New Healthcare Developments from HIMSS17

The massive meet-up known as HIMSS17 drew more than 42,000 healthcare IT professionals to Orlando during the last full week of February. Attendees learned the latest on artificial intelligence (AI) and blockchain technologies — and how they may impact the sector — along with crucial updates on information security and electronic health records (EHRs).

The non-profit host organization, the Healthcare Information and Management Systems Society, released a study showing that 56 percent of providers expect increases in their IT budgets this year. They’re also in sync with vendors and consultants on the top priorities for leveraging clinical IT, including privacy/security, care coordination, and population health, according to the research. At the same time, providers continue to struggle with how to get the most out of their existing EHR systems.

A ‘year of action’ in AI, cloud computing, and consumerism

IBM CEO Ginni Rometty’s opening keynote highlighted growth in the company’s Watson Health consultancy, which launched in 2015 and now employs more than 7,000 people. Watson Health has large “cognitive computing” projects underway at Memorial Sloan Kettering and Cleveland Clinic. Rometty said healthcare decision-makers elsewhere are in the midst of due diligence regarding cloud, data architecture and AI platforms.

Ed McCallister, CIO at University of Pittsburgh Medical Center, told Healthcare Informatics during the conference that 2017 will be “a year of action” rather than concept. “In the past, we talked about ‘to cloud or not to cloud,’ and now we’re hearing about approaches,” he explained.

Intermountain Healthcare CIO Marc Probst added, “Where we need to up our game is thinking about how to engage with the consumer and [how to] modify our overall operations and become a digital healthcare delivery system.”

Blockchain breaks through

Aside from those practical discussions, HIMSS17 also served up substantial buzz related to blockchain technology, which creates a permanent record of online transactions. A distributed database manages the records, secured by cryptography. Blockchain could be used in population health, for instance, to aggregate the patient and financial data that formerly would have been available only from separate sources such as health information exchanges and claims databases. A summary from Surescripts, which runs a nationwide network of healthcare entities, noted that the technology “has the potential to increase IT and organizational efficiencies, keep data secure, and streamline patients’ access to medical data.”

Security remains a top concern

Information security has been a constant worry in healthcare for many years, as the sector strives to match measures already in place in more advanced industries such as banking and finance.

Symantec released a report conducted by HIMSS Analytics showing growth in the number of IT employees dedicated to security. However, healthcare organizations devote just 6 percent of their overall IT budget to security, while over one-third have implemented only basic security controls.

More than 700 healthcare CIOs attending the concurrent CHIME Forum got a firsthand look at potential vulnerabilities from Kevin Mitnick, a former hacker once on the FBI’s Most Wanted list. Mitnick, now a “white hat” security consultant to Fortune 500 companies, provided a live demonstration of how easily organizational networks could be penetrated.

“You can always mature your security processes,” Mitnick advised, pointing out efforts to segment networks and use two-factor authentication. “You can take the steps necessary to make [your organization] a harder target so that the bad guys go to another company that doesn’t use rigorous security controls.”

Open EHRs evolve

EHR giant Cerner is focusing on making their software open and interoperable. “We’re going to do anything possible to move forward on interoperability,” commented company president Zane Burke. “We view it as a moral obligation in our industry.” Cerner will collaborate with partners to develop needed solutions that can plug into its EHR platform via application programming interfaces.

Meanwhile, EHR rivals Epic and Allscripts are also working on ways to extend their reach. Epic announced progress on two scaled-back versions of its flagship EHR — at lower price points. And Allscripts CEO Paul Black said, “When people talk about ‘open,’ our definition has to do with being vendor-agnostic, [allowing] a very deep level of integration.” Allscripts’ interoperability suite can pull out data from different EHRs and put it into a single community record, yielding one view of multiple subsystems.

But experts were quick to emphasize that the ultimate success of emerging EHRs depends on embedding physicians in the shaping of products. “Anything that takes too much time and detracts from patients will lead to a lack of interest in the technology,” observed Richard Deem, senior vice president of advocacy for the American Medical Association. Doctors become frustrated when poorly designed interfaces don’t match their workflow or fail to deliver patient information efficiently.

From all indications at HIMSS17, healthcare IT continues to transform in bold, interconnected dimensions. Click here to learn more about how NetDirector’s HealthData Exchange helps providers and vendors reach their goals by electronically moving clinical and financial data among disparate systems.

