Trip Report: The WATCH Society’s Future of Wearable Technology In Healthcare Conference

I just got back from the fantastic Future of Wearable Technology In Healthcare Conference hosted by the International Society of Wearable Technology in Healthcare over July 24-25 in Indianapolis. Their Twitter account is @IntWATCHsociety. Before I get on with the trip report, a bit about myself and Glass.

There were many great presentations at the WATCH conference, on Glass and medical education, HIPAA and privacy issues, real-time video streaming, teaching the autistic, smart belts for pregnancy, managing tech in operating rooms, and so on and so on! However, as is usually the case, this trip report skews toward workflow and workflow-related theme, plus some personal adventures, and the attendees and presenters I actually got to meet. (Including two people who attended because of a post I wrote about the then upcoming WATCH Conference!)

Enough preface!

The day before the conference I drove to Indianapolis. The corn got taller and taller and taller!

In the morning of the conference I used Google Glass’ fantastic turn-by-turn navigation GPS to find the venue.

I, and (Google Glass controlled, via Bluetooth) Mr. RIMP, listened to a most excellent welcome from Paul Szotek MD. He’s behind that pair of LED “eyes” in the upper left. (See the next tweet for a better photo!) Here’s a great write up in the IndyStar about how he got Glass and used it during surgery.

The following is one of my favorite comments, from @PaulSzotekMD, from the entire conference: Glass is a phenomenal platform to force healthcare to choose which data is important! Absolutely spot on. Glass is a culmination of a trend starting with tablets and smartphones. As screen form factors have shrunk, more-and-more intelligence must go into selecting just the right data and options to a smaller-and-smaller screen. My guestimate is that the Glass micro-display, at 640×480, with the smallest recommended font size of 26px, at eight feet away from the viewer, can present less than one percent of the information of a 1600×1200 desktop or laptop computer monitor.

Rafael Grossmann, MD (@ZGJR on Twitter) gave the kickoff keynote, via Google Hangouts. Rafael is such an enthusiastic ambassador for Glass in surgery and healthcare! He really charged up the audience.

I first learned of Dr. Grossman last year, when he was the first person to stream video from Glass during live surgery. It even showed up on the Drudge Report!

Next year’s conference will be in Amsterdam.

The 2015 WATCH Conference chair is Marlies Schijven, MD, PhD (@MarliesSchijven on Twitter). I found the following among tweets from @MarliesSchijven. Most Glass owners have lots of these, photos taken and tweeted during demos. :)

I was delighted to many of my slides from my February slide deck highlighted in one of the presentations.

Certainly, medical education was a big theme at the conference.

One of my prototypes that I wrote last year was even featured!

It’s not really a Snellen Eye Chart. It’s for developers and folks trying Glass on of the first time. The 90px through 26px are standard font sizes for Glass. So the question becomes, when I handover Glass for a two-minute demo: What is the smallest font size you can see? With your glasses? Without? One or the other, about 95 percent can see everything down to the smallest 26px standard font.

A big topic at the conference was Glass integration with EHRs. This was my mockup of realtime patient location and task updating. I did it last summer, but was glad to see it presented here. It fits into the important theme of improving EHR workflow and usability.

You can find the rest of my slides, along with related speaker notes and links to resource materials here.

Back to the WATCH Conference!

Nicolas Terry, Health Law Professor (@nicolasterry on Twitter) made what he conceded many think is a boring subject — HIPAA — into a tolerably interesting subject. (For which I greatly admire his intelligence and good humor!) Here’s his best slide, what do to about Glass at your healthcare organization. Be sure to click on the image and zoom in to better see the individual bullet items.

Up there with @PaulSzotekMD statement (that Glass is a phenomenal platform to force healthcare to choose which data is important!) is this statement from a video shown of Steven Horng, MD speaking about using Glass to access information from his hospital’s EHR. Glass is ultimate unshackling of physician from workstation.

Between these two insights, figuring out what is important “here-and-now” when “here-and-now” keeps changing, and freeing physicians to get back to face-to-face, hands-on patient care, is the greatest potential for Glass to improve patient care.

In fact, the result of the right info and options at the right time in a complicate workflow, and freedom to move around, from problem to problem, solving on the run, will be, as REMEDY’s tagline reads: See More Patients. It’s a pun, of course. To see more is to perceive more. And free physicians from their workstations will allow them to serve more patients.

@PaulSzotekMD described a whole bunch of Glass prototypes he’d help develop with collaborators.

