HIE Market to Grow Significantly

Gabriel Perna, Healthcare Informatics

According to a recent report from the Mountain View, Calif.-based research company, Frost & Sullivan, the health information exchange market is set to grow significantly over the next 18-24 months thanks to various regulatory factors. The report, U.S. Health Information Exchange Market: A Comprehensive Guide to Market Dynamics, Technology Vendors, and Future Trends, looks at the specific opportunities in this space.

Reform plays a big part of why HIE is set to grow. The report’s authors say the main reason for the growth of the HIE market is the renewed certainty around the Affordable Care Act, thanks to the Supreme Court upholding it and President Barack Obama getting re-elected. They also mention Stage 2 Meaningful Use requirements and the growing demand for care that goes beyond the doctor’s office as other reasons for the possible growth.

"Most healthcare providers realize that, despite the numerous complexities and challenges associated with the exchange of health data, HIE will continue to accelerate," Frost & Sullivan analyst Nancy Fabozzi, said in a statement. "The value gained from health data exchange is self-evident.  Today, most providers agree that the key issue in HIE is not whether to do it, but how best to do it so that benefits are maximized and any potential harm is minimized. This means that the data exchange platform must be trustworthy, comprehensive and secure." Fabozzi believes that the growth of cloud-based HIE solutions will necessitate new protocols and solutions that require state-of-the-art security systems expertise to alleviate concerns about data breaches.

Specific to the market, the authors of the report say demand for HIE-related services will go beyond simple transactional data exchange. They say value-added services which enable patient engagement and predictive analytics needed to better manage patient populations and contain risk will be looked at.

NFL Moves to EHRs

The National Football League (NFL) will make the switch from paper to electronic health records, contracting with ambulatory vendor eClinicalWorks to serve 32 teams nationwide.

"The health and safety of our players continues to be our number one priority," Brian McCarthy, NFL's vice president of communications, tells Healthcare IT News. "We want to provide team medical staff with the latest technology that will help with their care and treatment of players in real time at the team facility, in the locker room [and] on the sidelines. This solution will help medical staff with secure real-time information to make decisions that will benefit the player."

“The NFL prides itself in staying ahead of current healthcare developments,” said Anthony Yates, MD, president of the NFL Physicians Society, in a statement.

Yates, a physician at UPMC and team doctor for the Pittsburgh Steelers, is also a member of member of the EMRCommittee for the National Football League.

“We are always looking for innovative ways to enhance the organization," he said. "Electronic health records are the next logical step, and we look forward to partnering with eClinicalWorks on this initiative."

The NFL is implementing EHRs across the organization to streamline processes between locations and coordinate care, officials say. All 32 teams will have access to the EHR system, which will be accessible at stadiums during games, on the sidelines and at the training facilities.

Girish Kumar Navani, CEO and co-founder of Westborough, Mass.-based eClinicalWorks, says this implementation has some similarities to certain other ambulatory EHR deployments.

"It’s not very different in capabilities from an orthopedics and physical therapy clinic," he says. "eClinicalWorks has had orthopedic and physical therapy components within the EHR, so this will be the same system as we traditionally implement, with a few added features."

Still, Navani says that "extensive club visits" have led to the incorporation of some capabilities to the EHR that reflect "the uniqueness of the NFL."

One big difference? "In this implementation, there will be a direct video feed from the NFL for players, play-by-play, and we are integrating these feeds into the EHR," he says. "The League will be able to view video footage in the EHR of the injury occurring, which will help with treatment plans and follow-up once the player is off the field."

And, of course, there are other features necessary for an EHR tailored toward athletes playing a dangerous game, where injuries are common. "The EHR will connect with labs, radiology, PACS imaging and a concussion app," says Navani.


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Survey: When it Comes to EHRs, U.S. is on the Right Track

Gabriel Perna, www.healthcare-informatics.com

A new study from the Commonwealth Fund and Harris Interactive has found that physicians from the United States have made progress in adopting EHRs when compared to similarly developed countries. The study compared the attitudes and thoughts of primary care physicians from the US, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, and the United Kingdom.

According to the survey, which was conducted between March and July 2012 and appears in the journalHealth Affairs, 69 percent of US doctors report the use of EHRs. This puts them in the same realm as physicians from France and Germany. Above them are physicians from the Netherlands, Australia, New Zealand, Norway, and the U.K. The survey’s authors found that the spread of EHR usage in both the US and Canada has been “rapid” since 2009.

