Guest post by David McKanna, Nuance.
CIOs in healthcare face the constant challenge of doing more with less. Most are being asked to dramatically cut costs while continually tackling an ambitious list of responsibilities, including maintaining their organizations’ ability to demonstrate meaningful use, making the transition to ICD-10, sharing information through healthcare information exchanges (HIEs) and maintaining stringent patient privacy and HIPAA compliance programs.
Three key and often overlooked elements can help to address these tasks: document scanning, clinical language understanding and integration standards. Mastery of this electronic health record (EHR) trifecta can significantly simplify the healthcare CIO’s challenge.
Electronic health record adoption levels are steadily increasing, but ongoing interoperability issues result in high volumes of paper-based communications between providers. In fact, a survey conducted by the Bipartisan Policy Center in Washington, D.C., found that 71 percent of physicians identified lack of EHR interoperability and exchange infrastructure as major barriers to HIE.
This leads to incomplete or missing records from outside providers, delays in accessing paper-based patient information, and a prevalence of unstructured records (which are of limited use). However, enhanced document scanning software can enable automated paper workflows and turn distributed capture devices in a hospital into secure on ramps that accelerate access to locked, paper-based patient information within an EHR or enterprise content management (ECM) system.
Clinical language understanding (CLU)
Approximately 60 percent of the 1.2 billion clinical documents produced each year in the US are in unstructured form (i.e. dictated notes or paper records) and require manual processing to make the data accessible. CLU technology is a clinical-specific form of natural language processing that leverages one of the most comprehensive medical ontologies and state-of-the-art language processing algorithms. Combined with document scanning software, CLU enables you to analyze free text from scanned documents and tag the most important data elements to populate EHRs and support a wide range of applications requiring access to structured data.
Integration standards are fundamental to information sharing and continuity of care. Technology that complies with integration standards can facilitate increased compatibility and help healthcare organizations meet key challenges. For instance, software leveraging global IHE Integration Profiles such as XDS and XDR can create “intelligent documents” from paper records using the HL7 CDA format. Additionally, software that supports the Patient Demographic Query (PDQ) Profile can conduct dynamic patient look-ups directly from point-of-care scanning devices and enable accelerated and secure distributed scanning to the correct patient records in an EHR, ECM, or HIE platform.
Technology that meets “Content Creator” requirements for HL7 Consolidated Clinical Document Architecture (C-CDA) can convert scanned documents and extract discrete data with CLU technology to generate conforming structured C-CDAs which can be consumed by “Content Consumers” (such as EHRs or ECMs). The Integrating the Healthcare Enterprise (IHE) North American Connectathon is the industry’s largest IT interoperability testing event, and is an ideal indicator of how integration standards enable interoperability.
The 2014 event will take place on January 27 through 31 , and tens of thousands of tests will be run to demonstrate the most advanced technologies that meet industry standards for interoperability. It is vital for healthcare organizations to take advantage of the increased compatibility offerings demonstrated at this event.
What this all means for healthcare organizations and practices
Leveraging scanning technology and CLU can help healthcare organizations meet key challenges related to:
- Meaningful Use by converting scanned documents to C-CDAs to help meet transition of care, clinical summary, and data portability requirements
- ICD-10 by extracting and tagging key clinical terms in paper records, generating C-CDAs, and removing manual steps in clinical documentation improvement and computer assisted coding workflows
- Information sharing through HIEs by supporting global integration profiles (like XDS.b) designed to standardize how disparate systems communicate across care settings
- Patient Privacy and HIPAA compliance initiatives by locking down scanning workflows based on user authentication and keeping a complete audit trail of all scanning activities