There’s a familiar quote that says, “Never make predictions, especially about the future.” But ‘tis the season for doing just that so we asked some of the leading healthcare experts to give us their predictions for the industry in 2018. Their outlook on the coming year cover a wide range of issues including technological innovation, EHRs, cloud services, cybersecurity, healthcare costs, legacy data management and the Internet of Things.
Hayes' Healthcare Blog
By Dr. John D. Halamka, MD, MS, CIO of Beth Israel Deaconess Medical Center
The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 has been blamed for many things, including the diminished joy of clinical practice.
While HITECH certainly has its flaws, it’s hard to deny the positive impact. In 2008 before the act was passed, less than 10 percent of non-Federal acute care hospitals were using a basic EHR. In 2015, 96 percent of those same organizations had implemented a certified EHR system. No other sector of the U. S. economy has experienced such accelerated technology adoption.
However, HITECH is just one component of the legislation, regulations and demands that have increased practice burden without simplifying processes through automation.
What can we do to transform the EHR from a burdensome requirement into an essential tool that improves the quality of practice life? Ideally the EHR of the near future will integrate patient data from multiple sources - providers, payers, patients, employers and devices then turn that data into wisdom, providing the clinician with actionable advice that will improve quality and reduce total medical expense. To realize that goal there is foundational infrastructure to be built. Instead of wringing our hands and blaming “information blocking”, we should focus on a short term work plan with the following.
Long gone are the days of standalone demographic and paper medical record files in a physician office. A patient’s record is now digital and likely exists in multiple hospitals, physician offices, and other ancillary services across cities, states, and countries. Patients can now access their own records online to view medical results, schedule appointments, request prescription refills, and manage their medical claims.
Despite the sharp rise in dependency on electronics and technology in today’s healthcare industry, ensuring accurate patient identification is still a challenge. Mismatched patients are the primary cause of data integrity issues and has various causes – from human error to disparate electronic health record (EHR) systems, multiple visits for multiple reasons with multiple providers, etc. In the end, some things just get complicated. The AHIMA reported that 8 - 12% of all patients have a duplicate medical record.
Even with the technology of today, a patient’s identity is commonly confirmed verbally. A patient’s demographic data such as name, date of birth, gender, and social security number are indexed by assigning an MPI (Master Patient Identifier) to each person. Other validation options have been introduced over time including photo identification, the use of wristbands, and patient smart cards. Some organizations have implemented software using algorithms to help identify and link duplicate records.
Looking at the healthcare industry today, we see new shared technology constantly being introduced. The overall goal is to integrate the patient’s digital data so it can be linked, stored, retrieved, and shared with a few strokes of your fingertips. The success of the technology is dependent upon its optimization, which includes accurate patient records. Organizations with multiple integrated EHR’s or who provide high volume emergency or inpatient services see a higher risk of occurrence. But in order to address how to resolve these issues, we must first look at their causes.
By Joseph H. Schneider, MD, MBA, Department of Pediatrics, University of Texas Southwestern
Sitting on the exam table before a routine procedure, I listened as the nurse reviewed my medical information. She checked my name, address, and birthday. All was well until she said “..and you are allergic to Wellbutrin, Toradol, Darvon and sulfa”. My brain sprang to attention as she continued reading that I had shoulder repair and coronary bypass procedures, that my weight was down 50 kilograms and that my father was alive. It was very detailed.
It was also all very wrong. I have no medication allergies, nor have I had any of the named surgeries. My weight hasn’t changed. And my father passed away in the 1980s.
What happened? My record was mixed up with someone else’s and my healthcare information was now seriously incorrect. Fortunately, as a CMIO, I was able to get the 120 pages of my record rapidly corrected.
But what if I was an average person, without the influence to gain quick access and to make corrections? What if I hadn’t been having the procedure? The incorrect data could have led to dangerous consequences.
In the world of healthcare technology, there are numerous system implementations occurring each year. In order to make an implementation successful, it is crucial to develop your users into “super users” during the implementation process. It is common for implementations to include and involve roles such as Project Managers, Practice (Operations) Managers, IT System analysts, and trainers, among others. Each of these roles have well defined parameters and expectations. Often implementations involve super users, but this role is not always well defined and expectations are not always clear.
A super user is your department’s champion for system knowledge and workflows. This person becomes your expert for the system implementation and teaches other employees how to use the new system features. Once you've identified your super users, you need to have clear expectations for this critical role.
Questions should be asked early when selecting the super user. Questions to consider include: Which user should you pick? What qualities should a super user have? How do you train them? Sometimes, you may pick someone that you feel is right for the job but turns out to be someone that is not quite fit for the role.
Consider the following tips when choosing your super users for your next implementation:
Electronic medical record (EMR) implementations can be both stressful and costly. End-user proficiency with your new EMR is absolutely crucial to the success of all aspects of your healthcare organization including financial return, patient safety, patient quality outcomes and staff satisfaction levels. In order to undertake the enormous task of ensuring that every member of your organization is fluent in the new system, many organizations utilize at-the-elbow support post training classes to help smooth the transition between classroom training and live patient care. At-the-elbow support is essential to help your business, front desk and clinical staff learn and feel comfortable with their new workflows and technology.
As a leader in your organization, it may be your responsibility to find the best balance between highest functionality and lowest cost. Wouldn’t it make sense to ensure you’re getting the most "bang for your buck" when it comes to implementation at-the-elbow go-live support staff? Before you do, consider the four recommendations below.
Over the past decade rapid changes in healthcare technology have caused a whirlwind of medical software adoption, and, in some cases, an overconsumption of ancillary products. Medical practices have implemented EHRs, patient portals, and secure messaging to participate in programs such as Meaningful Use and Patient Centered Medical Home certification.
Even though the technology is in place, your staff may still be digesting the impact to current workflows resulting in the full product not being utilized. Now is the time to optimize product features and reap benefits far beyond just meeting minimum program requirements. One specific area of optimization frequently overlooked is secure messaging. So how can you leverage secure messaging in your practice?
The curfew for ICD-10 is fast approaching and with it comes a slew of changes for your documentation. Do you know what you’ll need for a successful implementation? Here are a few helpful suggestions:
Budgeting is arguably one of the most crucial parts of any electronic health record (EHR) implementation, whether it is your first go-live or you are moving onto a new system. The pressure to make the process go as smoothly as possible is undeniable. This includes being on budget and having the implementation be on time. Here are some proven tips around budget development that can save you time, money, and the headache of correcting costly mistakes later in the of EHR implementation process.
Ever heard the phrase “tech savvy”? Or “Information Age”? These are the times we live in. Everything is going electronic; from mail and photos to cars and phones. It seems like everyone knows the newer, faster gadget and how to use it. Along with the rest of the world, medical records and doctor’s visits are being taken electronic and, not surprisingly, the “digital generation” appears in the healthcare industry, as well. There are more and more people who have never worked on paper, only electronic health record systems (EHRs). But what happens if the system crashes? Or when the power goes out? Does patient care stop? Absolutely not. What happens to those tech savvy fishes when they’re tossed out of their electronic water and onto the stationery ground? Users sometimes struggle with the workflows using classic tools of paper and pen. These struggles then manifest as delayed patient care, frustration and anxiety. How can you ensure your organization is prepared for an unplanned downtime?