Electronic Health Reporter

Health IT pain points seem to be lingering long despite the never ending promises and hope eternal new technology innovation seems to offer. Every sector has its prickles, no doubt, and much is left to overcome in healthcare, but given the complexity and the copious amount of change and development here, it’s of little surprise that pain is being felt.

What may be surprising, though, is that like patient engagement, there seems to be a different type of pain, and severity of pain, depending on who you ask.

With that, for greater clarity, I decided to ask some of health IT industry insiders what they’re pain points were and why. Their responses follow:

Dr. Trishan Panch, chief medical officer, Wellframe

One of the biggest pain points for hospitals is that we’ve come across a health system’s inability to scale care management resources. They are effective in improving outcomes when patients are engaged, but because of limitations around existing models (i.e. human interaction via phone or in-person) only a small proportion of the patient population can be engaged. That’s why organizations are turning to technology solutions to scale care management resources to reach more people.

Dr. Mark Kaplan, vice president, medical affairs, DaVita Kidney Care

One of the biggest pain points for physicians today is the lack of interconnectivity between different IT systems. Participation in the meaningful use program has helped create some common standards for communication but, for a variety of reasons, these have not yet lead to widespread, effective clinical data sharing. Few physicians can operate in the ecosystem of a single electronic medical record, since they often work in systems that are different, from practice, various hospitals and other places of care.

Dave Wessinger, Co-founder and CTO, PointClickCare

Interoperability is a pain point in healthcare IT, particularly when it comes to transitions in senior care. Connecting the care delivery ecosystem to provide safer transitions of care is critical to long-term care. While some individuals may require short-term rehabilitative care, others may need home-based care, assisted living or long-term and hospice care. As seniors move through these different stages or between acute care and post-acute care, these transitions pose challenges for healthcare providers. Ideally, all the information that clinicians need to treat the individual will be available when he arrives at his new destination. However, this is not always the case. Healthcare providers, both long-term and acute, must invest in an infrastructure that supports seamless transitions of care; interoperability plays a vital role. Connecting healthcare providers across the care continuum will allow for better health outcomes, help reduce unnecessary hospital re-admissions, as well as keep healthcare costs down.

Rachel Jia, marketing manager, Dynamsoft

There are various statistics about the negative impact paperwork has upon providing healthcare. The AHA has estimated it adds at least 30 minutes to every hour of patient care provided. A main pain point continues to be the ability for IT to implement efficient EHR systems. At the core of any EHR system are its image capture capabilities. It must be simple to use throughout the workflow process. This includes image capture, editing, saving and sharing. The capture, or scanning, must be speedy. Editing features must be clear in how to use. This minimizes learning curves at the start. It also optimizes the speed of processing documents during the life of its use. Easy saving to local or network locations should also enable simple and secure sharing too. When one, some or all of these areas stall, it can cripple the realization of benefits from digital document management.

Josh Wollard, director of IT services, Austin Pain Associates

I would say our number one pain point for healthcare IT would be implementing systems that adhere to compliance standards (HIPAA, HITECH, TX-HB300). When you add to the equation that many users expect the same accessibility options that consumer level services provide (Gmail, iCloud, Dropbox), designing complaint systems becomes more difficult. IT staff needs to think of compliance first before enabling user activities, designing systems, or servicing requests from staff. This type of planned application requires training, forethought and oversight. How many of your staff knows the IT security policy and procedures? Do they understand why adding email to a phone may be wrong? Why is a screen saver and a paper shred bin not enough? Keeping our practice complaint while enabling healthcare staff has made healthcare IT quite demanding.

Jonathan Arfin, CEO, SeePoint

Interoperabilty in healthcare it is a major pain point. Systems need to talk to each other, but with HIPAA, software company fiefdoms and true security concerns, trading key information between systems is always a problem and risk area. This issue causes headaches for self-service implementation and other advances like telemedicine.

Jennifer Searfoss, J.D., C.M.P.E., CEO, Searfoss Consulting Group, LLC
Right now the requirements for the federal subsidy, avoiding the Medicare penalties for quality reporting and value-based modifier are so extensive — and not aligned — that clinicians are having a hard time seeing the patient in between meeting these requirements. Add to it certain administrative rules like CPOE that can’t be completed by a non-licensed professional and we are stymied in our workflow. Right now, it’s just too much change to focus on getting the job done which I thought was supposed to be providing quality health care to Americans at the right time in the right clinical setting.

