Lakeland (Fla.) Regional Medical Center - 'Technology is Our Differentiator'

Clinicians at Lakeland Regional Medical Center have a powerful tool to fight sepsis, but it's not some new antibiotic. It's data.

About two years ago, the medical center began utilizing a sepsis crawler that combs through data in the electronic health record system to identify at-risk patients. Sepsis strikes more than 1 million Americans yearly, and between 28 and 50 percent of them die.

“It identifies patients who are becoming septic even before our clinicians can,” says Elaine Thompson, president and CEO of the Lakeland Regional Health Systems.

Sepsis isn't the only area where predictive analytics is coming into play. The EHR also runs algorithms to spot patients at risk of deep vein thrombosis and catheter-related infections. And, a readmissions calculator helps to identify congestive heart failure patients who may be at risk of returning to the hospital within 30 days after discharge. That list is sent to care transition coaches who work with patients on their treatment plans.

“Instead of doing this for everyone with congestive heart failure, we can identify people most at risk and allocate the right resources at the right time,” Thompson says.

This philosophy plays out across the organization. An enterprise data warehouse pulls information from the inpatient and ambulatory systems, as well as other applications, to provide near real-time information — there's about a two-hour delay — to a team of data scientists who apply predictive analytics. They help to identify patients most in need of attention — those at risk of a readmission, those on a complex medication regimen or someone who doesn't have a strong support system. The organization then can target patients for interventions, says Vice President and Chief Information Officer Elizabeth Kerns.

Given that the medical center's leadership team boasts four engineers — to go along with three full-time doctors and a chief nursing officer — this kind of analytical approach to care delivery shouldn't come as a surprise. They see digital tools working in tandem with clinicians to improve not just care delivery, but also the health of the community, says Thompson. In fact, the organization's strategic plan calls for delivering nationally recognized health care, strengthening the health of the community and advancing health.

“Our mission, our vision, our culture all depend on technology,” says Kerns. “Technology is our differentiator. Nearly every business function and clinical process is built to leverage our technology foundation.”

University of California San Diego Health System - An Agent of Change

Edward Babakanian views his role more as chief technology evangelist than chief information officer.

“My job is to demystify information technology and to be a catalyst for change,” says the CIO of the University of California San Diego Health System.

For the past 20 years, Babakanian has worked to ensure that IT is not just a part of the health system's broad strategic plans but, in some cases, out in front; or at least anticipating change.

“IT needs to be ready to deploy when the hospital is ready to go. If the plumbing isn't ready, you can't deploy your plan,” he says.

Today, a large part of the change that Babakanian is championing focuses on patient engagement and connectivity. In 2012, UCSD was one of the first health systems in the country to start piloting technology with Qualcomm Life, a subsidiary of Qualcomm Technologies, to enable patients to send real-time health data to their care teams. Patients were given weight scales, blood glucose meters and blood pressure cuffs that could upload data wirelessly directly to the their health records.

“We are actively involved with many other companies, including Apple, that will be coming out with devices that can pick up your vital signs and transmit them to the medical record,” Babakanian says. “This will get us to the next step so that any clinical information that can be captured while people are just walking around is available.”

UCSD is also at the leading edge of using technology that's relevant in the here and now. Ambulatory clinics are stocked with point-of-care devices such as glucometers and urine analyzers that wirelessly transmit data back to the electronic health record. The real-time capture of data enables clinicians to make more informed decisions.

There's also a robust patient portal with close to 80,000 users. Beyond the typical transactional functions, the portal gives patients access to their health records, which is especially handy for those conducting virtual visits with their physicians.

Mostly done for low-risk patients, virtual visits are handled via videoconferencing where both the clinician and patient can view the requisite medical data. And while it's no substitute for an in-person visit, Babakanian says that they are seeing an uptick in usage.

“We are also enabling patients to use the secure portal to document their own care,” Babakanian says, noting that a patient could record that they get dizzy after a sugary intake, which could be a precursor to being diabetic, or at least something that a physician should know about. “This gives us the ability to do a better job of diagnosing and caring for that patient.”