EXPERT Q&A: Lior Miller, Chief Healthcare Solution Architect, Q-nomy

lior_blogLior Miller has over 10 years of experience as both a healthcare provider and on the vendor side as a solution specialist. He is an expert in medical and patient centric process management and is passionate about optimising work flows for healthcare providers of all sizes.  Lior was recently one of the brightest minds at the world’s largest Health IT conferences a (HiMSS 17) and shared his knowledge and experience with many of the 41,500 attendees. Here is what he has to say about the impact IT is having in the health space and what we can expect in the near future.

Q: You have been involved in the healthcare industry for quite some time. What are the 3 tech changes that have revolutionsed the patient experience in the past decade?

A: That is a tricky question because the main change I believe is one that has had a negative impact on the patient experience. The adoption of Electronic Medical records (EMR) and the race for digitization by healthcare providers has dramatically changed the ratio between direct patient care interaction and case documentation which leads to longer idle times, fatigued staff and a capacity management focus based on financial value.

The second change is the need for digital engagement with the patient. For the past decade, healthcare providers have evolved the way they engage with patients to ensure they are more involved in the continuum of care. This is delivered usually by accessible patient’s medical record and educational materials in the form of patient’s portal and other self-service tools.

Identifying a 3rd significant change is challenging as there have been so many IT advancements, like the start of population health and chronic care programs, Real Time Locating Systems (RTLS) improvements and the rise of the Business Process Management (BPM) in healthcare. I would say that the Telehealth adoption is one which directly affects all of us, as patients. The option to have a remote face-to-face interaction with your GP or even a specialist being just a few clicks away – now that is a game changer for healthcare providers and patients.   

Q: How are new technologies enabling operational efficiencies?

A: In most cases, operational efficiency is an outcome of new and well formatted work processes, resource availability and the desire to change and improve to achieve the goals set by the process owners.

Technology is not only the tool to use, manage and excel your process, but it accelerates the rate of process changes towards efficiency.

For example, new technologies like advanced blood count tests that can analyze and send in the results in matter of minutes, will improve the operational efficiency of many processes in for the Emergency Department.

In the IT eco system of a healthcare facility, technologies that are interoperability driven -  that can streamline processes that were handled manually, or had long SLAs for certain acts with in the process due to working on 2 systems at the same time or due to miscommunications ,  these technologies are the most contributing to operational efficiency. Technologies that incorporate these abilities with a flexible BPM engine can excel the most in optimized efficiency processes due to their option to take a logical process and automate into a smart, controlled workflow that can maximize resource utilization with an easier adoption and change process.

The main difficulty with operational efficiency optimization planning in a medical center’s dynamic environment is resource allocation, especially with the scarce and already fatigued human resource. I’ve participated many meetings on processes where new technology was not implemented due to the risk of staff overload.

Q: What does this mean for the patient?

A: To ensure the improved operational efficiencies directly enhances the patient experience, the process needs to be patient centred and not focused on the medical, administrative record or other hospital verticals which are more chart centered or “medical persona” oriented.

It is here that NEXA’s healthcare Solution excels - a focused patient centered optimisation platform that can achieve efficiency optimisation while always promoting the patient in their journey. We’ll explore this in more detail at the workshops coming up later this month.

Q: What is the biggest challenge healthcare facilities face when implementing a new technology?

A: The implementation of new technology can be disruptive initially and without a doubt, one of the biggest challenges is to shift the care givers perception of the change, solution and outcome.

I’ve been experiencing rejections of new technologies from care givers in the form of phrases like: “I will do it , but only because I have to” , “this is great , but it won’t work” or my favourite “I will not cooperate with ‘The Big Brother’ ”.

This emphasises that the implementation of new technologies should always:

a.      Consider that the solution should help staff concentrate on their tasks and not interfere with it.

b.      Try to enhance the care giver experience.

c.       Minimize care giver’s overload – hard to do, but can be achieved.

d.      Set a realistic goal together with the care givers. Try to make them partners and not just users.

e.      Have plan B and C, and be ready for changes along this process.

My advice in preparing for process change and later for implementation, is to do side-by-side shadowing of care giver (or any staff involved) activities and document every action and step along the way. This tedious task can significantly improve operational efficiency and staff satisfaction in day- to-day actions.

For example, while planning a real-time patient flow solution implementation in the Emergency Department we learned that a nurse in the treatment room does not know the next step destination of a patient and therefore needs to search for it in the physician notes or in the Triage nurse notes – this task will take 30-90 second per patient for an experienced and EMR oriented nurse. Multiplied by 450 patients a day -  this means that 7.5 hours per day are used for this task only. We solved this by automating the process of the patient routing by defining patients routes to choose from for the route decision maker. By completing the case in Q-Flow (within the EMR screen), the nurse will get an immediate response with the patient next step.

Q; What do you believe is the next big thing in optimising the patient journey?

 A: Healthcare facilities tend to be more conservative and economically challenged to adopt new patient journey optimisation tools as well as to change business processes in this stressed eco system.

Known “next big thing” technologies weren’t that successful to be adopted in healthcare facilities when it comes to direct patient interaction.  Such as RFID Tags for patients and staff, self-service scheduling and even CRM.

I believe that the Retail sector, Financial sector and consumers behaviour will lead the way for patient journey optimisation in the years to come. These sectors are radically changing customer journey towards efficiency, ease of use, ease of access and mainly journey automation.

The customer journey automation has grown towards personalization and real time engagement, and I believe healthcare is going towards Care Path Automation with open channels between a consumer (aka Patient) and a provider.

This means that an optimized patient Journey will allow healthcare facilities to receive and send information to their customers and automate the action needed to promote them in the journey. Gone are the days when we will not see patients arriving with a paper folder with medical history or their latest scan results to outpatients and all required information will be recorded and sent ahead of visit. This will allow the patient to be a meaningful active participant in his journey. The physical aspect of the journey will be planned to minimize customer length of stay at the healthcare facility and utilize omni-channel communications with the customer through face to face, video and other advanced digital channels at the same journey.

The definition of the patient journey is being continually redefined and this is a very exciting time to be involved in the technology advancements driving the changes.

Find out more about the advancements in patient journey technology and gain best practice insights to improve your patient experience at NEXA’s workshop ‘Optimising the Patient Journey’ taking on 28, 29 and 31 March 2017. More information is available here.


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