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VA Can Learn from DoD in EHR Overhaul

As the U.S. Department of Veterans Affairs (VA) moves toward replacement of its decades-old VistA electronic health record (EHR) system, a tumultuous first half of 2018 seems to have settled into a period of practicality.

President Trump fired VA Secretary David Shulkin from his post on March 28 after an inspector general report asserted violations of federal ethics rules and procedures related to an overseas trip by Shulkin. The agency’s acting CIO, Scott Blackburn, then resigned on April 17, leaving in limbo a $10 billion contract for VA to adopt the same Cerner EHR platform being pilot-tested by the Department of Defense (DoD).

The proposed VA-Cerner deal had already triggered concern in Congress that the project’s price tag wouldn’t cover an additional 50 to 60 percent in costs to upgrade supporting infrastructure as well as ongoing maintenance for the new EHR.

Nonetheless, VA announced on May 17 that a contract with Cerner had indeed been signed, capping out at $10 billion over 10 years, and stipulating that VA would adopt the same EHR platform as DoD. Acting VA Secretary Robert Wilkie, Shulkin’s successor, said the new system, when fully deployed, would represent “a monumental advance in veterans’ healthcare” and build on DoD’s experiences in rolling out its EHR.

Operating the VA’s and DoD’s EHR systems on the same platform would improve interoperability and health data exchange, which in turn would simplify and facilitate care coordination for VA providers, Wilkie explained.

System Shortcomings

While striving to meet high expectations for its new EHR, the VA will undoubtedly learn from DoD’s Cerner-based MHS Genesis EHR implementations at Fairchild Air Force Base, Naval Health Clinic Oak Harbor and Naval Hospital Bremerton — all located in Washington state — from September through December 2017. A DoD memo dated April 30, 2018, concluded that system rollouts at those three sites “[did] not demonstrate enough workable functionality to manage and document patient care.” The report said MHS Genesis “is not operationally suitable because of poor system usability, insufficient training and inadequate help desk support.”

Other specifics cited in the DoD memo included “poorly defined user roles and workflows, [which] resulted in an increase in the time required for healthcare providers to complete daily tasks.” Some providers complained that they needed to work overtime and saw fewer patients per day due to delays caused by defects in the EHR system.

In response, Cerner President Zane Burke told shareholders in May that the company was aware of certain issues upfront at the three test sites, but DoD’s delivery on the project had gone “incredibly well overall.” Cerner plans to evaluate and remediate as necessary at the pilot MHS Genesis sites, Burke added.

In doing so, Cerner will need to address the workflow issue in particular, according to Navy Vice Admiral Raquel Bono, director of DoD’s Defense Health Agency. “Workflow adoption is the crux of the change management that’s needed to successfully deploy an EHR system, Bono said during a panel discussion at the HIMSS18 healthcare IT conference in March. Bono noted that DoD would be working in concert with VA to ensure proper identification and “unanimity of workflows.”

Meeting Challenges Through Integration

Although the DoD and VA EHR implementations may be unprecedented in size and scope, the inherent obstacles translate to smaller but similar-in-concept projects underway at healthcare stakeholder facilities across the country. In many cases, cloud-based integration and strong data management are critical factors for success.

A single cloud-based platform, such as NetDirector’s HealthData Exchange, enables hospitals and physician practices to reduce the time, cost and effort associated with EHR integration. By streamlining clinical workflow and communications with trading partners, facilities can support automated processes in place of paper-based workarounds, thereby reducing administrative costs and complementing existing IT investments. And, in the end, that frees up providers for their primary task — taking care of patients.

To find out more about HealthData Exchange, please contact us or request a free demo.

Apple Leads Big-Name Tech Charge Focusing on Health Data

Apple’s $921 billion market valuation, perched atop the Fortune 500, reflects investors’ belief that the company’s relentless growth should continue in coming years. And an iPhone-based health record product, a test version of which Apple released in late January, could be a pivotal part of the expected progression.

