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Waiting For The Perfect “Standard” Is Not The Answer To Healthcare’s Interoperability Problem

Posted on October 16, 2017 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.

Have you bought into the “standards will solve healthcare’s interoperability woes” train of thought? Everyone understands that standards are necessary to enable disparate systems to communicate with each other, but as new applications and new uses for data continually appear, healthcare organizations that are waiting for universal standards, are not maximizing the value of their data. More importantly, they will be waiting a long time to realize the full potential of their data.

Healthcare interoperability is not just a matter of transferring data as an entire file from one user to another. Instead, effective exchange of information allows each user to select which elements of a patient’s chart are needed, and then access them in a format that enables analysis of different data sets to provide a holistic picture of the patient’s medical history or clinical trends in a population of patients. Healthcare’s interoperability challenge is further exacerbated by different contextual interpretations of the words within those fields. For instance, how many different ways are there to say heart attack?

The development of the Health Level Seven (HL7®) FHIR®, which stands for Fast Healthcare Interoperability Resources, represents a significant step forward to interoperability. While the data exchange draft that is being developed and published by HL7 eliminates many of the complexities of earlier HL7 versions and facilitates real-time data exchange via web technology, publication of release 4 – the first normative version of the standard – is not anticipated until October 2018.

As these standards are further developed, the key to universal adoption will be simplicity, according to John Lynn, founder of the HealthcareScene.com. However, he suggests that CIOs stop waiting for “perfect standards” and focus on how they can best achieve interoperability now.

Even with standards that can be implemented in all organizations, the complexity and diversity of the healthcare environment means that it will take time to move everyone to the same standards. This is complicated by the number of legacy systems and patchwork of applications that have been added to healthcare IT systems in an effort to meet quickly changing needs throughout the organization. Shrinking financial resources for capital investment and increasing competition for IT professionals limits a health system’s ability to make the overall changes necessary for interoperability – no matter which standards are adopted.

Some organizations are turning to cloud-based, managed service platforms to perform the integration, aggregation and harmonization that makes data available to all users – regardless of the system or application in which the information was originally collected. This approach solves the financial and human resource challenges by making it possible to budget integration and data management requirements as an operational rather than a capital investment. This strategy also relieves the burden on in-house IT staff by relying on the expertise of professionals who focus on emerging technologies, standards and regulations that enable safe, compliant data exchange.

How are you planning to scale your interoperability and integration efforts?  If you're waiting for standards, why are you waiting?

As a leading provider of healthcare interoperability solutions, Liaison is a proud sponsor of Healthcare Scene. While the conversation about interoperability has been ongoing for many years, ideas, new technology and new strategies discussed and shared by IT professionals will lead to successful healthcare data exchange that will transform healthcare and result in better patient care.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.

KLAS Summit: Interoperability Doing the Work to Move HealthIT Forward

Posted on October 9, 2017 I Written By

Healthcare as a Human Right. Physician Suicide Loss Survivor.
Janae writes about Artificial Intelligence, Virtual Reality, Data Analytics, Engagement and Investing in Healthcare.
twitter: @coherencemed

I had the privilege of attending the KLAS research event with leaders in patient data interoperability. From the ONC to EHR vendors- executives from EHR vendors and hospital systems made their way to a summit about standards for measurement and improvement. These meetings are convened with the mutual goal of contributing to advancement in Health IT and improvement of patient outcomes. I’m a big fan of collaborative efforts that produce measurable results. KLAS research is successfully convening meetings everyone in the HealthIT industry has said are necessary for progress.

The theme of Interoperability lately is: Things are not moving fast enough.

The long history of data in health records and variety in standards across records have created a system that is reluctant to change. Some EMR vendors seem to think the next step is a single patient record- their record.

Watching interactions between EHR vendors and the ONC was interesting. Vendors are frustrated that progress and years of financial investment might be overturned by an unstable political atmosphere and lack of funding. Additionally, device innovation and creation is changing the medical device landscape at a rapid rate. We aren’t on the same page with new data and we are creating more and more data from disparate sources.

