By Jackie Drees, Laura Dyrda and Katie Adams for Becker’s Hospital Review
The need for technology and digital capabilities accelerated during the COVID-19 pandemic, underscoring the importance of data and virtual monitoring to care for all patients while hospitals focused on patients with the virus.
Since March, Becker’s health IT team has spoken with several health system and hospital CIOs, chief innovation officers and other IT leaders about their experiences and where they are investing in the future. Based on those discussions, here are the 10 most significant advancements in healthcare technology over the past four months and where each field could make the biggest impact in the future.
Predictive analytics. The pandemic has highlighted how important it is for healthcare providers to look ahead and prepare for crises. Because spikes in COVID-19 cases have the potential to overwhelm hospitals and create drug and equipment shortages, healthcare professionals have piloted innovative ways to predict the location and severity of upcoming increases in COVID-19 cases. Hospitals nationwide have created predictive analytic tools to forecast how COVID-19 surges may play out, including Children’s Hospital of Philadelphia, Chicago-based CommonSpirit and Cleveland Clinic.
Children’s Hospital of Philadelphia’s model utilizes temperature and humidity data, as COVID-19 transmission often seems to rise as temperatures do. Its model also uses GPS data to track visits to nonessential locations, similarly to the strategy CommonSpirit’s model employs. Focusing more on an individual level, Cleveland Clinic’s COVID-19 risk calculator makes projections based on patients’ age, race, gender, socioeconomic status, vaccination history and current medications.
“This nomogram will bring precision medicine to the COVID-19 pandemic, helping to enable researchers and physicians to predict an individual’s risk of testing positive,” said Michael Kattan, PhD, chair of Lerner Research Institute’s department of quantitative health sciences at Cleveland Clinic. “Additionally, while testing solutions continue to be needed, it is so important to make sure we are responsibly and optimally dispatching our resources — including clinical personnel, personal protective equipment and hospital beds. Our risk- prediction model stands to greatly assist hospital systems in this planning.”
Business intelligence and analytics platforms. Health systems across the U.S. are making strategic investments in business intelligence analytics to better understand patients and tailor the patient experience. The systems can leverage data-driven insights using clinical, financial and operational data paired with patient feedback to build a full picture of how patients interact with their organization. Clinicians can use business intelligence to help coordinate treatment plans based on symptoms, identify patients for follow-up care and track readmission rates. On the operational side, business intelligence can help coordinate staff schedules and optimize the supply chain.
Neil Gomes, executive vice president for technology innovation and consumer experience and chief digital officer of Thomas Jefferson University and Jefferson Health said in an interview with Becker’s the pandemic has accelerated the system’s move toward digital solutions.
“Even while we are building digital solutions for the COVID-19 crisis, executives, leaders and managers realize that these systems can also give them data as quickly as they can store it and analyze it,” he said. “So how do we get it to them at the point of decision-making? You get it through business intelligence. And consequently, almost every solution we have built now or acquired during this time has had an expressed need for some sort of data front-end. Almost all of our internal clients are asking to rapidly review data using dashboards, to be able to analyze trends, to see if things are getting better or worse, if systems are working as they would like them too, etc. And they also want to receive all of this data in a visual format.”
Digital front door. During the era of social distancing, the way consumers interact with companies is changing and they are placing more value on the digital experience. The same is true for hospitals and health systems; many now see their “digital front door” as the first impression potential patients have of their health system and their online experience can make or break their reputation. In May, the CEO of Dallas-based Baylor Scott & White Health said the system was laying off 1,200 employees due to the pandemic, but at the same time would invest in digital offerings for the future and received a $100,000 donation from Reliant to support its mobile app.
Ben Patel, CIO of Cone Health in Greensboro, N.C., also mentioned the digital front door as an area where his system needs to invest in the next six months. The “digital front door” includes the health system website and mobile app, and often has functions such as the patient portal, scheduling, telehealth visits and patient education.
