BOSTON--To keep a focus on innovation while managing the long list of federal mandates in healthcare, John Halamka, MD, CIO at Beth Israel Deaconess Medical Center (BIDMC), said incorporating newer technologies is essential. Halamka spoke at the Medical Informatics World Conference on April 28 about SMAC—social, mobile, analytics and cloud technologies.
BIDMC has been using social media to expand on the idea of the care team approach by employing Wikipedia-like documentation. Care team members all contribute information to the patient record with one clinician curating the information and signing off on the record. “The idea is that many people create wisdom in a crowd,” he said. “We’re starting to break the paradigm of one EHR, one doctor with this social media, team-based approach. It’s important that we share everything we write with everyone on the team including the patient. It has worked really well.”
BIDMC has been employing social media principles for its problem and medication lists as well, Halamka said, for “community-curated records.” Also, a dashboard-type tool in the ICU tracks activity. Perhaps three patients are having procedures done at the same time or members of the regular staff are on vacation. The tool essentially shows clinicians how safe the ICU is at a given time, he said. Patients also have a tool that allows them to clearly see why they are there, their current medical interventions, their care plan, procedures scheduled for the day and more. They can opt to receive information by email and it allows for interactivity—the patient or a relative can request a provider meeting, for example.
After spending years creating EHRs and getting structured data, mobile technology is changing the landscape. Halamka said clinicians at BIDMC are using Google Glass in the emergency department. They log into a secure portal and the tool lets them scan a QR code and they are authorized to access the patient’s record. Every room has a QR code on the wall. “Google Glass recognizes where I am and therefore, recognizes the patient,” he said. Since this effort began in December, lives have been saved. Halamka cited a physician who was in the process of resuscitating a patient and was about to inject a medication when the record popped up via Google Glass and noted the patient’s allergy to that very medication. In the future, it won’t be bring your own device, Halamka said, but bring your own glass.
BIDMC has approximately 3 pedabytes of data and has been using analytics tools that help users mine the data and guide care more effectively. “Big data isn’t big anymore, we just need better tools for analyzing it.”
While many in healthcare are reluctant to adopt cloud technology because of privacy concerns, BIDMC has been creating its own private clouds, Halamka said. That allows for services at a low cost and he noted that most clinicians don’t have the expertise to keep servers in their offices.
He also pointed out that all of the Centers for Disease Control & Prevention’s data is stored on Amazon. “I do 4,000 data transmissions per day on behalf of the CDC.”
Despite the reluctance to use the cloud in medicine, “it is becoming a reality.” In fact, he sees a cloud services department replacing the IT department. IT professionals will serve less as providers of services and more as enablers or “care traffic controllers,” he said.
Halamka also recommended that his audience worry more about their trajectory than their current position. “Look at where we’ve come over the last four years. The road has been hard but our trajectory is good.”