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NEW CENTURY HEALTH

w w w.healthcareglobal.com

CHRISTUS HEALTH

November 2017

HOW

DRONE TECHNOLOGY IS SAVING LIVES

10

TOP

HIGHE$T PAID PHARMA CEO$

PILOTING A PATH FOR DIGITAL INNOVATION

EXCLUSIVE

An interview with Bill LeBlanc, Executive Director and CIO at Royal Adelaide Hospital


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FOREWORD HELLO AND WELCOME to the November issue of Healthcare Global. This month, our lead feature features San Francisco-based robotics company Zipline, who have worked to launch the world’s first autonomous drone blood delivery system within Rwanda. Counteracting the challenges of transporting vital medical supplies across the region, the US based company will save millions of lives, and its success has seen it expand its operations to Tanzania with support of supply chain specialist Llamasoft to further support those in need.

Our second feature this month looks at how the US Food and Drug Administration (FDA) is championing the implementation of digital healthcare solutions. With ambitions to eradicate bottlenecks created through its historic framework and existing regulations, the FDA is working to further support the innovation of new technologies to support patients for the future. Additionally, don’t miss our top 10 which profiles the highest paid pharmaceutical CEOs this year.

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Enjoy the issue!

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CONTENTS

F E AT U R E S

34

INSIGHT

06

SA Health

Health by stealth: How drones are saving lives

TECHNOLOGY

16

60 New Century Health

Piloting a path for digital innovation

72

TOP 10

26

Top 10 highest paid pharma CEOs

92

Epic Management Beaver


AUSTRALIA 34 SA Health

USA 60 New Century Health 72 Microsoft Health 92 Epic Management Beaver 100 Banner Health 112 Christus Health 124 Education Corporation of America

CANADA 138 Diagnostic Services of Manitoba 154 GE Healthcare

100

174 Allscripts

Banner Health

124

Education Corporation of Amercia

112

154

GE Healthcare

174 138

Diagnostic Services of Manitoba

Allscripts


INSIGHT

Hbyealth stealth: How drones are saving lives

Written by JULIETTE WILLS


Drones have been regularly linked to deployment as weapons, but more and more positive deployments are being devised for the new masters of the skies. In Africa, drones are undertaking life-saving tasks previously unimaginable‌


INSIGHT LAST AUTUMN, SAN Franciscobased robotics company Zipline teamed up with the Rwandan Ministry of Health to launch the world’s first drone delivery system operating on a national scale. Dropping urgent blood supplies to transfusion clinics across the country, Zipline’s drones embarked on a mission that sees them saving thousands of lives in an area not renowned for either its medical infrastructure or its ease of access. In 2018, Zipline will build on the success of its Rwandan operation by expanding into Tanzania, but for this particular service, the tech firm will seek with help from supply chain specialists LLamasoft. The Michigan-based LLamasoft is a global leader in supply chain optimisation technology and it will draw on its experience of previous supply chain projects with the Tanzanian Ministry of Health, to enable Zipline to maximise the benefit of their integration into the public health supply chain of Tanzanian, just as they did in Rwanda. With 12mn people living in an area the size of Switzerland, Rwanda is the most densely populated country in 8

November 2017

mainland Africa. The route to many of its 478 health centers is via unpaved, perilously steep, winding roads that might appear on an episode of Top Gear. The infrastructure is so poor that some roads simply disintegrate while the mountains can be notoriously impassable. The same can be said of Tanzania, where only 3,704km, of a total of 88,200km, of highway is paved, making deliveries by vehicle in either country, not only immensely time-consuming, but treacherous, too – particularly during the biannual rainy season during which some roads are completely washed away.


HOW DRONES ARE SAVING LIVES

“There is a large humanitarian emergency use case for drones” – Sid Rupathani, Regional Director, LLamasoft

9


INSIGHT Before Zipline came along, hospital staff would have to make three 60km drives per week to collect blood from Kigali, Rwanda’s capital, with those trips taking around four hours to complete – and those supplies often arriving too late for seriously ill patients. With vast and difficult terrain to cover, you’d be forgiven for wondering how many drones don’t actually end up where they’re meant to go, or simply fail to return to base. Zipline has avoided those pitfalls by using fixed-wing drones that

Zipline - Mbeya Tanzania 10

November 2017

are more resilient than the more common multicopter models. With a 75km delivery service radius, these drones are able reach eight million Rwandans from a single launch site. The drones are autonomous, so they fly in a straight line to the GPS coordinates of the delivery site and when they arrive, they come closer to the ground. Then the package is dropped from a simple paper parachute. Urgent supplies can be delivered right onto the doorstep of a hospital within minutes, which really can mean the difference between life or death for thousands of patients. Once the drop has taken place the drone turns itself around and comes back to base before flying straight out again. With unpiloted drones not requiring lunch breaks, they’re able to fly 24/7 and can make 500 drops per day. Sid Rupani is LLamasoft’s Regional Director: “Zipline works with the aviation authorities in each country so that we can adhere to no-fly zones,” he explains. “The drones actually fly very low to the ground, so they’re generally not around other planes to begin with. Plus, if one engine fails, the


HOW DRONES ARE SAVING LIVES

Lifesaving Deliveries with Zipline

plane can still fly itself home. Actually, even if a computer fails, the control can be passed to another computer. It really is a fail-safe system.” Aside from delivering life-saving blood supplies, Zipline is also able to drop vaccines for rabies and malaria, along with HIV medication and bloodtesting kits. Vaccines are small and valuable, and need to be refrigerated both in transport and storage. In rural

areas in developing countries it’s difficult to ensure that vaccines are being stored correctly and if they aren’t kept between two and eight degrees Celsius, they will spoil and have to be destroyed. Therefore, drones that able to deliver small batches of vaccines as and when required, by health centres and hospitals, are both cost and waste-effective. “If a large batch of valuable vaccines 11


INSIGHT

By spring 2018, the Tanzanian government will begin using drones to make up to 2,000 life-saving deliveries per day to over 1,000 health facilties

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November 2017


HOW DRONES ARE SAVING LIVES

is held at the health facility and there’s a power outage, then there’s a high risk of spoilage for those vaccines,” explains Rupani. “But by introducing smaller, more frequent deliveries, the amount of vaccine being held at the health facility is small. It’s actually possible that you can get better performance for no additional cost.” Zipline safely stores all medical products at its distribution center, enabling immediate access to even the most sensitive or scarce items. The process begins when workers at remote clinics and hospitals text orders to Zipline for the medical products they need, exactly when they need it. Within minutes the drone is launched, and races to its drop point at 110 km/h. Once there, the package is gently delivered by a paper parachute. Hospital staff are notified of its arrival, so there’s no danger of it falling into the wrong hands. While many Rwandan citizens were understandably bemused by these low-flying aircraft when they were first introduced, they were soon lining the perimeter of the base, cheering every launch and landing of the ‘sky ambulances’.

By spring 2018, the Tanzanian government will begin using drones to make up to 2,000 life-saving deliveries per day to over one 1,000 health facilities, serving 10mn people across the country. That’s an incredible achievement, but drone technology doesn’t only have the advantage in remote areas: it will also take over from traditional road or air deliveries in areas where infrastructure is usually sound, but has been hit by natural disasters such as earthquakes or hurricanes. When roads are blocked and people are hard to reach, drones will make a real difference. “There is a large humanitarian emergency use case for drones,” says Rupani. “Organisations like Medicin Sans Frontiers (MSF) and the World Health Organisation are looking closely into the disaster relief cases.” Indeed, drones have the potential to saves lives anywhere in the world – some with our help. The TU Delft Ambulance Drone, for example, is still in development, but has been designed as a prototype that integrates a cardiac defibrillator and a two-way communication radio and video to the side of the drone. In case of cardiac arrest, emergency services 13


INSIGHT

Zipline - Muhanga

would dispatch the drone to the patient which would then instruct bystanders on how to perform CPR and operate the defibrillator; holding fort until the emergency services arrive. Google’s parent company, Alphabet, has also been working on drone technology in humanitarian aid, with

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Project Wing, which is to be used for disaster relief and delivery of food, clean water and other medical supplies. It’s already been approved by the Federal Aviation Administration (FAA) to undergo full scale testing at one of the FAA approved sites. Zipline’s long-term mission is


HOW DRONES ARE SAVING LIVES

Zipline Delivery Time Lapse – Blood Delivery to Muhororo District Hospital

to build instant delivery for the planet, allowing medicines and other products to be delivered on-demand and at low cost – without using a single drop of fuel. Could it be that one day, LLamasoft will work with NASA to sort out a ‘Space Snack’ supply chain which sends deliveries to astronauts

while they’re orbiting the Earth? “Why not?” laughs Rupani. “If space logistics planning becomes large enough to be a relevant problem of impact – and coupled with the progress of SpaceX and other space players – then we’d totally want to work on it. Who wouldn’t?”

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TECHNOLOGY

– piloting a path for digital innovation Writ ten by: DAN BRIGHTMORE


Following the recent announcement from the US Food and Drug Administration (FDA) on the launch of its pre-certification pilot programme for new digital health software, we look at the potential for increased innovation in the sector, the opportunity for businesses to reach end users faster and consider areas for concern with experts in the field‌


TECHNOLOGY EARLIER THIS YEAR the US Food and Drug Administration (FDA) heralded the forthcoming launch of its pre-certification pilot program for new digital health software which it hopes will help revolutionise the regulation of digital healthcare solutions in the US and allow innovations to safely reach the global market in a timely way, to the benefit of end users. “We need to modernise our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate, and helps foster beneficial technology while ensuring that consumers have access to high-quality, safe and effective digital health devices,” said FDA Commissioner Scott Gottlieb, M.D. Warming to this user-centric theme, in a July FDA blog post, Gottlieb wrote: “This new program embraces the principle that digital health technologies can have significant benefits to patients’ lives and to our healthcare system by facilitating prevention, treatment and diagnosis; and by helping consumers manage chronic conditions outside of traditional healthcare settings.” In September, the FDA named the nine participants in the pilot scheme 18

November 2017

Scott Gottlieb, M.D. FDA Commissioner

“We need to modernise our regulatory framework so that it matches the kind of innovation we’re being asked to evaluate” – Scott Gottlieb, M.D., FDA Commissioner


P I L O T I N G A PAT H F O R D I G I TA L I N N O V AT I O N

(after fielding interest from over 100 companies). The FDA arrived at the final nine after considering “company size, demonstrated record of quality and organisational excellence, clinical focus area and the risk profile of the product”. The selection process identified companies representing different perspectives and unique approaches to digital

health technology development. “The number of applicants speaks to the significant impact this approach could have on facilitating timely advancement of software that has the potential to benefit health,” says Bakul Patel, associate director for digital health in the FDA’s Centre for Devices and Radiological Health.

THE FIRMS THAT MADE THE CUT ARE:

19


TECHNOLOGY

“This is the FDA acknowledging the old guidance for how software technology is regulated wasn’t working, and couldn’t keep up with the pace of innovation” – Howard Look, founder of the non-profit open-data start-up Tidepool

Back in 2015, Apple CEO Tim Cook bemoaned the FDA process, saying that its cycles were too long and hindered innovation and development. Apple has been keen to make further headway in the healthcare space using its Healthkit developer framework so, in May,

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November 2017

when Cook was spotted wearing an Apple Watch glucose monitor it hinted at what we may see the company release via the pilot programme. Fitbit recently teamed up with Dexcom – a manufacturer of continuous glucose monitoring (CGM) systems for diabetes management. Johnson & Johnson has a longstanding presence in this arena with products like OneTouch, Lifescan and Animas. Roche (like J & J) offers a variety of diagnostic tools but its involvement is significant given the Accu-Chek developments and recent acquisition of the mySugr platform for diabetes data. The South Korean electronics giant Samsung has become active in healthcare too, notably partnering with Medtronic to develop next-gen smartwatch connectivity. Verily (formerly Google Life Sciences) is Google’s health spin-off currently working on a smart lens program for ocular devices to correct age-related farsightedness. Phosphorous is focused on the better understanding of the human genome to bridge the gap between DNA and good health. Howard Look, founder of the non-profit open-data start-up


P I L O T I N G A PAT H F O R D I G I TA L I N N O V AT I O N

Tidepool, comments: “This is the FDA acknowledging the old guidance for how software technology is regulated wasn’t working, and couldn’t keep up with the pace of innovation we’ve been seeing in Silicon Valley and the consumer world.” “We commend the FDA’s Digital Health Innovation Action Plan initiative and the speed with which they are moving towards building a regulatory pathway to bring these important products to patients,” says Corey McCann, President and CEO at Pear Therapeutics, which completes the list of nine participants. Pear Therapeutics

is a leader in prescription digital therapeutics which integrate clinicallyvalidated software applications with previously approved pharmaceuticals and treatments to provide better outcomes for patients and smarter engagement/tracking tools for clinicians. Pear’s lead product, reSET®, is an FDA-cleared, 12-week interval prescription therapeutic for Substance Use Disorder, designed to be used alongside standard outpatient treatment. Dr Marisa Miraldo is an Associate Professor in Health Economics at Imperial College Business School, and 21


TECHNOLOGY

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November 2017


P I L O T I N G A PAT H F O R D I G I TA L I N N O V AT I O N

“Software has shown itself to be capable of looking at a medical image and providing a diagnosis that matches or exceeds what experts could achieve” – Timon LeDain, Internet of Things (IoT) Director, Macadamian

expert in public policy with experience working with the Department of Health. “Lengthy regulatory procedures feed significantly into this delay, generating substantial hurdles for adoption and diffusion of innovation,” she explains. “These hurdles are more significant in the context of digital health innovation

(versus pharmaceutical) because, with rare exceptions, there are currently no established system level pathways and processes to adopt and embed at scale these innovations in practice. This discourages innovation in general, but evermore in areas such as digital health in which product life-cycle tends to be increasingly shorter when compared to therapeutic innovation,” she explains. Dr Miraldo believes, from the regulator perspective, the commitment to post-market data collection shared by the innovator can potentially allow real time monitoring of the safety and even value added by these innovations, which is key for streamlining regulatory processes while safeguarding the public interest. While the healthcare industry appears to be embracing the pathway to market opportunities the Pre-Cert programme could offer, there are institutions keen to offer words of advice and caution. In its open letter to the FDA, the Medical Imaging and Technology Alliance (MITA) – the leading organisation and collective voice of medical imaging equipment, radiopharmaceutical manufacturers, innovators and 23


