Midyear Healthcare and Technology Progress Report

High availability, interoperability, and utility in population health management all figured prominently in an early 2017 forecast of areas where healthcare CIOs expect information technology (IT) to deliver significant impact for their organizations.

Here’s a look at how things are shaping up at the year’s midpoint.

Systems availability

While natural disasters or cyber-attacks can knock out — or lock out — critical IT systems without warning, healthcare entities still need to prepare for such events. In fact, the HIPAA Security Rule requires health care covered entities to have a contingency plan for responding to unavailability of electronic health information systems.

The Department of Health and Human Services’ Inspector General reported last year in a survey of 400 hospitals that about two-thirds have contingency plans addressing data backup, disaster recovery, emergency mode operations and testing/ revision procedures. Nonetheless, over half of the surveyed hospitals confirmed an unplanned disruption to their electronic health record (EHR) system, and about a quarter of those experienced delays in patient care as a result.

So far this year, EHR outages continue to make headlines:

  • An April 2017 poll, conducted by online physician community Sermo, found that 55 percent of 1,678 responding U.S. doctors had experienced an EHR outage or malfunction that jeopardized the health or safety of a patient.
  • Also in April, Erie County Medical Center and an associated long-term care facility experienced a system-wide shutdown attributed to a ransomware attack. The hospital’s backup process prevented loss of any patient records or financial data, but its EHR was taken offline for six weeks, during which time activities such as patient admissions and prescription writing had to be handled manually.
  • In a separate incident at the end of February, an ophthalmology-specific EHR experienced “technical difficulties” due to outages of Amazon’s S3 cloud-based hosting service.

Data center and cloud services provider Peak 10 recommends that healthcare entities not only review their IT privacy and security policies and procedures but also insist that their service level agreements with technology providers specify agreed-upon security objectives and how compliance will be ensured.

Interoperability

In late March, the Office of the National Coordinator for Health IT (ONC) shared several examples of what it described as “interoperability in action from coast to coast.” Among the programs ONC showcased:

  • An app that imports patient data — including personal and medical device data, remote monitoring and reminders — into a comprehensive family health dashboard.
  • A solution that allows clinicians to create customizable push notifications that can be tailored to individual patients or groups.
  • A smartphone app that allows patients to grant or revoke permission for providers to access, send or receive health information electronically.
  • A secure system for users to seamlessly store and share data with trusted care professionals.

Additional projects outside of ONC’s purview are taking aim at other aspects of interoperability. In April, Ascension Health, Cedars-Sinai Health System and Hospital Corporation of America opened the Center for Medical Interoperability. The lab will provide resources for researchers to test data-sharing connections for medical devices and EHRs. In February, the Personal Connected Health Alliance agreed to partner with the Integrating the Healthcare Enterprise initiative in efforts to improve health data exchange through conformity testing and certification with a focus on standards-based, open specifications.

Population health

No single type of data serves as a comprehensive source of information for population health management. For example, claims data includes patient demographics, diagnosis codes, and dates and costs of services; however, the information is retrospective and limited to just billable aspects of care, explains a recent HealthITAnalytics report. Likewise, EHR systems provide clinical details but often contain unstructured, free-text descriptions that are difficult to extract and analyze.

Still, healthcare organizations continue to press forward with population health initiatives. Vanderbilt University just released a report card — the first of its kind in the nation — intended to guide the planning, implementation, and evaluation of programs and policies to improve men’s health across the entire state of Tennessee. It identifies heart disease and cancer as the leading causes of death in the state and reveals a deficit in men having a personal health provider. Meanwhile, Stanford University’s Center for Population Health Sciences has awarded $275,000 in pilot grants to fund studies seeking to improve population and community health, including a mobile surveillance system that will map autism and gaps in treatment services.

