Meaningful Use and Beyond with the Cloud

W. Reed Liggin
W. Reed Liggin

Guest post by Reed Liggin, founder and president, RazorInsights.

Since the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law in February 2009, rural, community and critical access hospitals are turning to electronic health record (EHR) systems to receive significant incentive payments based on meeting meaningful use regulations. However, the impact on workflow makes achieving a return on investment (ROI) after implementation challenging. Additionally, the burden is placed on these hospital’s small IT departments to meet federally mandated deadlines such as meaningful use.

According to a 2014 HIMSS Analytics survey, 83 percent of healthcare providers are using cloud services. Compared to server-based networks, the cloud is especially beneficial to rural hospitals because of the lower upfront, implementation and maintenance costs, resulting in increased ROI. The cloud system’s pay-as-you-use method removes the need for expensive hardware, and the accessibility and security of patient records improves efficiency and patient care, allowing hospitals to prove they are meaningfully using EHR technology.

Implementation and Maintenance

Because of budgetary restraints, rural hospitals typically have outdated technology and some areas do not even have computers. Recently, I visited a hospital with only one computer on each floor and no EHR system in place at all. Because of this, these hospitals must implement user-friendly healthcare technology that is easily implemented across the network– even for clinicians with limited or no experience in a high-tech environment. This type of easy-to-use EHR systems not only improves patient care, but also helps hospitals qualify for federal incentive payments. However, time is running out. Hospitals only have one more year to receive incentives for being MU compliant. After this timeframe they not only won’t receive payments, but they will be penalized financially for not meeting regulations, which is especially detrimental to smaller hospitals.

Cloud-based solutions allow hospitals to deploy EHR systems quickly and at a lower cost. While server-based EHR systems can cost $40, 000 or more, a cloud network does not require any hardware to be installed on-site. Therefore, upfront, implementation and maintenance costs are much lower than a server-based solution. Less hardware means less opportunity for failure – thus, maintenance costs decrease drastically as the lifespan of a cloud-based system is much longer than a physical server solution.

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Utilizing Cloud-Based Technologies in a Compliant Industry: Healthcare

Travis Good
Travis Good

Guest post by Travis Good, M.D., CEO and co-founder of Catalyze, Inc.

Even if a bit delayed, the power and value of cloud-based technologies is starting to seep into healthcare. With each new cloud-based technology piloted or taken to scale by a healthcare organization, other institutions and corporations become more willing to roll the dice on deploying cloud-based technology. While still slow, it is happening, but not where you may think. Instead of found in the typical core applications of EHR or practice management systems, we find cloud-based technologies being introduced into the innovative health technology areas of virtual care delivery and patient self-reporting. Those areas are breaking down the barriers to cloud adoption in healthcare and that pace is increasing.

Cloud-based technology acceptance, along with everything else in the healthcare industry is moving faster than ever before. Accountable care, bundled payments, patient satisfaction, continuous care and the consumerization of healthcare are catalyzing changes to a very large, slow moving, highly regulated and risk averse industry. Technology and technology enabled services are essential for riding out these waves of change.

Every healthcare segment has seen these paradigm shifts and is trying to carve out a piece of the new pie. Large medical centers and health systems want to commercialize tools created in-house. Payers are building technology geared toward new forms of care delivery and price transparency, while biopharma is building technology to deliver continuous care powered by data from its core products – devices and medicines. All three of these healthcare segments can build technologies that utilize cloud computing and thus reap the following benefits:

Compliance and Cloud Computing

With recent changes to HIPAA that went into affect as part of the HITECH and HIPAA Omnibus Rule in 2013, a surge in compliance interest has developed, especially with compliance as it relates to cloud computing. The HIPAA Omnibus Rule created a new segment within the string of compliance leading back to covered entities. The new “subcontractor” segment is something of which every healthcare compliance officer must be aware. In much the same way as a business associate processes, transmits or stores ePHI for a “covered entity,” a subcontractor will also process, transmit, or store ePHI for “business associates.” And, subcontractors, like business associates, are required to sign business associate agreements (BAAs). These agreements outline the obligations of each party in meeting different aspects of HIPAA compliance rules, and delegate the risk based on different types of possible ePHI breaches.

In creating this new “subcontractor” entity, the Omnibus Rule accounted for the paradigm shift in technology development and cloud computing. The most commonly used example of a subcontractor is found in a cloud hosting provider like Amazon (AWS) or Rackspace; yet, many other types of services exist that could be considered subcontractors.

As data and services are being accessed via Web services (typically APIs), a huge number of BLANK-as-a-Service offerings have emerged. Many modern applications utilize third-party APIs for features and functionality to speed time-to-market, while adding value to users. Using simple to consume APIs, modern applications can tap into databases, messaging (SMS, Push, email or voice), usage metrics, logging, customer support, data sources, backup and so forth.

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