Guest post by John Squire, president and COO, Amazing Charts.
According to the 2014 Exclusive EHR Study conducted by the MPI Group and Medical Economics, 70 percent of clinicians said their EHR investment has not been worth the effort, resources and costs. Widespread dissatisfaction with electronic records systems is casting an unfortunate shadow over the great potential they hold for making today’s medical practices more efficient and for improving healthcare delivery. However, practices can help avoid future disappointment with their EHR decision and save time and resources by understanding how to avoid common implementation pitfalls.
1. Choosing the wrong EHR
The intuitiveness and ease of use of your EHR will affect every area of your practice. If you don’t consider yourself to be technologically savvy, finding an intuitive solution should be at the top of your list. (After all, presumably you’re a clinician, not an IT expert.) Was a clinician was involved with the development of the EHR system? If a clinician wasn’t involved, chances are your idea of “usable” won’t line up with that of the vendor’s.
Another aspect to consider is cost, which can vary across a wide spectrum from free to several thousand dollars a month. Decide on the maximum price that you are willing to pay. This will reduce the list of vendors for consideration. Oh by the way, beware of the word “free.” Your biggest hidden cost is not the dollars spent on software, but the hours of lost productivity from a system that impedes you with banner ads and other annoying distractions.
To be certain that the EHR you choose is the right one for your practice, do everything in your power to expose yourself to the software prior to purchasing. It is worth asking the vendor whether they offer free trials. If not, consider watching video tutorials, attending webinars and shadowing another clinician using the EHR.
2. Underestimating the importance of an implementation plan
To ensure the smoothest transition possible, develop an implementation plan that will introduce you to your new EHR and also help you identify specific questions to ask the vendor. Your EHR vendor will likely have one to give you – just ask.
At a minimum, a useful implementation guide should tell you how to do the following:
Guest post Michelle Blackmer, director of marketing, Healthcare, Informatica.
The Affordable Care Act is commonly surrounded by words, such as “analytics,” “electronic medical record (EMR)” and “population health,” routinely trumping the word that matters the most, the center and driver of the law: the “patient.”
A recent EMR Patient Impact Survey compiled by Aeffect, Inc. & 88 Brand Partners, illustrates that patients are experiencing a personal benefit of EMR adoption:
82 percent of patients visiting doctors that use an EMR believe they are receiving better care,
68 percent appreciate the convenience of being able to check for medical records and test results, and
44 percent, or almost half, of these respondents say they have a more positive impression of their doctor because he/she uses an EMR.
However, beyond these early and obvious benefits offered by information technology – convenience and improved service – there are more meaningful benefits ahead. Insights will be revealed that will change healthcare in ways we can’t even imagine. The adoption of EMRs is generating useful, consumable and sharable electronic data. It is also creating a forum to inspire and collect patient-generated data, including health history, symptoms, biometric data, treatment history and lifestyle choices.
According to a new report from digital health consultancy DrBonnie360, there are now an estimated 50 petabytes of data in the healthcare realm, and this volume is rapidly increasing. In fact, many Informatica healthcare customers have reported significant data volume growth. For example, The University of Texas MD Anderson Cancer Center recently communicated that its data storage (storage alone) is growing at 40 percent a year.
Today’s healthcare system is becoming progressively technology dependent. With the need to meet meaningful use requirements, convert to ICD-10, or work with health information exchanges (HIEs), healthcare organizations must have effective IT solutions, but building and implementing one successfully is not an easy task.
Below is a list of 10 fundamentals of successful healthcare IT project implementation, management and execution that will help your organization, whether clinical, business, or IT, design and develop a functional, patient-centered IT solution that fits its needs. It’s easy to let the highly technical elements overwhelm healthcare IT projects, but following these guidelines will help your team focus on the delivery of care.
Plan
Develop your plan with a detailed project introduction, clear scope, deliverables, schedules, project methodology, roles and responsibilities, and change management procedures. Consult ISO 9001/13485/62385 for information on best practices for quality management systems.
