National Health IT Week: Moving Toward EHR Interoperability

Tom Bizzaro
Tom Bizzaro

Guest post by Tom Bizzaro, RPh, vice president of health policy, FDB.

National Health IT Week has come and gone. The industry is focused on how far IT has come and how far it needs to go in healthcare. As most organizations have now adopted electronic records, one of the big themes this week has been EHR interoperability — getting these systems to work together.

Earlier this year, the Office of the National Coordinator for Health IT (ONC) published a 10-year vision to achieve an interoperable health IT infrastructure. The ONC publication is meant to move the industry toward the much coveted interoperability that will enable healthcare organizations to seamlessly share patient information. The simple fact that the federal government has issued this call to action and the industry is embracing it is a good sign for the future of healthcare. We will finally be able to share vital patient information that helps us improve care for individuals and populations, while cutting some of the unnecessary costs out of the system.

While the report is encouraging, this is a very real industry where change only comes after considerable effort. To help move toward the interoperable nirvana quicker – or at least make the journey more palatable — we need to:

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CHIME and Others Industry Leaders Call for Amendment to 2015 EHR Reporting Period MU Rule

In a letter to HHS Secretary Sylvia M. Burwell, the College of Healthcare Information Management Executives (CHIME), the Association of Medical Directors of Information Systems (AMDIS) and 15 other healthcare organizations issued an immediate call to action to adjust the 2015 EHR reporting period to help hundreds of thousands of providers meet Meaningful Use Stage 2 requirements in an effective and safe manner.

Responding to the Centers for Medicaid and Medicare Services’ (CMS) final rule on meaningful use flexibility, the letter states the agency’s decision to require a full-year of reporting using 2014 Edition certified EHR technology (CEHRT) in 2015 puts many eligible hospitals and physicians at risk of not meeting Meaningful Use next year and hinders the forward trajectory of the program.

“We implore you to take immediate action by shortening the 2015 EHR reporting period to 90 days and by adding flexibility in how providers meet the Stage 2 requirements,” the letter states. “The additional time and flexibility afforded by these modifications will help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner. This will reinforce investments made to date and it will ensure continued momentum towards the goals of Stage 3, including enhanced care coordination and interoperability.”

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NHIT Week: Raising Awareness to Improve Quality and Efficiency of Healthcare

For the ninth year, national health IT week is in full swing, from Sept. 15 – 19, 2014. Those in healthcare, policy makers and stakeholders have come together to “collaborative forum for public and private healthcare constituents to discuss the value of health information technology (IT) for the U.S. healthcare system.”

HIMSS is again hosting a lineup of events and activities centered in the DC. According to the organization, the event is designed as health IT continues its advancement to “improve the quality of healthcare delivery, increase patient safety, decrease medical errors, and strengthen the interaction between patients and healthcare providers.”

For those of us in health IT, NHIT Week is a forum, a conversation starter and an awareness builder that assembles healthcare constituents dedicated to working together to elevate the necessity of advancing health through the best use of information technology. As a brand awareness campaign, the effort is paying off and bringing about deeper conversations with health IT game changers, leaders and those who wish to learn more about the ramifications of the technology on the overall landscape.

That said, and because of the importance of the event, I asked a few folks for their reaction to NHIT Week. Their responses follow:

Arvind Subramanian, president and CEO, Wolters Kluwer Health, Clinical Solutions

Arvind Subramanian
Arvind Subramanian

Vision, innovation, hard work and perseverance are foundational to any significant change for the better. These are fundamental components of the health IT movement—an ever-evolving landscape that has experienced tremendous successes, along with its share of challenges.

National Health IT Week offers a platform for celebrating progress and expanding awareness of the tremendous potential of health IT to advance healthcare’s broader goals of improved outcomes and lower costs. It’s an opportunity for those deeply involved in the movement and those watching it unfold from a distance to come together and remember what forms the core of its agenda: improving the human experience and saving lives.

Here at Wolters Kluwer Health, we have the advantage of seeing the outcomes associated with advances in clinical content integration, clinical knowledge management and data analytics every day. Whether it’s a highly effective response to a public health crisis or the ability to mitigate adverse outcomes through real-time patient surveillance, our clients are experiencing a transformation to more highly-effective care delivery.

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“What is the Value of Health IT?”

For its second year of celebrating National Health IT Week, HIMSS is asking a simple question: “What is the value of HIT?”

Seems like a simple question, but there don’t seem to be any simple answers. The fact is there seems to be a different answer depending on who you ask. So, instead of offering my lone — and probably less than expert – opinion I’ve asked a variety of folks who are probably better able to give more insightful and valuable opinions than mine.

Brian Wells
Brian Wells

Brian Wells, associate vice president of healthcare technology and academic computing, Penn Medicine – UPHS “The value of Health IT is centered on the liberation of information. The act of capturing health data in electronic form allows that data to be used for multiple purposes: patient care, quality improvement, cost optimization, research, education, etc. The value increases exponentially if the data is stored and shared using structural and semantic standards.  This enables data from multiple sources to be aggregated while retaining its original meaning (value).  The promise of personalized or precision medicine will only be realized if health IT is used to gather the rich phenotypes of all patients and link that to their genotypes.”

