Hongsermeier app store for health


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Hongsermeier app store for health

  1. 1. Clinical KM 3.0 in a 1.0 EHR World Tonya Hongsermeier, MD, MBA CMIO
  2. 2. MU, ACO, PCMH, Safety, Readmission Prevention  Imperative to be Competent at Self-Improvement Care Context Guided Data Review Guided Decisions & Orders Guided Execution of Decisions & Orders Guided Assessments &Monitoring of Interventions Learning Context Identify Gap in Knowledge or Care: CDS Target Implement CDS Knowledge Measure Effectiveness Of CDS Knowledge Research&Discovery Update/Acquire Knowledge Curate Assets Knowledge Data 2 But: EHRs are not designed as Collaboration-ware or Learning-Ware
  3. 3. Self-Improving Organizations Know: Committee, Department, Researcher, or Other Proposes to Implement Content Guideline is Defined and Validated Functional Knowledge Specification For Encoding is Designed and Validated Ongoing Revisions or Eventual Sunset Of Encoded Guideline GOVERNANCE: Who decides what clinical problems to tackle with CDS, How to drive change adoption Specification is Engineered into Production Generating a Technical Specification PARTICIPATION: How to enable Subject Matter Experts engagement in CDS design COMMODITIZATON: Not to build what you can buy STEWARDSHIP: How to allocate resources to steward the CDS knowledge TRACEABILITY: To invest in technical tools to support build, dependency management, visualization, maintenance MEASURE EFFECTIVENESS: To focus on measurable targets and invest in continuous program evaluation 3
  4. 4. Lahey Health KM Investments • Governance and stewardship aligning systems with business drivers • Same regulations that force EHR adoption make them unusable • Focused on reconciling paradox of standardization and personalization of care • 3rd party content (usual suspects) • Externalization of CDS content from EHR to support curation • Collaboration Platform (JIVE)
  5. 5. Portalization Supports Transparency, Curation, De-Silo-ization of CDS Content Build-trackers and Stove-piped EHR content editors don’t cut it
  6. 6. Jive: Facebook plus Twitter plus Wikipedia plus Survey monkey plus Expertise Locator plus…
  7. 7. Jive: Mobile apps to further engage…
  8. 8. KM Platforms = Convergence Content Management Social Interaction Management Process/Transaction Management •Email •IM •Corporate Twitter •Portals/Virtual Rooms •Teleconferencing •Desktop Sharing •Idea Capture •Expertise Locators •Social Q&A •CMS •curation,versioning,auditing •Wikis, Blogs, RSS •Database Management •Document Management •Clouds •Semantics •Tagging •Taxonomies/Folksonomies •Search •User Profiles/Contacts •Rules Engines •Workflow Engines •Task Management •Scheduling/Tracking Leaders: •EMC •Microsoft •IBM •Oracle •OpenText Leaders: •Telligent •Jive •Atlassian •SocialText •NewsGator
  9. 9. Imagine if EHRs could “Learn” how to help Users/Health Systems Self-Improve how to anticipate user workflows and information needs Amount of data ProductivityofSearch Databases Web 1.0 1990 - 2000 The World Wide Web PC Era 1980 - 1990 The Desktop Keyword search Directories 2000 - 2010 Web 2.0 The Social Web Files & Folders Tagging Natural language search 2010 - 2020 Web 3.0 The Semantic Web Automated Content Analysis 2010 - 2020 Web 3.0 User Modeling User profiling Health System Profiling ** From: Making Sense of the Semantic Web, BY Nova Spivack The MetaWeb Web 4.0 We are about here, can’t find pt. data or knowledge in the swamp Intelligent Agents Connected Intelligence EHR vendors today impose enormous costs of conversion and curation of Data, Knowledge, Behavior