Efforts such as these will help drive discovery of what works in real-world practice of population health management. “As an industry, we can increase the socialization of toolkits and case studies so that healthcare organizations can more clearly define all aspects of population health management model design,” observes Jennifer Rogers, an analyst at Chilmark Research. She adds that optimal IT deployment will speed up gains in value for current and future adopters of population health models.

Availability, interoperability, and population health projects face a balance of challenges and opportunities as we enter the second half of 2017. NetDirector continues to innovate with cloud-based, foundational integration solutions that will help healthcare organizations seamlessly handle the electronic exchange of information in each of these areas within their respective ecosystems. For more information, please contact us or request a free demo.

When a Health IT Rollout Runs Off the Rails

If ever a large-scale health IT project needed a reboot, it was the rollout of Healthcare.gov. Fortunately, it got one — in the form of an emergency, behind-the-scenes “tech surge” assembled to salvage the government’s new health insurance portal after a halting launch.

To recap, only six people completed the online enrollment process on Oct. 1, 2013, the day Healthcare.gov officially opened for business, according to notes from war room meetings at the Center for Medicare and Medicaid Services (CMS), the agency charged with implementing the site. Things didn’t improve much the next two days, with a cumulative total of 248 enrollments successfully submitted and at times up to 40,000 consumers stuck in a waiting stage.

Malfunctions crashed Healthcare.gov twice more the last week of October, the second time while Kathleen Sebelius, Secretary of Health and Human Services (HHS), the parent department of CMS, was testifying before Congress about the website’s problems.

Administration officials advised consumers who experienced trouble with the online process to apply by phone — or even mail in a hard copy form.

President Obama called it a “well-documented disaster” and pundits had a field day.

“Only the government could come up with a website that’s slower than sending something by mail.” — Jay Leno

“If you are in need of healthcare, you have two choices: You can wait for them to get the site fixed, or you can enroll in medical school, graduate, and then just take care of yourself.” — Jimmy Kimmel

“People are getting a busy signal when they try to apply over the phone. You can’t use the Internet and you can’t use the phone. So now fax machines are like, ‘Look who’s come crawling back!’” — Jimmy Fallon

To its credit, the administration retooled and relaunched the site by December 2013 and hit its stated goal of signing up 7 million people by the end of the first quarter of 2014. Nonetheless, substantial damage had already been done. Hundreds of millions of dollars had been spent, and by April 2014 Sebelius had resigned after taking ultimate responsibility for the launch debacle.

What went wrong

In retrospect, the management and technical problems that plagued Healthcare.gov throughout its development seem fairly apparent.

A February 2016 report issued by HHS’ Office of the Inspector General stated that the most critical misstep made by the project team leading up to launch was “absence of clear leadership, which caused delays in decision-making, lack of clarity in project tasks and the inability of CMS to recognize the magnitude of problems as the project deteriorated.” Other contributing factors included devoting too much time to policy issues rather than to actual site development, poor technical decisions and improper management of the key development contract. The report also criticized CMS’ organizational structure and culture, which hampered coordination, pushed back against warnings of “bad news” and failed to alter plans in the face of problems.

The Government Accountability Office (GAO), in a separate analysis, pointed out CMS shortcomings in the areas of capacity planning for the site, as well as failure to correct software coding errors and implement full functionality prior to launch. Additionally, GAO said, “Healthcare.gov and its supporting systems were not fully tested prior to launch, and test documentation was missing key elements such as criteria for determining whether a system passed a test.”

A CIO retrospective summarized the project’s faults and how the fiasco could have been prevented: “Healthcare.gov was a single, Big Bang rollout that couldn’t be stopped.” The huge undertaking should have been tracked forward in incremental stages, with early and complete testing, and a more flexible scope to find areas of risk before they unexpectedly appeared.

Not a singular instance

Despite all the negative fallout, perhaps we shouldn’t be surprised with Healthcare.gov’s early-phase stumbles. Standish Group, an advisory firm focusing on software project performance, studied 3,555 projects from 2003 through 2012 that had labor costs of at least $10 million.

