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GE's Unique Approach to Command Centers

Posted by Matthew Smith on Jan 31, 2019 1:31:39 PM

Reading through healthcare magazines and websites, you may notice quite a few firms are talking about Command Centers. More firms than ever before presented their versions at Arab Health, and you probably see the same on LinkedIn and Twitter. You may also know that GE Healthcare is building command centers supporting dozens of hospitals in three countries with more starting each month. 

So How is GE's Approach Different?

GE Healthcare’s approach to Command Centers is agnostic and unique, and we view other firms as current or future partners rather than competitors. We believe there is virtually no overlap between our technology and theirs, and that by working together we can make a bigger impact for providers.

Command Center Landscape, January 2019

What’s different about GE Healthcare?

Our capability is unique in both technology and method. The technology is unique because our platform, Wall of Analytics, is scalable and agnostic (taking data from all sources), and delivers apps that are real-time, actionable, and create new information with AI. The method is unique because we deliver a holistic transformation. By holistic we mean physical space programming, new role creation, rules-based protocols, data integration, platform and apps, video wall, change, and activation. By transformation we mean that by engaging hundreds of staff in problem-back design and implementation, we not only ensure that staff understand and embrace their Command Center as an asset rather than a hindrance, but also that we help to achieve a more integrated culture. This approach has evolved through experience and so far has delivered breakthrough sustainable outcomes.

KLAS Report 

KLAS’s December 2018 report on “Operational Command Centers,” their first report on the topic, may be accessed here. It correctly captures some key points, but misses on a few others.

  • Key point: Page 4 correctly notes that GE Healthcare’s technology approach is unique in that we combine streaming data from multiple systems.
  • Key miss: The title of the report, Operational, is limiting. The scope of our Command Centers already extends into quality, safety, and other more clinical topics. We believe this scalability is essential for a great Command Center or "Mission Control," as some clients refer to their Command Centers.

Frost & Sullivan Award

Read the Frost & Sullivan report commending the GE Healthcare Command Center Solution here. This was an unsolicited award and came as a surprise when the firm called to notify us of the award. They found that "unlike competing command centers that serve specific objectives, GE Healthcare’s solution is holistic and custom- fitted,” and that “the GE approach is technology- agnostic.”

Vendor Perspectives

Epic and Cerner are incredible firms that automate all sorts of workflows… workflows which are the heart of organizing healthcare delivery. Along with Meditech and AllScripts, these are the titans of health IT. (We partner with all of these firms today to stream data into the Wall of Analytics).

The architecture of workflow systems, including EMRs, makes it an unnatural act to surveil risks across workflows in real-time. Thus the “Command Center” capabilities found in EMRs tend to feature retrospective reports and KPI dashboards rather than patient-level actionable alerts.

EMR companies are, of course, technology focused and we are unaware of any “consulting” services offered by these firms to help clients design and activate the non-technology aspects of Command Centers.

Care Logistics, Central Logic, Change Healthcare. These great companies make workflow systems for patient flow topics like bed management, EVS and transport, and transfer centers. (We partner with all of these firms today to stream data into WoA).

While many of their modules are often considered better than the EMR-equivalents, many of our clients are nonetheless in the process of replacing these systems with their Epic or Cerner equivalent because the clients believe EMRs are catching up and they want to consolidate workflow systems as much as possible.

The buzz around “Command Centers” has seen many groups re-label a bed management or transfer center as a Command Center. This makes sense in context, but is different from GE’s approach. By “Command Center” they mean displaying screens from a patient flow workflow system onto large monitors; and KPI-dashboards that show things like door-to-doc time, which is important but not actionable.

Steris, MedWorx, PedalMD, etc. There are hundreds of other workflow systems in healthcare, but they have not suggested “Command Center” capabilities. (We partner with the listed firms today and more to stream data into WoA).

Accenture & McKinsey. These and other consulting firms have suggested Command Center-like solutions from time-to-time. The most notable example was when Accenture won the bid from Rio de Janeiro to build a city health Command Center. But their capability was limited to retrospective BI and, in the end, the project was abandoned. 

BI, Reports, and Actionable Analytics

A key factor to consider is the difference between business intelligence dashboards, reports from workflow systems, and actionable analytics.

BI dashboards in healthcare are usually built on data warehouses which update once or twice per day. Tableau and QlikView are the market leaders while Microsoft and others have renewed their offers in this competitive space. These BI tools are useful for thousands of problems, but we find them not useful for real-time decision support. Since Command Centers, in GE’s meaning, are all about immediate action, we find that BI is not fit for this purpose.