Informatics experts in healthcare require a huge knowledge base to organize data sharing and create a needs based strategy for data sharing. They have such a unique perspective across the organization. Few of the other executives have the optics into the business sense of the organization. They have to understand clinical workflows and strategy., as well as financial reimbursement. Informatics management is a major burden and responsibility- they are in charge of improving care and making workflows easier for clinicians and patients. EMR use has frequently been cited as a contributor to physician burnout and early retirement. Data moving from one system can have a huge impact on care delivery costs and patient outcomes. Duplicated tests and records can mean delayed diagnosis for surgeons and specialists. Participants of the summit discussed that patients can be part of improving data sharing.

We have made great progress in terms of interoperability but there is still much to be done. Some of the discussion was interesting, such as the monumental task the VA has in patient data with troop deployment and care. There was also frank discussion about business interests and data blocking ranging from government reluctance to create a single patient identifier to a lack of resources to clean duplicated records.

Stakeholders want to know what the next steps are- how do we innovate and how do we improve from this point forward? Do we create it internally or partner with outside vendors for scale? They are tired of the confusion and lack of progress. Participants want more. I asked a few participants what they think will help things move forward more quickly. Not everyone really knows how to make things move forward faster.

Keith Fraidenburg of CHIME praised systems for coming together and sharing patient data- to improve patient outcomes. I spoke with him about the Summit itself and his work with informatics in healthcare. He discussed how the people involved in this effort are some of the hardest working people in healthcare. Their expertise in terms of clinical knowledge and data science is highly specialized and has huge implications in patient outcomes.

“To get agreement on standards would be an important big step forward. It wouldn’t solve everything but to get industry wide standards to move things forward the industry needs a single set of standards or a playbook.”

We might have different interests, but the people involved in interoperability care about interoperability advancement. Klas research formed a collaborative of over 31 organizations that are dedicated to giving great feedback and data about end users. The formation of THE EMR Improvement Collaborative can help measure the success of data interoperability. Current satisfaction measures are helpful, but might not give health IT experts and CMIOs and CIOs the data they need to formulate an interoperability strategy.

The gaps in transitions of care is a significant oversight in the existing interoperability marketplace. Post acute organizations have a huge need for better data sharing and interorganizational trust is a factor. Government mandates about data blocking and regulating sharing has a huge impact on data coordination. Don Rucker, MD, John Fleming, MD, Genevieve Morris and Steve Posnack participated in a listening session about interoperability.  Some EMR vendors mentioned this listening session and ability to have a face to face meeting were the most valuable part of the Summit.

Conversations and meetings about interoperability help bridge the gaps in progress. Convening the key conversations between stakeholders helps healthcare interoperability move faster. There is still work to be done and many opportunities for innovation and improvement. Slow progress is still progress. Sharing data from these efforts by the KLAS research team shows a dedication to driving interoperability advancement. We will need better business communication between stakeholders and better data sharing to meet the needs of an increasingly complex and data rich world.

What do you think the next steps are in interoperability?

Interoperability: Is Your Aging Healthcare Integration Engine the Problem?

Posted on September 18, 2017 I Written By

The following is a guest blog post by Gary Palgon, VP Healthcare and Life Sciences Solutions at Liaison Technologies.
There is no shortage of data collected by healthcare organizations that can be used to improve clinical as well as business decisions. Announcements of new technology that collects patient information, clinical outcome data and operational metrics that will make a physician or hospital provide better, more cost-effective care bombard us on a regular basis.

The problem today is not the amount of data available to help us make better decisions; the problem is the inaccessibility of the data. When different users – physicians, allied health professionals, administrators and financial managers – turn to data for decision support, they find themselves limited to their own silos of information. The inability to access and share data across different disciplines within the healthcare organization prevents the user from making a decision based on a holistic view of the patient or operational process.

In a recent article, Alan Portela points out that precision medicine, which requires “the ability to collect real-time data from medical devices at the moment of care,” cannot happen easily without interoperability – the ability to access data across disparate systems and applications. He also points out that interoperability does not exist yet in healthcare.

Why are healthcare IT departments struggling to achieve interoperability?

Although new and improved applications are adopted on a regular basis, healthcare organizations are just now realizing that their integration middleware is no longer able to handle new types of data such as social media, the volume of data and the increasing number of methods to connect on a real-time basis. Their integration platforms also cannot handle the exchange of information from disparate data systems and applications beyond the four walls of hospitals. In fact, hospitals of 500 beds or more average 25 unique data sources with six electronic medical records systems in use. Those numbers will only move up over time, not down.

