At this week's HIMSS conference, University of Pittsburgh Medical Center (UPMC) showed off mobile, touch-enabled software intended to give doctors quick access to the most important information they need about every patient they see, with visualization for at-a-glance understanding.
The goal is to organize patient information into "clinical pathways," where the most relevant information is always at the physician's fingertips, rather than hidden in the multiple screens and tabs of one or more underlying electronic health records systems. (UPMC itself uses a combination of the Cerner EHR for inpatient care and the Epic EHR for ambulatory care, plus other specialized software).
Called Convergence, the Windows 8 application was created by UPMC with help from Caradigm, a joint venture of GE and Microsoft, with additional help from Microsoft and Intel. Caradigm provides the single sign-on and data integration technologies that allow Convergence to pull information from multiple underlying EHRs and clinical systems, with the ability to navigate smoothly between the converged, visual view of the patient record and the underlying transactional systems for recording patient records and clinical orders.
Rebecca Kaul, director of the UPMC Technology Development Center, said she originally tried to create the application a year ago on the iPad. The doctors who tried it loved the visualizations her developers came up with, but they balked when told the iPad app would be read only and that they would still have to go back to their EHR to record data. They'd either have to go to their desktop or, at best, open up a Citrix session from the iPad, log in, and navigate to the right section of the EHR to log the data.
[Lack of CPOE compliance got you down? Read CPOE Stragglers: One Hospital's Fix.]
"That was a show-stopper," Kaul said. Their message, she said, was: "I don't want to work in more than one system -- it's hard enough for me to work in this one system."
In contrast, Windows 8 and the technologies provided by Caradigm made it possible to treat the EHR as an embedded component of Convergence, accessible with gesture control. "You can swipe right into the Cerner System, go right to the order entry screen, do exactly what you need to do, and then swipe back into the clinical pathway," said Kaul.
UPMC is a multi-hospital healthcare system built around the University of Pittsburgh Medical Center. As CIO Dan Drawbaugh explained in a recent InformationWeek Radio interview with my colleague Chris Murphy, UPMC has ambitions to become a technology company and create tech spin-offs such as its Evolent Health, which was started by UPMC and The Advisory Board Company. "It's not a hobby for us," Drawbaugh told me in a meeting at HIMSS. UPMC believes it's possible to pursue that goal and still maintain its stellar reputation in healthcare delivery, he said.
UPMC's Kate Scott demos Convergence.
One reason for creating technology products is so UPMC can use them for its own purposes. But another is to shore up the narrow margins inherent to hospital operations with the double-digit margins a good technology business can enjoy. "If you have a 2 to 3% margin, and you make one small mistake, then you've lost that margin," he said.
Before pursuing any commercialization plans, UPMC is piloting the software in its cardiology department, prior to deploying it more broadly this summer. Kaul said UPMC will be happy to spend the money on buying Windows 8 tablets and deploying the software if doctors demand it. She already sees signs that colleagues of doctors in the pilot program are feeling left out because they don't have access to it, which should be a good sign for technology adoption.
"We want them to beg for it," Kaul said.
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