“We view the future as consumers owning their own health data,” Apple COO Jeff Williams told CNBC.

The new Health Records section, accessible from the iPhone’s Health app, lets users stream in encrypted data (e.g., allergies, conditions, immunizations, lab results, medications, procedures and vital signs) from leading EHR systems. The idea empowers consumers to share passcode-protected data on-demand with their primary care doctor or hospital personnel.

As of March, nearly 40 U.S. hospitals had signed on to participate in Apple’s Health Records project.

Industry Reaction

David Harlow, who heads a healthcare law and consulting practice, pointed out the long-term promise inherent in Apple’s initiative: allowing more people than ever before to access their own health data more easily. If the pilot succeeds, he added, healthcare systems of all sizes across the country would be able to connect their respective EHRs to the Apple conduit.

Indeed, among a dozen Health Records beta sites interviewed by research firm KLAS Enterprises, all recognized the product’s potential to facilitate patient-provider interaction and help consumers improve care self-management. Patient record portability should be possible soon, according to 59 percent of beta testers, with associated benefits (giving patients access to their data, using the data to engage patients, and integrating data into patient care) expected within six months.

At the same time, however, Harlow cautioned that Apple faces several short-term challenges:

  1. Health Records is currently limited to personal health record data, not the full scope of EHR data.
  2. iPhone users account for only 15 percent of the overall smartphone market (although physician iPhone usage hovers around 75 percent).
  3. The pilot’s relatively small size limits demonstration of data integration from multiple provider organizations.
  4. Data flows only in one direction — from provider to patient.

Harlow concluded that it’s not yet possible to predict whether Health Records will become ubiquitous, although consumer advocates like Apple’s approach to handling end-user data. (It stays on the phone and Apple won’t be mining it for other purposes.)

Nonetheless, a practical consideration — some patients have to pay their provider more than $500 for a single medical records request, while others encounter an annual subscription fee, according to a recent Government Accountability Office report — could disrupt emerging data-sharing models. In this environment, Apple has gotten a head start on allowing patients to own and control their health data, even across disparate systems.

Integration in the Healthcare Ecosystem

NetDirector views these developments in a positive light as they relate to integration advances across healthcare. If Health Records and similar projects take flight, cloud-based platforms such as NetDirector’s HealthData Exchange will assist with streamlined adoption and implementation. The net result will be the ability for healthcare stakeholders to quickly and accurately put in place patient-centric services.

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

Technologies That Impressed at HIMSS18

Last month in larger-than-life Las Vegas, nearly 50,000 healthcare IT professionals and vendors convened for HIMSS18, the industry’s yearly focal point. Attendees sought common ground in improving care and business operations through the use of technology.

Reports from the conference yielded a wealth of new information from more than 1,000 exhibitors and scores of expert presenters. And — indicative of a setting where anything could happen — Jared Kushner and Magic Johnson stopped by to share their respective insights on better access to patient data and health, leadership and community-building.

But at the heart of the event, discussion of challenges and pursuit of new ideas revealed common themes among those serving at healthcare organizations and their counterparts on the developer side. The infographic below summarizes key aspects of health IT’s ongoing quest to support better patient outcomes in a fiscally sustainable ecosystem.

 

 

NetDirector’s cloud-based HealthData Exchange addresses these points of emphasis through low-cost, high-speed, secure data and document sharing capabilities among hospitals, physician practices, nursing facilities, pharmacies, labs, imaging centers, vendors, government agencies and insurance providers. The format- and transport-agnostic technology eliminates the need to maintain multiple interfaces while ensuring data consistency and integrity.

For more information on the HealthData Exchange platform, please contact us or request a free demo.

Cloud Services Advancing in Healthcare Technology

Nine hospitals across the country have filed for bankruptcy thus far in 2017. Small facilities, in particular, continue to feel the pinch from a combination of dwindling patient volume, rising capital requirements, escalating costs of care, bad debt accruals and lack of Medicaid funding.

Clearly, something needs to be done to stem the flow of red ink.

