Let's face it, a lot of doctors hate their computers. After reading through the article published by the New Yorker, I couldn't help but notice a lot of similarities in the various stories of different health professionals (nurses, health admins, neurosurgeons, etc) that are struggling with the adoption of new technologies in their fields. There seemed to be quite a few similar themes and patterns with each story. More and more organizations are adopting various technologies, and those technologies are rapidly advancing and always changing, so it can definitely be hard to keep up. However, instead of getting frustrated as an end user or forcing technology onto your organization "because it's the next greatest thing" as a leader -- you should have a strategy in place as well as an open mind.

Technology is a powerful thing and if implemented or used improperly, it can have adverse effects.  However, when done the right way, it can be life-changing, especially in the field of health and medicine. I've compiled a list of health professional's generalized complaints and frustrations, and how embracing technology can actually help solve the very problems the users seem to be encountering.

"A 2016 study found that physicians spend 2 hours doing computer work for every hour spent face to face with a patient growing the average workday to 11.5 hours"

Listen, no one wants an 11.5 work day. No one wants to have to do monotonous tasks that seem trivial or repetitive. That's not what technology is here to do. One of technology's main roles in your organization should be to automate and essentially increase productivity. For this, it starts at the top. The new technologies need to be rolled out properly by the organization's leaders. When introducing a new technology to your company, make sure there is significant training beforehand and deploy the technology in small groups. Start with one department and learn about their challenges and successes and build from there. Make sure there are plenty of resources and a support team for them to reference once completely immersed into using this technology on a regular basis. For example, one thing Managed Solution does for new Office 365 users is offer a Customer Immersion Experience (CIE). This is a hands-on discovery of the Microsoft Office tools. It's not a demo. It's not a presentation. We allow the new users to use dummy devices with real-life scenarios built into the devices and they experience it as if it was their own. We also only do this in groups of up to 12 users for one-on-one interaction. With this kind of implementation, we see user adoption increase incredibly versus those who don't. Oftentimes, when migrating and not opting for a CIE, we have customers come back and ask for it months later to ensure their teams are using the tools correctly.

"During the implementation phase, IT folks logged 27,000 help desk tickets"

Now that is a whole lot of support tickets! How could this have been prevented? Again, it begins with the training and deployment of the new systems, services, and tools. I can't emphasize enough to take things slowly and adopt one shiny new toy at a time. Migrate your data and information in phases. Test, test, test and then test again before rolling new software out to an entire organization or even an entire department, depending on the size. Start with small groups. As a leader of an organization or department, it's important to get feedback from those actually using the new software. How they use it in their day to day is going to be vastly different than a VP or CEO or someone in another department. That said, as a leader be sure to get input and consistently check in for feedback. As a user, make your challenges known as early as possible to reduce the probability of others running into the same one. At the end of the day, this technology should increase the users' productivity, not become a burden so it's important to communicate both challenges (and successes) to share with others.

"The new software/tool/etc allows multiple organizations/people to modify information you've already input."

There might not be anything more frustrating than doing your work and having someone else completely override it, whether intentionally (no matter if it was good intentions) or accidentally. There's no good in having to do the same work twice, especially when it's taking up hours of your time. To avoid this, you need to make sure you have identity management implemented.  Identity management determines whether a user has access to systems, but also sets the level of access and permissions a user has on a particular system. For instance, a user may be authorized to access a system but be restricted from some of its components. Another example is that your administrative assistant could have access to view certain documents or files, but only you can edit them. There becomes a chain of hierarchy and roles that allow for certain rights and access. Lastly, any modifications or changes should be backed up and stored somewhere in an archive that is easily referenceable to those who would need it.

Employees getting burnt out by technology is no surprise but shouldn't be so common. Doctors and other healthcare professionals are spending too much time trying to input data or find the right data, and not enough time with their patients, family or friends. With the work they are doing, if anyone deserves a work/life balance, it's them. We need to make sure we're equipping them with the right training, the right deployment schedule, the right resources and support throughout the technology adoption.  This could all start with building out the right technology roadmap. A technology roadmap or an IT roadmap can look one year or even three years ahead to plan for the adoption of new infrastructure, systems, and technologies. It outlines budget, timeline, adoption phases and more. Having this all outlined in paper and agreed upon by leadership helps to ensure success in the long run.

While in the short-term, there will be many headaches, especially for generations who didn't grow up using email, AOL Instant Messenger or Facebook. However, aren't most things challenging when we first start them? Change is never easy - it's not supposed to be. We need change. We thrive on change. Albert Einstein once said, "Insanity is doing the same thing over and over again expecting different results." Without acceptance for change, there cannot be growth. What would happen if we always gave up when things were hard?