TECHNOLOGY

product developers, representing companies whose sales make up more than 90% of the global market for advanced imaging technologies - commended the FDA for taking proactive steps for the regulatory review of software products. MITA hoped the FDA would “use the pilot to explore the use of external conformity assessment bodies (e.g. IECEE) for software development and change controls using relevant existing international standards”. Despite concerns voiced about the FDA program by some institutions such as MITA, Dr Miraldo is certain 24

November 2017

we’ll see a positive impact. “It will enable a dialogue between regulators and innovators enabling them to direct their strategies to key areas of value, minimising risk and maximising their chances of raising funding,” she argues, believing payers should also be included in this dialogue to formally incentivise innovation, not only on digital health but in pharma as a whole. Creators of SaMD (Software as a Medical Device) products like the Canada-based Macadamian – a user experience design and software development company focused on the development of healthcare solutions


“There’s already proof unregulated products like the Apple Watch and Owlet Care’s baby monitor have saved countless lives by providing consumers with information they previously never had access to” – Timon LeDain, Internet of Things (IoT) Director, Macadamian – is excited about the potential less regulatory oversight will bring for smaller and more nimble companies, like theirs, to compete in the same space as larger corporations. “With the advent of more complex solutions, like our My Diabetes Coach which leverages machine learning and artificial intelligence, the software and the medical device are merging,” says Macadamian’s Internet of Things (IoT) Director Timon LeDain. “The FDA has implemented the precertification pilot program to balance risk management with the agile development process. Software has shown itself to be capable of looking at a medical image and providing a diagnosis that matches or exceeds what experts could achieve.” Macadamian has also worked with the likes of Transcendent Technologies on projects such as the forthcoming Lifepod – an Amazon Alexa-powered virtual caregiver and digital health assistant – and specialise in creating

connected healthcare solutions. LeDain observes innovations can take years to reach the market, affecting manufacture, marketing and sale, with the increased cost ultimately transferred to the consumer. He thus applauds the opportunity to improve patient outcomes with the reduced regulatory burdens of the FDA program while driving down the costs of delivering healthcare. “The pros outweigh the cons and demonstrate the FDA is aware of its impact on healthcare innovation and is looking at ‘out of the box’ approaches to address this,” he says. “Some might argue the pendulum could swing too far towards the deregulated space with potential adverse health events as a result, but I don’t see this outweighing the benefits. There’s already proof unregulated products like the Apple Watch and Owlet Care’s baby monitor have saved countless lives by providing consumers with information they previously never had access to.” 25


TOP 10

TOP 10

HIGHEST PAID PHARMA CEOS The pharmaceutical industry is worth around $1.702trn worldwide, but which CEOs across the world took the most money home last year? Edited by OLIVIA MINNOCK


09 OLIVIER BRANDICOURT

10 WERNER BAUMANN Werner Baumann is CEO of Bayer, a company with 118,900 employees, which was founded in 1963 in Barmen, Germany. Baumann joined the company in 1988. He was CFO of Bayer AG as of 2010 and then carried the title of Chief Strategy and Portfolio Officer and Chairman of the Board of Management before becoming CEO in 2016. In 2016, Baumann took home $6.6mn. Bayer is a growing company, which made $25.27bn in 2016.

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Oliver Brandicourt is CEO of Sanofi. The company was founded in 2004 and Brandicourt joined in 2015. At this point he boasted nearly 30 years of experience in the pharmaceutical industry. He is a qualified physician who worked at Pfizer for 13 years and served as CEO of Bayer Healthcare AG before becoming CEO of Sanofi. In 2017, Brandicourt took home $11.6mn. Sanofi made a profit of $36.57bn in 2016 and currently employs 110,000 people.


07 JOHN MILLIGAN

08 SEVERIN SCHWAN

John Milligan is CEO of Gilead Sciences, a California-based company which was founded in 1987 and currently employs 9,000 people. The company made $30.39bn in 2016. Milligan joined Gilead in 1990. Previously, he had worked in many different positions in the biotechnology industry. In 2000, he became President of Corporate Development before being made CEO in 2016. Last year Milligan took home $13.9mn.

Severin Schwan is CEO of Roche, the company that was founded in 1896. Roche currently employs 78,604 people and in 2016, the company made $50.11bn. Schwan joined the company in 1993 as a trainee in the corporate finance office, and became CEO in 2006. Last year he took home $13.42mn.

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05 KENNETH FRAZIER Kenneth Frazier is the CEO of Merck & Co, a company founded in New York in 1891, which now employs 55,200 people. Merck & Co made $39.80bn in 2016. Frazier joined the company in 1992. Prior to this, he worked as a lawyer specialising in public affairs. In 2011, Frazier became CEO and his take-home pay in 2016 totalled $17mn.

06 JOSEPH JIMENEZ Joseph Jimenez is the current CEO of Novartis, a company which resulted from the merger of Cieba-Geigy and Sandoz Pharmaceutical in 1996. It now employs 118,700 people and made $48.52bn in 2016. Jimenez joined Novartis in 2007 as Division Head before being made CEO in 2010. His previous experience included having been head of HJ Heinz Company’s North American company from 2002-2006. In 2016, Jimenez took home $14.15mn.

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03 ALEX GORSKY

04 RICHARD GONZALEZ

Alex Gorsky is the CEO of Johnson & Johnson. The company was founded in 1886 and became a publicly traded company in 1944. It has 127,100 employees and last year made $71.89bn. Gorsky joined the company in 1988 as a sales representative for Janssen, a company within Johnson & Johnson. He gained experience in management, sales and marketing before becoming president of Janssen and then the Company Group Chairman of Johnson & Johnson throughout Africa, the Middle East and Europe. He became CEO in 2012. Last year Gorsky took home $21.2mn.

Richard Gonzalez is the CEO of AbbVie, which employs 29,000 people. AbbVie is a ‘spin-off’ of Abbot Laboratories which separated into two companies in 2013 allowing AbbVie to specialise in products such as diagnostic equipment and nutrition products, while Abbott focusses on research. Gonzalez has been CEO since then and last year the company made $25.56bn with Gonzalez taking home $18.18mn.

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TOP 10

02 JEFFREY M. LEIDEN Jeffrey M. Leiden is CEO of Vertex Pharmaceuticals. The company was founded in 1989 and currently employs 1800 people and last year turned a profit of $1.6bn. Leiden is a scientist and physician with a degree from the University of Chicago. For much of his career, he worked as a molecular biologist and cardiologist and he spent the last three decades working to improve the pharmaceutical and biotech industries. Leiden joined Vertex in 2000 and last year he took home $28.1mn.

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01 LEONARD S. SCHLEIFER Leonard S Schleifer is CEO of Regeneron Pharmaceuticals. The company currently employs 5,400 people and made a profit last year of $5.2bn. Schleifer founded Regeneron in 1988 and last year he took home $47,462,526. Prior to founding Regeneron he was educated at Cornell University and the University of Virginia and is a licensed neurologist by the American Board of Psychiatry and Neurology.

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The World’s Most ‘High Tech’ Hospital Written by John O’Hanlon Produced by Glen White


R O YA L A D E L A I D E H O S P I TA L

The new Royal Adelaide Hospital (new RAH) is showing the world how technology can vastly improve patient outcomes in a cost-effective manner: automation and data integration work hand-in-hand to get more people well

O

n 6 September 2017, the doors finally closed on the much-loved Royal Adelaide Hospital as an honour guard of about 100 staff members gathered outside its Emergency Department, spontaneously cheering and applauding as the last patient was wheeled out the doors and carefully loaded into an ambulance for the trip to the $2.3bn new RAH.

This marked the completion of a progressive ‘soft opening’ process. Minor surgical procedures and outpatient appointments had been taking place at the new RAH for some weeks to accustom staff to the different systems. As many as possible of the 600 in-patients had transferred to other hospitals. The remainder were moved across at the rate of approximately 100 a day on 4, 5 and 6 September. The official opening of the new facility can be best placed at 7am

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on Tuesday 5 September, at which point the old emergency department closed to new admissions and the emergency department of the new hospital simultaneously took over. It’s more than 30 years since a new hospital was commissioned in South Australia, so the opening was always going to be a landmark event for the state’s 1.6mn citizens. But the new RAH is much more than added tertiary healthcare capacity. It is the most advanced hospital in the whole of Australia, and the single largest infrastructure project in the history of the State of South Australia. The financing, design, construction and operation of the non-clinical services for the next 35 years was undertaken by SA Health Partnership Consortium (SAHP), made up of Hansen Yuncken, Leighton Contractors, Macquarie and Spotless. SAHP, incidentally, has recently rebranded as Celsus. This


AUSTRALIA

“We have had very few issues and we have managed them without affecting our service to the public: I am smiling from ear to ear!” Bill LeBlanc, Executive Director and CIO, SA Health “I started my career in IT at a hospital about 34 years ago and I worked there for four years, went into the private sector and then came back here in 2013 in my present role. When I started the IT was a back-office support function. It supported patient demographics, when they came in and left, what beds they were in etc but the medical notes were largely on paper, the biomedical devices were standalone electronic devices. These days you have convergence of technology, computer controlled biomedical devices and digitised electronic medical records. People at the sharp end of the business, delivering services to patients, now rely on technology to do their daily tasks. Ten years ago, if the technology went down there was little risk of patient harm. Now that risk is real and present. The mission critical nature of technology today has changed the role of the CIO in healthcare.”

w w w. h e a l t h c a re g l o b a l . c o m

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Passion Innovation for life Together we can save with more livespurpose Getinge is a global provider of innovative solutions for operating rooms, intensive care units, sterilization and endoscopic reprocessing departments, endovascular procedures and for life science companies and institutions. Based on our first-hand experience and close partnerships with clinical experts, healthcare professionals and medical-technology specialists, we are improving the everyday life for people – today and tomorrow.

www.getinge.com


Passion for life Getinge has been a strategic partner with SA Health throughout the ten-year journey that culminated in the opening of the new Royal Adelaide Hospital (nRAH) in September. The hospital itself represents a new benchmark in operational excellence and the integration of healthcare systems for the benefit of its patients: with the largest equipment and infrastructure package it has ever delivered, its opening certainly marks a milestone for Getinge. “We are incredibly proud to be a significant part of the team of medtech providers that has worked to supply world-class equipment and medical devices that support both patients and

staff in this new state-ofthe-art healthcare facility,” says Jaylea Strauch, ANZ President of the company. Among Getinge’s leading edge technologies at the hospital are its T-Doc sterile supply management system and the comprehensive infection control products that support the worldleading Central Sterile Supply Department (CSSD) at the hospital. The eight emergency rooms and 40 technical suites are fitted with its integrated technology control centres; TEGRIS for intuitive operating room integration in the technical suites and INSIGHT managing the patient flow throughout the hospital in both the technical suites and

Together we can save more lives

emergency department. This TEGRIS installation is Getinge’s largest in the world: “It provides central control for operating rooms and emergency suites,” explains Ms Strauch, “while our INSIGHT solution manages workflow from emergency admission to outcome – all the way through a patient’s treatment.” As a leading global medtech company, Getinge was able to bring together expertise from round the world, supported by a large team of local service engineers, to deliver unrivalled services at the new hospital. “For us, as for nRAH, enabling positive outcomes for the patient is always the priority,” concludes Jaylea Strauch.

www.getinge.com


R O YA L A D E L A I D E H O S P I TA L

state-of-the art hospital, delivered as a Public Private Partnership under the State Government’s Partnership SA Model and forming part of the South Australian reformed health system, will provide world-class care for the people of South Australia.

expect the new RAH to rank as the world’s leading high-tech hospital for long,” says Bill Le Blanc, CIO of SA Health. “Technology advances fast these days and each new hospital project learns from the last and leapfrogs to the front.” Le Blanc is responsible for all Rooms with a view aspects of ICT across the whole But more than this, of SA Health, leading it can lay a justified a division of 700 claim, at least for ICT specialists with the moment, to responsibility for deliver the most capital and operating technically advanced budgets over $240m healthcare in the annually. Thirty years world, including ago, when medical Number of Employees complex medical, technology was at SA Health surgical, diagnostic emerging, the IT team and support was still looked on as services and ‘super the backroom boys and speciality’ services including renal girls of healthcare, whose main job transplantation, major burns, and was to keep the lights on. The new complex spinal care. The new RAH, since the project was started hospital takes over all the services 10 years ago, has grown up in a of the current RAH and some of the different universe, one in which every more complex services from The stage of planning is strategically Queen Elizabeth Hospital. It will directed by a partnership of IT also provide high quality teaching and medical professionals. and research facilities. “We don’t “The technologies themselves

40,000

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are tried and tested,” says Le Blanc. “We have pulled them all together, borrowing ideas from other new hospital builds round the world in the last decade. What is leading-edge is the sheer amount of technology in a single facility. As for the move, it has gone remarkably smoothly. We have had very few issues and we have managed them without affecting our service to the public. I am smiling from ear to ear.” Nobody wants to be in hospital but if you have to be, the new RAH is the place to be. It has 800 beds, but you won’t find a traditional ward. Every single in-patient has his or her own room with en-suite facilities and, if they are mobile, easy access to outdoor garden areas. A variety of internal gardens, terraces and courtyards provide an interactive and uplifting environment, with internal and external performance spaces accessible to patients, staff, visitors and members of the public. Depressing corridors and waiting areas are also relegated to history - art integrated right across the 10-hectare site celebrates

Geoff Peach, co-Directors of the IT implementation programme at the new RAH Geoff Peach is a hospital IT guru based in Queensland. He has lived out of a suitcase, away from his family for three years to help deliver the new RAH work program. His ability to calmly lead technical teams through complexity while making it all look straightforward has been very impressive. There are a lot of new technologies in this hospital that Le Blanc’s established team were previously unfamiliar with. Peach’s know-how with these emerging technologies combined with a comprehensive big picture view of hospital business operations and deep understanding of supplier sub-contracts has been a critical success factor.


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More than 2,500 hospitals using our solutions globally, with now more than 100 clients, in South Australia, Victoria and Western Australia

www.allscripts.com

discrete patient data from diverse care settings, regardless of the IT supplier, into a single patient record that is semantically normalised. Allscripts solutions enable healthcare organisations to analyse and act—right at the point of care—to empower change, improve health and reduce costs. Allscripts solutions also earn industry recognitions. We’re consistently listed as a Black Book™ Rankings #1 Top Outpatient EMR Vendor in various categories and a Best in KLAS® honouree, to name just a few. At Allscripts, we’re helping build open, connected communities of health while strengthening organisations’ clinical and operation foundations.

Allscripts FollowMyHealth®, our patient portal, which has more than 3,000,000 active logins per month

Two Australian Offices—one in Melbourne and another in Adelaide, with teams also based in Sydney and Brisbane

Copyright ©2017 Allscripts Solutions, LLC and/or its affiliates. All rights reserved.


