Guest post by Justin Rockman, vice president of sales and business development, Surgimate.
Justin Rockman
Since the late ’80s, the inflexible and cumbersome Health Level 7 (HL7) protocol has been the standard form of sending messages between healthcare applications. However, HL7 integration is timely to implement, technically limited and costly. It is not uncommon for a medical practice to face upwards of $10,000 in expenditure for one simple message.
Application programming interfaces (APIs) have recently become a fashionable alternative. The term API sounds complicated, but it’s really just a way in which software applications (like your EHR) can talk to other systems, and exchange large amounts of data rapidly and securely. In short – they support better, faster, cheaper interoperability.
In addition to transmitting data between systems, APIs offer the ability to plug in chunks of functionality to another system, in a clean and predictable manner. Instantaneous and seamless interaction between systems is the leanest and trendiest way to design software in 2018. New applications should not “reinvent the functionality wheel” but provide unique integratable services.
As the EHR market estimated to reach $28 billion in 2016, it is no surprise that tech titans like Amazon, and Apple are looking for ways to get a slice of the pie. With top of the line products sure to come from those companies and others, here are 4 reasons why healthcare IT vendors must offer their clients a way to integrate using APIs.
Platform Stickiness
Physicians need easy access to data supported by EHRs, but hate the time it takes to manually enter patient information. It’s no wonder – doctors typically spend 50 percent of their day working with an EHR. If a physician isn’t happy with the usability or efficiency of their system, they’ll drop it and choose another. While the annual EHR adoption rate among providers is 67 percent, the EHR vendor switch rate is about 15 percent.
APIs offer cheaper and deeper integration options. For EHR vendors to provide better value for their customers they must embrace the API and ditch the expensive, outdated and rigid HL7 protocol.
Using an EHR that is integrated with other programs will make switching systems even more inconvenient. EHR vendors who give customers the additional functionality offered by their partners will be rewarded with brand loyalty, and lower churn.
An Additional Revenue Stream
Innovative EHR vendors are partnering with upstart technology companies to generate additional revenue. Greenway and athenahealth advertise an array of solutions in their marketplace, and provide partners with utilization of their APIs. In exchange, they receive monthly or recurring payment for each license sold. Since most practices already have purchased an EHR, finding new revenue streams is crucial for a company’s growth.
The healthcare API market is predicted to exceed $200 million in the next few years. Former engineers from Epic Systems saw the industry’s need for interoperability and raised $15 million in venture capital to found Redox – a company solely focussed on building bridges between healthcare applications. Creating platforms that deliver easy integrations at reasonable costs will greatly benefit the healthcare industry.
Jeff Lew, vice president of product management, Nextech.
The dawn of a new year brings anticipation for things to come—and this certainly holds true regarding health information technology. Electronic health records (EHRs) continue to evolve, and the next 12 months should provide some excitement as new developments emerge. In particular, there are three trends worth watching.
The inescapable shift to the cloud
More and more healthcare organizations are seeking cloud-based EHR and practice management systems, and it appears this trend will continue throughout the coming year. One of the primary reasons for moving to the cloud is the economics of these solutions. An organization does not have to maintain costly hardware and software or allocate resources for upgrades and other technology management functions. Instead, the system is housed remotely and kept constantly up-to-date by the vendor. Users can access the software with any device that has an internet connection, including laptops, tablets and, in some cases, smartphones. A cloud solution is especially cost effective for those organizations that have multiple facilities. Gone are the days of a server in each site—users can bring their laptops or tablets with them as they travel from location to location, logging in to the system from anywhere. Not only can this keep costs in check, it can also promote greater user satisfaction because the tool offers the flexibility to work from anyplace at any time.
Security and protecting an organization’s IT from threats will continue to make headlines like it has in the past year. It is a real and present risk that organizations must be acutely aware of and ensure relevant preventative measures are established and continuously maintained. This requires not just the relevant knowledge and skills, but also focus and resources, that many organizations may not have.
Ultimately, most—if not all healthcare providers—will shift to cloud-based solutions at some point. Although the move may not occur immediately for every organization, 2018 will see many healthcare entities take steps in that direction.
Complying with MACRA
This past November, the Centers for Medicare & Medicaid Services (CMS) released the final rule governing 2018 MACRA participation. The rule introduced several changes that stand to impact physician practices and other healthcare organizations. Here are a few key aspects of the rule of which to be aware for the coming year:
The exclusion thresholds have changed, and this may allow more specialty practices and other smaller organizations to exempt themselves. Note that CMS is now including Medicare Part B drug reimbursement in the calculations for exclusions, which may skew applicability for certain entities. If a physician practice uses a lot of Part B medications, for example, it may increase its revenue amounts and thus preclude the practice from exclusion.
