The Virtual Health Assistant

 

Watch as a Virtual Health Assistant Engages a Patient on a Smartphone

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Will virtual nurses and pocket health coaches improve patient engagement?

With the Alme natural language platform from Next IT, you can provide the personalized service of a concierge while delivering the business benefits of a technology-based self-service solution.

Alme is a multi-modal, multi-channel, multi-language platform designed to revolutionize customer service by creating intelligent virtual assistants capable of understanding what your customers actually mean. Alme uses this knowledge in unprecedented ways to deliver information and perform tasks, giving your customers an experience that’s all about them.

Talk, tap or type—Next IT virtual assistants are ready with the right answer, providing an integrated approach proven to boost customer satisfaction, user engagement and revenue.

Natural Language Processing has appeared in the business world. Much more powerful that a voice tree selection it offers a form of artificial intelligence able to understand selective questions and answers verbally.  Mobile  health and smartphone users are familiar with Apple’s Sirius, and Google Voice recognition.

Many companies have their own proprietary system specialized in their niche.

With Alme’s processing power,combining voice recognition and NL P (natural language processing) Your staff for  customer service, requests, and patient needs is multiplied and amplified many times.

By 2015, Gartner predicts that half of online customer self-service search activities will be via virtual assistant – that's just two years away. Companies will have a fire hose of patients coming at them – the smartest will know how to control and use it.

Every health facility and virtually every function within a company, wants better insight and greater confidence in understanding patient or provider needs, behavior, and preference. Which investments will give the greatest lift? Which processes or product improvements will create users that are loyal for life? Which touchpoints are triggers to grow share of market and yield increased efficiency and market share?

AMJMC

Virtual Health Assistants Poised to Revolutionize Healthcare Delivery - See more at: Technology continues to advance at such an incredible pace that it can be hard for many industries to keep up with the ways in which new systems and processes can help them be more effective. In this morning’s session, “Your Next Provider Will Be an Avatar,” presenter Thomas Morrow, MD, explained why it’s necessary for the healthcare industry to not only keep pace with technological innovations, but also to integrate these technologies into several aspects of care. - See more

The next revolutionary disruptive technology that needs to transform medicine, according to Dr Morrow, is the Virtual Health Assistant (VHA).   The VHA is a technology that is not only needed, but inevitable. There needs to be a sophisticated technology that is capable of cutting down on the high cost of medical care. Dramatic physician shortages—which are poised to only worsen—and the constant explosion of information that cannot be handled because of natural cognitive limitations are leading to less time for patients in the examination room. To prove this point, Dr Morrow mentioned that primary care physicians (PCPs), on average, take on 28% more patients than they are able to handle. Even worse, patients typically have only 27 seconds to explain their symptoms before being interrupted by their physician. Dr Morrow added a personal anecdote related to this statistic, telling the audience about how a patient he had been speaking to was having chest problems and went to see several doctors without having any improvement. The patient had been interrupted and misdiagnosed each time until Dr Morrow had actually stopped to listen to all of his symptoms and told him to ask his next doctor about potentially having an aneurysm, which turned out to be the case. The patient was admitted later that day. -

This may be one of those disruptive technologies that operate at the strategic level.

Here are some of the additional ways in which  VHAs will be able to transform the healthcare system:

• Managed Care Organizations: HEDIS and medication adherence improvements are the low hanging fruit right now.
• Disease management companies can utilize this technology to help patients better manage chronic conditions.
• Retail pharmacies can set medication reminders.
• Specialty pharmacies can use this technology for clinical assessments.
• Pharmacy benefit managers: can also use aspects of disease management and medication reminder programs.
• Pharmaceutical companies can use VHAs for patient recorded outcomes.
• Hospitals can use a variety of programs to reduce readmission rates.

The possibilities for VHAs in healthcare are endless. With the technology available at the disposal of patients, providers, and payers, it is essential to start incorporating these programs into daily life. With the potential for cost savings, no one can afford to ignore these technological advancements.   And as important as cost saving, better and more consistent outcomes may also be a by-product.

All Is Not Well in the HIT Space

 

Several upcoming deadlines are on the horizon that will impact operations of providers, hospitals, and intermediaries.

HHS has a fairly cavalier attitude about the changes mandated by Obamacare. Some of these issues are very serious and not to be taken lightly. For providers the impact will be major in terms of operations, ability to bill correctly and the liklihood for substantial expenses to convert ICD Coding from ICD-9 to ICD-10.

HHS and the ACA have set arbitrary and unrealistic deadlines for these changes.  Inexplicably Farzad Mostashari, who thus far has done an exemplary job planning, educating and implementing the changes cast upon us by the Affordable Care Act.   Farzad Mostashari, MD, is the National Coordinator for Health Information Technology. In this role, he oversees the Office of the National Coordinator for Health Information Technology (ONC), a division of the United States Department of Health and Human Services. He joined ONC in July 2009 and was appointed national coordinator in April 2011.

