Healthcare - August 2021 by Healthcare Global

August 2021 | healthcareglobal.com

Heart to Heart Hospice: Providing comfort and dignity NHS TEWV: Digital strategy beyond the pandemic

Healthcare Campuses

NHS Stotland

Team Work, Team Work, Commitment Commitment and Innovation and Innovation

Heart to Heart Hospice: This is a headline which is longer

Steven Flockhart tells us how collaboration enabled NHS TEWV: Steven Flockhart tells us how collaboration enabled his team at NHS National Services Scotland to build This is a headline his team at NHS National Services Scotland to build a highly efficient staff-enabling, COVID-19 response which a highly efficient staff-enabling, COVID-19 response is longer

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FOREWORD

The COVID-19 challenge isn't over, but that doesn't mean it won't be Many of us had hoped COVID-19 would subside this summer, but sadly this hasn't been the case.

“DataRobot's modelling can ensure vaccine trials are diverse and will work on the whole population”

HEALTHCARE GLOBAL MAGAZINE IS PUBLISHED BY

Vaccine distribution has been deeply unequal, with poorer regions getting left behind. The new Delta variant has wreaked havoc - first in South Asia before spreading to the west, where it is now the most prevalent strain. Now scientists warn that England's decision to lift restrictions despite rising cases will endanger the whole world. It's clear the challenge isn't over, but that doesn't mean it won't be. We spoke to DataRobot's Sally Embrey, who told us they are building data models to ensure vaccine trials are diverse and will work on the whole population. Wolter Kluwer and Premier Home Health Care explain how they use data to save lives in two very different ways: in clinical settings and in-home care. We also have a feature on the latest wearables, from post-operative care to reproductive health. We have the tools to make things better; they just need to be used.

LEILA HAWKINS

leila.hawkins@bizclikmedia.com

healthcareglobal.com

CONTENTS

Our Regular Upfront Section: 10 Big Picture 12 The Brief 14 Global News 16 People Moves 18 Timeline: How Korea’s ‘big 5’ hospitals are preparing for digital transformation 20 Trailblazer: Andy Slavitt 22 Five Mins With: Beth Griffin

Team work, commitment and Innovation

The next generation of wearable technology

NHS Scotland

Hospitals

Digital Health

Big data, big solutions

Northwell Health Defining tomorrow’s healthcare today

MercyOne

Transforming the ecosystem of healthcare

102 Viatris

Adapting to change the Viatris way

Technology

The role of tech in public healthcare

Be What’s Next. Embracing the Digital Economy in Health. Find out what Australia’s digitisation opportunity means for Health.

Download today

124 Virtusa

Bringing transformative technology to healthcare

116

Supply Chain

DataRobot: How AI is driving diversity in clinical trials

140 Top 10

Healthcare campuses

152

Tees, Esk & Wear NHS Foundation

A digital strategy for the pandemic and beyond

164

Heart to Heart Hospice

Because everyone deserves comfort and dignity at the end of life

BIG PICTURE

August 2021

Fundamental VR’s virtual classroom Worldwide

This is Fundamental VR's virtual classroom, where surgical trainees meet with their instructors for lessons, regardless of where they are in the world. The educational platform includes a virtual whiteboard, and thanks to haptic technology, students can feel realistic sensations whether writing on the board or picking up a surgical tool. FundamentalVR healthcareglobal.com

THE BRIEF “I take pride in community outreach. We can build a collaborative, data-driven effort to recruit all types of people, so we can all trust vaccines” Sally Embrey

VP of Public Health and Health Technologies, DataRobot  READ MORE

“We've had a tremendous uptick in employee retention. All of a sudden, we started to see we were engaging a workforce that has historically been cast aside”

BY THE NUMBERS Fourthwall Testing

94-99% Efficacy of Pfizer and Moderna vaccines after two doses

Level of immunity remaining after several months according to research by Fourthwall Testing

8-12

8 - 12 month time lapsed after the second vaccine when a booster shot may be needed

Clinithink's AI cuts diagnosis time for newborn baby Innovative AI technology from Clinithink helped diagnose a rare disorder in a newborn baby, saving its life.

Jennifer Gentzlinger

Chief Operating Officer, Premier Home Health Care  READ MORE

“The potential for technology to improve healthcare is almost limitless. The key is remembering where it starts and ends - with data” Peter Springfield

Cloud Product Manager, Node4  READ MORE

August 2021

Why are healthcare networks so vulnerable to attacks? Elisa Costante from Forescout Technologies explains how vulnerabilities in the healthcare sector occur and how to secure IT networks. Five minutes with... Stanley Healthcare's Troy Dayon We ask the President of Stanley Access Technologies how tech can help carers support an ageing population

Managing supply chain risk in a postpandemic world Sundar Kamak, Head of Industry Solutions at Ivalua, has two tips for healthcare organisations to take a more proactive approach to their supply chains. Apply technology solutions. Connect key IT systems to leverage data wherever possible to drive better decisions. Establish a supply chain risk and performance assessment, monitoring and mitigation plan. Explore a self-distribution model and more transactional automation with procure-to-pay solutions. When the time is right, and you’ve been able to automate much of the source-to-pay process, then you can engage in more supplier collaboration and innovation activities. Diversify and expand the supply chain. Healthcare organisations need to create a system that offers a better view of essential medical supplies to ensure that they are optimising highly fragmented supply chains. This will more effectively align potential demands to constrained supply by avoiding excess in some regions and shortages in others. Resiliency can be improved by dual sourcing raw materials and having multiple suppliers from multiple regions.

 AETNA Aetna Behavioral Health, a company owned by pharmacy retailers CVS, has partnered with Psych Hub to reduce suicide among Americans. Suicide is currently the second cause of death among people aged between 10 and 34 in the US.  NEW YORK CITY New York Mayor de Blasio is doubling the city's $500 million investment in life sciences to establish New York as the global leader in this field and create 40,000 new jobs.

 NHSX The UK government continues to cause controversy with its plans for sharing patient data, with critics labelling the latest NHSX document a "rush job" that puts "profits before patients"  INDIA’S VACCINE PROGRAMME Women are being left behind in India's vaccination drive, according to reports, with rural regions, in particular, seeing only 30% of vaccines going to women

W I N N E R S AUG21

L O S E R S

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GLOBAL NEWS

UNITED STATES

Most and least racially inclusive hospitals revealed The Lown Institute released rankings of the most and least racially inclusive hospitals in each state. Hospitals received a higher ranking if they had higher patient counts from area codes with greater proportions of nonwhite patients compared to their "community area" radius. Unfortunately, the research shows racial segregation is common in urban hospitals.

August 2021

UNITED KINGDOM

Coalition of experts forms to tackle eating disorders Experts in mental health and eating disorders have formed Hearts, Minds and Genes to tackle the causes of eating disorders. The group is calling for the government to urgently reform existing services, stating that "no one should be dying from an eating disorder in 2021."

EGYPT

Egypt to use technology to diagnose cancer for the first time Egypt is introducing digital pathology technology to diagnose cancer for the first time. The General Authority of Healthcare will be using the new technology to improve detection and diagnosis rates. The move meets Egypt's Vision 2030, which includes digitally transforming many of the country's healthcare services.

UAE

UAE launches central platform to improve disease prevention The UAE's Ministry of Health and Prevention has launched Public Health Management, a centralised platform that aims to improve disease prevention, manage public health projects, and encourage take-up of health programmes among local. communities.

FRANCE

France announces €8 billion research plan for healthcare French President Emmanuel Macron has announced a 10 year, €8 billion plan that will focus on research and advances in digital healthcare, biotherapies, and preparing for future pandemics. The plan aims to address gaps in healthcare revealed by the COVID-19 crisis.

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PEOPLE MOVES JOY FITZGERALD FROM: ELI LILLY AND CO TO: UNITEDHEALTH GROUP WAS: CHIEF DIVERSITY & INCLUSION OFFICER NOW: CHIEF DIVERSITY & INCLUSION OFFICER UnitedHealth Group, one of the largest healthcare companies in the world has appointed Joy Fitzgerald as its Chief Diversity & Inclusion Officer. Fitzgerald joins having worked at pharmaceutical firm Eli Lilly for the last seven years, serving as Chief Diversity & Inclusion Officer for the last four, during which time the company has been ranked one of the top 3 firms for diversity in the US. Before this, she worked at Rockwell Collins, an aviation company as Chief Diversity Officer among other roles. Fitzgerald has received a number of accolades, including being listed in “Elite 100 Black Women Executives” by Diversity Woman Magazine, and named a “Rising Star" by the Healthcare Businesswomen’s Association.

August 2021

"In her role, she will help us build and shape the healthcare workforce of tomorrow so that it is reflective of the people and communities we serve"

TERRY BECK FROM: TELADOC TO: WELLFRAME WAS: VICE PRESIDENT OF HEALTH PLAN SALES NOW: SENIOR VICE PRESIDENT OF GROWTH

DR PAUL BURTON FROM: JOHNSON & JOHNSON TO: MODERNA

Terry Beck joins digital healthcare platform Wellframe from Teladoc, the multinational telehealth company. Beck has 25 years of experience in successful business plan execution. While at Teladoc, he led the company's efforts to modernise healthcare experiences and offer improved health outcomes for patients. Prior to this he was an executive vice president of client solutions at Ingenios Health. Beck will lead Wellframe’s growth team, overseeing business development and helping to build new relationships with health plan members.

WAS: CHIEF GLOBAL MEDICAL AFFAIRS OFFICER NOW: CHIEF MEDICAL OFFICER Dr. Paul Burton joins Moderna after sixteen years with Johnson & Johnson. Since March 2020, he served as Chief Global Medical Affairs Officer of the company's Janssen Pharmaceuticals division, where he was responsible for Janssen’s worldwide medical affairs strategy and execution. He also led the Johnson & Johnson collaboration with Apple for the digital HEARTLINE™ study, and has led clinical operations for all therapeutic areas across the Americas. healthcareglobal.com

TIMELINE HOW KOREA’S

‘

BIG 5

’

HOSPITALS ARE PREPARING FOR DIGITAL TRANSFORMATION South Korea's healthcare system is often referred to as one of the best and most efficient in the world. At a recent conference hosted by Korean Doctors’ Weekly, the country's most influential medical newspaper, representatives from Korea's five largest hospitals shared their plans for digital transformation, which will enable them to lead medicine in the future

Seoul National University Hospital The Seoul National University Hospital has a new telehealth platform and a high-speed wireless network and data centre. It has also focused its efforts on research - setting up a medical technology research committee and, in November 2020, implementing a cloud-based big data research platform. 18

August 2021

Seoul St. Mary's Hospital

Asan Medical Center

One of the largest hospitals in South Korea, and part of the country’s largest healthcare network (the Catholic Medical Center), this hospital deploys contactless nursing care and AI-based voice recognition medical records solutions that have been particularly beneficial since the start of the pandemic.

Asan Medical Center also uses a voice recognition system, in this case, to read medical images in real-time. Artificial intelligence helps to automate nursing schedules; additionally, there's an integrated data management platform and a precision medicine platform.

Yonsei University Health System Yonsei University Health System is set to open two new hospitals in 2026 that will have digital systems at their core. Meanwhile, there are efforts to make the organisation's culture more digital, and a new "smart office" is set to open at the end of 2021

Samsung Medical Center Samsung Medical Center is planning to start using virtual reality for treatment, along with digital therapeutics such as smart glasses, cloud-based AI tools for patient selfmanagement, and a range of digital treatments for people to manage chronic conditions. There are also plans to build a "learning health" system to leverage medical data.

healthcareglobal.com

TRAILBLAZER

SLAVITT ANDY

Campaigning for better healthcare in the US

HEALTHCARE ADVOCATE

ndy Slavitt is regarded as one of the most influential healthcare leaders in the US. Formerly the acting administrator of the Centers for Medicare and Medicaid Services (CMS), Slavitt really rose to prominence after the COVID-19 pandemic took hold, in part thanks to his frequent Twitter updates and sharp criticism of President Trump's handling of the pandemic response. Slavitt has a background as an entrepreneur. In 1999 he founded HealthAllies, an online insurance platform for uninsured or underinsured people, providing them with low rates for medical expenses. From 2003 to 2013, he worked at UnitedHealth Group, eventually serving as the Group Executive Vice President for its pharmacy offshoot Optum, where he oversaw the delivery of new clinical and technology solutions for the company's clients. He has also worked as a consultant for McKinsey & Company and as an investment banker with Goldman Sachs. In 2015 he began working for CMS. In the two years he was Acting Administrator; he led the successful execution of the Affordable Care Act and the shift to valuebased payment models. His passion for improving access to care and greater transparency were key drivers of this work.

August 2021

After the election of Joe Biden to the White House, Slavitt was appointed as a senior advisor within the COVID response team, a role that was intended to be short term. During this time, he assisted with a hugely successful vaccination programme - after hitting President Biden's goal of 100 million vaccines well before his first 100 days in the presidency, they doubled the target to 200 million, a figure that was reached in April. Slavitt announced he was stepping down from this role in June 2021. The same month he released his first book, 'Preventable', where he gives his perspective on the US response to the pandemic, in particular the Trump administration's failures. He also hosts a podcast called ‘In the Bubble’, providing updates and information on the virus and vaccinations. He is currently on the board of Cityblock Health. The company uses technology to provide care from doctors, nurses, behavioural health specialists, social workers and community health partners to people living in low-income communities. Cityblock's model is based on resolving the causes of poor health, addressing issues like poverty and a lack of access to nutritious food. He is also chair of the United States of Care board, a non-profit that aims to improve the healthcare system by redesigning policies informed by US citizens.

healthcareglobal.com

FIVE MINUTES WITH...

BETH

GRIFFIN MASTERCARD'S VICE PRESIDENT FOR NEW SECURITY SERVICES IN HEALTHCARE AND CYBER & INTELLIGENCE, ON TACKLING FRAUD WITH ARTIFICIAL INTELLIGENCE

Q. WHAT ARE THE MOST COMMON TYPES OF FRAUD AFFECTING HEALTHCARE AT THE MOMENT?

» Data breaches that often include

personal health information are enabling bad actors to sell this valuable data at multiples much higher than even credit cards on the dark web. There are also increasing fraud attempts targeting senior citizens via telemarketing since so many have been stuck at home during the pandemic. The bad actors call, posing as Medicare or other legitimate organisations, to obtain social security numbers, bank account information, or other personal health data in order to take out a loan, access a bank account or open an account. We also continue to see medical device fraud, pharmacy kickback schemes and other fraudulent activity by bad actors.

Q. WHAT ROLE DOES AI PLAY IN FIGHTING FRAUD?

» Traditionally, members of a payer’s

Special Investigative Unit (SIU) have manually reviewed claims to identify anomalies and created their own algorithms to identify fraud or rely on outdated rules. With Mastercard’s Brighterion AI, much of the intensive manual review can be eliminated by using risk scores and actionable rationale at both the provider and claim levels, which enable quicker and more accurate decisions. Further efficiencies come by stratifying the risk scores into different categories where the selection and investigation of certain providers and claims can be automated over time, creating additional time and efficiencies to focus on cases that matter.

“ BLOCKCHAIN, ACCESS TO MANY DATA SOURCES, AND AUTOMATED SCANNING SOLUTIONS HAVE THE POTENTIAL TO DRIVE FRAUD MITIGATION IN A MUCH MORE EFFICIENT MANNER” Q. WHAT OTHER ADVANCED TECHNOLOGIES CAN HELP DETECT FRAUD?

» AI is still at an early stage in the fraud

market and has tremendous potential to help fully automate fraud detection, fill cybersecurity gaps that often lead to fraud, and identify individuals who can be recognised as bad actors before they even perpetrate a fraudulent act. Advanced anti-money laundering (AML) technologies that quickly identify

money movement also have the potential to complement the current techniques to identify funds quickly that have been captured by bad actors. Lastly, blockchain, access to many data sources, automated scanning solutions, and other advancements have the potential to drive fraud mitigation in a much more automated, efficient manner than today’s market. healthcareglobal.com

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NHS NATIONAL SERVICES SCOTLAND

August 2021

NHS NATIONAL SERVICES SCOTLAND

TEAM WORK, COMMITMENT AND INNOVATION WRITTEN BY: LEILA HAWKINS PRODUCED BY: JAMES BERRY

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NHS NATIONAL SERVICES SCOTLAND

Steven Flockhart tells us how collaboration enabled his team at NHS National Services Scotland to build a highly efficient staff-enabling, COVID-19 response.

Steven Flockhart Director of Cloud Engineering & Operations

hen Steven Flockhart joined NHS National Services Scotland’s Digital and Security business unit, it was two weeks before the lockdown began. As the Director of Cloud Engineering & Digital Operations, he has a remit to oversee digital engineering and operations, and continue to build and drive excellence in supporting the delivery of NHS Scotland’s digital infrastructure. However, this suddenly shifted to helping NHS Scotland respond to a highly infectious virus that quickly turned into a global pandemic. Flockhart's team is responsible for a number of digital infrastructure operations that underpin NHS Scotland. His particular NHS Scotland board – National Services Scotland – is a non-departmental public body that provides advice and services to the rest of Scotland's publically funded health system. It is accountable to the Scottish Government and in total supports 14 regional health boards that vary greatly in terms of size and need. "Things smaller boards may want to do for themselves but may not have capability or capacity, we provide for them," he says. This ranges from IT equipment to the provision of things like the Scottish Wide Area Network, a public sector ICT initiative in Scotland that aims to establish high-quality IT networking and communications services across the country. "It's the backbone of the Scottish infrastructure that connects all of us together. The education, healthcare, police and fire services all get these services from us," Flockhart says. healthcareglobal.com

NHS NATIONAL SERVICES SCOTLAND

NHS Scotland: Team Work, Commitment and Innovation

Flockhart's team are also supported by expert consultants in the NSS cyber security centre of excellence and from the clinical informatics team. These teams work very closely together on securing the NSS infrastructure and services to ensure that NSS is protected from both external and internal threats and that any clinical use of software, infrastructure or services meet with both internal and regulatory standards. Scott Barnett, Head of Information and Cyber Security at NSS, comments, “NSS have committed to providing cyber security services throughout the development lifecycle as well as monitoring these national systems from the moment they go live.” He continues, “With targeted attacks on the health sector becoming more common, there’s a focus on strategic partnerships across the NHS, academia and third-party service suppliers to build a national cyber security capability that’s scalable to support our evolving national infrastructure” 30

August 2021

Dr Brendan O'Brien, Chief Clinical Informatics Officer at NSS, heads up the clinical informatics team. His team have developed an NHS Scotland approach to clinical safety assessment for major health IT programmes. In the past year this enhanced and directed the clinical safety of the national contact tracing solution and national vaccination End-to-End digital solution. He commented that the team's approach is "based on international best practice such as ISO 14971:2019 and sets a new benchmark for clinical safety assessments in Scotland." The COVID-19 response During the pandemic, one of NSS’s Digital and Security’s first tasks was to stand up a centre for the contact tracing service. "We had a huge amount of work that we needed to do on the engineering side to enable lots of different applications to talk to each other", Flockhart explains. “This included cloud telephony and a case management system”.