So I asked, what was the relation among the prototypes. Did he imagine using one after another in a workflow? He said absolutely. I hope you can see that I’m not unreasonably to suggest the phrase “wearable workflow” as it might apply to workflow among not just Glass apps, but among these apps and other wearable devices?

I liked the following quote, from @MarliesSchijven’s presentation, so much I tracked it down its complete context.

“Anthony (Tony) Jones, M.D., is the vice president and chief marketing officer for patient care and clinical informatics at Philips Healthcare. He explains, “The most exciting potential application of Google Glass in healthcare is the ability to allow providers to ‘virtually’ be in two places at once, which will have a significant impact on workflow and patient care.”

For instance, imagine a doctor or nurse is with a patient and he or she is doing a basic procedure that requires both hands. An alarm or alert is triggered in another room.

“Rather than interrupting the current procedure, the provider can use the verbal commands to call up the patient monitoring data that’s triggering the alert, Jones explains. “At that point, the provider can decide whether the alarm can wait or whether it needs immediate action.”

Similarly, bringing some of the basic vital signs info from the monitor directly into the field of vision via Google Glass allows the provider to do the procedure and view the feedback data without taking their eyes off of the patient.

“It sounds simple, but small workflow improvements like this can reduce errors and have a significant impact on patient care,” Jones says.”

The following slide describes a study examining how often and how long, on the average, a resident looked away from the patient to consult a bedside monitor. It doesn’t compare to Glass, but one hopes it could help increase the amount of time patients get the full attention of their care givers. I look forward to more such statistics comparing w/Glass and w/o Glass conditions.

On the morning of the second day of the WATCH Conference, before I even got out of bed, I reflected what I perceived to be the dominate themes of the first day of the conference. This is what I tweeted.

  • Google Glass
  • Medical education
  • HIPAA
  • Live streaming video
  • EHR integration
  • Workflow

One of the highlights of the WATCH Conference was the opportunity to finally meet Brian Norris, who I had only previous known through lots of interaction of Twitter (he’s @Geek_Nurse). He’s a triple threat — clinician, developer, activist — who really cares a lot about the Indianapolis health IT innovation and startup scene. I heard frequent comments of appreciation about Brian from other local Indianapolis-based attendees.

Brian provided particularly valuable insight to anyone hoping to get an app into the Google Glass online app store. Basically, follow instructions! Use Google’s checklists. Conduct a self test. Pay particular attention to branding. Google wants the attention on the app and its functionality, not an implied relationship or partnership with Google. Watch the size and location of your images!

By the way, I went through the Glass UI style guide and combined all their different example screens into a single 640×360 image you can use a the (temporary) background in any glassware you develop. Just turn it on once in a while to see if you’re coloring outside the line, so to speak. :) You can access it directly from your GDK or Mirror API app at http://wareflo.com/glass-gutters-spacing.jpg.

One of the presenters didn’t show up, so I got to take his place! So, off-the-cuff (appropriate for a wearable tech conference) I presented Wearable Workflow, Google Glass, Wearlets and Mr. RIMP. I recorded it and I created a YouTube video from video of Mr. RIMP interacting with Glass, plus photos of his innards and from the conference. I got to talk about “wearable workflow” and “wearlets” (out of which wearable workflows are constructed). #

Many thanks to Brian Norris (@Geek_Nurse on Twitter) for tweeting the following photo of Mr. RIMP (and me).

Mr. RIMP attracted a lot of attention! Lot of folks wanted selfies with him.

I was particularly happy to get this group photo of Matt, a Google Glass Guide, Mr. RIMP trying on Glass, and myself.

John Springer give a great prevention about Glass in the operating room used manage supplies and devices.

By the way, I didn’t realize his Twitter account at the time, it’s @JohnSpriCST. Here’s his Twitter profile: “OR GLASS”!

springer

Divya Dhar of Seratis Health gave an overview of her company, and how Glass could fit into their mobile care coordination platform. From the @SeratisHealth Twitter profile, “Seratis brings doctors and nurses out of the pager era by allowing #healthcare providers to coordinate, track and analyze care across the team.” In particular, I was intrigued by “Seralytics.” Once you support and capture care coordination workflow, the next obvious step it to data mine it, looking for patterns and insights to improve those workflows.

Finally we got to what was, in my mind, the best presentation at the WATCH Conference, Kyle Samani’s Achieving Scalable Commercial Success With Glass In Healthcare (slides). I interviewed Kyle a year ago for my blog about health IT workflow.

PristineIO is developing a sophisticated mobile and distributed workflow management system for Glass, combining video communication, checklists, and just-in-time user guides.

