Perficient Healtchare Solutions Blog

Subscribe via Email

Subscribe to RSS feed

Archives

Posts Tagged ‘EHR’

Improve care coordination with direct secure messaging #HIMSS14

Direct secure messaging (DSM) is a transmission standard promoted by the Office of the National Coordinator for Health Information Technology that meets the Meaningful Use Stage 2 requirements of electronic health records (EHRs).  It works much the same way as regular email, but the message is encrypted, which prevents unintended use of the protected health information that is included within.  DSM can be used to send patient information among physicians, among provider organizations and to other 3rd parties, including patients.  

shutterstock_157839875Healthcare providers have been using direct secure messaging for care coordinating for a while but there may be ways to use it more fully to reduce readmissions, reduce unnecessary testing and procedures and even increase provider productivity.  Some benefits may include:

  1. Providers can insert secure messages into any point of their workflow.
  2. Primary care providers can interact with specialists to potentially result in fewer referrals; ultimately reducing costs to the healthcare system.
  3. Hospitals can improve transitions to nursing facilities and nursing homes can improve the communication with providers to reduce the need for readmissions back to the hospital.
  4. Medical records departments can interact with the patient send their records more easily saving them time and money.
  5. Researchers can seamlessly interact with patients on release of health sciences information.

Once HIEs are fully implemented, query based networks will provide robust data exchanges, but DSMs will continue to be valuable especially for smaller practices and hospitals that do not have the means to implement sophisticated EHRs.  Read the rest of this post »

Creating a single best view of the patient #HIMSS14

As healthcare organizations prepare for full scale integration of electronic medical records through EHR and enterprise wide data warehouse initiatives, identity resolution is a priority for everyone. 

shutterstock_128624354A Master Person Index (MPI) is a solution intended to solve the common problem where multiple systems or applications within the organization gradually become inconsistent with the most current data.  When this information changes and only one system is updated, the MPI solution ensures that the change is propagated to all other systems to create the single best view.  The MPI may be found at the single system level, facility level, enterprise or health information exchange (HIE) level.  A “person” in the healthcare context may be a physician, patient, member, payers, etc.

Data management is one of my favorite subjects and I’m very excited about the evolution of MPIs for identity resolution, as well as, other Master Data Management solutions. But let’s focus on the benefits of the Master Person Index.  Read the rest of this post »

Massachusetts launches important next phase of HIE

Today, Masachusetts moved into phase 2 of a very important Health Information Exchange (HIE) project. It’s called Mass HIway Health Information Exchange, and it was announced at Beth Israel Deaconess Medical Center, where Healthcare CIO, John D. Halamka works.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician.

Halamka is one of my favorite people to follow in healthcare technology (@jhalamka). He blogs at “Life as a Healthcare CIO” and wrote about the news today in a post titled “The Next Phase of Healthcare Information Exchange.”

Halamka gives us a sense of all of the work that went into this next stage of the project, including:

  • a patient index to track which patients have opted into exchanging their patient data with other providers
  • a portal for providers to log in and access the data
  • an EMR request system to support the request & release workflow
  • a system to keep audit trails of all of the activity

For those who are fans of a “No More Clipboards” type of future in their own patient care experience, news like this is very exciting. Halamka talks about how this massive project taking place in Massachusetts is an example of how the future of healthcare information exchange can be convenient, secure, and lead to better care and health outcomes for us all.

He writes:

“I can imagine a day in the next few years, when all patients in the Commonwealth, with their consent, benefit from secure, coordinated care.    My mother suffered a major medical error in California because of inaccessible primary care records.   I truly believe that my 20 year old daughter, attending Tufts University, will see significant reduction in preventable harm in Massachusetts during her 20′s.”

That’s very inspiring.

 

Top 5 Technology Trends in Healthcare – November 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

HCBlog Top5 Trends

Consolidation and Mergers

Healthcare entities, both payers and providers, have been making an increased effort to capture market share and dominate their geography. Smaller players are being picked up by larger players, consolidating physician practices and health plans. These mergers have driven digital strategy projects and paperless environments, with an increased interest in advertising and public facing websites to try to attract market share. 

Extending Your EMR

Healthcare professionals have been very vocal about the challenges that come along with electronic medical record systems. The workflow in many EMR systems was created by a programmer and works the way it was programmed, not the way healthcare professionals work. Several technology tools were made to extend or approve upon EMRs without ripping the code apart, often by putting it into a browser or allowing it to be mobile.

Read the rest of this post »

Top 5 Technology Trends in Healthcare – October 2013

The healthcare IT field is rapidly developing and changing. Emerging technology and updated regulations put pressure on healthcare providers and health plans to stay ahead of the curve. Perficient creates a monthly list that explores some of the current topics and issues in health IT. This list examines the most talked about issues and technologies that are currently affecting the industry.

 HCBlog Top5 Trends

Mobile Medical Applications

Last month, the FDA released its final guidance for developers of mobile medical applications. The FDA will focus on regulating potentially harmful apps instead of policing applications that pose minimal risk to consumers. These more harmful apps include those which are using mobile technology to make a specific diagnosis and those which transform mobile devices into a regulated medical device.

