Mobilizing 'big data' in healthcare

More than 500 technology and healthcare professionals descended on San Francisco last week to share, listen and learn about "big data" trends at the O’Reilly StrataRx 2012 conference: unveiling new markets, creating new products, advancing personalized and predictive medicine, and contributing to significant cost savings.

I attended this intimate gathering and had the pleasure of participating on a panel session titled "The Use of Mobile Technology to Improve Patient Engagement and Outcomes," with Cale Bruckner (Concentric Sky), Daniel Fitzpatrick (Slocum Center for Orthopedics), Stanley James (Slocum Center for Orthopedics) and moderator Kin Lane (API evangelist).

In just 40 minutes, we discussed data saturation issues, the effects of digital data on clinical workflow and the value of discrete data and electronic patient interactions. Below are a few highlights from our session:

Data saturation: Problem from a provider point of view
There is clearly a data saturation problem in healthcare. In fact, a recent Oracle study revealed that C-level executives wholeheartedly agreed that healthcare organizations are accumulating 85 percent more data than two years ago. And this data, which comes in the form of paper records and electronic data, is becoming unwieldy – a sentiment shared by all panelists. This problem is a distinct one that can be addressed through technology. But first, we must focus on answering a few fundamental questions:

• How can physicians be more efficient with documentation and patient-provided data?
• How can they better retrieve the information that they and their colleagues create?
• How do we better connect physicians with reference content and other medical information?

Clinical workflow: The effect of digital medical data
Having a lot of clinical data is not a bad thing in and of itself; it’s actually a good thing. However, it’s the potential impact on clinical workflow and patient care efficiencies that may suffer from a lack of proper information management and delivery. What was once as simple as flipping through a paper chart has transformed into what can sometimes seem to be a less-efficient and less-convenient task of finding information in a patient’s ever-expanding electronic medical record (EMR).

Yet there is hope. As physicians become increasingly mobile, so does the technology that supports their daily workflow. Mobile devices in the professional healthcare setting not only offer portability and easy data retrieval, they also allow physicians to document and capture the patient’s unique clinical story from anywhere and at any time. Most importantly, mobile app developers are sensitive to the concerns around information overload, and as a result are paying special attention to mobile EMR user interface design that truly supports the physician – this includes offering speech recognition data input for more efficient documentation within the confines of a mobile device, as well as extracting and organizing key clinical information and facts for streamlined data consumption.

Discrete data: Clinical value in the medical record
With a clearly defined problem, the panel discussion shifted to possible solutions. While the importance of preserving the patient narrative was unanimous, so was the clinical value of discrete data. Discrete data complements the narrative, and vice versa.

Today, technology exists that can structure the clinical narrative and extract facts, but simply structuring key information into discrete data elements is not enough. In order for mobile devices and apps to deliver on the promise of adding value to the physician’s workflow, discrete data must be unobtrusively presented and made accessible when, and where, the physician wants and needs it.

One concept discussed was the use of ‘voice’ to bridge the gap between the narrative and discrete data by supplanting simple utilitarian actions with more natural, human-like interactions between physicians, mobile devices and the software that powers them. In other words, using directed voice-driven question-response retrieval of discrete data elements such as problems, procedures, medications, allergies, vitals and social history was presented as a possible solution for overcoming some of the challenges associated with discrete data retrieval.

Patient interaction: Using mobile devices during the patient encounter
Closing out the session was a brief discussion about the pros and cons of leveraging mobile devices during the patient encounter. While many physicians may not yet be entirely comfortable introducing mobile devices into their daily workflow, an equal number are. And this trend continues to grow rapidly as physicians use mobile devices in the presence of the patient to educate and share information (such as the patient’s medical images), retrieve reference content (such as drug interactions and vaccine schedules) and document and access EMR data (both narrative and discrete data).

Patient engagement and improved outcomes are just the tip of the iceberg when it comes to advancements in mobile technology and the taming of big data. In particular, as mHealth evolves over the coming months and years, so will the number of value-add solutions that enhance workflow and contribute to improvements throughout the entire episode of care. Ultimately, it’s about physician choice, but so long as app developers focus on making vast amounts of data more accessible, the decision to adopt a more mobile workflow becomes a less uncomplicated one.

Jonathon Dreyer is senior manager for mobile solutions marketing at Nuance Healthcare.