Integration engines in place throughout healthcare today were designed well before the explosion of the data-collection tools and digital information that exist today. Although updates and additions to integration platforms have enabled some interoperability, the need for complete interoperability is creating a movement to replace integration middleware with cloud-based managed services.

A study by the Aberdeen Group reveals that 76 percent of organizations will be replacing their integration middleware, and 70 percent of those organizations will adopt cloud-based integration solutions in the next three years.

The report also points out that as healthcare organizations move from an on-premises solution to a cloud-based platform, business leaders see migration to the cloud and managed services as a way to better manage operational expenses on a monthly basis versus large, up-front capital investments. An additional benefit is better use of in-house IT staff members who are tasked with mission critical, day-to-day responsibilities and may not be able to focus on continuous improvements to the platform to ensure its ability to handle future needs.

Healthcare has come a long way in the adoption of technology that can collect essential information and put it in the hands of clinical and operational decision makers. Taking that next step to effective, meaningful interoperability is critical.

As a leading provider of healthcare interoperability solutions, Liaison is a proud sponsor of Healthcare Scene. It is only through discussions and information-sharing among Health IT professionals that healthcare will achieve the organizational support for the steps required for interoperability.

Join John Lynn and Liaison for an insightful webinar on October 5, titled: The Future of Interoperability & Integration in Healthcare: How can your organization prepare?

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies. In this role, Gary leverages more than two decades of product management, sales, and marketing experience to develop and expand Liaison’s data-inspired solutions for the healthcare and life sciences verticals. Gary’s unique blend of expertise bridges the gap between the technical and business aspects of healthcare, data security, and electronic commerce. As a respected thought leader in the healthcare IT industry, Gary has had numerous articles published, is a frequent speaker at conferences, and often serves as a knowledgeable resource for analysts and journalists. Gary holds a Bachelor of Science degree in Computer and Information Sciences from the University of Florida.

Healthcare Interoperability and Standards Rules

Posted on September 11, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Dave Winer is a true expert on standards. I remember coming across him in the early days of social media when every platform was considering some sort of API. To illustrate his early involvement in standards, Dave was one of the early developers of the RSS standard that is now available on every blog and many other places.

With this background in mind, I was extremely fascinated by a manifesto that Dave Winer published earlier this year that he calls “Rules for Standards-Makers.” Sounds like something we really need in healthcare no?

You should really go and read the full manifesto if you’re someone involved in healthcare standards. However, here’s the list of rules Dave offers standards makers:

  1. There are tradeoffs in standards
  2. Software matters more than formats (much)
  3. Users matter even more than software
  4. One way is better than two
  5. Fewer formats is better
  6. Fewer format features is better
  7. Perfection is a waste of time
  8. Write specs in plain English
  9. Explain the curiosities
  10. If practice deviates from the spec, change the spec
  11. No breakage
  12. Freeze the spec
  13. Keep it simple
  14. Developers are busy
  15. Mail lists don’t rule
  16. Praise developers who make it easy to interop

If you’ve never had to program to a standard, then you might not understand these. However, those who are deep into standards will understand the pitfalls. Plus, you’ll have horror stories about when you didn’t follow these rules and what challenges that caused for you going forward.

The thing I love most about Dave’s rules is that it focuses on simplicity and function. Unfortunately, many standards in healthcare are focused on complexity and perfection. Healthcare has nailed the complexity part and as Dave’s rules highlight, perfection is impossible with standards.

In fact, I skipped over Dave’s first rule for standards makers which highlights the above really well:

Rule #1: Interop is all that matters

As I briefly mentioned in the last CXO Scene podcast, many healthcare CIOs are waiting until the standards are perfect before they worry about interoperability. It’s as if they think that waiting for the perfect standard is going to solve healthcare interoperability. It won’t.

I hope that those building out standards in healthcare will take a deep look at the rules Dave Winer outlines above. We need better standards in healthcare and we need healthcare data to be interoperable.

Is There a Case to Be Made that Interoperability Saves Hospitals Money?

