Healthcare Analytics, Population Health Management, Healthcare Big Data

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As Hospital EHR Adoption Rises, What’s Next for Health IT?

- Hospital EHR adoption has officially reached more than three-quarters of the healthcare community, according to the newest data from the Office of the National Coordinator, and the rapid rise in health IT infrastructure development may actually just be at its beginning. 

Hospital EHR adoption and health IT infrastructure

With the majority of hospitals steadily increasing their health IT capabilities with more advanced EHR functionalities, healthcare providers are keeping an eye on clinical analytics and big data development that will help them meet future strategic organizational objectives.

In 2014, seventy-six percent of hospitals had adopted at least a basic EHR system that can accept clinical notes and perform other simple functionalities, and 96.9 percent had implemented or agreed to implement a certified EHR technology that can be used to attest to meaningful use. 

While a few states such as Hawaii, Kansas, West Virginia, and Kentucky remain significantly below the national average, hovering between 50 and 65 percent, basic hospital EHR adoption has reached 100 percent in Delaware and more than ninety percent in South Dakota, Virginia, Maryland, and Arkansas.

Compared to the landscape of hospital EHR adoption in 2008, when just two states had basic EHR implementation rates above 20 percent, even the slowest regions of the country have made significant strides towards health IT adoption and use.

Hospitals are not just putting the technology in place, but focusing on maximizing their abilities to leverage their infrastructure in a meaningful way.  Hospital adoption of comprehensive EHR systems has increased eleven times over since 2009, the data brief says, and the technology can now be found in a third of organizations.

But EHRs are only the beginning for healthcare providers, and especially for hospitals that are taking on a more active role in care coordination while accepting an increased amount of financial risk.  As Stage 2 meaningful use demands more in the way of data reporting and analytics capabilities, and Stage 3 looms with increased requirements for population health management and data-driven clinical quality improvements, hospital EHR adoption must move far beyond the basics.

For hospitals with a handle on their EHR technologies, what are the next health IT and data analytics projects that will help to improve the quality and delivery of patient care?

Interoperability and health information exchange

Healthcare stakeholders have picked up the pace when it comes to making health data interoperability a reality, yet basic health information exchange is still a hit-or-miss proposition.  Hospitals that act as community anchors must take the lead in HIE by dropping their competitive shields and sharing data with regional or state health information exchanges.  Only by putting the needs of the patient first can hospitals provide the truly effective care that consumers expect and deserve.

“Healthcare has evolved and people bounce from hospital to hospital, and it’s important for us to be able to have information at the fingertips of our providers as they deliver care at the point of care,” said Nicholas Desai, MD, DPM, MBA, CMIO of Houston Methodist Health System, in a 2014 interview with EHRintelligence.com. “As a provider, having information at your fingerprints is probably the most important piece, which most people take for granted.”

While developing an HIE infrastructure may not be easy for hospitals who are locked into vendor products that do not encourage interoperability, a growing emphasis on APIs, data standards, and other technologies will help to smooth the way in the near future.

Clinical documentation improvement and ICD-10

Adopting an EHR is one thing, but ensuring a high level of accuracy, completeness, and integrity of the data that lives within the system is quite another.  Clinicians must be educated about the importance of data integrity, especially ahead of the ICD-10 deadline.

In addition to supporting the October 1, 2015 transition to the more advanced and detailed code set, clinical documentation improvement can help hospitals save money along the way.  It can also prepare organizations for the next step in health IT use: data analytics that can be used for population health management, reducing readmissions, and allocating resources efficiently.

Big data analytics and clinical decision support

Big data analytics is the holy grail of healthcare technology, but it doesn’t have to be quite as hard to find.  Successful hospitals begin the journey by leveraging clinical EHR data into actionable insights about preventable 30-day hospital readmissions, chronic disease management, and patient outcomes, effectively setting themselves up for more informed participation in value-based reimbursement programs. 

Hospital EHR adoption is also the foundation for predictive analytics, which goes one step beyond the retrospective view that historical EHR data and claims information can provide.  Using real-time tracking, predictive modeling, and risk score algorithms, a small proportion of hospitals are currently able to alert clinicians to patient downturns, flag the development of sepsis, engage in proactive clinical decision support, and make more informed decisions about operational strategy.

Revenue cycle management and operational efficiencies

Since the beginning of the EHR Incentive Programs, healthcare organizations have been promised financial returns from their investment in EHR adoption.  While many providers might argue that the ROI has not manifested itself just yet, that isn’t stopping hospitals from putting more money into technology in order to save in the long run.  Investment in revenue cycle management technologies has been strong throughout 2014 and 2015, and is even slated to overtake EHR purchases this year as adoption reaches its peak.    

“Hospitals understand they must establish new business models in order to survive under a dramatically transformed provider landscape,” said Frost & Sullivan Connected Health Principal Analyst Nancy Fabozzi.  Part of crafting an effective financial strategy is developing a health IT infrastructure that can pinpoint opportunities for lowering unnecessary utilization rates, improving patient responsibility collections, and ensuring consumer loyalty in a time of widespread competition and change.

Integrating revenue cycle technologies into the health IT ecosystem is a top priority for many forward-thinking organizations that are aware that the high hospital EHR adoption rate is just the beginning of a long path towards using electronic data for improved patient care, higher quality, better outcomes, and more efficient financial gains.

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