Patient-centered healthcare technology is putting the power of good health into patients’ hands. All of the changes in American healthcare regulations point to one top priority, and that’s patient centered care. Why does this matter? Because patients who are empowered to manage their own health are more likely to be proactive and, theoretically, therefore healthier.
Knowledge in the world of healthcare can be a great thing, and the technology community is responding with thousands of apps and other healthcare IT initiatives, such as activity tracking devices and websites designed to help consumers keep close track of their wellness.
Researchers at the Mayo Clinic provided FitBits to 149 post-surgical heart patients. The researchers determined that using the FitBit to monitor mobility wirelessly was “easy and practical, and led to a significant relationship between the number of steps taken in the early recovery period, length of stay and dismissal disposition. The research indicates that an activity monitor such as a FitBit could positively affect post-discharge outcomes by empowering patients to take their recovery into their own hands. Better discharge outcomes leads to lower costs in the long run. This is just one example of many.
Guest post by Alexandra Sewell, executive director, emerging markets, Comcast Business.
As the healthcare industry moves through 2014 and begins planning for 2015, several trends continue to dominate the healthcare IT landscape. Healthcare organizations are grappling with the explosion of Big Data and implementing strategies to achieve varying stages of meaningful use. The industry is working toward interoperability, mobility and improving data security – all while looking to control costs and provide quality care.
New healthcare technologies hold great promise to improve both access to and quality of care, but they are in varying stages of adoption and federal approvals. This is leaving healthcare organizations and their IT directors searching for flexible solutions that can address current and future technologies.
Unfortunately, the industry’s approach to how technology is sourced, implemented and integrated as a business strategy is fractured. Many vendors offer different approaches to today’s healthcare technology challenges, but very few offer total solutions.
With that said, some technology is taking hold, such as digital hospital rooms, virtual medicine kiosks and mobile e-health devices, which allow physicians and other clinicians to monitor, diagnose and treat patients from remote locations. PACS imaging, electronic health records (EHR) and other data can now be shared within the entire healthcare ecosystem – from patients and clinicians to pharmacists and payers, and this is progress. But it’s been slow to take shape and there are still many questions to be answered.
In a letter to HHS Secretary Kathleen Sebelius, the College of Healthcare Information Management Executives (CHIME) and 47 other of the nation’s largest healthcare provider organizations issued a joint call for additional time and flexibility in the meaningful use program to ensure its continued success.
While underscoring the meaningful use program’s invaluable role in advancing technology adoption among hospitals and physicians, the letter states that strict adherence to current program requirements endangers overall success of the EHR program, disrupts providers’ healthcare operations and potentially jeopardizes patient safety.
“Given that we have just celebrated the anniversary of HITECH, we can look back at the last five years with great pride and take stock of how far we’ve come – as an industry and as a nation,” said CHIME President and CEO Russell P. Branzell FCHIME, CHCIO. “But we must look ahead and recognize the immense work in front of us. Now is the time to make much-needed course corrections to ensure that we continue this success well past HITECH’s 10th anniversary.”
The letter reiterates many points made by several organizations dating back to May 2013, including letters from CHIME; the American Hospital Association (AHA); the American Medical Association (AMA); the Medical Group Management Association (MGMA); the American College of Physicians (ACP); the American Academy of Family Physicians (AAFP); and the National Rural Health Association (NRHA).
The latest letter, the first to be issued jointly by more than 40 organizations, comes in response to concerns that the nation’s 5,000 hospitals and 550,000 eligible professionals must adopt the latest certified versions of EHR technology and meet more difficult program requirements to remain in compliance with the Medicare and Medicaid Electronic Health Record Incentive Program. Hospitals only have until July to adopt, implement, test and train staff to meet either Stage 1 or Stage 2 Meaningful Use requirements in 2014. Eligible professionals have until October to begin collecting data to attest to meeting program requirements.
According to new research from Accenture, despite slower-than-expected growth, the global market for electronic health records (EHR) is estimated to reach $22.3 billion by the end of 2015, with the North American market projected to account for $10.1 billion or 47 percent, released today at the annual HIMSS Conference in Orlando.
According to Accenture, although the worldwide EHR market is projected to grow at 5.5 percent annually through 2015, Accenture’s previous research shows that would represent a slowdown from roughly 9 percent growth during 2010. Despite the slower pace of growth globally, the combined EHR market in North and South America (The Americas) is expected to reach $11.1 billion by the end of 2015, compared to an estimated $4 billion in the Asia Pacific region and $7.1 billion in Europe, the Middle East and Africa (EMEA).
“Although the market is growing, the ability of healthcare leaders to achieve sustained outcomes and proven returns on their investments poses a significant challenge to the adoption of electronic health records,” said Kaveh Safavi, global managing director of Accenture Health. “However, as market needs continue to change, we’re beginning to see innovative solutions emerge that can better adapt and scale electronic health records to meet the needs of specific patient populations as well as the business needs of health systems.”
