During this Microdosing podcast episode, host Paul Schrimpf and Jeff Terry, CEO and founder of GE HealthCare Command Centers, have a candid discussion about some of the most critical challenges in healthcare today. Their outlook is optimistic and focused on how technology can help overcome these challenges. Here’s a summary of their conversation.
What is a command center?
As healthcare providers rethink and re-engineer systems that were built decades ago, they have an urgent need for information that enables ongoing, dynamic optimization of all their resources. That’s where the GE HealthCare Command Center technology makes an impact. It’s a suite of near real-time web apps on a common data infrastructure currently used by more than 300 hospitals globally.
The command center initially meant a NASA-style mission control. But today, a command center means real-time information at caregivers’ fingertips. It is continuously putting new data to work to power the daily operations of the hospital. It can help with all sorts of things, from access to throughput to staffing and quality. For example, in the pocket of every chart nurse is what they need to have an effective multidisciplinary round or a discharge huddle to identify bottlenecks and take action.
What’s the story behind the first command center at The Johns Hopkins Hospital?
It was initially inspired by some work we did with the city of Rio de Janeiro to help them imagine how they would manage health assets for the upcoming World Cup and Olympics. And through that work, we helped imagine this health command center for the city of Rio. We didn't build it for a lot of reasons.
But we took that idea to The Johns Hopkins Hospital. There, a great leader there named Judy Wright, the then-COO, saw it and loved it. Over the course of a year, we helped them imagine what a hospital command center could be. We explored questions like: Who works there? What does it do? What are the decision rights? How is it different than what we have today?
At the core, the challenges at the Johns Hopkins Hospital were initially around capacity and access. And that work continues at all the places we serve today.
Why is it a myth that healthcare is behind in technology?
I often hear it said that healthcare is behind in technology. And I know what people mean by that. But I also think it's the case that healthcare is on the cutting edge of so much technology. While some places certainly need more technology, your typical charge nurses have an earpiece and a pager and an iPad.
But, while each technology on its own may work terrific, they're not stitched together. It all collides with the caregivers, and it's the charge nurse, the case manager, the hospitalist, who are left to sort that out. Anything that's imperfect in the software, in the process, and in the policy is left to the nurse and the care team at the bedside to resolve. That’s where we need to use technology innovations to make a difference.
How is a command center different from an EMR
EMRs are a massive achievement. They create tremendous value for health systems every minute and contribute to a foundation of digitization upon which other types of value will be created for decades.
But, in the moment you can't dig through reports from the EMR and click around. And so care teams are often working blind, lacking the actionable insights they need right now. The GE HealthCare Command Center software fills a critical need in use cases where multi-modal information is required and some component of that information regularly changes on a minute-to-minute basis. EMRs struggle with these situations for architectural reasons.
What is Level 2 software and how does it make an impact?
To understand the architectural differences as well as the interconnectedness between the EMR and command center technology, consider this: the Command Center is a Level Two platform, which means it uses data from Level One systems such as the EMR, clinical workflow software, devices, and other sources in new ways.
And I think where the industry is now is realizing -- through painful experience -- that Level One software alone is never enough because it's transactional data. GE Healthcare’s Command Center software was born out of the urgent need to close that information gap and is architected specifically to connect the data in real time.
In order to connect the dots in real time (and then create all the intelligence that such a real-time cross-system data model makes possible), the Command Center software was built to constantly ingest real-time streaming messages from various systems, process-parse-and-persist those messages in sub-seconds, organize them into a data model, constantly recompute algorithms running against that data model, and serve users with apps designed with users to meet the expectations of modern intuitive software. This approach unlocks a host of orchestration, forecasting, resource allocation, care delay identification that could result into risk and other use cases which are otherwise impossible.
How are nurses under-appreciated?
Simply put, we've used our wonderful, amazing, dedicated nurses to paper over a lot of process problems. And I don't think that's broadly understood. I think one thing this labor crisis is bringing into focus just how much we ask our nurses to do.
How can a command center help address staffing challenges?
As we’ve developed and deployed hundreds of command centers, we’ve been collaborating with healthcare providers who are rethinking the deployment of their labor. For years, every healthcare leadership team of every big health system, along with nursing schools and many others, has been talking about the coming shortage of nurses and generational change. As we all know now, suddenly in 2020 and 2021, it really arrived.
It inspires me to help with the staffing challenge and the pressure the caregivers are under. To me, a hospital nursing unit is like an army at war. The difference is that armies go to war for a month or a year, and then they go home. The nursing unit is at war forever. They are on 24-hour operations forever. And that environment inspires me. And it inspires our team. That's what we're trying to help with. We clear some of that fog of war, we give a common operational picture, and we save them so much time.
The first outcome, the very first outcome is we save the charge nurse time. We save the case manager time. We save the bed coordinator time. You know, ten minutes per patient for the bed manager. And when we do that, we know that it adds up to goodness. And that goodness can just be sanity, but that goodness can be a lot of other things. More time to do the right thing. More time to hold hands. More time so caregivers don't burn out. We’re giving time back to those care leaders.