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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.

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.

HealthCare Cloud Computing Before It Was Cool

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.

Healthcare’s ascent

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.

Learn more about the further emergence of cloud-based healthcare data integration or request a free demo.