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Interoperability Problems Undercut Conclusions of CHIME Most Wired Survey

Posted on November 13, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Most of you have probably already seen the topline results from CHIME’s  “Healthcare’s Most Wired: National Trends 2018” study, which was released last month.

Some of the more interesting numbers coming out of the survey, at least for me, included the following:

  • Just 60% of responding physicians could access a hospital network’s virtual patient visit technology from outside its network, which kinda defeats the purpose of decentralizing care delivery.
  • The number of clinical alerts sent from a surveillance system integrated with an EHR topped out at 58% (alerts to critical care units), with 35% of respondents reporting that they had no surveillance system in place. This seems like quite a lost opportunity.
  • Virtually all (94%) participating organizations said that their organization’s EHR could consume discrete data, and 64% said they could incorporate CCDs and CCRs from physician-office EHRs as discrete data.

What really stands out for me, though, is that if CHIME’s overall analysis is correct, many aspects of our data analytics and patient engagement progress still hang in the balance.

Perhaps by design, the hospital industry comes out looking like it’s doing well in most of the technology strategy areas that it has questions about in the survey, but leaves out some important areas of weakness.

Specifically, in the introduction to its survey report, the group lists “integration and interoperability” as one of two groups of foundational technologies that must be in place before population health management/value-based care,  patient engagement and telehealth programs can proceed.

If that’s true, and it probably is, it throws up a red flag, which is probably why the report glossed over the fact that overall interoperability between hospitals is still very much in question. (If nothing else, it’s high time the hospitals adjust their interoperability expectations.) While it did cite numbers regarding what can be done with CCDs, it didn’t address the much bigger problems the industry faces in sharing data more fluidly.

Look, I don’t mean to be too literal here. Even if CHIME didn’t say so specifically, hospitals and health systems can make some progress on population health, patient engagement, and telehealth strategies even if they’re forced to stick to using their own internal data. Failing to establish fluid health data sharing between facility A and facility B may lead to less-than-ideal results, but it doesn’t stop either of them from marching towards goals like PHM or value-based care individually.

On the other hand, there certainly is an extent to which a lack of interoperability drags down the quality of our results. Perhaps the data sets we have are good enough even if they’re incomplete, but I think we’ve already got a pretty good sense that no amount of CCD exchange will get the results we ultimately hope to see. In other words, I’m suggesting that we take the CHIME survey’s data points in context.

Hospitals Sharing More Patient Data Than Ever, But Is It Having An Impact On Patient Care?

Posted on November 1, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Brace yourself for more happy talk in a positive interoperability spin, folks. Even if they aren’t exchanging as much health data as they might have hoped, hospitals are sharing more patient health data than they ever have before, according to a new report from the ONC.

The ONC, which recently analyzed 2017 data from the American Hospital Association’s Information Technology Supplement Survey, concluded that 93% of non-federal acute care hospitals have upgraded to the 2015 Edition Health IT Certification Criteria or plan to upgrade. These criteria include new technical capabilities that support health data interoperability.

Today, most hospitals (88%) can send patient summary of care records electronically, and receive them from outside sources (74%), ONC’s analysis concluded. In addition, last year the volume of hospitals reporting that they could query and integrate patient health data significantly increased.

Not only that, the volume of hospitals engaged in four key interoperability activities (electronically sending, receiving, finding and integrating health data) climbed 41% over 2016. On the downside, however, only four in 10 hospitals reported being able to find patient health information, send, receive and integrate patient summary of care records from outside sources into their data.

According to ONC, hospitals that work across these four key interoperability domains tend to be more sophisticated than their peers who don’t.

In fact, in 2017 83% of hospitals able to send, receive, find, and integrate outside health information also had health information electronic available at the point of care. This is a 20% higher level than hospitals engaging in just three domains, and a whopping seven times higher than hospitals that don’t engage in any domain.

Without a doubt, on its face this is good news. What’s not to like? Hospitals seem to be stepping up the interoperability game, and this can only be good for patients over time.

On the other hand, it’s hard for me to measure just how important it is in the near term. Yes, it seems like hospitals are getting more nimble, more motivated and more organized when it comes to data sharing, but it’s not clear what impact this may be having on patient care processes and outcomes.

