Speakers Encourage Health IT Leaders to Look Beyond Traditional Approaches to Improve Care
2.21.2019
Candace Stuart – Director, Communications & Public Relations
What should healthcare IT leaders really focus on to improve the health and care of their communities, and of the world overall? Five speakers at the CHIME HIMSS CIO Forum each offered answers informed by their personal experiences and passions.
Vivek H. Murthy, MD, who served as the 19th surgeon general of the United States from December 2014 to April 2017, opened the forum in Orlando, Fla., with a keynote address on emotional well-being and its foil, loneliness. Loneliness puts the body in a chronic state of stress that may be as detrimental to a person’s health as smoking 15 cigarettes a day, he said.
“Loneliness is not a sign that we’re broken,” Murthy said. “In fact, it’s a biological warning sign like hunger or thirst that tells us that an ingredient critical to our safety and survival – social connection – is missing.”
Murthy encouraged CHIME members and CHIME Foundation members in the audience to use their IT expertise to gather and assess data that can help the healthcare community better understand drivers and solutions for loneliness. “If loneliness is about fundamentally not feeling known and valued, we can ask ourselves whether the information we are gathering about our patients really tells us who they are,” he said.
He offered three pointers for members to help improve their emotional well-being and the emotional well-being of those around them: Focus on being present with those you love, help others (and accept help yourself) and recognize your gifts. “That’s what allows us to bring the best of ourselves to the world around us,” Murthy concluded. “We must help each other in this endeavor because we are all going to forget who we really are from time to time.”
Claire Pomeroy, MD, MBA, president and CEO of the Lasker Foundation, followed with a presentation about the social determinants of health. Her talk started on a personal note as she described herself as a 17-year-old girl, just aged out of foster care, who is forced to seek emergency care for asthma – and then could not afford the inhaler that she was prescribed.
“Those nurses and doctors were not bad clinicians,” she explained. “They followed all of the right clinical protocols. But they didn’t have the information they would have needed to truly make me better. They needed an understanding of my world and the world they were sending me back to.”
She called on the audience to help fill this information void by giving clinicians data about the social determinants of health. She defined these factors as race, ethnicity, gender, socioeconomic status, education, occupation and job security, safe housing, transportation, food access, safe neighborhoods “and as you heard this morning, one of the most important: social cohesion and community support. …If we want to move that needle, we have to talk about changing the social determinants of health.”
To succeed, health systems will need to collaborate with each other and with organizations like schools, social services and grocery stores to support patients appropriately. She cited lack of data, siloed data and an unwillingness to share data as key obstacles. “This is the thing that you can address – siloed data in different sectors that impact social determinants,” Pomeroy said. “If we are going to do this, if we are going give people what they truly need to get better, we will have to have intersectoral collaboration.”
Neil Jacobstein, chair of the Artificial Intelligence and Robotics Track at Singularity University and a distinguished visiting scholar at Stanford University Media X Program, shifted the dialog to technologies that will facilitate improvements in health and care. He noted that the pace of technical change has increased dramatically and urged the audience to grasp these developments before they whiz by. Artificial intelligence, which he described as a subset of computer science and the umbrella for many other advanced technologies, is a powerful tool that healthcare IT executives can use to make healthcare more personal, higher quality and more compassionate.
“Artificial intelligence is the hottest area of technology today, and the hottest area of artificial intelligence is healthcare,” he said. The FDA, for instance, has approved more than 70 AI-based products, according to Jacobstein, with many more innovations likely in the pipeline. Key among AI’s attributes in health IT is “expanding the range of the possible.”
He pointed to 5G as a technology that will allow networks to be a thousand times faster and enable the use of many more devices than systems can support today. 5G can open the door for sensor-based wireless networks, wearables, more advanced imaging capabilities and much more.
“Should you upgrade?” he asked. “Absolutely. When? Yesterday!”
The forum closed with a mother-daughter presentation by Kristina and Kate Sheridan. Kristina Sheridan is a department head for MITRE’s Center for Veterans Enterprise Transformation and Kate Sheridan is pursuing a master’s degree in Comparative Social Policy at the University of Oxford in the UK. They shared their personal journey managing Kate’s complex chronic conditions, triggered by an infected tick bite when she was a fifth grader, and how that led them to careers helping others who face similar challenges.
Kate Sheridan provided a patient story that included five hospitalizations and reams of medical records. Over the years she learned how to be her own patient advocate, helping her physicians understand her goals and needs. “We felt like equal partners in my care,” she said.
By meticulously tracking her 26 symptoms and their severity over time, they were able to tease out causes. “This system completely transformed the way we approached care,” she said. “I was prepared for visits because I had notes for what happened over the last two months. I did not have to rely on my scattered brain in the moment. At home, I could set goals, track my progress toward them, identify trends and finally I had hard data to what previously was just a gut feeling that something was off.”
In this way, they could spot problems like an infection or adverse reaction to medications and intervene early, avoiding a trip to the emergency room. It also made her an active participant in her healthcare and “an expert in what I was experiencing.”
Kristina Sheridan combined her expertise as a systems engineer and experience charting Kate’s illnesses and responses to treatments to build tools for others. “The realization that the patient’s voice is critical in getting them well came home to me,” she said. “I started in the space industry, and I realized that launching a satellite was easier for me than taking care of Kate (and their son) and advocating for them. That’s because patients are the only experts I know who don’t have any tools to help them.”
Kristina Sheridan switched careers to join MITRE, where she is developing tools that help complex patients manage their care, track symptoms and holistically capture data for clinicians. The tools serve as a communication mechanism as well, for instance, by allowing a patient to explain why he or she deliberately skips a medication. They tested the tool in a rural clinic.
She made a final request before ending the keynote. “When you go back home from this conference, please recognize that patients and caregivers are experts and please give them a seat at your table because once we work together, it will give the opportunity to every family to have the outcomes that we were lucky to have.”