Healthcare IT projects involve a lot of moving parts and many people from different professional backgrounds. Setting clear expectations that every project member agrees on will ensure a project runs efficiently. Meeting regulatory requirements, including meaningful use goals, is a crucial aspect of carrying out a successful healthcare IT project.
Set goals and objectives
Early on in the process, involve key players – clinical, business, and IT – in determining the goals and objectives of the project. Ask your team to agree on a definition of success. Depending on the project, involving patients may be valuable. A patient portal project is an ideal situation to solicit feedback from patients.
Adapt to changing objectives
Implement effective change management procedures to your plan to ensure that the project meets the goals on-time and within budget.
Change management is important in every project, in every industry. It is particularly important at this time in healthcare. Healthcare reform and government mandates, such as Meaningful Use, are ever-changing. Recently, the deadline for compliance with ICD10 was pushed back a year. If your organization was close to a switchover, ask your project team how those changing objectives impact your plan and your goals.
Mobile devices are completely ingrained in the fabric of our daily lives – from personal use to business – throughout the world.
The healthcare industry, usually resistant to the whims of technology trends, has been a fast and significant adopter of mobile devices. Apple’s introduction of the iPad appears to have been a watershed that brought healthcare IT into the 21st century. Besides improved efficiency in communication and administrative functions, clinicians found the devices much more practical to incorporate to patient interactions – from consultation to education. Now mobile devices have become almost indispensable in the daily care of patients. Physicians use smart phones and tablets wherever they review patient records, receive updates or alerts by secure text messaging and coordinate care among other clinicians. Care professionals are connected to health information like never before.
Telehealth has “connected” patients and physicians for decades in an attempt to deliver proactive healthcare, but mobile devices and cloud-based technologies are making remote healthcare more practical. Still, we are just scratching the surface as to what a “connected healthcare system” can look like. Despite strides, we still need to tie it all together: patients, physicians, devices, data, analytics, decision support, monitoring services and education – to achieve the best outcomes for our patients.
A connected patient is more compliant with a better chance to attain better outcomes. A connected provider has access to better information to make better decisions. The common goal is to keep the patient out of the hospital, lower costs, reduce the strain on an already strained healthcare system and provide better outcomes. How we implement the goal of a connected healthcare system is the challenge.
In assessing how to best utilize mobile technology with patients and providers, my belief is that one solution doesn’t fit all. We must align the right technology with the right patients. Smart phones and tablets with complex apps and expensive data plans may be common in demographic groups that may skew younger, or those with higher technical literacy and dexterity and more disposable income. Simpler technology using month-to-month or prepaid service plans may better suit seniors and those with limited and fixed incomes. Meaningful change will come faster by focusing on the 15 percent of the population that consumes 80 percent of healthcare costs. This segment traditionally includes the elderly and indigent, Medicare/Medicaid population. This group doesn’t overwhelmingly consume the “latest and greatest” devices with the hottest apps and seamless connectivity – 4G, Bluetooth, WiFi and syncing to the cloud is not reality. We must be realistic when we propose solutions to address something as important as the delivery of patient care, providing the right technology to meet the needs of the people using it. Acquiring the right data, at the right time, and right cost, to achieve the right (better) outcome for the patient.
CSC announces that it is pursuing the anticipated multi-billion dollar U.S. Department of Defense (DoD) Healthcare Management System Modernization (DHMSM) contract with Allscripts and HP. The CSC-led team intends to deliver a secure, enterprise-wide information technology (IT) solution that joins multiple disparate military health information systems into a single, open, interoperable and extensible platform that seamlessly connects patients and providers.