Posted on April 17, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Back in 2013 I argued that we needed a lot less talk and a lot more action when it came to interoperability in healthcare. It seemed very clear to me then and even now that sharing health data was the right thing to do for the patient. I have yet to meet someone who thinks that sharing a person’s health data with their providers is not the right thing to do for the patient. No doubt we shouldn’t be reckless with how we share the data, but patient care would improve if we shared data more than we do today.

While the case for sharing health data seems clear from the patient perspective, there were obvious business reasons why many organizations didn’t want to share their patients health data. From a business perspective it was often seen as an expense that they’d incur which could actually make them lose money.

These two perspectives is what makes healthcare interoperability so challenging. We all know it’s the right thing to do, but there are business reasons why it doesn’t make sense to invest in it.

While I understand both sides of the argument, I wondered if we could make the financial case for why a hospital or healthcare organization should invest in interoperability.

The easy argument is that value based care is going to require you to share data to be successful. That previous repeat X-ray that was seen as a great revenue source will become a cost center in a value based reimbursement world. At least that’s the idea and healthcare organizations should prepare for this. That’s all well and could, but the value based reimbursement stats show that we’re not there yet.

What are the other cases we can make for interoperability actually saving hospitals money?

I recently saw a stat that 70% of accidental deaths and injuries in hospitals are caused by communication issues. Accidental deaths and injuries are very expensive to a hospital. How many lives could be saved, hospital readmissions avoided, or accidental injuries could be prevented if providers had the right health data at the right place and the right time?

My guess is that not having the right healthcare data to treat a patient correctly is a big problem that causes a lot of patients to suffer needlessly. I wonder how many malpractice lawsuits could be avoided if the providers had the patients full health record available to them. Should malpractice insurance companies start offering healthcare organizations a doctors a discount if they have high quality interoperability solutions in their organization?

Obviously, I’m just exploring this idea. I’d love to hear your thoughts on it. Can interoperability solutions help a hospital save money? Are their financial reasons why interoperability should be implemented now?

While I still think we should make health data interoperability a reality because it’s the right thing to do for the patients, it seems like we need to dive deeper into the financial reasons why we should be sharing patient’s health data. Otherwise, we’ll likely never see the needle move when it comes to health data sharing.

Nominate Someone to the #HIT100

Posted on July 4, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As has become a July 4th tradition, the healthcare IT social media community comes together to recognize the incredible people on healthcare social media that influence their lives. It’s called the #HIT100 and happens on Twitter with people nominating the people that influence them for good. It’s really simple to participate and a great way to show some gratitude and love for someone you appreciate. Here are the details from the official announcement:

Required hashtags:

(Each nomination should have all of these)

  • #HIT100 or #HIT99 (One or the other is required)
  • #HealthIT (Optional)
  • #HITsm (Optional)

Optional hashtags:

(Please use only one of them so that the analytics have value)

  • #FHIR (Optional)
  • #Interoperability (Optional)
  • #PersonalizedMedicine or #PrecisionMedicine (Optional)
  • #Genomics

Some rules will change this year due to the analytical tools being put in place for the first time:

NOMINATION RULES:

  1. Nominations start
    Friday July 1st 2016 at 6PM and end on Friday July 8th at 6PM
  2. Only one person at a time may be nominated.  Multi-nominations in one tweet will not be counted though they might form part of the analytical information base
  3. Only direct nominations will be counted.  Retweets will not be counted though they may be analyzed for further enjoyment
  4. Favorites will not be counted though they may be analyzed for further entertainment
  5. There will only be one cycle of nominations.  No delegates or super-delegates here
  6. I reserve the judgement to disqualify a nomination that I find suspicious for any reason
  7. You are encouraged to include one of the optional hashtags above so that we can process with analytics to get some statistics about each one of them
  8. You can add a sentiment to the end of the nomination
  9. You must have fun and please follow each other as you discover new members of our community

If that’s too confusing, here are a couple examples. You can copy and then edit as appropriate.

I nominate @ehrandhit to the #HIT100 list – #HealthIT #HITsm #FHIR – Because they curate amazing content!

I nominate @techguy to the #HIT100 list – #HealthIT #HITsm He offers great insights into #PrecisionMedicine

Join in the fun and recognize your favorite people on social media! Happy 4th of July!