In addition, the survey's authors found that in places where EHR usage is commonplace, physicians routinely electronic order entry for lab tests and prescription drug. On the other hand, decision support was less common. In terms of multifunctional EHR capacity, the U.K. ranked near the top, while the US had much a lot of progress since the last survey from this group in 2009.

In terms of information exchange capability, New Zealand practices ranked near the top with 55 percent of physicians reporting the ability to do this, while Canada was ranked at the bottom.

Along with information on health IT usage, the survey looked at the attitudes of physicians from these various countries. In this realm, US physicians were ranked dead last. Only 15 percent of US physicians thought their system worked well. Germany was next with only 22 percent of their physicians thought that system was a good fit.

HIMSS: We Expect Continued Focus on Health IT

November 8, 2012  Gabriel Perna, Healthcare Informatics

The Healthcare Information and Management Systems Society (HIMSS) recently released a statement in response to the results of Tuesday’s elections, congratulating President Barack Obama and the other winners of the night. In addition, HIMSS said it anticipates that the Obama administration and congressional members will “continue their focus on health IT.”

HIMSS said congress is likely to examine interoperability, the Meaningful Use program, and IT innovation. It said the House Science, Space, and Technology Committee has already scheduled a hearing on Nov. 14, where HIMSS Board of Directors Chair Willa Fields, RN will present testimony.  Also, “Federal agencies are expected to soon release regulations to address key components of healthcare transformation, including the awaited ‘omnibus’ privacy rule, parameters for health insurance exchanges, and early designs on requirements for Meaningful Use Stage 3,” the organization said in a statement.

Other organizations, such as the American Medical Association (AMA) and the College of Healthcare Information Management Executives (CHIME), have released their own comments on the election.

Health IT could help with medication adherence, saving billions, study finds

Diana Manos, Senior Editor for Healthcare IT News

PARSIPPANY, NJ – A new global study by the IMS Institute for Healthcare Informatics shows that the use of healthcare IT to increase medication adherence could be a key factor in saving some $500 billion in healthcare spending worldwide.

Murray Aitken, executive director of the IMS Institute says the study shows that policies and practices that govern the use of medication are an essential and under-appreciated piece of the global healthcare puzzle.

[See also: Five ways health IT will reduce the cost of care.]

“Harnessing available information to set priorities, monitor progress and support behavior change among healthcare stakeholders – including policymakers, payers, clinicians, nurses, pharmacists and patients – is a vital first step,” he said.

Aitken said the increasing use of data in healthcare makes this a good time to apply the levers suggested by the study to lower healthcare costs, which are: 

• Increase medicine adherence by addressing patient beliefs and behaviors at the point of prescription and during medicine intake.
• Ensure timely medicine use that prevents avoidable and costly consequences among patients with highly prevalent diseases that increase in severity if diagnosis and treatment are delayed.
• Optimize antibiotic use to turn the tide on rising antimicrobial resistance worldwide due to the misuse and overuse of antibiotics.
• Prevent medication errors throughout the medicine provision pathway, from prescription to administration.
• Use low-cost and safe generic drugs where available to leverage the under-exploited opportunity in post-patent expiry markets.
• Manage polypharmacy where the concurrent use of multiple medicines, particularly among the elderly, risks costly complications and adverse events.

Aitken told Healthcare IT News that the Institute is getting interest in the study from a broad range of stakeholders, including payers, governments, pharmaceutical companies, pharmacists, and medicine wholesalers.

“We are hoping that what we’re doing is triggering a significant amount of renewed discussion in some of these areas,” Aitken said.

“Not all of this is new. Adherence is not new,” he added. What is new, however, is the ability to use data and predictive modeling to find which patients best respond to what type of medication adherence reminders, he said. Some need a visit from a nurse, which is more costly than using a text or a tweet. Predictive modeling can help an organization use resources wisely to get the most adherance from patients.

[See also: 5 ways telemedicine is driving down healthcare costs.]

Calling responsible medicine use an “urgent imperative” for the global health system, the IMS Institute study found that medicine policy is often isolated from other healthcare initiatives in the intensifying efforts to contain costs. Such an approach does not consider the significant impact that improved medicine use can have on overall health system spending.

The study also focuses on two key factors critical to driving improvement across the six levers: multi-stakeholder engagement, and the power of information.

The study can be found here online.

