Medical records. Hospital owned or patient owned?

I had an “ah-ha” moment while sitting in the New Jersey Hospital Association’s annual meeting.   We were listening to Dr. Eric Topol – Director of the Scripps Translational Science Institute, cardiologist, and author – discuss the technology changes that consumers have access to today.

In some cases the technology he talked about is only available to people with huge resources, but his point in showing the crowd of 500 people these things is – “They are coming.” Not only will these new technologies be available to patients, but the access to the technology will change the dynamics of the patient experience and the relationship they have with the entire healthcare system.

The technology advancements that are on their way are not new to you. I have been saying these things at the employee meetings over the last 3 years. I have shared a number of times that we need to continue to find ways to bring value to the patients.

But, I had one of those aha moments during the presentation. Dr. Topol wrote a book – “Patients Come First,” and in his book he talks about when the patient will be able to eventually preform their own EKG or X-ray, there will be a lot fewer emergency department visits because they will not need the services of a hospital or person for urgent intervention.   

Ok no big deal there.

What really struck me was when he started talking about who owns patient medical records. In each state, the laws define the “ownership” differently.

For example, in New Jersey the law says the hospital owns and maintains the records and the patients only have access to them. Vermont is the only state in the nation where the patient owns their own records.

I can bet that most of you know how to read a medical record, right? Well, when I have read my own medical record, I’m convinced the doctor must have written it in another language – to me it is just gibberish.

So when Dr. Topol began talking about the translation services (my description) that are now available to explain to patients what their scans and medical records say in layman’s terms, I was so grateful for what that could do for our patients and families! Patients will no longer need to rely on the healthcare professional to make sense of the words; technology will do it for them.

I know what you’re thinking – that’s just one more piece of technology that will replace us! But it’s not, it’s an advancement that will help, and I’ll tell you why.

The new technology cannot replace the plan of care and the value of developing the relationship that we as humans provide. This technology can help to speed up a task that would normally take time out of your day, allowing you to use that time to see more patients.

I get ads for shoes all the time while searching on the Web (and always thinking “How do they know I love shoes?!”). When someone is searching specific health issues they are concerned about via Google or Bing monitoring their activity, we could use the same data sharing that Amazon uses in their marketing efforts to “market” to our patients the information that will help them with carry-over care, help them get healthy or remain healthy, and to take their medications. Well, it could help any number of things!

Yes, this could have some ethical issues but if the patient controls their own records, they could participate in any number of different apps that give them the tools they need to manage their lives and care in entirely different ways. We are trying to do this already with our new Parent PAL app, but the inner connectivity to other information could be the game changer.

Ok just breathe. I’m not trying to scare you, but instead to inspire all of us to think about what our patients couldn’t live without. Then, to develop the technology to remedy their issue and help it to become essential to them.

You know I love my FitBit. It truly does make me feel better when I hit my goals and keep track of how my friends are doing on their personal efforts to keep up their cardio. How could we help people manage the stress in their lives?

Would love to hear your thoughts!

Technology: Is it hurting or helping?

One of the many things that I have always appreciated about the employees at Children's Specialized Hospital is how many of you who show no hesitation to ask questions and allow me the opportunity to give you a different view on shared topic I’ve talked about.

This blog post is a result of the last State of the State. I know some of you showed concern that all of this new technology was going to "hurt" what we know as Children's Specialized; that it would in some way change our ability to stay close to the families.

First, let me begin by saying that when I started working here we had only five (5) locations. Today, we have 13 locations.

In each of our locations, families tell me that they feel connected to our staff. They are struck by how each of you takes them into your lives, and in turn you become part of their families. 

Let me tell you, that doesn't happen by accident. It happens because we live our values and we love what we do. You have set Service Excellence Standards that we all work hard tolive up to.

We have dramatically changed our hiring practices so we hire not only based upon your skills, but based on who you are and what kind of heart you have. These are purposeful, deliberate strategies that we set out. Yes, we always can do better to ensure we are all rowing in the same direction, but we have made significant strides.

Secondly, there are things we may not see every day, things that we shouldn’t necessarily be proud of that are an unfortunate reality that many of our families go through. For example, we have 5,000 calls coming into scheduling. No matter how many people we hire to answer the phones, there are no more appointments to give them. Our wait for physician services went up last year and we have wait lists for EVERY ONE of our services.

