3M Health Information Systems (3M HIS), one of the world’s largest providers of software solutions for the healthcare industry, exemplifies 3M Co.’s legendary culture of innovation. By combining the power of a cloud-based data ecosystem with artificial intelligence (AI) and machine learning (ML), 3M HIS is transforming physician workflows and laborious “back office” processes to help healthcare organizations streamline clinical documentation and billing, enhance security and compliance, and redesign the physician-patient experience.
The cloud served as the foundation for this transformation. Migrating its 3MTM 360 EncompassTM System clients to Amazon Web Services (AWS) is helping 3M HIS improve the capture, management, and analysis of patient information across the continuum of care. 3M 360 Encompass is a collection of applications that work together to help hospitals streamline processes, receive accurate reimbursement, promote compliance, and make data-informed decisions. The cloud-based version of the platform has helped 3M HIS and its clients address three primary challenges: a disjointed patient care journey; the byzantine processes that often inhibit timely and accurate billing, reimbursement, and other record-keeping; and the ongoing need to protect and properly use patient data.
Improving the patient care journey with data and the cloud
The broader objective of 3M HIS’s evolving cloud transformation strategy is to help caregivers improve patient outcomes and staff efficiencies by removing barriers to care and providing access to contextually relevant insights at the time of care, according to Detlef Koll, Vice President of Product Development with 3M HIS. Caregivers now work with consistent, reliable tools within 3M 360 Encompass that improve communication and reduce the types of errors and delays that cause patient anxiety and revenue cycle inefficiencies.
The journey a patient takes through the healthcare system can span years and touch multiple providers, from primary care to specialists, test labs, medical imaging, and pharmacies. During each step, multiple types of data are captured in the patient’s medical record, which serves as an ongoing “narrative” of the patient’s clinical condition and the care delivered. Physician notes from visits and procedures, test results, and prescriptions are captured and added to the patient’s chart and reviewed by medical coding specialists, who work with tens of thousands of codes used by insurance companies to authorize billing and reimbursement.
A complete, compliant, structured, and timely clinical note created in the electronic health record (EHR) empowers many downstream users and is essential for delivering collaborative care and driving appropriate reimbursement. Supporting physicians with cloud-based, speech-enabled documentation workflows, 3M HIS further creates time to care by delivering proactive, patient-specific, and in-workflow clinical insights as the note is being created.
The goal of this automated computer-assisted physician documentation (CAPD) technology is to reduce the cognitive overload on physicians regarding coding requirements while closing gaps in patient care and clinical documentation. Without CAPD closing that loop in real time, errors or ambiguities in the clinical note lead to what Koll describes as an “asynchronous” process, requiring physicians to review and correct the note on a patient seen days earlier, thus taking the physician’s time away from patient care and causing delays in the revenue cycle.
To address the issue, 3M HIS needed a way to semantically integrate information from multiple data sources based on the needs of various use cases, so it deployed AWS data management tools and services, including Amazon RDS, Amazon Redshift, and Amazon Athena, for what Koll calls “opportunistic aggregation of information.” For example, for billing coding, the platform extracts only the relevant billable elements such as an office visit for which a claim will be submitted. This type of flexible, cloud-based data management allows 3M HIS to aggregate different data sets for different purposes, ensuring both data integrity and faster processing. “This is a dynamic view on data that evolves over time,” said Koll.
Improving workflows through intelligent, automated processes
The process for gathering data about a patient’s care, then extracting the billable elements to submit to an insurance company for reimbursement, has long been handled by professional coders who can accurately tag each medical procedure with the correct code out of tens of thousands of possibilities. Errors in that process can lead to rejected claims and additional time required by caregivers to correct any gaps or inconsistencies in clinical documentation, which in turn delays cash flows across the complex network of physicians, hospitals, labs, pharmacies, suppliers, and insurers.
3M HIS’s cloud transformation strategy addressed this challenge by giving clients access to a new suite of data management and AI/ML tools that deliver levels of processing power, functionality, and scale unthinkable in the former on-premises model.
