Wednesday, October 19, 2011

Hospital Readmissions & Chronic Condition Management




I would like to discuss the national report on hospital readmissions that came out from Dartmouth Atlas Project (http://www.dartmouthatlas.org/downloads/reports/Post_discharge_events_092811.pdf).

To start, this is the first time we have had a national report that reflects on the effectiveness of care coordination which affects readmissions. To quickly summarize the report, there was little progress in reducing readmission rates over the five-year period 2004 to 2009 and for some conditions, the readmissions rates have actually increased
nationwide.

When people get older, their health worsens. This is just how life is. With worsening health conditions, patients always have a need to be seen by a doctor in ED for various reasons. Once they leave the ED, they might end up in a nursing home, specialist clinic, hospice, and home or at any other care facility. One of the primary reasons for patients to come back to the ED within 30 days of discharge is poor communication between the various stakeholders who take care of the patients. In most cases, the care that is provided by hospitals are not compensated as most chronic condition patients are uninsured or underinsured. There is a tremendous need to improve care coordination. Another statistics that came out of the report was that many Medicare patients did not see a clinician within 14 days of discharge. This could happen when there is no tracking mechanism that is enforced by the hospital.

Without high-quality care coordination, patients will repeatedly be in and out of the hospital causing a heavy burden on hospital finances as well as increasing the total cost of episodic care. Hospital readmission rates are becoming a standard to evaluate a health systems’ ability to provide high quality coordinated care. To simply state, if hospitals can improve care coordination, the readmission rates will reduce and patients’ lives will improve while reducing costs.

As part of the Affordable Care Act, CMS will cut reimbursements for readmissions within 30 days of discharge. While this is a good step, we need to look at strategies to lower readmissions. Technology plays a major role and helps improve the care coordination process. Health Systems need to have the right set of tools and processes to manage patients once they are discharged. Providing patients with a personal health record is a first step – one that provides the tools that help patients manage their condition easily at home and also the ability for the patient to communicate to their doctor and share their health information with their care team. Then there are tools that hospitals need to outreach to these patients on a case by case basis as most chronic conditions are life long and need to be managed well. Then there is the need to connect patients with their care team irrespective of their location. If these three issues are addressed, then a Chronic Condition Management (CCM) program in any hospital will be successful. A good Chronic Condition Management solution should have good work flow and processes to support care coordination, enable strong patient outreach programs and enable patient self-management by providing the
right tool sets.

Chronic conditions have no definite end and need to be managed, and managed well.

Friday, October 14, 2011

Microsoft Mango Update Brings New Productivity to Phone Owners


Mango, the latest Windows Phone operating system by Microsoft, will formally be known as Microsoft Windows Phone 7.5. It has been getting positive reviews from industry experts. The latest review from CNET notes that Mango does an excellent job of providing benefits in three key areas: communications, new apps, and Internet use.

Launched eight months after its predecessor Windows Phone 7, Mango is bringing about 500 new features. Mango provides the following capabilities and more:


  • Background processing
  • New profiler and emulator for testing
  • Use of Silverlight + XNA together
  • Silverlight 4
  • IE9 web browser control
  • Live Tile enhancements: use of back of tiles and ability to update Live Tiles locally
  • Deep linking into apps from notifications and Live Tiles
  • Additional sensors; direct camera access, compass & gyro
  • Fast application switching
  • Networking / sockets for communications
  • Local SQL database for structured storage
  • Access to calendar and contacts for apps

As predicted by some major market research firms, such as Gartner and IDC, I can see how Windows Phone 7 will command a much higher market share than iPhone by 2015. The emphasis on consumers versus the traditional enterprise-oriented strategy by Microsoft seems to be working and doing wonders for the platform.  Mango Windows phone boasts cool new features such as Panoramic View, live tiles, Hubs, Linkedin and twitter integration, as well as Bing to name a few.

I have found it easy and simple to use the Windows Phone. The phone presents information in an elegant and simple manner without have to go through multiple clicks to get to the information you want. The design is based on the “Metro” design guidelines which help define the interaction design, motion design and the overall user experience.

To see the compelling user experience provided by the Metro UI, all you have to do is compare an application on Windows Phone against the same application on other platforms such as iPhone and Android. The difference is amazing.

Based on our experience in writing WP7 applications for Yelp, OpenTable, Intuit, Loopt and SoundTrckr amongst others, we can unequivocally say that the platform is well thought out and designed. For more information about the applications we have developed, click here.

With the news of the new Nokia-Microsoft partnership, one can expect the WP7 platform to grow even more. Microsoft will provide the much needed Marketing capabilities, Developer ecosystem and a lot of investment into platform innovation and improvement in User Experience.

iLink-Systems UX Overview - An overview of the UX landscape.

UX Today

Today, the challenges of delivering successful UX to users are greater than ever before. Whether your user is on a PC, using a mobile device, or possibly even interacting through motion on the Kinnect, the User Experience you deliver requires tremendous forethought, insight, and dedicated execution to be successful. From designing how your product will interact, to how it will look, and what technology it will run, requires UX people that truly understand how to focus your product to meet the needs of your users.

The Challenge

The current design era is defined as “User Centric” meaning, users are no longer expected to learn and adapt to your product, rather, your product should be instantly intuitive, usable, and effective. From Google’s stark “homepage” design, with nothing but a search box, to Apple’s iPhone, which made mobile mainstream, users now expect to be able to meet their needs without a manual. Moreover, users also expect their experience with products, whether on the web or smart phone to be consistent and effective.

