The Importance of Patient Data in Hospital Through Home

Matt Smith: Hey, everybody. Good afternoon. Welcome to our podcast series: Digital Solutions that Ease the way for Care Teams. I'm Matt Smith with GE HealthCare Marketing. Today, I'm joined by Neal Sandy and Julie Viola. Neal is the leader of the Monitoring Solutions business within GE HealthCare. Julie is the owner of Cody Health Ventures, a firm that helps industry players and healthcare organizations evolve the role digital solutions play in how care is delivered. Neal and Julie are joining us to discuss the importance of patient data from hospital through home. Welcome, Julie and Neal.

Julie Viola: Hi. 

Neal Sandy: Thanks, Matt.

Matt Smith: So, we'll start off with definitions and getting up to speed. So current dynamics are causing a shift away from discreet, episodic units of care taking place in specific locations to a more continuous care journey that is less dependent on the “where” component. Julie, can you start us off by defining longitudinal care and what that means in context of our conversation?

Julie Viola: Yeah, sure. So, the whole purpose of longitudinal care is really driven out of patient centricity, right? So, it's rooted in care coordination and continuity and really making sure that patients aren't readmitted to the hospital, that they're extending care beyond the hospital, and that there's bidirectional sharing of data no matter where the patient is on the care continuum. So that's probably the best way to describe it. And again, just as we have seen over the past few years, care is moving to the home, and so longitudinal care is critically important.

Matt Smith: Okay. So, digging into that concept just a little bit further. Neal, how do you see this approach impacting how care is delivered? And probably more specifically, how do we manage patient data?

Julie Viola: Yeah, I think the fundamental thing that's happening now is that access to the data needs to change. Historically, access to data came with interaction with a medical device at a point of care or interaction with an EMR off the point of care or in a mobile situation. But, in order to facilitate longitudinal care, we need to bring data together in a more holistic way, from devices, from lab systems, from EMR systems, in order to deliver the right information to the care team at the right time, whether that be in an acute care setting, a post acute care setting, or even into the home. And what that does is, provides the clinical team a means to access data, or the ability for companies to push data, relevant data, to the care team, so that they can make more clinically relevant decisions in real time with the patient. And that helps with a lot of things, not just patient care and better outcomes potentially, but also with the economics of the hospital and discharging patients sooner and the like.

Matt Smith: Okay. So, Julie, there's a term we talk about confidently discharging patients. There's a lot to this concept. Having the right information to make an informed decision while in the hospital, also knowing what's going on with the patients once they leave. Can you talk a little bit about the post-acute challenges and some of the considerations that are associated with longitudinal care?

Julie Viola: Yeah. So, I think there's a few things. The starting point is there's a lot of talk about the shift to home. Home isn't safe for everyone and understanding who is ready to go home, who should go home, and then who really needs the care in the hospital. These things are critically important. When we start talking also about post discharge, it's in a longitudinal environment. We're not just talking about blood pressure readings, SPO₂. We're talking about the holistic part of the patient. So understanding who's at home, are their utilities on, and collecting all of that different data. And so sometimes the payer has that, sometimes the provider has that, and we really need to do it in a way that's not creating more burden for clinicians. So that's the big thing. And so, you'll see that the health systems that were first into the acute hospital at home, those are the ones that understood care coordination, that had the bandwidth and the infrastructure to push care outside of the hospital. And the other thing is you have to have the infrastructure. So, when a patient is going home, do they have access to broadband? Do they have access to cellular?

Is there somebody checking in on them to make sure that, again, they have what they need to really be able to use the tools that are at home? Or as Neal mentioned, it doesn't have to just be the home. There's other settings that are outside of the hospital where care can be moved to and still deliver on the promises of longitudinal care. That would be one part of it. The second thing is that the stream of data and this infrastructure, there's so much of it. That's a challenge because, again, the purpose is not to burden the care providers. It's to empower the patients and, again, do it in the most customer and patient centric way possible.

Matt Smith: Okay. Based on what we've talked about here, we can clearly see that there's a single consistent stream that is critical to successfully delivering longitudinal care. But, Julie, in your opinion, do you think we're there quite yet?