NHS NATIONAL SERVICES SCOTLAND

Flockhart’s team was responsible for making sure that the infrastructure that underpins the information capture systems was in place. Information from this system such as COVID19 infection rates and deaths, was the critical intel provided to the Scottish Government daily, informing the daily stand up’s by First Minister Nicola Sturgeon. Flockhart explains, “The data has to be provided early each day in order to go through further processing and scrutiny so the availability of these systems is of critical importance to ensuring that information being given to the public is accurate and verified.” During the rapid establishment of NHS Scotland Track and Trace, there was rapid recruitment, training and enablement of several thousand ‘home-based’ contact centre staff. Flockhart says, “We had to ensure staff were connected to the case management system via the cloud telephony deployed onto their desktop. Quite often, we would be looking at very large numbers of agents coming on board at very short notice. There would be hundreds of people on a Friday that would need to be enabled for a Monday morning, so a lot of work for my team would be making sure that all these things were in place and functioning properly."

STEVEN FLOCKHART

DIRECTOR OF CLOUD ENGINEERING & OPERATIONS, NHS NATIONAL SERVICES SCOTLAND

TITLE: DIRECTOR OF CLOUD ENGINEERING & OPERATIONS INDUSTRY: HEALTHCARE/TECHNOLOGY LOCATION: SCOTLAND Steven Flockhart is a professional Technology & Change Executive who leads the Cloud Engineering & IT Operations function. Steven has spent time working with well-established companies such as Royal Bank of Scotland, Sainsburys Bank, Lloyds Banking Group & Tesco. After spending more than 20 years in Information Technology Services, Steven has delivered large scale Transformation and Technology change programmes with a strong focus across Public and Private Cloud Services, Data Architecture, Data Science and Advanced Analytics.

EXECUTIVE BIO

“ I'm immensely proud of what our board, and NHS Scotland have done throughout the pandemic. Most of all, I’m naturally really proud of my team”

STEVEN FLOCKHART

SECURING THE HEALTH CARE DATA • • • • •

Real time data monitoring Real time hyper scaling Protecting data loss Securing Public Cloud Workloads Securing Vital COVID-19 Applications WATCH NHS SCOTLAND CASE STUDY

Check Point Software Technologies and NHS Scotland: collaboration and trust Roddy Maccallum, Country Manager for Check Point Software Technologies in Scotland, tells us about Check Point’s partnership with NHS Scotland and working through COVID-19. Check Point Software Technologies is a leading provider of advanced cyber security solutions, supporting and securing over 100,000 customers globally across all industry verticals, having initially made its name as a firewall provider. The company's portfolio today is split into three core areas: Check Point Quantum, firewall and network security solutions; Check Point CloudGuard solutions for the public and private cloud; and Check Point Harmony, solutions for remote working that include mobile and SaaSbased protection. These three product families can be consolidated into a single architecture called Check Point Software Infinity-Vision. "It adds real business value because customers can consolidate from potentially as many as 10 to 15 security vendors, adding security benefits in terms of shrinking that landscape but also massive commercial benefits in terms of freeing up resources and consolidating costs."

Scotland were put under a lot of pleasure to create the app at speed and at scale. Due to the incredible trust and partnership NHS Scotland have with Check Point they were able to quickly spin up this application in Azure, as they do so knowing that all of the workloads deployed inside of their Azure platform are secure due to the world class security Check Point provides for their Azure environment “ Maccallum says. Having witnessed first-hand the immense stress NHS staff have been under as a result of COVID-19, Maccallum wants to express his gratitude for their efforts. "I would like to say thank you to the NHS, and I think it's really important to thank not just the frontline workers, but absolutely everybody connected to the NHS, from porters risking their own safety to transport patients in hospitals, to the chief executives that are under a huge amount of pressure to make sure their hospitals are able to support patients, right through to the IT teams. "IT plays a critical role in the NHS regardless of the pandemic or not. Having had an insight into just what NHS Scotland's IT staff have been through over the last 18 months, I have such huge respect and admiration for those guys."

Check Point Software has been working with NHS Scotland for over a decade, traditionally providing a basic network firewall, however Maccallum explains that this relationship flourished when Check Point Software began recruiting locally in Scotland. Today this partnership involves providing almost every element of cybersecurity to NHS Scotland, including network infrastructure and firewalling, through to securing all elements of NHS Scotland's public cloud workloads within Microsoft Azure. During the pandemic Check Point Software worked with NHS Scotland on mission critical programmes such as the track and trace app, which is hosted in Azure. "The team at NHS

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SCOTT BARNETT TITLE: HEAD OF INFORMATION & CYBER SECURITY INDUSTRY: HEALTHCARE/TECHNOLOGY LOCATION: SCOTLAND Scott Barnett is an established Information and Cyber Security leader, with strong people and risk management skills and a broad technical security knowledge. He has extensive cyber security experience gained from protecting the customers and partners of large and global organisations. He joined NSS after 12 years in the private sector where he held various cyber security roles including most recently Deputy CISO at TSB Bank. He previously served as a Police Officer in the Scottish Crime and Drug Enforcement Agency eCrime Unit, and has hands on experience of several major cyber security incidents.

EXECUTIVE BIO

NHS NATIONAL SERVICES SCOTLAND

1947

Year founded

Healthcare Industry

3,500

Number of employees

£797.7mn Revenue

Later in the response, the team moved to supporting the national vaccination programme. Flockhart's team pivoted to support the rollout, playing a key role in making sure an efficient scheduling system was developed and rolled out quickly and safely. As vaccination delivery accelerated, they swiftly moved on to supporting NHS Scotland’s efforts in running mass vaccination centres. "Initially, the focus was on provision of scheduling capability, but this expanded to the need for boards to run both mobile and community clinics. Therefore we were asked to equip boards with tablets and supporting security software so that they can efficiently and effectively administer vaccinations in any setting and run clinics that don't have to be in fixed locations". For Scotland, this is crucial to be able to deliver healthcare equitably, as the geographic diversity of the country means there are many remote communities to consider. "It's been a real help for NHS Scotland to have mobile capabilities so it doesn't have to depend on office buildings. 4G capability gives them the ability to use mobile technology." The digital journey While their focus over the last 14 months has been on the national COVID-19 response, the team's vision remains the same: to provide high quality services that deliver best value, and are as integrated as possible to make them simple for users right across NHS Scotland – staff, patients, and public. Modern technology will enable all of this. NHS Scotland commenced its new digital transformation journey in earnest in 2018, with the aim of using digital technology to make life easier for Scotland's citizens as well as healthcare services. This can and will benefit a broad range of services from healthcareglobal.com

Over the past 18 months the NHS has faced unprecedented demand and pressures due to COVID-19. The response to the pandemic was launched on many fronts - treating the ill, test and trace to minimise the spread of the virus and then the vaccine program. Scotland faced unique challenges in trying to manage at pace such a geographically disperse population, so it remained imperative that NHS Scotland had the ability to rapidly record and process data in real time. With NHS Scotland facing such an urgent problem, we approached them with a solution: working with Apple to acquire 1,600 iPads, which we then deployed with connectivity, dedicated software, mobile device management, logistics, support and crucially, network security, in partnership with Check Point Software Technologies. The iPads allow NHS staff to easily and securely record people who have registered for the vaccine, update details to the central database (via wifi and our 4G network), record which vaccine they’ve had and when their next appointment is due. We manage the full solution under our Digital Workplace portfolio, so they don’t have to - allowing NHS staff to focus on their day-to-

day work. Updates are immediate, ensuring that everyone always has the very latest information – essential for an effective, fast-moving rollout. Working closely with Check Point, we were able to ensure that the security embedded in this deployment aligned to what NHS Scotland uses in other areas - every device needs to be locked down, secure and protected from a malware, spam and data security perspective. With time ticking away, we distributed iPads all around the country in the three weeks leading up to Christmas, with Logan Air stepping in to deliver to the Islands on Christmas Eve. We ramped this up to 2,750 iPads by the end of January, ensuring NHS Scotland could get up to their full capacity of vaccination efforts. The programme was a direct aid to helping to put Scotland at the top of the European vaccination league. By Simeon Maurer O2 Business - Client Manager, Scotland

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NHS NATIONAL SERVICES SCOTLAND

screening programmes to the provision of services for GPs, to national platforms like the Community Health Index (CHI) platform – a unique ten-digit number used to identify patients across Scotland. COVID-19 has provided an opportunity to accelerate the digitising of more services, and has quickly enabled patients – particularly those in remote communities – with more ways to digitally interact with healthcare services. This even includes the ability to have virtual consultations with doctors. "It really did push us down some paths much quicker than perhaps would have happened through a traditional programme of change," Flockhart says. "I think some of these services will still exist going forward and will evolve to serve more than one purpose in the future. If we look at things like vaccinations, there's no reason why we can't run that vaccination service in a similar way to our flu vaccines which creates an opportunity to provide a more consistent and simplified approach on a ‘once for Scotland’ basis, for example." Supporting the workforce When the pandemic began, Flockhart's team assessed the capabilities staff would need to do their jobs from home. A small percentage had laptops and mobiles and were already using Teams, albeit in a limited way. "The first thing we did was make sure all of our staff could connect to the services they needed. We had to take a very close look at how much traffic we could have on our network and how many people could log on to the VPN at any one point." "We had to substantially increase our bandwidth, issue a huge number of VPN tokens, and a huge number of devices had to go out the door to staff to make sure people had the equipment they required."

“ We have all had a strong in this together momentum, moving in the same direction at the same time” STEVEN FLOCKHART

DIRECTOR OF CLOUD ENGINEERING & OPERATIONS, NHS NATIONAL SERVICES SCOTLAND

Office 365 and Teams were rolled out within two weeks, which staff embraced. "I would say this was probably the single biggest success we had in terms of enabling our workforce to be able to operate outside of the office environment," Flockhart says. "Yes, it comes with teething problems like anything else. But the ability it's given us to interact with each other in a connected, common, and consistent way has made a huge difference to people working from home. It's certainly one of the areas where we've had the most feedback and where people have found it the most helpful." Remote working put a strain on their helpdesk as people needed assistance with their equipment. "We saw call volumes go through the roof more or less overnight," Flockhart says. "I think that's a cultural thing – people think something is broken much quicker at home than when they're in an office environment, where the person next to them might usually be a quick point of help." Moving into the cloud The team provided the core infrastructure required to create online portals for vaccine bookings, which also allowed people to healthcareglobal.com

NHS NATIONAL SERVICES SCOTLAND

reschedule appointments if they couldn’t make them. "They're able to do it all themselves online. It's a seamless process," Flockhart says. Separate portals were developed for unregistered carers, i.e. people caring for someone in a home setting. "We worked collaboratively with the Scottish Government to create a portal for them to register to get their vaccines as a priority. That was stood up very quickly." These are secured thanks to the cloud, specifically Microsoft Azure. "We put a front door on our portal, so if you're not in Scotland and you're not supposed to be accessing the portal to generate an appointment for yourself, we will block these attempts and will be alerted to this. This type of technology is much easier, secure, and efficient for us to use than it would be for us to set up an on-premise environment." "Making use of Azure gives us the ability to be really safe. Once the data is in that environment, it's not accessible to anybody outside of that subscription. Humans don't necessarily have access to these types of things, as their security protocols are machine-driven rather than by individuals processing and moving data." "The dashboards that produce all the COVID statistics have systematic access that extracts information from the case management system. We're not relying on people to make these processes run; they’re automated. And because they all sit behind that firewall, it's a very ecure environment." "Our Azure subscription consumes information from our on-premise environment, done through a single connection which is secured", Flockhart adds. "This is monitored very closely because we need to proactively make sure 38

August 2021

we are ready for any issue. We've recently seen ransomware attacks elsewhere, so there's nothing to suggest that NHS Scotland wouldn't be a target as well.This is where our security team really come to the fore with the skills that they bring to the table. They are experts in this field and work continuously to provide us with a safe and secure environment to operate within.” Valued partners As well as Microsoft, NSS Digital and Security have critical partnerships with IT security firm Check Point and giants 02 and Apple. "Check Point is our primary defence barrier, both for our on-premise and our internet-facing services. They also provide us with equipment that supports our internal networking needs."

BRENDAN O'BRIEN TITLE: CHIEF CLINICAL INFORMATICS OFFICER INDUSTRY: HEALTHCARE/TECHNOLOGY LOCATION: SCOTLAND Brendan O'Brien is a Founding Fellow of the UK Faculty of Clinical Informatics; a Fellow of the Faculty of Public Health; and a professional member of the British Computer Society. In 2013 Brendan was the first CCIO appointed in Northern Ireland. In that role he established data extractions from GP clinical systems; delivered population risk stratification; established new information structures for the health service; and introduced Project ECHO®. In 2017 he was shortlisted for UK CCIO of the Year.

• Master's in Public Health • MSc in Computer Science and Applications

EXECUTIVE BIO

The partnership with 02 and Apple is around the provision of equipment in vaccination centres. "Through 02 and our relationship with Apple, we procured a very large number of iPads that have been deployed across Scotland for use in the vaccination clinics," Flockhart says. "They can be used anywhere from a mass vaccination centre like the Conference Centre in Edinburgh to a community hall in Dumfries and Galloway. All 14 health boards are using these devices in the centres. To be fair, in a very busy patient-facing environment, you want to very much minimise time being taken away from care (or in this case vaccinations), which is where the ease and efficiency of systems really come into the fore.” 02 provide the telephony, while Check Point provide the security software for

Brendan obtained his medical degree in 1994 and subsequently the following post-graduate degrees:

• MSc in Healthcare Informatics

NHS NATIONAL SERVICES SCOTLAND

the iPads. These relationships have been vital, as Flockhart explains: "Apple were a key supplier for us at a time when iPads were very much at a premium. We leveraged our good relationship with Apple and 02 to secure those devices just before Christmas when there was very high global demand." To bring this to life, on one occasion Apple chartered a plane to bring the devices over from China. "We were able to use our connections through the Scottish and UK Governments to speed up the process to meet the needs of the vaccination programme and get them through customs. The lead time for getting this stuff through customs is normally four weeks. However on this occasion, we got them through in 48 hours." Learnings from the pandemic Flockhart believes that a key lesson from the pandemic is that things can be done 40

August 2021

“ COVID-19 has provided an opportunity to accelerate the digitising of more services, and has quickly enabled patients – particularly those in remote communities – with more ways to digitally interact with healthcare services” STEVEN FLOCKHART

DIRECTOR OF CLOUD ENGINEERING & OPERATIONS, NHS NATIONAL SERVICES SCOTLAND

NHS NATIONAL SERVICES SCOTLAND

faster if necessary. "As somebody coming into the public sector for the first time, I think we can be far quicker to react to things. We must undertake tasks such as clinical safety assessments, cyber security assessments and penetration testing, but some internal processes perhaps could be revised to enable greater efficiencies and effectiveness." Another lesson has been greater collaboration. "When you start to work with different bodies, there's always a bit of clarity to work through who does what, but one thing the pandemic did was focus all of us on one specific outcome. It's created opportunities to work very closely and further develop relationships with organisations, like the newly formed Public Health Scotland, who we've worked with to build dashboards and reporting of COVID statistics. Also with NHS Education Scotland who developed the vaccine application which is a key part of the vaccination process."

"We have all had a strong ‘in this together’ momentum, moving in the same direction at the same time. It's been great building some of those relationships and even sometimes breaking down barriers as well." The same goes for NHS National Services Scotland. “It’s a vast organisation of a wide range of services and the COVID-19 response has even accelerated and created new connections for how our own organisation works even better together for the benefit of stakeholders” explains Flockhart. "I'm immensely proud of what our board, and NHS Scotland have done throughout the pandemic", he says. "Most of all, I’m naturally really proud of my team. There is no doubt in my mind that without their skills and commitment, we wouldn't be where we are today."

healthcareglobal.com

HOSPITALS

THE NEXT GENERATION OF WEARABLE TECHNOLOGY

WRITTEN BY: LEILA HAWKINS

Wearable technology has evolved massively since Fitbits appeared. We take a look at three key areas of innovation. 42

August 2021

HOSPITALS

earable technology for healthcare has evolved significantly since Fitbits started becoming household items. The combined possibilities of tracking data, constantly advancing technology , and a pandemic that forced most of the world to receive healthcare at home for more than a year, has led to huge innovations in wearable devices that do everything from reduce hospital stays to monitor the menstrual cycle. Post-operative care A complicated operation like an organ transplant typically requires a lengthy stay in hospital and significant post-op care. Two

major reasons for this are to prevent wounds from becoming infected, and regaining mobility. But what if there was a device patients could easily wear that helped both these areas so they could return home sooner? geko™ is the name of a wearable created by British company Sky Medical Technology, specifically for patients who have had a kidney transplant. This small muscle pump activator is worn round the leg, transmitting painless electrical pulses to stimulate blood flow. This prevents oedema, a common symptom of kidney disease caused by swelling due to a build-up of fluids, typically in the legs and ankles. healthcareglobal.com

Do More in the Cloud with Check Point CloudGuard and Microsoft Azure Check Point CloudGuard offers a full suite of security solutions targeted to critical cloud security use cases, such as protecting against advanced threats, achieving continuous compliance, and securing workloads— delivering unified security for Microsoft Azure.

LEARN MORE

HOSPITALS

Two trends to watch Femtech. The global femtech aka female technology market is expected to surge in the coming years. Women of Wearables (WoW) is a worldwide organisation that connects and promotes women in wearable tech across sectors, including healthcare, wellness, IoT and more. Wearable thermometers. As a result of COVID-19 temperature checks have become a normal part of entering public places. Fitbit and Huami make smartwatches that monitor rises in temperature; combined with data analysis this could help researchers track viral transmission and prevent an outbreak.

