Aalpen Patel, chairman of the radiology department at Geisinger, explains how point-of-care ultrasonography (POCUS) technology is revolutionizing imaging operations and improving both business and clinical outcomes.
Healthcare organizations are moving away from the bulky ultrasound machines of years past and embracing digital health platforms that make imaging more mobile and integrate directly with the EHR to improve care management and workflows.
One of those health systems is Geisinger, which today announced a partnership with medical imaging and software company Exo to streamline the mobile ultrasound process. The Pennsylvania health system is using point-of-care ultrasonography (POCUS) in its women's health, emergency, and sports medicine departments and plans to expand to more than a dozen other locations in the future.
The streamlining of inpatient services is on every executive's to-do list as healthcare organizations seek to reduce workflow stress on staff and clinicians, reduce hefty medical costs, and boost clinical outcomes through better data access and analysis. Medical imaging costs are a significant burden on a hospital's bottom line and an area ripe for innovation.
"POCUS is perhaps the single most revolutionary technological advancement in medicine in the last 30 years," says Aalpen Patel, MD, MBA, FSIR, chairman of the Geisinger's radiology department, in an e-mail conversation with HealthLeaders. "Its scope spans almost every specialty and exponentially extends the clinician's ability to make rapid diagnoses and guide many procedures safely."
"Historically, ultrasound was performed in radiology or cardiology, where in-depth, time-consuming studies performed by techs were then interpreted by a physician (not at the bedside). This often required the patient to be transported to another area of the hospital, which is problematic, especially if the patient is unstable. POCUS has significantly extended the bedside clinician's ability to rapidly answer important clinical questions about the patient and narrow their differential."
Aside from improving workflows and care coordination, the technology also impacts clinical outcomes.
"POCUS allows clinicians to rapidly diagnose or exclude life-threatening conditions at the bedside," Patel says. "It is also used for procedural guidance, making procedures significantly safer for patients. Having the ability to archive images and generate reports in a streamlined workflow allows other members of the healthcare team to view this data and make clinical decisions."
According to Patel, hospitals are turning to this technology for several reasons.
"First and foremost, using an enterprise POCUS workflow can improve the quality of care for patients," he says "It allows the ability to perform quality assurance on images. This data can be used for assessing clinician competency, helping with credentialing and privileging, and providing quality feedback for continuous POCUS skill improvement and education."
"It also allows health systems to collect previously uncaptured revenue for POCUS studies," Patel adds. "Creating a POCUS workflow and archive also provides a database for quality review and helps mitigate medicolegal risk. And it can improve ED and hospital throughput, decreasing procedural complications and high-end radiology utilization such as CT, MRI or Interventional Radiology."
On the other side of the ledger, there are challenges to adopting this technology. And in this turbulent economy the biggest barrier may be the cost. Imaging systems aren't cheap, and it's up to the CIO or radiology department head to connect the dots for the CEO and CFO between expenses and ROI.
"Sometimes it can be difficult to convince leadership that a standardized POCUS workflow is needed to ensure that POCUS is performed properly and safely," Patel says. "However, demonstrating the quality and safety benefits along with the positive ROI from both soft and hard revenues gained by investing in an enterprise POCUS workflow solution can help overcome this barrier."
Ther's also the challenge of integrating new technology into the workflow.
"Clinicians are extremely busy, and every extra click they are asked to make takes them away from direct, patient-facing care.," Patel says. "Ensuring that the POCUS workflow is streamlined and seamlessly integrated in the EMR can help overcome this barrier. These exams allow the clinician more time at the patient's bedside, and [the technology] has been shown to improve patient satisfaction and experience scores."
"Another challenge is the ability to standardize a POCUS workflow across multiple departments," he adds. "Different specialties have different needs and expectations from a POCUS workflow. Providing a flexible workflow with customizable reports can help overcome this challenge."
And finally, Patel says, it's important to have resources on hand to educate staff about how to use the technology.
"Some specialties have POCUS education embedded in their residency and fellowship training curriculum, but others do not," he says. "Providing attending clinicians with educational and training resources including internal courses, didactics, image review sessions, and hands-on training sessions and simulation can help overcome this challenge. Fortunately, POCUS is being incorporated into not only residency and fellowship training but in many medical school curriculums."
