Building the RTHS Infrastructure with Situational Awareness, Nexus Technologies and a Digital-First Mindset
- Posted by Jim Jordan
- On February 4, 2021
- 0 Comments
In the midst of a global pandemic, adaptation is the way forward. A year ago, we were all placed in a unique position, having navigated the course of our day-to-day lives primarily through technology. Due to the safety measures enforced to curb the spread of COVID-19 in our communities, all of a sudden, we’re attending meetings on Zoom, having groceries delivered at our doorstep, and homeschooling our children. While the development of a vaccine is an auspicious milestone, things will clearly never be the same. We’re all part of a “new normal” that is continuously being shaped by a renewed dependence on technology. Encumbered by the responsibility of providing care to those infected by this virus while making sure the rest of their community remains healthy, healthcare delivery organizations (HDOs) must acknowledge that now is the time to maximize technology and realize its full potential. Although HDOs have been rendering services virtually, our present reality calls for a robust and sophisticated real-time healthcare system (RTHS) that utilizes all relevant digital machinery to ensure operational efficiency along with a safe and secure patient experience for all– most especially in the age of COVID-19 and beyond.
Gartner, Inc. describes situational awareness as a core element of the RTHS which must be enhanced to build an effective smart hospital. Situational awareness refers to having precise knowledge and understanding of a care context in which a patient is involved as well as possible related outcomes. The RTHS is characterized by the activity and constant mobility of the people (e.g. patients, clinicians, and staff members) and resources utilized (e.g. medical equipment) within that context. Due to the nature of the RTHS, prompt access to human and material resources is necessary for optimizing operational efficiency and promoting a positive patient experience. In order to achieve these goals within HDOs, situational awareness should be enhanced through wireless healthcare asset management (WHAM) and location- and condition-sensing technologies (LCST). The primary functions of WHAM include transmission, retrieval, evaluation, and employment of real-time data while LCST provides flexibility in augmenting usage of sensor technologies and wireless networks. Enhancing situational awareness can be advantageous in managing business and clinical workflows such as locating patients, monitoring patient activity, ensuring proper identification of samples in laboratories, tracking medication, and notifying housekeeping for room maintenance.
Aside from an enhanced situational awareness within HDOs, providers can also benefit from adopting a nexus system comprised of technologies like the cloud, social networking platforms, mobile devices, and enterprise data warehouses (EDW). Gartner believes that it is likely for HDO CIOs to instantly recognize the valuable potential of cloud-based technologies since such mechanisms align with healthcare providers’ urgent need to become more receptive to operational and clinical demands while cutting costs. More specifically, the cloud can transform the way information assets are purchased, promote shared savings, and provide quick solutions to new challenges that may arise through the use of readily available cloud-based applications. The RTHS involves heightened activity and mobility; as a result, mobile devices can urgently address clinicians’ and patients’ needs within a care context. Smartphones and tablets can be used to perform clinical duties like taking vital signs, retrieving lab results, and e-prescribing medication. These devices can also be helpful in executing operational tasks such as managing mobile notifications as well as secure texting and critical messaging between medical practitioners and staff. Engaging in social commerce, which Gartner defines as “making a purchase as a by-product of social networking activity”, is essential if HDOs want to establish an amicable patient-provider relationship. Using social media platforms like Facebook, Twitter, and Instagram to improve patient portal functionality is one-way HDOs can both reach out to patients and market their services to consumers. Enterprise data warehouses (EDW) within HDOs have also been useful in managing information systems as they are capable of efficiently aggregating and retrieving data to elicit urgent action from people involved in a certain care context.