“ PPG-based monitoring solves the final technical challenge” DR. STEVEN LEBOEUF

PRESIDENT AND CO-FOUNDER, VALENCELL

In a randomised controlled clinical trial at Canada's Lawson Health Research Institute, 221 transplant patients were either given a conventional compression stocking or the geko™ device for six days after their operation. Researchers found that the patients wearing geko™ had less fluid retention as they were able to urinate more frequently. They experienced 31 per cent less swelling,

and were able to return home several days earlier than patients wearing the compression stocking. Perhaps the most remarkable outcome was the reduction in surgical site infections by nearly 60 per cent. Infections acquired in hospitals remain a huge problem worldwide, and transplant patients are at a particularly higher risk because of the immunosuppressant medication they need after an operation. Dr. Alp Sener, who led the trial, said: "The study results have been both surprising and exciting. Not only have we cut down wound infection rates, but we have also seen a considerable improvement in the new organ's function following transplantation. Patients reported feeling more satisfied with the transplant process and are more mobile." Sener is the Chair and Chief of Urology at Western University in Ontario. He added: "Reducing infection means a much better outcome for the patient and considering healthcareglobal.com

HOSPITALS

that recent data shows wound infections can cost the health care system thousands of dollars per person, it's a win-win situation." Monitoring menstrual cycles British medical device company Fertility Focus launched OvuFirst this year, a wearable sensor that helps women monitor their menstrual cycles. Worn on the arm or wrist overnight, it is alleged to be over 90% accurate at predicting ovulation, even for women with irregular cycles. It works by measuring temperature multiple times through the night. A woman's body temperature tends to dip slightly just before the ovary releases an egg; 24 hours later it rises and remains at the same level for several days. By downloading data from the OvuFirst sensor to a synchronised app each morning, it can track the ovulation period within an eight day window. The sensor works in a similar way to the company's existing product OvuSense, which is inserted like a tampon. While OvuSense is aimed at women who have been trying to conceive for a while, the wearable version is for women who are in the first months of trying to conceive, designed to be as noninvasive and simple to use as possible. “We took our revolutionary OvuSense patented technology proven in over 190,000 cycles of use, and used it to develop and test the most accurate skin-worn fertility monitoring sensor available on the market,” CEO Robert Milnes explained when the product launched. “We are proud to offer a convenient and easy-to-use solution to assist and support women during the early stages of their fertility journey, whether that is trying to start a family, or simply learning more about their bodies and cycles.” 46

August 2021

“ Not only have we cut down wound infection rates, we’ve also seen a considerable improvement in the new organ's function” DR. ALP SENER

UNIVERSITY OF WESTERN ONTARIO

Advanced blood pressure monitoring Perhaps the most common application of wearable technology is for measuring blood pressure. The prevalence of hypertension and its associated risks (it's frequently labelled "the silent killer") makes frequent blood pressure checks vital. Traditionally blood pressure monitors that work remotely have been uncomfortable, noisy and disruptive, until smartwatches were enabled to do this, leading to a wide variety of cuffless devices. The technology within these devices is evolving too. Pulse Transit Time (PTT) is the most common type of cuffless blood pressure monitors, the Apple Watch being one example. However PTT monitors use two sensors and need frequent calibration. PPG blood pressure monitors (or photoplethysmography to give their full name) only have one sensor and don't need to be calibrated.

HOSPITALS

Top 3 new wearables 1.

Fitbit. Their latest device, the Charge 4, has built-in GPS and a 24/7 heart rate monitor

2. Apple Watch. The newest model of smartwatch can take ECGs wherever the user is located 3. Withings BPM Connect. Worn as an armband, this measures blood pressure and shows the results straight away with easy-to-read visuals

August 2021

“ The marketplace will see finger clips, rings, smartwatches, headphones, hearing aids, chest patches, and more with PPG blood pressure technology” DR. STEVEN LEBOEUF

PRESIDENT AND CO-FOUNDER, VALENCELL

HOSPITALS

Valencell is a US-based biometric company that develops PPG sensors, and Dr. Steven LeBoeuf, President and Co-Founder, believes that PPG monitors are more accurate. "The advent of modern machine learning tools has helped earn PPG a solid edge in terms of accuracy, generality, and convenience" he says. "This is because the complexity of the PPG waveform and the richness of its features provide more information for machine learning approaches to “connect the dots” between PPG and blood pressure. " Calibration-free, PPG monitoring is ideal for small wearable devices, and the remote blood pressure market is growing steadily each year - by 2025 it is projected to be worth almost $3 billion.

"By enabling accurate, cuffless, calibration-free blood pressure monitoring within familiar wearable form-factors, PPGbased monitoring solves this final technical challenge" LeBoeuf says. "Ultimately, the marketplace will see finger clips, rings, smartwatches, headphones, hearing aids, chest patches, and more incorporating PPG-BP technology. This will enable seamless monitoring throughout one’s daily activities, providing the feedback needed to target user-specific therapies, managing hypertension, improving public health, and reducing medical costs." healthcareglobal.com

NORTHWELL HEALTH

Defining tomorrow’s healthcare today WRITTEN BY: JANET BRICE PRODUCED BY: JAMES BERRY

healthcareglobal.com

NORTHWELL HEALTH

A super-charged data lake strategy is helping Northwell Health connect with a population of 11 million New Yorkers – one seamless patient journey at a time

here are not many private healthcare providers around the world who serve an urban population of 11 million people but Northwell Health is one of them. New York’s largest health system is leveraging technology to deliver personalised patient experiences across its 23 hospitals and more than 830 outpatient facilities in order to outpace the accelerating digital landscape created by the COVID-19 pandemic. The numbers and sheer scale of Northwell Health, which also includes medical research at the Feinstein Institutes as well as medical and nursing education through the Zucker School of Medicine, does not detract from its aim to transform the health of every unique patient with their mantra ‘be better tomorrow than we are today’ — a goal which has stood the test of time since they were founded nearly 25 years ago. Today, it has never been more important for the 76,000-strong team to focus on a future driven by a digital transformation, which includes data lake solutions used to effectively ‘supercharge the data’. Northwell is focused on delivering connected digital patient experiences that complement their physical experiences inside and outside the Northwell system. With more than five million patient engagements every year, this digital transformation has accelerated the ease in which patients can access their electronic health records (EHR) and consult physicians

through virtual consultations, which was vital at a time when the state of New York imposed new visitation policies. Serving one of the biggest and most diverse populations on the planet could be perceived as a challenge but according to Marc d. Paradis, Vice President, Data Strategy for Northwell Holdings and Ventures, this provides a unique opportunity to “apply representative data and balanced analytics to real world clinical scenarios”. As a data scientist who combines the best of academia and industry know-how to drive the data strategy for Northwell Health, Paradis is responsible for targeted investments,

“ We have to remember we’re dealing with people at the most sensitive and vulnerable points in their lives it's a real privilege to be a caring part of those moments and to help them in their journey to achieve their health and wellness goals” MARC D. PARADIS

VICE PRESIDENT OF DATA STRATEGY FOR NORTHWELL HOLDINGS AND VENTURES healthcareglobal.com

Health Catalyst: An agile approach to healthcare data How to get the most out of your investment in data with Health Catalyst

Health Catalyst is quite literally a healthcare provider’s catalyst for change when it comes to their measurable, data-informed improvement in analytics, software and services. Founded in 2008 in Salt Lake City, Utah, Health Catalyst enables health care organisations to build a healthcare -specific, open, flexible, and scalable data platform and fully integrated suite of analytics applications. This enables health system partners, including Northwell Health in New York which serves a population of 11 million, to realise measurable value within months. “Our customers have recognised the potential to use data, to improve their clinical, financial and operational business outcomes,” said Mike Doyle, Chief Customer Officer. Formed by a group of healthcare veterans - with a quest to develop a data warehouse that could handle the complexities unique to healthcare data - they discovered the solution now known as Adaptive Data Architecture. Today, Health Catalyst helps clinicians in more than 250 hospitals, caring for more than 100 million patients each year.

Health Catalyst offers a solution in three parts: Data Operating System Cloud-based DOS is healthcare-specific, open, flexible and scalable. Analytics Applications Allows customers to make measurable clinical, financial and operational improvements. Services Expertise Experts that leverage technology to help customers make measurable, data-informed improvements.

“I think a key differentiator is our open platform that enables our clients to accelerate their own integration of data, but it is customisable, configurable in ways that make it unique. For example, during the pandemic our clients were able to put this healthcare-specific, flexible platform and fully integrated suite of analytics applications to use in ways we could never have predicted,” said Doyle. “We’re very grateful for our partnership with Northwell Health and want to thank these visionary leaders who are able to envision a future using data that is light years beyond what we can think of today.”

Learn more

NORTHWELL HEALTH

Northwell Health: Defining tomorrow’s healthcare today

joint ventures and innovations that support Northwell’s clinical and social missions by leveraging Northwell's data assets, intellectual expertise and clinical platforms. He also focuses on data strategy, predictive algorithms and digital partnerships. “My role is to empower our patients, augment our providers, support their families and to improve the health of all of the communities we serve through the use of innovative data solutions,” said Paradis who joined Northwell in January of 2020, just before COVID-19 was declared a global pandemic. “I have the privilege to help the system as a whole think through data strategy, looking at how we can enrich and leverage our differentiable and defensible assets. We have a decade of data on 11 million lives covering all of Long Island, the five New York City Boroughs and Westchester County which is probably the most genetically, culturally and demographically diverse 56

August 2021

population and clinical data set in the world. This is a tremendous resource to have,” he said. Paradis pointed out that the data set they are working with is unique and allows them to produce predictive models which can be validated on real world data in diverse clinical scenarios, which gives Northwell a competitive advantage. He also said that having such a vast platform of hospitals, ambulatory surgery centres and outpatient facilities enables them to rigorously test new technologies in the context of the full care continuum. “It gives us this fantastic platform to test new ideas, new technologies and put them through their paces. We use evidence-based best practices to ensure that they are actually delivering clinically relevant hard outcomes on the basis of changes in people’s behavior at specific points of intervention in the clinical workflow. These model-driven interventions are then packaged in solutions

NORTHWELL HEALTH

that lead to measurable value and clinical impact,” he said.

MARC D. PARADIS TITLE: VICE PRESIDENT OF DATA STRATEGY

• Northwell has a vast network of collaborators from research pioneers to entrepreneurs and educators who are all dedicated on their ‘mission to serve’ and are committed to providing: • The highest quality clinical care • Educating the current and future generations of healthcare professionals

INDUSTRY: HOSPITAL & HEALTH CARE LOCATION: NEW YORK Marc d. Paradis is Vice President of Data Strategy at Northwell Health. It is his responsibility to enrich Northwell Health's data assets in order to empower patients, augment providers, support families and raise the health of all the communities Northwell serves. For 25 years, Marc has been implementing models that drive action, providing measurable value to all stakeholders. While leading Optum's Data Science University he taught his unique approach to Product-Centric Data Science, Machine Learning, and AI to more than 2,200 individuals. He has a Master's in Cellular & Molecular Neurobiology from MIT and a Bachelor's in Chemistry from Cornell University.

Searching for new advances in medicine through the conduct of biomedical research Promoting health education and caring for the community regardless of the ability to pay

“ We have a decade of data on 11 million lives covering all of Long Island, the five New York City Boroughs and Westchester County which is probably the most genetically, culturally and demographically diverse population and clinical data set in the world. This is a tremendous resource to have” MARC D. PARADIS

VICE PRESIDENT OF DATA STRATEGY, NORTHWELL HOLDINGS AND VENTURES

EXECUTIVE BIO

Response to the pandemic Northwell has been on their digital transformation journey for several years but what the pandemic emphasised was the crucial role of cross-functional teams in which everyone across the organisation worked together to achieve a common goal. They quickly rolled out devices that enabled audio and video connections with patients.

We help you to digitize human experiences in healthcare by meeting you where you are. Sutherland is your partner in your quest to achieve the Quadruple Aim of improving patient experience, clinical experience, and health outcomes— all while lowering costs. We meet you at any point along your journey and accelerate your digital transformation.

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Sutherland Healthcare human touch to digital world Combine a human-centered design with the scale and accuracy of real-time analytics with Sutherland Healthcare Sutherland Healthcare provides the human touch to any stage of a digital journey. They do this by combining a human-centered design with the scale and accuracy of real-time analytics, Artificial Intelligence (AI), cognitive technology and automation. “We serve clients across the spectrum from backoffice processes, through to the end-of-customer experience and along the way, leverage big data and deep analytics”, said Matthew Collier, CEO of Sutherland Healthcare. Founded in 1986, Sutherland Health Solutions is a global organisation covering 144 countries with a team of 38,000 professionals conducting more than 43 million transactions each month. They work with businesses across a broad range of industries, from healthcare to hospitality and banking to retail. “We bring a deep domain expertise to each of the industries, particularly in healthcare,” commented Collier who stresses they meet their clients wherever they are on their digital transformation. “From the earliest spectrum of outsourcing through to the point of cloud, we can meet them.”

We help you to di experiences in he by meeting you wh

For 12 years, Sutherland has been a partner of Northwell Health-New York’s largest health system serving 11 million people. “This has been a true partnership and the outcomes have been really impressive,” said Collier. “I am looking forward to taking our partnership to the next level in this new era of big supercharged data sets, data lakes and deep analytics.”

The company heritage of being a “future-ready organisation” came to fruition during the pandemic. Sutherland is your partner in your quest to “By having deeply digital technology enabled service in the RCM arena, we were experience, able to flex up andclinical down improving patient exp with demands from our clients,” said Collier.

all while lowering costs. We meet you at a

“Sutherland is, at its heart, a tech enabled services accelerate your digital transformation. company and that gives us the edge when the best solution is neither a technology or services solution, but rather the hybrid of the two.”

Learn More

NORTHWELL HEALTH

11m

population served by Northwell Health

$13.4bn in annual revenue

Hospitals

830+ outpatient facilities

76,000 employees

$1.44bn investment in community impact

3,800

members of Northwell Health Physician Partners — the health system’s medical group

2m+

patients treated annually

5.5 m patient encounters annually

36,300

births each year

865,260 emergency visits

August 2021

NORTHWELL HEALTH

“ Part of our strategy over the coming years is continuing to build out that data Lake infrastructure and architecture. It's not just focused on EHR data. There are separate systems for lab data and radiology data, among others. The point of the data lake is to bring all of that data together in one place for a complete and personalized view of each patient that will supercharge Northwell’s data and analytics” MARC D. PARADIS

VICE PRESIDENT OF DATA STRATEGY, NORTHWELL HOLDINGS AND VENTURES

“When COVID hit it demonstrated to us the priority to move this digital transformation to the very top of the list and we moved rapidly — today we are in a place which would have probably taken years to achieve pre-pandemic,” said Paradis who pointed out it only took weeks to implement the entire telemedicine infrastructure for over 8,000 clinicians, including physicians in training and medical students. “People had been talking about telehealth for over a decade prior to COVID, and the foundational technology had been ready several years prior to the pandemic, but it required the pandemic to jump start the change management and adoption. “Even though we are over the peak of the pandemic we still expect to see a portion of care in a telehealth format to give patients the flexibility and choice to see their care providers at more convenient times and with less interruption to their daily lives. Telehealth visits also have the additional advantage of helping with sustainability and reducing the carbon footprint in NYS.” Paradis pointed out it was one small step at a time when it comes to changes in healthcare. “The way we solve complex problems is not with one expansive technology or one big application. We solve it by lots of little improvements which might only make it better for one per cent healthcareglobal.com

NORTHWELL HEALTH

Katz Institute for Women’s Health Northwell created the Katz Institute for Women’s Health, the only network of experts devoted to every aspect of women’s care as part of Northwell’s commitment to #RaiseHealth for all.

DID YOU KNOW...

Paradis pointed out much of medicine over the last 200 years has been defined by the simplistic research construct of the “75 kilogram spherical man”.

“So much of the research, so much of the drug testing for so long has been based around adult males, sidelining women and minorities. We recently started an initiative to recognise what is different and unique about women’s health and how we can make sure that we address those appropriately,” he said.

August 2021

How Northwell is reaching out to New Yorkers The image of a simple bubble travelling on the breeze through the Big Apple is used by Northwell Healthcare as a symbol of life’s resilience and fragility and is part of their Raise Health awareness campaign. The advert released in February 2021 challenges New Yorkers to collectively raise their expectations when it comes to healthcare – a year after the city became the epicentre of the COVID-19 pandemic in the US. As Northwell continues to roll-out the COVID-19 vaccines to millions of people, the healthcare provider has vowed to make public health their biggest priority.

NORTHWELL HEALTH

VICE PRESIDENT OF DATA STRATEGY, NORTHWELL HOLDINGS AND VENTURES

of the population. But if you do a hundred of those improvements, pretty soon you make it better for close to 100 per cent of the population.” But Paradis pointed out that although the technological changes were rapidly altering the way Northwell delivered their healthcare, the patient is always put first. “We have to

remember we’re dealing with people at the most sensitive and vulnerable points in their lives it's a real privilege to be a caring part of those moments and to help them in their journey to achieve their health and wellness goals.”

‘Supercharged’ data lakes Data lakes are next-generation data management solutions that help data scientists meet big data challenges and drive new levels of real-time analytics and are being used at Northwell Health for EHR and laboratory data. Their highly scalable environment supports large data volumes, collecting petabytes of structured, semi-structured and unstructured data in its native format from a variety of sources, including those previously untapped such as Internet of Things (IoT) devices.

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NORTHWELL HEALTH

Here for you today. Invested in your future success. When you’re under pressure to achieve better financial performance, it helps to have a dedicated revenue cycle management partner at your side. With athenahealth’s insights, technology, and expert support, you can close the gap between where you are and where you need to be. See how athenahealth can help you collect more, faster, with less work.

See our solutions

August 2021

Northwell Health taps athenaIDX to support revenue cycle performance and analytics efforts A beneficial partnership that enables efficient revenue cycle management athenahealth’s cloud-based and on-premise technology delivers measurable clinical and financial results to healthcare providers across the U.S. The relationship between athenahealth and Northwell Health dates back to 1984, delivering significant financial benefit to New York’s largest healthcare system. Marc d. Paradis, VP of Data Strategy at Northwell, is responsible for leveraging Northwell’s data assets. Partnership is essential, he says. “I welcome the opportunity to work with companies like athenahealth to create a balanced relationship, with mutual respect and shared goals.” A key goal for Northwell is to connect siloed information together in a data lake so it can be seen, linked and interrogated. “athenaIDX, athenahealth’s on-premise enterprise revenue cycle management suite, is one of the most vital data sets feeding into our data lake: without it we couldn’t deliver the best care or interact with the various groups we support.”

Dave Haight, VP of Advisory Services at athenahealth, confirms: “We’ve supported many facets of Northwell’s business operations. As Marc said, we are feeding the data lake that allows Northwell to look at strategic aspects of population health and value-based care. We are part of the ecosystem that feeds information to their organization, facilitating strategic decisions and investments, and how they reach out to the different communities that they serve. We’ve created a data-powered healthcare ecosystem that helps improve patient outcomes and business incomes. athenaIDX enables clients to control data and analytics, ambulatory and hospital billing, at scale across multiple states, boroughs and locations. It’s essential for them to be able to aggregate that information in a meaningful manner.” And athenaIDX is an important part of athenahealth’s robust revenue cycle portfolio, which allows us to meet the needs of large-scale systems like Northwell who have unique needs and require a customizable solution.

See our solutions

NORTHWELL HEALTH

“Part of our strategy over the coming years is continuing to build out that data Lake infrastructure and architecture,” said Paradis. “It's not just focused on EHR data. There are separate systems for lab data and radiology data, among others. The point of the data lake is to bring all of that data together in one place for a complete and personalized view of each 66

August 2021

patient that will supercharge Northwell’s data and analytics. “This will build the connections between those disparate data sets, while ensuring the appropriate data quality work resulting in datasets that, in a much more effective and efficient way, really follow and track the care journey within Northwell.

NORTHWELL HEALTH

LIFE-CHANGING BENEFITS FROM NORTHWELL’S 3D PRINTING Northwell's automated 3D printing laboratory is creating state-of-the-art, personalised treatments which will change the life for their patients. By uniting world class resources in prosthetics, aerospace and 3D printing, Northwell created a first-of-its-kind prosthetic known as the Fin. The Fin allows an amputee to enter and exit the water without changing prosthetics. It uses state-of-the-art carbon fibre materials and an ergonomic shape to ensure durable and efficient movement. The Fin is printed using a carbon fibre enhanced nylon to provide strength and flexibility. The result is a durable solution that is highly functional on land and in the water.

