Most experts would agree that healthcare in the United States is too expensive. Furthermore, there is a fairly strong consensus that the cost problem in the sector is not created by the simple fact that care is expensive, but instead by the amount of waste that is happening in the industry. Bi-directional system integration is emerging as a key tool to improve operational efficiency in healthcare, creating a more sustainable fiscal model moving forward.

Excess testing is one of the most commonly cited problems in the healthcare industry, as the lack of data sharing between clinics, physician offices and hospitals makes it difficult for various medical professionals to fully understand what procedures a patient has undergone and the results of those tests. It is not uncommon for a patient evaluation performed by a local physician to be repeated by a specialist in a hospital because, even if that doctor knows the patient has had the test, he or she likely does not have complete access to the results. This issue also extends into prescription writing and medication orders, as the lack of collaboration makes it difficult for doctors in diverse care settings to work together when working with a single patient throughout the treatment cycle.

Between extra tests, problems with orders and results, pharmacy-related troubles and other challenges that stem from poor data sharing, it is clear that the need to support collaboration is becoming essential in healthcare. The urgency of this move is especially evident in the Stage 2 meaningful use standards, which heavily emphasize going beyond basic EHR deployment and uni-directional integration and are now pushing hospitals, physician offices and clinics toward increased establishment of bi-directional integration solutions.

The financial implications of bi-directional integration go well beyond reducing waste. Each time a healthcare facility establishes a need to exchange data they subsequently have to invest in the HL7 interface, work with the vendor(s) and establish the necessary workflow to be successful.  Bi-directional data exchanges presents even greater challenges around registration and order management and the need to match patients and orders between systems. As a result, healthcare networks are filled with valuable, but technically disparate interfaces that are not inherently designed to communicate with each other. Interface engine technology is vital to getting the most out of these investments, as it allows the organizations the ability to leverage their interface investments and reuse these connections points to route the information.  This technology is a crucial piece to the interoperability puzzle and is imperative that organizations invest as part of their integration strategy.  

Tackling bi-directional physician office integration doesn’t have to be so hard.  How are you handling your data exchange today?

The rapid rise of EHR systems in the healthcare industry has created a major shift in how organizations need to establish their business continuity plans. Essentially, hospitals need to shift from an extremely industry-specific strategy to one that incorporates all of the traditional healthcare practices with typical enterprise-class continuity strategies that can help ensure IT systems are kept running in the event of a disaster.

According to a recent Worcester Business Journal report, organizations working to implement new business continuity strategies cannot look at the process as risk aversion or a simple backup policy to protect data. Instead, business continuity needs to be approached as a process aimed at resuming operations as quickly as possible in the event of a disaster so the company can stay afloat when an outage occurs.

The first step in planning for a disaster is to consider the worst-case scenario. Unusual weather conditions, for example, can knock out a company's systems and put it in a difficult position as it tries to recover from the incident. Therefore, it is essential to not only plan for the kind of issues that are common, but also for the unexpected. Furthermore, organizations need to put systems in place to deal with IT outages as well, as failure on the part of the network or other technological system can be extremely damaging if not handled effectively.

Companies also have to evaluate who will be involved in any business continuity strategy. According to the report, the answer should be just about everybody. Each department within the organization needs to be part of any continuity planning processes because each part of the organization will likely play a role in recovery or have systems affected by a disaster. It is also important that multiple users in each department are able to run the continuity plan effectively to ensure that somebody is available to complete the process.

When it comes to hospital-specific continuity programs, having technology and a downtime plan in place that are capable of operating in the event of an outage is critical. When disaster strikes, hospitals are usually at their busiest. Because of this, physicians need to have access to critical patient data, regardless of whether the primary power source, network or even EHR systems are available. A business continuity solution that can maintain key data availability under such circumstances is essential for hospitals. 

The Summit Downtime Reporting System can address your immediate need to access your critical patient data in even the most stressful times.  What's your organization's downtime plan for data accessibility?

Just a few years ago, HIE systems were akin to the Holy Grail of the EHR landscape, an ideal resolution to the quest for improved data sharing that appeared out of reach but was still the overarching goal of most providers. With the rapid rise of EHR infrastructure, led by government incentives that have enabled innovation, and the recent release of Stage 2 meaningful use standards, HIEs no longer look so unreachable and are emerging as more common data sharing solutions.

Now that HIEs are more accessible, the number of healthcare networks establishing new HIE infrastructure or joining existing systems is rising. This is leading to a fresh wave of innovation in the sector that could rival the initial rise of EHRs when it comes to the overall improvement to patient care. However, leveraging HIE technology to dramatically improve doctor-patient interaction is dependent on intelligent healthcare system integration that overcomes the inherent challenges in HIE setups.

