Patients Rewarded: Technology To Help Speed Up Doctor's Appointments

IBM and Florida International University team up to apply autonomic computing applications in health care.
It's many patients' pet peeve: Show up on time for a doctor's appointment, then wait well beyond the scheduled time to be seen.

Not only is that wasted time unproductive and frustrating for patients, it's also inefficient for the doctors trying to provide quality time and attention to each patient based on individual medical needs.

The trouble arises in part because receptionists often don't know how much time each patient will actually require and so schedule appointments based on estimates or general practice protocol. The typical scheduling process doesn't take into account, for instance, that a physician will likely need more time to examine and counsel an elderly patient newly diagnosed with cancer than would be needed for a follow-up exam of a teenager who's recovered well from a recent bout of the flu.

To help make the scheduling process one based more on science and actual patient history rather than worker intuition and loose office traditions, IBM and Florida International University on Wednesday said they're working together to develop advanced scheduling software based on "autonomic computing technology."

The emerging area of autonomic computing aims at giving systems "more self management," akin to the "human autonomic nervous system," says David Kaminsky, a master inventor of IBM Autonomic Computing who is involved with the Florida International development work. Kaminsky explains that the human autonomic nervous system kicks in, for example, when you're trying to catch a bus, it's 20 feet away, and you run to get on it, he says. During that short episode, the body sweats while you're running and then automatically cools down once you're on the bus. "You don't have to tell your body to sweat while running and then to cool down," he says. Autonomic computing technologies aim to bring this sort of automatic "policy-based" capabilities to systems like health-care scheduling, he says.

The goal of the software under development by IBM and Florida International is to create scheduling capabilities that take into account a variety of factors and historical information, including patient behavior and needs. For instance, data mining of historical information can help allot appointment time more accurately for individual patients based on factors such as the procedure they'll have done and whether an individual's prior appointment history shows the person tends to require more time for asking questions or getting dressed, or if a particular patient tends to arrive late for appointments--or has a record of no-shows, says Dr. Niki Pissinou, a Florida International professor and director of its Telecommunication & Information Technology Institute.

"If a recent MRI indicates a patient will need more tests, then that person might need more time during an appointment," says Pissinou. The goal is to embed into the scheduling system the ability to account for such factors, she says.

Says IBM's Kaminsky: "We're seeking to optimize the time each procedure takes, optimize the time of the doctor or the use of high-cost equipment like MRIs, and minimize the wait time for patients."

Determining a more accurate appointment start time is economically significant in health-care environments, says Kaminsky. For instance, in a hospital environment, an MRI machine can be more efficiently used for patient tests if the scheduling process takes into account usage spikes, types of procedures being conducted, and how long a doctor might need to wait for the equipment between patients.

In addition to the scheduling software, as part of the IBM and Florida International partnership, the team will apply autonomic computing technology to improve the security of patient's digital health records. Under the Health Insurance Portability and Accountability Act, current patient data-access requirements are based on type of information accessed and purpose, says Pissinou. However, the software being developed by IBM and Florida International will provide additional parameters for authorized personnel, such as the user's location and time of access, she says.

For instance, if a patient is on vacation and provides a doctor with permission to access his or her medical information, that doctor could be able to access that patient's information long after that patient goes home. New "privacy in transit" parameters that could be added to patient data security software could set rules for when and how long a patient's data could be accessed by a specific physician at a particular location, Pissinou says. That would eliminate the "blanket" authorized access to patient data that other health-record systems provide, she says.

The new software will be tested within the next year at a few health-care providers, including Baptist Health Systems of South Florida. The project's goal is to make the software available commercially to the health-care community, Pissinou says.

IBM says the partnership with Florida International is part of IBM's Shared University Research award program, which was created "to exemplify the deep partnership between academia and the industry to explore research in areas essential to fueling innovation." IBM has invested more than $70 million over the last three years in a series of Shared University Research awards like the collaborative work being done with Florida International.

IBM is supplying to the university eServer pSeries and xSeries server systems, as well as products from the IBM TotalStorage SAN Switch and the IBM ThinkPad X series. IBM products included in the project are the WebSphere Commerce Business Edition and DB2 Universal Database.

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