UX is at the heart of this challenge. Over the last 10 years, many companies defined UX as a “look and feel” issue, but it’s now quickly become a science, and the core of many product development teams. Companies need a competent approach to delivering good user experience to customers and a UX team that can:
  •  Understand the users’ needs and/or problems.
  •  Identify and design a streamlined user experience to meet the users’ needs.
  •  Design an interface that is cutting-edge, intuitive, and engaging.
  •  Learn from the user and improve the experience.

The Solution

Delivering on UX can be a daunting task for many companies but there are successful paths for companies to follow that help to ensure user experience success. At iLink-Systems, we have worked with 100’s of clients to understand common challenges companies face, what motivates users to interact with products, and how to deliver a user experience consistent with a company’s vision. Common principles of successful user experience include:

•  Engage and excite your user.

Technology has made it possible to deliver rich, engaging, and amazing experiences for users whether on the web, a smart phone, or a desktop application. Companies can now truly deliver on always creating exciting interfaces that engage the user with richer interaction.

•  Don’t reinvent the wheel.

Companies can learn a lot from what has already been done. Its important companies understand what kinds of interaction users are comfortable with in today’s world and take advantage of that knowledge.

•  Provide ROI for your user.

Every time your user clicks something in your application, they should get a return on their investment of time in using your product. If a product’s user interface is focused and positioned to solve a user’s problem, then the user will feel the value of your product. At iLink-Systems, we focus a lot of our energy on making a product useful and effective.

The iLink-Systems UX Advantage


iLink Systems team of UX professionals provides clients with a holistic understanding of what successful user experience requires. From Interaction Design (how a user will interact with your product to solve their goals) to Visual Design (the look and feel of your product) to the UX development (what technology you choose and how it behaves), the iLink Systems UX team has extensive knowledge in each domain. By utilizing a proven UX partner, companies can understand the challenges and goals of User experience design and development and deliver an experience with the user at the center and create an experience that is both effective and cutting-edge.

About Peter Denton, UX Manager of iLink-Systems

Peter Denton has been working in UX for the past 10 years on projects ranging from Enterprise-level collaboration to social-networking startups. He has experience in designing brand experience as well as developing user interfaces, working with companies such as Microsoft, GE, AT&T and many others.


Thursday, October 13, 2011

Business Intelligence For All Businesses


Exactly what is BI? Traditionally BI meant data warehousing, decision support and analysis. Business intelligence has come a long way and has transformed into a broader and deeper space as a key ingredient for aiding and executing business strategies.  Intelligence or understanding of the business is achieved through collecting key information about core business actives such as marketing, sales, services etc. and analyzing behavior of customers, staff, suppliers, so that right actions can be taken at the right time. BI system would involve continually collecting (data warehousing) information about the organizational activities and then further organizing it to facilitate analysis, reporting, data mining and catering to more diverse analysis needs.

In today’s economic conditions, to stay competitive – businesses need to react to market changes quickly and appropriately, optimize their operations as best as they can, identify cut backs and drive costs out among other things. Having access to the right information at the right time is key to this and hence you see information driven initiatives within organizations of all sizes and verticals today. It’s no surprise that Gartner Report earlier this year noted “It’s clear that BI continues to be at the center of information driven initiatives in organizations”. According to Gartner, BI and analytics is a $10.5 billion market. With businesses coming out of recession are expected to invest more in their information driven initiatives to grow this further in the next 2-3 years.
SAP, SAS, Oracle, IBM and Microsoft together control about 3/4th of the market.

As of Jan 2011, even though at 5th position in market share Gartner BI magic quadrant put Microsoft in the leader quadrant. Microsoft’s BI offering has grown 23.6% in 2010.

Gartner BI Magic Quadrant 2011
In Gartner survey, more Microsoft customers said True Cost of Ownership (TCO) was their #1 reason for selecting Microsoft as their BI vendor.


In Microsoft’s current offering in the market, SQL Server 2008 R2 combined with Office 2010 and SharePoint 2010 offer rich capabilities as part of Microsoft’s BI stack.  In the IT managed BI world, SQL Server Analysis services (SSAS) powered by SQL Server Reporting Services (SSRS) have offered centrally managed BI services. SQL Server Integration Services provides capabilities needed to bring data from preexisting IT infrastructure for Sales, Marketing, Finance and other operation management systems by SAP, Oracle, Siebel etc.



Microsoft's BI Stack

In the more recent trends of partial and complete Self serviced BI – Excel with Excel Services and PowerPivot, Microsoft Performance Point and SharePoint  BI are great choices to enable the end users with BI capabilities.

Performance point services in Microsoft SharePoint Server 2010 enable analysis and monitoring of Business Performance and Corporate Performance. Performance point enables power users create rich dashboards with ability to navigate to drill down data and perform deeper analysis all on the browser. With the ability to connect to a host of data sources including SQL Server and Excel, this empowers a power user to build necessary strategic intelligence, collaborate and share it.


Performance Point Dashboard

Excel’s Power pivot add-in is a simple and powerful way to analyze data by end user. SharePoint 2010′s ability to host an Excel document with power pivot and offer the same analysis capability on the browser makes this analysis collaborative yet protecting the data.
There are significant improvements in the reporting capabilities in the next version of SQL Server code named Denali and the BI offering code named Crescent. Stay tuned to this blog for more on that.