It comes down to focusing on the long game. Create a deployment schedule. Implement training. Have multiple training sessions. Roll out things in small doses. Just like some doctors have to wean some patients off medication, they need to be slowly introduced onto technology and increase their technology dosage. Little by little, increase the functionality, increase the availability of new software and they can more easily adapt.

Lastly, I'd like to end on a positive note. Instead of looking at all the negative that these technological advancements may be bringing to the world of healthcare, let's look at positives: You can now remotely check vital signs of a patient recovering from surgery who's still at the hospital while you're on the go.

• You can pull up medical history including a list of medications in a few clicks
• Computerization allows clinicians to help patients in ways that hadn’t been possible before.
  • In one project, doctors are able to scan records to identify people who have been on opioids for more than three months, in order to provide outreach and reduce the risk of overdose.
  • Another effort has begun to identify patients who have been diagnosed with high-risk diseases like cancer but haven’t received prompt treatment. The ability to adjust protocols electronically has let their team roll out changes far faster as new clinical evidence comes in. And the ability to pull up records from all hospitals that use the same software is driving real improvements in care.

Technology is a mighty powerful thing, but technology is empowered by people. Make sure you're empowering your people to leverage the right technologies and offering the right resources to digitally transform your business, leading to growth and success.

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MEET THE TECH EXEC
Charles Podesta
CIO
UCI Health

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To download the full magazine and read the full interviews, click here.

Over thirty years experience in Information Technology for Healthcare, the last eighteen years as a Chief Information Officer, Podesta has worked for Academic Medical Centers, Health Systems and Community Hospitals. He is currently the CIO for University of California Irvine Health. Previous to this engagement Podesta was SVP & CIO of Fletcher Allen Healthcare, a large academic medical center and health system in Burlington, VT.

Other positions included SVP & CIO at Caritas Christi Health Care, now Steward Health in eastern MA, CIO at Berkshire Health Systems, Pittsfield, MA, Director of IS and Interim CIO for Baystate Health Systems in Springfield, MA. And prior to that, leadership positions at St Vincent Hospital, Worcester, MA; UMASS/Memorial, Worcester, MA and Magee-Women’s Hospital, Pittsburgh, PA.

Over the years, Podesta has made numerous presentations at national conferences and is quoted widely in healthcare publications on a variety of IT topics including Epic’s Community Connect Program.

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What did you want to grow up to be when you were a kid?

I was interested in being a major-league baseball player or being in a band, and I currently play spoons for bands so I kind of made it. Maybe not with a real instrument but it’s fun, you can check out my YouTube account to learn more -just type in Chuck Podesta Spoons.

What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?

We're currently working on a huge strategic project with UC San Diego, we're changing our electronic health records from all scripts base to the Epic system. UC San Diego has already migrated to this system and will be hosting us, which is saving us a lot of money being we won't have to build a system from scratch. We're doing it as a collaboration with UCSD so from a strategy perspective we'll have two independent academic medical centers on a single instance of that electronic health record. Patients that we both serve will be in a single database so when physicians access that information they could see patient data from anywhere in the UCSD or UCI network. We're moving to population value based care and strategically working together on joint programs serving areas that may be underserviced from a standpoint of health. Having a single electronic record between the two organizations really supports that effort both in Orange County and in San Diego.

We go live in November with this big project but parallel to that we’re looking at a single support model from an IT perspective between San Diego and UCI because if we have a single instance of the electronic health record we don't really need two IT teams supporting it separately. We're going through a process looking at where we can share and centralize resources with the implementation. It's pretty exciting, we'll be the first two academic medical centers on the same instance of electronic health record in the United States when we go live. It's never been done before. We're making the single support model scalable so other UCs could potentially take advantage of that as well to reduce costs. It's more about IT following strategy, making sure you create the IT components to follow your business strategy and being a key partner throughout the process.

What's your take on Public Cloud and how have you as the CIO improved academic healthcare workflows due to cloud technology?

I just had a keynote speaking engagement on a panel at a recent cloud conference. If you look outside of healthcare, yes everyone is moving to the cloud. The issue with healthcare has always been with the Protected Health Information (PHI) and as CIOs we have been nervous about moving that information to a cloud based system with the risk of having a breach. That's always been in the back of our minds with the thought of how fast you really should move to the cloud. Some of the technologies we use aren't architected for the cloud, which is another reason we've been slow to adopt, but now it's starting to rapidly move in that direction.

