EHR and Health IT Consulting
40.4K views | +14 today
Follow
EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
Your new post is loading...
Your new post is loading...
Scoop.it!

Key Big Data Challenges Providers Must Face

Key Big Data Challenges Providers Must Face | EHR and Health IT Consulting | Scoop.it

Everybody likes to talk about the promise of big data, but managing it is another story. Taming big data will take new strategies and new IT skills, neither of which are a no-brainer, according to new research by the BPI Network.


While BPI Network has identified seven big data pain points, I’d argue that they boil down to just a few key issues:


Data storage and management:  While providers may prefer to host their massive data stores in-house, this approach is beginning to wear out, at least as the only strategy in town. Over time, hospitals have begun moving to cloud-based solutions, at least in hybrid models offloading some of their data. As they cautiously explore outsourcing some of their data management and storage, meanwhile, they have to make sure that they have security locked down well enough to comply with HIPAA and repel hackers.


Staffing:  Health IT leaders may need to look for a new breed of IT hire, as the skills associated with running datacenters have shifted to the application level rather than data transmission and security levels. And this has changed hiring patterns in many IT shops. When BPI queried IT leaders, 41% said they’d be looking for application development pros, compared with 24% seeking security skills. Ultimately, health IT departments will need staffers with a different mindset than those who maintained datasets over the long term, as these days providers need IT teams that solve emerging problems.


Data and application availability: Health IT execs may finally be comfortable moving at least some of their data into the cloud, probably because they’ve come to believe that their cloud vendor offers good enough security to meet regulatory requirements. But that’s only a part of what they need to consider. Whether their data is based in the cloud or in a data center, health IT departments need to be sure they can offer high data availability, even if a datacenter is destroyed. What’s more, they also need to offer very high availability to EMRs and other clinical data-wrangling apps, something that gets even more complicated if the app is hosted in the cloud.


Now, the reality is that these problems aren’t big issues for every provider just yet. In fact, according to an analysis by KPMG, only 10% of providers are currently using big data to its fullest potential. The 271 healthcare professionals surveyed by KPMG said that there were several major barriers to leveraging big data in their organization, including having unstandardized data in silos (37%), lacking the right technology infrastructure (17%) and failing to have data and analytics experts on board (15%).  Perhaps due to these roadblocks, a full 21% of healthcare respondents had no data analytics initiatives in place yet, though they were at the planning stages.


Still, it’s good to look at the obstacles health IT departments will face when they do take on more advanced data management and analytics efforts. After all, while ensuring high data and app availability, stocking the IT department with the right skillsets and implementing a wise data management strategy aren’t trivial, they’re doable for CIOs that plan ahead. And it’s not as if health leaders have a choice. Going from maintaining an enterprise data warehouse to leveraging health data analytics may be challenging, but it’s critical to make it happen.

more...
No comment yet.
Scoop.it!

Solo Practitioners Exempt from EHR Implementation in Minnesota

Solo Practitioners Exempt from EHR Implementation in Minnesota | EHR and Health IT Consulting | Scoop.it

One of the key issues that some healthcare providers have found with the Medicare and Medicaid EHR Incentive Programs is the mere financial impact of EHR implementation. In Minnesota, small medical practices – particularly solo practitioners – will no longer have to invest in costly EHR implementation plans due to a bill that was passed by Minnesota lawmakers in both the House and Senate.


Under the Minnesota Department of Human Services policy omnibus bill, there are various healthcare reform objectives including exempting solo practitioners and cash providers from having to invest in health IT systems and EHR implementation.


While this may benefit these providers financially and allow them to run their practice without monetary disadvantages, paper-based patient records could potentially lead to safety issues and additional medical errors that impact population health outcomes across underserved regions within the state.


Nonetheless, Minnesota seems to be the only state in the nation where an EHR mandate required all healthcare providers and hospitals to install and implement EHR systems by January 1 of this year.

The bill’s amendment on EHR implementation is now in place and providers will have to comply with it starting in January 2015, according to a press release from the Citizen’s Council for Health Freedom (CCHF), a Minnesota-based organization aimed at protecting patient privacy and rights.