Fortunately, we’re seeing a healthy response from health IT vendors, who’ve identified an opportunity among the chaos. Electronic health record (EHR) firms Meditech, athenahealth and eClinicalWorks have rolled out cloud-based versions of their platforms aimed at bringing cost-effective processing and simplified technology contracting to the small-hospital domain.

Even EHR stalwart Epic is joining the movement. On Nov. 1, Tahoe Forest Health System, which serves two rural counties across 3,500 square miles in California and Nevada, went live with a new version of Epic’s EHR. The health system’s CFO, Crystal Betts, anticipates “significant savings without the maintenance of eight EHRs and [retirement of] a host of third-party ancillary systems no longer needed.” Betts added, “The cherry on top is time saved and a boost to quality and safety with a tightly integrated EHR that just works.”

Likewise, athenahealth’s cloud-based EHR has made a significant impact at Coastal Orthopedics (Conway, S.C.), which implemented the technology a little over a year ago to replace separate EHR and practice management systems. “We wanted to be in a position to jump in quickly and effectively as population health management becomes [our] new top-of-mind issue,” noted practice administrator Andrew Wade. With the EHR taking on redundant data-collection tasks, providers and staff have been able to spend more time on patient care.

Above and Beyond

Meanwhile, the healthcare research/ academic community is also leveraging the power of cloud computing. For example, at the Icahn School of Medicine at Mount Sinai in New York, scientists and physicians have access to more than 100 terabytes of data generated by DNA sequences as they study the molecular basis of breast and ovarian cancer. They use Amazon Web Services’ cloud to support a genomics platform that dynamically scales to analyze tens of thousands of genomes in a matter of minutes.

In short, cloud computing has enabled management to shift from worrying about data storage, performance, and security to helping researchers understand the sequenced output data.

There’s more to come, too. “The cloud is poised to play a prominent role when healthcare organizations deploy telemedicine, mobile health applications, and remote monitoring tools — trends that are inevitable as organizations implement value-based care programs,” according to a HIMSS Analytics cloud computing survey.

Pathway to Progress

As healthcare organizations continue to put their faith in the cloud, they’re looking for partners who can facilitate implementation and replace layers of internal systems management and integration. And, not coincidentally, they want to do so with predictable ongoing costs.

NetDirector’s cloud-based HealthData Exchange fits the desired profile by normalizing data and documents to achieve EHR interoperability with an expanding array of trading partners, including physician groups, labs, registries and imaging centers. Subscription pricing meshes with organizations’ emerging reliance on scalable services made possible by cloud technology.

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

NetDirector Enters Comprehensive Agreement to Partner with My Constant Care, LLC for Integration Services

TAMPA, Fla.Sept. 28, 2017 /PRNewswire/ — NetDirector, a cloud-based data exchange and integration platform, has expanded their Integration-Platform-as-a-Service (iPaaS) offerings once again. A strong partnership has been forged with My Constant Care, LLC to provide them with a cloud based integration suite for the already cloud-centric company.

My Constant Care (MCC) provides a unified cloud-based platform for integration and delivery of preventive services such as Annual Wellness Visits, Chronic Care Management, Advanced Care Planning, and Preventative Screenings. Their turnkey delivery model provides patients with the full spectrum of preventive services to enhance overall care delivery without disrupting day-to-day operations of the practice. My Constant Care focuses on maximizing value to both providers and patients. They do this with expert coordination of preventive care options available today while strategically shaping these services to meet performance requirements expected of their future providers in the future. They offer a no-financial-risk solution to the physicians, providing the staff, software, and technology to perform their services.

Utilizing the cloud for integration was a clear next step to elevate the services offered by MCC. NetDirector’s One-to-Many style integration allows MCC to connect to NetDirector once and exchange data seamlessly with EHR systems, billing platforms, and more as the hub expands. Now, MCC’s services can integrate with existing provider platforms as well as future additions to a provider’s suite of technology solutions without relying on internal resources to bridge the gap between solutions.