The takeaway: Only about 6 percent were deemed successful. A majority, 52 percent were “challenged” — meaning over budget, behind schedule or failed to meet user expectations. The rest, about 42 percent, were either scrapped or started anew from scratch.

Further research, from Forrester Consulting, shows that less than 40 percent of IT executives believe their internal IT organizations can regularly deliver projects on time and within budget, due in large part to continually changing user requirements and overburdened departmental resources.

In general commercial environments, such a low success rate may be accepted as a “cost of doing business,” and the worst outcome could be scope creep or project delays. In healthcare, the stakes are higher, with patient lives potentially on the line when IT systems don’t work or aren’t available when needed. That’s why many healthcare entities are looking for trusted third-party help in gaining control over their interconnected systems and expanding ecosystems.

NetDirector has been around for almost 15 years, offering cloud-based services that are now considered a staple solution for data integration in healthcare and other industries. Learn more about the HealthData Exchange platform here or request a free demo.

NetDirector Enables Next-Generation Integration in Radiology with American Health Imaging

Tampa, FL – May 24, 2017 – NetDirector, a cloud-based data exchange and integration platform, has engaged in a rapid expansion strategy in the healthcare industry over the last few years. Recently, the Integration-Platform-as-a-Service (iPaaS) has completed implementation with American Health Imaging, a regional network of radiology providers across multiple states, to provide increased accessibility and data utility in their company.

American Health Imaging (AHI) began providing diagnostic imaging services in Decatur, Georgia, in 1998, and has since expanded to 21 locations. In each area, they distinguished themselves by providing excellent customer service and high quality diagnostic imaging for their patients and referring physicians. By partnering with NetDirector to provide cloud-based integration services, it is the goal of AHI to create an automation platform that will increase overall customer satisfaction through streamlined processes and to create internal manpower savings through enhancing their ability to scale the business without having to add staff.

“We want to provide the best possible patient care, to the maximum number of patients, while minimizing the need for human intervention in the process,” said Dan Balentine, Chief Operating Officer at AHI. “By utilizing the NetDirector integration, it has allowed us to take our staff’s focus off of the day to day busywork, and shift focus to providing unmatched patient care.”

With traditional integrations, a company like AHI could be paying upwards of $20,000 plus an 18% annual maintenance fee for each vendor that would be integrated with AHI’s EMR and other in-house systems. For AHI, this was clearly not the optimum solution. Several vendors might not have the volume of transactions to justify the integration cost, creating a system built around the exception and not the constant. NetDirector’s one-to-many integration approach allowed AHI to integrate once with NetDirector, and use that single integration to connect to the entire hub of HealthData Exchange participants.

Three main technologies formed the backbone of the AHI-NetDirector integration – HealthLogix, Exchange EDI, and IntScripts.

HealthLogix Integration – Patient Check-In, Appointment Confirmation, Patient Billing

AHI utilizes a patient engagement platform called HealthLogix to help follow up with patients after exams or appointments, confirm scheduling, prompt for surveys, create a seamless check-in process, and more. The cloud-based integration model helped AHI bring this information directly into their Fuji Radiology Information System (RIS) and patient billing databases, to keep patient records current and to leverage the data they were collecting most efficiently, and allowed the utilization of HealthLogix’s full functionality such as automating check-in procedures at a digital kiosk, and more.

Exchange EDI Integration – Insurance Coverage Confirmation & Verification

Additionally, in a time where high-deductible insurance policies are increasingly commonplace, insurance confirmation simply isn’t enough information. AHI utilized NetDirector to connect with Exchange EDI, which not only confirms the participation in an insurance policy or group but analyzes policy levels and remaining deductibles. This allows patients and providers alike to understand the patient’s responsibility up front – the transparency provided by this data allows for accurate collection of copays during visits, reduced collection costs down the line, and overall reduced revenue leakage for providers.

