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The Social Business of Fighting Disease

The Social Business of Fighting Disease | EHR and Health IT Consulting | Scoop.it

Whilst social media tools have primarily been used for commercial ends, there is a growing stream of evidence showing that it has scientific and social benefits as well. Nowhere is this more so than in the tracking and prevention of diseases.

 

For instance Google Flu Trends tracks search queries and applies its trending algorithm to gain an understanding of where flu outbreaks are occuring. A 21 month study by John Hopkins University found that the app was exceptionally good at predicting when hospitals would start to see people coming in with flu symptoms.

 

Primary investigator of the study, Dr. Richard Rothman, said that the results were promising for “eventually developing a standard regional or national early warning system for frontline health care workers.”

 

Social media context

 

It could be argued however that social media is a better method of tracking the spread of infection because it provides you with better context. Back in January the American Journal of Tropical Medicine and Hygiene reported that tweets and other public ‘status updates’ were a better way of determining the spread of cholera in post-earthquake Haiti than official channels. The research was conducted by scientists at Children’s Hospital Boston and Harvard Medical School and with over 6,000 people having died from the disease in Haiti, it has serious implications in terms of disaster prevention.

 

“When we analyzed news and Twitter feeds from the early days of the epidemic in 2010, we found they could be mined for valuable information on the cholera outbreak that was available up to two weeks ahead of surveillance reports issued by the government health ministry,” said Rumi Chunara, PhD, of the Informatics Program at Children’s Hospital Boston, Research Fellow at Harvard Medical School, and the lead author of the study. “The techniques we employed eventually could be used around the world as an affordable and efficient way to quickly detect the onset of an epidemic and then intervene with such things as vaccines and antibiotics.”


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Luca M. Sergio's curator insight, December 20, 2012 3:26 PM
so much potential from the social space to identify disease trends and act at an early stage ....
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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How Business Decisions Challenge EHR Integration Efforts?

How Business Decisions Challenge EHR Integration Efforts? | EHR and Health IT Consulting | Scoop.it

Over the past year, federal officials have grown increasingly interested the ability for healthcare organizations and providers to share information through the use of interoperable EHR technology, which has raised the need for EHR integration.

 

But despite all the focus on technology and functionality, misconceptions remain and continue to prove detrimental to advancing interoperability and health information exchange.

 

"One misconception surrounding EHR integration efforts is that the larger issues are technical in nature, when in fact they’re actually related to information architecture and workflows," Arcadia Healthcare Solutions CTO Jon Cook tells EHRIntelligence.com.

 

"For a long time in the technical field, we’ve known how to exchange data," he continues. "The challenge lies in whether or not the EHR vendor will permit the exchange of data, and if so, if the data is in a format that the receiver is able to understand and use. There’s been a lot of discussion surrounding transfer protocol, semantics and structure in the last handful of years, and these still remain a major issue."

Much is due to federal programs such as meaningful use for help mitigating the technical challenges associated with information sharing.

"Whether you love it or you hate it, meaningful use has shined a spotlight on integration issues. As health IT standards progress, we’ve seen vendors becoming much more willing to participate in the open exchange of data," Cook adds.

A byproduct of this maturation in health IT standards and EHR design is the growing demand among providers for more convenient approaches to health data exchange.

"Providers are now pounding their fists and rightfully expecting data exchange, and things are better than it ever has been in terms of integration. Despite this, there’s still a ways to go," says Cook.

In its most recent report to Congress, the Office of the National Coordinator for Health Information Technology (ONC) provided details about the barriers in the way of integrating health IT infrastructure across the country. One is a lack of information about the capabilities of health IT products, particularly functionalities related to information sharing.

In particular, providers cannot effectively compare solutions and select those that meet their needs when they lack access to basic information about the costs, limitations, and trade-offs of competing health IT products and services. This includes capabilities that will enable them to participate in new care delivery and payment models that leverage health information exchange and analytics. In addition, providers are more likely to become “locked in” to technologies, which diminishes incentives and opportunities for health IT developers to improve their technologies and compete to deliver more innovative, more advanced, and less expensive products and services that meet the needs of providers, patients, and the health care system.

Such is the reality that Cook and other EHR integrators encounter in their effort to support providers and the fluidity of their EHR data.

"While EHR vendors may say they have the ability to exchange data, we often find that all the data is not where vendors think it is. They’re unable to exchange data they don’t know is missing, therefore we’re seeing significant gaps in the data," he claims.

Only so much blame can be laid at the feet of EHR vendors and the health IT development community more widely. In their design to support clinical workflows, healthcare organizations and providers often make the decision to customize their EHR technology, which can have consequences for EHR integration efforts.

"Everyone wants to customize their system, but eventually they’ll need to integrate that system with something else," Cook explains. "With more customization, it becomes harder to integrate down the road. Providers are now more aware than they’ve ever been of the potential issues that come with customization, but it’s important end users keep this in mind as they build out their workflows."

So is it the case that technology is taking the blame instead of business decisions? The national dialogue appears to be trending toward the latter.

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CMS Extends MU Hardship Exemption Application Deadline | Healthcare Informatics Magazine | Health IT | Information Technology

CMS Extends MU Hardship Exemption Application Deadline | Healthcare Informatics Magazine | Health IT | Information Technology | EHR and Health IT Consulting | Scoop.it

The Centers for Medicare & Medicaid Services (CMS) has extended the deadline to July 1 for eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) to apply for a Medicare Electronic Health Record (EHR) Incentive Program Hardship Exemption.

The deadline originally was March 15 for EPs, and April 1 for EHs and critical CAHs. CMS said it seeks to give providers sufficient time to submit applications so that providers can avoid adjustments to their Medicare payments in 2017.

In late December, President Obama signed a new hardship exemption bill into law, designed to make it easier for healthcare providers to receive hardship exemption from financial penalties for failing to meet Stage 2 meaningful use EHR requirements. The legislation enables CMS to grant hardships not just on a case-by-case basis, but also to 'categories' after which time CMS would still have the case-by-case authority to grant hardship exemptions. Prior to this law, CMS was required to review all applications on a “case-by-case” basis.

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EHR Association Updates its Developer Code of Conduct | Healthcare Informatics Magazine | Health IT | Information Technology

EHR Association Updates its Developer Code of Conduct | Healthcare Informatics Magazine | Health IT | Information Technology | EHR and Health IT Consulting | Scoop.it

The Electronic Health Record Association (EHRA), a Chicago-based trade organization comprised of EHR vendors, and partner of HIMSS, has released an updated version of its EHR Developer Code of Conduct.

 

The Code, a transparent set of industry principles that reflect a commitment to safe healthcare delivery, continued innovation, and high integrity, was developed by the EHRA and first introduced in June 2013, the Association’s officials said. The Code applies to EHR developers, which might be stand-alone companies or divisions or business units of companies with other non-EHR lines of business. This revision is the result of a collaborative effort of EHR Association members, many of whom have adopted the Code, along with several stakeholder groups that provided feedback during the update process. The Code is being made available to the entire health IT industry.

 

Major changes in Version 2 of the Code include a new section on usability that reflects the critical importance of this topic, elaborates on the role of user-centered design (UCD) and usability best practices, and provides examples of how adopters of the Code might involve their clients in those activities.

 

What’s more, the section on interoperability and data sharing was also updated to add greater clarity on provisions regarding transparency to companies’ clients on pricing models, including components related to achieving interoperability.  The Association also reiterated its strong commitment to standards-based, cost efficient information exchange where it is valuable to the healthcare provider and/or the patient, and highlighted its opposition to data blocking. 

 

The EHR Association consulted with key stakeholder groups during the work to update the Code. Russell P. Branzell, president and CEO, College for Health Information Management Executives (CHIME) expressed CHIME’s support for the new version of the Code. “CHIME applauds the Electronic Health Record Association for updating its EHR Developer Code of Conduct. The revisions reflect the rapid changes we are seeing across the industry since the Code was first released in 2013.  The amended Code reflects the growing demand for increased transparency, security, and usability of health IT systems.  We are also encouraged that the revisions recognize the urgent need to adopt standards and achieve true interoperability.  We must work collaboratively across the industry to realize the potential for health information technology to transform healthcare,” Branzell said in a statement.

Leigh Burchell, association chair and vice president for health policy and government affairs at Allscripts, added, “We are very encouraged that the Code has gained wide recognition among EHR developers, as well as the broader industry, including provider organizations and policymakers. Their feedback was important as we looked at how the health IT industry has evolved since the Code was released in 2013 and what changes should be considered.”

 

The Code of Conduct also covers general business practices, patient safety, and clinical and billing documentation. The Association will continue to encourage adoption of the EHR Developer Code of Conduct by all companies that develop EHR technology, regardless of whether they are members of the EHR Association, its officials said.

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eClinicalWorks Moves into Acute Care Market | Healthcare Informatics Magazine | Health IT | Information Technology

eClinicalWorks Moves into Acute Care Market | Healthcare Informatics Magazine | Health IT | Information Technology | EHR and Health IT Consulting | Scoop.it

Electronic health record software vendor eClinicalWorks has moved into the acute care EHR market with the announcement this week of its eClinicalWorks 10i, a cloud-based EHR platform that creates a unified record across in-patient, out-patient and allied health settings.

 

The acute care platform will be available in 2017 and the initial release will focus on enterprise operations functionality, including inventory management, support for emergency and operating rooms, analytics, computerized physician order entry (CPOE) and bed management, according to a press release from the company.

Expanding on its experience in the acute care space in international markets where it has deployed technology in about 80 hospitals, the Westborough, Mass.-based health IT vendor is working with strategic partners, such as South Carolina’s Tidelands Health, to bring the product to market. Tidelands Health is a three-hospital health system with more than 300 beds and over 40 outpatient locations.

 

The vendor’s move into the acute care market has been somewhat anticipated by many in the industry. As previously reported by Healthcare Informatics’ Contributing Editor David Raths, Girish Navani, CEO and co-founder of eClinicalWorks, expressed interest in expanding into the acute market in a profile on the company last year. Speaking with Raths, Navani said, “I am not satisfied and am not going to stop with being an ambulatory vendor long-term.”

 

And, Raths also spoke with Erik Bermudez, a KLAS research director, who said he was not surprised to hear that the company was considering the acute care market. “They are as advanced as anyone, if not the leader, when it comes to technology. I don’t doubt that soon we are going to hear about them entering the in-patient space.”