A lot of the potential around this technology lies in its mobility. As health systems look to move more services outside the hospital and closer to the patient—be it in the home, a community health center, a remote clinic or doctor's office or even an accident scene—mobile ultrasound platforms are showing their value for providing on-demand care.
"POCUS technology and workflow is evolving at light speed," Patel says. "In the last 10 years these machines have transformed from large, clunky, cart-based machines with suboptimal image quality to compact and handheld units that can be taken to almost any environment inside or outside the hospital. Many newer machines are equipped with Wi-Fi capabilities, wireless technology, significantly improved imaging quality, and various Doppler technologies. Many of the newer devices have built in AI/machine learning [capabilities] that allow for auto-labeling and auto-calculations, and they can direct novice learners to the correct scanning plane and beam angle. And POCUS workflow reporting from various vendors allows mobile reports to be generated on iPhones, iPads, and android devices with a few swipes of the finger."
The recent flurry of collaborations between healthcare organizations and Big Tech is a good sign that health systems are finding their footing in AI development.
Healthcare organizations are joining forces with some of technology's heaviest hitters to push AI projects out of the planning stages and into the hospital.
The announcements are, in part, an effort to get in front of the AI hype machine and demonstrate that health systems are putting this technology to work to improve critical issues like workforce stress and administrative overload. The industry doesn't want to repeat the missteps of the EMR rollout, when news stories about bad experiences overwhelmed talk of the positives and hindered EMR adoption and development.
In just the last month:
Mass General Brigham announced the rollout of an AI algorithm for radiology "that will help increase operations' effectiveness and productivity." The technology was developed in a partnership with GE HealthCare, which agreed to a 10-year collaboration in 2017 "to explore the use of AI across a broad range of diagnostic and treatment paradigms."
HCA Healthcare announced that its partnership with Google, forged in 2021, had led to the pilot of an AI platform to document emergency department conversations between doctors and patients, and that the two were now testing an AI tool to facilitate nurse handoff reports.
"Everyone's trying to get ahead of it," says Avishkar Sharma, MD, CIIP, director of AI at Jefferson Einstein, part of the Philadelphia-based Jefferson Health network, which has been working with Aidoc in the radiology space for several years and is considered a leader in that space. "It's an ever-present conversation [in every health system boardroom]."
At the AIMed Global Summit this past June in San Diego—as well as other healthcare conferences like ViVE and HIMSS—the focus on AI was around what many call "low-hanging fruit." To wit, healthcare organizations are looking to use the technology to handle administrative tasks that consume time and energy for staff, including doctors and nurses.
"That's the immediate benefit," says Stephen Motew, MD, MHA, FACS, executive vice president and chief of clinical enterprise at the Virginia-based Inova Health System. "Where are the small, value-added opportunities in our day-to-day operations … that can be made more efficient?"
Indeed, while questions remain around AI governance and policy, health system executives who want to get their foot in the door are launching small programs that use tightly controlled, non-PHI data, finding the benchmarks and the benefits, then moving on to more ambitious projects.
Sharma fits AI adoption into the Gartner Hype Cycle, which charts the maturity, adoption, and social application of technologies. The five stages of that cycle are Innovation Trigger, Peak of Inflated Expectations, Trough of Disillusionment, Slope of Enlightenment, and Plateau of Productivity. He says AI has moved beyond that first stage and sits between the second and third, with health systems looking to find meaningful value beyond the hype and potential.
"We're very much in that turbulent phase," he says.
And that's why these recent announcements are important. They show that health systems are putting skin in the game and moving forward with pilot projects.
Motew says these partnerships are also important at a time when operating margins are thin and health system leaders are hesitant to take on new ideas. Few health systems have the IT talent on hand to make these moves on their own or scale them out to the enterprise.
Furthermore, these partnerships support health systems who are moving their data into the cloud and need help with cloud management.
"This is what everyone is trying to figure out now," he says. "And we want a seat at that table."
Sharma says partnerships are essential to developing and scaling AI programs across the enterprise, but they also have to be nimble. Owing to the evolving nature of the technology, an AI program created now that will use a specific subset of data to address a specific pain point won't be the same program in, say, a year's time. The technology, the data, and the governance around it will mature dramatically.
"You have to build relationships that are ongoing," he says.