For the first time, practices must submit cost measures, and these will represent 10 percent of an organization’s MIPS score. That percentage will rise to 30 percent in 2019. Since organizations will need to demonstrate cost performance, they may want to review that performance and see how it relates to their peers as well as the quality of care they deliver. Even if cost numbers are high, if they can be tied to good quality, then they are likely justifiable.
Organizations must start submitting cost and quality measures on January 1 and submit for the entire calendar year. They also must achieve a composite score of at least 15 out of 100, which is up from last year’s three out of 100.
The reason why many hospitals or medical practices fail to integrate the EHR system effectively is that they have not gone for in-depth healthcare workflow analysis before implementing the EHR tool. Healthcare workflow analysis helps hospitals and medical centers to find out areas where health IT solutions can help in increasing the efficiency of performance.
It is important to design an EHR which smoothly fits into the workflow pattern of the medical establishment. The same EHR model does not work for every medical center. This is where healthcare workflow analysis techniques come in useful in designing the best EHR system for the medical facility.
Here are some steps that need to be followed during the healthcare workflow analysis in order to implement the EHR system perfectly:
Mapping of processes
This is the first thing that needs to be done while carrying out healthcare workflow analysis. The core processes that usually take place with regard to individual patients and which need to be analyzed in detail are as follows:
Scheduling: When a person first approaches a medical center, an appointment is fixed. The medical center receives multiple appointment requests every day and all these appointments need to be properly recorded in schedule calendars. Fact sheets are prepared to record the number of patients that the medical center receives during a particular time period. The scheduling process also includes alerts. Both the patient and the doctor should receive alerts about the upcoming appointment in order to be ready for it.
Patient visit: When the patient comes to the appointment, the doctor conducts a medical evaluation. The general checkup is followed by a psych evaluation. After the evaluation process is over, the doctor carries out the diagnosis process. Every step needs to be recorded so that progress notes can be made and the doctor can charge the patient accordingly.
Patient admission: After the diagnosis process is over; the patient gets admitted into the medical facility on the recommendation of the doctor. The enrollment process requires the signing of various forms so that the medical facility gets all the details about the patient.
Treatment process: Once the patient is admitted into the facility, the doctor makes a treatment plan. Either individual therapy or group therapy is provided along with medication management so that the patient can recover as soon as possible.
Discharge from the hospital: When the treatment process comes to an end, the patient is discharged on the date suggested by the doctor. A discharge plan is made and lots of reports are generated in order to record the treatment process of the patient in detail.
As technology evolves and there’s more emphasis on streamlining business practices, there’s an increasing reliance on electronic health records. In 2014, private healthcare providers were required to adopt electronic medical records to maintain their existing Medicare and Medicaid reimbursement levels. The move was a part of the American Recovery and Reinvestment Act, which aimed to improve quality, safety, efficiency and reduce health disparities.
The Act also offered financial incentives to those providers who could prove meaningful use in the adoption of electronic health reporting. Non-compliant healthcare providers faced penalties, including a 1 percent reduction in Medicare reimbursements. When it was officially mandated, the U.S. Bureau of Labor Statistics (BLS) predicted a 12 percent growth in employment opportunities from 2014 to 2024. Positions they expected to open up included medical records and health information technicians, computer systems managers, health managers and computer support specialists.
If you’re unsure about the role electronic health reporting can play in your practice, using the following information as a valuable resource. Every practice can benefit from EHR, and it’s important to understand the how and why.
Electronic Medical Records vs. Electronic Health Records
Electronic medical records and electronic health records are often used interchangeably, but there are some key differences. Medical records offer a more narrow view of an individual’s medical history, and it’s used mainly for diagnosis and treatment. They are unique to a specific practice and are not designed to be shared outside of that practice.
Electronic health records, on the other hand, show a patient’s overall history. It is a comprehensive medical chart that’s intended to be shared with other practices. It includes everything from images to allergies to lab results. If the patient were to move across state lines, their electronic medical record would follow them, while an electronic health record stays with the practices they leave behind.
Improved Efficiency and Cost Savings
Electronic health records can provide immense benefits in terms of increased efficiency. This can be demonstrated by current statistics on EHR. One survey found that 79 percent of users stated that EHR allowed their practices to run more efficiently. Of the doctors surveyed, 82 percent reported that sending prescriptions electronically saved time, 75 percent received lab results even quicker, and 70 percent reported increased data confidentiality.