 

According to Judy Hanover, research director of provider IT transformation for IDC Health Insights, acute care processes, including EHR functionality, are prime targets for re-engineering for most hospitals, but such efforts are limited by the flexibility of existing EHR products installed at most U.S. hospitals. “A cloud-based acute care EHR would allow organizations to concentrate on workflows and efficiency in clinical delivery, while supporting process re-engineering with digital workflows. This industry is ripe for a new approach,” she said in a statement.

 

“The changing landscape makes it even more imperative to have solutions that give a complete, unified view of a patient that is accessible anytime, anywhere. By taking a cloud-centric approach, organizations will achieve higher ROI and lower total cost of ownership than with traditional systems. We are excited to enter the U.S. acute care market and to work with premier organizations, including Tidelands Health,” Navani said in a statement.

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Deciding to Ditch or Detain Your EHR

Deciding to Ditch or Detain Your EHR | EHR and Health IT Consulting | Scoop.it
Is it time to go a new route with your EHR system? Before you decide yes or no, weigh the positives and negatives.
 

Only 34 percent of physicians are satisfied or very satisfied with their EHR systems, according to a recent survey conducted by the American Medical Association and AmericanEHR Partners. Another survey published in the American Academy of Family Physicians' journal, Family Practice Management reported that only 39 percent of respondents who changed EHRs were pleased with their new system.

 

The results of these surveys outline how the decision to change EHR systems or not is a difficult one. After all, it's a significant financial investment and staff have spent a lot of time learning how to implement and use their system. If you change, your practice will have to foot these costs all over again. In addition, you face the potential loss of data and problems with data migration. 

 

HANG IN THERE

 

"A well-designed EHR should be physician centric, specialty specific, and serve as a tool for the physician to document a patient's visit," says John Pitsikoulis, managing director of Berkeley Research Group, LLC, a firm located in Hunt Valley, Md. "The EHR must also meet the practice's business needs, including the revenue cycle. When an EHR doesn't align with a practice's specific day-to-day work flows, it makes the physician's job more difficult by increasing [his] administrative and compliance workload. By negatively impacting the physicians' time, patient care is impacted."

 

While it's tempting to want to replace something that doesn't meet your expectations, under certain circumstances you may want to give it more time. "First, determine if your current system offers enough functionality for managing your practice and achieves meaningful use requirements set forth by CMS. Also, verify that the vendor's strategy for future enhancements outweigh any short-term disadvantages," Pitsikoulis advises.

If your practice likes some of the core features and functions of the system, already developed specialty-specific templates, and can live with navigating through notes, orders, and prescribing without overwhelming frustration, living with the current system makes sense at least for the short term, Pitsikoulis continues.

One common complaint of physicians is that they have become data entry clerks at the expense of patient care. "This is a common physician finding, regardless of the EHR system," Pitsikoulis says. "But changing systems could result in the same functionality."

 

The truth of the matter is that a lot of systems aren't lacking in functionality and can be beneficial if you take the time to learn how to use them, says Eagan, Minn.-based Derek Kosiorek, principal consultant of Medical Group Management Association (MGMA) Healthcare Consulting Group. One way to determine if this is the case at your practice is by finding out which physicians successfully use the EHR. If it's more than half, then the EHR isn't the problem and other doctors need to invest more time in learning to use the system more efficiently. See if those doctors can assist others in learning the system.

 

TROUBLESHOOTING

 

Before throwing in the towel, see if the vendor is willing to work with you on resolving issues. Work with the vendor to identify each problem and then ask if the vendor can offer a solution, says Mechanicsburg, Pa.-based David J. Zetter, founder and consultant at Zetter HealthCare.

 

If it is more difficult to order tests or enter information into the medical record than before having the EHR, something is wrong, says Ann Arbor, Mich.-based Joette Derricks, owner of Derricks Consulting, LLC. The EHR should streamline the work flow, not add more steps. If employees are printing out information and still depending on paper, something is probably not set up properly. Open communication is critical to identify and resolve problems.

 

Making some enhancements to the EHR documenting process with voice recognition software, streamlining the physician coding function with built-in coding software, and optimizing the EHR features and functions with templates, could provide some shortcuts that make an EHR more desirable, Pitsikoulis says.

However, be cautious when adding these enhancements. Engage consultants with operational, technical, and coding compliance expertise to integrate the physician's work flow with the technology. "Otherwise, you might end up with similar performance dissatisfaction with the next tool," Pitsikoulis says.

 

PULL THE PLUG

 

Sometimes, despite your best efforts, you may want to call it quits. Poor technical support is a key reason to get a new vendor. "Oftentimes, marketing staff is very accessible early on and then a year after implementation you can't get a basic question answered," Derricks says. In this instance, it's time to move on.

 

Furthermore, if the vendor does not update its software to facilitate new medical technology or contractual payment updates, that's problematic, Derricks says.

In addition, if an EHR lacks the ability to integrate with other software such as laboratory tests, diagnostic tests, practice management systems, and so forth, it's probably time to start anew, adds Zetter. Other reasons to say "adios" are if staff cannot effectively use the system, if it impedes patient care, or if it's just too costly to continue to use.

 

Or, if information is consistently incorrect because the system is set up poorly, or you're finding bad data, start over, Kosiorek says.

 

MAKING A DECISION

 

Even though EHRs may pose a lot of challenges, their ability to exchange health information electronically has enormous benefits. EHR capabilities, such as electronic prescribing, improve patient and provider communication, while providing for the patient.

 

If you're unhappy with your EHR, it's important to understand what went wrong in your last EHR selection so you don't repeat those mistakes. Perform a needs assessment by categorizing the current deficiencies and determine if these can be improved. If not, then it's time to begin the process of selecting a better EHR.

 

CHOOSE RIGHT THE FIRST TIME

 

After incorporating a new EHR system, many physicians will have to change the way they've done their job since beginning their careers. "They are being asked to take information in their paper chart, shuffle it like a deck of cards, and then have it presented to them in various places on a computer screen," says Eagan, Minn.-based Derek Kosiorek, principal consultant of the Medical Group Management Association Healthcare Consulting Group. "Then, they have to get used to navigating to where the information is relocated. This can be difficult, as some vendors in the early days of creating EHR software didn't design it in the most user-friendly way for physicians."

 

Fortunately, this is evolving, but as a result it's leaving some physicians wondering whether to stick with the old or upgrade to something new.

 

Whether selecting an EHR for the first, second, or third time, the selection, implementation, and integration of work flow with new technology is complex, and requires continuous process improvement. "Usually, the need to make a decision and begin the implementation process gets in the way of a complete and thorough understanding of the technology and the practice's needs," says John Pitsikoulis, managing director of Berkeley Research Group, LLC.

 

When beginning the process of selecting an EHR, a practice's providers and staff should have an opportunity to "kick the tires." Yet, very few often do, says David J. Zetter, founder and consultant at Zetter HealthCare. Trying out a potential system gives users a chance to determine if it's a good fit. For example, they should ask the vendor "How will the EHR work with the practice's way of documenting a patient encounter? How will the practice management part of the software suite work? And, what is the reporting like?" And to make sure that the EHR will fit your unique needs, talk to other same-specialty practices that use the same system.

 

In addition, practices often fail to thoroughly check references. "Don't accept only a few names as references," Zetter says. "Ask proper questions of many practices that have implemented it, such as 'Would they choose it again? Why or why not?'"

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Former ONC chief science officer: Providers must think in a 'systems approach'

Former ONC chief science officer: Providers must think in a 'systems approach' | EHR and Health IT Consulting | Scoop.it

AS VEGAS - While it's difficult to know whether the rise of electronic health records was accelerated by meaningful use or if it was an inevitable trend, the increase in data needs to be better understood to be useful, Douglas Fridsma, MD, president and CEO of the American Medical Informatics Association said Tuesday at HIMSS16 in Las Vegas.

 

"As we think about informatics and educating the workforce, it's not about understanding the data in the EMR, but how it fits in with all of the other pieces," Fridsna said.

Fridsma has a background in both academic and government settings, focusing on technologies in health informatics.

 

While at ONC, he coordinated health IT investment efforts across federal agencies through the Federal Health Architecture working with agencies like the Department of Defense, Department of Veterans Affairs and the Social Security Administration.

He's also an advocate for bringing this connected standardization and horizontal platform across the healthcare spectrum. 

Currently, providers look at each department, tool and app as a separate entity, Fridsna said. But this vertical way of thinking is hindering the ability of the provider to engage the technology. Data can't be learned side-by-side, Fridsna said. It needs to span across the organization.

 

This method doesn't connect to the practice and engage patients, he added. "We need to be connected; we can't just learn within a particular silo."

 

According to Fridsna, when considering EMR adoption, non-health data is another major key to help transform the healthcare workforce. "As we get more EMR data, the data from apps, cell phones and social media are increasingly important to transforming healthcare."

 

"We have technologies that can determine whether you're depressed based on cell phone interactions," he added. This type of data is "really a social network that will increasingly become more important as we knit this data together."

 

Education around informatics and heath information technology is maturing, Fridsna said. It started as an outgrowth of computer science, and now it's being taught at every level - including high school, which provides plenty of opportunity to change how the workforce handles data.

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ONC's Steve Posnack: New Interoperability Proving Ground 'like Match.com for FHIR'

ONC's Steve Posnack: New Interoperability Proving Ground 'like Match.com for FHIR' | EHR and Health IT Consulting | Scoop.it

LAS VEGAS – Steve Posnack of the Office of the National Coordinator for Health IT likened ONC’s new Interoperability Proving Ground to online dating sites.

“There’s a lot going on around interoperability, we just have to prove it,” Posnack, director of ONC’s office of standards and technology, said on Monday morning.

That is the intention of the Interoperability Proving Ground Posnack unveiled last week and outlined at HIMSS16 – to highlight interoperability successes and bring the community together to address challenges.

Posnack called that an example hidden in plain sight that other providers around the nation could learn from.

 

“It’s like Match.com for FHIR,” Posnack said. The Interoperability Proving Ground is not just for Fast Healthcare Interoperability Resources, however, the project is also for Consolidated CDA, eHealth Exchange, HL7 CDC Immunization records, Direct, and the Semantic Interoperability Framework.