My Constant Care helps primary care physicians provide a level of service to their Medicare population previously not achievable by small practices,” says Kellie Privette, the Director of Sales and Business Development at MCC. Privette added that “NetDirector’s integration expertise and technology allows MCC to seamless transfer patient data into their customer’s EHR and billing systems, without double entry of a substantial amount of information.”

This integration also increases a provider’s compliance, allowing even small practices to provide the quality and timeliness of service of a larger provider while maintaining and exceeding compliance standards for the healthcare technology industry. By eliminating data entry steps and automating the exchange of patient information securely, the integration allows for providers utilizing My Constant Care to focus more on the patients, and less on the technology behind the scenes.

“We’re very enthusiastic about our partnership with My Constant Care,” said Harry Beisswenger, CEO of NetDirector. “Their services fill a gap in the healthcare industry, and we’re looking forward to helping them achieve their goals of seamless preventive care for everyone.”

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 and SOC II Type 2 certified company, a 6-year member of the prominent Inc. 5000, and currently processes more than 8 million transactions per month.

Blockchain Technology: An Emerging Force in Healthcare Integration

Back in March, at the conclusion of the HIMSS17 annual conference, we pointed to blockchain as one of the most noteworthy recent developments in the healthcare IT space. We emphasized that blockchain technology, which uses a distributed database and cryptography to securely manage records and create a permanent record of online transactions, deserves recognition for its potential to increase IT and organizational efficiencies — highly valued attributes in light of Healthcare’s perpetually constrained resources.

An IBM Institute for Business Value study explains that data captured on blockchains can be shared in real time across a scalable group of individuals and institutions. “Every event or transaction is time-stamped and becomes part of a long chain, or permanent record, that can’t be tampered with after the fact,” according to the study report, which finds 16 percent of healthcare organizations ready to commercialize blockchain at scale in 2017.

Where will things go from here?

Room to grow

In practical terms, blockchain could be used in areas such as population health to aggregate patient and financial data that formerly would have been available only from separate sources such as health information exchanges and claims databases.

Further, blockchain’s ability to enable secure and irrevocable data exchange systems would provide “seamless access to historic and real-time data, while eliminating the burden and cost of data reconciliation,” explains Reenita Das, senior vice president of transformational healthcare at research firm Frost & Sullivan.

Micah Winkelspecht, founder and CEO of blockchain start-up Gem, characterizes blockchain as a tool for interoperability — in essence, an open-source protocol layer incorporating rules to which software can be written. “It’s basically like a language that all [participating] companies agree to speak in order to be able to interoperate with each other,” he adds. Unlike the current EHR-centric healthcare system, blockchain would be the “underlying fabric” for the entire continuum of care, “a decentralized, distributed, global data repository that’s basically shared and controlled by everyone,” he envisions.

Cross-industry philosophy

Related, in the mortgage industry, a similar foundational approach has experts believing in blockchain as an enabling technology empowering lenders to overcome current challenges in electronic processes.

Blockchain would be applied as a thin layer atop an existing document management system to effectively “freeze” a copy of the signed documentation, thereby proving it has never been altered and that the original document resides in its original location. Focus would shift from e-signature tools to blockchain as the core technology structure for compliance and document management — without requiring a completely reworked electronic process.

NetDirector recognizes ongoing and changing security needs in industries such as healthcare and mortgage banking. Companies on the front lines shouldn’t have to rewrite existing integrations or pay multiple vendors in their respective networks to operationalize individual system connections.

Within the healthcare ecosystem, NetDirector’s HealthData Exchange builds on a standard data model to map to HL7 or other data formats and achieve EHR interoperability while removing the bottlenecks of traditional interfacing. Such integrative technology holds the promise of making future security updates and landscape changes far more manageable.

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

Security in Data Migration, and When Not to Migrate

There’s no turning back on the cloud computing revolution. By 2020, more than 90 percent of data center traffic will be cloud traffic, according to Cisco’s Global Cloud Index forecast.

