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Cover Story A look into the healthcare IT market By Charlotte Martin, president and chief operating officer, Gateway EDI

The evolution of healthcare IT means going beyond managing costs to improve quality of care across the system. Progress in connecting providers, payers and patients will set the stage, with leadership coming from those with products that help providers fi gure out not only how to get paid, but how to care for patients. There is a clear need for payers and

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providers to work more closely to cut administrative costs. Directly connecting providers with health plans will reduce bad debt, eliminate the need to rework denials and lessen time spent collecting patient payments. As payment models shift and the world moves toward better outcomes and cost management, payer-provider connectivity will become the new way of paying, as well as the new way of measuring if care is appropriate. The game will keep changing for reimbursement (with 5010 as one example of trying to make improvements), which comes with some chaos. Healthcare IT organizations will introduce tools that

help patients and providers make better decisions and avoid getting crunched by industry changes. Consumer engagement will grow as costs keep shifting to patients. Patients want to know how their costs compare to what others spend. To meet the demand, social media will gain infl uence among patients making decisions. Like checking online consumer reviews to decide where to have dinner, patients will use similar tools to see how providers stack up against quality measures and their peers, share recommendations and decide who to trust for their care.

Gazing into the future of analytics By Daniel J. O ’Donnell, M.D.,

senior advisor for medical informatics, InterSystems

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Billions of dollars will be spent on HIT applications, and most of these applications will not be able to communicate in an effective, effi cient way. Pressures from all payers, including giants Medicare and Medicaid, will relentlessly ratchet up the demand for ever-more-granular data regarding cost, quality and outcome. This will increase need for real-time understanding of what is happening for innumerable

business reasons, including complex new payment metrics, such as those of ACOs. As a result, two fundamental HIT challenges will grow over the next few years: fi rst, diffi culty getting accurate clinical data into so many systems; second, diffi culty making sense of all that data. Each problem will

12 January 2012 EMR adoptions drive new trends

By Brandon Savage, M.D., chief medical officer, GE Healthcare

As meaningful use continues to play a

central role, we will see a signifi cant uptick in the adoption of EMRs among smaller physician practices in 2012. With this large infl ux, we will see three new trends emerging. First, there will be an increased demand

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for interoperability and communication, as seen in many other industries that have crossed a critical digitization threshold. Due to this demand, a growing number of EMR vendors will begin to embrace standards for communication. Vendors that embrace interoperability and openness will succeed. Second, physician practices will also demand the best ROI in EMR systems, leading to a need for more benchmarking and reporting capabilities. Since smaller practices typically do not have the IT support staff for performing this analysis, a new business intelligence and consulting market will emerge. Many vendors will take advantage of this. Third, we will also see the emergence of population health-management systems. Unlike EMRs, which tend to focus on the management of individual patients, these systems will enable healthcare delivery systems to manage their entire patient population, even outside of the offi ce walls. The technology will help care managers better identify patients in need of specifi c services and provide personalized services to improve

their health, prevent conditions and potentially avoid unnecessary ED visits or hospitalizations. Population health management will be crucial to preventing and managing chronic diseases, and for bringing down healthcare costs for the country as a whole.

grow in scope as complex medical knowledge grows; each must be taken into consideration, both for entering data and for understanding what it means: the critical analytics component. The result will be an increasing need for technology that will help clinical and business decision-makers make better evaluations and judgments in real time. Even in theory, this is complicated. And, in reality, it is extremely, and often surprisingly, diffi cult, expensive and prone to failure, as many organizations are painfully discovering. Proven technology already exists that will effi ciently aggregate, clinically organize and reliably move data from system to system, in real time for multiple purposes. This is a major advance over copying limited selected data to a static data repository and reporting from that repository. However, the use of this new technology, for real-time, active analytics, is still barely explored territory that will require many different, and possibly new, skill sets and organizational processes. My fi nal conjecture is that, within a few years, we will have a fundamentally different approach to using the content of free text, which will make clinical data entry and understanding easier.


Continued on page 14

Continued on page 14

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