The Patients Are Coming! The Patients Are Coming!
Beyond Electronic Health Records
The CDC recently reported that 55% of physicians are now using EHRs, and 85% of those were somewhat or very satisfied with the technology[1]. We are certainly moving in the right direction, but 55% is only a little over half. The EHR is a basic tool of clinical information management. It sometimes is limited only to the individual doctor’s office and his or her patients. Connecting doctors within the larger practice is a step in the right direction, but a more comprehensive kind of connectivity will be needed to handle the volumes that are already building and that will easily become unmanageable for physicians without some kind of electronic support.
Add to that the boomers’ own expectations and demands of their physicians that some kind of technology is employed. Boomers, who may often work, live and breathe technology, will look skeptically upon practices, clinics, hospitals and integrated delivery networks (IDN) that are not wired to support them. It’s basic customer service. Imagine going to your physician; he inputs the details of your visit into his office system; his practice happens to be in the same building as the regional hospital in your area; he orders lab work for you; his nurse prints out the lab order and you must carry this print-out 50 yards down the hall to the hospital lab because his practice and the hospital are not connected electronically. For how long do you think this will fly?
A new report by the MIT Enterprise Forum Northwest finds that boomers are already the top consumers of healthcare technology. “Baby boomers, ages 46 to 64, are poised to not only continue that trend, but to shape it–particularly in the field of mobile healthcare. Boomers view tech-enabled health products as a way to foster control and ongoing independence for themselves, especially in light of the rise in incidence in chronic disease with aging, and their desire to reduce costs,” the report reads. “Nearly 56 percent of boomers show a high willingness to use in-home health monitoring devices in tandem with the care of their primary physician.” The report’s authors point to the increased use of health apps for smartphones — 200 million worldwide. That and the aforementioned desire for more personal monitoring are an indication of where things are headed. They also note that technology enablers, like the FCC’s National Broadband Plan to bring high-speed web access to underserved areas in the U.S., will make the transition even easier.[2]
The Emergence of HIE
Independence. Control. Mobility. These healthcare preferences in aging boomers completely align with the way boomers have conducted their lives throughout, so it is not surprising that these goals will drive the overall arc of healthcare as they enter their golden years. To that end, health information exchange provides the logical option for delivering what the boomers want and what providers need. HIE delivers clinical information at the point-of-care in the moment-of-need, through whatever device the provider is using (laptop, desktop, mobile, etc.). In addition, the emergence of standards for data sharing and communication (i.e., CCDs, and NwHIN DIRECT) are key initiatives that the government is promoting to ensure that data is exchangeable and that communication is open to anyone that has access to the Internet. The engagement of providers in the use of HIE will be a critical stepping stone to support this engagement and the use of technology by patients. The whole premise of CCD, to allow data sharing and exchange to go to and from the EMR, is a key to aligning next generation technology with workflow.
HIEs work because they have been crafted to both aggregate and specify clinical data and deliver that data when and where it’s needed. The so-called “patient centric” HIE model enables multiple providers access and use of a particular patient’s record to securely provide information to the record as a result of interaction with the patient. The data can be centralized or distributed, but are increasingly being housed in the “clouds” as cloud computing is proving itself to be a very reliable, secure and inexpensive way of storing and distributing clinical data. This secure environment enables patient matching and a record locator service to be able to quickly respond to requests for patient information. In this model, the information is shared, but not replicated, at each participant location, helping to reduce redundancy and control costs. Authorized participants are also able to provide patient information as it pertains to each clinical encounter. The patient-centric model deals with both individual patient data and aggregated data so that it can be accessed across numerous care settings. [3] Patients will need to be engaged as well as physicians. Patient portals embedded in HIEs will become a key component of ensuring the patient is a participant in his or her own care, not only being apprised of medications and results, but also influencing care and outcomes.
Ultimately, this patient-centric HIE will become the standard for housing and transporting clinical data. The demands of boomers will require that providers be able to access, modify and store their data so that they (the boomers) and providers will be able to monitor, modify and deliver care when and where needed. Once again the boomers are in the driver’s seat. This time the technology and features are there to improve patient outcomes and reduce costs through access to clinical data as the largest and most influential cohort in human history stands on the brink of transformation … once again.
[1] “Physician Adoption of Electronic Health Records”; NCHS Data Brief; Number 98; July 2012; United States, 2011
[2] Report: Boomers will shape m-health technology efforts – FierceMobileHealthcare
[3] “All Health Information Exchanges Are Not Created Equal: Patient Portability versus Patient Centric Models”; 2012; John Tempesco; ICA
John Smith is Director of Communications at ICA. This blog post was first published on ICA’s HITme Blog. John has over 20 years of experience in healthcare communications with a focus on health information technology, having served as Senior Vice President and Healthcare Practice Leader at several communications firms, including Fleishmann Hillard, Manning Selvage and Lee and Brodeur Worldwide.