Intelligent Healthcare Capabilities

We introduced the concept of Intelligent Healthcare across several posts so far:

• What is Intelligent Healthcare
• Intelligent Healthcare: EHR Assumptions
• Intelligent Healthcare and Integration
• Federal Healthcare IT Initiatives
• The Intelligent Healthcare Manifesto
• Understanding Healthcare Inter-operability

Over the next several months we're going to cover a number of related IH topics and we thought it would be worthwhile to capture some of what we consider to be the most important IH-related enterprise level solution capabilities.

Next Generation Healthcare IT innovation begins with vision...

There are two perspectives into Intelligent Healthcare (IH) capabilities; the first is based upon how IH can be exploited as a methodology to orchestrate the design and implementation of Healthcare IT solutions. The second perspective is based upon how those solutions developed using the IH methodology actually impact the practice of Healthcare. Both perspectives are vital in helping to understand and support the eventual realization of the benefits implicit with Intelligent Healthcare

ID	Capability Title	Capability Description
C1	Patient-Focused Performance Engineering	Attributes that can be identified and included within any Healthcare solution design paradigm.
C2	Agile Lifecycle Federation	The ability to define solution best practices and make those practices available to communities either as recommendations or solution compliance guidelines.
C3	Solution Performance Metrics	Definition of systems performance expectations with strategies for mitigation of issues when or if they may realized. (SLAs with engineering support)
C4	Scenario-based Design Patterns	Definition of integration patterns; at the data level, services level, infrastructure level and combined.
C5	Dynamic Collaboration	Web 2.0 morphing into 3.0 – using Social Publishing capabilities to replace other traditional software support and tie together communities at a more detailed level. This covers project management, requirements management, COI management etc.
C6	Community Process Management	The ability to collaboratively define, publish and share process-based knowledge and functionality.
C7	Clinical Decision Support (CDS) Reference EA	Definition of follow-on architectures that can benefit from the Connect core – these reference architectures can help to further harmonize inter-operability initiatives.
C8	Semantic Reference Architecture - (plus management of Healthcare Ontologies)	Illustrating prototypical architectures for extending data inter-operability using emerging technologies such as RDF databases.
C9	Federated Enterprise Architecture	The ability to reconcile EA’s across domains using a Wiki-based knowledge framework rather than through proprietary EA tools.
C10	Innovation Management	Development of Innovation techniques, tools and processes designed to support integration of new technologies into existing initiatives. This capability provides IH with the proactive perspective needed to anticipate issues years ahead of time.
C11	Trend Identification	The ability to engineer trend management capabilities both within individual (local) and group (global) perspectives.
C12	Automated Data Collection	Self-configuring interface negotiation and message transport.

All of these capabilities are designed to facilitate a new paradigm wherein medical information becomes dynamic and problem-solving becomes collaborative.

Copyright 2012  - Technovation Talks, Semantech Inc.

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Intelligent Healthcare: EHR Assumptions

The term, Electronic Health Record (EHR), is often used synonymously with Electronic Medical Record (EMR) or Longitudinal Health Record to describe systems that capture medical chart data in electronic format. The nature of the data being captured and how it is used varies from system category to system category as well as across individual vendor implementations in every category. There is no standard solution configuration in terms of features, functions and performance. There is some standardization in relation to the data elements employed though as many vendors have attempted compliance with one or more Healthcare Interoperability standards. The design and implementation of EHRs does not necessarily take into consideration the larger ecosystem in which it will inhabit and in fact there are many different types of environments that they may be built to support including:

•    Smaller medical practices
•    Mid-sized Healthcare providers (clinics, specialty care)
•    Larger Healthcare providers (Hospitals)
•    Health Networks
•    Agency / National level (NHS SCR, DoD AHTLA, States etc.)

By now EHRs should be universal and fully interoperable - they're not...

The development and use of EHRs has in many instances been controversial and there has been significant resistance to it by practitioners and limited evidence of improved outcomes from organizations which have adopted them. One particular area of controversy revolves around whether the family of EHR solutions has either accurately understood and supported existing Healthcare processes or made any headway in actually improving those processes. Despite this situation, EHR technology has remained the primary focus for Healthcare solutions modernization or transformation. To understand why EHRs have not lived up to their potential, it is worthwhile to explore some of the (perhaps false) assumptions behind them:

•    Assumption 1 – That because much or most of current Healthcare process is ‘paper-based’ that it is necessarily inefficient. Paper-based process can in fact be highly optimized, or sub-optimized thus facilitating processes in situ. The enterprise perspective must also support the needs of component Healthcare delivery.

•    Assumption 2 – That full standardization of a domain of practice as complex and evolutionary in nature as Healthcare is even possible. And that the domain would become subordinated to the woefully incomplete (lagging) standardized view and thus tolerate degradation of care to support the larger goal of automation.

•    Assumption 3 – That technology might be imposed without engaging in full partnership with both care providers and patients. This is particularly critical in determining performance expectations in relation to care practice. In other words, if it takes a doctor 15 minutes to manage a typical patient encounter using a paper-based approach and 30 using an EHR then the EHR has failed to meet minimum expectations and communication between the IT provider and care provider failed.

Copyright 2012, Semantech Inc. All rights Reserved 

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What is Intelligent Healthcare ?

A definition and introduction...

“Intelligent Healthcare” (IH) is a metaphor both for design and for practice with the explicit understanding that through emerging technologies those two will become ever more closely intertwined. IH recognizes that there are or will be innumerable potential domain boundaries both internally and externally that will necessarily segment ‘islands of information.’ Those islands of information represent individual and community knowledge and practice options. The role of IH is to both harness those diverse information resources dynamically and apply them back to their respective communities to enable continuous practice improvements. So at the lowest level, Intelligent Healthcare requires tools and techniques that can access and distribute data across domains as needed. As the Healthcare environment becomes more sophisticated the technical goals will evolve to encompass:

• Pattern identification & management.
• Trend prediction and dashboards.
• Process and scenario driven dynamic integration of enterprise-wide data sources (the full spectrum of clinical systems).
• Multi-level Collaboration, from the immediate organizational perspective through to Global Communities of Practice.
• Symbiotic performance engineering (of both patient outcomes and solution service level expectations).

Intelligent Healthcare is a concept, a methodology as well as an architectural approach

The IH metaphor allows us to grow in evolutionary directions in order to achieve our primary goals with relation to Healthcare. It places all enabling technology in the context of a set of functional goals which are not likely to change anytime soon:

1. Improved patient outcomes.

2. Cost reduction and greater efficiency through practice / process improvement.

3. Rapid / agile adoption of innovation or emerging technologies which enhance Healthcare provision. 

Intelligent Healthcare is more than any single technical solution, more than any single standardized approach – it finally places the real challenges up front and ensures that all component elements targeted to those challenges do not become larger than the primary functional goals. Future posts will examine the architecture of IH in greater depth...

Copyright 2012, Semantech Inc. All rights Reserved 

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