Digital Health Thoughts

I will start this article by defining what I mean by the term a Cloud First hospital. The term cloud has been a buzz word in the past decade which led many organizations to declare their support for the cloud, sometime without understanding its true meaning. For the purpose of this article I am proposing a simple test to decide whether an organization is a cloud first or not. If you are software vendor you must have an IT department which directly in charge of the system up-time at your clients sites. If you are a health organization then you should never have visited the data center where your data resides. A Cloud First hospital is one which more than 50% of its systems reside in data center that none of its staff members ever visited or not even sure where they are. According to a recent survey by Datica, in the US only 17.7 percent of the respondents say they work with healthcare organizations that have more than 50% of the existing software infrastructure remotely hosted or ...

The world of economics has decided on this debate a long time ago: monopolies are bad, diversity is good. No matter what a monopoly promises, you can rest assure that over time the lack of competition will cause prices to go up and quality to go down. When it comes to healthcare IT, however, there is one unique factor that flips the coin – interoperability. Despite various attempts the healthcare industry has yet to solve the interoperability challenge in a satisfactory manner which will enable a full continuum of care across different health information systems within a health delivery organization. Taking a common scenario of prescribing a medication order in theatres using a surgical system to be later administered in a ward requires significant investment to achieve, even using the modern Fast Health Interoperability Resource (FHIR) protocol. The investment required to streamline the data flow across systems raise in an exponential order with every new system that is thrown to t...

All looks perfect when you are in love. The person you're with seems to have all the qualities you were looking for in a partner. He is always there for you, attentive to your needs, promising to fulfill all of your wishes. But as this story goes the statistics kicks in, and you soon find yourself sitting with your friends and moan about very similar things. When it comes to a healthy relationship between clients and suppliers it is good to follow the same advise a psychologist will give you for maintaining the relationship between you and your partner in life: have constant and open communication, align your plans together etc. But there is one very important recommendation that often escapes and is the hardest to implement and that is to keep your independence! The advice is really relevant for all industries and is not specific to healthcare, however, when it comes to healthcare it is much easier, as a customer to lose your independence and without even noticing it. Since he...

We all have this image in our head of an IT guy who surrounds himself with technology, obsessively try out every new gadget, and keep mentioning all kinds of weird acronyms that distance him from society. When I sat the other day in front of the IT manager of a big hospital while he was chewing a gum, I can't help thinking how far is that image of the IT guy from the person who was  sitting   in front of me.  In contrast to that image in our head the IT manager main concern is keeping the lights on. An IT manager who experienced an unscheduled downtime in one of the hospital mission critical systems, like many of them did, surely got his priorities straight after that event. The worst nightmare of an IT manager is to stand  first thing in the morning  in front of the CEO and to explain why the hospital network was hacked during the night. With such heavy responsibility  laying on their heads innovation does not even get into the top three in t...

Everywhere I go lately I hear people chatting about chatbots. It seems that every health organization is preparing to launch a chatbot service or at least has it on their roadmap. Once I noticed this trend, I keep asking the people I meet about their "bot strategy" and thus having my own small contribution to the trend. There are countless cases where a digital personal assistant or a chatbot could help physicians, nurses, patients or their families. From assistance in simple routine tasks like finding a doctor or scheduling an appointment, to better organization of patient pathways, medication management, help in emergency situation and offering a solution for simpler medical issues. The general idea behind the buzz is that in the future, these talking or texting smart algorithms might become the first contact point for primary care. Patients will not get in touch with caregivers directly for health questions but will turn to chatbots first. Only in case the bot can ...

In one of my visits to the hospital where our EHR system was being deployed the chief doctor turned to me and said: "My experience allows me to predict exactly what will be the patient's condition in the next few hours just by glancing at him, however, I am not able to pass this skill to my young doctors. What I need from you, software engineering people is to help me solve that problem". That sounded to me like a classic problem for computers to crack and bring value: to “connect the dots” between so many unrelated data points simultaneously in real time, in order to detect small anomalies indicating that a patient begins to fail, elusive even from a careful human observer. The year was 1998 and although predictive analytic has been a hot topic over the years and the vast improvement in computational power, predictive analytic products are not widely being used by health delivery organizations and are still being considered by many as gadgets. Treatment decisions ...

We all hear those stories every now and then about the outrages amounts of money that health organizations spend on buying a piece of software. There are no secrets in the healthcare industry about which software vendors are the ones lifting the expenditure bar. The majority of them are US-based companies looking to expand internationally after they have pretty much exhausted their opportunity in their home territory, leaving it with almost twice the health expenditure per capita from the runner up in the world. In any other industry, private companies generating large profits deserve nothing but applause. However, when it comes to the healthcare industry one cannot overlook the fact that money that was allocated to improve patients’ health is being transferred to wealthy businessmen. It will be naive to think that when it comes to the healthcare industry executives and shareholders will abandoned their playbook for the good of their society. Therefore, with that in mi...