Every year, the HIMSS Conference & Exhibition acts as a barometer for the healthcare industry. In mid-March, healthcare chief information officers, technology partners, and thought leaders convened at HIMSS22 for the first time in two years. This year, in Orlando, there was a palpable feeling of reunion, and energy was high as technology leaders shared insightful panels, discussions, and product and partnership announcements.
Quisitive’s very own Pat Becker, Chief Strategy Officer of Healthcare, was in attendance as a guest and demo presenter at Quisitive’s booth in the Microsoft pavilion. In the sections that follow, she shares her top five HIMSS22 takeaways and reflections.
Top 5 HIMSS22 Takeaways
1. Healthcare organizations are prioritizing health equity initiatives and access to care
Stark outcome inequalities emerged throughout the COVID-19 pandemic, which helped spur a national conversation around health equity. The topic was in constant discussion at HIMSS22 and figured heavily into keynote content and healthcare leaders’ strategic priorities.
Under discussion was the role of data and AI in helping to address and minimize health inequalities across America. Government and healthcare organization leaders shared strategies that focused on the collection of accurate and up-to-date patient data, which become critical foundations of any health inequity action plan. The CMS Equity Plan is prioritizing the collection of race, ethnicity, and language (REAL) demographic information. Along with social determinants of health (SDOH), adverse childhood events (ACEs) and other screeners, organizations can help develop culturally relevant and community-centric care plans, and help equip providers with relevant information to aid during visits. Quality and population health leaders can leverage organization-wide data to help identify broad gaps in care trends and drive actionable insights that can help identify and reduce disparities.
2. The healthcare at home movement is rapidly maturing
Moving the site of care homeward has long-promised benefits both to healthcare systems, but also to patients – helping to boost satisfaction while saving organizations money. Accelerated by the pandemic, and further driven by the increasing consumerization of healthcare and renewed interest in value-based care contracting and population health management, the movement enables patients to access care anytime, anywhere. Remote patient monitoring solutions that integrate seamlessly with the organization’s EHR are key, as are reliable and secure virtual care solutions that can easily connect patients and providers.
While lingering uncertainty remains among both physicians and healthcare organizations due to piecemeal reimbursement legislation, systems must be prepared for the growing consumer expectation.
3. Behavioral and mental healthcare are central to overall wellness
Covid-19’s long-term impact on behavioral and mental health will continue to manifest. Social isolation and loneliness have taken a deep toll, and according to U.S. Surgeon General, Dr. Vivek Murthy, we’re currently experiencing a “national youth mental health crisis.” Since the pandemic’s onset, the national conversation around mental health has blossomed.
This year’s event was no exception. Among attendees, there was a new general consensus that behavioral healthcare and physical healthcare are intimately intertwined. For patients, that means organizations are considering new ways to provide integrated care that will help remove silos and redefine “holistic healthcare” in a whole new way. For organizations, rising levels of provider burnout and clinical stress are challenging workforces and their ability to provide high levels of quality care.
4. The healthcare cloud is growing
Connections happen in the cloud. At HIMSS, leaders discussed the rise of the cloud and the benefits of migrating systems to support patient-centered, collaborative care. At the Microsoft Cloud for Healthcare booth, the conversation centered around improving the patient experience and leveraging data interoperability to empower clinicians at the point of care. The solution is built to boost patient engagement, empower clinical team collaboration, prioritize sensitive patient data security, activate data for actionable insights, and drive seamless data management for clinical and operational insights.
Built on Azure technology, the health cloud leverages data services to easily unite in-person clinical workflows, with images and screenings, medical devices, and more. The company is building out its Teams product to better support the adoption of telehealth, including virtual care visits and seamless integration with the largest EHRs.
5. AI and machine learning will power advances
Artificial intelligence-driven predictive models and screenings will help generate new efficiencies with applications that will reverberate across the industry. Faster methods of data entry, ingestion, and sharing can help advance interoperability while alleviating the manual burden on existing staff, which could help moderate the clinical burnout crisis and pervasive workforce shortage.
On a macro scale, predictive models can also be applied to emergency forecasting that will enable systems to prepare in advance of any future pandemics or infectious disease outbreaks. Attendees acknowledged that gaining broader patient-consumer trust around AI, natural language processing, and other machine learning techniques will be critical for the technology’s continued adoption and long-term use.
