Current Views on Health Data Access and Usability

Matt Smith: All right. Hello. Welcome, everybody. Welcome to our podcast series on digital solutions that ease the way for care teams. I'm Matt Smith with GE HealthCare Marketing. Today, I'm joined once again by Roshy Francis, who's the Chief Technology Officer for Patient Care Solutions business. Today, Roshy is going to be joining us to discuss current views on health data access and usability. Thanks for joining us this morning.

Roshy Francis: Thank you. Great being at HIMSS, and nice to see everyone again.

Matt Smith: So let's kick it off with usability. So when we think about the term usability with respect to medical technologies, it's become an increasingly broad term that we use in crafting the overall user experience. Can you elaborate a little bit on how the term is thought of in today's design practice?

Roshy Francis: So usability is a term that has been increasingly ingrained in our, call it medical technology design language for more than two decades now. So it's nothing really new, but it originated from this simple idea or a need to ensure that when an operator is interacting with a piece of medical technology, they can do that without causing errors, without creating errors that might lead to a patient safety issue. So it started out the foundation of patient safety. And over time, I think partly driven by rapid technological innovations, and also more recently, some of the big challenges that healthcare systems around the world are facing, the meaning of usability has evolved significantly. From being, how do I make the operator hit the right button at the right time, so that they have minimal chances of error? To how do I deliver a holistic user experience that really enables clinicians to deliver care in the most optimal way? I think that's really see today's definition of usability. And in that is included how data is looked at by a clinician. What critical elements of data is being looked at by the clinician, and can they interpret it right to make the right care decisions at the right time?

Roshy Francis: I just wanted to just say that when I mentioned rapid technological innovation, I've been thinking about what's been happening in our industry. So in the past, everything about the medical device, whether it is acquiring a piece of data from the patient, bringing it in and processing it, displaying it, and alerting the right user when it detects that something is out of range. They all needed to be packaged within the form factor of a box, a medical device, and there were dozens and dozens of them.  They became dozens and dozens of them around the patient. In today's technology, we can take each of those functions and decompose them and put them across the network within the hospital, next to the patient, on the cloud. So the meaning of user experience and the usability, the definition of usability is now not only thinking about it from a device perspective, certainly not from a safety perspective. It's thinking about how these interconnected systems perform. And together do they deliver the optimal user experience for the clinician who has to deal with the patient and some of the added complexity that technology may have brought into their workflows.

Matt Smith: That's great. So let's take a little bit of a deeper dive into the concept of data and usability. In our daily lives. We're just inundated with data. How is that similar in MedTech? Can you talk a little bit about that?

Roshy Francis: Yeah. So in our daily lives as operators, when we are receiving information, it's supposed to be helping us to make better decisions informed by what's going on around us. So it helps us be contextually informed. So as an example, if you're driving a car, in the past, we used to have just the speed information and the direction of travel.  Now, we have real time traffic alerts, we have navigation information, we have lane departure warnings, we have your seat temperature being too high, and everything is coming at you and they're coming at you in different ways. Some are coming at you as words and numbers on a screen. Some are coming at you as flashing lights. Some are coming at you as beeps and tactile feedback. And as operators, as humans, when we are inundated with that data, after the a certain point, there are studies that show that after a certain point, we get saturated with this situational awareness. Our situational awareness beyond that point cannot be extended because it's fundamentally limited by our cognitive capacity. So beyond the point of saturation, if we are presented with more and more information, we not only start to passively ignore them, we actually get worse in our performance.
And the same thing is true, obviously, in medical technology usage in the clinical space. So as designers of solution, what I think we have to do to mitigate the problem is that we have to be really thoughtful and decisive about what data is being presented to the user, to the clinician. We can't just take all pieces of data and present it to them on a crowded device screen or on a dashboard and assume that may be information that will help them make clinical care better. In fact, we are probably doing exactly the opposite by contributing negatively to the cognitive load that they have, that it increases mental and I would say physical stress on the clinician. So that's the biggest opportunity that we have using modern technology. How can we combine the data? How can we convert that into real, meaningful insights that can augment the clinicians in executing the tasks that they need to execute on a daily basis?

Matt Smith: So staying on the topic of usability with getting it differentiators in health care vendors, we all know that in our professional lives as well as our consumer experiences, there's technology vendors who really excel at data usability. And then obviously, conversely, there's others that struggle to find that right balance. How do you think or what do you think separates one from the other?

Roshy Francis: There are a lot of factors that we can talk about that are technology advantages, applications of data aggregation, machine learning, and all kinds of different technology things that we could say as differentiating in how that data becomes usable and presenting it to the right person at the right time. But on this one, I tend to go back to the basic, the fundamental. I think it comes down to the people who differentiate themselves are the people who really think about, have a design philosophy in product development that is deeply rooted in empathy. Because I see when our engineers, when our product managers, when our designers have this idea of an empathetic understanding of what the user is going through. They create better solutions using better technology that blends into the background so that the technology is not even visible. So I would say that's probably the number one differentiator. The number two probably is when we are creating a solution, we cannot only think about the primary user of the device. There is probably a primary clinical user who is using that solution. We have to think about everybody who is interacting with that solution around its life cycle.
That could be a biomed who is in charge of keeping that machine or that equipment up to date. It could be an IT professional who is in charge of installing, updating, upgrading, and interfacing that to ensure interoperability of that solution. And it could be a remote physician who we didn't really think about as using that information that is presented with that. These companies who really have this idea of empathy, they not only think about how a clinician is using that device to accomplish a specific task at that time, how you are clicking through the buttons. But instead, they really deeply discover what their environment is like. Before they are performing the task, they are going through a preparation. And so we need to understand the prep work that is behind when you start to interact with that solution. When they are interacting with that solution, there are competing priorities that they are trying to balance about patient care, about other conflicting things that they have to deal with success? And what were some of the pitfalls that they were trying to avoid when they were using that solution in that particular instance?
Being able to understand that wing to wing and across a network of users, I think it is fundamentally going to differentiate the companies that get this right, I think.