When we first started working on a recent analytics project, we had a large new data warehouse on premise that we just recently moved to the cloud. With HIPAA protection in place the savings are tremendous because now you're able to scale up or down and easily add more storage when its needed, making it a lot less expensive. We're seeing huge benefits from that right now so what I think you'll see is more and more movement going forward. Every time we look at a new

application we always look to see if we can run it from the cloud, either private cloud or public cloud. Now with all the security protection public cloud vendors are all moving in that direction, getting into the healthcare side of the business.

With our Epic project, both UCSD and UCI are having Epic host us on their private cloud at their large datacenter headquarters in Wisconsin. Electronic health will technically be in the cloud. If you talk to 100 CIOs you'll get 50% that express wanting to move to the cloud and the other 50% that aren't ready to move, I think we are at a crossroads. It's about timing, a few of us should try it; as we get a year or two down the road and see the savings without breaches the fear will be eliminated and others will get more comfortable.

What innovative projects are you the CIO focusing on this year to support the vison and mission of UC Irvine Health?

We're working with a start-up company doing quite a bit on the analytics side. We're building what we like to call an ecosystem with a new data warehouse. We like to call it an ecosystem because it's a living, breathing entity instead of thinking of it as a being a black box that receives information from all various sources like electronic health records or lab systems, mapping it to some data warehouse that you must update once a day for reporting. That worked in the past with Microsoft SQL but we're moving into a more native format wherever it comes from whether it be social media, IoTs sensor information, and again the electronic health record, tracking the data in real time and being able to use it right away. This way you don't have a bunch of people mapping the information, you've created a self-service environment. We now have dashboard graphics to display as data is refreshing in real time on a second by second basics, so they could start to use the data for research or operations. That's why we call it an ecosystem because what is looks like right now is different from what it looks like 30 seconds from now based on the data that its ingesting.

We're starting to do a lot of subscriptions with social media, it's amazing what's out there. Just from turning your location services on it's unbelievable with the amount of information being sent to the cloud. We could look at patients and see how they are using applications and how they prefer to collaborate, email vs. text messaging. If you’re going after a specific demographic with a message you could now see how you should target them based on the analytics.

With these analytics, we’re trying to create a personal experience designed to target a personal persona based on the data as a corporation group. Design an experience for patients without having to ask, we just know from the data insights. Part of how you get reimbursed is based on the patient experience. You're going to see a lot of Chief Experience Officers coming in to drive that experience into the healthcare space. We want patients to have a satisfying experience when they’re spending time to visit our facilitates.

What are your specific hiring challenges if any?

It's a very competitive area, Epic is one of the leading electronic healthcare systems along with Cerner, they probably take up 80% of market share between the two of them. Once you get on that specific platform it's hard to find talented professionals with those specialized skills and once they get the certifications in the product they become highly marketed, so consulting companies are recruiting your best employees. You need to get creative with some strategies, our UCI

undergraduate and graduate school is filled with smart engineers, as well as excellent students with math, science and even English majors. When you hire millennials right out of college and get them certified on Epic they get up to speed quickly because you’re trying to hire the best and brightest. I've had success managing and measuring success during my tenure at the University of Vermont where we would hire two or three millennials per year. Managing them is different. They produce very productive work but have a work hard, play hard attitude so actually work better and faster without a deadline. They enjoy completing projects so they could move on to the next thing, rather than waiting until the last minute when a deadline is provided. New graduates are also compensated at a lower pay scale so you may lose them after a few years as their pay scale goes up, if you manage them well they work very well. Don't get me wrong you also need to recruit employees with more experience, you should just leverage millennials as a strategic way to recruit.

What kind of messaging is coming down from key executives about their partnership with IT?

With the Epic implementation, our joint collaboration has been huge, we have 700 people across the organization working on this project. I just did a big presentation to our executive team addressing where we are on progress and the benefits in each of the areas whether it be revenue cycle or clinical, they are all looking for efficiencies within their area based on the new electronic health record. This is making nurses and physicians more productive while the revenue cycle is calculating charges we may be currenting losing so getting up in revenue by utilizing technology to empower the business going forward is key. Right now, we have a bunch of different systems but Epic will provide us with a single system that integrates efficiencies so everyone can really see where the information is flowing. That’s what they’re looking for right now. Our collaboration with UCSD is huge for us as they've been live on the system for a while now so they're educating us on how they are using it best.

If you won the lottery, what would you do?

I would start a foundation, build a school somewhere either in the United States in a poverty-stricken area or outside of the United States. That's something I've been thinking about anyway. I’m passionate about running marathons that support charities, so I'm at a stage in my life where I want to give back. I've been blessed with a wonderful family and life so I would definitely want to start a foundation that would give back in some way.

Has the idea of using cloud changed your mindset of outsourcing IT?

