Monthly Archives: March 2015

Video: Keeping Patients Out of ERs

If everything goes as Health and Human Services (HHS) has planned for the next three years, a major share of Medicare spending could be moving toward accountable healthcare, instead of the traditional or fee-for-service care that we are familiar with. A recent article published on MobiHealthNews.com has discussed the implications of this move in the context of the growing popularity of digital healthcare.

HHS Secretary Sylvia M. Burwell has recently announced a goal to tie “30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.”

With the general trend gradually shifting towards value-based care, medical caregivers across the country are striving to provide digital health programs, such as those based on remote monitoring and telemedicine, to support new care delivery models. Bloomberg has reported that Philadelphia’s Thomas Jefferson University Hospital, a 1,000 bed facility with $2.1 billion in operating revenue, and allegedly one of the most expensive places for medical care, is investing $20 million to open two new urgent-care centers, and to create a virtual consultation program using video apps so that patients with routine medical needs can stay in touch with their doctors and caregivers from the comfort of their home.

The first-of-its-kind video program, which was rolled out for testing late last year, already includes 100 Jefferson staff working as a team. In the next step of the program, the hospital’s providers will be able to collaborate with patients’ primary care providers post-discharge. Jefferson’s long-term plan is to build a “virtual emergency department” that would eliminate the need for patients to come to the ER. Dr. Judd Hollander, an ER doctor at Jefferson, said that the success of the program will truly arrive “when the ERs start closing.”

Talking about the program, Jefferson CEO Steve Klasko told Bloomberg: “The best way to save the system lots of money is to keep [patients] out of the hospital.” Even doctors and economists believe that this approach is not only better for patients but is also necessary to control medical expenditure in the U.S., which is higher than anywhere else in the world. However, the idea is not so great for hospitals that drive added revenue through “more tests, fancier treatments, and longer hospital stays.”

It will be interesting to watch the developments in Medicare spending. How do you think the impact will play out across the industry? We would love to hear your thoughts.

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

dr looking at monitor

Cracking the Code of State-of-the-Art Hospital Communication

A patient is rapidly transported into the ER.  He was stabilized by the paramedics on the way to the hospital and is immediately placed in the ICU.  The staff efficiently transfers him from the gurney to his bed and hooks him back up to the heart and respiratory monitors.  Then something goes wrong.  The patient’s heart stops.  The attending ER nurse rushes to her station, picks up her phone, and calls for a “code blue” response.

There’s only one problem, no one heard it because the emergency notification system was not designed properly.

In today’s world of high tech medicine, it’s easy to get overwhelmed with the advancements technology is bringing to our hospitals.  It really is an amazing time and something to behold.  However, the need to communicate effectively and efficiently is still at the core of providing essential care.

There are really two main parts to effective and efficient communication.  The first part is to make sure that all of the staff is speaking the same language.  Hospitals use a “color code” system to communicate different events within their facility and to trigger the proper response.  In the past many codes varied from facility to facility making that communication system inefficient and confusing at times.  To give a relevant true story:

“A hospital per diem nurse, employed by two different hospitals, began her shift to find that one of her patients had gone into cardiac arrest. She responded quickly by picking up the phone and announcing “code blue”. Within minutes she was surrounded by security guards and police officers with weapons in hand. To her dismay, the nurse was informed that code blue is a security alert in this facility. In her other place of employment, it means cardiac arrest. The correct team was quickly brought to the bedside and the patient recovered.”

This story illustrates two things.

First, it shows the need for some standardization in the color code system at least regionally for hospitals.  Hospitals in Washington, Oregon, and California are working on standardizing these codes for more effective communication and to minimize confusion for staff that may work in multiple facilities.

Second, even though the nurse gave the wrong code in the above example, something went right. 

The emergency notification and code announcement system worked.  The proper response for that hospital was implemented based on the code the nurse gave. This can only happen if the notification and code announcement system is designed properly.  So what are the core features of a state-of-the-art system?

Access

In order to be able to initiate a color code alert you first need a way to access the system.  Having multiple, convenient handsets or paging devices at nurse’s stations and other key areas assure the hospital staff will have the ability to communicate a color code and initiate a response.

Delivery

Once a code is initiated, there must be some way to communicate it to the rest of the staff for proper response.  The delivery system usually consists of public address (PA) speakers and sometimes may even include a method of alerting staff on personal mobile devices as well.

Coverage

A system that includes PA speakers must have the proper coverage.  The coverage is determined by the ceiling heights, area needing to be covered, and coverage pattern of the speakers.

