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Bipartisan thinktank offers FDA fixes

July 28, 2015 in Medical Technology

The Bipartisan Policy Center has issued a set of recommendations to Congress that it says will speed up medical cures and innovation. Central to the recommendations in the report, “Advancing Medical Innovation for a Healthier America,” is the use of healthcare information technology for post-approval studies, new uses for medical devices and an improved approach to clinical studies.

“It’s time to take action to significantly advance medical innovation in the United States,” said former Senate Majority Leader Bill Frist, MD, in a BPC release announcing the report. “Americans cannot afford to rely on 20th century methodologies for treatments when the world is on the cutting edge of new medical technologies. Federal agencies must be equipped to keep the U.S. at the forefront of medical innovation.”

Among the BPC’s health IT-related recommendations: Congress should adopt standards including those “required for accurate identification and matching of patient data, provider identification, transport, terminologies, clinical models, clinical data query language, security, and application interfaces.”

Those standards would then be required for certified electronic health records, providers receiving incentives under meaningful use and any system receiving federal funding for health IT.

However, much of the report focuses on improving the Food and Drug Administration’s ability to work more quickly to evaluate and approve new devices and therapies. Doing so – with more data from health IT applications and patient reported data – would not only improve the health of Americans, the BPC claims, but also reduce costs and make American device manufacturers and drug developers more competitive in the global marketplace.

The BPC set its sights on the FDA in March, when it called on Congress to enable the Food and Drug Administration to use hospital electronic health records and crowd-sourced patient experience data to revolutionize drug and medical device approval.

At that time, Frist noted that the FDA did not have either the resources or the Congressional authority to take full advantage of the data generated by contemporary healthcare IT applications to speed up the approval processes for drugs and devices.

It also expressed concern that the FDA might claim oversight and approval for healthcare IT applications themselves.

The FDA disputes many of the claims the BPC has made about its ability to respond quickly. In a letter to Healthcare IT News last March, Karen Riley, MPH., the FDA’s Deputy Director for Strategy, wrote that the “facts simply don’t support” such assertions.

“Last year FDA approved the most new drugs in almost 20 years,” Riley wrote. “We approved more orphan drugs than ever before. We used the accelerated approval process for more drugs than ever before. FDA is approving drugs faster than all other advanced nations — 40 days faster than Japan, 70 days faster than Canada and 174 days faster than Europe. And our medical device center is on track to meet all performance goals related to device review and approval.”

In the report released Monday, the BPC transformed those concerns into policy recommendations for FDA. Among those specifically related to clinical and patient-generated data:

Improving the medical product development process:

  • Accelerate the generation and use of more relevant evidence—including data from both clinical and patient experience–to support post-approval study requirements, approval of new indications for existing medical products, and ultimately improved clinical trials for regulatory review.
  • Assure greater harmonization of international standards and requirements.
  • Improve the interoperability of health information technology (IT).
  • Improve and expand the qualification and use of new drug development tools, including biomarkers and patient-reported outcomes, and assure that patient perspectives are included in the benefit-risk assessment associated with regulatory decision-making.

Increasing regulatory clarity:

  • Assess the rapidly evolving field of precision medicine and develop a regulatory framework that promotes innovation, protects patient safety, and is flexible enough to accommodate rapid changes in science.
  • Clarify that health IT should not be regulated as a medical device. Recognize independent bodies that can develop and assure compliance with consensus standards and facilitate patient safety reporting to continually improve the development, implementation and use of health IT.

Much of the report’s recommendations dovetail with the 21st Century Cures bill, which passed the House of Representatives earlier this month and next goes before the Senate.

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Pending MU rules making hospitals, EHR vendors sweat

July 27, 2015 in Medical Technology

The process has been repeated time and again: Regulators issue proposed rulemaking, stakeholders comment, a final version manifests. So what, this time, has the industry concerned in the case of two pieces of meaningful use?

Timing. And there’s precious little of it left before hospitals and vendors find themselves in a real bind.

Both healthcare providers and electronic health record vendors, in fact, are anxiously waiting for the Centers for Medicare Medicaid Services to release final rule changes to meaningful use regulations for 2015 through 2016, expected before Labor Day – in addition to final rules for meaningful use Stage 3 for 2017 and beyond, widely anticipated to drop before year’s end.?

