Health IT’s Most Pressing Issues (Part 4)

Health IT’s most pressing issues may be so prevalent that they can’t be contained to a single post, as is obvious here, the fourth installment in the series detailing some of the biggest IT issues. There are differing opinions as to what the most important issues are, but there are many clear and overwhelming problems for the sector. Data, security, interoperability and compliance are some of the more obvious, according to the following experts, but those are not all, as you likely know and we’ll continue to see.

Here, we continue to offer the perspective of some of healthcare’s insiders who offer their opinions on health IT’s greatest problems and where we should be spending a good deal, if not most, of our focus. If you’d like to read other installments in the series, go here: Health IT’s Most Pressing Issues, Health IT’s Most Pressing Issues (Part 2) and Health IT’s Most Pressing Issues (Part 3). Also, feel free to let us know if you agree with the following, or add what you think are some of the sector’s biggest boondoggles.

Charles A. “Drew” Settles, product analyst, TechnologyAdvice

Charles A. “Drew” Settles
Charles A. “Drew” Settles

First and foremost, of all the issues facing healthcare technology, I believe the top issue is the interoperability (or lack thereof) of most electronic medical records systems. Interfacing systems from disparate vendors usually takes expensive custom development, but hopefully the push for free access to EMR/EHR APIs in Stage 3 of the Meaningful Use Incentive program will finally bring semantic interoperability to health IT.

Paul Cioni, senior vice president, Healthcare & Infor Solutions Sales, Velocity Technology Solutions
The top issue facing healthcare CIOs is that there is simply too much for them to do, including major initiatives involving information security, patient confidentiality, and revenue cycle management and reimbursement. Most are focusing on what’s urgent, rather than on what’s important. All of these issues are not only competing for a CIO’s budget, but also for his/her time. With so many things on the “as soon as possible” priority list, healthcare CIOs barely have time to strategically plan. It’s difficult for CIOs to create a five-year plan for the organization’s IT when they’re trying to figure out the next five months. A disaster recovery plan, for example, may not get created when CIOs are more concerned with downtime of clinical applications or the reporting of a data breach to the regulatory authorities.

Paul Cioni
Paul Cioni

The use of the cloud — with a comprehensive but flexible portfolio of service options- helps relieve CIOs from what I call the “tyranny of the urgent.” By allowing a cloud provider to manage a variety of back-office and ERP-related functions, the CIO can shift his focus to systems that affect clinical outcomes. Extending the secure, private cloud approach to clinical systems liberates key resources — budget and people — to focus on achieving meaningful use or embracing population health initiatives. Cloud deployment options like disaster recovery as a service or desktop as a service can conserve capital dollars and speed time to outcome. It’s not one issue – it’s all of them.

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Telemedicine Services Have Yet to Gain General Acceptance

Telemedicine initiatives may have a promising future within the American healthcare system, and could alleviate the shortage of general practitioners, increase reliable access to basic and preventative care, and reduce overall costs. Despite potential positive outcomes of telemedicine platforms, patients remain dubious about this remote option and the quality of diagnosis made during virtual appointments.

According to a nationwide study conducted by TechnologyAdvice Research, nearly 65 percent of respondents said they would be somewhat or very unlikely to choose a virtual appointment, while only 35.4 percent stated the opposite. Approximately 75 percent of people reported they either would not trust a diagnosis made via telemedicine, or would trust this method less than an in-doctor visit.

Cameron Graham
Cameron Graham

“This is perhaps the largest issue that telemedicine vendors and healthcare providers will need to overcome,” said Cameron Graham, managing editor at TechnologyAdvice and the study’s author. “If patients don’t trust the diagnoses made during telemedicine calls, they may ignore the advice given, fail to take preventative steps, or seek additional in-person appointments, which defeats the point of telemedicine.”

Telemedicine is a newer technology in the medical industry, with greater lack of familiarity, but data from the study shows that younger patients may be less skeptical. Only about 17 percent of 18- to 24-year old respondents, and 24 percent of 25- to 44-year olds, said they wouldn’t trust a virtual diagnosis. Also, 65 percent of respondents said they would be somewhat or much more likely to use a virtual appointment system if they had first seen the doctor in-person.

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All I Want for Christmas: Health IT Stocking Stuffers

As we head into Christmas, and 2015, millions of Americans have hopes for a bright holiday willed with hope, health and happiness. And while America’s consumer engine is in full force, presents are getting bought, wrapped and covered with ribbons and bows, it’s hard to image that there’s little that can’t be bought and given in the spirit of good cheer for the betterment of man and for the greater good. But, as in all areas of life there are a few things that won’t fit nicely in the stocking or under the tree.