Intelligibility

Even if everything above is all in place, the system is worthless if the staff cannot understand the codes being communicated.  Intelligibility is key and may be one of the trickier parts of the puzzle.  The Speech Transmission Index (STI) helps rate the intelligibility of speech delivered.  In a hospital environment, there is little opportunity to redesign the space or add acoustic treatments to the hard, sanitary surfaces.  For this reason having equipment that can be adjusted for background noise levels and audio frequency responses is dually important.

At the end of the day, hospitals rely on efficient and effective communication to provide exceptional care and ultimately save lives.  First get all the staff on the same page, then make sure you have a state-of-the-art emergency notification and code announcement system.

For more than 20 years Avidex AV has provided innovative technologies that drive business outcomes for our clients. Is your organization looking for a new kind of technology partner? Connect with one of our Account Executives today to learn more.

 

Resources:

#1:  http://www.hasc.org/resource/hospital-emergency-codes

#2:  http://www.wsha.org/files/82/codeseducationslides.ppt

#3:  http://en.wikipedia.org/wiki/Speech_transmission_index

 

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

Top 10 Health Technologies to Watch in 2015

The field of healthcare technology has witnessed some radical changes over the past few years: advancements in continuity of care, virtual consultation, treatment and care process innovations, and more. What will be the impact of these changes? Will they enhance patient care, or blow up medical spending for infrastructure, capital equipment, and physician preference items? A recent article featured on Becker’s Health IT & CIO Review talked about the top 10 technologies that are making waves in the healthcare landscape.

The article focused on ECRI Institute’s compilation of topics, questions, and answers pertaining to the latest tech trends that are impacting treatment, patient’s care, and medical costs. Released last month, and titled “2015 Top 10 Hospital C-Suite Watch List,” the list includes the most relevant tech issues and topics that healthcare and IT leaders need to know about.

According to ECRI Institute, here’s a roundup of the top 10 healthcare IT topics and questions that C-Suite executives should be looking at over the next year:

  1. Disinfection robots: Will they be able to successfully combat healthcare-related infections?
  2. 3D printing: It will be interesting to see if 3D printing moves beyond the hype into a profitable investments for hospitals.
  3. Middleware (software connecting enterprise applications): Execs should be watching to see if it is able to achieve the National Patient Safety Goals on clinical alarms.
  4. Post discharge clinics: Preventing readmissions is the ultimate goal. Will clinics be able to reduce the number?
  5. Google Glass: While it may not be the right fit for consumers, there could be potential benefits to the healthcare industry.
  6. Anti-obesity devices: Should these devices be added to providers’ bariatric offerings?
  7. Caring for millennials with cancer: Will adolescent- and young adult-focused cancer centers produce better outcomes that traditional care centers?
  8. Fecal microbiota therapy: Will it offer new hopes in combating serious gastrointestinal disorders?
  9. Artificial pancreas device systems: What is next in the development of these systems?
  10. Telehealth: Have we experienced the maximum benefits that telehealth can provide?

Stressing the relevance and importance of these tech questions, Rob Maliff, Director of Applied Solutions for ECRI Institute said, “Hospital leaders must carefully examine their strategic and operational plans and assess the relevance of these new technologies or infrastructure initiatives for their organizations.”

How do you think these technologies will continue to impact healthcare in the coming years? We would love to hear your thoughts.

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

employee with dr on computer

Virtual Medicine: The Cure for Complying With Government Mandates

Keeping a lid on medical costs has proven to be a Herculean task.  Numerous financial experts –Warren Buffet, for instance – have warned that spending 20% of the nation’s GDP on health care is neither wise nor sustainable.  Consequently, policymakers, government agencies and legislation — including the Affordable Care Act — have attempted to reign in spiraling health-related expenses.

Today, hospitals have to comply with government directives aimed at reducing patient readmission rates by at least 5%.  The use of telemedicine to deliver patient follow-up care can help health providers reduce expenses and better comply with government regulations.

In fact, reducing patient readmission rates represents a major opportunity to trim health care expenditures.  For instance, studies indicate that as many as 25% of the patients discharged from their care facilities will be readmitted within less than a month.  Many patient readmissions are unnecessary and preventable.  Undoubtedly, the vast majority of patients would prefer to avoid a return stay.  Also, hospitals could save substantial sums if they could deliver quality follow-up care in the patient’s home via telemedicine.  After all, they would free up bed space for new patients even as they continue to generate revenue from their follow-up outpatients.  Therefore, all stakeholders have an interest in avoiding costly readmissions.