Indeed, this time crunch is as big of a deal as it looks. Here’s why: In the 2015/2016 proposed rule, all hospitals and eligible providers would be able to attest to 90 consecutive days of meaningful use for 2015 only, instead of an entire year.

If CMS makes the 90-day attestation period available in the final rule, the latest date that providers could begin recording meaningful use data would be Oct. 1.

That means until CMS delivers the rules EHR vendors cannot update their systems accordingly and, in turn, hospitals are left waiting on those upgrades before they can start the next phase of meaningful use.

What’s more, an exact date when the rules will come out is anyone’s guess, said Jason Fortin, senior advisor at consultancy Impact Advisors. So he’s playing it safe by checking the Federal Register three times a day.

GE Healthcare vice president Mark Segal – he’s also chair and vice chair emeritus of the HIMSS EHR Association – said changes to the measures themselves from what was proposed in April will likely be minimal.

Even still, two sticking points both Segal and Fortin would like to see clarification on include measures for population health management and patient electronic access.

Leslie Krigstein, interim vice president of public policy at the College of Healthcare Information Management Executives said CHIME is pleased that CMS listened to the industry’s concerns and included changes in the proposed rule for 2015/16 that would allow the 90-day reporting period and some other flexibility – but noted that if the final rule isn’t released soon, these added proposals won’t have the intended effect.

“We are urging and pleading with CMS to get the modification rules out there,” she said.

Krigstein added that if all else fails, CIOs could still make things work if  CMS would release just the 2015 portion of the rule by August and followed with the 2016 portion later.?

“In reality, 2016 is going to come with more changes and with a year-long reporting period,” she added, understanding that these might take more time before they can be released.

As a backdrop to all the waiting, some members of Congress are using the time to propose ways of blocking meaningful use into the future.  The American Medical Association added heat to that fire with a late July town hall meeting to voice complaints about electronic health records and meaningful use, attended and endorsed by House Budget Committee Chair Tom Price, MD (R-Ga).  

GE’s Segal said the added scrutiny from Congress is probably not making things any easier for CMS when it comes to getting these two critical rules released.

Diana Manos is a Washington, D.C.-based freelance writer with specialties in healthcare, technology, politics and policy.

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4 questions to consider when working with a payer on an ACO

July 27, 2015 in Medical Technology

The shift to value-based health care models is gaining speed, and providers can prepare for the transition by assessing their own readiness and unique needs. The Department of Health and Human Services set a goal to have 50 percent of traditional Medicare’s $362 billion in annual payments go to providers in value-based models by 2018.

The Health Care Transformation Task Force, which brings together patients, payers, providers and purchasers, has pledged that its members will put 75 percent of their business into these models by 2020. As a member of the task force, Aetna shares this goal.

Creating a sustainable business model in the era of value-based payments and care models depends not only on transforming, but also on growth. To enable growth, providers can align the value-based care contract model with their clinical model and state of readiness. There are four questions each organization should consider to determine the best path forward.

Four key questions to inform the accountable care journey:

1. Is your organization ready to invest in the necessary technology and tools?? To begin, calculate the financial investment needed for population health. This involves assessing your organization’s alignment of people, processes and technologies across key functions. These functions include informatics, care management and patient engagement.

You can then identify major gaps in the shift away from volume-based care. This will help you develop a financial analysis and a transformational roadmap with priorities and timing to close gaps.?

2. Are you prepared to design and implement an incentive structure that rewards doctors who meet quality, efficiency and patient-satisfaction measures? ?Assisting doctors in the transition to value-based care involves:

  • Engaging them in the development of new care processes that integrate the entire care team
  • Involving them in accountable care organization leadership to promote transparent practice patterns, quality and efficiency
  • Aligning payment and incentives with performance goals
  • As part of this effort, it is essential to deliver quality and cost metrics that help doctors accurately gauge their progress toward meeting targets.

