Progress on the Frontiers of Health and Medicine

The frontiers of medicine are not only in the development and transformation of delivering health care, but is also a physical impediment to delivering a level of quality health care.Rural health care presents unique challenges for delivery of care. There are fewer providers, facilities, and less economic support.

As described by Leila Samy, Meghan Gabriel, and   Jennifer King on HealthITBuzz , 

Leila Samy

  

                                                                Meghan Gabriel
                                                                                                               Jennifer King

              

Critical Access Hospitals (CAHs), some with a census of fewer than 10 patients, are the smallest of the small rural hospitals. In some regions, such as frontier areas, a CAH may be the only local health care provider serving an area the width of the state of Rhode Island! CAHs are small, geographically isolated and have limited resources.

CAHs are found in every region of the country, and represent roughly 30 percent of hospitals nationwide. Often serving as the focal point for all health care services in a rural area, CAHs often own and run the local rural health clinics and skilled nursing facilities. They may also be responsible for public health and emergency medical system services. These hospitals extend services to places where they wouldn’t otherwise be available. And those are the reasons why it is important for CAHs to have access to health IT systems and capabilities.

As of 2013, 89 percent of CAHs had an EHR in place; 62 percent of CAHs with an EHR had a fully electronic health record system, and 27 percent had a health record system that was part electronic and part paper.

Most CAHs adopted (as of 2013) or planned to adopt (by the end of 2014) the health IT capabilities evaluated in this study (i.e., telehealth, teleradiology, care coordination and health information exchange with other providers and patients).

As of 2013, CAHs reported the highest rates of adoption for teleradiology (70 percent) and telehealth (59 percent) capabilities. Fewer CAHs reported other capabilities related to electronic exchange of key clinical information with other providers. Even fewer (15 percent) of CAHs reported patient engagement capabilities (i.e., offer patients ability to view, download and transmit their health information

Among the challenges to health IT adoption among CAHs, financing and workforce related challenges were most commonly reported.

CAHs that pooled resources with other hospitals were more likely to have EHR and capabilities related to health information exchange and care coordination, compared to those that did not pool resources or engage in group purchasing.

CAHs with faster Internet upload speeds were more likely to have the capability to provide patients with the option to view, download, and transmit their health information compared to those with slower upload speeds.

The Federal Government is offering funding opportunities and offers Creative Solutions to Expand  Rural Health IT Funding

Benefits of Health IT adoption among CAHs and other small, rural hospitals

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Health Software Vendors

Software and hardware age quickly in health care. Software and hardware evolve, change and become obsolete quickly in the course of five years. Much changed during this 1/2 decade as providers and hospitals geared up for the HIT revolution.

Just ten years ago (2004) EMRs were very few and only 10-25% of providers or hospitals had any type of electronic health record.   The concept of health information exchanges and interoperability were still seminal ideas. Mobile health applications were few.

Following the HITECH Act the progress has been staggering. On the one hand it stimulated the adoption of EHRs, on the other hand in a rush to capture the incentive and avoid penalties, users were coerced to obtain inadequate electronic systems which were not tested for ethnology or true user functionality.  Many were and still are a barrier to efficiency and do not instill confidence in physicians by patients when providers faces are embeded in their display, which minimized face-to-face contact.  Transference as most providers realize is a key component of patient reassurance and compliance.  Score two big negatives for the current generation of EMRs.

Many providers have invested in EMRs, some already had EMRs which were compliaint enough to be CCHIT certified for interoperability (necessary to use HIX (health information exchanges) to exchange data with diverse EMRs.  Some were able to be upgraded to satisfy Meaningful Use, Stage I.

However many of these pre-existing systems are now insufficient to be further upgraded due to the increasing complexity of reporting metrics to CMS and Health Insurers.  Now faced with ACOs (Accountable Care Organizations the EMR and HIX face the challenge of further requirements.

For some the time as come to upgrade their EMR even though it may be only five to ten years old.

There have been many reports about physician dissatisfaction with first, or second generation systems. Offerings are divided between small practice, medium size practices, and large enterprise integrated health systems.

Perhaps a measure of change can be found in a report from MarketWatch of the Wall Street Journal.  I find the WSJ to be a reliable source of change in markets as they measure financial changes early on.

EPIC has been the leading software vendor for large enterprise systems.  This year however KLAS has ranked athenahealth as the top vendor replacing EPIC as rated by thousands of health care providers across the U.S., athenahealth is now rated #1 in the following categories:

-- 2013 Best in KLAS Overall Software Vendor

-- 2013 Best in KLAS Overall Physician Practice Vendor

-- 2013 Best in KLAS Practice Management Service, athenaCollector(R), for the 1-10 and 11-75 physician segments

-- 2013 Best in KLAS Patient Portal, athenaCommunicator(R)

The old guard of HIT leaders is finally being displaced by more nimble, innovative models designed for health care's future - not for its past," said Jonathan Bush, chairman and CEO, athenahealth

Health IT in Asia at Health 2.0 India

Read more about it at Health Train Express including these topics of interest

• Designing an improved patient experience for a Billion people

• Trending – Startups, Funding and Accelerating Health 2.0

• Health 2.0 in the village

• Quantified self, wearable sensors and trackers

• Mobile health in real life

• Rise of big data and better decisions

• Pharma and better outcomes

• C-Level executives unplugged

• Unmentionables amplified – Sex, Sport & Rock n’ Roll

Visit Health Train Express to learn more........