The final day of live sessions of HTN Now April 2021 was jam-packed – featuring five different sessions covering a range health tech topics. One of our Thursday morning talks included an expert discussion on how to make data more useful to clinicians.
Malcolm Pradhan, Chief Medical Officer at Alcidion and Andy Kinnear, Partnerships Director at Ethical Healthcare Consulting and a former NHS CIO, joined us to provide their perspectives.
Malcolm, chatting to us from Australia, kicked the session off with an overview of Alcidion and his experiences in encouraging better data usage in clinical settings.
He also began by highlighting how clinician engagement with data is key to better data gathering and creating higher quality data – which consequently, more clinicians will want and be able to use. He noted: “We’ve really been using patient data to improve patient safety and improve patient flow. One of the key barriers to using data is clinical productivity. That’s the key problem that we have to solve, otherwise there’s no driver for clinicians to use data. If we can’t get them to engage in using data more effectively, we can’t get the data quality to improve.”
“The angle that we’ve taken with this is,” he added, “we don’t believe just opening up the data and putting it in other databases is enough. We believe that there’s a whole lot of other technology required to make that data useful for clinicians in a variety of different settings.”
With a background in studying medical informatics and clinical AI himself, Malcolm explained, “the use of data, in terms of scaling, is to innovate locally, to support local innovations and new models of care.
“The prevailing model today…is that if you can just get data into a big database…you’ll automatically somehow get all these benefits. But that hasn’t really worked out. There’s a whole lot of other layers that you need…a lot of that is to understand the clinical context….if we can identify that then we can understand the significance of co-morbidities, significance of patient factors, identify key risks.”
However, Malcolm highlighted, “a lot of healthcare IT is still at the level of ‘let’s put all the data into a database and change its format’…but it’s still just a static database.”
“If you go back to before last year,” he continued, “prior to COVID, preventable error was the third leading cause of death [in the US]…huge investments in healthcare and yet preventable errors still prevail.”
“At the same clinicians are saying health IT, particularly monolithic EPR systems, ‘make my work longer’…actually it’s causing some problems. There’s a recent paper talking about the dose-related response of time spent on EPR and physician burnout. So that’s where we’ve come to, after all this time,” he said.
So what are the issues with data and what’s preventing more clinical use? According to Malcolm, “the issues are really around input…poor data quality, even where there is structured data….a lot of the time the forms and other forms we use to capture data are not properly coded so you can’t use them right across the healthcare system very easily.”
“Expecting doctors and nurses and everyone else to go in and use some front end – usually pretty clunky – to pull data out,” he said, was the equivalent of an “electronic filing cabinet model.”
But how can data be more useful for the clinicians? Malcolm explained that it should “save time, it should automate mundane tasks, it should let them know what’s important. And, also, it should adapt, because each speciality in the hospital is a different business.”
For Alcidion’s part, Malcolm added that the company has been “really keen on trying to improve the speed of access because, again, we have to save clinicians’ time. Every click or tap from a clinician in our world is pushing a friendship…make the right thing to do the easiest thing to do.”
Reasons for adopting a toolkit approach, he said, included being able to identify patients and cohorts of interest, using real-time monitoring and customising workflows by creating dashboards, tracking progress and automating best practice.
“Ultimately,” Malcolm re-emphasised, “healthcare IT must save time.”
Andy jumped in at that point, to talk through benefits realisation. “What I’m interested in doing is taking those technologies that Malcom’s described and seeing them implemented into real healthcare settings. But also to really get into the world of measuring and understanding the impact that’s having.”
“You can usually measure more than you think you can,” said Andy. “I certainly think, when it comes to safety and particularly around the clinical experience of using digital solutions and using EPRs like Alcidion’s…we can get into that in a really quite serious way.”
Using the Arch Collaborative as an example – which Andy explained includes 250 plus health organisations across the globe and 180,000 clinicians answering an annual questionnaire about their experiences of digital – he highlighted the importance of benchmarking to enable an understanding of why some users have better experiences than others.
Highlighting key factors, Andy also focused on the importance of training to provide a “good landing zone” and build “clinician trust.”
It was important, he said, to have “that strong culture within your organisation where you’ve got a continual improvement cycle with your clinicians…[where] they feel and they can see that when suggestions are made…those are followed through on.”
“Critically, to enable all of that is the ability to tailor and configure your clinical platform to support the way your organisation works,” he added.
“It’s still a bit trite to imagine that actually just installing the product is good enough. You do that bit and then work hard on the trust with clinicians element.”
“There’s a story here for me,” Andy concluded, “about how we move to the modern, future-facing EPR Landscape that Alcidion are helping drive forward…at the same time how do we put in place a systematic improvement cycle to make sure that the clinical experience around those new systems is optimised in a way that works for everybody?”
Enjoy the video of the session, below: