Medicine is a science, but the actual practice of medicine across the care continuum is often less consistent and less quantifiable than patients and practitioners would like or expect. Some of this is because treating people is more complex than a standardized production process such as manufacturing or repairing a car. But much of the variance in treatment is because the delivery of healthcare is managed on an ad-hoc and manual basis, even as discrete steps in the process are automated. The result is reduced visibility and ongoing difficulty in measuring both individual patient outcomes and improvements in population health.
A tremendous amount of time and money has been spent automating individual steps in the healthcare delivery process, including not only Electronic Medical Records (EMR) systems, but also scheduling systems, billing systems, and even patient portals. In most cases, multiple software products have been deployed in a single hospital, practice or surgery center, each automating one or more of a provider’s previously manual processes. However, the automation of separate silos leaves process gaps between the different software systems, gaps which are typically bridged using people and paper.
Morris Panner, Chief Executive Officer, Ambra Health
When President Obama signed the 21st Century Cures Act (HR 34) into law in December, the world of healthcare IT was turned on its ear. Interoperability and access – two concepts that have eluded old-school healthcare IT vendors – became enshrined as the cornerstone of the newest and most comprehensive healthcare innovation legislation to date.
In addition, although the Act didn’t intend to push healthcare IT into the cloud age, it may very well have, as the required access and sharing will be exceedingly difficult to accomplish without an agile cloud-based system. Like the financial services industry and others before it, the cloud may become a key driver of how information can be easily shared and consumers can be empowered.
Some leading edge vendors and institutions were already making waves by breaking down data barriers both within and across facilities that have previously impeded the creation of a holistic patient health record. The holistic patient health record not only reduces risks of medical errors and dangers such as radiology overexposure, but it can also provides a goldmine for medical research across shared and readily accessible data.
Mark Weber, Senior Vice President, Healthcare Development, Infor
Well, the election results are in with significant changes proposed with respect to the Affordable Care Act. While what ultimately gets implemented in law will unfold over time, the desire to reign in the cost of healthcare is shared by both major political parties. As big as they may be, these will be changes in means not the goal. It is not as if the new administration is trying to figure out how to increase the cost of care!
Working against the goal of lowering the total cost of care is the fact that the total volume of care is increasing. People are living longer, with more chronic disease, and there are an increasing number and sophistication of treatments available. The demographics of the baby-boom generation is driving a significant increase in Medicare enrollment.
As such, the macro trends in provider healthcare continue. Some will accelerate, some will adjust, but providers are being forced to adapt to an overall decrease in spend (i.e., lower revenues) through changes in how care gets paid for, how much is being paid, where it is delivered, and who pays. This creates big opportunities for some, and a diminished role for others.
Iatric Systems, a healthcare technology company dedicated to helping healthcare organizations enhance their IT investments, and Hospira, a Pfizer Company and leading provider of infusion technologies, today announced a formal partnership to develop interoperability between Hospira’s smart infusion devices and Iatric Systems Accelero Connect integration software solution. Hospira and Iatric Systems have signed a development agreement and are currently piloting smart pump-EMR interoperability (a/k/a IV-EMR interoperability) at an undisclosed U.S. hospital.
The smart pump-EMR interoperability between Hospira and Iatric Systems provides two-way communication that enables automation of pump programming with the validated EMR medication order, as well as documentation of medication administration data back into the patient’s electronic medical record.
“Hospira is proud to partner with Iatric Systems to make IV-EMR interoperability available to the hundreds of hospitals where Iatric Systems performs integration,” said Julie Sawyer-Montgomery, president, Hospira Infusion Systems. “After already becoming the first smart pump vendor to successfully integrate with three major EMR platforms, we are excited to add another major EMR system to the list once this pilot site goes live.”
Cerner, a global leader in health care technology, and Hospira, a Pfizer company and leading provider of infusion technologies, today announced that Sheridan Memorial Hospital in Sheridan, Wyoming, is the first hospital to integrate Cerner’s CareAware Event Management secondary alerting solution with Hospira infusion system Alarm Forwarding technology. CareAware Event Management is designed to route alerts from medical devices or nurse call systems to a clinician’s mobile device.
With this implementation, Sheridan expanded its infusion alarm management functionality. Within the hospital, clinicians can receive alarm information from Hospira’s Plum A+ infusion system through CareAware Event Management. The new technology also provides a system to escalate alerts among clinicians when assistance is needed or a primary caregiver is not available.
“Maintaining our position as one of the most advanced intensive care units in the area is a top priority,” said Charlotte Mather, chief nursing officer, Sheridan Memorial Hospital. “This technology helps our caregivers stay connected and flag issues to the right person at the right time.”