CCHF feels the EHR mandate that required all providers to participate in EHR implementation was too costly and had patient privacy implications the organization does not support. Essentially, Minessota was the only state that did not have an opt-out option. Other providers across the country could take the payment penalty hit from the Centers for Medicare & Medicaid Services (CMS) instead of being required to adopt certified EHR technology.


In particular, providers in Minnesota were required to implement an interoperable EHR system that was connected to a state government-approved Health Information Organization, which is a costly endeavor.

“We’re pleased that lawmakers have included this important amendment in Rep. Tara Mack’s bill that will allow small clinics and practices to continue to serve patients in Minnesota,” stated CCHF president and co-founder Twila Brase. “Many small clinics and practices cannot afford the cost of the EHR system, and many practices do not want to make their patients’ data accessible online.”

“This amended bill will allow small clinics to thrive in smaller communities,” Brase continued. “And it will allow single doctor’s offices to keep their doors open, rather than be forced to join a big practice.


Patients would be able to search for practitioners who hold their medical data truly confidential and for doctors that look them in the eye rather than turning their back on them and typing into a computer. Minnesota is the only state that, until now, did not allow healthcare providers to opt out of expensive, intrusive online-accessible EHRs. The federal HITECH Act mandates EHRs, but allows any provider to opt out. This amendment begins to give Minnesota the level of freedom and privacy available to doctors and patients in the rest of the nation.”


more...
No comment yet.
Scoop.it!

Did Meaningful Use Requirements Propel Hospital EHR Adoption?

Did Meaningful Use Requirements Propel Hospital EHR Adoption? | EHR and Health IT Consulting | Scoop.it

Ever since 2009 when the Health Information Technology for Economic and Clinical Health (HITECH) Act became law, the majority of healthcare providers began adopting EHR systems and other health IT tools in order to meet the meaningful use requirements under the Medicare and Medicaid EHR Incentives Programs and avoid the financial penalties set for 2015 and the following years.

The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS) supported EHR adoption among hospitals and physician practices through a variety of resources and advisories. Recently, ONC released a data brief that outlines the high EHR adoption rates among hospitals and other providers.


The brief outlines the trends in the adoption of EHR technology between the years 2008 to 2014. ONC also tracked the implementation of certified EHR systems that meet meaningful use requirements as well as general health IT systems.


The results show that 76 percent of hospitals have a basic EHR system. This statistic has increased tremendously over the years, rising by 27 percent from 2013. Out of these reported hospitals, 97 percent have adopted certified EHR technology that meets meaningful use requirements under the EHR Incentive Programs.


Hospital EHR adoption varies significantly across states, ranging from 50 percent to 100 percent. Delaware, South Dakota, and Virginia have the highest rates of basic EHR adoption among hospitals. Kansas, West Virginia, and Hawaii were the three states with the lowest adoption rate of basic EHR systems.

State adoption of EHR systems has also risen significantly from 2008 to 2014, the ONC data brief shows. In 2008, only Connecticut and New Mexico had adoption rates of basic EHR systems above 20 percent.


By 2011, this statistic rose and 32 states had a hospital EHR adoption rate above 20 percent while seven states had a rate above 40 percent. By 2014, hospital EHR adoption rates were above 60 percent in 48 states and above 80 percent in 17 of those states. Clearly, these trends are rising significantly to meet meaningful use requirements and prevent the financial penalties under the EHR Incentive Programs.


The use of advanced functionalities within EHR systems is also increasing. For example, many more hospitals are using EHR technology that includes clinician notes. Additionally, 34.4 percent of hospitals have implemented comprehensive EHR systems in 2014.

Essentially, the adoption of EHR systems among acute care hospitals has quickly increased once the HITECH Act was passed in 2009 and providers began pursuing meaningful use requirements. State EHR adoption rates have also steadily increased among hospitals since the legislation was passed.


“A favorite question of mine, asked during the sessions and included in the report, is the following: ‘The real question is not what data we want to collect, but what problem are we trying to solve?’ I believe the real problem we are trying to solve is how to advance the public’s health wherever people live, work, learn or play, using information and data as a tool,” National Coordinator for Health IT Karen B. DeSalvo stated on the ONC website.


more...
No comment yet.
Scoop.it!

