As 2014 approaches, the entire healthcare industry is rushing to prepare for several significant changes, including an influx of insured patients under the Patient Protection and Affordable Care Act, increasing financial pressures to expand care coordination efforts and a myriad of new IT standards and regulations, including meaningful use stage 2 and ICD-10.
Many of the changes in the healthcare industry will lead to more hospitals and health systems investing in and using health information exchange networks. Joe Casper, CEO of the physician-led health IT company Sandlot Solutions, has identified four major trends that will have a significant impact on the use of HIEs in 2014.
1. Big data analytics. Hospitals will continue to have access to an ever-growing amount of data through electronic health record systems, HIEs and other sources in 2014 and beyond. This data, when aggregated, analyzed and made actionable, will help hospitals succeed in an industry more focused on coordinating care. Big data analytics will "help hospitals find the gaps in care they typically wouldn't see," says Mr. Casper, meaning HIEs help hospitals succeed in the new world of accountable care organizations and other risk-based models.
The increased focus on big data analytics will lead to increased use of HIEs. "For the first time, we're seeing competitors willing to share data," says Mr. Casper, as there is and will continue to be increased recognition throughout the industry of the potential of big data analytics to provide valuable business insights.
"Many already have HIEs in their own system," he says. "Now more and more they're going outside their walls to get data."
2. Hospital and health system consolidation. Financial pressures and other factors will continue to drive consolidation of healthcare organizations in 2014. All this merger and acquisition activity means patients will have access to more providers within a single health system, but it will make the ability to seamlessly transmit patient information between providers all the more important, especially if the providers each have a different legacy EHR system.
"EHR systems aren't a major concern during merger and acquisition discussions. They're a 'B' or 'C' priority, not an 'A' priority," he says, meaning often consolidation results in an organization running several different EHR systems that are unable to share data.
Often, cost will prohibit a move onto a single platform, says Mr. Casper, a problem easily solved with a systemwide HIE to allow for shared patient information.
3. Readmission penalties. "Hospitals and clinicians are very aware of the readmission penalties," says Mr. Casper, which will spike up to a possible 3 percent of Medicare payments starting in fiscal year 2015. Having a systemwide HIE, or participating in a regional exchange, would allow providers to track patients readmitted to any participating facility, not just back to the facility where the patient was initially treated. This information would allow providers to better track discharged patients in their ongoing effort to reduce readmissions, as well as know if they are at risk for readmissions penalties.
"What happens now is they don't know their patient has been readmitted at another hospital until they see the fine," says Mr. Casper.
4. Mobile technology. As mobile devices proliferate, an opportunity emerges for providers to engage patients with their health information. Through patient portals, patients could access their test results, medications and other health information quickly and easily, allowing the patient to be on the front lines of his own care.
However, providers need to monitor the flow of data from the information exchange directly to the patient. Normal test results can be shared quickly and without explanation, though more sensitive or potentially upsetting news should be delivered differently, says Mr. Casper. "There needs to be added intelligence so [the information] is customized to be what's best for the patient," he says.
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