"As they look to the next five years, health IT leaders from provider organizations large and small discuss their spending strategies for those two key technologies"
The electronic health record (EHR) is the core piece of most hospitals and health system's health information technology. Chief information officers and other leaders in health IT depend on data from their record systems. Most budget seasons, EHR optimization is a top priority.
Another important technology is the population health management platform. They rely on EHRs that are finely tuned to perform optimally. CIOs are investing more in population health systems and their clinical teams in order to keep patients healthy. This will help them manage the quality and cost of value-based care.
Despite numerous declarations over the years about a new "post EHR" era of electronic health records, ongoing operation of electronic medical records and pop-health tools still require significant investment. But how much should they invest? But how much investment should be made?
We asked eight leaders in health IT to share their spending plans with us as we look at the near-term future for EHRs and pop healthcare. This is the fifth installment of Healthcare IT News' feature.
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This series features in-depth interviews of CIOs and other tech leaders. It focuses on six categories: machine learning, AI and interoperability; telehealth and connected health, remote patient monitoring; cybersecurity; electronic records and population health; precision medicine; and emerging technology.
These are the eight leaders in health IT that we spoke to for this installment:
- Cara Babachicos is the Chief Information Officer at South Shore Health. This health system is based in Weymouth (Massachusetts).
- Ascension's chief medical information officer, Dr. Samit Desai, is the nation's largest health system with more than 2,600 locations of care in 19 US states and DC.
- Dr. Shaun Grannis is vice president of data and analytics at Regenstrief Institute, Indianapolis.
- Matt Hocks is chief operating officer of Sanford Health in Sioux Falls (South Dakota), which includes both provider and payer organizations.
- Dr. J. Michael Kramer is the chief medical informatics officer for OhioHealth. He is based in Dublin. Ohio.
- Mike Mistretta, CIO at Virginia Hospital Center in Arlington.
- B.J. Moore, CIO of Providence. The health system operates 52 hospitals in seven states: Alaska, Montana Oregon, Washington, California and New Mexico.
- Michael Restuccia is the CIO of Penn Medicine in Philadelphia.
A Truly Epic Environment
This quarter, the massive Providence will be completed its journey towards an all-Epic EHR Environment.
Moore stated that EHR is only one step of a 10 point process. Moore said, "So, how can we optimize that environment?" What can we do to make caregivers' lives easier? How can we gain better insight from our patients? How can we make the standard EHR more useful? The EHR allows us to act as one health system and not 51 hospitals. We will continue to evolve.
Do you think We Can Double our Practice Volume in 5 Years?
Mistretta, Virginia Hospital Center said that "We are just starting to dip our toes in the water of popul health because it hasn’t been a priority for our population or payers so far." "Most of our primary healthcare practices are already PCMH [patient Centered Medical Home] and have key players. But the real push is to coordinate care from the hospital to the practice.
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He said, "We have recently hired a population coordinator who will have primary responsibility to monitor and place high risk patients with social service and coordinate follow up care as necessary."
The EHR perspective will see the organization continue to develop social determinants and disease registries that are specific to the diseases it wants to prioritize.
Mistretta stated that they are also starting to look into health maintenance campaigns, and beginning to study the creation of specific disease registers. We still have much work to do in order to make this information meaningful once it is gathered.
He said, "Selling this kind of care again wasn't difficult once we defined a business case. But it remains to be determined how deep we can dive into pop healthcare without a well-structured situation." We see this opportunity for growth as we grow our ambulatory services over the coming years. This could potentially double our practice volume in the next five year with the right business case. It is too early to predict exactly where this will go in our market at the moment.
Pop Health and EHRs: Pushing EHRs Forward
The Regenstrief Institute is involved in many fellowship, mentoring, and training programs. The institute and Indiana University Fairbanks School of Public Health host the Biomedical Informatics Research Training Program in population and public health informatics. This program is funded by the National Library of Medicine.