Matt Smith: You've teed us up for one of the last questions of defining success. How do we know when the usability is successful when it's correctly deployed in medical device design?

Roshy Francis: It's a complicated one because that is really a complex rubric. Again, I would go back to the basic of where usability started. Usability started with the foundation of patient safety. Getting through a task without it negatively impacting patient safety sounds very simple and basic for me to say, but it's actually hard to accomplish. There are still user errors that cause significant safety implications to the patient. So I think that's at the basic level, that's the first measure of success that I would still say is important.
The second one is when you're looking at that operator who is using that solution at that local level, when you're trying to get through a task, are they able to get through that with the efficiency that they need? Are they able to do that without fumbling through it? And then you have to look beyond the task itself and you have to look at a global level. What's the impact of usability truly at the departmental level? What's the impact that maybe even at the health system level? So if we do this right, we would like to conclude that great usability results in great patient outcomes, although practically that's actually very difficult to prove , scientifically, may be very difficult to prove. But then we can look at some intermediate things. We can look at did we enable that clinician to make the right timely decision? Did we improve staff satisfaction? Did we improve the cost of care by maybe cutting down what might have taken two people down to a single person task? Because we have designed it not thinking about it from a device centric perspective, but we are thinking about it from a patient centric perspective because that's what the clinician is really focused on and with this idea of empathy across the life cycle of that usage. So I think those are probably the biggest measures. And the last thing that comes to mind is staff satisfaction. Can we impact the staff satisfaction at a local level when they're getting through that process. Are they satisfied with how they went through it? And then think about a collection of tasks that the clinician has to go through throughout their day, And did we improve that in a meaningful fashion right at a global level? So I think staff satisfaction is probably the final one. 

Matt Smith: Okay. We've definitely covered a wide range of important considerations when assessing the impact of device and data usability. Any parting thoughts for the in person audience and the podcast at home? 

Roshy Francis: Yeah, I think thanks for having me. I think it's a pleasure to talk to the folks here at hymns and learn a lot from a lot of industry thought leaders and partners. And to do this well, I think, no solution vendor can really do this by themselves. I think that requires the level of commitment that's beyond just conforming to standards, of course, standards are important. I treat them as basic, but it's a level of commitment that is deeply rooted in that empathy that I mentioned. Being able to truly understand what the clinicians are going through in their day-to-day life, and that's a commitment. There is a lot of effort that is needed and so that means that it's a partnership between the solution providers like us and the customers. So customers should be willing to partner with us and we should also be willing to partner with other players in the industry because as GE HealthCare, even though we have a lot of different solutions out there, when you're thinking the kind of things that come around that patient, it's going to be multiple vendors. We have to partner with each other with this idea of patient centricity, not device centricity, not vendor lock in and that is a true commitment that we all have for each other beyond just basic check mark conformance to standards. And I think that's what we are here for, and if we do that well, I think we will meaningfully impact the way care is delivered from the hospital all the way to home and every other place in between, wherever care needs are required. 

Matt Smith: Sounds good to me. Thank you for your time. Thanks. Roshy Francis, everyone. 

Roshy Francis: Thank you, everyone. Thanks. 

Matt Smith: I´ll take your question. 

Public: I love your vision and having this global optimization, patient centric and how to reduce the doctor's vending rate. But what is a specific solutions you have. 

Roshy Francis: I thought I had to pass the mic.

Matt Smith: No, you're good 

Roshy Francis: When we think about taking the different types of data, so we are in different care needs from emergency care to critical care to labor and delivery etcetera, etcetera. So that's the space that I operate in. And in that we have a number of solutions where we're bringing data together in a vendor agnostic kind of way. So, we not only work with the GE HealthCare devices, we work with multiple vendors or devices because that's truly what represents that patients information. We think of it as really a slice. Every device captures a slice of information for that patient, and it's not complete until you combine all of the different devices that may be around the patient, and you have to combine that with contextual information that comes from EMR systems, right? And so, we have several solutions that bring all of them, and then convert them using algorithms, whether traditional algorithms or machine learning algorithms, into insights that are delivered to clinicians that are located, may not be located by the bedside, it could be in a large command center type of a setup right where we are looking at multiple patients. 

So, one specific example is our mural labor and delivery. So, in labor and delivery, we are looking at specific conditions like hypertension or oxytocin management and we are enabling clinicians to comply with hospital defined protocols in each of those conditions. So, if when you are out of compliance that is established by your own hospital, informed by some of the protocols that exist in the industry, we alert them. So, we alert them so that they know that timely intervention for that patient at the most critical time is possible. And the solution really enables you to do that instead of you having to log into a system and checking multiple systems to find out what needs to be done. So, we have several examples of solutions like that, where it's truly our commitment from a patient centricity perspective to be able to bring data together from bedside medical devices and other sources of data that increases that situational awareness but without overwhelming, without overwhelming the clinician and converting that into an actionable insight. Thanks for the question. 

Matt Smith: Yep. Thank you. 

Roshy Francis: Alright, thanks. Thank you.