Health care IT conference issues include meaningful use, regional connections

October 30, 2009
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Editor’s note: On Monday and Tuesday, the Amway Grand Plaza in downtown Grand Rapids is slated to host 250 attendees of the Healthcare Information and Management Systems Society’s Midwest Fall Technology Conference, sponsored by HIMSS chapters from six Midwestern states. Conference presenters include Dr. Greg Forzley, medical director of informatics for Saint Mary’s Health Care, and Spectrum Health CIO Patrick O’Hare, who is to welcome the group on Monday. O’Hare recently spoke with Grand Rapids Business Journal health care reporter Elizabeth Slowik about trends in health care information technology.

BJ: What are the top trends in health care information technology today?

O’Hare: Certainly, there is the whole issue in terms of advancing the use of electronic medical records to achieve what has now been described as “meaningful use.” There is criteria that’s been established in draft form, and will be approved by CMS (Centers for Medicare & Medicaid Services) yet this year, that will clarify what health providers … need to achieve in order to be deemed having achieved the status of meaningful use. The criteria are tied around the use of technology to improve not just the health status, but to provide safe and quality health care. That criteria is tied to financial incentives that providers may participate in if they can demonstrate they have, in fact, achieved meaningful use. It’s not just putting in electronic medical records for the sake of automation, but it’s purposeful automation that is intended to result in better care.

That is obviously receiving a great deal of attention because of the stimulus funding that has been provided in support of that initiative. Along with meaningful use, there are components that talk about interoperability: the ability to exchange data as we typically do with other business systems. … That is one of the criteria of meaningful use.

Another thing that’s getting a fair amount of attention is collaboration between providers to appropriately exchange data. And that, right now, is one of the programs the federal government is also supporting under the ARRA (American Recovery and Reinvestment Act) funding. (Health care providers) have the financial incentives for achieving meaningful use in terms of electronic medical records.

A component of that is also related to the interoperability, so they are putting some additional funding, via grants, to the states to have them advance health information exchanges within their geographic area.

One of the things along with the ARRA legislation was enhanced rules around patient privacy. Those rules, some of which have started to take effect and others that will be phased in, have to be addressed as part of this process as well. So as we put in automation, as we look at interoperability, we also have to do it with a focus on further insuring patient privacy.

BJ: What is the status of the health information exchange — here in Grand Rapids?

In terms of … the collaboration between Spectrum Health, Trinity (Health, owner of Saint Mary’s Health Care in Grand Rapids and Mercy Health Partners in Muskegon), we continue to meet and are going to, in the coming months, also involve other providers and stakeholders within the community. We believe that collaborating, we can better serve the overall community.

Is it going to continue to expand? I believe it will. The state of Michigan has a couple of different efforts based on these federal grants. One is the HIE cooperative, and so they are looking in terms of what the state can do, in a modest manner, to advance the health information exchange. …That is intended then to be able to interact with what the state will do — as they refer to it, as a state backbone for health information exchanges — so that in time, what we’re doing locally will be able to connect with what the state has planned, so that we can share data not only across the state, but also with other areas of the country.

Then there are efforts underway at the state level through another grant from the feds for a regional HIT extension center, which will be statewide, but that will require collaboration down to the regional and local level. And the intention of that is to assist provider groups, primary care provider groups and 10-physician practices or less, along with critical access hospitals, to advance the use of automation and achieve meaningful use.

I think you will see further collaboration, not just within the state but at the regional level, to assist both physician practices as well as other hospital providers with advancing their use of information technology to try to lift all boats, if you will, so that we can exchange data in a more meaningful way — again, focused on the patients.

BJ: What business opportunities exist as health care information technology changes?

The level of focus in terms of health care IT is expected to drive the creation nationally of tens of thousands of jobs.

There are local businesses that I think are currently participating in assisting health care providers on the adoption of technology. … I think there are opportunities; I think some of the consulting firms are already trying to pursue a niche in this area. … It’s sometimes difficult to build a consulting practice in terms of gaining the level of expertise you need to work in this area, in terms of what are the HIPAA regulations, what do you need to do to achieve meaningful use. It’s not just technology; it’s the process changes you need to assist the physician’s office in order to both have the technology and adapt their processes. … That does take a specific niche of organization to carve out a business in it.

There have been reported to be upwards of 200-plus EMR vendors in the provider practice space. … There are some that have much greater market share. There are still probably some individuals that think they could start today and build an electronic medical record and then have it positioned to achieve meaningful use. That’s a pretty big undertaking, and if local companies thought they were going to do that, I’d be very cautious. … It’s like: Great idea, but crowded field as it is.

BJ: Does information technology save money in health care?

If you can exchange data in terms of lab results or radiology results with the providers to make the data more accessible, there are studies then that suggest or support that the number of tests that need to be ordered can be reduced. … I can remember clinicians saying to me, ‘OK, you know, it’s easier to order a test than to wait for a chart to be located when it’s offsite’ and so forth. Because we’ve got X amount automated now, we’ve eliminated a lot of those issues over the last 10-plus years.

There are other opportunities in terms of evidence-based medicine, being able to not only provide suggestions from a quality perspective in terms of standards that have been vetted by not only national organizations, but in terms of standard order sets for certain conditions.

There is also the issue from a safety perspective and a quality perspective, drug interaction: drug to drug, drug to allergy, drugs based on certain lab tests and so forth. Those systems in terms of providing those alerts can avoid complications, and in doing so, reduce the cost of care.

It’s not technology for the sake of technology. Without looking at the process impact, you’re layering technology on a broken process. It’s not going to improve it.

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