SCL Health chief innovation officer Peter Kung also recently emphasized the “digital front door” as an important aspect of how people connect with healthcare providers without leaving their home, and the digital experience becomes a differentiator that offers a unique value proposition. “The experience should never devolve into mere clicks and transactions, and it should never make things easier for the healthcare system if it becomes more difficult for the consumer,” said Mr. Kung. “Having a true North Star, a clear value proposition, will help us get more in-tune with how we are doing to deliver value.”
Telehealth and 5G expansions. At the start of the pandemic as state and local governments across the country issued social distancing guidelines and stay-at-home orders to mitigate the spread of the coronavirus, telehealth became a lifeline for patient care. Aided by relaxed regulations from CMS and big payers, many hospitals and health systems launched and expanded telehealth programs in a matter of days. In response to the quick demand in access, HHS began allowing providers to use platforms such as FaceTime and Zoom for virtual visits covering a wide range of conditions, from urgent care, primary care check-ups, medication follow up and COVID-19 screenings.
“It’s like a light bulb or a light switch was flicked and people’s sort of mindset completely changed, both on the care delivery side and on the patient side,” UPMC chief medical information officer Robert Bart, MD, said in an interview with Becker’s. “The adaptation of our patient community and our clinicians to telemedicine was quite remarkable. I haven’t seen this type of change in any of my experience in 20 years in healthcare IT.”
Despite the loosened guidelines and increased willingness for adoption, some providers have struggled with network capacities and broadband access when trying to connect for virtual visits. In San Diego, Verizon on May 28 launched a new 5G wireless network, which offers download speeds 10 times faster than a standard network, in certain parts of the city to help healthcare providers conduct telehealth visits. The Federal Communications Commission on June 30 announced it is increasing funding for its rural healthcare program to $802.7 million this year as rural providers’ applications for high-speed broadband during the pandemic have exceeded the program’s $604.7 million funding cap.
AI chat bots. The public has experienced an increased need for reliable healthcare information and direction during the pandemic, and clinical experts’ time is more precious than ever. The use of artificial intelligence chatbots, which provide patients with essential communication, has grown amid the pandemic. By employing machine processing to educate and assist patients during this time of great information demand, healthcare providers have been able to more efficiently reach patients and — in some cases — triage their needs.
On March 16, Mount Sinai spinout Rx.Health launched a digital toolkit for hospitals and health systems responding to the pandemic, featuring a triage chatbot, artificial intelligence-powered clinical assistant and Microsoft cloud support. Days later, the CDC launched its “Coronavirus Self-Checker,” a tool that uses Microsoft technology and features an AI-powered online chatbot named Clara that asks a series of demographic and medical questions to assess users’ risk of having contracted COVID-19. Microsoft also launched a chatbot in April to identify patients who have recovered from COVID-19 and would be good candidates to donate plasma for treating the disease.
“Digital health solutions can help in prevention, triage and monitoring of COVID-19. We need a holistic approach that integrates a vast array of tools to intelligently deliver proactive outreach campaigns, digital triage through bots, referral to telehealth care and close surveillance for those in voluntary quarantine,” Ashish Atreja, MD, chief innovation officer of Mount Sinai and scientific founder of Rx.Health, said.
Robotics. The pandemic has forced healthcare providers to reduce in-person contact with patients as much as possible to mitigate the spread of COVID-19. As they reimagine the way they care for patients, many health systems are employing robotic technology to treat patients without a clinical staff member having to enter their room.
Notable examples of this include New Brunswick, N.J.-based Robert Wood Johnson University Hospital’s “video robots” that transmit a video to a physician inside the emergency room and Nuro robots, which have been used in California to deliver food, fresh linens and protective gear. Hospitals are also exploring ways robotics can be used to directly fight the novel coronavirus, such as Charlottesville-based University of Virginia’s decontamination robot that uses 3D imaging and ultraviolet light to kill COVID-19 pathogens.
Robots are also playing a role in patient care at some hospitals. The robotic technology can perform simple tasks in the patient’s room to preserve staff and PPE during the pandemic. In some cases, the robot may include a screen with a nurse or healthcare worker’s face or voice to connect with the patients on a human level while in isolation.