“As a practicing physician in the Navy and civilian sector, I personally understand the importance of this initiative and am honored for the opportunity to extend my experience and expertise in DoD mission and medical knowledge to this team,” said Dr. Robert M. Wah, CSC chief medical officer and current American Medical Association president. “CSC is the world’s largest health systems integrator. As such, we know that secure access to actionable data, system usability and agility will be critical to the program’s success. Together with our teammates, we will deliver a solution that improves care of military beneficiaries and keeps our fighting force strong and fit. We intend to provide to military members and their families the same outstanding service that they deliver to our nation on a regular basis.”
CSC will apply its leading commercial, government and global health technology experience to quickly and successfully deliver next-generation solutions that improve health outcomes. Allscripts, with one of the largest client bases in healthcare, will provide its comprehensive, integrated and interoperable electronic health record solution. Allscripts’ open architecture will enable DoD to innovate care anywhere while easily maximizing the reuse of systems and data as well as leveraging the full spectrum of future technological advancements. Allscripts clients are among the largest and most advanced healthcare organizations in the world including The University of Pittsburgh Medical Center, North Shore-LIJ Health System, New York-Presbyterian Hospital and the National Institutes of Health Clinical Center.
HP brings domain expertise in healthcare IT, developed from its 50-year history of providing innovative solutions for Military Health, VA, Health and Human Services (HHS), commercial healthcare organizations and state government health agencies. Each year, HP technology and services touch more than 200 million patient lives and are used to perform 2.8 billion healthcare transactions that deliver quality care around the globe. Its world-class IT will provide DoD with industry-leading products and services designed for the future.
Paul M. Black, president and chief executive officer of Allscripts, issued the following:
Doximity is the largest medical network with one in three U.S. physicians as members. Physicians use Doximity to instantly connect with other healthcare professionals, securely collaborate on patient treatment, grow their practices and discover new career opportunities.
Its vision is a future where medical communication is effortless — fast, simple, seamless and secure. Its mission is to “help physicians transcend the fragmented U.S. healthcare system and succeed in the care for their patients.”
Doximity was founded by Jeff Tangney, co-founder and former COO of Epocrates (EPOC), and launched in March 2011. Based in Silicon Valley, it’s backed by Emergence Capital Partners, InterWest Ventures, Morgenthaler Ventures (now Canvas Fund), Draper Fisher Jurvetson, T. Rowe Price and Morgan Stanley Investment Management.
Here, Alexander Blau, MD, vice president of physician marketing and medical director for Doximity — responsible for marketing and user acquisition teams oversees the development of clinical programs, including a socially curated medical literature filter and case-based discussion forums, manages the aggregation, analysis and product integration of diverse healthcare data in charting the first-ever nationwide clinical expertise map — discusses the company, its future and what he’s seeing from his perch.
Give us the short story on what you do and how you came to health IT?
My background is as an emergency physician. During my training, I was drawn to the latest in mobile health technology and eventually built my own app for medical interpretation. From that moment, I knew I was hooked on health tech. Three years ago, I joined Doximity to join a larger team to develop yet more tools that help doctors practice medicine every day.
Tell me about Doxmity. There’s been some press lately about how it’s really innovating the space. What are you doing that makes for such success? Care to share the secret sauce?
Doximity is the first health tech company really built for physicians — as opposed to hospital administrators, billing departments, etc. In just three years, we’ve grown to be the largest network of verified physicians in the US, thanks to our focus on what doctors truly need from technology. Our focus on doctors is the secret sauce.
What are some of the misconceptions you face? Obstacles you must overcome?
There’s a misconception that physicians aren’t technology savvy, which is absolutely not true. Doctors have been among the earliest adopters of all kinds of communication technologies starting with pagers and the first smart phones. When it comes to social media, doctors are necessarily skeptical about privacy and HIPAA compliance. The great thing is that Doximity is specifically built to address physician privacy requirements and enable them to communicate professionally on the mobile devices they rely on.
