Future Trends in the Evolution of E-Health

Ehealth also written as e-health is a term for healthcare practice which is supported by electronic processes and communication. It can also be defined as electronic or digital data for the patients used by the physicians. E-health assures the support for health behavior changes and enables preventing and managing the chronic diseases.

When analyzing the e-health future some of the people say that it will adopt rapid changes. Others do not agree with the statement because they believe that not all the citizens are used to the idea of paying for the supply of medical information. Another reason for reluctance is suspicion that technologies used in e-health systems are not accessible and user friendly. The issue of data privacy is also a major hindrance for e-health future. In other words they think e-health technology is so complex that it will not be recommended in the future.

Besides different opinions the vision of paperless hospitals is still rising for the better quality of healthcare. The use of Electronic Medical Records (EMR) and Electronic Health Records (EHR) is significantly increasing. Electronic data is supposed to be the essential parts of the healthcare centers.

In future the need is to build thorough legal framework to keep the electronic data secure. To fully implement the e-health technology it is desirable to reduce the discrepancies among population. Another future trend which is most reasonable for e-health is that it will be able to monitor and treat the chronic diseases, thus justifying the workload of the medical centers and reducing the constant travelling for hospitals and medical centers.

Evolution of e-health in today's world

Interoperability – Essential for EHR Societal Benefits

“Interoperability is one of the fundamental constituents required to derive societal benefits from Healthcare IT”

Interoperability is a major outcome that healthcare professionals are expecting from every healthcare IT product. What does interoperability mean?  We can state interoperability as a connected healthcare system. It connects healthcare system in a way to make real-time patient data available to every medical practice anywhere. For instance, if Mrs. Johnson moves from Florida to California, her new provider does not need to worry about whether she is allergic to antibiotics and what is her medication history. He does not need to carry out her laboratory tests again. All the information will be available to him online via EHR to EHR link. This is interoperability, and this is what we want to achieve in long-run via different healthcare IT products.

Janice Walker, a healthcare IT researcher, along with her colleagues wrote a paper “The Value of Health Care Information Exchange and Interoperability”. In the paper, she has discussed how interoperability can transform the health industry and produce impressive societal benefits. According to her, seventy-seven billion dollars can be saved from healthcare information exchange and interoperability.  Some of the benefits of interoperability she discussed are:

• With interoperable healthcare system, providers always have instant access to required information at the point of care
• It gives convenience and choice to patients to visit any medical practice or provider
• It gives better and valid data for medical research
• It reduces medical errors, improves patient care, and reduces costs

Electronic Health Records have various features that aid interoperability. EHR features such as e-prescription, redundant test reminders, lab connectivity and drug interaction checks, etc. have contributed significantly in creating interoperable healthcare system. There is still much to do for healthcare IT companies in order to have a complete interoperable system for realizing societal benefits of healthcare IT.

Fig. Interoperability – Essential for EHR Societal Benefits

Meaningful Use of EHR

Electronic Health Record (EHR) is a comprehensive and computerized healthcare record management system. The main objective of Electronic Health Record (EHR) software is to electronically collect health information, as all information is recorded digitally. Electronic Health Record (EHR) include various types of information such as demographics of a particular area, medical history of patients, lab test results, patients statistics like weight, age, medical record, insurance details etc.

The Medicare and Medicaid EHR provide incentive payments to professionals to implement, upgrade and demonstrate meaningful use of certified EHR technology. Meaningful Use is the term to describe the specific set of benchmarks that an eligible provider or hospital needs to meet to be able to qualify for the incentive program. Meaningful Use is a multi-year, staged approach that outlines specific requirements and threshold which will raise the bar over time.

Meaningful Use is measured in stages and each stage represents a level of adoption.There are two main components to receiving incentives:

• Using a certified EHR
• Demonstrating meaningful use of EHR

Over the course of the next five years (2011-2015) the criteria for meaningful use will be divided into three stages:

Stage 1 (Years 2011-2012)

Stage 2 (2013-2014 tentatively)

Stage 3 (2015 tentatively)

The criteria will grow more severe in the later stages.

Here is a summary of the three meaningful use stages: 

·         Stage One: 

      The first stage is simply a question of quantity; the CMS wants doctors and hospitals to report how often the EHRs are being utilized, in terms of a percentage of patients.

·         Stage Two: 

      The second stage requires doctors to begin using the data contained in the EHRs when they diagnose and treat patients.

·         Stage Three: 

      The most important stage is the third, in which the CMS expects to give patients tools for self-management, and get caregivers to use the EHRs to identify when trends become national concerns, and improve overall population health.

There is no doubt that the Meaningful Use program has energized the health care industry, hopefully this energy will result in the innovation necessary to improve our healthcare delivery system. 

