RamaOnHealthcare talked with pCare CEO Dave Bennett and discussed the digital hospital of the future. Here is their conversation.
RamaOnHealthcare (ROH): Can you provide a brief definition of what the digital hospital means from your perspective?
Dave Bennett (DB): When I think about the digital hospital of the future, I’m referring to digital transformation. It’s more than just using technology. It’s about new ways of delivering value. It extends from the ability to self-schedule appointments on the front end to using advanced analytics and Robotic Process Automation (RPA) to settle claims on the back end. For pCare, it’s about leveraging technology to streamline and improve care for all stakeholders. It’s not about removing the human component but using technology at every step to optimize the experience for all parties. So, for example, a patient in a bed can use his TV remote control to manage his room lighting or temperature without bothering a nurse. Or, as a nurse enters a room, the door sign surfaces critical patient information that will help them deliver better care to the patient. Again, it’s about new ways of providing value. It’s more than just using technology.
ROH: Why do you think this has become an important topic now?
DB: Cost and experience/expectations are the primary drivers of this movement, which will not slow down. Despite inflation and a threatened recession, we still feel the impact of the great resignation. Labor costs are ballooning, yet millions of jobs are still unfilled. Digital Transformation holds the promise to re-engineer processes to automate jobs that are increasingly difficult to staff. These tasks are often done cheaper and better, i.e., with fewer errors. This enables optimal deployment of a shrinking yet higher skilled labor force, digital natives with expectations that existing technologies will be utilized at their jobs. On the customer or patient side of the equation, we know that within the healthcare environment, one of the top priorities of the c-suite is addressing rising healthcare consumerism. Again, the demand is for the experience integrated with the latest/most remarkable technologies.
ROH: What challenges are hospitals trying to manage regarding creating the digital hospital of the future?
DB: Hospitals face challenges as they create the future hospital that span the gamut. On the front end, hospitals need to implement the latest digital technology, which can be a challenge depending on the age of their physical plants. This calls for Smart Devices that can be connected to the Internet of Things which require robust internet connectivity – wireless (wi-fi) and wired. Future planning of new construction can be challenging, but it gets tricky when trying to retrofit an existing building cost-effectively.
On the software side, during most of the 2010s, hospitals were focused on the meaningful use and implementation of government-subsidized Electronic Health Records (EHR). These were multimillion-dollar capital projects requiring significant process change management under a relatively tight, pre-determined schedule. Now, as we enter the “post-EHR” world, technology has continued to advance rapidly, and health systems are challenged with bringing on new, digital technologies that will interoperate with these Electronic Health Records systems – that are the foundations of their technology stacks – but were not necessarily designed to play nice with emerging technologies.
So, it is a big challenge all around.
ROH: What role is pCare playing in helping health systems along with this evolution?
DB: pCare is uniquely positioned to help our clients on both ends of the spectrum – on the hardware and software sides. That is where we shine and, quite honestly, what has been driving our business over the past couple of years. While our Interactive Patient Care System or IPS has won the best in KLAS award – for best software solution in the IPS category – we can provide a full-service solution that has driven our growth. More and more, architectural firms are contacting us on the front and having pCare create Computer-Aided Design (CAD) plans to help design what the future hospital will include from the comprehensive audiovisual (AV) perspective.
In addition to providing comprehensive IPS implementations, including interactive TVs with prescribed education, extensive entertainment, meal ordering, room controls, meds-to-beds, digital whiteboards, door signs, integrated telehealth, surveying, and rounding – we are also asked to design and deliver physiological hall monitors, nurse station status boards, conference, and auditorium AV solutions and more. We are trusted to design and produce solutions with minimal operational disruption because patient care delivery can’t stop.
ROH: What tips or advice do you have for clients considering or undertaking these changes?
DB: There are two key points of advice:
First, have a clear strategic care objective and then see how technology can be deployed/leveraged to deliver value in a new, more efficient manner that enhances the human connection in some form or fashion. This can mean using RPA to perform menial tasks freeing up staff to work at the top of their license, or presenting data meaningfully to help with the care management process. It bears repeating that the focus/objective must be on care, not technology.
Second, which is more on the tactical side, don’t underestimate the complexity of implementing new technology that, in the long run, will simplify operations, care, etc., for all stakeholders. This requires slowing down and taking a holistic view of integrating new technology into existing infrastructure. As I’ve mentioned, pCare is increasingly being engaged on the front end of the design process because folks have learned that maybe they didn’t consider the physical dimensions of two screens or didn’t plan for internet drops or power at the appropriate places. The devil is in the details; the best software can’t run on the wrong hardware. So, you need to consider the entirety of the project.
ROH: Where do you foresee the most significant potential of AI and Digital Health within healthcare in the future? Please provide a brief example.