Lastly, AI programs coming down the pipeline need to be guided by clinicians. Both Motew and Sharma also say that while the C-suite needs to set safeguards and parameters for AI use, the true value of the technology will be found by those using it.
"We encourage our teams to play around with it," Motew says. "The best ideas are going to come from the people using it every day."
"Clinicians very much need to be in the conversation and in the driver's seat," adds Sharma.
The health system is reporting positive results from a chronic care management program launched in 2021, and now wants the Geek Squad to manage more patients at home.
Geisinger is expanding its partnership with Best Buy Health to bulk up a remote patient monitoring platform that’s showing positive clinical outcomes.
The Pennsylvania-based health system launched ConnectedCare365 in 2021 and joined forces with the retail giant's Current Health subsidiary to give patients better access to chronic care management tools at home. According to health system officials, the program has enrolled more than 1,100 patients and is seeing an almost 20% improvement in care plan adherence, while speeding up the time patients begin the program after leaving the hospital and cutting technical issues by almost 20%.
The collaboration is being closely watched by the healthcare industry as more health systems move care pathways into the home and RPM programs show results, particularly in managing care for patients living with diabetes, congestive heart failure, chronic obstructive pulmonary disease, hypertension, and other issues.
The partnership enables Geisinger to refer patients identified in the hospital for RPM to Current Health, which visits the patient's home, sets up each patient with the right equipment for the program and ensures the devices are transmitting data to the care team at the hospital. Through the 'Geek Squad' format made popular by Best Buy's retail electronic and computer departments, Current Health keeps in touch with patients and helps with any technical issues.
"We know the myriad benefits of care at home for patients, families, and the health system, and the Current Health platform allows us to care for patients with chronic diseases in the home," Karen Murphy, Geisinger's executive vice president and chief innovation officer and founder of the health system's Steele Institute for Health Innovation, said in an e-mail to HealthLeaders. "In addition, working with the Geek Squad is a fundamentally different approach to a remote patient monitoring program. Instead of a patient receiving devices in the mail, the Geek Squad provides personal instruction on how to operate the device and how to communicate with the care team."
"Best Buy Health and their large supply chain and logistics capabilities offered a very promising solution for us," she added. "We’ve seen great results so far and are excited to expand the program to more use cases."
This isn't Best Buy's only partnership. Earlier this year the retailer joined forces with Atrium Health to support the North Carolina health system's Hospital at Home program. At the HIMSS conference in Chicago shortly thereafter, Chris McGhee, Current Health's co-founder and CEO, said the deal is indicative of a healthcare industry looking to be more consumer-friendly and apply some retail strategies to its platforms.
"We're fundamentally changing healthcare," he said, noting the Best Buy can pick and choose the technology needed to make the best and most reliable connections between a patient in the homes and his or her care team at a hospital. "Hospitals value that curation."
That's especially true as health systems like Geisinger expand their RPM programs to manage more patients with more health concerns. The ability to scale programs up and out and have Current Health manage the technology deployment and monitoring takes pressure off of health system executives and clinicians, giving them more time to focus on the clinical side of the program.
"Technology-enabled care-at-home programs allow us to extend their reach beyond the confines of traditional settings and bring high-quality care directly to the comfort of patients' homes," Murphy said. "These models have been shown to improve outcomes—especially readmissions—and provide more comfortable experiences and lower costs."
"Our work with Best Buy Health allows us to better cross the threshold into patients' homes and, through the Geek Squad, enable them to use RPM technology," she added. "The data shows the impact on the patient – they are getting the technology faster, adhering to their care plan better and having fewer technical issues. And they’re giving their experience high marks afterwards."
A new partnership will open primary care clinics in select YMCAs around Memphis, offering more convenient access to care for local neighborhoods as well as businesses.
A new partnership in Memphis aims to address local businesses' needs for primary care access for their employees as well as access to care in underserved neighborhoods.
Chamber Benefits, a health plan subsidiary of the Greater Memphis Chamber of Commerce, is joining forces with the YMCA of Memphis & the Mid-South and WeCare, a Florida-based provider of onsite and near-site primary care centers for businesses, to open primary care health centers in YMCAs across the greater Memphis area.
The project addresses an acute care gap in many cities: A lack of accessible primary care services for both businesses looking to get a handle on employee healthcare costs and underserved neighborhoods. Some cities have partnered with community health organizations and others to put health clinics in such sites as libraries, retail locations, and pharmacies or grocery stores.
