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Yale healthcare CIO shares what she's seeing on the front lines of digital technology in medicine
It’s hard to imagine an industry where digital technology has more of a clear-cut benefit than in healthcare, where it can extend the reach of the best and brightest medical minds to pretty much anywhere, and enable applications and “what if” scenarios that quite literally save lives.
That’s the impression you’re likely to get by talking for just a few minutes with Lisa Stump, SVP and CIO with Yale New Haven Health System (YNHHS) and the Yale School of Medicine. Stump heads up the 600-person IT group that serves the five-hospital network and its medical school, putting her on the front lines for some leading-edge applications of digital technology in medicine.
Case in point is the Tele-ICU service that’s been up and running for about a year. It involves digitally capturing patient vital signs from the bedside and transmitting them to an intensive care “bunker” at the Yale New Haven Hospital’s York Street Campus. There, the vitals are fed into decision support tools running an algorithm that can quickly detect any abnormalities.
From the York Street site, intensive care specialists, known as intensivists, monitor ICUs in hospitals across the health system, which today covers four campuses but will soon include six. When an issue arises, they use telemedicine technology that’s been around for some time, including video, to “visit” the patient’s room and diagnose the issue.
The technology enables the expertise of those intensivists to reach far beyond the confines of any physical hospital. Additionally, it presents a new business opportunity for Yale New Haven Health.
“We have the ability to extend the service to others outside our health system who want 24x7 ICU service, even in small community hospitals,” Stump says.
And it won’t just stop with ICU services. “We can make the medical specialists of Yale School of Medicine and the YNHHS Northeast Medical Group available nationally and internationally,” she says.
That’s because digital technology is driving fundamental change in the way healthcare service is delivered, she says. Today, if your primary care doctor feels you need to see a specialist, that means making an appointment, taking time off of work or school and getting yourself to wherever that specialist may be. But the advent of digital medical records (DMR) technology means those records can be made available wherever the specialist may be, and the specialist can treat the patient remotely – just as in the ICU example.
“We can make more services more accessible beyond our traditional geographic boundaries,” Stump says. “So it does create a growth platform for healthcare.”
From Fitbit to genome sequencing
Yale and YNHHS are also looking into ways to apply the logic behind its Tele-ICU service far more broadly and combine it with Internet of Things technology.
All manner of medical devices in patient homes are now sources of data about a patient’s health, from fitness trackers, to glucose and blood pressure monitors. Collecting and aggregating that data enables Yale to apply logic to it and uncover trends, both positive and negative. “We’re exploring those opportunities,” Stump says.
But that’s just the beginning. “We’ve spent the better part of two decades creating EMR solutions, deploying them and driving adoption to create all this patient data,” she says. “We’re now positioned to use that data to promote better health.”
The key to making that data actionable is human genome sequencing technology. “Genomics data are going to be the next wave,” Stump says.
Work is already underway at Yale and YNHHS to capture genomic data and use it to alert providers and patients when there’s risk of disease or some other negative outcome. It can also be used to determine which treatments will be safest and most effective.
“The way you metabolize medications is scripted in your genes, so we’ll have the ability to alert a provider that you metabolize a drug either excessively or slowly,” Stump says, perhaps drawing on her pharmacy background. “That has significant potential to drive the right therapy more immediately for an individual, rather than making decisions based on the norm and ruling things out from there.”
The technical infrastructure behind the science, which is known as pharmacogenomics, is already in place. In the coming year, Yale and YNHHS will be launching one or two pharmacogenomics programs to put the tools into practice.
Longer term, Stump can envision a day when newborns will routinely undergo genome sequencing, with the results informing their health care for the rest of their lives.
“It will become as routine as other data points we capture, like a child’s growth chart,” she says. “And it will allow your care team and you, as patient, to make more informed decisions about your health.
“Probably over the next three to five years we will see huge growth in how routine that testing becomes. For me, it’s incredibly exciting to be in an organization trying to help pave those paths.”