Posts Tagged ‘RHIOs’

Health Information Technology and the Stimulus Package: Information and Changes for the Public and Employment Opportunities

November 16, 2009

Health information technology (HIT) is a broad term used to describe the digital storage, management, and secure exchange of health information between patients, providers, government, and insurers.  The information being exchange primarily refers to but is not limited to Electronic Health Records (EHRs are sometimes called electronic medical records (EMRs)).

Earlier this year, Obama’s American Recovery and Reinvestment Act of 2009 (the Stimulus Bill) was signed into law.  One part of the Stimulus Bill; the Health Information Technology for Economic and Clinical Health (HITECH) Act, aims to increase the use of an EHR by doctors and hospitals by:

  • “Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.”
  • “Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT to electronically exchange patients’ health information.”
  • “Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in the quality of care and care coordination, and reductions in medical errors and duplicative care.”
  • “Strengthening Federal privacy and security law to protect identifiable health information from misuse as the health care sector increases use of Health IT.”

Information and Changes for the Public:
Health information technology and electronic health records will not only improve patient care but also change the way we experience health care.   Even the best doctors can make mistakes or unintentionally overlook important details; an EHR will reduce the risk of these errors.   EHRs negate mistakes made due to sloppy handwritten notes.  They have automatic drug-drug/ drug-food interaction and allergy checks, and since they are online, standard drug dosage information and educational patient information can also be accessed.  Built- in alerts remind doctors of preventive care timelines, and can track referrals and test results.

Another major advantage of EHRs is they are maintained digitally and once they progress to their full potential, they can be accessed from anywhere.  Because it is simple to back-up this data to another location, EHRs also guarantee information will never be lost or damaged as a result of a natural disaster.  In the event of an emergency hospital visit or sickness while away from home, a doctor will immediately be able to pull up a patient’s chart and access information potentially crucial in diagnosing and treatment.  Referral doctors will be able to see any treatment a patient is undergoing by other doctors and make decisions that will not interfere with that treatment.

Though there are many benefits, HIT is not without its drawbacks.  Advocacy groups like the ACLU are wary of HIT and question how secure confidential medical records will really be if they are kept digitally online.  The potential for online medical records to be hacked is real and very serious; electronic databases and servers regularly experience hack attempts and an EHR would be no different. 

It is easy to placate the fear of EHRs being hacked and find comfort in the idea that “if someone really wanted my medical file they could just as easily break into my doctor’s office.”  This leads to the conclusion that “nobody would break into my doctor’s office to steal my records, because I am simply not that important.”  However, hacking into an EHR system is not the same as breaking into your doctors.  The threat of your EHR being attacked is not only about your personal health information; hacking into an EHR means gaining access to everyone’s valuable health information.  Hackers could sell the information found in the nation’s family histories, mental health history, test results, current medication, etc… or use it to bribe and blackmail people in countless ways for countless amounts of money.  Even worse, they could change the EHR causing unimaginable damage.

However, the benefits of an EHR far surpass the risks.  The government is working hard to minimize the threat of hacking.  Part of the HITECH is to strengthen “Federal privacy and security law to protect identifiable health information for misuse as the health care sector increases use of Health IT.”

Information and Changes for Employment:
Employment for medical records and health information technicians is very good and is expected to grow faster than the average professional field.  The projected employment for 2016 is 200,000.  That is 30,000 more than 2006 or an 18% increase.  Physicians’ offices, home health care services, outpatient care centers, and nursing and residential care facilities will have the most job growth and creation of new jobs.  Job growth in hospitals will not be as great but new jobs will still be created.

The growth of HIT and increased use of EHR will benefit everyone and is not something to be scared of.

Questions: Does anyone work in a facility that has already implemented an EHR?  Have you experienced or do you foresee any other problems or risks with an EHR other than hacking?

About the Author: Erika Christenson is a Staff Writer with the Clear Medical Solutions Communication Team.  Her work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog. 

