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.
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.
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.
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 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.
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:
- availability of needed information;
- ease of locating records;
- ability to view outside records within the clinical workflow; and
- 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.
We have additional updates regarding the Ocwen/Equator transition, as the transition from Ocwen to Equator continues to move forward.
The process of creating the data integration is well underway with NetDirector and Equator. Currently, we are providing the integration with foreclosure files only.
Due to the upcoming and current changes, this integration piece should replace the previous Intelligent Data Agents (IDA) method used for the cut over. If your firm is still using the IDA method, contact your integration analyst about how to transition to the new integration.
Available integrations and specific updates include:
- Bankruptcy Referrals (IDA Process)
- Bankruptcy Orders, Motion for Relief, Proof of Claim, Notice of Payment Claim, Notice of Final Cure, Reorganization Plan, Supplmemental Proof of Claim
- Foreclosure Referrals (Data Integration)
- Finalizing the implementation process
- Standard Events/Deliverables (Data Integration)
- Will be for Foreclosure Orders only
- These events will require documents to be uploaded as part of deliverable
- Document Uploads (IDA Process, planning to move to data integration)
- Done through Equator (formerly ResWare®)
- Invoice Import (IDA Process)
- Still done through REALRemit®
If you have any questions about the transition, please contact your integration analyst.
Like its atmospheric modifier, cloud computing comes together in boundless shapes and sizes. Some say it’s a simple feat — accessing and storing data and programs over the Internet instead of on a hard drive — but a mind-boggling combination of data processing, synchronization, communication, and protection takes place beyond the individual user’s confines.
In any case, it’s big business, with public cloud companies projected to stake out an estimated $500 billion in market cap by 2020. “The depth and breadth of cloud progress is pretty shocking,” investor Byron Deeter of Bessemer Venture Partners told Forbes.
That’s a long way from the roots of the dot-com era, when Application Server Providers (ASPs) connected people via the Web to software hosted in offsite data centers, and thereby offered businesses a viable alternative to buying hardware and hiring people to manage it. Still, the drawbacks at the time — sluggish connections and sky-high ASP operations costs — kept traditionally late-adopter industries like healthcare mostly on the ground rather than in the cloud.
As recently as 2014 only about 22 percent of healthcare organizations surveyed by HIMSS Analytics were planning to use cloud computing for back-office functions. In 2016, nearly 47 percent of respondents have cloud usage in their back-office plans. The same holds true for business continuity/ disaster recovery functions and health information exchange: the former rising from 31 percent in 2014 to 47 percent in 2016, and the latter from 20 to 41 percent.
“In 2014, the cloud was primarily seen as a model that could support HIE and data storage, whereas, in 2016, it is being leveraged for a full range of functions including patient empowerment,” according to the survey report.
Indeed, healthcare entities cite the following factors (in order of importance) in their move to the cloud:
- Cost savings
- More complete disaster recovery capabilities
- More scalability for internal requirements
- Speed of deployment
- Improved user access to applications
- Plans to scale information and virtual care to patients
- Freeing up internal storage/compute cycles
- Accommodation of mobile workforce
- Regulatory compliance
- Accessibility to compute cycles
Another way to say it is that core health IT components, such as electronic health record (EHR) systems, cannot be at risk for downtime with vital patient care considerations hanging in the balance. With technologies coalescing in the background, tens of thousands of EHR users across multiple vendor platforms now use the cloud daily with complete trust.
Additional “hot spot” cloud applications in healthcare continue to emerge in the areas of telemedicine, medical imaging, public health and patient self-management, hospital management, therapeutic interventions, and secondary use of data for analysis and clinical research.
In response, cloud service providers “need to ensure uptime and performance, deliver on compliance and service level agreements, and offer reliable technical support,” the HIMSS Analytics report states.
NetDirector, one of the originators of the cloud-based integration platform, has built its healthcare business by ensuring the movement of clinical records between providers, helping them achieve a safer and more efficient level of care. The company’s HealthData Exchange combines cloud-based technology with world-class security levels to enhance workflow — which, in turn, allows providers to focus on patient care.
Ransomware, a form of digital extortion, involves lockdown of computers via malware or encryption of electronic files with a private key that only the attacker holds. Victims are left to pay the hacker to regain access, develop workarounds or isolate affected data/devices.
The FBI reports an increase in incidents in which users infect their computers with ransomware by clicking on a compromised website, often lured by a deceptive email message or pop-up window. A fairly recent variant encrypts files on a hard drive as well as any external or shared drives to which the computer has access.
