I’ve always been a sucker for trivia. In most cases, the information that sticks in my head is useless and, well, trivial. People — including those that know me best — often shoot me quizzical looks and wonder where the hell I came up the crap that pops out of my mouth. Most of the time I shrug and respond with the I’m-so-stupid-sorry-for-breaking-the-silence, “What.”
But, in healthcare, this kind of mindset set has a place; maybe it’s just a data place of mind sort of thing. Nevertheless, I’m comforted by all of the (sometimes) useful technology information floating around, and today, I’m proud to share a kindred spirit at HIT Consultant, who posts an incredible plethora of devourable data worthy of sinking your teeth into in the piece, “80 Mind Blowing EMR and Meaningful Use Statistics & Trends.”
Feel free to check out the full course, but for a primer, let’s dig in here.
• According to the list, 75 percent of patients are willing to go online for health information. Not surprised by this one bit. I’d argue the number is low. Check out this article by American Medical News for more on the subject. We spend our lives online wherever we can get online. If we have access to the web, we’ll be on it; this isn’t necessarily mind blowing, just trivia, and a reality.
• Next up, financial troubles at the practice level. Interesting topic, but given the conversations I’ve had with physicians I’m not surprised. More than 40 percent of physicians have financial troubles, and given the overwhelming reform practices face, it’s no wonder the private practice is being ambushed.
• More than 70 percent of hospitals employ full-time staff to scan charts into their electronic systems. WOW! Seriously? This doesn’t sound efficient to me. Someone please explain.
• “Solo practitioners are particularly unlikely to be using EHRs or to have plans to implement them. Also, older physicians are less likely to be pushing for adoption of HIT.” Again, no surprise, though, it’s sad. Truth is, both of these segments will be out of private practice in the next three years under the current healthcare structure. No joke.
• Just a bit more than 20 percent said their EHRs made them more efficient and only 6 percent said their making more money with their systems. Again, not surprised by this data. These are PR talking points EHR vendors push to sell their systems. Pay attention, you’ll probably see some CEO on this site talking the same points sometime soon.
• Apparently, according to a study reposted by Becker’s Hospital Review, 91 percent of physicians want/are interested in mobile EHRs. I don’t buy it. I’d like to see the data, but I bet it’s a flawed report. Physicians are too concerned with their in-practice solutions, mandates and reform. We haven’t tipped that far in the mobile direction yet. Not possible; just another PR talking point from a vendor.
• “Each patient visit requires approximately 10 to 13 pieces of paper.” That is shocking.
• Top 5 EMR vendors by number of users are:
o eClinicalWorks
o Epic
o McKesson
o Care 360
o Allscripts
Care 360 is in the Top 5? Hmmm.
• The feds believe they’re on the hook for more than $20 billion of taxpayer’s money for meaningful use before the program wraps. This is one of those facts that I’m not surprised by, but I am, if you know what I mean. It just makes me look side ways.
And the list goes on and on, some shocking pieces of trivia, some less so. The point is there’s much to consume, some more positive than others. But, HIT Consultant does make a great point: a lot of the data available doesn’t point to a land of milk and honey. On the contrary, there’s a lot of disappointment in health IT.
There’s apparently much to learn and much to improve. Everything is yet to be perfect, while some things are wonderfully, wonderfully good.
Lack of healthcare interoperability continues to throw its weight in the road of progress, stopping much traffic in its tracks.
But you know that already, don’t you; you work in healthcare IT. That electronic health records lack the ability to speak with their counterpart systems is no surprise to you. In fact, it’s probably caused you a great deal of frustration since the first days of your system implementation.
From my perspective, things are not going to change very soon. There’s not enough incentive for vendors to work together, though they can and in many cases are able to do so. The problem, though, is that vendors are not sure how to charge physicians, practices, hospitals and healthcare systems for the data that is transferred through their “HIE-like” portals that would connect each company’s technology.
The purpose of this piece is not to diverge into the HIE conversation; that’s a topic for another day. However, this is a piece about what have recently been listed as the biggest barriers physicians face when dealing with the concept of interoperability.