Health Information Exchange – A Glimpse of Future Health Technology

Health information exchange (HIE) refers to confidential and secure information sharing among healthcare institutions. The HIEs are governed by Health Information Organizations (HIOs) which are in quest to create a standardized model that ensure HIE’s confidentiality and security. Like EHR, Healthcare information exchange will evolve over time before it gets its final form. It may not ever get its final form as healthcare technology is ever evolving. Further advancements will keep on adding features to the standardized healthcare information exchange model. One may say that the final model of HIE will be all the way patient centric, reliable, scalable, and sustainable.

In an article “The value of health care information exchange and interoperability”, Walker J and colleagues discussed the value of HIEs between providers and independent laboratories and public health departments. Through a cost benefit model, they empirically proved net value of dollar 77.8 billion per year upon implementation of standardized HIEs. The non-standardized HIEs also proved to offer positive monetary benefits. HIEs implementation is a compelling and beneficial project that should be pursued to reform healthcare industry.

Fig. Health Information Exchange - Connectivity, Integration & Interoperability

Reference:

http://www.ahima.org/resources/hie.aspx

http://www.ncbi.nlm.nih.gov/pubmed/15659453

Benefits of E- Prescribing

Fig. e-prescribing

Electronic Prescribing plays an important role in advancing patient care and improving our health care system more effectively. Providers can better manage patient prescription with reducing prescription errors and drug interactions. Modern electronic prescribing software can provide a lot of benefits to a hospital and its staff. Some benefits of the software include:

• Detailed history of patient drug prescriptions
• Improved patient safety
• Reduction of medication errors
• E prescribing for discharge medications
• Improve patient safety and quality of care
• Prescription arrives at pharmacy before you leave doctors office

An electronic prescription allows you to send electronic prescription to the pharmacy, receive electronic refill requests and electronic replacement requests for a general medication. E- Prescription offers a powerful tool for physicians to safely and efficiently manage patient’s medications and to ensure greater convenience for patients. Electronic prescription also makes it easier for physician to access a list of medications and enhance overall medication management process.

Are you happy with your EHR?

EHR Always the right choice - In this ongoing era when healthcare industry is going through major transformation, implementing an EHR is a critical decision. If successful, it can double practice revenue and improves patient care by manifolds. However, if it fails, it can also go the other way around.

The positive and negative impacts of EHR implementation depend greatly on the EHR vendor and the way EHR is implemented. Not every EHR is suitable for every practice. First analyze your requirements and then choose a certified EHR from a reliable vendor. An EHR implemented module-wise and followed by proper trainings has less chances of failure and is expected to keep providers happy.

If you are not happy with your EHR, give it a try with some remedial measures before declaring it a failure. If your EHR is not working out, contact the vendor. Most of the time vendors make serious efforts to resolve the issue as it can hurt their reputation. If you think that providers are having difficulty in using EHR, you can ask your vendor to arrange trainings. It is always safe to choose EHR that offer 90-day trial period or warranty. This can save you from loss in case of EHR failure.

Fig. EHR - Always the right choice.

Integrated EHR pointing in the right direction

An integrated EHR or Electronic Health Record is an EHR which has the ability to interoperate across various applications and support information sharing/exchange with third parties. An EHR automates all the processes from patient treatment to billing, and bring increased efficiency to a provider’s office. Today’s EHRs are very advanced and have feature enriched capabilities. Many practices have been using basic EHR and billing systems since a long time and now need to upgrade or switch their EHR to qualify for Medicare and Medicaid meaningful use incentives. Migration to a new EHR is quite a challenging task because your old EHR holds all your data. The new EHR should have integration ability to work with your existing systems to enhance efficiency and workflow.

The top benefit of an integrated EHR is its ability to pull data from third parties such as labs, pharmacies, and insurance companies. A provider or practice using an integrated EHR does not need to fax or print any information. Integrated EHR users can send information to third parties from their systems and can also receive information such as lab results and insurance information right on their desktops. With an integrated EHR system, providers and practices can automate all their processes and enhance their workflow. The more resourceful processes are, the greater a practice’s chances are for qualifying for Medicare and Medicaid meaningful use incentives.

Fig. Integrated EHR perfection at its finest

EHR Usability: What is it?

EHR or Electronic Health Record is a major achievement of healthcare IT industry over the past few years. Whenever we hear about EHR, we hear providers talking about its usability. The promotional plan for EHR by Centre of Medicare and Medicaid is also based on EHR usability. Only those providers and practices are eligible for incentives who will demonstrate meaningful use of EHR. The question of the day is what exactly makes an EHR usable. Can we state an EHR usable if it supports e-prescription and lab connectivity or usability demands more?

EHR usability is quite a complex issue. It is really hard to define exact measures. However, we can say an EHR is usable if it adds to efficiency, is effective and satisfies the end user. The variations are always there. An EHR that may add to efficiency may not be effective. Similarly, different users have different satisfaction level. Another important factor is EHR safety. Does it care for data confidentiality and privacy? Office of National Coordinator (ONC) considers safety as a primary factor to measure EHR usability. ONC is still working on devising a policy to define EHR usability. Till the time a policy from ONC is debuted, we can consider efficiency, effectiveness and satisfaction as prime factors of EHR usability.

Fig. EHR Usability