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Half of Medication Errors Found In PA Study Involve HIT Issues

Posted on March 29, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study by a Pennsylvania healthcare organization has found that computerized order entry systems and pharmacy systems were the most commonly reported factors contributing to medication errors in the state.

The Pennsylvania Patient Safety Authority, an independent agency tasked with finding and reducing the rate of medical errors in the state, recently released a report on medication errors reported to the agency during the first six months of last year. Under state law, Pennsylvania-based providers cutting across several categories, including hospitals, ambulatory surgical facilities and birthing centers, are required to disclose adverse events and “near misses” to the agency.

Between January 1 and June 30, 2016, the state’s healthcare facilities reported 889 medication-error events which cited health IT as a factor in the event(s). The errors most often reported were dose omission, wrong dose or overdosage and extra dosages, while CPOE and pharmacy systems-related problems were the most commonly reported health IT issues. (High-alert medications such as opioids, insulin and anticoagulants – which pose a higher risk of harm if misused – occupied three of the top five drug categories involved in most events.)

When they analyzed the data, agency analysts found that health IT-related errors took place during every step of the medication use process, and worse, most of those errors affected the patient directly, the data suggested.  And things may get worse before they improve. To hear agency officials tell it, HIT-related medication problems have become more common as health IT infrastructures have matured.

“As more healthcare organizations adopted EHRs and such systems became increasingly interoperable, the Authority observed an increase in reports of HIT-related events, particularly in relationship to medication errors,” said agency executive director Regina Hoffman in a prepared statement.

The Authority’s data doesn’t gibe completely with other research. For example, a report by the Leapfrog Group and Castlight Health notes that CPOE use has been very effective at reducing medication error rates. The report specifically refers to a CPOE study led by David Bates, MD, chief of general medicine at Brigham & Women’s Hospital, in which rates of serious medication errors fell by 88 percent during the period studied. Elsewhere, Leapfrog has cited studies in which CPOE use seems to have cut hospital lengths of stay, as well as major reductions in pharmacy, radiology and lab turnaround times.

On the other hand, the same report notes that CPOE systems still have a long way to go before they realize their potential. According to the 2015 Leapfrog Hospital Survey, hospitals’ CPOE systems failed to flag 39 percent of all potentially harmful drug orders, as well as 13 percent of potentially fatal orders. So it’s not a huge stretch to imagine that CPOE-using Pennsylvania hospitals are still having medication errors fall through the cracks.

It’s also worth pointing out that doctors don’t necessarily see CPOE systems as their best friend either. A study published last year in the Mayo Clinic Proceedings found that physicians who use EMRs and CPOE had lower satisfaction with time spent on clerical tasks and higher rates of burnout. Of course, given that the study lumps CPOE use in with EMR use, the results are somewhat skewed, but it’s still a data point worth considering.

Emergency Department Information Systems Market Fueled By Growing Patient Flow

Posted on March 20, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new research report has concluded that the size of the emergency department information systems market is expanding, driven by increasing patient flows. This dovetails with a report focused on 2016 data which also sees EDIS upgrades underway, though it points out that some hospital buyers don’t have the management support or a large enough budget to support the upgrade.

The more recent report, by Transparency Market Research, notes that ED traffic is being boosted by increases in the geriatric population, an increasing rate of accidents and overall population growth. In part to cope with this increase in patient flow, emergency departments are beginning to choose specialized, best-of-breed EDISs rather than less-differentiated electronic medical records systems, Transparency concludes.

Its analysis is supported by Black Book Research, whose 2016 report found that 69% of hospitals upgrading their existing EDIS are moving from enterprise EMR emergency models to freestanding platforms. Meanwhile, growing spending on healthcare and healthcare infrastructure is making the funds available to purchase EDIS platforms.

These factors are helping to fuel the emergence of robust EDIS market growth, according to Black Book. Its 2016 research, predicted that 35% of hospitals over 150 beds would replace their EDIS that year. Spurred by this spending, the US EDIS market should hit $420M, Black Book projects.

The most-popular EDIS features identified by Black Book include ease of use, reporting improvements, interoperability, physician productivity improvements, diagnosis enhancements and patient satisfaction, its research concluded.

All that being said, not all hospital leaders are well-informed about EDIS implementation and usability, which is holding growth back in some sectors. Also, high costs pose a barrier to adoption of these systems, according to Transparency.