The core problem with HIEs is ensuring that data is kept accurate across diverse EHR systems.  Essentially, a Meditech EHR that handles patient data at a large hospital needs to communicate with another facility's Siemens HCIS, and vice versa. To accomplish this, healthcare organizations need to have flexible integration technology to support the different data transmission and receiving needs.  While HL7 transmission protocols have standards, in order to ensure systems can communicate effectively with each other, data will need to be manipulated to meet the needs of the receiving systems. Flexible and robust interface engine technology will be essential to ensuring hospitals have the control at their fingertips to connect all their systems effectively and streamline sharing of patient data.   

During the past few years, many medical providers have moved from the initial establishment of EHR infrastructure to deploying integration solutions that allow diverse EHRs to communication. This has not only led to more communication between hospitals, clinics and physician offices, but has also established a firm foundation for more HIE deployment. The industry is now witnessing the results of that solid core as more providers have the tools they need to make advances in HIE infrastructure.
 

When hospitals and medical providers  invest in new EHR and HIE infrastructure, they need those systems to work well together. An improved data gathering, storage and management system will help operations, but not revolutionize them in the same way that a platform that fosters information sharing and collaboration can. Because of this, interoperability and healthcare system integration are emerging as critical needs in the sector.

This trend is evidenced in a recent study from the Optum Institute, which found that healthcare CIOs are dealing with excessive financial burdens and operational challenges because they are having a hard time developing compatible EHR setups, Healthcare Informatics reported.

The study found that community healthcare providers have made significant progress in establishing EHRs that meet meaningful use requirements. They are also having success in advancing health IT in general and supporting innovation within the sector. This has led to many hospital CIOs recognizing the value of interoperability between their hospital and the community healthcare providers. Interoperability between physician EHR systems and hospital is emerging as one of the more important areas for growth in the medical sector. The study found that most HIE users have access to data from just 60 percent of patients within the infrastructure, making it difficult to streamline operations. This is making interoperability a critical procedural requirement, as poor compatibility between EHR systems detracts from patient care and the business side of the healthcare equation.

While interoperability is proving troublesome for many healthcare organizations, the study did reveal that significant progress is being made when it comes to IT innovation. . Approximately 87 percent of respondents are actively using EHRs, a clear indication that the technology is truly taking hold in the sector. Furthermore, 70 percent of those polled said they have achieved meaningful use level one and 75 percent expect to reach level two by 2014.

Integration is key to taking EHRs from the stage of being a useful tool and making them a revolutionary technology. When patient data is automatically updated and shared between various healthcare entities,  physicians can easily gain access to the information they need to provide optimal care and be assured that all of the content is accurate and up to date. Without such measures, EHRs are often limited in actual use.

A recent survey of health IT leaders at the HIMSS 2012 conference found that achieving Meaningful Use for EHR setups is the top priority when it comes to employing new information technology systems in the sector, Healthcare Informatics reported.

While the largest percentage of respondents cited achieving meaningful use as their top priority, the number of organizations striving for this goal declined slightly from last year. Approximately 38 percent of those polled said they consider meaningful use as their primary focus for health IT innovation. Last year, more than half of survey participants named meaningful use their most important focus. However, the news source said this could be indicative that more organizations have made major progress toward meaningful use and are moving on to other areas.

Focusing on clinical systems was revealed as the No. 2 priority among medical providers, with 15 percent of respondents identifying this area as their chief focus. Furthermore, 13 percent of respondents pointed to either data warehousing, clinical decision support and evidence-based medicine as their primary areas of emphasis.

The survey also revealed that financial issues are not holding back the sector. The study found that for the first time in years, money is not considered the main barrier to healthcare IT adoption. This indicates that federal grants may be helping fuel innovation and at least validates that many healthcare providers are dedicating enough resources to support technological growth.

Instead of financial limitation, the study found that staffing resources are now the greatest barrier to innovation in the sector. Approximately 22 percent of respondents explained that finding staff with the right training to implement IT systems is the greatest challenge they face. Financial barriers came in second, with 14 percent of respondents saying a lack of resources is limiting technological growth.

As more healthcare providers advance their EHR systems and other IT investments, it is essential that they find ways to integrate their healthcare systems to enable data sharing and similar advanced capabilities. As physicians depend more heavily on EHRs, automatically updating data between systems is essential to limiting errors and ensuring doctors can always get access to the information they need.

