A patient summons a nurse to his room. He is obviously distressed, but unable to articulate exactly what’s wrong. The nurse feels it, too – something’s not right – and yet, there are no obvious red flags.
Not so long ago, a moment like this would set off a diagnostic inquiry powered primarily by provider experience and intuition. If the patient’s instincts were right and his condition was deteriorating, it would be up to a physician’s detective work to figure out why and set in motion a solution.
Today, those same elements are in place, but with one key difference. The medical staff evaluating the patient would be empowered by a massive set of data and digital tools, electronically leveraging the patient’s own medical history as well as the experiences of thousands of other patients to narrow down a list of potential diagnoses. In fact, some of those tools might even advise the clinicians that something does not look right, long before the patient became alarmed enough to call for the nurse.1
The advancement from the first scenario to the second, from relying on the experience of one hospital to leveraging the experience of thousands of hospitals, is made possible by an expanding range of digital tools. It requires medical instruments, electronic health records, cloud-based data storage, easy-to-use software, and of course, user training.
That might seem like a laundry list of requirements, but in point of fact, those tools now come packaged together in a single bundle. It’s called software as a service (SaaS).
By now, anyone with a Google account knows what SaaS is. All those Google Docs and spreadsheets living in the cloud and accessible on a smartphone are perhaps the most obvious example of how SaaS has become a part of everyday life.
In the healthcare sector, SaaS has become a technological player, powering a wave of care innovation and optimization.2 As the technologies of big data, healthcare analytics, cloud storage, and data security have evolved beyond the capabilities of any single healthcare organization, SaaS has become a key link empowering hospitals to leverage the tools of 21st-century medicine without the overhead of building and maintaining such tools in-house.
As Andreas Tazanetakis, senior global product manager at GE Healthcare, put it, the SaaS model allows healthcare organizations to focus on their core competencies.
“If you are a hospital, your primary skill is not in building an IT design organization,” he said. “Your key focus is in building a hospital and caring for patients.”
Keeping Patients – and Patient Data – Safe
SaaS means a single subscription purchases a suite of services in one package. When a hospital buys a SaaS subscription from a vendor like GE Healthcare, they simultaneously benefit from the associated data security infrastructure. If that software company partners with a cloud services provider like Amazon Web Services (AWS), they get yet another layer of support.
“It’s the scale of Amazon and then the scale of GE Healthcare sharing security across all of their customers,” Tzanetakis said. “We can have a team that all they do all day is monitor and improve the security of our cloud installations.”
That’s a big deal in an era of costly “ransomware” attacks, which according to US Health and Human Services Department data have cost the US healthcare industry at least $157 million since 2016.3
Continual Optimization of User Experience
If data security is the must-have from an enterprise standpoint, usability is a key requirement for clinicians. A 2019 study in the journal Mayo Clinic Proceedings found most physicians were unhappy with their electronic health records (EHRs).4 When asked to grade their EHR’s usability, the 870 physicians who responded gave their systems an average grade of “F.” The study also showed a notable side effect of this lack of usability. The more frustrated a physician was with EHR usability, the higher the physician’s risk of burnout. The opposite was also true: for each 1 point higher a physician scored his or her EHR system, their risk of burnout dropped by 3%.4
As with security, Tzanetakis said the promise of SaaS is the ability to optimize user experience by leveraging the power of scale. SaaS vendors strive to evaluate and improve user experience by monitoring behavior and feedback across all users at all client hospitals. That means software teams have the information they need to respond quickly to feedback from users, and also quickly flag opportunities for optimization based on usage patterns with SaaS. Once those improvements are ready for commercialization, they can be pushed out to users in a timely fashion.
“You enable faster software cycles and can help be more responsive to the needs of customers,” Tzanetakis said.
Optimizing Patient Care
SaaS enables a level of big data analytics that would be virtually impossible for even large healthcare organizations to do in-house, and it can put the power of such analysis into the palm of a provider’s hand in the form of smartphone or tablet applications. In an optimal setting, CDS tools can provide physicians with a wealth of knowledge to support them as they make critical care decisions. Again, though, a CDS tool is only as strong as its usability. A February 2020 review article in Digital Medicine noted that design flaws can lead to data flaws.5
“In poorly designed systems, users may develop workarounds that compromise data, such as entering generic or incorrect data,” the authors noted.5
In a SaaS ecosystem, design flaws can be quickly sorted out. Moreover, users can also leverage tools like natural language processing that enable physicians to interact with data and tools in a manner as natural as conversation (think Amazon’s Alexa). Tzanetakis said this empowers providers to focus on patients, not on technology.
Fixed Costs and Fiscal Certainty
There’s one final place SaaS can transform a hospital’s operations: its budget. In a SaaS model, hospitals pay subscriptions rather than purchasing individual software or hardware components. The cost of SaaS services, therefore, represents a fixed cost, without the ongoing maintenance or surprise repairs that might be needed to house a program internally. SaaS provides subscribers the opportunity to automatically benefit from those improvements. In a sense, Tzanetakis said, SaaS has the effect of leveling the playing field, helping organizations to move at the speed of the science, regardless of whether the organization is a big-name health network or a rural hospital.
“Even a small regional hospital can have a first-class IT infrastructure, simply because they use it on the cloud,” he said.
References
1. Klepstad PK, Nordseth T, Sikora N, Klepstad P. Use of National Early Warning Score for observation for increased risk for clinical deterioration during post-ICU care at a surgical ward. Ther Clin Risk Manag. 2019;15:315-322. Published 2019 Feb 25. doi:10.2147/TCRM.S192630
2. Anderson K. How Healthcare SaaS Is Taking Off in the Medical Industry. Good Firms. Accessed July 15, 2020.
3. Bischoff P. Ransomware Attacks on Hospitals & Healthcare Cost $157m since 2016. https://www.comparitech.com/blog/information-security/ransomware-attacks-hospitals-data/. Published February 11, 2020.
4. Melnick ER, Dyrbye LN, Sinsky CA, et al. The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians. Mayo Clinic Proceedings. 2020;95(3):476-487. doi:10.1016/j.mayocp.2019.09.024
5. Sutton RT, Pincock D, Baumgart DC, Sadowski DC, Fedorak RN, Kroeker KI. An overview of clinical decision support systems: benefits, risks, and strategies for success. npj Digital Medicine. 2020;3(1). doi:10.1038/s41746-020-0221-y
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