References:
Bureau of Labor Statistics.  Occupational Outlook Handbook, 2008-2009 Edition.  Medical Records and Health Information Technicians. http://www.bls.gov/oco/ocoS103.htm

Title IV- Health Information Technology for Economic and Clinical Health Act.  January 16, 2009.  http://waysandmeans.house.gov/media/pdf/110/hit2.pdf

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Regional Health Information Organizations have a Long Ways to Go

September 1, 2009

In reading about Regional Health Information Organizations (RHIO), it is interesting to note how colossal and incredibly complex some possible solutions seem.  Health information exchange (HIE) is the goal of these organizations along with facilitating improvements in healthcare.  Unfortunately, many of the proposals being ping-ponged about today lose track of this goal due to financing, collaboration, and planning issues.  Currently, this movement and the technology are still largely in the visualization and troubleshooting phase.  There never has been a one-size fits all solution that could cure the health care system, and yet that is how many innovations including Electronic Medical Records, Computerized Physician Order Entry (CPOE), and RHIOs are presented.  It is important that development and application do not interfere with the health care process.  As a distant goal, HIE is an excellent idea that has the potential to facilitate a lot of positive developments, but perhaps on a smaller scale.  As a more immediate endeavor, it is presenting with mixed results and stumbling on issues like implementation, usability, and lack of collaboration.   pnetwork1m2

While each individual HIE endeavor and its successes and failures are unique, collaboration is an element that should be included in business plans more and more.  Many health care professionals continue to maintain that patients, consumers, physicians, IT professionals, and accountants should all be a part of discussion, development, and usage of RHIO and HIE.  In his article, “Health Improvement Technology,” Dennis Schmuland, M.D., writes, “The fixation of the industry and health information technology community on digitizing and exchanging health data and information has caused the industry to undervalue the breakthrough possibilities of collaboration technologies.”  Technology provides a means to achieve, but health information exchange cannot occur without participation from all parties involved.  Here in Milwaukee County, a major part of the Emergency Department Linking Project was an agreement and collaboration between the “CEOs of all the major health systems in the Milwaukee metropolitan area to commit to the project” (Hagland 1). 

Per the ED Linking Project Information Paper, “The primary goal of the ED Linking project is to provide patient health information where currently there often is none or very little available to help ED and Community Health Center clinicians in Milwaukee County provide patients quality, safe, and cost-effective health care” (Webb 1).  Initially, the project focused on sharing information on patients and visits to the emergency department.  Laboratory results, medication data, and insurance information will eventually be exchanged as well, if they are not already a part of this project.  Perhaps what hurts health information development most is extremely aggressive deadlines which make agreeable growth and collaboration between vendors, IT professionals, doctors, health care providers, and patients.  The incremental approach Milwaukee’s ED Linking project has taken allows for adjustment, adaptation, and room for growth.  According to Dr. Mark Friesse, Professor of Biomedical Informatics at Vanderbilt, “Every state is doing great things.  Everyone is teaching us a different part of the answer” (Blair 6).  In some ways, this may broaden perspectives and help piece together a model RHIO or HIE to build off.  Undoubtedly, some will chalk this up to progress being made, but real progress might more clearly be made via collaboration and real health information exchange. 

Unfortunately, there is no shortage of obstacles to tackle and issues to understand surrounding RHIO and HIE foundation.  If everyone was equally motivated, eager to learn, and up to date with the state of health care, modernization might be much to easier achieve.  Kind of like a science fair, this phase will undoubtedly have more successes and flops.  Establishing more meetings to initiate these exchanges is a good way to enable health information exchanges.  There are groups that focus solely on idea sharing, learning experiences, and problem solving dialogue for these reasons.  Listed below are some examples:

  1. North Carolina Healthcare Information and Communications Alliance Inc.   http://www.nchica.org/
  2. HIE Seamless Exchange Solutions  http://www.hielix.com/

What do you think about the progress of RHIO’s so far?  Is it beneficial for all to collaborate and work together? Please, don’t hesitate to chime in and share your thoughts. 

About The Author:

Mario Raspanti is a Staff Writer with the Clear Medical Solutions Communication Team.  His work is regularly shared on the Clear Medical Agency newsletter and the ClearManagementMatters.com blog.  

Bibliography:
Blair, Robin.  “RHIO Nation.”  Health Management Technology:  The Source for Information Systems Solutions.  February 2006.   http://www.providersedge.com/ehdocs/ehr_articles/RHIO_Nation.pdf

 Hagland, Mark.  “From Struggles to Success:  Part technology, part cooperation and part good old fashioned trial and error are what it takes to build or break a RHIO.”  Healthcare Informatics.  

http://www.healthcare-informatics.com/ME2/Sites/dirmod.asp?sid=&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=AE404FB40DFE434B91B79D9C2AD6BF50&SiteID=Main%20Si_e

 Schmuland, Dennis.  “Health Improvement Technology.”  Health Management Technology:  The Source for Information Systems Solutions.  May 2009.  http://www.healthmgttech.com/features/2009_may/0509_health.aspx

Webb, Denise.  “Emergency Department Linking Project Information Paper.”    <http://ehealthboard.dhfs.wisconsin.gov/materials/materials/EDLinkingProjectInformationPaper06102008update.pdf&gt;


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