3. How will you redesign your care delivery system to focus on keeping people well instead of a focus on sick care?? Population health represents a new approach to care, and clinical and financial integration will help smooth the transition. Claims analytics can reveal where care protocols are widely inconsistent. You can then identify opportunities for improving efficiency and quality improvements through care coordination.

Care managers play an important role. Whether they are based remotely or embedded in the practice, these care managers can supply more consistency and coordination. This helps make the care delivery system more proactive and patient-centered. Simple care-access measures, such as longer hours for primary care appointments, can help to reduce emergency room visits.

4. What steps will you take to support and encourage growth? ?To succeed in adding new revenue streams, take measures to:

  • Expand your network strategically
  • Grow your patient base
  • Maximize in-network care delivery

It’s important to help affiliated providers in adopting your system. Analytics can reveal where patients are going out of the network for care. You can then take actions to reduce unnecessary out-of-network care. Payers can help drive patients to the ACO with referral management and strategies that build loyalty and attract new patients.   

Getting started in collaboration
As you begin your accountable care journey, look to payers for industry knowledge and assistance in assuming risk, expanding distribution channels and improving care coordination. By joining forces, you can also benefit from a payer’s:

  • Expertise in financial risk management
  • Population health management tools, technology and expertise
  • Broad distribution channels to attract members
  • Insurance operations and administrative platform

Preparing for a value-based future
Early results show that value-based models improve clinical and financial outcomes. In September 2014, Centers for Medicare Medicaid Services reported Pioneer ACO performance year-two results. ACOs generated estimated total savings of more than $96 million. They qualified for shared savings payments of $68 million and saved Medicare Trust Funds approximately $41 million. They also improved in 28 of 33 quality measures, with a general increase of 14.8 percent.

Collaborations between payers and provider organizations are evolving to generate real savings in this changing landscape. This can happen more quickly with full commitment on both sides of the collaboration. By taking the time today to assess readiness, deploy the right technologies and align new payment models with cost, quality and patient-satisfaction goals, your organization can take on more risk and prepare for a sustainable, value-based future in the coming years and beyond.

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Why the EHR market continues to grow

July 27, 2015 in Medical Technology

Paper-based records are being phased out at a rapid pace in healthcare, and digitization and virtualization are creating a whole market within the global healthcare industry, according to Transparency Market Research, or TMR, whose researchers say the trend will continue until 2020.

The ball has been set rolling with more than 54 percent physicians in the U.S. adopting electronic health record systems, as of 2011, researchers point out the estimates reported by the U.S. Centers for Disease Control. In the same year, 50 percent of physicians who were not already using an EHR system said they planned to invest in one within the next 12 months.

[See also: EMR market to grow even without carrot.]

A similar change is taking place in the U.K., where the National Health Service is slated to go entirely paperless by 2018.

The global electronic health records market is projected to show a CAGR of 6.4 percent between 2014 and 2020. This marks an imminent phase of moderate growth that will largely be seen in traditional markets, according to TMR.

The global EHR market can be segmented based on the way the EHR systems are installed as Web-based or client server-based. Client server-based accounted for the better part of the market share in 2013, when considered from the revenue perspective. But, the CAGR of web-based EHR systems is expected to be higher through 2020 largely because the systems have only a nominal upfront cost, and do not call for the installation of hardware systems and components.

The market for EHRs can also be classified based on the end-users who purchase such systems. Hospitals were the dominant segment by revenue in 2013, as 90 percent of all hospitals in the United States had a certified EHR system in 2013, according to the Annual Health IT Survey conducted by the American Hospital Association.

[See also: EMR market surpasses $23 billion and EHR vendor marketshare and MU attestations by vendor.]

Most of the hospitals opted for a client server-based EHR because it facilitates faster data transmission between multiple facilities when compared with cloud-based electronic health record systems, according to TMR findings. However, the future growth prospects of the ambulatory centers end-user type are expected to be most promising for cloud-based vendors. With minimal or no upfront costs to ambulatory centers, cloud-based EHR systems offer an appealing solution, say researchers.

About 42 percent of the total global EHR market was held by North America in 2013. The second largest market was Europe, followed by Asia Pacific. Until 2020, these rankings are unlikely to change, as North America will continue to hold a lead over other regional markets supported by solid government funding, according to TMR.