Anatomical models Tumor resection models – used to highlight a tumor and surrounding tissue Orthopedic models – built from bone-like materials used for pre-surgery measuring Vascular models – These can be printed to identify abnormalities in the organ, tumors, blood flow, sliced chambers, valves, muscle tissue and calcified tissue Dentistry – digital dentistry in the form of 3D printed dental appliances

DID YOU KNOW...

3D printing is technology that produces a three-dimensional object from a digital 3D

file, such as a computer-aided design (CAD) drawing or a CT/MRI scan. This creates a device that is matched to a patient’s anatomy and is used in the following:

healthcareglobal.com

NORTHWELL HEALTH

“Our health information exchange is done through InterSystems and they do a fantastic job of giving us a single view of the patients, at the time of care and the point of care — even if they’ve been to multiple different hospitals and touchpoints across Northwell. “Bringing together our data lake and our health information exchange at an analytical level really empowers new kinds of analytics and applications that address each unique patient as a whole, not just limited to snapshots at points of time,” he said. Commenting on the road ahead for a more digitised healthcare, Paradis said the dynamics of care are changing rapidly — using the analogy of cars merging onto a highway where drivers respond dynamically to each other’s actions. “We make choices to deliver particular kinds of treatment or care and those choices impact the system, creating these interesting feedback 68

August 2021

loops. We're building out systems, machine learning systems and AI systems to understand and to track and to be able to intervene in these loops in a positive way that creates virtuous cycles of care. In effect we're learning how to merge onto these incredibly complex highways of health successfully and safely.” Importance of partnership with Health Catalyst Commenting on the foundational importance to Northwell’s ecosystem, Paradis pointed out the value Health Catalyst, Athena, Sutherland and Allscripts. “Health Catalyst is our data lake, they were very smart when they started by recognising that if you can’t efficiently and reliably connect to your data sources and move that data in a repeatable, scalable, high quality way, it doesn't matter what you build

NORTHWELL HEALTH

“ When COVID hit it demonstrated to us the priority to move this digital transformation to the very top of the list and we moved rapidly”

TOP 10 FACTS ABOUT NORTHWELL HEALTH

MARC D. PARADIS

downstream. It’s garbage in, garbage out. Health Catalyst built out these connectors that allow us to pull in data from all of our transactional and operational systems, and to write directly into a data lake that then feeds into their Data Operating System (DOS™), a canonical healthcare data model that includes clinical, claims, administrative and other data. Downstream from that Data Operating System, Health Catalyst has a whole series of pre-built applications to support clinical workflows, patient flow, finance and regulatory issues, among many others. “Health Catalyst is a fantastic partner from that standpoint and they also give us a world-class infrastructure that empowers us to generate our own insights in less time and with fewer resources. Paradis pointed out that Northwell’s partnerships with Athena, Sutherland and Allscripts were also essential for the correct functioning of the transactional and operational systems that feed the data lake. Sutherland’s robotic process automation automates outreach to payer websites for

DID YOU KNOW...

VICE PRESIDENT OF DATA STRATEGY, NORTHWELL HOLDINGS AND VENTURES

1. Pioneering bioelectronic medicine research at the Feinstein Institutes, which includes trial sites for treating lupus, rheumatoid arthritis and paralysis 2. Treats more New Yorkers for cancer than any other health care provider 3. One of the largest medical residency programs in the US, with 1,900+ residents and fellows 4. Sandra Atlas Bass Heart Hospital — one of top two cardiac surgery programs in US and Canada 5. Named a Best Place to Work by both Fortune and Glassdoor 6. Only hospital-based helicopter emergency transport service in the tri-state area 7. Largest hospital-based laboratory in North America 8. Lenox Hill Hospital the first on the East Coast to use the 3D video exoscope for neurosurgery 9. Created New York State’s first Centre for Cancer, Pregnancy and Reproduction 10. Cohen Children’s Medical Centre treats more paediatric cancer cases than any other children’s hospital in New York

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claim status updates, coding validations for bundled denials and electronic submission of clinical medical records data to the payers. These intelligent process automations have driven efficiencies of scale, increased productivity and accuracy across silos. In addition to RPA, Sutherland’s Health Analytics portal capabilities delivers actionable and prescriptive insights to end users via interactive dashboards, self-service BI and real-time business alerts. Athena has been a crucial revenue cycle partner for many years with respect to administering physician billing, accounts receivable management and associated analytics. All told Sutherland and Athena help to ensure the accuracy, timeliness and impact of data from the administrative source systems that feed the Health Catalyst data lake. “Of course, Paradis made sure to emphasise, none of this would be possible without the incredible partnership 70

August 2021

Northwell has with Allscripts. The Allscripts EHR powers everything that we are able to do for our patients and providers. The openness, scalability and extensibility of Allscripts are unique differentiators of their EHR. Other essential partners for the Northwell ecosystem include: • Tableau – an interface which helps to visualise and analyse data • Microsoft – provide the IT infrastructure • Microsoft Azure – platform for cloud, AI and ML • Google and Fitbit – wearables are being worked into the process of healthcare “Having a tool like Fitbit, which has wearables that can track heart rhythms to identify silent arrhythmias and atrial fibrillation, when tied to a user-interface, can empower a person, in partnership with

NORTHWELL HEALTH

VACCINE CLOUD TECHNOLOGY

DID YOU KNOW...

Northwell Health responded to the COVID-19 pandemic by leveraging Salesforce’s Vaccine Cloud technology. When the pandemic hit New York, the city’s biggest healthcare provider was already using Health Cloud so they extended that to include Salesforce’s new suite for vaccine management. Vaccine Cloud is part of Salesforce’s COVID-19 response technology solutions, which include vaccine inventory management, appointment scheduling, outcome monitoring, and public health outreach. At the beginning of the pandemic, Northwell started using Experience Cloud to allow self-service appointmentbooking for patients to schedule COVID-19 PCR testing. They customised workflows for call centres to automate incoming calls and added live chat on the website and built another patient self-scheduling application for vaccine appointments. The use of Marketing Cloud also helped them to communicate with patients through email and text messaging rounding off the patient experience.

“ I looked at ways to treat business data sets with the same methodological rigor and clarity of thought that we treat academic data sets with but on business timeframes and with a focus towards delivering products and services that work and provide value to people” MARC D. PARADIS

VICE PRESIDENT OF DATA STRATEGY, NORTHWELL HOLDINGS AND VENTURES

their care team, to change behaviours and prevent adverse outcomes,” said Paradis who pointed out that in the next couple of years streaming data sources such as wearables will revolutionise medicine. Predicting the future of healthcare Paradis said there will be a focus on the genome which will help cancer care. “That's been driven by an understanding of the specific mutations in a patient tumors and designing drugs targeted at those. I think we can expect to see similar types of drugs, similar types of interventions and procedures in other areas along with a change in protocol linked to a more personalised care. “My dream is that we begin to move the healthcare system from this episodic interventional system that we have now to fix a problem that's already occurred towards a continuous preventive maintenance and care model where the data from all aspects of your life is in full view of you and your care team in order to empower you to achieve your ideal health outcomes as you define them,” he said.

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BIG DATA, BIG SOLUTIONS

DIGITAL HEALTH

August 2021

DIGITAL HEALTH

Premier Home Health Care and Wolters Kluwer tell us how they are using big data to improve their service

WRITTEN BY: LEILA HAWKINS

Jennifer Gentzlinger Premier Home Health Care Services

Bill Flannery Wolters Kluwer

t Premier Home Health Care, staff have seen a substantial decline in the rate of hospital admissions among their patient population over the last few years. Since 2016, the home health care staffing provider has been training its workforce to spot symptoms that might trigger a hospital visit, using a population health management tool. Spurred on by the US healthcare's switch to value-based care, the initiative has been so successful that Premier Health has saved almost $6,400,000 over two years. The company operates in eight states in northeastern US, providing both care in the home and care for people who are staying in a hospital, rehab or other healthcare facility. While home health - which is professional and clinically trained - is generally covered by Medicare or private insurance, home care isn't. "It started out as a pilot with one of our partners in New York state" explains Jennifer Gentzlinger, Chief Operating Officer. "It was about helping them reach their quality incentive goals, like reducing falls, helping patients understand their care plan, and decreasing experiences of feeling lonely and distressed." After this the state introduced six potential avoidable hospitalisations (PAH): urinary tract infection (UTI), sepsis, anaemia, electrolyte imbalance, respiratory infection, healthcareglobal.com

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DIGITAL HEALTH

Jennifer Gentzlinger TITLE: CHIEF OPERATING OFFICER COMPANY: PREMIER HOME HEALTH CARE SERVICES INDUSTRY: HEALTHCARE LOCATION: UNITED STATES and congestive heart failure (CHF). Premier equipped the staff to look for symptoms that might indicate a decline in health. The carer then determines if a nurse or doctor is needed. "Most of the time hospitalisation is avoidable" Gentzlinger says. The home care workers now collect vital signs and other information in real time, recording it onto a dashboard. Gentzlinger says the tool, called Real Time Data (RTD), is a simple web-based platform containing visuals and graphs. It allows Premier's staff to access clinical profiles, diagnostics, see the medications they are prescribed, and even how many falls have happened in the past. This in turn helps inform decisions around care.

Gentzlinger started working at Premier Home Health Care Services in 2011 as an office manager trainee. This role involved working in every position she was going to oversee within the first year, including staffing coordinator and recruiter for long term care home health aide work and hospice supplemental staff. She became Assistant Director of Operations until 2017, when she moved up to Director and then Regional Director of Managed Care Services. After a stint as VP of Strategic Development she became the COO in March 2021.

“WE WANT TO FOCUS ON REDUCING HOSPITALISATIONS, AND ENABLING DATA POINTS FOR THE POPULATION WE'RE SERVING” JENNIFER GENTZLINGER

CHIEF OPERATING OFFICER, PREMIER HOME HEALTH CARE SERVICES healthcareglobal.com

DIGITAL HEALTH

Bill Flannery TITLE: VICE PRESIDENT IN ADVANCED TECHNOLOGY DEVELOPMENT COMPANY: WOLTERS KLUWER INDUSTRY: INFORMATION SERVICES LOCATION: UNITED STATES Flannery has worked at Wolters Kluwer for over 9 years, consistently in the field of advanced technology. Prior to this he was the Director for Global Planning, Strategy and Architecture at Dow Jones, and before that he worked at its affiliated research company Factiva in text and information mining. He considers himself a strategic leader, with a passion for building user-centric, innovative solutions, using advanced technologies that create business value.

Data-driven care One of the benefits of using big data in healthcare is having additional information, however it's not the quantity of data that is valuable, it's knowing what to do with it. "Big data, combined with advanced analytics, makes it possible to spot patterns in vast amounts of seemingly unconnected data" says Bill Flannery, Vice President in Advanced Technology Development at Wolters Kluwer. "This can be life-saving in a clinical setting, as it can provide an early warning or faster diagnosis than is possible by manually analysing smaller sets of data." Wolters Kluwer operates in a number of sectors alongside healthcare, and provides clinical tools that use AI, machine learning and visualisation. "The power of big data, artificial intelligence and machine learning is that they deal with much more than the simple comparisons that humans can perform" Flannery says. "The human brain can only look at a small set of variables and how they might interact. This puts a natural limit on the complexity of situations a busy clinician can address." Like Premier Home Health Care, Wolters Kluwer deploys big data to detect sepsis,

“HEALTHCARE HAS REACHED A TIPPING POINT: IT KNOWS THE POWER OF HARNESSING ACTIONABLE BIG DATA, BUT IT FACES A SYSTEMIC CHALLENGE” BILL FLANNERY

VICE PRESIDENT IN ADVANCED TECHNOLOGY DEVELOPMENT, WOLTERS KLUWER

August 2021

DIGITAL HEALTH

because it is difficult to diagnose and kills thousands of patients every year. "Surveillance of patient data is the most effective way to guard against an infection getting out of control, but it means scanning a huge set of routine results, tests and observations from thousands of patients at any one time. "This is exactly the kind of big data set that can be actively monitored, looking for connections and patterns that give an early warning of infection. Wolters Kluwer’s clinical surveillance tool Sentri7 has been designed to do just this" Flannery says. The importance of integration Sentri7 is embedded into the Electronic Medical Record (EMR) and uses a predictive algorithm to continuously monitor the inpatient hospital population in real-time.

It can analyse a range of different data, including patients’ vitals, lab results and even doctors’ notes with natural language processing (NLP). Combining this with AI makes it especially powerful, Flannery says, as "Sentri7 can monitor over 500,000 patients at any given time, and processes four billion lab orders every year." The challenge overall is integration; a hospital system Premier works with in North Carolina isn't integrated into Epic, the EMR. "They're doing duplicate entry and it's an absolute nightmare" Gentzlinger says. " Now we've started conversations with them about how they can take this platform and connect it to their entire network, and integrate it with Epic." Premier's RTD feeds data into a dashboard that can be integrated into any EMR. This healthcareglobal.com

DIGITAL HEALTH

“ BIG DATA AND ADVANCED ANALYTICS MAKES IT POSSIBLE TO SPOT PATTERNS IN VAST AMOUNTS OF SEEMINGLY UNCONNECTED DATA” BILL FLANNERY

VICE PRESIDENT IN ADVANCED TECHNOLOGY DEVELOPMENT, WOLTERS KLUWER

August 2021

DIGITAL HEALTH

is important to be able to capture different data points, particularly if another provider is involved, which could be transportation or a medical centre. "The dashboard enables them to see the same information everyone else is seeing" Gentzlinger says. Flannery adds: "One of the biggest challenges is linking data sets together to make them interoperable and comparable. As healthcare providers seek efficiencies by merging different organisations and trusts together, we have a growing problem of siloed, separated sets of data that can’t easily be combined or analysed. "In many ways, healthcare has reached a tipping point: it knows the power of harnessing actionable big data, but it faces a systemic challenge, in that the language of healthcare remains largely unstandardised, limiting what can be understood across platforms." In Premier's case, using data this way has helped them retain staff. "We have had a tremendous uptick in employee retention" Gentzlinger says. "All of a sudden we started to see we were engaging a workforce that has historically been cast aside, as they're neither doctors or nurses and they sort of go from agency to agency. But when we started investing in their training this created a career path." Next Premier wants to take RTD out of home care and apply it to the wider healthcare sector. "We operate in eight states so we have a few different goals. In Illinois they have a state funded care management system and I think this would really help them start collecting information about the patients that they're serving" Gentzlinger says. "We really want to tap into the Medicare space, and focus on reducing hospitalisations, and enabling data points and triggers for the population we're serving, whether it's home care or home health." healthcareglobal.com

MERCYONE

TRANSFORMING THE ECOSYSTEM OF HEALTHCARE WRITTEN BY: MELISSA KHAN

June 2021

PRODUCED BY: JAMES BERRY

MERCYONE

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MERCYONE

Mathew Dietz, Division Director, Digital and Virtual Care Strategy and Dr. Joel Ward, CMIO discuss why healthcare needs to go digital amidst the pandemic

f you’ve caught yourself watching one too many E.R. episodes, then this one’s for you. MercyOne – Iowa’s answer to Country General – is a relatively new health care system, founded in 1998 and currently operates out of 420 care locations across the state of Iowa and neighbouring communities. Mathew Dietz, MercyOne’s Division Director, Digital and Virtual Strategy, and MercyOne’s CMIO Dr. Joel Ward discuss everything from COVID19 to provider burnouts, and more. Dr. Ward has been with MercyOne for a little over six years serving as the Chief Medical Informatics Officer for the health system’s Central Iowa region, along with Dietz who joined about a year ago, as the driver for all digital health strategic and regulatory implementations across MercyOne's seven centres. Currently, the centres have been busy with vaccine implementation, and digital transformation is no longer on the back-burner. The executives talk about how COVID-19 created an urgency for telehealth and the birth of innovation in the light of adversity. The longstanding need for transformation With more than 20,000 colleagues under its wing, MercyOne is no small organization. To be a healthcare provider in a time when all eyes are on you is a lot of pressure, even for the most seasoned players. So what do

August 2021

Dr Joel Ward & Mathew Dietz

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MERCYONE

MercyOne Des - the virtual nursing is the new normal

you do when you’re thrown into the deep end of a global pandemic, at a time when people are looking for risk-free, affordable ways to get the best possible care they deserve? You improvise. Dr. Ward and Matt Dietz share a camaraderie that is evident not just through the interview but also in the way tasks are managed at the health system. While Dr. Ward oversees the provider and operational tasks in-house, Dietz spearheads the virtual care strategy at MercyOne. Together, they’re making sure the health system is at the helm of digital transformation. “Healthcare as an industry is usually two to three generations behind technology compared to other industries. The concept of cloud-based storage is something that still requires a large change management process.” says Matt Dietz, setting the premise for why a digital transformation was challenging but very much required. 84

August 2021

However, the need for a shift to digital didn’t arise solely from the lack of better infrastructure. Patients today want to be in control, whether it’s choosing a healthcare provider or physically commuting to a care centre of their choosing. Keeping this in mind, it was important for MercyOne to adopt newer ways of reaching their primary consumer – the patient. As Dr. Ward points out, “As providers, we've pretty much dedicated ourselves to taking care of our patients. And when our patients tell us that what they needed at the time was a digital transformation, it was pretty obvious to us because due to COVID-19 regulations we had to pause non-essential in-person care and our patient volumes cut down drastically, and some people were just afraid to come in because of the risks. But we didn't really have to look at just the COVID19 pandemic to realize there was a need for transformation, but it’s what the patients really wanted.”

MERCYONE

“ AS PROVIDERS, WE'VE PRETTY MUCH DEDICATED OURSELVES TO TAKING CARE OF OUR PATIENTS. AND OUR PATIENTS TOLD US THAT WHAT THEY NEEDED AT THE TIME WAS A DIGITAL TRANSFORMATION”

DR JOEL WARD TITLE: CHIEF MEDICAL INFORMATICS OFFICER INDUSTRY: HEALTHCARE LOCATION: UNITED STATES Joel Ward is the Chief Medical Informatics Officer for MercyOne Central Iowa Medical Group. He is trained in Internal Medicine. He received his doctorate of osteopathic medicine and received a concurrent masters in bioethics from the Kansas City University. He also has experience in utilization management and software engineering. Dr Ward works to achieve improved clinical outcomes through technology where informatics and utilization create workflow efficiency.

DR JOEL WARD

CHIEF MEDICAL INFORMATICS OFFICER, MERCYONE

Strategic partnerships that fuel efficiency At a time when hospitals are treating more patients than ever, it has become increasingly imminent that remote monitoring is the way forward. Speaking of steps taken by MercyOne to make this as seamless as possible, the subject of strategic partnerships cannot be ignored. Dr. Ward and Dietz mention two such partnerships that have helped the health system meet patient expectations as well as increase their provider output. “Phreesia is one of our most dynamic partners in creating the digital front door of our clinics.” They have helped develop a patient intake platform that saved MercyOne the pain of manually onboarding details of every patient, and prevented patients from endless paperwork. The health system did see a surge in in-patient numbers, but this has been managed effectively and in record time due to this alliance.

EXECUTIVE BIO

COVID-19 has also pushed the healthcare industry into developing virtual systems of care faster than ever, as a direct consequence of restricted movement, compromised immunity and legislation.

