Innovation and Technology

Meeting Notes, May 28, 2014

Session #1
 

  • Need to be a cutting edge community
  • Every senior use apps to get information
  • HIPPA concerns with HIE
  • What motivates people to be high tech.
  • Is there a return on investment
  • 600 – 700 systems
  • Quicker access to information
  • More reliable access of information
  • Good way to get information and data over years
  • Ease to share information between doctors
  • HIE has failed
  • Some HIE’s work and very functional
  • Doctor risk of liability in HIE
  • May improve service, no return on investment
  • If we had a free market return on investment would be immediate
  • Can compare Doctors now on the Internet
  • What is the reliability
  • No one has time to read 10 years of medical records for one patient
  • De-regulate
  • Let innovation fly
  • Bottom up innovation
  • Tech. already drives the system
  • When used correctly it is beneficial
  • Reward system for healthy life style

Session #2
 

  • Yes we should be an innovative community
  • Cutting edge is loaded
  • Technology already does so much – need to educate on how to use – will overwhelm the health  care system if you don’t.
  • Need good communications between the Network and Community
  • Federal mandates driving tech
  • Adoption by smaller practices
  • HIE we can all agree on
  • $10,000 per connection (costly)
  • Expensive to maintain
  • Could create an alliance to manage to electronic records
  • Coordinated care will drive down costs
  • Cause duplication of testing because doctors can/do not have a way of communication.
  • Some practices do not have updated computer systems
  • Costly
  • Telehealth
  • Biggest need in the community is case management
  • Outside people coming into our community
  • Need for a Tech. Health Care Task Force
  • There are opportunities to redesign systems
  • There are apps. for phones to track pregnancies and meds etc.
  • Work at what to do with little $
  • How do we connect everybody
  • Difficult to reach all in the community
  • Limited $ and duplicating process from one facility to the next  - e.g. registering at Manatee County Rural Health Services then Manatee Glens – then Hospital
  • People do know where to go so they go to the ER when ill
  • Educate the community where to go
  • Could put more information on the County WEB site

Session #3
 

  • Make existing Agencies aware of other resources available to citizens
  • Is there transfer of information among Hospital and Manatee Glens and MSO/LEO agencies
  • Some patients still have new providers using folders/written data recording.  Can they be required to get on track
  • Sharing of information between different providers – is this a conflict?
  • Benefits vs. Liability
  • Employ technology to identify trends of illnesses/epidemic
  • Is virtual medicine viable  - i.e. EKG on phone
  • Who provides information as to this technology
  • Radio frequency identification (as part of Obama Care) availability 2017
  • A microchip will be installed in the hand as part of Obama care
  • Site available as to Medical questions.  RX information available as to ER wait times
  • History information as to RX will be on chip
  • Did the telemedicine bills pass in the Legislation RE?
  • Health Care providers are our business not the Govt.
  • Latest tech needs to provide for an exchange of information
  • Govt. agencies have enough  med  already on persons
  • How much does med industry employ robotic assistance
  • Reverse 911 call availability in the event of chem. spill
  • Automatic alert via cell phones of emergencies (weather)

Session #4
 

  • Yes - we should be invested in tech so as to improve Health Care i.e. smart phone to record various information to help your physicians.  Track BP/Diabetes issues. Get away from written files.  Utilize wireless access  more often
  • Make electronic med records mandatory.  A persons history can be available on his/her cell phone
  • Any information reportable to Sate of Florida like Walgreens has.  Any Medical provider should have access to history of immunizations/meds
  • Danger of information discriminated to wrong individuals
  • Who decides what information will be shared?
  • We want to know # of persons treated within Healthcare community
  • Information must be safeguarded.  Develop safety guards
  • Microsoft recently advised users to employ a different Browser
  • Start small with phone apps (a smart phone, Tablets, Laptops).  Incentives given to encourage persons to utilize such programs
  • App:  Doctor Doctor was eliminated by Doctors because they were losing revenue
  • Post for general public what are the rates of different procedures by different clinics/providers, clearly indicating cost