The goal here is to improve community health as well as support local businesses. It also aims to reduce the strain on local health systems by improving access to immediate and preventive care and cutting down on unnecessary emergency room and clinic traffic.
Each 2,500-square-foot clinic will have full-time staffs that include primary care physicians and health coaches.
“This is a partnership united by its love of Memphis and desire to see greater access to primary care throughout our community,” Ted Townsend, president and CEO of the Greater Memphis Chamber, said in a press release. “ChamberCare Health Centers are designed to improve not only the health of our community but of our economy. Enrolling in this program will help small businesses, which create two out of every three jobs, provide their employees with exceptional benefits at low costs in a highly competitive jobs market.”
“This partnership perfectly aligns with our mission to support programs that build a healthy spirit, mind, and body for all," added Jerry Martin, YMCA of Memphis & the Mid-South's president and CEO. Providing access to quality healthcare, especially in areas with fewer options, enables us to broaden our services to continue to help families and individuals thrive on their journey to wellness.”
Organizers are currently deciding on three sites to open health centers, beginning in 2024. Businesses can enroll employees in the program for $40 per month per employee, while community residents can also enroll for $40 per month. Dependents are added on at no charge.
Following the opening of the first health centers, the partnership will open a new clinic in another YMCA location for every 2,000 people enrolled in the program, including dependents.
Northwell Health SVP and CIO Sophy Lu says health systems have to embrace consumerism—and the technology needed to support it—to establish personalized care experiences.
A health system's digital strategy won't work unless it's aligned with current trends and technologies, much like a car won't function at its best if its wheels aren't in alignment. And it's up to healthcare leadership to guide that transformation.
According to the HIMSS 2022 Future of Healthcare Report, roughly 90% of health systems surveyed expect to have a digital strategy in place within five years, and more than 60% say they're in the middle of that journey. But that strategy has to be planned carefully, focusing on how information is gathered from various locations, analyzed, and used to improve care pathways. Digital strategies won’t work unless there's a clear direction from leadership on value and ROI.
"We're in the business of delivering care," says Sophy Lu, senior vice president and chief information officer at New York's Northwell Health. And for that process to work best, she says, "We need to be in perfect synergy … with the patient experience."
And that begins with data.
"Data is the fuel for innovation," Lu said during a presentation at this year's ViVE conference in Nashville. This includes data from the health system's various platforms, like the EHR, as well as information from outside the network, culled from and about patients as well as payers. That data helps to create a plan to address a patient's healthcare needs and preferences and to work with payers to facilitate the patient's healthcare journey.
With so much data coming from outside the enterprise, health systems must invest in the technology to integrate and analyze that often-unstructured information. Lu says it's important for health system leaders to set the tone for that strategy by supporting digital health platforms that use data to improve the patient journey.
"Whatever we can do to enable that ease of experience will help us," she says.
It's a strategy that has been around long before the pandemic, Lu says, yet COVID-19 exposed just how slow the healthcare industry has been in effecting change. In many cases, she says, health systems are using legacy technology and antiquated processes for collecting, analyzing, and using data. Either they haven't committed the resources to upgrading that technology or they don’t feel they have the money to make those improvements.
"It takes a lot of energy technologically to integrate and validate" consumer-focused care with old tools and platforms, she says. "You have to invest in that change."
Many health systems are pulling in digital health partners to help execute that strategy. Northwell Health is working with b.well Connected Health, based in Baltimore. Company Founder and CEO Kristen Valdes says healthcare organizations often lack a background in understanding consumerism and need help on the intricacies of meeting patient needs, a concept she calls "shopability."
That includes learning how to work with partners to identify and implement consumer-friendly services, something the healthcare industry has traditionally avoided.
"The technology behind that is actually not a challenge," she says. "Change management is complex, [as is] learning how to collaborate. A lot of [health systems] need help as they make that transition toward consumerism."
Federal efforts to support interoperability and data transparency are helping to push healthcare organizations closer to sharing data, Lu and Valdes say. But the going isn't easy for an industry that has traditionally chosen to protect its own data in silos. Some are reluctant to share that data, especially with patients.