The New Standard of Care HRS has become a nationally-recognized provider of telehealth and remote patient monitoring solutions. HRS will continue to innovate to further the mission of improving the care and quality of life for as many patients as possible.

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Health Recovery Solutions Telehealth and Remote Patient Monitoring Health Recovery Solutions (HRS) provides healthcare providers and payers with the most advanced telehealth and remote patient monitoring solutions (RPM). Aimed at changing patient behavior to improve clinical outcomes and reduce healthcare costs, the HRS solution improves patient engagement by incorporating patients into their condition management— “the HRS solution is all about engaging the patient to be proactive in their disease management. If you can give patients the tools to be successful, they’ll surprise you,” said HRS CEO Jarrett Bauer. HRS’ disease-specific telehealth solutions are customized with symptom surveys, educational videos, care plans, and medication reminders while also integrated with Bluetooth peripherals to facilitate real-time biometric monitoring. The solution, which can integrate into a provider’s EMR, offers seamless communication tools including video chat, wound imaging, voice calls and text messaging. On the cloudbased clinician facing dashboard, ClinicianConnect, providers monitor their patients and respond to risk alerts in-real time. As the population ages, healthcare costs continue to rise, the capacity of hospitals is challenged, the social determinants of health continue to be center stage, and as the industry becomes more patient-centric, solutions that

enable continuous, collaborative, patient care are essential. “At the center of our product strategy is the experience of patients, clinicians, and caregivers. By harnessing the most innovative technologies, building robust integrations, and always focusing on clinical enablement, we are able to provide the most advanced telehealth and RPM solution,” said HRS Chief Product Officer, Jess Vamvas. HRS arms patients with tools to control and understand their health and allows clinicians to view a patients’ condition(s) holistically. Telehealth has a place across the care continuum —from primary and preventative care, to the Hospital at Home model, post-acute recovery, and end-of-life support.

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MERCYONE

“ PHREESIA IS ONE OF OUR MOST DYNAMIC PARTNERS IN CREATING THE DIGITAL FRONT DOOR OF OUR CLINICS” MATT DIETZ

DIVISION DIRECTOR OF DIGITAL AND VIRTUAL CARE STRATEGY, MERCYONE

Another noteworthy mention is Health Recovery Solutions, MercyOne’s remote monitoring partner for the Des Moines market. A historic partner of MercyOne, Health Recovery Solutions is making home health possible for over 1,600 patients just within Des Moines, allowing the care centre to make more informed empirical and algorithmic decisions without the patient leaving their home. This is a giant leap in the area of remote care, allowing patients to enjoy a quality of care that was previously unseen, from the comfort of their homes and equipped with the best technology. Extending nursing careers through a virtually integrated care program Speaking of virtual care, Dr. Ward has also spearheaded the introduction of virtual nurses as an extension of the care provided at MercyOne. This provides two noticeable benefits – round the clock patient care and reduced nurse burnouts. Unfortunately, due to pandemic-related restrictions, healthcare providers are overworked and unable to provide round the clock care. This, along with the need to put on a full PPE suit each time can extremely limit a nurse's movement and output. Similarly, visitors are finding it harder to arrange social visits amidst the lockdown and restrictions. What the virtual nurse does is that with a simple click, provides both the 88

August 2021

MERCYONE

DIGITIAL SIGN-INS Previously, patients spent seven to ten minutes on average filling out forms before they even saw a physician. Since implementing digital sign-ins, patients are now able to fill up a form before they enter the facility, reducing the overall onboarding time to two minutes. • Over $200,000 in paper/print savings due to paper reduction • Over 500,000 digital COVID risk screenings • Over 5000 individuals identified needing social services resources (through social determinants of health) • 18% increase in outstandin balance collection

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MERCYONE

Safe. Convenient. Contactless. Phreesia powers registration at health systems nationwide.

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MERCYONE

MATT DIETZ TITLE: DIVISION DIRECTOR OF DIGITAL AND VIRTUAL CARE STRATEGY INDUSTRY: HEALTHCARE LOCATION: UNITED STATES Matt Dietz is the Division Director of Digital and Virtual Care Strategy for MercyOne in Iowa. One of the industry’s telehealth leaders, Matt and his team lead the strategy, business development, and implementation of all MercyOne digital health and telehealth strategies across more than 420 care locations for MercyOne. Matt graduated with his Masters of Health Administration from Saint Louis University in 2015, and has dedicated himself as a lifelong learner in incorporating cutting edge technologies to health care such as artificial intelligence, machine learning, and blockchain.

“ THERE IS NO SUCH THING AS FAILURE. DIGITAL TRANSFORMATION IS STILL NEW, AND WE TRY THINGS OUT BECAUSE WE WANT TO IMPROVE THE CURRENT EXPERIENCE” MATT DIETZ

DIVISION DIRECTOR OF DIGITAL AND VIRTUAL CARE STRATEGY, MERCYONE

EXECUTIVE BIO

physician and their families with a full update on the patient's health. This, in turn, reduces the hours that nurses need to put in on the floor and gives them the chance to mentor new resources from the tele command centre, so hospitals didn't lose that deep well of knowledge. Eventually, the support that the virtual nurse provides is unmatchable, and in the words of Dr. Ward, "We're really able to wrap the patient with all manners of care from practically every service line, and it's been something that's been relatively new to the tele-health industry because really it comes down to supporting

MERCYONE

“ WE'RE REALLY ABLE TO WRAP THE PATIENT WITH ALL MANNERS OF CARE FROM PRACTICALLY EVERY SERVICE LINE, AND IT'S BEEN SOMETHING THAT'S BEEN RELATIVELY NEW TO THE TELEHEALTH INDUSTRY” DR JOEL WARD

CHIEF MEDICAL INFORMATICS OFFICER, MERCYONE

PARTNERS MercyOne’s strategic partners at-a-glance: Phreesia: A patient intake platform that drastically cuts down the time required to access a provider Health Recovery Solutions: Home health and remote monitoring platform that takes providers directly to their patients, improving the overall quality of car

August 2021

MERCYONE

Title of the video

the patient for the other 23 hours and 45 minutes that the doctor isn't in the room". A fearless approach to change With all eyes on healthcare, it is no surprise that institutions across the world are rapidly evolving. Matt Dietz shares some insight for peers taking on a rightful step towards digital transformation. "There is no such thing as failure. Digital transformation is still new, and we try things out because we want to improve our current experiences. And if something doesn't work as we originally hypothesized it doesn't mean it's a failure, it means that we're learning, it gives us an opportunity to improve upon something and that's what excites us the most about digital transformation. It gives us not a reckless mindset, but it allows us to be fearless sometimes – to try things that we never thought we could before."

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TECHNOLOGY

August 2021

TECHNOLOGY

THE ROLE OF TECH IN PUBLIC HEALTHCARE We take a look at the role the tech sector plays in public healthcare and hospital systems. WRITTEN BY: LEILA HAWKINS

atient backlogs, aging populations, increasing amounts of data, the COVID—19 pandemic and a workforce experiencing burnout are just some of the challenges the world's hospitals are experiencing. One increasingly popular area tech is helping with is making data more accessible in the cloud, Cloud Product Manager at Node4, all healthcare providers will need to make this change eventually. "Over time, as legacy technology gets older and the demands placed on it increase, storage systems often can’t keep up" he says. "There comes a point for every healthcare organisation when existing IT simply won’t meet its needs anymore. Instead, healthcare facilities need full, near— instant availability of data to make effective decisions and provide good patient care."

Patient data must be readily accessible when needed, stored in a regulation— compliant environment, while remaining cost effective. But how does a paper— based hospital with an overstretched workforce manage this process, while keeping data safe from cyber attacks? By finding a company that can provide the right solution, and working in partnership with them. Moving to the cloud The challenge in healthcare, Springfield says, is that many organisations have siloed pools of data stored in separate repositories. "Often, these systems don’t scale well and don’t have the security protections necessary to meet today’s requirements." healthcareglobal.com

TECHNOLOGY

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August 2021

TECHNOLOGY

“ THERE COMES A POINT FOR EVERY HEALTHCARE ORGANISATION WHEN EXISTING IT SIMPLY WON’T MEET ITS NEEDS ANYMORE” PETER SPRINGFIELD

CLOUD PRODUCT MANAGER, NODE4

"Cloud—based storage can scale as high as required. The best cloud vendors also assure high availability and good performance. And because organisations pay only for the capacity they use with cloud—based storage, costs can be lower. As a result, the cloud model also allows healthcare organisations to store and access all data associated with a specific patient, procedure or business unit in one place." Another option is to choose Storage as a Service (STaaS). "This is where a third— party provider owns and manages the

storage infrastructure, while the healthcare facility can dictate rules on storage, retention and access, along with service level requirements. This structure means that healthcare facilities can access storage on—demand, paying only for the amount they use, without worrying about buying, managing and maintaining physical devices." Most healthcare providers are choosing a hybrid model, which allows them to use the cloud for everything except the most sensitive data. "Because security and privacy

Node4 Node 4 is a British company that provides cloud solutions to help organisations with the process of digital transformation. Founded in 2004, the company helps firms in a variety of sectors including healthcare, with clients such as Nuffield Health, Benenden Health and BMI Healthcare. Node4 is included in the Microsoft Azure Expert MSP program, awarded to the most high—fidelity cloud managed service providers. healthcareglobal.com

TECHNOLOGY

3 ways public hospitals use tech • To access the latest healthcare tech. The NHS deploys state—of—the—art radiology equipment from Siemens Healthineers to its hospital trust in Manchester • To complete admin more efficiently. One example is through robotic process automation (RPA). UiPath's software bots are in use at a Dublin hospital to carry out repetitive processing tasks. • To analyse CT scans and detect abnormalities. Skin Analytics uses artificial intelligence to spot whether a skin lesion is cancerous or not. It is set to be implemented across NHS hospitals in England

August 2021

are critical issues for healthcare organisations, the temptation is to keep everything on— premises" Springfield says. "While that can make sense for especially sensitive workloads and applications because it provides tighter controls, it may not be viable for the longer term, as the amount of data that must be managed and stored continues growing." Data security Keeping patient data secure is not just crucial for the patients, but for the healthcare provider too. Ransomware attacks — where a hacker demands money in exchange for not releasing private data — have risen dramatically in recent years, particularly since the COVID— 19 pandemic began. In 2020 alone these rose by 55%, costing almost $21 billion in downtime.

TECHNOLOGY

“ HEALTHCARE ORGANISATIONS ARE MOVING AWAY FROM DOING EVERYTHING THEMSELVES AND DOING A LOT OF OUTSOURCING IN THE CLOUD” PETER SPRINGFIELD

CLOUD PRODUCT MANAGER, NODE4

Healthcare providers' inhouse IT departments may not have the knowledge or the resources needed to combat sophisticated attacks, making it necessary to partner with trusted cybersecurity companies. "Healthcare organisations are moving away from doing everything themselves and doing a lot of outsourcing in the cloud" says Terry Ray, Senior Vice President at cybersecurity firm Imperva. "They may have been running Cerner as their electronic medical record system for 15 years for example, but many are now shifting to say, "why am I running Cerner? Why don't I just pay Cerner to run Cerner? They can enter their data into Cerner's EMR and let it be their problem." healthcareglobal.com

TECHNOLOGY

“ YOU CAN'T HAVE GAPS IN SECURITY. ORGANISATIONS MUST LOOK AT EVERYTHING” TERRY RAY SVP, IMPERVA

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TECHNOLOGY

"The field is getting larger and larger, and the enterprise and scope of what needs to be secured is getting bigger" he adds. "You can't have gaps in security. Organisations must look at everything." Virtual healthcare While security and data storage are two typical areas where public healthcare providers lean on the tech sector, another has been emerging since the pandemic: telehealth. As well as providing access to doctor appointments during the successive lockdowns caused by COVID— 19, telemedicine can help deliver healthcare to remote or rural locations that lack health facilities. Virtual care solutions are wide— ranging, from Vodafone supplying the connectivity for IoT devices that help elderly people living on remote Greek islands to monitor their diabetes, to TytoCare's portable device that enables doctors to travel to remote regions and examine the heart, lungs, throat, and body temperature of patients using artificial intelligence. Busy doctors' surgeries are using digital platforms to help them triage patients — such as eConsult, a digital platform used by the British National Health Service (NHS) in primary and emergency care to assess which patients need to urgently speak to a clinician. As with all tech solutions, security and data privacy are vital. "The potential for technology to improve healthcare is almost limitless" Spingfield says "The key is remembering where it starts and ends — with data." healthcareglobal.com

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VIATRIS

ADAPTING TO CHANGE THE

VIATRIS WAY WRITTEN BY: MELISSA KHAN PRODUCED BY: MIKE SADR

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VIATRIS

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Ramkumar Rayapureddy, Global Chief Information Officer at Viatris, tells us about successfully managing a large consolidation during a worldwide pandemic

Ram Rayapureddy, Global CIO

he formation of pharmaceutical company Viatris has followed an atypical path. It was created in November 2020 through the combining of pharmaceutical firms Mylan and Upjohn, a Pfizer subsidiary. But when the combination was first announced in July 2019, no one could have predicted that the world would be fighting a global pandemic less than a year later. The IT team, led by former Mylan CIO and current Viatris CIO Ramkumar Rayapureddy, played not only a key leadership role in the successful integration but also had to help shift an entire company to working remotely on the journey to becoming Viatris. Integrating companies is never an easy task, and the Viatris transaction is no exception. For starters, this integration involves three companies instead of two – Mylan, Upjohn, and Upjohn’s parent company, Pfizer. The companies’ first order of business was the separation of Upjohn from Pfizer; following that separation, Upjohn and Mylan could combine to become Viatris. As Day 1 approached, timelines were tight, legalities were instrumental, budgets were analysed, and technologies had to function without a glitch. healthcareglobal.com

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Viatris - A global healthcare company

Rayapureddy shared his thoughts on what energised him and his team about the integration and their critical role to stand up a new kind of healthcare company: "At Mylan, we had the global scale, but we saw certain pockets where we could benefit from having a broader reach. Upjohn brought iconic products and a strong presence in Emerging Markets and Greater China. This is how we complemented each other. The coming together of these two great companies created a new kind of global healthcare company well-positioned to achieve its mission of empowering people worldwide to live healthier at every stage of life." The goal was to create a global company that brought together the firms’ scientific, commercial and operations expertise and portfolio of more than 1,400 approved 106

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molecules to more than 165 countries. The question facing Rayapureddy was defining a technology strategy to support the business strategy. "It looks magical when it happens, but there was a lot of work going on behind the scenes," Rayapureddy says. The first thing he did was to create a command centre of leaders from both companies and task them with driving the business alignment of the twenty-two workstreams required to get Viatris to a successful Day 1. Viatris’ workforce of nearly 45,000 employees spans the globe, and Rayapureddy set the expectation from the start that there was to be no business disruption during integration, and everyone was to collaborate on the same Microsoft Office365 platform.

VIATRIS

RAM RAYAPUREDDY TITLE: GLOBAL CIO INDUSTRY: PHARMACEUTICALS

“ THE CONSOLIDATION HAS CREATED A GLOBAL ORGANISATION TO FURTHER ADVANCE OUR MISSION OF PROVIDING HIGH QUALITY HEALTHCARE TO PATIENTS ALL ACROSS THE GLOBE” RAM RAYAPUREDDY GLOBAL CIO, VIATRIS

EXECUTIVE BIO

LOCATION: UNITED STATES Ramkumar “Ram” Rayapureddy is the chief information officer of Viatris, responsible for the execution of the company’s technology strategy and the alignment of that strategy to both the company’s business strategy and mission. Ram joined Mylan in 2014 as Head of Global IT Operations, bringing with him more than 30 years of experience in the pharmaceutical industry, including various leadership positions in business, compliance, automation, and information technology. He was promoted to chief information officer in 2016 and served in this capacity until the launch of Viatris in 2020. Ram earned a master’s degree in mechanical engineering from Clemson University after graduating from Jawaharlal Nehru Technological University in Hyderabad, India.

Cognizant Life Sciences: Advancing Science to Improve Patient Outcomes Cognizant drives industry impact and delivers business outcomes across life sciences companies. We are a strategic partner to Viatris delivering IT and business consulting services on key integration initiatives helping them meet their TSA commitments.

Learn more at: www.cognizant.com/lifesciences

Cognizant: Building a Vision of Efficiency Cognizant’s unique industry-based, consultative approach helps clients like Viatris envision, build and run more innovative and efficient businesses Cognizant’s unique industry-based, consultative approach helps clients envision, build and run more innovative and efficient businesses. Srinivas Shankar, Global Head of Life Sciences for Cognizant, talks to us about the massive shifts happening in the industry and how digitisation is helping clients like Viatris to find better ways of working. Shankar has been with the company for more than 12 years and remains so with a smile on his face. “I’m really happy to be here,” he says before delving into what makes the Cognizant life sciences business special. “At Cognizant, for us, life sciences are two distinct industry segments. The first is biopharmaceutical companies and the second is medical device companies. We work with all of the top 30 biopharmaceutical companies and 12 of the top 15 medical device companies. I’ve been with the company for 12 years now, all of it in life sciences. And I’m very passionate about what we do every day to leverage technology to improve the lives of patients.” Speaking to the drivers that are influencing the life sciences industry, Shankar says, “In relation to services that we provide to clients, we see significant adoption of digital technologies,

such as cloud, IoT, data analytics, and digital engineering. And we’re using all of these digital technologies to be able to bring solutions to clients.” On Cognizant’s relationship with Viatris, Shankar points out that the partnership is “very strategic.” “It predates the coming together of Mylan and the Upjohn division of Pfizer to form Viatris. In 2014, we started a relationship with Mylan. After that, we started providing a whole range of strategic services from infrastructure support and operations to application support services to large and complex ERP implementations. More recently, with the formation of Viatris, we have been supporting the organisation around core infrastructure services for day-one preparedness, which includes end-user support services for about 13,000 users across 14 global sites. We are also a strategic partner for post-integration services for the Viatris organisation.” “We’re truly excited about our strategic partnership with Viatris and I think that the coming together of both these organisations, Cognizant and Viatris, can truly drive meaningful positive value in the lives of patients.”

VIATRIS

The core integration team followed a key set of principles to keep them accountable, which ultimately made the integration's Day 1 a success: 1. The team established a strong governance model necessary to coordinate effectively between the companies. This model was used to establish and track workstreams, drive timelines and provide overall 110

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guidance. Bold decisions were made from the start, and any exception to the plan was evaluated with the expectation that it may not be accommodated. 2. The team was strategically integrated with business partners to ensure cross-functional needs were met. Understanding business dependencies were actively managed.