Future of EHRs: Interoperability, Population Health, and the Cloud

Future of EHRs: Interoperability, Population Health, and the Cloud | EHR and Health IT Consulting | Scoop.it

Ever since the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed in 2009 and the Medicare and Medicaid EHR Incentive Programs were established, healthcare providers have been quickly implementing EHR systems and adopting health IT tools. The overall movement toward improved quality of care and greater access to healthcare information will likely stimulate the future of EHRs.


Before predictions regarding the future of EHRs and their designs can be considered, it is critical to examine the history and evolution of EHR technology over the last five decades. The American Medical Association Journal of Ethics discussed how the earliest developments in EHR design took place in the 1960s and 1970s.  Healthcare leaders began forming organizations as early as the 1980s to develop standards for the increased use of EHR systems across the sector.

The very first health IT platforms, developed by Lockheed in the mid-1960s, were called clinical information systems. This particular system has been modified over the years and is now part of Allscripts’ platforms.  The clinical information system was capable of having multiple users on at once due to its high processing speed. During the same period, the University of Utah developed the Health Evaluation through Logical Processing (HELP) system and later Massachusetts General Hospital created the Computer Stored Ambulatory Record (COSTAR).


The COSTAR platform was able to separate key healthcare processes into separate entities such as accounting or billing versus clinical information. The federal government adopted an EHR system in the 1970s through the Department of Veteran Affairs’ Computerized Patient Record System.


Over the last several decades, there have been even more developments in EHR design and implementation, especially since the federal government constructed meaningful use objectives under the EHR Incentive Programs. In 1991, the Institute of Medicine (IOM) published a report analyzing the effects of paper health records and making a case for the use of EHR systems. The report also covered challenges to EHR adoption such as costs, privacy and security concerns, and a lack of national standards.


In 2000, the IOM also published its infamous report To Err is Human in which the high rates of medical errors were discussed and health IT systems were addressed as a potential solution. The history surrounding health IT will likely impact the future of EHRs, as the same principles toward better quality of care, lower costs, and improving patient health outcomes are at the forefront of EHR adoption.

EHRIntelligence.com spoke with three leaders in the healthcare IT industry to discuss the future of EHRs and the trends to expect over the coming years. Bob Robke, Vice President of Interoperability at Cerner Corporation, mentioned the importance of healthcare data sharing across multiple platforms.


“We’re moving out of the era of EHR implementation and adoption and into the era of interoperability,” Robke said. “Now that we’ve automated the health record, the next phase is connecting all of the information in the EHR. We need interoperability and open platforms to accomplish this.”


The functionalities possible in future EHR systems will also focus greatly on interoperability and Big Data. As telehealth functions spread across the country, patient health outside of the medical facility will be greatly considered.


“Interoperability has the potential to unlock a richer set of data that clinicians can use to help improve the care they provide to patients,” Robke explained. “More than ever, clinicians will need access to information about the patient’s care that happens outside of their four walls as healthcare moves from fee-for-service to value-based models.”

When asked what healthcare trends are affecting the design of EHR systems, Robke replied, “There is a lot of exciting work being done to advance open standards that enable information stored in one EHR to be accessed by other systems. A good example of this is the work being driven by the Argonaut Project to advance the development and adoption of the FHIR standard. We’re big supporters of the SMART on FHIR approach that allows information to be accessed from directly within the EHR workflow, and are enabling that within the Cerner EHR.”

Health information exchange and EHR interoperability will continue to impact the future of EHRs over the coming decades, as the healthcare industry continues to strive toward meaningful use of health IT systems. Robke spoke on the benefits of health information exchange and the strategic actions of the Commonwell Health Alliance, which is geared toward nationwide healthcare data exchange.


“Interoperability is a critical next step in the EHR world. Interoperability can provide clinicians with the data they need to manage the health of their populations and truly put the patient at the center of care,” Robke explained. “For interoperability to succeed, it will require all of the different information system suppliers coming together to find ways to connect their platforms, like those vendors who have joined together in the CommonWell Health Alliance. The great thing about CommonWell is vendors representing 70 percent of the acute market share in the U.S. have joined together to make interoperability a reality.”

