Health Information and Technology: Once a Barrier, Now a Bridge

Collective action has been a powerful resource in the COVID-19 pandemic. Across our industry, healthcare institutions are using technology to not only fight the virus at its head, but also improve patient outcomes and maintain safety to front-line workers.

Imagine what would have happened if this pandemic had arrived 10 years ago, when healthcare was still mostly paper. “It would be unbelievably challenging. These are still awful circumstances but instead of manila folders, we have EMRs and digitalization,” said Cris Ross, chief information officer at Mayo Clinic, during a recent panel hosted by Aashima Gupta, director of healthcare strategy and solutions at Google Cloud. John Halamka, MD, president of Mayo Clinic Platform, and Daniel Barchi, chief information officer of NewYork–Presbyterian Hospital (NYP) rounded out the group.

Dr. Halamka has been on the phone frequently with one-time “fierce competitors,” who are now working together to increase testing capacity and develop treatments. Collaboration at this scale may be uncharted territory for the industry, but it’s paramount to addressing the crisis. Advancing vaccines and cures not only takes “analytics platforms that didn’t previously exist but a level of collaboration yet unseen among EHR vendors, cloud platforms and providers,” said Dr. Halamka.

Scaling the Wall

If technology once seemed the barrier between patient and provider, it has proven to be the connective element in this crisis. Specific applications, like IoT devices and telemedicine, are allowing caregivers, patients and their families to communicate during these difficult circumstances. Massive efforts to digitize workflows that took years of planning, are now rolled out in weeks, or even days.

One example Ross gives is that in a period of personal protective equipment shortages, hospitals and health systems are using tablet devices to monitor and communicate with their COVID-positive patients in real time. But these tablets also offer a point of human connection, allowing patients, who may be frightened and alone, to video conference with friends and family and discuss their care with their doctors.

When it comes to connection, telemedicine’s role in healthcare has also significantly increased in the pandemic. When COVID hit New York City, there were still many other sick people to care for. “Telemedicine allowed us to reach out to the community to provide care,” said Barchi, estimating that 65% of patient visits at NYP are now using telemedicine compared to 5% two months ago.

After all, with a highly contagious disease, who wants to touch a clipboard? Until now, NYP has been bimodal: tech-savvy but still able to work in old ways. “Now the hospital is focused on doing it the right way: We’re building the questionnaires into the medical record so they can be done from people’s homes ahead of time,” said Barchi. “Technology has proven to be an enabler when we need to stay at a distance.”

Time as a Resource

The panelists also echoed how time has dramatically changed in light of this crisis. “We did eight years of change in eight weeks when it came to telemedicine,” said Dr. Halamka. Both providers and vendors pivoted to create change in weeks and days rather than months and years.

In rapid time, Barchi’s IT team surged to increase intensive care units (ICUs) capacity across its 10 campuses from roughly 450 to 900 ICUs by converting ambulatory care units and operating rooms. They also enabled their workforce to go 100% remote in a matter of days, as the health system worked with vendors to provide thousands of tablets and laptops.

But the future is pressing on the current moment. How can the healthcare industry be prepared for the next crisis? Will the industry need to go to strenuous efforts to make all this happen again? Dr. Halamka argued that the industry shouldn’t roll back but look for scalable platforms and applications that don’t take months to implement. “Whatever comes next, let’s respond to it with lower costs, more agility and less human fatigue than we have in the past.”

An Evolving Landscape

“As a nation, we are only beginning to grapple with how this virus has impacted different people in different communities,” said Barchi. Yet, the evolving research landscape has tremendous opportunities to learn from this crisis and prepare for that unknown future.

As horrible as this pandemic has been, Ross argued, it has also demonstrated the value of data. Through data collection and analysis, we’ve gained key insights into COVID-19, such as determining:

• Where the disease is
• What demographics are more prone to have the disease
• Why it causes morbidity in some groups rather than others
• What’s occurring in underserved areas
• What therapies are working or not working

Such vital information depends on the ability to aggregate data from many places. Ross hopes these efforts will build trust between patients and the organizations committed to making a difference.

“The next frontier is to deal with all the other sick people who are anxious for cures,” said Ross. In some cases, the tools used to attack COVID-19 have been straightforward. But to get further through the pandemic and to address other diseases, Ross believed they’ll need to use data in more sophisticated ways, “with privacy at the center.”

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Mayo Clinic and Google have embarked on a partnership to create an innovation platform that uses data in ethical ways to drive more cures. “We are firm believers that you can create cures with data while protecting patient privacy,” said Ross. “This pandemic shows us that it is possible.” He suggested that one way to do this is to bring analytics into a health system’s data repository through federated search so that health systems can assure patients that their data is being used for their care and focused on legitimate research purposes at the same time.

Another way, Dr. Halamka offered, is to reconsider the industry’s definition of “de-identified data.” Healthcare not only needs novel models that strip name-gender-date of birth and other HIPAA information but “cohort analysis that can determine if insights are adequately ambiguous but still helpful in supporting the clinical research,” according to Dr. Halamka. This level of analytics will involve many collaborations, much like that of Mayo Clinic and Google, to ensure that the data is both privacy-protecting and enabling.

Building Bridges

Whether it comes to fighting COVID-19 head-on, communicating with patients and their families, or broadening research capabilities to find cures—using technology is still a human endeavor.

“Each of us will have different technology preferences and experiences, and we need to build this new future recognizing that diversity,” said Dr. Halamka. While one patient may be comfortable going in and curating their lifetime of data, another patient may prefer a conversational interface such as a chatbot guide.

“Giving people devices is an opportunity to bridge gaps and provide access in different settings,” Gupta acknowledged. “Health equity means empathy for different patient segments and adapting to fit their needs. How do we reduce the friction points to help patients take the next step in their care?”

Barchi is encouraged by the level of communication he’s seen during telehealth visits in the last eight weeks. “Physicians are comfortable diagnosing without laying hands on patients, by simply talking with them. That is the most fundamental thing we can do and should strive for: to make that connection,” he said. Technology’s role continues then not to be a barrier but a bridge between patients and their care providers.

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