Hyland Healthcare recently partnered with HIMSS Media to survey leaders from healthcare provider organizations on their current interoperability initiatives for its second annual Connected Care and the State of Interoperability study. The results are published in a whitepaper titled Connected Healthcare: Interoperability Progress and Challenges Ahead and an infographic titled Breaking Down Healthcare’s Interoperability Gaps.
The study indicates year-over-year improvement in healthcare providers achieving their top interoperability goals. However, several obstacles to improving interoperability were also identified, including the management of unstructured data and content. Survey respondents indicated that 73 percent of unstructured patient data remains inaccessible for analysis, leaving a significant gap in health information.
Key results from 2020 Connected Care and the State of Interoperability in Healthcare include:
Year-over-year improvements to top interoperability goals:
Organizations’ ability to effectively tackle improvements in patient satisfaction increased from 45 percent to 63 percent
86 percent of respondents stated they are better able to meet regulatory compliance requirements
The ability to maximize the value from the EMR investment grew by 23 percent (from 31 percent in 2019 to 54 percent in this year’s study)
Challenges to achieving interoperability goals:
More than half of survey respondents stated the major obstacles to improved interoperability is the ability to keep pace with patient expectations
The most significant obstacles to improving interoperability include: Integration (59 percent); Adoption (58 percent); Consumerism (55 percent); Managing unstructured data/content (53 percent); and Managing Multiple EMRs (48 percent)
On average, 73 percent of unstructured patient data is still unavailable for analysis.
The ability to consistently share picture and archiving communication system (PACS) images
“Healthcare interoperability has never been more important than it is today,” said Colleen Sirhal, chief clinical officer for Hyland Healthcare. “Providers, patients and public health officials need all-encompassing data to better understand the still-evolving coronavirus and inform guidelines and treatment. The more we focus on breaking down the barriers to sharing key health information with varied clinical stakeholders, the better prepared we’ll be to ensure the best public health outcomes.”
Another major gap uncovered by the research was the ability to consistently share PACS images. Ninety percent of respondents agreed that access to images at the point of care is important; however, 18 percent of imaging data is captured offline and not integrated with core clinical systems. Additionally, only 11 percent of respondents connect with a vendor-neutral archive (VNA) for digital imaging and communications (DICOM) and non-DICOM images.
The lingering problems with integrating unstructured patient content is concerning, particularly with the evolution to a value-based care practice. Healthcare providers increasingly need a structured way to see all patient information to know the appropriate tests were ordered, administered and ultimately assess the results. This helps save money by not ordering duplicate tests, but also improves patient satisfaction.
HIMSS and Forrester today announced the results from a study that investigates adoption of consumer and employee experience capabilities within healthcare. Respondents were asked about their current strategies for improving both patient and provider experiences, and the perceived value of those programs.
Based on insights from more than 170 U.S. health systems respondents, the study found that strategies used to improve customer and employee experience in other industries are largely underutilized in healthcare. Additionally, the study finds that nine out of 10 health system workers do not believe that providers in their organization are equipped to deliver the best care possible.
Results further reveal that provider experience remains the forgotten leg of the Quadruple Aim – emphasizing that healthcare organizations (HCOs) must not ignore provider burnout within their organizations.
Currently, 60 percent of HCOs lack a formal strategy to accurately measure this. At the same time, more than a third of the health systems surveyed report that they have no strategy in place to measure electronic health record (EHR) satisfaction. According to the study, the most successful HCOs moving forward will be the ones that invest in a patient-centric and outcome-first digital strategy that helps build lasting doctor-patient relationships.
“We recognize all the hard work that so many have put into preparing for their presentations and panels that accompany every HIMSS conference,” said Hal Wolf, president and CEO of HIMSS. “Based on evaluation of evolving circumstances and coordination with an external advisory panel of medical professionals to support evidence-based decision making, it is clear that it would be an unacceptable risk to bring so many thousands of people together in Orlando next week.”
The advisory panel recognized that industry understanding of the potential reach of the virus has changed significantly in the last 24 hours, which has made it impossible to accurately assess risk. Additionally, there are concerns about disproportionate risk to the healthcare system given the unique medical profile of Global Conference attendees and the consequences of potentially displacing healthcare workers during a critical time, as well as stressing the local health systems were there to be an adverse event.
This will be the first time in 58 years the event has been cancelled, but it is now clear that cancellation is unavoidable in order to meet HIMSS’ obligation to protect the health and safety of the global HIMSS community, employees and local residents, as well as for the healthcare providers tasked with keeping our U.S. and global communities healthy.