If only everything we wanted and needed could be placed in our stocking to be unwrapped on Christmas morn, but there’s just too much on the list. The list would be long for those in healthcare – interoperability, improvement of policies, better communication with care providers, and even more, qualified employees to join healthcare-related ventures.

If only some of these Christmas wishes could be packaged and stuffed in the stocking. Here are a few ideas from several healthcare folks who wish they could make the world’s dreams come true.

Allen Kamrava, MD, MBA, attending staff, Cedars Sinai Medical Center, Department of Surgery, Division of Colorectal Surgery

Common language between all healthcare electronic health records (EHR) systems, such that they can communicate with each other and patient notes may be accessed between all providers. We have gone digital, but none of the systems communicate with one another. This does not make any sense. Patients should be able to elect to have their records “shared” between systems when they visit other physicians, and more so to have their accounts sync’d between systems so that all physicians are up to date with all tests, procedures and visits. For now, the only thing EMRs have provided for is more legible notes that are inundated with information required by national standards regulations. Healthcare is far beyond the rest of the IT world. Indeed, it functions in the pre-internet era – we have electronic systems, but they do not communicate in any meaningful way. Healthcare IT is still functioning as if we are in the 1990s.

Bill Marvin, president, chief executive officer and co-founder, InstaMed

Bill Marvin

Health IT Christmas wish: Interoperability. By integrating technology and processes across heterogeneous environments, providers automate administrative processes and simplify compliance requirements, resulting in lower operational costs.

Bill Fera, M.D., principal, EY Americas Health Care Advisory practice

I would love to see a fully functional telemedicine capability in every hospital and office across the country. What I mean by fully functional is that reimbursement hurdles have been cleared, apps are standard, we have a maturity and adoption model in place all so that patients are receiving the best care from the right clinician in the most optimal manner possible.

Charles Settles

Charles A. Settles, product analyst, TechnologyAdvice
There are a myriad of things I’d like to find in my figurative “stocking” come Christmas morning, but perhaps the one I’d like to see the most is more widespread patient, provider and payer use of health wearable devices or fitness trackers, i.e. Fitbit, FuelBand, Jawbone, etc. The spread of these devices is something we are keeping a close eye on here at TechnologyAdvice; we recently surveyed nearly 1,000 adults about their use of fitness trackers and uncovered several key insights. Perhaps the most actionable of those insights was that nearly 60 percent of adults would use a fitness tracking device if it would help reduce their monthly health insurance premiums. Of course, there are potential benefits to payers and providers as well — in the push to switch the healthcare reimbursements from a fee-for-service to a outcomes-based model, these devices could provide invaluable information to physicians that would aid in health maintenance, preventative care, and overall population health modeling. As these devices evolve and are able to track more and more biometrics, they could enable less expensive and higher quality telemedicine.

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Incentives from Physicians, Insurance Companies Could Significantly Increase Use of Health Wearables

Health wearables and fitness tracking devices have created an unprecedented opportunity for the healthcare community to collect valuable data that could greatly impact patient care and health insurance premiums. Still, adoption rates for such devices remain low in the U.S. adult population.

While the use of health and fitness tracking devices has more than doubled in the last two years, a new nationwide survey conducted by TechnologyAdvice shows that only 25.1 percent of adults are currently using either a fitness tracker or a smartphone app to monitor their health, weight or exercise. However, the survey also shows that nearly half of those not using such a device would be more likely to use one if it were provided free by their physician or health insurance company.

“Healthcare providers and health insurance companies are two of the largest stakeholders in the promotion of fitness tracking devices, and they have an opportunity to greatly influence their use,” said the report’s author, TechnologyAdvice managing editor Cameron Graham. “This survey revealed there are few real barriers to using health wearables, and also indicated adoption rates would increase if their use was incentivized by the healthcare community. If healthcare providers worked in tandem with health insurance companies, both stakeholders could benefit from the collected population health data.”

Nearly 44 percent of respondents did not have a specific reason for not tracking their fitness, while another 27.2 percent cited a simple lack of interest in wearing a fitness tracking device. Cost, data privacy, and device design did not prove to be overly impactful concerns. With these limited barriers to use, almost half (48.2 percent) of non-tracking adults said they would use a free fitness tracking device provided by their physicians, while 46.1 percent said they would use one provided for free by their health insurance company.

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