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Cedars-Sinai Joins the Group of Hospital-Based Organizations Nurturing Technology Development

September 1, 2016
by Heather Landi
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Richard Riggs, M.D., vice president and CMIO at Cedars-Sinai Medical Center, discusses the importance of fostering technology innovation in healthcare
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Last year, the Los Angeles-based Cedars-Sinai Medical Center collaborated with Techstars, a startup accelerator company, to launch the inaugural class of the Cedars-Sinai Healthcare Accelerator program. Like other programs of its type that have been emerging at hospitals and health systems around the country, this one has the aim of helping healthcare technology startups advance their solutions. As part of the 13-week program, companies selected for the Healthcare Accelerator have access to Cedars-Sinai’s clinical expertise, through its physicians and researchers, and information infrastructure, including hardware, software and digital health technical resources. And, the accelerator companies receive mentorship from the health system’s physicians, researchers, healthcare professionals and executives.

For Cedars-Sinai, a 900-bed hospital and multi-specialty academic medical center with 2,100 physicians, the healthcare accelerator program is helping to advance technology that empowers the patient or healthcare professional to better track, manage, and improve health and healthcare delivery. 

The 2016 Healthcare Accelerator class was comprised of 11 companies, and Cedars-Sinai has announced two partnerships so far with emerging companies that came out of the inaugural program. The next accelerator class is slated to begin in early 2017, and applications for the Winter 2017 program are being accepted through October.

Healthcare Informatics Assistant Editor Heather Landi recently spoke with Richard Riggs, M.D., vice president and CMIO at Cedars-Sinai Medical Center, about the importance of fostering technology innovation in healthcare and how the accelerator program is helping the health system bring breakthrough ideas to the bedside to improve patient care.

What was the catalyst for developing this healthcare accelerator program?

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There’s a good body of literature that talks about innovation, and innovation within spaces in relationship to the continual refinement and change in industries, but in healthcare in particular, and we’ve particularly seen this in the last decade or so with the emphasis on quality and understanding how to innovate around quality and also around value and efficiency. To give you an example, we’ve had an M.D./R.N. innovation challenge over the years, and this year, we had the frontline staff also develop ideas they see as clinically relevant. So we had a M.D./R.N. innovation challenge and we selected five groups to present their final product and then selected one of those for development. Those were things like developing an application and communication piece on an iPad for people that were intubated but alert, and the application focused on understanding what that patient needs and how to communicate with that patient.

I think that innovation comes from the concept of how can we change things, how can we do things better, what new pieces, either software or processes or communication styles or portals can we utilize to impact and accelerate our understanding of how we can care for patients and have better outcomes. At a system level, it’s really about innovation being a part of what we do. Cedars-Sinai is a very large teaching hospital and we are very much in the space of research, education and certain traditional academic models. So, having innovation running across the system is one of the tenets of why we wanted to do this.

Richard Riggs, M.D.

In addition, in healthcare we lack the accelerators that other industries have to expose these startup companies and help get them started. I think that many of these companies may not see the light of day. And, some of the solutions that have been developed have a more global application. The one I’d point out is Stasis Labs, a company that built a health monitoring device that’s being deployed in India because they don’t have the technology there to monitor patients. This particular monitor ranges about $100 in cost versus $1,000 or $1,500 for a standard monitor. There are different ways that this program can be helpful both in this system itself for innovation, but also for helping to understand how we can promote healthcare processes and companies even outside of the United States.

Many of these emerging companies and their technology solutions originated outside of the healthcare setting, so how is this accelerator program beneficial to Cedars-Sinai providers and the health system?

If you look at the 11 companies that were selected for the accelerator inaugural class, you’ll see that they covered a wide variety of topics that are germane to the healthcare space as well as intersect with technology. So they range from data analytics to mindfulness applications to medical device development to virtual reality to finding pricing models for underutilized services. So there’s a wide range of impact and focus within the initial group that participated in the accelerator program, and I think that speaks to not only the amount of opportunity within the healthcare field for this type of work, but also the different avenues in which technology may touch the healthcare environment, from administrative processes down to improving actual patient care, and even changing paradigms around patient care with regards to certain types of technologies.

