UHealth

__**UHealth **__

Russ Hill Jr Email: rph11c@my.fsu.edu Cell: 678-365-9665

Sarah Rudd Email: snr11@my.fsu.edu Cell: 4342587781

Travis Hunsberger: Email: tfh12c@my.fsu.edu Cell: (813) 418-0238

Benjamin Teuchert Email: bet13@my.fsu.edu Cell: 954-980-9440

UHealth Final Report Healthcare Informatics LIS 4785



Fall 2014

By: Russ P. Hill, Jr., Travis Hunsberger, Sarah Rudd and Benjamin Teuchert

Problem statement
In the research conducted by the UHealth development team we have found there is a large lack of transparency and finding reliable information about healthcare organizations for consumers. Many of the rating systems for finding reliable information and locating the best quality of care for consumers can be challenging and ratings are often conflicting. So the challenge for us was to create a system that consumers could use and actively participate in with healthcare organizations to provide a rating system that is controlled by the users. Not paid for by the healthcare organizations, not written by the healthcare organizations to better serve consumers.

A big problem in healthcare is transparency and finding reliable information about healthcare organizations (P. A. Keller). Openness between healthcare organizations and consumers is not the best and easiest connection. Consumers want the best care, and for that they need more information. There are a number of rating services that rate hospitals, some that even take into account consumer surveys. Yet these are not open sources and the statistics are flawed between services. This makes finding a reliable source of information on healthcare organizations very difficult.

This problem with reliable information is a problem for patients, researchers, and organizations to better provide and receive quality healthcare. This affects where consumers go, where money is allocated, and how organizations identify and attempt to fix problems. Each year different rating systems rate organizations different ways and rating to rating organizations can have multiple ratings, some good others poor (Comarow, 2014). This is something that needs to be formalized, standardized, objective, and fixed as soon as possible. This is something the rating systems need to fix as well as the organization in how they function and handle consumer experiences to make healthcare quality improve.

The reason this is such a critical problem is trust. People expect and need the highest quality of care anywhere they go. This requires trustworthy and constantly updated information. This will allow consumers to have the best information and healthcare organizations to fix problems they do have and improve the quality of care they provide. Without this change that is needed healthcare quality will continue to vary from organization to organization and lack of reliable information will result in a decrease in quality of care and more disconnect between consumers and organizations.

**Evidence to support the problem**

In the UHealth development teams research we found:


 * Preventable harm by healthcare organizations is the 3rd leading cause of death in the United States (Ornstein, 2013).
 * There are around 2 million consumers that have surgery or need care that involves increased risk of death or harm due to age, physical condition or infirmities. Ranking healthcare organizations allows consumers to have a resource to find the best care for their situation (Comarow, 2014).
 * Different reporters use different types of data, collection methods, quality measures and different indexing, weighting and aggregating of data to rank healthcare organizations. This makes it hard to make conclusion sense of information given on organizations (Ornstein, 2013).
 * Different reporters with different rating methods result in hospitals and healthcare organizations best-in-class in one award program and poorly in another (Ornstein, 2013).
 * Consumer Reports and other online raters are only used by 14% of consumers to review hospitals review hospitals or health-care facilities and by about 17% of consumers to review physicians or other health-care providers (Scheuer, 2013).
 * HealthGrades (Hospital rating company) works as a healthcare consultant for hospitals which includes many hospitals they grade well. This means that U.S. News supports their healthcare rating business by selling ads to hospitals to use their ratings (HealthGrades)(Comarow, 2014).
 * Even on the governments Hospital Compare website measurements of patient satisfaction, timely and effective care, medical imaging use and hospital acquired conditions are not presented so consumers can understand the information given easily and use it to distinguish which organization is best for their care(Ornstein, 2013).
 * Not all organizations are included in the different healthcare rating systems resulting in limited information from multiple sources to ensure validity and best care (Ornstein, 2013).
 * Many hospitals and healthcare organizations pay to use awards and rating names to show the quality of care they provide (Ornstein, 2013).
 * Dependent on the rating system this can cost healthcare organizations tens to hundreds of thousands of dollars to use a rating that portrays that organization in a positive light (Ornstein, 2013).
 * In 2012 there were 5,723 registered hospitals with 36,156,245 persons admitted across the nation, providing adequate healthcare in a timely manner to each individual is extremely important (AHA).