The EHR market is gathering steam in Australia and New Zealand as well as Asian countries such as China, Japan and India. The three Asian economies will exhibit the fastest growth, and will grow consistently to contribute to a major chunk of the market revenues by 2020, according to the report. 

The leaders in the electronic health records market have a grip on more than 50 percent of all revenues. The leading players include: Cerner, Epic, Allscripts, GE Healthcare and Epic Systems, according to TMR.

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Hackers hit business associate, swipe PHI and Social Security numbers

July 27, 2015 in Medical Technology

2015 thus far has been the year of hackers targeting the healthcare industry. And they don’t appear to be slowing down. Just last week, another business associate notified individuals that their protected health information was stolen following yet another “sophisticated cyberattack.”

Medical Informatics Engineering, the Fort Wayne, Ind.-based electronic health record provider and parent company of NoMoreClipboard, is updating an earlier breach notification with additional details.

[See also: Hackers swipe data of 4.5M at UCLA Health System in massive cyberattack.]

In a notice last week, MIE officials notified affected individuals that their Social Security numbers, lab results, medical conditions, demographic data, children’s names, health insurance policies and sign-on security details were compromised in a cyberattack that transpired May 7. The unauthorized access by hackers continued until three weeks later, when MIE officials detected “suspicious activity” on one of its servers.

MIE officials did not respond to Healthcare IT News‘ inquiry as to how many individuals were impacted by the breach.

Patients who received radiology services at 44 locations across Indiana, Michigan and Ohio were affected by the breach. Affected providers include Concentra; Fort Wayne Radiology Association; Parkview Hospital in Indiana; and Community Memorial Hospital in Hicksville, Ohio, among others.

According to the EHR provider, the company has instituted a “universal password reset,” improving password rules and storage mechanisms and boosting active system monitoring.

[See also: Hospital system fails mock cyberattack.]

Medical Informatics Engineering accounts for only a paltry 0.1 percent of the EHR market for providers, according to the most recent data from the Centers for Medicare Medicaid Services. As of spring 2015, only 261 eligible providers had reported using the company’s EHR. No hospitals reported being on the system.

MIE’s cyberattack follows a series of cyberattacks targeting the healthcare industry this year and last. Earlier this month, UCLA Health system notified 4.5 million patients that their protected health information was compromised in a hack that occurred back in September 2014.

In the largest HIPAA breach ever reported, Anthem in February notified nearly 80 million of its members and employees that their Social Security numbers and personal data were swiped in a cyberattack.

Premera Blue Cross followed closely behind after announcing in March it too was the target of a similar attack compromising the data of 11 million of its members.

[See also: Anthem hack: 'Healthcare is a target'.]

Since 2009, some 139 million people have had their protected health information compromised in a large HIPAA privacy or security breach, according to data from the Office for Civil Rights, the HHS division responsible for HIPAA compliance. In this count, only breaches involving 500 or more individuals are included.

What’s more is that hacking and/or IT events account for the lion’s share of that total number. Nearly 76 percent of those individuals had PHI compromised due to hacking-related events, including cyberattacks. 

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6 questions health IT leaders should ask

July 26, 2015 in Medical Technology

In the past, IT was often viewed as a cost center. But today’s healthcare IT professionals are business-savvy executives responsible for bottom-line results. They are important members of the corporate management team, tasked with improving productivity and efficiency. However, many IT leaders may be surprised to find a significant business loss caused by their own departments.

For example, a healthcare organization with 500 employees can potentially recover more than $100k per year by asking six key questions and making simple changes that often require zero development costs. They’re easy fixes that many IT professionals may be overlooking.

How does your company compare? Run through these questions and find out.

1. Approximately what percentage of your workflow is paperless?
A self-assessment tool users offered by Brother International Corporation has shown that paper is still critical to business operations in most industries. On average, only 36 percent of respondents are utilizing paperless workflow. While paper will likely never go away entirely, healthcare organizations can utilize technology to help reduce the paper, increase efficiency and minimize printing-related costs.

To potentially do this, consider adopting electronic document capture and sharing, enabling mobile-based printing and scanning, leveraging cloud-based services and moving to sustainable/“green” printing.

