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● Roundup: 2013 Forecast – EMRs/EHRs

Both Frost & Sullivan and KLAS forecast explosive growth in the implementation of analytics tools by healthcare organizations as they try to address this challenge. T is October the fi nancial penalty clock began to tick for hospitals that cannot reduce preventable readmissions and achieve prescribed target clinical outcomes. T at same clock has been ticking for four years on preventable complications. Add to that the specter of shared fi nancial risk and a bleak picture emerges for unprepared healthcare systems. As the reality of these megatrends sets in, hospitals are earnestly seeking solutions that can generate useful results in a matter of a few months rather than the customary 18-month implementation wait. T ey also crave a solution to help them prioritize improvement initiatives, so they can focus on what matters most to their survival. Hospitals are recognizing that their only sustainable course is to eliminate waste in three categories: 1) ordering care; 2) delivering the care that is ordered; and 3) reducing complications. Health systems that can demonstrate quantitatively that they provide high-quality, cost-eff ective and safe care have a competitive advantage in the emerging shared-risk payment environment.

Dan Riskin, M.D., CEO, Health Fidelity Next-generation EMRs will provide a more meaningful user experience Since before the QWERTY keyboard, capturing information has focused on increasingly intuitive data entry. T e fi rst generation EMR, currently the

predominant input system in healthcare, has been focused on capturing data and clinical workfl ow. Its drop-downs and text boxes help address key discrete data needs, though not in an elegant way. As the technology matures, next-generation EMRs will need to be more user friendly and provide a more meaningful user experience. Accomplishing this requires an understanding of natural language, which will enable physicians to bypass the check boxes that they fi nd so irritating. Natural language narrative notes have been used in healthcare for more than a century and represent the most robust source of clinical information. To date they have not been used for compliance and analytics, but that’s about to change. As organizations strive to improve healthcare quality, they must be able to make sense of big data. However, this data poses a challenge because narratives are unstructured and not coded for downstream use. T e EMR must be able to tap into this unstructured data and extract specifi c information critical to improving patient care. As we look to the future, clinical natural-language-processing technology will enable the next-generation EMR to use the narrative content that already exists to make data entry more intuitive, information more accessible and patient care more robust.

8 January 2013

Ray Desrochers, executive VP, HealthEdge Payers are willing, but their technology is weak T e good news: Our recent “State of

the Payer” survey confi rmed payers’ interest in leveraging and supporting many next- generation healthcare business models; 68.8 percent plan to participate in ACOs, 65.6 percent in pay for performance (P4P) and 58.8 percent in value-based benefi ts (VBBs) over the next three years. T e bad news: T ey don’t have the technology required. T e same survey showed 41 percent don’t have the technology needed for ACOs, 34 percent for P4P, and 47 percent for VBBs. Many payers are limited by antiquated core platforms,

signifi cant manual processing and large numbers of satellite systems that are hard to use and costly to maintain. As industry experts have predicted, continued reliance on these systems will prevent payers from taking advantage of new business models. It will also force them to continue incurring the massive administrative costs associated with manual processing of signifi cant numbers of claims; prevent them from meeting new challenges, including interoperability, transparency and enhanced customer service; and hinder their ability to meet new regulatory challenges such as ICD-10 compliance. With the future of health reform coming into focus, clarity

in the direction of next-generation business models and renewed consumer involvement in their healthcare, 2013 will be the year that payers begin making the necessary changes to their infrastructure – jettisoning their outdated legacy systems and embracing modern technology platforms – enabling them to meet their 21st-century business goals. T is year, we’ll continue to see the evolution of healthcare, with technology leading the way.

Eliot Muir, founder and CEO, iNTERFACEWARE EMR success requires the right integration tools In order to achieve meaningful use, more hospitals and healthcare organizations are implementing EMRs. According to a recent survey conducted by the Commonwealth Fund, usage of EMRs in the U.S. and Canada is up 50 percent since 2009. However, as organizations rush to comply with EMR certifi cation, many are struggling to make disparate systems – often with varying and/or conflicting standards – work with each other. One of the biggest questions remains, “We’ve adopted an

EMR, now what?” Some of the major obstacles to integrating EMRs include vendor resistance to making services more interoperable; centralized decision making creating an environment unfavorable to technological innovation; and the prevalence of legacy integration engines unable to keep pace with today’s data demands. Moving forward, there will be renewed interest among


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