Towards a more connected future
Overall, this year’s event was both a reunion celebration and a resetting of priorities for the rapidly evolving healthcare landscape. While reconnecting in person, themes of connection overall resonated throughout keynotes, demos, and discussions. Building greater and faster means of connection is key, from greater inclusion in healthcare to reducing stigma around mental health, and incorporating a broader set of patient demographic data to help expand equal care and coverage.
Underneath it all ran a common theme: technology will help improve outcomes by creating new means of connection and collaboration. From telehealth and healthcare at home to seamless data integration across the cloud and EMRs, and the potential of AI to expedite critical population health initiatives, technology promises the healthcare industry a means of providing patients equal, safer, and better care.
New uses and applications of technology are increasing, partly thanks to Covid-19. While already rapid, the pandemic has served to accelerate the pace of digital innovation and transformation. From the new adoption of telehealth to predictive analytics, digital contact tracing, and remote patient monitoring, the pandemic has fast-tracked digital transformation across the healthcare industry.
Throughout the pandemic, Quisitive has anticipated the shifting paradigm of consumerism in healthcare, working to identify the role technology must play to meet new challenges and deliver on the promising new models of care delivery. The sections ahead reflect on the past few years’ massive advances, anticipate upcoming developments, and identify the biggest trends in healthcare technology for 2022 and beyond.
Innovations that will advance healthcare delivery
Ultimately, technology is in service of human needs; it must always adapt to meet the needs of today. And today, the prevailing winds of innovation are driving agile advances in technology. That is the most thrilling aspect of technology today, for me. Over the last two years, healthcare leaders have become aware they must focus on migrating all apps, solutions, and data to the cloud.
Most recently, FHIR capabilities address roadblocks to tech enhancements in healthcare by ensuring cybersecurity and availability of all data for simple, secure exchange. With this infrastructure in place, organizations do not have to replace their entire tech stack – it’s actually much easier. The most exciting thing about healthcare technology today is the increasing popularity of open architecture for seamless communication and secure data sharing. We ensure that healthcare organizations can leverage their existing EMR, point solutions and vendors so that they can integrate new technologies into current workflows and deliver the greatest value to administrators, providers, clinical staff, and patient-consumers.
To address the challenges of today, lean in to the consumerization of healthcare
Open, secure architecture and agile platforms will have great implications for addressing two of the biggest pain points for healthcare organizations today: burnout and the rising cost of providing care. Pandemic care provider fatigue, rotating sickness, and general staffing shortages mean that there are not enough staff and provider resources to accomplish all the tasks needed. In turn, this spurs a vicious cycle, as it increases pressure on the workforce that remains, fueling the likelihood of additional burnout rates. When cloud-based technology is leveraged so that systems can communicate, openly share data, and accomplish tasks, efficiencies are realized. Nurses and front-office staff will spend less time on manual data entry and ordering processes, because the systems will be able to automatically input and transfer data. Schedule management, prescription fulfillment, form entry, data management, and more will become automated, freeing up valuable clinical and administrative bandwidth and time so that they can rededicate it to patient care.
On the other hand, the costs of providing care are rising. The existing supply chain technology built twenty years ago is not equipped to respond to the disruptions and inconsistencies of today’s supply chain. Without deep visibility into inventory, consumption, and pricing, healthcare has always operated on a “Just in Case” supply chain mentality, which resulted in waste. Now, healthcare must move from “Just in Case” to “Just in Time” inventory management, so that forecasting, ordering, pricing, and inventory management are in sync and based on data-driven consumption, transparent pricing, and accurate timelines. This will help reduce the bloat in procurement and inventory management and can mitigate the effect of shrinking margins on the industry as a whole.
Healthcare technology must become ‘situationally aware’
Throughout the pandemic, Quisitive has anticipated the shifting paradigm of consumerism in healthcare, working to identify the role technology must play to meet new challenges and deliver on the promising new models of care delivery. From our Supply Chain Management and eProcurement solutions to Back to Work and VaccineFlow, we were able to leverage Microsoft Cloud for Healthcare infrastructure to create responsive solutions that support organizations facing immediate and very real challenges today.