YOU SEE AN ICONIC STATE-OF-THE-ART HOSPITAL.

WE SEE OUR ESSENTIAL SERVICES REDEFINING HEALTHCARE SUPPORT.

New Royal Adelaide Hospital partnering with Spotless for asset management, facility maintenance, catering, cleaning, linen distribution, grounds and gardens, patient support and security services. ∙ Image courtesy of HYLC

www.spotless.com

enquiries@spotless.com SPOT0633


AUSTRALIA

South Australia’s unique landscape rates than you get in ward based and cultural history, creating a hospitals and reduced readmission welcoming, attractive place of rates.” Without increasing staff healing with the overarching creative numbers, he adds, more patients design theme of “a hospital within can be processed annually with a park – a park within a hospital”. the same number of beds. The Typical of a hospital stay is the trip simple innovation of having opening downstairs for an x-ray, scan, blood windows, looking out on greenery test or other specialist and controlled by the check. Patients at patients themselves, the new RAH won’t has been shown have much of that to to speed healing do, as the hospital is and wellbeing. equipped with mobile equipment that can Designed-in be wheeled into their Number of Employees technology room. Apart from The team dedicated at New RAH CT and MRI scans, to deploying mobile imaging allows technology to this the bulk of x-rays, hospital and its ultrasound procedures, and scope systems number around 200, but investigations to be conducted in the the people who put it to work day patient’s own room for in-patients. by day are the clinical staff. Getting This cuts down on anxiety as they everyone familiar with the systems wait for their turn to come round. ready for the move was the joint All this may sound expensive but: responsibility of the equipment “We believe it is efficient because it is manufacturers and the IT teams: designed to shorten length of stay,” and part of the planning had to says Le Blanc. “We expect better encompass agency staff too. It is clinical outcomes, lower reinfection no longer enough for agencies to

6,500

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send along qualified temporary nurses, who will always be needed to fill gaps in capacity and cover staff leave and sickness, unless they are ready to hit the ground running, so the hospital had to work with the firms it uses to pre-train the people they would send along to the new RAH. When everything is as smart as it can get it is hard to single out what to feature. After only a few weeks, though, some of the new systems are delivering quantifiable results. “I am very pleased with the investments we have made in the clinical data integration (CDI) technology. We are getting early feedback from doctors that this is already helping them make better-informed clinical decisions, resulting in better outcomes for the patients. I have been given examples where treatment decisions, that might not otherwise have been taken, have been made because of the technology they have access to. Better outcomes are already beginning to emerge”. Le Blanc also referred to the

John Edge, co-Directors of the IT implementation programme at the new RAH

Enterprise Patient Administration John Edge brings pedigree System (EPAS) whichahas beenin running very large-scale mission critical IT implemented at the new RAH, from paper the big medical end of town. With the replacing records dependence that modern health services at the old RAH and now being now have on reliable technology, implemented acrosssister South Australia. health’s unlikely industries from This will generate significant an IT standpoint are banking, defence reductions in medication errors and and advanced manufacturing. Edge’s extensive background in executing improve patient safety. This single technology projectselectronic in large banks and system for state-wide global motor vehicle manufacturing medical records now has close to ensured he brought a take-no-prisoners 2,000 users at any given time. approach to deliver a medical grade technology service that is responsive, highly resilient, and always on.


R O YA L A D E L A I D E H O S P I TA L

Automation that benefits patients

The 25 automated guided vehicles (AGVs) that deliver linen, food, surgical instruments and medicines across the hospital work round the clock and provide efficiency savings in terms of porterage and logistics. “The pharmaceutical robots give us efficiencies in staffing but, more importantly, reduction in errors, picking the right drug and dose, and getting that to the right patient,” Le

Blanc enthuses. “There are huge benefits in terms of volumes that can be picked in a day and accuracy. This allows the pharmacists to do what they are trained to do which is to consult with the clinicians on treatment and medical outcomes rather than process-based tasks.” Both of the new RAH’s pharmacies use medication dispensing robots. The system decreases turnaround time for dispensing and reduces

Carestream’s Clinical Collaboration Platform, highly acclaimed and operating in every state in Australia, is a feature-rich enterprise imaging platform for radiologists, specialists, referrers and patients, supporting true collaboration through the patient journey and improving outcomes. Carestream is a worldwide provider of medical imaging systems and IT solutions all backed by a global service and support network. The company is a leader in developing new technologies that address the needs of healthcare providers.

Level 3, 176 Wellington Pde, East Melbourne, VIC 3002 Free Call: 1300 651 786 www.carestream.com/collaboration


ROBOTS IN FOCUS

The largest hospital Automated Guided Vehicle (AGV) fleet in Australia and New Zealand The fleet delivers hot and cold food and beverages, laundry, pharmaceuticals, sterilised items and other supplies as well as several forms of waste between the patient wards and the kitchens, stores and the many other functional areas within the hospital. These flat, stainless steel robotic devices, measuring 1.7m in length, 60cm in width and just over 30cm in height, can carry large trolleys with goods at average walking pace and can talk to lifts, specific doors and portable phones. • • • • •

A fleet of 25 RA-GVs. Contour/Range-sensing navigation. Trolley pick/drop stations with automatic RFID signalling. Automatic Park’n’Charge area. Central fleet control station with automatic scheduling of RA-GV movements plus elevator & auto-door activation controls.

Benefits include: • Greater efficiency & traceability. • Increased safety. • Reduced costs. • Less damage to equipment. • More staff time can be reallocated to direct patient care.


THE 25 AUTOMATED GUIDED VEHICLES (AGVS) THAT DELIVER LINEN, FOOD, SURGICAL INSTRUMENTS AND MEDICINES ACROSS THE HOSPITAL WORK ROUND THE CLOCK AND PROVIDE EFFICIENCY SAVINGS IN TERMS OF PORTERAGE AND LOGISTICS

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the amount of inventory required by 20-30% and reduces wastage from expired stock. In addition, there are more than 100 automated dispensing cabinets in patient wings. Nurses input the patient ID and biometric authorisation using staff fingerprints. The cabinet ejects a drawer containing only the medication (and correct dosage) prescribed for the patient. This technology also contributes to the physical security of medicines, cutting the opportunities for drugs, especially narcotics and other controlled drugs, to go astray. Another smart application is the wireless system that tracks such assets as wheelchairs, infusion pumps, barouches. Over 3,200 wireless access points throughout the hospital can locate them in real time via embedded chips and IoT technology, much like triangulation from mobile phone towers. This locates the nearest available asset when it is needed by staff. Additionally, the system allows security officers to locate and attend staff quickly when

“We expect better clinical outcomes, lower reinfection rates than you get in ward based hospitals and reduced readmission rates!” – Bill Le Blanc, Executive Director and CIO, SA Health

they operate a wearable alarm. Within the operating theatres, the integration of clinical data onto monitors allows surgical teams real-time access to medical record information, data captured by cameras on medical scopes, biomedical metrics and x-ray, CT and MRI imaging. High definition video capture and transmission in all theatres and treatment rooms allows junior doctors and students to

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OPERATIONAL EXCELLENCE

Technical Suite

The hospital’s 40 operating theatres, or technical suites, give surgeons a data-rich environment thanks to the ‘clinical data integration’ approach. • Each suite measures 65 square metres • Most suites have large windows to allow in natural light • Critical trauma suites linked to the emergency department and the helipad by “hot lifts” for fast transport of patients • Ceiling mounted swing arms carry up to six computer monitors • Simultaneous data feeds from medical scopes, electronic medical records and biomedical metrics in real-time from the operation • Imaging, including x-rays, CT scans and MRI • Equipped with Clinical Digital Integration (CDI) technology high definition video cameras that capture all procedures on video • Ability to consult with specialists during the operation • Students observing the procedure see more but don’t crowd the theatre • Result: less risk of infection, better outcomes


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New Royal Adelaide Hospital Tour

be virtually present at an operation. The surgeon can consult with other specialists, and with only key participants present the risk of cross-infection is much reduced. Premiums from partnership

Design changes as technology advances. The building was originally designed to have three separate IT networks - one for biomedical traffic, one for conventional e-health and EMR patient administration data traffic and another for the PPP

partners’ IT systems that operate services like climate control, security and cleaning. However, over the construction period, Multiprotocol Label Switching (MPLS) technology, a data-carrying technique for highperformance telecommunications networks, progressed enough to justify simplifying this to a single physical network. “That was new for government, and relatively new for the industry,” says Le Blanc. “In the past,

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R O YA L A D E L A I D E H O S P I TA L

“The pharmaceutical robots give us efficiencies in staffing, but more importantly reduction in errors, picking the right drug and dose, and getting that to the right patient” – Bill Le Blanc, Executive Director and CIO, SA Health

biomedical data was something you’d always want to isolate physically rather than running it over the same wire as our administrative IT traffic and the builders’ IT traffic. It saved money because instead of having to route and switch networks

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for three different physical fibre networks, we are now on just one.” Since the building has the largest physical footprint in the southern hemisphere, the savings in wiring alone was considerable. Similarly, over the same period,


wireless networks developed, so more data traffic could safely be transmitted that way. “When it was first designed we would never have dreamed of running any biomedical equipment data over a wireless network,” Le Blanc says. “A lot of it still is wired but we are now running biomedical traffic over the wireless network as well.” The IT team has to go through a rigorous competitive process when awarding contracts. Value for money is important but in a medical environment it is not the primary parameter. Maybe 10 years ago, hospitals were not so dependent on technology as they are now to perform their core function. Now if some of that technology is not available the hospital will not be able to function. Robustness, stability and reliability are vital, according to Le Blanc. “We look for examples where the technology has been used in other medical situations and if that is not available, in other mission critical industries – banking, finance, defence even. We can’t do it all ourselves. These modern

Paul Lambert, Executive Director of the new RAH Paul is a seasoned health service executive leader and was tasked with overseeing the activation of the new hospital and transitioning services from the old hospital. This involved leading significant business change in almost every element of work practices as well as the complex logistics of the actual move without disrupting services to the public. Lambert ensured that the technology elements were core to, and integrated with, broader hospital work process redesign and training programs for staff. He has been an exemplary leader of change, with over 6,000 employees at the RAH being taken on this change journey.

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R O YA L A D E L A I D E H O S P I TA L

“We are getting early feedback from doctors that CDI technology is already helping them make better-informed clinical decisions, resulting in better outcomes for the patients” – Bill Le Blanc, Executive Director and CIO, SA Health

environments are so complex that you have to have a consortium of service partners who can assist you. We are physically a long way from the rest of the world here – if something goes wrong we can’t wait a couple of days for someone to fly out from Europe or the USA - we need local partners on the ground and that comes into the selection criteria as well.” So, an overseas technology supplier needs to be able to give strong local support. “One of the advantages for us in using that local offering is its tight integration with pharmacy reimbursements

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through our Medicare system which is more difficult for an international provider to keep up with,” Le Blanc observes. Examples include DXC Technology, which provides the iPharmacy pharmacy management system used by the new RAH in common with hospitals across Australia; Allscripts, the partner for electronic medical records and patient administration; Carestream for the medical imaging system and Cerner’s Millennium pathology system. “As far as possible we try to draw a straight line from any technology to show how that contributes to patient


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L-R Geoff Peach - Bill Le Blanc - John Edge

outcomes,” Le Blanc adds. IT in healthcare is all about finding new and better ways to do things. “We can’t take much of a breather now that the hospital is up and running because there is always room for improvement,” Le Blanc continues. “I am happy that the hospital’s first month has gone so smoothly of course, and that

has been down to every member of my team. We’ve had to ensure that the right people are available to deal with the inevitable speed bumps that come up. And because there is so much technology in this facility we have to make sure that once the patients move in the right technical people are on the spot. We have had a small army

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R O YA L A D E L A I D E H O S P I TA L

RAH Celebration Video

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of technical people in the building to address any glitches. For me, it has been more a matter of keeping the executive radar scanning and checking that there is no impact on clinical service delivery.” And he doesn’t take all the credit for IT, applauding the clinical and admin staff whose core skills do not lie in delivering a project of this nature. “Our staff were under pressure delivering high quality service at the old hospital while at the same time working out how the change to a new hospital would affect their work practices. That is a significant workforce change management challenge but they embraced it.” Technology is not about replacing people, he says, more about enabling them.


TRANSFORMING

SPECIALTY HEALTHCARE

with cutting-edge

technology


With technological prowess and industry expertise, New Century Health has established itself as a disruptive player in the specialty healthcare industry. By giving stakeholders innovative technology tools and big data, the company is equipping the healthcare industry for the digital age and, in doing so, it is ensuring high quality healthcare for cancer and cardiac patients Written by Laura Mullan Produced by Glen White


N E W C E N T U R Y H E A LT H

I

t’s an exciting time in the US healthcare industry. Technology solutions are driving innovation and more and more health plans and providers are departing from the traditional ‘fee-for-service’ healthcare model. By paying healthcare providers for keeping people healthy rather than for the cost of their treatment, the new ‘value-based’ models puts an emphasis on long-term outcomes and high-quality, cost-effective care. It seems that no company is at the forefront of this growing transition like New Century Health, a healthcare service provider based in Wellesley, Massachusetts. Under the direction of Shashi Tripathi, Senior Vice President of Technology and Operational Innovation, the company provides pioneering digital tools which help healthcare professionals in a rapidly evolving digital and clinical landscape. “We are a specialist business which focuses specifically on cardiology and oncology,” explains Tripathi, “and our aim is to really connect the three important players in healthcare - specialist providers, healthcare payers and, of course, the patient.

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Our goal is that by connecting these three stakeholders we can deliver the highest specialty care to the patients in a really cost-effective way.” Benefiting all stakeholders New Century Health offers innovative technology, clinical, and analytical solutions which enable high-quality, value-based healthcare. These include solutions such as a pointof-care clinical decision support platform that’s integrated into the physician’s practice; and offers evidence-based treatment pathways, physician referral management, and access to clinical quality data. Now celebrating its 15th year of success, the company’s business model is an innovative one which delivers for all stakeholders; it reduces the unnecessary variation in care that patients receive, lowers the cost of healthcare, and eases the administrative burden placed on doctors and hospitals. “Physicians and payers are really happy with the model we provide and that’s the main reason we have been so successful and continue to grow, says Tripathi.