Not only that, some hospital leaders don’t feel that it’s necessary to invest in an EDIS in addition to their enterprise EMR,. Black Book found. Thirty-nine percent of respondents to the 2016 study said that they were moderately or highly dissatisfied with their current EDIS, but 90% of the dissatisfied said they were being forced to rely on generic hospital-wide EMRs.

While all of this is interesting, it’s worth noting that EDIS investment is far from the biggest concern for hospital IT departments. According to a HIMSS survey on 2017 hospitals’ IT plans, top investment priorities include pharmacy technologies and EMR components.

Still, it appears that considering EDIS enhancements may be worth the trouble. For example, seventy-six percent of Black Book respondents implementing a replacement EDIS in Q2 2014 to Q1 2015 saw improved customer service outcomes attributed to the platform.

Also, 44% of hospitals over 200 beds implementing a replacement EDIS over the same period said that it reduced visit costs between 4% and 12%, the research firm found.

Hospital App Helps Patients After Surgery

Posted on March 15, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Patients are very vulnerable after surgery. If they don’t follow post-surgical instructions, they may be readmitted (never a good thing for hospitals these days), and far worse, may suffer real harm.

Unfortunately, many patients don’t retain or follow doctors’ instructions on how to best recover from surgery, particularly if these instructions aren’t documented well.  For example, a 2015 study appearing in Anesthesiology concluded that only 60% of 519 surgery patients who got verbal post-operative instructions or annotated EMR records complied with medication instructions.

In an effort to improve stats like these, Chicago’s Rush University Medical Center has introduced an app designed to support patients in their post-surgical recovery process. The app, SeamlessMD, prompts patients to ask for reminders about their surgeon’s instructions, according to a HIMSS Future Care article.

Anthony Perry, MD, vice president for ambulatory care and population health at Rush, told the publication that his facility had already implemented protocols for enhanced recovery after surgery before the app was created. But the app has potential to move patients’ post-surgical recovery to the next level, Perry said. “It’s not only a neat technology, but a neat technology that’s truly aligned with our own goals,” he noted.

Dr. Perry believes that presenting prompts and reminders via a personal mobile device offers benefits traditional care instructions can’t, particularly when the app is placed on a patient’s phone. “There’s a bridge that a smartphone gives us into a person’s everyday life that we don’t have when they come visit us in the office,” he said.

Rush’s initiative comes as hospitals around the world consider the benefits of rolling out patient-oriented apps. For example, four National Health Services hospitals serving the United Kingdom are testing apps that monitor patient health at home.

The hospitals are testing two apps, one focused on managing gestational diabetes treatment and the other addressing COPD monitoring and care. (As one might expect, the diabetes app collects blood glucose readings and the COPD app oxygen saturation levels.) The pilot, which is still in its initial stages, has already seen some success. For example, the number of office visits by patients with gestational diabetes has fallen 25% since the app was released to such patients.

This may be the dawn of a new age for hospital use of mHealth apps, which has been at best at a trial-and-error stage for several years. While most hospitals and health systems have toyed with apps to some degree, in the past there was neither a clinical nor technical approach for them to adopt. So many initial app projects went nowhere.

But with evidence piling up that at least some approaches work – such as remote patient monitoring for chronic disease management, as described above – hospitals are beginning to see apps as a practical tool for improving outcomes. Meanwhile, as they’ve adopted mobile-friendly infrastructures, hospitals have become more capable of supporting hospital-developed apps effectively.

Of course, there’s probably a number of functions apps can perform which nobody’s pursued just yet. But with some early successes in place, my guess is that hospitals will try lots of new app projects going forward.

ACOs Not Scaling Well, But Health IT Helps

Posted on March 13, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

ACOs were billed as the next big thing in healthcare, a model which would create economies of scale and tame rising costs of care. In theory, unifying hospitals and doctors into an overarching entity – and creating shared clinical and financial goals – should improve care and boost efficiency.

Of course, creating them doesn’t come cheap. In fact, creating even a modest ACO typically calls for between $1 million and $3 million in capital investment, according to Michael Deegan, MD, who recently developed a course on ACOs for the University of Texas at Dallas. It also takes 18 to 24 months to launch an ACO, Deegan told an interviewer at UT.

But once all of the Ts have been crossed and the Is dotted, ACOs can meet their stated goals, right? Actually, not so much, though health IT can help things along, according to Indranil Bardham, a colleague of Deegan’s at UT Dallas who serves as professor of information systems.