"They have to [come around to the idea] of how do I not just comply with a rule," Valdes says, but also invest in transformation that puts that data before both the patient and the provider and prompts them to collaborate.
In this era of shifting attitudes toward data, Lu says Northwell Health has to be "the harmonizer," leveraging data from multiple sources to create a longitudinal health record. Health systems that, as Valdes says, "own the process" will likely stand out among in an increasingly competitive field for care services.
"This is a journey toward personalized care," Valdes says. "How do we take a consumer and build an experience around them?"
The tool aims to predict a patient's chances of dying within 5-90 days of admission, helping care teams to decide when and how to integrate ACP into care management.
OSF Healthcare is using AI to help doctors and nurses integrate end-of-life discussions into care management plans.
A research team at the Illinois health system led by OSF Senior Fellow for Innovation Jonathan Handler, MD, tested an AI model that predicts the likelihood of a patient's death five to 90 days after admission. That information is then used by care teams to decide when to begin advanced care planning (ACP) for patients and their families.
The tool could help health systems improve care for a large number of patients. Surveys estimate only 22% of Americans have documented their end-of-life wishes. ACP can reduce the use of complex or intensive treatments at the end of life, thus reducing the cost and length of hospital stays and the amount of anguish placed on family members.
"Although experts agree on the importance of ACPs, clinicians cite time constraints and poor communication with other providers as barriers to having end-of-life discussions," Handler and his team wrote in a recently published study. Reduced access to healthcare in mixed-rurality populations may make ACP even more unlikely. Due to these barriers, many patients do not have documented preferences at the end-of-life and therefore do not achieve what has been termed an 'ideal death.'"
The researchers tested the tool on a dataset of more than 75,000 inpatient visits both before and during the pandemic, ensuring that the tool holds up over time and is equitable across genders, races and ethnicities, and against rural and socioeconomic factors. According to the study, the model helped to identify more than half of patients within the 5- to 90-day range.
"We sought a model to predict post-inpatient mortality to meet a different need – to help prioritize and encourage timely ACP conversations during an inpatient stay," the OSF team wrote. "The model’s intended use is to predict mortality soon after the length of an average inpatient stay. Therefore, the 5-to-90-day window was chosen to: 1) begin after the average 4-day length of an inpatient stay, 2) allow at least 4 days for an ACP if the inpatient stay is longer than average, and 3) create enough urgency to stimulate the ACP."
In their conclusion, Handler and his colleagues say their model holds up well over time and can help to "consistently and equitably help prioritize patients likely to benefit in the near-term from theses crucial conversations."
The Farm Family Resource Initiative offers telehealth access for mental health services to rural farming and ranching communities, where suicide rates are two to five times higher than other populations.
Rural health system executives looking to address the soaring mental health crisis may be interested in how Illinois is addressing the issue.
Illinois Governor JB Pritzker announced this week the state-wide expansion of the Farm Family Resource Initiative (FFRI), a program coordinated with the Southern Illinois University (SIU) School of Medicine to improve access to mental health services for rural communities, especially those in the agricultural industry.
"As governor, as a father, and as someone who has personally witnessed the mental health epidemic among family and friends, there is nothing more important than making sure every Illinoisan has access to the mental health services they need to lead happier and healthier lives," Pritchard said in announcing the program expansion at the 2023 Farm Progress Show in Decatur. "Our greatest problems require our most creative solutions — and I am confident that this grant program will simultaneously break down barriers and open up doors for our state's number one providers."
The program, supported by federal funding from the US Department of Agriculture's National Food and Agriculture (USDA NIFA) program, creates a statewide telehealth network for mental health services, along with a grant program to support Future Farmers of America (FFA) state chapters developing new projects aimed at encouraging and improving healthcare access through rural communities and their schools.
The effort addresses a particular pain point in rural healthcare. Farming and ranching communities are traditionally less open to talking about mental health issues, and as a result don’t access local hospitals or clinics when they need help. According to the Livestock Project, suicide rates among farmers are two to five times higher than the national average.
For health systems serving these communities, the challenge lies not only in providing resources, but reaching out to these populations and convincing them to access care. With that in mind, healthcare executives are looking at telehealth and digital health tools and platforms to bridge those gaps.