I saw the following point in several other demonstrations, a point with which I very much agree. Glass (and other wearables too, capable of delivering information to wearer and doing something in response to wearer intentions) requires considerable infrastructure and real-time management of information and workflow to be useful in healthcare. I made this very point in last year’s InformationWeek column Google Glass: Autocorrect For Your Life.

“For Glass to be the raging success I believe it will be, many Glassware apps — particularly in healthcare, the industry I call home — will require sophisticated self-adapting and user-customizable filters, priorities and workflows.”

Hub-and-spoke, central coordination and supervision, such as described in an earlier presentation, are all about what organizational psychologists call “span-of-control.” Information technology and machinery is, essentially, making it possible for less trained personnel to deal with more situations, but to subject to realtime quality assurance and immediately available specialized expertise. And it is this middleware layer, of contextually-aware computing combined with flexible workflow automation, which will make this increased span-of-control possible.

I didn’t tweet the slides, but one was a map with pins representing pilots and customers from coast to coast (accompanied by hint there are lots more in the pipeline). Kyle got there early (I think he was one of the first 1500 to receive Glass). Articulated a vision, executed aggressively, pivoted when necessary, all through while writing many blog posts about Glass and health IT along the way, to keep the rest of us up-to-date.

Conclusions

The WATCH Conference was well worth the trip, and bodes well for the future of the International WATCH Society. This “Conclusions” section as just a place for me to collect some thoughts that didn’t make it into the previous, more chronologically, thematically, presented slides, tweets, and interspersed commentary about them.

First of all, its interesting, the “WATCH Society” and “WATCH Conference”. WATCH stands for WeArable TeChnology in Healthcare. Glass is not the only wearable tech. And of course there are smart “watches” but 95-percent of the conference presentations were about Glass. There had been several large wearable conferences the weeks before, one on each coast, and in those conferences, Glass was not nearly as overwhelmingly represented. I think this is a testimonial to the grasp Glass has achieved on the collective imagination of healthcare clinicians and health IT visionaries.

Second of all, the two most impressive uses of Glass I saw, Glass to access EHR info at Beth Israel Deaconess Medical Center and PristineIO’s implementation of hub-and-spoke management of lesser skilled healthcare workers, both involve using Glass in ways Google did not foresee. In the case of Beth Israel, if you watch the video, the Glass app presents info in ways violating Google’s Glass guidelines. In the case of PristineIO, the native Glass Android operating system is being wiped away to make it literally impossible to violate HIPAA. One of the characteristics of transformation technology is that it ends up being used in a lots of ways unforeseen by the inventor of that technology. Twitter is a lot like that, for example, hashtags were invented by users. Now I don’t know if Glass is the Twitter of wearable tech in healthcare, but I think these unpredicted, even advised against, successful uses of Glass are the single best predictor something very interesting is going on.

Third, I don’t like to admit I am wrong. But I predicted last year that Glass would be an even bigger consumer phenomena than vertical phenomena (healthcare, energy, education, security, etc). While I program Glass with in eye toward uses in healthcare, I also love using it out and about. Its turn-by-turn navigation user experience is far superior to dashboard-based GPS. I love to be able to respond to a tweet or email (hands-free!) in almost sub-second response times. But I’ve changed my mind. Glass will be more successful in verticals such as healthcare, first.

Regardless, I am consistently and boundlessly effusive about Glass in person and online (2000+ tweets on the #GoogleGlass hashtag) was still surprised and impressed by the quantity, variety and subtlety of the Glass apps, projects, and envisionings I witnessed at the WATCH Conference. And, echoing what I heard from many people at the conference, WATCH was just the tip of an iceberg. There are many more stealth, under-the-radar, Glass in healthcare software development projects and startups than were presented publicly at the WATCH Conference.

Finally, many thanks and kudos to the doughty and visionary Indianapolitans who threw a great conference about wearable technology in healthcare! One more tweet!


P.S. By the way, I’m giving a keynote about Glass and wearable workflow at a healthcare conference this coming February. There will be a free webinar preview of that keynote September 16 I’ll tweet the registration link when it’s available. Here’s the title and abstract.