Workflow systems also offer a form of built-in BI which most users know as reports or analytics. These too are useful for thousands of problems but not for the real-time action needed in Command Centers.

Actionable analytics are real-time because they are created from high-velocity streaming messages rather than by querying the dB. This is extraordinarily difficult to do--requiring both the right technology and intense services--but when done well can be revolutionary for real-time decision support. This is a small niche where GE’s Command Center approach is making a difference.

Summary Table

Finally, please find below a quick matrix to summary the capabilities of the various firms as it relates to command centers. 

CC_CHART

Case Study: Humber River Hospital's Command Centre--Year One In Review

Posted by Matthew Smith on Jan 29, 2019 10:41:35 AM

Humber River Hospital's Command Centre is the confluence of artificial and human intelligence coming together 24 hours a day, seven days a week, detecting risk, coordinating complex care activity and backstopping care teams in real-time.

Read about:

  • How the Humber River Hospital Command Centre intervenes to alleviate pressure on the system as well as stress on hospital staff;
  • The difference the Command Centre has made on caregivers who no longer have to rely on daily heroics to deliver their best care;
  • Humber River Hospital's position in the GE Healthcare ecosystem;
  • How Humber River Hospital leadership achieved buy-in for the Command Centre
  • Generation 2: High-reliability healthcare; and
  • The future of data-driven decision making.

Click the button below for an instant download:

Humber River Hospital Command Centre

Topics: Command Center

Your Hospital's Command Center: Decision Support Tile

Posted by Matthew Smith on Jan 25, 2019 3:25:18 PM

Topics: Command Center

Humber River Hospital Unveils New Command Centre [via CTV]

Posted by Matthew Smith on Jan 25, 2019 2:59:37 PM

Topics: Command Center

Humber River Hospital: Building a Digitally Advanced Command Centre

Posted by Matthew Smith on Jan 25, 2019 2:00:33 PM

Topics: Hospital Command Center

Humber River Hospital: Canada's First Hospital Command Center

Posted by Matthew Smith on Jan 25, 2019 10:36:57 AM

Topics: Command Center

Top 10 2019 Trends for Hospital & Health System Boards

Posted by Matthew Smith on Jan 18, 2019 12:23:42 PM

In the January 2019 issue of Trustee magazine, Laura Jacobs, Managing Principal, GE Healthcare Partners, takes a look at the unrelenting forces and dynamic shifts that demand that hospital and health system boards get creative in their thinking and preparation for even more significant changes ahead.

As we head into the last lap of this decade, many trends will feel like a continuation of those we have dealt with throughout the past five to 10 years. Leading health care organizations, though, recognize that the next decade will be characterized by consumerism, personalized medicine, digital technology and artificial intelligence, and are evolving their cultures, business models and operational focus now in order to ensure success in the future.

Here is our list of top 10 trends for 2019 and what trustees should be addressing in the boardroom.

Click for Instant PDF Download

Topics: Trends

Winning Strategies to Transform Health Care in 2019

Posted by Matthew Smith on Jan 4, 2019 10:19:39 AM

By Geoff Martin, COO & Managing Principal, GE Healthcare Partners

Originally published by HFMA, January 2019

It's an amazing time to be a part of the transformation of health care. An industry that once changed at a glacial pace is now moving forward at breakneck speed, adopting new technologies and strategies from other industries to drive clinical, operational, and social advancements.

Executives are increasingly concerned about costly fixed assets, an evolving labor force, and rising payer and consumer expectations. Transforming and disrupting our industry is a necessity and will require new ways of doing business, with focused strategies that place patients’ needs at the center of the health system’s mission. Healthcare organization leaders should keep several key considerations top of mind this year.

Transformation, not incrementalism. The complexity of a healthcare delivery system serving patients across multiple ZIP codes rivals that of a Fortune 50 organization operating in dozens of countries. Yet health care lags in adopting sophisticated digital design tools to manage these complexities and stem the industry-wide decline in operating income. Burdened by expensive fixed assets, redundancy, and inefficient utilization levels, health systems need a major course correction if they are to provide 24/7/365 access, shift care to virtual and lower-cost settings, manage new competitive threats, and meet rising consumer expectations. Becoming 2 to 3 percent more operationally fit each year will not keep pace with the rate of change required.

To survive, organizations must determine what businesses they want to be in and how they want to deliver their services, and they then must design and implement a care delivery model that differentiates them from their competitors from operational, cost, and service-level standpoints. Walmart’s promise of “Everyday Low Prices” and Amazon’s same-day delivery are good examples of analytics-driven strategies that combine a strong brand promise and operational excellence to delight consumers, stay competitive, and control costs. Incrementalism is the enemy of healthcare organizations transforming their business models. These organizations must put considerable thought into what really matters to patients, align their brands and service levels accordingly, and then consistently execute on transformative strategies that deliver on customer expectations.