2. Do you currently utilize output management software to help secure, redirect or track print jobs in your office?
Output management software can help control costs and reduce paper usage, yet data collected from the self-assessment tool shows that only 19 percent of businesses are making use of these valuable tools. An InfoTrends whitepaper titled “Device Underuse and Unbalanced Fleets” reports that organizations can maximize cost savings and productivity through print management/cost recovery solutions to automate a range of print, copy, and scan tasks, including activity tracking, cost allocation, quota setting/enforcement, secure printing, job redirect and reporting.

Healthcare-specific solutions are also available. For example, organizations can deploy software that securely integrates printers with electronic medical records  or claims management systems, enabling jobs to be properly transmitted to the appropriate repositories.

3. How many pages does your organization print per month?
InfoTrends research shows a steady decline in printing, which can be attributed to a number of factors. Many healthcare employees choose to work from smartphones and tablets rather than from printed documents. Most print jobs are now five pages or fewer, and the decline in print volumes will persist as more operations move from paper to digital. This knowledge can translate into big savings for your organization.

Here’s a trick to aid in improving your bottom line: Many multifunction printers are capable of printing at least 100,000 pages per month. However, many SMBs typically print no more than 10,000 pages per month. For organizations committed to a common 100,000-page per month contract, this 90 percent underuse wastes valuable capital. Determine your total print volume, recalibrate to match the needs and help curb the monthly losses.

4. Which best describes your current document output environment?
A) Printers for Every Desktop, B) Mix of desktop printers, shared printers and standalone copiers, C) Primarily a shared standalone printer / copier? The ideal solution is a mix of desktop printers, shared printers and standalone copiers. Current self-assessment results show that 18 percent of companies provide a printer for each employee and 25 percent have a mix. However more than half (57 percent) rely on a shared standalone printer / copier – a strategy that may kill productivity and hurt the bottom line.

5. What is the approximate number of printers and printer/copiers in use at your organization?
To optimize productivity, maintain a worker-to-device ratio of approximately 8-1. A survey conducted by Clarus Research Group reveals that workers with more shared printers are also more digitally engaged. A greater number of these respondents say their companies encourage the use of digital documents, use multiple screens, find reading on screen easier, use more mobile devices than they used to and are more environmentally conscious. Those that have centralized printers are more than two times more likely to say their company printers take too long to finish printing jobs.

But just adding more printers won’t solve your challenges. This leads to question 6…

6. Estimate the average distance an employee needs to walk to use a standalone printer/copier.
Printer placement is the most critical step in maximizing your cost savings. InfoTrends data shows that poor allocation of office devices is a drain to corporate profits, wasting more than 4,000 hours and nearly $130,000 per year in long walks to and from copiers and printers. The solution? It’s simple – Make sure you have one printer within 25 feet of every workgroup.

The Clarus surveyshows that trips to the printer can also be a significant drain on productivity. Non-work conversations at the printer are 98 percent more likely to result in stops to chat with other colleagues about personal things, but only 28 percent more likely to chat about work. In fact, 61 percent of employees have conversations at the copier/printer versus just 31 percent who have conversations at the water cooler. This wasted time could be costly to healthcare institutions. As the technology manager, you can easily mitigate these business losses with more appropriate device allocation.

Getting Started
Many IT leaders overlook office devices when optimizing for cost and efficiency. If your company is like most, your printers may be too big, too far away and too expensive. A balanced deployment strategy the results in right-sizing your printer fleet can help you save time and money, and it’s surprisingly easy.

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Senate suggests Stage 3 MU delay

July 25, 2015 in Medical Technology

After a day spent hearing from health IT experts about information blocking practices, Republican Sen. Lamar Alexander, chair of the Senate Health, Education, Labor Pensions Committee, said Thursday afternoon that he’s asked HHS to consider a delay of Stage 3 meaningful use.

Before that hearing on Capitol Hill, Alexander noted he’d heard from many providers that Stage 1 MU had helped spur adoption, that Stage 2 had been a “mixed blessing” – but that Stage 3 was a “whole ‘nother kettle of fish.”