Farzad Mostashari, MD, the national coordinator for healthcare IT, asserted today there would be no extension of the deadline for switching from the ICD-9 medical coding system to ICD-10. The deadline for conversion would remain Oct. 1, 2014. 

Converting from the old ICD-9 diagnostic coding to ICD-10 is much more complex than adding or changing a few codes. The ICD codes are deeply embedded in provider actions and insurance company process. Most providers will be unable to accept ICD 10 codes as of the original deadline of October 2013, so the original deadline was pushed back 12 months until October 2014.

However even at that date most providers and/or insurers will have to use a dual system of legacy ICD 9 and ICD 10.

The consulting firm Deloitte’s White Paper elaborates in detail about the process of the conversion, the expense, and complex inter-relationship of HIT systems, including Electronic Medical Records, and coding. Switching to ICD 10 involves much more than adding codes (the increase is about 7,000 in ICD 9 to over 40,000 codes.

The lofty goal is worthwhile and obtainable. The process is well explained and oulined in this chart.

Mostashari is on the ‘firing line’ from both side s of the table for other issues as well.

Today in the third of three hearings held by subcommittees of the House Energy and Commerce Committee, Farzad Mostashari, National Coordinator for Health Information Technology reassured a congressional panel that health IT interoperability will take some dramatic leaps forward within the next two years.

Michael Burgess, MD (R-TX) vice-chairman of the House Subcommittee on Oversight and Investigation, questioned the sluggishness of interoperability.

“We do hear about this a lot,” Burgess said. “Even anecdotally, hospital systems in the same city, that have the same operating system aren’t talking to each other.”

“You’re the head, why don’t you fix that?,” he asked Mostshari. “Why don’t you just make that happen?” Was this a rhetorical question ?

This statement reveals the lack of understanding by congress how our health system operates and the complexity and workings of daily operations by hospitals and providers.  This type of political grandstanding serves no productive purpose, especially when all the principals  had mulitple reform deadlines given to them in an arbitrary fashion by HHS.

It also points out the misguided perception that throwing money at  issues is not the entire solution and also that ‘haste makes waste’  It appears that Congress learns slowly.

 

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Not having an Electronic Health Record

From:  The Glass Hospital

 

The 92 year old lady with a hip fracture, a not uncommon story.  What will happen?  Here’s one scenario.

 

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This frequent occurrence played out as such:

Orthopedic Dialogue

Six months ago I posted a story about a demented 94 year old patient who’d fractured her hip. She’d lost more than thirty pounds in the preceding months and had already had a collarbone fracture from a previous fall.

The course of action in this case resulted in a breach of ethical conduct, bad feelings in the department, and the opening for a medical malpractice incident. Fortunately only the first two occurred.

All of the above could have been avoided had there been an electronic health record.

After the outcome, the chairman of the department had this to say, which says it all,

At the end of our chat, the chairman handed me copies of pages from the patient’s chart.

“Is that your note?” he asked me. I nodded.

 

“I can’t read a word of it,” he told me.

The day is coming when this will no longer occur.

Electronic health records, health informaton exchanges, a national and/or regional health information network and interoperability will break the glass barriers between health information ‘silos’.

 

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BIG DATA META-DATA DATA-ANALYTICS DATA SCIENCE

 

Health care and health care informatics have an annual ‘buzz-word’. Physicians in clinical practice are bombarded with may medical terms which are fairly well mastered during the course of a career. Their has been many advances in science, biology, medicine and healthcare.

During the pre-clinical years students and physicians use some statitical means to measure probabilities, media, means, averages, standard deviations to determine risks and benefits of treatments. Statistics were taught as a separate free standing course, however unless one was going to be a researcher it was rarely used in every day practice.

In the current environment it has become vital to understand what informaticists learn and teach. Future practice patterns and evidence based medicine will be based on these studies.

In the past clinical situations have been measured fairly subjectively. Now with electronic data storage the data is much more objective, measured and quantified to be recorded.  Whether what we are measuring and recording are accurate is another story.  However it is the best we have for now.

The tools we use now are far more advanced and capable of storing almost an infinite numbe of data points.  Complex algorithms can be derived for calculating multi-factoral variables and to extract hidden relationships in a blizzard of seemingly unintelligible data.

Physicians and patients are just beginning to benefit from these new tools.  The evolution of ‘preferred practice patterns’, the cochrane studies, present more objective evidence based studies for clinicians. Meta-studies aggregate multiple related studies to build a greater and/or more diverse cohort.

Medical students and trainees are learning these techniques during their formal education.  However the current generation of clinicians have been left behind, as the current knowledge base explodes in size and in  methodology.

The growth is fueled by connectivity and also studies done in the late 20th century indicating the exponential growth of information and the technology to run it.