Care providers recognize that better patient monitoring and technological connectivity are essential to improving health outcomes.  In most cases, in-home care is the best option for all concerned.  Here are several ways providers can utilize video to deliver quality follow-up care.

  • Cloud-based Systems: Integrating communication, care and data collection when multiple parties are involved is essential. Cloud-based solutions enable hospitals, primary physicians and patients to collaborate across a unified platform, so medical services are delivered seamlessly.
  • Virtual Visits: Thanks to videoconferencing, physicians can remain in their offices but consult face-to-face with patients in their own homes or office.   In particular, telemedicine carts in a patient’s residence now include plug and play diagnostic peripherals, which allow remotely-located physicians and care providers to measure blood pressure, heart rate and other vital signs in real-time. In short, high-tech video examinations can be every bit as productive as actual visits.
  • Medicine Management: Telepharmacy involves the use of video and digital technology to fill prescriptions and connect patients with remotely located pharmacists.   Virtual druggists can dispense, monitor and manage patient medications electronically.
  • Daily Health Checks: Electronic in-home monitoring helps care providers track patient progress. Additionally, improved follow-up care and oversight encourages healthier habits among patients.

Studies indicate that follow-up care delivered by telemedicine can be every bit as good as traditional methods.  In fact, recently the AMA adopted the view that the appropriate use of telemedicine could benefit patients, both in terms of higher quality care and easier access to health services.  Video is emerging as a powerful tool in the healthcare arsenal.  It allows institutions, physicians and patients to cooperate more fully in the post-hospital treatment process.  Lower readmission rates made possible by telemedicine are a healthy sign for patients, hospitals and society as a whole.

Sources:

http://www.chqpr.org/readmissions.html

http://www.beckershospitalreview.com/quality/reducing-hospital-readmissions-rates-how-to-avoid-upcoming-penalties-and-maintain-patient-wellness.html

http://content.healthaffairs.org/content/31/6/1244.short

http://www.ncbi.nlm.nih.gov/pubmed/25373875 Continue reading

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com

polycom photo vid con

How is Video-as-a-Service (VaaS) helping the healthcare sector?

Video collaboration technology has been at the forefront of healthcare innovations recently. With the widespread adoption of telehealth and remote monitoring across the U.S and other countries worldwide, video is increasingly becoming a part of mainstream healthcare. The promise of the highest quality treatment, continuity of care, and round-the-clock medical assistance at lower cost than traditional healthcare practices make video contributions quite desirable. In this context, an article published on Polycom’s official blog discussed the scope of Video-as-a-Service (VaaS) in the modern healthcare sector taking into account, UK-based VaaS service provider, Imerja’s contributions in telehealthcare.

So what is VaaS?  It is a video conferencing solution that is fully-managed, hosted, and delivered on demand by a service provider. This mode of service ensures the highest quality video experience without having to incur infrastructure expenses. As a provider of simple, secure, and reliable VaaS services, Imerja extends remote monitoring capabilities to doctors and clinicians who can make critical decisions on treatment and care as efficiently as they would in a face-to-face scenario.

The article discusses various successful VaaS deployments driven by Imerja across hospitals and medical facilities in the U.K. Here is a sampling of them:

  • Video deployment in Alder Hey Hospital pediatric neurology department has eliminated the need for patients to travel in order to receive care from a specialist.
  • Lancashire Teaching Hospital’s renal department has enabled patients to perform dialysis at home under expert medical supervision and guidance via video conferencing.
  • Using video conferencing, Lancashire and Cumbria Telestroke Network have been able to save many patients’ lives through round-the-clock expert assistance, which can deliver post-stroke thrombolysis treatment.

Video-as-a-Service has improved treatment outcomes and patient experiences significantly, while helping hospitals save costs. Besides the cost savings, VaaS also provides the following benefits:

  • Enables better remote collaboration for faster response on critical medical conditions.
  • Takes treatment and care out of hospitals, providing 100% utilization rate across each hospital.
  • Prevents clinics from getting overcrowded and allowing effective space-utilization.
  • Allows patients in remote locations and rural areas with limited medical facilities to access quality healthcare at lower costs.

Providing both patients and healthcare providers with numerous benefits, VaaS has the power to transform the healthcare sector like never before by putting expert care within the reach of patients regardless of their location and ability to travel to a hospital or care center.

In what other ways do you think VaaS will extend the benefits of telemedicine, telehealth, and remote monitoring? We would love to hear your thoughts.

Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com