VIATRIS

“ HUMANS ARE VERY RESILIENT. I ALWAYS TOLD PEOPLE KEEP LOOKING FORWARD, AND TO START PLANNING FOR THAT” RAM RAYAPUREDDY GLOBAL CIO, VIATRIS

3. A strong change management program was established with proactive and targeted communications and training. Then came March 2020. The challenges of any integration are complex, detailed, and personal. When the pandemic hit, teams had to shift to working remotely overnight, adding an unimaginable layer of complexity. To address this, Rayapureddy quickly divided

his team in two – one to focus on the shift to remote work and one to keep integration planning moving forward. The remote work team ran disaster drills and upgraded infrastructure to ensure adequate bandwidth and that everyone had the right equipment to work from home. Operations moved into the cloud, using Microsoft Office 365, and communications shifted from Skype to Microsoft Teams. "We had been planning to roll out Teams as part of our long-term strategy, and that would have been a one-year exercise if things were normal. In fact, we moved to Teams in seven days, our workforce was very supportive, and the transition happened smoothly," Rayapureddy explains. As the full team could no longer meet in person, Rayapureddy and the integration planning team took the approach of “smaller, consistent, and concise.” Any planned in-person workshops were now conducted by smaller teams who could work remotely and focus upon very specific outcomes. The team was equally focused on employee engagement. Every Thursday morning, they held an informal check-in call. These were unrelated to work and purely to healthcareglobal.com

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share stories or swap skills with colleagues. Rayapureddy’s team came up with the idea of department-wide IT Challenges consisting of quizzes, Microsoft whiteboard Pictionary games, and virtual coffees with colleagues once a month. These events helped bring people together, Rayapureddy says, particularly given that their staff span the globe and come from a variety of cultures. “One of the other things we did was tell people that we will come out of this. Humans are very resilient, and if history has taught us one thing, it's that humans respond and adapt to change. I always told people to keep looking forward and to start planning for that." Despite these challenges, there was some advantage to being a global company, as team members were accustomed to working collaboratively in different time zones. And in November of 2020, Rayapureddy and the team were able to take their hard work and celebrate a successful Day 1 at Viatris. Given all of the integration planning and pandemic challenges the technology team delivered on their mission – Day 1 at Viatris saw zero glitches. "I remember Michael Goettler, our CEO, telling me how we made a highly complex process look simple. The team across the three companies, Mylan, Upjohn, and Pfizer, did a fabulous job for countless hours and for more than 12 months. And then obviously, so did our partners." To top it off, a live town hall was broadcast to the entire global workforce, welcoming everyone to Viatris. The 22 workstreams and 141 crossfunctional workstream technical teams were able to deliver 50+ business applications, configure over 100+ applications, launch a new company website (www.Viatris.com, which is live today in 33 countries), launch an upgraded intranet site and collaboration 112

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tool for 45,000 users, hold over 30 training sessions, and, in the span of a few hours, provide every employee with a new email address, all while working remotely. Viatris’ Day 1 would not have been such a success if it weren’t for Rayapureddy’ s leadership style, which created the foundation for the IT department and aligns with the Viatris mission. Despite the stresses of the last year, Rayapureddy says he never saw any finger-pointing during tense moments. "People said, Okay, we

VIATRIS

PANDEMIC SUCCESS: • Ram stayed current on the events happening globally and made pandemic prep a top priority. • Focused a team on ensuring VPN sustainability for 45,000 employees, processes established for equipment, processes for monitoring application usage to ensure no disruption • Team transitioned smoothly to remote work with minimal disruption • Created engagement programs to keep the team from experiencing pandemic fatigue. Pictionary with leaders involved, space to share pandemic workspaces, pets, kids, etc. • Adapted the in-person workshops planned with Pfizer to be done virtually by changing templates, holding smaller prep sessions with workstream leads, and adopting templates to capture the information

“THE ENTIRE WORLD HAS CHANGED BECAUSE OF COVID-19, AND THIS HAS AN INFLUENCE ON HOW OUR BUSINESS OPERATES. WE HAVE TO BE NIMBLE ENOUGH TO REACT QUICKLY TO THOSE CHANGES” RAM RAYAPUREDDY GLOBAL CIO, VIATRIS

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“ WE HAD BEEN PLANNING TO ROLL OUT TEAMS AS PART OF OUR LONG TERM STRATEGY, AND THAT WOULD HAVE BEEN A ONE-YEAR EXERCISE. IN FACT WE MOVED TO TEAMS IN SEVEN DAYS” RAM RAYAPUREDDY GLOBAL CIO, VIATRIS

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have a problem. Let's go see what we can do about it." We want to be flexible enough to adjust to the changes that are happening in the world," he adds. "The entire world has changed because of COVID-19, and this has an influence on how our business operates – we have to be nimble enough to make sure we can react quickly to those changes." How well the team collaborated throughout the entire integration process and during the pandemic helped to contribute to what Rayapureddy calls “The Viatris Way.” "It is a focus on people being performance-driven, but also being highly engaged in the diverse and inclusive culture we are building together. I’m really proud of the contributions of our IT team to the culture we are building.” In the future, Rayapureddy envisages a hybrid working structure, where some people continue to work from home while others return to the office, potentially on a part-time basis. "We are now experimenting with different technologies to see how we as a group can facilitate that," he says. For now, the team can celebrate the successful launch of Viatris, whose mission is to empower people worldwide to live healthier at every stage of life. “Access is part of our global mission, making high-quality medicines available to everyone, regardless of geography or circumstance,” Rayapureddy says. “If we don’t have the solution, we build partnerships so we can bring the right products to the right people. My team takes that same approach. We’re a pharma company, not an IT company, so we find partners with the technology to help us support our goals and who can provide the innovative solutions to give Viatris a competitive advantage as we deliver on our mission.”

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FEATURE HEADER DIVERSITY

DataRobot:

How AI is driving diversity in clinical trials Sally Embrey explains how DataRobot used AI to ensure participants in COVID-19 vaccine clinical trials were representative of the entire US population WRITTEN BY: LEILA HAWKINS 116

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SUPPLY CHAIN

“I take a lot of pride in the fact that there's a lot of outreach in the community”

istorically, clinical vaccine distributors and trials have been the Department of Health plagued by a huge and Human Services (HHS), issue - a lack of diversity scientists at DataRobot among participants. This developed a strategy to is problematic, as how can overcome this. "We were you ensure a medicine or looking for opportunities vaccine you're releasing that would help speed up will be effective across the the clinical trials" explains whole population, if it's only Sally Embrey, VP of been tested on a narrow Public Health and Health SALLY EMBREY demographic? Technologies. "At the VP OF PUBLIC HEALTH AND MEDICAL While the medical beginning of the pandemic TECHNOLOGIES AT DATAROBOT community has talked we reallocated 50% of our about this issue for years, COVID-19 finally R&D resources to examine COVID-19 as spurred people into action. Working with a data science problem. healthcareglobal.com

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#Disclaimer: GARTNER is a registered trademark and service mark of Gartner, Inc. and/or its affiliates in the U.S. and internationally and is used herein with permission. All rights reserved. Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner’s research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose.

SUPPLY CHAIN

“We built very specialised AI-driven epidemiological models to understand where surges were going to occur” SALLY EMBREY

Sally Embrey TITLE: VP OF PUBLIC HEALTH AND MEDICAL TECHNOLOGIES COMPANY: DATAROBO

VP OF PUBLIC HEALTH AND MEDICAL TECHNOLOGIES AT DATAROBO

INDUSTRY: INFORMATION TECHNOLOGY & SERVICES

"We started building forecasting models, trying to understand how to project as far into the future as possible, so we could understand where surges were happening ahead of time. That was how we originally got embedded within the clinical trials. We saw that if you waited for a surge to occur to open up your clinical trial enrollment site, by the time you actually got vaccines out the door, built up that site, got recruiters to bring people in and get their shots, the surge was over. You were missing an opportunity to get the endpoints required to develop the vaccine." Embrey says there are typically two main ways of doing clinical trials. The challenge trial involves purposely exposing people to COVID-19, after which they are administered the vaccine and monitored to see if they become ill. The other is to give people either a vaccine or a placebo, after which they carry on with their daily routine to find out whether either group develops COVID-19. "Most of the time, people are pretty opposed to the challenge trials, especially with something like COVID, because we don't understand the long term health repercussions. There's a big risk in terms of unknowns there" Embrey says.

LOCATION: UNITED STATES Sally Embrey is the VP of Public Health and Medical Technologies at DataRobot. Her career has focused on the intersection of public health, technology, and innovation. She has worked at numerous start-ups and Fortune 100 companies, leading data-driven initiatives using science as her guide. Prior to DataRobot her work included collaborations with Google and Gavi, using AI and IoT to inform last-mile vaccine logistics. Before that she was Director of Epidemiology at Praedicat and led the west coast Client Solutions team at AIG. She holds advanced degrees in epidemiology, environmental and occupational health, and environmental engineering from Emory and Stanford.

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“We were looking for opportunities that would help speed up the clinical trials”

AI-driven recruitment be out in public interacting Vaccine recruiters chose with others - and therefore the second method as have a higher risk of the most ethical, and so spreading the virus. "What DataRobot built forecasting we found most surprising models able to predict was how you could speed which areas would have up the clinical trials and a surge of infections eight to the recruitment process 12 weeks in advance. Using using this data" Embrey AI, they were able to drill says. "You weren't waiting down into hyperlocal areas. for people to fill out SALLY EMBREY "We built very a survey, you were able VP OF PUBLIC HEALTH AND MEDICAL specialised AI-driven to be proactive and say, TECHNOLOGIES AT DATAROBO epidemiological models hey, we are worried about to understand where surges were going to this area, let's go and start recruiting people occur. At the beginning of the pandemic within the next 24 to 48 hours." a lot of predictive models were looking at the This allowed vaccine recruitment sites US as a whole, or by state, whereas we were enough time to build facilities and start trying to look at very granular areas, at points recruiting ahead of a surge. The modelling of census track. That was only possible also enabled them to focus on areas with thanks to the power of AI." large minority populations, to help recruiters DataRobot tracked areas with a high rate find a more diverse group of participants for of mobility, where people are more likely to the trials. 120

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ways AI is fighting COVID-19

1. Botco.ai has developed a chatbot that uses AI and natural language processing to answer people's queries about the COVID-19 vaccine. 2. Closedloop.ai created an open source index that uses AI to predict which people are likely to develop severe complications from the virus 3. Aidoc is providing AI technology to radiology services across the UK, to help radiologists quickly detect issues and reduce the backlog of cases that has built up during the pandemic

Distrust in clinical trials When the first COVID-19 vaccine trials began, recruiters advertised online, aiming to recruit 30,000 people a month. However the vast majority of those who signed up were white healthcare workers. "If you put yourself in their shoes, at the start of the pandemic they had been hit unbelievably hard" Embrey says. "There were PPE shortages all over the world. It made sense that those people were the most interested in getting protected the fastest, but it resulted in a huge lack of diversity in the clinical trials." Distrust in clinical trials goes back a long way. Native Americans experienced abuse and exploitation in the name of medical research, and in the days of the slave trade Black people were experimented on against their will, their bodies stolen for dissection. "History has built up distrust in many minority communities about wanting to participate in clinical trials" Embrey says. "So what we often see is that participants are 90 to 95% white. For a long time I think people thought that was the best that we could do, and there wasn't a lot of action towards making those clinical trials more diverse. COVID helped underline what we've known was a problem, but gave us an onus to really fix it." Given the global spread of the virus, it was clear that the more diverse the clinical trial, the better understanding scientists would have of potential adverse events. "With an equal and diverse representative population, we'd be able to say with confidence that this is a very effective vaccine, that we understand our results. We'd know we aren't people putting people at risk long term and the efficacy of the vaccine holds across the entire population." healthcareglobal.com

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“Most of the time, people are pretty opposed to the challenge trials, especially with something like COVID” SALLY EMBREY

VP OF PUBLIC HEALTH AND MEDICAL TECHNOLOGIES AT DATAROBO

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Data strategies and education Embrey remembers the first time she heard an official statement addressing the importance of diversity in clinical trials. "In July 2020, the Food and Drug Administration hinted that they were going to slow down the vaccine trials. They said that based on the initial recruitment data which was from a largely white population, they were concerned about really understanding the long term effects of the vaccine without a more diverse representation. They didn't directly say they were stopping these trials, but said they were a little disappointed with the numbers, and there needs to be better representation." As well as a data-driven strategy, Embrey says there is work to be done within communities to dispel distrust and vaccine hesitancy. "I live in a very traditionally Black and Latin community in Los Angeles. What I found very interesting in the last couple of months is that I get one or two text messages a day encouraging me to get my vaccine at a local clinic or park, and I've had my city representative come to my door to ask me if I've had the vaccine. When I talk to my friends and family that live in less diverse areas of Los Angeles, that outreach isn't occurring." "I take a lot of pride in the fact that there's a lot of outreach in the community, trying to make those relationships stronger. Because I do think it will help in the future when we don't need to move at the speed of light like we had to with this pandemic. We can actually work with people to build a collaborative, datadriven effort to recruit all types of people, so we can all understand and trust the vaccines." healthcareglobal.com

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VIRTUSA

Bringing transformative technology to healthcare WRITTEN BY: MELISSA KHAN PRODUCED BY: JAMES BERRY

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VIRTUSA

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Anthony Lange, Senior Vice President & Head of Healthcare and Life Sciences, Virtusa, speaks about advancements in healthcare in light of a post-pandemic world

ver the years, global companies have chosen the path of digital transformation as the logical step forward in keeping up with emerging technologies. As such, these organisations look at partnering with digital service providers such as Virtusa to transform their product and processes. Virtusa is a global provider of digital strategy, IT services and engineering solutions to a variety of sectors. Anthony Lange, Senior Vice President & Head of Healthcare and Life Sciences, shares his insights on what digital transformation means for healthcare, the steps taken by Virtusa in enabling healthcare providers to meet the increasing digital demands and how Virtusa’s post-pandemic risk strategy is helping these service providers stay ahead of the game. “With COVID-19, the whole US$3tn healthcare industry is being disrupted and dispersed, and everyone's trying to figure out the shift from hospital to home and from service to value,” said Lange. Global supply chains are now being pressured to work with resilience as opposed to the lean model they previously operated on. This puts the onus on companies like Virtusa, who’ve been tasked to transform some of the most crucial processes within organisations in a short amount of time. Lange is no stranger to transformation. As someone who’s worked with Virtusa for

more than a decade, he witnessed first-hand the shift of technology from a nice-to-have to a must-have capacity. A charismatic and team-oriented leader, Lange’s role at Virtusa changed drastically with the onset of COVID19. Pre-pandemic, a large part of his role was based around travel, meeting clients and visiting site locations. This routine flipped on its head the moment lockdowns happened, but that didn’t stop Lange from working harder than ever and thinking of ways Virtusa could support their clients and partners through these unprecedented times. “I don't think I’ve ever worked so hard in my life, and a lot of it was about our employees' safety and making sure they were in the right place, both physically and mentally. We spent a lot of time ensuring we’re doing things the right way as fast as we can and with the right logistics in place.”

“ With COVID-19, the whole US$3tn healthcare industry is being disrupted and dispersed, and everyone's trying to figure out the shift from hospital to home and from service to value” ANTHONY LANGE

SENIOR VICE PRESIDENT & HEAD OF HEALTHCARE AND LIFE SCIENCES, VIRTUSA healthcareglobal.com

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Bringing transformative technology to healthcare

Lange prides himself on being a leader who is always available and says there is no other way to go about it. So, team calls and standups became commonplace, Lange quips, and while this was necessary to facilitate workflows, he believes it also did its part in ensuring the employees’ well-being was top priority at all times. Lange believes he challenges the status quo every day in pushing the organisation to be better and do more for its clients and ultimately those that depend on their services. When asked about what motivates him, Lange said: “In my perspective, the healthcare and life science team feel honoured to be in this industry, because while a lot of the other industries work to make other people rich, what we are essentially doing is trying to save lives, and we save lives every day.” Innovation as a service Speaking of some of the ways Virtusa has driven transformation in the healthcare 128

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“ I don't think I’ve ever worked so hard in my life, and a lot of it was about our employees' safety and making sure they were in the right place, both physically and mentally. We spent a lot of time ensuring we’re doing things the right way as fast as we can, and with the right logistics in place” ANTHONY LANGE

SENIOR VICE PRESIDENT & HEAD OF HEALTHCARE AND LIFE SCIENCES, VIRTUSA

sector, Lange points out a few innovative products and technologies developed by his department as part of Virtusa’s ‘Innovation as a Service’ methodology. One such technology is vLifeTM, a cloud-based platform consisting of a comprehensive HIPAA compliant data lake with multiple

VIRTUSA

ANTHONY LANGE TITLE: SENIOR VICE PRESIDENT & HEAD OF HEALTHCARE AND LIFE SCIENCES, AMERICAS Anthony Lange is Head of Virtusa’s North American Life Sciences & Healthcare portfolio. Prior to his position, Lange served as head of Global New Business Development for Healthcare, Insurance and Life Science, where he spent time building and cultivating the organisation’s new business development skills and extending the know-how into a broader geographic footprint. Before that, he led Virtusa's Healthcare new business development in North America, helping to build the foundation for Virtusa’s Healthcare business. Lange has more than 30 years of technology and management experience including extensive experience with global delivery models and Healthcare industry. Prior to Virtusa, Lange served as a leader at Unisys Global Outsourcing business unit and multiple start-ups. Lange has an BS degree in Computer Science and Finance from LeMoyne College.

MEET THE TEAM

MANU SWAMI TITLE: SENIOR VICE PRESIDENT & HEAD OF HEALTHCARE AND LIFE SCIENCE SOLUTIONS/ TECHNOLOGY PRACTICES

seasoned data and analytics professional with more than 20 years of global experience in leading transformation programs across data platform modernisation, advanced analytics, AI and master data management domains. He currently leads the Healthcare and Life Sciences solutions and technology practices for Virtusa. Prior to Virtusa Swami has been part of Enterprise Information practice at TCS driving data and analytics initiatives across telecom, hospitality and retail customers.

LISA STOUDT TITLE: PRESIDENT OF REVENUE CLINICAL SOLUTIONS, A PARTNER WITH VIRTUSA IS FOCUSED ON DELIVERING A COMPLETE END-TOEND SOLUTION TO THE PROVIDER MARKET Stoudt has worked in executive positions in both provider and payer organisations. Her expertise in building successful business units for some of the industry’s leading organisations has driven strong financial/ operational results. After building numerous companies within companies, she brought to marketRevenue Clinical Solutions (RCS). RCS delivers clinical products and services to both the provider and payer markets that focus on driving revenue back into organisations and providing new avenues of revenue opportunities.

