IHealthBeat | Hospital EMR and EHR

Many Hospital Executives Expect Big Health IT Investments This Year

Surprise, surprise. A new report from the Premier healthcare alliance finds that many hospital executives will make their largest capital investments in IT this year.

To prepare the report, known as the spring 2013 Economic Outlook, Premier spoke with 530 survey respondents, most of whom were hospital leaders. Survey respondents also included materials and practice area managers, reports iHealthBeat.

Roughly 43 percent of respondents said that their health organization’s biggest capital investment over the next year would be in health IT, a jump of 21 percent from two years ago. Offering a hint on where the money may be going, the report also found that 32 percent of respondents can’t currently share data across the continuum of care.

Other clues as to where the spending is going come from the study’s topline finding, which predicts a big shift from inpatient to outpatient care.

According to Premier, only 35 percent of respondents are expecting to see an increase in inpatient spending this year as compared to 2012, down 30 percent from predictions made last year. Meanwhile, 69 percent of respondents said they expect to see an increase in 2013 outpatient volume compared to last year.

Some additional intelligence from the report:

* 22 percent of respondents are in an ACO, and 55 percent plan to be by the end of next year

* 27 percent don’t have plans to pursue the ACO model, and may look to bundled payment, care management fees or pay for performance options

* 29 percent said overutilization of products and services and 22 percent said lack of clinical coordination were the biggest drivers of healthcare costs

* 48 percent said reimbursement cuts had the biggest impact on their health systems

* 40 percent said capital spending would increase over the next 12 months as compared with the previous year

* Almost 37 percent project a capital spending decrease

Making Devices Interoperable Offers $30B Savings Opportunity

Right now, it’s a hit and miss thing whether hospital medical devices can talk to each other or connect with the facility’s EMR. A lack of standards — and money for next-gen devices — has made such interoperability a very tough job. But getting the job done is worth the trouble, a new story in iHealthBeat suggests.

At present, patients in hospitals are treated with six to 12 medical devices in a typical intensive care unit, including defibrillators, electrocardiographs, vital sign monitors, ventilators and infusion pumps, typically from a mix of manufacturers, notes West Health Institute. Because these devices aren’t inherently interoperable, hospitals spend big on IT infrastructure to connect them.

There’s plenty of reason to make them connect, however. A study by West Health has concluded that if the industry could improve medical device interoperability and adhere to interoperability standards, it could shave $30 billion off of U.S. healthcare costs. According to the report, the U.S. spends $36 billion each year on “addressable waste” resulting from a lack of medical device interoperability. Savings the U.S. could realize breaks down as follows, iHealthBeat reports:

$17.8 billion from higher treatment capacity that would result from shorter hospital stays
$12.3 billion from increased clinician productivity
$3 billion from reducing the cost of providing care
$2 billion from reducing adverse events
$1.2 billion from wider adoption of interoperability standards

But getting to the point where interoperability is common could take a long time, according to West Health’s Joseph Smith, who recently testified on the Hill on this subject. Right now, only one-third of hospitals using six or more medical devices that can be integrated with EMRs have actually done the integration work, Smith told a House subcommittee.

What’s more, vendors will need to invest in R&D to turn out next-gen interoperable devices, a cost that will be at least partly absorbed rather than passed on to the buyer, Smith noted.

Hospitals Beware: EMR Copy And Paste Common

EMR templates are both a curse and a blessing. On the one hand, they systematize clinical data in a way that makes it far easier to share, aggregate and study trends. But the down side, and it’s a big one, is that EMR templates tempt clinicians to save time by cutting and pasting old data from patient’s record into current visit notes. The following study gives us a look at just how easily copy-and-paste can become a (bad) habit for clinicians in a hospital.

To study template use, an assistant professor at Case Western Reserve University School of Medicine brought together a group of colleagues to examine EMR-based progress reports. The group looked at 2,068 electronic progress reports created by 62 residents and 11 attending physicians, all of whom were working in the intensive care unit of a Cleveland hospital.

To determine how common cut-and-paste content was in the notes, the researchers reviewed notes for 135 patients over a five-month period using plagiarism-detection software, iHealthBeat reports. The results? They found that 82 percent of progress notes created by residents contained 20 percent or more of copied and pasted material from patient records. Meanwhile, 74 percent of progress notes created by attending physicians contained 20 percent or more of material cut-and-pasted from patient EMR records.

I’m not writing this to beat up on doctors, who certainly have their hands full simply coping with the new systems. Cut-and-paste is a natural instinct when you’ve spent your life doing so successfully in Word docs and spreadsheets. But as the iHealthBeat piece points out, courtesy of EHR Intelligence, there are reasons to be concerned when this much copying is going on, including outdated records, incorrect billing requests and worst of all, mistakes in documentation which could harm vulnerable ICU patients.

Seems that cutting and pasting within EMR documentation is a problem that’s not going to go away on its own.

M	T	W	T	F	S	S
« Apr
		1	2	3	4	5
6	7	8	9	10	11	12
13	14	15	16	17	18	19
20	21	22	23	24	25	26
27	28	29	30	31

Many Hospital Executives Expect Big Health IT Investments This Year

Making Devices Interoperable Offers $30B Savings Opportunity

Hospitals Beware: EMR Copy And Paste Common

Recent Posts

Calendar

Hospital EMR & EHR Resources

Recent Comments

Categories