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Safran info sage & disruptive innovation
- 1. 1 © 2013 Charles Safran InfoSAGE and Disruptive Innovation Charles Safran, MD Chief, Division of Clinical Informatics, Harvard Medical Faculty Physicians @ BIDMC Associate Professor of Medicine, Harvard Medical School
- 2. 2 © 2013 Charles Safran Disclosures • Intelligent Medical Objects – Director and shareholder • Elsevier – Physician Advisory Board • Cerner Corporation – Consultant
- 3. 3 © 2013 Charles Safran Outline • Why do we need innovation • Personal Health Technology • InfoSAGE
- 4. 4 © 2013 Charles Safran In the post‐EHR‐industrial era will innovation be stifled ?
- 5. 5 © 2013 Charles Safran Clinical Informatics • Clinical informatics applies concepts, methods and tools that enable the optimal use of information and knowledge to measurably improve patient care. • Clinical informaticians transform health care by analyzing, designing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician‐patient relationship. • Clinical informaticians are at the intersection of clinical processes and business processes and communication & information technology • Clinical informatics is applied ‐‐ interventional Clinical Processes Information Technology Business Processes
- 6. 6 © 2013 Charles Safran MR EMR EHR
- 7. 7 © 2013 Charles Safran • Contain information about a patient's medical history, diagnoses, medications, immunization dates, allergies, radiology images, and lab and test results • Offer access to evidence‐based tools that providers can use in making decisions about a patient's care • Automate and streamline providers' workflow • Increase organization and accuracy of patient information • Support key market changes in payer requirements and consumer expectations Electronic Health Records are real-time, patient-centered records. They make information available instantly, whenever and wherever it is needed.
- 8. 8 © 2013 Charles Safran Goals of EHRs • Quality and convenience • Accuracy of diagnoses and health outcomes • Practice efficiencies and cost savings • Care Coordination • Patient Participation Largely un-met
- 9. 9 © 2013 Charles Safran9 NSF Patient Empowerment Workshop Park City Utah, December 1-2, 2011
- 10. 10 © 2013 Charles Safran “Patients are the least utilized resource in healthcare” - Warner Slack
- 11. 11 © 2013 Charles Safran Personal Devices
- 12. 12 © 2013 Charles Safran Continuous Glucose Monitoring 1 2 • Implanted in subcutaneous tissue • Measure the level of interstitial levels of glucose NOT blood glucose levels – Q1‐10 minutes • Using advance algorithms are able to predict current blood glucose levels and trends • Currently device specific applications on desktops
- 13. 13 © 2013 Charles Safran Sometimes visualization reveals nothing
- 14. 14 © 2013 Charles Safran
- 15. 15 © 2013 Charles Safran CureTogether
- 16. 16 © 2013 Charles Safran CitiSense ‐ Open Transparency Adapted from Bill Griswold Crowd-Sourced Real-time Health Data
- 17. 17 © 2013 Charles Safran Where is health data coming from? • Hospitals • Physician’s office • Payors • Commercial Labs • Pharmacies • Public Health/ Gov • Mobile devices • Apps • Social media • Sensors • Computer games • Personal Health Records In the future, health data will overwhelming come from outside the health system.
- 18. 18 © 2013 Charles Safran
- 19. 19 © 2013 Charles Safran Problems to Solve • Aging creates healthcare decision‐making, information management, and communication challenges, for elders and their families • Care Coordination is exceptionally challenging • Respecting the elder’s preferences and priorities is often lost in transition
- 20. 20 © 2013 Charles Safran
- 21. 21 © 2013 Charles Safran • Population is Aging • Two‐Fifths Of U.S. Adults Care For Sick, Elderly Relative • Logistics of Care is Time Consuming • Caregivers are at risk for burnout
- 22. 22 © 2013 Charles Safran Goals of InfoSAGE • Identify the information needs elders and those helping to care for them, • Create a “living laboratory” • Longitudinally study elder and family collaborative interactions and information management • Evaluate the extent to which InfoSAGE improves communication, coordination, and collaboration for elders and their family.
- 23. 23 © 2013 Charles Safran Electronic Health Records Health Informa on Systems Visi ng Nurses Pastoral Home Services Other Services Social Networks PubMed Clinical Trials Search Physicians Nurses Personal Health Records Health Care Insurer Mass Media/ Public Ins tu ons Electronic Health Records Health Informa on Systems Visi ng Nurses Pastoral Home Services Other Services Social Networks PubMed Clinical Trials Search Physicians Nurses Personal Health Records Health Care Insurer Mass Media/ Public Ins tu ons
- 24. 24 © 2013 Charles Safran IdentityIdentity ConnectionConnection ContentContent CoordinationCoordination Event Bus
- 25. 25 © 2013 Charles Safran • Innovation post‐commercial EHR acquisition is not only possible but necessary • Clinicians will be overwhelmed by patient‐ sourced data • EHRs are too facility and physician centric to address the healthcare needs of elderly • Caregivers need tools
- 26. 26 © 2013 Charles Safran Charles_Safran@Harvard.Edu 1330 Beacon Street Brookline MA 02446