We still mainly handle IT inhouse but outsourcing, which we now refer to more as managed services has its place for certain things if you can get creative around that. I think outsourcing to other countries will slow down more, especially in healthcare. You really need to look at your core competencies and consider what you need to accomplish for them. We are outsourcing our datacenter to the cloud and letting those experts manage it as it’s not our core competency so I look at that as smart outsourcing.

If you could give guidance to any CIO about how they position their careers what would you tell them?

It’s interesting because it depends what they actually want to accomplish. Do they want to be a CIO or VP from an Operational standpoint? There is a place for both and depending on your work style you need to sit down and consider how you prefer managing and leading. Ask yourself the question, am I tactical and results driven when leading people day to day or do I like to sit back and look at what should be happening a year from now and take more of a strategic standpoint. Then you need to consider what both entail. I’ve seen employees get promoted to a VP or Director role and do extremely well there because they are hands on and could still patriciate in strategy but really excel in the day to day operations. I would say that role is 30% strategic and 70% technical from an operational standpoint. I’ve seen employees excel in these roles and get promoted to CIO and get lost, finding it hard to make that leap and start thinking in a unique way. You need to be introspective about yourself and really consider if you want that change because both roles are very important so if you excel as a Director or VP you could be very successful staying in that role rather than taking the leap. When I was in that role and interested in becoming a CIO I got a mentor who I asked to coach me in understanding the differences of the roles, so if you are ready for that leap there are defendable ways to achieve that but my initial advice would be to consider what role you would be more successful in as they are both very important.

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MEET THE TECH EXEC
Jason Fischer, CIO, PIH Health

To download the full magazine and read the full interviews, click here.

Jason Fischer is the Chief Information Officer for PIH Health Hospital, an IDS with 2 acute care facilities, home health, over 20 medical office locations, and a Managed Services organization.

Prior to joining PIH Health, Jason spent 7 years as the Director of Applications and Revenue Cycle at CHOC Children’s. During that time, he led the Information Systems application teams, project management office, development, revenue cycle and hospital coding departments. In addition, he was the executive sponsor for both the ICD 10 and Meaningful Use programs for the health system. Most recently, he was instrumental in the opening of a new patient care tower, tripling the size of the previous patient care facility and bringing in many new ancillary service lines. In addition, he assisted CHOC in achieving HIMSS level 6, a testament to the organizations goals for improving safety, minimizing errors, and prioritizing IT implementations.

Prior to CHOC Children’s, Jason gained broad industry experience as an auditor and management consultant with Ernst & Young LLP and Accenture. During his 10 years, he consulted with many of the leading health care systems in the country.

Jason earned his bachelor’s degree in Accounting and Biology from Syracuse University in New York. He is a lean six sigma green belt and CPA/accounting professional. 

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If you could have a superpower, what would it be?  

The ability to see into the future. With the healthcare IT landscape constantly changing, there are many shifts in resources that we need to consider, both in terms of people and technology, to be as impactful as possible. So if we were able to see into the future that would be great.

What’s the #1 area of focus CIO’s should concentrate on?  

In healthcare right now, the number one area of focus is security.  With all the breaches that are coming into the healthcare space for patient data and with the increased focus on exploited vulnerability, security is a top priority.  We've been focusing on everything from laptops to network vulnerabilities from an IT standpoint but the most important and biggest risk for us and any organization are the people. We have what we call a Phishing exercise where we send messages out to the organization on a quarterly basis to see who accepts the messages by launching an attachment or clicking on a web link.  This enables us to educate and notify those users thereafter in an effort to reduce continued risk. Because our entry point is our people through email or through other means regardless of how widely deployed our security technology is , any one associate or clinician can pose risk to the organization.

What’s your take on public cloud?  

We use the public cloud for a couple of different purposes right now and are working with a few outsourced vendors.  I think it’s a great, cost effective model for supporting healthcare IT, however I think that there are some challenges with risk and exposure, potentially HIPAA violations associated with data sharing that may take place outside of our control. The cloud has proven to be cost effective and beneficial from a growth standpoint and the public cloud decreases the need from our data center.  But the focus really needs to start with reviewing the risks when we select the vendor. We need to consider if the cost benefit outweigh the risk burden.  As one example, our human resources application suite is cloud based along with a few other niche applications.

Do you feel IT still carries the title of a cost center rather than revenue driver? 

I don't see IT necessarily as revenue driver but I also don’t see it as just a cost center. We are 100% a business partner within the PIH Health organization. That's how this organization sees it and that’s how I see it. We model our strategic plan from the organization’s strategic plan, roadmap and vision, which of course equates to growth, revenue, and quality in the healthcare space. So, while we're not necessarily a revenue driver we absolutely support, and have enabling technologies to support, those business models and the growth of the organization.    