As technology evolves and there’s more emphasis on streamlining business practices, there’s an increasing reliance on electronic health records. In 2014, private healthcare providers were required to adopt electronic medical records to maintain their existing Medicare and Medicaid reimbursement levels. The move was a part of the American Recovery and Reinvestment Act, which aimed to improve quality, safety, efficiency and reduce health disparities.
The Act also offered financial incentives to those providers who could prove meaningful use in the adoption of electronic health reporting. Non-compliant healthcare providers faced penalties, including a 1 percent reduction in Medicare reimbursements. When it was officially mandated, the U.S. Bureau of Labor Statistics (BLS) predicted a 12 percent growth in employment opportunities from 2014 to 2024. Positions they expected to open up included medical records and health information technicians, computer systems managers, health managers and computer support specialists.
If you’re unsure about the role electronic health reporting can play in your practice, using the following information as a valuable resource. Every practice can benefit from EHR, and it’s important to understand the how and why.
Electronic Medical Records vs. Electronic Health Records
Electronic medical records and electronic health records are often used interchangeably, but there are some key differences. Medical records offer a more narrow view of an individual’s medical history, and it’s used mainly for diagnosis and treatment. They are unique to a specific practice and are not designed to be shared outside of that practice.
Electronic health records, on the other hand, show a patient’s overall history. It is a comprehensive medical chart that’s intended to be shared with other practices. It includes everything from images to allergies to lab results. If the patient were to move across state lines, their electronic medical record would follow them, while an electronic health record stays with the practices they leave behind.
Improved Efficiency and Cost Savings
Electronic health records can provide immense benefits in terms of increased efficiency. This can be demonstrated by current statistics on EHR. One survey found that 79 percent of users stated that EHR allowed their practices to run more efficiently. Of the doctors surveyed, 82 percent reported that sending prescriptions electronically saved time, 75 percent received lab results even quicker, and 70 percent reported increased data confidentiality.
EHR Cost Savings
There are immense cost savings associated with EHR. For example, large hospitals can save anywhere between $37 million to $59 million over a five-year period, not including incentive benefits. The majority of those savings come from the ability to eliminate various labor-intensive tasks and other paper-driven responsibilities. With better access to patient data and smart error prevention alerts, the chances of medical errors are greatly reduced. You’ll also experience easier communication across the entire medical channel. You can track electronic messages from staff to labs to other hospitals and clinicians.
Many administrative tasks are streamlined, resulting in time reduction. Filling out forms and taking care of billing requests often take up a significant portion of healthcare costs. Electronic health records also provide more information on next best steps, and can automatically siphon information that needs to be shared with various public health agencies.
Then you are seriously in need of healthcare IT solutions.
With advancements in technology, the healthcare sector is becoming digitized. The focus is on personalized and patient-centric technology, which can help in accelerating the process of treatment.
Healthcare IT solutions are meant for delivering the best service to the patients as well as to enhance operational efficiency. The American Recovery and Reinvestment Act of 2009 was passed to provide $19 billion for the purpose of promoting the use of EHR technology in hospitals and medical practices. This proves the growing importance of healthcare IT solutions.
Healthcare IT includes the latest technologies like analytics, cloud computing, electronic health record systems, as well as data management systems. A growing number of institutions are successfully implementing healthcare IT solutions to improve their efficiency. It has been observed that manual entering of data and health records of patients are taking up too much time of the administrative staff as well as the medical personnel. This time can be utilized to provide better services to the patients.
Here are some of the benefits of using healthcare IT:
EHR technology –– Electronic health records are part of the digital revolution that has taken over the healthcare sector. EHRs make the whole process of keeping patient records very streamlined and efficient. Data can be accessed both by the doctors as well as the patients because it is available on an electronic platform. The personal health records portal helps in management of patient information. Medical personnel can take better care of the patients when they have all the information on one platform. Time and effort spent on manually entering the data are saved so that doctors can provide better treatment to the patients and can serve the people who are in need of doctor care.
Better coordination of patient care — Healthcare IT solutions help in better coordination between physicians, specialists, nursing staff, lab technicians and other medical personnel. Vital information regarding the patient’s health is available to all of them. When the same data can be accessed by everyone, the problems of duplicate tests, contradictory medication prescription and miscommunication can be avoided. This saves time and minimizes the chances of errors leading to improvement in the overall quality of care that is provided to the patients.
Patient empowerment– When the patient has access to all his personal health records, he can play a more active role in managing his overall well being and determine the outcome of the treatment that he receives. All the lab results, medical history records as well as drug information are available on an online platform for the patient. The EHR system allows the patient to schedule appointments, communicate with the doctor as well as to refill prescriptions. Such healthcare IT solutions increase patient satisfaction.