Manu Swami, Senior Vice President & Head of Healthcare and Life Science Solutions/ Technology Practices at Virtusa is a

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“ In my perspective, the healthcare and life science team feel honoured to be in this industry because while a lot of the other industries work to make other people rich, what we are essentially doing is trying to save lives, and we save lives every day” ANTHONY LANGE

SVP & HEAD OF HEALTHCARE AND LIFE SCIENCES, AMERICAS, VIRTUSA

data sources, pre-built APIs and AI/ML models. Offering niche tools that help users navigate even the most challenging needs, vLifeTM is designed to help biopharma and medtech companies access and means to synthesise a large volume of sensitive Electronic Medical Records (EMR) data which was practically unavailable earlier. Telehealth is another area that saw a huge boom in both necessity and innovation, with the onset of the pandemic as well as regulations around it loosening up, especially in the US. This put Lange and his team in full gear to support this almost overnight shift to home care – like building a portable dialysis machine that patients could now use at home rather than visiting a health centre. Improving the quality of life for patients is ultimately what life sciences innovation is about, and the team at Virtusa continually innovate with this ambition in mind. Diving deeper into what the innovation roadmap looks like for Virtusa, Lange adds that a shift from professionals to platform is imminent. What this means is, whatever a PCP (physical care physician) traditionally does for their patients can now be provided as a service on a platform, thereby cutting out the need for in-person visits and opens the patient to a potentially wider network of care. 130

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VIRTUSA

vLifeTM

A cloud-based marketplace consisting of a comprehensive HIPAA compliant data lake with multiple data sources, pre-built APIs, AI/ML models

Philips Lifeline

A life-saving 24/7 medical service equipped with fall detection capabilities to monitor and help patients in critical scenarios

Appeals and Grievances

A portal helping payers manage appeals and grievance processes as per government regulations

Provider Lifecycle Management

An end-to-end platform to manage prospecting, contracting, credentialing and servicing a provider in a payer environment healthcareglobal.com

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Ready to crush business complexity? VIRTUSA

For three decades, we’ve been living our values in what we say and do. We’re cutting through complexity with the power of Pega – and doing things you never thought possible. Contact us to know more.

Susan Taylor, Vice President of Core Administration at Pega, tells us about working with Virtusa and delivering solutions for the pandemic. Pega has been “helping people crush business complexity and get work done” for over three decades, whether to ensure a wire transfer goes to the right person or handling a complex claim. Susan Taylor, Vice President of Core Administration, explains: “Through our real time insights, our one-toone consumer engagement capabilities, and our leading customer service applications, we can bring back office transactions to front office engagements with consumers, and really surpass -their expectations.” The company has a long-standing partnership with Virtusa. “Our partner Virtusa is able to take our technology, and combined with their industry insights, truly deliver for the needs of our healthcare clients every day - whether it’s our compliance solutions, claims processing, or even managing the customer experience in direct interactions” Taylor says. “Together Pega and Virtusa are able to deliver a lot more value in an accelerated way every day, and it’s really exciting to see what we’ve been able to do.”

A key part of the business is providing automation, which helps people in operations to complete repetitive tasks and access the right information for their members and patients in real time. “When a consumer calls into a call center, wouldn’t it be nice to know what your last interaction was with them?” Taylor says “Were they satisfied with that phone call? Or, or maybe the interaction wasn’t on the phone, maybe it was a claim. Being able to pull all that disparate information together to deliver a solid, one-to-one personalised consumer experience is what we’re all about, and it’s what automation is all about” she says. Throughout the COVID-19 pandemic, Pega and Virtusa have provided solutions to help employers understand the new virus and its impact on their employee populations. In a very short span of time Pega developed and took to market an application for employers to track the health status of their workforce, whether through direct disease or exposure. “It’s been a great partnership” Taylor adds. “We’ve done some great things together to help organisations sustain the health and happiness of their employees and customers through these very challenging times.” LEARN MORE

VIRTUSA

Power of dual partnerships Partnerships at Virtusa are a critical part of their business, and Lange says there are essentially two kinds of partnerships that Virtusa builds – one is an enterprise platform partnership consisting of a host of digital vendors, and the other is their cloudbased partnership. As far as enterprise platform partnerships go, Pega is a primary partner that’s been with Virtusa since 2001. In a mature, long-standing relationship, 134

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Virtusa didn’t always have Pega as a vendor partner first. In fact, Lange says that Virtusa was initially contracted by Pega for their engineering services in order to build their brand. This then led to Virtusa using the technology that they built for Pega into their own operations. To this day, Pega and Virtusa continue to help each other in areas of emerging technology and engineering their products; it is this bi-lateral relationship that’s led to the creation of a life-saving

VIRTUSA

Virtusa Corporate Video

Philips platform called “I’ve fallen, and I can’t get up”. Essentially, it is a 24/7 medical alert system that has fall detection capabilities. Some of the other initiatives that Virtusa has engineered include ‘Provider Lifecycle Management’ – an end-to-end platform to manage prospecting, contracting, credentialing and servicing a provider in a payer environment; and the Appeals and Grievances platform, helping payers manage these processes as per government regulations. Working with Virtusa is a collaborative experience for Lange and the larger healthcare and life sciences division. Speaking on how Lange manages the customer experience aspect of the business, he adds, “We are a medium-sized company, and we tend to be very collaborative in how we work. So when we partner with a client, we want to fit into not only

their ecosystem of employees and partners but very deeply embed ourselves in their culture as well. We spend a lot of time trying to adapt to that different type of culture.” On the topic of digital transformation, Lange believes that companies that are embracing the change are likely to benefit in two areas: the first is that they’re able to provide a better quality of life for their patients and end-users, and the second, a better working environment for their employees. Revenue recovery and contract management Lisa Stoudt, President of Revenue Clinical Solutions, a strategic partner with Virtusa is focused on delivering a complete endto-end solution to the provider market. Providers need a full solution that combines healthcareglobal.com

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VIRTUSA

back into organisations and providing new avenues of revenue opportunities while simultaneously expanding quality outcomes and deliverables. Stoudt provided details around the first two combined products for Virtusa which will be Revenue Recovery and Contract Management. Revenue Recovery is focused on Retrospective Medical Necessity Denials/ Appeals and recovering revenue that is owed to hospital organisations. Stoudt discusses how millions of dollars are written off each year by CFO’s when unable to provide updated or correct clinical information back to payers. Stoudt discussed how critical it is for provider organisations who are writing off millions of dollars in the market today as

Superior Technology with Clinical Expertise. Stoudt noted that this delivery model is unparalleled in the market today as the majority of companies focus either on the technology or separately the clinical components. Virtusa will bring the combined solution to the provider market which will enhance and grow hospital organisations revenue but also provides the clinical expertise to provide improved healthcare outcomes and operational efficiencies. Stoudt has worked in senior and executive positions in both Provider and Payer organisations. Her expertise in building successful business units for some of the industry’s leading organisations has driven strong financial/operational results. After building numerous companies within companies, she developed and brought to market-Revenue Clinical Solutions (RCS). RCS delivers clinical products and services to both the provider and payer markets that focus on driving revenue 136

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“ We are a medium-sized company, and we tend to be very collaborative in how we work. So when we partner with a client, we want to fit into not only their ecosystem of employees and partners but very deeply embed ourselves in their culture as well. We spend a lot of time trying to adapt to that different type of culture” ANTHONY LANGE

SENIOR VICE PRESIDENT & HEAD OF HEALTHCARE AND LIFE SCIENCES, VIRTUSA

A FOCUS ON TECHNOLOGY...

VIRTUSA

Manu Swami, Head of Healthcare and Life Science Solutions, outlines his roles at Virtusa and how he is helping to drive solutions through technology. Swami helps to drive Next Generation Solutions and GTMs for Healthcare and Life Science verticals leveraging the latest Data, Automation, Cloud and Experience technologies. He also forges industry partnerships with established companies like Pega, Salesforce, CSPs etc. and niches vendors like Onyx to Mareana drive solutioning for clients. “My role is focused on delivering solutions and go-to-market strategy for the Healthcare Life Science segment for Virtusa. We invest in solutions to drive business goals for Healthcare and Life Science Clients” said Swami. “My team is a composition of business domain experts and technology leaders who build solutions to drive up quality and reduce cost of care for healthcare and life sciences clients and effectively leverage our solutions to meet their business objectives. We focus a lot on our engineering capabilities as a key differentiator when we are working with different clients.” Commenting on Virtusa’s market strategy, he said it is focused on four key pillars, which include; • Hyper Automation for Business Processes across the organisation • Leveraging Data and Insights across the business value chain • Drive experience for providers, members and employees • Platform modernisation on Cloud

“Automation has played a key part for us in the past year in our go-to-market areas like service experience transformation and supply chain and due to the pandemic. Next Generation AI and RPA technologies have played a key part in managing volumes of interactions coming from different healthcare parties and reducing cost of the operations.” “Connecting data across healthcare organisations is a key enabler to understand a patient's health. We have adapted our solutions driven by interoperability to provide personalised experience to providers and members.” Predicting technology trends in the healthcare market, Swami says the sharing of information between different healthcare organisations will “drive big changes”. Healthcare will be provided eventually on the edge on personal devices and Artificial Intelligence (AI) will be playing a key part in understanding and managing patient’s health. “As patients start to transmit information from devices they are wearing or healthcare apps, I think payers and providers are going to have much better insights on a patient's health, and they can tailor their products” “The advent of AI has become real for a lot of our technology clients like IBM. AI is driving a lot of solutions to be learning driven which were traditionally driven by business rules, and I think this trend is here to stay in the healthcare and life science space,” he said.

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hospitals are struggling financially. This is the main reason Revenue Recovery was the initial product to launch. Stoudt references two key factors to consider for provider organisations: • Denial write-off adjustments average 3% to 4% of net revenue, which equates to US$262 billion in initially denied claims for healthcare providers annually • One out of every five dollars of revenue cycle management (RCM) expenses are attributed to denials-related issues and to top it off, 67% of denials are recoverable while 90% of denials are preventable Utilising Virtusa’s exemplary technology capabilities combined with Revenue Clinical 138

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Solutions, clinical expertise providers will be provided an unparalleled solution to recover, grow and enhance their revenues. Contract Management is focused on missed opportunities with Value-Based Contracts. Stoudt states millions of dollars are lost from shared savings and hospital organisations need the combined solution to be able to achieve the goals/initiatives that are required by payer organisations. Stoudt notes there are several key factors to consider for hospital organisations: • Provider organisations are leaving potentially millions of dollars on the table by not ensuring that they have delivery models for their value-based contracts. • Provider organisations can overcome these

VIRTUSA

revenue losses to hospital organisations. Utilising Virtusa’s PLM Platform and implementing Revenue Clinical Solutions she noted that these solutions will deliver significant revenue back into provider organisations as well as drive improved and measurable clinical outcomes. Stoudt discussed that currently in the market today there is a minimal effort to combine Technology and Clinical Solutions. All claim that they are the full solution to gaps in services, but in fact they are only part of the solution. By combining superior technology with clinical expertise, it provides clients with a COMPLETE SOLUTION.

challenges and maximise their revenue by understanding the basics of payer contracts, diving deeper into contract language, creating a central space for contracts, and preparing for negotiations. United Healthcare reports that nearly $75 billion in annual payments to providers are now tied to value-based payment but frequently finds providers aren’t actually interested in working with them. Stoudt focuses on how once again Virtusa brings the full solution to the provider market. The combination of technology and clinical capabilities drive the financial results that are desperately needed for hospital organisations. Stoudt states that this is especially true post pandemic with significant

• Revenue – It’s all about delivering financial results with quality outcomes • Frequently clients state they have a solution but when you get additional details you find they have fragmented services and are not really getting to a full solution which would allow them to recover, enhance and/or grow their revenue • RCS created clinical products that are focused on revenue opportunities. Combining these products with Virtusa’s superior technology capabilities will create significant revenue opportunities for potential clients Virtusa is bringing new and creative solutions to the Provider Market. Stoudt states this is an exciting time to be delivering products and services to hospital organisations that will see an increase in revenue as well as provide opportunities to grow their revenue. Stoudt discussed how Revenue Recovery and Contract Management are the initial products to the market but other products are in development and will add to the technology/clinical suite of solutions. healthcareglobal.com

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TOP 10

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HEALTHCARE

CAMPUSES

We round up 10 top universities that excel in the healthcare and medical fields, but are also helping to advance new tech solutions

WRITTEN BY: LEILA HAWKINS

here is a worldwide shortage of healthcare professionals that the WHO estimates could reach 18 million by 2030. Additionally the pressures of the pandemic have led to staff burnout, and healthcare systems everywhere are

feeling the strain more than ever. But lack of resources and time can be addressed with technology. Here we've rounded up 10 top universities that excel in the healthcare and medical fields, and are also helping to advance new tech solutions.

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TOP 10

eCampusOntario Canada

eCampusOntario is a Canadian non-profit organisation that leads a consortium of publiclyfunded colleges, universities and indigenous institutes to test digital learning tools. It is currently spearheading an initiative with Lumeto, the immersive learning company behind virtual reality platform Involve XR. This is providing training to frontline healthcare workers in specialties like wound management, mental health de-escalation, and respiratory distress.

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Healthcare Leadership Academy United Kingdom

The Healthcare Leadership Academy (HLA) is a British initiative formed to provide young clinicians and medical students with leadership skills. Its aim is to inspire the next generation of healthcare professionals with mentoring, discussion, and philosophy. Its HLA:IDEAS programme has a mission to create change and is aimed at underrepresented or underprivileged communities. Its most recent cohort includes 6 very different organisations such as In2MedSchool which provides free mentoring to underprivileged school and college students aspiring to study medicine, and the African Caribbean Medical Mentors which supports current and future Black doctors and dentists.

TOP 10

The Ohio State University United States

One of the top 12 public research universities in the US, Ohio State University's medical department has four centres: the College of Medicine, College of Veterinary Medicine, The James Cancer Hospital and the Wexner Medical Center. The cancer centre is one of 51 National Cancer Institutedesignated centres, and one of only a few places funded to conduct both phase I and phase II clinical trials on novel anticancer drugs. Internationally-renowned oncologists are based here, and there is a strong focus on advanced technologies such as robotic surgery and computeraided colonoscopies.

Edge Hill University United Kingdom

Founded in 1885, this university is one of the UK's leading research institutions for healthcare and science. In 2021, Edge Hill researchers embarked on a study to investigate how AI could improve the early diagnosis of pancreatic cancer, and its bioscience department received investment of almost quarter of a million pounds to support STEM work. In June one of the university's academics, Dr Peter Leadbetter, won an award for leadership and commitment to widening participation in medicine. Edge Hill has previously held the UK University of the Year title (2014/15), awarded by Times Higher Education. healthcareglobal.com

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Enabling educators. Empowering students. Explore how we accelerate student discovery, learning and innovation with our Digital Education 3D Experience. EXPLORE THE 3D EXPERIENCE

TOP 10

National University Hospital Singapore

This hospital opened in 1985 as Singapore’s first restructured hospital. Each year, it cares for more than one million patients and is now the country's main teaching hospital, playing a key role in the training of doctors, nurses, allied health and other healthcare professionals. There are three national specialty centres for cancer, heart disease and oral health. Translational research is very important to this hospital; clinicians and scientists from Singapore's National University Hospital recently partnered with fellow institutions and clinicians in the UK to develop a device that reduces numbness and pain caused by certain anticancer therapies.

Northwestern Health Sciences University

United States

This university in Minnesota was first founded in 1941 as Northwestern College of Chiropractic. It has since grown into a large health system with a variety of clinics and services on its Bloomington campus, in the Twin Cities metro area, and in other states. The clinics serve a variety of populations, and all incorporate students into their services for them to gain clinical experience, with a particular focus on training the "behindthe-scenes" professionals like lab scientists, radiology technicians, and medical assistants enabling them to analyse medical samples and scans. It also offers programmes in nutrition, acupuncture and massage therapies. healthcareglobal.com

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Nottingham Trent University United Kingdom

This award-winning university was named University of the Year 2019 by the Guardian University Awards for its focus on retaining students from low-participation areas. It has also been rated Gold in the Government’s Teaching Excellence Framework – the highest ranking available. One of the UK's largest universities, it is also a hub for groundbreaking research. Academic work here has resulted in a prototype for a 3D-printed liver which will help surgeons perform liver surgeries with greater accuracy and deliver improved patient outcomes. The aim is for surgical students to rehearse their procedures and become familiar with the complexities of the operation prior to the real surgery.

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University of Amsterdam Holland

One of Amsterdam's largest public research universities, this institution is renowned for medicine and science studies, and opened a teaching hospital in 1983. In 2018 spin-off company Kepler Vision Technologies was founded, dedicated to computer vision and AI software. Kepler develops night vision solutions, such as Night Nurse, which uses artificial intelligence to monitor body language in the dark and can alert staff or carers when an elderly person has had a fall.

John Hopkins University United States

This private research university in Baltimore is one of the world's best known. Founded in 1876, it is named after its first benefactor, entrepreneur and philanthropist Johns Hopkins. One of the first research universities in the United States, it has gained further credentials throughout the pandemic for providing accurate details of transmission rates around the world as well as vital research in the fight against COVID-19. A number of Johns Hopkins laureates have won Nobel Prizes in Physiology or Medicine.

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TOP 10

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August 2021

George Q. Daley Dean, Medical School

Harvard University United States

One of the most prestigious universities in the world, Harvard has several medical schools dedicated to diabetes, cancer, children's health and dental health among others. Based in Boston, the private Ivy League institution was first established in 1636, making it almost 400 years old. Its acclaimed Harvard-MIT Program in Health Sciences and Technology, brings various Harvard schools together with the Massachusetts Institute of Technology to create solutions that combine science, medicine, and engineering. As well as counting notable people like Bill Gates and the Obamas among its alumni, there have been 14 Turing Award laureates who have been Harvard affiliates.

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TEWV NHS

A DIGITAL STRATEGY FOR THE PANDEMIC AND BEYOND WRITTEN BY: LEILA HAWKINS PRODUCED BY: JAMES BERRY

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TEWV NHS

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Kam Sidhu, CIO at Tees, Esk and Wear Valleys NHS Foundation Trust, tells us about their digital strategy through the pandemic and beyond

am Sidhu is the Chief Information Officer at Tees, Esk and Wear Valleys NHS Foundation Trust, a mental health and learning disability trust in the north-east of England. The trust's services cover adult mental health, children and young people’s services (CAMHS), mental health services for older people and forensic services. Sidhu's department broadly has three areas: business intelligence and reporting; development and technical which includes everything related to IT and management of systems (including delivering computers and answering service desk calls); and lastly the delivery arm, covering projects, compliance and training. The trust is in the midst of rewriting its digital strategy, with a key objective to fully exploit the technology it already has. "We're using MS Teams for example, but we probably only use a very limited functionality, and we need to fully maximise its benefits" Sidhu says. She emphasises the importance of not focusing purely on new technology, "because often you get a mismatch between what the organisation is ready to adopt versus what it thinks it should adopt." Investing in the team is also key, making sure there are no gaps in people's skills and knowledge, and ensuring they have the tech they need to build a digital workforce for the future. "The third element is striving for

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TEWV NHS

Improving Mental Wellbeing with Digital Transformation

excellence" she says. "We want to be a good place to work, and a great partner." To develop the strategy they adopted a co-creative approach, having consultations with internal staff and external partners, as well as issuing surveys to find out what the needs of patients and care groups are. "Obviously we have to manage national and local obligations, but we wanted to take on board people's views and what they would like from us. It's really a balancing act." The digital journey As part of the trust’s digital transformation it is continuing its journey to add more functionality to the electronic patient record (EPR). The software for the EPR and the trust's electronic management 156

August 2021

of prescribing and administration (ePMA) is provided by Civica, a global IT services provider that supports around 500 NHS departments. "It's very much a partnership" Sidhu says. "We have a co-creative, collaborative approach with them, and they've been very responsive and agile in terms of development. They're also very reactive, and they've got a lot of expertise in the area. I think their willingness to work with us in such a collaborative way has been really valuable." Utilising EPRs is an important part of the NHS Long Term Plan, a 10-year strategy for the UK's entire public health system which includes a big push to move towards digital services. "As part of our digital strategy we completed an independent digital maturity

TEWV NHS

KAM SIDHU TITLE: CIO INDUSTRY: HEALTHCARE LOCATION: UNITED KINGDOM Kam Sidhu started her career as a nurse 25 years ago, before moving into service improvement and IT roles within both the public and private sector. Now interim CIO at Tees, Esk and Wear Valleys NHS Foundation Trust, she is leading the digital transformation strategy that will provide innovative care in the mental health sector.

assessment to see what KPIs we've reached, and what capabilities we're delivering" Sidhu says. "We've chosen to have a three-year strategy, and I think that's the right timeframe for us because technology is so fast-paced." "When I was nursing I had to go through loads of handwritten notes, but actually using an electronic system that allows you to have the right data in the right place will make the trust more sustainable in terms of releasing time to spend on patient care." "I also think that digital transformation and sustainability are drivers for the future. There is environmental and financial sustainability that comes from digital transformation, in terms of how we can do things differently so we're not constantly asking for more funds" she says.