Although ransom amounts typically range from a few hundred to several thousand dollars per instance, hackers collected more than $200 million total in the United States during the first quarter of 2016.
Healthcare organizations, in particular, need to be on the lookout. Research conducted by security firm Solutionary reveals that the healthcare sector accounted for 88 percent of all ransomware attacks it tracked during the first half of 2016.
In perhaps the highest profile healthcare case of this year, 434-bed Hollywood Presbyterian Medical Center in Los Angeles paid $17,000 in bitcoin ransom to obtain a decryption key and restore normal operations after a lockout.
Why is healthcare such a target?
A number of interrelated factors play into healthcare’s ransomware vulnerability:
- Hospitals and health systems store detailed personal information on patients to make it readily available in the course of care. Stolen health insurance credentials can be used to commit medical fraud, fetching 10 to 20 times more than credit card numbers on the black market.
- What’s more, perpetrators can often get financial, identification and health information all packed together within health system records.
- Healthcare providers rely on electronic records to stay operational. With patients’ lives potentially on the line during a ransomware attack, they may be more willing to pay up quickly than victims in other industries.
- Healthcare institutions don’t spend a lot of money on data security. Roughly 80 percent of organizations surveyed by HIMSS Analytics reported allocating less than 6 percent of their budgets on data protection.
- Healthcare is a consolidating industry, with major care organizations merging and acquiring other facilities. Integration of disparate information systems often leaves gaps that give hackers access to sensitive data.
- Hospitals typically don’t train employees on cybersecurity awareness.
What can be done?
Threat intelligence experts at Solutionary say healthcare organizations can counter the threat of ransomware by using off-site backups for their data — and the systems used to access that data. They should also test the backups regularly to ensure data can be restored quickly.
While providing data exchange services to healthcare organizations, NetDirector utilizes IT infrastructure provider Peak 10’s offsite data center to ensure online backups, data recovery capabilities, minimal to no downtime, and the most current security certifications.
With the major risk of self-managing data security, it makes sense for providers to use a trusted vendor like NetDirector to protect against ongoing threats such as ransomware.
TAMPA, Fla., Aug. 23, 2016 /PRNewswire/ — NetDirector, a leading cloud-based integration and data exchange provider, has been named as a member of the prestigious Inc. 5000 list for the 6th consecutive year, a recipient of the GrowFL “Companies to Watch” award, and a member of the Gulf Coast 500 by Business Observer FL.
Companies like NetDirector that are included on the Inc. 5000 list are among the top companies in the nation, having demonstrated the highest growth in revenue over the last three years. The companies with the highest percentage growth and who meet the other qualifications are then published by Inc. as the Inc. 5000. It is an honor for NetDirector to be included in this list for the 6th consecutive year. With only 4.6 percent of the companies on this year’s list making it on for six consecutive years, it is a very rare accomplishment. NetDirector intends to continue the trend in the coming years with their expansion of integration offerings in the healthcare market.
Florida Companies to WatchSM chooses the 50 companies statewide that are expected to see significant growth over the next several years. NetDirector was among more than 500 nominees for Florida Companies to WatchSM, which is a statewide program managed by economic development group GrowFL, in association with the Edward Lowe Foundation. This is the first year NetDirector has been named as one of the Florida Companies to WatchSM.
The Gulf Coast 500, published by Business Observer FL, is awarded to the Top 500 ranked companies in nine counties along the gulf coast, as decided by total revenue. NetDirector earned a spot in the Gulf Coast 500 for the fourth consecutive year thanks to their steadily increasing client base and revenue.
By linking disparate systems with “plug-and-play” style connectivity, NetDirector eases the operations of companies in the mortgage banking and healthcare industries by allowing data to flow seamlessly from one party to another. Maintaining security and data integrity has been another key focus of NetDirector from the beginning. GrowFL, Business Observer FL, and Inc. recognize the importance of these key factors in today’s evolving mortgage and healthcare technology environments.
“To be included on these lists and receive these awards really tells us that we’re doing things right,” said NetDirector CEO Harry Beisswenger. “NetDirector is committed to the success of a variety of organizations in healthcare and mortgage banking, and we know the secret to that lies with seamless integration workflow. We owe all of our achievements to the NetDirector team, our customers, and our strategic partners/vendors.”
For more information on connecting to NetDirector’s ecosystem contact us at 813-749-7131 or email@example.com to explore how NetDirector fits in your organization.
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