[See also: Stage 3 meaningful use ignores market realities, says Brookings]

As such, his “instinct,” was to tell HHS Secretary Sylvia Burwell, “Let’s not go backwards on electronic healthcare records, but let’s not impose on physicians and hospitals a system that doesn’t work, and which they spend most of their time dreading,” said Alexander. “We want something physicians buy into, rather than something they dread.”

That morning, Alexander mentioned he was curious to hear from industry stakeholders about their thoughts on putting the brakes on the rush toward Stage 3 – “not with the idea of backing up on it,” he said, “but with the idea of, ‘Let’s get this right.’”

[See also: CMS lays out vision for Stage 3 meaningful use]

The HELP Committee heard testimony from Allscripts CEO Paul Black, DirectTrust CEO David C. Kibbe, MD, and others on one of healthcare’s persistent challenges – and a huge impediment to the industry’s efforts to move toward more seamless interoperability: information blocking on the part of vendors and providers alike.

There are several scenarios through which such data blocking could occur, said Alexander.

“My usual hospital refuses to share my information,” he said. “The electronic systems at both hospitals don’t talk to each other. My usual hospital says it will charge Vanderbilt a huge fee to send my electronic records. My usual hospital says it can’t share them for privacy reasons. Or, my usual hospital won’t send them because they cite concerns about data security.”

All of those could cause patient harm, he noted – and none of them are acceptable to a government that has spent some $30 billion dollars so far to spur health IT uptake.

Allscripts’ Black testified that, despite the bad rap it so often gets, interoperability among vendors and among providers does happen: “It is important to note that there are many examples of providers who have worked through the process of establishing connectivity and are making it work,” he said.

“It is true, however, that today not all stakeholders in the healthcare industry seem to be equally motivated to make information liquidity a reality,” said Black. “Clinical data exchange is not where it needs to be.”

[See also: ONC calls out information blockers]

To get there, he said, there are some big factors that need to be addressed. Among them: an expansion of  the standards development process, “building on the real progress underway with guidance from government and allowing the private sector to continuously develop, adopt and modify new standards.”

Also, “key constituencies, such as public health registries, labs, state health information exchange organizations and others who are not following available standards in their work, should be required to do so,” he added.

Ultimately, however, “the sluggish progress we’re discussing today most closely stems from one critical deficit,” said Black: “the lack of a strong business case or a true market driver for interoperability.”

From his perspective, Direct Trust’s Kibbe told the HELP Committee that “information blocking by healthcare provider organizations and their EHRs, whether intentional or not, is still a problem for some providers wishing to use Direct exchange, as well as for these providers’ clinical partners who want to be able to exchange Direct messages and attachments with them, and sometimes fail.”

[See also: Direct messaging finding stride, despite hurdles]

Still, he said, the fault for poor data sharing practices – and the onus to improve them – lies mostly with the private sector, not with feds.

“In my opinion, the responsibility for assuring secure interoperable exchange resides primarily with the healthcare provider organizations, not the EHR vendors, and not the government,” he said. “Healthcare provider organizations must come to realize that acting in the best interest of patients is to assure that health information follows the patient and consumer to whatever setting will provide treatment, even if that means in a competitor’s hospital or medical practice.”

One thing the government can do, however, is to help work with “trade groups, standards and policies organizations, and others to set expectations for interoperability of EHRs and other applications certified as interoperable, especially those that have been federally subsidized within the meaningful use programs,” said Kibbe.

Perhaps echoing Alexander’s comments about the headlong rush to Stage 3, he said: “Let’s finish what we started before moving to more complex solutions that may or may not work.”

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Healthcare headlines from across the Web, July 24

July 25, 2015 in Medical Technology

Healthcare IT News‘ focus is on technology, of course, but there’s so much else happening now across the broader realm of healthcare. We’re keeping track of all the top studies, articles and other big happenings in the industry and compiling them on this healthcare watch list. It’s updated daily, so check back in with us for regular updates.

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Big Data Byte: Developing an analytics-based organization

July 25, 2015 in Medical Technology

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EHR integration: Keeping patients at the center of care

July 25, 2015 in Medical Technology

As healthcare organizations scramble to meet the progressively more ambitious data exchange thresholds of Meaningful Use (MU), many are focusing on electronic health record (EHR) integration projects for improved flow of clinical data to enable better care coordination across the healthcare continuum.