Wearable Workflow Needs Health Systems Engineering

“From the original calculator watch to today’s Google Glass and smart clothing accessories, wearable technology seeks to weave (sometimes literally!) information technology into everyday life and work, making it pervasive, intimate, and, metaphorically, friction free. Especially promising are applications in healthcare. These, for example, include patient monitors for the well and unwell and wearable user interfaces to health information systems. However, wearable tech will not succeed unless we get its workflows right. Getting the workflow right requires both means of driving workflow at the point-of-care and -health AND systems for analyzing, creating, and optimizing this workflow. In other words, successful wearable technology in healthcare requires health systems engineering. This presentation provides an overview of wearables and how health systems engineering can help make them a success in healthcare.”

In other words: Wearable Workflow!

P.S.S. Check out my own Google Glass in healthcare prototype!

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My Keynote at the Healthcare Systems Process Improvement Conference: Wearable Workflow Needs Health Systems Engineering

(Here’s the webinar registration link.)

shs-ad-webinar

I’m honored to be giving the keynote for the Society for Health System’s Healthcare Systems Process Improvement Conference in Orlando, February 18-20, 2015.

Wearable Workflow Needs Health Systems Engineering

From the original calculator watch to today’s Google Glass and smart clothing accessories, wearable technology seeks to weave (sometimes literally!) information technology into everyday life and work, making it pervasive, intimate, and, metaphorically, friction free. Especially promising are applications in healthcare. These, for example, include patient monitors for the well and unwell and wearable user interfaces to health information systems. However, wearable tech will not succeed unless we get its workflows right. Getting the workflow right requires both means of driving workflow at the point-of-care and -health AND systems for analyzing, creating, and optimizing this workflow. In other words, successful wearable technology in healthcare requires health systems engineering. This presentation provides an overview of wearables and how health systems engineering can help make them a success in healthcare.

In other words: Wearable Workflow!

I’m giving a free preview webinar on September 16. Watch this space, or better yet, (Here’s the webinar registration link.) follow me on Twitter at @wareFLO for the registration link.

P.S. Also check out my Slides, Notes, Tweets for My Google Glass and Healthcare Information and Workflow Presentation from the 2014 Health System’s Healthcare Systems Process Improvement Conference.


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From Health IT Literacy to Health Workflow IT Literacy

Today’s #HITsm chat topic is near and dear to my heart: Health IT Literacy. I designed the curriculum for the first undergraduate degree in Medical Informatics/Health Information Science and that is exactly where I started! More specifically, I started with healthcare workflow as the conceptual foundation for health IT literacy. Today I’m raising awareness for the need for health workflow technology literacy along a variety of channels, blogs, Twitter, webinars, presentations, etc.

bpm-bridge

Health workflow tech literary is, in fact, an important, but not much unappreciated part of health IT literacy (oh the debates I’ve been in with the medical informatics folks…). So, below is my version of the five health workflow IT literacy questions.

Topic: Health Workflow IT Literacy

W1. Is health workflow IT literacy needed? If so, who is the audience?

W2: What type of health workflow IT literacy is required?

W3: Who should be involved in promoting health workflow IT literacy?

W4: How should health workflow literacy and health workflow IT literacy inter-relate?

W5: How will you promote health workflow IT literacy?

It should be an interesting #HITsm chat!

Cheers

Chuck

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10 Part Workflow Interview: Vishal Gandhi of ClinicSpectrum, Booth #870 at HFMA National Institute

It’s not often I meet someone as or (more?) obsessed with healthcare workflow as I am. I believe I’ve met my match in Vishal Gandhi of ClinicSpectrum. I’ve not done one of my multi-question, in-the-weeds, workflow interviews in a while … it feels good to be back in the saddle. Enjoy!

the_clinicspectrum_story_with_vishal_gan_170059526_thumbnail

(Image from Vishal’s excellent video interview with @TechGuy)

BTW You can visit ClinicSpectrum in Booth #870 Sunday, Monday, or Tuesday at the HFMA National Institute this week in Las Vegas.

map

  1. How did you come up with “Empowering Cost Effective Workflow”?
  2. Do you have any competitors? How do you think about them?
  3. What’s your workflow “philosophy”?
  4. What is a “Hybrid Workflow Model”?
  5. What’s your educational background? Industrial Engineering?
  6. What do you mean by “PROCESS dependent practice rather than a people dependent practice”?
  7. Is ClinicSpectrum turning into a Population Health Management/Care Coordination platform?
  8. Do you have a portfolio of workflow solutions?
  9. What is the single most important demo for folks to see at your HFMA Institute booth?
  10. Are your cost accounting systems up to value-based healthcare?
  11. Where in the world has been your favorite place to travel to?
  12. Thank you’s and leave taking… nice guy!

1. Let’s start with your tagline, “Empowering Cost Effective Workflow.” I’ve read that taglines should be simple, memorable, and functional. How did you come up with it?

