Sunday, November 24, 2024

The Positive Disruption of Telehealth on Healthcare within VA and Beyond

Recently, FedHealthIT’s Executive Vice President, Susan Sharer, had the opportunity to speak with Kartsen Russell-Wood, Group Global Marketing Leader Patient Care Analytics at Philips about the positive disruption of telehealth and understanding the Healthcare/ commercial sector gap.

The Relationship between VA, DoD and Philips

The real key is that Philips sees VA and DoD as incredibly significant partners. We don’t see them as just a partner but instead as part of an evergreen partnership. Our relationship goes back several decades and, rather than a transactional relationship through which we deliver products, it is focused on ensuring outcomes are achieved and that insights from the agencies are incorporated into future revisions so there is this continuous partnership. Rather than being about pilots, it is about progress and ensuring that we are not only delivering solutions but also ensuring that as an Agency, VA has the capability to scale and the capacity to ensure those solutions are accessible to the largest populations of Veterans.

What Challenges Exist?

I don’t think the challenges are unique to Federal providers, it is about Healthcare across the board and the changes advanced technology is trying to bring. The VA and other Federal providers have taken great strides to standardize EMRs with the Cerner partnership but when we’re speaking of scale, how do we ensure the distribution and equal access? Often telehealth will point to specific solutions and small targeted populations that took significant resources, time and manpower to deliver. Scaling that, moving from 10 to 100 to 1,000 and more, ensuring access to populations of beneficiaries in rural areas, ensuring the elimination of hurdles that may artificially limit a patient’s ability to benefit is key.

How Does Philips Provide Solutions?

There are two ways telehealth comes into play – through the experience of the patients through an acute in hospital visit and those who are looking for provider care and support after. One of the most rewarding partnerships Philips has is the eICU program which solves some of the key challenges including harmonization, sets a standard blueprint for telehealth that can be scalable and addresses accessibility for those Veterans who don’t want to bypass local community organizations in favor of a more urban center. eICU has grown significantly and the outcomes have demonstrably shown positive outcomes and have generated peer review literature showing a reduction in patient transfers.

What does the Buy-in Require?

The biggest challenge is changing behaviors, which is tough for anyone. It isn’t just about changing for the near term but changing to be impactful for the long term. With the eICU, what is most significant is not the technology but the process, that clinical transformation. When we undertook this it started with meeting to communicate what worked and what areas needed fixing. There is a need then to set objectives, and as change is adopted and the capabilities become mature, to report on them. That continuous process management allows you to tweak things that don’t work.

There also needs to be an understanding of meaningful data – what do you grab, how do you measure it and how do you use it to help drive positive outcomes? There is a great capacity to collect data but the challenge is that data is being collected in ways that aren’t equal. There needs to be certainty that data has the same representative integrity across the board. Philips approaches this through a process of standardization and normalization and exact prescriptive entry process so the data is uniform and represents the same thing.

What is Different about Data in Healthcare and Why are we Not at the Same Point?

In the Healthcare environment, consider the amount of data generated by one patient in one stay in ICU and it is unfathomable. It is also coming from so many pieces of equipment and labs and the challenge has been understanding what would drive capabilities to aggregate all of that disparate information to be able to use it in a more meaningful way.

As technology adopted, Healthcare was also burdened by an increase in physician burnout where, instead of only one or two pieces of information, there was so much more to assess and understand. We had to understand that it isn’t about providing more information, but about simplifying the information into a more easily digested format so the physician can react in a more prescriptive fashion.

The prevalence of signal-acquisition devices across the patient care continuum means that we are facing an unprecedented amount of data in Healthcare. This data is created to solve specific needs, for a specific environment. The result is a “constellation of technologies that often fail to speak to each other, much less have their output deliver data in a standardized and normalized fashion to enable further research and analytics. Data is the means to an end then that serves to create the insights and actionable initiatives where technologies can be applied. To be able to create meaningful data in Healthcare, the data has to support Healthcare’s needs to be delivered at scale, in a harmonized fashion, that is accessible in a clear and usable format by providers at every point in the patient experience.

Telehealth and Disruption

Last year we celebrated several 15-year visionary customers who embraced telehealth back in a time when the iPod was just coming out. To have, over that period of time, moved from telehealth being radical innovation to more mainstream, has been disruptive.

Those early US adoptions have extended globally and we’re seeing the world connecting through this vision, to as far off as the Middle East, Japan and Australia.

At the web-side, the virtual care team is leveraging advanced analytics to present patients with adverse trends to intervene prior to adverse events occurring. Philips leverages advanced analytics that can capture subtle changes over time that are undetectable through the bedside monitor in real time. Philips has one of the world’s largest databases of normalized critical care information to mine to create predictive tools that drive patient prioritization and earlier interventions. One example where this data can be harnessed for predictive analytics is the Discharge Readiness Score within the eICU Program Software Platform. Through over 700,000 patient data points across over 200 hospitals, a cohort was identified that supported development of a unique algorithm that aids in the identification of patients who would be ready to transition to the floor with statistically lower readmission rates to the ICU.

At the unit level, care coordination and patient prioritization supports efficient care team delivery. Here, daily rounds that are complimented by broader population data on admission and discharge criteria, enable the unit to function as a logistics center, ensuring that bed capacity is optimized.

At the bedside, providers are guided via a “heads up display” that is choreographed by the remote teams to ensure optimal provider-patient touchpoints while also ensuring that the complex multi-variate data elements are synthesized into a physiologic approach to targeted interventions to improve outcomes.

About Karsten Russell-Wood

As Group Global Marketing Leader Patient Care Analytics at Philips, Karsten is focused on several targeted roles including ensuring technologies within Philips’ portfolio can work together to create synergy and optimize the customer and patient experience; working with customers to maximize the potential they can achieve through the adoption of telehealth; and education and sharing to help foster an understanding of the potential of telehealth and the ways different technologies, processes and people can work together.

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Heather Seftel-Kirk
Heather Seftel-Kirk
A writer for more than a decade, Heather helps hone the voice of FedHealthIT, helping to shape the information we share, working with collaborators and stakeholders to ensure they are delivering the message they intend and that it is the information our readers want to hear. A firm believer that every person has a story to tell and that every story is worth sharing, if told right, she also believes the written word carries power – to inform, to educate, and also to bring people together.

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