Healthcare solutions that streamline operations and make life substantially easier for physicians are rapidly becoming more prevalent in the sector. However, these advances will all come to nothing if the patients are unable to recognize how EHRs improve their care. The medical industry is recognizing this and patients are responding. According to a recent study from the National Partnership for Women and Families, consumers are becoming increasingly aware of EHRs and are beginning to trust the new health IT tools.

Most of the respondents to the survey said they are beginning to accept that EHRs and other similar solutions will improve how doctors manage their care, even though they are still somewhat concerned about data privacy. While this worry is valid, respondents clearly see the potential gains of EHRs as greater than the risks.

The key difference is that the respondents are seeing their physicians use EHR systems. The study found that respondents whose doctors actually use EHR solutions are more positive about the technology's potential. Furthermore, even those whose physicians are still using paper records tend to see the advantages of EHRs. This has become so prevalent that approximately 75 percent of patients whose doctors depend on paper say their care would likely be improved if their physician turned to an EHR.

Christine Bechtel, vice president at the National Partnership, explained that the growing consumer support of EHRs is critical, as patients will likely drive the technology forward and ensure continued political efforts to drive innovation. "For health IT to deliver on its promise, consumers must support it. If they don't, we will see political pressure for repeal and the promise will be squandered. What we found is encouraging, but there are still potential landmines ahead," said Bechtel.

Farzad Mostashari, national coordinator for health IT at the U.S. Department of Health and Human Services, echoed this sentiment, pointing out that patients are often put on the back burner when technology becomes the focus, even though the innovation is designed to improve the patient experience.  For medical providers working to optimize EHRs for patient needs, healthcare system integration is emerging as a key technology. Integration allows organizations to connect their EHR platforms and automate data updates and other similar processes. This keeps all physicians within the care spectrum up to date and ready to meet the needs of patients.

Considering the rapid rise of EHR systems, the push to achieve meaningful use and the growing importance of HIEs within this sphere, healthcare system integration is emerging as a key need in the health sector. With the HIMSS12 Conference next week, the use of innovative healthcare solutions is undoubtedly on the mind of many healthcare practitioners.

As more medical facilities make the move to EHRs, many experts agree 2012 will see most organizations striving for meaningful use and working to deploy HIE systems in an effort to improve collaboration throughout the sector. Success in these areas will require creative deployment strategies, IT leadership and a focus on integrating information between different aspects of the EHR solution.

Enabling providers to effectively share medical information between emergency care EHRs and insurance and payment records systems is just one of the critical functions of information integration.

Topics of this nature will be a major priority at HIMSS12, with the event focusing on the motto "Linking people, potential and progress." Within the conference itself, this means that visitors will be able to interact with leaders in the healthcare IT industry and see first hand how different medical providers have implemented advanced technologies and integrated them to support information-sharing initiatives that are becoming so critical in the sector.

The catchphrase also describes the overarching trends in the healthcare industry, establishing the event as a microcosm of the sector as a whole. Progress is becoming the keyword of the healthcare sector. Years of inefficient operational models bred stagnation and created an industry that was built around insurance and billing, not patient care. Government initiatives are working to curb this trend, pushing for progress that will create potential in the industry.

The rapid pace of healthcare IT's evolution has established the sector's potential. Now that the foundation is in place, it is time for the sector to move on to integrating EHR infrastructure and developing policies that support meaningful use and HIE expansion. These measures could take healthcare from the goal of progress to the point where it reaches its full potential and brings the focus back to the people. Integration is an essential link between patients and the care that medical providers can offer them.

With its focus on progress, potential and people, HIMSS12 is poised to give medical providers the tools and knowledge they need to enable healthcare information integration and collaboration in such a way that they can better meet meaningful use standards and improve HIE infrastructure.

With a new year comes a fresh start and as 2012 creeps closer, it’s time to think about new IT approaches. Whether government mandated reform or non-required initiatives, certain IT practices will significantly help to streamline workflows, save money and improve overall patient care in the new year.

There is no question that meaningful use (MU) compliance should be one, if not the, top health IT priority in the new year. Along the same line, health information exchange (HIE) offers tremendous potential for the future, and is increasingly viewed as an essential step in improving the quality, safety and efficiency problems that plague U.S. healthcare delivery.

HIE interoperability is also key as it relates to meaningful use objectives like electronic exchange of clinical information and summaries of care, along with submitting lab results to public health agencies, etc. And while the full details of Stage 2 Meaningful Use are still emerging, it’s expected that data exchange requirements will be among the amped up mandates. Healthcare providers need to be prepared, especially providers within the MEDITECH community who find HIE connectivity particularly challenging.  

