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Q&A: Technology improves patient medical records (Includes interview)

IllumiCare is a tool for physicians to gather cost data and patient-specific risk data on labs and radiology while inputting orders into the system at the point-of-care. It was designed by a physician for physicians, as so not to impede their workflow.

To understand more about the technology and the approach, Digital Journal spoke with G.T. LaBorde, CEO of IllumiCare.

Digital Journal: What are the current issues with medical records?

G.T. LaBorde: It’s no secret that the Electronic Health Record causes a lot of challenges for clinicians. Of all the issues with usability, data quality, interoperability and more, one of the biggest challenges with the system is alert fatigue. The complaints have merit. The number of alerts constantly interrupting workflow, though intended to be helpful, are on the rise as technologists abuse the ability to fit more onto the screen. This precious real estate is being devalued, as alerts are ignored and shoved aside, studies show.

DJ: What solutions are there?

LaBorde: The solution lies in giving clinicians more control over their workspace. In doing so, we can reduce the burden of the system on the user to make it more useful, applicable to them personally, and insightful about a patient. Consider your smartphone and how many of us use it as our workspace every day. We have the ability to control the apps we put on it, where they are placed on the screen and the alerts that we receive. This design philosophy has proven successful in the implementation of IllumiCare’s Smart Ribbon technology, which gives clinicians cost, risk, opioid and other data through a floating ribbon of information that hovers over the EHR, which providers can choose to engage with or not.

In addition to a change in design, we are making the EHR more user-friendly for physicians by providing them information they can’t access otherwise. Similarly, physicians are being told to produce “value-based care,” but key inputs into that decision are not currently in the EHR. Having access to this type of information in an unobtrusive platform which they control improves their workflow.

DJ: Why did you establish IllumiCare?

LaBorde: Here is one story that shows the challenge we’re helping to alleviate. My co-founder, Mukul Mehra is a gastroenterologist, still practicing today. He had an encounter with a patient that built the foundation for the start of IllumiCare. He was consulted by a 36-year-old patient that had undergone eighteen CT scans in the prior three years. Being a physics major, he wondered how much radiation that was. It took about four hours of digging through medical records and calculating the effective doses. She’d had the equivalent radiation exposure of standing within one mile of ground zero of the atomic bomb explosion at Hiroshima…twice. Over the years, none of the doctors she had seen wanted this for her or ignored the tally; it’s that they simply didn’t have the information available to them to consider. This is what we are doing differently to help us stand out. Providing doctors with important information like radiation exposure, which illuminate the human and economic “cost” of clinical orders.

Now, the Smart Ribbon is expanding to include other apps for doctors – inpatient and outpatient opioid exposures, lab testing and frequency guidance, coding gaps, antibiotic overprescribing and more.

DJ: How did you develop the platform?

LaBorde: We started with one practicing physician’s idea and a crude sketch. But, we quickly sought the input from 140 other practicing physicians and also pharmacists, lab directors and hospital administrators. Because we see technology through the eyes of a practicing physician, everything we do is geared toward being informative while also being unobtrusive. We don’t want to interrupt the provider when placing an order or doing their work. We don’t want to clutter their workspace with things that aren’t meaningful and actionable. The platform was developed with these goals in mind.

DJ: How was the platform tested out?

LaBorde: We piloted the Smart Ribbon in select hospitals to start. The Texas Hospital Association has played an important role in piloting the technology, and we have incredible data from their hospitals. For one academic hospital system, across all hospitals/admissions, on a DRG-adjusted basis, there has been a $170.16 per admission decrease is the cost of inpatient medications, labs and radiology tests. There was a 14.2 percent average reduction of inpatient medication costs, 14.3 percent reduction in inpatient lab costs and a 5.6 percent reduction of inpatient radiology costs per hospital. Collectively, these pilot hospitals represented 143,338 annual inpatient admissions.

DJ: How have you addressed data security concerns?

LaBorde: In every way, security is built into the design of the system. We use the ISO 27001;2013 framework to ensure that our systems, processes and people are aligned with best practices.

DJ: How do you differ from your competitors?

LaBorde: While there are other platforms that send messages and alerts within the EHR, there is really no platform that operates like the Smart Ribbon, with the ability to be unobtrusive to workflow. Additionally, we are unique in the data we provide alerts on, focusing on patient-specific actionable information at the point-of-care that the provider would not know otherwise, like the cost of a medication and alternative options.

Our controlled substance app for the Smart Ribbon is a very unique offering to hospitals. Current tracking solutions in the hospital don’t show clinicians inpatient opioid exposure data because they contain only outpatient exposures reported to state Prescription Drug Monitoring Programs. To make the best treatment decisions, clinician’s need a full understanding of both inpatient and outpatient exposure, so we are closing the gap. The app provides comprehensive information on a patient’s opioid history based on the PDMP, tracks use in the hospital, and shows alerts at peak thresholds of administration. This allows providers to be more judicious in prescribing opioids based on a patient’s history and make better decisions about appropriate dosage.

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Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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