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 Healthcare Reform

Beyond the EHR

Examining the next technology drivers in healthcare improvement.

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   By Frank Ingari, January 2013

Now that the Affordable Care Act of 2010 has been upheld by the United States Supreme Court, the healthcare industry as a whole must respond aggressively to comply with a host of technology mandates designed to enhance individual patient care, improve the health of general populations and reduce skyrocketing costs. These three goals constitute the “Triple Aim” of these mandates.

The implementation of electronic health record (EHR) systems is a massive first step toward achieving these overarching goals. However, it is only the first step. Building on the EHR, three other technology implementation levels will be instrumental in making the Triple Aim a reality.

The role of the EHR as a technology platform

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 provided an initial impetus for technology adoption within healthcare. This act contains specific directives for the deployment of EHR systems by medical facilities large and small, as well as physicians in private practice.

However, EHR systems alone cannot solve the challenge of meeting the Triple Aim. Instead, they provide a critical foundation for the series of progressive technology moves the industry now must make. They offer a platform for the additional technologies needed to support multi-system integration, clinical data informatics and the transmission of health information across local, regional and national exchanges. Each of these technology levels will play a key role in achieving the goals the industry laid out:

Systems integration: To best maximize the deployment of an EHR system, healthcare organizations need a robust and scalable integration framework to create interoperability. Unfortunately, most EHR systems fall short in regard to strong integration capability. Although an EHR system may be capable of transmitting data across a single enterprise, rigorous and robust application programming interfaces (APIs) are necessary to ensure communication with disparate entities.

Right now, it is difficult to plug into the detailed user interfaces of EHRs, and software upgrades can easily wipe out any APIs developed. Consequently, healthcare organizations should plan to augment the EHR with complementary solutions capable of supporting diverse industry and technology standards.

Clinical and financial data informatics: The real-time availability of patient information to medical providers, for example, enables evidence-based care, which can include everything from identifying targeted patients for outreach in a chronic care setting, to guiding medical interventions and alerting physicians to dangerous drug interactions. Financial informatics is just as important; without the integration of clinical and financial informatics, risk-adjusted contracts cannot be created.

Yet the policy-driven rules and engines necessary to achieve this level of informatics are not present in EHR systems. Obtaining useful data informatics requires a separate business intelligence solution that features the capacity to integrate tightly and securely with the EHR for the purposes of aggregating data generated by disparate systems.

Information exchange networks: As growing numbers of EHRs are deployed in tandem with informatics solutions to capture and analyze patient data, the need for networks that can instantly transmit patient health information has become more obvious. An advanced, HIPPA-compliant, standards-based nationwide network will enable providers across the clinical continuum to cooperate and collaborate to provide better patient care at lower cost.

For such a network to come to fruition, the industry must publish well-defined standards for the synchronization and exchange of data. An example of this is the Continuity of Care Document (CCD), based on the HL7 standard, which has greatly streamlined the transmission of patient data from one healthcare facility to another.

The introduction of integrated systems, informatics, health information exchanges and other high-tech solutions into the clinical environment will put healthcare organizations of all delivery models on the path to realizing the Triple Aim.

About the Author

Frank Ingari is CEO of NaviNet. For more on NaviNet: www.rsleads.com/301ht-204


Tags:  Healthcare Reform