Over time, most interoperability measures I’ve seen have focused more on receipt and transmission of patient health data far more than integration of that data into EHRs. I’d argue that it’s time to move beyond measuring back and forth of data and put more impact on how often physicians use that data in their work.

There’s certainly a compelling case to be made that health data interoperability matters. I’ve never disputed that. But I think it’s time we measure success a bit more stringently. In other words, if ONC can’t define the clinical benefits of health data exchange clearly, in terms that matter to physicians, it’s time to make it happen.

Taming the Healthcare Compliance and Data Security Monster: How Well Are We Doing?

Posted on October 18, 2018 I Written By

The following is a guest blog post by Lance Pilkington, Vice President of Global Compliance at Liaison Technologies.

Do data breach nightmares keep you up at night?

For 229 healthcare organizations, the nightmare became a reality in 2018. As of late August, more than 6.1 million individuals were affected by 229 healthcare-related breaches, according to the Department of Health and Human Services’ HIPAA Breach Reporting Tool website – commonly call the HIPAA “wall of shame.”

Although security and privacy requirements for healthcare data have been in place for many years, the reality is that many healthcare organizations are still at risk for non-compliance with regulations and for breaches.

In fact, only 65 percent of 112 hospitals and hospital groups recently surveyed by Aberdeen, an industry analyst firm, reported compliance with 11 common regulations and frameworks for data security. According to the healthcare-specific brief – Enterprise Data in 2018: The State of Privacy and Security Compliance in Healthcare – protected health information has the highest percentage of compliance, with 85 percent of participants reporting full compliance, and the lowest compliance rates were reported for ISO 27001 and the General Data Protection Regulation at 63 percent and 48 percent respectively.

An index developed by Aberdeen to measure the maturity of an organization’s compliance efforts shows that although the healthcare organizations surveyed were mature in their data management efforts, they were far less developed in their compliance efforts when they stored and protected data, syndicated data between two applications, ingested data into a central repository or integrated data from multiple, disparate sources.

The immaturity of compliance efforts has real-world consequences for healthcare entities. Four out of five (81 percent) study participants reported at least one data privacy and non-compliance issue in the past year, and two out of three (66 percent) reported at least one data breach in the past year.

It isn’t surprising to find that healthcare organizations struggle with data security. The complexity and number of types of data and data-related processes in healthcare is daunting. In addition to PHI, hospitals and their affiliates handle financial transactions, personally identifiable information, employee records, and confidential or intellectual property records. Adding to the challenge of protecting this information is the ever-increasing use of mobile devices in clinical and business areas of the healthcare organization.

In addition to the complexities of data management and integration, there are budgetary considerations. As healthcare organizations face increasing financial challenges, investment in new technology and the IT personnel to manage it can be formidable. However, healthcare participants in the Aberdeen study reported a median of 37 percent of the overall IT budget dedicated to investment in compliance activities. Study participants from life sciences and other industries included in Aberdeen’s total study reported lower budget commitments to compliance.

This raises the question: If healthcare organizations are investing in compliance activities, why do we still see significant data breaches, fines for non-compliance and difficulty reaching full compliance?

While there are practical steps that every privacy and security officer should take to ensure the organization is compliant with HIPAA, there are also technology options that enhance a healthcare entity’s ability to better manage data integration from multiple sources and address compliance requirements.

An upcoming webinar, The State of Privacy and Security Compliance for Enterprise Data: “Why Are We Doing This Ourselves?” discusses the Aberdeen survey results and presents advice on how healthcare IT leaders can evaluate their compliance-readiness and identify potential solutions can provide some thought-provoking guidance.

One of the solutions is the use of third-party providers who can provide the data integration and management needs of the healthcare organization to ensure compliance with data security requirements. This strategy can also address a myriad of challenges faced by hospitals. Not only can the expertise and specialty knowledge of the third-party take a burden off in-house IT staff but choosing a managed services strategy that eliminates the need for a significant upfront investment enables moving the expense from the IT capital budget to the operating budget with predictable recurring costs.