“If you had to build some of the capabilities yourself, you would probably never get there,”
said Michael Dolezal, Vice President of 3M Digital Science Community. With AWS tools such as Amazon QuickSight and Amazon SageMaker, 3M HIS’s clients can “get there” today: “Now our clients not only have a cloud-based instance for their data, but they gain access to tools they never had before and get the ability to do things they otherwise wouldn’t,” Dolezal said. By bringing 3M 360 Encompass to the AWS Cloud, 3M HIS has been able to scale natural language processing and automation capabilities and leverage tools such as Amazon Textract to improve data input and processing to more efficiently organize a patient’s chart.
Automatic speech recognition to capture the clinical narrative at the point of care, along with AWS AI/ML services, helps 3M HIS aggregate, structure, and contextualize data to enable the development of task-specific workflow applications. For instance, to mitigate the administrative burden on physicians, real-time dictation and transcription workflows can be enhanced with automated, closed-loop CAPD, whereby a physician dictating an admit note can be “nudged” that a certain condition is not fully specified in the note and can fix the gap in real time.
Taking frontline physician-assistive solutions to the next level, embedded virtual assistant technology can automate everyday tasks like placing orders for medications and tests. Innovating incrementally toward smarter and more automated workstreams, the 3M HIS ambient clinical documentation solution makes documentation in the EHR a byproduct of the natural patient-physician conversation and not a separate, onerous task for the doctor. This frees the physician to focus completely on the patient during the visit, thereby transforming the experience of healthcare for all stakeholders.
“We want to reduce the inefficient steps in the old model by unifying and information-enabling workflows so that documentation of the procedure and the coding of that procedure are no longer separate work steps,” said Koll. “It has the potential to save hours of time per day for a doctor.”
Enhancing the security of patient data
The security and governance of patient data is non-negotiable in healthcare, an industry subject to the most stringent data privacy regulations. Administrators are obligated to make sure patient data is consistently used only for its intended purpose, is processed only by the application it was collected for, and stored and retained according to the specific national regulations involved. The cloud gives 3M HIS more confidence that the data passing through its platform remains secure throughout its journey.
“Using a cloud-based solution means you can apply the same security practices and protocol monitoring across all of your data in a very consistent way,” said Dolezal. The platform ensures a shared responsibility for security across 3M HIS, its clients, and AWS.
Securing patient data in an on-premises health information system puts the onus to protect that information on the client’s infosec team, with risks compounded by each client’s unique IT infrastructure and internal data access policies. Security by design is one of the underlying operating principles for AWS. With a single set of code to monitor, maintain, and patch, 3M HIS is able to keep its platform current, quickly respond to new threats, and vigorously protect patient data centrally, with more certainty that its clients are protected as well.
4 best practices for data-driven transformation
Dolezal and Koll advise anyone considering moving large sets of data to the cloud to follow some fundamental precepts in designing a new solution:
Start with the client and work backward to a solution: Be clear on the problem you want to solve and the outcomes you want to deliver to the caregiver and patient and work backward from there to identify the right technology tools and services to help achieve those goals.Don’t over-engineer the solution: Many IT organizations are moving away from traditional point solutions for collecting, storing, and analyzing patient information. To reduce complexity, enhance security, and improve flexibility, consider an end-to-end solution that is easier to deploy and update than traditional on-premises solutions, and lets organizations add new functionality incrementally.Bake in security from the start: In highly regulated industries, such as healthcare and financial services, security regulations demand high levels of security and personal privacy protection. These capabilities must be built in as foundational components of any system used to collect, manage, and analyze that data.Don’t constrain native data: Create a data management strategy that accommodates all types of data and isn’t confined to a specific set of use cases today. With both structured and unstructured data flowing into the system, the future ability to analyze the past means having data schema that doesn’t need to be re-architected.
In an intense environment with a relentless focus on cost reduction and improved clinical outcomes in conjunction with greater patient and physician well-being, 3M HIS helps clients efficiently capture and access patient data, gain meaningful insights from all the data, and drive high-value action to meet complex goals.
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Cloud Computing, Healthcare Industry