We continue to make great strides by using technology in registrations – reducing upwards of 5,000 hours of face-to-face time that parents have to wait to be registered by a person – creating a patient portal so families have access to their records, pharmacy refills digitally, and scheduling online in 2016.

But, we are still using modes of treatment that require families to come to us. Families have said that there are times in their lives that if they could do FaceTime or video treatment it would help them. If we had a 24-hour billing department that would allow people to chat online to understand their bill, like I can do with my cable company, that to would be easier for them.

We will hold to our values and continue the good things that we do have at Children’s Specialized. But we also have opportunities to better meet the needs of our families by the use of technology and pursuit of new ways to help their children meet their maximum potential that we must never stop striving for.

Disagree? Or did I miss your concerns? Let me know in the comments below.

It’s all about those apps

Earlier this month I told you about an invention that would make my life easier. Cell phones can really do it all nowadays, so I’ve been thinking a lot about smartphone apps.

I am fascinated by the different tools people have adopted to help them make their life easier; that one (or sometimes two or three) thing they have become so reliant on that it would be hard to imagine getting through the day without it.

I used the word "app," but the crutch can really be anything that has become necessary for you to get through your day.

I’ll share mine!

I don’t think I’m alone in sharing that the first and most obvious necessity is my iPhone. It truly has become the one thing I would turn around the car for if I forgot it at home. I have become so dependent on its uses and how connected it keeps me.

I often hear people say, "I have my life in there!" Since I’m always on the go, I can absolutely relate to that one.

So, what apps are on my phone? I have a few apps that are my go-to, but then others that I just think are really cool.

On the functionality side I guess it is those you would expect:

·         Google, - to get a quick answer to any question

·         Email, so I can stay on top of my email even when I’m not in the office

·         Fitbit, because you all know I’m obsessed with my steps

·         NJ.com, to stay up-to-date on news

·         Google maps, I’d be lost without it and love to check where I’m going ahead of time

On the fun side:

·         Shazam, so I can figure out what song is playing where I am and then purchase it immediately via iTunes (also another favorite)

·         Facebook, for obvious reasons!

·         Kindle app, so I can buy new books without having to lug them around

Amazon Smile is both a site and an app that I can’t live without. I am a one-click wonder. I get boxes every week from Amazon and it is has made my life so much easier when I don't have to worry about getting to the store to shop, but can order on line and from one vendor! Plus, I can justify my shopping habit with Amazon Smile since each order gives back to our kids!

The Asbury Park Press website has a data universe that will let you find any homeowner's address if they live in the State of New Jersey. It has been a huge help to me when sending notes to donors or some of you! I love not having to ask people for their address and keeping the element of surprise!

Before the end of this calendar year we’ll be coming out with two apps for our patients and families to use! Stay on the lookout for more about those two apps both here on Access Amy and through email and the huddles!

There’s got to be some things I’m missing, right? What are the items that you are you using that you would like to share? The apps or websites that you can’t live without!

The pros and cons of disruptive innovation

A lot of the healthcare trade journals have been printing stories about innovation. You have probably heard me say that I am truly concerned that disruptive innovation – something that will change how we use the healthcare system – will come from outside of the healthcare market place.

Just an example, the iPhone we know today evolved from the work of 3 guys in their garage – not at IBM or Hewlett Packard. Those companies will never hold the place they did in the marketplace before the disruption simply because they were not ahead of the curve – they will always be playing catch up. 

That is my worry for our hospital and for hospitals in general. We are a trusted place for families – a facility they come to filled with people they rely on. If technology evolves to a point where it can provide the same care they came to us for, how can we ensure that we can continue to be of value to our families?

I noticed something at the bank when I went to the ATM. I now have the option to “save” my most common transaction on the main screen when I log into the system so I don’t have to re-enter it every time. In addition, they give me my card back before they give my money because people were leaving their cards in the ATMs and causing a lot of risk, rework, and havoc.

These two small steps save me and the bank’s employees’ time and energy, and honestly I greatly appreciate the change!