When discussing how telemedicine and population health measures will affect the future of EHRs and the development of health IT platforms, Robke stated: “Connecting different information sources are key to successful telehealth and population health management strategies. Health care organizations need to access a patient’s full health history regardless of where that care was provided or what information system houses that information.”


“And yet, when it comes to results, there is an alarming failure in the healthcare industry.  Despite huge investments in enterprise systems, venerable healthcare organizations failing even at the basics like exchanging information electronically, communicating amongst care teams, and engaging patients,” Bush elaborated on the topic. “Some are even going bankrupt!  The shortcomings of software – the cost, the inability to share information at scale, the demands for onsite management and maintenance, and the sluggish pace of innovation—are chiefly responsible for this.”


The revenue cycle in the healthcare industry will also have a great impact on the future design of EHR systems and trends within this sector, Bush explained. The costs of investing in complex technologies will affect the future adoption rates while the financial incentives of the Medicare and Medicaid EHR Incentive Programs will also stimulate hospitals and physician practices.


“That’s why I believe that health care leaders are going to start thinking in terms of the total cost of driving results, not the total cost of ownership, when they contemplate the HIT of the future,” Jonathan Bush explained. “It’s crucial in the current landscape to adopt a cost calculation that accounts for labor and operational costs across several departments, as well as the opportunity costs of an underperforming system. As CIOs and health system boards are increasingly held to account for their investment decisions, I think we’ll start to see a new model for total cost of ownership emerge—and a fleet of next-generation services emerge to keep up.”


When asked what functionalities he thinks health IT systems will be able to obtain in the future, Bush replied: “Malleable IT strategies available from the cloud will reinvent what we ever thought HIT was capable of.  I agree with a recent IDC report and its vision for a future filled with ‘3rd Platform EHRs’ capable of functions we just don’t see in software today.”


“Those functionalities would include easy access to data; population-wide analytics; and network intelligence that crowd sources the wisdom of many to improve overall performance,” he continued. “These functionalities are already being built in to service value-based care organizations.  The promise is better healthcare in an accountable care environment.”


Next, the Athenahealth CEO discussed the importance of connectedness and interoperability when it comes to the design of EHR technology and future trends in health IT.


“Connectedness is a huge barrier to humanity in health care, as well as to the design of intelligent IT systems,” Bush said. “Achieving connectedness, or the meaningful use of health IT, isn’t reliant on getting all providers onto one system.”


“I believe that the one-size-fits all mantra is finally waning and that healthcare will continue to demand what I like to think of as the ultimate ‘backbone’ solution: lightweight technology that can unite data across multiple platforms and support advanced levels of care coordination and connectedness. That sort of infrastructure is not only more cost effective, nimble, and future-proof; it’s also best for patient choice and access and — ultimately — quality care.”


Some of the typical trends that are affecting the future of EHR technology include telehealth, population health management, accountable care, and health information exchange. Population health management in particular will affect the development of analytics software and statistical measurements vital for demonstrating healthcare quality improvements.


“The arrival of population health is, and will continue to be, huge. It’s trending in M&A, has wound its ways into vendors’ capability descriptions, and is on the required ‘must support’ list for healthcare organizations of all sizes,” Jonathan Bush explained.


“To do population health correctly, EHRs will need to gain insight into patient populations, translate that insight into meaningful knowledge for care teams, and enable a new standard of connectedness to manage and deliver care. To do such complex, hairy, and crucial processes, EHRs will have to leverage a combination of software, knowledge, and work.  Software alone simply isn’t cut out to do the job.”


EHRIntelligence.com also spoke with Practice Fusion Founder and Chief Executive Officer Ryan Howard about future trends in EHR design. Howard spoke about the importance of data sharing among health IT systems.


“The single biggest trend will be cloud-based EHRs. The biggest single problem in the space is not deployment of EHRs. It is sending data back and forth whether it’s for quality and accountable care or sharing data with a payer or a lab or other doctors,” said Howard. “In every spirit of this, data from EHR needs to be shared with another EHR system.”


“The challenges of that is to install software offsite. Most of the major competitors have enterprise solutions. The data is incredibly difficult to get out. A cloud-based model inherently has an exponential cognitive scale that allows it to do this easily,” Howard explained. “In our case, when we connected to Quest, every doctor on our platform has a connection to Quest now because they’re all the same multi-tenant cloud-based systems. I think the biggest problems in health IT will be solved by simple integration into the cloud.”