Empowering cost effective workflow was derived out of our organizational experience with transforming solo and individual practices over the past several years. Industry trends and healthcare changes after President Obama came into office leant toward saving money for healthcare from healthcare. This would only be possible through avoiding duplication of care, auditable billing activities and enforcing billing automation, thus providing major savings due to solving pre-existing issues of improper billing, low utilization and risk management. This is where ClinicSpectrum’s tagline or positioning statement of, “Empowering Cost Effective Workflow,” was born.

2. Do you have any competitors? How do you think about them?

I’ve never considered competitors, because no organization does what we do for healthcare service organizations with both back-office support and powerful software automation. Other back office service companies focus on providing back office resources, while our approach is to reengineer or restructure workflow with use of their local team, our technology team and our back office resources. As part of empowering cost effective workflow, we created custom tools, technologies and designed an ideal workflow plan for solo practices and large clinics to leverage and significantly reduce operational costs via three ways:

  1. Increasing productivity through self-accountability and benchmark within existing staff
  2. Enabling automation on some of the manual tasks
  3. Outsourcing some of the secretarial functions to back office team
    members with a salary range from $6.5/Hour to $9.5/Hour compared to local team starting with $14/hour

3. I think that “workflow” has so many interesting aspects and is so relevant to so many relevant healthcare and health IT problems and solutions. What’s your workflow “philosophy”?

When money gets tight, or in some cases tighter, organizations need to do more work for less money. So ultimately it boils down to automation or cost effective labor. There is no other way to do more work for less money while you are expanding or growing. One of the single most important functions in operational planning is reducing variable expenses as you scale up.

Workflow was built into our success as an ONC-certified EHR / Enterprise Practice Management / Revenue Cycle and Practice Consulting company. However we were restricting that knowledge for clinics only. Some of the companies we are consulting in for the past 12 years are in the practice management and revenue cycle management market as well, and so we have been exposed to several technology platforms that give us this experience in workflow planning.

One of my friends who owns a billing company mentioned one time during a discussion in 2009: “It is very hard for billing companies or practice management companies to survive just based on their knowledge domain. We need a knowledgeable team, technology and people to expand and grow.”

I told him, I can provide you with technology and people. You should focus on finding new business and retain your knowledge team. Leave the rest to me. In the last 5 years, the company has grown from the ground to more than 100 accounts, generating significant revenue for the practices we serve.

Creating a workflow plan using the three elements I’ve mentioned is a hybrid workflow model – knowledgeable team, automated technology, and back-office staff - because in which, we are using their team, our team and technology. I call this a triangle and it is called hybrid because the onus of performance is passed onto each element in the plan. Technology must work as desired. Back office team members must produce and deliver tasks accurately and the knowledge team must continue to audit and supervise.

Our technology platforms (4 of them have patent pending) are derived out of this hybrid workflow plan only.

4. What is a “Hybrid Workflow Model” and why have you gone so far as to trademark it?!

hybrid-workflow-model-86227424

Our Hybrid Workflow Model is a workflow plan that encompasses three factors:

  1. Workflow knowledge team (local)
  2. Technology suite
  3. Back office team

Using the above three elements, we deliver a defined process, deliverable tasks with a timeline for success and an audit. Each one of the elements has specific duties and continuous monitoring for achievement of those duties. The ultimate objective of the Hybrid Workflow Model is to create a COST EFFECTIVE, ACCURATE and CONSISTENT workflow.

Knowledge is too powerful to just reside with just one individual.

All of ClinicSpectrum’s knowledge is replicable on a FAST TRACK basis through organized video recordings, process manuals and rule engines. So when a company gets a big assignment, adding new team members is easy to do.

An existing customer recently relayed to us that they may need an additional 12 resources in the next 2 months. They wanted to know how we would scale up that quickly to meet their needs.

We work with our clients to institutionalize knowledge of their business so new team members can be brought up to speed within a short period of time. This is what we call process dependent workflow plan, rather than people dependent.

5. In your video interview, you sound like an industrial engineer. What’s your educational background?

I have a Bachelor’s in Electronics Engineering, so you are correct I am an engineer. My specialization in engineering is System Design. I also have earned a Masters in Business Administration. Additionally, I am a certified healthcare auditor, certified medical collector and I am pursuing a “CHMBE” by HBMA.

Additionally, I think it’s important to mention that we have filed four patents for some of our unique automation tools or products. One of my most favorite is PRODUCTIVITYSPECTRUM.