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Data has long been a popular topic in healthcare and is even more so after this year’s HIMSS. The industry is buzzing about the joint CMS and ONC announcement, which proposes a framework to improve interoperability and support seamless and secure access of health information. The pressure is on for healthcare to tackle their data as the two organizations strive to provide patients with the ability to leverage personal information in various applications. And, this pressure will only increase as we look into the future, making it even more imperative that payers and providers address the issue now.
Look more closely, and you will see that with their recent announcement CMS and the ONC are focusing on healthcare organizations’ ability to manage data across the enterprise. Historically, healthcare has worked from siloed applications and data sources with light integration using interface engines. Recently, healthcare organizations have pinned their hopes on leveraging data effectively through huge investments in new EHR platforms. The reality, pointed out by government officials at HIMSS in Orlando, is that this still results in significant challenges for healthcare organizations to manage information across the data value chain.
Although not part of their proposed framework, CMS and the ONC point out the need for better patient mastering across data sources. Organizations hoped their investment in a centralized EHR platform would solve this but that has proven to not be the case. In addition to patient data, healthcare organizations face challenges in mastering physician data, which can have wide impact, including on value-based care initiatives. The joint proposal also highlights that the ability to push back accurate, cleansed data to source systems is critical.
Healthcare needs a unified approach
Using FHIR to stop data blocking and push the industry towards a standards-based approach will help, but it’s not sufficient for the data challenges facing healthcare organizations. In addition to tackling the issues pointed out at HIMSS, healthcare organizations must:
The megalithic healthcare conference, HIMSS19, has come and has gone from the vast former swampland of central Florida. While I’m a relative newcomer to the show’s trajectory – I’ve been to four of the annual tradeshows since 2011 – this year’s version was, for me, the most rewarding and complete of them all. This could be for one of several reasons. Perhaps because I no longer represent a vendor so sitting in the exhibit hall in a 30×30 booth with a fake smile wondering when the day’s tedium would end and the night’s socials would begin may impact my rosy outlook.
Or, maybe I was simply content to engage in the totality of the experience, attend some quality sessions, meet with many high-class people and discuss so-called news of the day/week/year. Doing so felt, well, almost like coming home. Or, perhaps my experience at the conference this year was so good because of running into former colleagues and acquaintances that drove me to such a place of contentment while there. No matter the reason, I enjoyed every minute of my time at the event.
Something else felt right. An energy – a vibe – something good, even great, seems/ed about to happen. Something important taking place in Orlando, and I was blessed to be a part of it. Kicking off the week, CMS created news – like it does every year at about this time – with its announcement that it will no longer allow health systems and providers to block patients from their data. This was a shot across the bow of interoperability and the industry’s lack of effort despite its constant gibberish and lip service to the topic.
Another fascinating thing that finally occurred to me: no matter the current buzzword, every vendor has a solution that’s perfect for said buzzword. Be it “patient engagement,” “interoperability,” “artificial intelligence,” “blockchain”; whatever the main talking point, every organization on the exhibit floor has an answer.
But, no one seems to have any real answers.
For example, after nearly a decade, we still don’t have an industry standard for interoperability. Patient engagement was once about getting people to use patient portals for, well, whatever. Then it was apps and device-driven technologies. We’re now somewhere in between all of these things.
AI? Well, hell. It’s either about mankind engineering the damnedest algorithms to automate the hell out of everything in the care setting (an over exaggeration) or that AI/machine learning will lead to the rise of machines, which will help care for and cure people – before ultimately turning on us and killing or enslaving us all (again, I’m overly exaggerating).
By George Mathew, M.D., chief medical officer for the North American Healthcare organization, DXC Technology.
In mid-February, nearly 45,000 health information and technology professionals, clinicians, executives and suppliers gathered to explore healthcare’s latest innovations at the annual Health Information and Management Systems Society (HIMSS) conference in Orlando, Florida.
These “champions of healthcare” examined the greatest challenges facing the industry — including an aging population, chronic disease, a lack of actionable information and increasingly demanding consumers. They also explored how new solutions are being enabled by technologies such as predictive analytics, artificial intelligence (AI), machine learning and telemedicine.
The following four trends drove much of the conversation at HIMSS19 and will continue to shape the next wave of healthcare transformation.