Cognosante,electronic health record,Health Information Exchange,HIEs,interoperability,MARCA,Medicaid,Medicare,Medicare Access and CHIP Reauthorization Act,Office of the National Coordinator for Health IT,ONC,quality payment program,SIM,State Innovation Model
Megan Renfrew, Director of Health Policy and Regulatory Affairs and Policy Team Lead, Cognosante
Sunaina Menawat, Director of Business Development for State Solutions, Cognosante
Throughout the healthcare system, payers are shifting away from payment models that incentivize volume of services to models that incentivize quality, outcomes, and savings. Efforts to transform healthcare through value-based payment reform can be seen in state Medicaid managed care contracts that incentivize outcomes, delivery system reform efforts under Medicaid demonstration projects, State Innovation Model (SIM) efforts that seek to implement reforms across public and commercial markets, and Medicare’s new quality payment program established by the Medicare Access and CHIP Reauthorization Act (MACRA).
The ability to exchange health information is foundational to these efforts. For value-based reform to be effective, all parties must be able to access relevant, useable, and timely data. Policy makers need clinical and claims data to identify areas for improvement, and providers and payers need data to understand their performance relative to peers and competitors. All stakeholders need access to data to evaluate progress towards defined goals, a common one being a reduction in hospital readmissions.
Availity, the nation’s largest real-time health information network, announced that it will be using the HL7 FHIR standard for sharing critical data between payers and providers, including patient eligibility and benefits, lab tests, diagnoses, medical attachments, ADT, and other healthcare information.
Availity is currently implementing a FHIR solution for both solicited and unsolicited medical attachments. This enables providers to send supporting documentation in a patient’s file to a health plan without a specific request, saving the provider and the plans both time and money.
Availity is also developing a FHIR solution for member lookups. A provider could use this to determine coverage, pull patient demographic information such as address, date of birth, and gender—allowing providers to view information in real-time and saving front-office staff from lengthy patient eligibility processes.
“Availity has always been at the forefront of supporting industry standards that drive efficiencies and interoperability and reduce costs and administrative burdens for our customers,” said Russ Thomas, CEO of Availity. “FHIR enables our partners and clients to securely and easily exchange well-defined information. We believe that this standardization is essential to the shift to value-based models of care, where payers and providers are seeking secure ways to better communicate and exchange information.”
Liora Guy-David, Ph.D., Vice President of Data, medCPU
As long as the healthcare industry lacks true interoperability among dissimilar systems, clinicians will have incomplete patient information at the point of care. This includes gaps over time, as when a clinician is unaware of imaging tests already completed, and gaps across care team members who record documentation in separate systems. Both types of gaps can compromise patient safety.
While we don’t typically think of gap-closing as being a primary clinical decision support (CDS) function, CDS systems do exactly that. Its success in informing decisions depends largely on the ability to analyze information from multiple systems, closing gaps in real-time. As a result, CDS is emerging as an essential tool for improving quality of care.
Decision-making support built with a more complete view of the patient
CDS systems run on top of EMRs, analyzing documentation as it is being entered and issuing alerts in EMR windows when conditions indicate the possibility of a medical error or compromised patient safety. This is often a matter of giving clinicians information of which they were unaware.
To fully inform alerts, advanced CDS systems supplement the structured data in EMRs and pull information retrieved from other systems such as those in labs and imaging departments. CDS leverages its comprehensive patient view by applying rules-based analysis regarding diagnoses and courses of care. By augmenting a physicians’ expertise with real-time information retrieval and gap-closing, CDS systems play a key role in promoting patient safety.
Vocera Communications, a leading healthcare communications company, today announced that it has acquired Extension Healthcare for approximately $55 million in an all-cash transaction. Based in Fort Wayne, Ind., Extension Healthcare is a leading provider of clinical, event-driven communication and workflow collaboration software for the hospital environment.
The strengths of the two companies and their solutions will deepen interoperability of the Vocera Communication Platform with more than 120 clinical systems, including electronic health records (EHRs), physiologic monitors, enterprise clinical systems, and biomed devices such as ventilators. It will also extend the scalability of the enterprise-class platform and enable stronger person-to-person and system-to-person workflows within a single system from a single vendor. The addition of Extension Healthcare’s complementary software to the Vocera Communication Platform creates the most powerful and complete mobile communication and collaboration platform on the market.
“This acquisition extends the power of Vocera’s software platform for hospitals and health systems seeking one partner for all of their care team collaboration, workflow and communication needs,” said Brent Lang, president and CEO of Vocera. “In addition to offering a powerful combination of technology, Vocera and Extension Healthcare share a mission to improve care delivery, efficiency and safety, while also improving the lives of patients, families and care teams around the world.”
As Halloween approaches, the usual spate of horror movies will intrigue audiences across the US, replete with slashers named Jason or Freddie running amuck in the corridors of all too easily accessible hospitals. They grab a hospital gown and the zombies fit right in. While this is just a movie you can turn off, the real horror of patient data theft can follow you.
(I know how terrible this type of crime can be. I myself have been the victim of a data theft by hackers who stole my deceased father’s medical files, running up more than $300,000 in false charges. I am still disputing on-going bills that have been accruing for the last 15 years.)
Unfortunately, this horror movie scenario is similar to how data thefts often occur at medical facilities. In 2015, the healthcare industry was one of the top three hardest hit industries with serious data breaches and major attacks, along with government and manufacturers. Packed with a wealth of exploitable information such as credit card data, email addresses, Social Security numbers, employment information and medical history records, much of which will remain valid for years, if not decades and fetch a high price on the black market.
