InterSystems' CMO on interoperability

Advanced technology to support continuity of care
By InterSystems
02:43 PM
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(SPONSORED) M. Turner Billingsley, MD, FACEP, brings a unique combination of medical and technology expertise as well as thought leadership to the position of Chief Medical Officer (CMO) at InterSystems, a global leader in software for connected care, with headquarters in Cambridge, Massachusetts, and offices in 25 countries. In this role, Billingsley will be working with healthcare customers, assisting with ongoing development of healthcare technology offerings, and representing InterSystems in the healthcare IT sector.

Before joining InterSystems in 2011, Billingsley led the Physician Executives Group at McKesson Provider Technologies, a division of McKesson Corporation. He practiced clinically for nearly 30 years including work as a flight surgeon with the U.S. Air Force and as an emergency Department (ED) physician at St. Vincent’s Medical Center in Jacksonville, FL., where he held leadership positions in quality assurance and risk management. He also is the co-founder of Xpress Technologies, where he served as CMO and participated in development of an ED documentation system. Billingsley received his MD from University of Mississippi School of Medicine.

Q: The U.S. healthcare system and the technology that supports it have been evolving in recent years, and all signs point to more change. How do advances in technology affect a healthcare organization’s approach and ability to improve continuity of care across the healthcare spectrum?

A: Continuity of care is critical to success in today’s evolving healthcare environment, but has proven to be a stubborn problem. Many of the excessive costs that burden our healthcare system are related to duplication of studies when results aren’t readily available, poor communication as patients move between settings of care, complications related to an incomplete understanding of patients’ medical history or medications or just lack of knowledge of recent events such as admissions or ED visits.

Effective solutions to address these problems will require advanced technology that can bridge the gaps between care settings, technology solutions and providers of healthcare services. Bridging these gaps will enable caregivers in all settings to have complete access to data, as well as the ability to analyze and understand the information, and act on it.

Q: Meaningful use Stage 2 demands advancements in data sharing and patient engagement. How do you see these changes impacting clinical and fiscal results?

A: One change will be the replacement of traditional patient portals with bidirectional communication between patients and providers. Engagement not only calls for a two-way conversation, but also should be supported by rich content relevant to patients, or groups of patients. Analytics play a crucial role here as well, as real-time data and insights are essential to support the agility needed to take advantage of improved communication. For example, patients enjoy the convenience of making prescription-refill requests, but it is also an opportunity for the physician or other care team member to review their medications, and recommend changes as needed.

Q: What role does interoperability play in clinical performance improvement initiatives such as minimizing preventable hospital readmissions?

A: I have the privilege of gaining insights into this problem from my wife who is a family physician. In talking with her about her practice and specifically the issue of readmission, it is very clear that the gaps discussed above – between settings of care, technology platforms, and the timeliness and quality of communication – are crucial issues affecting the readmission challenge. It is not unusual for patients to arrive in her office after a recent admission with a limited understanding of their medical problems and new medications that have potential interactions with existing medications – and often the patient’s visit is the first notification of the admission.

An interoperability solution effectively addresses these problems, by sending “ADT” notifications to primary and consulting physicians, updating the patient’s comprehensive record across all settings (ideally in the native workflow of the user), and automatically updating important information such as diagnoses and problems, allergies and medications. At a population level, analytics are used to create real-time population dashboards that target at-risk patients and enable action based on specific measures – such as missed appointments, failure to fill prescriptions or indicators of likely readmission.

Q: Why must healthcare providers and organizations consider IT as part of their strategic approach to reducing adverse events and improving overall patient safety?

A: I have studied the impact of the strategic use of technology in another industry – aviation – for a number of years. During the many years I practiced, I was frustrated with healthcare’s safety record and the pace of technology uptake as part of the solution. Technology, adopted as part of an overall strategy, has the potential to be a critical lever in improving patient safety. We are already seeing great results in some areas of healthcare. For example, anesthesia has moved the bar from one of the riskiest care specialties to one of the safest for patients over the past three decades or so. This was accomplished by the systematic application of technology in addition to research, standardized practices and training, and relentless analysis of available data, including settled claims.

Along with a systems approach and adoption of proven, evidence-based tools such as the WHO surgical checklist, organizations need to employ interoperable technology that will allow them to “wire in” best practices for safety. In addition, just as modern technology helps air traffic controllers predict conflicts long before they occur, strategic technology solutions can enable predictive models that reduce the risk of adverse events.

What is strategic interoperability & why do you need it?
Strategic interoperability enables you to aggregate, normalize, and integrate data about every patient, from every care setting, so that clinicians and administrators can make decisions based on complete records and insight from real-time analytics.

Be sure to visit the InterSystems booth at HIMSS14, Booth 2741, Hall B to see presentations from North Shore-LIJ, RICOH, Seattle Children’s Hospital, Dr. Mark Blatt from Intel and more. You’ll also have the opportunity to bring your questions and comments to a variety of educational and networking events supported by InterSystems. Visit www.InterSystems.com/HIMSS14 for more information.

About InterSystems: InterSystems is a global leader in software for connected care, with headquarters in Cambridge, Massachusetts, and offices in 25 countries. InterSystems HealthShare® is a health informatics platform that enables strategic interoperability and analytics for action across a hospital network, community, region or nation. InterSystems’ products are used by thousands of hospitals and laboratories worldwide, including all of the top 15 hospitals on the Honor Roll of America’s Best Hospitals as rated by U.S. News and World Report. For more information, visit InterSystems.com.