ProductivitySpectrum is all about increasing productivity within existing team. As mentioned earlier, there are only 3 ways to do more work for less money. Either increase productivity or introduce automation or find cost effective work force.

ProductivitySpectrum focuses on first aspect of increasing productivity. For someone with subject knowledge and reasonable intellect, loss of productivity is due to

  1. Loss of focus or distraction due to social media, computer and other things
  2. Healthy competition or we call it BENCHMARKING

Above product has 2 components, MONITORING would take screen capture of their activities; identify resource wise time spent and employee desk time. So if they are wasting idle time due to NON PRODUCTIVE activities on computers, it would be streamlined. BENCHMARK comparison allows dynamic benchmarking through employee’s own best performance days. It keeps reminding of his/her efficiency against his/her best days and creates an automatic daily reporting for supervisory position.
It comes with smartphone app to monitor any employees’ activities on the fly.

6. On one of the slides in one of your PowerPoint decks, I saw the phrase: “PROCESS dependent practice rather than a people dependent practice.” Do you diagram and flowchart workflows? Even scribbled on a napkin! I think this kind of artifact wonderful evidence of what think of as a “workflow worldview.”

Below is a visual of our 3-step presentation, which defines an ideal front desk workflow plan. It has a graphical view built into it.

diagram1

(Cool graphic!)

7. I also saw this: “Every task/office function gets audited randomly across the practice” “-Patients who are non-compliant clinically -Reminders for tests/procedures” When I read this I start thinking — Population Health Management, Care Coordination, etc. — which are really hot topics these days. Is ClinicSpectrum essentially turning into a PHM company or care coordination platform? Plans? Ambitions? Do you have your eye on any specific technologies to help you realize your vision?

ClinicSpectrum is not essentially turning into a PHM or CC platform, instead we provide all technology and resources required to do PHM and CC.

Most EHRs have a built-in feature to do risk management or identify and cluster patients based on conditions, procedures and other demographic parameters including hospitalizations.

In order to do an effective PHM and CC, you need following items

  1. Technology or EHR product that defines risk management index or area of concern for high-risk patients.
  2. An automation engine that would remind patients’ for required visits, tests and lifestyle changes so that they can be kept out of emergencies and non-compliance.
  3. Team of professionals who can review clinical guidelines and call the patient, explain things they need to take care of, and bring them back as required to physicians’ offices for better risk management.

ClinicSpectrum aims to provide an automation engine (as we own a messaging platform called MessageSpectrum) and back office team members who are trained in various pay for performance programs, quality measures and risk management. We are currently providing support to several practices that are part of ACOs and PCMH programs.

8. I also notice you use the phrase “Workflow Solutions to Increase Profitability and Decrease Cost.” Do you have a portfolio of workflow solutions? What are they? How do they fit together? I notice more-and-more health IT vendors and service providers talking about “workflow solutions”. I think this is a natural and to-be-expect evolution. Now that we have some much clinical and healthcare financial data, we have to do something with it: workflow! But I’d love to hear you elaborate on whether you agree or not…

We are in business of either increasing revenue or reducing costs for billing companies, hospitals, healthcare IT companies, consulting organizations, multi-specialty groups and small physician’s clinics.

Our technology products such as

  • “InvoiceSpectrum,”
  • “CredentialingSpectrum,”
  • “AutoCollectSpectrum,”
  • “ProductivitySpectrum,” and,
  • “MessageSpectrum”

provide some of the most essential technology pieces to design and implement a workflow plan for increasing productivity and decreasing costs. To add to that, soon we will also launch HumanResourceSpectrum , EligibilitySpectrum and WorkFlowSpectrum.

As deductibles become a perennial issue, our EligibilitySpectrum product along with our eligibility verification services will enable complete front end eligibility checking for hospitals, clinics and any other healthcare facility.

WorkFlowSpectrum is a web-based document management and work allocation and management platform so organizations, including clinics, don’t have to use Dropbox or any other cloud-based service. This offering is more dynamic and target driven.

If someone retains your services on a monthly retainer basis, with our InvoiceSpectrum product, you can automate your entire invoicing cycle. It applies to billing companies, consulting companies or any healthcare service management company.

Now, if you need a team to provide consistent and persistent AR follow-up for clients with outstanding payments, our team can help. So together, with InvoiceSpectrum and back office AR follow-up, we can automate any healthcare company’s accounting or invoicing department.

These are just a few examples of how combining software products, in conjunction with our back office services, automate a department with reduced costs.