IntScripts Integration – Physician Referrals and Radiology Communication Integration

Finally, it was critical to make the ordering process for their referring physician population as simple as possible, so an integration was performed with IntScripts, which provided the ability to directly receive orders from the referrer’s EHR and have the results automatically dropped right into the patient’s chart.  This automation eliminates the traditional manual processes that were previously encountered by both AHI and referring physicians.

For patients, the NetDirector integration platform provides not only an elevated level of understanding of their coverage and responsibility through stronger integration between provider and vendor, but also makes life easier for their primary care doctor or other referring physician to communicate and refer patients. This increases the likelihood of single-service care, as primary care physicians are more likely to refer patients as needed, and patients can trust they are receiving the right treatment for them.

“The integration that we have created for American Health Imaging is a model case for the value of cloud-based integration in healthcare,” said Harry Beisswenger, NetDirector CEO. “When we set out to enter the healthcare industry, our primary goals were to reduce costs for providers, increase potential care level provided to patients, and create an environment of data transparency and communication. AHI’s integration has accomplished all of this and more.”

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. With security and longevity as a focus, NetDirector is a certified HIPAA Compliant company, a 6-year member of the prominent Inc. 5000, and currently processes more than 8 million transactions per month.

Integration Can Power the Tools for Patient Engagement

Roughly 70 percent of health systems, hospitals and physician practices proactively work toward getting patients more involved in their own care, according to a 2016 NEJM Catalyst survey. However, considering the drive to implement and deliver value-based care, industry observers are wondering why that number isn’t closer to 100 percent.

“[We] need to engage patients outside the exam room with frequent, creative interactions that do not have to always include their physicians,” according to Kevin Volpp, MD, PhD, and Namita Mohta, MD, who analyzed the survey results.

Patient portals, secure email, online/mobile scheduling, patient-generated data and social networks lead the way among engagement initiatives currently being used at scale, according to respondents.

Nonetheless, portals in particular tend to be “systems of record, not systems of engagement,” observes analyst Brian Eastwood of Chilmark Research, a health IT advisory firm. Today’s portals aren’t optimized for value-based care or population health management because they’re geared toward the individual and don’t encourage behavior change, he adds.

Forward-looking solutions must be built on a broader engagement model that loops in coordinated community care teams and enables bi-directional information flow, Eastwood explains. “The point solutions that consumers use to access the healthcare system will get bigger,” he continues. “We need to try to connect to these solutions in some way — and integration is the best we can hope for.”

A pathway to future success

Design and usability will be the main drivers of behavior changes in patient engagement, predicts Sean Duffy, CEO of Omada Health, a tech-based company targeting diabetes care through analytically identified trends.

“It’s about fine-tuning and personalization, [which will spawn] an incredible wave of potential in the way we work to improve the health of the country,” Duffy tells FierceHealthcare. Optimizing the way patients interact with engagement technology is a core part of the process so that a wide range of individuals can be effectively served.

And there’s good reason to expect positive patient response to emerging engagement technology. CDW’s 2017 Patient Engagement Perspective Study finds 70 percent of patient respondents saying they’ve become more knowledgeable about their personal medical information because of online access. Half of the same sample said they’ve noticed increased engagement with their own healthcare.

At the same time, it’s essential to view patient engagement as a two-way street. To wit, 67 percent of providers surveyed by CDW consider patient engagement to be an important part of improving overall care and the top motivating factor in spurring their respective organizations into action.

Indeed, leading healthcare institutions such as Johns Hopkins Medicine are making sure employees understand patient data and know how to communicate it. That behavior is “becoming very ingrained in the way we do our work,” says chief patient experience officer Lisa Allen.

NetDirector’s HealthData Exchange platform supports such initiatives by electronically moving clinical and financial data among disparate systems — transparently mapping it to the correct format of the recipient. In this way, HealthData Exchange serves as an engine for integrating engagement technologies, increasing the likelihood of not only utilization, but also the accuracy of data circulating in multiple environments without human intervention.