Scott Braynard, vice president of public sector, Bomgar

Legacy remote access tools. Many healthcare IT departments are still using legacy remote access tools that use an inbound or peer-to-peer connection that requires a port on the end-user’s system to listen for a connection. These “open” ports can be easily found through a relatively simple scan and then hackers simply guess or use brute force attacks to find the right log-in credentials. To eliminate these back doors, IT departments need to upgrade to modern remote support solutions that leverage outbound connections to access remote systems and allow them to support all types of devices. IT should also avoid using tools that give support technicians ‘all or nothing’ access and encourage the sharing of login credentials. A remote support solution should require each technician to use individual logins, and then allow administrators to set granular access permissions at the tech and team levels.”

Liam Walsh, US Healthcare and Life Sciences, KPMG

The priorities of healthcare IT departments have been largely focused on core infrastructure, such as patient records, and care coordination because of regulatory reforms and incentives. However, they are missing a significant opportunity related to patient engagement. The skills required to truly enable patient engagement — big data, CRM, mobility, user experience, cyber security, etc. — are in limited supply and have not historically been “core” to healthcare IT functions, limiting the capabilities of healthcare IT functions to conceive, architect, build and deploy these capabilities. Ultimately, the acquisition and development of these capabilities might be the ultimate arbiter of the pace of adoption of IT that focuses on patient engagement.

John Feucht, president, C3 Solutions
This may sound basic, but a top pain point is not having fast, immediate access to the information they need. When there’s a patient in the room, they can’t afford any downtime. If it takes longer than absolutely necessary to log into the system and get to the patient’s chart, that’s a huge problem. This can be caused by anything from the medical records software having issues (if it’s cloud-based, the servers could be down or degraded), to the computer running slow in general (older computer, malware on it, etc.). If the nurse/assistant/doctor is stuck with an IT problem for 30 minutes while the patient is waiting there, that’s the worst thing in the world to them; the patient feels like they’re getting poor service, and the medical office is losing money (they have to call patients to reschedule them if they get too behind schedule).

Donald Burt, MD, chief medical officer, PatientKeeper

There is no greater “pain point” in health IT than that of the physician who is forced to use a hospital system that wasn’t designed with physician users in mind. In such cases, physicians find themselves spending hours or days away from their patients in systems training; and once physicians are up and running on the system, they are hopping in and out of clinical applications that interrupt normal physician workflow rather than enhance it, resulting in even more time wasted navigating the system. Such pain is especially prevalent at community hospitals, where the push to attest to Stage 1 and 2 meaningful use with systems that are less than “intuitive” — CPOE is particularly notorious — has fueled considerable physician resentment. The physician backlash can take the form of complaints to IT and hospital management or, more seriously, physician defections to other institutions and the associated loss of patients and revenue.

Joe Welfeld, president, The Welfeld Group

The number one pain point is the inability of different healthcare IT systems to talk with each other and share data. This “‘interoperability” quandary diminishes, if not eliminates much of the prospective advantages of electronic data and information since data sharing among physician practices and hospitals is nearly impossible when different systems are in place. The cost of creating interfaces between and among these systems is cost prohibitive and time consuming, and adds to the long list of projects on a hospital CIO’s workload.

Michael Fimin, CEO, Netwrix

The critical path for security breaches in healthcare often lies through users’ access rights. The growing number of security incidents happened because of privilege misuse is a disturbing trend today that also shows that companies are facing the difficulty to detect the source of data leak, which often takes from days to weeks to be done. For that reason, monitoring users’ access to sensitive data on a regular basis and protecting systems against insider misuse is a must for healthcare providers and is a part of HIPAA compliance regulations. Having your IT system audited helps you easily track who changed what, when and where, and keep an eye on any malicious change made to access rights, therefore enforcing the protection of personal health information stored in the system. Change auditing solutions allow arranging changes made to user content and permissions into human-readable reports, so you can assure that your data is under permanent control, which is a key point for staying HIPAA compliant.

Joel French, CEO, SCI Solutions

One of the most significant pain points in health IT currently is the widespread belief among healthcare executives that EHRs alone are a comprehensive IT strategy. EHRs are not a strategy. While regulatory mandates and incentives have contributed to growing EHR adoption, the industry’s expectations of EHRs exceed what they were actually designed to do; today, health system survival requires patient, payer and provider coordination beyond the four walls of a hospital, and EHRs, by design, were not built for this. They do very little to help health systems connect with their community partners to direct patients and revenue back into the health system, and with inpatient revenues dramatically decreasing, healthcare executives need a business strategy, supported by IT, to fuel outpatient growth. Profitable health systems will be those that leverage more agile, cost-effective solutions — ones that live outside of EHRs — that will directly uncover new revenue streams.