This week we are thrilled to introduce the Expert Interview Series. This series of blog posts will feature top thought leaders in healthcare discussing industry trends and developments as 2012 approaches. We look forward to sharing perspectives on relevant topics, including electronic health records (EHRs), meaningful use standards, Accountable Care Organizations (ACOs), and care collaboration.
John Lynn, our first featured expert, is the editor and founder of nationally renowned blogs EMRandHIPAA.com and Healthcare Scene. John tackles EHR selection and implementation as a physician's advocate. Since 2005, John has published close to 2,000 articles on EHRs, which have been viewed more than 6.4 million times.
What HIT success stories are your favorite examples of improving care and reducing costs from 2011?
In 2011, the HIT success stories have focused on doctors getting meaningful use dollars instead of about how they improved patient care or increased the volume of patients they saw or how they were able to coordinate care with other doctors. The stories have all been, "How did you get EHR incentive money?" It's hard to pinpoint too many stories coming out of 2011 that focus on improving care and reducing costs.
In 2012, we'll see more EHR vendors that start saying, "Okay, we were able to achieve meaningful use but we also were able to improve quality of care, or we were able to achieve reduced costs." I believe that those who are able to show that they can improve care and reduce costs are going to be able to differentiate themselves from other EHR vendors who are still just touting, "Oh, we're able to achieve meaningful use and earn incentive money." Doctors waiting on the sidelines are waiting for those stories to say, "Okay, where are the doctors who saw the reduced costs and improved care?"
What do you predict as the biggest developments in Health IT for 2012?
I think unfortunately for 2012, the biggest development is still going to be meaningful use. We're still going to be talking about meaningful use and how many people got paid. Meaningful use stage 2 will finally come into focus as far as what the Office of the National Coordinator for Health Information Technology (ONC) will require for stage 2. I think the decisions that the ONC makes when it comes to meaningful use stage 2 will likely have a big impact on how many doctors actually come forward and do meaningful use and go after the EHR incentive money. How many providers will go, "You know what? Maybe I don't want to go down the path of meaningful use." I think it will be a pivotal year for meaningful use and the decisions that doctors make. It's going to definitely dominate the conversation.
Another development I think will come more into focus is the continuing talk of Accountable Care Organizations (ACOs). How does an ACO interact with the EHR, and how will healthcare IT enable the ACOs, and how are they going to implement those? I like the description that ACOs are a unicorn - they're something everyone knows about but no one has ever really seen one. Hopefully, in 2012, we'll start to see what that means and how healthcare IT can facilitate the model of ACO.
What are the benefits of mobile care and equipping physicians with the right patient information in the exam room?
Many times, doctors were put into positions where they had to provide healthcare with limited information. In fact, one person described that EHR workflows are such a challenge because there's actually a workflow. Before the workflow, you just did the best you could with what you had. Now with an EHR, the information is mobile and available to doctors. So now, sure, there are some workflow challenges with having an EHR and accessing an EHR, but we can have that information available to doctors so they can make better decisions at the point of care, whether at the hospital or on the road or on vacation. There's a critical piece of information they have to deal with because it's some life-threatening situation. When they get a midnight call and the nurse says a patient is in the hospital and information is needed, doctors can respond in real time. Mobile care enables the doctors to be able to have access to that information and be able to provide much better care.
You think that will really cause doctors to choose an EHR provider?
I do. I think doctors will talk to other doctors to get first-hand experiences since they're very social within their own networks. They'll want to be able to talk to other doctors, hear first-hand experiences. They'll gravitate to vendors where other doctors say, "Yeah, this is much better for me over using paper."
What unanticipated challenges do providers face during the meaningful use attestation process?
One of the biggest challenges with the meaningful use attestation process really happens before attestation -- when a practice decides to do it and what does it really mean to achieve it. Once you're ready to attest, it's pretty straightforward, especially in stage 1, when you mostly answer a series of questions from your EHR. The biggest challenge to come is that it ends up being really unique to the specialty physicians have. Each specialty has challenges with different meaningful use measures.
One of the biggest challenges providers face is understanding what they really have to do. A simple example is core measure 15, which says providers need to do a privacy and security analysis. Many assume that the EHR vendor will do it, or it's part of the EHR package. It turns out they have to perform this themselves, and they have to make sure they do it. Also, it can be quite different from what they did to satisfy the HIPAA security rule. I think a number of providers are going to run into issues where:
- The provider didn't understand the core measure.
- They thought the EHR vendor would do it.
- They thought it was satisfied through HIPAA or something else that they did.
How can all healthcare stakeholders help medical practices to be more prepared?
The #1 stakeholder for a medical practice in achieving meaningful use and being prepared for EHR implementation is the EHR vendor itself. This is true at least in the small practice environment and ambulatory space; hospitals may be a bit different. The EHR vendors are being relied upon heavily by the practices to be able to implement the EHR and achieve meaningful use.
The biggest thing EHR vendors can do is to be involved with the process, help shape the process -- and help educate their users on what's really required to meet meaningful use. Some EHR vendors are actually really good at this and have done a great job, but a lot are leaving their EHR users out there without much benefit. Sure, they talk about it, and they've met the certification, but they haven't truly prepared them for what's necessary to implement the EMR and become "meaningful users."
What helpful functionalities of the EHR do providers most often overlook?
One of the interesting things that providers often overlook is the technology that could interact with their EHR. For example, a lot of providers don't integrate the fax server right away because they already have a fax machine, and they figure they can just scan it all in, so they miss out on that. Or maybe they have access to the lab interface, which would allow them to order labs electronically and receive the results electronically, which saves all this process and workflow in receiving the lab results.
It's the interfaces providers set aside and don't realize how beneficial they could be, to integrate with the lab, to integrate with the fax server, to do e-Prescribing and how beneficial that could be. I would say that's often overlooked and should be addressed sooner rather than later.
Thanks again to John for sharing his predictions for 2012. Think he's on target? Did he miss a trend you're watching for 2012? Leave a comment on our blog, on Twitter, on Facebook, or on LinkedIn. Stay tuned for our next interview in this series.
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