The proving ground works like this: Participants sign up, share information about projects they’re undertaking, what has worked, what has not, and then much like the way dating sites operate, the can elect to receive alerts when topics of interest are updated.

And there’s an interactive map so participants can see who in their geographical region is working on, say, FHIR and also view what other hospitals are doing around the country

 

Posnack pointed to the work of exchanging records that HealthShare Exchange of Southeastern Pennsylvania embarked upon while gearing up for Pope Francis visit.

Ultimately, the test ahead of the Pope’s visit laid the groundwork for the HIE’s goal to swap data with the 15,000 providers in the greater Philadelphia area moving toward its goal of connecting 100 percent of those physicians and 90 percent of hospitals and community health centers in the region by the end of 2016.

 

“For those of you who have done something really cool in the last 12 months, put it in,” Posnack urged attendees. “It will be in the completed table but it will still be in there. If you have results share those as well.”

Echoing Posnack’s sentiment that there is more happening in interoperability than is widely recognized right now, Elliot Sloane, President of the nonprofit Center for Healthcare Information Research and Policy and a HIMSS Fellow said in a subsequent session that the interoperability problem is bigger than any one entity, be that federal government or private sector.

“But there’s light at the end of the tunnel and it’s not an oncoming locomotive,” Sloane said. “We’re making progress.” 

 

Acknowledging the mild irony of the Office of the National Coordinator for Health IT to say, Posnack explained that what ONC is trying to do it build on that progress by working with federal agencies, private healthcare organizations and the vendor community.

 

“Cooperation without coordination is what we’re looking for,” Posnack said, adding that, having been with ONC for 10 years, today he is optimistic about interoperability.

“First we were worried about adoption, then HITECH came along so we worried about getting meaningful use set up,” Posnack said. “In 2006 I would have given my right arm to have the adoption rates of today. We have better problems to solve now.” 

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Epic and Tableau deal links analytics to electronic health records

Epic and Tableau deal links analytics to electronic health records | EHR and Health IT Consulting | Scoop.it

LAS VEGAS -- Tableau Software, a business analytics vendor, announced Monday at HIMSS16 a technology agreement with electronic health records software kingpin Epic Systems Corp. under which healthcare organization clients can deliver insights from Tableau to users of Epic’s EHR. The insights should allow physicians and other caregivers with greater clinical analysis, the vendors said.

 

Under the agreement, client-created Tableau analytics workbooks and dashboards will be integrated with Epic’s EHR, enabling direct access from EHR users’ workflows. Further, the vendors added, the community of clients that use both Tableau and Epic products can share knowledge, innovation and best practices to accelerate time-to-value from both technologies, focusing on helping customers leverage their data assets.

 

“Tableau has been essential in our effort to transform clinical data from Epic into actionable insights, enabling us to deliver these insights into the real-life workflows of clinicians and healthcare administrators,” said Ari Robicsek, MD, vice president of clinical analytics and associate chief medical information officer at NorthShore University Health System. “Examples include predictive models that drive our population health and readmission reduction efforts and actionable quality dashboards for primary care providers.”

 

This collaboration comes at a time of further recognition for Tableau in healthcare. KLAS, an independent research firm, has placed Tableau among the top business intelligence and analytics vendors for healthcare in the 2015 KLAS report, “Enterprise Healthcare BI: The Search for Outcomes.”

Attendees at HIMSS16 can learn more the agreement between the two vendors and about their technologies at exhibit hall booth #11937 and at the Clinical and Business Intelligence Knowledge Center Kiosk #14077.

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7 Key Trends in EHR Technical Support to Know in 2016

7 Key Trends in EHR Technical Support to Know in 2016 | EHR and Health IT Consulting | Scoop.it


Quality EHR technical support/experience is the key to continued loyalty, utilization, and overall customer satisfaction, according to recent arly 2,200 health It users. Conducted in Q4 2015, Black Book surveyed hospital and network physician based EHR software users, employing eighteen key performance indicators specific to comprehensive technical support experiences in Q4 2015. Managed tech support vendors evaluated included EHR and HIS vendors, EHR partnered consultants and IT firms, and independent outsourcing firms to determine variances in overall user satisfaction and the effects on long term vendor loyalty. Cerner was named the only EHR/HIT offering comprehensive, full, four level technical support with established clients

Key Findings

The survey reveals EHR firms not offering internally, or through a competent partnering IT support firm, an impressing customer technical support experiences stand to lose potential new customers, as well established clients. 82% of hospitals surveyed now insist comprehensive outsourced tech support from their EHR vendor will be a leading competitive differentiator in 2016, and a third of those are not presently pleased.

 

The usage of outsourced tech support centers is expanding quickly in the healthcare provider sector. 16% of hospital respondents outsource at least half of their tech support needs currently. By year end 2016, 35% of hospitals over 100 beds expect to increase their tech support outsourcing spend by 100%.  Additionally, expertise and quality of tech support services offered are weighing heavily on users’ overall loyalty. 61% of hospital users prefer that their EHR provide direct, comprehensive tech support. 79% of those employing third party outsourcing tech support are significantly dissatisfied with their outsourcer’s level of response and the quality of their services.  

Overseas offshored tech support centers scored the worst among healthcare providers on EHR, HIE, analytics and other applications. 97% of physicians practices and 93% of hospitals overwhelmingly prefer US-based, American-English speaking representatives. 100% of both surveyed groups confirmed that negative offshore experiences from outsourced tech support firms (either partnered with or provided by their HIS vendor) have tarnished the users’ overall perception of the vendor’s brand and product lines.

Black Book identified seven major trends in EHR technical support:

1. Cloud Applications

With the increasing amount of providers selecting cloud-based EHRs, a key issue will be how EHR vendors provide a differentiated support service experience that allows users to click from within the application to get immediate help.

2. Tech Support Communications via Video Chat

Hospitals are complex healthcare delivery organizations with multiple applications and skill levels operating the different segments of operations. Physician practice are demanding more live video support immediately, as well. Video chats boost client service by speeding processing like claims management and patient financial services, providing important value-adds to users.

3. Growth of high-accountability support model

Most EHR and HIS tech support centers, both provided directly by vendors and by outsourcers, organize around traditional escalation support models, which includes issue passing between tiers and areas of expertise. But in 2016 and beyond, more tech centers will have to employ a high-accountability or ownership model for more efficient resource utilization. The majority of EHRs are not set up for this passing the parts or the whole process to partner and third party tech support firms. With a high-accountability model, individual support personnel take ownership of the customer experience directly.

4. Social media is an important channel of tech support communication.

Patients and staff, alike, are increasingly venting complaints on their poor tech support experiences on social media. 69% of EHR/HIT users do not believe their vendors or tech support outsourcers monitor these channels frequently or effectively enough to respond to issues and deflect them.

5. Predictive Analytics need Support

Making sense of healthcare Big Data is persisting and related technical support needs are on the table waiting to be addressed by EHRs.

6. Support Service Transparency grows

An increasing number of EHR and HIS vendors are giving customers controlled access to support-related tools and information. Mobility will lead the way, giving health IT users more seamless and transparent interactions, which will ultimately give them instant access to data on their relations with EHR, HIE and, Population Health application vendors.

7. Shift in Channels of Tech Support Communication

2016 is seeing huge leaps in self-help, mobile and web along with a continued focus on voice for difficult provider application issues, especially engineering and analytics support.

 

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Analytics's curator insight, March 24, 7:42 AM

 

Quality EHR technical support/experience is the key to continued loyalty, utilization, and overall customer satisfaction, according to recent arly 2,200 health It users. Conducted in Q4 2015, Black Book surveyed hospital and network physician based EHR software users, employing eighteen key performance indicators specific to comprehensive technical support experiences in Q4 2015. Managed tech support vendors evaluated included EHR and HIS vendors, EHR partnered consultants and IT firms, and independent outsourcing firms to determine variances in overall user satisfaction and the effects on long term vendor loyalty. Cerner was named the only EHR/HIT offering comprehensive, full, four level technical support with established clients

Key Findings

The survey reveals EHR firms not offering internally, or through a competent partnering IT support firm, an impressing customer technical support experiences stand to lose potential new customers, as well established clients. 82% of hospitals surveyed now insist comprehensive outsourced tech support from their EHR vendor will be a leading competitive differentiator in 2016, and a third of those are not presently pleased.

 

The usage of outsourced tech support centers is expanding quickly in the healthcare provider sector. 16% of hospital respondents outsource at least half of their tech support needs currently. By year end 2016, 35% of hospitals over 100 beds expect to increase their tech support outsourcing spend by 100%.  Additionally, expertise and quality of tech support services offered are weighing heavily on users’ overall loyalty. 61% of hospital users prefer that their EHR provide direct, comprehensive tech support. 79% of those employing third party outsourcing tech support are significantly dissatisfied with their outsourcer’s level of response and the quality of their services.  

Overseas offshored tech support centers scored the worst among healthcare providers on EHR, HIE, analytics and other applications. 97% of physicians practices and 93% of hospitals overwhelmingly prefer US-based, American-English speaking representatives. 100% of both surveyed groups confirmed that negative offshore experiences from outsourced tech support firms (either partnered with or provided by their HIS vendor) have tarnished the users’ overall perception of the vendor’s brand and product lines.

Black Book identified seven major trends in EHR technical support:

1. Cloud Applications

With the increasing amount of providers selecting cloud-based EHRs, a key issue will be how EHR vendors provide a differentiated support service experience that allows users to click from within the application to get immediate help.

2. Tech Support Communications via Video Chat

Hospitals are complex healthcare delivery organizations with multiple applications and skill levels operating the different segments of operations. Physician practice are demanding more live video support immediately, as well. Video chats boost client service by speeding processing like claims management and patient financial services, providing important value-adds to users.

3. Growth of high-accountability support model

Most EHR and HIS tech support centers, both provided directly by vendors and by outsourcers, organize around traditional escalation support models, which includes issue passing between tiers and areas of expertise. But in 2016 and beyond, more tech centers will have to employ a high-accountability or ownership model for more efficient resource utilization. The majority of EHRs are not set up for this passing the parts or the whole process to partner and third party tech support firms. With a high-accountability model, individual support personnel take ownership of the customer experience directly.

4. Social media is an important channel of tech support communication.

Patients and staff, alike, are increasingly venting complaints on their poor tech support experiences on social media. 69% of EHR/HIT users do not believe their vendors or tech support outsourcers monitor these channels frequently or effectively enough to respond to issues and deflect them.