In Sandy's wake, hospitals share stories of success, survival

Erin McCann, Associate Editor | Healthcare IT News

With the support of health information technology, astute preparation by staff and, yes, even some good old-fashion lucked, hospitals and health systems along Hurricane Sandy’s path emerged from the storm relatively unscathed.

Officials at Atlanticare, one of New Jersey’s largest healthcare systems, based in Galloway and Atlantic City, N.J., cite early preparation among IT and safety staff as key to surviving this kind of storm. 

“I had actually been tracking the weather the week prior,” Debra Fox, chief safety office at Atlanticare, tells Healthcare IT News. “Thursday is actually when we initiated our planning and communication to the leadership around beginning to put their operational preparedness plans in place,” she adds. This included topping off generator fuel and ensuring that the facility is able to withstand a loss of power.

[See also: After Sandy, help for healthcare infrastructure.]

Christophere Scanzera, vice president and CIO at Atlanticare adds that IT staff communication and responsiveness across the health system was key to keeping things up-and-running. 

“We have an IT command center that we opened up, staffed with about a dozen people, and basically the responsibility there is to monitor and respond to any system-related outages,” he says. “We had staff in each of the campuses both from a user standpoint and from a technical support standpoint in the event there were any outages that need to be addressed.”

Scanzera says that, due to the diligence of staff, there was no interruption of service in 98 of the 100 sites he is responsible for. In the data center, he mentions there was power outage from Monday into Tuesday, but no interruption of service occurred.
“To only to have had to wait 24 or 48 hours to get the last two [sites] back online, given what you see out there in terms of the devastation, I think we’re very fortunate,” says Scanzera.

Atlanticare’s clinical information system, patient financial management system and all the administrative systems were uninterrupted at all points during the storm, he adds.
When asked about whether or not health information exchange is important in a crisis like this, Scanzera says, “Yes and no.”

“When you’re in the middle of a storm, and you’re treating patients emergently, to have access to the information, yes, would be helpful, but really quite frankly, the focus is on treating the patients and moving them through in that emergent situation,” he says.
Officials at Philadelphia, Pa.-based Einstein Healthcare Network also cite staff preparation as a crucial element to survive the storm.

"On the days leading up to the storm, we took the warnings very seriously," Ken Levitan, vice president and CIO at Einstein Healthcare Network, tells Healthcare IT News. "Through network-wide meetings, employee updates and constant communications with leaders and staff throughout the network, we were able to ensure that clinical staff, and support staff, such as the IT, was available and prepared at each Einstein campus."

"We printed hard copies of our electronic health record and ran reports so clinical information was available in the event of a system outage," Levitan adds. "IT staff also ensured that all of the local 'disaster' workstations were in good working order. We utilize these local workstations during downtimes, planned or unplanned. They provide access to clinical information (EHR and PACS) imaging in a view-only state."

Levitan says none of the Einstein Healthcare Network facilities experienced flooding, and no patients had to be transferred during the storm. Two hospitals, Einstein Medical Center Elkins Park and Einstein Medical Center Montgomery, did lose power, but it "was never disrupted at either facility as it was immediately transferred to their emergency generators," he adds. All of the health IT systems were fully functional during the storm.
Officials at the 431-bed West Islip, N.Y.-based Good Samaritan Hospital hoped for the best but prepared for a worst-case scenario.

The hospital location, situated on the south shore of Long Island, less than a mile from the ocean, gave officials enough reason to worry.

“We are very prone to flooding, so that was a big concern for us,” Theresa Jacobelis, spokesperson for the hospital, told Healthcare IT News.

Before the storm hit, hospital staff evacuated some 60 patients to other Catholic Health Services hospitals. Come 7:00 p.m. Monday evening, the power went out, and flooding was anticipated.  

“As it turned out, we were very fortunate. We didn’t have any flooding issues whatsoever,” adds Jacobelis, who says the water rose to the beginning of the hospital’s rear parking lot.

She also says the fact that the hospital has yet to go live with its electronic medical record system, which is slated to be up-and-running March 9, could very well be a “blessing in disguise.” Hospital officials are accustomed to working with paper records, so there was no transition when they lost power.    

Tuesday morning, the hospital started taking patients back. “We’re still in that restoration mode,” says Jacobelis.

Having survived the storm, Good Samaritan officials are now talking about the possibility of taking in some patients that are being evacuated from New York City Hospitals.