For MEDITECH organizations working to embrace meaningful use, HIE initiatives such as the process of updating and feeding data to its healthcare information system and exchanging data bi-directionally with physician offices can be especially difficult. These organizations need automated, scalable integration technology to bridge their healthcare systems and an expert interoperability partner to manage the process.  Building an integration landscape to store and manage more data and to have the ability to extract the data more rapidly will allow hospitals to participate more easily and quickly when MU standards are finalized.

For instance, Beaufort Memorial Hospital, a 197-bed acute care hospital in Beaufort, SC, is using Summit Express Connect to help report immunizations to public health agencies and exchange data directionally with physician offices. The engine enabled Beaufort to reduce its number of interfaces needed to develop or deploy to have data exchanged between its various applications, the EHRs and other electronic ordering systems used by doctors in the Beaufort community. Furthermore, building an interoperability environment to manage more data to meet the Stage 1 Meaningful Use criteria, Beaufort will have the basic infrastructure in place for health information exchange, which by design will enable the hospital to qualify for the more complex HIE requirements that are expected for Stage 2.

Beaufort Memorial is a great example of how health IT initiatives like MU and HIE go hand in hand and how strategically meeting meaningful use guidelines can be achieved by implementing an HIE.

What IT practices will your healthcare organization take on in the New Year?

Achieving meaningful use in MEDITECH HIT environments brings some special challenges – technical, financial and cultural.  While overcoming these challenges requires a lot of hard work, focus and specific expertise, organizations that take a smart approach to meaningful use (and other major initiatives like 6.0 migration, HIERHIO connectivity, and provider office integration) can not only achieve success for the immediate goal, but can also set the stage for long term benefits including significant cost savings and streamlined integration projects going forward.

Technically, the MEDITECH platform presents a number of challenges for organizations seeking to implement an EHR and demonstrate meaningful use.  Most of these boil down to the difficulty and expense associated with establishing one- or two-way data sharing among MEDITECH, the EHR and the other clinical and financial systems in the organization that need to be integrated to achieve meaningful use. 

The financial challenge – above and beyond the time and expense associated with implementing integrations among systems – is that organizations must purchase each MEDITECH interface with another system and pay annual maintenance fees.  Those incentive payments are nice, but between the EHR itself and all of the interface costs alone, no one is making a profit on meaningful use.

The good news is that interface engine solutions that replace many point-to-point integrations with a single one-to-many connection can eliminate those interface fees, save a lot of time and effort in integration work and ongoing management, and make every future integration initiative a much more time- and cost-effective proposition.

We have worked with many organizations – see our case study from Olympic Medical Center – to save big bucks on interface costs while streamlining integration efforts with Summit Express Connect.  Do you have an interface engine success story?  We would love hear it. 

Crawl before you can walk, walk before you can run...we all are very familiar with the concept.  But how many individuals that you know leap into huge automation and integration projects without knowing the why behind the how?  If you don’t clearly understand the ‘why’ of a project, knowing the ‘what’, ‘when’ and ‘how’ is harder than you think! 

Enter in Scripting… scripting is the jack of all trades.  Motto in the Summit halls “if you can type it, you can script it!”  Scripting is typically categorized in three flavors:  Batch, Real-Time, and Interactive.  Batch scripts are the big time savers allowing you to connect to a datasource (i.e. spreadsheet) and enter in buckets of data in minutes with no human transcription errors!  Talk about efficiency.

Back to the original question though – how many times has your organization been faced with the situation where you need to connect to a disparate 3^rd party system and interfacing is just simply not possible or cost prohibited? Or perhaps your desired interface is needed immediately but the timelines delivered by your HCIS or 3^rd party vendor just don’t jive?

Again enter in scripting!  A scripted interface (Real-Time) is quick to deploy and can achieve a near real-time data exchange as well as provide a means to map or cross-walk data between systems. Some examples include Blood Bank interfaces, glucose interfaces, point of care devices, streamlined registration or remote office connectivity.  The possibilities are endless!  We have clients currently integrating clinical patient centric data between their 3^rd party ED systems and MEDITECH with scripting playing a key role. Talk about cost savings, ease of use and contributing to the goal of a comprehensive patient EMR.

Last use case worth mentioning because I don’t know about you but time is precious these days… Ever consider interactive scripting?  Let the script act as a FTE.  Examples include patient registration kiosks and real-time eligibility/ insurance verifications.

Finally, a few words of wisdom to impart; Set the standard high on what automation technology you are going to invest in.  You want a reliable and scalable solution to handle any of the flavors above including a technology platform that is interchangeable no matter what HCIS or HCIS version you are running. 

Ready to accomplish more with less?