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“Some of the intellectual property we have put into this system is just huge”

Shashi Tripathi Senior Vice President of Technology and Operational Innovation Shashi is responsible for advancing the company’s scalability and technology-enabled solutions capabilities. An accomplished healthcare technology leader, Shashi brings almost 20 years of innovative experience in clinical decision support platform development, business applications, product management and service delivery excellence. Immediately prior to joining NCH, Shashi was chief information officer at Springfield Clinic, a leading multi-specialty clinic. His background includes multiple technology executive positions including Vice President/CIO at Facey Medical Foundation and EVP at AGNITY Healthcare. Earlier in his career, he held IT application development, product management and systems management roles at St Jude Medical, IDEXX Laboratories, Medtronic, Inc., and i2 Technologies. He holds a MS in industrial engineering and operations research from the Indian Institute of Technology. He received a BS in mechanical engineering from MMM Engineering College in Gorakhpur, India.consequia sita que dolut ilibusam quatiss itatintis etus dis recesti w w w. h e a l t h c a re g l o b a l . c o m

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NCH has a growing provider network of over 8,000 specialty physicians. Given the growing patient population, particularly in oncology and cardiology, practices are under tremendous pressure to deliver high-quality healthcare in the face of increasing clinical complexity, growing administrative tasks and draining resources. Through their nationally deployed digital clinical decision support tools, New Century Health aims to alleviate the burden placed on the healthcare industry so that stakeholders can focus on what matters – providing high-quality healthcare care. “Healthcare payers like our services because we offer predictable cost trends whilst maintaining the highest quality care in the market,” Tripathi adds. “Healthcare providers like our services because we offer treatment pathways, clinical guidelines and quality benchmarking tools that

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New Century Health is licensed or permitted for utilization management in all 50 states.

are easy to use. As a result, the patient benefits because we are ensuring the delivery of evidencebased care and, in turn, improving the overall quality of care.” Expertise and innovation Whilst innovative data and technology are at the heart of New Century Health, the company is keen to champion the deep expertise and skills of its staff,


USA

up this innovation in technology and, emphasizing that it doesn’t just offer on top of that, ensure that the solutions technology, it offers a comprehensive are scalable, easy and intuitive to solution focused on improving patient our end users, and of course have a outcomes. “One of the key aspects high-level of security and privacy.” of New Century Health is that our With over 20 years of experience in health solution has two components,” the industry, Tripathi has established explains, Tripathi. “There’s the himself as an accomplished technology solution - which is the healthcare technology leader. Under software, the code and the tech his guidance, New - and then there’s Century Health expertise and the hopes to offer an human element. We innovative set of offer a collaborative tools that enable solution that is was founded in care delivery underpinned and stakeholders to supported by effectively deliver technology, but it high-quality really requires the healthcare in a digital expertise which landscape. With his we also offer to the deep level of expertise and industry healthcare payers or providers.” knowledge, he is confident that New There is no lack of innovation at Century Health is up to the challenge New Century Health and maintaining of creating innovative technologies its momentum is perhaps the most that meet the needs of healthcare pressing challenge the company providers, payers, and patients alike. faces today. “We are innovating and Continuing to grow as a national developing solutions very quickly,” notes Tripathi. “My team’s challenge is company, New Century Health provides services to more than how we can keep

New Century Health

2002

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“We’re focused on the total cost of care but our underlying belief is that improving quality drives better outcomes and appropriate costs” – Shashi Tripathi, Senior Vice President of Technology and Operational Innovation

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eight million members across the United States. However, perhaps the company’s greatest asset is that it provides solutions which meet the needs of the marketplace, fitting into the clinical workflow of cardiology and oncology practices all across the country. For instance, by using experience gained from the perspective of physicians, New Century Health has worked hard to minimize the number of mouseclicks needed to use its digital services and, in doing so, has created intuitive user-facing platforms. Big data Tripathi is keen to stress how data can make a difference in care delivery. By operating in 43 states, with about 8,000 providers and eight million members in its specialty care management program, New Century Health can effectively compare and benchmark healthcare providers and pinpoint areas where their treatments align with or deviate from evidencebased care guidelines. For example, solutions may pinpoint that, based on a patient’s specific medical

condition and genetic markers, some treatment options are more likely to have better outcomes than others. By using that data, the company can alert physicians of precisionmedicine treatment options which ensure that patients receive the highest level of care at a low cost. “Some of the intellectual property we have invested put into the system is just huge,” notes Tripathi. “We deliver systems to the physicians which enable them to document care, select the appropriate care, and get clinical metrics about how they’re delivering care in comparison to their peers, because often there are variations in care that haven’t been as visible before. Additionally, we are delivering a solution that fits into practices all over the board with their own medical health record systems. We are really striking the balance between a customizable solution that meets the needs of the practices and a scalable solution which meets the needs of the marketplace.” Striking the balance between forward-thinking technology and deep-rooted expertise, New Century

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N E W C E N T U R Y H E A LT H

“Want to remain focused on the specialty side because we feel that’s the area where we can help the most and make a difference to provide high-quality care in a cost-effective way” – Shashi Tripathi, Senior Vice President of Technology and Operational Innovation

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Health has become a leader in specialty healthcare solutions, putting the needs of patients, healthcare providers and payers at the core of its vision and ethos. “We’re focused on the total cost of care but our underlying belief is that improving quality drives better outcomes and appropriate

costs,” reflects Tripathi. “We want to continue to positively impact the true care of healthcare and we want to remain focused on the specialty side because we feel that’s the area where we can help the most and make a difference to provide high-quality care in a cost-effective way.”

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THE HEALTHCARE

Revolutionaries We go behind the scenes to see how Microsoft is transforming the medical industry Written by Catherine Rowell Produced by David Kulowitch


Health


M I C R O S O F T H E A LT H

M

icrosoft is best known for its key role in the computing revolution. Less well known is the role Microsoft plays today in the health industry, but a similar revolution is underway and once again the company is at the center. Responsible for helping customers and partners navigate that change is Dr. Simon Kos, chief medical officer. What is a doctor doing working for a technology company? “No, I don’t provide medical services to employees!” Kos quips. Whilst practicing critical care medicine in Australia, he saw firsthand just how fragmented information in healthcare was, and recognised the risk that posed to patient care. An interest in technology became a career as Kos explored first Electronic Medical Record (EMR) systems, then later a much broader

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portfolio as he ran the health division for Microsoft Australia. His current role might be different in scope and scale, but the industry challenges remain. “Digital transformation is underway all around us, and will dramatically change how we deliver and receive health services.” A time of change Health today is at an inflection point. On the one hand, standard operating procedures and a risk averse culture foster predictable, high quality care. On the other however, healthcare costs are unsustainable and new models of care are required, largely to address the increased burden of chronic disease in our modern society. This paradox – an industry resistant to change that fundamentally needs to reinvent itself – is playing out across the


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MEDICAL IMAGING

ENABLING MEDICAL ADVANCES IN THE

CLOUD Today’s technological breakthroughs are changing how we live. We see it every day and know what’s coming – driverless cars, reusable rockets, 3D printing. Advances are changing medicine as well. For example, recent breakthroughs in medical imaging can isolate tiny anomalies long before they become life threatening. Although imaging technology has advanced, a physician’s ability to access and collaborate on the images has not, and the situation is exacerbated as imaging files grow in size and complexity. The problem is that today’s enterprise image management technology is already a decade or two old – introduced long before the cloud – and is not designed for speed, mobility or the latest imaging files. This undermines our clinicians’ abilities to fully leverage the advances in imaging. Cloud technology can harness the breakthroughs in medical imaging

and it delivers what physicians need most: speed, access and collaboration. It can engage patients and get them more involved in their care. And it provides a secure and cost-effective way to relieve the strain on enterprise systems. As I see it, back-end cloud technologies can now keep up with the front-end excitement. And unlike enterprise technologies, where decisions to buy are capital intensive and all-or-nothing bets, a health system can choose to deploy the cloud for image management when and where they need it most. In essence, one can simply “tiptoe into the cloud” to enable advances in medical imaging.

- Chris Hafey

Chris Hafey is Chief Technology Officer at NucleusHealth – TM

a leading technology firm developing and deploying powerful, proprietary solutions to manage medical images in the cloud for fast and secure access using any web enabled device and modern browser. To learn more about NucleusHealth or our nucleus.io™ technology, visit us at www.nucleushealth.io or www.nucleus.io. You can reach Chris at info@nucleushealth.io.


USA

globe. “The Microsoft health vertical is substantial, with over 168,000 health customers and an estimated 30,000 partners, we have a broad base for telemetry.” Kos explains. Central to the Microsoft business model is the concept of partnership. “We essentially have two core functions. Engineer high quality, interoperable software platforms, and support partners who use those platforms to create solutions.” Kos rationalizes. He goes on to note that it is common for health organizations to have thousands of applications in their technology portfolio, and an ecosystem approach is required to manage information effectively. This aggregate view allows Microsoft to spot emerging technology trends, view cutting-edge innovation, and disseminate best-practice. He goes on to say “Healthcare IT has historically been focused on automation through systems of record, like the EMR. That’s an important step, but just the start of the journey. Unlocking value through systems of insight, collaboration and innovation is where transformation occurs.”

Digital transformation So, if the EMR isn’t the end-state, what does digital transformation look like in health? Microsoft uses a model based on the Quadruple aim1. 1) Engage patients 2) Empower care teams 3) Optimize clinical and operational effectiveness 4) Transform the continuum In fact, this model might just as readily be applied to other industries like retail or banking, because the drivers of digital transformation are affecting every industry. “Think about how booking travel, shopping online, catching a ride, or even just watching a movie, has changed in the last decade. As consumers, we expect more today. Now think about the patient experience. We’ve got a long way to go.” Kos observes. Most health organizations have a portfolio of initiatives underway that map to these four pillars, whether they’ve consciously thought about it in this framework or not.

Bodenheimer, T. & Sinsky, C. “From Triple to Quadruple Aim: Care of the patient requires care of the provider” Ann Fam Med Nov/Dec 2014, vol. 12 no. 6 673-576 1


We have you covered Lumen21, in partnership with Microsoft, is supporting healthcare’s digital transformation by enabling an environment that allows for better data sharing, collaboration, and communication among healthcare providers in a HIPAA-compliant cloud environment. Lumen21’s security expertise and in-depth knowledge of the requirements for regulatory compliance provide a breadth of support for healthcare companies working to meet the needs of patients and the rest of the healthcare marketplace.

Microsoft Healthcare Cloud Partner of the year

2016

Lumen21 The Microsoft 2016 Healthcare Cloud Partner of the year

lumen21.com | sales@lumen21.com


Lumen21 and Microsoft offer the only joint public cloud plus service provider offering that is HITRUST-vetted.

HITRUST-VETTED COMPLIANT CLOUD ENVIRONMENT FOR HEALTHCARE APPLICATION WORKLOADS Lumen21’s Compliant Cloud Computing Platform leverages Azure’s platform HITRUST certification, adds to it a client-facing HITRUST certified environment for client workloads. A complete HITRUST environment that Simplifies Compliance. Validated for HIPAA Compliance Load and go Managed for continued compliance

COMMUNICATE AND COLLABORATE SECURELY USING OFFICE365 Office 365+ RAP proactively assesses your environment to identify the security and compliance areas mandated by regulations that should be addressed. Results mapped against the HIPAA regulations for compliance GAP Analysis of your current Office356 configuration Gaps ranked as High, Medium and Low Remediation recommendations Results for input into the company’s annual risk assessment

BEING COMPLIANT DOES NOT ALWAYS MEAN YOUR ENVIRONMENT IS SECURE Risk-based approach to define and implement compliance solutions that support a robust security and governance program for your organization. Cloud Compliance and Security Cloud readiness assessment Defining security roles, responsibilities, processes, and service levels for a cloud environment Developing metrics for measurement and continuous monitoring Information Security Program Development Assessing current security practices Developing a strategic security plan Building risk management, incident management, vendor management, and privacy programs Policy development and standards mapping

We have you covered on the full spectrum of Compliance, Security, and Cloud; whether it is your own workloads or a PaaS or SaaS environment, if it involves compliance and IT, who else but Lumen21?


M I C R O S O F T H E A LT H

Patient engagement We’ve all experienced the healthcare system at some point. It can be frustrating, scary, and confusing. “It’s one of the only industries I know where information needs to be kept totally private yet shared with everyone.” Kos observes. What does patient engagement look like? At the simplest level, it’s technology that promotes the patient to an active, empowered position in the care relationship. That could be as simple as a patient view into the clinical care record, online meal ordering, or a kiosk check-in process. Many organizations have already replaced bedside entertainment systems with patient infotainment systems, allowing patients to access contextual, accurate and personalized health information, and even interact with the care team. Where could it lead? “I see precision

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medicine, medical wearables, and the connected patient home as aspirational goals. The technology is not the limiting factor.” says Kos. Patient engagement strategies are about more than simply adding a pleasant veneer to a healthcare encounter. “That wouldn’t be transformation.” explains Kos. He illustrates using an example from Children’s Mercy Hospital in Kansas City. They changed how they monitor certain cardiac conditions at home, replacing the traditional three-ring binder with an online record shared in real-time with the care team. The addition of video footage from the webcam has made a dramatic improvement, and they have decreased the mortality of hypoplastic left heart syndrome from 20% to almost zero. Their story is publicly available on Youtube and well worth a watch: This model is currently being rolled out to other hospitals nationally, and will redefine the prognosis for this condition. As a model of care however, it could just as readily be applied to any other condition


USA

that would benefit from remote monitoring – acute or chronic. Similarly, tools that empower the patient or carers with information about their condition, allow them to document and monitor progress, and interact with their care team, can improve the experience and outcomes of care.

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Empowering care teams “We have to move beyond the EMR. It’s a poor proxy for communication.” Kos begins. He continues to note that whilst many US health systems have spent hundreds of millions or even billions of dollars on their EMR systems, the spend has not boosted productivity or improved clinical workflow. A digital health record is important, but when coupled with a last-century pager system for communication, a disorganized intranet for policies and procedures, or a manual clinical education process, the potential value goes unrecognized. “The growth of shadow IT in health is phenomenal. I see clinicians using personal email addresses, swapping patient files over personal cloud storage, texting patient images and EMR screenshots

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on their personal phones, even using personal messaging services for patient handover or online groups for clinical research.”. Kos observes that clinicians aren’t trying to be rogue with medical information, but they are frustrated with the tools that they are expected to use in the workplace. There are better ways to help clinicians communicate, collaborate, team and learn. For each insecure, consumer cloud service, there is an enterprise grade, HIPAA compliant


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alternative. Kos points to the Office 365 suite as an example that does email, calendaring, messaging, telephony, webcasting, groups, intranet, business intelligence, social networking and more. “The irony is that many health organizations own this technology, yet haven’t rolled out these capabilities to their clinicians.”. Is better communication and collaboration the end-goal? Again, Kos describes it as building blocks for transformation. “Using

these digital capabilities to deliver care in new ways is the objective. Telemedicine for example, or centers of excellence on enterprise social networking.”. One of the most radical initiatives involves augmented reality. Case Western Reserve University is using the new technology to reinvent the whole way they teach medical students anatomy, going as far as to remove cadavers from their curriculum in favour of holograms. Their story can be seen here.