More broadly, as individuals, we’ve become accustomed to the idea that technology responds to what we need at any given moment, even if we did not originally plan for it. Consider Uber; the app is able to update in real-time in response to an array of unforecasted factors, including traffic, changing locations, payment models, additional stops, human whim, and more. Every industry needs to adapt in this way. Healthcare must continue its focus on leveraging AI and cloud capabilities so that we can make use of the data we already have to plan for situationally aware decisions.
AI, NLP, and other innovations will unleash the promise of virtual care
About seven years ago, we began an autonomous application thought exercise designed to build out technology applications that thoughtfully apply to very real patient care pathways. For instance, we might know that three days after a patient returns home following surgery, she needs to take a series of medications and change bandages. We developed dashboards knowing that certain activities need to be performed, so we can build in reminders along the way. This way we can scale recovery management for thousands of patients at a time, instead of placing the burden of individual and direct outreach on a small and overworked nursing team. Our initial version of Mazik CarePath was the first step in orchestration of care leveraging tech automation.
Now, we are making the tool even smarter by building AI into the algorithm. Based on a series of factors, patient data inputs, and timing, the technology will create necessary recommendations and interventions to optimize the best next step in care management. The world of connected devices is making this process even smarter. Remote patient monitoring devices, such as blood pressure cuffs, blood sugar monitors, anticoagulant devices are already connected and can securely provide data so that the system can offer intelligent recommendations. Now, back to that concept of leaning into consumerization. Consumers expect that their wearables will also play a role in their healthcare decisions. Apple, Samsung, and Google devices connect data on a daily basis; connecting these devices to patient portals and the EMR will deliver another layer of value – and increase patient satisfaction. It’s up to us to manage security guidelines and ensure patient privacy is respected.
Our top development priorities: deployment speed, the patient experience, healthcare at home
From founding to present day, Quisitive strives to develop agile applications that may be practically applied to create efficiencies and address the very real pain points of today. With that in mind, there are three main areas we’re focusing on to deliver the greatest value to our partners:
- Expediting deployment
The general idea is that faster deployments yield faster value for our partner organizations. As there are so many nuances involved in data interoperability, it can cause delays in implementation. Leveraging four different technologies on Microsoft Azure, we’re developing a pre-built EMR connector that is already configured to seamlessly integrate with Epic, Cerner, and many other EMRs. It will reduce deployment time significantly. It will enable us to instantly connect everything within the platform on a unified tech stack, to vastly reduce implementation timelines – and headaches for any tech stakeholders.
- Enhancing the patient experience
The patient experience is infamously fragmented. With various EMR integrations, a single patient may have multiple patient portal accounts, sometimes as many as four to five. We believe the experience should be decentralized from the EMR, and reimaged around the patient-consumer him or herself. This will help create a more connected system that can automatically deliver health insights for both patients and providers, integrate data from wearables and daily life, and deliver the benefits of remote patient monitoring (RPM) more directly.
- Expanding virtual health scenarios
Covid-19 will continue to drive new ways of delivering healthcare. Home healthcare will continue to grow in popularity and importance, especially as the hospital becomes more a site of care for emergency application and long-term healing. Quality of care measures will continue to reinforce these trends, as deeper, long-term and remote relationships will equip healthcare providers with the ability to help manage better daily quality of life for patients with chronic conditions. To that end, we are working to support new ways for providers and patients to connect virtually – both for visits and RPM. We will leverage Microsoft technology, including Teams, to facilitate these appointments and integrate patient-generated healthcare data directly into the patient portal and EMR.
Ultimately, innovations on the backend will power human-centric solutions designed to respond to the real-time needs, momentary changes, and incoming data generated by patients and providers. Building on the cloud will usher in a new era of secure, agile technology developed in service of today’s workflows and patient journeys. Completely new healthcare scenarios will be identified, such as the emerging use case of the virtual ICU.
Digital health platforms connected to wearables and patient remote monitoring devices will lighten the burden on hospital staff and the emergency department by enabling quality care for specialized treatments in the safety and comfort of a patient’s own home. The virtual ICU, integrated patient portals, and other enhancements to the healthcare experience like these, will unlock new workflow efficiencies and cost savings, drive greater patient satisfaction, deepen patient-provider relationships, and result in a higher overall quality of patient care – both inside and outside of the hospital walls.
As healthcare providers increasingly focus on improving patient care, they need to find innovative and streamlined solutions for four core areas of change – system modernization, supply chain, virtual care, and data insights. These topics are all covered in this blog, which summarizes the key takeaways from the recent Healthcare Technology Summit hosted by Quisitive.