According to an article in HealthcareITNews, Bardhan recently completed a study on ACO performance which concluded that health IT had a measurable impact on their efficiency. The study, which drew on 2013-2015 data from CMS, reviewed the performance of 400 ACOs.

Among the key takeways Bardhan took from his research was that the larger an ACO was, the more likely it was to be inefficient. This flies in the face of conventional wisdom, which would suggest that bigger is better when it comes to improving efficiency.

On the other hand, health IT use had the effect its champions might hope for, though modest in scope. The study concluded that a 1 percent increase in HIT usage was associated with an 0.5 percent increase in ACO efficiency.

The thing is, these measures represent just a couple of ways to evaluate ACO performance, making it hard to tell just what is working, Bardhan told HIN. “Healthcare, with respect to ACOs, is fascinating because there is not just one single output measure that you are using to compare performance,” he told the magazine’s Bill Siwicki. “…It is difficult to measure the performance of organizations against each other when you have multiple outputs that cannot easily be transformed into a single dollar number.”

This squares with commentary by other ACO researchers, who seem to agree that the whole ACO evaluation process is a bit mysterious. As health policy analyst David Introcaso notes, in a review of ACO-based Medicare Shared Savings Program, CMS isn’t helping either. “While CMS details financial and quality performance results, the agency does not explain, at least publicly, how results, favorable or unfavorable, were achieved.”

Without knowing more about what we should measure, and why – much less what steps helped in achieving their results – it’s too soon to tell what type of health IT should be deployed in ACOs. But looked at more optimistically, once we have a better idea of what ACO success factors are, it seems likely that health IT tools will help execs address them. (For a look at one completely health IT-based ACO concept, see this piece on the Virtual ACO.)

EMR Add-Ons On The Way

Posted on March 3, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

A new study backed by speech recognition software vendor Nuance Communications has concluded that many healthcare leaders are planning to add new technologies to supplement their EMRs, Popular add-ons cited by the study include (naturally) speech recognition, mobility options and computer-assisted physician documentation tools. While the results are partially a pitch for Nuance, of course, they also highlight the tension between spending on clinical improvement and satisfaction and boosting the bottom line with better documentation tech.

The study, which was conducted by HIMSS Analytics, was designed to look at ways to optimize EMRs and opportunities to improve care at hospitals and health systems. Conducted between August 17 and September 6 of last year, it draws on 167 respondents from 142 different healthcare organizations. Forty percent of respondents hold C-suite titles, and an additional 40% were in IT leadership. (It would be interesting to see how the two groups’ perceptions vary, but the study summary doesn’t provide that information.)

According to HIMSS, 83% of respondents reported having confidence that their organization would eventually realize their full potential, particularly improving care coordination and outcomes.

To this end, 75% of respondents said they’d boosted their EMR efforts with training and support resources, while two-thirds have increased staff in at least one IT area since implementing their system. Respondents apparently didn’t say how much they’d increased their budget, if at all, to meet these needs – and you have to wonder how these organizations are paying for these efforts, and how much. But the report didn’t provide such information.

To increase clinician satisfaction with EMR use, 82% of respondents said providing clinician training and education, 75% are enhancing existing technology and tools and 68% adopting new technology and tools. To read between the lines once again, it’s worth noting that hospitals and health systems seem to be putting a stronger emphasis on training than new tech, which somewhat contradicts the study’s conclusions. Still, EMR add-ons clearly matter.

Meanwhile, about one-quarter of survey respondents said that they planned to introduce EMR-enhancing tools at the point of care, primarily to improve documentation and boost physician satisfaction. Those included mobility tools (44%), computer-assisted physician documentation (38%) and speech recognition (25%). These numbers seem a bit lower than I would have expected, particularly the mobile stat. I’m betting that establishing mobile security is still a tough nut to crack for most.

While increasing clinician satisfaction and improving care outcomes is important, boosting financial performance clearly matters too, and respondents said that improving documentation was central to doing so. Fifty-four percent said that better documentation would reduce the number of denied claims they face, 52% expect to improve performance under bundled payments, 38% predicted reduced readmissions and 38% thought documentation improvements would better physician time management and improve patient flow.

Again, I doubt that C-suite execs and IT leaders will pay equal attention to tools which improve their finances and those which meet “softer” goals – and financial goals have to take priority. But these stats do suggest that hospitals and health systems are giving EMR add-ons some attention. It will be interesting to see if they’re willing to invest in EMR enhancements — rather than burrowing deeper into their existing EMR tech — over the next year or two.