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TACKLING POPULATION HEALTH ONE PERSON AT A TIME

The transformation to value-based care is driving significant changes and healthcare providers are now recognizing a fundamental need for actionable, customer-intimate, patient-centered solutions. That’s where Health360 comes in. Built for the Microsoft Cloud, Health360 enables providers to personalize care experiences, ensure quality, lower costs, and increase satisfaction and customer loyalty. Consumer Engagement Care Coordination Consumer Experience Care Network Management Scan the QR Code with your mobile device to view a quick video and learn how you can achieve more personalized care with Tribridge Health360.

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Optimize outcomes and operations “Health is data rich and information poor.” Kos goes on to say that the data collected in clinical systems is generally for operational, communication, or medico-legal purposes. Most systems do not store information in a way that makes analytics easy, and an enterprise wide view across systems doesn’t emerge organically. “For an industry that prides itself on being evidence based, health does a poor job of using the most recent and relevant evidence – their own!” Kos exclaims. He sees analytics as a continuum spanning retrospective reporting, real-time dashboarding, predictive analytics, and even prescriptive decision-making using cognitive services and machine learning. Even relatively basic initiatives like patient journey-boards and KPI dashboards can have a huge impact on baselining performance, identifying bottlenecks and streamlining operations. Kos sees the effective use of data and analytics as the only practical way of achieving population health. Whether it is managing a chronic

disease to prevent unnecessary readmissions, or supporting patients as they manage through a care plan, timely and accurate information is key. Assistance in Recovery (AiRCare) is doing exactly this, leveraging Tribridge’s Health 360 solution. This allows them to identify patients for proactive care, and engage them with clinical and behavioural care protocols to create a unique personal care plan. They have risk-based scoring for factors like suicidality, pregnancy, and relapse, that take into account age and history. This approach has been published as the AiRCare Model of Behavioural Health Crisis Management, and is considered an international best practice. The results are indeed impressive, including a lift in the 12 month continuous abstinence rate from the national average of 35%, to 72% for AiRCare patients.

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Going forward, Kos sees a real role for cognitive services in health. “We have an asymmetry of information, and the scarce time of the clinician is the bottleneck in redressing the balance.”. Microsoft makes cognitive services available as APIs to developers to create bot agents. He calls this conversational computing, and sees it applied to everything from the logistics of figuring out what health services are covered by your plan, to

assisted medical triage for non-urgent care. “The things cognitive services can do today is quite remarkable. They can ‘hear’ by interpreting your spoken voice, they can ‘see’ by analysing pictures, and they can even predict how you are feeling. The more information we feed a machine model, the smarter it becomes.” For a fascinating view on how this has come together to revolutionize the life of one blind man, see the story here.

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M I C R O S O F T H E A LT H

Transform the continuum Some of the most exciting models of care leverage cloud computing. This is currently the primary focus for Microsoft. Once viewed with skepticism by the health industry due to perceived security or control limitations, the cloud is now undeniably being embraced by health organizations around the world. Indeed, Gartner predicts that within this decade organizations will be going to the cloud precisely because it is more secure than the on premises counterpart. Part of this momentum is driven by cost efficiencies and outsourcing, but there is another motivator that is becoming increasingly apparent – some capabilities are only possible in the cloud. “The cloud is essentially a global

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supercomputer, that you can access on demand and pay only for what you use. You get all the benefits, yet the cost is spread across all the users. Kind of like timeshare.� Kos reflects. The virtually unlimited storage pool makes medical imaging storage cost effective, or any other big data scenario for that matter. The incredible processing power makes genomic sequencing feasible. Machine learning and artificial intelligence are most practical in the cloud. Aggregations of software as a service providers, like an enterprise app store, allow organizations to discover, trial and deploy new applications with a minimum of risk and hassle. Kos sees the potential of the cloud to defragment all the data silos that frustrate holistic health information management. The cloud can also be a place for partnerships. Application developer Gojo teamed up with hand hygiene specialist Purell to create an innovative approach to combat hospital acquired infections. By combining information from activity monitors about staff traffic into a patient room, together


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with usage feedback from the hand sanitizer dispenser, it is now possible to track with accuracy handwashing compliance. See the story here. Making cloud computing trustworthy is a key priority. Part of that involves making sure it is secure, and Microsoft invests over a billion dollars annually to that end. Just as important though is making sure that the cloud can be used compliantly, so Microsoft has invested in industry certifications like HIPAA through a Business Associates Agreement, HITECH, and FedRAMP. Keeping information

private, being transparent about datacentre operations, and allowing users the controls to manage their own data round out the trust story.

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M I C R O S O F T H E A LT H

1. Empower your care teams Balance the ICT portfolio

3. Optimize your clinical & operational effectiveness Unlock & utilize the data asset

2. Engage your patients & partners Extend beyond org boundaries

4. Transform the care continuum

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Modern platform agility to embrace & sustain innovation


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The importance of partnership Operating within the nucleus of Microsoft is a global partner network with entry criteria set deliberately low, so any development organisation using Microsoft technology can join through an online signup process. This is intended to bootstrap entrepreneurs, providing immediate benefits like access to technical support, training, and programs like Bizspark that subsidize development licensing costs and provide a certain amount of free cloud hosting each month. The network is tiered, allowing partners to differentiate their product or capabilities through certification, and at the higher levels to tap into co-marketing and co-selling directly with Microsoft. “For health organizations, this means an ecosystem of partners on a common technology platform providing capability, choice and competition.” Kos summarizes. For more information about the Microsoft Partner Network see here.

Conclusion Kos sees change accelerating for the health industry. The sector is not immune from digital disruption that has changed so many other sectors and redefined our perspectives. Moving beyond digitization into transformation is the new challenge, and health organizations across the globe are rallying with innovation. “This is ultimately why I continue with healthcare IT over clinical medicine. For me, the choice is between changing the world one patient at a time, or having impact on a global scale. I see Microsoft playing a key role in the digital transformation of healthcare.” Kos concludes.

Health

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THE TECHNOLOGY

THAT’S GIVING DOCTORS MORE

TIME WITH THEIR PATIENTS Written by Leila Hawkins Produced by Denitra Price


E P I C M A N A G E M E N T, L . P.

As well as providing a wide range of administrative services to physician practice groups in southern California, EPIC Management’s new implementation of technology is giving doctors more time with their patients.

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wned by the longestablished Beaver Medical Group, EPIC Management LP is a management service organization that serves as the group’s administration arm. It provides a range of administrative and support services including contracting, finance, clinical

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and operations support and staffing, business development, information services, human resources, marketing, claims, billing, supply chain, and facilities management to 27 clinical sites across the Inland Empire region of southern California.

EPIC Management provides services for a wide range of small


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to large physician practice groups and IPA’s. In total, EPIC’s clients include over 300 physicians and 1,300 employees. Since it was founded in 1995, EPIC has attained a market leading track record of developing and managing high quality healthcare services for its clients. Its services make it possible for doctors to focus on their patients while benefiting from the company’s administrative and operating strength.

Time-saving tech

One initiative that’s proven extremely beneficial has been the implementation of automated scanners for supply replenishment, a system that enables the barcoded inventory storeroom to be easily categorized and managed. Using the Opticon Scanner system in conjunction with the McKesson Medical Surgical online supply manager platform, replenishing and ordering of supplies is now truly automated. At no cost under

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E P I C M A N A G E M E N T, L . P.

a Medical Distribution agreement, the Scanner and Barcode system interfaces directly with the Online requisition software platform. Before this was introduced, to re-stock medical supplies in storerooms, nurses and clinicians had to place orders using paper. Jason Gateas, the Executive Director of Supply Chain Management, oversaw the move from this system into online requisitioning. Two years ago he introduced the use of the Opticon scanner which barcodes every single

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item making the process of replacing clinical supplies much faster, saving the time it takes to replenish supplies in the clinical setting. It took about a year and a half to roll it out to all the clinical sites but it means that now all the medical and non-medical products are documented onto a computer. The only items this doesn’t apply to are pharmaceutical items as these are kept in controlled environments. Then, when it comes to ordering, clinicians simply enter the quantity they need based on the shelf levels. “All they [clinicians] do is press a

button and that online requisition goes to purchasing,” Gateas explains. “It takes 50 per cent less time to replenish supplies.” Although this system hasn’t impacted EPIC in terms of a hard cost savings, Gateas explains the savings are invaluable for the medical staff in the reduced time it takes in managing critical medical supplies. “As far as the contracting cost goes it doesn’t affect us,” he says. “What it does affect is the soft savings cost as far as the backoffice time and supplies, so it gives

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E P I C M A N A G E M E N T, L . P.

that time back to the clinicians to do important clinical work and better attend to their patients.” There is a difference between the big health groups and smaller practices and hospitals. Gateas explains: “Larger medical groups are more technology-savvy and more complex when you’re dealing with aggregate volumes, vs. the smaller clinics that don’t have the same time and resources for complex software systems” He says the latter can be a challenge however also a

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benefit if managed correctly and where Supply Chain Management acts as a professional consultant to the clinical teams. Change management utilizing a Lean management process combined with technology usually leads to a win-win scenario for the clinical and administrative teams.

more efficiently and accurately will lead to more informed purchasing contracts with manufacturers. The maintenance is the challenging part.” As far as EPIC’s market goes, it’s currently servicing over a dozen sites that provide care to more than 150,000 patients in the Inland Empire region of the Southern California marketplace.

Looking ahead

The main challenge, however, is to keep up the efficiency of this system. “It’s an on-going training process, he says. “You have staff turnover. Tracking and managing inventory

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Delivering

wellness to the West

Banner Health’s supply chain is recognised by Gartner as one of the best in the country, and not just in the healthcare Supply Chain: this has been achieved by a culture that involves every decision making process from capital spending decisions down to the procurement of consumables Written by John O’Hanlon Produced by Denitra Price

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B A N N E R H E A LT H

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ased at Phoenix, Arizona, Banner Health is one of the largest not for profit healthcare organizations in the United Sates. It was founded in 1999 out of a merger between Samaritan Health System and Lutheran Health System, since when it has grown the number of hospitals and medical centers under its umbrella to almost 30. Its Western Region facilities serve a number of rural areas -- many are the only inpatient facilities available within the community. It also embraces nearly 300 clinics, and employs more than 50,000 people in seven western states. In the Arizona Region, Banner Health is the state’s largest private employer, and is one of Northern Colorado’s largest employers. As such, Banner Health operates a highly complex and important supply chain process, and it is one that is known for being datadriven, disciplined in cost controls, and results oriented with its supply chain, leaders, physicians and clinicians all working together. The company’s efforts were

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acknowledged in this year’s Healthcare Supply Chain Top 25, which recognizes leadership in improving human life at sustainable costs. A regular in the report, Banner Health placed twelfth in the 2017 edition, lining up alongside such well-known names as Johnson & Johnson, Cleveland Clinic and Pfizer. “The company maintained strong Truven Health Analytics results and a strong bond rating,” said the report. “Banner Health is a $7bn regional system that has methodically built a cadre of solutions in the centralized distribution center over the past five years. Most impressive is how the company managed these capital projects on a limited budget with partners. Capabilities of their vertically integrated supply chain include traditional distribution as well as custom procedure trays, home delivery, pharmacy repack, compounding operations and global sourcing initiatives. “The company’s supply chain continues to be a model for alignment to corporate strategy. The supply chain’s alignment to


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“Women play a major role in Banner Health’s workforce, comprising 76% of its nearly 49,900 employees as of late May”

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reshape healthcare IT

Konica Minolta helps our customers re-engineer workflow processes to improve document and data management, enhance staff productivity, contribute toward patient satisfaction and reduce the cost of care through the following innovative solutions:

• Enterprise document and diagnostic image management • Print management • Cloud-based, telehealth technology • Managed IT and HIPAA Consulting Services For more information visit ReshapeHealthcareIT.com

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Banner Health’s 2020 vision has the organization moving from an acute care focus to clinical quality to now a focus on population health in its supply chain response. “The company’s acquisition of the University of Arizona Health Network is progressing. It is showing savings through a segmented supply chain response that takes a slightly different approach to supply chain for academic medical centers vs. its base community health efforts.” As part of Banner Health’s

continuous commitment to improvement, it recently signed a strategic deal with Amsterdambased devicemaker Royal Philips. The 15-year contract that will use technology to improve efforts in telehealth, population-health management and other areas. It’s the fifth partnership Philips has signed in North America in roughly a year and a half, and one of dozens the company has signed globally in the past decade. The agreement with follows up on collaboration between the two

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organizations on telehealth. Banner previously piloted Philip’s Intensive Ambulatory Care program, which uses telehealth to support treatment of patients who are having complex medical issues due to multiple chronic conditions. By identifying populations that could benefit from coaching and linking care teams from different disciplines, the program aims to help hospitals better treat these patients, who carry significant healthcare costs. The companies say the Intensive Ambulatory Care program reduced overall costs of care by 35%, lowered hospitalisation by 50%, cut average length of stay by 50% and reduced 30-day readmissions by 75%. In the company’s history, there have been many mergers and alliances, a notable example of which is last year’s joint-venture with Aetna to develop a health plan in Arizona. The jointlyowned health plan company, Banner Aetna, was established with designs on improving quality, affordability and the patient experience. The partnership combines Banner’s care management capabilities and high-quality facilities, providers

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and delivery system with Aetna’s leading health plan expertise, cutting-edge analytics and health information technology. Together, they will provide health coverage to employers and their employees in Maricopa and Pinal counties with plans for future statewide expansion. The partnership builds on the success of Aetna and Banner’s five-year Accountable Care Organisation relationship, previously announced in 2011, strengthening the companies’ shared commitment to reward value over volume of care for the delivery of better outcomes and lower health care costs. The new health plan will focus on the consumer experience by combining fully integrated care teams, health insurance and administrative services, with a goal of eliminating redundancies in care as well as administrative hassles. Savings achieved by streamlining care and services will be passed on to consumers and employers through lower premiums. “We are committed to finding new ways to deliver more efficient and effective care for our members in


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“We are committed to finding new ways to deliver more efficient and effective care for our members in Arizona and across the country” Arizona and across the country,” said Gary Loveman, Aetna’s executive vice president and president of Consumer Health and Services. “Together, Aetna and Banner are rethinking, reimagining and redefining the health care model to reward better outcomes and create

healthier days for our customers.” Banner Health is also an organization with its finger on the technology pulse; its North Colorado Medical Centre (NCMC) recently announced its use of a 3D printer to enhance treatment for cancer

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Diversity at Banner Health

patients undergoing radiation. NCMC’s Oncology Department began treating its first skin cancer patient using 3D-printed molds, called bolus, earlier this month. Since then, providers are now treating multiple cases with plans to expand its use to other cancer treatments and other Banner hospitals later this year. “The sky’s the limit when it comes

to 3D printing,” said Dr. Alexander Markovic, Medical Physics Program Director for NCMC’s Radiation Oncology. “With the 3D printed bolus, we are able to better target the radiation dose so that the treatment is more effective.” Markovic and his team pioneered the new 3D printing program at NCMC’s Cancer Institute, paving

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B A N N E R H E A LT H

“The sky’s the limit when it comes to 3D printing”

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the way for providers to roll out the programme at Banner MD Anderson Cancer Center in Gilbert, Ariz., as well as McKee Medical Center in Loveland, Colo., in the coming months. In addition, Banner has proudly announced that its Desert Medical Center’s executive leadership team is now comprised entirely of women, following the recent addition of Chief Operating Officer Cristal Mackay. The facility’s leadership team also includes Laura Robertson, CEO; Tanya Kne, chief medical officer; Cindy Helmich, chief nursing officer; Cheryl Tong, chief financial officer. Many members of this team also lead Cardon Children’s Medical Center, which is located on the Banner Desert campus, along with David Morimosato, MD, who is chief medical officer for that facility.