Upgrading to a dynamic RTHS may be a novel venture, but just like any undertaking, it has its drawbacks. Most HDOs lack preparation in developing a more sophisticated situational awareness as evidenced by limited resources, thus impeding the efficiency of operational and clinical workflows. Apart from this, overlapping LCST has created confusion in monitoring relevant care context elements like location, position, and temperature among others. Even though progress in incorporating nexus technologies within HDO IT systems has been slim, it has also been stymied due to concerns surrounding interoperability, privacy and security, healthcare reform, electronic health records (EHR), and consolidation of industry resources. Regulatory compliance can also be a major hurdle for HDO CIOs once cloud adoption commences. Maximizing mobile device use within HDOs has also been met with uncertainty among CIOs because of issues related to device acquisition, costs, security, and support to name a few. Engaging with patients and consumers on Facebook also has its caveats since retailers have yet to see it as a successful platform for establishing social commerce. It is also worth noting that Facebook’s data security issues have negatively skewed its customer satisfaction ratings. As far as information management is concerned, HDOs are prone to undervaluing the scope and complexity of the techniques they use for supervising content. It also appears that unstructured data (e.g. scanned and office documents) haven’t been fully integrated into a digital space.
Despite these seemingly insurmountable challenges, feasible solutions exist. Gartner suggests that HDOs can install WHAM initially before advancing to LCST. To further reinforce situational awareness, laying the groundwork for an enterprise-wide PPID (positive patient identification) is advisable; this can be achieved by combining WHAM and LCST with other systems such as patient throughput and capacity management (PTCM). PPID focuses on deciphering distinct identifying information which is often seen on a wristband or tag assigned uniquely to each patient. With this feature, HDOs can avoid misidentification of patients, thereby promoting patient safety. PPID is also essential in improving business and clinical workflows, staff mobilization, and equipment utilization. Gartner also believes that HDO IT specialists should consider running a fused IT (information technology) and OT (operational technology) infrastructure in order to achieve an enhanced situational awareness. IT and OT are normally delineated by separate technology structures due to their differences in operational duties and computing platform requirements; in spite of such distinctions, these enterprises have homogenized (e.g. patient-monitoring equipment), consequently opening doors for a higher level of situational awareness. When selecting new systems to adopt, HDO CIOs should prioritize cloud-based applications more than others. Preparing for a hybrid IT ecosystem is an important undertaking for IT specialists within HDOs as they will have to oversee and secure it themselves. What HDO CIOs need to understand is that this IT ecosystem is not merely a technological upgrade but a service that inspires creative solutions like leveraging nexus technologies. Gartner also recommends that HDOs should find the business value of IT systems as they gradually evolve into the RTHS. This can be achieved by highlighting the business services that can simultaneously support their operations and showcase the business potential of each service, instead of the technology that fuels them. Moreover, having a clear understanding of the price of healthcare IT is necessary for it can help determine whether pursuing a sophisticated IT system is a boon or a bane to providing affordable healthcare. HDOs should also expand their patient portal operations by allowing patients to access services (e.g. making and canceling appointments) directly from their Facebook page and other social media accounts.
The overall response to the COVID-19 pandemic shows that various industries have relied heavily on the use of digital products and services as these are the safest alternatives to conducting in-person business operations. This unprecedented shift to remote, online business operations (and even personal interactions) presents an opportunity for healthcare providers to take advantage of their IT system by promoting a digital-first strategy. This approach has already capitalized on existing online services like telehealth, remote patient monitoring, and using chatbots to give information, treatment recommendation, and risk assessment before patients show up for an in-person doctor’s appointment. From here on out, HDOs must prioritize a digital-first approach in making strategic decisions since digital engagement can be influential to the fulfillment of their clinical, financial and technological goals. Having a digital-first mindset can open business opportunities through optimizing digital platforms to develop a sense of community with patients and consumers. Likewise, it can improve clinical outcomes with remote monitoring because patients and consumers can now choose to receive medical advice and treatment 24/7. Most importantly, a digital-first approach accentuates the responsibility of HDOs to make healthcare accessible and convenient for all, especially now that patient care demands are skyrocketing.
A dynamic and sophisticated RTHS is, without a doubt, the future of healthcare. Though getting there will surely be a daunting task, we cannot envision a post-pandemic society without embracing a digital-first approach to keeping our communities safe and healthy. The global landscape has shifted significantly since the pandemic began, with diverse industries relying on digital platforms to stay afloat. There is no escaping the inevitable. A robust RTHS built through the convergence of IT and OT infrastructure and powered by wireless, sensor, and nexus technologies is bound to happen– hopefully much sooner rather than later.