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Early Phase EHR Adopters Focus on Health IT Infrastructure

Healthcare organizations in the early phase of EHR adoption are focused primarily on health IT infrastructure, such as interoperability and data security, according to a roundtable of 31 high-level healthcare executives.

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Source: Getty Images

By Fred Donovan

- Healthcare organizations in the early phase of EHR adoption are focused primarily on health IT infrastructure, such as interoperability and data security, according to a roundtable of 31 high-level healthcare executives.

The roundtable was sponsored by LexisNexis Risk Solutions in collaboration with the College of Healthcare Information Management Executives (CHIME).

Participants said that healthcare interoperability is an “ongoing challenge,” as organizations look to exchange health data within their systems and externally with data partners. Interoperability is about data exchange, data consumption, and meaningful use of data.

“You can have all the connectivity you want, but if you’re not able to deliver that information into the clinical workflow of those who would use it, then you shouldn’t even bother,” said one roundtable participant.

Participants said they were using one-time passwords, biometrics screening, and knowledge-based authentication as part of a multi-layered strategy to beef up their data security.

Healthcare executives are less concerned about checking compliance boxes and more concerned about earning and retaining patient trust, they noted. This is done by keeping health records secure, maintaining accurate and complete records, and providing a personalized healthcare experience.

Providers are the custodians of patient data, and securing that data is important regardless of whether HIPAA requires them to do it, the roundtable participants agreed.

“You lose the patient’s confidence in your ability to deliver healthcare. Patients will go somewhere else because they don’t trust that you can take care of their data,” one participant said.

Organizations heading into phase two of their EHR implementation are more concerned about data governance and patient and provider directories, the roundtable judged.

In terms of data governance, ensuring medical records are current, complete, and accurate is an important concern for organizations. Siloed approaches to data governance don’t work. Healthcare executives are focused on an enterprise-wide effort that includes input from health information management and quality assurance.

For participants, managing patient directories is a difficult task, particularly if they are going through mergers and acquisitions. Many favored having a national patient identifier, which they said would support interoperability across the healthcare ecosystem, but some doubted this would happen. Accurate provider directories should be maintained in order to support referrals and coordination of care, the participants stressed.

Organizations that are in phase three of their EHR implementation are worried about data analytics and patient engagement. The ability to mine data and partner with clinical operations is important in an era of value-based care, the participants observed.

“We’re working diligently to ensure we provide the highest quality care at the lowest cost,” one participant said.

Part of this effort is to set accurate risk adjustment targets and analyze data for patient encounters across the entire continuum of care. Unfortunately, there can be gaps between the data the health plan uses to set targets compared with claims data that the hospital submits.

Data quality and integrity are ongoing issues for organizations. “As we’re on this data analytics journey, we find that the data integrity is one of the biggest limiting factors and challenges in getting good, accurate insights,” said one participant.

Patient engagement is becoming a more important concern in the new era of healthcare consumerism, participants agreed.  

Healthcare executives are striving to personalize the healthcare experience for patients. They seek to provide the patient with the ability to communicate with providers on multiple platforms, including email, phone, mobile app, texting, and websites. This communication needs to be interactive, not generic.

They also predicted that the era is coming of patient-owned medical records available in a universal format where patients decide who accesses their data. Some were concerned that patients would not be able to manage their health data, while others thought the patients would be up to the task.

“Protecting, sharing and ensuring the accuracy of patient health information in the EHR is about doing what’s right for patients—not just complying with a regulation. When organizations take this approach, they gain patient trust and loyalty,” the report concluded.

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