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© 2013 Charles Safran
InfoSAGE and Disruptive Innovation
Charles Safran, MD
Chief, Division of Clinical Informatics,
Har...
2
© 2013 Charles Safran
Disclosures
• Intelligent Medical Objects 
– Director and shareholder
• Elsevier 
– Physician Advi...
3
© 2013 Charles Safran
Outline
• Why do we need innovation
• Personal Health Technology
• InfoSAGE
4
© 2013 Charles Safran
In the post‐EHR‐industrial era 
will innovation be stifled ?
5
© 2013 Charles Safran
Clinical Informatics
• Clinical informatics applies concepts, methods and tools that enable 
the o...
6
© 2013 Charles Safran
MR EMR EHR
7
© 2013 Charles Safran
• Contain information about a patient's medical history, 
diagnoses, medications, immunization dat...
8
© 2013 Charles Safran
Goals of EHRs
• Quality and convenience
• Accuracy of diagnoses and health outcomes
• Practice eff...
9
© 2013 Charles Safran9 NSF Patient Empowerment Workshop
Park City Utah, December 1-2, 2011
10
© 2013 Charles Safran
“Patients are the least utilized resource in healthcare”
- Warner Slack
11
© 2013 Charles Safran
Personal Devices
12
© 2013 Charles Safran
Continuous Glucose Monitoring
1
2
• Implanted in subcutaneous 
tissue
• Measure the level of inte...
13
© 2013 Charles Safran
Sometimes visualization reveals nothing
14
© 2013 Charles Safran
15
© 2013 Charles Safran
CureTogether
16
© 2013 Charles Safran
CitiSense ‐ Open Transparency
Adapted from Bill Griswold
Crowd-Sourced
Real-time
Health Data
17
© 2013 Charles Safran
Where is health data coming from?
• Hospitals
• Physician’s office
• Payors
• Commercial Labs
• P...
18
© 2013 Charles Safran
19
© 2013 Charles Safran
Problems to Solve
• Aging creates healthcare decision‐making, 
information management, and 
commu...
20
© 2013 Charles Safran
21
© 2013 Charles Safran
• Population is Aging
• Two‐Fifths Of U.S. Adults Care For Sick, Elderly 
Relative
• Logistics of...
22
© 2013 Charles Safran
Goals of InfoSAGE
• Identify the information needs elders and 
those helping to care for them,
• ...
23
© 2013 Charles Safran
Electronic
Health
Records
Health
Informa on
Systems
Visi ng
Nurses
Pastoral
Home
Services
Other
S...
24
© 2013 Charles Safran
IdentityIdentity ConnectionConnection
ContentContent CoordinationCoordination
Event 
Bus
25
© 2013 Charles Safran
• Innovation post‐commercial EHR acquisition is 
not only possible but necessary
• Clinicians wil...
26
© 2013 Charles Safran
Charles_Safran@Harvard.Edu
1330 Beacon Street
Brookline MA 02446
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Safran info sage & disruptive innovation

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Transcript of "Safran info sage & disruptive innovation"

  1. 1. 1 © 2013 Charles Safran InfoSAGE and Disruptive Innovation Charles Safran, MD Chief, Division of Clinical Informatics, Harvard Medical Faculty Physicians @ BIDMC Associate Professor of Medicine, Harvard Medical School
  2. 2. 2 © 2013 Charles Safran Disclosures • Intelligent Medical Objects  – Director and shareholder • Elsevier  – Physician Advisory Board • Cerner Corporation  – Consultant
  3. 3. 3 © 2013 Charles Safran Outline • Why do we need innovation • Personal Health Technology • InfoSAGE
  4. 4. 4 © 2013 Charles Safran In the post‐EHR‐industrial era  will innovation be stifled ?