It’s vital for healthcare systems to address three important business drivers in order to meet new challenges and offer advanced patient care at competitive prices. Medical technology innovation, strategic technology transformation, and structural change must be on the radar of all health systems.
Medical Technology Innovation: New therapeutic, diagnostic and care innovation models are arising from the move toward digitalization, medical innovations, the advancement of science, and new technology entrants. Providers must adapt and align to make sure they are ready to deliver in these areas.
Strategic Technology Transformation: Major changes are on the way concerning how the industry uses technology, arising from applied innovation, disjointed user experiences, and disruption in technology standards and architectural principles. As a result, systems need to innovate with the cloud, data analytics, and artificial intelligence.
Structural Change: Healthcare is no longer confined within the four walls of a hospital. Retailers, digital giants and digital natives continue to expand their reach into care delivery with virtual care, wearable integration, and primary care or chronic condition services — putting pressure on providers to accelerate competitive offerings and partnerships. New competition can be great for consumers, but healthcare systems must adapt and drive change to meet patient needs in the digital age.
Supply chain operations represent a huge opportunity to trim costs while improving patient outcomes. Given that supply chain costs account for 37.5% of total patient care expenses, just behind labor, it comes as no surprise that there is a strong movement to include the supply chain in efforts to reduce costs and enhance the patient care experience.
For example, it is common for clinical staff to spend large amounts of time managing inventory on the floor and conducting other supply chain-oriented tasks that take away from time with patients. By installing new technologies, such as an ERP system that automates and streamlines supply chain processes, El Rio Community Health Center was able to return over 5,000 hours a year of clinical time to caregiving activities. In some cases, nurses were spending up to 20 hours a week on supply chain tasks such as inventory control and order procurement.
“The importance of being in tune with your supply chain is [crucial] to ensure that we can always provide the best care.”
– Tim Snowball, Procurement Director for El Rio Community Health Center
Investing in a dynamic ERP system has brought numerous benefits to El Rio, including improved visibility into inventory levels and the ability to rapidly ship orders from its warehouse, often within hours of receiving an order. In addition, El Rio has full insight into PO confirmations and automated reorder levels throughout its warehouse.
When pursuing these improvements, it is imperative for health systems to develop KPIs for specific supply chain management tasks. A few key ones include:
- Supply expenses as a % of net revenue
- Spend under management
- Inventory turns
- Supply FTEs per 1 million total non-labor supply expense
- Expired products as a % of total on-hand products in inventory
In the age of digital healthcare transformation, consumers are in the driver’s seat. Consumer-centric patterns emerged before the pandemic, but the global health crisis caused a paradigm shift from the traditional patient experience to the world of virtual care, where consumers have more choice. For example, the pandemic accelerated the movement to health clinics provided by retailers like CVS, Walgreens, even Walmart. When traditional healthcare systems had to limit appointments during the pandemic to protect staff and patients, these retail health offerings grew exponentially. Many consumers already have existing relationships with these retail providers. Healthcare systems recognize this trend. Because they are not in a position to compete on price point, some systems are collaborating with retail providers by acknowledging that they represent a strong alternative for select urgent care services, but not for everything. In those cases, systems are utilizing referrals.
Healthcare systems need to consider that virtual care provides an opportunity to expand their customer base into at-risk and underserviced regions. Ideally, virtual care increases access to care for everyone. However, issues around health equity prior to the pandemic only increased during the health crisis.
“Health systems must ensure that virtual health is a tool for good … and doesn’t actually increase healthcare inequalities.”
– Antoinette Toni Thomas, Chief Experience Officer, US Health & Public Sector Industries, Microsoft
Healthcare systems can address this by evaluating patient populations to determine how many customers have access to laptops, mobile phones, and the Internet. It is also crucial to evaluate the availability of 5G networks in your service area, as virtual health visits perform best over 5G. Providers and payors can utilize data insights to better understand populations leading to improved virtual healthcare offerings and outcomes.