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NetDirector Exceeds Demanding Security Standards with SOC2 and HIPAA Certifications

TAMPA, Fla., March 1, 2017 /PRNewswire/ — NetDirector, a cloud-based data exchange and integration platform, has recently completed work with A-LIGN to undergo rigorous and valuable security certifications. NetDirector was recently awarded attestations in compliance with HIPAA and SOC2 Type II standards, the leading security standards in Healthcare and Mortgage Banking, respectively.

The SOC 2, or Service Organization Controls 2, is an examination under AICPA standards designed for technology service companies to demonstrate controls around data security and processing integrity. The SOC 2 reports are intended to meet the needs of a broad range of users that need to understand internal controls at a service organization as it relates to security, availability, process integrity, confidentiality and privacy. The Type II report is a report on management’s description of a service organization’s system and the suitability of the design and operating effectiveness of controls.

The Health Insurance Portability and Accountability Act, or HIPAA, defines policies and procedures, as well as processes, which are required of companies that store, process, or handle electronic health information that is considered “protected” (ePHI). HIPAA compliance is increasingly valuable to both technology service providers and integrators like NetDirector, as well as providers, electronic health records systems, billing platforms, and others integrating and utilizing healthcare data.

Both the SOC 2 and the HIPAA audit were performed by Tampa-headquartered nationwide security and compliance solutions provider A-LIGN. A-LIGN specializes in helping businesses across a variety of industries navigate the complexities of specific audits and security assessments, and both the SOC 2 and HIPAA reports of A-LIGN’s findings can be made available to prospective or current customers.

“NetDirector displayed the necessary controls in their HIPAA and SOC 2 attestation reports,” said Scott Price of A-LIGN. “Their security and management teams were great to work with throughout the process. There is a strong attention to detail in the organization.”

In addition to the in-house attestations, the data centers utilized by NetDirector through Peak10 maintain the same security standards or higher in all aspects of their company. Many technology companies have recently been brought to light as claiming true “compliance” in their organization, when they really mean that their data center has gone through the rigorous examination. At NetDirector, the belief is in transparency and clear communication regarding security, including compliance audits at all ends of the process.

“I am very proud of our team for successfully completing these important 3rd party audits,” said Harry Beisswenger, NetDirector CEO. “Both the mortgage default servicing industry and the health data environment come with very unique security and compliance requirements, and these certifications and reports strengthen the trust that our clients place in us to safely integrate their platforms and transform their data.”

Company Bio:

NetDirector provides a secure cloud-based data and document exchange solution for the healthcare and mortgage banking industries to deliver seamless data integration between parties. NetDirector bridges gaps created by disparate systems & technologies by allowing companies at any location to share data & documents securely over a single internet connection with any other member of the ecosystem. Our approach allows trading partners to collaborate and exchange data in a seamless, bi-directional, real-time manner. NetDirector currently processes more than 8 million transactions per month.

Healthcare Data That Makes a Difference

Physicians and hospitals in Kansas are pilot-testing a new analytic tool that gives them access to clinical data for patients across all providers linked to the state’s health information exchange (HIE).

The technology enables providers to pull reports from a dashboard package built around high-risk patients, preventive care initiatives, readmissions and disease registries. The aim is to help physicians deliver higher quality, more efficient and less expensive patient care.

“I can look at my patient population and see those patients who are in trouble,” explains Joe Davison, MD, a family doctor practicing in Wichita who participates in the project. “I may not have known they were in trouble, but when I look at the analytic reports that represent my panel of patients, I see I have a certain number who have poor to no control of their diabetes. I can identify those patients, extract a list [of them], and then I can act on that information.”

Data sharing on the upswing

Separately — and on a larger scale — the U.S. Department of Health and Human Services is funding a 12-month data-exchange initiative. The Patient Centered Data Home (PCDH) Heartland Initiative hit a significant milestone in December 2016. The Indiana Health Information Exchange, the Michiana Health Information Network, and the East Tennessee Health Information Network agreed to support data sharing among their HIEs to ensure that patients’ healthcare records would follow them wherever they seek care.

Seven HIEs across five states will be exchanging health information at the completion of the project, which also includes Great Lakes Health Connect, based in Grand Rapids, Michigan; HealthLinc (Bloomington, Indiana); Kentucky Health Information Exchange (Frankfort, Kentucky); and The Health Collaborative (Cincinnati, Ohio).