What are you (the CIO) doing to support innovation in the company and its own organization to deliver better solutions?  

PIH Health is focused on mobile technologies around telemedicine, analytics and clinical processes.  Telehealth is a current initiative we're starting up for the stroke service line. We have a mobile solution that we are going to deploy here in the next 30 days for our physicians in the in-patient setting to access labs, radiology results and orders all through their mobile phones.  For management across the organization, we've deployed a mobile application which essentially is an analytics scorecard, where you can view key financial and performance indicators across our two hospitals.  We are also focusing on analytics in general. Analytics in the healthcare industry can be improved. In addition to security, we have a huge focus on using all of this data that we've aggregated for many years now in a meaningful way to help drive business decisions whether they be in the finance space addressing what we should invest in and where we should grow, or in the quality space around patient disease classifications, whether it be asthmatics or diabetics. We have been collecting data (both clinical and financial) for many years and are now starting to use it to drive business decisions across the enterprise.

The other thing that I think is really exciting for us, you may even experience this in your personal life as well, we started deploying a patient engagement kiosk in our physician practices.  Upon arrival, it allows patients to check in without having to wait in line or complete paperwork, or as an option a “pre-visit” check in from a web based platform in the comfort of your own home.  The whole purpose of this is to expedite your patient visit so you can spend more time with your care provider as opposed to completing paperwork that you then have to hand over to a person who has to enter that information into the system before you could be seen. Another innovative approach is our interoperability platform. These allow us to share patient data with other facilities so they could have visibility into your problems, your allergies, medicines and so on. Data sharing is another focus in the healthcare industry right now. We are participating in a closed program with seven health systems in the Los Angeles area as well as a major payer to exchange data across our patient base. The purpose is really two-fold and includes increasing the quality of care for all patients whom are part of that population and managing costs.

We run on average about 50 projects through our department at any point in time, and these are not just IT projects.  They are organizational initiatives, so we have a lot of examples of things we are doing to advance the business. The whole purpose is creating efficiencies where we can in departments, as well as to determine how we grow and establish ourselves in the community as a care provider that has the highest level of quality and is the most efficient.

We are hearing so much about the internet of things – what does or could the internet of things for your business look like?  

The one thing that comes to mind is connectivity of devices, patient monitoring devices or infusion pumps are currently separate from our IT systems. When you start connecting through IoT we're sending patient data to those devices and they are sending clinical data back to our electronic medical record.  We are just beginning to plan for this level of integration and are researching the security concerns to ensure a safe and efficient connection. As an industry, I think we need to get past the security concerns with some safeguards. The vendors we are working with in that space that support those technologies right now are working collaboratively with us and our EMR vendor toward integration.

Are there any hiring challenges?  

Yes, every day. The market for healthcare IT specifically, for good talent is challenging. It is really hard to find the right fit with the right skill set. PIH Health has open positions all the time. We try to fill them, but it's that balance of finding senior-level experience who have niche knowledge of a particular electronic medical record platform or a particular technology. These people are really hard to find because they are sought after so you see salaries increasing as well, which is good for the economy.  Our department on-site has about 100 full-time employees. We have an off-site support service in Buena Park and 30-40 full-time employees that we utilize in India, so we have a 24/7 IT support team.

What did you want to grow up to be when you were a kid?   

An orthopedic surgeon. I became more interested in the business of healthcare and had a heavy interest in IT. I balanced that out by keeping my focus in healthcare.

What kind of messaging is coming down from the CEO/Key Executives about their partnership with IT?  What are they expecting you to look at?  

IT is seen as a business partner. We provide shared services to the entire organization. Our senior leaders understand that to achieve our goals around revenue growth and efficiency,  technology and a technology team that partners with them is integral. That is why we model our IT strategic plan off of the organization’s plan. We're in the third year right now of a plan that we're going to refresh for another three years based on where the organization’s priorities and roadmap take us. From a service line perspective, growth prospective, efficiency and cost perspective, as well strategic advancement, the message is clear that IT needs to be a partner. We're also looking at the offset of those investments as well. Whether it be in people or other areas where total cost of ownership can be decreased, it is important to constantly evaluate the benefits of any IT investment.

Has the idea of using cloud changed your mindset of using outsourced IT rather than keeping in house?  

I don't think so. As I mentioned earlier when we discussed public cloud, we have our HR suite, we also have a private cloud that we outsource for database support of our EMR platform that services this organization. I'm all for it where it makes sense and where we can show a proven track record. We still have two data centers full of server stacks that must be on-site right now for applications we host on-site.  But I do see it as a cost reduction when utilizing larger businesses like our EMR vendors who have larger datacenters that end up costing less. So I fully support it when it makes sense for the business, it’s never an all or nothing decision.

