Thought Leaders

Current EHRs capture most information – patient demographics, medications and problem lists – as structured data, and often codify the details to support billing instead of clinical activities.

Cautionary tales of throwing the patient out with the paper – in technical terms, failing to fully utilize unstructured clinicians’ notes in the EHR – are surfacing everywhere. In her April 22 New York Times commentary, Pauline Chen, MD, discussed the importance of the patient narrative, and the challenges of replicating nuances of care in current EHRs. A month earlier, Gordon Schiff, MD, and David W. Bates, MD, wrote in The New England Journal of Medicine that “free-text narrative will often be superior to point-and-click boilerplate in accurately capturing a patient’s history.”

Thought-critical, free-text physicians’ notes are under threat. Current EHRs capture most information – patient demographics, medications and problem lists – as structured data, and often codify the details to support billing instead of clinical activities. The frequent use of the word “structured” in the definition for meaningful use released by the Centers for Medicare and Medicaid Services (CMS) may further encourage and compound this trend.

Due to uncompensated care, many hospitals are losing money from their emergency departments (EDs). Eligibility screening can help reverse the trend.

Many uninsured patients do not know that they may qualify for a range of public and private healthcare programs. Screening ED patients to determine health-insurance eligibility for programs, such as Medicaid, and facilitating a patient’s application to these programs, can provide hospitals with funds to cover otherwise uncompensated care. Allocating the necessary levels of staff and finances to address eligibility, however, is often not economically feasible – and will become less so in three years, when healthcare reform mandates take effect.

The adoption of EMR technology holds the promise of improving processing times, patient care, information redundancy and records integrity.

A quick visit to any online practice-management buying guide reveals dozens of alternatives from companies whose products are designed to streamline the operations of today’s healthcare practices. Whether single-tenant installed or multitenant systems built on a software-as-a-service (SaaS) platform, the technology space has grown increasingly crowded as insurers and practitioners strive to operate more efficiently and deliver better patient care.

Simple ways exist for implementing technical safeguards to mitigate security risks, while becoming compliant and maintaining current levels of service.

Government-mandated migration to electronic medical records (EMR) brings with it inherent risks of healthcare information technology. Patient data in digital format is constantly at risk from intentional data manipulation or theft, accidental record access, and the ever-present risk of exposure to malware.

Other issues include the high cost of initial implementation, the logistical challenge that comes with necessary work-flow restructuring and the pressure to maintain current levels of service without interruption. Often, these issues pose significant challenges to business continuity and take priority over security – which can threaten compliance with HIPAA.

The chasm between finance and nursing can be addressed with features and functions that safeguard the quality of patient care by optimizing appropriate and effective staffing.

Finance and nursing have different perspectives and priorities for hospital-information technology. This is particularly evident in the evaluation of enterprise work-force-management systems for staffing and scheduling. In fact, when it comes to staffing and scheduling, there is a chasm between finance and nursing.

Monitoring service provides end-user analytics and assures the hospital of the availability of its physician-application site.

The opening of two hospitals in 2009 – expected to attract many new patients and prospective physicians – prompted a renewed focus on El Camino Hospital’s Web operations. Specifically, the hospital needed to leverage its Web presence to better serve the needs of this growing number of patients and physicians, in a cost-effective, productive and brand-enhancing way.

Providers can take a number of actions right now to reduce healthcare costs, and improve efficiency and effectiveness of the U.S. healthcare system.

So what is the future of healthcare? Nobody knows for sure, but it must change, and we must strive for quality care that is affordable and delivered by a sustainable system for all parties involved. It will take us years to get to where the U.S. Department of Health and Human Services is now steering the direction of healthcare information technology – moving to electronic health records (EHRs) and establishing a nationwide electronic health-information system (HIS).