Data is a crucial tool when it comes to the growing focus that healthcare providers place on patient satisfaction, physician engagement, and quality of care. The use of data can have a major impact on many areas, including:
- Increasing patient care plan adherence
- Reducing patient no-show rates
- Determining propensity to pay
When it comes to patient no-shows, a missed appointment represents less of an operational challenge than it does an actual quality of care challenge. Initial visits and follow-up visits are critical aspects of the care chain to ensure that patients adhere to scheduled treatments. Data analysis tools can help to identify the most significant factors driving patient no-show rates and can reduce the frequency of these events by enabling new approaches to improve patient communication. Analyzing demographic variables such as insurance type, geographic location, and the time of day of an appointment, for example, can help to determine which patients respond best to certain kinds of messaging, thereby helping to reduce missed appointments.
“Data analysis can identify factors that may cause some patients to avoid care because of an inability to pay.”
– Robert Carek, Project Executive, Director Global Solution Development at Quisitive
Similarly, data can have a major impact in analyzing patient demographics to determine their propensity to pay. Non-payment of healthcare costs is a significant factor in most healthcare system’s bottom line, usually because of the client’s inability to pay, or because of fraudulent use of insurance. In turn, solutions can be put into place to work with this population. It is vital for patients to get the treatments they need, and providers should utilize data to identify patterns that indicate which patients are more likely to face challenges when it comes to paying their bill.
Quisitive’s Healthcare Technology Summit emphasized that data is a company’s most important asset, and is often underutilized. Our healthcare solution, MazikCare, provides powerful access to real-time data – leading to more informed healthcare decisions and improved patient care.
Vaccine management is a top concern for those of us who are planning to return to work, school and community activities. Restrictions and guidelines have been changing day by day. And with the rushed rollout of vaccines, there isn’t a consistent or agreed-upon way to track who has been vaccinated, and who hasn’t.
Quisitive’s MazikCare Vaccine Management, however, allows you to do just that. With our Covid-19 vaccine management solution, you can consolidate all of the vaccine information of your employees, staff, and students, all into one easy-to-use app.
With MazikCare Vaccine Management, you can:
- Enable users to create digital vaccine passes.
- Track the vaccine status of members and visitors at your location.
- Know who’s experiencing symptoms in your school, office, or community.
- Automatically send out reminders and notices for users to log responses.
Fast-track and digitize your Covid-19 management process. Our solution is intuitive, quick-to-deploy, and affordable. Most importantly, it will help you keep your population healthy and functioning.
MazikCare Vaccine Management has been successfully implemented at numerous high-ranking institutions and locations such as Denton County, Purdue Pharma, Fresenius Medical Care, Virginia Mason Memorial, and Johns Hopkins. Ensure your community is protected, too.
Unifying organizational systems is not optional if you want to reduce data errors, streamline operations, and create actionable analytics. Dynamics 365 Finance and Operations customers understand the value of data extraction, importation, and translation to create seamless data flows between in-house and vendor systems. This article will give readers information on how to get started accomplishing the much-needed integrations.
Users are required to perform double key entry as vendor systems are not out-of-the-box integrating with our system of record, Dynamics 365 Finance and Operations. We can perform imports and exports with some vendors, but it seems we always need to massage the data. Also, flat files with PII are having to be encrypted and maintained manually outside the system.
Furthermore, employee additions and updates are not getting to the payroll vendor, end of month invoicing is painful, and mistakes happen due to double entry by hard-working quality conscience individuals. We need to unify and streamline our operations quickly.
There are several options for data exchange with Dynamics 365 Finance and Operations. The most common is the file-based Batch Import/Export feature, which is utilized for timed runs as needed; typically, nightly once business activities have subsided (ETL).
Unfortunately, at this time the Microsoft Common Data Service used by D365 CRM and many other platforms is not available for use with Dynamics 365 Finance and Operations. However, there are several 3rd party OData Clients for Visual Studio that can serve the purpose, but most are heavy and somewhat cumbersome to implement.
As a result, we created several smaller OData C# repositories within Azure Functions for real-time integrations with the various Finance and Operations modules such as Vendor Payments, Invoice Journal, and Employees. These smaller units of work helped create fast decomposed services, which can be deployed separately and often.
Figure 1 – Integrations Architecture and Process Steps
1. On post of such D365 entities as Vendor Payment and Invoice business events are relayed to the API Management (APIM) endpoint.
3. The Logic App now starts its orchestration.
4. First, it fires the Function App GET method.
5. This invokes the required OData query to gather the newly entered Dynamics 365 Finance and Operations information (Invoice, employee, payroll, …).
