- The foundational technologies that make up health IT infrastructure are critical to supporting telehealth, patient engagement, population health management, and value-based care.
According CHIME’s Healthcare’s Most Wired: National Trends 2018 report, the ever growing need to improve healthcare depends on foundational infrastructure technology including integration and interoperability.
“Before provider organizations can achieve outcomes with their strategies for population health management, value-based care, patient engagement, and telehealth, they must first ensure that foundational pieces such as integration, interoperability, security, and disaster recovery are in place,” said the report.
The increasing complexity of introducing new digital tools into a health IT infrastructure makes interoperability and integration a critical priority for provider organization. Disparate IT systems can have trouble communicating which prevents these tools from exchanging the data they need to be effective.
“Beyond improving patient care, interoperability can also help provider organizations achieve outcomes like increased operational and workflow efficiencies,” said report authors. “By investing in robust infrastructures that can support and facilitate communication in the complex healthcare environment, organizations can make better data-driven decisions and achieve greater outcomes.”
The end goal of introducing new technologies into a health IT infrastructure ecosystem is to streamline workflow and give clinicians fast acting tools that don’t need as much human attention. This lets them focus on the patient while still taking advantage of the latest technology.
According to the report, this end goal most organizations have adopted clinical application suites and remote published applications.
“Nearly all participating organizations report that at least 95 percent of their clinicians regularly access clinical information electronically,” the report explained. “This includes medical history, nurse notes, order sets, care plans, diagnostic study results, operative reports, medication reconciliation, discharge instructions, care plans, and clinical summaries.”
“Similarly, almost all physicians can electronically access their organization’s EHR, CPOE, clinical guidelines, medical images, and evidence references while in the hospital or clinic,” report authors continued. “However, only about half of physicians can access these same resources via mobile applications. Adoption of secure messaging also lags behind other remote access functions; both represent opportunities for the industry to advance the current communication infrastructure.”
Integrating medical programs and devices like patient-monitoring tools with EHRs is one of the most critical integration steps. The report found that most organizations send blood glucose, bedside blood pressure, bedside pulse oximetry, and EKG data directly to their EHR.
However, there are still significant gaps in the integration between EHRs and patient monitoring equipment.
“Only 25 percent of participating organizations send data from their IV pumps directly to their EHR, and only 10 percent send data directly from in-bed scales,” said the report. “Furthermore, when tracking hospital-acquired infections, 59 percent integrate this data with their EHR, 33 percent store the data electronically, and 8 percent use manual processes.”
Many organizations also integrate clinical surveillance systems with their EHRs which can help clinicians identify life threatening conditions quickly. Integrating these systems with EHRs can provide real-time communication between the patient and critical care units.
“Meaningful use certification has helped facilitate CCD exchange,” said the report. “Ninety-four percent of participating organizations can consume data in some form from a CCD, and 97 percent can contribute to a CCD. Most of the organizations who report that their EHR can consume discrete data are receiving the data from external hospitals and physician practices. Exchange of discrete data with home health and skilled nursing facilities is lagging.”
Integrating advanced patient monitoring and other tools with EHRs is becoming more critical as organizations continue to expand their health IT infrastructure. Considering what needs to be integrated and developing a strategy around that can help organizations make better use of their tools.