Illinois launched the FFRI several years ago as a pilot project in six counties, offering both telehealth services and a helpline. Officials say the program has worked so well, improving access and clinical outcomes, that it's being extended to all 102 counties in the state.
Through the program, rural families can access up to six free telehealth sessions with mental healthcare providers through the SIU School of Medicine.
The program could be a model for other states and health systems looking to address mental healthcare at a population health level, targeting groups such as forestry workers, fishermen, migrant workers, and Native American communities.
The health system is the latest to test the technology on administrative tasks to address stress and burnout, and will also explore opportunities to use it as a caregiver tool.
HCA Healthcare is collaborating with Google on a generative AI platform designed to handle time-consuming administrative tasks for clinicians, and has already seen success in an ED pilot.
The Nashville-based health system, comprising some 182 hospitals and 2,300 ambulatory sites of care, is the latest organization to test large language model (LLM) technology to improve workflows and reduce stress and burnout among clinicians and staff.
“We’re on a mission to redesign the way care is delivered, letting clinicians focus on patient care and using technology where it can best support doctors and nurses,” Michael J. Schlosser, MD, MBA, FAANS, the health system's senior vice president of care transformation and innovation, said in a press release. “Generative AI and other new technologies are helping us transform the ways teams interact, create better workflows, and have the right team, at the right time, empowered with the information they need for our patients.”
The collaboration with Google is the latest activity in a partnership launched in 2021, which initially focused on privacy and security issues. It signals a growing interest among healthcare's biggest networks to apply AI to address key pain points in business operations.
In a pilot program launched earlier this year, HCA Healthcare integrated AI technology with smartglasses developed by Augmedix to enable 75 emergency department physicians in four hospitals to document conversations with patients. The platform used natural language processing and Google's AI tech and multi-party speech-to-text processing to convert the conversations into notes, which the physician would then review before entering into the medical record.
The health system and Google are also working on applying AI to nursing operations. They're developing a platform that can generate handoff reports, with specific attention paid to medication, vital signs, labs, patient engagement, and response to treatment. The goal is to give nurses a tool that reduces the time and energy spent on documenting patient encounters and gives them more opportunities to interact with patients.
HCA Healthcare has been refining the platform after receiving nurse feedback and is now testing the technology at UCF Lake Nona Hospital in Orlando, Florida.
Beyond addressing workflows and administrative functions, healthcare organizations are interested in using AI as a clinical decision support (CDS) tool, enabling care providers to quickly and easily access the information they need at the point of care. Researchers at Boston's Mass General Brigham recently announced that a test of ChatGPT as a CDS tool found that the LLM platform was 72% effective in making clinical decisions and 77% effective in making a final diagnosis.
With that in mind, HCA Healthcare is first examining the value of AI for caregivers through Google Cloud's Med-PaLM 2 LLM platform. The idea there is to create a tool that caregivers can use to access resources and find answers to medical questions.
“Having an LLM tailored for medical questions and content could be beneficial for certain critical use cases,” Schlosser said in the press release. “We expect Med-PaLM 2 will be especially useful when we’re asking complex medical questions that are grounded on scientific and medical knowledge, while looking for insights in complicated and unstructured medical texts.”
Tampa General Hospital's vice president of innovation and managing director of TGH Innoventures talks about looking beyond the 'shiny new objects' to find real ROI
Finding innovation in healthcare that works is challenging. An idea must be developed and tested by those who would use the new strategy or technology, all while mapping out value and showing data that prove clinical or business outcomes. And that ROI had better show up now, not next year or even next month.
"It's a lot like Whack-a-Mole," says Rachel Feinman, vice president of innovation at Tampa General Hospital and managing director of TGH Innoventures, the hospital's innovation center and corporate venture fund. "And all those shiny new objects out there aren't really helping us."
With concepts like AI and virtual care on the landscape, healthcare executives aren’t about to ignore the innovation space altogether, but they need a firm grasp on the plausible at a time when budgets are thin and the pressure to get better is heavy. Some organizations are launching their own innovation centers and spinning out their own startups, with the idea of growing and nurturing ideas from within.
Rachel Feinman, vice president of innovation and managing director of TGH Innoventures, Tampa General Hospital. Photo courtesy Tampa General Hospital.