Howard was of the same opinion as the other CEOs when it comes to the functionalities EHRs will need in the coming years. Interconnectedness, interoperability, or the efficient sharing of health data between disparate systems will become a necessity in the quest to improve patient care and health outcomes.


“The biggest single thing [that will affect the future of EHRs] is that systems need to seamlessly connect to each other,” the Practice Fusion CEO stated. “Most of the systems are pretty robust, but I think the major cloud-based systems will need to interoperate. I think the major cloud-based vendors in the marketplace will connect and all their doctors will be able to interoperate. I think all the doctors will migrate to cloud-based systems.”


“This is only possible in a web-based or cloud-based model where the population data is in one place,” Howard said. “There’s very little value in doing this in a solution that’s installed in the doctor’s office. In that situation, all the data isn’t in one place and, in a population health management program, you’re constantly rolling out new rules and tackling new chronic conditions.”


When asked what healthcare trends will affect the design of EHR systems, Howard replied: “Population health management in addition to the electronic health records role in enabling telemedicine will all be key in the marketplace. Unless you have the patient’s record which only exists in the EHR, then there will be very little value on the telemedicine platform.”


“However, if I’m using a telemedicine platform that’s connected to the EHR, I have all that data in real-time. Most EHRs that are certified do drug-drug and drug-allergy checking dynamically in the system. That’s a good example of the value that comes from the platform.”


In predicting the coming impacts in EHR developments, Howard said, “cloud-based systems, population health management, private care management, and big data” are the major catalysts in health IT design.

“I think most vendors don’t have a population health management solution. The challenges of that is that population health does not work unless all the data is in one place,” Howard stated. “For population health management to work, take a look at diabetes. What the system is doing in a population health management model is that it is constantly monitoring your patient on a day-to-day basis.”


If a patient hasn’t had a required test done, “the system should automatically be reaching out to that patient to drive awareness – get them to book an appointment – and the system should also be prompting the physician with the standard of care during the visit.”


more...
No comment yet.
Scoop.it!

Amazing Charts Releases 2015 Predictions for Medicine and Technology

Amazing Charts Releases 2015 Predictions for Medicine and Technology | EHR and Health IT Consulting | Scoop.it

Amazing Charts, a leading developer of Electronic Health Record (EHR) systems for physician practices, today issued its healthcare predictions for 2015.

1.      Membership Medicine Comes on Strong: The patient membership approach to medicine will grow in all forms, including value-based Direct Primary Care (DPC), high-end Concierge Medicine, and primary care services contracted directly by employers. Market-driven medicine, fueled by changes occurring in healthcare today, such as inexpensive health plans with very high deductibles, will continue to encourage consumers to explore more cost-effective alternatives for primary care.

2.      Patients Help Define the Experience: The patient, in partnership with the provider, will help define the care experience going forward. This trend will be powered by technologies that enhance face-to-face interaction in the exam room. One example is the projection of an EHR onto a large display screen to facilitate information sharing between provider and patient. This in turn will help reduce errors and misdiagnosis, as well as motivate patients to take a renewed interest in their own healthcare and treatment options.

3.      EHRs Get Personalized: The EHR market will further mature and become customizable for individual patient needs and treatment plans. Intuitive data analytics will play a critical role here, helping clinicians measure, assess and manage their specific patient populations to better define specific gaps in clinical care and introduce the latest evidenced-based treatment procedures or diagnostic techniques.

4.      Wearable Health Devices Empower Patients: Led by FitBit, the market for mobile health monitoring devices saw explosive growth in 2014. Now Apple is entering the scene, and 2015 promises to see even more apps and devices introduced to consumers. How the government regulates these devices may depend on how they are marketed. For example, a glucometer could be unregulated if the intent is for a user to monitor blood sugar levels for better nutrition. If the same glucometer is marketed for monitoring diabetics, however, it may be more strictly regulated as a medical device.