CredentialingSpectrum has been a major attraction for several larger groups. As defined by one of our existing customers, it is one of the most comprehensive products for credentialing and contract management.

9. You’re going to be at the Healthcare Financial Management Association conference (HFMA National institute) in in Las Vegas. When attendees visit Booth #870 (I looked it up), what is the single most important thing for them to see? A demo? Of what? Something else? Also, what great list of speakers! I know you’ll be in your booth a lot, but who are you excited to hear and why?

  • AutoCollectSpectrum to manage and automate patient balance collection
  • CredentialingSpectrum to manage entire credentialing activity
  • EligibilitySpectrum to manage front end eligibility, while most insurance plans today have high deductibles.

And, of course, providing additional information on our back office services and Hybrid Workflow Model implementation.

I am sure that there are a number of speakers that I would l like to hear. Most of all I will be interested in any topic that shows an innovative way for practices to collect patient balances. While we hear so much about patient engagement on the clinical side for quality of care, it is critical that we do not overlook engaging with the patient on the financial side. I welcome being sent suggestions for talks to attend that address this.

10. Believe it or not, I was a pre-med Accountancy major (University of Illinois, Champaign-Urbana). I’m checking the ClinicSpectrum blog and I see lots of cost and financial accounting material (plus credentialing, patient education, and other good stuff). As healthcare moves from maximizing volume-based reimbursement towards value and cost improvement strategies, where do you see medical practice management systems evolving? Will managers ever get anywhere close to knowing the “true cost” of a specific procedure or patient encounter (say, door-to-door). Are your current systems up to it?

Yes in fact we are building a cost matrix in our enterprise practice management system currently that would do 2 things:

  • Allow to add all fixed costs: rent, utilities, malpractice and any other
  • Allow to insert monthly variable costs: salary, supplies, outsourced services, etc.

Even though the industry relies on an RVU based model, it is not accurate. Our system will create a procedure performance based on six months of trending data and derive, by procedure, reimbursements by payer or plan.

Our cost matrix will pick up all fixed and variable expenses and divide it among total number of patients and total number of procedures by visit code.

This will allow them to scale up or scale down depending upon this cost to revenue matrix, and also allow them to plan for both breakeven and revenue targets for new providers.

11. To round it out – where in the world has been your favorite place to travel to?

I cannot say that I have a favorite place, but rather that I like to travel to as many places as possible. I am going to Barcelona, Spain on July 17th. This will be my 9th country that I have traveled to. I am also a passionate photographer, so you can imagine, I would love to travel to one new country every year and capture beautiful images.

12. PHEW! Those questions were really in the workflow and processes weeds! I thank you so much for your patient consideration and answering of these relatively technical questions (which are, nonetheless, so important to the financial health of your medical practice customers!).

I thank you very much as well for spending so much time and being so thoughtful and thorough. I All of your questions were meaningful and relevant to current challenges in healthcare, and I enjoyed answering each one.

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My #HITsm Health IT Business Process Management Success Story, Plus a Conference Report

While working on my BPM & Case Management Global Summit conference trip report, I saw this tweet about sharing health IT success stories at the Friday, 12 EST, weekly #HITsm Twitter chatup (Health Information Technology Social Media).

As I’ve just given a 45-minute presentation to a workflow tech audience about healthcare and health IT opportunities, I thought, maybe now would be a good time to reflect on progress being made. By the way, I created the following YouTube from my slides and audio from that talk on 6/16.

While I’ve been giving presentations about workflow tech in healthcare literally for decades, I joined Twitter in December of 2008 (averaging 25 tweets a day) and starting blogging in earnest in 2009 (about a post a week). An important part of my strategy has been to blog and tweet about health IT to attract workflow tech community interest and followers. And to blog and tweet about workflow tech to attract health IT interest and followers. And, most important, get both communities engaged, on social media and face-to-face, with each other. Have I seen more sophisticated thinking about workflow and more use of workflow tech close-and-closer to the point-of-care? Yes, I have.

For example, each year I look at every web site of every exhibitor at the yearly HIMSS conference. Sites mentioning workflow tech or emphasizing workflow went from 8 percent in 2013 to 16 percent in 2014. Last week I was honored when John Lynn, without a doubt the top and most trafficked health IT blogger, contacted me about blogging once-a-day about workflow on his website, while he went on a well-deserved vacation. Check out the comments from both health IT and workflow tech professionals. Then there was the BPM and Case Management Global Summit early this week near Washington DC. (BPM stands for Business Process Management). When I started going to BPM and workflow conferences four years ago, there were no health IT folks at all. And the workflow tech folks were just beginning to get curious about opportunities to solve healthcare’s many workflow problems.