Coming out of the accelerator program, we have partnered with all the companies in some form in order to help facilitate their product development and growth. For instance, the one that’s being deployed in India, we’re helping them to apply for FDA approval to understand what the applications of their device might be within the U.S. While we’re not utilizing the product, we are facilitating that particular avenue. With many of the others, we’re doing proof of concept with regard to understanding how the pieces integrate into the patient flow. We have had a great success rate with regard to converting the companies into a proof of concept or real-world trial in and around the product that came out of the accelerator.

So these technology solutions are not integrated into clinical workflow at the medical center during the accelerator program?

There’s not enough time in 13 weeks to do an implementation as a proof of concept and understand what it may look like on the back end. The best we can do is have physicians or clinicians understand the platform and perhaps have some care communications around it. One company is looking to develop a laryngoscope with a camera, so a disposable intubation scope that enables a better intubation method in the field or in the operating room and with a camera. So having the ear, nose and throat physicians actually being able to experiment with that and see what it looks like and understand the technology was important for us to understand how we might help the product be developed or what was missing or what may need refinement, but we didn’t actually put the scopes in our carts at day one. So we have to understand the product and then at the end, we look at how we might be able to utilize the technology.

Same with the end-of-life solution that a company was developing and looking at how do you apply this at the ER. And one company was looking at the credentialing process and developing a process so people could be credentialed across multiple different organizations that are affiliated. We’re Cedars Sinai, but we also have a wholly owned entity, Marina Del Ray Hospital, and a joint venture with UCLA Health System and Select Medical. All three of those would require different applications from a physician. So this company developed an idea where you have a central repository of information and that information can be pulled for applications and references and other pieces for the different affiliated organizations across the Southern California area.

Cedars-Sinai is now partnering with several of the health IT companies that came out of the inaugural class. What made the program successful last year?

There’s a couple of pieces. One, TechStars has a great model. We are not egotistical enough to think that we know how to set it up and run it. So we filled the slot of providing the clinical resources and executive access, as well as pairing people with mentors. These mentors took the company under their wing, from a clinical standpoint, to help open doors for access for them to understand and get the answers they needed. The direction for Cedars-Sinai executives was, these folks have 13 weeks so if there is a request for a meeting then that meeting needs to be this week at the latest. Many times it’s just connecting these companies to the next level. For instance, for the mindfulness application that’s been developed, we connected them to physicians who take care of chronic pain patients on an ongoing basis to help the company understand, from the clinician’s point-of-view and their view of the patient, what the most impactful pieces around that might be and how that might be integrated into their care model. It’s not so much giving advice on the technology pieces, it’s the clinical insertion of the technology into the clinical space and where that might fit that’s most helpful to these companies.

Many of these companies came into it from a personal experience. For instance, HomeHero is a non-medical home care provider based here in California; in that case, the mother of one of the founders became very ill and his father had to quit his job to do the care coordination. He founded the company because he felt there needed to be an easier way to do this, to screen, schedule and have a connection with home care providers. For that company it was about understanding how do you have the on-ramp, when you’re discharging patients from hospital, or you have chronic patients, patients who are neurologically impaired or have neurological decline, how do we have an on-ramp for those people so they understand where the resources are with the goal of maintaining quality of life for the patient and the caregiver. It was about understanding all that context of social workers and care coordinators and the other pieces that may impact how this technology optimally gets applied. The technology itself is a platform to interview, schedule and manage caregivers, but how it gets integrated, that’s the magic sauce that we can help provide to make sure the product actually fits in the right clinical space.

What has been the feedback from Cedars-Sinai physicians, clinicians, researchers and executives who have been involved with the accelerator program?

The feedback I’ve gotten has been positive and there’s a lot of excitement. I think folks here want to go further so we’ll harness that and help to channel that. The fact that we have the accelerator, quite literally, across the street from the hospital makes it convenient for people to do drive-bys, so to speak, in order meet with the companies. If a company wants to talk to a social worker, or a cardiologist, or the vice president of finance because they want to ask about models around reimbursement around x, y and z under Medicare, having all those different types of resources available at different times helps to create a well-rounded ability to not only peek under the clinical workflows but also the practical workflows of how healthcare is financed and paid for, as ultimately these companies need to be financially viable in order to survive, so that’s an important piece too. 

What sells the Cedars-Sinai team on picking a startup for the program?