Patient Engagement and Connected Health

With the progression of patient engagement, consumers are looking to become involved in their own care and health. The quantified-self movement helps patients track their health, physical activity, food consumption, heart rate, and more. From mobile apps to worn digital sensors like the FitBit to implanted devices, patients keep track of their own health data – which eventually may be used to create a more personalized experience.

Read the rest of this post »

Chronic Disease Management through Disease Registries

Chronic diseases, those diseases lasting 3 months or more that cannot be prevented by vaccines or cured by medication1, are placing an increasing burden on our healthcare system.  Unfortunately, the United States has one of the highest rates of illness, disability and death due to chronic diseases, such as asthma, diabetes, coronary heart disease and obesity.  According to the Centers for Disease Control and Prevention (CDC), 7 out of 10 deaths among Americans each year are from chronic diseases and as a nation, 75% of our health care dollars goes to treatment of chronic diseases2.  In 2005, 133 million Americans, almost 1 out of every 2 adults, had at least one chronic illness1. Regardless of the impact of these preventable diseases, a recent survey found that only 56% of recommended care is being provided for patients with chronic illness3.  As a result, provider organizations are seeking new strategies for effectively managing these large and expensive populations4.  “There is a great need for a systematic and comprehensive approach to caring for patients with chronic diseases to help improve the quality of chronic care delivery.” 4  One such strategy is implementing disease registries to capture and track key patient information that assists care team members in proactively managing patients with chronic diseases5.

In this blog post, we will take a high-level look at the some of the key functions and limitations of a disease registry as it relates to chronic disease management.

Functions of a Disease Registry

A registry can be defined as “an organized system for the collection, storage, retrieval, analysis, and dissemination of information on individual persons exposed to specific medical intervention who have either a particular disease, a condition (e.g., a risk factor) that predisposes them to the occurrence of a health-related event, or prior exposure to substances (or circumstances) known or suspected to cause adverse health events.” 6

Read the rest of this post »

Why is Healthcare lagging in IT adoption?

Earlier this week Phil Fasano, EVP & CIO at Kaiser Permanente, wrote a blog post posing the question: If other industries have proven that IT can improve processes and reduce costs, why has healthcare been so slow to adopt? Phil’s post discusses the current state of healthcare IT as well as what entrepreneurs can focus on in the future. Here are a few key points from the article:

  • If we hope to… improve the quality of care and make it available to more people, while still reducing costs – it is imperative that our health system embraces new and disruptive technologies.
  • According to Insight Research, health care IT spending will grow 9.7 percent annually between 2012 and 2017. That compares to an annual 6.4 percent growth rate in overall healthcare spending.
  • IT systems have…revolutionized financial services, and as a result banks have since saved billions of dollars as consumers first used ATMs for deposits and withdrawals, and then started to pay their bills and make purchases online. According to a Bain & Co. brief, transaction costs have dropped from $4 at the teller window to just 8 cents when paying a bill via a smartphone.
  • EHRs are already proving to save lives and costs, from identifying redundant tests and dangerous drug interactions to revealing trends in treatment outcomes.

The healthcare industry has a great opportunity to employ IT to improve the quality of care and lower spending. But where do we start? Phil suggests that entrepreneurs in the healthcare space being by focusing on: Read the rest of this post »

The Quest for My Complete, Portable Health Record

As I have written before, I currently see several physicians who do NOT use an EMR in the office.  They are awesome diagnosticians, people and mentors but they have not taken the leap to the electronic health world.  Now, add in two hospital networks that do NOT have patient portals for accessing my records and you get one big, fat medical record quagmire!   I would love to have my entire medical record in one place AND have portable access to it.  Will I ever reach that goal?  Do I need to establish a relationship with a new physician just to obtain my goal?  I certainly hope not!  So what can be done to make my dream a reality?

puzzle personThis quest has certainly led me to devour insights from industry experts, read countless blogs and articles and consider the drastic move to a new physician.  So I was intrigued when I read the Wall Street Journal article, “Image Sharing Seeks to Reduce Repeat Scans”, this week.  Allowing patients to have access and the ability to TRANSFER images to multiple providers reduces cost, redundancy and ultimately, radiation exposure for the patient.  In addition, it allows the patient to “own” their health.  Although this is certainly a step in the right direction, this is an isolated sharing of information, not connected to the rest of the patient’s history, just another piece of the puzzle.  How can we solve the entire puzzle?

Read the rest of this post »

HIMSS 2013: An Interview with John Lynn

Last week at the HIMSS 2013 show we spoke to John Lynn, Founder of Healthcare Scene blog network and Influential Networks. In the first video, John gives a description about the role of each website in the healthcare IT world. John also discussed the hot topics he has heard at HIMSS, including interoperability and the newly created CommonWell Health Alliance, as well as what he believe healthcare organizations should focus on in 2013. John, an active member of the Health IT Twitter world, shares his thoughts on the power of Social Media in healthcare.