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

What’s Top-of-Mind for Healthcare Provider Connectivity?

Healthcare connectivity covers a lot of virtual territories, evolving technologies, and boots-on-the-ground personnel. On the human side alone, stakeholders involved in the creation, exchange, and use of health information include individuals, patients, physicians, hospitals, payers, suppliers and ancillary service providers.

Concurrently, healthcare’s ecosystem relies on technical standards, policies, and protocols “to enable seamless and secure capture, discovery, exchange and utilization of information” in all its various forms among stakeholder parties, according to the HIMSS Interoperability & HIE Committee.

Healthcare organizations have been hammering away at this multi-faceted challenge for decades, making incremental progress. “The next step is taking data and using it to create a more accurate picture of the patient that drives better healthcare decisions,” observes Carla Smith, HIMSS executive vice president.

Industry-wide activity is trending toward population health initiatives. Case in point: Catholic Health Initiatives (CHI) in Englewood, Colo., has stepped up its population health strategy through the use of advanced data analytics. Since rolling out the program, CHI has cut pneumonia mortality by 21 percent; catheter-associated urinary tract infections by 27 percent; surgical site infections (SSIs) following colon surgery by 34 percent; and SSIs following hysterectomy by 45 percent.

Concurrently, Atrius Health in Newton, Mass., is focusing on lowering inappropriate hospitalizations and reducing lengths of stay in nursing facilities. Atrius pairs patient histories from its EHR with claims data for alternative payment contracts to identify at-risk groups who could benefit from early interventions (e.g., those with chronic kidney disease) while also managing patients already diagnosed with chronic conditions, reports Becker’s Hospital Review. The goal is to develop customized and comprehensive care and treatment plans.

Areas of opportunity

Aside from these types of leading-edge programs, hospitals and health systems are hard at work in more fundamental areas of health information exchange. The U.S. Department of Health and Human Services (HHS), in a 2016 statutorily required report to Congress, noted that about three-quarters of hospitals could electronically exchange health information with outside providers, highlighted by a spike of 23 percent between 2013 and 2014. However, physician practices lagged behind in their ability to electronically share patient health information in the same manner.

At the same time, HHS said it will pursue incentives “to stimulate more collaborative business arrangements and uninterrupted information flow.” In broad terms, these financial levers will be intended to motivate higher-value care, reward teamwork and integration in the delivery of care, pave the way for more effective coordination of providers across settings, and “harness the power of information” in improving care across populations of patients.

All this needs to happen in concert with more fully engaged patients. While 72 percent of hospitals enable patients to electronically request an amendment to their own health information, other areas must come up to speed. For instance, only about 40 percent of hospital patients can request prescription refills or schedule appointments online, and just slightly over half of hospitals allow patients to send and receive secure messages electronically.

Increasingly, healthcare providers are looking to build out capabilities in a unified, streamlined ecosystem. NetDirector’s cloud-based HealthData Exchange platform is designed to make this level of connectivity a reality. HealthData Exchange allows hospitals and physician practices to make a single connection that instantly gives them access to dozens — and potentially hundreds — of other providers and vendors via pre-defined integrations. NetDirector currently processes more than 10 million data and document transactions per month.

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

Troubleshooting IT Stressors in Healthcare

 

If technology’s not working well or as expected at a U.S. hospital or health system, the chief information officer (CIO) is the first to hear about it. CIOs and their staff respond to front-line issues but also take on continuous challenges from top-level administrators regarding strategic issues impacted by IT.

NetDirector surveyed the health IT landscape and compiled representative questions being fired at CIOs in executive suites across the country. Our list isn’t meant to be all-inclusive, but highlights industry experts’ approaches to some of healthcare’s most troublesome challenges.

We’re still hearing complaints about the EHR. What can we do to get more out the system?