“ For me, data is about articulating a business problem, not about getting a new app” KAM SIDHU

CIO, TEES, ESK AND WEAR VALLEYS NHS FOUNDATION TRUST

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Creating patient-centred solutions Paul Sanders is Managing Director for Clinical Systems at Civica. We talk through Civica’s partnership with Tees, Esk and Wear Valleys NHS Foundation Trust. Civica is one of the UK’s largest software providers for the public sector. The company’s partnership with Tees, Esk and Wear Valleys NHS Foundation Trust, a mental health and learning disability trust in the North East of England, started back in 2008. It involves four main areas, an electronic patient record (EPR), an electronic prescribing solution (ePMA) and a documents and content management solution called Cito delivered on a cloud-based managed service.

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“I’ve been very impressed with the work they’ve done” Kam Sidhu, Chief Information Officer at the trust says. “Clinicians often come up with lots of different ways they’d like to work, but sometimes what they have on paper doesn’t transfer very well to a digital solution. Our development teams have been working closely with Civica to come up with solutions that are really fit for purpose.” Sanders explains that to do this they undertook more than 30 face-to-face workshops that brought together technical people, clinical staff and service users. “To bring this insight back to our technical team has been so powerful, because this isn’t

about software – this is about making things better for vulnerable people.”Looking ahead, Sanders says they aim to be at the forefront of new technologies like machine learning, robotic process automation, and patient chatbot technology, whilst continuing to deliver domain-focused, clinically usable features to enable Sidhu and her team to get positive outcomes. They have also created Civica NorthStar, an innovation lab focussed on creating enhanced outcomes for public services. “We’re one of the market leaders in housing and social care, so from an integrated health and social care agenda, we can join the dots between those systems’ technologies, and track the data journey as a citizen moves through the care system” Sanders says. The innovation lab applies fresh ideas around data, automation and new technologies to also enable the trust to improve patient outcomes. “Having data from different areas is very powerful because data in isolation doesn’t give you the complete picture of what’s happening to that patient” Sidhu says. “In terms of our partnership, this is only the start. Cito is the next phase, then the ePMA programme and the patient portal, and then there’s more to come.”

Learn more

TEWV NHS

"A good example of financial environmental sustainability has been during COVID. There has been a reduced carbon footprint because there's been less travel and therefore less cost per mileage. I think that, although going forward there'll be a more blended approach to how we deliver care, a lot of those aspects are going to remain." 160

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“ Digital transformation and sustainability are drivers for the future” KAM SIDHU

CIO, TEES, ESK AND WEAR VALLEYS NHS FOUNDATION TRUST

TEWV NHS

The effects of the pandemic COVID-19 caused new digital services to be implemented almost overnight. But this carries the risk of leaving behind people who don't have access to tech or digital skills. This is a particularly important issue for Sidhu, who is ensuring that by taking a digital-first approach the trust doesn't widen the gaps in access to technology, which are greater

in the north-east than in other parts of the country. "There is a higher percentage of digital poverty here compared to the Midlands for example, where I worked previously. We need to take a blended approach to delivering digital capabilities to ensure there is equitable access." There are discussions ongoing with Vodafone and BT Connect to find solutions to tackle digital poverty. While plans are still very much in their infancy, there is a pilot in the pipeline with BT Connect to help monitor patients' health in their own homes. With Vodafone they are exploring the possibility of enabling people to visit a Vodafone store to use the network provider's data, stepping into a soundproofed booth where they can carry out online assessments or the learning required to have video consultations. The trust is also offering Attend Anywhere, a project between Government, hospitals and health systems to help make video call access a normal part of dayto-day life. This has enabled patients to continue having appointments with doctors while the pandemic has been ongoing. The trust is one of the biggest users of Attend Anywhere in the country, with over 70,000 video appointments held since April 2020. Additionally, tablets, laptops and smartphones have been provided for both staff and patients. "It was very important that we weren't isolating patients that needed access, so we've been delivering tablets to patients' homes so they can conduct virtual appointments with healthcare staff. Then, following infection prevention rules, we wipe down the tablet and move on to the next patient. It was important that we worked with what we had at the time in terms of technology" Sidhu explains. healthcareglobal.com

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“The new normal is very much about a blended approach. Ultimately it has to be about patient choice” KAM SIDHU

CIO, TEES, ESK AND WEAR VALLEYS NHS FOUNDATION TRUST

Meanwhile their phone lines were constantly off the hook, as people called in with concerns over the new virus. "I was very impressed with the work the team did to quickly deploy additional headsets to manage the call volumes, and then start producing interactive reports that allowed us to really drill down and find out where there were real concerns in terms of COVID numbers. It was all done very quickly." Using data to tell the patient story Sidhu's approach to using data is leveraging past and present data to build a picture of the complete patient journey, which will inform service provision and how they deliver care in the future. Her team used data to build a digital poverty map so that areas experiencing the most difficulty can be targeted. They also use data for trend analysis to understand what's happening in the local population, and have issued questionnaires for people in the community to tell them what they would like to see from the trust's services. "For me data is about articulating a business problem, not about getting a new app. I think sometimes people have a tendency to talk to each other and one of them has a friend down the road using a specific app, and then the other person wants it without understanding the business problems. We've changed our focus - now it's about using data to find out what we need to inform care, the way the service works, and inform service provision in the future."

Healthcare in the "new" normal "Most organisations had been looking at doing virtual consultations before the pandemic started, but were very slow with adoption" Sidhu says. "We've now got a new way of delivering care, and I believe it will be a blended approach that works for the patients and the staff." There are also new ways of delivering training and support, such as e-learning, which she believes will continue. Another change is making better use of their buildings, and utilising any space that previously wasn't in use. "The private sector is much further ahead in terms of hot desking, so we might look at that. But some of the buildings have been left empty for probably a long time in certain parts of the trust. We want to look at how we use these differently." But possibly the biggest change has been to ways of communicating. "The way we are communicating now was very alien to a lot of people, but it's become very normal now. My mother who is in her 70s now knows how to use Whatsapp video, and I'm so glad I taught her because I'm in the north-east of England while she's in the Midlands." "I do think these new forms of interaction are here to stay, but I think the new normal is very much about a blended approach. Ultimately it has to be about patient choice."

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HEART TO HEART HOSPICE

BECAUSE

EVERYONE

DESERVES COMFORT AND DIGNITY AT THE END OF LIFE

WRITTEN BY: LEILA HAWKINS PRODUCED BY: JAMES BERRY

HEART TO HEART HOSPICE

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The team at Heart to Heart Hospice tell us how a digital transformation is helping patients in their care live life to the fullest, especially at the end of life’s journey.

he COVID-19 pandemic disrupted every single industry and sector of society, with very obvious repercussions for healthcare systems. For hospice care, which is based on compassionate, person-centered care, social distancing restrictions and the requirement to wear PPE meant staff had to get very creative to continue providing the reassuring care their patients needed. At Heart to Heart Hospice, which cares for patients across Indiana, Michigan and Texas, the technology they began implementing a few years previously as part of their digital journey helped to overcome many of these challenges. Russ Abercrombie, Chief Information Officer, explains what the first few days were like after the pandemic was declared: "A very serious communication gap was created when the COVID pandemic was declared. It was critical that our care teams remained in contact with their patients and family members and also the staff needed to stay in contact with each other for coordination of care. Within days we procured a video conference solution for each office and deployed the mobile client to over 1800 mobile devices. Additionally, people still needed hospice services, so admissions were made virtually for the first time, and with the CMS 1135 Waiver, telehealth services were allowed, which enabled Heart to Heart’s psychosocial and spiritual care staff members, as well as bereavement support, to remain available.” healthcareglobal.com

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RUSS ABERCROMBIE TITLE: CIO INDUSTRY: HEALTHCARE LOCATION: UNITED STATES Russ Abercrombie has been Chief Information Officer at Heart to Heart Hospice since April 2016. Prior to Heart to Heart he was Regional IT Director with LifeCare Healthcare Partners, a long-term acute care hospital system. At LifeCare, he was responsible for the western region and directed enterprise level healthcare and business information technology initiatives. For 30 years, Russ has worked in all levels of IT operations and high tech micro processor industry, where he tested many of the technologies we take for granted today. Russ is a graduate of Northwestern University in Chicago with a Master of Science in Healthcare Informatics.

“ We are here to care for the patients and their families. We do that by providing stable, flexible, secure technology that works consistently” RUSS ABERCROMBIE

CIO, HEART TO HEART HOSPICE

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HEART TO HEART HOSPICE

Title of the video

The electronic medical record (EMR) also required very quick, specific updates to accommodate changes coming out of CMS. “It was a challenge that I could never have imagined”, says Abercrombie, but all the hard work we did for the digital transformation really began to pay off.” Holistic, person-centered care Modern-day hospice care aims to enable patients who have a terminal illness to be comfortable and as pain-free as possible when they are nearing the end of their lives, allowing them to enjoy the time they have left with their family and friends. More than being a "place" where people are cared for, hospice care is about ensuring all the patient’s needs are met - whether physical, emotional, mental or spiritual. "We meet the patient wherever they are, even if that's under a bridge or at a homeless shelter", explains Heather Lumsdon, Chief Clinical Officer. "We are, in a sense, a hospital without walls."

Lumsdon cites the example of a 39-yearold woman who had terminal breast cancer. Towards the end of her life, she had a lot of difficulty swallowing the medication she needed to keep her pain under control. She was also barely able to move around, to the point where she couldn't change her position in bed. But the hospice's clinical team realised that she was still able to move her thumb, so she was given an IV pump which allowed her to keep her pain under control on her terms. "When you're in a hospital, you usually don't get that choice," Lumsdon says. "Her family watched her pass away with no pain. There is such a thing as a good death, and it can be beautiful, and it can be peaceful. That's what hospice care is about - literally living well till the very last breath." It's a common misconception that a hospice is a place where people go to die, but this view is gradually changing. "Here in the US, from the early to mid-2000s, there healthcareglobal.com

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HEART TO HEART HOSPICE

were around 750,000 people receiving hospice care, now it's more like one and a half million. So definitely there's been a change," Lumsdon says. "When our clinicians identify an unmet need, whether physical or emotional, and refer a patient to the hospice, what we hear over and over again is, "I wish I'd known about this sooner". There is a natural fear surrounding what a hospice is, but Lumsdon explains that it doesn't have to be this way. "I think that to accept what the hospice is, is to have to face all the things that you've been fighting against, whether you're the patient or the family member. People develop these coping mechanisms like, "well, the cancer hasn't spread yet, so we're still okay". Accepting hospice care unwinds all the coping, and you have to reconcile that there is an end, and it's on the horizon."

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HEART TO HEART HOSPICE

HEATHER LUMSDON TITLE: CHIEF CLINICAL OFFICER INDUSTRY: HEALTHCARE LOCATION: UNITED STATES Hospice management for over 24 years. Positions held include RN Case Manager, Patient Care Manager, Hospice Inpatient Unit Director, Executive Director, Regional Vice President of Clinical Operations/Area Clinical Manager/ Regional Clinical Director and Area Director of Operations SW IN. Currently Chief Clinical Officer. Trained in Joint Commission for Hospice and CHAP. History of State deficiency free surveys and deficiency free Hospice CHAP survey and Validation survey. Start-ups. Policy and Procedure development and implementation. Strong knowledge base of Hospice regulations and QAPI. Served on Pharmacy & Therapeutics Committee. Operations and Sales Management. Prior certification in Hospice & Palliative Care Nursing (8 yrs). Prior nursing experience in OR and Long Term Care.

“If we changed the word hospice to relief, maybe more people would see it for what it is” HEATHER LUMSDON

CHIEF CLINICAL OFFICER, HEART TO HEART HOSPICE healthcareglobal.com

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“ The massive digital growth of Heart to Heart Hospice started at the foundation in the data centre, networks, and the restructuring of Support Services. The new Heart to Heart normal for patient care is providing reliable, robust data and support services; absolute must, no excuses” DAVID SPITZER

VICE PRESIDENT OF IT INFRASTRUCTURE AND SUPPORT, HEART TO HEART HOSPICE

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"Once you accept that and you embrace the concept of living life every day to the fullest, there's this huge sense of relief," she says. "If we changed the word "hospice" to "relief", maybe more people would see it for what it is." Evolving healthcare The US healthcare system is currently undergoing huge changes with valuebased reimbursement models and the introduction of patient risk stratification which directly ties into palliative and hospice care. "Hospice, because of the palliative care component, is now being invited to join the care continuum to assist in the care of the seriously ill patient population," Abercrombie says. "This is exciting, because we have a chance to positively affect a seriously ill person’s life by providing palliative care long before hospice services are needed with the expectation of improving their quality of life.

“Short term acute care facilities in addition to provider groups have been using electronic medical records (EMRs) for many years now" Abercrombie says, "The reason for the digital transformation began with Kelly Mitchell, CEO of Heart to Heart Hospice. Kelly saw a need for us to have an EMR so we could join the care continuum on a technological level.“ Abercrombie was hired in 2016 when the hospice began its digital transformation. "We had to start at the very bottom," he says. "The entire infrastructure had to be replaced to support the business and technology vision Kelly had. "Throughout 2016, we replaced the network and re-platformed the data center with enterprise-class core switching, data storage, and a high availability VMware environment. At that time, we were about 29 sites, but by the end of this year, we'll be a little over 50. So we had to build a scalable, flexible, secure infrastructure to be able to support the growth of the company." “The healthcareglobal.com

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IT Support group, led by David Spitzer, Vice President of Infrastructure and Support, did an amazing job.” “We selected Homecare Homebase as our EMR partner and began implementing the system in January 2017. The project took an entire year and was led by Patrick McPherson, Vice President of IT-EMR. This was a huge under-taking and with Patrick’s leadership, the team met the challenge.” Abercrombie emphasises that implementing an EMR and all the ancillary systems is a clinical project first and foremost and cannot happen without a close relationship between the IT and clinical teams. "They know how to care for patients; they know what is needed," he says. "And obviously, we know the technical side and project management. So this was a very close partnership."

While the aim of the hospice is to go digital, there is still a substantial amount of paperwork required, so a document management system was acquired. "Our partner for that is Forcura," Abercrombie says. "They also provide secure texting and secure video services and provide a mechanism for legal consents to be executed electronically. They've been an excellent partner for us.” "Over the last four years, we implemented a total of eight systems", he adds. A few of them are: Nuance Medical One for physician dictation, traditional dictation for remote patient recertification that automatically flows to Forcura, analytic capabilities, internal communication tools, and MuseMedalogix AI.”

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“Heart to Heart Hospice has navigated the last decade so successfully by maintaining the focus on the wellbeing of the patient” PATRICK MCPHERSON

VICE PRESIDENT OF IT - EMR, HEART TO HEART HOSPICE

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Technology to improve lives Muse-Medalogix AI system is the latest system Heart to Heart has adopted. "Muse is an artificial intelligence system that provides a window into the EMR", Abercrombie explains. "One of the large culture changes that happens when you replace paper with an EMR is that all the spreadsheets and three-ring binders’ people used all of a sudden disappeared. All that information is on the computer now, and to get to it; we trained constantly and developed a sundry of tools and dashboards for the agency staff to manage their census. But the Muse AI system has been transformational for us - you can quickly see where your patient resides, how many visits have been made and scheduled, diagnosis, vitals, and many other data points needed for daily patient care." The system even has a patient level trending chart, which includes nursing notes from past visits, to enable the nursing manager to build a better picture of why the patient might be in decline. "It's been instrumental in enabling the care teams to get their arms around the data and then to turn that into care", Abercrombie says. The AI capabilities provided by Muse have been particularly important in this respect. "Part of our mission is to be present [with the patient] at the most important time," Lumsdon says. "Muse allows nurses to focus on where the patient is today, and it alerts our team if their condition changes. Coming from an oldfashioned paper world, I used to carry binders around when I was on call, containing a list of patients, their addresses and their medication. Now I can use my laptop or tablet to go into a chart in real-time and to see what's going on with the patient." "This also helps us to see any changes happening that we need to discuss as a team and if we need to increase our services. It's really helped us to see a patient's trajectory 176

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- each illness process has its own trajectory, and Muse helps you to map this out over time," Lumsdon says. The ability to chart the progression of an illness is perhaps even more important in palliative care than primary services, for instance, because there is no second chance to get the care right. "A patient may be with us for four months. If we miss that patient's transitioning and we weren't there at the end, there is no do-over," Lumsdom says. "Guided by the data, we've actually seen our visits go up in the last three to seven days of a person’s life. When we

HEART TO HEART HOSPICE

“ Behind the scenes, we can use technology systems to increase the bedside time. That's what feeds the souls of nurses”

look at our performance compared to other hospice providers, we have more visits, and that typically translates to better care because we're there at the end of the patient's life," she adds. "Nurses don't work in hospice care because they want to do a lot of paperwork, they do it because they want to be at the bedside" Seeley Avery, VP of Marketing and Education, says. "Behind the scenes, we can use technology systems or processes to increase that bedside time and those conversations. That's what feeds the souls of nurses, and anything other than that can be very frustrating." The EMR has vastly increased the amount of time nurses can spend at the bedside. "They used to spend so much time doing paperwork", Avery adds. "Once you're trained in how to use the EMR, it's so much easier. We'd hear of nurses who, after tucking their kids into bed, would then have several hours' worth of documentation to write up. Now they can document it into one system before they leave the hospice patient and then go home and get back to their lives. If it improves their lives, that improves their care and employee satisfaction, and it's just this whole upward spiral." "It's been a huge ride," Abercrombie says of the last four years. "I won't say smooth, but with a clear, direct partnership with the clinical team and Heather, it's been really enjoyable and rewarding. We've had some hard times changing the culture, but we are here to care for the patients and their families. We do that by providing stable, flexible, secure technology that works consistently. We don't want staff to worry about whether their tablet is going to boot up or a system is not available. Ultimately it's all about the patient."

SEELEY AVERY

VP OF MARKETING AND EDUCATION, HEART TO HEART HOSPICE healthcareglobal.com

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