Mark Frisse, M.D., professor of biomedical Informatics, Vanderbilt University “Health IT enables patients and their clinicians to make more informed decisions by bringing to care settings a comprehensive view of the patient’s health status as well as evidence-based care guidelines to inform consensual decision-making. Health IT promises more efficient and effective care delivery, accurate reporting of care quality, and timely assessments of public health. Health IT can enforce patient privacy preferences and other policy requirements. Properly implemented within a system of care, these technologies enable better communication and may allow clinicians and patients to transform care in positive and sometimes dramatic ways.” Continue Reading

View, Download and Transmit: ONC’s Mostashari Encourages HIT Vendors to Get Involved in the Patient Engagement Movement

Farzad Mostashari, national health IT coordinator, says more progress has been made in health IT in the last 20 months than during the last 20 years. It’s a statement he made during the first day of National Health IT Week in September.

Increased adoption of electronic health records and the push toward meaningful use have been the catalysts for this movement, most of which has been driven by the financial incentives associated with meaningful use.

The ultimate goal of meaningful use, and the subsequent adoption of the healthcare technology, is data collection. A subset is patient engagement.

To a lot of different people, patient engagement means a lot of different things. For some, it’s about patients having access to their information, and for others it has nothing to do with “giving” patients information, but more about making them the center of care, Mostashari said recently.

Health and its information are owned by its community, he said, and the community must have access to its information. Policies and practices need to be set in place to unleash and unlock the activities of the community.

One effort to encourage this is “Blue Button.”

“Blue Button is national symbol for the concept of ‘give me my data,’” he said during his address at National Health IT Week in September 2012.

But the effort is transcending patients. It’s being brought to the vendor community, and their commitment is being requested. Mostashari has challenged vendors to make it easy for consumers, by as early 2013, to view, download and transmit to another party their health information through Blue Button. Engaging the vendor community is exactly the kind of effort the market needs since they have a seat at the table.

So far, several vendors have committed to meeting the deadline for the challenge, which is by the HIMSS Annual Conference in early March 2013. The current list of vendors to accept the challenge (those deserving some recognition) include:

Engaging the vendor community in this effort, for an early push toward view, download and transmit, is the right thing to do and it’s encouraging to to see Mostashari putting ONC’s muscle behind this effort.

Vendors are the folks playing a huge part in the overall effort for a transformed healthcare system and they plan to gain the most because of it. As such, it’s good to see them encouraged to take greater ownership of this process and play a larger role in encouraging the patient engagement process.

Paper Health Records More Likely to Be Breached than Electronic Health Records

In honor of the first ever National Health IT Week, here’s a gem of a story that seems to voraciously support the need for more integration of electronic health records, and technology in general, to find their way into more medical practices.

According to an article published by Referral MD, in a report issued by Health and Human Services (HHS), despite all of the attention surrounding the security of electronic health records, in actuality, between May 17 and June 17, there were 45 security breaches involving paper health records – 42 more than with EHRs.

I shouldn’t be surprised by this, but I guess I am. Perhaps I’m programmed to think about EHRs exclusively, but paper records are still the majority of records kept, at least in the smaller ambulatory practices where EHRs haven’t been implemented, so security breaches in environments like this are quite likely.

According to the report, the following fit the definition of a “breach,” including theft, unauthorized access, improper disposal and loss.

Some of these I understand, to a point. Loss. That’s easy. It’s one of the most common complaints about paper health records. They get shuffled about the office, from room to room. With the library of other records, it’s surprising that more don’t end up getting misplaced. Getting found is another story, though. If they’re found, what happens to them? Are they then stolen? Five-fingered discounted from the crevice in which they’ve been laid? And, truly, if practices are losing copious volumes of paper records – I’d think losing records would be somewhat of an ongoing problem because of internal procedures and record keeping – then I don’t want to patronize the practice.

Improper disposal. Well, that doesn’t take too much imagination, either. In fact, I once remember not too long ago that the state of Oregon disposed of thousands of Medicare patients’ records improperly by simply tossing them in a dumpster behind the state’s office building, in the same dumpster shared by the state’s capitol newspaper, The Statesman Journal.

If an organization as large the state of Oregon improperly destroys paper records, I’m sure countless others do so as well.

Unauthorized access. Okay, sure. Unwanted eyes get their mitts on the occasional (I assume it’s the occasional) record and potential danger ensues. I’m not sure how one goes about getting his mitts on someone else’s records since I’ve never thought of wanting to see someone else’s record, but I assume it has to do something with hurdling the records desk and making a mad dash for the shelves with the millions of cream-colored folders.

I jest. Obviously, info thieves aren’t jumping over counters. Perhaps one of you can set me straight, but I imagine it happens as a passerby passes someone’s record that’s sitting in the pocket outside the exam room door or something similar; just a passing glance at someone’s record as they scurry on by.

The hard one for to understand, though, is record theft. How are these records getting stolen? From a doctor’s car as he runs into the convenience store for a soda? Are they misplaced in some unfortunate public place? Are they scattered to the winds by disgruntled employees?

How on earth do they disappear?

And, perhaps more importantly, could any of these breaches been avoided with the use of an electronic health record?

Happy National Health IT Week. Enjoy.