Hackensack University Medical Center

Shafiq Rab

Just as mobility has become the fabric of our lives, similarly cloud technology will be the game changer and the equalizer between the ‘must haves and have-nots’. Cloud technology is already being used extensively and will become ubiquitous like mobility. The cost of cloud computing is becoming more affordable by the day and will become the path to make enterprise class IT Infrastructure more obtainable for all. The traditional barriers to moving healthcare to cloud computing such as HIPAA privacy and HITEC security are being eliminated by Independent Software Vendors (ISV) who have realized the massive multi-billion dollar market potential with the added bonus of saving lives. Presently, the most common form of cloud technology in healthcare is Infrastructure as a Service (IaaS) as it is the most trusted and is obtainable at a relatively low entry cost.

“The truly complete cloud computing strategy is a move towards delivering Platform as a Service (PaaS)  and Software as a Service (SaaS)”

The truly complete cloud computing strategy however is a move towards delivering Platform as a Service (PaaS) and Software as a Service (SaaS). In terms of healthcare applications, their associated infrastructures and vendor readiness, this complete strategy has until recently been significantly expensive and unmanageable for a majority of providers. From the technical perspective over the past few years, the teams at Hackensack University Medical Center (UMC) lead by our director of enterprise architecture, Jeremy Marut have overcome many of these obstacles to help us realize the benefits of providing the full complement of Infrastructure, Platform and Software as a Service. Their work resulted in not only a converged technical infrastructure, but a converged team structure where the walls between data center and applications analysts have been eliminated.

Today, we see this same model being provided by many ISVs turnkey out of specialty appliances and hosted data centers. As Jeremy puts it, “this convergence allows us to scale highly customized environments in a highly standardized way.” Presently 1.8 billion people are online using the Internet. By the year 2020, five to six billion people will be online. In essence, mobility has allowed for the sublimation of the communication process. Healthcare has always been personal and at Hackensack UMC , we are fortunate to have a patient portal known as MyChart, which can be downloaded as an app and gives full transparent access to all our patients via a mobile device.

From MyChart, patients can do the expected basics such as schedule their appointments, look at their personal health record and pay their bills. However, Hackensack UMC is on the cutting edge of the mHealth movement. It is one of the only hospitals connecting patients’ personal activity trackers such as Fit Bit, home scales/weighing machines, and pulmonary function tests to the MyChart app at home through the Wi-Fi connection into the cloud and directly into their medical record. The greatest opportunity for reduction in healthcare costs is in the acute-care setting. This happens by reducing readmissions in the hospital, seamlessly transferring the patient home or to a skilled-nursing facility, and/or reducing the length of stay. All these metrics are possible only if there is a great network of care coordination. Mobility and cloud computing has made this possible and attainable for all providers.

We are very lucky at Hackensack UMC that we are using cloud computing and mobility to improve care coordination as proven by our recent success with the HackensackAlliance Accountable Care Organization (ACO). We were one of the few ACOs that have actually saved money. At the same time, this care coordination between the acute-care facility, home, primary care, and the patients through the use of mobility and cloud technology has many times saved the lives of patients by decreasing medication error in assisting with medication reconciliation. At the same time, the Hackensack UMC cloud computing and mobility can generate alerts for patients and even go as far as to call a cab to take a patient to see his/her doctor. The impact of cloud computing and mobility extends to tele health and telemedicine. It has allowed us to provide great care for highly complex and chronic diseases, but the greatest benefit we have received is that it has enhanced the patient satisfaction and the patient experience. For the first time, the control of healthcare has gone back to the patient by monitoring his/her own heart rate, blood pressure, the amount of calorie intake, the speed at which he/she walks, and getting alerts to do the right thing for himself/herself.

This information is now coordinated with the patient’s electronic health record the primary care physician, the specialists and the acute-care settings. We can boldly say that with mobility, cloud computing and coordination the circle of healthcare may, for the first time, be available for people to choose and make informed decisions about a healthy lifestyle. These are the days of the patient experience and patient control. The only thing that allows us direct access to and from the heart of the patient is the mobile device connected through the cloud and back into the electronic health record.