It’s hard to imagine an industry that stands to gain more from going digital than healthcare.
Done right, a system of collecting, storing and safeguarding our electronic health records would give caregivers the power to employ analytical tools that quickly identify and treat conditions—before they deteriorate to the point that they need to be rushed off to the emergency room.
Indeed, keeping people healthy and out of the hospital could be the elixir for our $3 trillion-a-year healthcare system, which is beginning to feel the crush of an aging population that’s demanding more care.
But despite the obvious benefits, the science of medicine is still shockingly unscientific. At a typical office visit, your doctor may only have a few sets of bloodwork and vital signs – taken months or years apart – to help judge your condition. She probably won’t have access to results from a critical series of tests, because they’re stored at a clinic you visited while on a trip to Kansas City. And even if she did have access, the key insight might be buried in the write-up because the tests were taken to assess an unrelated issue.
Now, finally, the USA healthcare system is taking steps to modernize – in no small part because changes in healthcare laws are nudging facilities to convert to electronic health records, or EHR. Even without the new laws, though, some hospitals, clinics, nursing homes and other institutions are finding that employing EHR quickly delivers on the dual promise of saving money and making patients healthier.
Take Covenant Health, a network of 26 hospitals, nursing homes and other healthcare facilities in New England. Covenant, which insures its 6,000 employees, decided to implement EHR and analytics with its own employees to improve care and cut costs. Soon they learned that 9% of employees were responsible for 40% of the overall healthcare costs at their hospital in Nashua, NH. Of those, seven COPD patients’ care cost $600,000 a year – and $550,000 of that was devoted to treating one employee.
By tailoring plans to take better care of the higher-risk employees, they’re healthier and happier. And Covenant’s on track to save $1.5 million this year.
CATALONIA’S EXAMPLE
Converting records to EHR has brought similar results abroad. Catalonia, Spain, like many regions across Europe, is facing the same issues as the U.S.: an aging population with healthcare costs that already are at an unsustainable level. So healthcare providers urgently need to contain costs.
The Catalan Institute of Health, known as ICS in Spain, sets aggressive goals for its EHR project.About one in four of the nearly 6 million people that ICS covers are over 65. And 60% of that group suffer from chronic conditions. Together they make up less than 20% of the population ICS serves, but are responsible for 70% of healthcare costs.
ICS worked with IBM to connect patient data with available data on the diseases themselves. The pilot project cut costs by 10% to 15%. It also reduced re-admissions between 10% and 12%.
Lakeland HealthCare, which has three hospitals and 30 other facilities in southwest Michigan, had a more targeted goal with its recent EHR project. Lakeland deployed EHR in the intensive care unit to help prevent potentially fatal catheter-related infections, or sepsis. When treating sepsis, time is of the essence – and the new system enabled caregivers to quickly identify early warning signs and act in the first few hours.
Results – dramatics results – came quickly. In the first three months, the sepsis mortality rate dropped to 4.5% from 17%. And charges to sepsis care patients have dropped to the $20,000 range, compared to a national average in the $60,000s, Lakeland reports.
Carilion Clinic, a Roanoke, Virginia, healthcare network, had a similarly focused objective when it set out to identify patients who are at risk for congestive heart failure, or CHF. Prediction and early detection is critical to minimize the effects of CHF, but it’s notoriously difficult to do. The American Academy of Family Physicians estimates that conventional methods of early detection are only about 50% accurate, which isn’t precise enough to be able to direct care.
STRUCTURED DATA
That’s partly because some key indicators aren’t found in so-called structured data, like blood pressure readings and blood-test results. Warning signs like stress levels and shortness of breath while bending are found in clinicians’ notes, discharge papers, doctor reports and other forms of unstructured data.
Carilion started with Epic’s widely-used EHR platform. And they used IBM’s natural language processing technology and analytics to uncover the clues buried in the unstructured data. The result: the pilot project was able to identify patients at risk for CHF with 85% accuracy.
Centura Health, a Colorado care network, is focusing on electronic tools to better manage patients’ health after they’ve been hospitalized for a heart condition. Centura has turned to CaféWell Concierge, a smartphone platform powered by IBM Watson’s natural-language processing technology. CaféWell Concierge is designed to keep patients actively engaged in caring for their health at home.
Centura hopes the pilot project will cut costs by 1% and reduce hospital readmissions by 15%.
If the other projects are any indication, Centura may be pleasantly surprised by the results.
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