Dr. Steve Ommen, medical director of Mayo Clinic’s Center for Connected Care
Dr. Steve Ommen, a cardiologist by training and medical director of the Center for Connected Care at the Mayo Clinic, believes that, if patients have to think about using technology in their interactions with caregivers, somebody is doing something wrong.
“Our vision is that, if we are successful, patients and physicians won’t be aware that they are using connected care systems,” Ommen says. “They’ll just be using them.”
In Ommen’s view, the use of technology ought to be simple and not impose a significant learning curve on anybody involved. He compares that vision to the way people make lunch or dinner plans. Friends might text each other, then move on to phone calls to refine their plans. Nobody thinks about the SMS technology behind the texting or about the switch to mobile voice. Whatever works is what they do.
Healthcare needs to strive for that kind of intuitive ease, Ommen says. Ideally, it also should save money, too—and not just for the healthcare system, but for patients as well.
Of course, getting to that point won’t be quick or cheap. It will require a big investment in systems, along with research and development, to make things work. It will also years to accomplish. But, among the healthcare organizations in the Digital Hospital 500, Mayo Clinic is among the farthest along.
Interest grew organically
Ommen earned his medical degree at the Mayo Clinic School of Medicine and the Mayo Clinic School of Graduate Medical Education, where he was a resident in internal medicine and later a fellow in cardiovascular diseases. Prior to that, he earned a bachelor’s degree in biomedical engineering at Northwestern University.
Ommen says he began thinking about a career in medicine during high school, which led to him taking a part-time job drawing blood at a local hospital. He attributes his commitment to connected care partly to the experience of watching heart-attack patients moved to another hospital that was qualified to administer a new clot-busting drug—a situation that now might be handled using a telemedicine link between the two hospitals.
Later, Ommen says, his interest in using technology in patient care “grew organically” from the day-to-day challenges of caring for patients. He found that using tools like secure messages were incredibly useful in managing the care of patients, especially when long distances made it impractical to do everything in the office.
“I was doing some things with my patients that seem kind of low-fidelity now,” Ommen says. But those experiences convinced him of the potential of using connected technologies to enhance patient care. About two and a half years ago, when he got the chance to head up the recently formed Center for Connected Care, he saw it as a good fit.
But why put a highly trained cardiologist in charge of what is, essentially, an information technology organization?
“That’s the Mayo philosophy,” Ommen says. Mayo Clinic, he says, puts physicians in charge of nearly everything. Having connected care as part of Mayo Clinic’s medical practice—as opposed to making it an information technology function—is intended to make it better suited to the needs of doctors and patients.
Among the services Ommen’s department oversees are:
- An online portal that patients use to communicate with care givers and keep track of their overall care. Ommen says Mayo’s portal is used by 65% to 70% of patients—roughly three times the industry standard for academic medical centers, Mayo says. The portal can be accessed via a computer or a mobile app. Ommen says that, in the past year, more than 1.5 million secure messages were sent via the portal.
- Emergency telemedicine, which uses video links to provide acute medical assessments to people who need immediate emergency care. A Mayo Clinic medical specialist connects via technology with local care teams to assess, diagnose and treat patients.
- Video doctor visits, which enable patients to have non-emergency visits—for things like following up with a surgeon after a medical procedure—from a distance. This is important, Ommen says, because Mayo Clinic’s patients come from all over the country, or even overseas. Enabling them to check in with their doctors remotely can save patients a lot in travel costs.
- Mayo’s eConsults system, which allows doctors—including those at about 40 outside practices who contract with Mayo Clinic for the service—to interact securely. The eConsults system benefits patients by eliminating the need for a second visit, in most cases. It benefits referring care providers by allowing the care management to stay within their control. Mayo says eConsults take about one-third of the time of face-to-face appointments.
- Remote monitoring of patients via devices that upload important patient data to the Mayo Clinic. Once remote patient monitoring is ordered by a provider, clinical assistants in Rochester help the patient understand the process and set up the equipment. Registered nurses monitor the information transmitted electronically through the equipment from the patient’s home. The RNs also provide support, educational information, and tools to help the patient. They might answer questions about medication dosages or help to establish new behaviors for disease management including diet, exercise, and anxiety management.
- Mayo Clinic mobile apps developed for patients or consumers. Using May Clinic’s mobile platform, patients can do things like request an appointment, view and manage details of their appointment itineraries, view test results in real time, conduct secure communication with caregivers and view radiology images and exams.
Looking forward, Ommen says, the Center for Connected Care is exploring ways to “activate and engage patients in their own care” using remote monitoring devices and automated plans of care designed for each patient. The care plans would be guided by “smart rules” that adjust patient instructions based on updated information. In other words, if a patient’s instructions might change if his or her weight goes up or down.
In addition, Ommen says, Mayo is working with outside parties to research how artificial intelligence and machine learning can be employed in patient care.
Spending About $1 Billion
Beyond the scope of the Center for Connected Care, Mayo Clinic has shown a willingness to make expensive, multi-year commitments to new technology, when it deems that to be necessary. In February, Rochester, Minn.-based Mayo said it plans to spend $996 million over the next three years to consolidate electronic health records systems onto a new centralized digital medical records system from Epic Systems Corp.
The electronic transition is a massive undertaking for an organization as big and complex as Mayo Clinic, which operates more than 70 hospitals and clinics across four states and treated about 1.3 million patients in 2016.
The medical records project started In January 2015, when Mayo Clinic, announced it would combine three disparate medical records systems onto a new Epic system that 45,000 Mayo employees ultimately will use. The past two years have been spent getting ready for the transition. As part of the process, Mayo sold its primary data center in Rochester to Epic in February 2016. The sales and lease deal was valued at $46 million.
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