In the past, projects aimed at optimizing data exchange within EHRs concentrated primarily on improving the transfer of information between providers; little effort was spent making sure that patients were in the loop. While some data sharing exists between providers, patients are all too often left in the dark as to their overall care plans, the cost of treatment and even their own EHR or medical history. As a result of this breakdown in data sharing, most patients tend to receive care passively; with few proactive patients initiating participation in their own care.

All of that stands to change, however, with value-based care on the horizon. Patient engagement and overall patient experience are becoming key parts of the care delivery equation, as focus continues to shift towards better coordinated care efforts. Today, it is generally accepted that patients must play an active role if healthcare is to become more effective and cost efficient. 

Best practices for bringing patients into the loop

Achieving success in the value-based care environment – while improving care coordination – requires a renewed emphasis on ensuring that health information moves just as smoothly for patients as it does among clinical staff. Engaging, educating and informing patients must remain central goals as healthcare organizations invest in major EHR data exchange optimization efforts.

A phased method of EHR integration, for instance, allows IT executives to evaluate, analyze and ensure support for improvements at each stage of an EHR rollout. As organizations introduce new or more integrated systems, IT professionals must assess benchmarks relevant to the workflows impacted during these transitions.

It is important for project managers to gather “before” and “after” data snapshots so they can properly evaluate the impact of each phase of EHR integration. Consequently, technical leaders should work with clinicians prior to any rollout to gather metrics around existing key performance indicators (KPIs). As new processes are phased in, further metrics collection can enable data-driven comparisons.

Take, for example, the metrics that might be used to help drive a patient-centered approach to medication administration. Since placing calls to the pharmacy to clarify physician orders is a time intensive task, it directly affects the timeliness of patient care. Therefore, one goal set for the implementation of e-prescribing or computerized physician order entry (CPOE) might be an 85 percent reduction in calls to the pharmacy within 60 days of implementation. Measuring the number of calls to the pharmacy pre- and post-implementation would be one way to measure success.

Similarly, other metrics could align with MU guidelines, such as prescribing antiplatelet medication for Coronary Artery Disease (CAD) patients. Recording and reporting this data through integrated EHRs eliminates the need for labor intensive, manual information gathering.

Aligning patients with EHR integration benefits everyone

In order to best facilitate the care delivery process, patients must be integrated into the fold as EHR integration is a key component in improved care coordination efforts. There are tangible benefits to keeping patients at the center of all EHR integration efforts, including:

·       More patient engagement. When patients “own” their health records, they become active participants in their care, which eases care coordination tasks.

·       Better decisions. Sharing information allows better decision-making for all stakeholders and drives multiple areas of care delivery improvement — including a more coordinated plan of care and reduction of duplicative tests.

·       A proactive approach. Educated consumers — who now are shouldering more of their healthcare costs — can help drive the decisions that lead to more coordinated, proactive and cost-effective health.

In fact, there is an enormous range of clinical and financial advantages healthcare organizations can expect from comprehensive, patient-centered EHR integration.

Another striking — and cost-effective — example involves chronic care. Patients with chronic conditions create an intense need for coordination, since safety and quality requirements for these individuals are highly complex. One study indicates people with chronic conditions see an average of four or more physicians a year, with 46 percent taking four or more prescription drugs regularly. This information has drawn the attention of the Centers for Medicare and Medicaid (CMS), which announced plans to pay physicians a monthly fee for monitoring, collaborating and coordinating care for patients with two or more chronic conditions.

Patient engagement yields improved outcomes

Ultimately, to achieve the promise of increased patient engagement and improved care delivery, healthcare IT professionals should ensure that they are aligning EHR integration, technology and clinical goals for the benefit of patients and the providers who serve them. Executive leadership can support these initiatives with top-down messaging that consistently incorporates advanced, patient-centric EHR integration as part of the organization’s mission and values. When providers and patients alike are empowered with information, organizations are more likely to see cost decrease and care quality and coordination improve.

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