5.      EHR Interoperability Still Around the Corner: While all EHRs will not be able to seamlessly communicate in 2015, the core infrastructure for increased data liquidity will largely be in place. The data standards of the CCDA and its predecessor, the CCD, are increasingly used by EHR vendors. In addition, Meaningful Use Stage 2 mandates that patients can receive a digital summary of their own records on demand. These positive steps forward will combine in 2015 to get us closer to the promise of data interoperability.

6.      EHR Switching Accelerates: Many practices selected an EHR system lured by the promise of Meaningful Use incentives and now find themselves dissatisfied with their decision, primarily because the solution is not user friendly and slows them down. Despite barriers to switching systems, we will witness a mass conversion of solutions toward EHRs that better meet providers’ expectations and requirements.

7.      The Doctor Will NOT Be In: In 2015 and beyond we will see reimbursements drive the “virtual” appointment, whereby health plans will reimburse clinicians for online patient visits. Patients and their providers will connect over virtual platforms for scheduling, reviewing test results, writing prescriptions, etc. As they do, more and more insurers will follow suit as technology advances and claims its place in the doctor’s office.


more...
No comment yet.
Scoop.it!

4 Stumbling Blocks to Avoid in System Implementation

4 Stumbling Blocks to Avoid in System Implementation | EHR and Health IT Consulting | Scoop.it

Every organization, at one time or another, goes through some type of system upgrade or implementation. Common practice is to develop a very detailed project plan. These documents are laid out to ensure that all tasks are performed and that all deadlines are met. Meetings are scheduled, milestones are agreed upon, and staff are informed of what to expect. Unfortunately what may look like a well thought out plan on paper may not address the day-to-day issues that can often disrupt a thoughtful plan.


So how do you prevent this kind of interruption? It is good practice to think about possible stumbling blocks that can cause employee angst, reworking of project plans, and/or potential deadline delays. Take a look at the following potential road blocks and how to prevent them.


Potential stumbling blocks:


  • Calendar disruptors – Consider outside elements that may cause changes to the calendar. For example, are there holidays which need to be taken into account during the timeline development? A long three day weekend, like Memorial Day, typically means a reduced staff for testing and training. In the northeast, is it wise to plan for a winter go-live? In Florida, which of the months could impact a successful project during hurricane season? Weather conditions can have the potential to wreak havoc on a well thought out project plan.
  • Business office constraints – Take a look at potential business office constraints. If the expectation is to have business office staff training during month end close it is unlikely that those training sessions will be well attended. Are there any other upgrades or implementations that may be going on at the same time? If so, there may be a limited resource pool to pull from. Keep in mind that employees may already be concerned if they are currently spread too thin.
  • Training and testing limitations – Depending on the size of the office that is scheduled to attend training or provide testing assistance take all schedules and workloads into consideration. If it is a small office, where each provider has a heavy schedule, how likely will it be that staff can attend training classes or testing assistance while ensuring that patient care is not being compromised? Look at additional resources or supplemental staff to fill in so staff can leave the office and attend training sessions.
  • Inadequate go-live support – Another component worthy of evaluation and consideration is go-live support. Most organizations incorporate a “help line” to aid the staff after a go-live. But what happens to that large practice that has a long line of patients, phones ringing, providers requiring attention, and employee anxiety? There needs to be a plan in place to circle back with those practices and make sure they are getting the necessary support.


To ensure your system implementation goes smoothly, consider the following steps:


  • Develop a well thought out project plan.
  • Make sure the objectives are clear.
  • Coordinate training schedule with business office needs.
  • Allocate resources and back-up plans early in the planning process.
  • Provide consistent and clear communication.


It is important to understand that little changes may impact well intentioned go-live of a system implementation. A well thought out project plan that accounts for these stumbling blocks and has contingencies built in will help to ensure a successful go-live. You can then focus on ensuring employee and patient satisfaction, which helps everyone in the long run.

more...
No comment yet.
Scoop.it!

Do Health IT Systems Need Greater Interoperability?

Do Health IT Systems Need Greater Interoperability? | EHR and Health IT Consulting | Scoop.it

The medical sector is aimed at reaching the triple aim of healthcare by incorporating health IT systems and EHR technology. The triple aim focuses on improving patient care, lowering medical costs, and boosting population health outcomes.