If you won the lottery what would you do?  

I would probably still work. I enjoy what I do here at PIH Health, I enjoy the operations side and more so the growth, so I would probably just continue with the status quo.

If you could give guidance to any CIO, IT Manager Director about how they position their careers what would you tell them?  

I grew up in IT moving through some of the ranks and had an opportunity at different stages of my career to broaden my horizon and not just be niche focused. For any individual who is interested in growing into a larger management role in IT, I would absolutely suggest creating both breadth and depth to get a good feel for what the department has responsibility for and how it runs.  Getting a good feel for what works and what doesn’t is very important. You get to develop your own opinions and your own management style as you grow. I think it’s a lot easier to manage a broader department if you have greater insight into the overall scope of what that department does, so my advice would be rather than being more linear and niche focused, be a little bit broader throughout your career.

About Managed Solution

We're technology enthusiasts with a people-first approach. For over two decades, we've witnessed the profound impact that the right technology and support can have on businesses and individuals. Success, to us, is seeing our clients, partners, and team conquer challenges to achieve their greatest goals and build lasting connections. This relentless pursuit of inspiration drives us forward, pushing us to deliver innovative solutions that empower growth and lasting success. View Services. 

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How web search data might help diagnose serious illness earlier

By Mike Brunker as written on blogs.microsoft.com

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While vaccines save millions of lives each year and are among the most cost-effective health interventions ever developed, about 1.5 million children die each year from vaccine-preventable diseases, according to the World Health Organization. Some factors that contribute to the availability of vaccines globally include unreliable transportation systems and intermittent storage facilities, which make it difficult to preserve high-quality vaccines that require refrigeration.

But with the use of smart technologies, including the Internet of Things (IoT), healthcare and medical device companies are improving ways to keep vaccines stored and protected throughout the supply chain. One great example is the Weka Smart Fridge, which enables clinicians in the field to better manage vaccine distribution, helping them save lives.

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“Clinicians in areas of Africa and other regions where power is unstable or inaccessible can use our Smart Fridge to store and dispense vaccines. And the Fridge is small enough that you can put it in a van. So if you can’t bring the people to the vaccine, you can bring the vaccine to the people,” says Alan Lowenstein, COO of Weka Health Solutions.

The Fridge automates vaccine storage and dose dispensing to save time and enhance patient care. It includes remote monitoring services to ensure vaccines are stored at the right temperature, while automatic inventory tracing saves staff time and ensures a reliable vaccine supply. The refrigerator houses each vaccine in its own cartridge, in keeping with required storage protocol by the Centers for Disease Control and Prevention. In addition, access is limited through a small drawer on the front of the Smart Fridge to protect vaccines from temperature change.

The Vaccine Smart Fridge uses an IoT platform that collects real-time data from numerous sensors on every unit to enable 24×7 monitoring and analysis. BlueMetal, the 2016 Microsoft Internet of Things Worldwide Partner of the Year, worked with Weka to develop the IoT-enabled device that keeps vaccines fresh, secured and accounted for. The real-time visualization of vaccine inventory throughout the network enables Weka to understand the vaccination rates at every location. And by using business intelligence capabilities such as those in Azure Machine Learning, organizations can be alerted to upcoming vaccine shortages at specific clinics or in certain areas. For example, if a clinic unexpectedly runs out of a vaccine, the system can let a healthcare worker know there’s a physician’s office a few miles away that has a surplus of that type of vaccine in stock.

Controlled refrigeration and monitoring also helps reduce financial losses. “Physicians generally have $40,000 to $60,000 worth of vaccines in their refrigerators,” says Lowenstein. “If the clinic suffers a power outage or the traditional fridge fails, they risk losing the entire inventory of vaccines.” By using automated processes to manage inventory through IoT sensors, the Fridge can deliver proactive alerts on inventory shortages or changes in temperature.

In addition, Weka estimates that a medical practice that dispenses approximately 400 vaccines per month could reduce human-resource costs by more than $1,000 a month with the Fridge’s monitoring system. This system helps ensure that the first vaccines in the refrigerator are the first that come out, so patients never receive an expired or recalled vaccine, and it reduces the manual task of vaccine management by clinicians.

The Smart Fridge is a great example of how companies can accelerate digital transformation with smart solutions to increase staff efficiency and quality control and automate inventory management. Weka’s Smart Fridge is currently scheduled to go to market at the beginning of 2017.

