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Technology transformation to sweep emergency departments

By Shane Hade, CEO, EDIMS

It is widely perceived that people with non-urgent needs and the uninsured are crowding the nation’s emergency departments (ED), helping drive health costs sky high. However, the Centers for Disease Control and Prevention shattered these perceptions after it released a report last May that found the percentage of non-urgent patients had declined from 12 percent in 2006 to 7.9 percent in 2007. Furthermore, the CDC found that seniors and those on Medicaid were most likely to access ED services. The fi ndings have serious implications for EDs. Observers expect the 32 million uninsured Americans who will be extended insurance to schedule primary-care visits rather than

Look to ACOs for value-based delivery

By Kerry Winkle, chief marketing officer, Eldorado, an MphasiS Company

While Medicare is leading the way to reform healthcare delivery with accountable care organizations (ACOs), many payers and providers see ACOs as a way to generate more targeted revenue and improve the quality of healthcare. Hospital system-sponsored ACOs will require hospitals to become payers overnight. Health plan-sponsored ACOs may benefi t from integrated claims and care management systems that will give them a leg up on identifying at-risk populations and opportunities for cost savings. ACOs represent a distinct opportunity to improve on the

Empowering the small practice with EHRs

By Tom Giannulli, M.D., chief medical information officer, Epocrates

There has been much discussion about

electronic health record (EHR) adoption. However, many EHR systems are designed for hospitals and large institutions, and they are often prohibitively complex and costly for smaller practices.

In 2011, I know fi rsthand that there will be more EHR solutions designed specifi cally for smaller group practices. This will allow physicians to adopt the technology without

12 January 2011

delay or forgo care that could land them in the ED. The argument is logical except that many patients presenting at the ED have insurance and urgent problems. Health reform – plus the fi rst wave of 78 million baby boomers turning 65 this year – will increase, not decrease, the burden on EDs. Before the meaningful-use fi nal rule made EDs eligible for incentives, hospitals were concentrating on automating the inpatient environment. Now, they will expand their focus to automating and integrating the ED with the inpatient side, giving them the global data they need to address one of the highest medical cost areas. Additionally, hospitals will make process improvements, such as building “fast-track” areas to address patients with non-urgent problems and adding observation areas to determine whether people really need emergency care. EMRs will be the linchpin that makes these different areas of the hospital work together.

payer-controlled case management of the 1980s. Comprehensive patient care management under ACOs will be directed by the primary care provider, who will be accountable for and incentivized to improve outcomes through preventive initiatives and promote wellness, disease management and proactive population management based on predictive modeling analytics. Single- and multi-payer pilots will require an unprecedented level of interoperability and rely on

technologies such as SOA/Web services in order to achieve the desired level of highly coordinated quality care and benefi t from cost savings. Beyond EHRs, ACOs must be able to connect and correlate membership demographics, analytic tools, medical and pharmacy claims, lab data and more. And on a broader scale, they must also be able to integrate with health information exchanges (HIEs) on local, regional and (later) national levels.

turning into IT administrators. SaaS-based EHRs will become more common as a way to offer a cost-effective and secure solution for implementation. This eliminates the hurdles of the time and cost commitment of a full-scale, server-based EHR. SaaS EHR solutions allow physicians to have uninterrupted access to patient data via the Web. EHRs need to be designed to maximize today’s technology and be customizable for different practices. Specifi c needs that will be

addressed for offi ce-based physicians will include mobility and intuitive interfaces.

I believe that between the HITECH Act incentives and the availability of more physician-centric solutions, 2011 will be the year of widespread EHR adoption.


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