EHR and Health IT Consulting
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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
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Will Altering EHR Incentive Programs Raise EHR Implementation?

Will Altering EHR Incentive Programs Raise EHR Implementation? | EHR and Health IT Consulting | Scoop.it

While the HITECH Act and meaningful use requirements under the Medicare and Medicaid EHR Incentive Programs have truly increased the number of healthcare providers implementing and utilizing EHR systems, new research suggests that these federal regulations may have also led to specific disparities in patient care. A study stemming from Weill Cornell Medical College found “systematic differences” between doctors who were avid participants in the EHR Incentive Programs versus those who did not invest as much time and resources into meeting meaningful use requirements.


The study was published in the June edition of Health Affairs and analyzed more than 26,000 doctors across the state of New York. Additionally, the researchers looked at payment data from the Centers for Medicare & Medicaid Services (CMS) and the state Department of Health.


The payment data analyzed in the study stemmed from the years 2011 to 2012. The results show that participation in the Medicaid EHR Incentive Program increased by 2.4 percent during those two years. However, participation in the Medicare EHR Incentive Program rose much more quickly, showing a 15.8 percent increase in the number of providers taking part in the program and implementing certified EHR technology.


The results show that early and consistent provider participants in the EHR Incentive Programs have more financial capacity, better organization and resources for supporting EHR implementation, and previous experience using health information technology.

While meaningful use requirements pushed EHR adoption forward, the process of using the systems on a constant basis had a new set of challenges that some providers were unable to attain, the researchers said. However, the differing rates of participation in the EHR Incentive Programs is leading to higher quality care at some physician offices while others are lacking and administering lower quality healthcare services.


“The expectation is that physicians and hospitals should be electronic,” senior author Dr. Joshua Vest, an Assistant Professor of Healthcare Policy and Research at Weill Cornell Medical College, said in a public statement. “How would everybody feel if only half of the banks were electronic nowadays? Without additional support to move forward there is the potential to stall out among those who don’t have the resources or capability to adopt EHRs.”


The researchers explained that there is a “digital divide” among different healthcare providers due to the participation in the EHR Incentive Programs. These results may play a role in the future of healthcare policy. Since there are certain providers who dropped out of the Medicaid EHR Incentive Program, it may behoove federal agencies to make some significant changes to the objectives within this particular program in order to keep providers participating.


“Electronic health records are vital not only because of their ability to efficiently provide physicians with a comprehensive portrait of and decision support for their patients, but also to drive new healthcare delivery models that can improve the value and quality of clinical care,” Dr. Rainu Kaushal, Chair of the Department of Healthcare Policy and Research and the Frances and John L. Loeb Professor of Medical Informatics at Weill Cornell, said in a public statement.

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How Can Providers, HIEs Partner to Achieve Interoperability? | EHRintelligence.com

How Can Providers, HIEs Partner to Achieve Interoperability? | EHRintelligence.com | EHR and Health IT Consulting | Scoop.it
Choosing a partner for data interoperability and health information exchange depends on an organization’s long-term objectives.
Interoperability is a popular topic among healthcare stakeholders, but with all the different organizations offering to help providers achieve efficient, effective, and viable health information exchange (HIE), choosing a partner can be a daunting task.  Between private, local HIEs and state-level exchanges, third-party commercial offerings and EHR vendors in the cloud, providers have any number of options to help them along the road towards freely flowing patient data that supports safe and coordinated transitions of care.
“I don’t think there’s ever going to be a singular nationwide system that does everything for everybody,” said Jeff Miller, Executive Vice President and General Manager of Clinical Network Services at Surescripts to HealthITAnalytics. “You can look at the telecommunications industry as an example of that.  We don’t have a singular communications network for the country.  We have some people that offer a very broad set of services – voice, data, video – and they offer it nationally. And you have some people who look and offer regional service and maybe only focus on a smaller set.  Some people offer wired and wireless; some are only wireless.  So I think the market will settle out and will offer services where they can generate value for their constituents.”
“We shouldn’t try to be too prescriptive as an industry about this, because the last thing we want to is to exchange information just to exchange information,” he added.  “The whole goal behind health information exchange is to ensure that we can appropriately impact the quality and effectiveness of the healthcare system, not just to ensure everybody can exchange all the information with everybody.  Because I’m not sure that is cost effective or even necessary.”
For providers looking for a solution that meets their particular needs, looking towards the community in which they primarily operate is a good first step, says Charles Fennell, Vice President for Information Management and Chief Information Officer at St. Joseph’s Hospital Health Center in Syracuse, NY.   “There are a number of independent community-based providers that choose to practice at St. Joseph’s, and our objective was to make our organization and our network of services the easiest system to practice in,” he said.
“With the understanding that we are going to live in a heterogeneous environment, we needed an interoperability strategy to work with community-based providers.  We recognized the opportunity to adopt and to promote the Direct protocol to distribute results in a way that fits into the physician’s workflow. Healthcare providers need to choose the means by which they accomplish that, whether they use their local RHIO or health information exchange, or whether they use a third party like Surescripts.  Different communities may have different answers to that question,” he said.