The project looks to demonstrate that a standards-based approach can cost-effectively, scalably and seamlessly deliver data across state lines, health systems, and referral regions. “Knowing about medical events that occur outside their local area will allow hometown physicians to build more complete patient medical records, thus providing more informed care for their patients,” notes Leigh Sterling, executive director of the East Tennessee network.

Payer projects

Health insurers are also following a similar track. For example, Aetna recently announced a collaborative effort with the Camden (New Jersey) Coalition of Healthcare Providers to expand the use of integrated data among providers. In doing so, the Neighborhood Health Compass project expects to improve outcomes for individuals with complex health and social needs.

At the federal level, the Centers for Medicare and Medicaid Services (CMS) provides actionable government data to clinicians in an effort to promote innovation and best practices. CMS’ Comprehensive Primary Care initiative, which ran from 2012 to 2016, included the continuous use of data to guide improvement at practice sites in Colorado, Oklahoma and the Ohio/Kentucky region. Data-aggregation specialists worked with payers in each area to combine data and streamline its delivery in a secure manner.

Providers “were able to quickly and easily identify gaps in patient care and see exactly which services their patients were receiving outside their practices,” according to Patrick Conway, MD, CMS’ deputy administrator for innovation and quality. Having information across multiple payers helped to build provider confidence in selecting appropriate interventions, identifying trends and assigning care management resources.

In a similar way, NetDirector’s integration platform can take existing healthcare data and allow it to be shared easily and effectively, with a degree of automation. This allows data that has been collected and stored to become a tool for achieving provider success and enhanced patient care.

For more information, please contact us or request a free demo.

Is Interoperability Disruption Inevitable in Healthcare?

The College of Healthcare Information Management Executives (CHIME) closed out 2016 with a cautionary message regarding future interoperability challenges. CHIME’s Board of Trustees raised concern over “persisting lack of interoperability among and across our disparate health system” in a December 16 letter to Centers for Medicare and Medicaid Services (CMS) Administrator Andy Slavitt.

While generally praising CMS for giving healthcare organizations more flexibility in the use of IT pursuant to new physician payment models, CHIME recommends a single set of standards to facilitate more seamless data exchange.

“We do not believe interoperability will become widespread without more uniformity in the use of health data standards,” the letter states. “A stronger state of interoperability facilitated by a uniform set of standards, including a national solution ensuring accurate patient identification, is our best hope for driving better care.”

Where things stand

At its highest level, “semantic interoperability” supports the electronic exchange of patient summary information among caregivers and other authorized parties via potentially distinct electronic health record (EHR) systems and other systems to improve healthcare delivery.

Progress is being made, argues Sam Weir, MD, lead informatics physician at UNC Health Care in North Carolina: “Physicians are increasingly working in large healthcare systems with relatively mature EHRs. These systems are working with their EHR vendors to implement the nationwide interoperability roadmap as quickly as they can.”

Nonetheless, that same trend favoring migration toward mainstream, integrated EHRs such as Epic Cerner and Allscripts may actually hinder longer-term interoperability success, according to Mike Restuccia, chief information officer at Penn Medicine. In the meantime, he agrees with the need for widely adopted and deployed semantic, data model and data definition standards.

Mario Hyland, the founder of IT consultancy Aegis, warns that interoperability obstacles are just starting to come to light — as in the case of hospitals using separate EHRs being able to exchange data until a software upgrade by one or both organizations causes an interface problem. He estimates that 35 to 40 percent of all visits result in an interoperability request, with achievement more likely to be “broken than solved.”

The path ahead

Former Apple CEO John Scully, who’s now chairman of pharmacy benefit management firm RxAdvance, and Humana CEO Bruce Broussard recently urged a push for disruption in healthcare through changes in behaviors, data analytics, interoperability and aligned incentives. They cite breakthroughs in the implementation of standards-based protocols such as Fast Healthcare Interoperability Resources (FHIR) in support of healthcare alliance efforts. The executives also point to data exchange between payers and providers enabling real-time, proactive alerts to the prescribing physicians to prevent drug-drug interactions or other potentially harmful outcomes.

Interoperability in such forms will lead to a more holistic approach to patient care, they predict, with mobile devices and other technology combining with data analytics to open up a deeper level of personalization.