6. Next, the Logic App sends the queried information to the Integration Service where it is transformed from OData Json to Common Data Model (CDM). Note: The CDM has the ability to house all organizational data and is ‘common’ amongst inhouse systems.
7. CDM then gets stored in CosmosDB for consumption by various services.
8. Finally, the frontside Logic App publishes to the appropriate service bus topic and subscription.
9. The backside Logic App subscribes to the newly posted business event and goes to work.
10. Step 1, it fires off the Function method to go get the new CDM data.
11. Step 2, it uses the Integration Service to transform CDM into the appropriate ‘Consumer Data Model’. Note: The CDM could be transformed into XML, Json, HL7, flat file, or whatever the receiving party requires.
12. Step 3, the Function method takes the transformed data and pushes it out to the 3rd party receiver, which includes SFTP, REST, Shared Folder, SOAP, and other protocols.
13. Azure Active Directory where D365 is registered in order to acquire JWT tokens and securely interface with the Dynamics 365 Finance and Operations data store.
Figure 2 – Example Business Event Wire up
This is not a one solution fits all scenario. Depending on your application stack, dataflow, and D365 F7O usage an entirely different design could emerge. Some of the options we considered include:
- Utilize 3rd party OData Client within Visual Studio
- Secure App Service Web API over serverless functions
- Logic App Dynamics 365 Finance and Operations Connector (ISE prohibited us from using this option)
- Mappings and transforms within the C# code (AutoMapper or equal)
- SQL instead of CosmosDB
Solution security is met with implementation of Azure ASE and ISE environments, data encryption at rest and in transit, APIM encrypted API calls (TLS & JWT), user and app authentication & authorization, and the suite of Azure tools for security, alerting, and logging.
Not depicted are the typical NSGs, RBACs, Firewall and a ‘Zero Trust Security’ posture required by healthcare systems today.
Our selection for IDE was Visual Studio. We needed a robust set of features and capabilities to handle all the different demands required by the various vendors and in-house systems. We used Postman and Microsoft Edge Beta (Developer) for building and testing our OData queries and we used Table Browser Caller in Chrome for viewing Dynamics 365 Finance and Operations entities and tables.
Figure 3 – Example Postman GET Employee call
Asynchronous, message-based, decoupled, and decomposed services are the key to scalable, durable, and successful integrations. Keeping components siloed, so they are testable and deployable without effecting other systems will serve you well.
Make security a no-compromise part of the design from day one. From the first line of code, all the way through to production and you’ll have happy users.
If integrations were easy, we’d all be throwing Machine Learning on a pile of data and creating actionable outcomes to bolster our futures. The truth is working with multiple vendors to create easily maintainable integration endpoints can be difficult.
Let’s keep it as simple as possible and set realistic goals and timelines.
Dynamics 365 Finance and Operations has now been broken up into 4 distinct modules:
- Dynamics 365 Finance
- Dynamics 365 Supply Chain Management
- Dynamics 365 Commerce
- Dynamics 365 Human Resources
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Currently, the organization is using email and SMS text messages to communicate with customers. As a result, process timing can be disrupted, the company loses valuable insights from data, and missed opportunities to serve their customers abound. They need a unified solution for housing customer service and sales conversations initiated by their mobile app.
1. Mobile users cannot be maintained through our organizational Active Directory
2. Mobile users need to authenticate through a different provider, yet be under our control
3. Customer conversation data security is essential
4. Understanding customer sentiment, top questions, and common interactions are needed
5. Integrations with our current Dynamics 365 user base is critical
6. Conversations must be saved for at least two years
7. Solution must be intuitive with minimal learning curve
8. Should easily integrate with our suite of office software and business workflows
There are multiple ways in which to approach this paradigm; however, the time constraint of implementing a scalable messaging solution within 2 to 3 weeks was motivation for using as much in place technology as possible and why we chose Microsoft Teams, conversation bots, and Azure for our solution.