In a Health Affairs Blog, National Coordinator for Health IT Karen B. DeSalvo discusses the landscape of information technology in the medical space.  DeSalvo emphasizes the need for interoperability among health IT systems and mentioned how the Office of the National Coordinator for Health IT (ONC) is developing new implementation standards. Additionally, the need for privacy and security of patient data is also asserted by DeSalvo.


The sharing of patient data through health IT systems has been a major focus for the healthcare industry over the last year. To improve EHR interoperability, ONC has listened to the health IT community to develop a roadmap for establishing strategies and opportunities to move the country toward greater health data exchange.


DeSalvo has participated in many listening sessions across the country and learned about certain issues that harm the interoperability of health IT systems and plague hospitals and providers. Rural communities in Alabama, for instance, do not have full broadband access while bordering state privacy laws in New Jersey block medical data exchange. The overall essence of DeSalvo’s discussion revolves around the importance of interoperability among health IT systems.


“I also listened to my own experiences — as a doctor, as a daughter, and as a consumer,” DeSalvo stated. “I thought of countless patients whom I have seen and those I continue to see when I am in clinic. Of visits where I did not have the information needed to make a decision that day, requiring patients to return and miss work, school, or other obligations. Of patients who want to engage and feel empowered but need not only data, but information, to help them level the playing field, to allow them to meaningfully engage.”


“Of being a caregiver for a mother dying of dementia and being frustrated at just how hard it was to get access to the information I needed to help her. And, as a public health advocate and official, needing information about my community to prioritize resources to help them address the broad determinants of health,” said DeSalvo.

Over the last six years since the Health Information Technology for Economic and Clinical Health (HITECH) Act was passed, the healthcare industry has gone forward with meeting many of the goals ONC established such as widespread implementation of EHRs and health IT systems. More and more eligible providers began meeting meaningful use requirements under the Medicare and Medicaid EHR Incentive Programs.


While these achievements are impressive, DeSalvo mentions the need to digitalize “the care experience across the entire care continuum” and gain “true interoperability.” ONC is currently working on a plan for both public and private sectors to gain interoperability. The next step for ONC and the healthcare industry is to go beyond meaningful use and EHR implementation in order to truly bring better health for patients across the country.


more...
No comment yet.
Scoop.it!

Important Features For Your Practice Computers

Important Features For Your Practice Computers | EHR and Health IT Consulting | Scoop.it

Medical computers are an essential element of the modern health care system. They help increase efficiency in every setting from the front office to exam rooms, surgery, and radiology departments. Choosing computers for your practice is an important task, so here are some features to look for:


Sanitation Promoting Features


A clean environment is indisputable in health care facilities, and a critical component of a medical grade computer is their ability to support one. Hygiene-promoting features on your practice computers should include the following:


  • Sealed enclosure resistant to liquid and can be cleaned with disinfectant.
  • Antimicrobial coating on keyboards and monitors or all-in-one computers.
  • Fanless design to reduce dirt accumulation in the system and dust from circulating.
  • Minimal crevices that are potential homes for bacteria.


Mobility and Accessibility


When medical computers are mobile and accessible, health care organizations can save time, money and improve patient care. Nurses and doctors can bring computers with them on patient rounds or during check-in. This accessibility in medical computers lets doctors and nurses focus on patients, not hardware, during appointments. Look for computers that fit into a variety of settings, whether they can be placed on wall mounts, medical carts or nursing stations. VESA mountable computers are the preferred industry standard. The medical computer supplier you choose should offer assistance in installing your computers where you need them. Also, check for an internal lithium battery that allows for mobility without interrupting data management.

Touchscreens are another significant option that lets caregivers focus on patients. When they are easy to use, caregivers can easily enter data and interact with the computer, while still giving attention to patients. Medical Computer touchscreens are also more hygienic since they can come with an antibacterial coating.


Administrative Tools


A high performing and efficient hospital or clinic has central coordination, and medical grade computers reinforce this. With medical grade computers, administrative staff can enter and edit a patient’s medical, insurance and billing information in a patient environment. Each computer on the network should have access to this information, with a setup that allows for HIPAA compliance. Elimination of redundant inputs, reduction of errors and the switch to electronic rather than paper billings all save costs.