Driven by consolidation and the federal Meaningful Use guidelines, the United States is expected to remain the largest EHR market in the Americas and globally, with a projected annual growth rate of 7.1 percent and will total $9.3 billion by the end of 2015. Along with increasing U.S. market demand, Brazil, projected at $0.4 billion, may represent the greatest relative growth opportunity as a country-wide federal initiative, the Unified Health System, is expected to drive 9.7 percent annual growth over the next several years.
Robert Hitchcock, M.D., FACEP, is T-System’s vice president and CMIO, leading the company efforts for solving regulatory issues and identifying trends. He is a nationally recognized meaningful use expert and active member of the HIMSS Physician Committee and other HIMSS subcommittees advocating usability and responding to regulatory issues.
Dr. Hitchcock also is a practicing ED physician and an Emergency Department Practice Management Association (EDPMA) board member. In 2001, he earned recognition for excellence in teaching from internal medicine residents, and in the early 2000s, he trained basic and advanced life-support EMS providers. His goal is to advance system adoption and usability to improve the quality and efficiency of ED delivery.
Here, he provides perspective about developments of meaningful use Stage 2 and Stage, how meaningful use is impacting vendors and practices, how they feel — or should feel — about it, and what Stage 3 means for everyone in the industry.
How do you see the market responding to meaningful use? How are physicians moving forward, or beyond, it?
The market’s overall response to meaningful use is generally clear: they’re pushing back, particularly on Stage 2. Vendors aren’t ready, so there are not as many certified products out there. Physicians and hospitals are both calling for delays. By some estimates, as many as 50 to 70 percent of physicians who were successful in Stage 1 will not be successful in Stage 2.
To give some perspective, the Eisenhower interstate system was authorized and construction began in 1956. Phase 1 was completed in 1992. It took 35 years to build roads in this country, a decidedly low-tech undertaking. With meaningful use, we’re attempting to take a relatively un-automated industry and automate it beyond what was ever considered possible in six years. Everyone is pushing back because it’s simply too much, too fast.
Guest post by James Hofert, Roy Bossen, Linnea Schramm and Michael Dowell of Hinshaw & Culbertson.
In 2013, healthcare industry stakeholders, including associations, EHR vendors, practitioners and providers, raised significant concerns relating to the implementation timing of meaningful use Stage 2 and 3 criteria, including problems with interoperability, usability and regulatory failure to assess “value added” by implementation of meaningful use criteria to date. On December 6, 2013, federal officials announced that Centers for Medicare and Medicaid Services (“CMS”) were proposing a new timeline for the implementation of meaningful use stage criteria for the Medicare and Medicaid Electronic Health Record (“EHR”) incentive programs. The Office of the National Coordinator for Health Information Technology (“ONC”) further proposed a more regular approach for the update of ONC’s certification regulations.
Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers had completed at least two years in Stage 2. The goal of the proposed changes is twofold; to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2, as well as evaluate data from Stage 1 and Stage 2 compliance, to date, to create and form policy decisions for Stage 3.
Roy Bossen
CMS expects to release proposed rulemaking for Stage 3 in the fall of 2014, which may further define this proposed new timeline. Stage 3 final rules would follow in the first half of 2015.
Despite CMS’s positive response to stakeholders concerns relating to the timeline for implementation of Stage 2 and Stage 3 meaningful use criteria, significant reservations continue to be enunciated, on a monthly basis, by providers at both Health information technology (“HIT”) policy committee and work group meetings. Providers continue to urge rule makers to institute consensus standards that could be adopted broadly across the healthcare industry to ensure both usability and interoperability.
In early 2013, former national coordinate Farzad Mostashar chastised electronic health record vendors for improper behavior in the marketing and sales of systems that continued to frustrate interoperability goals. This frustration with EHR vendors continues to be enunciated in HIT policy committee and work group meetings as recently as January of 2014.
Ohio Republican Senator Rob Portman recently submitted a bill, the Behavioral Health Information Technology Coordination Act, that would add mental health providers to the nation’s EHR network, which essentially has been the catalyst for the surge in adoption of health information technology systems.
Mental health providers are not eligible to receive federal electronic health record incentive payments under the meaningful use program.
According to Portman’s news release on the topic, “Due to a disconnect between our nation’s doctors and mental health care professionals, Americans suffering from mental illness are among the nation’s most underserved and overlooked populations. By fixing an oversight in the system and making health IT the bedrock to fully integrated care, my bill will enhance care and treatment for the mentally ill and put them on a path to lead healthy and productive lives.”
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.
Document scanning
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.
In a letter to HHS Secretary Kathleen Sebelius, the College of Healthcare Information Management Executives (CHIME) and 47 other of the nation’s largest healthcare provider organizations issued a joint call for additional time and flexibility in the meaningful use program to ensure its continued success.
According to new research from 