The below reference architecture outlines the as-built solution, which includes the following components:
- Azure AD B2C
- Azure API Management (APIM)
- Azure App Services (Web and Messaging API)
- Azure Bot Registration Service
- MS Teams Conversation Bot
- MS Teams
- Notifications Hub
- Integrations – Azure Logic App, Function App, Service Bus, and D365 Common Data Service
Figure 1 – Teams Bot Solution Architecture
Component Architecture Examination
1. Mobile app incorporates a typical messaging component for sending and receiving messages.
2. All inbound traffic must go through APIM for first line of defense and examination for routing to the WebAPI.
3. Once traffic passes the APIM it can hit the various messaging calls including CRUD operations and Teams user ‘Presence’ indicator.
4. Messaging Service serves as the orchestrator for routing to the various backend resources including Azure Bot, CosmosDB, Notifications Hub, and Dynamics 365 CRM where messages get stored as Account Activities.
5. Azure Bot receives the mobile user message and pushes that message to the Teams Traffic Manager.
6. Teams America Traffic Manager endpoint (for today, for our region) and facilitate the Azure Teams bot wire up.
7. Teams Bot holds the commands for user interactions such as /Reply and /Help.
8. MS Teams where customer service or sales will respond to the mobile user message.
9. Bot authentication resides in the hands of Azure AD App Registration.
A. All send/receive messages are stored in CosmosDB containers for analysis and mobile app interactions.
B. Dynamics CRM holds the Teams users from customer service and sales and is integrated into the solution (CosmosDB) via Logic App, Service Bus, and Function App components.
C. Backend tells Notification Hub a new message is available from customer service and a push notification is sent to the mobile app.
Conversations initiate from the mobile app where the user will have need to contact customer service or sales for various reasons such as project state, order processing, or patient information.
Mobile app messaging commands go through APIM to the Web API for authentication, validation, and routing to the called Messaging Service method. As previously stated, the Messaging Service acts as the command orchestrator.
1. Save sent and received messages to CosmosDB
2. Send direct messages to Teams user
3. Push Teams user replies to the mobile app
4. Instantiate push notification on message replies
5. Post all message data to Dynamics 365 CRM as an Account Activity
6. Integrate CRM customer service and sales account personnel
Messaging Services works in conjunction with the Azure and Teams Bots to help facilitate these commands.
Figure 2 depicts the start of a conversation between the mobile app user and customer service within the Teams client. The bot prepends the mobile user’s name, account number, and generates a unique message id, which will be used by customer service to keep the conversation going.
Example of how to code Teams Bot Reply Command [Stephen PhysicianC][Client A] Message Id: egCIsZbvGid – Hey (Microsoft Teams in Healthcare).
Figure 2 – Teams Bot Reply CommandThe /Reply along with the message id tells the bot to route the message back to the mobile user and extend the conversation. This satisfies the requirement of not having to add mobile users to the organizations AAD or Teams as guests, which greatly reduces maintenance and onboarding.
Figure 2 – Teams Bot Reply Command
Figure 3 displays the simple Bot Command available to the Teams user including /Reply, /Help, and /CacheTeamsInfo, which stores Teams data in CosmosDB for conversation setup from the mobile app side shown in Figure 4.
Figure 3 – Teams Bot Command Set
Figure 4 – Teams Bot / CacheTeamsInfo Command
Solution security is met with implementation of Azure ASE and ISE environments, data encryption at rest and in transit, APIM encrypted API calls (TLS & JWT), Bot and user authentication & authorization, and the suite of Azure tools for security, alerting, and logging.
Not depicted are the typical NSGs, RBACs, Firewall and a ‘assume breach’ posture required by healthcare systems today.
Messages can now be analyzed, insights gained, customer interactions bolstered, and no more text messages on employee mobile phones or emails that are hard to mine. The organization now has the well supported MS Teams as its messaging backbone.
Furthermore, messaging history can be viewed in Dynamics 365 CRM, Power BI is wired into CosmosDB messaging data for analysis, and the solution is set up for phase 2, which will include multiple AI components to better serve their customers.
Healthcare messaging just got better.
The Role of Natural Language Processing In Managing Healthcare Records
Healthcare record management is a common pain point for medical professionals who need organized information so they can provide efficient treatments to patients. Healthcare records can be extensive and detailed, filled with vast patient medical history information that’s crucial to review before beginning the diagnosis and treatment processes.
Natural language processing is an automated and advanced way for medical professionals to manage these healthcare records and identify key elements pertinent to their patients. When a comprehensive natural language processing system is implemented efficiently, it can eliminate the task of flipping through hundreds of pages of handwritten records to find a patient’s last bloodwork results or past surgery date.