Freeing capital dollars to invest in other digital transformation strategies and enabling IT staff to focus on mission-critical activities in the healthcare organization are benefits of exploring outsource opportunities with the right partner.

More importantly, moving toward a higher level of compliance with data security requirements will improve the likelihood of a good night’s sleep!

About Lance Pilkington
Lance Pilkington is the Vice President of Global Compliance at Liaison Technologies, a position he has held since joining the company in September 2012. Lance is responsible for establishing and leading strategic initiatives under Liaison’s Trust program to ensure the company is consistently delivering on its compliance commitments. Liaison Technologies is a proud sponsor of Healthcare Scene.

Connecting the Data: Three Steps to Meet Digital Transformation Goals

Posted on July 16, 2018 I Written By

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

A white paper published by the World Economic Forum in 2016 begins with the statement, “Few industries have the potential to be changed so profoundly by digital technology as healthcare, but the challenges facing innovators – from regulatory barriers to difficulties in digitalizing patient data – should not be underestimated.”

That was two years ago, and many of the same challenges still exist as the digital transformation of healthcare continues.

In a recent HIMSS focus group sponsored by Liaison, participants identified their major digital transformation and interoperability goals for the near future as:

  • EMR rollout and integration
  • Population health monitoring and analytics
  • Remote clinical encounters
  • Mobile clinical applications

These goals are not surprising. Although EMRs have been in place in many healthcare organizations for years, the growth of health systems as they add physicians, clinics, hospitals and diagnostic centers represents a growing need to integrate disparate systems. The continual increase in the number of mobile applications and medical devices that can be used to gather information to feed into EMR systems further exacerbates the challenge.

What is surprising is the low percentage of health systems that believe that they are very or somewhat well-prepared to handle these challenges – only 35 percent of the HIMSS/Liaison focus group members identified themselves as well-prepared.

“Chaos” was a word used by focus group participants to describe what happens in a health system when numerous players, overlapping projects, lack of a single coordinator and a tendency to find niche solutions that focus on one need rather than overall organizational needs drive digital transformation projects.

It’s easy to understand the frustration. Too few IT resources and too many needs in the pipeline lead to multiple groups of people working on projects that overlap in goals – sometimes duplicating each other’s efforts – and tax limited staff, budget and infrastructure resources. It was also interesting to see that focus group participants noted that new technologies and changing regulatory requirements keep derailing efforts over multi-year projects.

Throughout all the challenges identified by healthcare organizations, the issue of data integrity is paramount. The addition of new technologies, including mobile and AI-driven analytics, and new sources of information, increases the need to ensure that data is in a format that is accessible to all users and all applications. Otherwise, the full benefits of digital transformation will not be realized.

The lack of universal standards to enable interoperability are being addressed, but until those standards are available, healthcare organizations must evaluate other ways to integrate and harmonize data to make it available to the myriad of users and applications that can benefit from insights provided by the information. Unlocking access to previously unseen data takes resources that many health organizations have in short supply. And the truth is, we’ll never have the perfect standards as they will always continue to change, so there’s no reason to wait.

Infrastructure, however, was not the number one resource identified in the HIMSS focus group as lacking in participants’ interoperability journey. In fact, only 15 percent saw infrastructure as the missing piece, while 30 percent identified IT staffing resources and 45 percent identified the right level of expertise as the most critical needs for their organization.

As all industries focus on digital transformation, competition for expert staff to handle interoperability challenges makes it difficult for healthcare organizations to attract the talent needed. For this reason, 45 percent of healthcare organizations outsource IT data integration and management to address staffing challenges.

Health systems are also evaluating the use of managed services strategies. A managed services solution takes over the day-to-day integration and data management with the right expertise and the manpower to take on complex work and fluctuating project levels. That way in-house staff resources can focus on the innovation and efficiencies that support patient care and operations, while the operating budget covers data management fees – leaving capital dollars available for critical patient care needs.

Removing day-to-day integration responsibilities from in-house staff also provides time to look strategically at the organization’s overall interoperability needs – coordinating efforts in a holistic manner. The ability to implement solutions for current needs with an eye toward future needs future-proofs an organization’s digital investment and helps avoid the “app-trap” – a reliance on narrowly focused applications with bounded data that cannot be accessed by disparate users.

