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.
Patients are not the only ones who will become more engaged as mobile devices continue to infiltrate healthcare; physicians, too, are reaping the so-called rewards.
As the debate continues to rage about the efficiencies created when EHRs are used in a practice setting, there seems to be little argument as to whether tablet PCs, smart phones and even applications like Skype actually improve the business of communication and interaction with patients and their physician partners and physicians with their colleagues.
A physician whom I very much respect, Dr. David DeShan, is one such physician who communicates with patients and colleagues via Skype from his mission outpost in Moscow, Russia.
Spending weeks at a time in Russia each year, he also maintains his status as a partner and practicing physician at a growing OBGYN clinic in Midland, Texas. As an early adopter of the virtual visit, DeShan is able to maintain contact with his patients if they need a consult, and he’s also able to maintain his connection to his practice so he can check labs, review diagnosis and provide counsel to his practice mates should they request it.
By his own admission, he works a full-time practice schedule from abroad in addition to his full schedule as the leader of a major international mission. By partnering Skype and his EHR, DeShan is essentially a full-time practicing physician without a need to be restricted by the brick and mortar location of his practice. At the same time, he’s able to dedicate himself to his medical mission work in Russia and serve individuals throughout the world’s largest country in places that would never receive even the most primitive of care without him and his network of medical volunteers.
But, I digress. I’ll save DeShan’s story for another day.
The point I’m trying to make is in support of CDW Healthcare’s article “Momentum Surges for mHealth,” which cites a recent IDC Health Insights observation that shows clinicians use more than six mobile devices in the care setting each day.
Accordingly, as the mobile world continues to open new opportunities in all aspects of life, physicians, like all of us, know that they will come to rely more on these devices to practice, communicate and collaborate.
Clinicians and practice leaders continue to embrace the devices in the care setting, and they expect practices to allow them in their work. When technology delivers upon its promise and actually makes life easier, it is obviously going to be supported and used, like DeShan has done with Skype.
The technology helps him bridge gaps and essentially eliminate a half-the-world-away gap between himself and his practice. But, in some places, there are policies in place to inhibit this type of care offering. (Policies in opposition to this type of approach should be considered archaic and simply regrettable.)
The CDW piece goes on to state that according to a University of Chicago School Medicine study, providing tablet PCs to residents actually reduced patient wait times in hospitals. Likewise, the study found that the same residents did not have to look for an open computer for medical charting and actually allowed the residents to spend more time with patients.
Novel concept. Technology working as promised. Not so unbelievable when spelled out so clearly as this.
As I said, mobile health will continue to grow in popularity. If internal policies are not supported and encouraged, you’ll quickly find yourself in a BYOD environment, which is not such a bad thing.
In fact, if it develops or if you’re unable to support your own internal mobile device initiative, set some rules and let it bloom.
According to CDW, “You need to establish and enforce policies for mobile users including setting up passwords, separating personal from corporate data on devices … and you need to educate users on how to securely use mobile devices.”
When managing a population that’s more likely to use or own a mobile device like a tablet PC than the rest of the consumer population, the infiltration is well underway so it’s time to begin reaping your mobile rewards.