“Banner Health takes great effort to maintain a diverse workforce, bringing together a wide variety of professionals to provide excellent patient care,” said Jackie Hunter, executive recruiter who oversees Banner Health’s workforce diversity efforts. Women play a major role in Banner Health’s workforce, comprising 76% of its nearly 49,900 employees as of late May. Several members of Banner’s Senior Leadership Team are women, including Becky Kuhn, chief operating officer; Alexandra Morehouse, chief marketing officer; and Naomi Cramer, chief human resources officer. More than half of Banner’s 348 senior managers are female. Among 21 CEOs across the system’s acute care facilities, 57% are women.

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Redefining healthcare IT and technology


Through an aggressive digital transformation, CHRISTUS Health has redefined healthcare technology and IT Written by Dale Benton Produced by Andy Turner


C H R I S T U S H E A LT H

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ith a network of over 45,000 Associates, more than 15,000 physicians on medical staffs providing compassionate, high quality care, CHRISTUS Health is one of the largest Catholic health systems in the United States. The company has been committed to extending the healing ministry of Jesus Christ for more than 150 years. As the founding father and sister initially began their mission by forming CHRISTUS in Houston, Texas, there was always a wider vision of expansion, extending its footprint across the United States. Six years ago, a decision was made to relocate the company’s base of operations, its home of over 150 years, from Houston to Dallas. As with any major relocation, particularly after decades of operation, CHRISTUS faced a sizeable challenge. “Having such a rich legacy, we had a lot of very loyal and dedicated associates and leaders who had given their entire lives to CHRISTUSt,” says Bennetta Raby, System Director, Strategy, Performance

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Improvement, ITSM, TBMO, Learning and Development, Christus Health. “When the decision was made to uproot and move, from a technology perspective we lost a significant portion of our workforce over 60%. Everyone from leadership roles to external facing roles, we lost people from across the board.” Such a loss of resource meant CHRISTUS had to embrace a new strategic direction that gave it the best chance to first survive, and then thrive despite such a seismic level of change This is where Bennetta Raby, having successfully worked in transformation, project management and healthcare IT for more than 10 years, was brought in alongside Christa Barclay, Strategy, Performance Management & Innovation Program Manager, Office and ACIO, to bring vision, strategy and stability to the organisation. “When myself, Christa and our SPI team were brought into the organisation, it was a time of turmoil and uncertainty,” she says. “But we thrived on that, and it allowed us to be able to identify from a transformational standpoint, key


“Having such a rich legacy, we had a lot of very loyal and dedicated associates and leaders who had given their entire lives to CHRISTUS”

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– Bennetta Raby, System Director, Strategy, Performance Improvement, ITSM, TBMO, Learning and Development, Christus Health

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TRANSFORM THE WAY YOU WORK

Find out how ServiceNow replaces unstructured work patterns with intelligent, automated workflows of the future so that IT, HR, security, customer service, and everyone in the enterprise can work at lightspeed.

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areas where we lost intellectual capital, or we weren’t as mature.” CHRISTUS had a long-standing tenure with people who had been a part of the business for decades, who understood the systems and, as Raby explains, “did not rely on a transformational practice or discipline, but rather their own individual longstanding knowledge.” This of course, only serves to emphasise the significance of losing 60% of staff and the challenge that

“As with most IT organisations, the lack of clarity and static annual budget cuts can kill the revolutionary capabilities that technology innovation can provide” - Christa Barclay, Strategy, Performance Management & Innovation Program Manager, Office and ACIO

was facing Raby and Barclay. But what the two of them brought to the organisation, was a fresh and innovative approach. “Any time an organisation is faced with losing that level of capital, to me, is an opportunity to gain new talent, new philosophies, insight, methodologies and systems that could position us better for the future,” says Raby. First up for Raby, as noted, was identifying where the organisation’s growth opportunities were, where she could really implement strategic

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C H R I S T U S H E A LT H

“We operate as a technology division that is innovative, customer focused and one that can go out in front and communicate” - Christa Barclay, Strategy, Performance Management & Innovation Program Manager, Office and ACIO change management. Through visiting and communicating with every last one of the organisations internal customers and community leaders, Raby was faced with a challenging situation. “There were some very skilled people that were not positioned in the right places to align with their

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strengths and skillsets in order to drive growth in the organisation” she says. “So, I attracted a team of innovative thinkers to focus on the back-end work while I focused on change management and customer relationship.” This team, aka “The SPI Team”, consists of strategic individuals that actually function


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as strategic partners across all financials were over budget with a real disciplines (Strategic Automation, lack of clarity as to why. As with most Performance Improvement, IT organisations, the lack of clarity Workforce Transformation to and static annual budget cuts can Financial Management). kill the revolutionary capabilities that These two teams joined forces technology innovation can provide.” and aligned to develop a stronger She was tasked with installing a technology solution team. This is financial maintenance infrastructure where Barclay was and building data brought in to look bases to monitor the at implementing spend and accruals strategy and in order to “clean improve financial up the financials.” performance. Leveraging The year As was the case Barclay’s financial CHRISTUS with Raby, her strategy background Health was leadership team was with Raby’s SPI founded faced with a lack Team, attention of digital maturity, turned towards and was quick to a much more identify the key growth opportunities widespread digital transformation, through the implementation of strategically partnering with digital technology platforms and key vendors to become a bleedingenablers that stunt the opportunity edge department, one that was for these platforms to grow. no longer coming at this strategic “There was a big gap when I came change management from behind. in,” Barclay acknowledges. “The “We have made the flip from simply processes were not documented; the a transformation division to becoming financials were based purely on tribal more of a partner,” says Barclay. “We knowledge and the organisation’s operate as a technology division

1999

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C H R I S T U S H E A LT H

CHRISTUs and Microsoft

that is innovative, customer focused and one that can go out in front and communicate with customers and help them realise what growth opportunities can be made through technological implementation.” No digital transformation can be achieved alone and CHRISTUS has strategically partnered with Microsoft and Service Now, two partners that have truly enabled Raby and Barclay’s drive for innovation across upwards of 12,000 applications in CHRISTUS’ healthcare system.

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“When we look at a transformational partner, we look for the ones that see the mission of CHRISTUS and support it and want to work alongside it, we use John Kotter’s mantra everyday which is Changing Hearts and Minds,” says Raby. “Everything that we’ve been striving to achieve, Microsoft and Service Now have been with us and supported us every step of the way.” This is a feeling shared by Barclay, particularly coming at it from the transformational requirements


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10,001

Number of Employees at CHRISTUS Health that were needed in order to bring maturity and stability to the organisation’s capital expenditure and budget management. “They have redrawn the lines for what it means as a technology vendor to truly partner,” says Barclay. “It’s been amazing to come alongside in their field, to use their technology solutions and their resources to facilitate what myself, Bennetta and team have been trying to achieve. Our team: Omar Martinez, Velisha Mosby, Aaron Almaraz, Alan Carrington

and Kevin Frye take every available opportunity our vendors have to offer to continuous build solutions that close the execution gaps.” With any digital transformation, there is an immediate change and impact that one can point to. An efficient and faster way of working, working smarter, but what legacy will this transformation leave, not only for the future of CHRISTUS, but other healthcare organisations? Raby can already point to industry

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C H R I S T U S H E A LT H

YourCHRISTUS - is an easy, secure way to manage your health at

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recognition, with CHRISTUS becoming the first healthcare organisation to receive an award for strategy and innovation. At its core level, the award recognises Raby and the SPI Team and all of CHRISTUS for its technology business management. For Raby, it goes yet further. “We have been recognised for our resilience against a very difficult backdrop of organisational change, losing revenue, lack of resources. We were an organisation drinking from a fire hydrant for six straight years”

she says. “They saw us as pioneers in change management and IT. “It’s not me bragging, the road has been and continues to be very difficult and challenging, but with the help of strong partnership and our togetherness and understanding of what we want the road ahead to look like, it’s been a winning combination to steady the course.” That road ahead, whatever it may be, will be one of digital maturity, and a steely resolve to continue to deliver on a promise made all of 151 years ago.

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Student-centered

procurement Charles Leslie, Vice President of Procurement at Education Corporation of America discusses how it continues to innovate in order to drive significant cost savings

Written by Catherine Sturman Produced by Denitra Price


E D U C AT I O N C O R P O R AT I O N O F A M E R I C A

T

he procurement industry is undergoing a revolution. No longer viewed as something solely operating behind the scenes, the sector has gained increased prominence within business organizations. Ensuring businesses remain competitive, but also drive value across all operations, Vice President of Procurement Charles Leslie saw the growing potential of such a transformative industry and the opportunity to make a long-term impact within Education Corporation of America’s (ECA’s) procurement operations. Upon ECA’s acquisition of Kaplan Higher Education Schools’ 38 campus locations across the US two years ago, Leslie had the ambition to transform the organization’s procurement services to become best-in-class and deliver long-term advantages to both the business and its students, with the support of ECA’s Chief Executive Officer Stuart Reed. “At that point in time, I said that if we’re going to make this work and set up a sustainable model so that we are able to acquire new companies, then we needed to have a best-inclass procurement organization,” Leslie explains. With a background in accounting, he notes that working with vendors and finding ways to gain additional savings remains an exciting challenge which continues to bring abundant rewards.

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ECA acquired Kaplan Higher Education Schools’ 37 campus locations across the US two years ago

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Data analytics Completing a deep dive, Leslie successfully ascertained the nuances of ECAs department budgets and potential bottlenecks in its operations, alongside ongoing business drivers. “This has enabled us to therefore provide a less expensive, higher-quality service,” he adds. The analysis has also enabled Leslie to grow from a ‘one-man procurement band’ to a strong procurement team. His launch of e-procurement solution, Coupa, also now works to support the future of ECA’s procurement transformation. Through Coupa, past volumes of suppliers and categories have been reduced and streamlined, as it is now responsible for ECA’s data analytics and subsequent monitoring of ongoing spend from all campuses under its umbrella. The tool – Charles Leslie, Vice President is also vital in centralizing data surrounding the of Procurement purchasing of supplies, placed into one main portal. “We can report off all this data and therefore start using our volume to negotiate better prices with suppliers, and we can use it to our advantage,” Leslie says. “If we’re able to drive savings down to the bottom line in each function, this frees up additional funds to spend on better innovations and tools which allow for a better student experience at a campus level. “Vendors are also engaged, especially where they have realized the value and savings which we could bring.”

“We can report off all this data and therefore start using our volume to negotiate better prices with suppliers and we can use it to our advantage”

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“Where we were purchasing office supplies from four or five suppliers; now we’re able to use one supplier and push that down to campus level” – Charles Leslie, Vice President of Procurement

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“Simply put, procurement has an effect on our bottom line,” supports Reed. “This allows us to provide more dollars to invest in the student experience - through lower tuition, through better technology, and through refreshed curriculum. Supplier relations With ambitions to strengthen its relationships with suppliers, ECA has utilized market intelligence and undertook a spend diagnostic and cost cube analysis. This has enabled its procurement team to identify not


USA

only long-term market spend, but administration and faculties related spend, as well as product order spend throughout its operations. “We used these assessments, developed a strategic sourcing framework, then issued the RFP and determined who our best partners were,” explains Leslie. “This has weeded out a lot of vendors, and allowed us to consolidate where possible. Where we were purchasing office supplies from four or five suppliers; now we’re able to use one supplier and push

that down to the campus level.” “Cost efficiency gives us the assurance that we can continue to invest in the latest technologies,” adds Reed. “The use of bestin-class procurement practices gives us the confidence that we will be able to invest in a sustained manner, rather than stop and go. In a sustained manner, we invest in the best that technology has to offer.” Streamlining inventory Noting that every campus had previously utilized different suppliers,

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“If we’re able to drive savings down to the bottom line in each function, this frees up additional funds to spend on tools which allow for a better student experience” – Charles Leslie, Vice President of Procurement

the use of Coupa has enabled ECA to not only centralize its supply purchases and look at the remaining spend and use of resources, and led the team to analyze the top 200 items purchased at campus level. “I think we found that our campuses were ordering 10 different types of staplers, for example,” chuckles Leslie. “We decided to find the one stapler that’s going to give us what we need, and negotiate better pricing for that one particular item.” Going forward, ECA’s e-procurement solution will only enable contracted items to be purchased to steer all campuses in the same direction.

