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Douglas Goldstein eFuturist Lead…Innovate…Transform www.DouglasGoldstein.com 703.626.0798 Quality and Safety through Knowledge at the Point of Care

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Page 1: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

Douglas GoldsteineFuturistLead…Innovate…Transformwww.DouglasGoldstein.com

703.626.0798

Quality and Safety through Knowledge at the Point of Care

Page 2: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Driving Forces Accelerate…

Page 3: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Let’s Explore…

Distinctive Innovation

Stories

Continuum of Care – Knowledge at the Point of Care …and Beyond

Page 4: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

A Combination of Deadly Medical Errors - Josie King

Page 5: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Initial Solutions…

John Hopkins response included

• dedicated patient transport teams

• pharmacists in ICUs,

• medication reconciliation at the moment of nursing discharge

• daily short-term goal sheets for patient rounds,

• relabeling of Buretrol and epidural catheters.

Page 6: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Distinctive…

• Something or process is ‘Distinct’ if it’s not equal to the previous state

Page 7: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Innovation

• New ‘Idea’ ‘Product’ or ‘Process’ that is useful and practical – ‘different’– ‘improved’

Page 8: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Types of InnovationBreakthrough

Distinctive

Is Your Innovation a Product or Process?

Page 9: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

• …happens in complex systems by teams working smarter with appropriate tools and technology

2 Six Sigma = 308,357 DPMO6 Six Sigma = 3.4 DPMO

Page 10: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Take a Moment to…

• Describe a recent ‘Distinctive Innovation’ that you contributed to or developed

Page 11: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

ER Diversion – Losing Admissions

• Problem: Loss of admissions through ER diversion

• Solution:– Two consulting engagement with outside firms @ cost

of $250,000 that never got implemented

or– Internal Six Sigma analysis with

internal team where the same people who identified the problem could also fix it

Page 12: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

…it smarter, better with the right tools and technology…

Page 13: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

…Online!

Beyond Email…

…Smart Collaboration

Page 14: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Ascension Health ExchangeElevating Quality and Service through

Knowledge Transfer and Innovation

Page 15: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

https://kx.afms.mil/demo

Page 16: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Distinctive Innovation Bon Secours Health System

QUALITY FIRST Energized by Six Sigma & Knowledge Transfer

Page 17: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Knowledge Transfer - Quality

Technologies:

• Paper• U.S. Mail• Email• Copy machines• Phones

BEFORE Distinctive Innovation...BEFORE Distinctive Innovation...BEFORE Distinctive Innovation...BEFORE Distinctive Innovation...

Processes:

• Print Based Toolkit of Resources – Photocopied and Mailed

• Photocopying and distribution within local systems

• Email and Phone – for progress reporting

Page 18: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Beyond Email to Web Services

Page 19: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Performance Metrics Online – One Click Access

Page 20: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

‘Share Resource’ – Structure Makes it Easy to Share Innovations, Tools and Resources

Page 21: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Smart Collaboratives & Online Community of Excellence

• Provides Learning/Working Environment • Delivers Knowledge @ Point of Need • Supports Behavior Change from Email to Web Sharing

Share Search

CollaborateKnowledge

Innovate

Support

Smart Collaborative

Communityof Excellence

Page 22: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Right Knowledge Right Person Right Time Right Form

Right TechnologyReal Fast

Current State

Page 23: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas GoldsteinSource - http://www.aurorahealthcare.org/aboutus/continuum/index.asp

Provider Centric

Continuum of Care

Page 24: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Right When I Want…Anywhere!

Future State

Page 25: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Page 26: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Consumer Centric

Continuum of Care

Page 27: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Mercy Health System Uses HealthBuddy to Increase Medication Compliance from 34% to 94%; Reduces Hospitalization Rates 41% Per Patient Per Year

Page 28: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

PLUS:

Charges for CHF encounters decreased from

$25,013 to $11,854

Mercy’s Return on Care

• Medication compliance increased from 34% to 94%

• Hospitalizations per patient per year decreased to 1.18 from 1.99

• 93% said they had a better understanding of their condition

• 93% believed Health Buddy helped them better manage their disease

Page 29: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Anywhere Disease Management, But Not By Your Doctor

Page 30: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

500,000 Medical Information Access Cards and Counting

ww

w.m

em

oria

lcare

.com

Page 31: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

A Driving Force for EHRs

Page 32: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

EHRs & PHRs = Disruptive Innovation

For Everyone!

Page 33: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

My Health eVet Interactive Medical Record

Page 34: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

TeleHealth by Veterans Health

Flexible Sensor Connectivity

Blood sugarBlood sugar

Blood pressureBlood pressure

ThermometerThermometer

StethoscopeStethoscope

ECGECG

Pulse O2Pulse O2

CameraCamera

Digital ScaleDigital Scale

309

VitalSign Monitoring Unit by Panasonic

Page 35: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Mike Manages His Heart Disease Using Digital Technology

Page 36: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Data-mining yields unique health status reports •Patient•Family•Doctor

•customizable to needs •individual•cultural.

MARC Smart In-Home Monitoring System has the following unique characteristics:

• low-cost sensor technology,

• retrofits easily in existing homes

Smart In-Home Monitoring

Page 37: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

@ HomeAirWatch from iMetrikus allows

a patient to shares their respiratory data immediately

with their doctors

Page 38: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Tele Presence & More

Assisting the elderly by:

• reminding

• connecting– tele-presence technology

• collecting data & monitoring

• manipulating objects

• Helping them feel less isolated.

Pearl, created by the University of Michigan,

Pittsburgh, Carnegie Mellon, and Stanford

Page 39: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

I Wear My Health (Sensor)

Page 40: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Drug Delivery - BioMEMs

Implantable devices that deliver drugs via nano-sized valves and pumps that are controlled by

sensors that regulate delivery rates

www.chiprx.com

Schematic of Self Regulating Responsive Therapeutic System

Page 41: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Nanomedicine Rx

Page 42: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Page 43: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

For Everyone!

Page 44: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Liberate Your Potential…

…is the Way!

Page 45: Douglas Goldstein eFuturist Lead…Innovate…Transform  703.626.0798 Quality and Safety through Knowledge at the Point of Care

© All Rights ReservedDouglas Goldstein

Douglas E. Goldstein• eFuturist…Beyond Theory to Action

• Speaker - Lead..Innovate…Transform

• Consultant and Author

Other Recent Publications:

•Quality, Safety and Cost Effectiveness through Leadership and Health Information Technology •eHealthcare: Harness the Power of Internet e-Commerce & e-Care•Best of the Net Guides to Health and Wellness and Healthcare and Medicine

New Book:

Medical Informatics 20/20: Quality and EHRs through Collaboration, Innovation and Open Solutions

www.DouglasGoldstein.com 703-626-0798