ONC’s HealthIT.gov published the following graphic aimed directly at consumers, expanding on its education strategy. For those that live in health IT, much of the information included here has been seen multiple times. Perhaps there is little new here.
However, there are a few nuggets that I personally find of interest that are worth sharing. According to the the feds, “between 2001 and 2011, the number of doctors using an EHR system grew about 57 percent, making it easier for you and all of your doctors to coordinate your care, and often reducing the chance of medical errors.”
Now that studies have suggested that about 66 percent of the population would switch to a doctor using an EHR versus one not using one, we’re going to see this stat is every piece of collateral in support of the effort; in fact, that same story has been reported here at this twice (this makes the third time). That detail is included here, too, as we would expect.
I’m a cynic and I’m snarky. They are character traits earned from my days as a reporter at the newspaper. Constantly being pitched the greatest new thing meant to change the world when rarely these things lived up to their promise made me this way.
The latest offering from the Office of the National Coordinator for Health Information Technology (ONC), the site is being billed as a place for public input to update the Federal Health IT Strategic Plan.
According to the site, the plan outlines goals and strategies for the nationwide shift to electronic health records and information exchange, and for creation and spread of new health information technologies. “On this site, you can learn about these issues and be part of the public discussion that will shape the new plan. Whether you’re a patient, consumer, provider, insurer or IT developer, you should have a voice in this process.”
The rest of the site focuses on a variety of topics in discussion board fashion (think late ‘90s comment-based webpage) where consumers, the general public and anyone else with an opinion of any kind can respond to the seeded ONC topic.
Some of the topics include:
Current Efforts: Empowering consumer action
Current Efforts: Shifting attitudes
Supporting “shared decision-making” through health IT
Supporting “personalized healthcare”
The list goes on, with a few sparse comments to support the topics addressed, and some questions and responses.
The rest of the site features some meager announcements and a bit more info about PlanningRoom.org.
I’ve been a supporter of many of HealthIt.gov’s work and have featured it multiple times on this site for the availability of their information and the organization’s outreach to the public and the HIT community, but PlanningRoom.org is a limp attempt at a public information movement.
I’ve got to hand it to ONC for trying to engage the public in an information and educational campaign, but this effort wreaks of propaganda. For the most part, the comments are thin and generic and the “conversation” here seems someone staged.
This sure seems to resemble the acts of a start up site looking to generate page views and buzz. Certainly, there are people interacting with the site, but it comes off as fluff; a bit too polished if you will.
Call it the cynic in me, but at present, this effort just isn’t enough to make me think it’s going to drive any real change. Perhaps as it grows and evolves it will be worth a lot more, but in its current, state, not so much.
I’ve long been an advocate of HealthIT.gov, which I’ve profiled here multiple times for the guidance the site provides about electronic health records and ways to use the technology.
A new addition to the site is guidance for physicians about mobile health technology, which is beginning to pervade the healthcare landscape.
As healthcare workers and professionals continue to use mobile devices in the care setting, they’ll need accurate and helpful information to protect them and their patients from issues such as security breeches.
To that end, it’s nice to see the Department of Health and Human Services to assemble a series of tips and information to the public’s greater good.
The site features several articles and videos designed to offer support and education about using mobile device in healthcare.
For example, articles include topics such as:
How Can You Protect and Secure Health Information When Using a Mobile Device?
You, Your Organization and Your Mobile Device
Five Steps Organizations Can Take To Manage Mobile Devices Used By Health Care Providers and Professionals
For those who prefer video, topics covered include:
Worried About Using a Mobile Device for Work? Here’s What To Do!
Securing Your Mobile Device is Important!
Dr. Anderson’s Office Identifies a Risk
A Stolen Mobile Device
Can You Protect Patients’ Health Information When Using a Public Wi-Fi Network?
In addition, there’s also frequently asked questions and downloadable materials. All in all, the site is filled with a great deal of rich content.
On top of that, there’s a plethora of other information including tips for integrating privacy and security into a medical practice, building a health information privacy and security plan, information about health IT security resources, cyber security and mobile device security.
Simply put, this is a great resource for all of us in healthcare, patients included. Well done, well done, HealthIT.gov.