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Coupa has enabled data surrounding the purchasing of supplies to be centralized into one main portal However, despite such focus on sourcing potential savings, Leslie notes that the team “tends to look beyond these price savings to adopt a more holistic approach into managing costs and come up with savings to the bottom line which will be reinvested in the student experience”. “With these dollars, we can then take education to the next level. That

is our aspiration,” supports Reed. With an aim to reduce administrative work for its faculty and staff, content strategy and logistics company Ed Map, Inc. has also been brought on board to oversee all of ECA’s textbook orders based on its current projections as part of this student-centric drive. However, the procurement team remains responsible for the

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delivery of each campus’ student uniforms, which is also done without traditional orders being placed. “We run all of the projections and modelling out of our student record-keeping system, and we’re able to place a centralized order to our uniform supplier who deliver all uniforms to campus level,” Leslie says. “We’re still delivering all of the supplies and the content, but we’re not having to get much involvement from the campus level as far as placing orders, we’re able to do that centrally.” This is also being developed further through the implementation of kits, which will be built for each student, rather than the procurement of single items. These bulk orders will then guarantee long-term savings for ECA and provide longterm advantages for its students.

Moving forward With a focus on providing exceptional procurement, Leslie constantly looks at ways to innovate and provide long-term benefits across ECAs operations. He concludes that this also extends towards its workforce. “It is vital for each team member to know the business inside and out, and each function inside and out. “They are then able to move up the procurement cycle. I want to ensure that the procurement team is able to speak the language of the other business functions and are able to be transformative across the entire organization. We rotate functional assignments to deliver the most experience possible within the team. This will further develop the team into future procurement leaders.

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DIAGNOSTIC SERVICES MANITOBA

Providing Results That Matter Written by Fran Roberts Produced by Quiyonni Borja


DIAGNOSTIC SERVICES OF MANITOBA

2017 marks the 15th anniversary of Diagnostic Services Manitoba (DSM). Its mission is simple – to serve communities across the province, aiming to provide all Manitobans, no matter where they live, with high quality laboratory tests and rural Manitobans with diagnostic imaging procedures

D

iagnostic Services Manitoba (DSM) touches the entire scope of the healthcare system from prenatal testing to autopsy and forensics; from pediatrics to geriatrics; from medical and surgical programs to public health and mental health and all other health services in between. While accounting for 3.5% of the provincial healthcare budget, their services influence over 80% of clinical decisions with laboratory and imaging results. As DSM celebrates its 15th year milestone, the company is keen to acknowledge the keys to its success.

“Our success over the last number of years has been a direct result of prioritising, collaboration and relationship building. We’ve developed important relationships with so many of our clinical colleagues and have really studied how best to deliver value to their work,” says Jim

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D S M O P E R AT E S 82 SITES ACROSS MANITOBA


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1,600

Number of employees at Diagnostic Services of Manitoba

Slater, Chief Executive Officer. And Slater is not alone acknowledging the role relationships have played in the success of DSM over the years. “Another unique dimension to Diagnostic Services Manitoba is our philosophy that relationships are collaborative partnerships,” states Petr Kresta, Chief Operating Officer. “We have 82 sites across Manitoba delivering diagnostic services and our staff work hand-in-hand with nurses, physicians or other allied health workers to deliver quality healthcare services to the communities they serve. Over the years we’ve seen a trend towards centralisation within laboratories, and while this may be true, it does not mean that we work in isolation from our clinical and regional partners. Without a strong collaborative partnership, we wouldn’t be able to provide efficient and effective

diagnostic service models of care that deliver value for our patients.” Not just a laboratory

DSM is Manitoba’s public sector diagnostic healthcare service provider. “We’re not just a laboratory, we’re a full-scale diagnostics service centre. We manage laboratory testing, rural diagnostic imaging and diagnostic cardiology, which is what makes our model so unique within Canada,” comments Slater. “Our tagline is, ‘We deliver results that matter’. Instead of passively providing lab results or conducting an x-ray or EKG, we work closely with clinicians to ensure that they’re ordering appropriate tests for their patients to help improve outcomes.” The appropriate use of diagnostic tests has become a significant topic of conversation among the international medical community. A 2015 study published in the

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DIAGNOSTIC SERVICES OF MANITOBA

Another unique dimension to Diagnostic Services Manitoba is our philosophy that relationships are collaborative partnerships – Petr Kresta, Chief Operating Officer

Academic Emergency Medicine Journal found that over 85% of respondents believed too many diagnostic tests are ordered in their own emergency departments, and 97% said at least some of the advanced imaging studies they personally ordered were medically unnecessary. “If you think about it, unnecessary diagnostic tests can cause harm and delays to patients. It can also cause unnecessary costs that burden the healthcare system. What we’ve found in the last few years is that by working closely with our clinical colleagues we are able to

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collaborate on what clinical tests best improve their patient’s outcome and help minimise unnecessary testing,” Slater observes. For example, every x-ray and even more so every CT, exposes patients to the increased risks associated with radiation. DSM has made it a priority to work with its partners to ensure that only necessary imaging tests are ordered and performed. “When we meet with the emergency department we can actually talk about these issues and discuss as a team what makes the most sense for the patient,” explains Dr. Amin Kabani, Chief Medical Officer. “Patient care has always been our top priority. While we are working with our clinical partners to address the use of unnecessary tests and to extract the efficiency and resource savings that go along with that, patient safety and care is never compromised. We have checks and balances in place within DSM to make sure the patient always receives the most appropriate testing and best possible care. As an organisation we pride ourselves


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DSM IS ACCREDITED BY THE MANITOBA QUALITY ASSURANCE PROGRAM

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The appropriate use of diagnostic tests has become a significant topic of conversation among the international medical community. A 2015 study published in the Academic Emergency Medicine Journal found that over 85 per cent of respondents believed too many diagnostic tests are ordered in their own emergency departments, and 97% said at least some of the advanced imaging studies they personally ordered were medically unnecessary.

on our track record of being accredited by the Manitoba Quality Assurance Program (MANQAP) and College of American Pathologists (CAP), which is one of the highest ranked accreditation agencies for medical laboratories in the world.” Significant investment

By creating such efficiencies, DSM has been able to increase investments in other areas. “By eliminating unnecessary testing we’ve been able to redirect resources and significantly invest in genetic testing, which is one of the biggest challenges we are facing today,” Slater observes. “The future of diagnostics is becoming very genetics-based.

There are drugs, for example, which will not work if you do not have the right gene, gene combination, gene expression or gene inhibitor. A major challenge for everyone across the world, frankly, is how do we keep up with the science of genetics with high quality, reproducible genetic testing? Many cancers now are not only diagnosed or staged simply on traditional pathology morphology, but are now using genetics to differentiate them.” A broad mandate

Of course, as a province-wide provider of diagnostics services, DSM has not solely invested in genomics. “We’ve made a significant investment, between

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CA$25mn and CA$30mn, in our decision making. We can now look provincial laboratory information at costing data, utilisation data, system,” advises Slater. “A stocking data in an integrated way significant portion of that is a that allows us to make rational critical Provincial Laboratory decisions, particularly when we’re Information System (PLIS) – talking to our stakeholders,” chemistry, hematology, adds Kabani. “All our microbiology – that provincial sites are linked we call the core up to our information. It laboratory and doesn’t matter which we’ve rolled out site you’re talking Diagnostic Services the PLIS across to, you’re working of Manitoba the province.” from the same Annual Revenue Having one system. This allows repository of us to actually be costlaboratory data across effective and economic, but Manitoba has greatly more importantly in our minds, benefitted DSM. “Fifteen years it helps us make good decisions.” ago, we used to have limited data In addition to the laboratory that was very fragmented and we information system, DSM is also couldn’t use it as effectively for rolling out a provincial Anatomic

US$200mn

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DIAGNOSTIC SERVICES OF MANITOBA

Our tagline is, ‘We deliver results that matter’. Instead of passively providing lab results or doing an x-ray or doing an EKG, we work with clinicians to ensure that they’re ordering appropriate tests for their patients to help improve outcomes – Jim Slater, CEO

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Pathology Laboratory Information System (AP-LIS), due to be fully implemented by the end of the fiscal year. “A big part of that investment was publicly funded by our provincial government. We also have partnered with the Canadian Partnership Against Cancer (CPAC) who has provided funding to DSM to make significant investments in AP-LIS that will enable synoptic reporting, along with another federal funding partner, Canada Health Infoway,” notes Slater. “Manitoba has made a major investment in digital imaging contributing to the creation of a province-wide digital imaging system. Most recently, the province of Manitoba made a CA$25mn investment in digital mammography that was delivered under the leadership of DSM and funded almost entirely by our provincial government. DSM receives 9599% of our funding through the public sector. As we are a Canadian Corporation this allows us to enter into partnerships with industry, business and funding

agencies. It makes us unique in the country, unique in the world, I would think, because we have such a broad mandate.” Geographic challenges

Indeed, DSM’s mandate is broad both in the sense of the services that it provides but also geographically. “We have a land mass that is 1.5 times the size of the state of California and so we’re a very large geographic area,” Kresta advises. The population is also not evenly distributed. The 2016 Census of Canada found that approximately 1.3mn people live in the province and around 778,000 of those live in the metro Winnipeg area, located 68 miles from the US border. This uneven distribution can be a struggle for DSM at times. “It’s very challenging at some of our sites. If you look at the map, we have pretty remote and isolated sites – sites which you can only fly into,” Slater observes. “If you look at our farthest northern site on the map, which is Churchill, it is only accessible by air travel and by ship

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DIAGNOSTIC SERVICES OF MANITOBA

D S M O P E R AT E S W I T H 95-99% PUBLIC FUNDING

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for part of the year. So, it’s a very big challenge.” Despite this, DSM works hard to service such communities. “We’re actually able to provide remote support to our rural staff through technology, and this is an area where I think others in the country are looking to learn from our various models of diagnostic service delivery,” advises Slater. Future value

Looking ahead, DSM is in a period of transition, as they become part of a new provincial health organisation called Shared Health Services Manitoba on 1 April 2018. “All of the value and all of the benefits, the positive things that we’ve been talking about for DSM are going to get even broader. Shared Health Services Manitoba’s mandate is set to transform Manitoba’s health care system and will go well beyond just diagnostic services. It will look at how to deliver more connected and coordinated health care services across the province,” Slater concludes.

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Making healthcare digital Written by Nell Walker Produced by David Kulowitch


G E H E A LT H C A R E

As a business composed of digital natives, GE Healthcare is well placed to make great technological strides. We speak to Charles Koontz, Jon Zimmerman, and James Richards about how GE Healthcare has transformed both itself and its industry

“We

are digital natives. We are purely about people, process, information, and IT. We speak, eat, and breathe digital.” Jon Zimmerman, Vice President and General Manager at GE, is animated and eloquent as he describes his responsibilities over GE Healthcare’s valuebased solutions portfolio. GE Healthcare exists to leverage its best-in-class technology and digital expertise to deliver outcomes for its customers, with a core focus on value-based care: enhanced care quality, increased practice efficiency, lower per capita costs and provider

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satisfaction. Zimmerman is hugely excited by GE Healthcare’s ability to ensure that “the right people are in the right roles, with the right skills, in the right quantities, at the right time.” But it takes a detailed and sophisticated strategic vision to achieve the standards GE Healthcare has set itself – a vision that has led the organization to consolidate resources into a tight, streamlined, horizontal platform, as described by Charles Koontz, CEO of GE Healthcare Digital and CDO of GE Healthcare. “We’ve created horizontal capabilities, which we’re driving at several levels,” he explains with a passion borne of experience. “There’s the Internet of Things, which we take advantage of using our Predix analytics platform – it connects devices, collects the data,


CANADA

Central to GE Healthcare’s digital strategy is the use of cloud technology – to collect, analyze and process data and to serve as a common founda

WE SPEAK, EAT, AND BREATHE DIGITAL – Jon Zimmerman, Vice President and General Manager at GE

Jon Zimmerman Vice President and General Manager, ValueBased Care Solutions

Zimmerman is the VP and GM of Value-Based Care Solutions at GE Healthcare. He was previously at Availity, where he served as the General Manager of Clinical Solutions, leading the strategic development, planning and delivery of clinical information exchange via the Availity Health Information Network.


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G E H E A LT H C A R E

Charles Koontz President and CEO of GE Healthcare Digital and CDO of GE Healthcare

Koontz is Chief Digital Officer (CDO), GE Healthcare, and President and CEO, GE Healthcare Digital. In his roles, Koontz leads the horizontal implementation of analytics, cloud technology and deep learning solutions across all of GE Healthcare, and the strategy and operations of the Healthcare Digital business, which includes software solutions for enterprise imaging, workforce management and financial management.

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and ingests it into the cloud. We do a lot of what we call Advanced Preventive Maintenance, which is driven across the company and applied to healthcare. Plus, we are driving two dimensions of horizontal: the internal IT system that we call Digital Thread, and a consortium of third-party developers.” The Digital Thread is, quite literally, what connects all operational processes within GE Healthcare. The thread automates processes and enables insights and actions that improve performance. This lies within the remit of James Richards, the company’s CIO, who summarizes its purpose. “The simplest phrase I consistently use to explain ‘digital’ is that we need to get more output with less input,” he says. “Most companies that have been successful in digital have not entirely built their own technologies; they have leveraged existing capabilities and put them together in a way that drives customer benefit for far less input than would have been required in the past. I also need to make it eminently easier for our employees


CANADA

GE Healthcare is building digital twins of hospitals, mining data to improve performance at the individual asset and entire network level

to perform their jobs, with better tools and better applications, and in some cases this means completely eliminating non-value-added tasks that no longer need to exist.” Artificial Intelligence as a service For GE Healthcare, technological advancements are a staple of its operations. However, there is particular excitement around AI something the business has been hard at work developing and is now deploying to tremendous effect. “We’re partnering with hospitals around the country. They have

millions of patient records, and in those records are millions of images collected from GE machines,” Koontz explains. “Let’s say, for example, you have a lung condition – we provide algorithms that can identify an issue that might need immediate intervention, allowing the radiologist to more rapidly provide a diagnosis and begin delivering treatment. We use these clinical partnerships to help create the algorithms, and then the radiologist will give us a thousand images of nodules in the lung, creating what’s called curated data. The potential accuracy

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G E H E A LT H C A R E

James Richards CIO, GE Healthcare

Richards is the Chief Information Officer (CIO) for GE Healthcare, based in Chicago, IL. He was appointed to his current role in March 2016. Prior to joining Healthcare, Richards was the CIO, Finance. This role was created in Jan 2014, and was responsible for Enterprise & Finance Systems strategy, operations and deployments across the company. He partnered closely with the Finance, IT, and Global Operations teams in driving these priorities.