The magazine cites a study in which more than 70 percent of the physicians said that their EHR was unable to communicate electronically with other systems. This is the definition of a lack of interoperability that prevents electronic exchange of information, and ultimately will fuel health information exchanges.
It is notable that 30 percent of physicians said that their EHRs are interoperable with other systems. That makes me wonder if this is a verified fact or perception only verified by a marketing brochure.
Another barrier, according to the report, is the cost of setting up and maintaining interfaces and exchanges to share information. According to this statement, physicians are worried about the cost of being able to transmit data, too, which puts them in line with vendors, who, like I said, are worried about how they can monetize data transfer.
An interesting observation from the piece: “Making progress on interoperability will be essential as physicians move forward with different care delivery models such as the patient-centered medical home and the medical home neighborhood.”
What amazes me about this conversation is that given the purported advantage employees gain from the mobile device movement and how BYOD (bring your own device) seems to increase a staff’s productivity because it creates an always-on mentality. I don’t think it’s a stretch to think the same affect would be discovered if systems were connected and interoperable.
An interoperable landscape of all EHRs would allow physicians and healthcare systems to essentially create their own always on, always available information sharing system that would look a lot like what we see in daily lives with the devices in the palm of our hands.
Apparently, everyone wants and interoperable system; it’s just a matter of how it’s going to get paid for. And moving the data and the records freely from location to location opens up the health landscape like a mobile environment does.
Simply put, this is one issue that seems to resemble our current political landscape: a hot button issue that needs to be addressed but neither side wants to touch the issue because no one wants to or is able to pay for it.
One of the problems with this approach is that if we wait long enough, perhaps interoperability also will be mandated and we’ll all end up on its hook.
So, let’s take a lesson from the mobile deice world and allow for a greater opportunity to connect healthcare data to more care providers on behalf of the patients and their outcomes.
In an effort that could revitalize the EHR space (at least the mainstream market), the Veterans Affairs Department’s classic and still heavily used VistA (Veterans Health Information Systems and Technology Architecture) system is getting the open source EHR treatment.
In a move that is revolutionizing other technology sectors — like manufacturing, gaming and the device world and because of the success of such sites as Kickstarter (I know because I represent clients in this space and have seen their success first hand), which is a haven for open source projects, allowing volunteer programmers who are passionate about code and perhaps even passionate about healthcare, is really a pretty swell idea.
From the VA’s perspective, how else could it possibly bring a beleaguered and somewhat bemoaned product like VistA to the modern area after more than 30 years in use? Certainly, the government didn’t seem to have the funds or the necessary experience to overhaul the system by itself.
According to Rick Baker, chief information officer for the VA, even though there is a contract with a firm to make changes to VistA’s code to make it less complex and more readable, the open source community will be involved directly, day to day, with the EHR’s refresh.
The success of involving the open source community in healthcare, and in the development and maintenance of EHRs, is showcased at Oroville Hospital in Northern California, which recently passed on some of the mainstream vendors like McKesson and Meditech for a personalized, customer version of its.
Leaders at the hospital wanted the flexibility to make changes to its EHR system, and they wanted to ensure they received the attention they felt they deserved from their vendor of choice. Ultimately, they wanted total control over the hospital’s electronic health record.
The best solution to the problem for the hospital? Build its own EHR.
In addition to gaining every advantage over the creation and implementation of the home-grown system, Oroville Hospital plans to save a bunch of money by not purchasing a commercial system even though it is building a complete EHR soup to nuts.
The hospital chose to build the system with the help of the same open source folks who are working on the VistA system; the same folks the VA is using to update VistA. Once done, Oroville Hospital’s EHR was even certified for meaningful use and the hospital received more than $5 million in meaningful use incentives.
What all of this seems to suggest is that custom solutions are viable options in a sea of corporate technology offerings. With open source now breaching the professional world of electronic health records, this may only just be beginning of a wave of technology innovation, especially as hospitals and practices seek more efficient solutions and more control of their EHR technology.
Given the time, patience and buy in of leaders, healthcare facilities may be closer to independence than we’re used to in the regulated and oversight-driven world that has become healthcare.