You can see the shift happening. If you visited a hospital or physician practice this year, you may have seen electronic records.
You can sense the shift happening. From physician to CIO conversations, there is a different tone to how patient care is being implemented.
In all of this, there is still an understanding that we have a long way to go in order to achieve a true connected health care system, yet we know the movement is happening. The work is underway by a dedicated, growing team of people – physicians, clinicians, and health IT professionals alike – as they pull it all together.
As I look back on 2011, outlined below are my thoughts on the 6 shifts occurring in health IT.
#1 – Shift to EHR/EMR: According to the Centers for Disease Control (CDC), “57% of office-based physicians used electronic medical record/electronic health record (EMR/EHR) systems.”
If you look at hospitals, the Centers for Medicare & Medicaid Services (CMS) “reported 2,215 eligible hospitals have registered for Medicare and Medicaid EHR incentive programs” (as of Sept. 30, 2011). Both of these stats indicate that HITECH and Meaningful Use are driving a shift to EHR/EMR adoption and use.
#2 – Shift from Paper to Electronic: Each time I walk into a hospital or doctor’s office, I look to see if clipboards and paper are still being used as the predominant way to collect and store information. Although results are mixed, I see signs that the transition is coming.
It is one thing to have the new EHR/EMR in place; it is another thing to see the clipboards disappear. Essentially, it is the difference between co-existence of paper and electronic records and sole electronic usage.
#3 – Shift to More Patient Involvement: Even with Google Health disappearing, patients are beginning to take a more central, engaged role in their health. There are more discussions about how patients can – and should – get involved in their care and be unafraid to have open and honest conversations with their physicians. Additionally, there are many supporting applications for consumers that better equip them to do this. Just check out Health 2.0 for sample companies and the Society for Participatory Medicine for engaging conversations.
#4 – Shift to Connectivity Outside Four Walls: According to eHealth Initiative, Health Information Exchanges (HIE) continue to grow: the “known number of initiatives increased by 9% from 234 in 2010 to 255 in 2011.” The growth of HIEs becoming operational means that hospitals and other providers now must connect into various HIEs and begin the shift to exchange patient data.
Simply stated, many providers were becoming more comfortable with exchanging data within their four walls and, now, they are being asked to extend their reach outside their four walls.
#5 – Shift to New Systems: Many new healthcare applications and systems have been implemented. To support these new systems, health IT infrastructure also is being updated. It is about supporting the data flow and, ultimately, the reporting and analytics.
The unsung shift may be the updated IT infrastructure that is being implemented to support all the new initiatives. A solid IT infrastructure is what will make all the new applications, interoperability requirements, and exchange demands work.
#6 – Shift to Social Media: Physicians, clinicians, and some health IT professionals are actively embracing social media as a way to learn from others, share information, and enhance relationships. It is amazing to see the growth of Twitter and YouTube use by hospitals.
According to Ed Bennett (Source: ebennett.org/hsnl), 575 hospitals have YouTube channels, 1,068 hospitals have Facebook pages, and 814 hospitals have Twitter accounts. Add in the number of physicians, nurses, and others in the healthcare profession and you have a significant shift in communication practices happening in healthcare!
Even with the healthcare shifts, there are a few disappointments, too. For me, there are 3 frustrations.
#1 – Stage 2 Meaningful Use Delayed: In November 2001, the U.S. Department of Health and Human Services (HHS) announced that eligible providers who started participation in the Meaningful Use Stage 1 incentive programs in 2011 can delay meeting the new standards for Meaningful Use Stage 2 to 2014, rather than the original deadline of 2013.
I understand the arguments that more time is needed to implement the workflow, application, and reporting requirements. My take is two-fold: First, HITECH and Meaningful Use is an incentive program, meaning funding is made available to meet higher objectives. Second, the move to digitize patient data needs to happen as quickly as feasibly possible. Momentum cannot be lost in this mission.
#2 – More Push on Patient-Centered Actions: Although there has been much discussion on how patients need to grab control of their health care, the message is not getting through loud-and-clear. There needs to be a national campaign, I believe, sponsored by the application vendors and healthcare trade associations to raise awareness and offer tangible recommendations for patients and physicians.
Much more needs to be done… more voices needed to be added to this essential initiative.
#3 – More Innovation on How to Sustain an Interconnected Patient Data Flow: Although HIEs are growing, I am unsure if this is the right model. It seems that we have just taken an existing and unproven concept and started throwing money at it. Sustainable HIEs are still few, and the right model does not seem to be defined yet.
There needs to be more thought, more innovation on what is the right sustainable model for patient data exchange. Should it be more patient-centered? Should Personal Health Records (PHRs) be in the middle, letting us determine who gets what data? These are the type of questions that need to be asked and driven to innovate on the best way to exchange patient data securely and productively in the future.
Looking ahead to 2012, more shifts, changes, and disappointments will happen. The crucial point is change is happening in healthcare, and health IT is a key part. We need to continue to stand up and do more to drive this vital change. It is necessary for the future of our healthcare system as well as our own personal care. These, indeed, are exciting times in healthcare!
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