Organizing and innovating around patients
As patients gain access to more information about their health and new technologies empower them to be proactive consumers of healthcare, the industry is focusing on how patients as consumers will drive new models of care. Topics such as patient engagement, patient-centric health information exchanges, personalized care and the consumerization of health were prominent during HIMSS19 learning sessions and conversations around the expo hall.
By Rom Eizenberg, vice president, Bluvision segment of the identification technologies business within HID Global.
A doctor or a nurse can find themselves under duress in an instant. A patient unexpectedly attacks a doctor in a room. A nurse, who is leaving her shift at 3 a.m., is jumped by a masked assailant in the hospital parking lot. A patient’s angry family member confronts a doctor about the care protocol or frustration over a lack of response to the treatment. Each of these examples can create threatening situations that generate concern and could pose a risk to the safety of hospital personnel.
Hospitals and other healthcare organizations have a responsibility to protect not only patients but also clinical staff. Growing concern about the dangers that doctors, nurses and other caregivers face on a regular basis is increasing dialogue in the healthcare industry about what is needed to ensure that staff get the support from hospital security teams and law enforcement when they need it – and at exactly the location where they need it.
About 25 percent of nurses experienced workplace violence each year. While the healthcare sector makes up just 9 percent of the overall U.S. workforce, it experiences nearly as many violent injuries as all other industries combined. Between 2005 and 2014, the rate of healthcare workplace violence increased by 110 percent in private-sector hospitals, according to a U.S. Bureau of Labor Statistics report.
According to a 2015 study published in the Journal of Emergency Nursing, 76 percent of nurses at a private hospital system in Virginia said they had experienced physical or verbal abuse from patients in the previous year. Hospitals can utilize technology more effectively to reduce these violence rates and protect their caregivers, especially if such incidents escalate.
To trigger a duress signal that catapults security forces or police officers to the rescue, healthcare leaders must understand the five key things about an effective response system to address real-time duress during a high-risk situation:
By Donald Voltz,MD, Aultman Hospital, department of anesthesiology, medical director of the main operating room, assistant professor of anesthesiology, Case Western Reserve University and Northeast Ohio Medical University.
In his HIMSS keynote address, Alphabet’s former executive chairman and now current technical advisor Eric Schmidt warned attendees that the “future of healthcare lies in the need for killer apps.” But he also cautioned that the transition to a better digitally connected health future isn’t just one killer app, but a system of apps working together in the cloud. He also advocated transforming the massive amount of data held in EHRs into information and knowledge.
Schmidt is correct in his assessments. There is a need for interoperable “killer apps” for new health IT priorities and procedures. The apps need to deliver better patient outcomes by integrating and optimizing patient data while driving healthcare facility financial incentives such identifying cost savings and streamlining insurer payments. These types of needs are accelerating convergence in the health care sector for interoperability across clinical, financial, and operational systems, not simply EHR connectivity.
One of the cloud “killer apps” that is a strategic component of convergence and hospital growth are Annual Wellness Visits (AWVs). First introduced by private insurers and then by CMS in 2011 as part of its preventative care initiative under the Affordable Care Act (ACA), AWV’s are designed specifically to address health risks and encourage evidence-based preventive care in aging adults.
The typical visit requires a doctor or other clinician to run through a list of tasks like screening for dementia and depression, discussing care preferences at the end of life, asking patients if they can cook and clean independently and are otherwise safe at home. Little is required in the way of a physical exam beyond checking vision, weight, and blood pressure.
On its own merit, some could argue that while this app can greatly contribute to better patient care, it does not significantly impact hospital and clinic growth, but when integrated with other apps, it becomes a key healthcare growth catalyst with its treasure trove of patient data. That data, when streamlined, can enable expedited payments to government and private insurers, help lay the foundation for AI and other knowledge initiatives as cited by Schmidt.
Chronic Care Continuum App
Another “killer app” is the care continuum integration of treatment for chronic diseases ranging from diabetes to dementia and behavioral and mental health issues such as the U.S. opioid epidemic, heroin addiction, alcoholism and suicide. The ECRI Institute released its “Top 10 Patient Safety Concerns for Healthcare Organizations” in March 2018 and cited the management of behavioral health needs in acute care settings as the 6th highest ranked safety concern.
“Organizations should consider working with other partners, such as psychiatrists, behavioral health treatment programs, clinics, medical schools and teaching programs, and law enforcement,” says Nancy Napolitano, patient safety analyst and consultant, ECRI Institute. “Being able to communicate remotely and seamlessly, assessing risk and complexity, as well as delivering high-quality connected care are critical. Relationships and partnerships are what get you what you need.”
