I recently participated in a few panels at the 2016 Becker's CIO/HIT Conference in Chicago and wanted to share a few of my thoughts in regards to these healthcare IT topics and issues. Today I'll cover the Q&A around the topics of EHR Optimization & Patient Portals.
Q: What core aspects of EMRs Are providers spending time and resources optimizing?
Re-establishing formal (as opposed to informal, just in time) training of all providers expected to use EMR systems. Formal plans for periodic training using professional methods are critical to be sure all providers have same basic understanding and competency. This also reduces work-around short cuts, which usually reduce productivity and accuracy in the long run. Also, where response time is an expressed concern, infrastructure evaluation and upgrade to be sure current versions are operating on recommended and needed platforms. Remote hosting options should be evaluated as part of this process. Communication to providers needs to be comprehensive and clear to all providers. It also needs to be timely.
Here’s an example – issues in the EMR that require vendor updates and enhancements need to be clearly communicated with anticipated delivery dates. Temporary work-arounds and pending upgrades, that are approved by the CMOs, CMIOs and IT Steering Committees, should be well understood and discontinued when the updates are in place to resolve the issues.
Providers should be encouraged to participate in dialog, conferences, and/or meetings with vendors so that they have a voice from the field as to issues affecting everyday work.
Q: What is the overall spend on analytics as a portion of overall IT spend? Why is this so important?Spend is still relatively small as compared to licensing of systems, upgrades, etc., but it is growing as we enter the next phase of EMR interoperability and focus on outcomes. The next few years should see a marked increase in analytics spend. Organizations will need to carefully consider options and partnerships to best accomplish the needs of their organizations – i.e. customer development, out of the box solutions, small vendors, large vendors, etc.
Q: Are providers spending a lot of time focusing on meaningful use? How well is this working?Providers have spent much time and funding on meeting MU requirements due to government incentives primarily. As we enter the phase of MU Stage 3, MACRA, etc. with a focus on outcomes and measureable results, everyone is hopeful that meaningful use measures will indeed be meaningful to the practice of medicine. There are many who question the validity of MU measures currently and previously in place.
Q: How much focus is there on cost reduction/revenue cycle optimization?There is significant focus as there has been for years – on cost reductions and strategies for rev cycle optimization. Although interest is strong in this area, many are waiting to see specifically how to transition to alternate reimbursement models, quality, etc., and there are questions on how to keep the lights on while the transition occurs.
Q: How hard is it to find the right talent in IT departments?As healthcare systems increase in complexity – and they have – more and more specialized talent is needed. As mentioned earlier, analytics, data warehousing, and advanced reporting are all requiring specialized skills that a typical small to medium sized facility typically doesn’t have on staff. Outsourcing and resource sharing have been and will continue to need to be more closely adopted.
Q: Are providers generally focused on a single portal strategy, and if not, why not?
Most portal strategies have been directly tied to EMR vendor solutions, which work against the goal of ‘one patient – one record.’ Portal sprawl results where patients need to sign in to several sites causing frustration and lack of utilization.
Q: How much participation are providers generally able to obtain with regard to portal usage?
15-18% is common now. There are a few success stories out there, but the number of success stories is quite limited.
Q: Why is this so low when consumers are demanding access in other sectors?
Patients aren’t seeing the value proposition that they see in other sectors due to the lack of the ‘one patient – one record’ available to consumers.
Q: How can providers make portals more useful?
Combine portal use with health coaching and outcome measurements. Engage the patient in reasons to sign on frequently.
Q: Should providers seek to make unique and innovative portals as a competitive distinguisher? Are providers offering telemedicine through portals?
A stand-alone portal for both ambulatory and acute can work with options such as scheduling and secure provider communications.
Telemedicine through portals is definitely a use that is growing and is generating excitement in the concept. Not highly available now.
Q: What are some of the game changers we can expect in the next 5 years?
Just to name a few:
- Interoperability with EHRs
- Growth of HIEs
- Increased use of telemedicine with patients and between providers. This will especially increase as utilization of acute care continues to give way to ambulatory procedures.