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Grannis, Regenstrief Institute said that the Regenstrief FSPH program is also known as the Indiana Training Program in Public and Population Health Informatics. The highly-respected program prepares postdoctoral fellows and graduate students to work in a wide range of healthcare organizations and academia as well as in local, state, and federal public health departments.
He said, "These trainees fulfill a need for informaticians that can design and validate solutions for organizations critical to the maintenance or improvement of human health." EHRs contain valuable information that can help with population health.
He said that the company is committed to making the data accessible to both clinicians and administrators, who are responsible for providing the best possible care. "For example, the Health Dart app gathers pertinent data and presents it to the provider to aid decision-making and allow for more time with patients.
He said that Regenstrief is also working to train future doctors in EHR use. Although medical students are not allowed to use the technology in their daily work, they do have some experience. Students can get real-world experience with health IT through the Regenstrief Teaching EMR. We currently have the program in 12 schools across the country. We hope to expand our reach.
Value-Based Care Gets a Boost
Penn Medicine has made substantial investments in recent years in the design, construction, and deployment of its integrated electronic medical record for inpatient, ambulatory, and home care environments.
Restuccia, Penn Medicine said that "this investment already enabled population health efforts" and that it positioned the organization for further advancement of its value-based healthcare initiatives. "We will continue to improve these capabilities and utilize our advanced data analytics platform for areas of clinical opportunity.
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Kramer from OhioHealth believes that their AI, interoperability and digital outreach are all part of their EHR/population Health strategy.
He explained that four models from the AI program will help identify patients at risk. These models have been a foundational tool for payers. These tools will be foundational for health system workers in identifying risk and clinical care opportunities.
The Spotlight on Population Health
South Shore Health has made substantial investments in electronic health records, population health platforms, and other health information.
Babachicos, South Shore Health said that "Like many organizations, we must ensure that we have seamless solution that works well together." We also need to make sure these tools provide great options for patient engagement and can be customized to our specific needs while interoperable with the major electronic medical record system.
She said, "The main question in the next few years is how to leverage population health systems to understand patients and use these systems to proactively reach them in new ways that are appropriate for their support."
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Sanford Health's Hocks says that they want to keep people healthy and well. They offer innovative services to patients in order for them to manage chronic conditions and improve their health.
He said, "We have formed partnerships with technology vendors in order to coordinate care between clinics and medical facilities. We also connect patients to community resources and services that support their health and well-being beyond the hospital or clinic setting."
He said that technology advances in both software and hardware are the backbone of providing high-quality rural care. Sanford providers are able to deliver behavioral health services to remote communities because of the digital infrastructure that we have. This allows them to reach people who live up to three hours away from a specialist.
Sanford Health is also exploring new technology to allow clinicians to use 2-way texting to check in with patients with chronic conditions. All patients would have access to this technology, regardless of whether or not they own or use smartphones.
Pop health: A Proactive Approach
Ascension's strategy plan emphasizes the importance of a coordinated, proactive approach to managing population health. This helps accelerate its efforts to improve health outcomes for the people and communities it serves.
Desai of Ascension stated that "our clinical, technology, and experience teams have been working together in order to lay the foundations for a holistic system-wide solution to population health."
He said, "Among other things we moved our data into the cloud to make them easier to access and combine to give us insight into our patients' needs." "We are creating a care coordination platform that will enable performance analytics to help identify groups of needs within defined populations. This will allow for program creation and expertly coordinate and manage care of these defined population."
In order to better understand where patients are and what happens throughout the continuum, the organization is also reimagining its interoperability strategy.
He said, "Our customer relationship management software will serve as our engagement platform, integrating with both care coordination platform (eHRS) and electronic health record systems to notify clinicians about care gaps and nudge patients via outreach."
He concluded that "We are increasing our analytics capabilities in stratification, risk assessment of our populations, payer quality and rate adjustment to better understand medical trends and continuity to optimize care delivery for our population."
Reference: https://www.healthcareitnews.com/news/cios-plan-big-investments-ehr-optimization-and-pop-health-it
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