Potential solutions (list 3-5)

 * A smartphone and Web app to compile statistics and data on various hospitals, doctors, clinics with data gathered from government sources and consumer rating data. This allows for consumers to have more access to information to find the best care for themselves and loved ones based on not only the hard data received from healthcare analysts but also on personal experiences of consumers and their family members who have had consumer side experience with these organizations.
 * A faster, more accessible way of selecting a doctor, practice, clinic or hospital and the ability to make an appointment through an application.
 * Formalized healthcare organization rating system that includes consumer input published yearly but not paid to use by healthcare organizations.
 * A Web app nurses can utilize to keep a continual flow of information about current wait times to provide helpful information to consumers. Viewing long wait times could discourage non-emergent cases from going to the ER and if a hospital is currently overwhelmed or short staffed, consumers would be aware and could chose an alternative.

Research on existing/alternate solutions tried by others
There are traditional rating systems that are offered by numerous different magazines and online services. While these are current alternatives to the proposed system we are creating none of the current solutions have all of the features that UHealth will offer. Some of the rating systems available are:
 * [|__http://health.usnews.com/best-hospitals/rankings__]
 * [|__http://www.leapfroggroup.org/cp__]
 * [|__http://healthinsight.org/rankings/hospitals__]

Feasibility of each solution
Each of our solutions should be fairly simple to implement. For the smartphone and web application, compiling the information needed to keep consumers informed would consist of public records that can be accessed by virtually anyone. The information provided will be what the doctor’s speciality and practice is, which is typically advertised on their website or under their own practice, and personal experiences will be shared by consumer ratings that are posted to our application.

Traditional standards of finding a doctor typically involves word of mouth, or extensive research to find a care facility that will meet your needs. With UHealth, our GPS system will allow you to search via your location based off of city or zip code, and you can filter your search results down to the specialty needed, or even by the doctor him/herself. Again, with most of the data already being available to the public, we are just utilizing it in a convenient manner for a medical facility search that will remain unbiased and free from corporate persuasion.

Established a healthcare rating system will be fairly simple. Using our GPS feature, we will track where users of our application our and only allow people to post about a certain location if they are X amount of feet away from the healthcare facility. This will allow for authenticity of reviews, and stop false posts from being created. Consumers will also be able to upvote or downvote reviews written by other people, in the event that a false review has been written. Peer editing can help with monitoring whether or not a visit was pleasant or uncomfortable.

A feature that we would hope hospitals would see as an incentive to adopting UHealth is our ER wait time clock. Essentially, ER nurses would be able to update this feature by setting how long an ER wait time would be. This should theoretically discourage non-emergent cases from going to the ER to prevent a waste of hospital resources, and also encourage consumers to find another place of treatment in a timely manner like a walk-in-clinic. Keeping an up to date wait time would be simple, as the ER nurses are typically in-charge of time management in those settings.

Your chosen approach (and reasons)
The UHealth development team chose to create a Web application that will be easy to use for consumers and give them control over the ratings of healthcare organizations. The system we have created is an improvement on the current systems with more features and ease of use. Reasons this approach is feasible and better than the current systems in place.
 *  Easy to integrate
 * There are numerous rating systems, of which we can take what features we like and utilize them to best fit our needs.
 * Data on health care facilities and physicians are already open to the public. By compiling them and putting them available on our application, ease of use and convenience will attract consumers to our application.
 * Security with location based services are Opt-In.
 * Insurance integration: our application will only ask for the name of your healthcare provider (Like Florida Blue), and never any personal information such as social security number or health insurance plan number.
 *  Low cost powered by consumers.

Your timeline for completion
The UHealth development team began the process of creating this Web app in early September. Our first priority was establishing what we wanted our application to do. By late September we had decided on our key features: A rating system for hospitals, doctors, nurses, emergency rooms, and clinics; search functionality to browse by facility or by physician; maps to locate physicians or healthcare organizations based on location; a directory of all doctors, physicians, nurses, and health organizations; an ER wait time; an appointment feature; and insurance verification by facility.

October and November was dedicated towards the creation of our wireframes. We used this as an opportunity to brainstorm ideas for the development of our application. Questions such as “How do we want to implement each feature”, “What features should be paired together”, and “What kind of functionality do we want the homepage to have” are some key example of design process we came up with.

By late November and early December we had our wireframes completed for presentation. After sharing our ideas with the class, we received feedback about solutions to make our application more of a success. These included the addition of color, finding a way to verify authenticity of reviews, an insurance validation feature, and again, more color. For our final presentation we decided to use a different wireframe provider that allowed for a more professional appearance of our application which had a very positive reaction among our classmates.

Our timeline is as follows:
 * September: Establishing the purpose of our application. Key features were decided during this time.
 * October: Finalization of our features were decided and our team fully committed to the creation of UHealth.
 * November: Creation of our wireframes took place. Key design elements had been decided and implemented, and our design process was finalized.
 * December: Presentation of our wireframes. Classmates provided our group with solutions to make our application more successful and efficient. Ideas like color, assurance of authenticity, and even more color were suggested. We adapted our product to their demands and improved our application in general.