HIMSS Social Media Ambassador Debate: FHIR and Patient Focus

Posted on June 8, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at HIMSS, I had a chance to do a “debate” with my good friend, partner and fellow HIMSS Social Media Ambassador, Shahid Shah. This was facilitated by Healthcare IT News, and the debate was moderated by Beth Jones Sanborn, Managing Editor of Healthcare Finance. Shahid and I had a good debate on the topics of healthcare interoperability and FHIR. Plus, we talked about the need for healthcare IT companies to focus on the patient and whether they deserve the bad rap they get or not. Enjoy the video debate below:
Read more..

A Complete Patient Record and You

Posted on March 9, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have discussed the first steps to getting an enterprise imaging facility but what does this and a complete patient record mean for the average patient? If I were to stop someone walking down Las Vegas Blvd (I would shoot for the more sober hours) and ask them “Who owns your medical records?” I am sure I would get the same look and response over and over. The look of confusion and the response of “my doctor’s office?”  This is exactly what enterprise data sharing is set out to change.

A complete patient record for the patient means that a patient can go from their primary care physician to sub specialist without having to call ahead and have their records faxed over. It means that in the case of an emergency room visit they don’t have to worry about leaving with paperwork and getting it back to their primary care physician. It means their records follow them to whatever doctor they (or their insurance) choose.

For example, a couple weeks ago I won myself a trip to the emergency room after cutting a chunk out of my hand while slicing vegetables on a mandolin. (OUCH!) Not knowing my experience in healthcare IT, the resident, who came in first, was checking off all the boxes and asked “do you have a primary care physician?” In my pain ridden and snarky voice I responded “Why does it matter? Your computer can’t talk to hers anyway.” He got a chuckle and said I had a good point and then asked if I was in healthcare. But we have all been there. We have seen one physician only to turn around and have to tell the story all over again with the follow-up care physician because the records just aren’t there.

Not to mention I had pictures of the wound on my phone I had taken right after the incident. My follow-up physician asked that I send her these photos so she could take a look (because she didn’t have access to photos snapped in the ER). I asked her if she could put them into my patient record being my PCP? Her response, “no I don’t have a way to get them uploaded.” Similar to what Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital, said in his session at HIMSS16, he has multiple pics on his phone and there is nothing wrong security wise with that, but that’s not where the belong.

A complete patient record should include all medical data related to you. This includes images or all kinds whether an X-ray or photo snapped on an iPhone, textual reports (path, lab etc), and even larger data files including genome sequencing data, and digital breast tomosynthesis. I don’t think you would find one physician who would argue that any of your data is unimportant and can be left out.  In the wise words of John Halamaka, MD, CIO of Beth Israel Deaconess Medical Center the next time you ask why your patient record can’t be all in one and they (physicians or IT) respond because there is too much data to store, you should ask them “well how does Google do it then?”

De-silo Health IT

Posted on March 8, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
So we have started on the path of enterprise imaging with redefining the EMR, but we can’t stop there. Although, I noticed more familiar faces at HIMSS16, there weren’t enough imaging professionals. We need to de-silo the IT departments within healthcare systems and align them with the strategy that IT is just technology whether it’s radiology, cardiology, mammography etc. The overall IT department should be focused on interoperability and coming together to create a cohesive EMR including enterprise imaging.

Imaging is no longer limited to radiology, yet we still have specific radiology IT staff. This creates more siloes. I have seen it time and time again where the specialty IT departments are at odds with the hospital IT because they want to claim ownership of the data. I can’t blame them though because if something goes wrong with that data they are held responsible. So I don’t blame them, but like redefining the EMR to include all types of data we have to align the IT departments to reflect the whole EMR.

There should no longer be specific departmental IT rather there should be one large IT team with breakout teams that are dedicated to specific departmental (cardiology, radiology, pathology, billing, etc.) software and applications like the PACS or picture archiving system. They should be under the EMR and be tuned into it to create a cohesive team that can complete the patient within the EMR. No more “this is my data and you can’t touch it.” It is now this data belongs to the patient and it needs to be readily available to the patient and all the point of care physicians.

