‘Healthy data’ and the crucible of COVID-19

eHealthNews.nz: Clinical Software

Monday, 9 November 2020

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FEATURE – eHealthNews editor Rebecca McBeth on behalf of InterSystems

Picture: Dr Lloyd McCann, CEO & Head of Digital Health, Mercy Radiology & Clinics and Healthcare Holdings Limited in New Zealand

COVID-19 has been a massive catalyst for health innovation in New Zealand and ‘healthy data’ is key to driving the ongoing transformation the system is now in a position to embrace, heard attendees at the InterSystems Virtual Summit 2020.

Dr Lloyd McCann, chief executive of Mercy Radiology and Clinics and Head of Digital Health for Healthcare Holdings Limited (HHL) spoke at the Virtual Summit about the organisation’s digital journey and impact of COVID-19.

He encouraged viewers to think of the art of the possible, noting that nine months ago the idea of doing a remote go-live of a fundamental system such as an electronic medical record (EMR) would have been unthinkable, yet when the pandemic hit, it became the preferred option for MercyAscot.

“The TrakCare EMR is foundational in terms of allowing us to continue to automate, to utilise things like Artificial Intelligence, and to embed a culture of change across the organisation,” said Dr McCann.

The crucible effect of COVID-19

MercyAscot went live with New Zealand’s first integrated patient administration system/EMR solution deployed in the cloud in May of this year.

The group operates across three hospital sites, running 23 theatres and 220 inpatient beds. Every year, 15,000 - 20,000 patients go through its doors for everything from hernia repairs, right up to more complex surgeries such as neurosurgery.

Mercy Radiology also runs 16 branches across the greater Auckland region offering a range of diagnostic services.

Dr McCann said health services need to change to become more consumer centered and one of the key drivers of this is value-based care.

“This is where we define value in healthcare as the outcome we’re able to deliver for our patients, divided by the cost of that key episode,” he explained.

An example of this is work MercyAscot did to transform a neck lump clinic from an 8-12 week pathway into one 45 minute appointment for a patient, bringing together all the necessary clinicians, enabled by technology.

Digital health is a critical enabler for value-based care and an EMR is fundamental to that.

Dr McCann described COVID-19 as creating a “crucible environment” as it hit just when the organisation was gearing up to implement the TrakCare EMR, forcing it to look at a virtual go-live.

HHL had started to see skills and knowledge fade in the use of the EMR and it “got to a point where the benefits of waiting were outweighed by the risks of waiting”.

This created a real reliance on technology, utilising tools like Microsoft Teams and the remote support of InterSystems staff to ensure a smooth go-live.

“A whole new paradigm was created out of the crucible that was COVID-19 to enable MercyAscot to go-live and deliver the care that was needed for our patients,” he told the summit.

“Huge thanks to InterSystems, who really came to the table to deliver as our partner in that virtual go-live.”

Data driven decision making

Dr McCann said PAS and EMR are a foundational enabler to delivering excellent healthcare and the use of data to drive decision making is critically important for HHL.

MercyAscot had been a predominantly paper-based hospital system and “that held us back as it doesn’t enable data driven decision making through the use of healthy data”, he explained.

Without the foundational EMR in place, it was not able to deliver on the promise of data driven decision making.

This means turning data into useful information and insights that can drive decision making and shifting from ‘what do I think?’ towards ‘what do I know and therefore what do I think?’ said Dr McCann.

The organisation’s digital journey has three horizons and the first is getting the EMR in place.

Next is about becoming a mature analytics organisation.

“That's around driving value for our patients, but also driving value for the organisation in terms of understanding our processes and understanding where we can make improvements around processes,” he said.

For example, MercyAscot is now able to track consumable utilisation in real time, which has meant a significant lift in terms of process optimisation and revenue recognition.

“We want to shift from that descriptive base, which we've now got to, to actually utilising predictive, and eventually prescriptive analytics,” explained McCann.

Horizon three is the innovation horizon and COVID-19 has been a catalyst for some already.

Healthy data

InterSystems Vice President of Healthcare Solutions Don Woodlock also presented at the InterSystems Virtual Summit about “healthy data”, which he defined as accessible, usable and ready for action.

“The goal of healthy data to have healthier patients and more empowered clinicians.”

He encouraged viewers to think about the most important tool the health system has to fight the COVID-19 pandemic: could it be ventilators or personal protective equipment?

“I think the number one tool we’ve had has been data,” he said, citing the importance of data to determine case rates, peaks and waves of infections and how governments should respond.

“Data has been the centrepiece of knowing how to fight this pandemic and the healthier the data, the more accurate it is and the more understandable and useful,” Woodlock said.

Responding to the challenges of COVID-19 for customers who are working on the frontlines against the virus had been a huge focus for InterSystems in 2020.

The company’s other key theme for this year has been implementing the FHIR standard.

“FHIR is the best approach to get data out of the systems they are in and make it usable for you,” he told Summit attendees.

A bionic approach

Dr McCann said: “a key lesson we've learned through the crucible of COVID-19, and over the course of 2020, has been that partnership is one of our key weapons to ensure we deliver benefits for our patients and for our organisation.”

He advocated a bionic approach to driving transformation: blending the best of human with the best of technology.

For MercyAscot, getting the EMR in place would not have been possible without a strong partnership with InterSystems and key to the success of the virtual go-live was the human teams working collaboratively.

While there is an increased willingness for change and engagement with technology, old habits and ways of working still die hard, so having a strong partner is crucial to leveraging the best of humans and technology.

“The interesting thing about our health system through this period was that people had a huge appetite to engage in the change process,” said Dr McCann.

However, he said there needs to be a culture of change embedded across the health system and across organisations.

“It’s only when people are comfortable that change is part of the new normal, do we start to derive the true benefits and value of these digital health approaches,” he said.