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of these algorithms is over 99 percent.” GE Healthcare now has clinical partnerships that address a number of disease states and focus areas, including lung, brain, cardiovascular, pelvic and women’s health. The company is leveraging its existing advanced imaging capabilities alongside the clinical expertise of its partners to develop algorithms that will aid physicians in the speed and accuracy of their diagnoses. “This is going to be critically important for emerging countries, many of which have


CANADA

Through a partnership with University of California San Francisco (UCSF), GE Healthcare is developing a library of deep learning algorithms, one

a shortage of radiologists. This is real, and the solution is being developed today,” Koontz adds. For Zimmerman, ‘artificial intelligence’ is no longer an appropriate term for what the technology has become. “I personally do not believe in artificial intelligence,” he says with a touch of humor, before swiftly expanding on his position. “It’s because A) there’s nothing really artificial about it anymore,

it’s real intelligence, and B) it really doesn’t have any value unless it’s applied to something. Our team and our customers think of it more as applied intelligence. If you apply machine learning to the various data types, insights and intelligence will be born. That intelligence then has to be planted into the workflow of, or the experience of, a consumer, a clinical professional, or a revenue cycle person. So, as

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Qvera & GE Healthcare Customers Shoulder-To-Shoulder for More Than 15 Years Qvera is proud to be the trusted go-to interoperability partner for GE Healthcare customers through the most revolutionary time in healthcare IT.

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we invest in understanding data and what it’s telling us, we try hard to do things that make a difference and create better outcomes.” A common source of truth Through its Digital Thread, GE Healthcare has aggressively rationalized its application landscape to achieve these levels of technological advancement. Like any large enterprise, it had evolved from an operation that ran its own data centers and databases and deployed point solutions, leading to thousands upon thousands of applications speaking to each other, making IT incredibly complex. “The mission of Digital Thread is to turn that spaghetti of applications into a consistent global set of pillar applications, which form the foundation of the business,” Richards explains. “When you have a consistent data set across the organization, you have a common source of truth. Then, you can start building applications and analytical tools which sit on the foundation, allowing you to do

incredibly powerful things.” Fully harnessing the data driven by this cleaner, more uniform process is, in Zimmerman’s words, “a wonderfully large, hard problem to tackle.” With 37 years of experience in this industry, he is still thrilled by the advancements he has seen and is continuing to help develop, because he is able to see the ever-improving outcomes from the inside. “One of the biggest challenges is the fact that data is largely defined by individual health systems, meaning there’s a huge quantity of it and it is often highly fragmented. This isn’t just in healthcare, of course – this is across the world at large, and really, it’s only in the early stages of being tackled. You have to be able to understand data in all its forms, so that it can be correlated and applied.”

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The art of growth regarding how important technology Part of what helped GE Healthcare is and how increasingly pervasive it grow into its current status as an is, is the intelligent harnessing and industry giant is acquisitions, meaning application of it to make a difference,” a lot of systems have been cleaned up he continues. “To embrace quality, to create consistency. That, combined efficiency, and the ability to be rewarded with the streamlining for the work that you do.” of GE’s own data An example of good systems, meant IT that GE Healthcare a concerted drive has firmly embraced is towards consolidation. cloud computing. Since “The whole idea part of the company’s here is that some digital consolidation was IT energies are the funneling of huge good, some are volumes of information bad,” Koontz says. into taut, legible “We’ve consolidated streams, an effective – James Richards, hundreds of vendors data storage system CIO, GE Healthcare down to four primary was key, and cloud ones, and we’re standardizing our technology met that need. processes into something horizontal.” “Three years ago, if you went to The good and bad IT energies a CIO in a hospital and said, Koontz mentions can be found “What about cloud?”, across the entirety of the digital they would have been landscape, reaching far beyond hesitant,” Koontz GE’s own in-house technology. In says. “Now, Zimmerman’s words, “technology with the in and of itself is a very powerful and dangerous intoxicant.” “I think the challenge we have

“When you have a consistent data set across the organization, you have a common source of truth”

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volume of data, they are more than willing to talk about cloud. Whatever the type of data – be it operational, financial, lab, or clinical – hospitals are wanting GE and others to help them process that data in an applicable form.” But it’s not just the elevated level of service it enables GE Healthcare to provide, Richards says. It’s fundamental to GE Healthcare’s success in the future. “If you think about what legacy organizations look like – doing everything ourselves, setting up in our data centers, deploying our own applications across multiple functions and various regions – that complexity does not enable sustainable growth,” he says. “That’s one of the major reasons why we’re pushing for a common foundation for the entire enterprise. By moving to cloud – and 40 percent

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of our applications are already there – we’ve made huge progress. The real value here is when you build a core foundation where you can rely on data integrity, that enables you to build things that may be very specific given new markets, new customers, and new regions. We can build lightweight capabilities accessible across the globe through a smartphone. That’s how you do sustainable growth.” Change from within None of GE Healthcare’s incredible work toward peak operational efficiency and top-level digital technology would have been possible without the initial step of changing minds from the top down. “There are major change management processes and methods that need to be put in place and should never be underestimated,” Koontz says. Looking at who the company can count on and how the organization moves forward is where change management comes into play, and the vision must be laid out for all. “You say ‘here’s the objective, here’s what we’re trying to achieve,


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here’s why it’s important to the business, and here’s the role I need you to play in that vision’. That communication must be frequent and cascading,” he continues. Of course, all of this would mean nothing without GE Healthcare’s customers, and their patients in turn. Part of Zimmerman’s job, and one of his favorite elements of it in his own words, is engaging deeply with customers: “Those hospitals, clinics, and physicians give me the great privilege of understanding their operations, their challenges, and their needs,” he says. “I am blessed to bridge those two worlds. I get to

bring the best technologies to life, in a way that customers can adopt and use them to achieve better outcomes. That’s my role in life and I’m thrilled beyond words to be able to do this.” Richards adds: “We have to push a willingness to think through what the art of the possible is. There’s an insatiable demand for better patient outcomes, which is what we’re really after here. This goes beyond advancements like making it easier to make restaurant reservations – we’re talking about real lives at stake. “So I think that’s the exciting part – that the demand will always outstrip the supply.”

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HELPING CANADA LEAD THE CHANGE TO SMARTER HEALTHCARE Written by Stuart Hodge Produced by Quiyonni Borja


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Jennifer MacGregor, Allscripts Managing Director for Canada, talks to us about the company’s Canadian heritage, what lies at the root of Allscripts’ success and what innovations the future holds

A

t the heart of Allscripts Healthcare Solutions’ core mission lies a commitment to revolutionizing the way that digital healthcare is delivered, not just in Canada but beyond our borders as well. That may sound like a very grandiose dream; but, since it was founded in 1986, the company has been building an infrastructure to empower health professionals to provide ‘proactive’ rather than ‘reactive’ care through an open, connected community of health. Allscripts’ Sunrise™, an enterprise-wide digital healthcare platform, is widely used throughout Canada, the United States and around the globe as a premier provider of electronic health records, population health management and operational solutions. The company’s network connects 2,500 hospitals and 45,000 medical practices. Allscripts Managing Director for Canada, Jennifer MacGregor, spoke to Business Review Canada about how Allscripts uses that network to help healthcare providers deliver superior care to every single citizen. And the key distinction therein, is that MacGregor w w w. a l l s c r i p t s . c o m

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talks of ‘citizens’ rather than ‘patients’. She explains: “We are focused on establishing an open and integrated solution across the care continuum and being able to provide the level of insight required to our providers, our clinicians, our citizens – we call them citizens for a reason, because we do not want our people to be ill – and our program administrators, whether it be jurisdiction, governmental or hospital administrators. “We want to provide them with the right information so that they can make the best decisions about the way that they are deploying care from a program perspective. We also want to provide them with the knowledge base to know how they’re generating value out of their investments and how they’re ensuring that they’re providing the best level of service to their patient and population catchment areas across the continuum. “It means we need to have active and dynamic care plans that will enable transition through care, postacute and out into the community – and also establishing a network in the community so that we can provide

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the types of services and access to ensure people get proactive care, not getting ill to the point where they’re needing high-cost services. “That way it’s well people, and not sick patients – that is very important. I would say one of the greatest assets we have is the passion that every Allscripts associate believes in the mission of ensuring that our providers and our clients are looking after well people and not sick patients. That is what permits us to do what we do every day.” It’s all very well and good saying that – but how exactly does that work on a day-to-day basis? MacGregor says: “Okay, let’s look at it in terms of someone who is being looked after in a jurisdiction with access to all of our solutions. Say, perhaps, that the individual may have been identified as potentially having a chronic disease and may not be following appropriate guidelines to take good care of themselves. “What often happens in this situation, is that patients degrade in that situation to such an extent that


WE WANT TO PROVIDE OUR CLIENTS WITH

THE RIGHT INFORMATION” – Jennifer MacGregor, Managing Director - Canada

they have to come into the emergency room needing immediate help. But with our solution, not only are we able to identify that patient on the premise of potential lab results or diagnoses in our system, but we can see early on that there is an individual in our citizen portal who is engaging with our care providers. “All of these providers have one view of this patient’s health record and their condition and through our interaction with that patient, we can also evaluate that they may not be

Jennifer MacGregor Managing Director - Canada

Before joining Allscripts 12 years ago, Jennifer studied for a genetics degree and some of her early roles saw her working in medical clinics, implementing billing and scheduling systems, whilst at university. During her first six years with Allscripts, she was very focused on implementation, working across several sites in California, Texas and other parts of the U.S. Her areas of expertise were benefits realization, clinician and physician adoption and computer provider order entry and workflow redesign. She then joined the international business unit just over 4 years ago, dealing with Allscripts’ global business. That role was focused on the company’s professional services and ensuring that solutions were delivered and clients’ expectations and performance targets were being achieved. Then finally, at the beginning of 2014, she was asked to become the company’s MD for Canada, expanding her purview so that she now has responsibility for not just implementation but also sales and operations across the country.


A L L S C R I P T S H E A LT H C A R E S O L U T I O N S

exercising or achieving the goals that we have agreed upon in the care plan, which is also viewable on the citizen portal, and that they may even be missing follow-up appointments. “With our solutions, we can proactively contact somebody in the care team to reach out to that patient and intervene, preventing a potential decline and them having to come into the emergency room or the hospital. “It changes the paradigm, from waiting to deal with the concerns and issues of the patient in a reactive way, to proactively identifying individuals

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who need earlier intervention to ensure a better health outcome.” In order to do that, there has to be a strong infrastructure in place and the backbone of Allscripts offering is the Sunrise platform. MacGregor describes this as the company’s “flagship solution” and also revealed that it was invented here in Canada. She adds: “Sunrise was actually developed in British Columbia and the first market it was used in was Canada. It came out of a


TECHNOLOGY

history of previous development programs that go all the way back into the 1970s in British Columbia. “It’s through that evolution and innovation coming out of British Columbia that we’ve been able to grow and provide a solution base which services hundreds of clients across 15 countries.”

“WE’RE VERY PROUD OF THAT CANADIAN HERITAGE”

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One of the hospitals which uses the Sunrise platform is St Joseph’s Health Centre in Toronto, a teaching facility in the west of the city which treats more than 20,000 patients a year. The hospital’s Deputy CIO Purvi Desai told us that Allscripts is one of their biggest IT vendors, and that the relationship remains strong due to the company’s flexibility and responsiveness. She comments: “As we take on major initiatives in any clinical area,

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Allscripts is a key resource to help us understand the capabilities in the application and to provide us with options in terms of how we leverage functionality in the system. “For my team, they help us with how to configure and manage the application for the end users. Then, once functionality is operational, they are our tier-two level of support. My team would do preliminary troubleshooting and if it was something that wasn’t with the realm of our understanding we


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would escalate over to Allscripts so that they could assist us with our troubleshooting. “Sometimes they need a bit more information in terms of how it’s impacting our end users but we articulate the priority of the need, so if it’s something front-facing, impacting clinicians and patients, they certainly understand the important of providing a resolution as quickly as possible. “As we’re exploring opportunities or new projects within our clinical programs we reach out to Allscripts to find out what solutions will be available to us and to help us strategize if we have a business problem in front of us – how do we best tackle it for our end users? There’s a constant dialogue in

terms of planning, implementation and execution and then ongoing support and maintenance. Those are the key areas where we work together.” But it’s not just Sunrise that is at the root of Allscripts’ success. The company has four key areas of focus which allow them to offer such a comprehensive infrastructure for health providers and patients to benefit from. The third “pillar”, as MacGregor likes to refer to them, is Allscripts’ CareInMotion™ population health platform where data is aggregated from across various systems, harmonized and then served up to a clinicians within their workflow. She says that’s “a significant

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A L L S C R I P T S H E A LT H C A R E S O L U T I O N S SERVICES Full HCIS Implementation Clinical & Business Transformation

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CANADA

IT CHANGES THE PARADIGM,

from waiting to deal with the concerns and issues of the patient in a reactive way, to proactively identifying individuals who need earlier intervention to ensure a better health outcome. – Jennifer MacGregor, Managing Director - Canada

differentiator” for clinicians, because they’re not going to have to go anywhere else to find the information, it comes to them. CareInMotion is where the ‘citizen portal’ that MacGregor mentioned earlier is used, and the backbone of it is a platform called dbMotion™, which is in use across the province of Manitoba and Fraser Health Authority (the second largest health region in Canada). But the fourth area of focus is the one that sounds particularly exciting, the company’s precision medicine platform. MacGregor’s background is in genetics, so you

can understand why she speaks with genuine excitement about the company’s work in this field. She says: “Allscripts’ wholly owned subsidiary 2bPrecise is about being able to incorporate genomic information into clinical practice, so building the last mile from medical research to clinical practice at the point of care. We’re just at the forefront and it’s not just going to be Allscripts, as you can imagine. “As we’re looking down the path of using sequencing information to guide treatment decisions and ensuring an understanding what it

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“We reach out to Allscripts to find out what solutions will be available to us and to help us strategize if we have a business problem in front of us.” – Purvi Desai


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Senior Vice President and General Manager of Allscripts Acute, Rich Berner, visiting St. Joe’s Hospital

means to practicing clinicians. For example, from a pharmacogenetics perspective if a different drug will be more effective for a patient because of a biovariant we can identify that and provide guidance to the provider. We are at the precipice of being able to incorporate that information into clinical decisions whilst our clinicians are seeing patients, very exciting.� The 2bPrecise platform became

generally available earlier this year and the company have partnered with the National Institute of Health. It will be exciting to see the further strides that the company makes with the platform in the years to come, and it also serves to explain why MacGregor is just as excited about her work now, if not a great deal more so, than when she first joined Allscripts some 12 years ago.

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The source of value

Procurement executives across the globe continue to see the potential they can unlock throughout the supply chain. They understand that business today is about engaging, collaborating, adapting instantly to evolving needs, and finding new sources of value. Getting that value, however, can prove a challenge.

Healthcare Global - November 2017  
Healthcare Global - November 2017