Thought Leaders

Appliances, free software and software-as-a-service offerings all provide feature benefits, as well.

Telephone consultations constitute 10 percent to 20 percent of all primary-care interactions, up to 80 percent of after-hours care, and account for more than one quarter of all medical decisions in some sub-specialties. Though phone interactions are characterized by a greater probability of malpractice lawsuits than face-to-face interactions, providers document fewer than 30 percent of phone interactions and most commonly rely on medically untrained phone operators to screen and relay messages to on-call providers.

The importance of electronic health records increases exponentially when made available throughout the healthcare community.

The delivery of healthcare relies on accurate, up-to-date patient information. Unfortunately, much of that information resides in individual stores of paper, electronic records, databases and files scattered across all of the systems of numerous stakeholders. This is where electronic health records (EHRs) and health-information exchanges (HIEs) shine, and why so much of the national discussion now under way about the need to cut costs and increase care focuses on the meaningful use of EHRs within and among providers.

The current political focus is targeted on healthcare reform, and the recently passed house bill HR 3962, with its additional 990 pages, has many people concerned about the approach Congress is taking. Is there a positive aspect of this situation that relates to technology? How can the CIO win as the political winds change?

One issue is that, in the stimulus bill, money was allocated for technology to automate medical records. Money was also allocated to study medical outcomes through comparative effectiveness research and the creation of a health board. While these may sound like positive inclusions, these two components match with the NICE system in the United Kingdom, which is used to ration care. Add the public-option insurance plan run by the government, with its mandatory requirements, and the landscape of healthcare changes.

PM is a disruptive force in medical practice that has been evolving rapidly over the last few years.

As the drive toward global adoption of electronic health records (EHRs) gains momentum, the need for provider organizations to leverage these expensive investments gains importance. American Recovery and Reinvestment Act payments represent a short-lived financial benefit. Where, however, are the more-significant opportunities to transform care and generate significant long-term value from EHR investments?

Personalized medicine (also known as genomic, molecular, information-based or precision medicine) is a disruptive force in medical practice that has been evolving rapidly over the last few years. By guiding physicians to the most-effective treatment for each patient based on their individual disease state, as well as helping to avoid treatments that are of no value or are likely to have adverse effects, personalized medicine improves outcomes for the patient, saves time and reduces waste in medical care by avoiding inappropriate interventions.

Those who implement electronic health records early will reap the benefits, including receiving a greater amount of incentives for which they will be eligible.

With Medicare and Medicaid financial incentives for meaningful use of certifiable electronic health records (EHRs) becoming available to eligible hospitals and physicians Oct. 1, 2010, providers should act rapidly to establish eligibility and quality for the maximum incentive money. Providers should leverage their existing information-technology infrastructure, use a best-of-breed strategy and partner with vendors offering risk-sharing approaches.

The American Recovery and Reinvestment Tax Act (ARRA) uses a "carrot-and-stick" approach to drive inpatient and outpatient use of EHRs by 2015. The carrot is that the earlier facilities begin using EHRs, the greater the amount of incentives for which they will be eligible. Based on the number of annual discharges and other factors, early adopters can receive a minimum of $2 million to a maximum of $11 million payable over four years.

Now is a good time to ensure that the right technology is in place, before medical necessity reviews are required.

Earlier this year, hospitals and physicians in 17 states received pleasant news from the American Hospital Association (AHA) regarding the Centers for Medicare and Medicaid Service’s (CMS) permanent recovery audit contractor (RAC) program. According to the AHA, reviews that are the most difficult to manage and track – RAC complex reviews for medical necessity – will not begin until early 2010; with diagnosis-related group (DRG) and coding reviews late this year. RAC automatic reviews, which require fewer resources and time, began in late June for the first wave of permanent program states.

The use of open source in healthcare will break down many barriers, from high cost and lack of interoperability, to inaccessibility and complexity.

Since taking office, President Obama has pledged to ensure that all U.S. hospitals become paperless within the next five years. The success of this mandate will hinge on its ability to move health IT vendors, hospitals and practitioners to the ideological center in support of electronic health record (EHR) interoperability standards, transparency, HIPAA compliance and affordable implementation.