5. Predictive Analytics need Support

Making sense of healthcare Big Data is persisting and related technical support needs are on the table waiting to be addressed by EHRs.

6. Support Service Transparency grows

An increasing number of EHR and HIS vendors are giving customers controlled access to support-related tools and information. Mobility will lead the way, giving health IT users more seamless and transparent interactions, which will ultimately give them instant access to data on their relations with EHR, HIE and, Population Health application vendors.

7. Shift in Channels of Tech Support Communication

2016 is seeing huge leaps in self-help, mobile and web along with a continued focus on voice for difficult provider application issues, especially engineering and analytics support.

 

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Getting more value from electronic health records

Getting more value from electronic health records | EHR and Health IT Consulting | Scoop.it

Electronic health records are typically touted as providing two primary and vital services: readily accessible patient records and protection against contraindicated medications. But at Intermountain Healthcare, we're benefiting from a growing versatility in the application of electronic health records that has the potential to transform the healthcare landscape far more broadly.

Key to it is trust – in the data, in its utility, and in the people developing and advancing it. Achieving that trust requires an organizational culture from top-to-bottom that is data-driven.
 
Intermountain Healthcare pioneered electronic health records in the 1970s, so their application is not new to us. Still, technological advances in recent years have evolved significantly, and that evolution has made more versatile applications possible.
 
Today, the many benefits that we are receiving from electronic health records include the following: analyzing relationships between conditions; improving patient procedures; reducing rates of infection; reducing antibiotic use; tracking vital signs; and reducing supply chain costs.
 
Extending the benefits and value of electronic health records requires an organization that has a data-driven culture – a culture that understands that what can be measured can be improved and that improvement depends upon data that is both real and trustworthy.
 
Creating that culture starts at the top: the CEO and the Board of Trustees must be focused on data and view it as essential to the performance of the healthcare system and to their own performance. But building that culture requires two other key groups of people: clinicians, who understand how to define analytics, develop them and use them; and statisticians, who can build algorithms that are useful to those clinicians.
 
The statisticians – medical informaticists – are more easily trained and hired. The clinicians have to be trained to combine their clinical experience with a comfort with data and how it is extracted, transformed, and loaded. That takes a substantial investment of time, sometimes months or years.
 
Extracting the data is relatively easy, as is loading it, but transforming it is complex. That's where effective collaboration between clinicians and statisticians is so vital. That's where the clinicians' skill and reputation are key.
 
Interestingly, I've found nothing generational about what makes a good data-driven clinician. We have many seasoned clinicians – with decades of clinical experience each – who are essential to our electronic health record initiatives. Their experience ensures that the data is real (that it captures what the clinicians want) and that it is trustworthy (that it provides the needed information in a form that is useful and dependable to the practitioner). Their reputation within the healthcare system enables them to command respect and help push proven improvements out across the system.
 
At Intermountain, we have created a group of clinical programs, conceived by Brent James, MD, executive director of our Institute for Health Care Delivery Research. These are a hierarchical structure of teams of clinicians and statisticians that propose data to be analyzed, work to refine it, test it, and then push proven best practices out broadly across the healthcare system.
 
Each clinical program has both a physician lead and a nurse lead, additional clinical staff members reflecting a broad array of disciplines, and staff statisticians. Every clinical program has its own budget and reports directly to the chief medical officer and the chief nursing officer.
 
The clinical programs are so well-respected that their recommendations of best practices are broadly accepted and contribute fundamentally to the trust needed for a data-driven culture to be effective. That culture and the clinical programs generate proven products that practitioners will adopt.
 
The use of those products is where the value of electronic health records can grow exponentially. With their use healthcare will improve dramatically – through models that can be widely shared and implemented.

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Amid surge in malpractice lawsuits, EHRs often targeted in litigation

Amid surge in malpractice lawsuits, EHRs often targeted in litigation | EHR and Health IT Consulting | Scoop.it

As if healthcare executives don't have enough worries about implementing electronic health records, yet another issue is starting to ramp up.

"What's been happening more frequently in the last few years is that certain plaintiffs' lawyers – a kind of group of them who communicate with each other – have started to see the medical record as an opportunity for litigation," said Mary Re Knack, a Seattle-based attorney for the firm Ogden Murphy Wallace.

Knack will be presenting an exploration of these emerging litigation troubles in the session "Just Press Print: Challenges in Producing EHRs in Litigation" with colleague Elana R. Zana at HIMSS16, beginning in late February.

Electronic health record design is paramount among those issues, Knack said, because EHR vendors quite naturally did not build the software with litigation in mind.

"The data is all stored in these templates, and depending on what you are trying to look at, whether it's a summary or lab reports or such, the data then populates the template on a screen. But when you print it, it doesn't print out as cleanly or as nicely,” Knack said.

One of these obvious challenges in trying to review somebody's care is how do you see it? How do you even read what the care was? Who did what? And when?

"You may have a case that's very straightforward medical malpractice, but because of the way the medical records get printed out, the same piece of data may appear in five places. Somebody who looks at it, whose goal is to show how it's confusing, can then start to challenge the care that was given based on the fact the medical record is confusing,” Knack explained. “They can take another step, and that is questioning whether the data in the medical record is accurate or if it has been changed."

As a result, Knack said, a healthcare provider can find itself in litigation that is ostensibly about the care provided when in actuality that organization has to " defend how the medical record works."

Practically speaking, she said, the potentially expensive situation needs to be addressed by enhanced communication between provider organizations, particularly C-suite staff, and their vendors, and also internally within provider systems.

"In the healthcare community, the medical negligence work, because of the way it's insured, tends to kind of be off on the side,” she added. “This isn't true in every healthcare setting, of course, but it's off to the side many times so the people who are the decision makers with respect to bigger issues aren't necessarily aware of how these particulars are being used in litigation because litigation is handled 'over there.'"


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Tech Issues Come into Focus for Practices in 2015

Tech Issues Come into Focus for Practices in 2015 | EHR and Health IT Consulting | Scoop.it


Cloud vs. Server-Based EHRs

Despite some consolidation in the EHR market in 2015, there were more viable cloud-based EHR options from vendors such as CareCloud, Practice Fusion, and athenahealth. “Five years ago, there weren’t really cloud-based products out there, so no one was considering it” said Mark Anderson, CEO of consultancy AC Group Inc. in Montgomery, Texas. “Security was a big issue,” he said, “so was speed, but that has largely been resolved now.” One huge advantage for the cloud-based vendors, he said, is that upgrades are painless and by and large invisible to end-users, whereas they tend to be disruptive and cause interface headaches in the client/server world.

That was the experience of Tim Dudley, family physician of DTC Family Health in Greenwood Village, Colo. When their three-physician practice had a client/server-based EHR, “every time there was an upgrade it was fairly problematic,” Dudley said, noting that there are a lot of platforms that pull together “best of breed” applications. “Every time there is an upgrade the connections between those best of breed systems falls apart, and sometimes it is hours to get back up and sometimes days to get everything properly linked up. That was extremely frustrating.” DTC switched to a cloud-based platform four years ago where everything is hosted together on a single platform.

“I never have to worry about IT issues,” Dudley added. Working with this cloud-based EHR, the practice has never missed a meaningful use attestation. “If it looks like we are sketchy on any one indicator, they will proactively reach out to us and offer to help.”


Anderson said the cloud-based systems still appeal more to smaller practices that don’t need to customize as much. Plus, if you have a 50-physician practice, you have an IT staff in-house and it may be more expensive to let somebody else host the system for you. “These cloud-based systems are designed for practices that can’t afford their own IT staff,” he added.


HIPAA, Privacy and Security

Although there were no new significant federal privacy and security regulations rolled out in 2015, many practices continue to struggle with their responsibilities in terms of risk assessments and patient communications. In a survey of more than 1,000 practices sponsored by software vendor NueMD, only 58 percent of respondents said they had a HIPAA compliance plan, and only 45 percent said their practice has a formal policy for breach notifications. The most frequent data breach issue continues to be lost devices, especially laptops with large data files on board. (And remember, any loss of data must be presumed to be a breach unless the practice can show there is a low probability the information will be used improperly.)


Other issues practices grappled with, according to James Hook, director of consulting services for the Fox Group LLC in Upland, Calif., include lack of encryption of files and failure to do a risk assessment. The federal Health & Human Services Office for Civil Rights audit program did not really get off the ground in 2015 due to a lack of resources. But the signs are that 2016 could be different. The OCR audit tool examines every aspect of compliance with the Security Rule, looking for policies and procedures and evidence of training.

“OCR gives organizations a very short time frame to respond to requests for materials for desk audits,” Hook said. “If the request goes to the wrong person in the organization, the deadline may be missed and a more extensive audit initiated. Practices should make sure everyone knows who the privacy officer and security officer are, so a letter gets routed to the appropriate person.”


Robert Tennant, senior policy advisor of the Medical Group Management Association (MGMA), said the organization’s members still find HIPAA a bit challenging, “not so much on the privacy side. They can get their arms around that in terms of policies and procedures,” he said. “It is the security side that is more challenging for practices. It is getting into areas they are not comfortable with: encryption, virtual private networks, remote access, and portable devices. All those things are trouble areas in a practice.”


Secure Messaging

In 2015, there were challenges on several fronts for physicians regarding secure messaging: There was the Stage 2 of meaningful use requirement that 5 percent of patients send secure messages and there were growing pains in using Direct secure messaging with other providers in transitions of care.


Steven Waldren, a family physician and the director of the Alliance for eHealth Innovation at the American Academy of Family Physicians (AAFP), said providers with younger, urban professional patients find it easer to adopt secure messaging, whereas physicians in rural communities and those with elderly populations have more significant challenges. “We don’t have really good data yet as to what makes a practice successful or not,” he said.


But MGMA’s Tennant said practices that have found good portal software and embraced secure messaging have increased their effectiveness. The portal products, however, “range from reasonably good to extremely bad for both physicians and patients,” he said. You have to make it easy and secure, and that has been the challenge for the industry.”


Tennant called Direct secure messaging between clinicians “an elegant communication solution,” but it is not seeing quite enough uptake yet. “We have dozens of members who are Direct-enabled, but say they can’t find anybody in their area to take a Direct message. Give it two to three years and there will be a whole lot more folks using this system.”