Cleveland Clinic Works To Eliminate Tech Redundancies

Posted on March 1, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

The Cleveland Clinic has relied on its EMR for quite some time. In fact, it adopted Epic in the 1990s, long before most healthcare organizations were ready to make a bet on EMRs. Today, decades later, the Epic EMR is the “central data hub” for the medical center and is central to both its clinical and operational efforts, according to William Morris, MD, the Clinic’s associate chief information officer.

But Morris, who spoke about the Clinic’s health IT with Health Data Management, also knows its limitations. In an interview with the magazine’s Greg Slabodkin, he notes that while the EMR may be necessary, it isn’t sufficient. The Epic EMR is “just a digital repository,” he told Slabodkin. “Ultimately, it’s what you do with the technology in your ecosystem.”

These days, IT leaders at the Clinic are working to streamline the layers of additional technology which have accreted on top of the EMR over the years. “As an early adopter of Epic, we have accumulated quite a bit of what I’ll call technical debt,” said Doug Smith, interim chief information officer. “What I mean by that is multiple enhancements, bolt-ons, or revisions to the core application. We have to unburden ourselves of that.”

It’s not that Clinic leaders are unhappy with their EMR. In fact, they’re finding ways to tap its power to improve care. For example, to better leverage its EMR data, the Cleveland Clinic has developed data-driven “risk scores” designed to let doctors know if patients need intervention. The models, developed by the Clinic’s Quantitative Health Sciences group, offer outcome risk calculators for several conditions, including cancer, cardiovascular disease and diabetes.

(By the way, if predictive analytics interest you, you might want to check out our coverage of such efforts at New York’s Mount Sinai Hospital, which is developing a platform to predict which patients might develop congestive heart failure and care for patients already diagnosed with the condition more effectively. I’ve also taken a look at a related product being developed by Google’s DeepMind, an app named Streams which will ping clinicians if a patient needs extra attention.)

Ultimately, though, the organization hopes to simplify its larger health IT infrastructure substantially, to the point where 85% of the HIT functionality comes from the core Epic system. This includes keeping a wary eye on Epic upgrades, and implementing new features selectively. “When you take an upgrade in Epic, they are always turning on more features and functions,” Smith notes. “Most are optional.”

Not only will such improvements streamline IT operations, they will make clinicians more efficient, Smith says. “They are adopting standard workflows that also exist in many other organizations—and, we’re more efficient in supporting it because we don’t take as long to validate or support an upgrade.”

As an aside, I’m interested to read that Epic is tossing more features at Cleveland Clinic than it cares to adopt. I wonder if those are what engineers think customers want, or what they’re demanding today?

The Distributed Hospital On The Horizon

Posted on February 24, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If you’re reading this blog, you already know that distributed, connected devices and networks are the future of healthcare.  Connected monitoring devices are growing more mature by the day, network architectures are becoming amazingly fluid, and with the growth of the IoT, we’re adding huge numbers of smart devices to an already-diverse array of endpoints.  While we may not know what all of this will look when it’s fully mature, we’ve already made amazing progress in connecting care.

But how will these trends play out? One nice look at where all this is headed comes from Jeroen Tas, chief innovation and strategy officer at Philips. In a recent article, Tas describes a world in which even major brick-and-mortar players like hospitals go almost completely virtual.  Certainly, there are other takes out there on this subject, but I really like how Tas explains things.

He starts with the assertion that the hospital of the future “is not a physical location with waiting rooms, beds and labs.” Instead, a hospital will become an abstract network overlay connecting nodes. It’s worth noting that this isn’t just a concept. For an example, Tas points to the Mercy Virtual Care Center, a $54 million “hospital without beds” dedicated to telehealth and connected care.  The Center, which has over 300 employees, cares for patients at home and in beds across 38 hospitals in seven states.

While the virtual hospital may not rely on a single, central campus, physical care locations will still matter – they’ll just be distributed differently. According to Tas, the connected health network will work best if care is provided as needed through retail-type outlets near where people live, specialist hubs, inpatient facilities and outpatient clinics. Yes, of course, we already have all of these things in place, but in the new connected world, they’ll all be on a single network.

