically.

Medstar Health is widely recognized for its history of innovation in information management systems. What are some of the key strategies you are helping shape, using the clinical data generated by these platforms as an asset for improving health outcomes?

Rather than delve into the specifics, I’d like to make the point that much of our work is focused on providing access and views into the relevant, contextualized data for the situation being addressed. In other words, in a world where 90 percent of data was created in the past two years, my sense is that the answer is in finding ways to provide resolution into the right data. The team has worked on a number of solutions over the years. One that’s still actively and rapidly being developed is a tool that ultimately enables busy emergency providers to quickly sort through hundreds of documents in a patient’s electronic health record (EHR) by filtering for information most relevant to the patient’s visit, including high-risk medications and conditions. It’s a smart document viewer that uses FHIR® to pull a patient’s reports and notes from the EHR, process them through an algorithm, and allow provider interaction. It has an easy-to-use interface embedded the EHR. Additionally, we are also focused on applying the scientific rigor of human factors to create a safer and more efficient healthcare environment. Human factors is a discipline that optimizes systems, processes, and devices to be consonant with how humans think, work, and interact. Stated plainly, we’re not seeking to redesign humans; the team instead redesigns the system within which humans work. If you think about this from the standpoint of an EHR-related error, we aren’t “blaming and shaming” clinicians who make errors, we’re working across a range of stakeholders to improve the usability, safety, and transparency of EHR systems instead.

The emerging emphasis on data and technology in healthcare can be overwhelming to providers in the changes to workflow, time management, and communications with patients. What ideas do you have for education and training to support for the workforce to successfully adapt to care delivery innovation?

MI2 recognized a long time ago that in a rapidly changing healthcare environment we would likely need to innovate in our education and training capabilities too – so our simulation lab for training and education was created. The simulation lab operates according to the principle that when the mission is patient first, you don’t try innovation first on patients. The lab offers a blended learning model for all of our associates. It includes interactive online training, 3D virtual simulation, and hands-on, high-fidelity simulations.

Of particular relevance to this conversation, the diverse team includes a games team that creates virtual learning experiences that mirror clinical environments. As an example, the team is developing a virtual reality experience that places the clinician being trained into a scenario as team leader during a “code” and prompts them to assign roles to other members of the team, answer questions, and make assessments. It underscores that human learning is still critical, and that technology can play an increasingly large and innovative role in that, too!

For fellow entrepreneurs, what advice do you have for engaging with health systems to identify opportunities to create the tools and services that are needed for solving the most important problems your health system faces?

It’s a unique and very rewarding experience going from being an entrepreneur intent on disrupting industry incumbents to an innovator inside a large organization. I would say that MedStar is very open to working with startups to help accelerate our ongoing efforts to improve health and wellness, as well as access, for our patients and consumers throughout the mid-Atlantic region.

That said, my specific advice to entrepreneurs would be to try to better understand how your “point” solution fits into the larger system, and present us with a realistic view of the potential returns. Simply saying that you are willing to put the contract value at risk isn’t enough – you need to demonstrate that you know how meaningful this solution can be to our patients. Additionally, it would be very helpful for you to truly understand the competitive landscape in which you operate. Simply saying that there is no company exactly like you – of course! – isn’t adequate. Tell us about all the near competitors and the other companies that work around you. In other words, help us understand the ecosystem as you see it. Finally, be realistic about the effort and time that it will take on our side to implement your solution.

The views and opinions expressed in this blog or by commenters are those of the author and do not necessarily reflect the official policy or position of HIMSS or its affiliates.

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