HIE expansion about supply and demand? Well, if you read this blog regularly, you’ll know that I spend a good bit of time perusing HealthIT.gov. Though it’s not flashy and overwhelming, the site is informative and actually provides a great deal of information, which says a lot since it’s a government property.
What HeatlhIT.gov does well is provide a nice primer of information about a variety of subjects from meaningful use, electronic health records and health information exchanges.
In addition, the site puts everything in plain and simple language for all the world to understand.
For example, take a look at the reasons why health information exchanges are important to the healthcare landscape:
The ability to exchange health information electronically is the foundation of efforts to improve healthcare quality and safety. HIE can provide:
The connecting point for an organized, standardized process of data exchange across statewide, regional and local initiatives
The means to reduce duplication of services (resulting in lower healthcare costs)
The means to reduce operational costs by automating many administrative tasks
Governance and management of the data exchange process
And for good measure, here are a few examples of how health information exchanges are benefiting the healthcare landscape. Some of these concepts are a bit obvious and overstated here, but still this provides a nice starting point in support for the soon to be possible movement.
Benefits of health information exchanges:
Provide a vehicle for improving quality and safety of patient care
Provides a basic level of interoperability among EHRs maintained by individual physicians and organizations
Stimulates consumer education and patients’ involvement in their own healthcare
Helps public health officials meet their commitment to the community
Creates a potential loop for feedback between health-related research and actual practice
Facilitates efficient deployment of emerging technology and healthcare services
Provides the backbone of technical infrastructure for leverage by national and state-level initiatives
I’m not alone in the belief that I feel HIEs’ most important role is one of creating interoperable opportunities to connect physicians and their patients to a web of other care givers and health community members.
It seems that the closer we get to HIEs and their overall acceptance in healthcare, doesn’t it seem like we take two steps back?
What are some of the hurdles keeping HIEs from reaching their full potential? Glad you asked.
Cost has to be the clear front runner. As I’ve previously stated, the questions remain – who’s going to pay for them? The government clearly wants a healthy HIE community because it is believed that they will lead to greater adoption of EHRs while vendors want part of the action so they can charge physicians to transfer data through the networks. Vendors can’t figure out a financial model for them and until they can get someone to pay for them, there may be little movement here.
Another hurdle of HIEs is that for those that exist, the data often exists in silos. Problem with siloed data is that the data doesn’t go anywhere. Sounds a lot like an EHR, but an EHR may be more user friendly and robust. Just saying.
Finally, lack of standards impede their advancement. More development for standards is required for the variety of HIEs to be able to communicate. Profiles, like the need for structured data in EHRs, will help advance the cause and promote their development.
Ultimately, HIE expansion will most likely come down to basic business 101: supply and demand. When the population demands it, we’ll see the supply increase and in so doing, we’ll see cost containment, industry wide standards and completely interoperable systems that will completely open up the health IT market place.
In continuing a series based on HealthIT.gov’s “How to Implement an EHR,” now seems like an appropriate time to seek additional insight into how to prioritize your implementation plan and identify critical tasks to perform when putting your system in place.
As the HIT world continues to reel from continuous change – meaningful use stage 2, ICD-10 postponement and mobile health among the biggies – like any commercial market, there’s bound to be some constant ebbs and flows.
Selecting, and changing, an EHR are bound to happen no matter what else is going on in the market. So, though much of the market may be focused on regulation and reform related to EHRs, there are still practices who haven’t yet implemented, and there are practices that are looking to get out of their current solutions.
According to the Office of the National Coordinator (ONC), “Building an EHR implementation plan becomes critical for identifying the right tasks to perform, the order of those tasks and clear communication of tasks to the entire team involved with the change process.”
Implementing an EHR is really about implementing a change management process: new rules, new ways of doing things and new things to learn. That’s an oversimplification, but it essentially hits the mark.
Setting up an implementation plan (the plan should be in place before the implementation begins) first starts with segmenting tasks into three categories, according to ONC:
What new work tasks/process are you going to start doing?
What work tasks/process are you going to stop doing?
What work tasks/process are you going to sustain?
The three categories help determine the future work environment of the practice; how things will work after the change.
