Leading in real time An investigation of the impact of real-time business on strategy and management HEALTHCARE Towards predictive medicine Written by The Economist Intelligence Unit The adoption of real-time data in healthcare is limited and scattershot, but providers are building the skills they need for the systems of tomorrow F uturists, describing the healthcare of tomorrow, often present a vision of the connected patient in the connected home—healthcare provision that is remote and pre-emptive, powered by Internetconnected weighing scales, telemedical nurse visits and smart pills that report back to the hospital to record when you’ve taken them This vision is partly enabled by new connected and wearable devices—but ultimately it is data that will bring it to life getting real-time data: you step on the scale, and within one second we know how much you weigh.” The system allows caregivers to set up alert thresholds in such a way that within a few minutes of a patient recording a metric that is out of the ordinary, doctors can conduct a telemedicine visit or dispatch a home nurse Doses can even be adjusted remotely, if needs be At the Beth Israel Deaconess Medical Center (BIDMC), the Harvard Medical School teaching hospital renowned for its innovation, this vision is already a reality This real-time, data-enabled approach to health, whether at home or in the hospital, promises a more efficient, pre-emptive care system “We have wired the bathroom scales, blood pressure cups, glucometers and other devices in the home,” says John Halamka, BIDMC’s chief information officer These devices relay information to a central electronic health record via individuals’ smartphones “We’re So far, however, the use of real-time information among healthcare providers is limited and scattershot In a recent global survey of executives across industries, conducted by The Economist Intelligence Unit and sponsored by Cisco, over one-third (35%; Cisco Technology Radar / More information at https://techradar.cisco.com the most common answer) of respondents from the healthcare sector said: “We make limited use of real-time information, but we have no overarching strategy.” petabytes of data,” he says, describing his IT infrastructure “It is impossible for my doctors to look at those data What they actually need is information, knowledge and wisdom.” Across all industries, four in ten (41%) companies have incorporated real-time information in up to half of their business processes or more Among healthcare companies, this proportion is just 27% Ensuring that data are effectively converted into useful information often requires an organisational shift At US hospital and clinic operator ThedaCare, for example, it required the integration of its analytics capabilities into operations.” As we began to really understand the power of information flow and to understand clinical business intelligence, we were able to begin to marry the analytics side of the organisation with the operations side,” explains John Toussaint, CEO of the ThedaCare Center of Healthcare Value, the company’s research division The key challenge, healthcare executives reveal, is designing processes that incorporate real-time data— 40% identify “incorporating real-time information into existing business processes” and “designing new business processes around real-time information”, respectively, as the greatest challenges to their use of such information It is vital, Mr Halamka points out, that doctors are not overwhelmed by data overload “I have four Decision support The most common goal of using real-time data among healthcare executives is to “improve decision-making across the business”, as identified by 46% of respondents in the sector What are the primary goals for your organisation's use / planned use of real-time information? % of healthcare respondents 46% Improve decision-making across the business 40% Enhance customer service, satisfaction and retention 38% Improve organisational agility Maintain or achieve market leadership in our industry 37% Better integrate functions through the real-time exchange of information 37% 33% Improve executive oversight of the organisation 31% Launch new products and services % of healthcare respondents 0% Cisco Technology Radar / 5% 10% 15% 20% 25% More information at https://techradar.cisco.com 30% 35% 40% 45% Nowhere is the potential value of real-time information more apparent than in clinical decision support (CDS) systems, which provide up-to-theminute data to help doctors decide which course of action to take The more up-to-date these data are, the better the decisions can become At Beth Israel Deaconess Medical Center’s intensive care unit (ICU) such a system provides real-time monitoring of patients’ vital signs and constantly evaluates the level of risk for each one “This application is really looking at the beat-to-beat variation, all the data coming in from the monitors from the ICU,” says Mr Halamka “You could call it ‘situational awareness’.” Meanwhile, 44% of respondents say they expect their organisation to acquire one or more companies in order to boost its real-time capabilities in the next three years This is slightly ahead of the crossindustry average of 39% and bodes well for real-time data one day leading to predictive medicine “We ought to be able to predict what’s going to happen,” says Mr Toussaint He foresees a future scenario in which automated systems could spot the emergence of antibiotic resistance within a community in time to warn doctors off prescribing them Such systems make doctors’ lives easier by automating decisions—to a degree BIDMC’s system applies around 2,000 rules to the CDS data For example, if a patient is taking one medication, it will alert the doctor not to prescribe a drug that might clash “It’s early days,” says Mr Halamka “We have these streams of data, but at the moment we lack a lot of the sophistication to really understand these data and act on them appropriately.” But there is limited appetite within the profession for fully automated decision-making For one thing, doctors are prone to “alert” fatigue, says Mr Halamka, when they are overloaded with automated instructions A study published in June 2015 found that CDS systems fail to yield recommendations two-thirds of the time, due in part to the difficulty of writing effective rules Clearly, there is much room for improvement in the use of real-time data in healthcare But there are also signs that organisations in the sector are making the investments required to make that improvement happen For example, 49% of healthcare executives say they have hired experts in real-time information This compares with an average of just 38% across all industries Americas Headquarters Cisco Systems, Inc San Jose, CA - Written by The Economist Intelligence Unit This article, written by The Economist Intelligence Unit and sponsored by Cisco, examines global organisations’ use of real-time information and its impact on strategy and management It is based on a global survey of 268 executives, just under one-third of whom hold positions in the IT department, while 47% are members of the C-suite Respondents were drawn from companies in the healthcare, transport, retail, healthcare, manufacturing and energy sectors, 49% of which have annual revenue over US$500m Asia Pacific Headquarters Cisco Systems (USA) Pte Ltd Singapore Europe Headquarters Cisco Systems International BV Amsterdam The Netherlands Cisco has more than 200 offices worldwide Addresses, phone numbers, and fax numbers are listed on the Cisco Website at www.cisco.com/go/offices Cisco and the Cisco logo are trademarks or registered trademarks of Cisco and/or its affiliates in the U.S and other countries To view a list of Cisco trademarks go to this URL: www.cisco.com/go/trademarks Third party trademarks mentioned are the property of their respective owners The use of the word partner does not imply a partnership relationship between Cisco and any other company (1110R) CISCO TECHNOLOGY RADAR ... ahead of the crossindustry average of 39% and bodes well for real-time data one day leading to predictive medicine “We ought to be able to predict what’s going to happen,” says Mr Toussaint He foresees