DB: Good question. Yes. It’s an evolution. I believe the most significant potential with AI and Digital Health lies in precision medicine. What we are doing now is with cohorts of people. So, within my Medicare Advantage population, I split out patients with diabetes, find out who is due for an annual eye exam and then send them a message to match their communication preferences. This is population health in action.
With advances in AI, I can now get into the realm of precision medicine – which is much more targeted. With the ability to model and train millions of records, we can now find patients who look more like me, so the care recommendation is much closer to 1:1. It’s going way beyond the annual eye or foot exam. For example, the data may show that a patient with my demographics – medical, socioeconomic, genomic, etc. – responds best to specific care protocols. That then becomes the recommended course of management. We see this now with radiology and the training of millions of images used for diagnosing cancers. Epic is making 160 million de-identified patient records available in its Cosmos database for this purpose.
ROH: Can you provide an example of the role data plays within these solutions to create meaningful insights into processes and outcomes among organizations, providers, and patients?
DB: Ok. Let’s continue with the example we’ve been discussing and layer in some non-clinical data relevant to social determinants of health which we know have a significant impact on health status and outcomes. You may want to start with zip code which is now considered the most important determinant of health status. Layer on top of that pharmacy data, grocery store data, public transportation data, and community-based organizations (clinics, food banks, community centers, etc.), and you get a better picture of the resources available to patients in the communities served. Now, let’s say you have initiated a finely tuned screening process for SDOH – such as have you been able to pay your bills, do you feel safe in your community, have access to transportation, etc. As data is collected, modeled, and trained, predictive and prescriptive algorithms may emerge. So, for example, 68-year-old Joe – a retired teacher, with no car, tech-savvy, lives in a food desert, and is relatively healthy – can be successfully put on a digital care program to manage his diabetes. Lorraine, is a 68 year-old, retired stockbroker, owns a car, is also tech-savvy, lives in a suburb, and is borderline obese – needs to be brought into the office for a series of 1×1 meetings with a Nurse Practitioner to get on track. Jeff is a 68-year-old carpenter, who is not tech savvy, relies on public transportation; is not healthy, is on Medicare, has a low income, and needs in-person help from a local Community-Based Organization (CBO). The provider organization can efficiently allocate the right resources to care for patients with a program tailored to the patient’s medical, socioeconomic, and psychographic profile and suggested by the complete data profile.
ROH: How does your product address and accommodate various settings, environments, services, professions, patients, and more?
DB: pCare provides an integrated Cross Continuum Solution. Because we did start inside the hospital, I’ll answer your question from the inside out – starting with the patient room. Our core product is the Interactive Patient Care System, or IPS, which leverages the television infrastructure as a communication hub for education, entertainment, and empowerment. Built on an open architecture, our API integrates with the EHR so the system can dispense education videos to patients based on why they are in the hospital and what happens during their admission. Answers to learning verification questions help the nursing staff understand how best to educate patients on their care management. That’s the education aspect. Of course, in terms of entertainment, there is TV programming. We also offer a package of on-demand, theatrical movie releases, relaxation videos, music and spiritual content, audiobooks – and the ability to photo share, which converts the TV screen into a digital frame – and launch video calls with friends and families using the TV. So, the patient has multiple options to decompress and relax during their stay to get them in a healing state of mind. As it pertains to empowerment, a suite of integrations with Health Information Technology (HIT), such as facilities, communications, dietary, pharmacy, etc., allow the patient to manage non-clinical aspects of the admission. For example, the patient can change the room’s temperature, lower the lights, order a meal, and place a service request without asking a nurse. It gives the patient a sense of control in an unfamiliar environment and relieves the nursing staff from doing non-clinical tasks. And speaking of the nursing staff, we also offer a digital patient room whiteboard and digital door signs, which convey critical information to family and staff – such as daily schedule, precautions, patient repositioning, and the current care team. It also automatically updates the hospital IT systems without manual inputs from staff. It’s a great time saver.
Moving outside the patient room, TruthPoint Rounds is our digital rounding solution used for various staff and leadership rounding and data collection. As you move throughout the hospital facility, you will also find location specific IPS configurations such as our pCare Infusion for chemotherapy and dialysis chairs and desktop exam room applications.
Moving outside the hospital’s four walls, pCare Practice is designed for office-based and clinic waiting rooms where video education and practice promotion information is displayed for patient and family viewing. Finally, pCare Ambulatory is our mobile consumer care management app. Physician prescribed digital journeys populated with articles, videos, surveys, and polls, guide patients through a specific care episode, such as elective surgery, or help with the ongoing management of a chronic condition. A provider dashboard that integrates with the EHR allows the care team to track patient progress throughout the journey.
Across the continuum, pCare creates applications delivered through various devices to best match user preferences and the moment in care – which is an important consideration. The needs of the consumer versus the patient versus the provider are not the same – so we work to provide the optimal experience dependent on the user and use case. This level of detail has driven our success over the past 70+ years and resulted in seven consecutive Best in KLAS awards.