As talks continue about big data and how to aggregate and share it electronically, we need to keep our ultimate goal in sight – giving providers the information required to better manage the health of the individual patient, in real time at the point of care. So, as the data tsunami continues with states well underway with HIE development and more ACOs coming online, we still have to bring it back to the patient and ask – what will it take to make the millions of gigs of information out there make a real difference to the guy in the hospital gown? Or, to the grandmother rehabilitating from hip surgery at home?
Fortunately, the government’s investment in health information technology sharing has resulted in faster adaptation of EHRs and information sharing. Still, many clinicians don’t have convenient access to usable data for a specific patient encounter at the point of care. And this can only happen when all of this big data coming into the HIE and ACOs can be accessed and is usable by all users and in all settings.
Now developers and providers are finding themselves at the place of actually aggregating and sharing big data electronically and getting closer to the ultimate goal of giving providers the information required to better manage the health of individual patients, in real time and at the point of care. For some, this must feel like the moment of truth. Still, there are a number of barriers and rivers to be crossed before we can actually make this data personal or work for the patient and the clinician. And over the last four years, many of us have experienced many challenges on the road to HIT nirvana.
So, what will it take to get to the HITECH end-goal where we use technology to make healthcare safer, more efficient, effective and, of course, patient-centric?
If I were a betting man, I would say another requirement.
In time, it certainly appears that the government will require integration of all care providers across the spectrum to not only report, but to improve patient outcomes at the point of care. This of course, will require documentation by all users and all settings to be interoperable and connected. There are a number of steps that EHR developers and providers need to consider and take to get to move closer to providing patient-centric care.
1) Integration and expansion of all users. While many physicians are on EHRs and sharing data with physicians in their network, the care isn’t coordinated across the enterprise or with other users. Namely, with the nurses, who are responsible for administering the care based on the clinician’s diagnosis and orders. Until recently, nursing protocols were not available for documentation. They are today and as they come online and available in more EHRs, clinically coordinated healthcare is no longer going to be the exception, but will rapidly become the norm. The efficiencies and accuracy achieved as a result will make it impossible for providers who don’t use technology to coordinate care to compete. Protocols for ancillary caregivers and therapists will also be integrated into EHRs so that the entire care team can use the EHR to document and share information in real time. This will facilitate communications between doctors, nurses and therapists, improving efficiency and accuracy.
2) Integration of all settings. Until we can communicate across the enterprise and ambulatory settings, the clinician really isn’t able to get a clear picture of the patient nor is care expedited or comprehensive. The capability exists to do this today and the efficiencies that stand to be gained from unifying ambulatory and enterprise setting are huge. Not only are the foreseeable meaningful use requirements a motivator to unify all settings, but the cost savings and competitive edge should be as well. Think of how this could improve communications, reporting accuracy and of course, patient care.
3) Accurate, timely documentation that meets all requirements. In addition to ensuring that all users and settings are using technology to share information and document patient encounters, providers and developer need to ensure that documentation is accurate and meets all requirements. Think about it this way, if information isn’t coded accurately and quickly, then errors get moved along to the next clinician. And given that the clinician needs information in real time at the point of care, it’s really imperative that documentation occurs in real time on the spot. If the enterprise hasn’t employed an EHR that takes care of documentation at the point of care, then now is the time to consider upgrading or adding a tool that will take care of documentation, of course, without burdening the clinician.
4) Interoperability. EHRs have to, sooner than later, talk with other EHRs outside of their network. Open-ended design software is critical to flexibility and adaptability. Very seldom do patients stay within one network nor do they stay at home or in one location. Healthcare has to be mobile along with their medical records. It’s becoming increasingly important to not just be able to network stateside, but globally as well.
