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Safran info sage & disruptive innovation
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© 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
© 2013 Charles Safran
Disclosures
• Intelligent Medical Objects
– Director and shareholder
• Elsevier
– Physician Advisory Board
• Cerner Corporation
– Consultant
- 3. 3
© 2013 Charles Safran
Outline
• Why do we need innovation
• Personal Health Technology
• InfoSAGE
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© 2013 Charles Safran
In the post‐EHR‐industrial era
will innovation be stifled ?
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© 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
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© 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.
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© 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
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© 2013 Charles Safran9 NSF Patient Empowerment Workshop
Park City Utah, December 1-2, 2011
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© 2013 Charles Safran
“Patients are the least utilized resource in healthcare”
- Warner Slack
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© 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
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© 2013 Charles Safran
CitiSense ‐ Open Transparency
Adapted from Bill Griswold
Crowd-Sourced
Real-time
Health Data
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© 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.
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© 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
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© 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
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© 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.
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© 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
© 2013 Charles Safran
IdentityIdentity ConnectionConnection
ContentContent CoordinationCoordination
Event
Bus
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© 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
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© 2013 Charles Safran
Charles_Safran@Harvard.Edu
1330 Beacon Street
Brookline MA 02446