NetDirector factors into this discussion as a proven disrupter in the area of healthcare data exchange — especially one-to-many integration that allows for ease of adoption and quick implementation. That approach allows providers to focus on patients care with confidence that technology such as NetDirector’s cloud-based HealthData Exchange will seamlessly handle the movement of clinical and financial data among disparate systems, and deliver it when and where needed.

For more information, please contact us or request a free demo.

Healthcare Year in Review: The Data Perspective

As 2016 comes to a close, major developments in health information technology reveal continuing storylines for the year to come. Here’s a brief overview of progress made and ongoing opportunities for health information exchange to surmount pending challenges.

Value-based care

Medicare and commercial insurers are moving quickly toward valued-based payment models, leaving fee-for-service behind. Nonetheless, the implementation of supporting technology remains a work in progress. The 2016 HIMSS Cost Accounting Survey reveals that about half of healthcare provider organizations participate in some type of alternative payment model, but only 3 percent believe they are highly prepared to make the pay-for-value transition. “It will be critical that the industry reaches some level of consistency in terms of how providers should manage the exchange of clinical and financial information between all parties involved in an episode of care, regardless of whether they are part of the same healthcare delivery system,” explains Pam Jodock, HIMSS’ senior director of health business solutions.

Legislation

On December 13, President Obama signed into law the broad-reaching 21st Century Cures Act, which makes significant investments aimed at solving some of the nation’s biggest health challenges. Among its many varied provisions, the Cures Act seeks to improve health IT interoperability by promoting complete access, exchange and use of all electronically accessible health information for authorized use under applicable state or federal law. The legislation puts a priority  — and calls for a Government Accountability Office study — on patient-matching technology that would accurately identify patients for electronic exchange of health information among providers.

Cloud computing

The shared-resources, data-on-demand model known as cloud computing continues to evolve as a trusted healthcare technology core component “underpinning the continued development of electronic health records and big data analytics,” reports HIT Infrastructure. This aligns with increased use of software-as-a-service offerings in areas such as clinical data systems and technical support desks as organizations look to lower costs and improve overall operations, according to research firm Gartner. Cloud security and compliance concerns remain in play, however, especially in the handling of health data and protected health information.

Data sharing

Data is seemly everywhere these days, continually growing, with much of it available to be shared. Despite concerns about the privacy and security of health data, 77 percent of respondents to Rock Health’s 2016 Digital Health Consumer Adoption Report are interested in sharing their health information — especially to get better care from their doctor. Among those surveyed, 79 percent said they would divulge their health history, physical activity (76 percent) and genetic data (64 percent) with a physician. On the flip side, in regard to accessing health information, it matters most to those in poor health. Twenty-eight percent of respondents who self-rated their health status as poor or bad highly desired an electronic copy of their health records, while only 19 percent of those in good health were as interested.

Behavioral health and special care innovation

The U.S. Department of Health and Human Services projects treatment spending on mental and substance use disorders will total $280 billion in 2020. Including individuals with intellectual or developmental disabilities and those who require long-term services and support because of chronic medical conditions or physical disabilities, more than 35 percent of U.S. annual healthcare expenditures flow toward care for groups that constitute less than 20 percent of the population. Efforts to understand population health risks and intervene with preventive care models that reduce costs and improve care have started to gain traction, reports CIO. In one such initiative, Quest Diagnostics is working with University of California San Francisco to tap a database of 20 billion lab test records, combined with a five-minute cognitive assessment, for early detection and treatment of dementia.

NetDirector’s cloud-based HealthData Exchange comes into play in many areas of the developments that have shaped health IT during 2016. The service not only facilitates EHR integration and streamlines clinical workflow and communications with the extended provider community, but also complements existing IT investments.

For more information, please contact us or request a free demo.

EHR Satisfaction is Up, but Interoperability and Support Issues Persist

EHR Satisfaction is Up, But Interoperability and Support Issues Persist

Satisfaction with electronic health record (EHR) systems is on the rise, according to a recent survey of healthcare professionals across a broad range of facilities. However, system interoperability and support operations raised some red flags among respondents.

The 340 responses compiled by Healthcare IT News compared 2016 EHR ratings to the prior year based on interoperability, interface, security, user experience and support services.

EHR systems from Epic, Cerner, GE Healthcare, Allscripts, eClinicalWorks and Meditech led the way in total satisfaction ratings, followed by Siemens, McKesson and NextGen. All but eClinicalWorks and NextGen scored higher in 2016 than 2015.

