Healthcare IT Regulatory Compliance Drives System Interoperability

Chris McNabb
Chris McNabb

Guest post by Chris McNabb, general manager, Dell Boomi.

Many healthcare IT organizations find themselves caught between a regulatory rock and a technological hard place. The breadth and increasing complexity of today’s healthcare regulatory compliance is putting tremendous pressure on them to rapidly and efficiently establish interoperability between the variety of systems, applications, data sources and devices that populate the diverse healthcare ecosystem of providers, payers, government agencies, labs and more. However, most of these IT departments don’t have adequate budgets, resources and bandwidth to make major investments in new technology while also maintaining expensive legacy systems and trying to manually consolidate their highly fragmented data silos. Instead, they remain mired in outdated application integration strategies based on traditional middleware solutions that require long and costly development cycles, making it impossible to satisfy the new and ever-changing regulations anytime soon.

There is a better way. Integration Platform as a Service (iPaaS) enables the rapid and economic integration of applications in cloud-to-cloud, cloud-to-on-premises, and on-premises-to-on-premises integration scenarios. Because iPaaS is offered as a service, similar to the way Software as a Service (SaaS) is delivered, the barrier to entry is dramatically lower and the shift from CAPEX to OPEX delivers predictable costs. And because the integration will work with existing applications, IT will be able to focus immediately on meeting the challenges of the most significant new regulations, such as meaningful use, accountable care and the ICD coding standard. Let’s examine these regulations for their application integration challenge and see how iPaaS can help.

Meaningful Use

Even as healthcare organizations work to digitize their medical and clinical records, the requirement for meaningful use of certified electronic health record technology (CEHRT) means that the use of patient records needs to directly benefit patients through greater portability across health and insurance systems. This in turn requires IT to establish new, complex processes for recording patient information as structured data and exchanging summary care records. Several system providers and consulting firms offer solutions designed to overcome the portability challenge, but their proprietary interfaces can be a significant downside. As a result, the healthcare industry has been slow to attain compliance with the “meaningful use” requirement for EHR technology.

Accountable Care

Accountable care organizations (ACOs), which are designed to dramatically improve patient services, come with a new payment model. Instead of direct payments for services rendered, ACOs get paid based on the overall health of a population within the boundary of a defined community. Actually receiving payment, however, requires the ACO to produce a new set of metrics that must be collected from multiple systems, including EHRs, the Physician Quality Reporting System (PQRS), a variety of legacy on-premises applications, and the many new cloud applications that health organizations are adopting. The data must then be rapidly integrated for analytics and measurement. If this integration can’t be done rapidly, securely, and at a relatively low cost, the ACO model simply won’t work.

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More Physicians and Hospitals Are Using EHRs than Before

Significant increases in the use of electronic health records (EHRs) among the nation’s physicians and hospitals are detailed in two new studies published today by the HHS Office of the National Coordinator for Health Information Technology (ONC).

The studies, published in the journal Health Affairs, found that in 2013, almost eight in 10 (78 percent) office-based physicians reported they adopted some type of EHR system. About half of all physicians (48 percent) had an EHR system with advanced functionalities in 2013, a doubling of the adoption rate in 2009.

About six in 10 (59 percent) hospitals had adopted an EHR system with certain advanced functionalities in 2013, quadruple the percentage for 2010. Unlike the physician study, the hospital study does not have an equivalent, established measure of adoption of some type of EHR system; it only reports on adoption of EHRs with advanced functionalities.

“Patients are seeing the benefits of health IT as a result of the significant strides that have been made in the adoption and meaningful use of electronic health records,” said Karen DeSalvo, M.D., M.P.H., national coordinator for health information technology. “We look forward to working with our partners to ensure that people’s digital health information follows them across the care continuum so it will be there when it matters most.”

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