Meeting Notes, June 3, 2014

Session #1

  • Microsoft was hacked 2-1/2 years ago.  What guarantee are we going to have? Criminals tracking through medical records.  How are we not going to suffer $ losses?
  • Telemedicine cutting costs allows people interact from home.
  • Being able to access who offers what and how much that costs.  By way of internet Health Information Exchange (HIE) could reduce healthcare costs.  
  • Don’t duplicate same tests.
  • How about texting capabilities for 911
  • Educating patients how to use technology available.
  • Portal for access by patient to see records
  • Currently the hospital tells the county how much to pay (is this true)?
  • Patients re-admitted, is there a way to monitor community (patient) education on discharge instructions.
  • Doctor should track patient even after discharge (personal story on husbands care at hospital).  Doctor’s staff could communicate with patient using web-cam.  Free access through Skype, yahoo etc.
  • Case Management after the fact.
  • More patient knowledge upon discharge
  • Some tests available for home where patient can send to lab
  • Blood pressures could be sent from home also.
  • Who will patient pay for the at home self-care.
  • Bringing services to the community through mobile care.
  • Hospital should be using technology constantly to communicate with the community now.
  • Education, preventative care.
  • Education prevents cost/big component.
  • Important for doctors to provide education prior to discharge.
  • Nurses have no time now to do their job.
  • Electronic charting is very time consuming.
  • You can’t have a cutting edge community without technology.
  • They spend more time with electronics than they do with their patients.
  • Legibility and tracking capabilities with electronic records.
  • Humans make mistakes.  Is there a system that can eliminate human error without increasing the cost and outcomes?

Session #2

  • We have cutting edge health care.  Excellent cancer, ortho, ENT, endo care, and cardiac.
  • Humans treat humans.  Need family doctor
  • Need primary care to prevent crisis
  • Innovation in patient experience.  Make appointment within room, etc.  The process to get health care is difficult.
  • Go to schools or work place (outreach).
  • Change how people access care, make it easier.
  • Large portion of county is unaware of how to access care and what is available to them.  How do we get there and what does that mean.  What can we provide?  Specialist care is not readily available.
  • Average person doesn’t know where to go so they go to the ER.
  • Go from hospital (one system) to a rehab (another system).  These multiple systems do not communicate with each other.
  • We need one seamless integrated system.
  • Also Rx technology should communicate with one system.  Answer to?  Maybe because who will pay for it.
  • Define your needs and then look for a tool that would work.
  • Would medicine be more accessible using the internet?
  • A lot of education on the part of the public patients goes to ER for service.
  • Break the trend of going straight to ER and instead go to a primary doctor.
  • Must adhere to rules of electronic communication.
  • One way to stop trend is to go to Urgent Care facilities.  Those Urgent Care facilities could also educate while patient is there.
  • ER must take very patient in ER regardless of means to pay.
  • Takes 3-5 months to get an appointment at MCRHS.
  • MCRHS is not free.
  • Looking for places where patient can get immediate care.

Session #3

  • Should we be a cutting edge community?
  • Opportunity is available  - on verge of cutting edge everyone looking for a model
  • Adapt with information technology – communication information> timely.
  • Telemedicine is future – Dr’s. do VA long distance helps with access to physicians.  Still operated by Dr’s Still operated by Dr’s, 99.99% no error (Dr’s operate robot)
    • Improves Access
    • Reduces duplication
    • Not that expensive
  • Clinical demonstrations – robots
  • Robot errors?.
  • Technology only as good as how humans use it.
  • Need connection to all records – talk to each other
  • Integrated system (don’t miss information, common database, same rules, etc.) – reduce duplication and seamless.
  • Health Information Exchange
  • Breakdowns occur at handoffs.
  • Share access – connect, reconcile primary, specialists
  • Include rehab and home health in conversation
  • Interface (cloud) databases
  • Bring entities together and consultant and design together
  • Computer upgrades make obsolete – chasing technology.
  • Develop education for people ($5 memory card) thumb drive.  Each patient gets one to provide to physician to download information on patient.  Electronic Benefit Transfer System (EBT).  Originally for federal programs into electronic system.  Look at how to use this to full potential in terms of health care, nutrition, medical records, and W.I.C.  Unlimited potential – more than food stamps.  Could reduce duplication of shots, etc.  Chip or swipe card?
  • Drive healthcare in community
  • Telehealth bill drives cost down
  • 3 Layer Model – Live Health Online, L1-L2 (see Dr online, L1 $49), consultants – primary care (radiology), L3 equipment in the home – chronically ill patients – monitor parameters (can check/monitor online) will determine when need to intercede.  
  • Reduce expensive utilization, intervene early.
  • Trends/reminders