Digital contact tracing and interoperability. Data tracking technologies have emerged as a way to enhance traditional contact tracing efforts. In May, Apple and Google launched their jointly developed, interoperable API, which allows governments and health agencies to track the spread of COVID-19 using Bluetooth technology, and Salesforce partnered with New York City to build a city-wide contact tracing program.
Rochester, Minn.-based Mayo Clinic developed its own electronic system that combines medical records, non-clinical data and contact tracing resources to identify employee exposures within an average of two hours of a confirmed case. The digital toolset has helped enhance the health system’s contact tracing notification efforts, Laura Breeher, MD, medical director of Mayo Clinic Occupational Health Services told Becker’s.
“You can only make so many calls within an hour, and so some employees may get those calls first and some employees may get those calls after a half hour to an hour,” Dr. Breeher said. “The new system allows us to compress that assessment into a very short period of time because all the employees are being informed at once.”
Remote monitoring and wearable devices. With the shift to virtual and remote care during the pandemic, wearable devices and smart technologies are gaining more traction as tools to deliver providers real-time patient care insights. Stanford (Calif.) Medicine in April teamed up with Scripps Research and Fitbit on a study that aims to detect early signs of viral infections such as COVID-19 through data collected from wearable devices.
The pandemic has also spurred innovation in remote monitoring platforms at hospitals and health systems across the country. To continue taking care of patients who no longer require hospitalization, University of California San Diego engineers built a remote monitoring program that automatically transmits data from patients’ wearable devices and uploads it to a dashboard that providers can monitor and use to intervene when necessary. Chicago-based CommonSpirit Health expanded a similar program, which supports at-home patients through biometric monitoring via a mobile app, voice platform or tablet with devices that track and transmit patients’ vitals and symptoms in real time.
Kristin Myers, executive vice president, CIO and dean of IT at New York City-based Mount Sinai Health System, said in an interview with Becker’s that she expects to see academic medical centers continue investing in remote monitoring, health sensors and wearables over the next five years as well as continued disruption by big tech companies in the health IT landscape and discussions around patient privacy and data protection.
3D printing. The pandemic has spurred new uses for 3D printing in hospitals that can help address immediate PPE needs and shortages. When the pandemic first began to hit hospitals across the U.S. hard in March and April, health systems including Boston-based Massachusetts General Hospital and New Hyde Park, N.Y.-based Northwell Health used 3D printers to create PPE such as masks and face shields as a precaution.
“We are all in this together and it’s heartwarming to see so much collaboration — and cross industry collaboration — to combat this fatal virus,” said Todd Goldstein, PhD, director of 3D design and innovation at Northwell. “From PPE, to machine conversion to oxygen tubes and nasal swabs, the potential for the 3D printing industry to help is endless and I look forward to doing my small part in this war against COVID-19.”
Healthcare providers have also used 3D printing to make parts for ventilators as needed.
Precision medicine. The pandemic has accentuated the need for reliable precision medicine available to healthcare providers. The health systems and organizations with the most advanced clinical data collection and analytics capabilities have been able to share vital information about the best personalized treatment pathways for patients and implement them swiftly; those without a focus on precision medicine leave caretakers to use a standard approach for all patients, potentially wasting PPE, ventilators and other resources for mild cases while not acting quick enough for those at highest risk. On July 1, the National Institutes of Health provided $75 million in funding for innovations in genomics, especially for diverse populations, over the next five years. Clinical sites that received funding include Rochester, Minn.-based Mayo Clinic and Chicago-based Northwestern University.
Baltimore-based Johns Hopkins saw the clear value in precision medicine and entered into a five-year partnership with Microsoft Azure on June 18 as part of its precision medicine initiative. Azure’s artificial intelligence and cloud abilities will now support InHealth. CEO Paul Rothman, MD, sees precision medicine as the future, especially when dealing with the pandemic and other large crises.
“We know certainly that there are some things such as age or underlying [conditions] like obesity which could predispose you [to COVID-19],” he said in an interview with The Media Line. “There are likely some genetic predispositions and some blood types [that affect severity]. I think working through that requires the analysis of big data and AI, and these will help better predict who will get very sick and who might benefit from different therapeutic interventions.”