Healthcare // Electronic Health Records
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2/28/2014
09:18 AM
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UPMC Tablet App Speeds EHR Access

Convergence, a touch app for Windows 8 tablets created by the University of Pittsburgh Medical Center, gives fingertip access to patient summary data pulled from one or more underlying electronic health record systems.

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At this week's HIMSS conference, University of Pittsburgh Medical Center (UPMC) showed off mobile, touch-enabled software intended to give doctors quick access to the most important information they need about every patient they see, with visualization for at-a-glance understanding.

The goal is to organize patient information into "clinical pathways," where the most relevant information is always at the physician's fingertips, rather than hidden in the multiple screens and tabs of one or more underlying electronic health records systems. (UPMC itself uses a combination of the Cerner EHR for inpatient care and the Epic EHR for ambulatory care, plus other specialized software).

Called Convergence, the Windows 8 application was created by UPMC with help from Caradigm, a joint venture of GE and Microsoft, with additional help from Microsoft and Intel. Caradigm provides the single sign-on and data integration technologies that allow Convergence to pull information from multiple underlying EHRs and clinical systems, with the ability to navigate smoothly between the converged, visual view of the patient record and the underlying transactional systems for recording patient records and clinical orders.

Rebecca Kaul, director of the UPMC Technology Development Center, said she originally tried to create the application a year ago on the iPad. The doctors who tried it loved the visualizations her developers came up with, but they balked when told the iPad app would be read only and that they would still have to go back to their EHR to record data. They'd either have to go to their desktop or, at best, open up a Citrix session from the iPad, log in, and navigate to the right section of the EHR to log the data.

[Lack of CPOE compliance got you down? Read CPOE Stragglers: One Hospital's Fix.]

"That was a show-stopper," Kaul said. Their message, she said, was: "I don't want to work in more than one system -- it's hard enough for me to work in this one system."

In contrast, Windows 8 and the technologies provided by Caradigm made it possible to treat the EHR as an embedded component of Convergence, accessible with gesture control. "You can swipe right into the Cerner System, go right to the order entry screen, do exactly what you need to do, and then swipe back into the clinical pathway," said Kaul.

UPMC is a multi-hospital healthcare system built around the University of Pittsburgh Medical Center. As CIO Dan Drawbaugh explained in a recent InformationWeek Radio interview with my colleague Chris Murphy, UPMC has ambitions to become a technology company and create tech spin-offs such as its Evolent Health, which was started by UPMC and The Advisory Board Company. "It's not a hobby for us," Drawbaugh told me in a meeting at HIMSS. UPMC believes it's possible to pursue that goal and still maintain its stellar reputation in healthcare delivery, he said.

UPMC's Kate Scott demos Convergence.

One reason for creating technology products is so UPMC can use them for its own purposes. But another is to shore up the narrow margins inherent to hospital operations with the double-digit margins a good technology business can enjoy. "If you have a 2 to 3% margin, and you make one small mistake, then you've lost that margin," he said.

Before pursuing any commercialization plans, UPMC is piloting the software in its cardiology department, prior to deploying it more broadly this summer. Kaul said UPMC will be happy to spend the money on buying Windows 8 tablets and deploying the software if doctors demand it. She already sees signs that colleagues of doctors in the pilot program are feeling left out because they don't have access to it, which should be a good sign for technology adoption.

"We want them to beg for it," Kaul said.

Engage with Oracle president Mark Hurd, NFL CIO Michelle McKenna-Doyle, General Motors CIO Randy Mott, Box founder Aaron Levie, UPMC CIO Dan Drawbaugh, GE Power CIO Jim Fowler, and other leaders of the Digital Business movement at the InformationWeek Conference and Elite 100 Awards Ceremony, to be held in conjunction with Interop in Las Vegas, March 31 to April 1, 2014. See the full agenda here.

David F. Carr oversees InformationWeek's coverage of government and healthcare IT. He previously led coverage of social business and education technologies and continues to contribute in those areas. He is the editor of Social Collaboration for Dummies (Wiley, Oct. 2013) and ... View Full Bio

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David F. Carr
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David F. Carr,
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2/28/2014 | 10:59:49 AM
Re: IT as revenue driver
I asked CIO Dan Drawbaugh what approach he would take if he was to parachute in to some struggling inner city hospital as its CIO, rather than having all of UPMC's resources to draw on. He maintained that he'd favor the same strategy of carving out some fraction of that hospital's limited IT resources to work on innovation and try to generate additional revenue for the hospital.

I'm not sure he convinced me that would be a practical strategy for everyone to pursue, but there's always a case to be made for thinking big.

What do you think?
David F. Carr
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David F. Carr,
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2/28/2014 | 10:54:55 AM
Have you seen other things like this?
Have you seen other tools that do a similar job of bringing multiple #EHR and clinical applications together around a "care pathway"? This reminds me of some of the web technologies for integrating multiple apps at the user interface level, with iframes and a bit of JavaScript, rather than trying to do heavy-duty integration.

A lot of other systems on display at HIMSS14 focused on bringing doctors and institutions together across the continuum of care. UPMC and its partners focused on bringing together the info the individual doctor needs in the course of his work and minimizing the friction associated with switching from one application to another.
ChrisMurphy
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ChrisMurphy,
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2/28/2014 | 10:25:48 AM
IT as revenue driver
UPMC is much more aggressive than most companies about taking its ideas for tech-driven internal improvement and turning that into commercial tech products to sell to other healthcare companies. My sense is that companies need to commit to this IT-as-revenue as a business model like UPMC has, and that it's hard to do for a one-off great idea IT has. Do others out there have experience with doing this? 

[If you're really interested in this idea, I'm going to be interview Rebecca Kaul and UPMC's CIO at the InformationWeek Conference in a month. Details at informationweek.com/conference. ]

 
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