Separate analysis from 451 Research finds enterprise spending on hosting and cloud services up by 26 percent in 2017 over 2016, outpacing a 12 percent increase in total IT budgets during the same span. “Hosting and cloud services are becoming a focus of IT investment, via both new projects and the migration of existing workloads,” observes Liam Eagle, research manager at the firm.

In healthcare, 76 percent of new or existing workloads are moving to the cloud, in areas such as data archiving, backups/disaster recovery, back-office applications and server virtualization.

Some might even say the transition to cloud is happening too quickly. In fact, the simplicity of initiating cloud projects has raised eyebrows among industry observers — especially since protected health information (PHI) is at stake. “The ease of spinning up a cloud application can create, in and of itself, a risk,” says Shane Whitlatch, enterprise vice president at data security firm FairWarning. “Because cloud projects are easy to start, it’s also easy to just leave them there and not monitor them.”

Does he have a point?

Setting the record straight

Without a doubt, companies across all industries have made some missteps in migrating data to the cloud. In certain cases, organizations have viewed data migration as a one-time event rather a process that will likely be repeated over the years. Therefore, it’s important to analyze whether an IT infrastructure can hold up to the demands of a full-scale migration, reports HealthITInfrastructure.

Closer to home in healthcare, organizations often fail to assess data-quality issues before embarking on a migration. This might come into play, for example, when moving data from a legacy electronic health record (EHR) system to a new EHR application.

And while it’s certainly possible for a healthcare provider to fall victim to the scenario Whitlatch envisions (e.g., gathering PHI for research purposes and later abandoning that data outside established controls on a cloud-based platform), most organizations would avoid that type of vulnerability through due diligence. They recognize that cybersecurity is a shared responsibility between cloud provider and customer. HIPAA’s Security Rule, for instance, applies in equal force to data protection whether the data resides in on-premise systems or in the cloud.

Additionally, above all other factors, healthcare organizations are concerned about adherence to regulatory requirements such as HIPAA when selecting a cloud services provider, according to a 2016 study conducted by HIMSS Analytics.

NetDirector’s HealthData Exchange, a cloud-based platform for exchanging data between healthcare entities, has been certified as HIPAA-compliant under audit by a third-party security and compliance solutions provider. This certification “strengthens the trust that our clients place in us to safely integrate their platforms and transform their data,” explains NetDirector CEO Harry Beisswenger.

For more information on the HealthData Exchange platform, please contact us or request a free demo.

What Can We Learn from eClinicalWorks’ Big Mistake?

Electronic health record (EHR) vendor eClinicalWorks (eCW) and several of its executives are on the hook for $155 million to resolve a False Claims Act lawsuit alleging that the company misrepresented the capabilities of its software. The U.S. Department of Justice announced the settlement on May 31.

Resolution of the case also required eCW to enter into a Corporate Integrity Agreement (CIA) with the Office of the Inspector General at the U.S. Department of Health and Human Services (HHS-OIG), which oversees “meaningful use” incentive payments to healthcare providers relating to their adoption and implementation of certified EHR technology.

According to the government, eCW concealed that its software was “hardcoded” to meet certification requirements for standardized drug codes instead of actually retrieving the proper drug codes from a complete database. Other cited faults in eCW’s software included:

  • not having an audit log for accurate recording of user actions;
  • not reliably recording diagnostic imaging orders;
  • not reliably performing drug interaction checks; and
  • failing to satisfy data portability requirements for transferring patient data from eCW’s system to other vendors’ software.

All told, because of the deficiencies, “eCW caused the submission of false claims for federal incentive payments based on the use of eCW’s software,” HHS-OIG charged. $125 million of the company’s fines will go to repay Medicare and Medicaid for incentive disbursements under their respective meaningful use programs. (eCW customers who successfully attested to meaningful use in good faith will not be linked in on the government repayments.)