There is no one answer to healthcare’s digital transformation questions, but taking the following three steps can move an organization closer to the goal of meaningful interoperability:

  • Don’t wait for interoperability standards to be developed – find a data integration and management platform that will integrate and harmonize data from disparate sources to make the information available to all users the way they need it and when they needed.
  • Turn to a data management and integration partner who can provide the expertise required to remain up-to-date on all interoperability, security and regulatory compliance requirements and other mandatory capabilities.
  • Approach digital transformation holistically with a coordinated strategy that considers each new application or capability as data gathered for the benefit of the entire organization rather than siloed for use by a narrowly-focused group of users.

The digital transformation of healthcare and the interoperability challenges that must be overcome are not minor issues, nor are they insurmountable. It is only through the sharing of ideas, information about new technologies and best practices that healthcare organizations can maximize the insights provided by data shared across the enterprise.

About Gary Palgon
Gary Palgon is vice president of healthcare and life sciences solutions at Liaison Technologies, a proud sponsor of Healthcare Scene. 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.

Improving Data Outcomes: Just What The Doctor Ordered

Posted on May 8, 2018 I Written By

The following is a guest blog post by Dave Corbin, CEO of HULFT.

Health care has a data problem. Vast quantities are generated but inefficiencies around sharing, retrieval, and integration have acute repercussions in an environment of squeezed budgets and growing patient demands.

The sensitive nature of much of the data being processed is a core issue. Confidential patient information has traditionally encouraged a ‘closed door’ approach to data management and an unease over hyper-accessibility to this information.

Compounding the challenge is the sheer scale and scope of the typical health care environment and myriad of departmental layers. The mix of new and legacy IT systems used for everything from billing records to patient tracking often means deep silos and poor data connections, the accumulative effect of which undermines decision-making. As delays become commonplace, this ongoing battle to coordinate disparate information manifests itself in many different ways in a busy hospital.

Optimizing bed occupancies – a data issue?

One example involves managing bed occupancy, a complex task which needs multiple players to be in the loop when it comes to the latest on a patient’s admission or discharge status. Anecdotal evidence points to a process often informed manually via feedback with competing information. Nurses at the end of their shift may report that a patient is about to be discharged, unaware that a doctor has since requested more tests to be carried out for that patient. As everyone is left waiting for the results from the laboratory, the planned changeover of beds is delayed with many knock-on effects, increasing congestion and costs and frustrating staff and patients in equal measure.

How data is managed becomes a critical factor in tackling the variations that creep into critical processes and resource utilization. In the example above, harnessing predictive modelling and data mining to forecast the number of patient discharges so that the number of beds available for the coming weeks can be estimated more accurately will no doubt become an increasingly mainstream option for the sector.

Predictive analytics is great and all, but first….

Before any of this can happen, health care organizations need a solid foundation of accessible and visible data which is centralized, intuitive, and easy to manage.

Providing a holistic approach to data transfer and integration, data logistics can help deliver security, compliance, and seamless connectivity speeding up the processing of large volumes of sensitive material such as electronic health records – the kind of data that simply cannot be lost. These can ensure the reliable and secure exchange of intelligence with outside health care vendors and partners.

For data outcomes, we’re calling for a new breed of data logistics that’s intuitive and easy to use. Monitoring interfaces which enable anyone with permission to access the network to see what integrations and transfers are running in real time with no requirement for programming or coding are the kind of intervention which opens the data management to a far wider section of an organization.

Collecting data across a network of multiple transfer and integration activities and putting it in a place where people can use, manage and manipulate becomes central to breaking down the barriers that have long compromised efficiencies in the health care sector.

HULFT works with health care organizations of all sizes to establish a strong back-end data infrastructure that make front-end advances possible. Learn how one medical technology pioneer used HULFT to drive operational efficiencies and improve quality assurance in this case study.

Dave Corbin is CEO of HULFT, a comprehensive data logistics platform that allows IT to find, secure, transform and move information at scale. HULFT is a proud sponsor of Health IT Expo, a practical innovation conference organized by Healthcare Scene.  Find out more at hulftinc.com