 

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Source: Healthcare IT News

 

While respondents overall gave positive marks for user experience and security provisions, they were most dissatisfied with intrusive alerts at the interface level, and — not surprisingly — interoperability.

Indeed, “interoperability with other systems” lagged other capabilities for users of all included EHRs except NextGen. Even among users of Epic, the survey’s top-rated EHR, interoperability graded out at the lowest level of all measured attributes. “It would be nice if it were possible to have exchange data from third-party EHRs be incorporated as structured data,” noted one Epic respondent.

Another area of concern was ongoing support. An eClinicalWorks user complained that technicians required remote access to the customer’s computer to fix problems, which ties up operations. The user said he would only recommend the EHR for standalone clinics with a full-time IT staff to deal with problems.”

EHR software also presents a timing problem in regard to exchanging data among providers: Successful data exchange between hospitals using different EHRs can be disrupted when either or both connected hospitals upgrade to a new version of the software. In a separate article, Penn Medicine CIO Mike Restuccia predicted that interoperability would fail to meet expectations until widely agreed-upon data standards are put in place and vendors take up the call for integrated solutions.

NetDirector’s HealthData Exchange integration solution addresses the problems holding back some EHR users. It enables data mapping once during set-up so that clinical data can move seamlessly among different systems used at hospitals/ practices, labs, pharmacies, imaging centers and government agencies. The data is transformed to the correct format of the receiver during transport.

Additionally, healthcare facilities only need to manage a single connection to NetDirector instead of multiple integrations to each disparate system. That cuts down on internal IT resources and frees up time to focus on delivery of care.

For more information, contact NetDirector or request a free demo.

Why is Interoperability Progress So Slow?

A little over a year ago, a group of electronic health record (EHR) vendors and providers gathered to map out objective, transparent measures of health information exchange.

Research firm KLAS and the College of Healthcare Information Management Executives (CHIME) shortly thereafter released a joint study of more than 240 provider and 15 vendor organizations. The resulting report identified the most-needed improvements for EHR interoperability: better coordination among vendors, timely location of patient records and greatly enhanced parsing capabilities.

“The data show that there is a lot of activity around health information exchange and data sharing,” CHIME CEO Russell Branzell added. “Providers and vendors, however, agree that effective management and use of standards is critical to moving forward.” He also cited patient identification as a major barrier to creation of an interoperable health network.

Further, the report emphasized that better data flow between providers would be essential during healthcare’s transition from a fee-for-service environment to a value-based delivery model and reimbursement system.

Recent gauge on progress

At the end of August 2016, the KLAS Interoperability Measurement Advisory Team unveiled details of its framework for benchmarking and assessing interoperability performance among EHR vendors. The work focuses on clinical end users’ experience related to:

  1. availability of needed information;
  2. ease of locating records;
  3. ability to view outside records within the clinical workflow; and
  4. impact on patient care.

Roughly a month later, KLAS published its 2016 Interoperability report, which highlighted “significant immaturities” in the marketplace. Of particular note, only 6 percent of surveyed providers confirmed delivery of information accessed from exchange partners on a different EHR in an effective way to facilitate improvement in patient care.

At the front end of the process, respondents reported reasonable access — 28 percent of the time — to information on a different EHR. The ability to locate records was “automatic or simple” a mere 13 percent of the time. Receipt and location of desired information within the clinician’s workflow via integrated display or EHR tab happened just 8 percent of the time.

“We learned that challenges related to effective sharing, especially with a different EHR vendor than your own, are experienced across all facility types and across all vendors,” observed Bob Cash, vice president of provider relations at KLAS.

Nonetheless, Cash expressed optimism that vendors and providers would work through the identified challenges, with the current results serving as a baseline for tracking progress in coming years.

A forward-looking approach

While vendors and providers continue to ramp up interoperability efforts among individual systems, NetDirector has already established expertise in EHR integration, delivering data through a cloud-based exchange. And since NetDirector’s HealthData Exchange uses HL7 standards, it can enable information exchange not only with EHRs but also with practice management systems, lab information systems, health information exchanges, PACS and radiology information systems.

Hospitals and physician practices have engaged with NetDirector to reduce the time, cost and effort involved with EHR integration. What’s more, the technology streamlines clinical workflow, an essential component of ongoing interoperability initiatives across the industry.

For more information, contact NetDirector or request a free demo.

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