Ed Kopetsky, CIO of Lucile Packard Children’s Hospital Stanford, Stanford Children’s Health
Among hospital and health system leaders, implementing digital health technologies is a shared focus across the industry. Key among the goals for digital health are to reshape the ways physicians and patients interact and share health information, and to virtualize visits and data collection to enable better access to care and continuous data management when needed. Collectively, digital health tools are perhaps the greatest enablers to establish new care models built around the patient and family in their daily lives.
Digital health initiatives are central to being on the leading edge of the evolving health care landscape. And for our hospital and network, it is essential to advancing care as well as minimizing the burden of travel and time on our patients and families. In pediatric care especially, families with children who have complex care needs are primary benefactors of these technologies. Many of our patients have long term and continuous care needs well served by emerging digital health technologies.
As I’ve experienced integrating digital health services into the Stanford Children’s Health system, scaling, platform integration, cross-organization collaboration and adoption have stood out as keys to successful implementation.
Scaling Digital Health
At Stanford Children’s Health we are focused on transforming healthcare for mothers and children worldwide through technology — by making it faster, safer and easier. We need to scale our digital health offerings to keep up with our patients’ needs. One of the ways we have done this is through enhanced access to telehealth services by enabling patients to connect with their care team from multiple clinic sites and via mobile. We are aggressively expanding telehealth programs across our broad range of specialty services and our community network. In 2018, we have enabled 24 additional sites of care for telehealth, and have exceeded our goal for new visits. We are targeting a 10x growth in telehealth visits over the next two years.
By providing accessible, unified care experiences via digital connectivity, we can innovate and standardize high-quality outpatient care. When it comes to implementing this model, I encourage healthcare leaders to keep in mind that the rate of adoption is not technology limited, but requires change in clinical practice process and flow.
97 percent of hospitals across the country now have a certified electronic health record (EHR) system. With more patient data being collected through digital health tools, it is crucial that hospitals and health systems implement integration platforms to streamline information so that physicians have access to the right information when needed.
One example is a technology Stanford Children’s Health’s clinical informaticists created called GluVue, an API-enabled app developed to interchange data from the patient to the provider, giving pediatric endocrinologists visibility to the blood glucose levels of Type I diabetic patients. Directly linked to a patient’s electronic health record (EHR) via Apple’s HealthKit, GluVue detects patterns and generates visualizations of glucose values collected from multiple sources, including inpatient and outpatient visits and continuous glucose home monitoring devices. What makes technologies like GluVue effective is they allow clinicians to monitor their patients remotely and on an ongoing basis, as well as provide consultations through virtual visits, or call them in for an appointment when they feel it’s necessary.
Pediatric specialists at Stanford Children’s Health are working with clinical informaticists and Information Services (IS) to identify opportunities to leverage data being collected by tools like GluVue, wearable devices or in-home monitoring equipment or simply by parent observation. What remains paramount is determining how to integrate that data into the care workflow to facilitate the delivery of individualized patient care, as well as improving accessibility and convenience across our continuum of care. More importantly, quality and safety improve as we from episodic location-based care to continuous monitoring and real time data collection.
Collaboration among clinical and non-clinical teams is essential for digital health service implementation to ensure that the correct data is being collected and analyzed, while also being continuously monitored and protected. Our clinical informatics program is a leader in exemplifying the harmony between clinicians and IS required to achieve extraordinary outcomes. For example, about one third of our IS department is comprised of clinicians–nurses, pharmacists, MDs and more–many of whom are still in practice and understand the patient care work flow, challenges and processes. This affords collaboration between our frontline clinicians and our nationally-recognized clinical informatics and IS team, which includes both nurses and physicians who are evolving our innovation.
Whether it’s maintaining connections with patient families via digital technology or sharing EHR-derived information across institutions, healthcare organizations are always anticipating the potential risk perspectives on patient data leaving our walls, and this will be a persistent and evolving challenge facing the entire health care industry. Information security is paramount in our initiative to be a digitally-empowered health network, and our advancement in managing clinical technology together with emerging patient-centric mobile capabilities, is a new focus area for our information security program.
The Future of Digital Health
As an academic medical institution, our physicians have a desire, responsibility and mission through clinical research to identify solutions for the most complex challenges in their fields. Thanks to the evolution of digital health tools use of real time data, clinicians are now able to more thoroughly and efficiently track patient health to not only serve individual patients better, but also to share knowledge with other institutions to advance care on a greater scale.
Digital health is already playing an integral role in defining the needs and expectations of patients and families. Organizations that take the necessary steps to scale digital health services, integrate the latest platforms and collaborate among different organizational units will find themselves well-positioned at the forefront of the digital health movement and its revolutionary impact on the delivery of care.
Courtney Fisher-Lewis, Associate CIO, Saint Luke’s Health System & Ex-Sr. Director, IS Program Management, Children’s Mercy Hospital David Chou, SVP & CIO, Harris Health System & Ex-Chief Information & Digital Officer, Children’s Mercy Hospital