Hospitals can leverage the technology to improve HIT systems and meet meaningful-use requirements.


The drive toward integrated technology is transforming healthcare. Adopting health information technology (HIT) across care settings provides hospitals visible staff efficiency, quality and safety improvements, coordination and efficiency of care benefits and patient engagement.

Healthcare informatics and meaningful use have become some of healthcare’s top priorities that have had a profound impact on overall quality of care. Interactive patient education systems can achieve quick return on investment in the pay-for-performance model by helping meet meaningful-use criteria, reducing hospital readmissions and associated costs by providing enhanced patient engagement and combining care coordination.

The rise of medical informatics

The digital revolution that swept America more than a decade ago has reached healthcare. Universities and vocational schools now offer educational programs and specializations in digital information collection. The growing trend of medical informatics has given birth to a new nursing specialization, nursing informatics and patient applications for use with personal devices, such as interactive patient-engagement systems.

Patient uses TeleHealth patient
engagement system.

This rising trend, fueled in part by government incentives, has aided in the use of interoperable technology, helping eligible hospitals meet their meaningful-use benchmarks and, subsequently, fully participate in The Health Information Technology for Economic and Clinical Health Act (HITECH) incentive program.

Hospitals seeking strategies for automating information gathering can leverage available patient interactive systems, significantly enhancing the patient experience. These systems utilize real-time, reciprocal information exchange to empower and engage patients, providing a better experience and individualized healthcare information. Offering unparalleled levels of control, patients can make requests and access educational information to help them outside of the professional care environment while also allowing healthcare professionals to push content that is relevant and specific to individual profile, condition or recovery. This automation can work without staff intervention, allowing care teams to focus on other job-related tasks to improve care outcomes. With a system-stored, educational-content library, clinicians can prescribe individual care plans based on specific conditions and needs. Patients can also submit feedback about their care and imminent needs while hospital staff can use this real-time information to address patient satisfaction and care priorities. This streamlines meaningful-use efforts by automating electronic documentation of patient participation in surveys, routine tests and education requirements.

Interactive systems and meaningful use

HITECH specifies the meaningful-use benchmarks necessary for providers and eligible hospitals to qualify for Medicare and Medicaid incentive payments in three distinct stages. Each builds on the last as the goals and benchmarks become more demanding. A primary criterion of Stage 1 requires eligible hospitals adopt and implement patient-specific education curriculums to “more than 10 percent” of their patient population.

Interactive patient-engagement systems can help healthcare organizations satisfy guidelines for patient-specific education resources by integrating with an EMR to ensure that patients receive specific education resources. This interface with an EMR allows nurses and administrators to prescribe or automate customized, condition-specific educational plans. Once a patient has participated, the educational session can be documented to the patient record via the EMR. When automated via the interface, this function can save even more valuable clinical time. Ultimately, this helps ensure patient comprehension, decreases medical errors, aids in meeting patient and family engagement regulations and helps health providers qualify for reimbursements for EMR implementation as outlined in the American Recovery and Reinvestment Act (ARRA).

The challenge is not simply the implementation of EHR technology, but its meaningful use, which entails a host of additional requirements beyond the core patient education feature, such as defined menu objectives. Due to bidirectional information gathering through these systems, other objectives this technology provides include:

• Electronically record advance directives for patients age 65-plus;

• Record the smoking status of patients over 13; and

• Provide an electronic copy of discharge instructions to at least 50 percent of patients who request it.

Stage 2 criteria will require advanced clinical processes, including overall quality improvement (patient satisfaction), at the point of care and the ability to share and exchange collective demographic and individual patient data electronically. This meaningful-use Stage 2 implementation paves the way for hospitals to meet benchmarks focusing on improved outcomes, safety, quality and care efficiencies.

The final utilization is found in Stage 3, when meaningful use includes “patient access to self-management tools.” As the strain on traditional care resources continues to increase, care efforts will undoubtedly be pushed to the patients themselves and/or informal caregivers. Interactive patient education systems can play an integral role in aiding healthcare organizations in providing consistent, top-quality education and care through the use of their patient-engagement system. The criteria seem predominately focused on healthcare providers, with only an indirect focus on patients and caregivers, but interactive patient-engagement systems may be the one technology that is able to provide this ancillary benefit to all, allowing for further use of HIT in meaningful ways, leading to significant improvements in healthcare delivery and outcomes. Beyond self-management, this includes the patient engagement needed to make these transitions successful, especially from an outcomes perspective.

Interactive systems: a proactive solution

Hospitals must adopt practical, proactive approaches to meet existing compliance regulations as well as current and future meaningful-use objectives. Administrators and decision makers must integrate internal applications while positively impacting patient service outcomes. This leads to three positive results:

• Adaptability – the ability to adapt to varied data requirements;

• Independence – the ability to eliminate total reliance on external organizations for goal achievement; and

• Positive patient encounters – the ability to deliver excellent, efficient healthcare, resulting in high patient satisfaction.

How can these systems meet the flexible needs of America’s hospitals in different stages of adoption? Like meaningful use, interactive patient engagement is deployed in stages, providing scalability and a more sustainable capital outlay. Optimal solutions facilitate growth in sophistication and breadth as the hospital evolves. Interactive patient engagement technologies are typically not IT intrusive with turn-key solutions that offer non-burdening implementation protocols. This can be a great motivator for taxed IT resources – they receive much of the appreciation for interactive engagement systems during tough EMR implementations, and can offer options based on the current technology level availability.

A patient uses the TIGR
(telephone-initiated guided response) interface.

Some interactive patient engagement systems can also provide scalability for active or more-passive patient populations. For example, one unit may choose the in-room telephone as the control device for information delivery based upon patient demographics or patient receptivity. Other areas that have different patient expectations may choose to utilize the pillow speaker or keyboard as the control device. This is a critical factor to consider, as no one device is the optimal navigation technology for all patients.

Meeting HITECH challenges translates into long-term advantages

Meeting all three stages of meaningful use poses varying types of challenges for participating hospitals; even so, with the right technologies in place, the criteria are achievable. By employing an interactive patient-education system in their achievement plans, hospitals can leverage the technology to improve their HIT systems considerably, while also meeting the requirements for meaningful use and receiving incentive funds. Benefits gained from utilizing such technologies reach far beyond the scope of meaningful use and will continue to create positive results and revenue opportunities long after incentive funds are gone. Hospitals engaging in this proactive approach to HITECH will see considerable improvements in care outcome, lower readmission rates, higher efficiencies and improved financial performance.

George Fleming is president and CEO of TeleHealth Services.
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