We want to recruit the strongest companies into the program and then bring them further along, accelerate their development and technology and processes. With provide the clinical view, and the TechStars component is their evaluation based on their methodology. For myself, I was drawn to companies with a global impact even if we won’t fully integrate their technology here at Cedars-Sinai. There are things that can have such a great impact on worldwide health, such as the simple water filter pieces that were developed a few years ago, for safe drinking. Those spaces are meaningful and there is a clinical hook. And, frankly, if there are spaces that large companies and other organizations haven’t tackled or done well, then that’s a great space to innovate in and accelerate.

 


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LabCorp Joins Apple Health Records Project

November 5, 2018
by Rajiv Leventhal, Managing Editor
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LabCorp, a provider of clinical laboratory and end-to-end drug development services, has announced that it has enabled Apple’s Health Records feature for its patients.

This iPhone feature aims to make it easier for LabCorp patients to access their LabCorp laboratory test results, along with other available medical data from multiple providers, whenever they choose, according to officials.

In January, Apple announced that it would be testing the Health Records feature out with 12 hospitals, inclusive of some of the most prominent healthcare institutions in the U.S. Since that time, more than 100 new organizations have joined the project,  according to Apple.

LabCorp test results are viewable in the Apple Health app for LabCorp patients who have an account with the company, and enable integration with the Health Records app. In addition to their LabCorp test results, patients will have information from participating healthcare institutions organized into one view, covering allergies, medical conditions, immunizations, lab results, medications, procedures and vitals.

Patients will receive notifications when their data is updated, and the Health Records data is encrypted and protected with the user’s iPhone passcode, Touch ID or Face ID, according to officials.

“LabCorp on Health Records will help provide healthcare consumers with a more holistic view of their health. Laboratory test results are central to medical decision making, and broadening access to this information will help patients take charge of their health and wellness, and lead to more informed dialogues between patients and their healthcare providers,” David P. King, chairman and CEO of LabCorp, said in a statement.

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HIMSS Analytics Introduces Infrastructure Adoption Model for Health Systems

October 25, 2018
by Rajiv Leventhal, Managing Editor
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HIMSS Analytics, the research arm of the Healthcare Information and Management Systems Society, announced the introduction of the Infrastructure Adoption Model, or INFRAM, which is designed to measure the technical infrastructure used within a health system.

The INFRAM focuses on five technical subdomains, allowing organizations to benchmark how their infrastructure operates within the following areas: mobility; security; collaboration; transport; and data center.

Similar to HIMSS Analytics’ well-known Electronic Medical Record Adoption Model, or, EMRAM, the INFRAM is an eight-stage model (0 – 7) that allows healthcare IT leaders to map the technology infrastructure capabilities required to reach their facility’s clinical and operational goals, while meeting industry benchmarks and standards.  The final stage, Stage 7, guides organizations towards optimized information integration, contextualization and orchestration essential for the delivery of higher order local and virtualized care processes.

For reference purposes, Stage 0 on the model represents that an organization does not have a VPN, intrusion detection/prevention, security policy, data center or compute architecture. Stage 3 signifies that an organization has an advanced intrusion prevention system, while Stage 5 represents having video on mobile devices, location-based messaging, firewall with advanced malware protection, and real-time scanning of email hyperlinks.

HIMSS officials note that by identifying specific benchmarks for organizations to reach before they go live with EMR, systems, the INFRAM aims to ensure that a health system’s infrastructure is stable, manageable and extensible. Through this, organizations can ideally improve care delivery and create a pathway for infrastructure development tied to business and clinical outcomes.

 “The INFRAM is a welcome addition to our maturity model suite and addresses a longstanding need – guiding healthcare organizations in securely implementing the infrastructure with which their EMRs are built upon,” Blain Newton, executive vice president, HIMSS Analytics, said in a statement. “We have seen health systems engage with advanced clinical applications, only for them to ‘glitch’ under infrastructure that isn't powerful enough to support their tools. With the INFRAM, healthcare providers can develop a detailed, strategic technology plan that defines their organization's current state, desired future state, and each stage in between to achieve their clinical and operational goals.”

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Additionally, the system provided extensive and comprehensive reporting with data analytics showing where and to what extent response improvements were made, but also providing the information the hospital needed to better utilize the system and make adjustments to improve results.

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