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Designing secure health solutions with Azure

Receive guidance and considerations you need to make regarding the secure use and implementation of Azure cloud technology

Since its launch in 2010, Microsoft Azure has gained rapid adoption from organizations of all sizes around the world, spanning many industries. The users of Azure benefit from agility, reduced costs and complexity, limitless scale, and innovation made possible by cloud computing.

For organizations in regulated industries, such as healthcare, where laws regulate protected health information (PHI), the need to understand how cloud adoption affects their privacy, security, and regulatory compliance posture is paramount. These organizations should seek deeper understanding and guidance in solution design and cloud deployment operations.

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FaST-LMM and Windows Azure Accelerate Genetics Research

Today, researchers can collect, store, and analyze tremendous volumes of data; however, technological and storage limitations can severely impede the speed at which they can analyze these data. A new algorithm that was developed by Microsoft Research, called FaST-LMM (Factored Spectrally Transformed Linear Mixed Models), runs on Windows Azure in the cloud and expedites analysis time—reducing processing periods from years to just days or hours. An early application of FaST-LMM and Windows Azure helps researchers analyze data for the genetic causes of common diseases.

Searching for DNA Clues to Disease
The Wellcome Trust in Cambridge, England, is researching the genetic causes of seven diseases—including hypertension, rheumatoid arthritis, and diabetes. The project involves searching for combinations of genomic information to gain insight into an individual’s likelihood to develop one of these diseases. With a database containing genetic information from 2,000 people and a shared set of approximately 13,000 controls for each of the seven diseases, they needed both massive storage and powerful computation capacity.

They are storing their vast database of genetic information in the Windows Azure cloud, instead of traditional hardware storage, which represents a profound shift in how big data are stored. ”We are taking on the challenge of taking what would be traditional high-performance computing, one of the hardest workloads to move to the cloud, and moving to the cloud,” observes Jeff Baxter, development lead in the Windows HPC team at Microsoft. “There’s a variety of both technical and business challenges, which makes it exciting and interesting.”

Exploring the Power of the Cloud
Resource management is one of the primary issues associated with big data: not only determining how many resources are required for the project, but also identifying the right type of resources—within the available budget. For example, running a large project on fewer machines might save on hardware costs but result in substantial project delays. Researchers must find a balance that will keep their project on track while working with available resources.

The FaST-LMM algorithm can analyze enormous datasets in less time than existing alternatives. Microsoft Research also has the infrastructure that is required to perform the computations, explains David Heckerman, distinguished scientist at Microsoft Research. With more CPUs dedicated to a job, computations that would ordinarily take years to finish can be completed in just hours.

For the Wellcome Trust project, the team’s available resources included a combination of Windows HPC Server, Windows Azure, and the FaST-LMM algorithm. The team knew that they had a powerful set of technologies. The question was, could it achieve the results required in the desired timeline?

“For this project, we would need to do about 125 compute years of work. We wanted to get that work done in about three days,” explains Baxter. By running FaST-LMM on Windows Azure, the team had access to tens of thousands of computer cores and an improved algorithm that was able to expedite the work. “You’re still doing hundreds of compute years of work,” he explains, “but with these resources, we can actually do hundreds of compute years in a couple of days.”

While the results were impressive, there was something that had an even bigger impact. “The most impressive thing was how quickly we could take this project from inception to actually completing it and generating new science,” Baxter notes. “This is stuff that, without both the improvements in the algorithms that the Microsoft Research guys had come up with and the ability for us to provide the tens to hundreds of thousands of cores, would have been infeasible.”

The Future for Big Data Research
The Wellcome Trust project is just the beginning of what could be a major shift in how research databases are stored and analyzed. “With this new, huge amount of data that’s coming online, we’re now able to find connections between our DNA and who we are that we could never find before,” Heckerman says. The ability to analyze that data more quickly, and with greater depth, could help scientists make faster breakthroughs in genetic research—and breakthroughs in critical genetic research. The FaST-LMM algorithm running on Windows Azure is helping to accelerate just such breakthroughs.

Talis Clinical

Healthcare Technology Firm Launches New Perioperative Solution on Microsoft Azure

Talis Clinical wanted to make an innovative anesthesia information management system more widely available, so it redesigned the application to run in the cloud on Microsoft Azure. Called ACG-Anesthesia, the patient-centric solution provides centralized, automated visibility into patient risk factors and changing physiologic conditions from the decision to perform surgery through recovery.

In addition, built-in advanced clinical guidance and evidence-based care protocols empower physicians to more effectively manage all phases of perioperative care.

Making healthcare smarter

Sharing data quickly and accurately across multiple processes is important for all businesses, but nowhere is it more critical than in a hospital setting where the right information at the right time can mean the difference between life and death. Among the most critical events in patient care is the intraoperative episode, where the anesthesia care team must simultaneously monitor and react to multiple physiological parameters.