Ultimately, even if brick-and-mortar hospitals never disappear, virtual care should make it possible to cut down dramatically on hospital admissions, he suggests.  For example, Tas notes that Philips partner Banner Health has slashed hospital admissions almost 50% by using telehealth and advanced analytics for patients with multiple chronic conditions. (We’ve also reported on a related pilot by Partners HealthCare Brigham and Women’s Hospital, the “Home Hospital,” which sends patients home with remote monitoring devices as an alternative to admissions.)

Of course, the broad connected care outline Tas offers can only take us so far. It’s all well and good to have a vision, but there are still some major problems we’ll have to solve before connected care becomes practical as a backbone for healthcare delivery.

After all, to cite one major challenge, community-wide connected health won’t be very practical until interoperable data sharing becomes easier – and we really don’t know when that will happen. Also, until big data analytics tools are widely accessible (rather than the province of the biggest, best-funded institutions) it will be hard for providers to manage the data generated by millions of virtual care endpoints.

Still, if Tas’s piece is any indication, consensus is building on what next-gen care networks can and should be, and there’s certainly plenty of ways to lay the groundwork for the future. Even small-scale, preliminary connected health efforts seem to be fostering meaningful changes in how care is delivered. And there’s little doubt that over time, connected health will turn many brick-and-mortar care models on their heads, becoming a large – or even dominant – part of care delivery.

Getting there may be tricky, but if providers keep working at connected care, it should offer an immense payoff.

Indiana Health System Takes On Infection Control With Predictive Analytics

Posted on February 22, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

At Indiana University Health, a 15-hospital non-profit health system, they’ve taken aim at reducing the rate of central-line associated bloodstream infections – better known to infection control specialists as CLABSIs.

According to the CDC, CLABSIs are preventable, but at present still result in thousands of deaths each year and add billions of dollars in costs to U.S. healthcare system spending. According to CDC data, patient mortality rates related to CLABSI range from 12% to 25%, and the infections cost $3,700 to $36,000 per episode.

Hospitals have been grappling with this problem for a long time, but now technology may offer preventive options. To cut its rate of CLABSIs, IU Health has decided to use predictive analytics in addition to traditional prevention strategies, according to an article in the AHA’s Hospitals & Health Systems magazine.

Reducing the level of hospital-acquired infections suffered by your patients always makes sense, but IU Health arguably has additional incentives to do it. The decision to attack CLABSIs comes as IU Health takes on a strategic initiative likely to demand a close watch on such metrics. At the beginning of January, Indiana University Health kicked off its participation in the CMS Next Generational Accountable Care Organization Model, putting its ACO in the national spotlight as a potential model for improving fee-for-service Medicare.

According to H&HN, IU Health has launched its predictive analytics pilot for CLABSI prevention at its University Hospital location, which includes a 600-bed Level I trauma center and 300-bed tertiary care center which also serves as one of the 10 largest transplant centers in the U.S.

Executives there told the magazine that the predictive analytics effort was an outgrowth of its long-term EMR development effort, which has pushed them to streamline data flow across platforms and locations over the past several years.

The hospital’s existing tech prior to the predictive analytics effort did include an e-surveillance program for hospital-acquired infections, but even using the full powers of the EMR and e-surveillance solution together, the hospitals could only monitor for CLABSI which had already been diagnosed.

This retrospective approach succeeded in cutting IU Health’s CLABSI rate from 1.7 CLABSIs over central-line days in 2015 to 1.2 last year. But IU Health hopes to improve the hospital’s results even further by getting ahead of the game.

Last year, the system implemented a data visualization platform designed to give providers a quick-and-easy look at data in real time. The platform lets managers keep track of many important variables easily, including whether hospital units have skipped any line maintenance activities or failed to follow-through on CLABSI bundles. It’s also saving time for nurse managers, who used to have to track data manually, and letting them check on patient trend line data at a glance.

The H&HN article doesn’t say whether the hospital has managed to cut its CLABSI rate any further, but it’s hard to imagine how predictive analytics could deliver zero results. Let’s wish IU Health further luck in cutting CLABSI rates down further.

National Health Service Hospitals Use Data Integration Apps

Posted on February 20, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While many providers in the US are still struggling with selecting and deploying apps, the UK National Health Service trusts are ready to use them to collect vital data.

According to the New Scientist, the four National Health Services serving the United Kingdom are rolling out two apps which help patients monitor their health at home. Both of the apps, which are being tested at four hospitals in Oxfordshire, UK, focus on management of a disease state.