Team workload and roles
The Uhealth development team worked collaboratively for the majority of our research and assignments for this project. Russ Hill, Jr. was the project manager but the development team of Travis Hunsberger, Sarah Rudd and Benjamin Teuchert took equal parts in accomplishing tasks to create the best system for consumers to find the best quality of care in their area.

Meeting minutes
The UHealth development team met on a weekly basis after class and maintained remote communication through Facebook, text messages and Canvas. Extra meetings occurred as needed to coordinate presentations and discuss changes made to the web application.

Solution prototypes
== ==

Final solution
The Uhealth development team was able to formulate a live demo of a Web application of the UHealth Web App and mobile app from the prototype MyBalsamiq mockups above. To view the live demo the web address is below: [|__http://rjhill007.wix.com/uhealth#!login/c142k__]

The features that we included in the final solutions are:
 *  A Rating System for: Hospitals, Doctors, Nurses, Emergency Rooms, Clinics. This will allow consumers a chance to share their experience with others and create a diverse pool of information other consumers will have at their disposal. While promoting healthy competition and best practices amongst the healthcare community, consumers will also be put at ease by being able to see how a certain physician works with his/her patients, or how friendly the nurses are at a location. Oftentimes consumers are nervous about going somewhere new, as data often shows consumers will lie about their medical history, even to doctors they have visited for a long period time. Our goal is to let UHealth reviews put consumers at ease and feel comfortable around any healthcare practitioner.
 *  Search functionality: By Facility or by Physician. This feature will let consumers filter their search by what they view as most important: a physician in particular or a specialized facility. This search feature will also use location services so the consumer can find places based off of their location.
 *  Maps to locate physicians or healthcare organizations based on location services will also be available. This feature will utilize a consumer's zip code for precise findings of local physicians and healthcare organizations.
 *  Directory of all doctors, physicians, nurses and healthcare organizations will be available. This information will be provided by open records that consumers can already find online, made convenient by our application compiling them into one location.
 *  ER Wait Times will be listed by nurses to keep the public informed about how long it will take to be seen for non-emergent cases. Our hope is to discourage non-emergent cases from going to ERs so hospital’ resources are not wasted.
 *  Appointment feature will let consumers make appointments at a facility they have chosen through our search features. Available time will be imported to be chosen from.
 *  Insurance Verification will be shown at each healthcare facility. This will let consumers see if a physician is accepting their health care plan or if they need to look elsewhere. No personal insurance information will be necessary.
 *  Location Based Services (Opt-In). With security about personal information always remaining in the forefront of consumers mind, we are making our location based services optional. Even though UHealth does not require, or collect, personal information to perform our features, we nonetheless want consumers to feel secure.

Final Screenshots

Next steps
The next steps for our project is to bring in a development team to start working on the code for our application. Once we have a working prototype ready to go, five launch cities will be selected in order for use to do some alpha and stress testing. So far we decided to launch in Tampa, Tallahassee, Miami, Jacksonville, and Atlanta. By keeping four launch cities in Florida, it will be easier for us to compile the public records of healthcare facilities and doctors since they should be all in the same database. We chose Atlanta due to the proximity with Florida, while the city also has a large population that would allow for essential stress testing to make sure our application can handle tons of users.

Once we have a running prototype with a successful alpha test phase, we will enter our beta testing - UHealth will go live while we offer our product to hospitals so the ER wait times feature can go live. We hope to provide a convenient and easy to use application that will make hospitals want to adopt its use, while also understanding that the review system UHealth has will create healthy competition, allowing for their facility to shine and prove its worth.

· "Medicare Hospital Compare Quality of Care." Medicare Hospital Compare Quality of Care. N.p., n.d. Web. 24 Sept. 2014. .
== · Ornstein, Charles. "Should Hospital Ratings Be Embraced — or Despised?" ProPublica. Pro Publica Inc, 28 Oct. 2013. Web. 24 Sept. 2014. . == == · Rau, Jordan. "Looking For D.C.'s Best Hospitals? Here's A Little Advice." KHN: Kaiser Health News. Henry J. Kaiser Family Foundation, 11 Oct. 2013. Web. 24 Sept. 2014. . ==

· "The Right Hospital." Healthgrades. Healthgrades Operating Company, n.d. Web. 24 Sept. 2014. <http://www.healthgrades.com/find-a-hospital>.
== · Scheurer, Danielle, MD. "Consumer Reports' Hospital Quality Ratings Dubious." The Hospitalist. N.p., Aug. 2013. Web. 24 Sept. 2014. <http://www.the-hospitalist.org/details/article/5026531/Consumer_Reports_Hospital_Quality_Ratings_Dubious.html>. ==