HJLR Mar/Apr 2019

Healthcare Journal of little rock I  MAR / APR 2019 15 than we’ve had in the past. Having said that, there are still many instances where we are not able to extract data cleanly from the EMR, which means there is a lot of manual data abstraction that still goes on today. The technology opportunity going forward is having all this unstructured, free-form data, and how to make sense of it on a large scale. I think artificial intelligence is an example of one way technology can help us under- stand all this unstructured data in a way that informs us about how we care for people. One thing that has been extremely helpful when you talk about quality and outcomes is using predictive analytics to identify problems with patients before they occur. In our ICUs, we have technology that tells us where there is risk, and whether there are patients whomay take a turn for the worse if we don’t intervene. This began in 2005 when we put in the eICU program. Fast forward to today and we now have the ability to pre- dict when a patient is likely to become sep- tic. Sepsis is a bloodstream infection that is really bad and is typically the cause of the highest mortality in most hospitals. So, if you want to prevent sepsis from escalating, and if you see it coming early, now you can intervene to slow it down and potentially stop it. Those are the kinds of things we can do today because of electronic medi- cal records that we couldn’t do in the past because there was no way to have a real- time view of the data. We are also now able to provide clinicians with relevant quality improvement opportunities. In the past, it took a really long time and manual effort to extract the data. Now, with some automa- tion and software technology, we can pro- vide caregivers feedback on how they are doing with their quality outcomes. Editor How have hospitals evolved over the past 20 years? Are the changes pri- marily payer driven? Wells  This is an interesting question because I have been in this for about 22 years, so I think I have a pretty good per- spective of that window of time. At a high level, I would say hospitals have evolved to become more externally focused. What I mean by that is we have seen dramatic changes in health-care financing and policy that have forced hospital providers to con- stantly change, evolve, and look externally for how to position themselves, and what role they play in the overall health-care landscape. Twenty years ago, we were deal- ing with the full impact of the balanced bud- get amendment of 1997, and that was start- ing to flow through the system, which was the first wave of turmoil I saw in my career. After that, it was less about health care and more about the overall economy for at least a decade. The Affordable Care Act is argu- ably the most significant health-care policy legislation that has ever been passed outside maybe Medicare and Medicaid in the 1960s. This has all created an environment where everyone is trying to understand where they fit in. Twenty years ago, that wasn’t neces- sarily the case. Hospitals had a pretty good sense of what they were, what they were doing, and their role in the community. I We are always working to improve every day to serve people in the communities we are in.