The HIMSS Annual Conference is a forum for Health IT vendors and end-users to share information regarding the latest health IT technologies and implementation methodologies. Stemp CEO, Morris Stemp and Account Manager, Beverly Wachtel, are at HIMSS this week (Feb 20 thru Feb 24, 2012) attending educational sessions and speaking with exhibitors about what’s new. At the center of the discussion are electronic health records (EHR) systems and supporting infrastructure, both hardware, and software.
Our first day at the conference was spent at an all day workshop called “EHR Vendor Evaluation, Selection and Implementation: Mission Possible – Choosing and ‘Meaningfully Using’ Health IT for Quality Care Delivery” led by Jacqueline B. Rosenblatt, PhD, CPHIMS. Ms. Rosenblatt is the Director of Ambulatory Quality Improvement at MPRO (The Michigan Quality Improvement Organization for the State of Michigan) and specialized in EHR implementation consulting. A summary of some of the more salient issues covered in this workshop follows.
The first steps for doctors moving from paper to electronic medical records involve selecting an EMR/EHR vendor and managing workflows with an EHR. This process is all about the significant change implementing an EHR system will require. Change is the central issue; managing the change from paper to electronic medical records can only be successful with the involvement of a team of users, a practice assessment, goal development and process flow mapping. Implementing EHR is not simply automating the paper process. To achieve the benefits of an electronic system, and especially to achieve Meaningful Use as defined by the government, involves learning and adapting to new workflows. The workflow has to involve capturing data in real time, in the right order, by the responsible user.
During the vendor selection process, it is necessary to identify those vendors which have the functionality important for a given practice/specialty and to identify a set of key differentiators which set one vendor apart from the others. The fact that an EHR is certified for Meaningful Use does not mean the EHR will meet your needs. Training is essential and should be scheduled as close to go-live as possible – when staff will be most engaged. When getting started, it is essential to set realistic and measurable goals, understanding what the system will and will not do. For example, an EHR will eliminate the need for chart hunts, but it will not initially save the provider time during patient encounters.
The second day of the conference started off with the keynote address by Biz Stone, co-founder of Twitter, who spoke about the events that led up to his creating Twitter. He described how he wanted to build something that would quickly and easily connect people and the criticism he first encountered that Twitter was not useful. He soon discovered the power of his emerging system when in 2007 a user tweeted that the party he was attending was too loud and he was going to a different party across the hall. Biz noticed that within 8 minutes, 800 people had moved to the second party. We expected that Mr. Stone would discuss how the use of social media would influence healthcare, but he fell short of drawing a parallel to healthcare. This keynote address was, unfortunately, quite disappointing.
We subsequently attended a session describing the current state of interoperability between EHR systems from various vendors with hospitals and each other. One of the most sought after goals of implementing an EHR system and a pivotal target of Meaningful Use Stage 2 is to electronically share patient data. Benefits of interoperability include that a patient will only need to fill out forms at one medical facility to have the information available at other medical facilities, unnecessary repetition of medical tests will be eliminated, and a patient’s history will be available when a patient is brought to the Emergency Department.
As you can imagine, sharing data between totally disparate systems is quite a difficult and sophisticated challenge with many technical barriers. This is the challenge that the session called “Connecting EHRs to HIEs: Defining a new level of interoperability” addressed. The Interoperability Workgroup which now consists of 10 states and 26 vendors including EHR vendors and Health Information Exchange (HIE) vendors, and led by the NYS eHealth Collaborative, is working to create standard specifications to allow “out of the box” connectivity between health information exchanges (HIEs) and EHRs, and thus between EHRs and EHRs. Their goal is to adapt existing standards to format and present the totally of a patient’s records in a manner which can be transferred from any EHR system and uploaded into any other EHR system at a private practice or hospital. While this information sharing methodology requires a great deal of collaboration between competing EHR systems, the EHR vendors have come together and the benefits of this collaboration should be available in new software releases in the near term.
We intend to visit the Interoperability Showcase at the conference to learn more about how the sharing of patient medical records will actually work. Vendors plan to demo pre-release versions of their software actually transmitting data back and forth between competitive systems.
The first days of the conference have proved to be a very informative. Tomorrow we’ll share some of the new technologies being shown in the exhibit hall.