To address those challenges, an application was developed and implemented at Ohio’s Cleveland Clinic that integrates data from patient monitors, medical devices, and electronic health records (EHR) to provide centralized insight and multiparameter decision support. The anesthesia system was already being used in more than 270 operating rooms when the development team and an experienced medical entrepreneur decided to establish a new firm called Talis Clinical and offer the solution to other healthcare organizations.

Talis immediately began expanding the scope of the anesthesia system to include preoperative and postoperative events. In addition to improving patient care and safety, the extended solution would help healthcare providers get more value from the electronic health records (EHR) systems that many organizations had installed and augmented to satisfy recent regulations. Gary Colister, Chief Executive Officer of Talis, explains, “EHR technology alone does not provide the level of vigilance needed in perioperative care; it mostly enables the clinical team to record what happens.”

Moving to the cloud

Talis spent a year looking at an array of cloud platforms from specialized medical platforms to large commercial vendors. The new company decided that Microsoft Azure was the best choice for commercializing its application. “We went through all of these evaluations, and then we actually realized that we’re a Microsoft shop, with all of our technology built on a Microsoft platform,” says Colister. “We’re also moving very fast, and we needed to make sure that not only the individual pieces of software we deployed had the necessary robustness, but that our cloud partner had a deep awareness of our technology stack. It really came down to that support.”

Using the Microsoft Visual Studio development system, including Visual Studio Team Foundation Server, Talis redesigned its anesthesiology solution to run in the cloud on Microsoft Azure Virtual Machines. The highly scalable, flexible environment provides a range of benefits, including easy integration with virtually any endpoint including diverse EHRs and medical devices. On the back end, Talis gained similar advantages, including support for its databases, which ran on Linux operating systems.

The solution, called ACG-Anesthesia, continuously collects patient data such as heart rate and blood pressure, and provides real-time, clinical views of specific patient conditions in multiple rooms. It also includes electronic case summaries and hand-off checklists so that comprehensive information can be shared efficiently with all members of a medical team. ACG-Anesthesia automatically pulls data from Talis clinical products, medical devices, EHRs, lab systems, pharmacies, and more.

In the operating room, the anesthesia care team uses an intuitive touchscreen to access and record information. Elsewhere, the supervising physician can use a mobile device to remotely monitor multiple rooms staffed by nurses or other members of the care team. In addition to providing a way to monitor patient health through a central interface, the solution pushes real-time alerts to devices including tablets and smartphones. It can be customized for a wide range of scenarios, including general, cardiac, and pediatric care.

Built-in clinical guidance supports complex decisions by calculating multiple parameters and events. As a result, the solution can alert caregivers to potential adverse conditions and reactions. And besides providing operational and clinical guidance at the point of care, ACG-Anesthesia helps hospitals collect and report data required by healthcare reform acts and other regulations.

Talis is also migrating other clinical products to the cloud, including a portal that establishes and measures protocols for preoperative testing and image-based, documentation technology that is used for assessment before anesthesia is administered. Both products are already integrated with ACG-Anesthesia. Brought to market in just two years, the suite is available across North America.

Improving healthcare

By taking advantage of Microsoft Azure, Talis Clinical can help medical organizations throughout North America improve patient care and safety at all stages of treatment and recovery.

Provides better support for innovation

With the Microsoft cloud, Talis was able to launch an innovative product that can help hospitals improve performance. “We have determined that Microsoft Azure can help us serve clients better than other traditional platforms,” says Colister. “We want our clients to feel like we can deliver the highest level of service that they expect. To be able to provide insights that help clinicians be more vigilant and at the same time produce legal documentation for compliance—that’s a big achievement in our space.”

Improves patient outcome

By providing timely, relevant data through remote apps and devices, Talis can help clinicians improve patient care. “The perioperative surgical care model is being studied at a lot of prominent medical centers around the country, and it emphasizes continuity and measuring patient information from the preop to surgery, subsequent physical therapy, and beyond discharge” says Karen Alexander, Vice President of Business Intelligence at Talis Clinical. “With Microsoft Azure, we can build the technology to implement this new care model and improve patient outcomes.”

Increases clinical efficiency

Talis is also improving workflow for hospital staff, which frees up valuable time where it matters most. “We’re talking to clinicians who tell us that our product saves them an hour each day in documentation, and it also reduces downtime because it’s more accurate,” Colister says. “With Microsoft technology, we’re creating solutions that make physicians more productive so that they can take better care of patients.”

Source: https://customers.microsoft.com

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