Key Components of Connected Medicine
What is patient-centric health care?
Connected medicine brings the focus of health care back to the patient. Integral to this transformation are six key components—factors that impact an organization’s effectiveness in creating a patient-centric care delivery environment. These include: 1) use of electronic health records and data; 2) communication networks; 3) initiatives to effect cultural change; 4) facility design and construction; 5) HIT core infrastructure; and 6) total cost of care.
Episodes of “health care” can no longer be considered in isolation. The industry is embracing an overarching view that considers all facets of the practice of medicine and the total cost of care. This model embraces primary care, preventative care, well care and end-of-life care—all serving as an adjunct to procedural care to reduce costs. In other words, health care can no longer be defined as a single hospitalization or office visit; it must be viewed across a spectrum of locations, diseases or technologies.
Traditionally, health care has defined communication as a provider interacting face-to-face with a patient in the office or at the bedside. Opportunities for communication have expanded and, in the current global environment, often occur in the cloud. Traditional phone calls, for instance, turn into chat-based Internet conversations. Devices can automatically communicate critical lab values to wireless phones at the bedside. Briefly put, emails, social media and tablets are the common currency of patients and families keeping in touch. Health care must likewise push communications to the cloud, meeting patients who are already there and embracing the power of this new landscape. Many aspects of access to care and the quality of care will depend upon it.
Health Information Management
EHRs have transformed health care and still command the spotlight—although rarely for the right reasons. While representing the first step towards automating and digitizing health information, EHRs in and of themselves have limited value. Without a doubt, EHRs represent a tremendous opportunity for health care, engaging engage patients like never before. The true value of an EHR, however, is that captured data can be turned into information, which is transformed into knowledge, which changes behavior. In the future, dashboards and artificial intelligence will revolutionize our industry into one based on and driven by outcomes, real data and quality.
The health care landscape today is very different from the days of Marcus Welby. Complex, team-driven and technology-laden, quality health care requires coordination, communication and a focus on outcomes. In the modern era, health care can use cloud-based communication, mHealth, telemedicine and data to make health care virtual, accessible and, most importantly, patient-focused. Changing the current health care culture is critical to achieving this transformation. We must return to our roots of focusing on the patient (and thus the population) and acknowledge 1) that times have changed, 2) that the opportunity to provide better health care has changed and, most importantly, 3) that patients and their expectations have changed.
Environment & Infrastructure
An essential element in transforming health care is the design, layout, integration and construction of health care facilities—from small office buildings and clinics, to diagnostic facilities, to tertiary hospitals. Options to promote healing include single-patient rooms, natural-light healing and computer-enabled technologies. Visionaries recognize that buildings are living entities, much like patients. They require preventative care, troubleshooting acute issues and chronic maintenance. Initial design and construction are critical to ensure that building systems are carefully laid out, integrated and leveraged for maximum productivity. A wide array of features—networks, HVAC conduits, water supply, building management, security, to name a few—directly impact the point of care. In an exam room or at the bedside, providers require real-time data for medical decision making in a safe, secure and respectful healing environment.
HIT Core Infrastructure
The HIT core infrastructure binds health care together. In a modern society, patients (consumers) are fundamentally enabled by the consumer electronics market, carry powerful phones and tablets, and have high capacity computers in their homes. In the same fashion, all health care facilities have components of HIT—demonstrated in the wired and wireless networks that enable mission-critical mobile technologies. Regardless of the type or location of data, the HIT infrastructure must be always on, available, secure and responsive. Multiple types of data— notes, CT reports, radiation plans, speech-to-text profiles—are in constant motion across multiple locations—the home, office, hospital or procedural suite. Highly leveraged voice, video and data networks are linked to data centers housing virtualized servers, storage networks and sophisticated monitoring tools. In short, the common thread across clinical service lines, types of patient care and diverse locations is the HIT core infrastructure that houses, enables and transports data necessary for all types of health care.