Aside from the financial penalties, eCW’s CIA, which extends for five years, requires the company to retain an independent oversight organization to assess its software quality control systems, with semi-annual written reports to be filed with HHS-OIG. The CIA also mandates that eCW allow its customers to obtain free software updates; customers also have the option of transferring their data to another EHR vendor without penalties or service charges.

Industry fallout

eCW agreed to the settlement without acknowledging any wrongdoing. The company said it did so to avoid lengthy and costly litigation. eCW’s EHR system remains certified under the meaningful use program. Nonetheless, the underlying facts of the case appear to have cast a broad shadow across the health IT landscape.

A report compiled by market research firm Reaction Data after announcement of the settlement found 71 percent of respondents saying they would be extremely unlikely to consider eCW in the future. What’s more, 27 percent indicated that the case had lowered confidence in their current EHR vendor, and 35 percent reported being “significantly more suspicious” of other EHR vendors.

Healthcare attorney Bob Ramsey told Healthcare Informatics that the eCW allegations may be an extreme case, but added, “Interoperability and data portability is viewed as necessary in the health world, but it’s easier said than done.”

Peter DeVault, vice president of interoperability at EHR vendor Epic, recently noted that healthcare providers would be well served to rely less on EHR certifications moving forward and to concentrate more heavily on demonstrated benefits.

NetDirector’s vendor-neutral approach to data exchange elevates providers’ ability to achieve EHR interoperability while working toward meaningful use incentives. In an environment currently clouded by skepticism, the HealthData Exchange platform automates integrations in a manner that exceeds industry standards.

NetDirector CEO Harry Beisswenger puts the technology in perspective: “It’s important for us to aid healthcare providers and vendors in reaching meaningful use benchmarks because we know that ultimately impacts the level of patient care.”

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

NetDirector Streamlines Patient Experience in Healthcare with New Health Logix Integration Suite

Tampa, FL – June 27, 2017 – NetDirector, a cloud-based data exchange and integration platform, continues to expand the presence of their cloud-based integration-platform-as-a-service (iPaaS) in the healthcare industry. In their most recent integration, NetDirector has partnered with Health Logix to deliver a technologically advanced patient experience and to streamline the process of data acquisition for providers.

Health Logix is a Software-as-a-Service (SAAS) offering delivering its customers the ability to engage patients both before and after exams or appointments by confirming scheduling, for surveys, create a seamless check-in process, and more. The cloud-based integration with NetDirector helps those clients move pertinent information directly into their Information System (RIS, EHR, HIS, etc.) and patient billing databases, to keep patient records current and to leverage collected data most efficiently.  Health Logix additionally allows for the utilization of its full functionality including automating check-in procedures at a digital kiosk, and more.

By utilizing Health Logix and integrating with NetDirector the entire continuum of healthcare data becomes more accessible to both patient and provider. Patients feel more cared for and satisfied by having reminders and surveys, while providers have the information they need faster and more cost-effectively. The information collected through Health Logix is passed through the NetDirector HealthData Exchange and is delivered directly to billing databases and information systems through a one-to-many style integration.

Health Logix chief technology officer Reynold Yordy stated that “NetDirector’s ability to simultaneously, accurately, and cost-effectively move critical patient information, to multiple partner platforms, allows us to deliver a service that both saves cost and generates real revenue to our customers.”  He further stated, “after searching for many months, we are excited to have finally found an integration partner that actually deliver on true interoperability, one of the biggest gaps in healthcare”

Interoperability has been a major hurdle in healthcare – as providers and vendors work towards Meaningful Use Stage 3, interoperability becomes critical for all systems. Communication between existing and future systems is a must have, and the NetDirector integration with Health Logix is a strong example of this kind of interconnected healthcare environment.

“It’s important for us to aid healthcare providers and vendors in reaching their Meaningful Use benchmarks because we know that ultimately impacts the level of patient care,” said Harry Beisswenger, CEO of NetDirector. “Health Logix is an exceptional system, and we’re excited to make it even easier for healthcare providers to maximize the potential it has.”

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 9 million transactions per month.

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.