Cost savings — Healthcare IT not only saves time, but expenses too. Easier documentation reduces the administrative cost and increases the number of patients that a medical facility can treat. This leads to an overall increase in revenue generation.
People perform better if they have a vested interest in the outcome of a given situation. Employees who are given an ownership stake in their company historically perform better and enjoy a higher degree of satisfaction from their respective jobs than do their non-stake-holding counterparts.
Recent research has shown that a similar premise holds true in healthcare. Patients who are engaged in their own care generally have better outcomes and enjoy higher satisfaction in the care they received. According to the American Journal of Managed Care, “A growing body of research has established the benefits of patient activation, which is defined as the knowledge, skills, confidence and motivation to make effective decisions and take action to maintain or improve one’s health.”
According to a 2016 New England Journal of Medicine survey of 340 U.S. healthcare executives, clinician leaders and clinicians at organizations directly involved in healthcare delivery, 42 percent of respondents indicated that less than a quarter of their patients were highly engaged, and more than 70 percent reported having less than half of their patients highly engaged. And to underscore the importance of this result, 47 percent of those surveyed revealed that low patient engagement was the biggest challenge they faced in improving patient health outcomes.
This is not only true for hospitals, but also for specialty care practices. In these environments, it is imperative that practices understand the very specific needs and behavior of their patients, so they can determine how best to conduct effective outreach that will increase patient engagement and patient portal utilization.
Importance of User Interface
A results-driven (or high performance) patient engagement platform helps turn patients into partners in their own healthcare. In addition, a proper next-generation solution supports compliance with MIPS (Merit-based Incentive Payment System), a component of MACRA (Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act), and with meaningful use (MU), by providing patients the ability to view, download or share their medical record. Payback is many fold: In addition to helping providers meet regulations through a user-friendly interface, patients are freeing up time for caregivers to spend with them by self-populating data fields that would previously have been handled by caregivers. This streamlining of the patient intake process delivers significant time and cost savings to the practice.
Equally important is a patient portal that helps patients remain engaged while enabling practices to comply with government requirements under meaningful use and the MACRA regulations, thereby increasing Medicare payments and minimizing takebacks. It is imperative that the patient portal seamlessly integrates with the organization’s electronic health record (EHR), health information exchange (HIE) and accountable care organization (ACO), if the practice is participating in one. Ideally, the solution should be able to adapt to any healthcare facility’s IT system—not the other way around. Patient engagement initiatives should permeate the practice’s entire healthcare ecosystem.
Engaging for ACOs, Triple Aim
Originally a concept born of healthcare reform, accountable care organizations (ACOs) were initially little more than a way of redefining the shared responsibility of doctors and hospital staff to coordinate care, improve quality and lower costs. It did not, however, specifically examine the role of the patient. That all changed when the Affordable Care Act (ACA) came along and the ACOs were officially codified into law. Furthermore, the law also recognized that ACOs could not succeed without patient engagement. According to the IHI, “quality,” in this case, is defined from the perspective of an individual member of a given population, hence the logical focus on patient-centric care and patient engagement.
Throughout the technological age we are currently living in, the advances in medical technology have gone far beyond what was once considered possible. Thanks to the introduction of the Internet and smart phones, information has become more readily available then ever before. Social media platforms have also made it possible for us to personally connect with people across the globe. These advances have shaped the way medical field has stored and held information. Medical providers are increasingly realizing the advantages of switching to electronic heath records (EHRs) as opposed to traditional pen and paper patient records. EHRs allow patient records to be more readily available, allowing for better office efficiency and patient relations.
The Old: Provider-centric EHR Software
However, patient convenience is still a factor within EHR technology that needs improvement. In today’s society, it has become the expectancy to be able to find information on the go at the touch of our fingertips. This is especially true when the information they are in search for is relevant and relates to them. Unfortunately, EHR features have become focused on billing and coding, as opposed to being more patient centric. This is a result from physicians being typically paid based on the exams and procedures performed during an office visit. Physicians need their software to document complex billing codes to ensure they’re properly paid.
It’s Time for EHR Software to be Patient-centric
It’s time EHR vendors stride towards the next evolutionary step to becoming patient-centric. This problem can be solved by following the lead of an outside innovator in sharing and viewing information about individuals: Facebook. Facebook is the front-runner for social media platforms, and their results show. Facebook is the fourth most valuable brand in the world; so clearly, there is something about this technology and interface that people appreciate.