Guest post by Michael Leonard, director of product management, healthcare, Commvault.
Once a year, the healthcare community gathers to discuss the hottest healthcare trends. This year, the event took place in Sin City, and the turnout was staggering. Topics of choice at the show ranged from EHR best practices to the rising need for telehealth services.
Now that I’ve had a chance to step back and digest, there are a few key moments that jumped out from the event. Here are my top two:
The HIMSS survey showed healthcare organizations are ready for telehealth.
During the show, HIMSS released a survey that had some exciting results around connected technology in the healthcare field. The results showed that 52 percent of hospitals are currently using three or more connected health technologies. Technologies being used by that group that stood out to me include mobile optimized patient portals (58 percent), remote patient monitoring (37 percent) and patient generated health data (32 percent). It’s fascinating to see these results, and important for healthcare and health IT professionals to know that the telehealth wave is here to stay.
The U.S. Department of Health and Human Services’ (HHS) made a key interoperability announcement.
At the show, the HHS Secretary Sylvia M. Burwell made a major announcement around interoperability that was backed by the majority of the top electronic health record (EHR) vendors and is supported by many of the leading providers. This news will enhance healthcare services and allow doctors and patients to make better informed decisions. It certainly has the potential to catapult the industry forward, allowing healthcare partners to increase accessibility by improving their clinical data management solutions.
As always, the conversation at HIMSS was engaging and educational and I left with some great takeaways and predictions for the future of health IT including:
With the yearly bluster and promise of HIMSS, I still find there have been few strides in solving interoperability. Many speakers will extol the next big thing in healthcare system connectivity and large EHR vendors will swear their size fits all and with the wave of video demo, interoperability is declared cured. Long live proprietary solutions, down with system integration and collaboration. Healthcare IT, reborn into the latest vendor initiative, costing billions of dollars and who knows how many thousands of lives.
Physicians’ satisfaction with electronic health record (EHR) systems has declined by nearly 30 percentage points over the last five years, according to a 2015 survey of 940 physicians conducted by the American Medical Association (AMA) and American EHR Partners. The survey found 34 percent of respondents said they were satisfied or very satisfied with their EHR systems, compared with 61 percent of respondents in a similar survey conducted five years ago.
Specifically, the survey found:
42 percent of respondents described their EHR system’s ability to improve efficiency as difficult or very difficult;
43 percent of respondents said they were still addressing productivity challenges related to their EHR system;
54 percent of respondents said their EHR system increased total operating costs; and
72 percent of respondents described their EHR system’s ability to decrease workload as difficult or very difficult.
Whether in the presidential election campaign or at HIMSS, outside of the convention center hype, our abilities are confined by real world facts. Widespread implementation of EHRs have been driven by physician and hospital incentives from the HITECH Act with the laudable goals of improving quality, reducing costs, and engaging patients in their healthcare decisions. All of these goals are dependent on readily available access to patient information.
Whether the access is required by a health professional or a computers’ algorithm generating alerts concerning data, potential adverse events, medication interactions or routine health screenings, healthcare systems have been designed to connect various health data stores. The design and connection of various databases can become the limiting factor for patient safety, efficiency and user experiences in EHR systems.
Healthcare, and the increasing amount of data being collected to manage the individual, as well as patient populations, is a complex and evolving specialty of medicine. The health information systems used to manage the flow of patient data adds additional complexity with no one system or implementation being the single best solution for any given physician or hospital. Even within the same EHR, implementation decisions impact how healthcare professional workflow and care delivery are restructured to meet the constraints and demands of these data systems.
Physicians and nurses have long uncovered the limitations and barriers EHRs have brought to the trenches of clinical care. Cumbersome interfaces, limited choices for data entry and implementation decisions have increased clinical workloads and added numerous additional warnings which can lead to alert fatigue. Concerns have also been raised for patient safety when critical patient information cannot be located in a timely fashion.
Solving these challenges and developing expansive solutions to improve healthcare delivery, quality and efficiency depends on accessing and connecting data that resides in numerous, often disconnected health data systems located within a single office or spanning across geographically distributed care locations including patients’ homes. With changes in reimbursement from a pay for procedure to a pay for performance model, an understanding of technical solutions and their implementation impacts quality, finances, engagement and patient satisfaction.