A synopsis of the important medical events and recent health developments is right at the medical professional’s fingertips and records are safely stored and organized on the cloud. Natural language processing saves time, which is an important resource that can save lives in the healthcare field. Learning more about how natural language processing works in the medical industry will help you find out how this feature can improve your medical record-keeping processes.
What Is Natural Language Processing?
Natural language processing is an automated procedure that involves artificial intelligence and computer algorithms. The complex system scans numerous documents quickly, interpreting the language, and picking out the crucial elements to summarize important pieces of the documents.
With a natural language processing system in place, medical professionals could review a synopsis of their patient’s records that highlights the important elements and historical medical information. It’s one vital aspect of cloud computing that makes record management more organized and efficient. Medical records that are summarized and kept safely in the cloud are easily and quickly accessible for all medical professionals focusing on a patient.
Making Sense of Billions of Healthcare Records
Data is a crucial element to healthcare and patient treatment, which is why medical records are comprehensive and exhaustive. They can include aspects that relate to:
- Clinical data.
- Patient information.
- Pharmaceutical records.
- Financial details.
- Research and developmental elements.
According to Stanford Health, healthcare records are consistently growing. About 2,314 exabytes (one exabyte = one billion gigabytes) of healthcare records data will be produced in 2020. Compared to the 153 exabytes of data produced in 2013, it’s clear the management of healthcare records will only become a bigger hassle.
It’s impossible for the human eye to analyze all of this data, choose the highlights, and organize it so it’s stored securely. Detailed healthcare records will continue to grow as more patients visit, making healthcare record storage even more of a daunting task.
Addressing the Need For Integrated Data
When patient data is stored in an unorganized and unstructured fashion, it’s easy for medical professionals to skip over pertinent elements of a patient’s medical history. It can also lead to unsafe storage practices that put patient security at risk.
As a medical professional, one of the top priorities is ensuring that patient data is safe and cared for. Organized and structured data that’s safely stored using security, such as healthcare record blockchain technology, saves medical professionals time and worry.
How Does Natural Language Processing Help?
With an integrated cloud-based operations system in place that includes the latest natural language processing technology and safe storage techniques, medical professionals could quickly skim important characteristics of their patients’ health and history before treating them. One comprehensive health record-keeping system that stores information on the cloud makes it easier for all medical staff, from the receptionist to the surgeon, to retrieve data.
When natural language processing is included in a robust health record-keeping system, processes can be streamlined so that medical professionals can provide faster and more precise treatments. With improved efficiency, healthcare professionals can provide better quality care to patients.
Synthesize and Summarize Data
Natural language processing reviews large amounts of data and condenses it by identifying only the crucial elements and events. By relaying only pertinent information for the healthcare professional, this process allows for a quick skim to learn more about a patient’s history and needs.
The process of finding meaningful data in a comprehensive chart or detailed pages of records is eliminated from the medical professional’s job duties. For example, instead of flipping through 50 pages of records to learn about a patient’s last blood sugar level readings, the integrated AI system uses natural language processing to highlight the latest bloodwork results as the first line item.
Clinical Decision Support
Organized data is one of the most important elements for healthcare professionals when making decisions about a patient’s treatment plan. This is especially true for ongoing health management and when making decisions about chronic disease treatments. With extensive data, healthcare professionals may get overwhelmed or miss important information.
When natural language processing is included in an integrated artificial intelligence (AI) recordkeeping system, it sifts through extensive data and accurately relays the information healthcare professionals need to know. When medical professionals can quickly and precisely review records, they can have more time and ammo to make smart decisions about treatment and health management.
Convert PDF Documents Into Text Files
Handwritten patient forms and other paperwork that’s scanned as PDF files can be less-than-useful in an online recordkeeping system. These files must still be read and examined by hand for data to be interpreted properly, which is a time-consuming and complicated job. With the integration of a natural language processing system, PDF documents are turned into text files, which are easier for the system to scan so it can retrieve vital information. These records are kept safe on the cloud through advanced blockchain technology.
Tackling the organization and management of healthcare records without an integrated and advanced system is a daunting task for healthcare professionals. With a system that includes technologically evolved AI with natural language processing and safe storage technologies, these records can be used by medical professionals as a crucial tool in the diagnosis and treatment planning processes.