After a five-year contraction in employer healthcare spending growth, medical inflation in the U.S. is projected to rise to 6.8 percent in 2015, according to PwC’s Health Research Institute (HRI). In its annual report, Medical Cost Trend:Behind the Numbers, HRI projects that the stronger economy is now reaching the health sector, releasing a pent-up demand for care and services. Despite some higher utilization and the cost of expensive new cures, the higher expected growth rate in 2015 is modest compared to the double-digit annual increases seen throughout the late 1990s and early 2000s. However, the fact that health spending continues to outpace GDP underscores the need for a renewed focus on productivity, efficiency and ultimately delivering better value for healthcare customers.
Confident consumers are spending more freely on healthcare because of the improved economy, as well as increasing numbers of newly insured, and HRI expects that trend to continue through next year. In addition, the high costs of specialty drugs will increase the healthcare spending growth rate, according to HRI. As exemplified by new Hepatitis C therapies, which are estimated to have a big cost impact next year – responsible for a 0.2 percent increase in spending growth – drug development continues to play an inflationary role in the short run. However, over the long-term, these innovative new therapies may improve quality of life and reduce other medical costs. Other inflationary factors identified by HRI are shifts to higher payments for physician practices acquired by hospitals and health systems, and IT integration investments for large-scale health system mergers and acquisitions.
“Due to a demand for value and increased efficiency in the healthcare industry, medical inflation will be modest this year” said Kelly Barnes, PwC’s U.S. health industries leader. “It is still too early to tell whether the drive for transparency and better value for each healthcare dollar – the cornerstone of the new health economy – will be able to temper spending growth once millions of newly insured access the healthcare system.”
The report notes that additional factors are helping to moderate the growth rate. Three factors holding down spending growth include:
• Healthcare providers gaining efficiencies through ‘systemness’ – streamlining administrative activities and standardizing clinical programs to eliminate redundancies and lower operating costs
• Cost-conscious consumer shopping brought about by employees shouldering more of the financial responsibility for their healthcare
• Risk-based contracts in which healthcare providers are held accountable for patient outcomes
After accounting for likely changes in benefit design, such as higher deductibles and narrow networks, HRI projects a net growth rate of 4.8 percent in 2015. Benefit design changes typically hold down spending growth by shifting financial responsibility to consumers, who often choose less expensive options.
Informatica Corporation, the world’s number one independent provider of data integration software, today announced the availability of a new research report by the Ponemon Institute LLC, entitled, The State of Data Centric Security. Based on a global survey of more than 1,500 IT and IT security professionals, the study reveals how organizations understand and respond to data security threats in today’s information-everywhere world.
According to the study:
Not knowing the location of sensitive or private data is the foremost concern of today’s IT security practitioners, topping hacker attacks, malicious employees and concerns around compliance.
Organizations are in the dark regarding sensitive data, withonly 16 percent knowing where all their sensitive structured data resides, and a miniscule seven percent knowing the location of all sensitive unstructured data, including data in emails and documents.
Automated sensitive data-discovery tools would reduce risk and increase security effectiveness. The vast majority of respondents (nearly 75 percent) believe their security activities would benefit from an automated solution for discovering the locations and relationships of sensitive and private data. However, only 40 percent of organizations use an automated solution, and only 22 percent of those use it to discover sensitive data in emails and files.
Key Survey Findings
With today’s escalating threat landscape and with sensitive and private data no longer restricted to traditional enterprise boundaries, it is imperative to know data location and proliferation to protect it adequately. According to the Informatica-sponsored Ponemon study:
57 percent of respondents say not knowing where sensitive data resides keeps them up at night, followed by those who say migration to new mobile platforms (51 percent), temporary worker or contractor mistakes (50 percent) and outsourcer management of data (42 percent) are top sleep-robbing concerns.
24 percent do not know where their organization’s sensitive structured data resides, and an additional 60 percent have only limited knowledge.
41 percent do not know where their sensitive unstructured data resides, and an additional 52 percent have only limited knowledge.
Current security solutions often do not provide visibility into data location and user access, while existing data protection procedures are most often poorly conducted.