Now does it make me stay with this bank versus another? Probably not, but I do appreciate the fact that I can see they are thinking about how to improve the customer experience.

The Tablet Registration, the Patient Portal, and taking steps to allow families to schedule their appointments online are all examples of how we are doing this for our families. They are all ways to ease how patients and families interact with us and ensure that if we aren't the place that develops this disruptive technology, we are actively working with our them to improve their experience as well as provide great care for their children.

I still believe the best place for the disruption to come from is from you. You on the front lines see and hear everything. Throw those ideas out there and you never know what may happen!

Smartphone – what will it think of next!

I recently read a Wall Street Journal article discussing the transformation of the healthcare system with technology.

You may have heard me use the expression that it is my hope that the transformation comes from us, inside the healthcare system. The likelihood that the transformation will come from outside the system is great because we often get caught in the trap of knowing how the process works and find it difficult to imagine how it could be different or better.

I know I have given you this challenge before, but if the sky was the limit, how would you use technology to change healthcare?

For me, my healthcare technology fantasy is related to time.

There are many times that I know something is wrong, but I don’t feel it is “wrong” enough for me to take off from work and make a doctor’s appointment. My doctor is not close by and in order for me to see him, it requires at least a 3-hour block of time between 9 a.m. and 5 p.m. during the week. So, unless I am hacking up a lung, I am not taking the time to see him.

I haven’t crossed over yet to the minute clinics, but I am starting I might give it a try. I wish I could e-mail my doctor and tell him my symptoms, or send him a photo of a rash and see if he can diagnose it just by looking at the picture. Then he could help me work through it without having to come in.

It might sound bogus to you now, but over time it’s definitely something that could happen in health care! After all, we use the VGo robots now with some of our patients so our doctors can check on them remotely.

So what is your technology wish?

Technology allows our Docs to make house calls

You have heard me tell you that technology is revolutionizing how we will provide health care to our children. Children’s Specialized Hospital is fortunate to be the first pediatric rehabilitation hospital in the country to offer the telemedicine robot, VGo.

What is VGo? It’s a robot. A robot that uses HIPPA-secure technology to provide two-way video, audio and motor driven action. This is SO COOL! Thank you to Dr. Haines for being the driving force behind bringing VGo to our patients. 

Currently we are using VGo in two ways.We use VGo on our inpatient units where our doctors can sign on from their home computer and drive VGo around the unit to check in on patients and answer parent’s questions without physically being in the hospital.So Dr. Fantasia can sign on from her home computer without coming into the hospital.Talk about improving the patient experience – having a doctor available 24/7!

Now this is really great; we are currently sending home a VGo, with some of our infants and their parents, for the first week. For many of these patients this is their first time outside of a hospital setting and having access to the medical team that has helped them through what is probably one of the most challenging times in their lives is priceless. 

Dr. Burke and her team will schedule appointments to check in on the patient; with the home health nurse too. In a few cases, Dr. Burke has been able to avoid ED visits and readmissions because of these check-ins.One time, a baby’s trach came out during the visit and she was able to successfully talk the parent/nurse into reinserting it. 

Currently, we have two VGo robots in our New Brunswick site, as well as one at each of our LTC centers. But we hope to add more VGo robots to our inventory and help improve access to pediatric specialists and outpatient care to children living in medically underserved communities. 

Special thanks to Drs. Haines and Burke for being true champions of VGo and for embracing this new technology to its fullest. Thank you too to our facilities team who go to the ends of NJ to deliver our VGos, and bring them home. 

In the short time that we’ve been able to use these devices, VGo has offered endless opportunities to help our children in a way that we never thought was possible. Not only can our physicians check in on their patients at any point in the day from wherever they are, but we are now able to have our physicians consult with one another across our sites, right at the patient’s bed side by just dialing into the system from a computer or iPad.

We strive to help every child live in a world where they have every opportunity to reach their goals. Advances in technology, such as this, make it possible to save more lives and help our kids reach new heights.

I am excited to see the other opportunities the VGo system – or any other new form of technology – offers the children at Children’s Specialized Hospital.

Have you used the VGo system yet, or used any other form of telemedicine to help improve patient care? Do you have any idea on how we can use our VGos? I’d love to hear your thoughts.