EHR adoption up, ONC discussing further plans at national convention

Almost all hospitals have implemented certified electronic health record (EHR) systems, a notable increase from 2008 survey data. In order to further the efforts to ensure transmission of health information between providers, the Office of the National Coordinator for Health Information Technology (ONC) will convene with public and private sector parties at its 2016 annual meeting, where sessions will educate those attending on current advancements and future plans.

Increased adoption

According to the ONC’s May data brief, 96 percent of reporting non-federal acute care hospitals had certified EHR systems in 2015. Eight of 10 small, rural, and critical access hospitals possessed at least basic EHR technology, although only about half of children’s hospitals and 15 percent of psychiatric hospitals had done so. Across all states, at least 6 out of 10 non-federal acute care hospitals had adopted basic EHR, a significant increase since 2008 when most either reported none or less than 20 percent.

Future of health IT

The annual meeting’s agenda includes presentations on the federal government’s commitment to better health, advances in interoperability, research, and health innovation. The government is particularly interested in precision medicine, which ensures that treatments are individualized to each patient’s needs. The presentations also cover the health IT response to the Zika virus, advancing health IT for Medicaid programs, and cybersecurity.

NQF report helps providers HIT their way through patient safety

Effective health information technology (HIT) that adequately considers patient safety can be measured by nine key metrics, according to a report from the National Quality Forum. The nine factors measure proper design, implementation, and use of HIT to reduce medical errors and inefficiency while improving quality of care. The NQF identified a need to develop a set of measures to help providers and vendors identify HIT related patient safety risks so that those concerns can be mitigated and HIT can begin to reach its potential. The NQF believes with a set of high-priority areas of focus, a more efficient process can develop to improve HIT.

Key measurements

The key measurements include:

  • clinical decision support (CDS);
  • system interoperability;
  • patient identification;
  • user-centered design and use of testing, evaluation, and simulation to promote safety across the HIT lifecycle;
  • system downtime (data availability);
  • feedback and information-sharing;
  • use of HIT to facilitate timely and high-quality documentation patient engagement; and
  • HIT-focused risk-management infrastructure.

Clinical care

The report explains that while CDS is one of the most promising aspects of HIT, because it allows clinicians access to tools to quickly and efficiently analyze patient data, CDS can also greatly disrupt patient safety and care efficiencies if it is poorly designed. The interoperability of HIT systems is also considered a crucial measure because “complete information” about patients allows providers to make safer and more cost-effective care decisions. For the same reason, patient identification is an important factor in the effectiveness of HIT. If HIT systems are not able to reliably identify patients, providers run the risk of duplicating records, overlaying one patient’s information onto the wrong patient, or ordering care for the wrong patient.

Use

The NQF determined that the user-friendly nature of a HIT system is critical to its success because it can reduce the risk of errors and subsequent threats to patients. The ability to engage in system simulations is also important to identify breakdowns and inefficiencies in system processes. System “downtime” is an important factor in the usefulness of an HIT system because if systems go offline in an unscheduled manner, providers can be forced into a sudden and unexpected change in clinical processes, which can threaten patient safety.

Sharing, timeliness, and engagement

The report suggests that information sharing between vendors and providers is an important and effective way to identify HIT system problems before they become patient safety issues. Additionally, the NQF believes that the timely use of HIT, specifically through electronic health records, is important to ensure efficient, complete, and quality care. Specifically, the report indicates that timeliness is an important factor because it allows for safe care transitions between providers. In terms of emerging concerns, the report suggested that providers place emphasis on patient access to HIT. The NQF acknowledged that patients who engage in their care tend to have more favorable health care outcomes. Finally, the NQF believes that effective HIT requires a comprehensive risk management program that can address and resolve patient safety problems in real time.

Effective HIT

The report identifies HIT as a cause and solution of patient safety issues. Although it poses some risks, the NQF considers HIT an important way to drive efficiencies and improve the quality of care. To reach the potential of emerging HIT, however, providers need to develop a multi-step process taking the nine factors into consideration. The report also reminds stakeholders that effective HIT does not fall on any one entity’s shoulders. HIT is a shared responsibility, which calls on the influence on clinicians, health care organizations, vendors, and even patients.