Obviously, if you are moving from an existing EHR, you’re probably going to be more familiar with how things will work once the system is in place, with a few exceptions. However, moving from paper to electronic records means there are going to be a great number of changes that, if not accounted for, may cause some initial hurdles along the way.
Your next steps should include:
Mapping your current workflow and analyzing how you get things done
Mapping how the EHR will affect your workflow, and how you hope it will enable you to perform certain tasks or functions like how you plan for them to create more efficiencies and reduce duplicate processes?
Creating a backup plan to address issues that arise during implementation. This is crucial as issues beyond your control will come up and if you’re not prepared for them, they could derail your process and set you back. Think of worst case scenarios and plan for them to happen then hope for the best. No implementation is ever the same as another; each are there own experiences.
Building a project plan to blueprint the transition then appoint a team member to manage the plan.
Identifying data that must be transferred to the EHR either from paper or from the previous EHR (charts are the most obvious example here)
Finally, find out what can be transferred to the new system like patient demographics and schedules.
Once this point has been reached, you can bring other parties into your plan, like consultants and vendors, to get the plan rolling and potentially start the implementation.
In taking a look around the HealthIT.gov site recently, I once again stumbled upon its series dedicated to offering practices insight into how to implement an EHR. A several part series, topics included cover what to look for when selecting a product, how to conduct training and, ultimately, how to reach meaningful use.
Given that nearly 50 percent of all practices currently have some sort of EHR, the process for setting up and implementing the systems are becoming more well known; however, having a clear plan and getting a little advice goes a long way.
So, without further ado, the following information is valuable and bears repeating, at least in part, even if you heard some of it before.
When starting an EHR implementation, a practice should assess its wants and needs. Keep in mind that no implementation is going to go completely smoothly (or at least as smoothly as imagined) so it helps to have a plan for what to expect and the plan should include room for error. Figure 10 to 15 percent in added time, resources and staff commitment over and above what you originally plan.
During the assessment, there will be some error and a few hurdles to jump. Don’t allow yourself to be told otherwise. If someone tries to tell you differently, that person does not have your best interest in mind.
If it’s a vendor, run. Do not purchase the product from the company because it’s only the beginning of what’s likely to be a long road of misinformation and false expectations. And no one appreciates being snowed, especially when you’re spending money on something.
Asking yourself questions
During the assessment phase, you also need to determine if you are even ready to implement a system, and if not, what more you need to accomplish. Assessments are designed to answer the “why” of implementing an EHR, and what is working and can be improved by installing one.
According to HealthIT.gov, “practice leadership and staff should consider the practice’s clinical goals, needs, financial and technical readiness as they transition.”
The site provides the following questions that practice leaders should consider during the process:
Are administrative processes organized, efficient and well documented?
Are clinical workflows efficient, clearly mapped out and understood by all staff?
Are data collection and reporting processes well established and documented?
Are staff members computer literate and comfortable with information technology?
Does the practice have access to high-speed Internet connectivity?
Does the practice have access to the financial capital required to purchase new or additional hardware?
Are there clinical priorities or needs that should be addressed?
Does the practice have specialty specific requirements?
What will the future look like?
Next up, it’s time to envision the future. Think about what you want to accomplish with an EHR, and write as part of your plan some things like: how are patients going to benefit, how can the care provided be better and how are providers’ lives going to change?
Finally, set some goals. According to HeathIT.gov, “goals and needs should be documented to help guide decision-making throughout the implementation process. And they may need to be re-assessed throughout the EHR implementation to ensure a smooth transition for the practice and all staff.”
Goals guide an EHR implementation, and are set once an assessment has been completed. As in life, goals provide an achievable end to an arduous task; the medal at the end of the race, if you will.
When developing goals for the implementation forgo conclusions like trying to determine what amount of savings will be created or how much of an increase in the number of patients or revenue will come into the practice. For now, these are intangible and often create a sense of failure if not immediately met after the EHR is “turned on.”
Keep the goals more process oriented and related to practice strategy and team building. For example, what goal do you have for the transition team? Do leaders emerge? Do advocates and coaches come to the forefront of the team that you had not expected? What practice visions are realized? Are you now more technologically savvy and able to attract better talent to the organization?
Perhaps you have business goals (other than the aforementioned money goals). Do you have a stronger business-planning process and clearer organization objectives now?