Julie Viola: I don't think we're there quite yet. I think there's folks that are pushing the envelope, and I think you phrased it perfectly with that single stream of data. That is where our health system partners are trying to get to is how do I have a singular view of that patient, no matter where they are in the care continuum or what setting that they're in? I think there's some really great health systems that have embraced digital technology, probably on the forefront. I think if you were to push them and ask them if it's been easy, they'll say no. I think there's been a lot of... I think if you rewind maybe five years ago, there was a different set up between vendors and hospital systems than there is today. I think now everyone's trying to figure out how to do this. There's a lot more partnerships. I think there's also a lot more openness than there was five years ago. So, interoperability, bi directional data sharing, these are themes that we're hearing a lot about, but we still have to do more. So that's where my hesitancy of saying, yes, we're there. A lot of it is around how that data is going to flow. Is it actionable or is it creating noise?

Matt Smith: So, on the right path.

Julie Viola:  On the right path. We're getting there. We're moving in the right direction. I'd say the full launch should not care. That's the North Star that we're all moving towards as an industry. And I think it's exciting.

Matt Smith: So, this next one is for both of you. And we're talking about drivers with the paradigm shift of this huge magnitude, multiple drivers at play. Can you talk a little bit about what those key drivers are and what the trends are with each of those?

Neal Sandy: Yeah. The hospital capacity issues is certainly a main driver here, but also the shortage of clinical staff all over the world, actually. Nearly every customer I visit has a shortage of nurses or physicians, and I think those are two big drivers for hospitals today.

I think the first thing is that technology should not be the lead here. Year, the patient should be the lead. And Julie mentioned it earlier, this notion of patient centric access to data, requires the medical technology companies to change their view on things. If you're a medical device company, the data that's in the device is not the end all. It's only an input to the broader longitudinal data that's necessary to deliver care no matter where the patient is and really no matter where the clinician is as well. And so this notion of patient centric data sets means that you have to bring the data together, but it doesn't have to be in the same place. There used to be a lot of discussion on the technology front about data lakes and putting all the data in the same place, same set of servers or something like that. It's really not a very elegant solution because there's a lot of coordination that has to happen in that regard. If you make it patient centric, you really need to only knit the data together from disparate sources, not even located it in the same place, all with the patient in mind.

And then distribution of that data to the care team, wherever that care team is, be it bedside with the patient, overseeing a home situation, or throughout their journey in a hospital, becomes a lot easier because once you have the coordinated data set, meaning not necessarily in the same location, but tied together in the name of the patient, then you can distribute it to the care team wherever and whenever it's needed.

Matt Smith: Okay. So, tying this all together, we've got our industry implications, the collaboration. Everything that we've talked about in this discussion really feels like it's much needed, but it's a massive undertaking that obviously requires an immense amount of coordination. Question I'll give to you both. What role can a company like GE HealthCare play in making longitudinal care a reality?

Julie Viola: I think number one, there's a tremendous amount of change management that's needed. I think going out and working with customers is great. I think I look around here and I see things like the command center and the new wearable type of technology. These are the types of things that you're seeing open up a bit. We're no longer tethered to a wall. We're starting to look at things like capacity management and really, again, keeping that provider in mind where we're not overburdening and we're trying to loosen things up a bit. I think the other thing is that... We talk about bidirectional sharing of data, it's also bidirectional sharing between the vendor and the partner, the vendor and the health system. These things are really important.

The other thing I'd say is when you're in a bidirectional data sharing environment, it enables you to share a lot more with all these startups. We've all been hearing a ton about ChatGPT, AI, all these different things. That means that people can go really deep into certain verticals. So I take something like a diabetes management. Maybe there's a larger vendor like GE that doesn't want to necessarily go super deep into diabetes, but you can visualize that data into a command center onto a bedside monitor. That is really empowering. And you start thinking of all the other different comorbidities that patients are presenting with, or people who are delaying care and they're presenting in the emergency room. Having that data, again, going back to what we mentioned at the very beginning, that longitudinal view being visualized in an actionable way, that is where the magic can happen and we can start solving problems.

Neal Sandy: Yeah. And I would say that almost by definition, if you're going to talk about longitudinal care and getting access and aggregation of data sets, you can't do it as an individual company. You really need to have an open stance toward partnering with other large companies in the case of health care or even with startups that have some innovative technology because at the end, that patient centricity matters to the care team and of course to the patient. And so gaining access to the data and then distributing it again is super important. And no one company is going to be able to do that. So you need to have an open stance toward partnering.

Julie Viola: For sure.

Matt Smith: All right. Said, thank you both. Really appreciate your time today. Neal, Julie, thanks for coming.

Julie Viola: Thank you.

Neal Sandy: Thanks for having us.

Matt Smith: Neal Sandy and Julie Viola.