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3 Best Practices For Effective EHR Replacement, Adoption

3 Best Practices For Effective EHR Replacement, Adoption | EHR and Health IT Consulting | Scoop.it

When beginning an EHR replacement project, it is important to carefully consider your practice's true needs and intentions.



The health IT industry is changing, and an upsurge in EHR replacement makes that change clear. From ever-changing meaningful use requirements to varying practice needs, healthcare organizations find that their original EHR acquisition may not have been the best choice. Upon facing substantial EHR difficulties, these organizations seek to find a better replacement for their technology.


Changing EHR replacement trends can be credited to the ubiquitous adoption of the technology following the meaningful use program implementation and the changing landscape of the healthcare industry.


As more healthcare organizations are expected to replace their EHRs, it is important for them to understand best practices to keep them from having to undergo the same process years down the road. Below are some of the industry’s best advice for successful EHR replacement:

Be thoughtful and patient when determining practice needs

Organizations considering an EHR replacement do so because they have some considerable problem with their existing technology. Because of that, it might be easy for the hospital’s health IT leaders to quickly jump to what they think may be a cure-all solution to their problems.


Industry experts caution against this, explaining that IT leaders should be patient when developing an idea of what they specifically need in a new program. By taking the time to flesh out exactly the kinds of issues the practice has been dealing with, and exploring different options for fixing those issues, an IT team can better assess the direction in which they need to go.


Mark Hess of Stoltenberg Consulting Group, a company which guides practices through EHR replacements, says this has been his most successful practice in helping to facilitate an effective EHR replacement. Choosing a slower EHR replacement process is key to alleviating biases IT teams may have due to failures of old systems.

"Optimally, if we can get them down this road, we see the biases become diluted, they become more objective, and many times they'll come up with a very different decision than they would've had they gone the 90-day or quick-turn process," Hess told EHRIntelligence.com.


"By having corporate site visits, by having several rounds of demos, they come to a different way of thinking about how to make a decision,” Hess continued. “It's more global and enterprise-wide, more strategic in nature, less biased, and really what's best for the organization."


Foster physician buy-in, positive hospital culture

Once IT teams have chosen their new EHR software and taken time to determine new goals for using the software, it is important for them to foster physician buy-in.


Physician buy-in is crucial because if a physician doesn’t believe in the benefits the product promises to display, he won’t use the technology to its fullest potential. Physician resistance to EHR systems is one way that otherwise successful implementations fail.


IT teams and other organizations leaders need to remember that although their EHR system may be changing, it is their hospital culture that will make all of the difference. In a 2015

KLAS publicationImplementation Potholes 2015: How to Smooth Out the Ride, researchers explain that an EHR vendor can’t change practice culture; only leaders can.


One of the best ways to facilitate physician buy-in and promote good morale and positive workplace culture is to emphasize the patient safety benefits an EHR system will bring. IT leaders should also emphasize the long-term benefits of the system to negate the short-term difficulties providers are sure to face in replacement.


Showing executive commitment to the provider may also boost morale and facilitate positive culture. Providing ample help resources to providers when implementing an EHR was one way Avera McKennan CEO Dave Kapaska, MD, was able to see success.


“We tried to put as much help at the shoulder as we could so they weren’t left swimming at sea with the process,” Kapaska said. “[We] just committed ourselves both as on the administrative side but most of all on the physician side to get this to a point where it was functional and efficiently effective.”


Consider meaningful use changes


A new added foil to the EHR replacement issue is the impending change to meaningful use requirements.


Since the start of meaningful use, many providers have shaped their EHR adoption and replacement intentions around meaningful use requirements. However, since the Centers for Medicare & Medicaid Services (CMS’s) Andy Slavitt’s announcement that the meaningful use programs will essentially be broken down and restructured, providers will have new meaningful use concerns.


Per Slavitt’s announcement, the meaningful use programs will most likely focus more on provider needs to give quality care to the patient rather than abiding by sometimes arduous government requirements. Because of this, IT teams will need to take into account provider needs when selecting potential EHR replacements.


IT teams may have more EHR options going forward, too. Slavitt explained in his statement that one of the tenets of the future meaningful use is flexibilities for vendors to develop systems that cater to provider needs. This could make all of the difference when approaching EHR replacement.



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EHR Adoption to Support Healthcare Data Evolution in 2016

EHR Adoption to Support Healthcare Data Evolution in 2016 | EHR and Health IT Consulting | Scoop.it

n just a few years, we’ve seen many notable developments, including a steady move toward value-based care, more widespread EHR adoption and a greater provider focus on patient engagement; not to mention technology advancements — from security to robotics to virtual reality — that are truly beginning to take shape. It’s an exciting time to be in healthcare, and I can see the industry as a whole taking big leaps ahead to improve patient care and outcomes.

 

More specifically, the amount of healthcare data we see today will continue to grow. We are in a world where data is in excess and we have yet to truly harness its true potential. In 2015, we saw steps taken with consumer wearables leaping into popularity and healthcare companies partnering to make the resulting data actionable. We’re in the early stages of using and understanding of all this data, and 2016 will be the year we take it to the next level.

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This will be the year of the Healthcare Data Evolution—and it will impact all providers, from those just starting out with harnessing data, to those who are using data analytics platforms to harness deeper insights. I anticipate the following four trends to take hold in 2016:

Data will become interoperable. Healthcare data is rapidly growing, and has been estimated to be evengreater than 150 Exabytes. Wearables, DNA, environmental factors and other health factors will drive an exponential increase in data. To make it actionable for clinicians, the industry will continue to see interoperability as the key ingredient to foster the seamless flow of data across the enterprise in a secure environment, enabling actionable intelligence to help improve patient care. Data will need to flow fluidly and securely between multiple information sources—ranging from EHRs, tablets and patient monitoring devices — giving providers access information that is pertinent to a given clinical situation, no matter where they are.

Hospitals will invest in new enterprise-wide healthcare IT infrastructure to mine the data in the EMR and other clinical systems. EHR adoption is largely complete. Now the question is how do we mine this data and make it useful for clinicians in ways that enable them to manage the cognitive load. This will require new thinking regarding enterprise HIT architecture, large investments in infrastructure, staff resources and a new way of working for clinicians. In 2016, providers will start to put the pieces in place to build the healthcare IT system of the future – one that can accommodate advances in genomics, smart computing, analytics, operational intelligence and other emerging clinical and technology innovations, while increasing security to protect patient health data and enabling the real-time, interoperable health system.

Data will drive “smart technology” for clinicians. We’re living in an era where every major consumer technology brand has their own “Siri” or “Cortana” to serve as our own virtual assistant, reminding us of appointments, researching weather patterns and answering questions about the ratio of pints to gallons. Clinicians are constantly juggling increasing amounts of information, so technology that can filter out what’s important (and what’s just noise) will allow them to do their jobs more efficiently and confidently. This kind of technology will make a big impact in healthcare in 2016, giving clinicians the data and insights they need, right when they need it.

IoT will expand the use of wearables. The Internet of Things (IoT) is beginning to play a role in the evolution of wearables by making the data wearables create interoperable and actionable. Right now, people are beginning to use consumer wearables to take health and fitness tracking into their own hands. As wearables become more sophisticated (e.g., tracking body temperature, heart rate, oxygen levels, glucose and other key metrics), there will need to be an easier way for health practitioners to receive and harness this enormous and growing amount of patient data. The IoT and cloud are making this kind of data collection possible, but applications need to be built to make sense of that data, and algorithms will need to trigger action and kick off new processes that improve care delivery—like automatically scheduling a visit to test for diabetes, or adjusting a prescription for cholesterol.

The year ahead will be pivotal for healthcare IT, and the growth in data will touch more than just CIOs and IT professionals — it will impact physicians and patients too. It will be key for all stakeholders —from technology innovators to healthcare executives and providers — to mine this data in ways that make it useful to clinicians and patients alike.

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CHIME Announces Support for OpenNotes Movement | Healthcare Informatics Magazine | Health IT | Information Technology

CHIME Announces Support for OpenNotes Movement | Healthcare Informatics Magazine | Health IT | Information Technology | EHR and Health IT Consulting | Scoop.it

The College of Healthcare Information Management Executives (CHIME) has announced a partnership with the OpenNotes team to bring greater awareness of the note-sharing movement and other patient-facing technologies to CIOs and other health IT leaders.

 

The collaboration, which will help empower patients to become advocates in their care, was announced as part the Obama administration’s Precision Medicine Initiative Summit. OpenNotes is an initiative that urges health systems and clinicians to offer patients easy and secure access to the medical notes that are part of their electronic health record. The goal is to improve communication and engage patients, and often their families, far more actively in their care.

 

The power of OpenNotes first came to light in a 2010 study involving 105 primary care physicians and 20,000 patients at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in rural Pennsylvania and Harborview Medical Center, a safety net hospital in Seattle. Patients were invited to read the notes in their health record using a secure patient website. The study found that two-thirds of patients who accessed their physicians’ notes reported feeling more informed about their medical condition. Additionally, more than 85 percent of patients said that having access to notes would influence their future choice of providers.

 

Since the 2010 pilot, a rapidly growing number of health systems have adopted this change in practice, including the entire Department of Veterans Affairs. Now, CHIME will collaborate with the OpenNotes team to bring greater awareness of OpenNotes and other patient-facing technologies to CIOs and other health IT leaders and support the spread of OpenNotes across the U.S. In January, the CHIME Healthcare Innovation Trust, along with HeroX, officially launched the $1 million crowdsourcing competition aimed at finding a solution to patient identification.

“We are seeing a tremendous swing toward value-based care and consumerism in healthcare,” said CHIME President and CEO Russell Branzell, who is participating Feb. 25 summit at the White House. “Patient engagement is a big part of that movement, but to be true partners in their care, patients must have access not only to their basic health records, but the notes that clinicians make during appointments. This partnership with OpenNotes is a terrific opportunity to promote innovative change in medical practice designed to increase patient engagement.

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Consistent Compliance: A Smart Plan for 2016 

Consistent Compliance: A Smart Plan for 2016  | EHR and Health IT Consulting | Scoop.it

The dawn of a new year represents a logical time to look at current business operations and commit to making improvements. One key area that physician practices should focus on is compliance.