Many EHR implementations were fast-tracked in an effort to meet federal meaningful use requirements, but they typically restricted providers from achieving a clear return on investment, emphasizes a 2017 KPMG report. What’s needed is an organized plan to move forward. KPMG advocates a long-term approach that seeks incremental process changes to improve efficiency and quality. Without such change, “the EHR operates in a silo and doesn’t align with the way clinicians practice medicine or with new industry demands, which creates dissatisfaction and underutilized technology,” the report warns.

Healthcare CIOs agree with placing priority on EHRs, with 38 percent planning to allocate the majority of capital investment over the next three years to EHR system optimization and implementation of additional features. That projected budget distribution outpaces plans for investment in accountable care/population health technology; consumer, clinical and operational analytics; telehealth technology enhancements; revenue cycle system replacement and ERP systems replacement.

We just bought a new server. What are we actually getting from our data center besides hardware to be amortized?

Healthcare administrators are questioning their organization’s readiness to transition to cloud computing. Going all-in on a move to the cloud should yield IT cost savings of about 30 percent, according to Oracle CEO Mark Hurd. IT departments unchained from the constant distractions of support, upgrades and patches can refocus efforts on new development in areas that deliver competitive and financial advantages. “Innovation actually accelerates,” said Hurd, “and that happens simultaneous to the reduced cost and other benefits.”

For example, Beth Israel Deaconess Medical Center in Boston expects the use of cloud services in 2017 to bring about “high reliability, robust geographically distributed disaster recovery, security best practices, lower cost and enhanced scalability.”

How are we streamlining interactions with care partners in the community? We can’t be a player in value-based care without them.

IT consulting firm Gartner predicts that building a digital ecosystem will be a top CIO priority throughout 2017 and beyond. The ecosystem refers to related entities sharing digital platforms in pursuit of mutually beneficial goals (i.e., in healthcare, improving patient outcomes at lower cost). “A combination of core and evolving digital technologies enhances interoperability among digital ecosystem partners and supports participation,” advises Gartner.

We just heard about another ransomware attack on a medical group last month. What are we doing to make sure this doesn’t happen to us?

The referenced attack exposed to hackers protected health information on nearly 18,000 patients. In response, the medical group worked with an IT firm to remove the ransomware virus from two servers that had been infected, installed a firewall, and set up a secure email system. A risk analysis of the group’s IT system has also been scheduled.

IDC FutureScape forecasts a doubling of healthcare ransomware attacks by 2018, prompting IT departments to take a more proactive stance. “Six years ago, we had two people involved in IT security. Today we have 50,” observes Marc Probst, CIO of Intermountain Healthcare in Salt Lake City. “We’re a soft target compared to financial services or some of these other organizations, but we’re trying to stay on top of it.”

Why can’t the IT staff handle what’s on our plate?

Staffing firm Manpower reports employers are having trouble filling IT positions due to lack of technical proficiency, experience and soft skills. Among the hardest areas to permanently staff up are information security and big data. CIOs may have to look beyond traditional HR channels to the “gig economy,” independently contracting with IT talent on an as-needed basis.

Relieving IT stress

NetDirector’s HealthData Exchange opens up opportunities to address many of the IT issues keeping CIOs awake at night. For instance, the platform integrates clinical and financial data among disparate systems, enabling greater interoperability of core EHR systems with other partners in the organization’s care ecosystem. The cloud-based solution also eliminates the need for hardware and software on premise and locks down data in a secure environment. And integration with NetDirector reduces IT resources needed for day-to-day operations, freeing up your tech team for strategic initiatives such as population health or data analytics.

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

 

 

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.

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 Data in 2017

IT executives in healthcare face an expanding array of challenges in 2017 as the industry takes initial steps away from transactional-based, fee-for-service models and toward reimbursements tied to measures of value and quality. The clock has started ticking on Medicare reform’s implementation, with provider performance data gathered this year providing the basis for physician payments in 2019.

“To succeed in the value-based environment, health systems need to invest heavily in technology,” reports the Deloitte Center for Health Solutions.

The following areas should see significant impact.