Low-Cost Installation


While changing to a medical computer system or getting an overhaul of your current system will undoubtedly involve some expense, you can minimize it in a few ways. One is by choosing a system compatible with as much of your existing systems as possible. For example, inquire about the extent of inputs and outputs that would be necessary with a new system; you may be able to make use of parts of your current system and thus save trouble and money from redundant equipment purchases.


Another way to reduce the initial investment cost is to consider the time and resources required to get doctors and other employees able to operate the system. First, software should be easy to use. Look for medical grade computers that support your preferred software programs or that come with new software that is simple to learn. Insist on getting a free trial before committing to a purchase.

Second, be sure to train employees before your upgrade is complete. Extra time from tutorials is expensive to a hospital or clinic, so find out how long it typically takes for users to master the system. If possible, purchase your medical computers from a company that provides follow-up support..


Cloud-Based Systems


Your practice computers need to be compatible with the cloud. As recently explained on this site, 96 percent of health care organizations are using or considering the cloud. Those who do can hope for average cost savings of 20 percent each year.


Using the cloud has additional advantages over cost savings. It allows for unlimited storage and frequent backups. Also, storage on a remote server rather than a large server on site prevents the risk of losing data in case of a flood, fire, etc. Check for a computer with EN/UL 60601 medical certification with which protects against power surges, failures and improves on-site safety.


A quality medical grade computer has a number of important characteristics that allow for reduced costs and upgraded patient care. Keep a list of necessary features in mind when you shop for your new computer or system, and your health care organization may soon see benefits.


more...
No comment yet.
Scoop.it!

What Has Hindered Progress toward EHR Interoperability?

What Has Hindered Progress toward EHR Interoperability? | EHR and Health IT Consulting | Scoop.it

EHR interoperability and the many forces working to promote interoperability of healthcare information are receiving a lot of attention these days. As well it should be!


It has been more than ten years since the Office of the National Coordinator for Health Information Technology (ONC) under the leadership of our first National Coordinator David Brailer, MD, published a seemingly straightforward four-step plan: implement EHRs, connect clinicians — remember regional health information organization (RHIOs)? — bring patients online, and enable population health.


Ten years and $30 billion of taxpayer funding later, we can report immense progress in EHR adoption, yet we are miles away from the ability to fluidly share patient records among providers and a partisan Congress wants to know the reasons. The $2 billion invested in health information exchange (HIE) startup grants has yielded very mixed results, with sustainable HIEs operational in few communities.

Many reasons can be cited for the limited progress — this list is not exhaustive.


For all the latest on interoperability in the healthcare inudstry, visit our new online publication HealthITInteroperability.com.

It isn’t that easy! The frequent comparison of healthcare information exchange to the ATM network greatly oversimplifies our challenge. Healthcare is a far more complex data model, and provider organizations vary widely across the country.


Stages 1 and Stage 2 Meaningful Use regulations include only limited interoperability goals. Hospitals and eligible providers attesting to meaningful use achieved those targets. Six years into the program most of the incentive funds have been received, only limited penalties remaining to further incent providers. Providers will surely weigh those penalties against the cost of Stage 3 Meaningful Use compliance.

Many of today’s standards are imprecisely defined, leaving room for flexibility in their interpretation by technology vendors and provider organizations. This has accommodated the structural differences among EHR products as well as the variation within and between provider organizations while leaving apples-to-apples comparisons across organizations difficult. The Continuity of Care Document (CCD) and the Consolidate CDA (C-CDA) standards in use for exchange across organizations are insufficiently granular to enable vendors to populate the EHR for convenient access and use by physicians.


Congressional restriction on exploring unique patient identifiers leaves us with various matching algorithms to identify and combine patient records across organizations. The best routines, including reconciliation by staff, are claimed to yield a 98-99% accuracy rate. Some organizations report mismatches in excess of 10%. Every mismatch becomes a patient safety issue, with either missing patient information or information incorrectly combined.


Organizations like HL7 and the Argonaut Project continue to advance the art and science of interoperability standards. CHIME recently announced a $1 million HeroX National Patient ID Challenge for the perfect patient matching solution. Both are essential to providing our physicians the information necessary for the best care they can give to their patients.

more...
No comment yet.