 

There are a myriad of rules and regulations of which practices must be aware. For example, with the ICD-10 code set in place, there are new and expanded coding guidelines. Similarly, organizations have to have strong procedures for safeguarding proper medical waste disposal, worker safety, and patient information.

 

Compliance in these areas can fall short, especially in smaller practices that have limited resources, and consequences can be severe, ranging from financial penalties to blemishes on a physician practice’s reputation. Organizations cannot afford this negativity given the competitive and costly nature of healthcare today.

 

Although keeping up with the multitude of regulations may seem daunting, it does not have to be. Even though different government requirements touch on diverse topics, organizations can take a similar approach to meeting all the rules. Not only is this cost effective, it also ensures that nothing slips through the cracks.

 

The following are some key resolutions that practices can make to commit to and execute upon a strategic compliance plan:

 

Appreciate the scope. First and foremost, physician practices must familiarize themselves with the applicable regulatory requirements. Getting a firm grasp on what an agency mandates is vital to understanding the extent of necessary compliance efforts. For example, two critical Occupational Safety and Health Administration (OSHA) regulations are the bloodborne pathogens standard and the hazards communications standard. These rules dictate that organizations must have detailed written policies that outline the risks present in the organization and describe how the practice plans to address those risks, including needlesticks, exposure to dangerous chemicals, and so on. On top of these two main standards, OSHA has other requirements that relate to personal protective equipment, hazardous chemicals, workplace violence, ergonomics, and so on. Like many other compliance areas, OSHA offers information about what’s required on its website, however, this can be overwhelming and a little unwieldy to navigate. Practices should look for resources, including consulting firms and online tools, to bring the regulations down to size.

 

Perform a gap analysis. After getting a handle on what’s required, the practice should compare its current performance against the applicable regulations to identify any holes. This may involve performing an in-depth review of existing policies and/or observing operations. In the case of HIPAA, an organization may also want to have conversations with staff about how they maintain patient health information security. Although a physician practice can do some of this on its own, an outside resource, such as a software program or other side-by-side comparison tool, can ensure the assessment process can be more thorough.

 

Provide training. Once a physician practice identifies compliance gaps, it should work to implement strategies to address them. Training is often necessary at this stage because it builds awareness with staff and can alter behavior so that the organization becomes more consistently compliant. For example, targeted staff training can help with coding compliance in that it demonstrates which codes a practice should use when and why. Training can take many forms, but should include real-world examples and opportunities to practice. To make sure staff retain information long term, facilities can employ knowledge retention strategies, such as periodically quizzing staff on certain compliance situations or having them engage in sample exercises.

 

Updating policies. Another applicable resolution for closing compliance gaps is to verify that the practice has all the appropriate policies in place and these documents contain the right level of detail. OSHA, in particular, is keen on whether an organization has comprehensive policies and whether the facility regularly reviews them. Even if a physician practice experiences a compliance breach, the regulatory agency may be more sympathetic if the practice can demonstrate that it has the correct policies and is aiming to consistently follow them.

 

Gain staff feedback. Staff can be a valuable resource in compliance efforts, and organizations should empower individuals to speak up about any perceived hazards or ways to improve compliance efforts. For example, if a staff member feels that waste disposal procedures are sub-par, he should feel comfortable bringing his concerns to practice leadership, and there should be an established method for securely and safely expressing opinions. Periodically surveying staff to get their thoughts and impressions is also a good idea. One thing to keep in mind is that employee concerns should be — at the very least —acknowledged, if not directly addressed. If a staff person shares feedback, but feels that nothing ever comes of it, he or she may be less likely to report concerns in the future.

 

Now, more than ever, is a good time to commit to renewed compliance efforts. By taking a strategic approach, organizations can meet the bevy of requirements while keeping costs in check—something that will ensure a better and safer environment as well as long-term practice viability.

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Report: Healthcare Industry Needs to Accelerate Interoperability Efforts, Aim for December 2018 Deadline | Healthcare Informatics Magazine | Health IT | Information Technology

Report: Healthcare Industry Needs to Accelerate Interoperability Efforts, Aim for December 2018 Deadline | Healthcare Informatics Magazine | Health IT | Information Technology | EHR and Health IT Consulting | Scoop.it

The healthcare industry should aim to achieve health information interoperability sooner than the timeline outlined by the Office of the National Coordinator for Health Information Technology’s (ONC) 10-year roadmap, more specifically, by December 31, 2018, according to the Healthcare Leadership Council (HLC).

 

That recommendation is part of a comprehensive report on the healthcare industry titled “Viable Solutions: Six Steps to Transform Healthcare Now” and is the result of HLC’s National Dialogue for Healthcare Innovation (NDHI) initiative. The HLC report stated that in order to meet that deadline, which is three years away, the nation must achieve nationwide exchange of health information through interoperable certified electronic health records (EHRs) technologies.

 

According to the report, NDHI participants identified challenges to achieving full-system interoperability, including conflicting and competing standards, the need for dissemination of emerging best practices in patient identification and matching, the lack of consensus on clinical workflow and payment reform best practices, and the complex provider collaborations involved in new delivery and payment models.

 

“According to NDHI participants, this date of December 31, 2018 is achievable if driven by the private sector and the parameters and barriers noted above are sufficiently addressed,” the report stated.

HLC is a coalition of chief executives from various disciplines in the healthcare industry, including payers, providers, manufacturers and health information technology firms, and its NDHI initiative is a platform through which various health industry sectors collaborate with patients, employers, academicians and government to examine, discuss and build consensus on how to address issues affecting the course of 21st century healthcare progress.

 

In March 2015, under the auspices of NDHI, leaders of more than 70 healthcare organizations, including the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA), convened to identify the barriers impeding progress toward a high-value, innovation-driven healthcare system, according to HLC.

 

“NDHI participants came to the conclusion that healthcare in the U.S. can be significantly improved by focusing on actions that are readily achievable via legislation, regulation, or voluntary actions by various health system players. Positive health system transformation does not require a wholesale remaking of health delivery structures, but rather the enabling and acceleration of patient-centered innovation,” the report stated.onclusion that healthcare in the U.S. can be significantly improved by focusing on actions that are readily achievable via legislation, regulation, or voluntary actions by various health system players. Positive health system transformation does not require a wholesale remaking of health delivery structures, but rather the enabling and acceleration of patient-centered innovation,” the report stated.

 

According to the report, the companies, organizations, and policy experts participating in the NDHI process agreed on six policy recommendations to improve U.S. healthcare:

  • Comprehensive care planning
  • Medication therapy management
  • Health information interoperability
  • Changes to federal anti-kickback and physician self-referral (Stark) laws
  • Health information flow improvements focused on patient privacy laws and regulations
  • Food and Drug Administration (FDA) reforms

In the area of health information interoperability, the NDHI initiative supports the establishment of a December 31, 2018 deadline for health information interoperability, “on or before which the nation must achieve nationwide exchange of health information through interoperable certified EHR technologies.

 

“Consumers should also have easy and secure access to their electronic health information, be able to direct it to any desired location, learn how their information can be shared and used, and be assured that  this information will be effectively and safely used to benefit their health and that of their community,” the report stated as another key goal.

 

Following the summit and to continue work on these six steps, NDHI participants established three workgroups focusing on the following areas: patient engagement and adherence, data strategy and electronic health records (EHRs) interoperability and outdated and/or ineffective laws and regulations.

 

“The workgroups collaborated throughout 2015 to agree upon policy approaches that transcend the theoretical and are viewed as clearly achievable, whether through legislation, regulatory action, or proactive steps initiated by healthcare organizations. What emerged from this process is a blueprint that will be offered to executive and legislative branch policymakers and healthcare leaders,” the report authors wrote.

 

In the area of interoperability, the HLC report notes that “while challenges still remain, the past decade has brought tremendous progress towards the adoption and meaningful use of health IT.” And the report authors state that since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, there have been several major efforts by the public and private sectors to move toward an interoperable healthcare system.

 

“All stakeholders agree on the fundamental components of interoperability, but definitions of and timing for national interoperability differ, the report authors stated.

The HLC report notes the Office of the National Coordinator for Health Information Technology’s (ONC) Interoperability Roadmap released in October outlines a vision for interoperability with a timeline and private/public sector opportunities for achieving the goals of interoperability. However, the ONC Interoperability Roadmap is a 10-year roadmap that lays out a plan to achieve nationwide interoperability by 2024.

 

The HLC report outlines a more ambitious goal with a national objective to achieve widespread exchange of health information through interoperable EHR technology nationwide on or before December 31, 2018, which is in parallel to the recommendation made in the Medicare Access and CHIP Reauthorization Act.

“NDHI believes that, by bringing together the ideas and technological expertise from both the public and private sectors, interoperability is an achievable goal that can and should be accelerated through innovation and partnership between government and the private sector,” the report stated.

The HLC report also outlined a number of other recommendations for policymakers in the area of health information interoperability:

  • Policymakers should encourage exchange of material and meaningful health data through the use of technologies and applications that enable bidirectional and real-time exchange of health data currently residing in EHR systems (e.g. open and secure API technology).
  • Policymakers should use appropriate authority to certify only those EHR technology products that do not block or otherwise inhibit health information exchange. ONC should decertify Meaningful Use products that intentionally block the sharing of information, or that create structural, technical or financial impediments or disincentives to the sharing of information.
  • The federal government, in collaboration with the private sector, should build on current and emerging best practices in patient identification and matching to identify solutions to ensure the accuracy of every patient’s identity; and the availability and accessibility of their information, absent lengthy and costly efforts, whenever and wherever care is needed.
  • Any interoperability requirements or incentives should be “technology neutral” and focused on outcomes—active interoperation between and among systems—rather than on adoption or use of specified technologies. It is critical that future policies do not stifle potential innovations in health system connectivity.

The HLC stated that the recommendations in the report are intended to “drive health system transformation and a movement toward value and innovation."

"The consensus viewpoints contained in this report are also consistent with steps currently being taken by the federal government to guide a health system transition from fee-for-service to pay-for-value and toward more integrated, coordinated care. These recommendations should serve as a catalyst for further debate and decisive action," the report stated.

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The Pros and Cons of Switching EHRs 

The Pros and Cons of Switching EHRs  | EHR and Health IT Consulting | Scoop.it

If you're not happy with your EHR system, making a change is not easier said than done. Take some time to weigh the pros and cons before a making this big decision.