This year, there was intense conversation among a variety of health IT and workflow tech thought leaders. In addition, I’ve seen more-and-more healthcare workflow, BPM, and case management success stories. I tweet them whenever I find them. And I archive links to many at http://EHR.BZ.

I was delighted to see @TechyDoc there! I could not agree more wholeheartedly with his tweet!

BPM and Case Management Global Summit Short Trip Report

Well, so far this post has been about counting healthcare workflow tech blessings. I’ve enjoyed it! But it’s back into the weeds, so to speak. The rest of this post focuses on presentations, conversations, and impressions from the recent BPM and Case Management Global Summit. Did I mention I spoke there? Oh, yeah. Please feel free to watch my slides paired with recorded narration, on YouTube. (There’s also this half-as-long outdoor rehearsal, in front of the Capitol dome, recorded with Google Glass, waving printed slides around on a windy day.)

This is what the conference venue looked like. (At a Ritz-Carlton, very nice!)

Jim Sinur kicked off the conference. I especially like this slide about a spectrum of process styles.

I like how the Whitestein Living Systems Process Suite elegantly combines high-goals, organizational roles, and workflow automation. So, let’s say a workflow is executing but assumptions or conditions change. Workflows can also change, on-the-fly, based on reasoning about goals. LSPS is not (yet) used in healthcare, but I can imagine a future EHR workflow system actually helping patients and physicians think through, for example, quantity vs quality of life constraints and tradeoffs.

Here I am hanging out at the Whitestein Living Systems Process Suite booth.

I also enjoyed the Computas FrameSolutions presentation about its adaptive task management platform. I’d love to see FrameSolutions applied to clinical task management.

Nice overview of tasks in enterprises, including healthcare enterprises.

Users can create tasks, execute them, and assign them to others. Task can also be automatically created, assigned, executed, etc., all the while consulting organizational models (which, in healthcare, could include physician, nurse, tech, and so on).

Love it! Integrated tasks management and execution easily integrated with existing systems. Users can easily change the rules that fire, execute, adaptive tasks. Workflows can be programmed, but also “emerge” from user behavior. All the while all these activities are time-stamped and made auditable.

Here’s an interesting diagram. In traditional workflow management and BPM systems models of workflow and their execution are at their core. In other words, users and data are adapted to fit to these models. Of course, these models can be changed in ways that software without executable models (such as most health IT systems) cannot. However, adaptive case management puts data, about, for example, patients, at the core, and then automatically, semi-automatically, and manually triggers snippets of workflow. Instead of big workflow models (rigid during execution, though plastic during design), workflow is actually driven, moment-by-moment, during the work of problems solving, by data at hand, both from previous transformation and newly arrived from the outside world.

More on tasks as process snippets.

Users can create intelligent tasks.

Users can intelligently manage and share tasks.

I tweeted lots more slides from the FrameSolutions presentation, but I do want to get on to Keith Swenson’s presentation, a fitting windup for the conference from my perspective.

Keith has a seven-pillar model framework to compare and contrast different kinds of workflow software. All the way on the left, that’s traditional software development. On one hand, anything is possible since everything is simply a matter of programming. On the other hand, workflow is also “frozen.” To change workflow requires an expensive programmer, who won’t get it right, and even if they do, there will be bugs, so there’s a long and expensive cycle of testing, deployment, and training.

All the way on the right is email, phone calls, Twitter, etc., in which anything goes, but the user has to do all the work too. In between? Those are five general classes of workflow tech, from relatively rigid process models to relatively flexible models that just try to support and empower users, without getting in the way.

I’ll note I think of the seven columns more as rows of layers. On the bottom we have traditional server-based programs. On top of that bottom layer we have process models, starting out rigid and infrequently changed, but, as we ascend the stack, more flexible but also require more work and smarts from users, until we get to the top layer of emails, phone calls, Twitter, etc. All of these layers exist together, interacting, building on each other, but also causing occasional glitches. A programmer might be deep in the bowels of a Java program, but in the next moment tweet snippet of code to his programmer followers.

The following tweet lists the folks at the BPM & Case Management Global Summit with whom I tweeted most frequently. If you’re interested in any of the same things I am, I hope you’ll consider following them on Twitter.

And here is a special shout-out to Nathaniel Palmer, who organized the conference. He even coined the #BPMCM2014 hashtag, without which my above tweets could have been possible — literally!



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