  5. 5. 5 © 2013 Charles Safran Clinical Informatics • Clinical informatics applies concepts, methods and tools that enable  the optimal use of information and knowledge to measurably improve  patient care.  • Clinical informaticians transform health care by analyzing, designing,  implementing, and evaluating information and communication  systems that enhance individual and population health outcomes,  improve patient care, and strengthen the clinician‐patient relationship. • Clinical informaticians are at the  intersection of clinical processes  and business processes and communication & information technology • Clinical informatics is applied ‐‐ interventional Clinical Processes Information Technology Business Processes
  6. 6. 6 © 2013 Charles Safran MR EMR EHR
  7. 7. 7 © 2013 Charles Safran • Contain information about a patient's medical history,  diagnoses, medications, immunization dates, allergies,  radiology images, and lab and test results • Offer access to evidence‐based tools that providers can use in  making decisions about a patient's care • Automate and streamline providers' workflow • Increase organization and accuracy of patient information • Support key market changes in payer requirements and  consumer expectations Electronic Health Records are real-time, patient-centered records. They make information available instantly, whenever and wherever it is needed.
  8. 8. 8 © 2013 Charles Safran Goals of EHRs • Quality and convenience • Accuracy of diagnoses and health outcomes • Practice efficiencies and cost savings • Care Coordination • Patient Participation Largely un-met
  9. 9. 9 © 2013 Charles Safran9 NSF Patient Empowerment Workshop Park City Utah, December 1-2, 2011
  10. 10. 10 © 2013 Charles Safran “Patients are the least utilized resource in healthcare” - Warner Slack
  11. 11. 11 © 2013 Charles Safran Personal Devices
  12. 12. 12 © 2013 Charles Safran Continuous Glucose Monitoring 1 2 • Implanted in subcutaneous  tissue • Measure the level of interstitial  levels of glucose NOT blood  glucose levels – Q1‐10 minutes • Using advance algorithms are  able to predict current blood  glucose levels and trends • Currently device specific  applications on desktops
  13. 13. 13 © 2013 Charles Safran Sometimes visualization reveals nothing
  14. 14. 14 © 2013 Charles Safran
  15. 15. 15 © 2013 Charles Safran CureTogether
  16. 16. 16 © 2013 Charles Safran CitiSense ‐ Open Transparency Adapted from Bill Griswold Crowd-Sourced Real-time Health Data
  17. 17. 17 © 2013 Charles Safran Where is health data coming from? • Hospitals • Physician’s office • Payors • Commercial Labs • Pharmacies • Public Health/ Gov • Mobile devices • Apps • Social media • Sensors • Computer games • Personal Health Records In the future, health data will overwhelming  come from outside the health system.
  18. 18. 18 © 2013 Charles Safran
  19. 19. 19 © 2013 Charles Safran Problems to Solve • Aging creates healthcare decision‐making,  information management, and  communication challenges, for elders and  their families  • Care Coordination is exceptionally challenging  • Respecting the elder’s preferences and  priorities is often lost in transition
  20. 20. 20 © 2013 Charles Safran
  21. 21. 21 © 2013 Charles Safran • Population is Aging • Two‐Fifths Of U.S. Adults Care For Sick, Elderly  Relative • Logistics of Care is Time Consuming • Caregivers are at risk for burnout
  22. 22. 22 © 2013 Charles Safran Goals of InfoSAGE • Identify the information needs elders and  those helping to care for them, • Create a “living laboratory” • Longitudinally study elder and family  collaborative interactions and information  management  • Evaluate the extent to which InfoSAGE  improves communication, coordination, and  collaboration for elders and their family.
  23. 23. 23 © 2013 Charles Safran Electronic Health Records Health Informa on Systems Visi ng Nurses Pastoral Home Services Other Services Social Networks PubMed Clinical Trials Search Physicians Nurses Personal Health Records Health Care Insurer Mass Media/ Public Ins tu ons Electronic Health Records Health Informa on Systems Visi ng Nurses Pastoral Home Services Other Services Social Networks PubMed Clinical Trials Search Physicians Nurses Personal Health Records Health Care Insurer Mass Media/ Public Ins tu ons
  24. 24. 24 © 2013 Charles Safran IdentityIdentity ConnectionConnection ContentContent CoordinationCoordination Event  Bus
  25. 25. 25 © 2013 Charles Safran • Innovation post‐commercial EHR acquisition is  not only possible but necessary • Clinicians will be overwhelmed by patient‐ sourced data • EHRs are too facility and physician centric to  address the healthcare needs of elderly • Caregivers need tools
  26. 26. 26 © 2013 Charles Safran Charles_Safran@Harvard.Edu 1330 Beacon Street Brookline MA 02446
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