 

"The advantage of keeping a sub-par EHR is that you don't have to go through the arduous process of changing EHRs," says Wanda is also president of the American Academy of Family Physicians. "However, one of the biggest disadvantages of keeping an EHR you don't like is that it tells the staff that they're not worth the investment in a better solution. Don't avoid making a switch because of the effort involved or the money you've already spent."

 

The advantage of making a change is that you'll hopefully pick a system that's more compatible with your needs. "Because you have the experience of what doesn't work in your current system, you can look for one that works better for your needs,” says John Meigs, Jr., a family physician at Bibb Medical Associates in Centreville, Ala., who is president-elect of the AAFP.

 

Filer's organization ultimately decided to change EHRs because, "the software was an unmitigated disaster. It was an incredibly expensive and time-intensive project to undertake, but I'm absolutely glad we switched EHRs."

 

Meigs, who has supported the use of EHRs for more than 20 years, hasn't liked any of the EHRs he's used. "Our current system takes too many clicks to do basic things, and the data isn't displayed in a way that is useful for patient care," he says. "The advantage to sticking with the devil you know is just that — you know what issues, challenges, and hassles you have to face."

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Professor: For EHRs to pay off, behavior change must come with the rollout

Professor: For EHRs to pay off, behavior change must come with the rollout | EHR and Health IT Consulting | Scoop.it

AS VEGAS – Some hospitals see their electronic health record go-live as an endpoint. But one expert speaking at HIMSS16 Tuesday said the smart providers realize that’s only the beginning.

 

According to Elizabeth Regan, department chair and professor of integrated information technology at University of South Carolina, it's what comes after the EHR implementation, what's done with the patient data collected, that will decide how much value an organization will realize from that investment.

Regan offered the advice Tuesday at her session, "EHR Optimization: Why Is Meaningful Use So Difficult?"

 

People, processes and a host of other factors can affect these projects' outcomes, she said, which is why providers are seeing such a disparity of results even when the technology is the same. It’s also why many hospitals abandon projects such as computerized provider order entry rollouts, even after investing thousands of hours and millions of dollars.

 

"Realizing value requires more than technology," said Regan. "If we want different results, we have to do things differently."

Innovation is a journey, not a destination, she said. "The path from technology to value is not a straight line. In many ways, it's much more like putting puzzle pieces together."

 

Too often, healthcare providers are focusing on wrong things when it comes to EHR deployments, said Regan – offering a list of these misconceptions and a plan for each.

Value doesn't come from capturing data, she said. It comes from using it, and allowing it inform changes in the way care is delivered.

 

By the same token, "value doesn't come from customizing technology to fit the way we always do things," said Regan. "It comes from using it to improve way we do things."

Also, changes in thinking do not lead to changes in behavior, she said. In fact, it's the other way around: True behavior change can eventually upend old misconceptions.

 

That's why the purpose of meaningful use "is not to pay for technology," said Regan. "It is to incentivize behavior change."

But that change doesn't come easily, she said. "Buy-in does not lead to engagement. It's the other way around," she said.

Meanwhile, "cost cutting does not lead to streamlined processes" – in fact, it usually leads to taking shortcuts, said Regan. Instead, streamlining processes can lead to lower costs.

 

"Individual innovation projects don't necessarily lead to improved outcomes or lower costs," she said. True value comes from changing the entire system, not isolated pieces.

 

Adding technology to existing processes often only makes for expensive old processes, said Regan. "Using technology to integrate workflows and improve continuity of care reduces cost and improves outcomes.

 

Finally, it's a myth that people naturally resist change; change is a natural process that most folks are fine with. Instead, she said, "People resist having changes – especially those they don't understand – forced on them."

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At CIO Forum, execs look ahead to a patient-centered future for health IT

At CIO Forum, execs look ahead to a patient-centered future for health IT | EHR and Health IT Consulting | Scoop.it

LAS VEGAS – If 2015 had its share of challenges for CIOs and their hospitals, 2016 "is off to an amazing start," said CHIME Board Chair Marc Probst, chief information officer of Salt Lake City's Intermountain Healthcare, at the CIO Forum presented by CHIME and HIMSS on Monday.

 

Specifically, he said he looked forward to moving beyond the "check-the-box" mentality that's been necessitated by meaningful use these past few years – and toward a near future where CIOs are able to take a "much more active and strategic role" in helping their organizations meet the Triple Aim.

 

[Also: Intermountain innovation chief says healthcare must have a ‘passion for people’]

Probst pointed to some new initiatives from CHIME that are already showing huge promise – notably, the $1 million National Patient ID Challenge it launched in January. Already, 171 innovators from around the world have formally signed on help solve the "vexing problem" of inaccurate patient matching.

"Done right, a national patient ID will save lives," he said. "This is a momentous occasion of CHIME."

Another new initiative is CHIME's partnership with OpenNotes – announced just this past week – to spur patient access and increase information sharing between physicians and those in their care. CHIME will help OpenNotes with its ambitious goal of expanding the program to 50 million patients in three years – opening a huge opportunity for people "to have much better clinical information" to help inform their care decisions, said Probst.

After all: The future of healthcare is personal.

That was the title of the CIO Forum's opening keynote address, delivered by Thomas Goetz, Iodine CEO and former executive editor of WIRED.

Goetz's talk offered an illuminating look at the challenges and opportunities posed to healthcare data – and the information technology needed to analyze and share it – as patients become more empowered.

Patients only interact directly with the healthcare system about 10 hours a year, he pointed out. But increasingly, providers are understanding that patients' experiences in the real world – the other 8,750 hours of the year – are critically important.

"We assume people are always acting as patients – behaving passively," said Goetz. "If medicine is based on the assumption that people are doing what they're told, everything works."

The reality is a bit more complicated than that, of course. Healthcare "is not a science; it's a process where there's a lot of human behavior, a lot of failure," he said.

"Medicine is a human experience and that matters," said Goetz. And it's the job of those who work with health information technology to "measure the mess" – calibrate it, help make sense of it and integrate it with existing IT systems.

The good news is that the dawn of patient-generated data holds huge promise for informing better decisions and "can be incredibly powerful for costs," he said. 

Yes, there are big challenges for integrating patient-reported measures – taking data from sensors and apps and working to validate, integrate and measure its benefits. But there has lately been a "profusion of tools and services" to help improve the technology infrastructure needed to do so, and CIOs hold the skills to optimizing them, he said.

If data scientists might be described as "janitors," cleaning up patient information so it can be put to use, "you guys are plumbers," said Goetz – laying out and connecting the tools to make that data work.

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Adrian Adewunmi Ph.D's curator insight, March 21, 11:00 AM

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jawad's curator insight, March 22, 4:42 AM

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Cloud, mobile among top EHR trends to watch in 2016, consultant says

Cloud, mobile among top EHR trends to watch in 2016, consultant says | EHR and Health IT Consulting | Scoop.it

With the market for electronic health records predicted to be worth about $35.2 billion by 2019, the steady rise of data has increased the need to strengthen the software to make data more accessible, reduce errors and increase the ease of use.

"You have two driving forces – demand and technological capabilities," Cathy Reisenwitz, a researcher with software firm Capterra, told Healthcare IT News.

For many years, EHRs have been "aimed at satisfying regulators, not just what clinicians want or need," she said. That's changing, though, as developers work more to make health records more appealing to end users on both sides of the doctor/patient relationship. Better mobile interfaces, for instance, are "clearly desired by patients and physicians."

Reisenwitz laid out four EHR and other health IT trends the industry can expect to see in 2016.

1. EHRs are moving toward the cloud. Start-up costs for EHRs can prove burdensome for some institutions, while cloud-based tools offer minimal start-up costs and can make better use of providers' current resources. The cloud also enables better continuity of care and easier software updates. In the coming year, more and more EHRs will offer cloud services.

2. EHRs will improve the patient portal experience. Though patient portal usage got off to a slow start, it's been steadily gaining momentum. More providers will both offer and promote patient portals. Some may even have patients use the portals during office visits to begin getting their data into the system. And patients will start to see their value.

3. Telemedicine will finally find its stride. The telemedicine market is forecasted to exceed $30 billion in the next five years, as providers increasingly see the need to reach seniors and patients in rural areas. The mass adoption of wearables will promote telemedicine, as well, especially when patients are willing to share device data with providers.

4. EHRs are going mobile. More and more providers want to provide medical care from their smartphones, and more patients want to access data through mobile devices. To accommodate this need, EHRs will will offer better mobile design and functionality. Scheduling and patient chart updates will align with prescribing functions on mobile devices, as well.

Providers will need to overcome some hurdles for these trends to take hold, Reisenwitz said, noting that, at the moment, "there's a huge space where the data isn't able to be fully utilized, as it's unstructured or poorly structured; therefore not easily accessed nor interoperable."

The other big EHR challenge is cybersecurity, she added, stoking fears that are preventing even wider acceptance of mobile and cloud platforms.

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Preventing EHR lava pits: what healthcare can learn from the gaming industry

Preventing EHR lava pits: what healthcare can learn from the gaming industry | EHR and Health IT Consulting | Scoop.it

Healthcare can learn a lot from the finance and retail sectors, but there is another industry that hasn't been mentioned where healthcare, particularly electronic health record systems, can take some notes: the gaming industry.

 

A large part of the reason the gaming industry has captivated an entire generation, including my son, is their extensive user testing. Several years ago, my son was interested in buying the game Halo 3. Since the game is assigned an 'M' for mature rating, I had to do my own research to see if it was appropriate for him.

 

While I was a gamer in my college years, eight years of intense medical training and beginning my career had put me a little out of touch with the gaming landscape. The days of Atari and Nintendo were pretty simple. I soon realized that today's gameplay had transformed from a D-pad and two buttons and pixelated graphics to complex controllers and cinematic storylines, and popular titles boast intuitive, addictive qualities.

 

One of the articles I read, in WIRED magazine, centered on Microsoft's user testing of Halo 3, which is unlike anything I've ever seen in the healthcare world. Microsoft hired a doctor of experimental psychology to lead its Halo 3 user testing in its labs, which are outfitted with a one-way mirror, video cameras, and wired controllers, so that every moment – action and reaction – is digitally recorded.