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‘Action First’ Vital in Health Information Exchange

‘Action First’ Vital in Health Information Exchange | EHR and Health IT Consulting | Scoop.it

The conversation within the health IT industry and federal agencies is geared toward health information exchange (HIE) and improving data sharing through EHR systems. More healthcare providers and EHR vendors are joining forces to fully implement the exchange of data between hospitals, laboratories, physician practices, pharmacies, public health agencies, and other entities.


CommonWell Health Alliance, an organization dedicated to developing a vendor-neutral platform for effective health data exchange, recently announced the addition of five new members to its team. Jitin Asnaani, Executive Director of CommonWell Health Alliance, recently spoke with EHRIntelligence.com about the organization’s mission of making significant inroads with HIE development.


“The addition of five members who joined CommonWell will improve healthcare data exchange for everybody. Specifically, it raises our ability to connect into acute care settings, ambulatory care settings, and opening the doors to connecting to other care settings,” Asnaani said. “One of the fundamental principles behind CommonWell is that all healthcare data should be focused around the person.”


The inclusion of these additional members will expand data exchange in radiology, eye care, cardiology, post-acute care and more. The movement toward nationwide healthcare exchange is growing, as more healthcare systems and EHR vendors have begun showing interest in information exchange, according to Asnaani.


“We’ve seen a surge of interest [in HIE] over the last couple of years since we formed,” stated Asnaani. “The promise of value-based reimbursement models and greater quality of care to the patient, the healthcare industry is realizing that being able to hoard data and create your own unique view of the patient dependent on the storage of data [is no longer beneficial]. I think we’re seeing that this is eroding. We’re looking towards being able to unlock the data, create a new view of the patient, and do so affordably across the US.”


One new member of CommonWell Health Alliance, PointClickCare, joins as another vendor of cloud-based software. The Executive Director mentioned the advantages of both premise-based and cloud-based EHR technology.


“From my perspective, there are advantages to both cloud-based and premise-based technology models. I think one of the advantages of cloud-based business models is that it is easier to deploy software and functionalities to your customers because of more direct control of the environment in which the software is deployed,” said Asnaani. “Premise-based can have its own set of advantages such as the ability to more easily customize the software to align with the goals of the customer.”


Asnaani also spoke about the major benefits of effective healthcare data exchange and how discussions have centered around HIE development over the last several years. However, while interest in data exchange is high, not enough activities are taking place to advance EHR interoperability.


“Health information exchange and interoperability are concepts that have been discussed for a long time,” Asnaani explains. “They have been a topical focus for the last several years. What some people don’t realize is that there is much more discussion around those topics than there is actual action.”


“CommonWell’s distinguishing factor is that we started and have continued to go down the path of action first and discussion as a complement,” he continued. “We have built real software and services that are serving real clients in the real world for real information exchange.”


HIE development has many key advantages particularly with regard to patient care. The ability to access data in real time enables providers to improve quality of care, reduce medical errors, and account for drug allergies or other key health issues.


“Health information exchange fundamentally enables better care of patients,” said Asnaani. “When a provider needs information that will make a difference in the diagnosis or create a solution for the best care possible, they are often lacking of the data that they need. Health information exchange and real-world interoperability enables that provider to get the data they need to take the best care they can of their patients.”


CommonWell also supports patient-centered care through effective health information exchange and feels that it will lead to greater confidence in providers and ease for patients. With patient engagement initiatives playing a key role in meaningful use requirements, HIE development could be an important part of improving the patient experience.


“It’s not about where the data is. It’s about who the data corresponds to. Our aim is that every person enrolled in CommonWell has data that can be accessed by whoever is taking care of that person no matter where [the data] resides,” Asnaani stated.


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