Apps to support healthcare providers. There is high demand for analytics apps to inform and address clinical and operational issues in real time, leveraging technologies such as artificial intelligence (AI), machine learning, and natural language processing. The issue for most professionals is not data availability—it’s accessing the right amount of relevant data when and where it’s needed. If information is buried in the electronic health record or another IT system, it might as well not exist at all. Liberating the most relevant data in real-time and presenting it in a simple, accessible way will help professionals focus on key processes, such as managing patient flow in the emergency department and aligning critical activities to keep patients safe. Most important, these apps don’t just highlight the problem; they inform actions on how to mitigate or solve it.

More precise health care. Some of the biggest challenges (and opportunities) in health care revolve around improving patient outcomes and operational productivity. Today, lack of tailored diagnostics leads to wasted exams and treatment delays, preventing true value-based care delivery. Our nation’s annual excess cost of waste from disjointed, siloed care has topped $700 billion.a Precision health—better outcomes delivered more efficiently—shows considerable potential in addressing these and other issues. By leveraging data science, medicine, and technology to enable precise, predictive, personalized care, organizations are empowered to do the right thing, at the right time, for every patient, at scale.

Big data and AI are foundational tools in precision health, and adoption in health care is accelerating. For hospitals and health systems, the advantages are clear. Applying precision health to optimize care pathways could enable better patient outcomes while unlocking $500 billion in value over the next decade through higher productivity.b

Collaborative disruption. Given the complexity and high stakes of health care, a partnership approach to solving thorny issues around quality, cost, and access seems only logical. Even Amazon—known for innovative disruption on its own terms—has enlisted a blue-ribbon team of experts to guide its entry into the industry. The company’s healthcare venture with J.P. Morgan and Berkshire Hathaway to reduce the healthcare costs for their employees, along with the acquisition of PillPack, new health information data mining capabilities, forays into supply chain management, and expanded use of Amazon’s cloud-based voice service, Alexa, into healthcare delivery are all indicators that Amazon sees an opportunity to disrupt traditional healthcare channels.

Similarly, we see innovation-focused, outcomes-aligned relationships between health systems and vendors as the evolutionary next step in creating sustainable value in a highly unstable market. An outcomes relationship enables true risk-sharing. Success comes from achieving mutually agreed-upon financial, quality, and patient experience metrics, where the two organizations are co-resourced and co-governed to ensure they have shared objectives and both have a meaningful stake in achieving organizational success.

Core competency, outsource, partner—or avoid. As healthcare executives contemplate their business strategies, they must manage countless competing priorities and external pressures to service their mission, communities, and employees while remaining good financial stewards of their resources. They constantly face decisions around core competencies and objectives regarding matters such as employing versus affiliating with physicians, buying versus renting, and going it alone versus partnering to deliver post-acute care. In other industries, non-core functions are more often outsourced and strategic actions like divestitures, and partnership agreements are commonplace. In health care, however, we see a growing trend for executives to succeed based on saying “no” and making tough choices on things they have not considered before. Although decisions whether to insource or outsource are complex in health care and the results often not popular, such decisions must be made. Staying true to the organization’s strategy and missions will be critical when making these tough choices.

Looking Ahead

Health care’s evolution over the past decade has been astounding, but even more amazing changes lie ahead, with the focus on delivering precision health, building world-class operations, and delivering care as cost effectively and safely as possible. More progressive healthcare organizations are seeking out and adapting strategic approaches, tools, and technologies that have proven successful in other sectors and using them to thoughtfully redesign or supplant legacy processes that are no longer working. Innovation that is both deliberate and disruptive is essential to transforming healthcare.

  

Footnotes

Institute of Medicine (US) Roundtable on Evidence-Based Medicine, Yong P.L., Saunders R.S., Olsen L.A., eds., The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. National Academies Press National Academy of Sciences, 2010.
 
Singhal, S., and Coe, E., “The Next Imperatives for U.S. Healthcare,” McKinsey, November 2016.
 
Publication Date: Tuesday, January 01, 2019

Top Healthcare Trends for the Coming Year: Position for Digitally-Enabled Healthcare in 2019 and Beyond

Posted by Matthew Smith on Dec 14, 2018 10:07:16 AM

The new year brings with it new—and old—opportunities and challenges for the nation’s healthcare providers. Systems will continue to deal with financial constraints amid public policy and a fluid political environment, while continuing to address the rise of consumer choice and personalized care delivery, all with the additional challenges of an aging and evolving workforce.