Microsoft analyzed more than 3,000 hours of play by over 600 gamers. Through weekly tests and user heat maps, they found snags that stopped users in their tracks, like a "mutant alien that was far too powerful" or "a lava pit that too many players fell into." They also paused users frequently with pop-up one-question surveys to see how engaged, interested, or frustrated they were at that moment.

 

WIRED described this usability testing as "an awfully clinical approach," which is when it hit me: I was struggling with clunky EHR software in my local hospital to save real, human lives during the day, yet I could effortlessly interact with complex gameplay options to take alien lives during the evening? Why aren't EHR vendors and hospitals alike doing more to prevent physicians from falling into EHR lava pits? How can EHR vendors know when a doctor feels frustrated every time she hits a particular screen?

Perhaps even more importantly, how are individual hospitals and clinics measuring how well their users are adopting the local tweaks and enhancements made to the EHR vendor's initial configurations? In my 15 years of working with EHRs, I have yet to see any hospital or health system settle on the EHR vendor's out of the box configurations. So, even if an EHR vendor does engage in usability studies, there are still significant changes that occur at the local level that will affect "gameplay."

 

And the reality is that most EHR vendors aren't even participating in thorough user testing at the vendor level. According to a  2015 JAMA study, EHR vendors are falling short even on the user testing required by federal design rules. The researchers examined usability test results from the 50 most commonly used EHRs.

 

An incredible 18 percent did not have a public report of usability testing on file with the Office of the National Coordinator for Health Information Technology. Of the 41 vendors who did file, about one-third did not state the type of user-centered design process. Most alarmingly, a mind-blowing 63 percent engaged fewer than 15 participants in end-user testing. Further, 17 percent didn't have any physician participants in the usability tests of their computerized physician order entry systems.

 

ONC has stated that user-centered design processes and testing must be applied to a dozen primary EHR capabilities, but even if vendors comply, this is often done at the very end of the development cycle. EHR vendors need to do more to involve clinicians in the beginning phases of developing new features, so they are truly designed with their workflows in mind. It has taken years, but a few are starting to immerse staff in customer facilities and follow and track clinicians as they use their EHR system.

One well-known EHR vendor now has a staff of about 400 focused on product usability and are taking advantage of clinician feedback during breakout sessions at large industry conferences. They're also beginning to test eye-tracking software and other user-testing technology.

 

On the provider side, hospitals and health systems also need to make sure implementation and training times on new systems aren't rushed, so clinicians have the time they need to adapt to imperfect technology. One physician and workflow designer once told me that "I can't learn everything in one sitting, but the EHR's design should be 'figure-outtable.'"

 

Until the EHR design is a little more intuitive, providers need to build in those many "sittings" for training and be prepared to deal with clinician frustration and polarization. As one of my favorite reference books, The Inmates Are Running the Asylum: Why High Tech Products Drive Us Crazy and How to Restore the Sanity, notes:

 

"High cognitive friction polarizes people into two groups. It either makes them feel frustrated and stupid for failing, or giddy with power at overcoming the extreme difficulty. These powerful emotions force people into being either an 'apologist' or a 'survivor.' They either adopt cognitive friction as a lifestyle, or they go underground and accept it as a necessary evil. The polarization is growing acute."

 

Providers cannot place the sole blame on the EHR vendor for poor usability; they must do their part to encourage adoption and avoid polarization.  A lack of thorough user-testing for EHR systems not only frustrates physicians and nurses on a daily basis, but it also is detrimental to patient safety and in delivering the quality care our patients deserve.

 

Microsoft's user testing was able to reveal flaws and bottlenecks that could be fixed in time for Halo 3's release. We can't put the genie back in the bottle, but we can start making positive steps, on both the EHR vendor and provider sides, to make future versions more user-friendly and take EHR systems to the next level. If user testing is taken that seriously for play, healthcare should engage in diligent user testing for systems that help save lives.

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Tech support from EHR vendors essential as many hospital clients vent frustrations

Tech support from EHR vendors essential as many hospital clients vent frustrations | EHR and Health IT Consulting | Scoop.it

electronic health record vendors that don't offer robust customer technical support services risk losing established clients and new customers, according to a new report from Black Book Market Research that found that one-third of hospitals surveyed is currently unhappy with their IT support.

More than 82 percent of hospitals say tech support, whether from the vendor itself or from an outsourced partnering firm, will be a leading competitive differentiator in 2016, according to Black Book.

Tech support outsourcing is expanding, the survey data shows, with 16 percent of hospital respondents outsourcing, at least, half of their IT support needs. By the end this year, some 35 percent of hospitals with more than 100 beds expect to increase spending on outsourced support by 100 percent.

"Enterprise tech support is a highly complex and niche area in healthcare, where specialists can make a big difference in client loyalty by catering from Level 1 to Level 4 product support to ensure all the provider's business goals are aligned with technology readiness," said Doug Brown, managing partner of Black Book, in a statement.

Vendors scoring highest among the four levels of technical support are Cerner, Allscripts, MEDITECH, and McKesson, according to the report.

Cerner was the only vendor offering comprehensive four-level technical support with established clients among the 2,200 participants polled.

Other findings from Black Book: 61 percent of hospitals prefer their EHR provide direct, comprehensive tech support, and 79 percent of those employing third-party tech support are highly dissatisfied with the level of response and the quality of their services.

Perhaps unsurprisingly, overseas tech support centers scored the worst among healthcare providers with regard to EHR, health information exchange, and analytics applications, with 97 percent of physician practices and 93 percent of hospitals saying they overwhelmingly prefer U.S.-based, American-English speaking representatives.

"EHR and HIS vendors cannot afford bad customer experiences, and with new revenue responsibilities, tech support organizations can't miss a beat to best serve established clients," said Brown.

According to Black Book, there are several trends to watch in the tech support space

For example, cloud apps can help EHR vendors offer a differentiated support service experience, enabling users to get immediate help from within an application.

Physician practices are also demanding more live video support, according to Black Book, putting more emphasis on offering communications via video chat.

In 2016 and beyond, more tech centers will have to employ a high-accountability or ownership model, according to the report. But most EHRs are not set up for this passing the parts or the whole process to partner and third-party tech support firms.

Social media can also play a major role. Patients and staff are increasingly venting complaints on their poor tech support experiences on social media. But more than two-thirds of health IT users don't believe their vendors monitor these channels often enough to respond to issues, according to Black Book.

Making sense of health care big data is a complicated task that demands strong technical support, Black Book said, which is driving the need for support for predictive analytics.

"The key question to providers has to be, is your outsourced tech support provider, equipped to deal with the industry changes, or better yet help your organization create a competitive advantage?" said Brown. "EHR vendors should be asking themselves the same thing about their tech support firm partners."

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Analytics market struggles with value-based care, EHRs make inroads, study finds

Analytics market struggles with value-based care, EHRs make inroads, study finds | EHR and Health IT Consulting | Scoop.it

Though analytics technology is evolving to help healthcare providers manage the switch to value-based care, the market is still playing catch-up, according to the "2016 Clinical Analytics for Population Health" report published this week by Chilmark Research.

Analytics functionality has improved measurably in recent years, according to Chilmark, but workflow integration remains a key hurdle, with clinicians who could benefit from point-of-care insights unable to use the tools optimally.

For example, too often providers are required to exit the electronic health record and toggle to a different clinical portal for analytics reports, the report said.

Healthcare organizations are already working to arrive at analytical insights for their population health and value-based reimbursement goals – and integrate those processes into their clinical workflows. To help with that, they're seeking vendor partners who are up to the task.

"While our findings reflect significant advancements in the industry since the 2014 edition, not a single vendor earned a full 'A' rating as no solution is currently meeting the user engagement and clinician workflow needs of the healthcare organizations these products are intended to serve," writes Chilmark analyst Brian Murphy in a blog post.

Chilmark profiled more than two dozen vendors in the report – from payer-developed analytics tools such as Aetna's ActiveHealth Management and HDMS, technology from EHR giants such as Cerner and Epic and other big players such as IBM Watson.

Providers are now straddling two different payment regimes, Murphy said. Value-based reimbursement necessitates scoring quality benchmarks while existing fee-for-service frameworks mean closing gaps in care is key to cash flow. Ideally, clinical analytics tools in 2016 should help address both.

But as health systems aim to lower costs and cut utilization, most tools are still underperforming on that front. Murphy pointed to a dearth of product offerings, for instance, that feature functionalities that could detect excess imaging tests or antibiotics prescriptions, or overstays in skilled nursing facilities.

Still, workflow integration remains perhaps the biggest barrier to effective analytics use.

"While most vendors can provide their solution to an EHR user, few do this in practice," he said. "Making these applications palatable to a distracted and time-pressed user population is not easy. The most frequently described use case involves an ambulatory setting in which an office manager prepares physicians and other clinicians, via a morning huddle or patient-specific face sheets, with information about patients with care gaps being seen that day."

Meanwhile, Murphy said EHR vendors are making progress in the analytics space – with companies such as eClinicalWorks, Epic, and Cerner bolstering their clinical intelligence functionalities and continuing to see strong adoption.

"They enjoy a kind of home field advantage over the independents with the large hospital and health system customers that all vendors are targeting," he said, adding that independent analytics vendors continue to enhance their products and make market inroads.

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Drchrono launches iPhone EHR, claims app is first 'fully functional' platform

Drchrono launches iPhone EHR, claims app is first 'fully functional' platform | EHR and Health IT Consulting | Scoop.it


In the ongoing battle at the small end of the electronic health records market, drchrono claims to have struck new ground by bringing its EHR to the iPhone.

While versions of EHRs running on mobile devices are widely available, the distinction here is that drchrono claims this latest version is a fully-functional EHR, rather than one retrofitted for mobile phones.

The company said the iPhone edition enables doctors to "document a full patient encounter," then lock the note and submit the claim to a billing agent or insurance company.

It's no surprise vendors are bringing mobile-optimized software to the market. Just about every EHR-maker – from big guns, such as Epic and Cerner, to smaller shops like HealthFusion and iPatient Care – offers versions for tablets.

Practice Fusion, in fact, released an iteration engineered specifically for tablets in October 2014 and said at the time that it was evaluating whether or not to also build a version for phones.

According to survey results Black Book published this summer, 72 percent of participating physicians plan to adopt mobile EHR systems this year and 31 percent are already using a smartphone to manage patient data in one way or another.

Whether doctors will find a phone screen is large enough to be practicable when using an EHR or not, however, remains to be seen.

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