About HealthcareScene.com:

Top Trends at HIMSS 2013:

Read the rest of this post »

Healthcare’s Tomorrowland – Interoperability Showcase at HIMSS

T-minus 7 days till HIMSS 2013.  Preparing for HIMSS is like planning a trip to Disney World.  You are excited to jump on your favorite rides and see your favorite attractions (education sessions and exhibits in our case!) that you have come to love over the years.  But when you get there, somehow they have managed to make everything even more spectacular than you remember.

A good example of this at HIMSS, from my perspective, would be the Interoperability Showcase.  It was at the HIMSS Conference in Chicago, in 2009, when I experienced this event for the first time.  It was about the time when EHRs were really starting to gain momentum within the provider space.  Providers were beginning to understand and accept some of the obvious benefits of EHRs, but the one question that was still of concern and that I heard over and over again was, “will my EHR be able to share information with another EHR?”  It was amazing to see how, through these mini HIEs within the Interoperability Showcase, seamless sharing of patient information was being demonstrated across various clinical systems.  It was like nothing I had ever seen.  Physicians were witnessing the power of HIEs to improve the continuum of care. Read the rest of this post »

Pushing the Blue Button for Meaningful Use

It has been shown that active patient engagement results in fewer hospital readmissions, decreased medical errors, and less consequences resulting from poor communications.  Engaging patients improves healthcare, saves money, and reduces errors.  Meaningful Use has a program goal to deploy technology to raise patient engagement.  The timing is ideal, since more patients are connected every day using smartphones, tablets, and other mobile computing devices.

Improving healthcare is a training problem, which I discussed in an earlier blog.  Along with changes to our general education about healthcare, we can adopt new technology to enable this education.  Many organizations are providing online content, encouraging patients to manage their own health, and more technology solutions are appearing every day.  For example, the HealthIT.Gov group has released details of their Blue Button + campaign.

mj blogThe Blue Button + program is intended to engage consumers (patients) in three distinct ways:

  • First, by easily providing access to patient’s health information.
  • Second, by allowing patients to take action on this information.
  • Finally, to shift the patients attitudes about their role in their own healthcare.

The technology behind Blue Button + is designed to ensure everyone can access their health information easily and quickly.  The success of this has been proven.  In 2010, the Department of Veteran Affairs started the Blue Button initiative.  Since then, over 88 million Americans have been given access to download their health record from portals offered by CMS, Department of Defense, Aetna, and United Healthcare.  Over one million Americans have downloaded their health records.

This is a challenging issue because healthcare data most often lacks structure, is inconsistent, has no secure transport, and is not seamless.  The Blue Button + program has been released to address these issues.  It does so by offering a structure and transport mechanism for the data, pre-defined anchor bundles, and triggers to automate the transmission.

Structure is accomplished using a Consolidated CDA (C-CDA) template.  This same XML template is described in the Meaningful Use Stage 2 requirements.  It uses a standard message format to move data between systems.  Most modern Health IT solutions support CDA and will support C-CDA soon.

Transport leverages the DIRECT protocol using SMIME/SMTP transport to move data between systems.  This uses the same infrastructure used by email to transmit health information between systems.  DIRECT adds security to this process by pre-defining trust relationships between the sending and receiving systems.

All of the requirements listed so far are Meaningful Use Stage 2 regulations.  Blue Button + adds some extra considerations to provide a better experience.  This includes the Blue Button Anchor Bundles to pre-define collections of trust relationships, transmit context to help label messages based on their source and time of transmission, and finally enable the ability to automate the message push function via triggers.  Triggers enable automatic updates to receiving systems when patient data changes on the source system. These let patients, when they register, determine how often data is refreshed between these systems.  Once this trigger has been defined, the patient has nothing else to do, yet still receives updated data each time the data is updated at the source.

Have you had experience with Blue Button + or downloading your health information by other means?

EMR 3.0 and Doctors Lacking an Analytic Engine

As a big fan of kevinmd.com, I enjoyed reading David Nash, MD’s take on how doctors need an “EMR 3.0” analytic engine for accountability and that creating an analytics tool that monitors gaps in care for a provider’s population is very important for accountable care.  We also agree that as successful as the big EMR vendors have been that they don’t have an analytics engine that promotes accountability and measurements of quality and safety.  My argument is that as a result of the large number of data sources in the typical healthcare organization due to the myriad of healthcare applications, the analytics engine needs to combine data from all of those sources, normalize the data and deliver the quality and gaps in care dashboards independent of the EMR system.

David’s practical idea that clinicians need an analytics engine that sits on top of the EMR, one that is capable of sweeping up clinical data and converting it to information that will improve clinical decision making, is accurate and exists today.  Moving all of those data sources into a centralized enterprise data warehouse with a comprehensive and standard healthcare data model is the key to success.  Reconciling the medical vocabularies to a set of consistent data elements empowers real analytics.  Those capabilities exist in a well-established product called BI-Clinical from CitiusTech and that product has the key capabilities outlined on David’s wish list as an “accountable” primary care clinician in the modern healthcare environment, including: Read the rest of this post »