“As we head into the last lap of this decade, many trends will feel like a continuation of those we have dealt with throughout the past 5 to 10 years,” said Laura P. Jacobs, Managing Principal, GE Healthcare Partners. “Leading industry organizations recognize that the next decade will be characterized by consumerism, personalized medicine, digital technology, and artificial intelligence. They are evolving their cultures, business models, and operational focus now in order to ensure future success.”

Jacobs suggests the following core trends should be on the minds of leaders in the healthcare industry in 2019:

  1. Economic Pressures
  2. Changing Demographics
  3. Service Area Dynamics
  4. Technology and Biotechnology
  5. Public Policy, Politics and Regulations
  6. Human Capital
  7. Consumerism
  8. Artificial Intelligence
  9. New Care Models
  10. System Transformation

 

“These first six trends are unrelenting challenges, or core trends; Just because they aren’t ‘new’ doesn’t mean they are any easier to address,” Jacobs said. “In many respects, these six may be the most difficult trends to address, since the ‘low hanging fruit’ has already been picked. Hospitals and health systems must continue to address them, and in many cases, new strategies and approaches may be required to address the lingering challenges.”

GE Healthcare Partners’ list of ten new and continuing trends include:

1. Economic Pressures

Financial constraints will continue to be the top concern of CEOs. Wages, benefits, supplies, drugs, information technology (IT), facility costs, and interest rates are rising faster than revenues. Health plans are keeping premiums low with limited or no increases. A rising percentage of revenues are from government payers, such as Medicare and Medicaid, and typically cover less than full costs. Demands for capital continue to be high for new facilities, renovations, and IT.

As a result, hospitals and health systems need to find greater economies through mergers and acquisitions, right-sizing clinical programs and continually applying lean principles to achieve sustainable efficiencies. Cost-cutting approaches must move beyond across-the-board-cuts to sustainable ways of addressing labor, non-labor, and pharmacy expenses, as well as unwarranted clinical variation. Leaders will move toward employing robust analytics, simulation modeling and strategic analyses to identify opportunities to save.

2. Demographics and Health Status

Societal trends continue to point to an older, sicker population in most communities. Some rural populations are shrinking, and many urban areas are growing more complex, with great disparities in health status across the population. Obesity, chronic disease, and opioid dependencies continue to plague most communities and require targeted, coordinated strategies to affect a turnaround.

Unless housing, food and income disparities are also addressed, it will nearly be impossible to make a lasting impact on the general health status of the community.

3. Service Area Dynamics

The forces of disruptive innovation are always evolving, blurring lines between providers, payers, pharma, and retail organizations. Examples include the CVS/Aetna merger, Walmart and Humana and many provider-sponsored health plans and payer-owned provider networks.

Private equity-backed ventures are entering many local communities, providing services such as primary care, virtual care, chronic disease management and population health programs. Employers are also taking a leading role in organizing networks to manage the health of their employees.

4. Technology and Biotechnology

Cybersecurity remains a top priority for all healthcare organizations, which produce extraordinary volumes of data from monitors, sensors, electronic health records and financial and other operating systems. Organizations that diligently protect and optimally utilize the valuable data available to them will have an advantage in delivering high-quality, efficient personalized care to patients.

Digitally-enabled healthcare will provide exciting opportunities to diagnose and treat patients with greater precision while being less invasive. Yet choices will have to be made regarding capital resources and clinical priorities. The expanding capabilities of 3-D printing will create new opportunities for academic medical centers to train physicians, refine pre-surgical planning, and provide new hope for some patients, while also changing the way equipment is repaired and serviced.

5. Public Policy, Politics and Regulations

Governmental decision-making will always be a part of the healthcare equation. At the federal level, the Centers for Medicare & Medicaid Services (CMS) will continue to evolve payment models to shift from pure fee-for-service to greater reliance on value-based payment. Examples of this include accountable care organizations and mandatory bundles.

Any radical changes are unlikely at the federal level but watch for changes at the state level such as Medicaid reform, changes to insurance regulations or transparency requirements

6. Human Capital

Most health systems must grapple with an aging workforce while simultaneously responding to the needs and expectations of a multicultural, multi-generational team. Addressing burnout at all organizational levels will be important, as challenges and pressures to reduce costs and perform at high levels stress organizations and individuals.