IT as a key enabler

Healthcare organizations are recognizing IT’s mission-critical role in ensuring continuous high availability of systems and support of operational commitments, according to the 2016 Harvey Nash/KPMG CIO Survey. Fifty-two percent of healthcare CIOs expect their IT budget to increase over the next 12 months, compared to 45 percent across all industries. The boards of healthcare companies also place a higher priority than their counterparts in other industries on increasing operational efficiencies, improving business processes and delivering business intelligence/ analytics. Additionally, the report finds that “cloud and other collaborative digital technology enhancements have improved health IT access, scalability, reliability and sustainability.”

Interoperability essentials

Healthcare CIOs are enthusiastic about the transition to value-based models of care, but they admit it will be a tough task to actually implement population health management programs that can pull data from multiple organizations and analyze that information with a predictive component. Interoperability of data and technology will be an essential lever in making population health and wellness a reality. “Continuity-of-care documents, electronic health records (EHRs) and other types of data must all come together in an organized, orderly marriage,” observes Transcend Insights, Humana’s population health subsidiary. “A health information exchange for data and Fast Healthcare Interoperability Resources (FHIR) for application interfacing [will be] the easiest route forward.”

Interoperability also tops the list of EHR development projects slated for 2017, according to a Healthcare IT News survey of health technology executives. Specifically, respondents say top EHR projects will be geared toward improving interoperability, workflow and usability, as well as adding population health tools and migrating to the cloud. “EHRs were put in basically as dumb data communication systems without emphasis on exchange and workflow,” explains John Halamka, MD, CIO at Boston’s Beth Israel Deaconess health system. “But because of payment reform, we have incentives to do data exchange. Different things are bubbling to the top.”

Opportunity in digital health

Digital health tools such as health-related apps, activity trackers and smart watches have the potential to help consumers become more engaged in their own health. Unfortunately, that’s not happening yet. For instance, 75 percent of consumers who use mobile or Internet-connected health apps are willing to share the data they collect with their provider; however, only 32 percent say that type of exchange actually takes place, according to a digital health survey conducted by HealthMine. Additionally, 60 percent of digital health users say they have electronic health records, but only 22 percent use them to make medical decisions. HealthMine CEO Bryce Williams says, “Digital health is still crossing the chasm from lifestyle and fitness management to chronic disease and holistic healthcare management.” Williams looks for that gap to close during 2017 as health plan sponsors apply collected consumer health data to gain insights and manage populations toward improved health.

Tamper-proof technology

On December 12, Quest Diagnostics revealed that an unauthorized party obtained protected health information of approximately 34,000 individuals via an Internet application. Accessed data included names, dates of birth and lab results — but not Social Security numbers or credit card, insurance or other financial information. As such, it was a relatively mild intrusion measured against other data breaches during 2016. In comparison, a hacking of health insurer Anthem compromised tens of millions of patient records, all of which were stored unencrypted in a centralized database. In a New York Times op-ed, cybercrime expert Kathryn Haun and healthcare futurist Eric Topol call for a move away from health systems “storing and owning all our data.” They advocate for an encrypted data platform known as blockchain, which would “give patients digital wallets containing all their medical data, continually updated, that they can share at will.” The co-authors note that the private and academic sectors are working on the emerging technology.

Data in motion

Girish Pancha, CEO and founder of data flow management company StreamSets, views data as “the final frontier in the quest for continuous IT operations.” Pancha predicts 2017 will bring recognition of data management “as a living, breathing operation that must run reliably and automatically on a continuous basis” — on par with how IT oversees applications, networks and security. Organizations will need to analyze potential changes to their processes, tooling and structure to ensure the availability and accuracy of data in motion, he adds.

All told, it will be an eventful year with healthcare organizations planning for important challenges in their respective data and integration environments. NetDirector stands ready to assist with its proven cloud-based HealthData Exchange, which moves clinical records between providers and all trading partners in their ecosystem.

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