At Tampa General, Feinman and her team partnered with the People Development Institute (PDI), a career development and growth facility developed by the hospital and the University of South Florida's Muma College of Business, to launch IdeaMVP, a program modeled after Shark Tank that enables health system staff to shepherd an innovative idea or technology from concept to solution. The solution is then evaluated by Tampa General's C-suite and, if found good enough, greenlit for implementation.
Feinman says hospital staff often have a unique view toward solving difficult problems, and they know what needs to be done.
"We have to have a broad view on what is innovation," she says, "but we also have to be clear that it's solving a need or a problem within the organization. There are a lot of [start-ups] out there right now that have great ideas in search of a problem."
"This isn't for the faint of heart," she adds. "At the end of the day, you are talking about adding something to somebody else's already-busy plate. It had better be good."
Feinman has a unique skill set to lead Tampa General's innovation strategy. After graduating from law school and spending more than a decade in that field, she pivoted to executive director of the Florida-Israel Business Accelerator, creating a pipeline between the Sunshine State and a country well known for its active healthcare technology innovation space (one look at the large Israel pavilions at HLTH or HIMSS is all it takes). She came to Tampa General in 2021 and has been instrumental in putting the hospital squarely in the innovation arena.
Feinman, who works closely with the IT department and reports directly to the hospital's two CIOs (information and innovation), says technology is an ever-growing tool to improving outcomes and workflows, but it's only a tool. Innovation to her is mostly about strategy, or about thinking up new ways to do things that are better than the old ways.
"Innovative projects hardly ever fail because of the technology," she says. "They fail because of change management. If that isn't [addressed correctly], nothing goes forward."
To that end, she says, the PDI is an important resource to help those within the organization understand how to design an innovative service, including how to secure buy-in and manage expectations around new workflows. For example, a nurse with a great idea of how to improve in-patient care must factor in both patient and nurse viewpoints, while an IT staffer who has come up with a new algorithm needs to make sure everyone associated with that technology, from nurses to doctors to IT support, understands why this new tech will help.
Feinman and her team are also at the head of a seismic (if very slow) movement in healthcare: The shift from episodic to value-based care. She acknowledges that "we still live in a fee-for-service reality," but says the future lies in VBC. That means identifying actual value in healthcare services and, just as importantly, learning how to collaborate with payers to support those services.
It also means understanding healthcare consumerization and taking the friction out of the healthcare experience. As the movement continues, value will be determined as much by the consumer as by the provider, and programs that don’t address consumer preferences and convenience will fail to gain traction.
"Healthcare is the last industry to [embrace] consumerization," she says. "That's the world that we are living in now, and that's how we have to respond."
The HHS' Advanced Research Projects Agency for Health is looking for 'proven technologies developed for national security' that can help health systems address cybersecurity attacks and ensure that patients continue to receive care.
Federal officials are looking for help developing cybersecurity solutions to address healthcare data breaches.
The Advanced Research Projects Agency for Health (ARPA-H), a division within the Health and Human Services Department, is seeking "proven technologies developed for national security" that can be used to counter cybersecurity attacks.
The effort comes as the nation's healthcare industry faces an increase in malicious attacks, including ransomware attacks. Some 344 data breaches were reported by US healthcare organizations in 2022, according to the Identity Theft Resource Center's 2022 Data Breach Report, the third straight year that healthcare was the top industry to face attacks.
One particular goal of the Digital Health Security (Digiheals) project, officials say, is to ensure that patients continue to receive the care they need in the wake of a cyberattack.
“The Digiheals project comes when the U.S. healthcare system urgently requires rigorous cybersecurity capabilities to protect patient privacy, safety, and lives,” ARPA-H Director Dr. Renee Wegrzyn said in a press release. “Currently, off-the-shelf software tools fall short in detecting emerging cyberthreats and protecting our medical facilities, resulting in a technical gap we seek to bridge with this initiative.”
“By adapting and extending security, usability, and software assurance technologies, this digital health security effort will play a crucial role in addressing vulnerabilities in health systems,” added ARPA-H Program Manager Andrew Carney. “This project will also help us identify technical limitations of future technology deployments and contribute to the development of new innovations in digital security to better keep our health systems and patients’ information secure.”
Healthcare organizations are asked to submit proposals through the Sharing Health Applications Research for Everyone (SHARE) BAA. Officials say they expect to issue multiple awards, depending on the quality of proposals and availability of funds.