Low unemployment and shortages in key jobs such as physicians, nursing and technology will require new strategies for recruitment and retention. Addressing the gap between low reimbursement increases to higher compensation expectations from physicians and staff will require new approaches to compensation and benefit and incentive structures. Leadership requirements will continue to evolve, as population health management, consumer-focused strategies, and larger health systems will require cultural shifts throughout the organization.

These next four trends illustrate the dynamic shifts that are fundamentally changing the way healthcare is purchased, delivered, and organized. These will demand creative thinking and preparation for even more significant changes ahead.

7. Consumerism

Informed and connected consumers will have higher expectations for Uber-like responsiveness and accessibility. This is not particularly new, nor unexpected. The stakes are much higher for the competition for consumer loyalty.

Companies like Amazon, Apple, CVS, and other consumer-oriented organizations are playing bigger healthcare roles, with watches and other wearables tracking many aspects of individual health, and a physician visit just a click away via a virtual tele-visit. Patients will have no patience for 2-3 week waits for office visits or results reporting.

Additionally, the healthcare marketplace shopping via Amazon-like platforms will increase the demand for real price transparency and rational fee structures.

8. Artificial Intelligence

The time is now to plan for a digitally-enabled workforce. Artificial intelligence (AI) is expanding across many healthcare applications and digital tools are facilitating better information-sharing across multiple platforms. The impact on the roles, responsibilities, and expectations of individuals across the workforce will be profound. Some roles could be eliminated, but others may be created, which will require new training or skill development.

AI won’t take the place of humans, but it can eliminate repetitive tasks and allow clinicians and other care team members to maximize their skills. For example, predictive analytics can facilitate the ability to ensure the right care at the right time, if there is clarity regarding which actions must be taken and who will take the action, based on the data presented.

9. New Care Models 

The evolution of the care delivery model to incorporate family or other caregivers, community resources and other nontraditional approaches will be necessary to be responsive to the demographic changes, complex disease states and consideration of social determinants of health.

Care that has traditionally been provided in the hospital is continuing to shift to the home or outpatient setting. Advanced practice providers, such as nurse practitioners and physician assistants will play an increasingly visible role in care delivery.

Widespread availability of genomic testing will create the need for physicians and other clinicians to be prepared to respond to new questions from patients armed with detailed information about their bodies. Care protocols will be personalized to address specific genomic characteristics.

10. System Transformation

With all the aforementioned changes, the core care delivery model of healthcare organizations must also adjust. These many changes will cause hospitals and health systems to question traditional ways of financial forecasting, strategic planning and even the option of outsourcing key functions. As payment models shift to risk for the total cost of care, traditional metrics of success such as emergency department visits or inpatient days will have to change.

Some organizations will outsource back-office functions such as revenue cycle, IT support and population health management rather than build the infrastructure themselves. Health systems will continue to expand payer strategies and retail and consumer strategies through partnerships or other means, resulting in increasingly complex organizations.

As in past years, financial concerns—expenses, capital improvements, ensuring consumers a competent workforce, patients’, and insurance companies’ ability to pay—are at the top of the list. Healthcare in the United States continues to evolve: Healthcare providers, systems and organizations must also evolve.

“The drivers of change are many and are originating from multiple fronts,” Jacobs said. “While challenging on a day-to-day basis, there is also the opportunity to harness these changes into opportunities for improving the health of the community, all while creating optimal experiences for patients and staff.”

Topics: Trends

Halting the Hype: Humility and Other Trends in Health Analytics

Posted by Matthew Smith on Nov 16, 2018 9:01:58 AM

Scenario planning with simulation analytics and problem-back machine learning make the trend list.

By Jeff Terry and Andy Day

Our team at GE Healthcare uses analytics to help caregivers improve outcomes and efficiency. Our work includes retrospective analytics to assess performance and monitor KPIs, simulation analytics to align leaders with a strategy by testing alternative futures, and actionable analytics to support real-time decisions with predictive and prescriptive information. Here are some recent trends we observe in health analytics:

1. Humility. We notice growing humility among healthcare leaders regarding the use of data and artificial intelligence (AI) to support real-time decisions. It’s quite striking. A few years ago, the CIO, CTO or CMIO of many major institutions would hold forth about their big data strategy and growing army of data scientists. Vendors spoke of data lakes, AI platforms and digital envelopes; it was an international broken record of buzzwords and futures. If only we had all the world’s data, then we’d find something to do with it.

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Jeff Terry is CEO of Healthcare Command Centers, GE Healthcare. Andy Day is a principal, advanced analytics, with GE Healthcare Partners where he leads the global analytic consulting team and the design of GE’s real-time data analytics for hospital command centers.

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