We as vendors and providers need to think of the patient record as the point of documentation rather than each individual department and physician creates their report and then sends it to the referring physician. The patient’s team of physicians and departments where studies and test are completed should be considered team data.

Next time you head into your doctor or head to the ER ask the question: “What is your hospitals standard for sharing?” If they respond with “Well we’ll send you home with a CD or we’ll provide you with a paper print out of a PDF.” RUN and run far away from that place. While a CD may sound like a good idea I am pretty sure you don’t have a DICOM viewer in your basement to view these images. Most likely your point of care physician doesn’t have the same viewer as the images were taken on and what if the CD gets scratched in transfer or even worse lost. If you get my drift, a CD is not the answer. Those images belong in the EMR and so does the radiology software and application support staff.

If you think about it, when you log into an online banking account like Chase you don’t have to log into your mortgage, credit card, savings account, checking account and investment specialists to get all the additional information. You have ONE VIEW of all these accounts as soon as you log in. I don’t know about you, but I consider all my banking information: social security number, credit score, retirement savings as vital as my healthcare information and should be kept as secure. Therefore I see no reason that HIT shouldn’t be aligned more like banking and offer a complete patient record. HIMSS gives us an ideal platform to align all of these departments.

Redefining the EMR

Posted on March 7, 2016 I Written By

The following is a guest blog post by Erin Wold, Account Based Marketing Program Manager at Hitachi Data Systems. You can follow Erin on Twitter: @ErinEWold
Erin Wold
Walking through the HIMSS 2016 exhibit hall, booth after booth I see interoperability this and interoperability that. So I decided to stop and ask the vendors, “When you say interoperability, what do you mean?” Answer after answer I heard, “We integrate with the EMR and other vendors to provide data into the patient record.” When asked to clarify what types of data, the majority mentioned all types of textual data. Never once did anyone respond with images of any sort. I actually got the response of “Why would enterprise imaging be at HIMSS?” when I asked “What about enterprise imaging?”

Here ladies and gentlemen lies our problem. When going to HIMSS vendors and attendees alike aren’t thinking of enterprise imaging for the most part. When you search for sessions, very few pop up when searching for imaging. This year’s HIMSS has seen a few more familiar faces from the imaging scene which is extremely exciting for the future of healthcare and patient engagement.

I was able to sit in on multiple imaging sessions and was lucky enough to go to one that was actually about enterprise imaging but neither were titled or tagged that way in the program. All great sessions with very informative information on why enterprise imaging is a must. It is not only easier for the point of care physician to access the patient record but it will increase patient care and reduce time between study and treatment.

As we move into the era where telemedicine is becoming a reality and anyone can receive care at their corner Walgreens, enterprise imaging is crucial to patient care. How do we get there?  How do we get the EHR gurus to work with the imaging gurus. After sitting through a session led by Alex Towbin, MD, Director of Radiology Informatics at Cincinnati Children’s Hospital; I see how it needs to start.

It started right then and there after he said we must redefine EMR.  We as vendors and providers have defined the EMR as a repository for textual data. We have done ourselves a disservice and we now have to reverse it. The EMR should be a central location where the patients care team can enter ALL data that has been collected on that patient. In essence it should be more like your teenage cousin’s Facebook page where they put everything than your Myspace page from 10 years ago where nothing has been uploaded because you can’t remember the password to gain access.

I was shocked when John Hamlaka, MD, CIO of Beth Israel Deaconess Medical Center, presented that only 50% of pediatric scans are read by the correct sub-specialist. This is in part due to the referring physician, the radiologist and the sub specialist lacking a way to share these scans and therefore the sub-specialist never knew it existed. Enterprise Imaging makes way for this to happen. Other risks that arise because of a lack of enterprise imaging: double exposure to radiation, misdiagnoses, crucial lapse in time between scan and start of treatment, and an incomplete patient record.

A step in the right direction was taken this year at HIMSS by aligning with SIIM or the Society for Imaging Informatics in Medicine and hosting dual sessions as well as a meet-up at the HIMSS Spot. Eighteen months ago they created a coalition of innovative members from both organizations. Moving forward it will take leaders from medical societies: HIMSS, SIIM, RSNA, ACR,  etc. Redefining  is only the beginning. While it seems like a long, hard road ahead we have to start somewhere.