One, called GDm-health, helps manage the treatment of gestational diabetes, which affects one in 10 pregnant women. Women use the app to send each of their blood glucose readings to the clinician monitoring their diabetes. The Oxford University Institute of Biomedical Engineering led development of the app, which has allowed patients to avoid needless in-person visits. In fact, the number of patient visits has dropped by 25%, the article notes.

The other app, which was also developed by the Institute, helps patients manage chronic obstructive pulmonary disease, which affects between 1 million and 1.5 million UK patients. COPD patients check their heart rate and blood oxygen saturation every day, entering each result into the app.

After collecting three months of measurements, the app “learns” to recognize what a normal oxygen sat level is for that patient. Because it has data on what is normal for that patient, it will neither alert clinicians too often nor ignore potential problems. During initial use the app, which already been through a 12-month clinical trial, cut hospital admissions among this population by 17% and general practitioner visits by 40%.

NHS leaders are also preparing to launch a third app soon. The technology, which is known as SEND, is an iPad app designed to collect information on hospital patients. As they make their rounds, nurses will use the app to input data on patients’ vital signs. The system then automatically produces an early warning score for each patient, and provides an alert if the patient’s health may be deteriorating.

One might think that because UK healthcare is delivered by centralized Trusts, providers there don’t face data-sharing problems in integrating data from apps like these. But apparently, we would be wrong. According to Rury Holman of the Oxford Biomedical Research Centre, who spoke with New Scientist, few apps are designed to work with NHS’ existing IT systems.

“It’s a bit like the Wild West out there with lots of keen and very motivated people producing these apps,” he told the publication. “What we need are consistent standards and an interface with electronic patient records, particularly with the NHS, so that information, with permission from the patients, can be put to use centrally.”

In other words, even in a system providing government-delivered, ostensibly integrated healthcare, it’s still hard to manage data sharing effectively. Guess we shouldn’t feel too bad about the issues we face here in the US.

Many Providers Still Struggle With Basic Data Sharing

Posted on February 15, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

One might assume that by this point, virtually every provider with a shred of IT in place is doing some form of patient data exchange. After all, many studies tout the number of healthcare data send and receive transactions a given vendor network or HIE has seen, and it sure sounds like a lot. But if a new survey is any indication, such assumptions are wrong.

According a study by Black Book Research, which surveyed 3,391 current hospital EMR users, 41% of responding medical record administrators find it hard to exchange patient health records with other providers, especially if the physicians involved aren’t on their EMR platform. Worse, 25% said they still can’t use any patient information that comes in from outside sources.

The problem isn’t a lack of interest in data sharing. In fact, Black Book found that 81% of network physicians hoped that their key health system partners’ EMR would provide interoperability among the providers in the system. Moreover, the respondents say they’re looking forward to working on initiatives that depend on shared patient data, such as value-based payment, population health and precision medicine.

The problem, as we all know, is that most hospitals are at an impasse and can’t find ways to make interoperability happen. According to the survey, 70% of hospitals that responded weren’t using information outside of their EMR.  Respondents told Black Book that they aren’t connecting clinicians because external provider data won’t integrate with their EMR’s workflow.

Even if the data flows are connected, that may not be enough. Researchers found that 22% of surveyed medical record administrators felt that transferred patient information wasn’t presented in a useful format. Meanwhile, 21% of hospital-based physicians contended that shared data couldn’t be trusted as accurate when it was transmitted between different systems.

Meanwhile, the survey found, technology issues may be a key breaking point for independent physicians, many of whom fear that they can’t make it on their own anymore.  Black Book found that 63% of independent docs are now mulling a merger with a big healthcare delivery system to both boost their tech capabilities and improve their revenue cycle results. Once they have the funds from an acquisition, they’re cleaning house; the survey found that EMR replacement activities climbed 52% in 2017 for acquired physician practices.

Time for a comment here. I wish I agreed with medical practice leaders that being acquired by a major health system would solve all of their technical problems. But I don’t, really. While being acquired may give them an early leg up, allowing them to dump their arguably flawed EMR, I’d wager that they won’t have the attention of senior IT people for long.

My sense is that hospital and health system leaders are focused externally rather than internally. Most of the big threats and opportunities – like ACO integration – are coming at leaders from the outside.

True, if a practice is a valuable ally, but independent of the health system, CIOs and VPs may spend lots of time and money to link arms with them technically. But once they get in house, it’s more of a “get in line” situation from what I’ve seen.  Readers, what is your experience?