As we approach National Healthcare IT Week in the U.S., The American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act (PPACA) have attempted to move the nation toward impactful healthcare reform. In my opinion, true reform is impossible without system-wide adoption of electronic health records (EHRs) and nationwide health information exchange.
Healthcare providers today have the same goals as they always have—to deliver high-quality care that produces the best patient outcomes. Until recently, medical practices and hospitals were designed to offer patients the best staff, technology and clinical care as defined by providers. The Affordable Care Act, however, is already changing the way care is given and reimbursement is determined, which can either be a good thing, or bad thing depending upon how it is administered. And that’s where Meaningful Use comes into play in a big way. Meaningful Use requires system efficiencies that reduce costs while optimizing clinical outcomes.
By Gary Palgon, Vice President of Health Systems, Liaison Healthcare Informatics, Alpharetta GA
As we approach National Healthcare IT Week in the U.S., The American Recovery and Reinvestment Act of 2009 (ARRA) and the Patient Protection and Affordable Care Act (PPACA) have attempted to move the nation toward impactful healthcare reform. In my opinion, true reform is impossible without system-wide adoption of electronic health records (EHRs) and nationwide health information exchange.
Healthcare providers today have the same goals as they always have—to deliver high-quality care that produces the best patient outcomes. Until recently, medical practices and hospitals were designed to offer patients the best staff, technology and clinical care as defined by providers. The Affordable Care Act, however, is already changing the way care is given and reimbursement is determined, which can either be a good thing, or bad thing depending upon how it is administered. And that’s where Meaningful Use comes into play in a big way. Meaningful Use requires system efficiencies that reduce costs while optimizing clinical outcomes.
At the same time, patients are becoming more engaged about their needs and their healthcare options—they demand a better, more inclusive patient experience that eliminates duplicate tests and time wasted having to provide the same information repeatedly to different entities. They also want a complete “picture” of their health instead of a “snapshot” from each doctor they visit.
Meeting patients’ expectations requires a patient-centric team approach to care, which requires seamless communication among all of a patient’s care providers. The only way to meet the multitude of obligations placed on healthcare providers is the effective sharing of health information, within their own organization’s walls as well as with external providers.
There are many ways to construct an effective health information process. Yet as healthcare organizations work to meet internal needs and regulatory deadlines, it is important to avoid a short-sighted view of the value, purpose and capabilities of information exchange platforms. Building successful, sustainable health information exchange processes requires careful thought about the structure and interaction of each of three distinct “building blocks.”
Practice-level foundation
Patient information, which typically is collected at the physician practice level, creates the foundation for any program that relies on sharing health information among different sources, including physicians, hospitals, and clinics. Not only does this critical patient information need to be captured on electronic health records (EHR), but to meet Stage 1 Meaningful Use requirements providers must demonstrate the use of key EHR functions. As providers move toward Stage 2 requirements, they must demonstrate meaningful exchange of information with other providers and patients by providing easy access to electronic health information.
Information technology is key here. Even physician practices that have adopted EHRs often rely on technology that is limited in scope. For example, a physician may use a laptop or exam room computer to document into the EHR during the exam, but the patient’s health history still is obtained on a paper form that must be manually entered by staff into the EHR. By contrast, giving patients the ability to use tablet computers to complete health history forms that are automatically uploaded to the EHR increases efficiencies in the office and captures information more accurately—plus makes more information available for use at the point of care.
Mid-level longitudinal records
While access to a patient’s health information related to a single provider is important, the true value of the sharing of health information for patient care is realized when the patient’s records from multiple providers could be aggregated into a single record. This longitudinal record presents a complete picture of patients’ medical histories.
Technology that enables patients’ health information to follow them throughout the continuum of care is a critical component to the core process of effective data exchange. However, many healthcare providers have implemented a single, “stove-pipe” EHR application that allows exchange of information only within the four walls of a single hospital or unified health system.
The more difficult – but much more essential – component of health information exchange is the ability to share information with outside organizations. This capability results in improved patient care, cost-savings for insurers and patients, and optimized reimbursement for providers.
It is when the provider who collects individual patient information at the visit level is able to communicate with and integrate information from multiple sources—office tablets, other mobile devices, laboratories and diagnostic services—that the foundation for effective information exchange is laid.
Top-tier analytics
Although providers can analyze the contents of a patient’s record at each of the first two levels of data exchange to identify the best care for an individual patient, the aggregation and analysis of data at a macro level can result in ongoing care quality improvements throughout an entire patient population.
The global analysis of clinical practices and outcomes helps clinical managers and researchers identify best practices that proactively affect a population’s health – essential for the development of population health management programs.
In addition to promoting clinical improvement, analysis of clinical practices compared to financial outcomes also helps health leaders identify best practices that result in cost-effective patient care.
The bottom line…
There are many technologies designed to support the sharing of information, but the goal is not to use the newest or the greatest number of technologies—the goal is to use those tools that will interact with each other most effectively to create the best structure for data exchange.
The right building blocks include individual patient information as a foundation, the aggregated longitudinal record as a solid core, and global analytics that top the entire process. Creating a foundation for the sharing of health information that meet’s today’s needs while establishing a solid, central structure that can be expanded upon to meet future needs is possible with the selection of the right tools and technology, ultimately improving the future of patient care.
About The Author
Gary Palgon is vice president of healthcare solutions at Liaison Healthcare, an Atlanta-based company focused on integration and data management in the cloud. Palgon has developed and marketed enterprise software for over two decades. His expertise bridges the gap between the technical and business aspects of data security, electronic commerce, and healthcare. Palgon is a Certified Information Systems Security Professional (CISSP) and holds a bachelor’s degree in computer and information sciences from the University of Florida. A frequent speaker on cloud computing topics and information security, Gary was name Best New Speaker and inducted into the Speaker Excellence Hall of Fame at IBM Common in 2008.
